Review by Terry Messman

[dropcap]I[/dropcap]n Mad In America, Bad Science, Bad Medicine and the Enduring Mistreatment of the Menatally Ill (Perseus Publishing), one lone author bears moral witness to the suffering of hundreds of thousands of people abused, tortured and damaged by the psychiatric establishment. In a stirring act of resistance, author Robert Whitaker names the names that deserve to live in infamy: the inventors of lobotomy and electroshock and tardive dyskinesia.
Robert Whitaker’s book, Mad In America, is a towering achievement that stands shoulder to shoulder with the best investigative reporting in U.S. history. His book invites comparison with other momentous examples of muckraking journalism, such as Rachel Carson’s prophetic environmental expose, The Silent Spring, or William Lloyd Garrison’s liberating reporting on the fight to abolish slavery.
Whitaker’s revelation of two centuries of psychiatric mistreatment serves to unlock the locked wards that for too long have hidden nightmarish abuses from the public. Mad In America also tears away the shroud of silence that has prevented the public from hearing how psychiatric patients themselves have described the untold suffering caused by electroshock, lobotomy, insulin coma therapy, and mind-numbing doses of neuroleptic drugs.
Mad In America is one of those rare works of journalism that truly gives voice to the voiceless. Through Whitaker’s compassionate writing, we now can hear the cries of patients locked away in the permanent silence of asylums; and we can see that they were never really asylums at all, but warehouses of anguish where frightened and traumatized human beings were locked away from the larger society, unseen and undefended in their torment.
Perhaps even more impressive than the insights he has unearthed, however, is the sheer bravery of Whitaker’s full-scale dissent from the accepted wisdom of psychiatry. The boldness of Whitaker’s indictment of the psychiatric establishment is as stirring as Chief Bromden’s unforgettable act of defiance in Ken Kesey’s novel, One Flew Over the Cuckoo’s Nest.
After Randle McMurphy has been lobotomized for instigating an uprising in the mental hospital, Chief Bromden, who has silently endured endless cruelty and dehumanization as an inmate, finally finds the strength to rebel against the spirit-crushing psychiatric overseers. The Chief jerks an impossibly heavy steel-and-cement control panel out of the floor and throws it with all his might through the wire-mesh windows of the locked-down ward, then runs away to his freedom.
In writing Mad In America, Whitaker gathered armloads of scientific research, as weighty as a steel control panel, and hurled it all right through the locked wards of every dehumanizing psychiatric institution in the country. His book is a massive blow against the legacy of psychiatric abuses he has so carefully documented.
Whitaker originally was a highly regarded medical reporter at the Albany Times Union and also wrote off and on for the Boston Globe. A series he co-wrote for the Boston Globe on harmful psychiatric research was a finalist for the Pulitzer Prize in 1998.
In a fascinating twist, when Whitaker began his research into psychiatric medications and drug trials as a medical reporter, he believed that psychiatry had been making steady progress for decades in the treatment of mental disorders. His belief in the wisdom of psychiatry soon began to unravel as he gained new insight from his research into psychiatric practices such as electroshock, lobotomy, insulin coma, metrazol convulsive therapy, and neuroleptic drugs.
Psychiatrists told the public that these techniques “cured” psychosis or balanced the chemistry of the brain. But, in reality, the common thread in all these different treatments was the attempt to suppress “mental illness” by deliberately damaging the higher functions of the brain.
It may seem self-evident now that electroshock and lobotomy purposely assault and incapacitate the brain, but the next generation of antipsychotic medications also created the same kind of brain pathology by blocking the neurotransmitter dopamine and essentially shutting down many higher brain functions.

A ‘Chemical Lobotomy’

In fact, when antipsychotics such as Thorazine and Haldol were introduced, psychiatrists themselves said that these neuroleptic drugs were virtually indistinguishable from a “chemical lobotomy.” That is why Mad In America is subtitled “Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill.”
Whitaker traces a clear path from the crude use of lobotomy and electroshock to today’s much-hyped neuroleptic drugs and newer “atypical” drugs, and shows that all these treatments indiscriminately disrupt higher brain functions and short-circuit patients’ thoughts, emotions, memories, and even their basic personality.
Dorothy Day of the Catholic Worker newspaper said that the sacred task of the journalist is to “comfort the afflicted and afflict the comfortable.” Whitaker’s book is indeed full of compassion for the afflicted victims of psychiatry. But, oh, how his book afflicts the comfortable!

Whitaker reveals how Benjamin Rush, the “father of American psychiatry,” theorized that insanity was caused by “morbid” qualities in the blood, leading him to conclude that as much as “four-fifths of the blood in the body” should be drawn away; Rush bled one patient 47 times, removing four gallons of blood over time. He also strapped patients horizontally to a board and spun them around at great speeds. He confined others in his “Tranquilizer Chair” that completely immobilized every part of their body for long periods and blocked their sight with a bizarre wooden shroud, while they were doused in ice-cold water.
That is how psychiatry began in our country — with practices indistinguishable from torture.
Whitaker’s book uncovers a shameful history of psychiatric mistreatment, in which teeth and bodily organs (including gall bladders, colons, and the ovaries of women) were surgically removed to get rid of the “bacteria” thought to cause insanity.
Under the guise of “therapy,” patients were put in coffin-like boxes and nearly drowned in ice-cold vats of water; while others were weakened by being whipped, nearly starved and given nausea-inducing agents. Silent generations of patients were penned up in psychiatric dungeons for life to keep them from ever having children.

Forced sterilization in the United States and Nazi Germany

Whitaker unveils a truly frightening history of prominent psychiatrists joining with the eugenics movement to rid the gene pool of the “insanity gene” by classifying mental health clients as debased and subhuman. Eugenicists sought to cleanse America of the mentally ill by forcibly segregating them in asylums so they couldn’t procreate, and then sterilizing tens of thousands of patients to prevent them from breeding.
The U.S. eugenics movement was a key inspiration for Nazi Germany’s similar programs to segregate and sterilize mentally disabled people, and German scientists even traveled to California to study our program of forced sterilization.American eugenics may have reached its apotheosis in 1935 when Alexis Carrel, a physician at Rockefeller Institute for Medical Research in New York, wrote that the mentally ill “should be humanely and economically disposed of in small euthanistic institutions supplied with proper gases.” The U.S. psychiatrists who embraced the program of compulsory sterilization directly influenced the doctors of the Third Reich, who would soon begin the “mercy killings” of mental patients.
As psychiatry advanced in the 1940s and 1950s, the scientific assault on the brains of patients became, if anything, more methodical and in some cases more terrifying. Insulin coma, metrazol convulsion therapy, electroshock and lobotomies were used to cripple the frontal lobe and the higher brain functions that separate human beings from the lower primates.
This assault on the brain then came fully into the present with the widespread use of neuroleptic drugs such as Thorazine and Haldol, and the current use of the new “atypical” antipsychotic drugs Zyprexa, Clozaril and Risperdal.
Both the neuroleptics and the atypicals create brain pathology by blocking the flow of neurotransmitters, leaving patients dulled, lethargic and vegetative. The neuroleptics unleashed a devastating epidemic of “persistent Parkinson’s” symptoms and the terribly disfiguring neurological dysfunction called tardive dyskinesia. The new atypicals have already been linked with immense weight gain, diabetes, and the dangerous depletion of white blood cells.

A stirring act of resistance

The publication of Mad In America is a watershed moment in the history of human rights. I was not the same after I read it. It is a searing historical expose that has an impact comparable to reading the stories of Holocaust survivors. It is a song of lamentation for the human beings we have lost. It is an act of compassion that reclaims the humanity of psychiatric survivors.
For over 30 years, patients rights groups have been speaking out against psychiatric abuses — the torturous treatments, the loss of freedom and dignity, the misuse of seclusion and restraints, the neurological damage caused by “antipsychotic” drugs. But these groups have been condemned and dismissed by the psychiatric establishment, and their truths censured and denied.
Perhaps it takes a book by an outside journalist who fully believed in the widely parroted story of “progress” being peddled by the giant pharmaceutical corporations that utterly dominate the practice of psychiatry today. Through his historical and scientific research, Robert Whitaker has shattered that myth of progress and has shown that antipsychotic drugs are nothing more than the latest, most trendy form of “brain-damaging therapeutics.”
Mad In America is an astonishing indictment of 250 years of psychiatric mistreatment, dehumanization, torture, and the deliberate infliction of brain damage. One only wishes that it could be prescribed as a form of “forced treatment” and made mandatory reading for every psychiatrist and corporate drug pusher in the land.