The treatment for the mentally disabled has certainly changed and developed throughout time (from “skull drills” to “happy pills” – as put by inquiriesjournal.com), but aside from the distraction of new technological advances and developments (that helps 40% of those in need), has the treatment truly improved, or has society just become better at disguising the real issues? 

HISTORY

Starting in the Early Intermediate Period (ca. AD 200-600), treatments for the mentally insane were developed for the first time. Trepanation is an ancient cranial surgery. The goal of this surgery was to drill a hole all the way through the patient’s skull, just up until they get to the brain. Although, back then it was common to use sharp stones for this process, unlike the electric drills today, and the patients were not under any anesthesia. This was often used to try to reverse mentally unstable minds, head injuries, and heart sickness, and sometimes it worked. This surgery continued to be performed in this way for hundreds of years, and is sometimes still performed today, even after little success was evident.

Neolithic Trepanation

Dating back to 1247, London’s Bethlem Royal Hospital was founded. It was nicknamed “Bedlam”, which soon had a meaning of chaos, mayhem, and confusion in the English language. The Italian Bishop Goffredo de Predetti founded this building. The church ran mental institutions until the 1600’s, when the control was transferred to the state. This institution was built directly above a sewer that constantly had issues with overflow.

The Trenton Psychiatric Hospital also partook in the poor treatment of the mentally disabled. One type of “treatment” that they tried was called rotational therapy. This is when a patient was unwillingly strapped in a chair, and the chair was then suspended from the ceiling. Once it was “secure”, a person began spinning the chair in the direction of a doctor. Usually this was done quite fast, at least 100 rotations per minute, usually more. As a result, the patient would usually vomit uncontrollably and experience extreme vertigo, however, these were believed to be healthy reactions that had the ability to eventually heal the patient. This was also known as the gyrating chair. The purpose was to shake up the blood and tissues of the patient in order to restore equilibrium in their body; however most ended up unconscious, with no reports of a successful result from this technique. Other treatments in the Trenton Psychiatric Hospital included being beaten on a daily basis, starved, and dunked in freezing bath water. It was believed that if their body was exposed to an extreme temperature difference, then their minds would be shocked back to normal. Most of the asylums had unlivable conditions, some holding up to ten times the amount of patients it was meant to. This often left them having to sleep in their own filth and excrement. Most of the staff was also unqualified to works in asylums, some even hiring prisoners to take care of the patients. Patients who were said to have uncontrollable emotions were thrown into cages for long periods of time. Asylums eventually began making money by allowing people to pay to come in and see all of the “psychos” interact, much like the set up of the early zoos with the animals in small, restricting cages.

Lobotomies are one of the next surgical treatments developed throughout history, in the early 1900’s. It was the process of slicing off slivers of the frontal lobe of the brain, which as mentioned before, contains all of the elements that make someone human, by drilling holes in the tops of the patients’ skulls, or in 1/3 of the cases, by going through the eyes (patients often walked away with deep bruises around their eyes). Another form of lobotomy came out a few years later, referred to as ice pick lobotomy. This is where the doctor would insert an ice pick in the patient’s eyes, and swirl it around in the brain’s core, in hopes of fixing something. Lobotomies had no age restrictions, in one case being performed on a four-year-old named Howard Dully. Dully now fights to eliminate child abuse, so children don’t have to have the traumatic experience he did, without any scientific proof that he had a mental disease. Even after the long and dangerous process of the lobotomy, 2/3 of the patients remained institutionalized in a psychiatric ward, showing no or little improvement. Roughly 18% of the 1/3 that were not deinstitutionalized died from the lobotomy process.

Icepick Lobotomy

Paul Eugen Bleuler, a Swiss psychiatrist, discovered schizophrenia in 1910. The word literally translates to “split mind”. This is not the same disorder as having split personalities (multiple personality disorder). It is believed that schizophrenia is as old as mankind itself, because there have been findings of Stone Age skulls with hole drilled in them, most likely to release evil spirits. This mental disease was not believed to have anything to do with science at first, but more as a divine punishment from God or demonic possession. It wasn’t until the early Renaissance that people began thinking that schizophrenia may be due to natural causes. Before antipsychotic medications were invented, many different “treatments” were used, one being “fever therapy”.  A doctor would purposely try to induce fevers in their patients, because illnesses such as malaria were observed to temper psychotic symptoms. Psychiatrists went to such measures as injecting sulphur or oil into their patients’ bloodstreams. Other treatments such as sleep therapy and gas therapy were used. Deep sleep therapy (DST) is when a patient is given drugs to keep them unconscious for weeks, and gas therapy uses nitric oxide, which is inhaled by patients to widen blood vessels (both of which proved to be unsuccessful treatments for schizophrenia).

Electroconvulsive therapy (ECT) is used in most cases with patients who have Cotard’s Syndrome. ECT is a procedure that is done while the patient is under general anesthesia (however back when this disease was first discovered in 1882, the patient remained fully aware), in which small electric currents are passed through the brain, with the purpose to intentionally trigger a brief seizure. As Dr. Peter Breggin explained it, “ Both electrodes are placed over the temples, overlapping the frontal lobes of the brain. The most intensive surge of electricity hits the memory centers in the tip of the temporal lobes and affects the highest human functions in the frontal lobes.” The frontal lobes of the brains are what make people caring, insightful, inquisitive, and creative. After this process, the frontal lobe remains cut off from the rest of the brain. Dr. Breggin refers to this treatment as the “brain-disabling principle of psychiatric treatment”, and states that electroconvulsive therapy “works” only by “damaging the brain and suppressing brain function.” Most post ECT patients live the rest of their lives apathetic, increasingly losing awareness in everything that they used to be passionate about. It ultimately ends up changing the patient’s brain chemistry. Most cases of electroconvulsive therapy are performed without the patient’s consent.