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.

Field Of (Broken?) Dreams

Field of Dreams, Tewksbury State Hospital 

The Views From There: Abandoned Lives Edition

Part of what I find so striking about the abandoned Medfield State Hospital are the small moments of decaying remnants that still reflect the experiences of the people who lived and died at this now abandoned asylum. While I walked through the grounds today, accompanied by an occasional turkey running off to the side of me and the sounds of cicadas surrounding me like a summer symphony, I tried to picture what it was to see these images when the asylum was bustling with life.

Here are a few of the moments that captured my imagination. What memories do you think are hidden within these images?

The Human Face of Same Sex Marriage

I recently became involved in a discussion on Facebook about same sex marriage. I generally avoid these sorts of situations. Discussions such as the one I got myself involved in generally become banal and rather frustrating. They usually don't end up very well. Sure, the back and forth is interesting, for a while. In the end the narrative is always the same: one side blames the other for being (circle one: ignorant, uneducated, defensive, stupid) while the other side generally resorts to accusing the other as (circle one: ignorant, uneducated, defensive, stupid). Facts are provided. Facts are disputed. Both parties, in the end, become something akin to a dog, tied to a stake, running around in circles tearing up all the grass.

The end of the conversation went something like this:

Forgotten History

I recently came across a link to the London Science Museum on the Mind Hacks blog. It lead to an interesting morning clicking around looking at all sorts of medical oddities. Where else would I be able to find a diorama of Dr. Lister's ward where he pioneered modern antiseptic techniques? Perhaps you are interested in something older? How about a different diorama depicting the removal of a cataract in 11th century Persia? If that one didn't make you flinch how about an antique dentist chair? There is the interesting (antique acupuncture needles) and the gory (a German amputation knife). Have more prurient interests? How about a reusable condom that needed to be washed, powdered, and dried flat? How about an electric "massager" circa 1913 that physicians used to treat "hysterical" women. Talk about forgotten history!

Of particular interest to me were two grave markers in the London Science Museum collection. These markers came from a place first opened in 1765 as the House of Industry for Looes and Wilford Incorporated Hundreds (a work house for the poor), named the Suffolk County Lunatic Asylum in 1827, renamed again the Suffolk District Asylum in 1906, and then called St. Audry's Hospital for Mental Diseases from 1917 until it closed in the 1990s. The grounds are rather pretty.

Some people spent most--if not their entire--lives in this hospital. They grew up, aged, and died on the grounds of this hospital. The only memory that remains of them are numbered metal grave markers. Recently even the markers were removed when workers came in to renovate the old asylum grounds into a golf course. The surviving buildings have been converted into residences.

There was no record left of these human beings. No mention of their hopes and dreams or their struggles and pains. Reduced to small rusted metal crosses with an embossed number, these people disappeared. I wish there was some way I could reach back in time and let the persons now known as #325 and #1587 know that they were valuable just because they were.

I can't do that. None of us can. We cannot travel back in time and we cannot right what has been made wrong. We can remember the past to honor those who were thrown away. For example, there is a website that collects and chronicles the experiences of workhouses in the United Kingdom.

We can treat each person like they matter--with dignity, respect, and honor. Can you try that today?

Snake Pit: Madness in the Movies

Poor Mrs. Cunningham. The doctor tells her "Don't be afraid, we just want to talk to you." Would you really want to talk to Dr. Kik? I'm not sure I would.

In the 1948 movie "Snake Pit" Olivia de Havilland plays the role of Virginia Stewart Cunningham. Mrs. Cunningham has gone mad and is hospitalized at Juniper Hill State Hospital. What do we learn about madness from this movie? What does the "Snake Pit" show us about madness in 1948? One interesting way to interact with a movie or text is to watch it while asking a single question framed as such: "Mad people are people who ..." 

This basic structure can be used to look at  lots of different questions. For example, what does a particular advertisement for a car company tell you about people who drive that car? In a recent car commercial I watched there were a few key images: children in the back seat, parents singing to classic 80s music, children being embarrassed, children in the backseat watching a DVD quietly, and children in another car not being able to watch TV.

Plug this into the basic structure: People who drive this car have children; people who drive this car sing 80s music; people who drive this car are embarrassing to their children; people who drive this car are better than people who don't; etc. What are you really buying here--a car or a tool to feel better than the people who don't have what you have?

Back to the movie.



3:43 "You heard me ladies, fall in. No talking." Mad people are people who need to follow rules.


4:43 "No talking ladies." Mad people are people who need to follow the rules.


4:56 "Why do we have to keep in line? I don't like regimentation." Mad people are people who need regimentation. Mad people are people who don't know what they need.


5:21 "They treat you like criminals." Mad people are people who are criminals. Mad people are people who are treated like criminals.


Part three might be traumatic for some. Watch at your own peril: it depicts a scene of electro-convulsive shock therapy from 1948.





0:05 If I say I demand a lawyer they'll have to do something. It's in the constitution." Mad people are people who have demands. Mad people are people who don't have rights afforded by the constitution. Mad people are people whose demands are ignored


This next clip offers a harrowing depiction of what might be seen as a hallucination starting at 6:17.




6:35 "Come on. Stop it. Get in there before I..." Mad people are people who are ignored. 

6:52 "Come on, cut it out. No one is going to hurt you." Mad people are people who are not to be taken seriously. 


This final clip offers us the view--and line--that gave us the title of the movie.




9:21"It was strange. Here I was among all those people and at the same time I felt like I was looking at them from someplace far away. The whole place seemed to  me like a deep hole and the people down in it like strange animals, like snakes." Mad people are people who are different. Mad people are people who are in a hole. Mad people are people who are strange animals, like snakes.

Not a pretty picture, eh? What images of madness have you seen and accepted as true? Over the years of our lives each of us accumulate schema--patterns of understanding--for madness and mental illness that create our understanding of the phenomena. What are your's? Have you questioned them?

Can you look beyond your schema and see something larger?

The last of 3,000

Recently a reader of the blog sent me a link to pictures from the abandoned Broadview Developmental Center. What this reader didn't know is that I actually have a connection to the abandoned hospital. Having spent a few years living away from Northeast Ohio, I returned. The first job I got when I moved back was as an assistant house manager for a group home serving people with profound developmental disabilities. The twelve residents who lived in this house were among the last people moved out of Broadview Developmental Center.

I never actually toured the abandoned center. The center had already been closed down for two years--the program I had worked in had been existence for two. Most of the staff remember driving the twelve residences from Broadview Developmental Center to their new home. As they described it, these 12 were literally from the last 25 people who had not been placed in a new home.

I've not thought of Maple House for years. It was a hard job. I was young and inexperienced--and yet really had the impression that I knew what I was doing. Perhaps not the best combination. Perhaps it was a very good combination. The people that I worked with had little or no language skills. Those who were able to talk were very limited. One resident was able to repeat most of the things she heard (a condition called echolalia). Some residents were able to point at things that they might like. Another, who I remember well, relied upon a sole skill at communicating: she would pinch people incredibly hard to signal that there was something she needed. Ouch.

For the most part, the residents were lost to the fog of their minds. I would sit for hours watching the residents. In my eager youthful inexperience I would sit and watch for hours hoping that I would be able to find some sort of meaning in their repetitive movements of mindless stares. I hoped that I could somehow crack the code of their language and bring them back to life.

For most, my efforts were futile. One resident and I traveled a great distance one icy winter day to a well known clinic for people with developmental disabilities. I was trying to find a way to help her: she spent her days engaged in repetitive self-mutilating behavior. The doctors told me that this is just the way it was and the best we could do is medicate the individual so she didn't have enough energy to hurt herself so much. I still feel like I failed her: there had to be some way we could have listened to her closely, heard what she wanted, and restored a bit of dignity and humanity back to her life.

I wonder sometimes if a group home was really any better than an institution. Their environment looked much better: rather than a cold sterile hospital environment they lived in a beautiful home situated on a beautiful tree-lined street in a beautiful suburban town. There were goals for each resident to help them to be as independent as possible, quarterly meetings to discuss their progress, and social programming.

On a deep pessimistic level, I sometimes feel that I was just engaged in a piece of community theater. We had a pretty set, lots of great props, had a great story line.... but behind it all, the props were just cardboard, the story line was empty, and nothing was really accomplished. It felt like we moved these people from a ugly institutional warehouse to a pretty suburban one that was designed to make us all (the non-disabled) feel better.

On more optimistic level I know that I did a lot. I would tirelessly bring in other people to consult on issues facing residents. I discovered that there were people who taught sexuality to those with developmental disabilities: I worked hard to bring those professionals in to help us find ways to restore that part of humanity to the residents (you'd be amazed, despite the evidence to the contrary, how many people insisted that the residents weren't interested in this). I devoted a significant amount of my time to learning about adaptive communication equipment and trying to find the funds to purchase that equipment to help some of the residents communicate their needs to the outside world (you'd be amazed at how many thought this was a waste of money).

The most honest assessment is that I accomplished little. There were no "Awakenings" moments for the residents. There lives were much  more comfortable, that was sure. They were afforded a bit more dignity and respect. Still, much of what we did was group home theater. There was no realistic expectation that any of the people would be living independently. Their disabilities were too profound. Their brains were too damaged by genetic defect, birth trauma, or head trauma sustained from childhood accidents.

Just because these people are damaged people does not mean we don't have to offer them dignity and respect. The hurt, lost, and forgotten of the large state institutions have taught us that lesson in a painful way. Many people who were different got swallowed up by these large institutions who could have functioned very well in an independent setting (people with epilepsy, for example, found their way to these institutions).

But what of the people who cannot be independent? What of the people who cannot ever communicate, feed themselves, or dress themselves? I think it is only right that we treat them with as much dignity and respect. I think offering them loving-kindness is the moral thing to do.

There is something much bigger here to be learned. In looking at these pictures of Broadview Developmental Center, Foresthaven Developmental Center, modern day asylums around the world, and abandoned asylums in the United States, I've learned something unexpected. In restoring humanity to those who are hurt, lost, and forgotten, what I really was doing was finding my own humanity. I hope in looking at these images you can find part of your own humanity being restored too.

On the Inside

Stanley Milgram

As many do, I thought I new everything in college. It was 1991 and I was in the middle of my undergraduate education. Among other things, I was learning about the ethics of psychology. I remember hearing stories of stuff way back when--Stanley Milgram and his experiments about power and obedience, Phillip Zimbardo's Stanford Prison experiment, and John Watson's study with little Albert.

The essence of what I was taught was this: we've come a long way. Along that way we've learned about ethics, and the importance of protecting people who participate in research projects. In other words, we've gotten better at caring about people. I thought psychologists were so smart--so ethical. The world back then was dark, unethical, and filled with horrors. The world now was filled with compassion, thoughtfulness, and ethical behaviors.

At the same time I was learning this, Forest Haven Developmental Center (sometimes called Fuller State School and Hospital or Patuxent Mental Hospital) was shut down by the Federal Government after the center was successfully sued. This was not the first lawsuit: one was filed in 1978 about poor conditions and then another in the 1980s. I was so wrong about the world being filled with compassion, thoughtfulness, and ethical behaviors.

Who was in Forest Haven? Elroy was one resident. He grew up in Forrest Haven and was given a home in the community when the center was shut down. Here is what the Washington Post wrote about him in 1999 in an expose about the still damaged system for caring with people who have developmental disabilities:

Elroy lives here. Tiny, half-blind, mentally retarded, 39-year-old Elroy. To find him, go past the counselor flirting on the phone. Past the broken chairs, the roach-dappled kitchen and the housemates whose neglect in this group home has been chronicled for a decade in the files of city agencies. Head upstairs to Elroy's single bed.

"You're in good hands," reads the Allstate Insurance poster tacked above his mattress -- the mattress where the sexual predator would catch him sleeping. Catch him easily: The door between their rooms had fallen from its hinges. Catch him relentlessly -- so relentlessly that Elroy tried to commit suicide by running blindly into a busy Southeast Washington street.

These days, reconciled to living, Elroy has fashioned ways to cope. He keeps private amulets against a misery he doesn't fully grasp. There's the leatherette Bible he can't read; the Norman Rockwell calendar of family scenes he hasn't known.

And there's his strategy of groping his way down to the bare-bulbed basement again and again to wash the sheets from his violated bed, as if Tide could cleanse defilement. "God is a friend of mine," he says. But absent divine intervention, "you just gotta do what they say." Just got to add soap powder, and more soap powder, turn the dial to hot. "Gotta not let the worries pluck your nerves."

Here are a few images of what is left of this former state-of-the-art facility for the treatment of children and adolescents with developmental disabilities (and some children who were just discarded and thrown away by their parents for no apparent reason).

http://www.urbanatrophy.com/

http://www.urbanatrophy.com/

http://www.urbanatrophy.com/

http://www.opacity.us

I'd like to say that we've learned a lot since 1991 when this facility was shut down. In some ways we have. In the mid-1990s I spent some time working in upstate New York in a supervised apartment program for people with developmental disabilities that was exemplary. I learned some powerful lessons--lessons that have deeply influenced my work. Those lessons involve deeply appreciating the right of everyone--regardless of ability or disability--to make an informed choice and have the dignity of risk.

Sadly, we have a lot left to learn. One need only to look here in Massachusetts at the Judge Rotenberg Center for evidence of the work that needs to be done. In 2006 the Boston Globe released a report that detailed:

•  JRC employs a general use of Level III aversive behavioral interventions (electric shock devices, restraint chairs) to students with a broad range of disabilities, many without a clear history  of self-injurious behaviors. 
• JRC employs a general use of Level III aversive behavioral interventions to students for behaviors that are not aggressive, health dangerous or destructive, such as nagging, swearing and failing to maintain a neat appearance.   
•  The Contingent Food Program (withholding food as a behavioral conditioning tool) and Specialized Food Program may impose unnecessary risks affecting the normal growth and development and overall nutritional/health status of students subjected to this aversive behavior intervention

To my knowledge, the JRC hasn't changed. Regardless of whether their techniques work--or don't--are these ways in which we want to treat another human being? Are these ways in which we want to offer care to the hurt, lost, and forgotten?

In The Noonday Demon, Andrew Solomon writes "Most demons--most forms of anguish--rely on the cover of night; to see them clearly is to defeat them". Mistreatment is one demon that we can scatter with sunlight. We have a lot more to learn about how to care for those who are most vulnerable. We need to do better. We need to let the sunlight in.

Out of Sight, Out of Mind

Did you know that as of 2005 countries such as China, Thailand, El Salvador, Turkey, and Vietnam had no laws protecting psychiatric patients? In total 25 percent of countries in the world don't offer any sort of legal protection  guaranteeing the humane treatment of people with psychiatric patients.

Eugene Richards did a photo essay of the conditions some individuals face around the world who have mental illnesses. The people that Eugene document truly represent some of the most disenfranchised, lost, and forgotten people in the world.

Why am I writing about this today? In part it's because I'm fascinated. I'm fascinated how madness/mental illness has been depicted. I'm fascinated how those depictions have both changed and not changed.

More importantly, today I'm writing about this because I think it's important to be reminded every now and again of those in our world that are hurt, lost, and forgotten. It's becoming increasingly easier to insulate ourselves from things we don't want to know about: the right has news programs that present the view from the right, the left has news shows that present the view from the left. Our friends list on social networking sites are generally populated by people who think like us. We readily agree and support those who think like us, argue in a polarized way with those who don't, and close our minds to that which is different.

Every now and again, like when I came across this photo essay, I see something that stretches me--something that  makes me think about things that I would rather not. In this era when so many say we can't afford to care for those who are most vulnerable, I think it's important to see what happens when we don't care for those who are most vulnerable. I think it's important for us to see what we don't want to see.

What don't you want to see? Can you find a way to look at it today?

My First Trip to the Asylum

Worcester State Hospital

One of my first jobs was a case manager for a social service agency. We worked specifically with people who were (1) homeless (2) had severe mental illnesses and (3) had never received any sort of public services before. Being the newest case manager, I was assigned to work with people who were committed to the local state hospital because they were judged to be not guilty by reason of insanity. By law, each and every person in the hospital, regardless of background or status, had a community case manager to advocate for them and help them prepare to be released from the hospital at some point in the future.

These were people that most of society had considered hopeless. All had committed some sort of violent crime. All suffered from hallucinations and delusions that medication were unable to help. Some had been in the hospital since the 1950s! Most had never used an ATM, used a phone that didn't have a rotary dial, and of course none had ever even known there was an internet. 

I went to the hospital every two weeks to visit a handful of people. Every time I went it was a strange experience. The building was something that looked right out of a Dickens novel. I'd pull into the parking lot, register in the office, and pick up a set of keys. At least, I would try to pick up a set of keys. Sometimes other case managers had all the keys so I was left to fend for myself. 

Taunton State Hospital

I'd go to the building were my clients lived. Work my way through security. When the elevator door opened to the secure floor I'd feel most of the humanity get sucked out of the room. A mass of people would be on the floor. Some would watch TV, others would stare aimlessly out the window. I never saw a single hospital person interacting with the patients. 

The staff would all be locked inside the office area. There were always a group of patients banging on the door trying to get someone's attention. They'd usually be responding to some sort of hallucination or delusion. It was sad--and I was sad. I was not yet even 23 and thought I could change the world. I learned quickly there was not much to do to help these people. My sadness grew--in part because there was not help--but mostly because I could not help the staff there. I couldn't ever seem to convince anyone to care about the people banging at the door or staring out the window. 

Greystone Park State Hospital

I also had a sub-clinical anxiety in the hospital. I worried that someday I'd be mistaken for a patient, be stripped of my humanity, and refused exit and told that I was hallucinating and wasn't actually a case manager.   Of course, this came true in a way. One day there were no keys available were the social worker's checked in. There weren't even any ID badges. I did my visiting and had a meeting with staff. I left the staff offices for the elevator to leave. Of course I couldn't leave because I didn't have a key to operate the elevator. There were no staff on the floor to be found. As you  might be guessing, I soon joined the couple of people banging on the door of the staff office. My sub-clinical anxiety now a real thing: locked inside, ignored, trying to get the attention of the staff. 

It took me 20 minutes to get someone's attention.

I leave you today with these images from 19th century insane asylums. They were big, graceful, beautiful places. The hospital I visited was similar to these images--I know what they looked like in the early 1990s. Ever wonder what they looked like in the late 1800s or early 1900s?

These images are all of Kirkbride designed hospitals. Dr. Kirkbride was a 19th century physician and asylum superintendent who wrote about hospital design. He had an enormous influence on the conceptualization and construction of insane asylums in the latter part of the 19th century. The design of the building itself was seen as an agent of change to help patients return to sanity. You can find out more here. The views change a little bit when you look inside and away from the places where the administration worked.

Buffalo State Hospital

Iowa State Hospital

Cherokee State Hospital

Athens State Hospital