Wednesday, August 17, 2005

Psychiatric History Pt. 2
Kings Park State Hospital circa 1960
I was in the Intake unit and didn’t get to the locked long-term back wards very often. Perhaps once or twice. It was full of people sitting around on the floor (no furniture) babbling nonsense and drooling, and mostly naked. Right out of the movies only worse. Two or three were pointed out to me as having been lobotomized. Far worse was the Violent unit, which was terrifying and chaotic. They had a room near the nursing station where they kept people who were in “double restraints.” Strait-jacketed and strapped to a mattress-less bedspring.
I think what bothered me most was the diagnosis procedure. New patients, and patients about to be released, all had to undergo an official “diagnosis and disposition.”  Often highly confused, new patients were led in pajamas into a theater where a hundred or so people in suits were sitting in the audience. At a desk on the stage was a fat, imperious, arrogant bastard who was the hospital’s Clinical Director. His last name was Dr. ——- and he was related to —— ——. He’d ask four or five questions, then start dictating his impressions and diagnosis, right in front of the patient.
I don’t know if the procedure was purposely designed to be as humiliating as possible or not but it bothered me a lot.
Also, back then, they had a catchall category called “psychopathic personality disorder.” (Now they call them “sociopaths”). This was applied automatically and uniformly to criminals and murderers who lacked a conscience, and to alcoholics and homosexuals. The catch was that a personality disorder was not considered a mental illness so these individuals were ineligible for any kind of treatment, or any disability benefits. The hospital usually kept them for the required 30 or 60 days, then release them.
It never seemed to occur to them that someone with a personality disorder could also get severely depressed, or become schizophrenic, in addition to the personality disorder. Other doctors recognize that you can have two diseases at once. But not psychiatrists, for some reason. Because of this blind spot, nearly all studies of homosexuals, prior to about 20 years ago, were conducted among mental hospital patients, most of whom were severely depressed (often for good reason). Conclusions were then applied uniformly to ALL homosexuals. This resulted in an extremely skewed view of homosexuality and its causes.       
There is a short story about one of my “psychopathic” patients, a small-time gangster who wrote poetry, in my book “Weird Hikes.”
The ECT doctor at the hospital was one of the stupidest, and most insensitive people I’ve ever met in my life. How such a person became a doctor boggles the mind. He had no ability to relate to people whatsoever.


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