Here’s the rules:

1. Pick a quote of one or more paragraphs from something you’ve read, in print, over the course of the past week. (It should be something you’ve actually read, and not something that you’ve read a page of just in order to be able to post your favorite quote.)

2. Avoid commentary above and beyond a couple sentences, more as context-setting or a sort of caption for the text than as a discussion.

3. Quoting a passage doesn’t entail endorsement of what’s said in it. You may agree or you may not. Whether you do isn’t really the point of the exercise anyway.

Here’s the quote. This is from the book I’ve been reading on and off most mornings this week, Ann Fessler’s The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Roe v. Wade. This is from chapter 6, Going Away, which focuses on the institutional set-up of the maternity homes themselves and the experiences that pregnant women had when they arrived in them. Although this passage doesn’t discuss it, elsewhere in the book Fessler notes a couple of things which may help put the rest in context: first, Fessler points out elsewhere that, in all the social-work discussion of the causes of illegitimacy, every new wave of theory offered a different explanation of the unwed mother’s defects. Never discussed was whether unplanned pregnancies had anything to do with the personal characteristics, social position, attitudes, psychology, or actions of unwed fathers. The development of theory after theory by the self-styled experts was not a good-faith intellectual effort, and it didn’t emerge in an ideological vacuum; it was theorizing driven by the need to rationalize a social process of shaming and blaming. Second, she also mentions elsewhere the emerging notion of social work professionalism, and the kind of coercive tactics they used, didn’t emerge in an institutional vacuum, either; they were caught up with the fact that maternity homes were increasingly being transformed into intermediaries in health and social services spending by state governments. Women mentioned how social workers would coerce them into surrendering, if they expressed second thoughts, by saying that they would have to pay the state back thousands of dollars for their stay in at the maternity home and for their hospital bills. At the far extreme, one of the women she interviews mentions a case she had heard of, in which a mother who refused to relinquish was forcibly committed to a state mental hospital (on the grounds that she must be crazy) until she agreed to surrender her baby, months later. Anyway. Keeping that in mind, on with the quote:

For most of the women I interviewed, however, especially those who were younger, being sent to a maternity home was a traumatic experience. They had been banished from their schools and homes, they were soon to give birth to a child, and rather than being surrounded by caring family members they were living in institutions among strangers. Although many felt camaraderie with the other young women who were there, they also felt that the environment was cold and demeaning and that the disapproval of those who looked after them was palpable.

The philosophy and mission of maternity homes had changed considerably since the early 1900s, when the maternity-home movement began. The religious women who first ran the homes saw themselves as sympathetic sisters who were there for women who had no other place to turn. The home was a place of refuge and spiritual reform for women who had, in their eyes, been seduced and abandoned. Motherhood, they believed, would increase a woman’s chances of living a good and proper life. During this time, babies were not separated from their mothers except under extreme circumstances, as when women cannot be helped or compelled to meet their obligation as parents. The homes generally encouraged bonding through breast-feeding and they helped the women find employment–usually as domestic servants–which would enable them to care for their child and to work. Well into the early 1940s, some homes still encouraged, if not required, the mother to breast-feed her baby to ensure that a bond developed between mother and child.

But by the end of World War II, a sea change had occurred in the mission and philosophy of the homes. Maternity homes of the 1950s and 1960s were, to a great extent, a place to sequester pregnant girls until they could give birth and surrender their child for adoption. If a young woman was unsure of or uninterested in relinquishment, the staff attempted to convince her that it was her best, and perhaps only, option. Though maternity homes were the only place a girl in trouble could turn for help outside of her family, by the 1950s they best served her interest if her interest was in giving her child up for adoption at the end of her stay.

The change in philosophy was highly contested among those who ran the homes and did not come about uniformly. To a great extent the views at individual homes changed as the staff changed. Between the turn of the century and the 1940s, the women who had founded the homes were supplanted by professional social workers who reshaped the understanding of nonmarital pregnancy.

In the first two decades of the twentieth century, social work evolved into a genuine profession, and those who helped professionalize the field were eager to differentiate themselves from charity workers and reformers, whom they saw as overly sentimental and old-fashioned. These professionals formulated what they considered to be more rigorous approaches to social problems, rather than basing their practices on religious perspectives. As the professionals took positions at maternity homes and began to work alongside religious reformers, philosophical clashes resulted. Social workers claimed expertise. As trained professionals, they considered themselves better equipped to diagnose the problems associated with illegitimacy. While their religious predecessors had generally attributed out-of-wedlock pregnancy to the social circumstances of the women’s lives and to outside social forces, the new breed of social worker focused on the women themselves. Over many years, they posited a number of theories about why single women became pregnant, all of which were predicated on the problems inherent in the women themselves.

In the early 1900s, most social workers argued that women who became pregnant out of wedlock were feebleminded; their pregnancy was proof of their feeblemindedness. This made them seem especially dangerous to society because it was believed that these women were not only likely to be repeat offenders, but that they would produce offspring of low intelligence, claiming that the country was in the midst of moral decay and that the family was breaking down, as evidenced by lower birthrates among the better classes of people. They believed that unwed mothers were both the product of bad homes and the cause of broken homes. During this time the concern over nonmarital pregnancy was so great that many feebleminded unwed mothers were either institutionalized or sterilized.

Classifying all unwed mothers as feebleminded, however, proved impossible. Social workers had to acknowledge that many of the women who became pregnant were normally intelligent and relatively well-balanced young women. So a new category was identified, that of the delinquent. This type of womanhad a parallel in the male population. But where delinquency in the male was identified by criminal behavior, female delinquency was defined in sexual terms. The young women who fell into this category were largely seen as those belonging to the working class. By the 1920s, many single women were working in factories, offices, and department stores. They enjoyed a degree of independence and opportunities to fraternize with men. Their sexual lives did not always conform to middle-class standards and in those cases were labeled sexually deviant. This behavior, incidentally, was soon to invade the ranks of the middle class.

Despite the widespread characterization of unwed mothers as either feebleminded breeders or sex delinquents, letters and internal correspondence from Florence Crittenton homes operating in the 1940s offer evidence to the contrary, and the personnel at the homes were still generally supportive of and empathetic to the girls in their charge. A concrete example of such support was found in the application materials for the Kate Waller Barrett Scholarship, which was sponsored by the Crittenton homes in the early 1940s. These scholarship funds were described in materials printed by the Florence Crittenton Mission as being available to a girl who wishes to continue her education to enable her to care for her child. The application required support letters from the superintendent of the home and if the application was successful, the agreement stipulated that the staff at the Crittenton Home would assume responsibility for the care of the child, if necessary, while the mother attended school.

. . .

The kind of support and compassion demonstrated by maternity-home staff in these letters seems to have all but evaporated in the years after World War II. The ongoing struggles between those who aligned themselves with the sentiments of maternity-home founders and those who adopted newer professional strategies came to a symbolic if not an actual end in 1947, when the National Florence Crittenton Mission abandoned its policy of keeping mother and child together.

As the philosophical differences narrowed in the 1940s and social workers coalesced towards agreement on the best course of action for unwed mothers and their babies, efforts to identify the cause of out-of-wedlock pregnancy took a new turn. With the dramatic rise in premarital pregnancies after the war, and as greater numbers of middle-class women became pregnant, it became increasingly implausible to label all of those women as either feebleminded or sexual delinquents. Social workers noted that many of these new unmarried mothers were middle-class girls from good families. A Crittenton social worker wrote about these girls that the sizeable numbers further confound us by rendering our former stereotypes less tenable. Immigration, low mentality, and hyper sexuality can no longer be comfortably applied when the phenomenon has invaded our own social class–when the unwed mother must be classified to include the nice girl next door, the physician’s or pastor’s daughter.

Social workers turned to the growing field of psychiatry for their answer and, as early as the 1940s, began to classify middle-class girls who became pregnant as neurotic: the unwed mother was a neurotic woman who had a subconscious desire to become pregnant. This theory dominated much of the diagnosis and treatment of unwed mothers in the decades that followed the war. Though social workers had been quick to condemn working girls as sex deviants, this new explanation was more appealing in explaining middle-class pregnancy because it downplayed the issue of sexual drive. By identifying the young woman’s goal as pregnancy, rather than sex, the diagnosis of deviance could be bypassed. Though a young woman’s peers, family, and community may still have attributed her pregnancy to loose morals or an overactive sex life, professionals determined that the problem was in her mind.

One of the outcomes of this new professional diagnosis was the justification of the separation of mother and child: a neurotic woman was seen as unfit to be a mother. Given the stigma of illegitimacy in the 1950s and 1960s, many middle-class parents were quick to agree that the solution to the problem was relinquishment and adoption. Following this course, their daughter would be given a second chance. Her pregnancy would effectively be erased from her history and she could expect to go back to a normal life as if it had never happened. Without her child she would be able to marry a decent man and have other children. She would not have to live with her mistake. Adoption also came to be understood as being in the best interest of the child. Rather than growing up with the stigma of illegitimacy and an unfit, neurotic mother, the child would be raised by a stable, well-adjusted married couple.

And though some maternity-home workers were still empathetic to young women who did not want to surrender their baby for adoption, in the postwar years this breed of social worker was rapidly becoming extinct. Internal struggle at the maternity homes continued even into the 1950s, and are evident in correspondence between the leadership of the Florence Crittenton Association of America and the newly hired staff of individual homes. In a letter dated December 23, 1952, Robert Barrett, the chairman of the Florence Crittenton Mission, expresses his concern over a move to shorten the minimum length of a girl’s stay in the maternity home postpartum. The purpose of a mother’s and child’s returning to the home after birth was, Barrett asserts, to give the mother time to be with her baby before making a final decision to surrender. He writes:

Personally I feel very badly that a girl in our Homes shall not be given every opportunity and help to keep her baby if she wants to. Often a girl who has made up her mind to give up her baby feels different after the baby comes and her mother’s instinct is aroused. Not to give her that chance seems a cruel and unnatural proceeding. I am not sure but I feel it would be better for the girl if she tries to take her baby and fails and has to give it up later.

The new policies were shaped by the experts–primarily psychiatrists, social workers, and medical professionals–and promoted by social organizations that had the power and the means to disseminate the ideas. The women whose babies were being placed for adoption were not in any position to influence the policies made on their behalf. Shame is a very effective way to silence individuals, and those who are less socially or economically powerful are rarely in a position to influence the decisions that affect them.

. . .

In theory it was not the social worker but the mother who made the ultimate decision whether to parent or relinquish. A Florence Crittenton brochure from 1952 reads, The mother is under no compulsion, either to leave her baby with us, or to take him with her. There is no priority for either. But it also states that although the mother should perhaps make the choice, not always is she well qualified to make this last decision. And though maternity homes were thought to be safe havens and the goal of all these efforts combined is to induct into society a mother and child, each well started on the road to successful living, in reality this goal was often not fully realized.

Rather than young women being given a realistic picture of the responsibilities and costs of raising a child and allowing them to weigh that information against the resources available to them so they could participate in making an informed decision, they were rendered powerless. And though it might be easy to empathize with a social worker’s efforts to try to persuade a young woman of few resources to be realistic about raising a baby, especially if she lacked family support and did not understand the difficulty and sacrifice involved in raising a child as a single parent, the persuasive techniques were often quite forceful. The degree of pressure put on the women to surrender sometimes crossed the line from persuasion to outright coercion. Many of the women I interviewed recalled high-pressure campaigns waged by the maternity-house staff.

I remember the woman at the adoption agency, a very pleasant woman, smiling, always smiling, and using comforting tones. She sat there and said that I had nothing to offer a baby. I had no education, I had no job, I had no money. Oh, God, they really knew how to work you. Talk about no support, it was how far can we beat you down while we’re smiling?

The social worker was telling me, No man is going to want to marry you, no man is going to want another man’s baby. She proceeded to tell me that the adoptive parents they would find for the baby would be college educated, degreed, they would be much older, they would own their own home, have high incomes. They would be able to give the baby everything that I could not.

They told me I was unfit because I wasn’t married. I didn’t have this, I didn’t have that. Well, it turns out her adoptive parents were just a couple of years older, and neither one had a college education. Nothing against them, but the adoption agency lied to me. They also divorced when she was fourteen. I’m with the same man for thirty-eight years. Financially, her adoptive family was better off than we were, but other than that it wasn’t anything like what the agency promised.

—Christine

The argument that others would be better parents presumed, of course, that the mother’s own economic standing would not improve anytime soon, if ever, through further education, job or career training, marriage, or family support. It also presumed that the adopting couple’s status would not deteriorate through divorce or job loss. Essentially, the gap in economic and marital status between the mother and adoptive family was seen as fixed, whereas only a decade earlier the mother’s circumstances had been viewed as temporary and improvable, and steps were taken to help her become self-reliant.

In the postwar years, most of the homes aimed simply to ensure that the physical needs of the women were met until they could give birth and relinquish the baby. And despite the momentous life change that they were about to go through, most were sent to the hospital knowing nothing about childbirth, nor were they counseled about the impending separation. Most were completely unprepared for the emotions that would follow their transition from pregnant girls to mothers.

. . .

Of course, the pregnant women who went into hiding were not of one mind; nor were the staff of the institutions they entered. A few women reported that they were counseled in a respectful manner and came to their own decision. But the majority of the women I interviewed did not make a decision to surrender. Many women, even those in their twenties, followed the only path that was available to them–the one prescribed by society, social workers, and parents. After all they had been through, and all they had put their parents through, they felt that, more than anything, they needed to regain their family’s acceptance. Some women decidedly did not want to surrender but were unable to devise a plan that would allow them to care for their baby without some temporary assistance. Many of the women who wanted to parent would have been capable of doing so with a modest amount of support, the kind offered to Bea only a decade or so earlier. But by the mid-1960s professionals were no longer offering this kind of support, and more than 80 percent of those who entered maternity homes surrendered.

–Ann Fessler (2006), The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Roe v. Wade. New York: Penguin. 142–153.

Trigger warning. The video of a local news story, below, may be triggering for experiences of sexual violence.

When anarchists suggest that a civilized society can do without government or its cops, we are always asked how people in an anarchistic society would be protected from violent criminals like murderers and rapists. If we suggest that people could handle their own protection through consensual private arrangements — individual self-defense, cooperative community defense, or hiring out help, if need be — we are constantly told that we need monopolistic government control in order to ensure that professional police go about their policing in a way that’s transparent and accountable to the people.

In northern Ohio, a woman named Hope Steffey is suing the Stark County sheriff’s office and several of the deputies and prison guards working for them. Here’s why.

So, a gang of uniformed women and men, violently exercising the power of the State, pinned a screaming woman down on the floor of a jail cell and tore off her clothes to search her, over her screams of protest, while male guards were not only still in the cell, but in fact wrenching her arms behind her back, and then left her naked in the freezing-cold cell for six hours, in full view, without even a blanket to cover her body or keep herself warm. This was, of course, justified by means of unilaterally declaring Hope Steffey crazy, so that they could officially record that they had to inflict that kind of extreme violence and sexual humiliation on an imprisoned woman, over a period of hours — for her own good. Afterwards, when a local news station interviewed Hope Steffey, and aired video of what the cops and prison guards did, they ended up facing a series of unkind words about their character and professionalism. And here is how the dedicated public servants of the Stark County sheriff’s office have transparently and accountably responded the strains resulting from public exposure of their treatment of Hope Steffey:

CANTON — Stark County sheriff's deputies who were vilified after a Cleveland television station aired video of them stripping a woman at the Stark County Jail have filed a lawsuit saying they are victims of one-sided reporting.

Last year, WKYC Channel 3 began airing reports on a lawsuit filed by a Salem woman who says she was strip-searched at the jail in October 2006. The reports included video of sheriff's deputies and corrections officers pinning Hope Steffey to the floor of a jail cell and removing her clothes.

This week, those deputies — Kristin Fenstemaker, Laura Rodgers, Tony Gayles, Richard T. Gurlea Jr., Andrea Mays and Brian Michaels — sued reporter Tom Meyer, WKYC and its parent company, alleging defamation and invasion of privacy.

The lawsuit seeks damages of more than $25,000 and is assigned to Stark County Common Pleas Judge Charles E. Brown Jr.

— CantonRep.com (2009-01-30): Deputies sue TV station over reports about woman stripped naked

The lawsuit may seem obviously retributive; it may indeed seem like a thuggish attempt to silence criticism by shooting the messenger. But the strip-searchers would like the press, and a judge, to consider how hard it’s been on them, having their privacy invaded like that.

When you write about politics — and the politics of policing, especially — the problem is that, if you try to write anything more articulate than just expressing how much the whole thing makes you want to spit nails, you’ll soon find that the usual tools of satire, or even simple sarcasm, end up useless: the facts themselves, just as they are, constantly outstrip any sort of ridicule, no matter how over-the-top, that you could possibly craft.

See also:

• GT 2008-02-05: Rapists in uniform
• GT 2008-03-07: Rapists in uniform #2: four more women come forward
• GT 2008-03-08: In Their Own Words: Just following orders edition
• GT 2008-05-10: Rapists in uniform #3: a sixth woman comes forward
• GT 2008-06-23: We need government cops and government courts because private protection forces and private arbitrators would be accountable to the powerful and well-connected instead of being accountable to the people. (#2)
• GT 2008-11-13: Rapists in uniform #4: Standard Operating Procedure
• GT 2008-09-14: Omerta

(Via Cheryl Cline @ der Blaustrumpf 2008-12-02: Trusting Doctors.)

The first step is that the State grants legal privileges to doctors. Or, more specifically, to those doctors who practice medicine according to the approaches favored by the government and government-backed medical guilds like the American Medical Association. These privileges for officially-approved doctors to force their competitors out of business with threats of fines, jail, or death, and thus to force captive patients to seek their services. In many countries, these privileges include a large apparatus of government-subsidized healthcare, in which government-approved doctors are paid largely, or entirely, by funds that the government has taken from unwilling taxpayers. (Healers whose practices are not officially approved by the government, obviously, receive none of these subsidies.) In some cases, they also involve the power of doctors — especially psychiatrists, or other doctors treating children, or treating adults labeled as insane or feeble-minded — to force invasive treatment on unwilling patients through the use of deception, threats, restraint, and, if necessary, outright violence.

When the government gives doctors this kind of unaccountable, legally-backed plenary power to control or coerce their patients, it converts the medical profession into a class of legally elevated and legally regulated mandarins, who expect and enjoy considerable political power through their legally-privileged professional associations and through the State apparatus itself. Since doctors enjoy special privileges over their patients, and depend on legal force rather than on their patients’ judgment to get their way, the legal privilege helps foster a culture of arrogance and entitlement. And at the same time it creates a situation where doctors depend on government power for their wealth and cultural prestige, since they depend on it to create an artificial scarcity of medical services, and to keep patients captive to the doctor’s preferred regimen. Moreover, whenever medical doctors get special political privileges over their patients, politics defines what will be counted as legitimate medicine, and so medical doctors necessarily become politicians, acting a minor faction of the ruling class, just by establishing professional standards. When those professional standards are enforced by law, State-approved doctors’ professional associations are transformed from voluntary associations into a branch of the government, and medicine is transformed from a service to the patient into an arm of State policy.

And whenever, wherever, and exactly to the extent that the State gives doctors this kind of power over their patients, and makes them instruments of State policy, State-privileged doctors will owe their primary loyalty to power of the State, not to their patients.

The results of that shift in loyalty will depend on the nature of the State that claims their loyalty. When a State is relatively restrained, or simply incompetent, doctors will still help their patients, for the most part, rather than hurting them. When a State becomes more predatory, or lethal, politically-privileged doctors will be called on to be fine-tuned instruments of the predation or the murder. Since they depend on the State, politically-privileged doctors will usually answer the call, even if it means subjecting their victim-patients to malpractice, torture, or murder. Indeed, since a more powerful and invasive hygienic or therapeutic State means more power and influence for politically-privileged doctors, many of them will not only side with and collaborate with a predatory or lethal State, but will actively urge it onwards toward ever greater atrocities, and beg to be given the responsibility for carrying them out.

As Yoel Abells, a Toronto family doctor and medical ethicist, said of the experience in Germany under the Third Empire, and America under the United States government’s Global War on Terror:

One fact Abells found particularly disturbing was that doctors joined the Nazi Party in greater numbers than other professionals.

Almost half of all doctors were members of the Nazi Party, he said, compared with only a quarter of lawyers or musicians, and to the 9 per cent of the German population as a whole.

Joining Nazi groups, he said, was intoxicating for many doctors because of the power over life and death it gave them.

Today, Abells said, a disturbing number of doctors continue to be involved in genocidal campaigns, terrorist organizations, torture and the interrogation of prisoners of war.

A report in the New England Journal of Medicine in September found that the U.S. Army continues to use doctors in its interrogation of suspected terrorists, despite every major medical association condemning the practice.

— Stuart Laidlaw, HealthZone.ca (2008-11-05): Medical atrocities did not end with Nazi era

As Cheryl Cline writes:

The collusion of the medical profession with the State is certainly nothing new. And sadly, it is not all that surprising. Intuitively, the public trusts its doctors and others perceived as public servants more than it trusts, say, its lawyers or ad men. (The popular TV show Mad Men is a perfect example of capitalization on our distrust of the capitalist-minded. Can you think of a show that would portray doctors in a similar light?) With so many people putting blind faith in government bureaucrats to foster the public good, it’s hardly surprising to see the two entities take advantage of the public's trust to merge and consolidate power.

— Cheryl Cline, der Blaustrumpf (2008-12-02): Trusting Doctors

When doctors have this unchecked power to wreak torture or death on patients — whether it’s thrust upon them by an aggressive State, or whether they collaborate with an ambitious State to get it — then you will always get atrocities. And that’s an outrage. But it should not be a surprise. It is not an abuse of power; the power itself is the abuse, and doctors will always and everywhere sweep aside their ethical obligations to patients in favor of political obedience to the State, as long as it is State power rather than patients’ consent that determines what counts as legitimate medical practice, and as long as State privilege transforms medical practice from a consensual service into a forcibly-wielded instrument of public policy — which is to say, an instrument of State power. Sometimes it happens in little, obnoxious ways (under little, obnoxious legal regimes), and sometimes it happens in big, deadly ways (under big, deadly legal regimes), but it’s been going on for a long time now, and there’s no way around it. No way, that is, except genuine freed-market medicine, the only thing that can free the medical profession from the influence of State power and to make doctors accountable to patients rather than to power. No way, that is, except to abolish all forms of political command-and-control over the practice of medicine and to let doctors return to providing nothing more, and nothing less, than a consensual, life-affirming service to willing patients.

See also:

• Charles W. Johnson, M.D., Medical Political Protection, in Rampart Journal of Individual Thought IV.3 (Spring 1968).
• GT 2008-06-25: State ownership of the means of reproduction. (#2)
• GT 2008-05-05: Texas psychoprisons
• GT 2007-10-29: For her own good
• GT 2007-10-25: Radical healthcare reform
• GT 2006-04-13: How physicians learned to stop worrying and love Big Pharma

It’s done a lot. We have a lot of prisoners in there totally naked. — Timothy Swanson, Sheriff of Stark County, Ohio.

For the past several months, Sheriff Tim Swanson has refused all requests for interviews about the Hope Steffey case, claiming that it was inappropriate to comment on the case in the media while it was still being reviewed in court. Of course this was complete bollocks; as he just proved, the real issue was that he had an election coming up in November, and he didn’t want to say anything on teevee that could be used against him, and now that he has been safely re-elected he is happy to wallow around in front of a camera and say any damn thing he pleases about the case. For example, that his gang of hired muscle down at the jail are doing this sort of thing all the time, and it’s not his fault because he can’t ship people down to the local mental ward anymore and that it’s O.K. for his crew to strip down women with men in the room because he just can’t be bothered to figure out how to hire enough women that he won’t be routinely sexually traumatizing women in his jail, for their own good, but, hey, it’s all O.K. for the Stark County Sheriff’s office to be running their own personal Abu Ghraib, because the mixed-gender hired muscle that strips women down in cells and leaves them there naked for hours at a time has a nifty four-letter acronym, which makes it all official and O.K.

There is absolutely no conceivable excuse for treating anyone this way, ever. Whether man or woman, calm or belligerent, nice or nasty, crazy or sane. This is gang rape, professionalized and excused by Official Procedures. What is becoming clear is that Sheriff Tim Swanson and his goon squad, not only have convinced themselves that this kind of brutality is sometimes acceptable, but also that they have an especially broad understanding of the sort of situation that calls for it. They are a pack of dangerous predators, and their uniforms and badges don't make them any better than any other gang of serial rapists.

See also:

• GT 2008-02-05: Rapists in uniform
• GT 2008-03-07: Rapists in uniform #2: four more women come forward
• GT 2008-03-08: In Their Own Words: Just following orders edition
• GT 2008-05-10: Rapists in uniform #3: a sixth woman comes forward
• GT 2008-06-23: We need government cops and government courts because private protection forces and private arbitrators would be accountable to the powerful and well-connected instead of being accountable to the people. (#2)

I spent most of this morning reading through The American Prospect‘s recent insert on the politics of mental illness. With only two exceptions, the articles generally range from dull political hack-work to unsettling exercises in missing the point to disturbing demands for massive, federally-driven centralization and escalation in the size, scope, power, and invasiveness of State-backed institutional psychiatry, its regimentation of everyday life, and its access to fresh captives to call patients. (The two exceptions were a first-person account by a woman who had been diagnosed as schizophrenic, which is mainly about how you should be nice to people who have been labeled mentally ill and treat them like human beings worthy of your concern; and another article on treatment alternatives, which spends about half of the article talking about Clubhouse model centers, which were founded by former inmates of the psychoprison system, which are strictly voluntary, and which are organized around principles of participation and equality among the crazy owner-residents and their hired helpers.)

I was originally referred to the feature by an Utne online feature focusing on the articles that had most to do with the intersection between institutional psychiatry and the prison system; the point of that feature (and the articles it referenced) was to call for more diversion programs and mental health courts. If you’re not familiar with the concepts, the way a diversion program works is this: somebody, usually somebody poor, gets busted by the cops for doing something that endangered nobody, or at most endangered herself, like consensual drug use, or prostitution, or just acting kind of funny in public, but which other, usually more privileged, people in her society find distasteful, contemptible, or trashy. She is forcibly restrained and locked in a cage for this victimless crime. Some professional busybody, usually a shrink or a government social worker, is sent by to declare that the poor thing can’t help herself, and that, rather than being locked in a cage for even longer, she should have a judge order her into a program that will teach her what a worthless shit she has been all her life, and how she needs to submit to the help being forced on her by court order so that she can live a worthwhile and healthy life, where healthy is defined as holding a low-wage job in a legal capitalist workplace, paying a landlord regularly for an apartment which you keep reasonably neat and tidy, and generally living up to a lowered set of social expectations and not acting in ways which your neighbors find obnoxious. It is an overt tool of normalization through the use of force and the threat of even more violent measures against a captive victim-beneficiary (usually, the threat of throwing you back into a hellhole jail or prison; if you have children, this is often accompanied with the threat of abducting your children and putting them into the hellhole foster care system). This is then passed off as an act of liberal humanitarianism and wise statesmanship by self-congratulatory government legislators, judges and bureaucrats. These programs typically make use of special court systems in which defendants are stripped of normal procedural rights on the excuse of a non-adversarial process supposedly being carried out for the good of the defendant’s soul — like a mental health court, which is a special court of inquisition, in which defendants have no right to a trial by jury, no due process rights against self-incrimination, and in which it is expected that the defendant’s legal representative will be collaborating with the judge, with or without the knowledge of her client, to come up with invasive and controlling treatment regimens of captivity in institutions, submission to all kinds of invasive surveillance by doctors and government hirelings, and, more or less invariably, some form or another of forced drugging, with the threat of prison used as a back-up plan if the defendant refuses to comply. Once again, this reversion to the standards of jurisprudence popular in the early modern trials for heresy and witchcraft, usually inflicted only to control the behavior of non-violent offenders, i.e., as an act of aggression against those who have done nothing to invade anyone else’s rights, is passed off as both pragmatic cost-control and humanitarian concern for its victims.

Of course, it’s generally true that diversion programs and mental health courts and the like are in some ways notably better than what they replace — that is, the torture and confinement of harmless people in government jails and prisons. Being whacked on the head with a hammer is better than being shot in the head by a shotgun; but if someone came up to me and said I ought to kill you for what you’ve done, but, you know, I feel sorry for you, so I’m going to divert you into the hammer-whacking instead, I think the proper response is, Well, don’t do me any favors. The real solution is for the State to stop violently persecuting people who aren’t invading anyone else’s rights, and for shrinks and social workers and all the rest of the crew to confine themselves to offering help to those who are looking for help, rather than having a dangerous street gang grab people off the street for their own particular use.

But of course you won’t see that, or anything like that, unless, and until, the majority and the politico-therapeutic power elite no longer agree amongst themselves more or less unanimously on the propriety of treating anyone who can be labeled crazy as something less than a fellow individual human being, with her own thoughts, desires, goals, dreams, and reasons for doing the things that she does. But of course if you insist on respecting a crazy person’s inner life, or on taking her seriously as a human being with thoughts and reasons of her own, which, even if you disagree with those thoughts and reasons, can and ought to be understood and engaged with, rather than fixed, then you will be immediately shouted down by a hooting horde of self-appointed experts and advocates who will insist that you are romanticizing a serious illness, and who will make ridiculous pronouncements like this comment in response to an article written after David Foster Wallace killed himself:

It is nothing more than dangerous romanticism to think that we can logic our way out of mental illness.

As a culture, we need to start accepting that the gifts of the mentally ill — in this case, I’m told, his brilliance as a writer and thinker — often come with dangerous deficits.

But thinking and writing wasn’t enough to cure this man’s illness, just like a bottle of Wild Turkey wasn’t enough, either.

Don’t think you can make sense out of youngish man hanging himself. There is no sense in it. It is mental illness. Untreated mental illness, that had probably been overly glorified as profundity.

— Gina Pera, in re: David Foster Wallace (1962–2008)

The problem is that this is utter nonsense. We’re not talking about someone who, oops, managed to hang himself by accident. He had his own reasons for doing so, and everyone I know, either personally or through writing, who killed themselves or tried to kill themselves, had some fairly specific reasons for wanting to die. Often they are willing to tell you what those reasons are if you ask, or even if you did not ask. These are acts that are invariably part of a larger life story, and they are always done for perfectly explicable reasons that are plausibly connected with what somebody is going through in their life.

Those reasons, once explained, may be bad reasons; they may even be bizarre reasons. But it is completely irresponsible, and chillingly dehumanizing to the people whose lives you claim to care about, to talk as if those reasons just didn’t exist, even when it’s been explained to you what they were, or as if they can simply be waved off just so many meaningless chirps coming from a broken brain, rather than the results of a serious and impassioned process of reasoning and deliberation. Bad reasons need to be engaged with, not fixed, and the fact that you happen not to agree with them doesn’t make them any less real, or any less important in understanding why people do what they do, or any less vital to understanding the best way to help them if you really care about their lives.

One of the important points that Peter Breggin makes repeatedly in Toxic Psychiatry is the way in which official psychiatric ideology about mental illness literally dehumanizes people labeled crazy, and provides an excuse for laziness and aggressive disregard for the integrity of mental patients’ lives. The problem is almost never that what somebody being labeled crazy does or says cannot be understood; it’s that the rest of us fail, or actively refuse to understand it, and we rationalize our failure and blame it on the person herself:

Biological psychiatrists–nowadays most psychiatrists–are fond of saying You can’t talk to a disease. The communication of so-called schizophrenics makes no sense at all to these doctors who want to control symptoms, such as hallucinations and delusions, with drugs, electroshock, and incarceration.

The idea that these extremes of irrationality are due to a disease is inseparable from the survival of psychiatry as a profession. If schizophrenia is not a disease, psychiatry wold have little justification for using its more devastating treatments. Lobotomy, electroshock, and all of the more potent drugs, including neuroleptics and even lithium, were developed at the expense of locked-up people, most of whom were labeled schizophrenic. The search for biochemical and genetic causes keeps psychiatrists, as medical doctors, in the forefront of well-funded research in the field. The notion that patients have sick brains justifies psychiatry’s unique power to treat them against their will. It also bolsters psychiatry’s claim to the top of the mental health hierarchy. In short, if irrationality isn’t biological, then psychiatry loses much of its rationale for existence as a medical specialty.

— Peter Breggin (1991). Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the New Psychiatry. New York: St. Martin’s Press. 23. #

He stresses that this is true of so-called affective disorders just as it is true of so-called schizophrenia.

When we cannot readily identify with the depressed person’s plight, more often it is due to our own lack of understanding than to the obscurity of the causes.

— Peter Breggin (1991). Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the New Psychiatry. New York: St. Martin’s Press. 126.

And, once again, on schizophrenia:

On July 27, 1986, 60 Minutes produced a show entitled Schizophrenia. It was based on biopsychiatric theories, and one of their experts declared, We know it’s a brain disease now. It’s like multiple sclerosis, Alzheimer’s disease. On the show, vignettes of patients were presented to impress the audience with the bizarre quality of their communications, and hence the absurdity of any psychological meaning or underpinning to their disease.

The first 60 Minutes patient, Brugo, bolsters his identity with spirituality, as well as religion, and declares that he’s not extinct: And I’m Croatian Hebrew, which is Adam and Eve’s kin. And I have been Croatian Hebrew for centuries and cent–upon centuries. And I’m a Homo-erectus man, and I’m also part Neanderthal, and I mean to keep that heritage, ’cause I’m not extinct.

Packed into these few remarks is symbolism about his desperate need for personal value and dignity, his identification with religion and humanity, and perhaps his awareness of primitive impulses stirring inside himself, as well as his fear of personal extinction. Here is more than enough material to stimulate anyone’s desire to communicate with him.

The second patient, Jim, is dismissed by the interviewer because he is convinced he was shot to death when he was a baby. Yet his brief remarks seem like a metaphor for child sexual abuse by a male: I had my head blown off with a shotgun when I was two years old. And–and before that, things happened in my crib. I remember all these things and stuff, but I just remember, you know. I remember all this stuff.

A therapist with experience in listening to people immediately would wonder about what lies behind Jim’s direct hints about terrifying memories from early childhood, not to mention the symbolism of the crib in relation to his present trapped condition. More than one patient of mine has begun with just such anguished fragments of memory before discovering the agony of his or her abusive childhood and its relationship to current entrapments.

. . . The patients’ quotes were selected by 60 Minutes to demonstrate that so-called schizophrenia is a biochemical disease rather than a crisis of thinking, feeling and meaning. Yet people with real brain disease–such as Alzheimer’s, stroke, or a tumor–don’t talk symbolically like these people do.

Instead of metaphors laced with meaning, brain-damaged people typically display memory difficulties as the first sign that their mind isn’t working as well as it once did. They have trouble recalling recently learned things, like names, faces, telephone numbers, or lists. Later they may get confused and disoriented as they display what is called an organic brain syndrome. In fact–and this is very important–advanced degrees of brain disease render the individual unable to think in such abstract or metaphorical terms. The thought processes that get labeled schizophrenia require higher mental function and therefore a relatively intact brain. No matter how bizarre the ideas may seem, they necessitate symbolic and often abstract thinking. That’s why lobotomy works: the damage to the higher mental centers smashes the capacity to express existential pain and anguish. As we’ll find out, it’s also why the most potent psychiatric drugs and shock treatment have their effect.

How are we to approach people who get labeled schizophrenic? Do we think of them as troubled humans struggling in a self-defeating style with profound psychological and spiritual issues, usually involving their basic worth or identity? Or do we view them as if they are afflicted with physical diseases, like multiple sclerosis and Alzheimer’s disease, in which their feelings, thoughts, anguishes, and aspirations play no role? Do we try to understand them, or do we try to physically fix them? . . . If we are beings rather than devices, then our most severe emotional and spiritual crises originate within ourselves, our families, and our society. Our crises can be understood as conflicts or confusion about our identities, values, and aspirations rather than as biological aberrations. And as self-determining human beings, we can work toward overcoming those feelings of helplessness generated by our past spiritual and social defeats.

By contrast, the typical modern psychiatrist–by disposition, training, and experience–is wholly unprepared to understand anyone’s psycho-spiritual crisis. With drugs and shock treatment, the psychiatrist instead attacks the subjective experience of the person and blunts or destroys the very capacity to be sensitive and aware. No wonder the treatment of mental patients often looks more like a war against them. It often is.

— Peter Breggin (1991). Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the New Psychiatry. New York: St. Martin’s Press. 23–26.

See also:

• GT 2008-08-05: Iatrogenesis
• GT 2008-06-24: Medicated madness
• GT 2008-05-05: Texas psychoprisons
• GT 2007-10-29: For her own good