Iatrogenesis

In medicine, the term iatrogenesis refers to a condition in which symptoms or complications are themselves caused by attempted medical treatment or the conditions under which it is administered.

John Perceval, a member of a prominent English family and the son of a former Prime Minister, resigned a military commission in 1830, underwent a conversion to an unconventional Christian sect, and had a break-down while traveling in Scotland and Ireland. His older brother, then a Member of Parliament, took him back to England and had him locked away, against his will, in two private asylums, first in Bristol and then in Sussex. Here are a couple things that he had to say about what he observed during his confinement, as noted by Thomas Szasz in The Manufacture of Madness.

I will be bound to say that the greatest part of the violence that occurs in lunatic asylums is to be attributed to the conduct of those who are dealing with the disease, not to the disease itself; and that the behavior which is usually pointed out by the doctor to the visitors as the symptoms of the complaint for which the patient is confined, is generally more or less reasonable, and certainly a natural result, of that confinement, and its particular refinements in cruelty; for all have their select and exquisite moral and mental, if not bodily tortures.

— John Perceval, Perceval’s Narrative: A Patient’s Account of His Psychosis, 1830–1832. Edited by G. Bateson. Stanford, California: Stanford University Press, 1961. 114. Quoted in Thomas Szasz, The Manufacture of Madness. New York: Harper & Row, 1970. 129.

And:

But when the lunatic doctors say that the presence of friends is hurtful to lunatic patients, they are not aware of the fact—at any rate do not acknowledge it—that the violent emotions and disturbance of spirit, which takes place on their sudden meeting with them MAY arise from their being overcome by a sense of their relations’ conduct toward them, in neglecting and abandoning them to the care and control of strangers, and from the treatment of the doctors themselves. The doctors naturally do not acknowledge this, for if they are acting from stupidity, their pride refuses correction, and will not admit the suspicion of being wrong; if they are acting with duplicity and hypocrisy, they necessarily preserve their character, and cannot in consistency confess that there is any error on their part—who can expect it of them? You cannot gather grapes from thorns. Nevertheless, it is true.

— John Perceval, Perceval’s Narrative: A Patient’s Account of His Psychosis, 1830–1832. Edited by G. Bateson. Stanford, California: Stanford University Press, 1961. 218. Quoted in Thomas Szasz, The Manufacture of Madness. New York: Harper & Row, 1970. 129–130.

After he gained his freedom in 1834, Perceval wrote two narrative accounts of his treatment in the asylums. After being released, he spent the remaining four decades of his life campaigning for the liberty of people labeled as mentally ill, notably founding an Alleged Lunatics Friends Society and leading a petition campaign against the Lunacy Act, which allowed for involuntary commitment and denied involuntary patients the right to challenge their imprisonment in court.

Please note that, today, the shrinks and their flunkies, who continue to inflict on unwilling patients every sort of isolation, restraint, confinement, physical torture, and emotional trauma that the mad doctors of Perceval’s day inflicted — the shrinks and their flunkies who continue to march forward with the same invincible ignorance, using the same involuntary commitments and the same hellhole prison-camp asylums, — the shrinks and their flunkies who, in spite of the lessons clearly taught by men like Perceval, still continue to display exactly no self-awareness or critical insight whatsoever into either the history of their own discipline or the possibility that the phenomena they supposedly study and correct may be at least partially the results of their own coercive treatments — those shrinks and their flunkies, I say, now have the supreme gall to turn around and claim John Perceval, the man who their forebearers imprisoned and tortured, and who spent the rest of his life opposing their forebearers’ exercise of arbitrary and absolute power to imprison and torture innocent people who have been labeled as diseased by doctors or family, as a pioneer … for the mental health advocacy movement.

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5 replies to Iatrogenesis Use a feed to Follow replies to this article · TrackBack URI

  1. Natasha

    When I was forced into a psych ward, I was essentially told that my crying was inapproaite. I was about to be transferred to a hospital where my regular psych. guy works, and she brought up acting “approiately” when leaving. That just drove me back to my room where I could freely damn her.

  2. Anon73

    I suppose now would be the appropriate time to make some jokes about former lunatics and asylum dwellers being avid readers of this blog….. but nothing comes to mind.

  3. Black Bloke

    Off-topic: the flash McCain ad is jarring in it’s appearance here. That disclaimer in the corner is more important than I previously realized.

  4. LadyVetinari

    The whole issue of mental health is problematic from all sides. On the one hand, I’m certainly opposed to involuntary commitment. But on the other, the idea that mental illness isn’t real leads people to think that those suffering from depression or bipolar disorder or schizophrenia simply need to “buck up” rather than undergo therapy or take drugs. Of course it’s intellectually possible to argue against involuntary commitment and for greater awareness of mental health issues. It’s just rhetorically difficult when there’s a heated argument going on.

· November 2008 ·

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