Back to the Future: Thorazine for Sanity

healing or control?

I sat around in a circle with my cohort of post-doctoral fellows appropriately snickering. Our training director, Joe Shay, had distributed a list of hundreds of different types of psychotherapy. Many of them were laughable, sad, or just outrageous. How could anyone have practiced these therapies with a straight face? Didn't they know they were quacks?

With our recently minted doctorates in hand, we all looked smug and self assured. We were training to practice dialectal behavioral therapy--the state of the art treatment for people diagnosed with borderline personality disorder. Our mentors were elite luminaries in the field.  Our offices were in the heart of Harvard Square in Cambridge Massachusetts. I felt I arrived in the liberal elite intellectual promised land.

With a deft few words, our training director swept away my smug look of superiority and taught me an enduring lesson. This post today is what I came to know in thinking about Joe's lecture that day.

People have come for treatment for hundreds--if not thousands--of years for phenomena that we currently call borderline personality disorder. People have turned to shamans, priests, friends, psychiatrists, psychologists, and others to receive treatment. Many have gotten better. Some have not.

I walked into that training room as a post-doc thinking I was learning a superior treatment. I couldn't imagine that the treatment I was providing--DBT--could ever be viewed as ridiculous, barbaric, old fashioned, or just plain weird. I could never be seen like those people we were learning about in Joe's lecture. We were better. I was better. These are modern treatments.

As many do, I failed to look forward. I failed to account for the fact that society is evolving. What one considers humane now, will be inhumane tomorrow. What are considered unquestionable facts today will be seen as antiquated examples of magical thinking tomorrow.

I will become a dinosaur one day. The way I practiced psychology will be looked at by some (if I am even remembered) as laughable--or worse.

I had this in mind yesterday morning while I was looking at vintage advertisements for Thorazine.

Extraordinary Escapes of a Lunatic

Sunday March 4, 1860 -- "This day, a lunatic, named Wheedon, was caught and taken back to the Northern Ohio lunatic Asylum from which he had escaped. The Cleveland (Ohio) "Herald" gives the following strange account of him and his escapes. it says:--

Among the inmates of the Northern Ohio Lunatic-Asylum is a person named Wheedon, once a highly-respectable citizen in good circumstances, and said to have been a member of the former coal-firm of I.C. Pendleton & Co. He has been in the asylum for some time.

For some time past he has manifested a strong disposition to escape, and the utmost care and vigilance have been exercised to frustrate his designs, but not always with success. Before being places in his sleeping-room at night, he has always been stripped and carefully examined, to prevent the secreting of any instrument, and all his clothes, but his shirt, pantaloons, and stockings, taken away In spite of these precautions, he has succeeded three times within a few days in escaping from his room.

About two weeks since, he took a set of false teeth out of his mouth, and, by constant work, contrived with them to saw a hole through the floor of his chamber, sufficient to admit of his dropping through into another part of the house, and then escaping. He was traced and caught at the house of Mr. Pendleton, on Euclid Street.

A few days since he secreted a pin, and with that exceedingly unlikely instrument managed to pick the lock of his door and escaped into the hall, where he was fortunately arrested. He then stated that a pin was of more value than ten thousand dollars when he wished to escape from a room.

Last Saturday night he was carefully examined, as usual, before being placed in his room, but succeeded in secreting a small brass ring, split at one part, in his hair. On being locked up for the night, he set to work, and, with the ring, he cut through the window-sash and shutter, so as to enable him to remove them from the window. He then took the coverlet of the bed and tore it into strips, with which he made a rope reaching nearly to the ground,--a distance of some twenty-five or thirty feet. Some of the cotton batting with which the coverlet was wadded, he placed in his stockings, to protect his feet, as he had no shoes. Then, dressing himself in shirt trousers , and stockings, he slid down the rope and escaped.

Striking across the country to Eight Mile Lock, he then took a two-path of the canal and walked to University Heights, where he arrived yesterday afternoon. The officers of the asylum on his track came on him yesterday (Sunday) afternoon. he was very quiet when arrested and spoke freely of his escape, and made no resistance to being taken back to the asylum. We question whether this series of extraordinary escapes can be well matched."

I find it interesting that poor Wheedon, a former employee of  I.C. Pendleton & Company, was so desperate to escape from the Northern Ohio Lunatic Asylum. Even more interesting, why did Wheedon escape the asylum and head to Mr Pendleton's house? Was this the owner of his former company? Was Wheedon's ingenuity based in some paranoid or delusional process about Mr. Pendleton? Was he tossed into the asylum to hide some sort of wrong doing and an irate Wheedon kept trying to escape to find justice?

Give a moment of your time to Wheedon and wonder what the nature of his stay at the asylum was all about. While the facts of the story are likely forever lost, the people who lived and died within the walls of America's asylums are important. There voices help us understand who we were, where where were, and where we are going.

For more about the Northern Ohio Lunatic Asylum click here.

Northern Ohio Lunatic Asylum

Hawthornden State Hospital

A couple of years ago I wrote a blog entry about my first visit to a state run psychiatric facility. It was a harrowing experience that continues to influence my work as a psychologist in complex ways.

Recently someone left a comment on my original blog post. Shuko raised some interesting questions that I want to answer in more detail. That will have to wait for a future blog post since I've managed to get distracted (imagine that!). While you are waiting, check out Shuko's blog here. She has a great way of exploring the history around us in both images and words.

I visited Western Reserve Psychiatric Hospital every two weeks when I was a 23 year old case manager. The hospital has gone by several different names including Hawthornden State Hospital, Western Reserve Psychiatric Habilitation Center, and currently operates under the name Northcoast Behavioral Healthcare.

That's a whole lot of names. What surprises me is that there isn't a lot of information available on the internet about this hospital. It's especially surprising that the hospital hasn't been subject to any significant historical research. It seems that one of the precursors to Northcoast Behavioral Health Care found its way into a national magazine. The article was called Bedlam, 1946 and discussed the Northern Ohio Lunatic Asylum. We'll explore the Bedlam of Cleveland in a minute.

Here is an aerial view of Northcoast Behavioral Health (aka Hawthronden, aka Western Reserve Psychiatric Center) as it looks now.

Google Maps

Let's go back in time. The Ohio Department of Mental Health makes a single reference to the Hawthornden State Hospital. They write:

Hawthornden State Hospital, later known as Western Reserve Psychiatric Habilitation Center, operated as a farm for Cleveland State Hospital from 1922 until 1938. It was established as a separate facility in 1941. 

That's not a lot of information. The blurb however gives me an important clue. The property got its start as a farm for the Cleveland State Hospital. This means our first stop in exploring the history is a field trip.

Fenn College field trip, Special Collections, Cleveland State University Library 

It just so happens that in researching the Cleveland State Hospital, the first image I came across was an abnormal psychology class taking a field trip in 1946. Look at those eager young faces peering into a model of the brain and marveling at it's structure--and perhaps wondering what separated them from the patients in the asylum. Do you think as part of their field trip that they got to meet actual patients? I wonder what these young students thought about as they encountered those who were removed from society and kept for treatment in an asylum.

I also wonder if any of them were aware of the abuses that were going on at the hospital they were visiting. This class visited the same year that Life magazine published the article Bedlam, 1946. Look at the pictures in the article. The broken and abused people being "cared" for by the hospital in 1946 are far removed from the fresh faced college students pictured above.