That which is Caesar's. [Autobiographical reminiscences. With a portrait.].

Relating the circumstances which resulted in his year-long commitment to a mental asylum, the author deliberates on the

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That which is Caesar's. [Autobiographical reminiscences. With a portrait.].

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Perditus Librer Presents the rare OCLC: 504877005

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That Which is Caesar’s   by   H. G. Woodley   Published 1948

          THAT WHICH IS CAESAR’S

By the same author CERTIFIED SYNTHETIC MANIA HANDBOOK FOR             MENTAL NURSES etc.

 

      Copyright Pen-in-Hand Publishing Co., Ltd. 11 St. Michael’s Street. Oxford.

  No part of the contents of this book may be reproduced in any form whatsoever, other than by reviewers and critics during the course of reviews etc., unless the permission of the publishers has first been obtained in writing. First published 1948

          Printed In the City of Oxford by Hall the Printer Ltd. 2 Littlegate Street,                              Oxford.

CONTENTS     Publisher’s Note Preface Prelude Book One Book Two      Part One      Part Two      Part Three

PUBLISHER’S NOTE ───── In the knowledge that throughout the whole of his fifty-eight years of writing, Mr. H. G. Wells rarely consented to read Authors’ manuscripts, it seems remarkable that he should, after laying down his pen, on the publication of his last book, MIND AT THE END OF ITS TETHER, take it up once again to champion the cause of the Author. Since the publication of CERTIFIED, it is well-known that Mr. Wells was so keenly interested in the works of “The Other H.G.W.”, as he affectionately referred to Mr. Woodley, that he actually volunteered to print and publish CERTIFIED at his own risk and expense. It is, we think, significant that the great novelist, who never wrote prefaces, introductions or public commendations of any kind, should, at the time of his death, be about to write a preface to this book; moreover, the fact that a distinguished psychiatrist should write to the Author the letter which he has used as his Preface, bespeaks the great urgency of the problem with which Mr. Woodley deals so ably.

PREFACE ─────     “From _______________, M.D., D.P.M.                      Lecturer in Psychological Medicine                      To the University of _____________ ______________ Mental Hospital. 22nd July, 1947.           Dear Mr. Woodley, Very many thanks for the complimentary copy of CERTIFIED, which I have re-read with pleasure. You will be interested to hear that on the morning of the 11th July, before I had seen Harold Nicolson’s review, the latter was quoted at a very full meeting of the Royal Medico-Psychological Association (at their Annual Session at Eastbourne), by Dr. Rees-Thomas, a Senior Commissioner of the Board of Control, and next year’s President of the R.M.P.A. He pointed out the outstanding impressions of our mental hospitals left on the Author’s mind, as told by the reviewer, and drew the attention of the assembled members to the need for change in many respects, including the important one of Classification. So you will see that your efforts will bear fruit, in time. I shall be very happy to receive copies of SYNTHETIC MANIA and THAT WHICH IS CAESAR’S when they are published; and I know I will take pleasure in re-reading them. I wish you every luck with them, and hope they will repay you financially as well as morally and socially for all the work and effort you have put into them.   Yours sincerely,                         _______________”       

PRELUDE     Today, I have been turning over my store of recollections, so that my mind goes back across the interval of thirty years—to a seat in the moonlight where I was caught up in a gust of passion… Thirty years? It might well have been yesterday, so vivid now is my impression of Elsie Ainley… She was the sun, and I, the growth that stretched out to reach her… When first we met, she was a school-girl of fourteen, with her hair in plaits; and although at that time I spoke to her in the knowledge that she was only fourteen, at the back of my mind was the thought that she would soon be fifteen, sixteen, seventeen—that one day soon, she would serve another’s purpose. Indeed, if otherwise, then why was she born? I last saw her when she was eighteen, and—to my way of thinking, greatly changed. Her dark hair was ‘up’ and she wore a blouse that exposed her arms and enhanced her newly-found bosom. Her length of skirt displayed attractive legs; and like all other normal girls of eighteen, she was wiser than a man of twenty. She was aware of herself—aware of her purpose and her worth. She was different from the school-girl of fourteen, in that she was wise—as one who had eaten of the Tree of Knowledge of Good and Evil; and this wisdom I later suspected to be due to the onset of her menstrual periods. Now, this early impression of the female in no wise 1

sprang from sexual depravity; in any case, sexual depravity, like madness, is a matter of degree; nor can I attribute this impression to the morbid. It was an impression arising solely on account of the fact. It was but an example of an unreasoned prompting from my animal ancestors. It was knowledge without learning, and independent of instruction, which had been passed on and on through the countless ages. Because of this knowledge, and even as my eye looked steadfastly into hers, my soul gazed at her bosom—and below it; for was she not the female, and I, the male? Yes, indeed; wherefore on all occasions of our meeting, an urge rose up from my innermost depths, bidding me investigate her. I therefore spoke soft words to her, so that one moon-lit night she agreed to accompany me for a walk in the park… Gentlemen, although I am not old-fashioned, I somehow feel that the moon had a share in what happened that night; indeed, my life with the insane has,

in some measure provided the proof; for notwithstanding that the original theory—which attributed lunacy to the effects of the moon—has long since been scorned to its grave, it remains a peculiar fact that the illusions and delusions of the insane are much in evidence with the rising and setting of the moon, and infinitely less throughout the day. Can it be mere coincidence that delusions occur so strongly at morning and night? No, gentleman, it is no coincidence; for the moon is the Spring of the Night—a Call from out of the Darkness, to the chaste and to the loose, bidding us speak and mate; and that night as I sat with Elsie Ainley, a bright moon was shining—filling the air with softness, mystery, knowledge and wisdom—its eerie light making the park seem empty of life. I gazed at that moon, and then at my companion. She was fine—as the mechanism of a field gun—she was to be desired more than rubies; and yet, when again I looked at the moon, I understood its power to create false ideas and 2

false effects; for like Whisky, this creator of illusions and delusions offers power, hope and happiness that is non-existent… I see her now—a pretty girl, with hair going off in curls of darkness from above her dark lustrous eyes. There was a pretty necklace around her neck; and a small brooch of gold nestled in her throat. I guessed then, and I know now, that the necklace, golden brooch, her neck, throat, exposed arms, shortened skirts and conspicuous legs were merely the sum and substance of an effort to focus attention upon her vagina… Even to those far off days, I can look back and appreciate that the veneer called Consciousness was slowly sliding from me—as blankets from the bed of a sleeping man; for at adolescence I was ready, and indeed, quite willing to return to the animal whence I came. At that early age, I possessed the ability to wonder why humans consider the penis and the vagina by stealth, and under cover of darkness. In those days, I was proud of this thought. Today, I am prouder—in the knowledge that such thought was justified; for I had been separated from truth at my birth. I had been deprived and frustrated… Deprived and frustrated… Oh ho! Gentlemen… Ho ho! Bring your minds to a halt, and pause by the wayside of life with me, to consider the lion in trousers and the tigress adorned with camisole and silken hose. Come! Join in my mirth; for it is laughable, gentlemen… laughable! And yet, not so amusing; for in those days my teachers, poor people, taught me concerning a Garden of Eden, wherein God spake, and said, “Behold the man has become one of us, to know good from evil … and lest he

put forth his hand to take of the tree of life, and eat, and (therefore) live for ever, let us put him out of the Garden to till the 3

ground whence he was taken … and so, God drove out the man… They also taught me that Canaan begat Sidon and Heth, and the Jebusite, and the Amorite, and the Girgasite, and the Hivite, and the Arkite, and the Sinite, and so on and so forth. Moreover, and notwithstanding God’s fear that man might live for ever, these same teachers with much industry endeavoured to instil in my simple soul the desire to live for ever; they told me of the lifeeverlasting which the same God had so strangely promised me and you; and whilst they told me of a God of Love, they seemed to derive pleasure in recounting the damnation that was to be mine if I ignored a certain Divine eye that was for ever watching me—generally with disapproval, I thought. Failing to understand these things, and being unable to reconcile the one with the other, I looked upon them as the mummified remains of the JudaeoChristian mythology—by now so old and dry that it crumbled in my hand and lost its shape and form before I could recognise it; and it was many years later that I realised how much better it would have been for me had my teachers used Gray’s Anatomy as their text-book. How different our lives would have been had they reassured the girl by illustrations of the penis, and the boy by illustrations of the clitoris and its environs… Laughable, gentlemen … laughable… But I was telling you about our seat in the park… With the moon looking down upon me, my arm enfolded her soft warm waist; so that I naturally wanted her—and badly. My breath came fast, and I spoke to her in a voice I failed to recognise as my own; and yet, even as I spoke, I was able to consider the power of the emotions—so strange and so strong as to affect the speech, hasten the pulse, speed the heart and distort the features. It was, of course, the effect of mind upon body—as throughout lunacy. 4

And then, I gripped her savagely, as, in a voice choked with passion, I said, “God! How I love you, Elsie!” Her laughter made me angry; and when she giggled and said, “Go on— Don’t be silly!” I felt as my ancestors had felt on being deprived of a tasty morsel; for bodily need is a need of the mind; and what the mind desires the body must have. If otherwise, then frustration must intervene; and frustration is Lunacy. Fearing frustration, I grabbed wildly at her waist… Something

snapped; and I was intrigued, nay, enraptured by a brief glimpse of silken knickers, ere she arose, and with head held high, hurried from the scene… She left me with the knowledge that it was not her I loved, but myself. I have acquired much other knowledge since that night—amongst other things, that my behaviour pointed to the mentally unstable; and that such instability was due to my mother’s failure to teach me truth. My mother had lied to me— she had done worse; for she had passed on to me dead traditions and rubbish, in leading me to believe that I was possessed of eyes, cars, legs, nose, hands, feet and ‘privates.’ Privates, indeed! Better for me—and for her, had she nurtured me upon Sex; for upon lack of knowledge concerning matters of sex rests the Foundation-stone of Lunacy. That the penis and the vagina are but Emblems of Insanity, a survey of history clearly reveals. Did not Judah ‘take’ the daughter of the Canaanite, and did not Scheckem the son of Hamor the Hivite ravish and defile Dinah the daughter of Leah? We are told they did; and throughout Genesis, Exodus, Leviticus and Numbers these Emblems stand out as warning beacons. Not only in the Old Testament do these things stand out in relief, but in the New, where, despite countless centuries separating the Woman of Samaria from the Dinah of Jacob’s day, we find that when the woman is asked to fetch her husband, she confesses her spinsterhood: 5 “Thou hast had five husbands; and he whom thou now hast is not thy husband; in that saidst thou truly.”

Is it not obvious that it was because of these things that Potiphar’s wife asked Joseph to lie with her? And is it not for the same reason that the Boss so frequently puts his arm around the waist of his typist? So it goes on throughout the generations; and although in our generation Potiphar’s wife no longer implores Joseph with words, her desire finds expression in fullyfashioned Nylons; and so it was with Elsie Ainley and me… I assure you that these things are so, and that my desire sprang from an unstable source; happily, with this early knowledge and understanding I was able to remove instability from my system. Self-deception is our own executioner, therefore, let us no longer deceive ourselves; for Civilisation—that whim of Evolution which permits the dog and the bitch to do their works openly and upon the public highways, has driven man to do his works under cover of darkness and in fear; and this,

because the two most public members of our anatomy have been handed down to us as ‘strictly private.’ Not only are the penis and the vagina public members of our bodies, they are the very foundation upon which our minds are erected. Not only are they the most natural things in this unnatural world, but our glorious heritage—so that life might continue for ever… The story of the Creation… That Serpent-enemy… The Fall of man… Laughable, gentlemen … most laughable… 6

BOOK THE FIRST     I.   There are times when I think, perhaps a little too vividly, of those horses that go round and round grinding the beans or whatever it is they do. I also think—perhaps a little too vividly, that if we tried as hard to reduce our selfishness as we do to gain our own ends, we would be happier; and thus do I realise that ours is, in the main, a pagan country; and that unless we supply it with a philosophy to replace its cast off creed, it certainly will slip back into the nothingness whence it came; and the great pity of this is that there was never anything wrong with the fundamentals of that creed—Charity and Unselfishness. The trouble is that we have allowed that creed to become obscured, overgrown, distorted and riddled by the evils of self-seeking it set out in its early enthusiasm to cure. If we followed that creed of unselfishness there would be no need for class hatreds, revolutions, atom bombs, or the housing of their human casualties in mental hospitals. Today, we live in a selfish world—a world of Dollars; and yet, how fortunate that in a world of chaos and strife, of selfishness and directed labour, it is still possible for a little fellow like me to call upon such giants in Literature as H. G. Wells and J. B. Priestley. How much more so that such giants should be great enough to stoop down and offer me expert advice— stranger still that I should not accept such advice. 7

My last book makes clear that although H. G. Wells offered to print and publish that book at his own expense, I declined his unique and most generous offer—that I insisted upon publishing my own ‘unorthodox’ work; and with what success; for the reviewers without a solitary exception were indeed kind to me.   II.   Now, J. B. Priestley is one of the hardest-worked men in the world today. Nevertheless, despite running an International Unesco Conference during a heat wave, and notwithstanding that he ‘put on’ two highly successful plays this summer, he found time (I hardly know where) to read this book. Like his

friend H. G. Wells, Priestley was kind enough to give me freely of his advice. With a tolerant smile on his good-natured face, he told me that my “Prelude” is well done—that this book is full of interesting and valuable material—that now and then I get near to the point of view of Jung, whose works he has studied for many years, and with whom he has had many talks. He told me other things too—things like Wells told me—things chiefly concerning the ‘technique’ of writing. I am deeply grateful to Mr. Priestley; and he knows I am. He is also aware that I have no intention of acting upon a particular portion of his advice—for the same reason that I did not act upon Mr. Well’s advice. Both in CERTIFIED and in this book I have endeavoured to prove the suggestion of the great philosopher Lin Yutang—that technique is nothing when compared with the story—that, despite publishers and critics, it is the story that counts. I therefore propose here to disregard the ‘technique’ and to continue with the ‘unorthodox.’ 8

It is not because I cannot comply with the rules of literature that I make this decision, but simply because I am convinced that such is the only way for a book dealing with this subject—may the critics forgive me. What purpose is to be served in writing a purely objective book on Insanity? Of what avail a colder and more objective tone, when, throughout the years many such books have been written—all without success? The unorthodox is the only way; and although a distinguished psychiatrist has recently suggested that medical reviewers have a special commination service all ready for those who dare to transgress against the ethics and etiquette of Medicine by voicing original opinions that are not corroborated by text-books, I am unperturbed as I await the commination service they most certainly have all ready for me.   They will consider my criticism a harsh one—experience acquired ‘firsthand’ notwithstanding. And yet, it cannot be otherwise. Unless I be as harsh as truth and as uncompromising as justice my effort is in vain. Only thus can I hope to prove there is no mystery and no real difficulty—that apathy is our only obstacle; that if, in the realm of psychological medicine men will come forth determined to transform failure into success, success will be ours. As it is, the majority still cling to the belief that these urgent matters will automatically right themselves. I am certain that if, by the grace of God, a heart-felt desire for change and improvement existed deep in the mind of Psychiatry, reforms and improvements would at once bear witness. Once in a

while throughout the years arises the desire to do something; so that here and there a Weatherley, a McManus, a Macartney or another is seen as a cork on the ocean; and then, the desire which sponsors such efforts perishes; and so perish the insane. 9

III.   It was not because they certified me that I wrote CERTIFIED, but on account of the thoughts, observations and impressions which were mine for the strangest year of my life. A year which seemed to be spent in a dream—a year so strange that even now as I sit in the shadow of the Grampians and look back, it still seems that the fantastic happenings of that year really did occur in a dream—a dream in which, although I was the dreamer, other characters stood out in relief. That year was spent in a close-up study of the life and the ways of the strange and unhappy community in which I found myself. There, I saw with a hopeless clearness. I saw with the danger of being blinded by the sight that met my gaze. What I saw I have already told; and yet, I cannot refrain from repeating here that the incorrigible egotism which filled the souls of my companions—which sealed their consciousness against all good influence— which made them laws unto themselves, so that they accepted mental vapours as reality and believed things held good by the majority to be bad—that made them but disruptive forces against things as they are, was entirely due to frustration in their youth and childhood. Moreover, that year provided ample proof of Tennyson’s wisdom, when he wrote: “All thoughts, all creeds, all dreams are true, All visions wild and strange; Man is the measure of all truth Unto himself. All truth is change. All men do walk in sleep, and all Have faith in that they dream; 10

For all things are as they seem to all, And all things flow like a stream. There is no rest, no calm, no pause, Nor good nor ill, nor light nor shade; For nothing is but all is made.”

  IV.   Now, of the lay public who honoured me by reading CERTIFIED during the period that it was circulating privately, was Mr. II. G. Wells. He wrote me as follows: — “25th May, 1945. Dear Mr. Woodley, CERTIFIED tells a keenly interesting story—an urgently necessary story which will alleviate the misery of multitudes of entrapped people. But, you omit an important revelant fact in your story. The days of censorship are over. There is nothing now you need suppress, unless you are giving way to self-love. In some instances you have been very brutal (and rightly so) with yourself; but side by side with this is the thing you are mysterious about. I suggest you drop that now needless mystery and tell it all. My warmest and friendliest good wishes to you on your return to this mad world. H. G. WELLS.”

The ‘mystery’ to which Mr. Wells referred arose because we were at war when I wrote CERTIFIED. Having no 11

desire to write anything that might in any way be regarded as a disservice to my country at war, I refrained from mentioning the cause of my certification; indeed, I made clear to the reader that it was my desire and intention to evade this matter. With Hitler’s star in ascendancy, there was much talk about the persecution of the Jews; and at that time, I became the father-in-law of a Jew—which is to say, although his ‘people’ have lived in England for a hundred and fifty years, it seems that his forefathers once resided in Portugal, where, one presumes they would have been known as Portugese Jews. This son-in-law was in the

fighting forces; and it so happened that one day I received a letter-card from his father; and in that letter-card his father did unwisely and without just reason suggest that his son was a victim of such persecution—that he was being ‘kept back’ on this account, and that he would at once have the matter looked into at Whitehall! I was friendly with his Commanding Officer, with whom I occasionally partook of a glass of whisky; so that, due to that error of judgment so quickly wrought by whisky and by mental disorder, I showed the C.O. the letter-card. And here, I think it well to suggest that we must all agree that, if, during a war waged on account of the persecution of the Jews, one were to suggest that the Jews in our own armed forces were being persecuted, such a suggestion must of necessity produce a very grave outlook. So grave indeed, that such a statement must be choked at birth—in the interests of the State. The ‘funny’ thing is, that I am well aware that there was not the slightest grounds for such a suggestion in this particular instance. On receipt of this advice from Mr. Wells, however, I deemed it wise to amend my book, so that it revealed as much of the truth of my certification, as seemed to me wise. I did 12

not go into the full details; for well I knew that such an extraordinary statement might well be regarded as nothing more than the fantastic allegations, suspicions and illusions of persecution held by the paranoiac. This then, makes clear the reason why I did not act entirely upon Mr. Well’s advice. At the request of Mr. Wells, I agreed to go so far, and no farther. How far I did go, is revealed in the Wells copy, from which I take the following: “…Now, I was acquainted with a Commanding Officer; and one fine day, whilst sitting in his lodgings, I showed him a letter-card which I had that day received from the South. He did not like its contents, and asked if he might take a copy of it. Gladly did I comply with his request; but when next day, I called to retrieve my letter-card, his manner had changed—as had his countenance; for he said, ‘Not ruddy likely—I’ll keep this ruddy thing!’ I therefore told him that his behaviour was quite absurd, and that I would call on the morrow to collect my property—that if he still declined to return it, I would have no alternative but to resort to the law. Next day found him adamant—and me too; so that I went to my lawyer and asked him to serve a summons upon the Commanding Officer. Consequently, in due course, he was summoned to appear at the county court.

It was about a week later, that the Procurator Fiscal informed my lawyer that although I was perfectly justified in my action, we must remember that there was a war on, and that such an action was therefore, against the interests of the State. He further suggested that I should withdraw my charge—I was right, but I should withdraw; indeed, if I failed to do so the Crown would intervene! But, said I to myself, How can the Crown possibly intervene? I am an honest man—fearless; and no one can point a finger at me. Withdraw? I certainly will not! 13

And so, the case went on… It came up, and was then put forward for a few weeks; so that I almost forgot its existence. And then, one fine day, found me snoozing before the dining-room fire. It was the hour of siesta; my dog lay at my feet. The door-bell rang, and the village constable and a ‘gentleman’ were ushered in. “How do you do, Mr. Woodley?” said the constable, “This is DetectiveInspector Green!” “Oh, How do you do?” I replied. “I have a warrant for your arrest,” said the detective; and he proceeded to read over the charge against me… The following morning, I was taken (from my prison cell) into the Court which, apart from my solicitor, the Procurator-Fiscal, the Sheriff Clerk and the constable, was empty. After some minutes, the door at the end of the gallery was thrown open and, without ceremony, the Sheriff entered the Court; and although he made the usual bow to the Court, I thought he looked ridiculous in his lounge suit; so that as I gazed at him I could but think how less than ‘ordinary’ he looked; for that spurious air of dignity with which his wig and gown had hitherto cloaked him, had departed—leaving in its wake an air of the incongruous. The charge was then read to me—That, whereas, I did, on the evening of the Nth, threaten to shoot the Commanding Officer, at his residence at_____, in the parish of _____, in the county of—etc. And that, whereas, I did, later that same evening, threaten to shoot the Rev. Blank, at his Manse, in the parish of_____, in the county of_____, and so on. I waited in vain to be asked whether I pleaded ‘Guilty’ or ‘Not Guilty.’

I then asked why it was that with such damning evidence in their hands, the police had allowed seven weeks to elapse 14

before carrying out the arrest. Why had the police not taken possession of the revolver and ammunition? Had anybody else suggested there was a revolver? Had a search been made for arms and ammunition? Did the Court realise the deadly peril of the community whilst such a dangerous man was left at large for seven weeks?   The Sheriff seemed embarrassed, and mutely appealed to the Fiscal; and the Fiscal realising that his police force had failed to come up to the scratch, asked for an adjournment. Straightway I appealed for bail; but the Fiscal intervened with, ‘M’lud—M’lud—I strongly oppose bail—This is a very serious case—and there is a question of the mental state!’   Clearly, freedom was not for me.   Later that day, I telephoned for my doctor, to come to the jail and certify me sane. He was not permitted to do so. I therefore asked for three independent doctors, whose fees I would pay, to be sent to examine me. But no—The Crown would supply the doctors—and so it did!…” On receipt of the letter from H. G. Wells, I made these amendments and then submitted the book to a first-class publisher. This is what he wrote: — “London, W.C.l.              30th November, 1945. We are quite willing to undertake CERTIFIED, but we feel quite strongly that since the value is in the essence of the story, the book should be presented either without an explanation, or with a completely frank one. As it stands at the moment, the explanation detracts from a just estimate of the merit of the work.” 15

V.   And so—I entered a primitive lunatic asylum, there to commune with my soul for three-hundred-and-seventy-five days and nights…Nevertheless, I would ask you to spare me from your kind sympathy, as I tell you that the

asylum which made me so bloody left me quite unbowed; for no sooner had the outside world vanished from my sight, so did thoughts of perjury—of injustice—of the insanity of our Civil Laws and the regrettable scope provided under Section XV of our Lunacy Law, vanish from my mind, to be replaced by thoughts of insanity and the insane; so that thoughts of what Justice had done, or left undone gave way before the knowledge and evidence of what Psychiatry had failed to do. Therefore, my sole object in writing my book was to draw attention to the sorry plight of our lunatics, and to the gross failure of our psychiatric system. I wrote to tell Social Science that it seemed proud to boast of our 200,000 certified lunatics; a figure which does not include the countless thousands of ‘incurables,’ and which does not take in those beyond the reach of ‘statistics.’ It does not include the ‘unascertained,’ the ‘uncertified’ and unemployables; nor does it include the criminals and prostitutes. This then being my purpose, the miserable explanation of how a sane man came to be certified insane and consigned to one of our primitive lunatic asylums seemed so insignificant that I decided to remove all ‘explanation’ from my book. I did so, and then submitted it to Victor Gollancz, who accepted it.   VI.   I was happy … my book was to be published… I 16

had got rid of my load—successfully, and was happy in the thought that my days and nights would no longer be disturbed by the conflict between hope and despair; for soon, my book would be on sale; and I would gaze through the windows of the bookshops with my heart filled with pride. And yet, in my heart, I knew it was not so much joy of publication as happiness in having achieved my object; for now, the world of psychological medicine would see I was in grim earnest. Social Science would see how long and soundly it had slumbered; and social disorder would prepare to organise. Because of these things, I felt it my duty and my pleasure to acquaint some of those who had read my book, with the news of its forthcoming publication. My letters were brief and to the point. To Mr. Wells, however, I wrote at greater length, and told him that after acting on his advice and telling the whole truth, I had sent the book to a first-class publisher who failed to acknowledge a truth he found to be stranger than fiction.

I left the matter there, for I had other books to attend to—one of which I considered of greater importance; and one day, I would launch it upon a selfish and indifferent world. Meanwhile, I was at peace—at peace in a deckchair in my garden. In the distance rose the Grampians, sparkling as the granite of Aberdeen on a sunlit day in June. The sun beat down. The air was still, and a gossiping village siesta-ed. There was peace in our village, where, in common with the big cities the natives know nothing and care less of the horrors of our primitive lunatic asylums; But I would tell them—I certainly would. Henceforth they would not easily forget. Yes, indeed—that amiable doctor who had ‘received’ me into the asylum. Amiable, but slightly disrespectful; for somebody had suggested that I was a lunatic; so that whether I was or was not, he could afford to be slightly disrespectful; for the lunatic is nothing more 17

than a joke of civilisation. So long as Dignity lives, the unhappy memory of that unfortunate would-be psychiatrist will be mine; for lack of dignity defiles a psychiatrist more than mud… I said I was at peace. I ought to have said I was as near peace as is possible for me; for my mind is ever disturbed by memories of filthy bathrooms—the reckless drugging of our insane and of their ill-treatment. Memories of the illtreatment of your fathers, mothers, husbands, wives, brothers, sisters, sweethearts, sons and daughters—yours. Horrors unparalleled, or if otherwise, paralleled only by the indifference of Social Science… Dope… Paraldehyde… Forcible drugging… Horrors unthinkable… Blasphemy unspeakable… Dignity buried ‘neath shame and filth… And then I went into the house…   VII.   The afternoon post. Nothing of importance. Just one letter:—

“13, Hanover Terrace,                              Regent’s Park,                              London, N.W.l                    July 17th, 1946.           Dear Mr. Woodley, Please make no concessions in your story. If you will submit the story in its uncensored form to me I will go over it carefully and if necessary print and publish it at my own risk and expense. I’ve always wanted to be a publisher and this seems a fine opportunity. Yours sincerely,                                       H. G. WELLS.”           18

I was astonished. Why did Mr. Wells come to my aid? Only a few months previously he had written his last book, and in it he had told us that not only was mind at the end of its tether, but the world also—that he was ‘through’— that he had no more to say, and that he never would have anything more to say. And now, he wished to be allowed to publish my book—my book! Ah well, little did I dream when typing my book midst the great and awful desolation of Lunacy that it would come to this pass. In those’ days, when I lived with individuals who did not live with me, I could not foresee this happening; nor, as I watched the grotesque behaviour of the obsessionalneurotic, who, in the grip of Compulsion, washed his hands in the lavatory pan and ignored the H. & C. basin at his elbow, did I imagine such an outcome. In a great and deep loneliness did I write—in the hope that others might benefit; and lo! Hey Presto! and a champion falls at my feet. Instead of a letter, I saw a cheque; and some day, when I had the time to spare, I would cash it. Meanwhile, one thing stood out in relief—this letter would do much towards the publication of my books. I therefore telegraphed Mr. Wells that I was coming to see him; and at the same time, I sent him both versions of CERTIFIED. But Wells or no, I knew then that I would never amend my book. It was a sad and poignant record without its ‘explanation,’ and the publication of the whole truth would not only startle a great many people, but would attract so much attention that the story would be lost in the explanation; and after all, the story is the thing. I therefore decided to compromise with Mr. Wells—by telling the truth through the pages of the

Press; and this I would arrange to coincide with the public appearance of the book. 19

VIII.   A few days later, I was in London, reading a strange post-card which had been sent on to me from home. The address side of the card bore the printed name and address: — W. Livingstone, Esq.         1, Manchester Square,                    London, W. 1.

This had been crossed through, and my name and address substituted. The reverse side of the card contained a printed Notice of a Company Meeting, which was also crossed out; and in the various corners of the card, was the following message: — “Dear other H.G.W. Don’t dream of coming to see me in London yet. I have been working on your copy and it has all the copiousness of mania. Everything can be told in about half to one-third of the verbiage, and told better. Forgive this strange card. It is the only one I can put my hands on.”

IX.   So this is the day! The great day of my interview with the greatest novelist and most prolific writer of our time. A man who has written ninety-eight books, but seldom reads the work of others—who never writes prefaces or forewords. 20

A man of satire, shrewd, methodical and punctilious. A kind and mischievous man hidden from the world in that impenetrable fortress known as 13, Hanover Terrace. Hanover Terrace, which it pleases journalists to describe as “The most breath-taking architectural panorama in London”—whose ‘Nash’ houses are linked with a theatrical colonnade and a pediment over a continous loggia—and I, from a country cottage. I must therefore leave nothing to chance. Above all I must be punctual. I therefore synchronised my watch with the pips of the B.B.C. and set out for Regent’s Park, where I arrived with an hour to spare. And now, I would spy out the land, and ascertain the exact whereabouts of Hanover Terrace. I found it, and noticed that each of the houses in the Terrace was numbered with the usual three-inch figures, so that I was intrigued to observe number 13 announced in twelve-inch figures. “Make no mistake,” it said to me, and to all people. “This is where H. G. Wells lives—THIRTEEN’S the number!” Having satisfied myself in this matter, I decided to rest for the remainder of the time, on the outskirts of the Park. I sat upon a chair quite near the main road, and exactly facing the imposing Victorian houses of the Terrace. Workmen were busy on some of these houses—converting them into flats. Soon, they were to work on number 13 also. My back was towards the Park, so that at times I glanced over my shoulder at the crowds of pleasure-seekers, at the children enjoying life upon its waters, at the canoes and the motor-boats. A row of cars were parked on the edge of the road a few yards from where I sat. With my brief-case upon the ground, I mopped my fevered brow. It was the hottest day of 1946, and I hailed from a cooler clime. I thought of his life—of his fifty-eight years of writing—of his ninetyeight books… The Time Machine… Love 21

and Mr. Lewisham… The History of Mr. Polly… The World of William Clissold… Tono Bungay… Tono Bungay, ah, that was a good ‘un—it was more; for it was the life .of the man I was about to meet. New Worlds for Old —yes, indeed, New Worlds for Old. Kipps… Kipps, the story of the Simple Soul; and here was I with a story of a simple soul. Extraordinary thing—I was Kipps; and Kipps-like did I gaze at 13, and dream dreams. And then I thought of myself … so small and so insignificant. An exlunatic, about to meet the great novelist—the great sociologist… So this is London—this is where H. G. Wells lives… A kindly breeze fanned my hectic brow… I looked at my watch. Zero Hour was approaching. Twenty-five

minutes to Zero Hour… My life with the insane… The loneliness that had flooded my soul during my 375 days and nights with the mad… Why were they mad?… The medical superintendent was a kind man—knew nothing of Freud, and possibly cared less—but he was kind. That story I had partly related in “Certified,” and fully in “Synthetic Mania”… That girl I had so strangely met, whilst enjoying asylum parole … that day when Dostoievski stood before me; and now, once again he stood in front of me. He was saying, “Wretched woman! I tell you that in all the world there is no more horrible trade than yours… Your name will vanish as utterly as though you had never been born … and at night, when the dead raise the lids of their coffins, you will cry aloud, ‘Suffer me to go and live a little longer in the world, good people. I lived, but I never knew life; for my life served but as a cloth for others to wipe their lust upon’ ”… Yes, that was what I wrote; and I wrote it because of the surreptitious advertisements that were beginning to appear in some of our papers and periodicals—in a half-hearted manner that bespoke apology for their intrusion. 22

I wrote it in the hope that those responsible for such things might come to see that instead of pasting “V.D.—The Shadow on Health,” upon the walls of our public lavatories, they ought to paste them upon the walls of our class rooms. I was gazing thoughtfully into space… Cars were passing… Young men and maidens sat in the park… Fathers with young daughters, mothers with baby sons… A woman was walking the’ pathway between Hanover Terrace and the Park. I was but a few yards from that pathway. She was walking that path … smiling to me… I still looked into space—into the nothingness upon which she was superimposed. She smiled again; so that I awoke from my trance and smiled to her; for it now occurred to me that here was copy for a story. Walking to my side, she smiled again—a fearful smile, and said, “Warm, isn’t it!” “Very!” I replied. “Think I’ll sit down,” she said. “Yes, do,” I suggested. Drawing her chair close mine, she gazed curiously into my face. She was thirty, and I, fifty-five. Was I a shuttle-cock that the gods should treat me thus? For there was that little joke they had played at my expense, by locking me behind the doors of a

lunatic asylum; and now, despite my age, and (I hope) respectability, they seemed determined to continue their joke. It was fifteen minutes to Zero Hour. I glanced at my companion, who was a woman of the ‘working class,’ dressed in a cheap and shabby summer frock which exposed girlishly a pair of inelegant legs. Mental instability was writ large upon her nondescript eyes; for it must be evident alike to the student and the lay thinker that to offer one’s body for hire, is but the outcome of a disordered mind; the degree of 23

disorder being of secondary importance. Social Disorder revelled, and Social Science slept, as she rubbed her leg against mine—Like cats at play, I thought. “I can’t take you home,” she said, “I have an invalid husband!” “Is he bed-ridden?” I enquired. “Yes,” she said. “What do you suggest?” I asked her. “Well,” she said—with a stupid smirk on her face, “I usually find a nice boy with a nice car!” This obviously because of the cars parked nearby. “I’m sorry, I have no car,” I told her, and added, “Those cars belong to other people. I am waiting to go across there—” I pointed to Hanover Terrace —“Where I have an appointment.” “How long will you be?” “Difficult to say,” I said; “for the appointment’s his, not mine.” “You’re a nice boy—What nice eyes you’ve got—I’m sure you could do with some fun!” said the prostitute. So instead of saying “All the better to see with!” I said, “You bet I could!” “Let’s go across to that knoll—just behind the trees,” she said. My watch now registered eight minutes to Zero Hour. “I must do some shopping before the shops close,” said my fairy godmother. “Perhaps I shall be sitting here when you come back,” I said, and added, with a reckless sympathy, “I shouldn’t like to miss you!” “That’s a dear—I wouldn’t miss you for the world,” she said, and added, “Got a cigarette?” With thoughts of the world—of my daughters, and yours, I gave her a cigarette. 24

She was walking away, when I said, “In case I should miss you, take this as a little gift from me.” I handed her a ten-shilling note—in the belief that I was the world’s biggest fool. But who knows?   X.   At 4.28 p.m. I arose and walked towards the entrance to Hanover Terrace. At exactly 4.30, I rang the bell. A pleasant maid answered my ring, and in reply to my “Is Mr. Wells at home?” said, “Oh, you’re Mr. Woodley, aren’t you? Will you please come this way?” Without knocking, she opened the door of an upstairs room, and announced, “Mr. Woodley, Sir!” I entered that room as though I had been born in it—as though I had lived my life in it. Mr. Wells was seated in an old-fashioned arm-chair. He did not attempt to shake my hand; and was at first glance, a sick man, whose violent cough, physical weakness and age, spoke of numbered days. Indeed, so sure was I of Brother Death’s presence at our meeting that later I was amazed to learn that his sudden end had surprised his people. By his people, I mean his two sons and that kind, tolerant and charming personality known throughout the publishing world as “Marjorie Wells”—his daughter-in-law. I was not asked to be seated, so sat myself down upon the settee, and looked around me—to observe one copy of “Certified” upon a table across the room, and the other upon a small table near Mr. Wells’ chair. I had barely finished thanking him for the honour he had done me in receiving me into his presence, and indeed, in becoming my patron, when the maid appeared with tea. Whilst she set the table, I gazed around the booklined shelves—at the nice ornaments, and at a huge Indian God—in whose face I saw the face of Kosumba, the coloured inmate of 25

Blankville Asylum, of whom I have told in “Certified.” It was clear to me that I was to be ‘mother,’ and he, ‘father,’ so, with a pretty china tea-pot in my hand, I asked whether I might pour him some tea. “No,” he said, “I’ll have milk!” I lifted a plate of sandwiches, and asked, “Would you like a sandwich, Sir?”

“No—They’re all yours!” he said, and added, “I wonder what’s under that lid?” On removing the silver cover from the dish, I exposed eight small evenlycut pieces of heavily buttered toast. “Now, four of these are for you, and four for me,” said Mr. Wells. I passed the plate—so that he could remove ‘his’ four. I then removed ‘mine’; and so our tea began. After discussing “Certified,” I mentioned two other books—“Synthetic Mania” and “That which is Caesar’s.” “ ‘Synthetic Mania,’ ” I said, “Is really a medical book, and perhaps would not appeal to the lay public.” “There is no lay public,” he said—“Put out your books without regard to profession or laity.” “I am particularly interested in ‘That which is Caesar’s’ ” I told him. “It is much nearer ny heart than ‘Certified’; but after all, I am a layman. However, I am determined to publish it—to tell Psychiatry how and why it has failed; and in the hope of removing Psychiatry from the clutches of the State. Why, in the days to come, the people will never believe we were the fools we are!” He laughed outright at this. There followed a pause, in which I said to myself, “If a publisher is bold enough to publish ‘All aboard for Ararat,’ I am sure I’ll find one bold enough to publish ‘That which is Caesar’s’.” He seemed to read my thoughts; for he said, “Whatever 26

you do make no concessions. Tell them the truth, but no concessions. Go to your publisher and tell him I will be your guarantor—I will take the risk, and if necessary, pay for publication—But no concessions!” Another pause, and then he said, “I can afford it, you know!” I next approached the subject about which he had written me, and suggested that as the book was in the hands of a good publisher, it would be better to leave it in its present form—that I could make known the ‘explanation’ in the press—that space for this purpose had already been offered me. To this he agreed. “You say well when you state that a drunken man is a lunatic, and a lunatic a drunken man… I have also written on insanity, you know,” he said. “Oh yes, I know that very well,” I said; “for I well remember reading your ‘Christina Alberta’s Father,’ twenty-three years ago. I have based ‘Certified’ upon that book. Indeed, I may tell you that I stole from its pages a score of

your words. You see, Sir, I thought to myself, ‘Mr. Wells is a man of such multitudes of words, I am sure he’ll never miss these few—so I’ll pinch ‘em.’ So I did so. I hope you don’t mind, Sir!” “That’s all right,” he said, “But don’t steal too many, for you are already suffering from a copious loquaciousness!” This, doubtless, because he had been reading the original version of “Certified,” which I well knew to hold much that was redundant. I laughed outright. It was laughable—Not because of his satire, but because there sat the two H.G.W.’s. One, the sanest of all the world’s millions, and the other, an exlunatic; both plotting to over-throw the remaining millions—planning to open their eyes to Truth. 27

“Tell them the truth, and watch the outcome. I shall not be here to see the result, but you will. Continue to tell them the truth. You are a shrewd fellow’—many of your remarks are quite shrewd—shrewd; but make no concessions!” I was proud, and told him so. My heart swelled within me as I thought of my little village at the Foot of the Grampians—of tire ‘natives’ with whom I had for twenty-five years made my home. Sitting there with H. G. W. was indeed an escape from the slumber of rural places; and yet, my means of escape but took me back again to my village; so that as I gazed at Mr. Wells’ face, I saw a son of the soil entering the village post office, and heard him ask for a ‘pair of stumps.’ I recalled an alphabet that omits the letter ‘A,’ and a vocabulary boasting neither ‘please’ nor a ‘thank you.’ What they would think could they see me sitting with Mr. Wells, I wondered. What would they think of it? For of course, they would come to know. In a village one has only to change one’s mind and the natives are aware of it. What did it matter, anyhow; for apart from the fact that the natives drag their feet, and, maybe, despise one who doesn’t, they are a good lot. I then gave Mr. Wells the outline of “That which is Caesar’s,” and was greatly encouraged by’ his interest. “It is good,” he said—“It is necessary— urgently necessary—they need such enlightenment!” Pause. “If you will send me your books I’ll read them; and if you will let me have ‘That which is Caesar’s,’ I will write a Preface for it!”

This was wonderful news, and most flattering; so with the highest of spirits, I asked whether I might pour him another cup of milk. “No—Tea, this time!” he said. 28

A lovable man—a kind man—rather a funny man, I thought. He reminded me strangely of my father, who died when I was nine. He also reminded me of George Ponderevo; and here and there I saw a streak of William Clissold…   XI.   I had been with him exactly an hour, when he said, “I must turn you out now!” As I stood before him and thanked him profusely for his kind interest, he picked a book from the table—“The Outlook for Homo Sapiens.” “Have you a pen?” he asked. He then wrote at the front of the book: — “To the other H.G.W. and all his works, With best wishes from H. G. Wells. 24th July, 1946.”

He made no attempt to shake hands with me; so emboldened by all that had come to pass, I walked around the table, and lifted his hand (which rested limply upon his thigh), and gripped it warmly and gratefully. “Goodbye, Sir. And thank you again for all you have done for me. I am very proud of this book, and conscious of the great honour you do me. I hope to see you again, soon…” I wondered whether I should ever see him again… At 5.30 p.m., rich in pride, I let myself out of the house, I did not look back to my seat in the Park, but walked quickly towards Baker Street station, and was soon in town. That night, to celebrate the occasion, I went to the Adelphi to see A. P. Herbert’s “Big Ben”; a superlative satire which had that very day been totally eclipsed by Mr. Wells’ remarks to me. 29

Later that evening, when passing over Waterloo Bridge, whose bluish lights sent forth an air of mystery, loneliness and peace, I observed the real Big Ben—with its light shining brightly in the tower above the clock, to tell

people who happened to look that way, that Parliament was still in session— that they were discussing the affairs of State, and no doubt, the Staff of Life; for Bread Rationing had been introduced that week. One thing seemed certain —they were not discussing Social Science; nor did they consider the foolishness of pasting placards upon the walls of our public lavatories instead of upon the walls of our class-rooms. Orion was clearly visible. Also, the Seven Sisters and the Milky Way— things I had gazed at with intrigue as a child—gazed at midst the nightscented air of Calcutta, and through the windows of a primitive lunatic asylum. I had coupled these things with mankind; for they pricked my soul in my more emotional moments. On the escalators that night, I watched the people. The old and the young, the youth and the maid. One and all were victims of their mothers’ teaching. They had been brought up in the belief that they possessed eyes, nose, mouth, feet, hands and ‘privates.’ Truly, there is no lay public; nor is there private anatomy. My companion in the Park had been lied to in childhood; if otherwise, how came she to be a prostitute?   XII.   On August the twelth, I finished “That which is Caesar’s,” and the following morning, despatched it to Mr. Wells. That same evening, I listened to the Nine O’clock News—to loam with regret, but not surprise, of the passing of my patron. 30

Right enough, he had been. He would not be here to see it. But I was here—minus a preface for my book… Alone in my room, with the wireless switched on, I heard no more of the Announcer’s voice; for I was thinking… It all seemed very strange… First, within three weeks of my liberation from the asylum, I had lectured in a mental hospital. Next, I had dined with an eminent psychiatrist; and now, H. G. Wells had become my champion; so that when I recalled the filth, horror and indignity of that asylum, I was glad they had ‘certified’ me.   XIII.   Although it was but the fifteenth of August, in my village Winter was already looking over Autumn’s shoulder. There was frost in the air, and the

Grampians looked unusually threatening, as I opened a letter from Mrs. G. P. Wells: — “I am returning your two manuscripts, which he had been working on until about a week ago——”

Ah well! I was about to place the manuscripts on my book-shelf when I decided to open one… It was astonishing—amazing. The great man who was dead, now spoke to me from its pages—‘Just as Caruso still sings to us,’ I thought. My patron had re-written my book; so that now it was “Certified,” by H. G. Wells. Why, I could send it to any publisher—they would jump 31

at it, as a fine example of how best a story may be told—as literary technique at its best. And yet, why should I? His was the work of a brilliant artist, and mine, the story of a simple soul. Because of this, my version must be better than his; for mine is a soul on paper, without regard to literary technique. Mine is poignant, with power to hold because of its sheer simplicity. Besides, my patron was not a certified lunatic. I was that lunatic. It is my soul and my story. And as I turned its now mutilated pages, and compared my multitude of words with his few, I realised how little I know of the art of writing. I did not grieve however; for although I am the other H. G. W. I am not H. G. Wells. And yet, I could but wonder whether he was altogether justified in telling me that I was a victim of copious loquaciousness. Ah well! He was dead! I am alive, and though he is dead, he spoke to me. “I must turn you out now,” he was saying; “but before you go, I present you with a handful of wisdom—its all you are capable of coping with at the moment; and er—I’ll leave my words with you, other H. G. W. Use them to the best of your ability. You’ll find the people unwilling to believe; for like some of your lunatics, they hide from truth and revel in fantasy!” How could I use those words? In Fleet Street they told me his letters were worth much fine gold… I read the re-written CERTIFIED, and found wisdom, education and entertainment… I then replaced it upon my bookshelf, where, of my few

worldly possessions, it represents the most valued—a value which is increased a thousand-fold in the knowledge that in recording MIND AT THE END OF ITS TETHER as the last work of H. G. Wells, history errs. His last work was the re-writing of my 32

book—which he accomplished but a day or so before leaving a world impoverished by his going. Moreover, it was his parting shot at Homo Sapiens—the last of many such shots which invariably hit the mark… H. G. Wells in all truth lived; for his life was one long endeavour to get the people to become aware of themselves. He strove so that the child Homo might grow into manhood—that the child might remove the blinkers from his eyes and gaze with unrestricted and limitless vision upon his world of reality; and how well he knew that Homo was disinclined—that there are certain devious things in all of us which we will not face. This calamity he appreciated fully, for he at least, realised that where the reluctance to face an illusion is greatest, that illusion is also the greatest, and becomes still greater in its security. These things he knew… And what does Homo know? What does he care? Alas, alas, Homo laughs at Homo. Homo does not see that it is the way of Homo continually to seek escape from Truth. He wilfully participates in the greatest of all catastrophies—the fleeing in fear from Truth! Homo knows nevertheless—though he pretends he doesn’t, that such is the way of the insane; for they too, seek shelter from Truth in the Sanctuary of Fantasy. Moreover, he knows—deep down within him he knows, that he thus resorts to fantasy because he is a coward—because he finds in fantasy the most convenient and agreeable pattern of life for his fearful mind; and because of this he knows that there is more truth in the delusions of the lunatic than in the religious beliefs of the sane; and how well he knows that although the former are beliefs weird and distorted as the image of a figure seen through a mountain mist, they are at least the reflection of a reality. Fear has done this thing… FEAR that lies twisted about life’s deepest roots. Fear of the Unknown, upon which 33

Religion sets up its Corner-stone… The re-writing of my book was his parting shot at brother Homo. The close of a life of endeavour…  

XIV.   That night, I lay in bed thinking… I hadn’t done much good in this unbelieving world, but at least I had made an attempt—Yes, I had tried… That eminent psychiatrist who had told me that if the benefit hoped for could be attained, I would have carried out a great mission in life … a great mission in life … a great mission in life… He was dead too… How vain and fleeting is this thing called Life—this worrying thing which pains… Nobody cares much about Truth—less of the greatest of all truths—that there is no pain in death—that it is the great nepenthe—rest, cessation— sleep… Strange thing is, we do not see ourselves die; but there, neither do we see a race or a language die. They die… And yet, if death it be, I saw H. G. Wells die. Yes, indeed; and at that moment the Universe stood still, and he saw the whole world gazing upon his countenance—affectionately—gratefully. He was vividly aware of the great appreciation that was now his, and conscious, happily, that he had not toiled in vain; for in that same moment Time halted, and rewarded him for his fiftyeight years well spent. At that moment, as just before complete and absolute anaesthesia, arose a great multitude of voices wherein afar off, he listened to the sayings of the small and of the great—to the voices of the lesser prophets acclaiming him with eulogies of the highest … eulogies of the highest. The champion of Homo Sapiens is dead… H. G. Wells is dead… Long live H. G. Wells… 34

And as the darkness enveloped him, he was conscious of a great silence, much peace, happiness and rest ever-lasting… Dead? He is no more dead than I whose poor words you read. He has taken his great life with him…   XV.   Kipps-like, I lay between the sheets, thinking… Sixty years ago, he was Kipps—looking forward. Today, he has reached his zenith, and I am caught up in the cycle of time. I am left standing where he stood—at the bottom of the ladder. He lives, and will be with us for many centuries. He lives, and I shall remember him for ever—a memory sweet and

proud to become a light to light me on my way when I too, take off into the darkness of the great Unknown… And I? At least, I have made an attempt… I have tried to live… Tried? Why, I too, have lived. LIVED, I say; and thou canst rob me now, only of some long life that ne’er has been. The life that I have lived so full, so keen, is mine! I hold it firm beneath thy blow, and, dying, take it with me where I go…   End of Book I. 35

         

BOOK THE SECOND   And they brought Jesus a penny; and he saith unto them. Whose is this image and superscription? And they said unto him, Caesar’s. And Jesus answering said unto them, Render to Caesar the things that are Caesar’s, and to God the things that are God’s. And they marvelled at him. St. Mark: 12:6.           37

PART I THE INSIDE WORLD     The hawthorn … the gean blossom … soon, the broom would brighten the country-side; for it was Spring. Spring, mark you—when hope runs high. Yes, I can clearly see that hawthorn and gean blossom; and the hallucination of broom I had that day, will remain with me for ever… I was sitting perched high above the river, and the air was clear as crystal. I remember that just before I half slid and half walked down the bank to the river’s edge, that I took a long look at the Grampians which were sparkling in the distance. Peacefully, blissfully and happily, I walked the winding river path. The trees were showing signs of budding, and the birds happy in their song; for Spring was coming, and life in its glory lay ahead. And then, it happened; for two hours later, on that lovely day, with a suddenness appalling in its intensity—with a terrible suddenness, it happened; so that it seemed that the sun went out, the birds ceased their song, and the death knell sounded in my ears. I found myself travelling in a car with a police constable and a Public Assistance man; for they had ‘certified’ me. Yes, they said I was mad; indeed, a dangerous lunatic; so that my thoughts were as the fallen leaves of autumn, caught up by a sudden gust, and sent swirling and swirling, some to drop here, and others there, some to fall with a heavy thud on my home and my home life, 39

and others to speculate on Madness and the Unknown. Thoughts that soon became as the tail of a comet—breaking off into myriads of particles, to fall away into the great Nothingness. Something had happened—something to make me different from other men—to set me apart—to stigmatise me, and shut me off from the great world of wasteful men and women. It was eerie—it was frightening; and worse was to come, for something further was going to happen to me. What was it? What was going to happen next? I knew not, but wondered; for I was face to face with the Unknown. I was mad—at least, they said I was; so that it really mattered not whether I were sane as you, or mad as the maddest Hatter. They had spoken, so that henceforth the problem would be mine alone. Of what use to protest? Once on the wrong side of an asylum door expostulation could avail me nothing; for I well knew that all lunatics continually proclaim their

innocence of this terrible charge. Alas, I regretted this knowledge; for happier were I without it. But there it was. I was mad—mad—mad. A dangerous lunatic certified by the Crown and consigned to Blankville Lunatic Asylum. I was trapped, so that Frustration stood out in relief upon my soul…   II.   By observing very closely for 375 days and 375 nights, the ways and the life of the strange community in which I found myself I reached the conclusion that there is little difference between insanity and sanity. Like senility and senile dementia, it is a question of degree; for insanity is merely an exaggeration of sanity; it is sanity under the microscope—sanity magnified; and I could clearly see this 40

exaggeration whenever I observed the so-called schizophrenic; for as I gazed upon such patients during their stuporose phase of dementia praecox, I not only saw a hunched up pitiful caricature of manhood, with downcast eyes, staring unseeing into space, mute and motionless, utterly oblivious of his surroundings, deaf to words and commands, immune to pain, indifferent to food and heedless of the calls of nature, but saw in it all, myself. I could see that such a person was but an exaggerated version of myself day-dreaming; for one can day-dream and not realise that one is being spoken to. One can day-dream and be ‘miles away.’ One can day-dream and not realise it is dinner-time. It therefore seemed clear to me that if I could lose myself thus in a day-dream, it was much easier for a person with schizophrenia in his roots to day-dream, and lose himself for indefinite periods; for the object of the life of the schizophrenic is the avoidance of reality. He loathes reality, and therefore buries himself deep in a world of fantasy—a fantasy he loves so well that he actually forgets it is fantasy; indeed, he does not desire to remember—so that he forgets to come back to reality—forgets to come back to earth. It is to be seen that if a normal person is day-dreaming, he does not eat whilst so engaged. He does not read whilst he is day-dreaming—he does not wash, and does not use the bathroom when he is day-dreaming; it is only after he has apologised for being ‘miles away’ that he realises that it is dinner-time, and that perhaps he had better run up to the bathroom first.   III.

  The fumes were rising like incense to the ceiling as, with the soft low’ chuckle of a hebephrenic ringing in my ears, and 41

frustration cutting into my soul, I watched the doctor walking through the corridor. He did not look at me; and why should he? He was sane. I was certified insane. A jangle of keys, a whiff of fresh air, the snap of an automatic lock, and he had gone—leaving me once again to realise how very far distant lay the outer world of freedom, with its shops, streets, men and women—its rush of life and its surreptitious announcements concerning venereal disease. Not only was the atmosphere foul; for whilst a stream of choice epithets was flowing from the lips of a mongol, unbelievable blasphemy poured from the mouth of another of my companions. One individual was singing hymns, and another reading the bible; and although I was a certified lunatic, I was quite able to appreciate that such strange searching after a God was, like crawling after a woman, but a brick in the house of insanity. I then passed to the bathroom, where I beheld the dribbling caricature of a man wearing a night-shirt which was ripped completely down the front. On one side of the bath-room was the grotesque figure of a man reposing upon a lavatory without a seat, whilst a young girl assisted him to balance himself. And then, I entered the inner closet. There was no seat and no toilet paper; nor had there ever been a seat or toilet paper. Despite lack of seats and paper however, I at once concluded that what was most needed was disinfectant; but deodorisation was quite unknown there; so that the foul smells which putrified the whole institution remained part of it. Outside, the world was locked in deadly struggle for the cause of Right and Progress. From the bathroom I passed to the Admission ward where the majority were sane in sleep. Deeply depressed, I strolled on to the Sick ward, where I observed a man who, suddenly caught by the upward swing of the manicdepressive pendulum, was relating a funny story to a melancholiac—thus 42

giving proof of his own insanity; for only the insane attempt frivolity with melancholiacs. Likewise, only fools offer provocation to maniacs; the wise agree with them, and quickly, ere it is too late. And as the maniac told his funny story, a dementia praecox who for a week had lain inanimate as a corpse, chuckled loud and long—so that a novice might well think that the

D.P. had been amused by the frivolity of the maniac; but not at all, for that D.P. was oblivious of the maniac’s existence as our Government, who disregard the existence of our primitive asylums and helpless lunatics—who prefer to house these mentally ill at the expense of the rate-payer; for it is at your expense that these unfortunates await their hour of dissolution. Think, ladies and gentlemen. Think—to be stored (never mind at whose expense), till that day when they shall fall to pieces and sally forth to occupy an unknown tomb in the necropolis of the devil. Surely, if there be any good in us—if we would express our unselfishness whilst we are still here to do so, we should do it now. If otherwise, then what exact purpose do we serve? Are we but self-centred hypocrites who talk glibly of a God—of a Christ who once asked the question our lunatics are today asking you—“Why hast thou forsaken me?” Ladies and gentlemen, if there be any good in us, let us think on these things, for the sake of those who come after us—to their benefit and to our glory; for to stem this fast-moving tide of instability we must not only think now, but act—or perish. In that asylum, it seemed to me that fortunate indeed were those for whom illness acted as a drug to drive away grief; and because of this, my thoughts were mainly centred upon the unhappy, demented and tormented great majority; for whilst on the one hand our Government ignored their sorrowful plight, on the other, although the practice of leucotomy had been in use in the United States for seven years, it was 43

unknown in Britain. In those quite recent days, there were whisperings amongst our psychiatrists concerning the possibilities of Somnifane; and by this same token, when prefrontal lobotomy was to come their way, they were to whisper about that also. In the interim, leaving my companions, and—but for the decency of the medical superintendent, myself, to a living death. It is not that I hold a brief for somnifane or leucotomy, and if it were only death we had to contend with this criticism would be unnecessary, for once dead, there’s no more dying then. But, as it is not like that, we have no alternative but to concern ourselves with the living and those who come after us; for this ghastly disease which is more insidious than cancer and a far greater scourge than tuberculosis, is in itself an avalanche—increasing in size and weight. In that asylum, we each lived in a little world of our own. They in theirs, and I, in mine. Each of us was exclusive in our own sort of way. Some always laughing, some always crying, some shrieking, some blaspheming, some dying, all dreaming, and I, thinking, thinking, thinking; and so it was for me

every day. Every day, for 375 days and nights. Like that were my fellow travellers in a lost world; and of such was my kingdom in those days. This thinking business had become a habit with me since that day when I heard a nurse say to another, “Punch the old Bastard in the guts! ” Yes, I began to think then. I at once thought of the great pity of this; for with that suggestion the whole superstructure of psychological medicine was shot up—showing that the Foundation-stone of Psychiatry had either been removed, or never laid. The golden rule was not; for antagonism was not averted, but solicited; so that the objective of Psychiatry, to ease the minds of the mentally afflicted, was lost. It was then that I vowed that should it be my good fortune to return to the world of sanity, I would tell Psychiatry to its 44

face that it was but a Sleeping Beauty. I would tell it how and why it had failed. Also, I.would tell its Ugly Sister—the. State, that it was possessed of less imagination than a robot. It was with these things in mind that I lay in bed and watched Old John—a senile dementia. He was rising slowly from his bed; for he would make himself more comfortable. A nurse gave John a ‘bottle,’ and waited for him to relieve himself. Unfortunately, this wait was relieved by a patient at the other end of the ward suddenly biting the ear of the patient in the next bed—just as one horse sometimes bites another horse; and as the nurse ran to the other end of the ward, in the hope of restoring order, John, being left to his own devices and desires, raised the bottle to his mouth, and drank the contents. A ghastly act which, in all truth, was a toast unto Insanity; so that it was clear to me that the light of Psychiatry had never been lit, or if otherwise, it had sunken and gone out long since. At ten o’clock the following morning, I looked on as a bed was shifted to the corner of the ward; for those who were about to die were placed in this corner a few hours before Brother Death came to release them from a life worse than any death; and although I have mentioned these episodes in the book CERTIFIED, I think they will lose precious little by being repeated here. Besides, it seems necessary for me to repeat these things so that you may have the desired atmosphere. The two nurses who shifted the bed were singing; and why not, pray? Two others were jitter-bugging to the music thus provided. Clonk! went the bed against the wall, so that the loonie’s head wobbled from side to side. “ Hell!” said one of the songsters, “I believe the old B____________’s ‘away’ already!”

All too true, he was ‘away.’ No more would his restless soul stretch out to grasp that which was beyond his reach. 45

Never again would he struggle to understand that which was beyond his comprehension. Already the path he trod was dim, and would soon be covered with weeds; but as his death did not give rise to a By-election, it passed unnoticed.   IV.   After but a brief sojourn with the mad, I realised how little it needed a Darwin to suggest that man and monkey sprang from a common source; for once lunacy touches man, he swiftly returns to the lower animal world. His behaviour bearing witness that human life is but a permanent pretence made possible by a perfect brain, and that it is only the perfect brain that can stave off the persistent call of the wild. But although such thoughts filled my lonely life, the interest I derived from the study of lunatics and lunacy did much to dispel the depression which had at first enshrouded my soul. And then, one day, as I sat in deep soliloquy, watching the stereotyped monkey motions of a katatoniac, such thoughts of Darwin were interrupted by that aggravating jangle of keys, and the provoking snap of the automatic lock. I looked to the door, and observed a kindly attendant. “This way, the ‘walking men’!” he said. Joyfully, I stood upon my feet and moved towards the doors, for a privileged and motley few were about to walk around the asylum grounds. Never shall I forget the indignity I suffered for the sake of that fresh air; for it was then that I made the acquaintance of that melancholiac with the felt hat and mournful eyes, whom I have mentioned in CERTIFIED. Alas, he was nearer normal at that time—on that lovely May afternoon, than he will ever be again; for then, he had been but lightly touched by the morning mists 46

of Melancholia. Alas, by now, he will possess a high degree of potentiality for suicide; so that if he but knew what I know, he would make a very successful job of it. It was six weeks later, that I was granted parole; and as the automatic lock snapped behind me, I laughed. My laughter was not so much maniacal as diabolical, for the devil was laughing with me. Loud and long we laughed—

and often; for he and I had thoroughly enjoyed our jokes ever since the day that somebody had suggested I was mad. Light-hearted and comparatively care-free, I walked past the home of the refractories where, from a broken window, a voice cried out to me, “Hi—hi, Mister, give me a cigarette—” And yet another, “Come on, Jimmy, give us a fag.” And then in an awful unison, “A fag—a cigarette—a fag—a cigarette!” But what were these parrots to do with me? There were other windows too— their panes filled in with strangely distorted faces; and coming towards me were the ‘walking men.’ Walking men, indeed—to me they were walking trees—blighted trees. That evening, rejoicing in my newly-found freedom, I took another walk around the grounds; and after completing the second circle, I stepped off the gravel path, passed through a gap in the hedge, and found myself in a wilderness. Once a walled-in bowling green, with summer-houses at its four corners, it was now a neglected spot overgrown with weeds; its summerhouses derelict, bent and twisted as lunatics. Bowling, indeed! Why, thousands and thousands of mad must have come and passed on since last the biased ball sped o’er its green lawn; with never a one pausing for a moment to ask himself how and why he was insane. As I sat gazing through the broken windows of the ‘pavilion,’ I was arrested by the tramp of many feet, and the sounds of raised and angry voices. This was followed by sounds of a struggle, some lurid curses and the noise of a 47

stone falling into the nearby bushes. Fearing there was to be a fight, I stepped back on to the pathway—only to find a solitary individual in the act of relighting the remains of a pipe. It was “Joe”—a victim of hallucinations well and truly. His had been the footsteps. His, the raised and angry voices; and having cursed his accusers, he had ended the argument by throwing a stone at them. I resumed my seat in the ‘pavilion,’ and was thinking how sad it really was that Joe should be unable to understand that all these ‘voices’ were but his voices—that he was the one who actually spoke through his ‘voices’ just as he was the one who heard, saw and obeyed the ‘voices,’ when a rather pleasant and real voice said, “Hello—D’you mind if I come in?” The owner of the voice was Eve Lester—a girl of nine-teen, who, apart from the smudge of Lunacy which smeared her face, was handsome and even featured, and well-named Eve. Once a Problem Child, she was now known as

a Moral Defective, and presented the deeply intriguing spectacle of a combination of sexual depravity and kleptomania. In an indefinable manner she was tempting, enticing and vicious. “Come on!” she seemed to say, “I’m full of life, and its O.K. by me!” She did not know, nor did she care that the war which was then in full swing, would produce many more problem children than the world had ever before known. Many an evening thereafter did I sit in the pavilion with her; and although my soul was bowed down with loneliness, I managed to confine my interest in her to a study of her character. Sometimes I held her hand—sometimes I squeezed that hand, but always I considered her masochistic soul; for well I knew that this over-sexed girl had been born from out of frustration—that henceforth her desire must be to stretch outwards and downwards—down, to the very depths of hell 48

—to be hurt, to be mastered and subdued as a vicious mare; indeed, to be rent asunder. And whilst I harboured such thoughts, I could but face the ironical fact that she should be so strangely separated from the G.P.I.-man; for in like manner does the victim of dementia paralytica suffer frustration in his desire to subject women to his will—to bend them, to hurt them, to rend them in twain. It is solely on this account that his form of insanity at times creates in him the desire to sever his disappointing penis from his failing body; and this he sometimes manages to do.   V.   As the weeks went by, the wonder of my strange and fascinating world took possession of my soul. I became wholly and solely concerned with lunatics and lunacy; so that the agony of my incarceration was not; and loneliness and sorrow vanished for long periods. Whether or not I was a lunatic did not concern me; and I began to look back upon myself with an almost perfect detachment. For 375 days and nights, did I consider the insane and insanity at pointblank range. On every one of those days and nights, did I consider the idiosyncrasies, eccentricities, obsessions, compulsions and delusions of my companions in distress. The merry glitter, the play of facial expression, the exaltation and depression of the maniac, the suspicion, the crankiness and selfishness of the self-centred paranoiac, these things did I consider. I watched the maniac in his glory, and the melancholiac in the slough of despond, and so

acquired the knowledge that Mania is Inverted Melancholia, and Melancholia but inverted Mania, It was plain that all were victims of frustration. 49

Also, I was able to realise that although my companions were mad, they were quite unaware of the fact, for madness is as death, in that one is transferred to another life, and like death, one passes over to it without the realisation that one has crossed the border. This strange state may become more apparent and understandable when I tell you that I lived with a man who was just like you and me—except, that he believed his neck was made of glass and would break if he turned his head. Not wishing to break his neck, he never turned his head; nor was he ever known to do so; indeed, he simply could not turn his head. Thus he has lived for many years, and thus he will die. The reason is ‘insanity’; and his behaviour is due to deception— deception from morbid imagination—which is to say, he is the victim of illusions; so that all the glass-blowers and all the King’s Horses shall never dissuade him. Similarly, I knew a young woman. A few years older than Eve Lester, she was known as Joan. On a few occasions I sat with her in a secluded part of the asylum grounds; but, whereas I was, or could have been happy with Eve Lester (because of the recklessness born of my unjust confinement), I was never altogether ‘at home’ with Joan, whose close proximity I found strangely awesome and eerie. To me, the smart clothes which invariably covered her body were as a binding cloth; and her oval-shaped head but a storied urn. And yet, Joan was like other girls; indeed, she was ‘sane’ and highly intellectual. But—during my conversations with her I drew forth the ‘fact’ that she had been pestered by a strange man who persisted in following her on frequent occasions—that ultimately she had been ravished. Her body usurped and her soul pillaged. So that instead of having a meaning, life was now a burden to her. With this knowledge I was never happy in Joan’s company, because apart from the sexual frigidity which froze her soul, medical 50

evidence guaranteed her virginity. When I tell you that no amount of medical evidence, nor all the hosts of medical men shall ever dissuade her, you will perhaps understand that one passes over to insanity unaware of the passing. Nevertheless, resurrection from such death is to be deplored rather than envied; for one cannot rise again as a whole, but merely as a half-dead body; and perhaps for this reason it would be better not to be resurrected. Besides,

once a lunatic, always a lunatic—for which reason, no doubt, the lunatic so frequently returns to his asylum…   VI.   It was during the last few weeks of my confinement at Blankville Asylum, that I wrote the book CERTIFIED; and this, oblivious of my forthcoming liberation, for I was unexpectedly released from that dreadful place solely on account of the broadmindedness and kindness of the medical superintendent there, so that in writing the book I cast no stone at this great humanitarian. His memory will remain evergreen with me; indeed, as I write these words, his kindly face looks on. He frowns, and his face screws up in perplexity as he anticipates the thing I am about to do. Already I know that he is perturbed because of my book CERTIFIED. Already I read his thoughts that I have exposed his asylum to the public gaze—that I have ‘unfairly’ told of some of the happenings in that place. That he will assure me that there are worse places, I know as surely as I know of the worse places. I would ask him to understand that I expose a system, and not individuals. Let him take comfort in the knowledge that because he is a most excellent medical superintendent, and not a nurse, sister or attendant, he simply cannot be held responsible for what goes on there, 51

just as it goes on in all our mental hospitals. But he need not worry; for I (and you) exonerate him from all blame; and this, because our mental hospital accommodation is mostly primitive, and until there are more and modem buildings, with smaller wards and more staff, segregation and individual treatment will not be achieved, and his efforts will be fruitless. But although he is cramped for space, without trained psychiatric staff, and lacking everything essential to a mental hospital, he holds in one of his hands the Secret of Psychiatry; for he is kind, generous in spirit, and filled with that dignity so sadly lacking in our asylums. True, he is no Freudian. Unhappily, Psycho-analysis knows him not; so that apart from random Shock-therapy, ‘treatment’ is unknown there; and yet, I say unto you that our Psychiatrists of greater eminence, who deal in somnifane and leucotomy, are not arrayed as he; for in his other hand, he holds latitude, privileges, parole and freedom. He cannot cure the insane—for two reasons; firstly, because there is absolutely no provision for treatment of any description. Secondly, because treatment is quite out of the question

unless the patient is treated in the early stages of his illness. Fully-fledged lunacy is as a cancerous growth of long standing, in that it does not respond to treatment of any kind. Therefore, this good fellow gives them privileges, latitude and freedom. Not only ground parole, not only the right to go into the nearby village, but to the town—and beyond. For the others, he fills their stomachs, and stores them against the day of their dissolution; and what more can he do for the best? Yes, a kindly fellow. I see him now, and recall that by the time he informed me of my forthcoming liberation, my eagerness for freedom had left me; so that his information aroused in me but little interest, for, as I have said, I had lost count of time, and optimism had departed from me. I 52

dared not speculate on liberation; and anyhow, I had grown so accustomed to the place that the mad and I were friends—so much a long communion tends to make us what we are. Yes, in all truth the mad and I grew friends, so that when I departed from out of their sight for ever, I left them with my unspoken promise that I would draw your attention to their sorry plight; and as they receded from my sight, they were still singing hymns, reading the Bible, laughing, crying, shrieking, blaspheming and dreaming. With virginity still intact, Joan still clung fondly to the memory of her usurper. Eve Lester was still vicious, tempting and enticing, and still making her nightly visit to the pavilion. My old friend was still endeavouring to remove that imaginary cobweb from his grotesque face, and the katatoniac was still engaged in the performance of his stereotyped monkey motions, as, with the soft low chuckle of the hebephrenic ringing in my ears, the automatic lock snapped behind me for the last time. Life with the mad—Life in all its vivid and grim reality, and not theory, was the school in which I studied lunacy and lunatics; and it is from that school I come. Armed with grim knowledge acquired ‘first-hand,’ I venture to offer this criticism to the world of psychological medicine, and to those who govern our people; for our well-stocked asylums are nothing more than forbidding monuments to their lack of imagination. There is an abysmal ignorance of, and indeed, indifference to the immense toll exacted by mental disorder, and of its terrible pervasive and weakening influence on our national life. Mental illness is an urgent national problem, and its solution must be likewise. Our 200,000 certified, lunatics—not to mention the vast army of uncertified, are but a monument to the failure of

society to grapple with the problem; and I would here say to you, in the beautiful words 53

of a progressive psychiatrist, whose friendship I am proud to claim: — “If the life-saving properties of penicillin required for its production the expenditure of millions of pounds, who can say that a like expenditure on organised psychiatric research would not confer equivalent benefits to a large section of stricken humanity?”

Yes, indeed, who can say?   I fully realise how very easy it is for us to be destructive; so much so, that destructive criticism comes to us as easily as the Sadistic desire to play golf with a buttercup, or to swish off the head of a daisy with a walking stick. It is because I have no desire to swish off the head of Psychiatry, that I have called this book a Constructive Criticism; and this I make in the hope that my Widow’s Mite may be regarded as an earnest effort towards the solution of the world’s greatest mystery—which in truth, is no mystery at all. One thing is certain, that the custody of the lunatic must no longer be our one consideration; for whilst it is, this, together with our archaic and barracklike structures with complete lack of treatment, will merely exaggerate that fear and horror of mental disorder so firmly embedded in society’s deepest roots.   VII.   My book about Caesar is not only small, but highly controversial; for which reason perhaps, it would have been the better for the backing of my champion; and it is because of Mr. Wells’ absence that I have preceded it with the supplementary Book I. I realise of course, that no writer should expect his work 54

to produce an immediate and tangible result—that all one can hope to do is to cause men to think. This hope then, is mine; and who can tell what seeds of goodness may fall from these pages into the lap of Psychiatry, there never to die?

Also, I am aware of the danger in which I place myself by writing this criticism; for despite my strangely acquired friendship with some of our eminent psychiatrists, I cannot expect Psychiatry to welcome me. In the interim, however, I find fortitude in the knowledge that in this instance Psychiatry will not suggest that the cobbler stick to his last. And here, I should like to quote three letters—the originals of which, together with those mentioned later in this book, may be seen at any time, by any person sufficiently interested as to communicate with the author. On reading the remainder of this book the reader may find more in these letters than here meets the eye. Psychiatrist K: “I have read THAT WHICH IS CAESAR’S with deep interest. No one can fail to appreciate many of the points you put forward. I am grateful to you for sending me your books from time to time . .

  Psychiatrist L: “I cannot altogether share your views on the various methods of physical treatment. I regard Electric Convulsion Therapy selectively used and with a good technique as being one of the most considerable therapeutic advances of recent years. Insulin treatment too has a big quota of successes; and even prefrontal leucotomy has an important role to play.” (The italics are mine.)

  Psychiatrist M: “Herewith THAT WHICH IS CAESAR’S, which I much enjoyed reading. Many thanks. I know you will not expect me to agree with 55 a lot of it, as our approach to the fundamentals of Psychiatry is so vastly different; but I assure you there are cures, and many… However, though we may disagree on the means, we are at one in the ends to be achieved.”

It is therefore the more interesting to note that whilst on the one hand I am assured of ‘cures,’ on the other hand, a distinguished psychiatrist is making the following statements in the British Medical Journal (June 21st, 1947): —

“Some authorities maintain that permanent memory disturbances and intellectual impairment result from Electric Convulsion Therapy… “The operation of leucotomy makes the disturbed and noisy patient more easily managed, and the nurse’s task less irksome and difficult… (But) aggressiveness and other such traits may become more pronounced after this operation … the patient may become less self-critical and hasty-tempered, with resulting conflict with his antisocial environment… The mortality rate is low, and usually death is due to haemorrhage…”

It is of course, well known that the mortality rate attaching to leucotomy is not only disturbing, but significant; and this is expressly pointed out by the masters of the subject. Moreover, it is frequently found that death from cerebral haemorrhage occurs as long as three years after the operation, and that serious injury to the personality invariably results, even in those cases where intellectual injury does not follow. It therefore seems to me that such statements savour of the suppression of truth; and surely, the suppression of truth is the suggestion of a falsehood. False facts are highly injurious to psychological medicine; for they endure long. 56

PART II THE OUTSIDE WORLD     I.   More than five years have slipped by since I left the asylum, and yet, it remains fresh with me. It clings about my being; for although the faces of the mad grow dim, the asylum does not fade. A change however, has taken place in my outlook; for as each year has passed the impressions of horror, desolation and loneliness that once assailed me, have receded into the distance, as sign-posts of yesterday, leaving but the outstanding impression that we harbour countless thousands of lunatics in asylums which can be and must be emptied—that no person, whatever the apparent degree of his ‘madness,’ should be committed to an asylum without having first passed through one of the observation wards attached to some of our general hospitals; for not only would such individuals escape the stigma of certification, but they would receive thorough physical and mental attention, instead of being merely cast into the bottomless pit. This necessity for such clearance through an observation ward assumes great urgency when I recall to mind a man I met in Blankville Asylum. He was sane—even as you; and he told me a strange story, from which I gathered that one night, he had foolishly indulged in much too much drink; and the following morning, he found himself begging cigarettes from me—in a lunatic asylum. When I saw him, he was sober, and perfectly sane; and yet, he remained there 57

for many months, and might well have been there for life! Daily, he came to me—imploring me to rescue him from his appalling fate; and I, a certified lunatic! The position worried me as much as it did him. I saw the absurdity of it, the terrible tragedy of it, the horror of a diabolical machine that can produce such a state—such an unbelievable state in the 1942nd year of Progress. Being on full parole, I was fortunate enough to enlist the aid of a certain vicar—who proved to be a very good man; so that finally, somebody was found who volunteered to employ this man, and to accept responsibility for him; for it is the unwritten law that unless some responsible person collects

the patient and accepts responsibility for him, he remains a certified lunatic and cannot be liberated. That night, as I lay falling asleep, my old friend and I cracked our little joke together. Yes, the devil sat upon my pillow, and sneered. “He saves others—Himself he cannot save!” That’s what he said; but I did not worry—if only because of the thought that it might have been you, your father, your brother or your son. But this incarceration of a sane man was not the only amazing feature of that asylum ward; for on looking around it, I was astonished to find that it housed epilepsy, paranoia, G.P.I., T.B., mania, melancholia, post encephalitis lethargica, a mongol, an epileptic child, two cases of delirium tremens, simple and silent ones, violent and noisy ones, highly suicidal patients, together with dementia praecox and senility. Now, surely, one simply cannot imagine any curative possibilities in such surroundings—even supposing that treatment were available. One had a high temperature, another—on the last lap, had an oxygen apparatus at his bedside, and another was being shaved by an attendant who sat astride the patient’s tummy, whilst two nurses sat upon the patient’s shoulders; and whilst a maniac stamped and 58

raved in the centre of the ward, another attendant came hurrying in with the latest news. “Christ!” he said, ‘Tobruk’s fallen—loss of 25,000 men, and bloody good men at that!” It was then that I grimly realised that the error of judgment of those who govern us is no less than that found in all lunatics; for these 25,000 ‘bloody good men’ had but paid forfeit to the wrong conception of Right and Progress. So that as I sat gazing at the maniac banging and shouting in the middle of the ward, I could but think that the same egotism which had sealed his consciousness from all good influence, had also sealed ours against the knowledge that that which is fundamentally wrong can never be right. There was absolutely no treatment whatever in the main block; and in the hospital block—where I spent my stay, there was really nothing either. For many years, they had played with Cardiazol Shock-therapy; and this they recently abandoned in favour of the Solus Bini apparatus which, from my experience, and from my special observation, seemed to do very much more harm than good. There are but few patients ‘suitable’ for shock treatment; so that a large number of those who, through ignorance, were subjected to its diabolical torture, worsened immediately and permanently. As for the ‘suitable’ few, it merely livened them for a day or so, after which they slipped

back deeper into the mire of depression. And because of these things, the flame of enthusiasm which at first lighted up the Solus Bini operators had burned low before I left the asylum—so low indeed, that the apparatus was seldom used, and together with the patients, seemed in danger of being forgotten by those who knew them best. Shock treatment is based upon the experience that shocks of any type have been known to temporarily improve the condition of the mentally ill— especially those suffering from 59

deep depression; and such shocks may be found in ordinary surgical operations, broken bones, asphyxiation, intoxication and so on. “Nevertheless,” says one man, “the old custom of chains and flogging for patients with mental disorder had not been revived because of the obviously anticipated revolt of the civic conscience.” Surely, this good man need not stop at the old custom of chains and flogging, but should continue with the more recent custom of Shock Treatment; for Shock Therapy is based upon the theory that only by damaging the brain can any alteration be effected in the psychotic states. Shock Therapy, like Leucotomy, damages the brain, and is frequently followed by a terrible aftermath which includes fits and tuberculosis. So horrible, grotesque and diabolical is this treatment when given by the unskilled, that rather than again undergo its tortures, six patients in one series alone, committed suicide. Also, relapses are ‘too numerous for comfort.’ In ‘my’ asylum—and in many others, all ‘technique’ is lacking, and the treatment is given at random by unskilled and inexperienced operators. Despite this, indeed, because of this, I feel in honour bound to say that I do know a few hospitals where this treatment is applied most skilfully, by operators of long experience; in such hospitals the effect on the whole is excellent. And whilst on this subject of shock treatment, I feel that this perhaps is the appropriate place for me to tell you that I have before me a copy of a Report made by two Commissioners of the Board of Control, on their visit to a wellknown and highly progressive mental hospital. The Report, which is dated 1945, reads, “Electric Convulsion Therapy is given to a number of cases (at this hospital). The best results are said to be obtained amongst those suffering from depression.” And whilst one wonders exactly what other purpose the Commissioners consider Shock Therapy would serve (for obviously, its sole purpose is the dispersal of 60

depression in certain types of dementia praecox and melancholia), it seems to me to be more to the point for us to consider what useful purpose our Commissioners serve.   I would much like to repeat here the description of exactly how the visit of our Commissioners is conducted at our asylums, but as I have done so elsewhere, I must refrain. I will only add that if a record of drugs supplied to our institutions was compared with the drugs on hand, it would provide ample proof of the indiscriminate drugging of our insane; and if more ‘authentic’ evidence is desired, how very easy for a journalist to enter an asylum as a voluntary patient, and record these truths in his own language.   It was with these things in my mind, that immediately after my liberation, I sent forth into the sane world two copies of my book—with the object of placing these dark truths under the noses of our foremost psychiatrists, in the hope that their consciences would smite them. Also, I would tell them that the time was at hand when Certification must be dispensed with altogether. We do not need to be ‘certified’ physically ill, and we must not be certified mentally ill; for the stigma of certification at once arouses fear in the patient, fear in the relatives and fear in the public. Clearly the time has come for certification to be abolished in this civilised country, and admission made on a voluntary basis; or, if compulsion should be necessary, it must be by compulsion and not certification; for certification not only deprives one of his right to the writ of habeas corpus, but deprives him of everything that ever was his. To be compulsorily placed in an asylum one would still remain a man, whereas, to be certified one at once reaches the great and awful meridian of Nothingness, which is only equalled by death. 61

II.   Now, it has been said, that so rapid is the growth of mental disorder throughout the world, that fifty years hence, one half of its population will be fully engaged in nursing the other half; and although there is a good deal of truth in this, it certainly is exaggerated; or if otherwise, I am sufficiently optimistic to believe that if we will only cease evading the issue and face the facts, not only can we call a halt to this rapid march, but we can turn it about to our advantage. However, it might be as well to see what others have to say about the existing state of things.

Major-General Hershey, the United States Conscription Director, has stated that mentally disordered people are one of the greatest threats to the future of the United States—that nearly one out of every three men rejected for the United States military service in the World War was turned down for mental diseases and neurological causes—that the treatment and cure of neuropsychiatric cases ranks with the most pressing problems facing the United States—that 1,767,000 men out of 4,800,000 rejected for military service were suffering from mental diseases or neurological causes; and that no other single factor accounted for more than 350,000 rejections. Also, mental disorders were blamed by Dr. Allan Challmer, of the neuro-psychiatric division of the United States Army, for the greatest loss of manpower, absence from duty and sickness. Both Hershey and Challmer were giving evidence in support of a U.S. Government Bill to establish a £1,125,000 National Neuro-psychiatric Institute. In our own country, we find that in the House of Commons, a debate is instituted regarding conditions in our own mental hospitals. Allegations are made with regard to the existing archaic system. Protests are lodged against the state of things in this year of Progress. We are informed, 62

that according to General Practitioners, 30% to 50% of their practice is concerned with people suffering from functional nervous disorders—that in our general hospitals 17% of those referred to general out-patients’ departments suffer from psychological illness without serious organic component.   There are complaints of the remoteness of our high-walled asylums—of their bleakness and of their locked doors. Complaints that patients are not classified according to their type of mental disorder, but as a rule, by their degree of physical infirmity, by the degree of noise, and by habits—whether clean, dirty, destructive or violent—that epileptics and potential suicides are scattered throughout the hospitals.   Meanwhile, from our progressively-minded psychiatrists (many of whom are my friends) a cry for help ascends. Unfortunately, this cry of “To arms, or perish,” has long since become the cry of “Wolf! Wolf!!” So that all the best in the realm of Psychiatry cry out in vain, for new hospitals to be built—for these to be built near our Universities and Medical Schools—for medical superintendents to be teaching members of such Universities or Schools—for

a Chair of Psychiatry to be established at all our Universities. “What we want,” they cry, “is smaller wards, more nursing staff and more trained psychiatric staff!” It is a cry for earnest and immediate attention to this grave and evasive problem.   How can we ever hope to remedy this evil if we will not face truth? Alas, we cannot; for the pity of it is, that where the reluctance is greatest to face an illusion, that illusion is also the greatest, and becomes still greater in its security. It is for this reason that I would like to suggest what is wrong, and why it is wrong; and having over a period of five years been in close contact with many of our distinguished psychiatrists—and having acquired ‘firsthand’ experience with the very mad themselves, I feel I may justly claim to be 63

in a position to make a helpful suggestion regarding this dark, dreadful and neglected subject.   III.   It is to justify my statements that I have told you that a few years ago, I was certified insane and consigned to one of our primitive asylums. This fact, together with the following representative selection of some of the wellknown individuals who honoured me by reading the typescript of CERTIFIED—which I circulated privately amongst them before seeking publication, is made known solely in the hope that I may hold your interest till the end of this story: —

DR. E. B. STRAUSS, Physician for Psychological Medicine, at St. Bartholomew’s Hospital, and late Examiner in Psychological Medicine to the Royal College of Physicians, etc. MISS MARGERY S. FRY. SIR HECTOR HETHERINGTON, Principal of Glasgow University. SIR D. K. HENDERSON, Lecturer in Psychiatry at Edinburgh University, and Medical Superintendent of Edinburgh Royal Mental Hospital. ANN TEMPLE, of the “Daily Mail.” Dr. T. J. HENNELLY, Lecturer in Psychological Medicine, to the Welsh National School of Medicine, and Medical Superintendent of Cardiff City Mental Hospital. “THE SUNDAY PICTORIAL.” DR. ANGUS MACNIVEN, Lecturer in Psychological 64 Medicine, at Glasgow University, and Medical Superintendent of Glasgow Royal Mental Hospital. The Late DR. J. G. PORTER-PHILLIPS, Medical Superintendent of Bethlem Royal Hospital, and Examiner in Psychological Medicine to the University of London. COLLIE KNOX, of the “Daily Mail.” The Late DR. R. D. GILLESPIE, Lecturer in Psychological Medicine at Guy’s Hospital, and Examiner in Psychological Medicine to the Royal College. WELL-KNOWN COLUMNISTS of the Daily Press. THE CHURCH. MEMBERS OF PARLIAMENT, and some members of the world of Medicine proper.

Now, whilst my two copies travelled throughout the country—as Ravens in search of testimony, I followed in their wake. Armed with knowledge acquired first-hand, I went forth into the world to study the ways of psychiatrists and psychiatry’. I wrote to, and interviewed many of these distinguished men; and as a lunatic (for once a lunatic, always a lunatic), I was their guest. With the reek of Lunacy strong upon me, I dined with them; and some, when they gazed upon me, clothed, and in my right mind, were afraid. They told me that sorrow encompassed them round about—that the way of Psychiatry was a very hard way. Others said, “Brother, put off your armour, and throw away your sword, for we are with you in your effort. Long

have we striven in vain. We have groaned under the yoke of the State which compels us to render to it the things which are Medicine’s; and as the Ethics of Medicine deny us the sword, thou shalt be our champion. Come, sup at our table; for we are with you to the end!” And soon, I found they were right— that there was no need for me to go into the attack against them; 65

and this, the following letter from an Examiner in Psychological Medicine to the Royal College of Physicians, and whose name is known throughout the world, will surely make clear: “I took your book ”Certified” away with me for Whitsun, so as to have an opportunity of reading it at leisure. As you can imagine, it did not give me a “comfortable” Whitsun; but then, it would have failed desperately in its object if it had; and one would have to be unbelievably complacent not to be very’ moved by it. I know from my own observation, and from accounts from patients that your description of Mental Hospital conditions is a true and unsensational one. I am afraid that it will be a very long time before the mentally-sick patient, who happens to be poor in this world’s goods as well, receives even elementary justice. The world has got itself into such a desperate state of mess and muddle, that it cannot be expected to realise that the treatment of the potentially and actively insane is an important and “priority” problem (to use the current jargon). It still regards a hundred-and-one other questions of greater urgency. But something will come of it all. It took centuries and a major war to abolish slavery, although slavery had weighed heavily on the public conscience since the Christian ethic began to make itself felt. I think it is important that your book should be published and not merely circulated privately amongst a few cognoscenti.”

Another of my readers seemed to hail me as the Messiah of the world of Psychological Medicine, and appeared to 66

believe I was possessed of hypnotic and psycho-analytic powers; but as I had so much else to do, I did not attempt to disillusion him. “Your book is what society is waiting for!” he said. Another stated that if I could succeed with my book, I would have carried out a great mission in life, and so on, and so forth; and all this from the world of Psychological Medicine! But when an eminent

psychiatrist said that the book was a remarkable achievement, from the point of view of the remarkable knowledge I had acquired of the subject, I removed the ‘technical’ matter from its pages; for it was not my desire to exhibit a ‘remarkable’ knowledge, but to tell psychiatry and society the plain truth concerning our lunatics and our asylums.   IV.   The first reader (the Professor David, referred to in CERTIFIED), sent me the following letter: — “I have read your book with great interest. It is most necessary, and what the world is waiting for—so get it published. Dr. —— has also read it, and fully agrees. There is so much I want to say about this book, that I would like to know when you will be in town, when we could perhaps arrange a little talk.”

Therefore, with the cries of the mad still ringing in my ears, I set out on a two-hundred-miles journey, to see this man, whom I shall call, PSYCHIATRIST A., Lecturer in Psychological Medicine, and Superintendent of a Mental Hospital.

“You have accomplished much,” he said. “The world 67

is waiting for this book—so get it published—” He was rather excited, and most enthusiastic; and during my four-day stay with him, I could see that the light burned brightly within him, as an electric lamp set in a box of alabaster. I found him to be a man of untiring effort and infinite patience. A man of skill, and just a little eccentric, I thought; for one day, he took me over his hospital, where I walked the wards with him. As I walked those wards, my mind was absent from the glory of the achievement; for it was centred upon my own entry into the Admission Ward at Blankville Asylum. Whilst he chatted to me, I heard him not; for all I could hear was the far-distant voice of a kindly attendant at my asylum, telling me, “This is not the place for your kind—but I suppose you’ll get used to it! ” I saw him hand me this strange consolation together with a night-shirt minus buttons, a pair of shoddy slippers, both for the left foot, and one minus a sole. So garbed, I saw him lead me away to that

Admission Ward. Again, I saw myself depart from this big selfish outside world, to gaze in astonishment upon the occupants of my new world who were only at first glance men. Once again, I smelled the strong aroma of urine —the revolting stench of faeces … But enough—the Professor was speaking to me … Yes, yes—I must control my mind—must pay attention to him, or he would wonder at my behaviour… We were now standing in the Lecture Room of the hospital. On the blackboard were the words: — “Korsakow’s Syndrone” “Drug Addiction” “Paraldehyde” Across the passage, and much too near the Lecture Room, the mad were sitting up in their beds. My mind was running fast—Had I really left Blankville Asylum? Was this a dream, or an illusion? 68

… “I’d like Dr. Brown and Sister Russell to meet you,” the Professor was saying; and with that he left me—to return with a junior psychiatrist and a senior sister. Immediately after this introduction, this strange but able disciple of Freud removed his hat from the table, and, addressing the doctor and the sister, said, “Mr. Woodley will address you for a short time—I’ll be back in twenty minutes!” And so saying, he put on his hat, and departed. Steeped deep in the stigma of Lunacy, I stood there for thirty minutes, expounding upon Lunacy and Lunatics. And that evening, as I dined with the Professor and some others of the world of Psychiatry, I sipped my sherry most thoughtfully; for I was thinking that but a few weeks earlier I had been slipping up on the filth of a filthy bathroom floor—that I had been using a lavatory without a seat, in a place where toilet paper is unknown—that I had been deafened by shrieks, curses and blasphemies; and because of this, I knew there was something far amiss with Psychiatry as it stands to-day. Nevertheless, the professor is a great man. Yes, indeed, I see him now—as I walked reverently backward from his greatness. We were standing on the hospital steps, waving each other good-bye. “Keep in touch,” he said—“Keep in touch—” And a moment later the big sane world had swallowed him—and me; and we never met again. The fact that we never met again is of no

consequence, for I carry from him to you some highly important information. The professor specially asked me to tell society this amazing fact: — In his town, was a girl suffering from paralysis of the right leg. She was the daughter of very wealthy parents who for some time had been paying large fees to quite an army of Specialists; for they seemed to possess unto themselves, a consulting physician, consulting surgeon, consulting 69

ophthalmologist and a consulting osteopath. Now, none of these consultants was able to consider any other than ‘physical’ causes for the paralysis of that leg—and this, presumably, because they did not deal in mental diseases; and so the consultations went on and on —the payment of the fees went on and on—and the paralysis went on and on. And then, one day, a relative of this girl—in the form of a young medical student who was studying under Professor David, brought the girl before David, who at once recognised the trouble as ‘mental.’ Need I tell you that it was Conversion Hysteria? But the professor was powerless in face of the Etiquette of Medicine. The girl was not his patient, and the interview was made in secret. Such was the state in 1943, and such it remains, despite the advances in the understanding of this subject which have been obvious in the United States for seven years. The cause is blind fear; and the remedy very simple—in this instance, the removal, of FEAR—of the fear that not only strangles society, but many of its medical men. The removal of such fear however, is no easy matter; for wealthy parents do not readily listen to suggestions of ‘mental’ causes—even to save their loved ones. Such a thought is too horrid to contemplate; for is not ‘mental’ synonymous with ‘lunacy’? and are not lunatics madmen?   V.   The letters I have received in connection with my book make a bulky volume; so that here, I would quote from but few; and this solely for the purpose of making clear the type of thought prevailing in the world of Psychological Medicine to-day: — 70

PSYCHIATRIST B. M.D., F.R.C.P., D.P.M., F.R.S., Lecturer in Psychiatry, and Superintendent of a Mental Hospital.

“It was most kind of you to send me the typescript of your book CERTIFIED. I have read your book with interest; but I confess I am disturbed by the tragic and lurid descriptions which you give of life in a mental hospital as it is constituted to-day. I recognise and appreciate that conditions vary and differ from one mental hospital to another, and that some places are managed and controlled better than others, and that where modem conditions prevail people are not subject to be mixed in with others whose condition gives rise to concern and anxiety. It is of course, difficult from your typescript to appreciate how and why it was that you yourself came to be in a mental hospital; but I realise that the pictures which you draw are real pictures which, unfortunately, do make mental hospital conditions extremely difficult for those who are sensitive and appreciative of the conditions under which they are living. There are, therefore, many things in your book which are quite true, which are very unfortunate, which are to be deplored, and which everybody would only be too glad to see on a better basis.” PSYCHIATRIST C. (The late Dr. J. G. Porter-Phillips), M.D., F.R.C.P., F.R.S., Lecturer in Psychological Medicine, and Superintendent of a Mental Hospital.

“I must thank you most warmly for presenting me with such an illuminating and human document. One 71

must regard it as an epic in the world of Psychological Medicine. You have my congratulation on your achievement, which must have been the outcome of much distress and toil; and if the benefit hoped for can be attained, I am sure you will have carried out a great mission in life. I can assure you that I shall treasure this book as one of my most valued possessions; nor can I conceive such a human document failing in its mission.”

─────────────── PSYCHIATRIST D.M.D., F.R.C.P., Lecturer in Psychological Medicine, and Superintendent of a Mental Hospital. “I was pleased to read the copies of the letters which you have received as more or less Press Notices of your magnum opus. I can only repeat what I have said before, that you have my very best wishes, and I hope your book will be a source of inspiration in all directions. I am still looking forward to the time when I shall have the pleasure of meeting you personally.” PSYCHIATRIST E. (The late Dr. R. D. Gillespie), M.D., F.R.C.P., D.P.M., F.R.S., etc., Examiner in Psychological Medicine to the Royal College, and to the University of London. Corresponding Member of the American Psychiatric Association. ───────────────

“ ‘Certified’ is a moving piece of literature. How much of what you describe is avoidable, depends on a continuance and intensification of the improvements in mental hospital conditions that really had been going on before the war. But there is still much to be done. So much will depend also on economic 72

factors as well as on the progressive state of mind of administrators.” ─────────────── PSYCHIATRIST F. M.B., Ch.B., M.R.C.P., D.P.M., F.R.S., Lecturer in Psychological Medicine, and Superintendent of a Mental Hospital.

“I have read ‘Certified’ with great interest, and find much in it with which I am in agreement. You do not say whether you propose publishing this book. I hope this is not your intention, because I feel that publication would do more harm than good. Indeed, I think it would to some extent, defeat the aim you had in writing it; namely, to give a true picture of mental hospital conditions, and to initiate and encourage improvements and reforms in the treatment of mental illness. I can assure you that all reputable psychiatrists are alive to the need for improving the existing conditions, and of the need for the provision of

additional facilities for the treatment of mental illness; and at the present time, Mental Specialists are busily engaged in drawing up plans for a Comprehensive Mental Health Service. If these plans are adopted, as I think they will be, the result will be a very great improvement in the existing conditions, and many of the criticisms you make in your book will receive attention. It is not just a question of whether your account of these conditions presents a true picture. The important thing is the effect it would have on the public. It is very difficult indeed to give a true picture of the conditions in a mental hospital, and I certainly believe it is impossible to give a true picture by writing about them as you have done. I do not suggest for a moment that you have 73

falsified anything; but the dramatic atmosphere which pervades much of what you have written, although legitimate, and even perhaps desirable from a literary and artistic point of view, gives the reader a false impression of the true state of affairs. I do not know whether you will agree with me in this, but I do not think that as a rule medical matters lend themselves to what one might call artistic treatment. If one is to get a true picture, the writing must be entirely factual, bald and unemotional; and then of course, it is apt to be dull. However, I appreciate the good points in your book, and I think that in many ways it is a remarkable achievement, both from the point of view of the remarkable knowledge you have acquired of the subject, and in the humane and enlightened attitude with which you have approached the subject. I am very glad to have had an opportunity of reading this book. Many of your criticisms arc very well founded; and I assure you that efforts are being made to rectify the defects in our Mental Health Services with which you deal.” ─────────────── PSYCHIATRIST G. M.D., F.R.C.P., F.R.S., Lecturer in Psychiatry, and Superintendent of a Mental Hospital.

“I admit the cogency of many of the points which you raise, but I do not consider a book of this sort would serve the purpose which you have at heart; for it draws a picture and expresses views that would merely distress rather

than help the lay public. People have a great fear of mental illness, and of everything associated therewith. Your book would exaggerate that fear.” ─────────────── 74

 

PSYCHIATRIST H. M.D., D.P.M., Lecturer in Psychological Medicine, and Superintendent of a Mental Hospital. “Controversial or not, if ‘Certified’ helps to improve the Psychiatric Services of the country, it will have served a purpose.” ─────────────── Well-known DAILY PAPER. “I found ‘Certified’ to be very interesting and moving, and very sad indeed; and from your descriptions of the life and the ways of that community in which you found yourself, there is a great wrong crying to be put right.”

Gentlemen of Psychiatry, you tell me that medical matters do not lend themselves to artistic treatment—that the statements must be factual, bald and unemotional. This is no artistic treatment gentlemen, but the factual and bald truth from a layman. And if the people have a great fear of mental illness, it is because you have made such a mystery of mental illness. Secrecy, and the fears that secrecy breeds are your deadly enemies. Gentlemen of Psychiatry, when you tell me that you are disturbed by my tragic and lurid descriptions, do you not realise that war is lurid and tragic—that wars are fought that others might live in peace and safety? It is to save life that wars are fought; and it was with the hope of saving life that I wrote “Certified.”   VI.   Time passed by… My book was still circulating in the realm of Psychological Medicine. Meanwhile, nobody decided to come forward and again certify me. Indeed, I 75

lived my life in the peculiar knowledge that although the insane in our asylums have been certified insane, those outside the asylums have not yet been certified sane; and because of this, I rejoice in the knowledge that I at least, have been certified sane. But although time passes by, the asylum and all it means stands out vividly before me. It always will; for as I read the newspapers of the sane world, and read therein the tales of Belsen, Buchenwald, Sadism and human butchery, my memory continued to hand me the awful picture of a young mental patient being kicked to death—so that his bowels gushed out of his anus. On reading

the Twenty-fifth Annual Report of the Board of Control, I felt quite at home when I read of an Enquiry which had been held by the Commissioners, as to the cause of the death of a patient. The Commissioners were unable to determine the precise (sic!) manner in which the fracture of the sternum and ribs occurred. But they found that in view of the length and severity of the struggle in which two nurses and the deceased were concerned, that the night nurse should have communicated with a doctor forthwith, and asked for instructions. Truly, morphia is much kinder than wrestling matches. Morphia is the antithesis of Sadism. And then came one of Summer’s best days. Green trees were swaying softly in the breeze, so that my mind went out to Richard Tauber’s “Trees.” The garden was abloom with roses and bees were on the wing. Summer sunshine filled the air as I listened on my long distance communications receiver to the direct transmission of News from New York. Once again, I was in charted waters; for the Announcer was telling the world that an inmate of an American asylum had been kicked to death, and that an Enquiry’ was to be held. This I heard at ten o’clock (B.S.T.) on the morning of July the twentyfirst, 1945… At the same time, on the same day. 76

in the same year, the world was talking loudly of Sadism, of human butchery and of places hitherto unheard of, but now well-known throughout the whole world as Belsen and Buchenwald. Meanwhile, I was experiencing difficulty in finding a publisher who would accept my book. Most of them seemed pleased to agree with my sentiments, but at the same time to deplore the great scarcity of paper occasioned by the war. One thoughtful publisher suggested that I should re-write my book in the form of a novel; for a narrative written in the third person cannot be held to bear any relationship to Truth; and would so remove responsibility from the publisher and me. Another wrote, “You will understand there are certain difficulties attached to telling the truth in this ‘free’ country; and you will no doubt realise that it is a serious matter to publish a work which attacks so strongly entrenched a body as the medical profession.” But I digress; let me continue with my criticism…   VII.   Now, as there is nothing mysterious regarding a compound fracture, tuberculosis, appendicitis and indigestion, neither is there any mystery

attaching to mental illness—other than that attached to its cause; for mental disorder is merely a state of thought and behaviour not in agreement with the standards of ‘normality’ set up and conformed to by the great majority; so that its outstanding characteristic is the entertainment of ideas, washes and beliefs not entertained in connection with similar subjects by the great majority. Because of this, it is at once evident that by placing a nurse in an asylum ward, the inmates’ and not the nurse’s thought and behaviour will be ‘normal’ thought and behaviour. 77

Likewise, the ‘strange’ rites and ‘queer’ behaviour of the tribesmen of Central Africa appear to us as madness; and to the members of such tribes, our quiet attitude towards life makes us lunatics in their sight. In short then, the whole thing is relative to time and place—to the ideas and social customs prevailing at that time and place. It is thus clear that madness is Universal, and that it is merely a matter of degree that places us either on that side or this side of an asylum door. Surely, in the days of the Ancient Britons, our present-day behaviour would have been looked upon as insanity; and who knows that a thousand years hence it will not still be regarded as insanity? Indeed, it is certain that it will be; for when one considers the World Wars and the Atom Bomb, one must realise to the full that we are madder than the maddest Hatter. War is the essence of insanity—in that it changes nothing except the faces of those who sway the Rod of Empire. True, it makes the rich poor, and the poor temporarily rich; apart from this, humanity remains unchanged. Therefore, with the realisation that there is nothing mysterious about mental disorder, let us not attempt to hush it up. Let us not try to bury it; and let no man deceive himself into thinking or saying that the people have a great fear of mental illness, and of everything associated therewith—that we should keep it dark, lest we exaggerate that fear, and so distress the people. Better for a man to be dumb for ever than render such terrible disservice to Psychiatry. Let us shout, and let the people know.   VIII.   Through error, ignorance and prejudice it has become an accepted fact that Insanity and all things associated with it, 78

should be confined to those in the realm of Psychological Medicine, and that the lay public, which in this instance includes the world of Medicine proper, should avoid this subject as the plague. Consequently, when one hears that Mrs. Smith has “gone off her head,” or that Mr. Brown has “gone out of his mind,” and been taken to the asylum, one is curiously intrigued and nervously excited. The general practitioner who is called upon to certify such a person, is also deeply excited by the occasion; for it is intensely exciting for him to do this thing. A compound fracture, or appendicitis, yes; but that one should “go off one’s head,” or “out of one’s mind,” is quite another matter. Such an attitude can only give to the public the impression that an asylum is a place where raving madmen are kept under lock and key—to prevent them running amok, and smashing things. We therefore conclude an asylum to be a place where homicidal-maniacs are kept in chains. We do not see that it cannot house homicidal-maniacs, for the reason that such exist only in the minds of fiction writers; indeed, any other lunatic if you wish, except the maniac. We do not see that Lunacy is a personality, and not a disease; that it is purely a difference of ideas and beliefs—a psychic affair pertaining to the soul—which is the mind—which is the individual minus his flesh, bone and muscle. It seems too, that an erroneous belief prevails that a person becoming insane must of necessity be placed in an asylum. This is-not so; for apart from those who prove a nuisance or a danger to the general public, there is no law making it compulsory for the insane to be certified and confined. The main reason why people are placed in asylums, is because their relatives will not, or cannot be bothered by looking after them at home. The people do not realise that insanity is no respecter of persons—that it lighteth where it listeth, on rich and poor, on king and peasant, and on hovel 79

and palace. They do not appreciate that mental disorder is never of mushroom growth, but that it is either pre-disposed, or caused by injury or disease. The worry or anxiety which is looked upon as the cause of the disease is merely one of its early symptoms; for just as the dipsomaniac drinks because of his insanity, and the kleptomaniac steals because of her insanity, so is the irritability and impairment of reasoning power which occur in the early stages of mental disorder, the effect and not the cause. We must learn to appreciate that the dipsomaniac is not insane because of his drinking bouts; he drinks like this because of his mental disorder. Likewise, the kleptomaniac is not a kleptomaniac because of her morbid impulse to steal for unknown reasons,

but because her form of mental disorder causes her to steal. There is no question of “unknown reasons.” The reason is Insanity. And even though some forms of insanity are hereditary, all that is inherited is a pre-disposition towards the disease, and not the disease itself. The person concerned may be apparently normal for many years, and then break down from slight causes—causes insufficient to produce a break down in a person of sound ancestry. And yet, such a person with a pre-disposition to mental illness may remain quite healthy until his load of life becomes too great to bear. Indeed, such a person may never break down at all—if the stresses of life never reach his breaking point; and because of this, when we talk of the victims of the 1914-1918 War still confined within our asylums, and of the many more who have since joined them on account of the Second World War, we must keep in mind that the tendency was already there, and that the war was only the match that lighted the fuse. But one aspect of mental disorder is the fact that during wars the admissions to asylums tend to decrease. It is when the war is over that the admissions greatly increase; and this. 80

because during the hustle and bustle of war, the neurotics have been too busily engaged to confine their thoughts entirely to themselves, whilst, when it is all over, they are again free to consider themselves leisurely and ad lib; a fact which seems to bear out my Utopian suggestion of one psychiatrist to one patient; for neurosis is the state of being at war with one’s self, so that when others are at war, the neurotic returns to peace. At war, the neurotic forfeits his neurosis, as he does whilst in the company of a psychiatrist; and to stop the war, or remove the psychiatrist, leaves the neurotic to continue the war against himself; for clearly, there is nothing else for him to do. It is entirely a matter of sustaining his interest in things other than himself, and this can only be accomplished—apart from war or other exciting causes by a companionpsychiatrist; for the body of the neurotic can be likened unto the Lists where Knights do combat—where Consciousness meets Unconsciousness in grim encounter. Simultaneously, they throw in their gloves—they attack—but to no purpose, for they are both pessimists. On the other hand of course, in some cases of heredity the weakness is apparent from birth, and presumably the brain was defective from birth. Also, it is frequently found that the disease misses a generation or two, and then reappears. When there is much insanity in a family—as there frequently is, it is found that the disease tends to commence at an earlier stage in the younger

generation, and the type of illness tends to become worse; for instability is like an avalanche, in that it gathers and increases. Hence, it is well said that fifty years hence one half of the world will be engaged in nursing the other half. For example, a man who has an attack of mania in adult life,’ may have children who develop dementia praecox in adolescence; and their children in turn, would probably be imbeciles. If there be no trace of mental instability in such 81

parents, an investigation of the aunts, uncles and grand-parents will in all probability reveal the source; for source there must be. And in a like manner the marriage of cousins and other closely related persons is obviously liable to lead to mental disorder in their children; for it follows the original track of incest—that first of Taboos. And anyhow, is it not clear that the more closely people are related, the more likely they are to resemble each other—both in the strong and the weak points of their character? If then, there is any tendency to mental instability in a family, there will be more in the offspring, for unsoundness of mind multiplies, extends, expands and increases, and it has never been known in the history of mankind for it to decrease or to temporarily subside. Because of its cause, it must increase and increase.   IX.   Now, in our journey through life, we frequently come across those whose conduct is not in accordance with the standards we have set up as indicating a correct way of living, and such departures from the normal we recognise in some cases as being due to the inability of the offender to understand what is required of him, because his mind is abnormal—which is to say, he is exactly the same as his fellow-men, except that his ideas, wishes and beliefs are not adopted by the great majority. Such people are divided into two groups—a distinction being made between those in whom the abnormality dates back to the earliest years, and those in whom the abnormality has occurred after development has proceeded sufficiently long to show that the person affected was normal to start with. This latter group is that of the Insane, and the former group is known as the Mentally Defective. In short, the insane person is bom rich with full brain capacity, and becomes poor owing to disease or 82

pre-disposition in later life, whereas the mental defective has been born poor, and his brain never develops normally. These mental defectives are divided into four main groups—Idiots, Imbeciles, Feeble-minded and Moral Defectives. The idiots and imbeciles are not subject to treatment or hope of any description; and although by treatment and close attention the feeble-minded may derive some little benefit, it is with the moral defective we should concern ourselves; for he is the off-spring of Instability—so that when we can find a ‘cure’ for Insanity, we shall also have a cure for Moral Defectiveness. What are we doing towards finding this cure? Nothing! for the truth is that little or nothing can be done by our present system; and it is no exaggeration to say that since Christ entered the country of the Gadarenes, and encountered there the man whose name was Legion, nothing whatever has been done— unless it be that instead of the Chains that could not hold Legion, we now supply a padded room and some drugs. Alas, the evil spirits remain, and we are unable to cast them out—neither into swine nor elsewhere; for our present system at once checkmates Psychiatry. And so shall things remain until we decide to scatter psychiatric clinics throughout our land. We must talk less about Freud, and follow him post haste; for one thing at least is clear—that children are the problem and responsibility of our generation. Sore has been my heart as I have stood at the bed of a child in the asylum; but who cares? Who cares, indeed! Why, whilst I was in that asylum a child was born in the female ward there! Ladies and gentlemen, please try to imagine what this means. An innocent child born in a lunatic asylum. What a tremendous calamity for that child— which might have been YOU. Think of the Birth Certificate, and then, with me, wonder when those responsible for such crimes will be brought to book. Obviously, no pregnant woman should be remitted to an asylum. Such should be sent to one of the observation 83

wards attached to some of our general hospitals; and what a difference that would make in the years to come, not only to the child’s reputation, but to its mind. Woe unto you who remit pregnant women to our asylums. Woe, I say…   X.  

Now, when any man, and more so, a layman, dares to criticise so strongly entrenched a body as the medical profession—and indeed, that more strongly entrenched body known as the State, that man must expect to be ignored by the State, and informed by the medical profession that his criticisms are “emotionally determined” and “not based on factual knowledge.” Because this is so, I am happy, nay proud, to tell you that my criticisms which may or may not be regarded as “emotionally determined,” are not only entirely based on “factual knowledge,” but have the support of a number of our most distinguished psychiatrists—three of whom are Examiners in Psychological Medicine to the Royal College of Physicians. These criticisms then, are made after a year’s close-up of Lunacy and Lunatics, and four years close contact with Psychological Medicine during which I have especially observed the results of continuous narcosis induced by somnifane. and the practice and results of Leucotomy. The knowledge thus acquired leave not the slightest doubt in my mind—nor in the mind of any unprejudiced person, that we must seek elsewhere for the solution. It seems at once obvious to me, who am naturally affected by the extent to which Psychiatry has been frustrated in its efforts to solve this problem, that we must get straight to the root of this thing. Therefore, we must begin by digesting the fact that whilst Science has been trying to unravel the mysteries of mind and body, bodily disease has yielded up nearly all its secrets; that 84

although throughout this same period great hope has been entertained that the post mortem room would succeed in finding the solution of the problem of insanity, its cause, its treatment and perhaps its prevention, nothing whatever has come to light; so that until the introduction of somnifane and leucotomy, this hope had been abandoned. During forty years, and despite intensive laboratory work, carried out with infinite patience by skilled observers, nothing of the slightest value has ever been produced. Despite the most minute studies which have been made in laboratories equipped at great expense, the total results yielded may fully and truthfully be described by the word, NIL. So that when we realise the wonderful progress made in the world of Medicine proper, and then consider the defeat of the world of Psychological Medicine, we ought to look closely at our subject. If we do this, we shall find that during the course of evolution each species has evolved along its own particular lines—the character of its development being determined by its particular surroundings throughout its history, and perhaps more so, upon the way it has been able to adapt itself to

these surroundings. Further, we find that conditions favourable to life on the surface of the earth have varied from time to time, and that many forms of life have died out, or have been unable to find food suitable for their existence. Others have perished from hostile causes. Some forms however, by the possession of greater adaptability, have managed to persist by changing physically and mentally with the changing conditions—as we must surely now change in our attitude towards mental disorder. Nevertheless, whilst recognising and appreciating that the course of evolution is deadly slow, and therefore the change from one generation to another almost imperceptible, we must make no doubt about the fact that in each successive generation of a species, like begets like. In this manner do 85

we inherit the ancestral mind and instincts—an outstanding factor in the consideration of mental disorder; for both in Lunacy and in normal life the ancestral mind and instincts play a major part. Now, it seems to me to be worthy of notice that although some forms of life, such as the Dinotherium, and the Dinosauria group, have died out, the physical character and constitution of all the surviving animals, excepting man, has remained constant. The fact that man has degenerated is so obvious to us all that it can pass without illustrations here. Hence, we are frequently told that we are a degenerate race—a decadent race, and so on. The reason for such deterioration is not far to seek; for whereas the other animals are stable, man is unstable; and, as I have said, because instability is like an avalanche, man’s instability must go on increasing. The cause, no doubt, is the fact that man is possessed of a consciousness as well as an unconsciousness, whereas all other animals have but one sense of awareness—their unconsciousness, which it pleases many of us to refer to as consciousness. You see, when we look back upon our ancestors living in their natural surroundings, we find them possessed of but one system of awareness, in that they would be conscious of their behaviour and their surroundings. Therefore, does it not follow that to remove an animal from its natural surroundings, and compel it to live in an ‘unnatural’ civilised world, that animal will either resist to the death, or assume a veneer with which to cloak itself; so that henceforth it will possess two selves—the original having become the ‘true’ self, and the veneer, the conscious self—or Consciousness; as instance the monkey or dog which is taught tricks. Such an animal is ‘unnaturally’ tethered to a chain, taught tricks, and perhaps dressed in a jacket and a hat, and made to go around the crowd soliciting pennies, whilst its master turns the barrel-organ.

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Now, it is not easy to train animals to do this kind of tiling, for the animal is unwilling. In time however, it comes to realise that unless it does its master’s bidding, it will be thrashed and deprived of food. It therefore sets up a barrier between its real self and its artificial life (from which it sees no way of escape), by smothering the original with the newly acquired; this barrier we know as Consciousness. It would therefore seem that the man-trained animal will re-act in a totally different manner to the wild animal; moreover, it seems unlikely that the animal of the Wild is capable of experiencing the dream state; whereas, it is a well-known fact that the man-trained animal is as much subject to this ‘peculiar’ state as human beings. Therefore, from this point of view, Consciousness is not merely a barrier between our ‘true’ internal selves and the external world of reality (a purely relative affair, as we have chosen to make it), but a barrier between Truth and Pretence. If this is not so, whence the dream state? Is it not clear that by accrediting man with a ‘true’ self, and a ‘conscious’ self, we confirm a living lie? For a man cannot serve two masters—in that he cannot be faithful to both. So that if we bear in mind this aspect of Consciousness, and at the same time, take a close-up of Lunacy, Dreams and Lunatics, we shall be able to appreciate the possibilities of lunacy, and appreciate the value of Psycho-analysis; for with this knowledge we are able to realise that a man under the influence of sleep, must be wholly at the mercy of sleep; for being asleep, and therefore insensible, he is deprived of that Consciousness which the organ-grinder’s monkey possesses. In this defenceless state, he must accept the dream and do its bidding; and so in like manner, are the insane (whose life is a non-stop dream) deprived of their Consciousness with which they might have defended themselves. They, also, obey the dictates of their ‘dream’; for insanity is a dream, and a dream 87

insanity. There is absolutely no difference whatever; nor is this a ‘new theory,’ but a very old fact—because of which, I offer the following extract from “The Life of Sir William Osler,” for your consideration: —

“I dreamt of you last night as operating on Hughlings Jackson. The great principle you said in cerebral surgery is to create a commotion by which the association paths are restored. You took off the scalp—like a post-mortem incision—made a big hole over the cerebellum and put in a Christ-Church whipped-cream wooden instrument and rotated it rapidly. Then you put back the bone and sewed him up. H. J. seemed very comfortable after the operation and bought three oranges from a small Neapolitan who strolled into the Queen-Square Amphitheatre! I have been studying my dreams lately and have come to the conclusion that just one third of my time is spent in an asylum— or should be!”

The same goes for me; for I too, have studied my dreams, and long since reached the conclusion that one third of my time (my sleeping hours) is spent in an asylum.   XI.   Now, if we take a near view of the Unconscious, it becomes clear to us that from that time in our earliest infancy when first we were able to develop an awareness of our surroundings, there has taken place within us a continuous process of recording of experiences, sensations, emotions and so on; and these have impressed themselves upon us as and when they have occurred. Most of them have long since made their way into the Unconscious; and our troubles now arise from the fact that although these recordings are retained 88

within the mind, we are no longer aware of them; and in addition to these impressions there are tendencies and desires which have been transmitted to us from our ancestors. ‘Unfortunately,’ many of our instinctive wishes and strivings have been restrained and controlled by moral codes, laws and social conventions—thus giving proof that Consciousness is a comparatively ‘new idea’ which, whilst it endures, enables us to cover up the lusts and viciousness which, in common with all other animals, is our heritage. Here, therefore, it would perhaps be well for us to note an important and highly relevant fact, i.e., the outstanding factor in mental disorder—that the female animal does not resort to silken underwear, nor does the male animal wear trousers. Consequently, they see each other in nakedness—which is truth; and as they live their lives in natural surroundings untarnished by civilisation, they possess but one system of awareness—their Unconsciousness.

Moreover, we find that as the natural world of the lower animals does not boast a Garden of Eden, it has no Tree of Knowledge of Good and Evil at which to point threateningly; and it is because of this that the mother animals found no cause to lie to their off-spring, whereas, as we now know to our cost, our mothers lied to us; and how badly they lied, for they fed us with childish fables concerning a wicked Serpent that spoke. Of a Serpent that was not only more subtle than any beast of the field, but clearly more subtle than any of us human animals; for if we are to believe one thing, we must believe another from the same School—that the Serpent said, “If ye eat of this tree, ye shall not surely die.” And today, we realise how very wise was that Serpent, for it spoke the truth; but truth notwithstanding, our mothers, through fear of the Unknown, persisted in lying to us. They continue to do so to this very day. They teach ,us that we have hands, feet, eyes, nose, mouth and “privates”; and although they teach the purpose of the hands, feet, eyes, nose and mouth, they lie 89

to us about our penis and vagina. They foolishly maintain that the penis and the vagina are strictly “private,” whereas, of course, they are obviously the most “public” members of our anatomy. Ladies and gentlemen, if we would deceive others, let us do so; but for pity’s sake let us dispense with self-deception—let us away with our own executioner. Let us admit to our long-suffering souls that we are certain about one thing—that the eyes of the boy rest upon the vagina, and the eyes of the maiden upon the penis. If it were otherwise, there would have been no need to publish surreptitious advertisements suggesting V.D. to be the Shadow on Health; for that shadow is totally eclipsed by the shadow of this original lie. That the foregoing is all too true is made known to our innermost souls by the conflict set up within us, which arises from our state of opposition between primitive instinctive wishes and tendencies, and forces of a social land preventing their gratification. This is a conflict between natural and artificial impulses; and it is interesting to note that in communities farthest removed from the lower animals—that is to say, in highly civilised communities, the instinct with which the social impulse is most in conflict is the sexual instinct. The constant state of irresolution brought about by this striving, frustration and deprivation of the natural instincts and desires, sooner or later becomes impossible to the person; so that in his frantic efforts to do something about it, he gets himself deeper and deeper into the maze. What is desired is a logical

and fully conscious choice on the part of the individual—his own conscious control; for if such logic and control were possible, and were always adopted, mental disorder would be prevented. The trouble is however, that in many individuals, conscious control does not take place, resulting in the wish impossible of gratification being banished into the Unconscious 90

Mind. The complex is forgotten, and remains unconscious, for it cannot be recalled by any effort of will; and now, all might have been well, were it not for the fact that although the complex cannot be recalled, it still remains to influence conscious thought and action. It is thus that a conflict arises on account of the conscious thought having been repressed into Unconscious. Forgotten wishes and tendencies thus repressed, are kept out of consciousness by a barrier; but despite this barrier it remains a fact that a complex, although unconscious, still influences thought and action. Influences? Nay, it governs all thought and action. It is therefore evident that a complex can be likened to a malignant growth, which not only grows at the expense of the normal mind, but evades and distorts the proper adjustment of the individual to the world of reality. Thus, for example, the paranoiac on his steady path of progression has, by the time he has travelled but half way along the road to death, very little normal mind left; for by that time, the malignant growth will have devoured most of it. Unfortunately for Mental Science, our first acquaintance with this subject of the Unconscious Mind is somewhat bewildering, and not a little complicated. A little patience however, and we find that on second asquaintance, it is simplicity itself; for when we take another look at it, we can plainly see that at any time, and with more or less clearness, we can become aware of the various items of our experience—also that we can repress from our consciousness any particular item to which we would rather not pay attention. Moreover, having been trained from childhood to check certain tendencies which are not for the greatest good of society, we are able to replace such by others which we deem more desirable. After all, what we speak of as Consciousness is really only the advanced outpost of our true personality; and although it has been likened to a kind of Customs-house on the frontier of 91

our true selves and external reality, it is in fact, a veneer covering our true selves. It is a lie—a sham—a pretence; for on tearing aside this veil, we find an individual whom time has not touched—a fact conclusively proved by our dreams. Now, if we take the behaviour of a child, we shall find that the child offends against society just as the insane. As a result of training, threats and deprivations however, the child soon ceases to show these undesirable tendencies, and later, becomes completely unaware of their existence in him. Nevertheless, they have not vanished; for training does not remove these traits and tendencies, but merely deals with them so that they cannot express themselves directly in the child’s conduct. Thus the knowledge of their existence passes from his knowledge. Training is a process of deprivation, frustration and repression; and if, for peculiar reasons, we suggest that it is not so, we lie. Apart from children, we find exactly the same process at work in our everyday life, where many people when faced with an unpleasant idea find themselves unable to face it, and avoid reality by resorting to the process of repression. This is especially so in the case of those pre-disposed to insanity. It therefore becomes clear that unpleasant memories, abandoned hopes, repressed tendencies and the like, are by no means done away with, but remain with much else in the Unconscious Mind; and although we are blissfully unaware of their existence, they have a very powerful effect upon our opinions and our behaviour. Why, surely, if we will pause here but for a moment to reflect, we will at once appreciate that the Unconscious is a very important part of our personality; indeed, it is our personality—our real personality which civilisation has caused us to relinquish. It is for this reason, that although the Unconscious Mind may appear dormant, it is in truth, never at rest; for there is never a thought or action of ours which it does not influence. Whilst life is ours, the 92

contents of the Unconscious Mind—according to the amount of emotion with which they are charged, are for ever endeavouring to come back into consciousness. Life is a continuous endeavour between the repressed and the repressing force; and it is the various efforts made by the repressed material to avoid repression, and to rise to the surface, together with the varying means the individual adopts to maintain and strengthen his repressing power, that produces the condition known legally as Insanity. 93

PART III WORLD OF PSYCHOLOGICAL MEDICINE     I.   The fact that mental disorder in one form or another, has been recognised from time immemorial, and that it is only in comparatively recent years that serious attempts have been made to understand it, seems to me not so much an excuse as a charge against the profession. It is perfectly idle to suggest that progress has been slow because of professional apathy and public prejudice; for if this were so, both apathy and prejudice could long since have been removed by educating the people in bodily and mental health and science. We know that progress has been infinitesimal; indeed, according to the eminent McDougall there has been none; for he states: — “As to the making of minute studies in laboratories equipped at great expense, the total results as regards prevention and treatment of mental disorder may fairly be described in one word—NIL.”

This then being the position, what purpose is served by ‘giving perspective’ to modern psychiatric problems, by the mention of ‘important landmarks’ in the social history of psychiatry? Since lack of trained psychiatric staff and lack of experienced men offers so very little by way of ‘cures,’ we 94

ought to go all out for prevention. After all, our psychiatrists agree that there is practically no hope of a cure for the fully-fledged lunatic, and that there is positively none for those accursed with paranoia and paraphrenia. Instead of seeking the only certain remedy, Psychiatry relates its somewhat inglorious history, and tells us that perhaps the earliest reference to the treatment of the insane is contained in Plato’s Republic (Bk. xi, c. 13)—“If anyone is insane let him not be seen openly in the city, but let the relatives of such a person watch over him at home in the best manner they know of, and if they are negligent let them pay a fine.” So that we must conclude that our present day attitude towards this problem is the result of such history.

Surely, the fact that Saul, David and Nebuchadnezzar were victims of epilepsy has nothing to do with a cure for the half million insane in our midst; and what has the arteriosclerosis found in Elliot Smith’s mummy to do with the appalling growth of paralytica dementia? Does the fact that early Egyptian papyri contain certain references to mental disturbances, in any way help us to straighten the appalling confusion and ignorance concerning so-called Schizophrenia? Now, before the birth of Freud, many scientific observers held ‘Freudian’ views; and although Freud did not start this business, to simplify matters, we shall here assume that he did. As you know, this great man had a number of disciples—two of whom were Alfred Adler and Carl Gustav Jung; and as is the way of Psychological Medicine, dissention arose amongst Freud and his disciples whilst seated in Vienna. It was there that the split in the Psychoanalytic School occurred, and there that Freud, Adler and Jung parted company—Freud to continue, and to modify some of his ideas, Adler to start the School of Individual Psychology and Jung to become the exponent of Analytical Psychology. Now, if one reads the works of Freud, Adler, Jung, Bleuler, Clouston, Krepelin, 95

White, May, Paton, Storch, and so on, and ultimately lands down upon the upto-date Henderson and Gillespie, the clear impression is—apart from the tremendous interest and fascination, that dissention stands out in relief all along the line. We have tried ‘bleeding,’ chains and fetters, flogging and other forms of torture, to no purpose; and we find that although the history of Psychiatry suggests Caelius Aurelianus to be worthy of much praise because he denounced the ‘cures’ of semi-starvation, bleeding, chains and fetters, and excessive drug-therapy, we still hold fast to indiscriminate and forcible drugging. And although I do not class prolonged narcosis induced by somnifane as indiscriminate and forcible, I do consider it a step that is very unwise unless the necessary skill and experience is behind it. If it is not, the treatment is a very grave danger; for unless the patient has the constitution of an ox, prolonged narcosis may well become murder. The mortality rate is four per cent, and at best the patient runs the risk of being poisoned. In addition to such undesirable effects there are numerous other dangers attaching to this technique, as the works of Kooy, Dauerschlaf, Oberholzer, Jenny and Klassi testify. This treatment is only valuable in the hands of highly skilled psychiatrists, and provided that it is followed up by other treatment. Its

possibilities are therefore small when we consider the dearth of psychiatrists. There are, of course, one or two hospitals where highly skilled technicians are to be found, and where this treatment by continuous narcosis yields encouraging results. Alas, in 95 per cent, of our hospitals it is quite unknown.   II.   We believe that in the 18th Century, great indignation was aroused throughout the British Isles by the ‘treatment’ 96

meted out to George III—who was a maniac; for this royal lunatic was treated with singularly little respect, and no hesitation was evinced in knocking him down. Further, he had to submit to ‘blisters,’ and to the strait-jacket. Even so, and notwithstanding the Wynene’s Act, which was introduced in 1808, what have we done to unravel this mystery? With such a history before us, we should take steps to eliminate this dissention, and having done so, at once proceed to the task of searching the minds of the potential ones—indeed, the minds of one and all, by means of psychiatric clinics for mothers and children; and how fortunate we are to find that such a method has already been made possible by the ingenuity of Sigmund Freud; for his startling technique embraces the discussion and analysis of dreams, which, as we now know, are expressions in disguised forms, of thoughts that were repressed at some earlier time into the Unconscious of the individual, there to form the basis of the complex. Freud found that dreams were a great help to the study of unconscious thoughts in the insane; for in insanity, where the mental control is mostly nil, the patient is living in a daylight dream, and his symptoms (his delusions, etc.) which go to make up his ‘dream,’ are really unconscious thoughts that have, as it were, escaped from captivity; for unconscious thoughts are prisoners of the conscious mind, and the occasions on which the unconscious ones escape from the conscious only occur when the conscious mind is not on guard—in other words, when the conscious mind becomes weak or useless owing to insanity, injury, anger, alcohol, anæsthetics and sleep; so that, for example, at night, when we are falling asleep, complexes which have been banished into the Unconscious, emerge and overwhelm the personality. Repressed ideas pour in upon the dream world. Sometimes, these visions are quaintly disguised; some being clothed with material derived from the sleeper’s memory of the incidents of

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the day. Others may be disguised in dramatic and symbolic form; but however cloaked and however strongly disguised, the fact that a dream is insanity and insanity a dream, stands out vividly. It is plain to see that our dreams when compared with our conscious life are mostly absurd, for we are immensely wealthy, extremely happy, all powerful and fearless. So it is with insanity too. But whereas in normal life, the dream takes place whilst the senses are unconscious, in insanity it occurs whilst the senses are conscious. It is so very easy to observe the parallel in the absurdness, loss of discretion, weakness of judgment and over-estimation of ability; and in both cases the factor of time is discounted. Thus we find insanity to be but a dream which has taken up a permanency.   III.   Fifty years hence, and one half of the world will be fully engaged in nursing the other half! Can this be true? Let us run quickly over the figures—and the facts. We have heard General Hershey and Dr. Challmer. We have listened to the debate in the House of Commons. We have taken a survey of the background of Lunacy; and if our primitive lunatic asylums represent the best that our government and Psychiatry can offer by way of a ‘cure,’ remedy or prevention, we realise exactly how far we have progressed. These things notwithstanding, nowhere does this great and awful problem receive the attention it merits; indeed, it receives no attention at all. The public, through prejudice, superstition, ignorance and fear, run blindly from this ogre and from his house of mystery. Such fear is wrong and needs to be remedied. We no longer live in fear of thunder storms, 98

or fear that we may pick up a devil from an epileptic. Of course we do not. We do not fear the things we understand; and that is why I believe that research, by increasing our understanding of mental disease, will not only remove such ideas, but will remove a fear which is worse than the disease itself. The government—under compulsion, mention the matter but furtively, and without the slightest realisation of the urgent necessity for strong preventive

measures to be adopted immediately. Meanwhile, 2% of our entire population are suffering from neurosis, whilst one out of every three persons who pass through the hands of our doctors is suffering from neurosis. In the British Isles there are more than 200,000 certified insane persons confined within our asylums; and this appalling figure does not include the uncertified, the unascertained and those beyond the reach of statistics. In addition, there are more than 300,000 certifiable mental defectives; and added to this figure there are more than 600,000 children of school age who are backward to an extent that would require special arrangements for their education. This ‘grand’ total can at least be trebled when we take into account the unascertained and uncertified, together with the unemployables, the delinquents, criminals and prostitutes who are beyond the reach of statistics. Despite these alarming figures, nothing whatever is being done about it; and although from time to time we read of “Forty-five Admissions, compared with Thirty-eight Discharges”—and regardless of how these figures are arrived at, they are totally inadequate to disperse the fog overhanging the world of Psychological Medicine. Such statistics—having no true bearing on the problem of insanity, cannot dispel the feeling of frustration which is giving our progressively-minded psychiatrists so much concern. It seems to me, that before Psychiatry can hope to find 99

a cure, it should gaze with intensity at its causes. If it does so, it will no longer enter culs de sac in pursuit of phantom cures, but will go all out for the only remedy—Prevention. And when Psychiatry does seriously consider the causes, it will realise how much greater is the problem of mental disorder than either the cancer or tuberculosis problem to which so much public attention has for so long been directed. For myself, I can only say that a life-time’s study of humanity, 375 days face to face with the insane, and five years face to face with Psychological Medicine, suggests to me that insanity must be attributed to the following causes: —

Lack of teachers. To telling the boy his penis is ‘private,’ instead of teaching him exactly what purpose this part of his anatomy is meant to serve. To encouraging false modesty in the maiden, so that she grows up in the belief that her vagina is strictly ‘private.’ Lack of education in the up-bringing of children. Ill-treatment of children. Lack of psychological instruction and of psychological knowledge. The hiding of truth. Bad living. Excessive alcohol. Inter-marriage. Reckless intercourse by men over fifty years of age.

If these be the causes, the obvious remedy lies in the removal of the cause —which can best be effected by educating the people concerning Sex; for of all the paths of 100

life, this is the darkest. It is overshadowed by mystery, secrecy, social custom and dirt on the one hand, and by desire, pleasure and necessity on the other. If it is not sanctioned by the Church and the Law it is a sin and a crime. Educate the people with regard to the far-reaching effects of venereal disease, by pasting notices upon the class-room walls, instead of upon the walls of our public lavatories—by establishing psychological clinics for mothers and children. Tell the children about Sex. Surely, as we have spent so many millions upon war, we can afford just a little to save our sons. We, of course, readily admit that in every pathway of civilised life there is room for improvement from the humanitarian point of view. We only admit this however, and the admission is a darned nuisance; for we are so peace-loving a people, so indifferent and self-centred that we trust that this and other social evils will automatically right themselves—in a pleasant atmosphere, without provoking disturbance, and without recourse to the sinister, morbid and lurid. How then, shall we manage it? We shall certainly not manage it if our psychiatrists adopt the view of Psychiatrist G. whom, you may remember, wrote me that the “people have a great fear of mental illness, and of everything associated therewith,” and who advised me not to publish my book, and so exaggerate that fear!

Ladies and gentlemen, during the last 150 years, we have achieved nothing; for except for the classification of the various disorders, today we are still living in the Country of the Gadarenes. True, we no longer believe the mad are the victims of the devil, or that some are affected by the moon; for we now differentiate between the various types, and recognise them as neurotics, psycho-neurotics, maniacs, melancholiacs, paranoiacs, paraphrenics, epileptics and so on. Also, we have come to know that the seeds of mental disorder arc sown in childhood. 101

IV.   Now, there are many reasons to account for this defeat; one of which is that Psychiatry begins at the end instead of at the beginning. Also, it seems that for no reason whatever, it continually changes the names of its various disorders; so that Dementia Praecox (which everybody understands) becomes changed to that grandiose misnomer Schizophrenia—which nobody understands. Not content with the creation of a misnomer of the first magnitude (for all mental disorders can be described under this title—which means a splitting of the consciousness), it has recently raised it to the status of Schizophrenic Disturbance; so that any man, however well versed in Mental Science is never quite clear as to what tire other man is talking about. A perusal of the textbooks will bear out my statements, and will make clear to the lay, or skilled reader that Psychiatry sabotages its text-books, and seems to rejoice in the consequent confusion of the student.   Better far for Psychiatry to recognise that Melancholia is a birthright—as is any other form of insanity; for melancholia, involutional or not, is written upon the individual’s Birth Certificate; and because Psychiatry awaits the involutional period before looking into this matter, it checkmates itself, and leaves a lunatic on the board.   In the book “Certified,” I have stated that when I encountered doctors and psychiatrists as certified lunatics, the futility of curing fully-fledged lunatics was borne fully upon me; so that when I tell you of an eminent psychiatrist who has become mentally deranged, your mind may go back some years… “If thou can save others, save thyself”… But no, he cannot; nor can any other now do so… 102

V.   Amongst my collection of letters, I find the following, from PSYCHIATRIST X. M.D., F.R.C.P., D.P.M., F.R.S., etc. Lecturer in Psychiatry, and Superintendent of a Mental Hospital. Examiner in Psychological Medicine to the Royal College of Physicians. London, W.l.       2nd November, 1944. “My dear Mr. Woodley, I hope you will think of me at my best as I have been at my worst recently, both mentally and physically…” ___________________          

Now, not so very long ago, I read in the press of the suicide of a young ‘society’ woman. It was clear from the evidence at the inquest, and from her father’s statements, that this young woman was of unsound mind. Further, it was stated by the coroner that the suicide had studied Medical Psychology and Dreams; and in his summing up, the coroner stated, “There is one branch of psychology that stands quite apart, and is not a suitable or desirable subject for all or any people. I refer to psychological medicine, or medical psychology. Doctors as a class do not practise it… Unfortunately, some nonmedical and untrained people, and some with a morbid curiosity dabble in medical psychology. The woman in this case was one of them. She had dabbled in that part of it concerned with dreams and their interpretation… This morbid curiosity on her part, has led, in my opinion, to her tragic and untimely end… Clearly, there is not the’ least particle of common-sense 103

in this well-meaning and kindly statement of the coroner. Surely, the morbid study of anything whatever, cannot have the slightest effect upon the individual of sound mind. The truth is—laying aside all ‘morbid curiosity,’ dreams and medical psychology, that to commit suicide one must be insane; and insanity has a clear origin. Therefore, however comforting it may be for the world of Psychological Medicine to be shrouded in mystery, and however much such extravagant statements may add to this ‘mystery,’ such suggestions are nothing more than a disservice to Psychiatry.

And in like manner should we view folie à deux; for Psychiatry states that suggestibility plays a part among other factors in the genesis of folie à deux, or communicated insanity—which is the term applied when two persons closely associated with one another suffer a psychosis simultaneously, and when one of the pair ‘appears to have been influenced by the other.’ They tell us that folie a deux is commonest in people living secluded lives—husband and wife, brother and sister, parent and child, or friends of the same sex living closely together; and further, that this disease usually takes the form of paranoia, or of the manic depressive state. Are we then to believe that by reading Freud’s “Interpretation of Dreams,” or by living in seclusion, we invite insanity? Surely, such a theory savours strongly of Sax Rohmer and his Magic, and is unworthy of us. Is it not obvious that such cases of folie à deux (or trois), are merely instances of the pre-disposition coming to the surface—first in the one, and then the other? The ‘fact’ that separation frequently brings about the ‘recovery’ of one of the pair is but a coincidence. If this is not so, perhaps Psychiatry can offer an alternative reason as to why a certain psychiatrist of international repute is now mentally deranged; and as this psychiatrist is not a psycho-analyst, he cannot be accredited 104

with the contagion afforded by the practice of that technique.   VI.   It was in the year 1935, and due to the daring and enterprise of Messrs. Freeman and Watts, of the George Washington University, at Washington, D.C. that an amazing surgical technique was launched upon the world; for in that year it became obvious in the United States that the earlier experiments of Professor Egas Moniz had resulted in finding an Aladdin’s Lamp, which in all truth offered new minds for old. Seven years later, at about the same time as I was making my bow in the world of the insane, the British world of Psychological Medicine interested itself in this new idea, which had so greatly exceeded the expectations of its brothers in the U.S.A, where doubt and pessimism had been abandoned, and optimism set to infinity. Besides, Freeman and Watts having removed all obstacles, the road was now open to British Psychological Medicine. Here then, let us take a brief glimpse at that miracle known as Leucotomy —a psycho-surgical technique originated by Professor Egas Moniz, who first

conceived and executed a valid operation for mental disorder, on November 12th, 1935. The operation is known as prefrontal lobotomy, and is reserved for psychotic patients who suffer from severe depression or tense obsessional states; it consists in cutting the white nerve fibres in the frontal lobes of the brain, thereby severing the connections of the frontal cortex with other parts of the nervous system—especially the thalamus and the hypothalamus. In short, this operation cuts the lines of communication, and thus puts an end to continuous thinking on a given subject. To perform the operation, the surgeon uses a specially made cutting instrument known as a leucotone; and this he inserts into the subcortial white matter, 105

in which he then cuts a number of one centimetre cores”—thus inactivating a large number of connections within the frontal association areas, where repose the mechanisms of the “association of ideas.” Prefrontal lobotomy is invariably staggering in its results, and frequently in more ways than one; for the alteration in the personality is truly amazing— some symptoms being relieved, some being aggravated, and, wonder of wonders, new ones brought into existence. These effects are sometimes temporary, but more often they are permanent; and whilst the final result may be pleasing to the psycho-surgeon and his neurologist, it is frequently disastrous to the patient’s family or his immediate associates. Moreover, nothing is guaranteed; so that that which appears to be satisfactory for the first six, twelve or eighteen months after the operation, may unexpectedly become a tragedy of the highest order. Also, due to complications caused by the operation, death may (and frequently does) occur as late as three years after. Nevertheless, prefrontal lobotomy most assuredly provides new heads for old; but whether this change is altogether desirable is another matter. The change in the personality resulting from this operation is indeed remarkable; and whilst on the whole, the timid person becomes more timid, the affectionate more lovable, and the aggressive angry and fierce, there is often a reversal of such characteristics; so that the good becomes bad, the bad good, the quiet boisterous, and the noisy ones subdued. Frequently, the change is reflected in the individual’s delight in giving all and sundry ‘a piece of his mind’; and although there is a striking lack of depression, obsession, malice, imagination and energy, there is all too often a frightful exhibition of profanity and vulgarity, which at times, is accompanied by fearful behaviour and references to sex at its lowest; so that the relatives of such patients, whilst appreciating the amazing change in the individual who

106

has ‘benefited’ under the operation, also appreciate the other side of the question—by saying, “It’s so wonderful, we can hardly believe it’s true. The change is a miracle—but we wish we had not got to live with him!” In one series of operations, two-thirds of the total showed ‘improvement’—which is to say, although they lost certain troublesome features, such as violent or impulsive behaviour, faulty habits or destructiveness, their other symptoms persisted. One-third, not only showed no improvement, but many of these were made much worse as a result. Physical as well as mental changes take place, and whilst epileptic seizures are but one of the consequences, many women subjected to the operation show hirsutic changes; for instance out of seven women, four, who, prior to the operation had a pronounced facial growth of hair, after leucotomy developed veritable beards. Further, the operation frequently ‘succeeds’ so well that it abolishes all the finer sentiments that have hitherto kept the individual within reasonable bounds of social behaviour—the subject becoming an animal of the lower order. So that whilst I pay tribute to the great skill of the neurosurgeon, and to the daring and the enterprise of Messrs. Freeman and Watts, I am, nevertheless, convinced that this is not the solution of our problem; and this I fee! will be apparent when I suggest to you that by severing the hands of the kleptomaniac we do not cure kleptomania; for stealing is done by the mind and not by the body. In like manner is ‘negativism’ a mental disorder arising from the infantile life of its subject; so that when we counter the negativism of a patient (or of a child) by using his own weapon against him, we achieve nothing more than temporary peace and satisfaction. His negativism remains with him; and the problem with us. By the same token, the use of dexedrene, benzedrene, or 107

similar drugs, as a cure for the early symptoms of the depression of early neurosis must be a forlorn hope; for whilst these drugs do, for a time at any rate, alleviate the state by the temporary dispersal of such depression, the cause remains untouched. Negativism, depression and all other forms of mental instability lie deeply embedded in the roots of our infantile life, and it is there that we must attack them. Now, there are few individuals ‘suitable’ for the operation of prefrontal lobotomy, and amongst these few, the mortality rate is high, and the

possibility of relapse never to be ruled out—even years after the operation, as we are now learning to our cost. Apart from such aspects, however, the allround results of leucotomy offer striking proof that the operation does not, and cannot cure insanity; and this is the point I wish to make clear; for both medical and lay readers fall easily into the erroneous belief that when successful, leucotomy cures insanity. That it does not is obvious from the works of Freeman and Watts, Egas Moniz, Bagdasar, Keller and Ackerly, and Donaggio and Sciuti; and whilst these masters of the subject do not set out to mislead us, for some obscure reason they do not make clear this very important fact. They have not clearly told us that it merely changes the personality of one lunatic into that of another. This fact we must fully grasp, even where recovery or improvement is reported; for in such cases it is only certain significant symptoms that have responded, and not the basic condition of insanity. At this experimental stage, we must realise that the mortality rate which is so depressing and distressing, is really unavoidable, and must therefore pass without comment; for as the subjects of prefrontal lobotomy belong to the living dead, it seems to me that they are losing precious little by joining the dead dead. Therefore, the operation is undertaken in the form of a gamble—in the hope of turning the patient into a happier frame of mind, by freeing him or her from 108

terrifying hallucinations and deep depression—by rendering dangerous sick men harmless sick men; so that with regard to mortality we need not unduly concern ourselves; and as I make this ‘callous’ statement on top of 375 days and nights spent face to face with the mad, I hope you will accept my word for it.   At the present stage of the experiment, it is unanimously agreed that the greatest (and perhaps only) value of leucotomy is to be found in relieving the states of morbid emotional tension and distress, by disrupting the behaviour patterns dependent upon such states. Moreover, it is agreed by all the masters of this subject, that leucotomy is not a remedy for any specific mental disorder—that it is fraught with very grave dangers and risks, and that only after all other measures have failed, and the case appears quite hopeless, should it be resorted to. Grave indeed is the responsibility of the physician who recommends it; for he must frequently envisage the substitution of a soulless robot for the insane patient.

  And yet, I come not to bury Leucotomy, nor to praise Psycho-Analysis. I come to you with the suggestion that the only cure for insanity lies in the removal of the cause; and as will be seen, the chances of psycho-analytic methods offer the best hope; for whereas leucotomy attempts to effect a cure by treating the brain, psycho-analysis treats the mind; and since anxiety causes insomnia, and insomnia anxiety, this seems to be the most likely, and most suitable method of approach to the subject. After all, the other name for insanity is a diseased mind—not a diseased brain.   Meanwhile, it is interesting to note that Professor Freud, the father of Psycho-Analysis, died a Jew in exile, and Professor Egas Moniz, the father of Leucotomy, was, in 1939, shot at and seriously wounded by a paranoiac patient. 109

VII.   Now, in the daily press, on the 5th June, 1946, I read of a youth aged seventeen years, who had murdered his father and mother. He was tried at Norwich Assizes, and found guilty, but insane, and was ordered to be detained during his Majesty’s pleasure. One of our distinguished psychiatrists gave evidence at the trial, and suggested the youth’s insanity was curable by an operation—presumably prefrontal lobotomy. So here let us follow that youth into the criminal lunatic asylum at Broadmoor, and see what happens to him there. We shall find in all probability that no attempt is made to treat him for his illness; for why waste time with an individual who is to be detained during his Majesty’s pleasure? He is now ‘certified,’ and confined for life—from the age of seventeen; and this, in the year of Progress, 1946! On the other hand— assuming he is a fit subject for prefrontal lobotomy, and supposing this operation is performed, he remains there for life! Is it not obvious that if Psychiatry boasts a cure, we expect Psychiatry to at once take steps to effect that cure? Yes, indeed, it is obvious—so that a sceptical public grows more sceptical; and why not, pray?   VIII.   In the press of December the 14th, 1946, we read of the youth Charles Templeman Brown. He is accused of a double murder which took place a year

earlier at Pollokshiels railway station, at Glasgow. Three distinguished psychiatrists are called to give evidence as to his mental condition. All three emphatically state that the youth is of unsound mind. Meanwhile, throughout the British Isles all psychiatrists are watching the trial with extreme interest; for they see in the 110

accused a fine example of schizophrenia. A perfect picture of one phase of dementia praecox is set before them—and before the judge; but what can the psychiatrists do about it, since the judge, having heard the evidence of the medical experts, sentences the youth to be hanged by the neck till he is dead? Indeed, what can anybody do about it—except presume that this rendering unto the State of the things belonging to Medicine, goes on with increased vigour simply because, during the preceding fifteen years there has been no death sentences in Scotland? On the 14th July, 1946, Britain’s foremost psychiatrists were criticised by the Lord Justice Clerk for having too many charges of murder reduced, by making ‘exaggerated and unproved claims.’ The Lord Justice Clerk told the delegates to the Royal Medico-Psychological Association, “It has been evident to me within the last four or five years that the thing has been overdone. A great deal of harm has been done in the cause of criminal reform.” He urged them, in dealing with criminal cases, to verify carefully the data on which mental diagnosis was made; and he quoted a case in which a remarkable story had been accepted by the psychiatrists and was later proved to have been a complete invention. The Lord Justice Clerk also mentioned that in the fifteen years from 1928 to 1943, there had been no death sentence in Scotland. Now, it is quite true that the ‘split personality’ is, at times, adopted— successfully, as a good line of defence in cases of murder; so that to some extent I agree and sympathise with the great and conscientious Lord Justice Clerk. Nevertheless, we must not allow this aspect to blind us to the main issue. Besides, there are black sheep in every fold; so that here, as in war, the innocent are in danger of suffering with the guilty. The difficulties that beset the Lord Justice Clerk and others of his noble profession are but part of the cost of Progress; and surely, it is little enough to ask that a few 111

criminals be allowed to escape their deserts in exchange for progress? Fortunately for Psychological Medicine, in the case of Charles Templeman Brown an appeal was lodged, with the happy result that a fortnight later, the

State was prevailed upon to return to Medicine that which it had stolen from it —the body of Charles Templeman Brown; and yet, better maybe, had he been hanged by the neck rather than be confined for life in one of our archaic prisons. From the same standpoint I ask, “What purpose was served by the execution of Neville Heath?” Are we to believe that such behaviour was the reflection of sanity? The Sadistic nature of his behaviour removed from us the ability to comprehend that it was the outcome of a disordered mind, aggravated by alcohol, as I have endeavoured to make clear in the book SYNTHETIC MANIA. It seems to me strange that whilst on the one hand we deride witchcraft, on the other we still cling to a belief in its magics and evils. Stranger still that we should despise the heathens of ‘darkest’ Africa, whose civilisation is so far in advance of ours, and at the same time, confine a man for life, or execute him, on no other charge than of being mentally ill. Who are we indeed, to point a finger at primitive man?   IX.   Be assured that it will not take centuries and a major war to solve our problem, if only we will render to the State the things which belong to the State, and to Medicine the things which are Medicine’s. Justice and Progress demand that these two be separated for ever. That Custom warps the mind, corrodes the heart and removes the imagination more completely than prefrontal lobotomy is painfully evident; and 112

but a moment’s thought reveals our blindness. Is it not obvious that to murder parents to whom we are devotedly attached bespeaks madness? And as the mad are innocent of their madness, and can therefore do no wrong, it surely follows that as there is no suggestion of punishment for the person who develops appendicitis, there can be none for the victim of mental illness? It is because the law cannot punish us for what takes place in our dreams that it must not punish us for what occurs in insanity. The two states are but one; and with this knowledge future generations can but look back upon us, and laugh (or weep) at our primitive ideas of Justice.   X.  

I have advocated Psychiatric Clinics as one approach to our problem. There is another, the fundamental approach, without which we can do nothing. I have in mind Research, whose object is to find out more about the Nervous System, and to apply that knowledge to the prevention and treatment of mental illness, and to the promotion of peace, harmony and fulfilment in the world. Whose plan of attack is to use any and every line of approach that will help to reveal how the brain works, in health and in disease—to make use of every scientific technique. The fields of Neuro-Psychiatric Research include the Biochemical, Physiological, Histological, Endocrinological, Psychological, Physical and Pathological. They also include the wider aspects, such as Anthropological, Genetic, Zoological and Sociological. The immediate objective facing this branch of research is to study the biochemistry of the nerve cell and the distribution of enzymes and other substances in the cytoplasm and nucleus—to discover what changes are associated with functional activity of the brain. To study the effects of 113

fatigue and exhaustion. To investigate the changes with emotion and to look for biochemical changes in Schizophrenia. To investigate the anatomical, biochemical and physiological basis of every measurable mental process— intelligence, memory and emotion. To establish clinical tests for recognising mental diseases. To devise tests for recognising the normal carriers of defective genes associated with mental disease. To investigate the nature of mental pain and the biochemical changes associated with it. I could of course, extend this list indefinitely, but the foregoing is sufficient to assure you that there is work enough to occupy the lifetimes of an army of research workers. It is because I have told you of Blankville Asylum, and also because I know of very many worse places, that it seems to me only fair to say that there are just a few mental hospitals where good work is being done, and where no path is left unexplored. Where real treatment is available—where small bands of men work on—always interested, and for ever hopeful. I have in mind two in particular, the Maudsley Hospital in London and the Cardiff City Mental Hospital, at Whitchurch, Cardiff. The former is a recognised Medical School, and so is assured of certain funds from various sources. The latter is not so fortunately placed however; for despite the fact that their research laboratory is the largest in the country, they are in urgent need of funds; and if devotion to a cause were money they would be wealthy beyond the dreams of avarice. This Cardiff hospital, which formed the background of Phyllis Bottome’s pretty story, entitled PRIVATE WORLDS, shines like a

blazing torch in the darkness and muddle of the world of Psychological Medicine. “Cardiff City” represents all that is best in Psychological Medicine; and yet, the existence of its splendid research department is made possible only by the efforts of the Cardiff City Council, the L.C.C., the Medical Research Council and 114

other bodies supporting the research which is now being carried out there. The present scale of psychiatric research however, is quite inadequate to meet the magnitude of the problem before us, and the existing laboratories are sadly lacking in funds for their proper staffing and equipment. Is it not strange that there is not a single psychiatric research laboratory in the whole of the country comparable in size to the ordinary research laboratories attached to many of our industrial firms? Consequently, neuropsychiatric research which is so desperately needed is limited to a few small laboratories, in which there are many empty benches; for although keen research workers are available and asking to do this great work, the money to provide permanent posts for them is lacking. Today, we find “Cardiff City” actively engaged in research along the lines indicated. We find them attempting and hoping to raise a mere £25,000 for a short-term plan, and later, another £60,000 for a more extended programme. How can they obtain this money? Surely, an Imperial Fund should be formed to encourage and, indeed, make possible such activities on a much larger scale; for is it not obvious that what sums of money ever do reach such places are generally devoted to bricks and mortar—to adding a Nurses’ Home, or an extra wing? Likewise, is it not also obvious that by encouraging such research, ultimately we should be able to effect so great a number of real and lasting cures that instead of adding new wings to our hospitals we would be able to close many of them? How very strange that millions should be spent every year on the maintenance and staffing of our mental hospitals which house between 250,000 and 300,000 mental patients, when, by diverting a few millions into research we could save so much money. The need is for preventive, rather than palliative measures; and unless this obvious and most urgent need receives immediate attention Psychiatry faces checkmate. 115

Meanwhile, there issues a ray of hope from the world of general Medicine, where, as a result of magnificent and untiring research, we are at least able to appreciate that the temperament of the individual reflects the efficiency, or the inefficiency of his endocrine glands. But although a course of hormone treatment works wonders and throws much light upon the darkness of Lunacy, psychological medicine is slow to move. It seems to me, that as the inefficiency of the pancreatic gland upsets the ‘physical’ system, so does dysfunction of the endocrine (and incidentally, the pituitary) glands upset the personality; and this, despite the fact that this avenue of approach has been abandoned in favour of leucotomy; so that, as insanity is in all truth a diseased personality, it is to be assumed that its cause is primarily due to glandular dysfunction—leaving us the question, “What can aggravate, or alleviate such a state?” Should not this ‘physical’ irregularity, which has so great an effect upon the mind, be countered by education along psychological lines? The body and the mind are one; consequently, by disturbing the body we disturb the mind. By distorting the mind, we distort the body—as in Lunacy; and since we know to what extent the personality, balanced or otherwise, can be controlled (as is well illustrated in goitre and other ‘physical’ ailments), we must be hard upon the scent of a cure. The world of Psychological Medicine is unanimously in agreement that so interwoven is mind and body, that we can easily deduce the constitution of the mind from the constitution of the body; likewise can we deduce from the peculiarities of the mind, the corresponding bodily characteristics. Therefore, what ‘physical’ ailments we cannot cure by ‘physical’ means—such as dosing with thyroid, etc., we must cure by mental means, i.e., by psychological clinics for mothers and children; 116

so that if we bend the mind straight, the glands will automatically right themselves. In other words, if the various emotions, forms of instability and depression are brought about by an unbalanced glandular system, we can well afford to ignore that glandular system, and set out to guide and control the emotions by other means; for as the sapling clearly indicates the direction of the prevailing wind, so does the child; and as we quickly stake that sapling, so that it will withstand the prevailing wind, so must we stake the minds of our children; for if we leave the sapling and the child to grow till they are thirty or forty years of age they will not respond to any amount of staking.

True mental illness (the psychoses) is much more progressive than cancer; for it spreads and disseminates throughout the system with a far greater rapidity and subtlety. The cure then, is the removal of the cause. And in reaching this conclusion I do not under-estimate the genetical and hereditary factors in the production of mental disorder; nor do I disregard the psychogenic factors other than sexual. Indeed, these factors form the basis for my suggestion. Must we throw up the sponge because of these factors? Surely, the removal of the common cause would, in a generation or two, do much to weaken such factors. Like begets like; and the further removed, the less likeness.   XI.   As we have seen, historians have told us of certain landmarks in the history of Psychiatry; and here, I would add to these by pointing to one of more recent origin and of tremendous significance; for when, in 1870, Henry Maudsley stated that the observation and classification of mental disorders had been so exclusively psychological that we had 117

not sincerely realised the fact that they illustrate the same pathological principles as other diseases, and are reproduced in the same way, and must be investigated in the same spirit of positive research, his followers were somewhat misled, and the belief that the body and mind are an inseparable one—that fundamental of Psychiatry—vanished; and they beheld a Psychiatry wherein convulsion therapy and leucotomy were to become the accepted order. On November the 26th, 1946, Dr. D. W. Winnicott, one of our ablest psychiatrists, read before the Medical Section of the British Psychological Society a paper entitled “Physical Therapy of Mental Disorder”; and because the paper was read in the right place to the proper people, it evoked no more than the usual discussion which follows all such papers; and had it not been for the fierce controversy which took place some six months later, this landmark would not be visible. However, on the 17th May, 1947, the British Medical Journal published an abridged version of the paper—with startling results. As much of the paper is ‘technical’ it would serve but little purpose for me to repeat it here, and it may perhaps suffice for me to say that in short it was as follows: —

Dr. Winnicott stated that compared with psychiatric illness a broken neck was not much, and a broken leg nothing. He raised strong objections to the practice of Convulsion Therapy in general and to Electric Convulsion Therapy in particular. “If the sociological results of convulsion therapy are bad,” he said, “the sociological results of leucotomy are deplorable, and I think leucotomy is the worst honest error in the history of medical practice. In mental hospitals the results of leucotomy is a new accession of power to the neurosurgeon, an unqualified practitioner from the point of view of the psychologist… Let us not be deceived by his high degree of skill as a neurosurgeon, this having nothing whatever 118

to do with the case… If one deplores leucotomy and its collaterals one must deplore the convulsion therapies that paved the way for it… The feeling against leucotomy is too great to find expression, and the general public and doctors alike are too appalled by this application of empirical method to do anything about it; they are afraid that if they raise objections the psychiatrists will cease to relieve them of the awful burden of insane relatives and patients… Leucotomy should be a quack remedy for those who seek ‘cures’… What we need to do is to pool experiences of the feelings and ideas found during analysis of patients who have had convulsion therapy, and of patients who are in touch with fellow-patients who have undergone convulsion therapy…” It was then that it happened; for the publication of this courageous paper fell as a thunderbolt upon the world of medicine, where the masters of leucotomy and psychosurgery, having already admitted their limited knowledge, looked on in awe, as there arose a mighty tempest which swept throughout the land. Over Harley Street, and through Wimpole Street did it blow; and whilst the tempest raged the British Medical Journal became a battlefield where medicine fought medicine, where dog ate dog, and where gentlemen became virulent; so that the four subsequent issues of the B.M.J. took from Medicine the dignity it had hitherto claimed. The opposing armies were well matched; but because none had sufficient knowledge of his subject, his incomplete learning and inexperience proved but as a spear in the hands of his adversary. Those who were bold enough to stand at Winnicott’s side, acclaimed the paper an inspiring and stimulating document which shone like a blazing beacon in the dark world of Psychiatry; and the non-combatants took sides with Winnicott. And when the tempest

abated it was seen that this action was more than a blazing beacon—that it was 119

an imperishable monument to the glory and courage of Donald Woods Winnicott. In no uncertain voice his supporters declared themselves entirely against the practice of Electrical Convulsion Therapy; and with equal courage they described leucotomy as a dreadful operation in which one can pay tribute only to the skill of the surgeon and to nothing else. Thus dissension clings to Psychological Medicine, as stigma to the lunatic; and yet, perhaps it is not so much dissension as the refusal to co-operate; from which is seems to me, that only when our ‘eminent’ psychiatrists forget their ‘eminence’ and mix in friendly and co-operative spirit with their brothers, will dissension give way to progress. Let us get together, or perish. Let us pool our experiences; for men there are who can know a thing and yet know it quite ineffectively if it contradicts the general traditions and habits in which they live.   XII.   With these facts before us, let us again refer to the history of Psychiatry. We find that because of lack of faith, and incidentally, lack of support, hardpressed Psychiatry was forced to grasp the extended hand of Neurology, who quite decently offered to escort it to a land where it might be given a hearing. A black day indeed for Psychiatry, for it had to travel light; and amongst the things it left behind were two of its essentials—the original theory that masturbation leads to insanity, and its governing conception that the body and mind are an inseparable one. No longer did it have this fundamental stone upon which hitherto it had sat; for having accepted the invitation of Neurology it decided to make its fundamental optional, so that thereafter came times when it 120

was in unanimous agreement that body and mind are an inseparable one, and times when it was deemed wiser to ignore this important matter. Consequently, today Neurology and Psychiatry find themselves lost in the Wood of Neuropsychiatry. Anxiously they look for a way out; and although that way is clearly marked “Psychosomatic Unity,” they do not see it.

Permit me to illustrate this point: In days gone by Psychiatry held the wise belief that masturbation led to insanity. Today, however, if one were to write on this subject Neuropsychiatry would at once accuse the writer of attempting to reinforce, or to resurrect an old illusion. Present day Psychiatry suggests that if the individual so inclined performs his ‘rites’ openly and without fear, no harm will result from the practise of masturbation. Subject to extreme moderation, my knowledge of psychological medicine places me in entire agreement. But, as I have said elsewhere, the student, on entering the domain of Psychological Medicine, will soon ask himself what the word ‘neurasthenia’ is doing there. Knowing that it means ‘weakness of the nervous system,’ he will conclude that it has broken loose from its moorings in the world of General Medicine, and is drifting aimlessly in the world of Psychological Medicine. In time, however, he will come to realise that there can be no distinction between the ‘physical’ and the ‘mental’—that they are one and the same. The student will find that neurasthenia is a condition of nervous exhaustion in which, although the patient suffers from no definite disease, he becomes incapable of sustained exertion—that he suffers from a bodily and mental weakness without organic content. It is therefore, not unnatural to suppose, nor indeed, difficult to see that the individual who wastes his substance in such riotous living, must degenerate bodily and mentally. 121

Each such loss of bodily strength automatically applies tension to the mind; or, if you will, to the nervous system; so that such works performed ad lib must inevitably produce in the masturbator all the symptoms of neurasthenia; and neurasthenia is quite clearly a mental disorder having as its characteristics physical weakness, irritation, impatience, instability of purpose and lack of effort—all without organic content! “Cecil,” of whom I made a considerable study during my stay at Blankville Asylum, was a fine example. One could well imagine that he had masturbated ceaselessly since adolescence; and I understand that he has done so twice daily in the asylum. One therefore concludes that instead of the grey matter that forms the brain of normal people, his must be formed with so much ‘saps.’ It is with these things in mind that I have suggested sexual intercourse by men over fifty years as one of the causes of insanity in their offspring.

Further, I have in mind not so much the temperate individual, but he who ‘lives’ on intercourse, and whose accompanying behaviour and thought must be on a par.   XIII.   In his remarkable book, “Our Threatened Values,” Victor Gollancz writes these remarkable words: — “I am told that readers do not care for long quotations. Well, whether they care for them or not I am going to print a whole series. If you are sickened or surfeited by them, so much the better; fourteen million human beings had and have to endure these things, not merely read about them.” 122

Now, I am no Victor Gollancz, nor is Herbert Woodley my name; nevertheless, I am disposed to imitate this great humanitarian, by stating that whether you care for it or not, I am going to make, not a whole series, but a few quotations. If you are sickened, so much the better; more than 300,000 human beings stored in our archaic lunatic asylums are enduring these things. “LIFE IN A MENTAL HOSPITAL” “DEMAND FOR A NATIONAL ENQUIRY” “CALL FOR A CRUSADE” Thus the striking headlines of “Picture Post,” and here, a few quotations from that paper: — “Not all mental subjects are treated with consideration. Through the strain of war, I, unfortunately, was in a mental hospital, for five weeks in 1944. The patients there had served in various theatres of war; the attendants had in some cases, not been on a ship or out of England. Yet, I have seen some of these attendants, with my own eyes, subjecting patients to very harsh and unnecessary treatment, including punching hard in the stomach, smashing one backwards on a bed, pushing patients around, and taking comforts provided for the patients, for the use of the staff. F.J.M., Lower Edmonton, N.9. (Picture Post, 7th December, 1946).”

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“I broke my heart in a mental hospital—to think that in this England of mine, people had to work their lives away, and were given the most appalling filthy 123

food to eat!… I lay in the reception ward for a month, crawling through an illness not mental but physical, not even knowing that I had been certified insane and threatened with forcible feeding because I could not (not would not) eat solid food. My personal advice to anyone would be, ‘Avoid a mental hospital like a pestilence, for it is a living hell for anyone with the average intelligence’… I behaved myself and walked about for two months in agony, outwardly calm, inwardly furious at the injustice of it all. That one man has the power, if you lose your temper, to put you in a padded cell or into a villa with abnormal people, is just beyond my comprehension. I wish to God I had been the insane person they thought I was; then I wouldn’t be haunted with the things I should never have seen or known… That’s what a mental hospital did for me… Mrs. T., East Finchley, N.2. (Picture Post, 14th December, 1946).”

─────────────── “At the present time, after a total war of 6 years, there must be numbers of people suffering from various forms of mental illness; and while widespread sympathy goes out to those physically wounded and maimed, those who have been less obviously wounded in the service of their country—mentally wounded—get far less sympathy. Although it is probably true that mental illness is a far more terrible ordeal for a person than almost any other form of illness, traditional ways of thought and behaviour still make ‘madness’ a subject which few can discuss in an objective manner. Many people are inclined to treat it with the furtive snigger that some schoolboys treat sex. And while we have learnt to talk openly about sex, politics, economics and money, as regards mental illness 124 and hospitals we still have many of the taboos of the early Victorians… Surely here is a crusade that can unite men and women of goodwill in all political parties and classes, that Britain shall be second to none in the treatment and cure of mental disease, and that all in need should be able to get the best possible help and attention; for there are few things more defenceless and helpless in this world than the certifiably insane, or the temporarily deranged. While the

community must be protected if neurotics are dangerous, neurotics also need protection from lack of knowledge, and sympathy on the part of the public, or more likely, their relations. Were we to obey the injunction of, to my mind, the greatest prophet, the greatest economist and psychologist, the greatest Jew, the world has ever known, namely, ‘Thou shalt love thy neighbour as thyself,’ there would be no need for class hatreds, revolutions, atom bombs, or the housing of their human casualties in mental hospitals. Let us hope that in a hundred years our grand-children will look back at the way we treated the mentally ill, with the same amused horror with which we read in Charles Dickens of the Scrooges, the Squeerses and Dotheboy institutions, amazed that human beings could behave towards their fellow-men in a way so cruel, so callous, so unthinking, and, above all, so stupid. The Hon. Anthony Strachey, Travellers Club, S.W.l. (Picture Post, 14th December, 1946).”

XIV.   Having, to the best of my ability, given the reader an introduction to Mental Disorder, and the various paths it 125

follows, and having herein and elsewhere made certain charges against Psychological Medicine, I have thought well to produce here not only a further illustration of insanity, but some evidence in support of my charges. After I had left the asylum, I occasionally wrote to some of the inmates— to cheer them up. Sometimes, I sent them writing paper and cigarettes; and whenever I wrote I invariably suggested to them that life outside was difficult —that the war, with its Points and Coupons made life one long struggle, so that those I had left behind ought not to worry unduly. After all, the asylum was not such a bad place; besides, they were relieved of all the worries and troubles I was now experiencing. I told them that there were times when I wished myself back amongst them—times when I looked back upon my sojourn with them as a badly-needed rest—as a holiday in fact. Hence the wording of the following letter, which is representative of the many I have received. It is written by an M.A., B.Sc. Formerly a schoolmaster, he has been in the asylum fifteen years: —

“The Asylum,                  Blankville.       5th May, 1945.           Dear Mr. Woodley, Thank you for your nice letter. It reminds me of the days when I used to hammer out some of my communications on a typewriter. But what on earth inspired you—or rather, I take it to be, who prompted you to send me the writing pad, envelopes and cigarettes? Thanks, welcome and all that kind of thing. Cela va sans dire. Only I find the receipt of such favours being entirely unmerited and undeserved as being just in the minutest degree, well, shall we say, embarrassing? I can only express the hope that whoever put you up to it—and I’m 126 sure somebody did—had at least the decency to pay you for them. But if your experience of the state of spiritual grace of the people who run these things in any way resembles mine I fear the hope is a slender one. Since I got myself into my present mess I have been put to endless bother and some expense, and been robbed many times; but damn me if this isn’t the first time I ever got something for nothing. Let it go at that. I do hope I have not slipped and caused any offence by saying the wrong thing. I have merely endeavoured to deal with the matter in such a fashion as seems to me best. No, I don’t go into Blankville quite so much as I used to do; partly because I am tired of the place, partly because the only way in which I can get a change is by altering my habits, and partly because I have had so much bother lately that I find it necessary to conserve my energies by cutting out all needless running about. Your remarks as to the advantages of being here are, no doubt, valid up to a point; but I am afraid the consolations of philosophy prove in practice somewhat pallid and unsatisfactory. I don’t think Willie is keeping so well as he used to be. He gets his meals in the sick ward now, but otherwise his habits are unchanged. Cecil is here again, as you say. Always seems to be in some kind of trouble or hot and bothered about something. It really is a pity for him. I’m afraid he’s not made to be even reasonably contented anywhere. Got out, and wouldn’t stay. The war and the change in money values has struck him rather badly I think. But apart from that, he makes most of his own bothers. The matron came through one day and didn’t happen to notice him—

he wanted an explanation. She said she hadn’t noticed him. “Well,” he said, “you should keep your eyes open!” 127 We have a Mr. _______ with us whom I don’t think you knew. Apart from that things are pretty much the same as they were. Finally, don’t start thinking you’d like to retire from the turmoil of the world into some place of this kind. It might be all right for a year or eighteen months, but after that you’d wish to hell you were out again. Yours sincerely,                                       ___________________”          

The perusal of this letter again gives proof that the insane are by no means ‘raving madmen’; and whilst the lay reader may view it as a somewhat amusing epistle, the psychiatrist will observe in this unconscious confession the classic example of insanity; for he and I look helplessly on as we witness the grim and awful struggle of Intelligence against the Demon of Insanity. The Demon laughs at the writhings of his victim—he laughs because there is neither escape nor reprieve; for paranoia and paraphrenia are highly progressive diseases; so that the longer the afflicted one lives, the more hopeless does his case become; and if it strikes you as passing strange that one so intelligent should be certified and confined in an asylum, I would point you to the ‘logic,’ ‘method’ and ‘suspicion’ of the paranoiac, so clearly displayed in the letter. It is by way of contrast, and to offer evidence to support my statements that I append a copy of a letter from a London lady, who managed to reach me through my publishers: — “London, N.W.3.                              13th July, 1947.           Dear Mr. Woodley, I trust you will not mind an ‘unknown’ writing to you, but I have just read a review of your new book, which has interested me greatly. I have not read your 128

book, and I hope you will not misunderstand me when I say I do not intend to; my reason is that I could not bear to read of the sufferings of a fellow human being in those circumstances. You see, I had the same experience as you. From the brief review of your book I did not learn (and indeed, this may not form any part of it) the way in which you managed to get into your asylum. In my case, it was just a sharp trick which I did not see until the trap had closed behind me. Briefly, in June, 1939, I had reason to complain to the police about something which was troubling me at the address where I was then staying. I was then working as Assistant Company Secretary, and had a responsible position. I had no friends, and was living alone in a ‘bed-sitter.’ I had already complained to them twice before, but they obviously regarded my complaint as not worth bothering about, and I received no help from them. On this third occasion, being properly disgusted and indignant, I was determined to make these lazy officers do something; for, after all, are they not paid by public money to look after members of the public? Of course, now I know that only a corpse can have the effect of making them realise that something must be done. I therefore stated my case to the disinterested police officer; and he asked me whether (as the police doctor whom they had recommended was not available) I would like to see the police surgeon. I said “Yes,” so the police surgeon was called. I gave him a few brief details, and he said that before the police could take any action they must have medical evidence; and therefore suggested that I should go into an ordinary London hospital for medical examination—for a few days. I agreed to do this, quite voluntarily, it appearing to me to be the best thing to do. This was on a Thursday 129 evening in June, and I had, of course, been at my work as usual on that morning. There was nothing whatever wrong with me in any sense, and I anticipated that, after this medical examination, and the few days entailed, I would be able to return to my job on Monday morning. I therefore, in all innocence, entered St._____’s hospital. The following day, after waiting for my medical examination, which did not take place, I was told that I was to go to another hospital. I did not question this decision, as I thought that perhaps the bed was required at St._____’s. However, in the ambulance besides myself was another woman, obviously very poor, illiterate and below normal intelligence. With her was a man attendant, and on hearing their conversation I became suspicious and alarmed. This man was making arrangements with this poor woman for the disposal of her possessions, as she was evidently ‘going into the country for a nice long rest!’ I began to wish I had not agreed to go

into St._____’s hospital. I decided to wait till I got to this next hospital, and then get my clothes and go home. There, I was ushered into a low-ceilinged room, with what looked like outsized cots in it. I thought at first that this must be the special hospital for women which, I was told, was St. P_____ hospital. However, I cannot by any means endorse what you say with regard to nurses and doctors. These, in my experience, were, as far as the attendants were concerned, mere ruffians, and those in charge—the sisters and doctors—were cold, haughty, supercilious devils, without a spark of humanity or understanding beneath their stiff starched exteriors. Needless to say, I found myself in an L.C.C. mental institution, although at first I thought I had been flung into prison, which, as I later found, would have been infinitely preferable; for there at least, one could have 130 some sort of reasonable communication. After being pushed and pulled about by the ruffians in question, I was dumped into a bed, and at about 7.0 o’clock, after every vestige of personal possession had been taken from me—including the grips from my hair, I was told to remove my denture. This I resolutely refused to do, whereupon I was set upon by half a dozen of these ruffians, hauled out of bed, rushed down the corridor and into a padded cell! So that, the day before having been calmly at my books, I now found myself being treated like a bloody lunatic. I realised with horror the awful predicament in which I found myself; and for the first time in my life I knew fear. My one thought was how to escape from this captivity. I had no friends, and knew that no appeal to distant relatives, who cared little about me, would have any result. Now, where in the name of humanity is the justification for men and women who are supposed to be expert psychologists, behaving in this way towards any woman? As an ordinary lay person, I think that the average man would never treat an animal in such a way, far less a human being. But there, it is only in the ranks of the ordinary men and women where we can expect that blessing of common-sense. Of course, I demanded my freedom, and of course, it was refused. I demanded to see the matron, and was told there was none. I asked to see the sister, and was informed that she was on holiday. They told me I would be able to see a doctor in the morning. A madhouse all right! I saw this starched female as predicted, and to my appeals all she would say was, “You’ll see the Justice of the Peace on Monday morning.” So I was left. Oh

hell, never will anything again have power to agonise as those weeks of waiting, waiting, waiting, in suspense— 131 my fate unknown, my freedom, most precious gift of life, lost behind locked doors and bolted windows. On the Monday morning, dressed in pauper hospital clothes, my hair falling around my face, I went, accompanied by stiff, starched, smart females to see this Justice of the Peace. I had asked to be represented by a solicitor, for whom I had offered to pay; but this was refused, and I had no one to speak in my defence. Seeing this side of our much vaunted British Justice, and the array of talent opposed to me—men and women, none of whom had said more than half a dozen words to me, and none of whom had talked to me, I determined to be my own advocate. Surely, I thought, if these men and women are honest they must in fairness admit that there is nothing wrong with my mental state. Well, I said my say. I pleaded for my release, and the J.P. sitting before me wrote. I did not know what was the nature of the ceremony I was attending. A Court? Had a charge been made against me? Innocent? Or had I been found guilty? What was to be my punishment for this unknown crime? I was told nothing. The next day passed, and the next and the next. Still there was no word of going out. The suspense and anxiety were cruel. What was to happen about my job? On the following Saturday morning, to my surprise and delight, my clothes were brought and I was told to dress. My own clothes once more. A triumph for British Justice, which although having erred in the first place, was now on the point of making honourable amends. My fingers shook as I fastened my garments; but, I conjectured, within an hour or so I would be back in my own little room, and then back at my job on Monday morning. A week later than I had intended, certainly, but I hoped I would be able to explain that. I wondered 132 if I would receive an apology for the humiliation and inconvenience I had suffered. Anyway, I felt so glad to get out that I had determined to accept such an apology and get away from the whole poisonous atmosphere as quickly as I could. An attendant came, and led me to the door, which was unlocked for me and then locked again behind me. There, outside stood another ambulance. My heart stood still! Yes, I was to get into it. Where was I being sent. To another L.C.C. institution in the

country, at C_____, Surrey. I got in mechanically, seeing and hearing nothing, and at that moment, something within me died; and this has changed and spoilt my whole life. The ambulance rolled up the drive, and I got down, no longer a woman, but a mere mechanical walking, breathing bit of flesh and blood. I realised that all my pleading had been hopeless from the start and that my doom was sealed from that time when I heard the words spoken to the woman in the first ambulance. A ‘long rest in the country,’ and here it was. The torment of the damned. I believe some attempt was made to give me food of a better kind—fried fish, to be eaten with a spoon, for instance; but I did not want food for my physical body, when my soul was so outraged. As is stated in the review of your book, I too found the society of these certified people very hard to contend with. One could not rely upon anything they said, so ordinary conversation became impossible, and I became shut up in myself. I had an occasional word with an attendant, but for the rest, night and day, I was locked in a room with about sixty mentally deranged women, in all stages of mental affliction, from completely imbecile to the milder types. There were fights and brawls to get used to, and all the other miserable 133 accompaniments of institution life. To sit at a table for food with three other women, one of whom would burst out laughing for no apparent reason, another who would be swearing and talking to herself and to a non-existent friend, and a third who kept jumping up and down, and leaving the table on various pretexts of her own devising. Food in such surroundings and in such conditions—Why, it stuck in one’s gullet, and threatened to choke one. Every night I prayed most fervently that I might not open my eyes to another day. But daylight would come, with another sickening day to get through somehow. The head of this establishment told me, shortly after I had arrived here—no doubt because of my frequent lamentations—that they didn’t want me here. He suggested that the only way of escape was to get my parents (who lived 300 miles away) to apply for my release. This, I at first refused to do, because I had entered the hospital voluntarily, and therefore considered that I should also come out voluntarily. However, I saw that if I declined to do this, I was destined to spend the remainder of my life in the institution. I therefore made the application, and, when all the necessary regulations had been complied with, I was duly set at liberty. As a further example of the perfidy of the doctors with whom I had the misfortune to come into

contact, there was a youngish one at C_____ who had the audacity to suggest to me that I had had a nervous breakdown. I told him, with much spirit, that he was lying —that I had not had a breakdown, and that I had no intention of having one; and further, that if he was trying to find an excuse on which to hang the mistake which they had made, he was doomed to disappointment; for it was my intention to sue the authorities as soon as I regained my freedom. They knew there was no mental 134 instability which any doctor could suggest, and this excuse seemed, I suppose, a good one from their point of view. I had, by the way, been refused independent medical opinion, although I had offered to pay for this—in the same way as I had been refused legal aid. My mother was asked to make a journey of 600 miles, for the purpose of extracting me from my predicament; and I need not enlarge upon the theme of relatives’ opinions on such matters regarding people who ‘disgrace’ themselves and their relatives by getting into mental hospitals. My empty purse was returned to me —my money being returned subsequently—on application. As I was forced to return to my parents’ home, my own room having been given up for me, I had, into the bargain, lost my job. I was liberated in August, 1939—exactly eight weeks from the day of my incarceration. I took a fort-night’s holiday in the North, to try to get over my ghastly experience, and then returned to London to look for work. My holiday in the North had sadly depleted my meagre savings, and I found myself in August, 1939, with no job, and my sole wealth amounting to £2 plus a few shillings. I was beginning to wonder what people did when they had no money to pay for their rooms, when fortunately, I got a job as a Civil Service Short-hand Typist, in which I remained for most of the war years. I therefore began to save as rapidly as I could; and I worked night duty, Sunday shifts and extra turns to augment my £2, so that I could bring an action against the Police or the L.C.C. or whoever was responsible for such a travesty of justice and violation of human rights. By Easter, 1940, I had about £20 saved, which I considered sufficient to enable me to consult a solicitor about the action which would enable me to restore my 135 peace of mind. But to my utter dismay the solicitor informed me that no action could be taken, as more than six months had elapsed (actually six months and a

fort-night). Since that time I have tried every means in my power to get this stigma removed, but of course, without the law, the authorities are prepared to sit tight. What is the complete ruination of one life to them, against the scandal of having to pay for their mistakes? These wreckers of human life and happiness! I endorse all you say of the hopeless, helpless feeling such an experience leaves behind. In my own case, my struggles over fifteen years (I was 29 when the incident referred to occurred), to make some progress with my career were swept away and brought to nought, as if they had never been—all within the space of a few weeks—by individuals who did not know me, and who had spoken to me for only five minutes. This terrible blight struck me down and wrought havoc at a time when any woman in a civilised country should be going about her affairs and pleasures without necessity for fear and hatred. But this, it seems to me now, is the one final answer to anyone having the temerity to complain in official quarters of malpractices which the whole of one’s being revolts at as being contrary to decency and justice. It is the one way of enforcing silence which the victim has no power to contradict or repudiate; so that I smile when I read the papers and see people who have committed some offence, being remanded for medical report. A very cheap and easy way out of a difficulty against which there is no answer. At the moment, I am making my plans to emigrate. The thought of remaining in a country which has done so much damage to me makes me feel sick. I hope soon 136

 

to shake the dust of this worthless country from my feet for ever, and adopt a new country as my own, where the name ‘British’ will not stink in my nostrils. I must apologise for the length of this letter, but I thought you might be interested to know of a fellow human who has suffered a similar experience to your own. I, fortunately, like yourself, am not inarticulate, but what of others, who, not being ready of tongue or pen, can even do less to obtain justice? What becomes of them? And, incidentally, what would have become of me if my parents had refused to come to my rescue? Would I have remained in that charnel-house of decayed bodies and diseased minds? Yours faithfully,                                           ________________(Miss).”          

How wise is my correspondent when she declines to endorse what I have said concerning nurses and doctors. I am wise also; for I was aware that if I had told the whole truth in my book CERTIFIED, nobody would have believed it, so that by doing so I would have defeated my object in writing the book. Wisdom tells me that here I must confine myself to pointing out the element of frustration—the ill-treatment and invitation to antagonism so clearly displayed in this letter. How vividly my own words now appear before me. How suddenly the veil is drawn, so that memory unfolds the beastly scene in all its grimness and horror. How brightly the words of this unfortunate lady illumine the darkness of our archaic Mental Health Services. So vivid and bright that once again I see that bathroom with its broken screen—the great splashings on the wall— the blood on that bath, and the very denial of my existence… You will forgive me if I ask to be excused from 137

commenting upon the mental state of my correspondent. Not only would such a step be out of place, but experience tells me that despite her intelligence and her ability to express herself so well, it remains possible that when she sought the aid of the police she may have been suffering from hallucinations, or illusions; and this I say so that I might continue to write without prejudice; for a prejudiced thing is a lie. Whether or not this lady was suffering from paranoia at that time, and whether she is still its victim does not concern us here. What does concern us is the manner of her treatment; for sane or insane, she was treated unjustly. She asked for independent medical opinion, and it was refused. Likewise was legal aid denied her.

Every reputable psychiatrist will readily agree that my correspondent’s letter gives a true and unexaggerated description of her treatment—that during the eight weeks of her confinement she was fully aware of the treatment meted out to her. This being so, I would now take you back to Psychiatrist B. who wrote, “I recognise and appreciate that conditions vary and differ from one mental hospital to another, and that some places are managed and controlled better than others, and that where modem conditions prevail people are not subject to be mixed in with others whose condition gives rise to concern and anxiety… I realise that the pictures drawn are real pictures which, unfortunately, do make mental hospital conditions extremely difficult for those who are sensitive and appreciative of the conditions under which they are living.” It is because the majority of our insane are very sensitive and appreciative of the conditions under which they live, that we are left with the question, “Where in God’s name do modern conditions prevail?” We know that British Justice is rightly the pride of the world. We are aware that it does not stink in anybody’s 138

nostrils, and it never will. We therefore readily forgive this lady, who, because of her great distress, makes this statement; and whether he likes it or not, the reader must join me in forgiving the Justice of the Peace referred to; for his knowledge of Law, and his conception of Justice are both obliterated by his fear and ignorance of mental illness. In like manner shall we forgive the doctors and nurses for their indifference and neglect; for they too, are victims of ignorance and fear. But, never can we forgive Psychiatry, for it ought to know better. Can Psychiatry offer the slightest reason as to why this lady’s pleas were ignored? Can it offer any reason why it should ignore such pleas, even though made by the insane? Is not Psychiatry’s objective to case the minds of the mentally ill? And is it not a grave indictment of Psychological Medicine that it should ever be deemed necessary to remove dentures by such drastic means? In very rare instances it may be deemed wise to remove dentures and spectacles from potential suicides. Even so, is it not abundantly clear that by the use of an hypnotic the doctor could induce sound sleep, during which he could remove such dentures with dignity? Such a humane system would at once dispense with the need for ‘ruffians’ and padded cells. If such treatment is part of our Mental Health Services, how shall we ‘cure’ insanity; and how shall we remove from mental disorder that fear and horror which seems in

danger of checkmating Psychiatry? There can be only one approach to the problem of mental illness, and that, the Human Approach. There is no substitute. Gentlemen of Psychiatry, what a letter! Any magazine editor would gladly pay a good price for it as a first-class thriller. What a time! What civilisation, Gentlemen! This is neither the time nor the place to speculate on the State and some of its archaic laws which makes a thing so 139

wrong possible in our mental hospitals as they are constituted today; but rather should we dwell for a moment on these horrors perpetrated in the name of Psychiatry. How true, indeed, is a broken leg nothing in comparison with a broken mind; and prison a home from home when compared with life in a mental hospital. Vaguely, the people talk of “The Commissioners.” More vaguely, of “The Board of Control.” To what purpose, when, in the Twentieth Century of civilisation we remain indifferent to the awful state of things as they are— when we remain unmoved on hearing that a refined young lady who rightly declines to part with her denture, is rushed into a padded cell. What is the use of talking of Right and Wrong—of Justice and of Christianity, when we care not a jot concerning the fate of a young lady who has been deprived of her hair grips—whose hair is falling about her face, and whose fingers tremble as she fastens her garments? To hell with such laws, and up with Humanity. On with the Crusade that shall unite men and women of goodwill in all political parties and in all classes, so that not only shall Britain be second to none, but above all others in the treatment of her mentally ill. Let us be above all others, as Humanity is above all Nations; and then, not in a hundred years—not in fifty, but in a few, shall we look back in amused horror to these pictures I have drawn of our Mental Health Services as they stand today.   XV.   Is it not interesting, ladies and gentlemen, to find that five years after I had written the book CERTIFIED, the press and the patients from mental hospitals should testify to the truth of what I have written? Is it not amazing that 140

Psychiatrist B. should write me and say that my pictures are real pictures, which, unfortunately, do make mental hospital conditions extremely difficult? Is it not appalling that we should know of these things, and yet, do nothing towards a remedy? Gentlemen of Psychiatry, it is up to you—the ball is at your feet. Aim for Prevention—by instituting in all our villages and towns clinics for mothers and children—by seeing that observation wards are attached to all our general hospitals. Cry aloud for a Chair of Psychiatry to be instituted in all our Universities. Fight, so that funds may be forthcoming to enable our grand army of research workers to find the solution of our problem. See that all responsible doctors in all our mental hospitals hold the Diploma in Psychological Medicine, without which they can never become psychiatrists; and after all, it is psychiatrists, not doctors, that is our urgent need. Put Psychological Medicine first in all our Medical Schools, and see that our Licensed Houses are closed for ever; for Section 13, of the Act of 1866, when granting the use of these private nursing homes for the mentally afflicted, placed their owners in jeopardy. Let us place our mentally ill into the wards of our hospitals, where they can be seen and heard, lest another Cronin arise, and another Citadel be published. Enlist the aid of your M.P. Tell the children the truth; and above all, let no man say to another, “The people have a great fear of mental illness and of everything associated therewith; wherefore do thou nothing to exaggerate that fear—lest ye distress the people.”

Instead, let us make the subject common property. Let us away with pretence and modesty, and proceed to a study of the causes underlying all insanities—by gazing long and 141

ardently at the penis and the vagina, so that we may grow to understand these Emblems of Insanity. Meanwhile, whilst we await the cure that will surely follow, let us not ill-treat our mentally ill—let us not ignore their very existence when they wish to speak to us; but rather let us install radio in every ward, and so parry the demoralising thought that our insane are completely shut off from the outside world. Above all, let us see that Occupational Therapy is the outstanding feature of our asylums; for as the idle dog worries the sheep, so do the morbid imaginations of the insane mind worry the mentally ill.

Gentlemen of Psychiatry, I come to you from one of our most primitive asylums. Back from the dead I come, to offer this unprejudiced criticism; and if this cause were not my very own, yet would I come to you on behalf of those who remain sealed behind locked doors and barred windows; for I still see the faces of that strange community in which I so unexpectedly found myself. I shall always see them; and I shall recall their love for me. Love, because I listened to their pleas. Love, because I gave them sympathy. Love, because I did not deny their existence, but recognised in such dribbling caricatures, human beings who had fallen on a hard bit of way. Love? Nay, Obeisance; for they looked upon me as a god, placed me upon a pedestal, presented me with the Freedom of their Miserable City, and obeyed my commands…   XVI.   On the 24th July, 1947, I sat in my garden—thinking… I thought of Mental Disorder which has been known to us since the earliest days, and realised that its development as a scientific study has been lamentably slow, not because of the inherent complexities of the subject, but because of 142

professional apathy and public prejudice. I could also see that it was being set back by lack of funds and lack of interest in its research departments. And then, I gazed back upon its early Statutes and saw that the early terminology employed spoke of the religious and superstitious beliefs of the time. I could see that although its terminology had changed, superstition, apathy and prejudice remained with us. It was evident to me that whilst the lunacy laws were designed primarily to protect the ‘lunatic’ and his property, they had failed to protect the sane and their property; for whilst on the one hand the lunacy laws state that no person may be detained as a lunatic except upon two medical certificates and an Order by the Court, they have omitted to state that these certificates must be rendered by qualified persons, i.e., by those in possession of the Diploma of Psychological Medicine, and by those only. And as I sat there, I saw a vision of a fair lady—a young lady of culture and extreme intelligence. She was struggling on an asylum bed, and some attendants were wrestling with her in an endeavour to take away her denture; and because she resolutely refused to part with it, I saw her rushed along the asylum corridor and flung into a padded cell, there to weep and to wonder at the way of life. I watched the bitter tears she shed. So great was her

astonishment at the way of life in the Twentieth Century that she was bereft of speech. And when I thought of Section 15 of the Lunacy Law, I saw it as a boomerang cast forth in 1862, only now to return with added force to strike Psychiatry on the head. I gazed at this girl, and saw that she had no champion —that never would she know championship. Her hands trembled as she fastened her garments; so that I thanked God for the dead, realised that the State had sinned whilst Psychiatry had slept—and I wept… It was on the same day, in the same garden, that I 143

opened the following letter. It came to me from an M.D., D.P.M. A great man, and a great Lecturer in Psychological Medicine—a great and humane superintendent of our most progressive mental hospital: — “22nd July, 1947.           Dear Mr. Woodley, Very many thanks for the complimentary copy of CERTIFIED, which I have re-read with pleasure. You will be interested to hear that on the morning of the 11th July, before I had seen Harold Nicolson’s review, the latter was quoted at a very full meeting of the Royal Medico-Psychological Association (at their Annual Session at Eastbourne), by Dr. Rees Thomas, a Senior Commissioner of the Board of Control, and next year’s President of the R.M.P.A. He pointed out the outstanding impressions of our mental hospitals left on the Author’s mind, as told by the reviewer, and drew the attention of the assembled members to tire need for changes in many respects, including the important one of classification. So you will see that your efforts will bear fruit, in time. I shall be very happy to receive copies of SYNTHETIC MANIA and THAT WHICH IS CAESAR’S when they are published, and I know I will take pleasure in rereading them. I wish you every luck with them and hope they will repay you financially as well as morally and socially for all the work and effort you have put into them.”

And whilst I renewed my thought that the State had sinned whilst Psychiatry had slept, I thanked God for the living, and knew much joy… It was a few days later that I received yet another letter; and this is what it said: — 144

“The Board of Control,                     32, Rutland Gate,                       Knightsbridge,                    London, S.W.7.           30th July, 1947.                      Dear Mr. Woodley, At the time I spoke about the review by Harold Nicolson of your book CERTIFIED, I had not read it, but I found it very interesting; and I shall certainly read any subsequent volumes you produce. For my part I can assure you that I am happy to hear any criticisms of the hospital system. It is only thus that we can be brought face to face with problems, the solution of which sometimes eludes us. Social reactions, after all, determine social welfare activities, and it is in this sense that I am very happy to hear that you are putting your point of view. Very sincerely yours, W. Rees-Thomas.”          

This letter, together with the interest displayed at the Annual Session of the R.M.P.A. says much for the great value of persons like Dr. Rees-Thomas; and it is indeed gratifying to know of such individuals whose hearts are in this business—who continue to strive against great odds, for the betterment of the lot of the insane. In Knightsbridge the other day, I had the pleasure of meeting Dr. Rees-Thomas, and was deeply impressed by his sincerity and his keen desire and determination to do all in his power to rectify the defects in our Mental Health Services. There are others too; and it gave me much pleasure to meet in Wimpole Street a day later, a very great man whose efforts are worthy of much praise. These are right men in the right places; and what we so sorely need is many more—more great men 145

and fewer heavily and falsely buttressed reputations. I must confess however, that it seems to me strange that we should talk of “problems, the solution of which sometimes eludes us.” A recent letter from the medical superintendent of ‘my’ asylum contained the same expression. I can only think that if Psychiatry as a whole would look upon those left to its care as human beings, many such problems would solve themselves.   XVII.

  My garden … morbidly, a Garden of Gethsemane, where I sit and rue the crimes that are committed, and which will continue until society forbids it… In that garden I am sometimes worried by the letters which reach me from places as far apart as Ipswich and the U.S.A.—Australia and Plymouth, and Chelsea and South Africa. Let me show you three of these letters: — “London, S.W.5.              Dear Mr. Woodley, I have been reading your book CERTIFIED, and am looking forward to the next one. I have found your book intensely interesting, if very saddening, and am wondering if there is anything at all which I, an elderly but still hard-working spinster can do as a member of society to help in the problem of the mentally afflicted. Although there is no hereditary pre-disposition to insanity in my own family, I have always had great sympathy with those who are less fortunate, and, about a year ago, was much distressed that a kind old friend of mine should have been certified at the wish of her sister, and should very 146 shortly afterwards have died in ‘hospital.’ I had previously done all I could to discourage the idea of certification, which I considered quite unnecessary (as had the patient’s own doctor); but I had no legal status, so what could I do? Of course, I entirely agree that medical examination should be compulsory before marriage is sanctioned, but, supposing that this could be made law, would it prevent the mentally deficient in all their varying grades from propagating their kind? Hope springs eternal; and I have known quite intelligent men, including doctors, to many into families well-known to have a mental or T.B. taint… I don’t want to pass by on the other side, but what can I do while fully occupied in earning my own living and doing my best for those at hand in these days of food shortage and underfed youngsters?”

“From the Rev. _______           South Africa.           Dear Mr. Woodley, I am looking forward to reading CERTIFIED, as I was nearly five years in a place here—a government affair having 1,300 patients of every kind and colour. I went in on my own with anxiety neurosis; but conditions were so hellish that I got worse, and after about two years they thought the best thing to do was to certify me! Believe me, I suffered all they had to give, and saw everything and more that H. G. Wells describes in one of his books—forcible feeding thrown in. As a result (according to official records), I lost sixty pounds in weight. Luckily, I am a powerful six-footer of 200lbs., so could stand going down to 140lbs. But it was hell!! 147 Wells is accurate in all details… I saw that all… What made things worse was the fact that the whole staff were Boers, and their language Afrikaans; and did they take it out of the Imperial troops when many scores of them were off-loaded from Durban to this asylum with war neuroses!!! I lived with that for two years; but I am omitting this from my book. Many of the things I saw and suffered were unspeakable … they were horrible… My own little book is dispassionate, and a well-known novelist in England has praised it highly, although she slaps it for certain things; so I am re-writing it, after which, I shall send it to you to read. I do not think you will waste your time reading it… I am well acquainted with the psychological side of things, as I was one of Sir Cyril Burt’s students when he was a demonstrator at Liverpool University in 1909. Years later, I studied psychoanalysis under a colleague of Crighton Miller’s. All this helped me enormously; so that I was able to turn fear into interest. But I am puzzled on one question—the possibility of a cure for the genuine psychotic. The neurotic, we know, is a fairly easy job; but the paranoiac—what about him? Phyllis Bottome tells me that he can be cured. She is, of course, a great admirer of Adler who, she says, claims this. I have never seen such a thing… I saw shock treatment—at close range, and found it to be worse than useless… I have retired from the Ministry—thank God, and now live in a pretty little village a hundred miles from _______. After terrific law business I have recovered

a small income and live in the cheapest place in the world. We who have been in Hell have things in common, 148 so I hope to hear from you…                                                                       Yours sincerely, (Rev.)______________”

… A Gethsemane whence I look across the seas to an erstwhile disciple of Christ writing from his Hill of Calvary … a hundred miles from _____, and countless millions from his one time God. Poor devil! Like insanity, certification respects neither parsons nor persons; the criminal, the sexually perverted, the Holy man and I, are but grist to its mill… Sitting there in profound soliloquy, I thought I would like to tell the reverend gentleman that all was going to be well—that I had made friends with the eminent ones, and that they were behind me solidly… I then recalled Fritz—the German P. o. W. who had interested me during my stay at Blankville Asylum. Fritz—not only removed from the world of the sane, but separated from his country of birth … and hero was the parson situated likewise… 1,300 patients of every kind and colour! What a cure for that type of hysteria Freud once misnamed anxiety neurosis! And those gallant ones who leapt from Afric’s shores to fight for the cause of Right and Justice. What of them? “And did they take it out of the Imperial troops when many scores of them were off-loaded from Durban, and sent to this asylum with war neuroses!!!” They did—in a manner that my correspondent begs to be excused from explaining. Verily, they came like water, and like wind they went. Is it not surprising that the government of South Africa should permit these things? Is it not astonishing that in England’s Green and Pleasant Land—in this country of the 149

‘free,’ we should stand by and witness the same, without rising in protest? Strange that he should mention Phyllis Bottome and Adler; for there was a time, when, owing to an injured wrist, I sought the services of a professional typist, to make some copies of the M.S. of CERTIFIED. She informed me that

she had typed for Phyllis Bottome and Alfred Adler—that after typing for the latter he had dropped dead in his Aberdeen hotel! Adler is dead; and more the pity, or I would have reminded him that throughout the history of psychological medicine, no man has ever been known to recover from paranoia—that when a cure is forthcoming for this diseased personality which offers the classical example of insanity, there will be no more mad; automatically will come the cure for all insanities… The parson is wise, and happy would he be to know that those who are greatest in the realm of psychological medicine, not only uphold my assertion, but my cause… “25th September, 1946.           Dear Mr. Woodley, I have just finished reading your book, “Certified”; and although realising you will have received many letters of appreciation, I hope you will accept my thanks, too. From personal experience, I can support your statements regarding the appalling easy manner in which persons can be sent, and admitted, to our mental hospitals—the difficulties so frequently experienced when the ‘patient’ is fit for discharge and his relatives or friends shirk their responsibilities; and lastly, the shocking conditions still— in 1947—existing in such hospitals, 150

particularly the way in which meals are served, and the lack of privacy (to say the least of it) in the bathrooms and lavatories. I am a State Registered Nurse, and was sent to a mental hospital following Shock Therapy, given by a psychiatrist, privately—who hoped to relieve depression following a serious abdominal operation. I was a private patient, and received great personal consideration from the medical superintendent, who, realising there had been ‘an error of judgment,’ discharged me after a stay of nine days only. As I was not a ‘bed patient,’ I had every opportunity of gaining insight into the daily routine of the hospital, and was frankly horrified. I do hope your book will bring these very urgently needed reforms to the notice of the appropriate authorities. I am sure that Shock Treatment is a menace, and should be forbidden… Yours sincerely,                                 ______________(Miss).”       

It is well known that temporary depression can, and frequently does, follow serious surgical operations. In such instances, Electric Convulsion Therapy, given with a good technique, is often beneficial. BUT, where experience and technique are wanting, the resultant damage, both physically and morally is appalling; so that in the great majority of cases E.C.T. stands for nothing more than a crime against the innocent—a cowardly and reckless attack against a naked and defenceless person… And so—my correspondent enters a lunatic asylum, where, fortunately, the damage rights itself, and where, more fortunately, the kindly superintendent sends her back to her rightful home… 151

Lucky Miss! I am lucky, too; for your loss in dignity is my gain in evidence of the “bad sociological results of Shock Therapy.” It was because of these things that the supporters of Dr. Winnicott declared themselves strongly against the practice of Electrical Shock Therapy … they declared themselves against a therapy which is so horrible, grotesque and diabolical when given by the inexperienced and unskilled doctors who comprise 90% of our ‘psychiatrists,’ that rather than again undergo such tortures, SIX individuals in one series alone, committed suicide… And yet, should we worry unduly as we continue to experiment thus upon our brothers and sisters? After all, they are but

lunatics presenting our opportunity; so let us assault them in their defencelessness… We therefore do so… We do so… Ah me! Today, I am mindful of the world famous lunatic and philosopher, Neitzsche; so that I can but say that the curiosity of the psychologist is great in me also—so great, that I regard it as quite a special privilege to have lived at the right time, and to have lived precisely among lunatics. I regard it as quite a special privilege that it was I, who, during my confinement as a dangerous certified lunatic, typed on this very typewriter, the operational instructions relating to the Solus Bini electrical shock apparatus—so that it might thereafter be used by unskilled operators… And it came to pass that the Solus Bini was brought into ‘play’; so that once again, I regard it as quite a special privilege that it was I who witnessed the ghastly and terrifying results of the first hundred ‘treatments’… That it was I, matters not. I still regard it as a special privilege to have lived at this time… LIVED, and to have typed those instructions… What did I type? What, I say… Five nurses will be required to hold the patient down… 152

One nurse will wash the patient’s forehead—leaving the temples moist… The electrodes will then be placed in position … the resistance of the patient in the circuit having been measured, start off at 70 volts. The doctor will glance around to see that all is in order, and then press the switch… If the voltage is insufficient, loss of consciousness will result, but not a convulsion. Such ‘subshocks’ however, are to be avoided; for too many produce cardiac irregularities, wherein the patient stops breathing and collapses … in which event, try 80 volts, and if this also fails to produce a convulsion, try 90 volts; but if this also fails, no further attempt should be made that day. On the next occasion you may try from 90 to 110 volts, till a convulsion does take place… Do not be over cautious, for the margin between the proper dose and the lethal dose is very wide. In the event of collapse, and if artificial respiration fails, the hand should be put into the patient’s mouth and the tongue and epiglottis drawn forward … the patient can then be put back to bed… One should not give up the possibility of treatment in the face of difficulties, but should see how they may be overcome. Risks, of course, should not be run which are incommensurate with the gains to be expected from success… And so—the patient is returned to his bed, where I will leave him; for I would ask you to spare me from sickening you with a picture of such lives after such ‘successful’ treatment. Let it suffice for me to remind you that

lethal means death, but, as I have pointed out, there are two forms of death— the dead one and the living one. E.C.T. minus experience and technique is the last named… And what of the other letter? A kind old friend certified at the wish of her sister… “What can I do to help?” What shall I answer her? 153

I will say, “Psychological Medicine has done this thing; and, inasmuch as you have accepted this state without protest, you too, have done this thing; and yet, it seems to me that reform cannot come from Psychological Medicine alone, but from the State also; for although medicals are excellent as individuals, collectively they are not only highly reactionary, but the oldest trades-union in the world; and in this matter of certification they have the most arbitrary powers in the whole community—powers which are yours and not theirs—powers which are tolerated solely because of your illusion of Witchcraft and Medicine Men—powers not infrequently abused. This reactionary body sails smoothly under your flag. Honest seamen individually, but pirates collectively; and as pirates they fear neither you nor me; but like all pirates they do fear the Law. Therefore, because the people are the government, and the government the people—because the Church is the people, and the people the Church, you have done this thing. Undo it now. Approach your M.P. and never leave him till he has brought about these necessary reforms. Certification must be abolished—for your protection. Christianity and God notwithstanding, we close our eyes to these things, and wallow in the selfishness which is the Taboo of Christianity. Comfortably we close our eyes to acts which no God worthy of the name would approve. How then, can your particular God countenance such deeds? ‘God knows, I’m no’ the thing I shou’d be, Nor am I even the thing I cou’d be, But twenty times, I rather wou’d be an Atheist clean, Than under gospel colours hid be just for a screen.’ ”

XVIII.   Gentlemen, I have stated the problems and offered 154

solutions; and as I bring this criticism to a close I cannot refrain from repeating that Electric Convulsion Therapy, unless used selectively and with a good technique, does more harm than good—that the same applies to Insulin Treatment. It seems to me therefore, that the only cures forthcoming in 95% of our mental hospitals are those related to cases arising from child-birth, the menopause and the climateric—cases which ought never to have reached a mental hospital, but which should have been remitted to the observation wards of our general hospitals. The great majority of other ‘cures’ are but bubbles that burst; for when we publish our Annual Figures as 115 Admissions, and 98 Discharges, deceive the public by withholding the terrible fact that of the 98 Discharges, 66 return to the asylum; indeed it was to make certain of these facts that I waited five years before publishing this book. These years have been spent not only in collecting evidence, but in drawing from eminent psychiatrists their admission of the truth of my statements; and having obtained this admission, I would repeat the adage that ‘statistics lie.’ Likewise do percentages lie—unless we first ascertain the number representing 100%. When we decide to balance our 100% by stating that 3% worsened, 24% showed no change, 53% improved and 20% recovered, we must start at the beginning—in the knowledge that 100% of the mental may well equal 1,000 patients; and that this total is made up of a score or so of different varieties of mental disorder. Of this score, we find perhaps only three varieties of disorder that can in any way be considered for treatment by Electric Convulsion Therapy. For example, of the schizophrenic variety only the depressed type could be considered; and whilst a convulsion may (or may not) temporarily relieve a catatoniac stupor, it will in all probability leave him deluded and hallucinated. Nor is E.C.T. suitable for depersonalisation, hysteria, anxiety neurosis, 155

obsessional neurosis and many other states. Our figure of 1,000 is therefore reduced to 125 cases to be considered as to their suitability for E.C.T. Medical examination finally reveals that of this 125, there are 61 ‘suitable’ for the treatment. It is, therefore, from this 61 out of the original 1,000 that the analysis is made—only to find that 75% of the ‘improved’ and ‘recovered’ relapse. Of the countless thousands who enter our lunatic asylums, 90% remain there to die.   XIX.

  That is all, Gentlemen—except perhaps, for a memory which clings about my being as the slain to their killer. It is the memory of a youth—a laddie of seventeen years. You may recall that I asked you to follow this boy from the Court at Norwich, and to pass with him through the portals of Broadmoor Criminal Lunatic Asylum; but you were afraid, so I went with him. Alone, we two crossed the threshold—not only because I am without your fear, but because I had been there before. Besides, in the course of 375 fearful days and restless nights, I exchanged my fear for contempt; so that willingly, indeed, morbidly, I went forward with that youth for whom the Thought has now become the Deed; and as I bade him farewell and kissed his soul, I wept; for I could well see that his was in no wise a ‘selected’ constitution. E.C.T. was not for him; for there was neither good technique, nor bad—technique was not; and even prefrontal lobotomy could play no part in his living death. And as I recalled the Pharisees and Herodians who once enquired as to the lawfulness of paying tribute to Caesar or to God, I realised just how deeply the State had sinned against society. I saw that great skill in medicine was not enough—that expert knowledge of law was 156

insufficient whilst the great essential of Imagination was lacking. Yes, indeed, and ironically, that- great gift that rules us in neuroses and is master in our dreams, was lacking. So I left him there. Him to dream whilst his senses were conscious, and I to dream whilst my senses were unconscious. Him to be sane in sleep, and I to be mad in my dreams.   XX.   Quo Vadimus? How opportune is this question recently addressed to you by him that is greatest among you—whose greatness is only surpassed by his modesty? Quo vadimus? Is it not time we called a halt and reorganised our ideas? Mark you well, my journey has not been without its toil and its troubles; for in very nakedness, and at some expense have I reached you—only to tell you that it is not a serious matter to publish a work which attacks so strongly entrenched a body as your good selves; indeed, on looking backward, I think it has been easy.

Come, you are of better fibre than I. Wherefore I leave you with my burden—which I here deposit at your feet; and although you may find it a more difficult matter to attack so strongly entrenched a body as the State, I wave you into the attack—and God speed; for it is absolutely essential that we render to Medicine the things that are Medicine’s, and to the State the things that are the State’s. Besides, Psychiatry must be expanded and expanded— because instability increases and increases. Go you therefore into the attack, if only that you might take from cancer and tuberculosis the attention of which they have hitherto robbed you. It is because I also hold “that in this modern world it is second only to murder to starve and cripple the mind of a child,” that I rejoice in the thought that the day draws 157

nigh when the Serpent-enemy and the Fall of man, together with Private Anatomy will be preserved with our other legends. Gentlemen, I beg of you to put back your commination service into the Book of Common Prayer, where alone it might avail; and in its stead, take up my quarrel with the foe, as, to you from failing hand I throw the Torch. Be yours to hold it high; for Look—a thousand Blossoms with the day Woke—and a thousand scatter’d into Clay; And this first Summer Month that brings the Rose Shall take the Insane and the Sane away.

END OF BOOK II.   H. G. WILKINS, Doune House, Edzell, Angus, January, 1948. 158