Scream

Arthur Janov, the pioneer of Primal Scream therapy, recently passed away. Here are some thoughts about the context in which developed his therapy…

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Fifty years ago, in 1967, the California-based Arthur Janov was operating in a strange mental health environment.

That year Scottish therapist R.D. Laing published The Politics of Experience, which questioned orthodox therapies. Psychologist Timothy Leary’s psychedelic experiments were publicly called out in the pages The New Republic. In 1967’s The President’s Analyst, James Coburn played a psychotherapist more than willing to seduce his attractive female patients. Disenchanted, he eventually leaves Washington, D.C. to settle in a hippie commune. The National Institute of Mental Health (NIMH) was finally acting on the 1963 Community Mental Health Act. In 1966, the first Community Clinic opened. By 1967, 53 more opened across the country.

Arthur Janov, with degrees from UCLA and a PhD in Psychology from Claremont Graduate School and sporting a shock of curly hair, created Primal Therapy in 1967. Tapping into the California counterculture and appealing to celebrities with his avant-garde approach, Janov created an unconventional therapy that resonated throughout the 1970s and beyond.

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Antiestablishment undercurrents challenged the American love affair with mental health expertise at this time. Debate was rife. It took place over psychiatric nosology (a fancy way of saying the classification of mental illnesses), scientific legitimacy, and the value of evidence-based diagnosis. The debate focused on the forces of modernization, psychopharmacology, (de)institutionalization, and social psychiatry.

There was significant chatter about mind control: The Manchurian Candidate. LSD brainwashing. MK ULTRA. This latter state-sponsored and well-funded CIA project, of course, included trippy research on behavioral therapy, chemically-induced brain concussions, brain wiping, hypnosis, extrasensory perception, cutting-edge polygraph techniques, sleep research, and on and on and on.

Ex-patient groups, whose members referred to themselves as ‘survivors’ or freed ‘slaves,’ garnered more attention. All this tumult was regarded as a “child of its rebellious, anti-establishment times.” Yet intra-professional restlessness was far from new, and it carried into the 1970s.

A majority of mental health experts recognized that the system was in disarray, a jumbled mess that President Jimmy Carter had to reform. To this end, Carter, who embodied for many the limits and austerity of the era initiated a presidential commission to investigate mental health in the U.S.

The term radical fluctuates from era to era and individual to individual, but this historical moment was definitely unique. Thinking about the 1960s-1970s probably conjures up images of Bobby Seale and Huey Newton’s Black Panther Party, which was organized in October 1966 and challenged the status quo by activating and channeling African-American disenchantment – in addition to forming coalitions with domestic and foreign organizations. Yet, the 1970s also calls to mind the Weather Underground, a homegrown terrorist organization intent on fomenting revolution, and which detonated a series of bombs in 1970.

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Biopsychiatry, antipsychiatry, and a host of alternative therapies rose against this backdrop. Amid these changes, Arthur Janov pioneered and championed primal therapy with his 1970 book, The Primal Scream: The Cure for Neurosis. It was a form of therapy in which patients entered extreme emotional states to allow for the jettisoning of any deep-rooted “Primal Pain” experienced in childhood. In addition, the method was often accompanied by shouting and screaming. These “post-Primal” patients would attain a genuine normality, thereafter occupying healthy, neurosis-free bodies.

As indicated in the title of his book, he did not shy away from the curative and indeed the transformative nature of his therapy. In a series of books between 1970-1972, including The Anatomy of Mental Illness and The Primal Revolution, Janov contended that patients who concluded his therapy effectively would overcome the diseased state common to most people. He suggested, too, that his therapy offered physical cures. Repression, in Janov’s estimation, stunted physical development, and successful Primal Therapy would enable the natural growth of breasts, hair, and hands.

Janov, born and raised in California, had worked as a psychotherapist for the Los Angeles Children’s Hospital and Veterans Administration, among other places, when in 1967 he developed his theory. It was an atmosphere of questing energies and transformation in California, and one that also gave rise to Transactional Analysis and other New Age ideas.

Janov’s therapy struck a chord with the countercultural set and other Americans hungry for alternative approaches to the mainstream establishment. Finding the limelight, he went on mainstream television programs, called traditional psychiatry a hoax, and told how of how the establishment scorned him. His papers could not get published, and his colleagues walked out on his presentations. The press hated him, too, he said. Undeterred, Janov pronounced “Primal therapy is THE therapy, nothing can stop it.”

He cagily played around with themes of intergenerational antagonism, repression caused by postwar society, and the ways in which physical experiences and emotions as trumped neutral reasoning; more than that, he touted altered states of consciousness and the more specific view that personal (and perhaps national) liberation depended upon the violent overthrow of corrupt systems. These altered states, however, did not include pot, LSD, or MDMA, and had to be reached without any artificial aids. Janov fully rejected the use of illegal intoxicants, uninhibited sexual activity (“free love”), and transcendental meditation.

Seeking out altered states was not a pathway to fulfilment in his view but rather an unconscious compulsion of an unwell mind. John Lennon and Yoko Ono, who of course experimented with many substances, underwent Primal Therapy in 1970 after The Beatles disbanded —and, along with a “primal concept album” John Lennon / Plastic Ono Band (1970), helped popularize the therapy.

In assessing the mental health landscape and Primal Therapy of the 1970s, Alfred Yassky, the Executive Director of the American Psychotherapy Seminar Center, based in Manhattan, held that the tectonic plates of mental health shifted. Americans were different. The therapeutic geography had perceptibly altered. As he put it, Americans are becoming alienated and are hungering for a sense of meaning, identity, happiness, and even salvation, we are wanting more from therapies and therapists. One way of putting it is that in many ways psychotherapy has taken over the function of religion. Therefore, the therapist is supposed to take over the function and roles of shaman, guru, wiseman, minister, rabbi, or priest. We are expected to help with spiritual matters on the one hand and scientific on the other…

Primal Therapy, which shone brightly until the 1980s, helped to fill that gap.

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The mental health arena in the 1970s witnessed several new entrants, with the rise of patient groups, new therapies tailored for mass consumption, and the continuance of psychedelic psychiatry. Patient-consumers could dip toes into New Age medicine, and draw from the fountain of naturopathy and homeopathy, as well as Eastern-influenced medicine or teachings from sources like the Esalen Institute in California.

They might sample alternative mental health therapies, including Primal Scream Therapy or Transactional Analysis, or find psychic solace in the form of new religious movements. Primal Scream, in short, filled a void for many Americans. It let them shriek and wail to their heart’s content.

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For more short pieces on strange therapies and radical mental health, see below.

This piece is about radical psychiatry and pacification in the 1960s

http://www.bbk.ac.uk/hiddenpersuaders/blog/agents-of-pacification/ 

This article is about Transactional Analysis and its founding in the 1960s

https://thepsychologist.bps.org.uk/volume-30/september-2017/harnessing-fierce-energy-counterculture

Slightly different, this piece is about heroin and end-of-life discussions in the 1980s.

http://www.cmaj.ca/content/189/39/E1231.full.pdf+html

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Agents of Pacification, Agents of Change: Radical Psychiatry in 1969

Check out my new piece with Hidden Persuaders. Check it out and get transported back to Miami, 1969!

CFP. Mental Health and Money: Past and Present

A Call for Papers.

Socioeconomic factors and mental health: past and present

Editors: Professor Matthew Smith and Dr Lucas Richert (University of Strathclyde, UK)

This article collection will examine how the relationship between socioeconomic factors and mental health has been and is understood in an array of different places and periods. Although much of the focus of current mental health research and clinical practice is on the neurological aspects of mental illness and psychopharmacological treatment, historical research demonstrates that a wide range of factors — from vitamin deficiencies such as pellagra, and infections such as syphilis to traumatic life events — have contributed to the onset and exacerbation of mental health problems. Among all these factors, one looms largest: socioeconomic status. On the one hand, socioeconomic inequality has been long recognised as a potential cause of mental illness, as the history of mental hygiene and social psychiatry during much of the twentieth century demonstrates. On the other hand, however, the mentally ill have also historically faced much socioeconomic hardship; today, a high proportion of the homeless and incarcerated in many countries suffer from mental illness.

By exploring this topic across time and place, this collection aims to provide a historical context for today’s mental health crisis, and also to inform current mental health policy, especially attempts to prevent or alleviate mental illness through social change.

Insights on a broad spectrum of themes are welcomed, including, but not restricted to

  • Homelessness and mental illness;
  • Social psychiatry and mental hygiene;
  • Community mental health;
  • Forensic psychiatry;
  • Race and mental health;
  • Psychiatry and various economic/political systems (e.g., communism, socialism, capitalism);
  • Socioeconomic factors and child mental health;
  • How health professionals deal with poverty and mental health;
  • Social policy and mental health;
  • Social activism and mental health.

This is a rolling article collection and as such proposals and submissions will be welcome throughout 2017. However, full submissions received by November 1 will be considered for publication as part of the collection’s formal launch in 2018.

Please do think about submitting.

LSD: Insight or Insanity?, 1968

From the NIH. A post by Professor Erika Dyck on the history of LSD.

Circulating Now from NLM

Circulating Now welcomes guest blogger Erika Dyck, PhD, Professor and Canada Research Chair in the History of Medicine at the University of Saskatchewan. Today, Dr. Dyck shares some insights on a recently digitized film in the Library’s collection highlighted in our Medical Movies on the Web project.

For Rebels, it’s a Kick…

It’s the late 1960s. Teenagers, a hip voice clues us in, are always looking for kicks, and today’s teens express themselves with cool fashions, groovy hairstyles, and kooky pranks. Not so long ago, our narrator played the character of “Plato,” a troubled teenager, in the 1955 classic Rebel Without a Cause. In that film, Plato idolizes the reckless machismo of young Jim Stark (played by James Dean). In an epic display of bravado, Jim and another boy play a game of “chickie run” in which they drive their cars in parallel directly toward a cliff. Jim leaps…

View original post 623 more words

Mad To Be Normal

Mad To Be Normal at the glorious Glasgow Film Theatre. The film stars David Tennant in the lead role and is directed by Robert Mullan.

I was lucky to sit on a panel afterward to offer some historical gems. It was a great conversation with Matthew Smith, Luke Fowler, Richard Warden, and the other attendees…

…oh yeah, and the film was really strong. Here’s a review in the Guardian.

 

 

Adolf Meyer and American Psychiatry

In Susan Lamb’s excellent new book, Pathologist of the Mind, we are exposed to the history of American psychiatry and Adolf Meyer.

Her express goal, as I write in the new issue of History of Psychiatry, is to rediscover Meyerian psychiatry and establish a foundation on which future scholars of psychiatry might build. The book is both a hospital history and biography of Adolf Meyer, the “most recognizable, authoritative, and influential psychiatrist in the U.S.” during the first half of the twentieth century. (3) A Swiss neurologist and psychiatrist, Meyer created the convoluted theory of psychobiology, presided over the Henry Phipps Psychiatric Clinic at Johns Hopkins University, and helped establish psychiatry as a clinical science.

For Lamb, there is a consensus within the history of psychiatry field that Meyer is “the definitive influence on the development of American psychiatry.” (8) Yet, she makes the case – which is certainly convincing – that Meyer is underrepresented in the historiography, that neither the substance nor the reception of his ideas and practices have been analyzed systematically, and, worse still, that certain prominent historians of psychiatry have marginalized his significance. Her book thus acts as a corrective.

OAMY HR_Pathologist (1)

However, Lamb’s book is not a comprehensive history of Meyerian psychiatry. She makes this abundantly clear. In covering the years 1908-1917, Pathologist of the Mind is limited to the decade in which the Henry Phipps Psychiatric Clinic in Baltimore was planned, built, and run in its earliest days. It would, under Meyers’s pioneering stewardship, employ novel investigational and diagnostic practices as well a regime of bed rest, recreation, good nutrition, and social interaction – what Lamb calls an innovative “therapeutic experiment.” (23)

The basis of Lamb’s argument is nearly 2,000 patient records and Meyer’s notes, lectures, and correspondence. And, she asserts, there is so much more to be written on Adolf Meyer. In her view, scholars have “an embarrassment of archival riches and raw data” at their disposal and it could “yield stacks of diverse monographs” from a dozen different disciplinary perspectives.” (9) Her monograph was conceived as merely a starting point for a larger conversation.

A Great Beard

To the author’s credit, Meyer is not venerated. Lamb is respectful, but unintimidated. She is balanced, but not boring. On occasion, she rightfully demolishes him.

For example, Lamb’s criticism of Meyer’s impenetrable, meandering style of writing is a constant in the monograph. At the same time, with anecdotes about his mother’s troubles with mental illness and references to his unfortunate “ominous crow” nickname, Lamb successfully revives and humanizes Meyer as a meaningful character in the unfolding drama of American psychiatry. The result, I suggest, is that the reader begins to detect the shimmering outlines of a whole being, in all its uniqueness and quiddity.

As scholars, physicians, and other critics question the rise of the pharmaceutical industry and its influence on modern society (what Healy calls Pharmageddon), Lamb’s book provides valuable historical context. Her book is worth a read! The full review is here: http://hpy.sagepub.com/content/current

healy

 

Twin Addictions? Zombies (i.e., The Walking Dead) and Bath Salts

In 2015, we are grappling with the addictive properties of The Walking Dead. Based on the best-selling comic book and developed for TV by Frank Darabont, the series has proven to be as enduring and enslaving as many popular drugs.

walking-dead

With only a month left in Season 6, many questions surround the future of Rick, Daryl, and the rest. The zombie hordes have broken through the wall. Ron has set his sights on Carl and the next episode, which is called “Start to Finish,” will likely see the end of a character. But who will it be? Who’s going to lose a body part or two? Tune in…

But zombies don’t only frequent the big and small screen. They don’t simply occupy pages of novels and graphic novels. Quite the opposite. In recent years, drug addicts on bath salts have been portrayed as nightmarish zombies tearing at the flesh of unwitting victims. Let me explain.

bath salts

Bath salts are examples of new classes of designer drugs, which are sometimes referred to as “legal highs.” These are substances with psychotropic effects that have been or are marketed and distributed for recreational use by exploiting gaps in existing drug legislation. Another popular example is the synthetic cannabinoids (“fake marijuana”) marketed under names such as Spice.

In 2012, the Americans made bath salts illegal through the Synthetic Drug Abuse Prevention Act and then with the Synthetic Cathinones Control Act a year later. At roughly the same time, Canada introduced measures to ban the key ingredient in bath salts, methlyenedioxypyrovalerone (MDPV).

The move to schedule and control the drug was surely warranted, yet one can easily detect how the drug was sensationalized as part of this process. Lurid and grotesque stories were reported about bath salts, including the naked zombie attacker who was shot by police in Miami while biting a victim’s face. Rudy Eugene, the face-chewing “zombie,” wasn’t on any bath salts, contrary to a majority of the stories.

Yet, the nation went into full-on moral panic mode. From PBS and Spin to Forbes and GQ magazine, the public was exposed to the new menace in American society. It was the stuff of nightmares. It was a Zombie Bath Salt Apocalypse.

The Big Picture

Cathinones are naturally occurring amphetamine-like substances that come from Khat, a plant found in eastern Africa which has been chewed since at least the tenth century. Synthetic cathinones, not surprisingly, are lab-created derivatives of this compound, dating back to 1928 or so.

By the 1990s, the use/misuse of the synthetic cathinones began to pop up on radar screens and became an issue with law enforcement and government officials.

Before the recent regulation in the past few years, the designer “bath salts” were purchased from dealers, through online distributors, or at book stores, gas stations, and head shops. They got the nickname because they resembled the everyday Epsom salts that bath-lovers pour in their water when they take a soothing soak.

But there are trade names as well: “Ivory Wave,” “Purple Wave,” “Ocean Burst,” “Monkey Dust,” “Sextacy,” “Vanilla Sky,” and “White Lightning” are just some of the varieties one can put in the body rather than the bathtub. Tough to detect, they can be snorted, smoked, or injected.

And the effects of these are similar to MDMA. Users have reported increased energy and empathy, more sociability, and mental and sexual stimulation. The negative side effects of bath salts, on the other hand, have included difficulty breathing, fatigue, insomnia, muscle twitching, nausea, paranoia, violent behavior, and tachychardia.

A Vicious Circle

Compared to traditional psychotropic drugs (cocaine and LSD, for instance), there is relatively scant medical information available. That has not prevented its assignment to the category of Schedule I, meaning it has no known and accepted medical use.

Yet certain researchers raise interesting points. One is that classifying bath salts as schedule I substances without pre-clinical or human research is very problematic.

This move restricts the number of laboratories and institutions with licenses to study the bath salts. As a result, finding an accepted medical use becomes even more difficult, even though there have been suggestions that bath salts could be a viable alternative to amphetamines in dealing with Attention Deficit Hyperactivity Disorder (ADHD) or severe, treatment-resistant Depression.

This is, in short, a case of the snake eating its tail, and one does not have to look any further than LSD to detect some historical parallels. In the late 1960s, the recreational abuse of LSD as well as the anti-authority, counter-cultural, and outright malevolent images associated with it helped to scuttle research. Now, after over forty years, LSD has begun to make a slow return, and perhaps even a comeback.

lsd

Hyperbole and inaccurate information played a role in the scheduling and controlling of LSD, in other words. This was also the case when it was reported that crazed Mexicans who smoked marijuana went on vicious rampages, or when it was reported that Chinese workers were raping white women in opium dens while customers were “Chasing the Dragon.” With bath salts, which are the latest in a long line of drugs used for their euphoric effects, this hyperbole was readily apparent.

No, bath salts will not turn you into a cannibalistic criminal like Rudy Eugene in Miami. And, no, bath salts will not give you super strength. But the media had no problems in pushing such narratives on news consumers.

Should we be surprised about this type of journalism? Or that it dovetailed with the first synthetic cathinone legislation in 2012, which was passed the same month as the attack? Far from. If anything, the history of drug policy demonstrates how predictable this is.

In the future, the best way to avoid cowering in bed (or hiding behind a big wall) in the face of an imminent zombie bath salt apocalypse is with candor. It’s probably best not to cut off avenues of research or focus on gory thoughts about face-chewing.

the-walking-dead

And, at the very least, it would be prudent to recognize the challenges and dangers of designer drugs like bath salts, even as we place them in a longer history of drugs. This way, like Rick and Daryl, we can create a proactive strategy for evading the zombie hordes.

Saskatoon top place in Canada to be charged for marijuana possession

Saskatoon is one of the cities in Canada that cracks down hardest on possession of minor marijuana and this is incredible, especially in light of the provincial government’s newly unveiled policies on liquor regulation.

As seen here and  here, the Wall government has ushered in a series of new rules that liberalizes alcohol policy in Saskatchewan. We are privatizing liquor in the province. And we are also – to supporters, at least – rationalizing widely unfair policies.

booze 1

It’s strange, then, that the rate of enforcement for possession of marijuana is so variable. In Saskatchewan, for example, Regina is much more lenient than Saskatoon. And we must question what this ultimately means? Just as consistent liquor policies drove debates in government and within the electorate, the lack of rationalization and parity in enforcement rates deserves more consideration.

 

Mr. J. Lundstrom, a Saskatoon -based marijuana advocate.

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The CBC decided to interview me recently about Saskatoon’s enforcement of marijuana.

This is the beginning of the story:Saskatchewan is the place you’re most likely to get busted for simple possession of marijuana and Saskatoon tops the list of major Canadian cities. According to 2014 data from Statistics Canada, 77 per cent of the time Saskatoon police stop someone suspected of having pot, they lay a charge.That compares with 48 per cent in Regina . The Canadian average was 39 per cent.

Meanwhile, if you look at the per capita rates of pot charges, Saskatoon ranks fourth behind Kelowna, Gatineau and Sherbrooke.

Lucas Richert, a history instructor at the U of S who has an academic interest in pop culture and drugs in North America, said we have to look at many factors when it comes to any conclusions we derive from enforcement rates. “Saskatchewan is a microcosm of wildly inconsistent enforcement rates across Canada.” Saskatoon has chosen a specific course of action on pot, Richert said.

“Saskatoon has traditionally adopted the so-called broken windows approach to enforcement of marijuana,” he said. “The broken windows approach is the idea that a visible police presence and severe crackdown on smaller infractions will deter larger crimes.” He added that resources are a large factor to consider when looking at these rates, as well as “the philosophy of a given chief.”

Dried Buds
Dried Buds

Now, the full article can be seen here: http://www.cbc.ca/news/canada/saskatoon/saskatoon-top-place-in-canada-to-be-charged-for-marijuana-possession-1.3249579

On a final note, I wanted to underline a CRUCIAL part of this tale, a part of the interview that didn’t make it to the news – Police Chief Clive Weighill has been very progressive in certain areas, but his policy vis-a-vis marijuana is perplexing. Part of the story has something to do with the fact that he is President of the Canadian Association of Chiefs of Police (CACP), although this deserves much more exploration in the months and years ahead.

Lumbersexuality in Saskatoon? Oh – and a Bit About Psychiatry

First David Beckham brought us the metrosexual look and now we have witnessed the rise of the “lumbersexual.” In fact, the Oxford English Dictionary just named it one of the most important words of 2015. (Emoji won. But “lumbersexuality” was in the mix.)

In Saskatoon, SK, you will see these particular bearded, booted, manly-men in specialty coffee shops on 20th Street as well as Broadway Avenue. They frequent the Farmer’s Market and craft breweries. Back in October, these hirsute individuals were given the label “lumbersexual” by the website GearJunkie.  And since then, popular culture has taken this term and run with it.

download lumbersexual look

While the U.K.’s Daily Mail has showcased Ben Affleck and Kanye West in flannel and denim, Cosmopolitan asked its readers, “Are you Dating a Lumbersexual?” Here at home, the CBC got it all wrong. It suggested in November, 2014 that the lumbersexual tends to reside in urban centres like New York, Los Angeles, and Toronto.

Of course, this is not entirely accurate.  Anyone who has visited the University of Saskatchewan campus recently can attest that we have real, live lumbersexuals in Saskatoon as well. This is not just a “big” city phenomenon.

However, it is a men’s fashion trend with a long history and it’s wrapped up in the history of psychiatry. At the turn of the 20th century, men trapped in cities began suffering from neurasthnenia, a new disease that skyrocketed to near epidemic proportions in 1880-1890s. There was a concern that middle-class white men were growing more anxious, tired, and depressed.

George Beard, M.D, came up with the term in 1881 and believed that the fast-paced lifestyle and modern industrial economy caused disruptions in man’s “nervous energy.” The way to balance this energy was not simply with drugs. Beard’s answer was to withdraw from the pressures of urban life and get active.

For him, neurasthenia was a catchall term for a broad set of symptoms. And whereas women were ordered to bed for hysteria (or prescribed other unmentionable treatments), men were instructed to get back to nature, find their primitive side, and be masculine. That is, be wild. Outdoorsy. Think Thoreau.

In an effort to capitalize on this diagnosis, the lumberjack image – a rugged, axe-wielding, naturalist – was created to serve as a model of manliness. He was a cure for the chronic neurasthenics and was also a tool of journalists and advertisers. This archetype came to life in magazines and newspapers and was used to sell all manner of goods.

University of Virginia
This chart from American Nervousness, Its Causes and Consequences by George M. Beard (1881) illustrates the progression of symptoms attributed to neurasthenia.

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Are we seeing something similar now in the use of the lumberjack motif?  In an age of increased awareness about Depression and other mental health issues, are we seeing the cyclical return of a 135-year old fashion trend?

Of course, this is what happened with metrosexuality. And the broader lumbersexual phenomenon, according to Tim Teeman, is just straight culture’s latest attempt to theatricalize masculinity – decades after gays got there first.

In Teeman’s view, lumbersexuality is the “latest pasteurizing of sexuality…” It is, he writes (half-seriously) just another way that straights have stolen from gay culture. First it was design expertise, gym dedication, and gift-buying acumen. Now this. “What else can we give you?” jokes Teeman.

In other words, that fellow working in the coffee shop or strolling through the mall is helping reinvent a century-old fashion trend. And his long but well-maintained beard, polished leather boots, tattoos, and dark jeans – let’s be honest, the great style – has a history stretching back over a hundred years.