“Is Psychiatry Scientific? “A Letter to a 21st Century Psychiatry Resident” is the title of a lengthy article by Jose de Leon, MD from The University of Kentucky Mental Health Research Center at Eastern State Hospital in Lexington, KY published last September.
He wrote the article because during the development of the DSM-5 the mainstream press was publishing articles questioning the scientific validity of psychiatry.

He hoped as he said “to provide 21st century psychiatry residents with ways of answering these attacks by defining the concepts and history of psychiatry (a branch of medicine), medicine and science.”

He concluded it is a difficult and imprecise task to define these things and ends his article  telling the psychiatric residents they will have to answer for themselves whether psychiatry is a science or not.

But in discussing the history of psychiatry, he makes this interesting statement -“The most important psychiatric advances, electroconvulsive therapy and major psycho-pharmacological agents, were discovered by “chance”, not by scientific planning.”

These two methods of torturing patients were the most important psychiatric advances?

Psychiatry began by embracing Freudian analysis and later variations which explored something that actually existed – the connection between upsetting experiences of the past and their effect on current emotional feelings and behavior. The treatment, involving conversation between two people in a calm setting, did not injure the patient beyond the effect on his pocket book. It even included some ideas drawn from the widely shared ideas about body, mind and spirit found in the fields of religion and philosophy.

But in the early 20th century a new school of psychiatry developed by Kraepelin pushed Freudian analysis into the background. This school used classification of symptoms and the establishment of categories of disorders to set the stage for the so-called “psychiatric advances” praised by Dr. Leon.

A Brief History of the Lobotomy

A neurologist in Portugal named Egas Moniz performed the first modern leucotomy in 1935 in a Lisbon hospital – drilling holes in the patient’s skull to achieve access to the brain for cutting connections. He got the Nobel Prize in medicine in 1949 for this feat.

In 1936, a psychiatrist Walter Freeman and another neurosurgeon performed the first prefrontal lobotomy on a Kansas housewife – renaming the procedure “a lobotomy.”

Freeman believed that an overload of emotions led to mental illness and “that cutting certain nerves in the brain could eliminate excess emotion and stabilize a personality.”

Looking to speed up the procedure without drilling into a person’s head he created the 10-minute transorbital lobotomy (known as the “ice-pick” lobotomy). He first performed this at his Washington, D.C. office on January 17, 1946.

Freeman is credited with doing 2,500 lobotomies – he once performed 25 lobotomies in one day. Reportedly he liked to shock his audiences by to inserting picks in both eyes simultaneously.

“As those who watched the procedure described it, a patient would be rendered unconscious by electroshock. Freeman would then take a sharp ice pick-like instrument, insert it above the patient’s eyeball through the orbit of the eye, into the frontal lobes of the brain, moving the instrument back and forth. Then he would do the same thing on the other side of the face.”

Freeman’s “major psychiatric scientific advance”, the ice-pick lobotomy, became wildly popular. Some 40,000 to 50,000 of these were performed in the US in the late 1940’s and early 1950’s.

A Brief History of ECT – Electric Shock Therapy

Another “chance scientific discovery” was made by Uno Cerletti, an Italian neurologist and psychiatrist.

In the 1930’s he’d been fooling around with giving electric shocks to dogs and other animals in order to cause an epileptic fit in these animals.

The current “science” of the day believed that people with epilepsy were immune to schizophrenia. Therefore, if you could introduce epileptic seizures in the body of a schizophrenic person he would be magically cured as someone with epileptic seizures couldn’t have schizophrenia!

The brilliant idea to use ECT in humans came to Cerletti when he was watching pigs being anesthetized with electroshock before being butchered, as a kind of anesthesia to make them docile. Cerletti observed that the hogs were subdued and calm moments before slaughter after the application of 125 volts using metallic tongs clamped to their temples.

The fact that many of the animals he shocked had died under his treatment did not prevent him from desiring to test it on humans even though he had stated he had “doubts regarding the danger of electric applications to man.”

“At this point I felt we could venture to experiment on man, and I instructed my assistants to be on the alert for the selection of a suitable subject.”

An unlucky man found wandering the streets of Rome in a confused state was brought by the police to Cerletti’s hospital. The man was known only by the initials S. E. – a perfect human guinea pig.

On April 15, 1938 after deciding that S.E. was a schizophrenic Cerletti gave S.E. a shock using 80 Volts through the head observing that the man jumped, stiffened and fell back on the bed and then began to sing.

“It was quite evident to all of us that we had been using a too low voltage,” Cerletti wrote. He discussed the patient with his colleagues and decided to let S.E. rest before giving him another shock. The patient, who had – unbeknownst to Cerletti – been listening to the conversation said clearly in Italian “Not another one! It’s deadly!”

Cerletti wrote about this moment.

“I confess that such explicit admonition under such circumstances, and so emphatic and commanding, coming from a person whose enigmatic jargon had until then been very difficult to understand, shook my determination to carry on with the experiment. But it was just this fear of yielding to a superstitious notion that caused me to make up my mind. The electrodes were applied again, and a 110-volt discharge was applied for 0.2 seconds.”

Natural human terror at being tortured is seen as a “superstitious notion” in the face of “scientific advance”.

More and more such experiments followed. Psychiatrists claimed that one of the unexpected benefits of electroshock was that it provoked a loss of all memory of events immediately anterior to the shock, including its perception. “Therefore, the patients had no negative feelings towards the therapy.”

In 1963, Cerletti is quoted as saying “When I saw the patient’s reaction, I thought to myself: This ought to be abolished! Ever since I have looked forward to the time when another treatment would replace electroshock.”

A Brief History of the Psychopharmacology of Schizophrenia

Psychopharmacology is defined as the study of the effect of drugs on the mind and behavior. Using the example of schizophrenia we can see exactly how “scientific” was the psychiatric profession move into its next big advance – drugs that would keep a patient quiet and docile with all the surgeries or shocks.

Here are some trial and error “treatments” (most people would call them “tortures”) inflicted on schizophrenia patients prior to the creation of pharmacological drugs:

  •     The prescription of cocaine
  •     The prescription of manganese
  •     The prescription of castor oil
  •     The injection of animal blood
  •     The injection of turpentine into the abdominal wall of a woman in order to produce  a large abscess with accompanying fever
  •     The painful injections of sulphur in oil to create fever
  •     Sleep treatments induced with multiple injections of barbiturate (with fatal pneumonia as a side effect)
  •     CO2 inhalation – the “gas cure”
  •     Injections of apomorphine
  •     Injections of the barbiturate sodium amytal
  •     Hypoglycemic treatment, aimed at repeated, reversible comas induced by insulin
  •     Convulsive treatment carried out first with intramuscular injections of camphor
  •     Convulsive treatment carried out first with intramuscular injections of metrazol
  •     Electroconvulsive therapy (electric shock treatments)

In 1952 a surgeon named Laborit was experimenting with an anesthesia model he called “hibernation” created by giving the patient a cocktail of narcotic, sedating and hypnotic drugs. He called on a pharmaceutical company to brew up something for him with enhanced sedative effects and the result was Chlorpromazine – later marketed as Thorazine – the first anti-psychotic drug.

Thorazine

Chlorpromazine produced strange effects which could be likened to a “chemical lobotomy.” He recommended this drug to his psychiatric colleagues and they were off and running. Thorazine secured FDA approval on March 26, 1954 as the first psychiatric medication. By 1990 some 40 variations of this type of antipsychotic drug had been created.

Unpleasant side effects included constipation, sedation, low blood pressure, restlessness and the inability to stop moving, sustained muscle contractions and twitching, and tardive dyskinesia.

Tardive dyskinesia is irreversible and characterized by repetitive involuntary movements like grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips and rapid eye blinking – not the best way to display an elderly aunt when the wealthy family members came to visit the mental institution, so the drug companies got to work on new antipsychotic drugs.

There are now at least 11 “first generation” antipsychotic drugs including the infamous Thorazine and Haldol and 19 atypical “second generation” antipsychotics including the infamous Abilify, Clozaril, Zyprexa, Seroquel, and  Risperdal – all with long lists of debilitating side effects.

New experimental ones are being developed on the usual pattern of psychiatric scientific advancement – “I wonder what would happen if we ….”

They have cheery working titles like DU-127,090, ACP-103 and SCA-136 – nameless drugs for nameless patients.

Is psychiatry a science?

Those students in psychiatric residency who still have any doubts about the history and intentions of psychiatry should visit the CCHR museum in Los Angeles or one of its traveling exhibits called “Psychiatry: An Industry of Death” for a full presentation of the facts.

http://en.wikipedia.org/wiki/Ugo_Cerletti

http://www.cerebromente.org.br/n04/historia/shock_i.htm

http://www.ect.org/cgi-bin/faq/smartfaq.cgi?answer=1014926706&id=1014926466

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843011/

http://katherinegscott.wordpress.com/2011/02/03/a-short-history-of-thorazine/

http://www.hawaii.edu/hivandaids/History%20of%20the%20Psychopharmacology%20of%20Schizophrenia.pdf

http://psychcentral.com/blog/archives/2011/03/21/the-surprising-history-of-the-lobotomy/

http://en.wikipedia.org/wiki/List_of_antipsychotics