"This is a field where fads and fancies flourish," Joint commission on Mental Illness and Mental Health, 1961

Who is considered insane? In 1959, Jonika Upton's family committed her to a Sanatorium. The reason being, they were upset that Jonika had run off to Santa Cruz, California, several weeks earlier with a twenty-two-year-old artist boyfriend. She’d also had a boyfriend they suspected was “homosexual,” and she walked about carrying ‘Proust’ under her arm. Proust is one of the most influential authors of the 20th century, but apparently Jonika's parents were unhappy about their daughter's intellectual and social pursuits. The admissions record for Jonika described her as “alert and cooperative but [she] makes it plain that she doesn’t like it here.” Well, who would?

At the Sanitarian, doctors ran high-voltage electric shock currents through Jonika sixty-two times in three months. Electroshocks, severe trauma to the head, were usually done to a bound, terrified person. They can lead to permanent impairment, lowered cognitive function, memory less, and diminished intuition and imagination, however the message given to the public was that it was safe, effective, and painless, yet it was barbaric and dangerous physical torture.

Up to forty percent of patients suffered bone fractures with electroshock. If a patient resisted, they would choke him until he came to, then shock him. In California, (oh that progressive state), doctors used electroshock to quiet down noisy patients. Jonika’s doctor in Albuquerque lamented, “She has not become nearly as foggy as we might wish." At the end of treatments, she was peeing on herself, wandering around naked, and confused. She died from "treatment."

Mad in America is the best book I’ve read about the cruel, corrupt, non-scientific medical field. It’s well researched, and a fascinating, horrifying page-turner. It should be required reading.

Psychiatry began as a form of social control. It was heartless, judgmental, racist, classist, and concerned about money and power of the practitioners. Eugenics was the rational used for the mistreatment, sterilizations, and experimentations done to people who had experienced trauma, or a temporary break, or were Proust reading, independent young women.

A dishonest narrative was crafted that people who had a psychotic break are lunatics or beasts to be broken, degenerate stain of humanity, social wastage, malignant biological growths, specimens to be exterminated. The chemical imbalance theory is not science based and has been disproved, but it is still believed.

In 1883, Galton coined the term eugenics for the science that would improve the human stock. Eugenicists believe there are two classes: eugenic (well born), and cacogenic, (poorly born). Insanity was seen as the end progression of being poorly born, a fault of the germ-plasm that is poisonous slime.

The unfit, those deemed to have inferior genes, (including many immigrants), were prohibited from marrying and sterilized. A study disproved the genetic link theory, but Dr. Rosanoff manipulated his study by expanding the definition until he got almost an exact match to the number needed to support his hypothesis.

Gynecologist William Goodall reported that removing a woman's ovaries could cure insanity. in 1907, Indiana passed the first compulsory sterilization law. In 1921, the selling of eugenics in America began. This coincided with the wealthy being concerned about their tax burdens and wanting to do away with degenerates. Eugenicists wanted to send the mentally unfit to detention camps, not therapeutic hospitals, until they were past reproductive age.

The U.S. was the first eugenics nation. By 1921, nearly 80 percent of the 3,233 eugenic sterilizations done in the U.S. had been performed in California. They wove a narrative that doctors found sterilization to be therapeutic. They said the mentally ill desired it.

In 1925 Adolph Hitler wrote Mein Kampf, influenced by America, (particularly California), in which he hailed eugenics as the science that would rebuild the nation. Germany had become the most progressive nation in restricting fecundity among the unfit. Theodore Roosevelt was in favor of it too. Then the question arose, "Should a state simply kill it's insane?"

In 1935, 83 percent of all Californians favored eugenic sterilization of the mentally ill. Alexis Carrel at the Rockefeller Institute for Medical Research wrote that the insane should be “disposed of in small euthanasic institutions supplied with proper gases.” Nazi Germany began doing this in 1940. Over eighteen months, Nazis gassed more than 700,000 mental patients. It’s disturbing to see who was making decisions about who was crazy and who wasn’t.

After World War II, Americans looked at their mental institutions: inhumane places with prisoner-patients in foul, cruel, disgusting conditions to confine them away from society. The AMA hired John Grimes to head a committee studying mental institutions. Grimes prepared a 121-page report of dismal, inhuman conditions, which is what he found. The AMA asked him to suppress his report, he refused, and was fired.

Early psychiatry used bleeding, purges, emetics, nausea-inducing agents, surprise plunges into water, a swinging apparatus to make patients dizzy, blistering, shaming, chemical restraints such as morphine, opium, and sedatives, straightjackets, shrink wraps, and starvation diets.

In the 1930s, those deemed mentally ill were subjected to insulin coma, Metrazol convulsive therapy, electroshock, clitoridectomies to curb masturbation, injected with chemicals and cerebrospinal fluid, had their teeth removed, whipped, fed sheep thyroid, and given prefrontal lobotomies, (icepicks into the eye sockets to pick out the part of the brain that makes us human, gives us motivation, and higher thinking).

Proust carrying and other people deemed unfit also were subjected to removal of their healthy organs: tonsils, parts of the colon, gall bladder, appendix, fallopian tubes, uterus, ovaries, cervix, and seminal vesicles. They were injected with malaria infected blood, given refrigeration therapy, and nitrogen instead of oxygen.

All these things hurt or killed people, but the doctors got paid.

The Metrazol triggered such immense seizures that could fracture bones, loosen teeth, hemorrhage organs and make the victims feel like they were being roasted alive. They cried out "in the name of humanity, stop the injections!" These doctors were torturers.

Doctors got paid well for saying that a man's wife, or children who didn't behave as their parents wanted, were daft. People were labeled as mentally ill without any real way to measure, or by some sort of prejudice. Masturbation, imagination, a circulatory imbalance - too much blood to the head, a chemical imbalance, exhausted nerves, organic illnesses were said to be the causes.

Then began the lobotomies, which injured the frontal lobe of the brain with an icepick inducing a childish state, apathy, and "loss of sparkle." Doctors with impressive resumes, who were bought off, pontificated on unscientific theories, and rigged their studies.

Lobotomy, as many harmful medical fads like plastic surgeries, was sold with heavy disinformation and a strong, dishonest public relations campaigns. Lobotomies could relieve everything from tension to insomnia, panic to hallucinations, and more. Patients were given coloring books, dolls, and teddy bears afterwards. “Too bad,” some of the doctors said, "some of our patients were highly gifted and ambitious," but ya know, they had become sick because they were too inventive. Those damn artists! Besides, lobotomies yielded a pretty penny for the doctors.

The eugenic conception of the mentally ill allowed doctors to deem frontal lobotomies a success. Some people - mostly women - sought out the icepick-in-the-eyes operation, (that was sold as "minor surgery"), as a cure for simple depression. Families had a say in who was a candidate. How would you like your dysfunctional family having a say about whether you were drugged up, shocked, or given a lobotomy? People were dying, seizing up, left incontinent, and disoriented. Ah, the miracles of medicine. The last lobotomy was done in 1954.

Families still do scapegoat a person and set them up for a life of false diagnoses and mistreatment.

In 1954 riding in on a fake white horse came Thorazine, a lobotomy in pill form. It took a decade to turn it into an antipsychotic. The patients were "a bother to no one," in this drugged state. In 1954, a Swiss psychiatrist said thirty-seven percent of his patients treated with chlorpromazine, (Thorazine), showed signs of Parkinson's.

In 1951, Senator Humphrey cosponsored an amendment to the FDA that "greatly expanded the list of medications that could be obtained only with a doctor's prescription." This turned doctors into the drug vendors they are today and a much more privileged status in society. "Drug companies began showering them and their professional organizations, with their marketing dollars, and that flow of money changed the AMA almost overnight."

As the money from drug companies poured in, the AMA dropped its critical stance toward the industry. It "stopped publishing it's book on useful drugs, abandoned its seal-of-approval program, and eliminated its requirement that pharmaceutical companies provide proof of their advertising claims." They didn't even require drugmakers to prove drugs were effective.

Ads in journals exaggerated benefits and obscured risks. Medical journals refused to publish articles criticizing drugs and methods. Pharmaceutical companies ghostwrote the articles. They recast neuroleptics as safe, anti-schizophrenic drugs. In 1954-55 Time and The New York Times hailed Thorazine as a wonder drug. Nothing was said about Parkinson's symptoms or lethargy.

Gregory Zilboorg, a NY psychiatrist, said the public was being grossly misled. The purpose of the drug was to make hospitalized patients easier to handle. Lawrence Kolb, former director of U.S. Public Health Services' mental-hygiene division said neuroleptics are "physically more harmful than morphine and heroin." Neuroleptics hinder recovery; patients said they turned them into zombies. People treated without drugs function better and relapse less.

in 1961, The National Institute of Mental Health concluded the exact opposite about neuroleptics than their peers did a decade earlier. This dishonest transformation landed psychiatry as a modern discipline, able to offer "curative" pills. Pharmaceutical firms had lifelong customers and a public clamoring for pills that alter a person's behavior by shutting down vital dopaminergic nerve pathways and impairing the limbic system, (which regulates emotion), thus providing a drug-induced lobotomy. Our perceptions of how we see those with people deemed mentally ill is affected by how we see them drug-impaired.

In Vienna in 1916-1917, there was an epidemic of the infectious encephalitis lethargica, characterized by among other things, double vision, delayed response, and lethargy. When this epidemic passed, the physical symptoms attributed to schizophrenia were dropped from the definition. The concept of schizophrenia was conceived amid diagnostic confusion. In the 1960s, American psychiatrists applied the schizophrenic tag to a wide range of people who might just be moody or non-conformists, 69 percent, as compared to 2 percent in London. American doctors were preferentially applying the label to people with black skin and the poor. African American slaves were diagnosed as mentally ill when they tried to run away. Asylums were used as poorhouses.

David Rosenhan did a famous experiment in 1973 where he and seven other normal people went to mental hospitals. They behaved calmly, but feigned auditory hallucinations in the interview process only, saying they heard a word, "thus, empty, or hollow." Once admitted to a psych hospital they behaved normally. All but one pseudo-patient was diagnosed as schizophrenic. Rosenhan wrote, "We now know that we cannot diagnoses sanity from insanity."

Neuropsychiatric drugs cause akathisia. In one study, 79 percent of people on neuroleptics who tried to kill themselves suffered from akathisia. 75 percent of patients treated with one Haldol injection experienced akathisia. They also became violent and suffered from poor health. In 1969 it came out that Soviets used neuroleptics to punish dissidents.

The idea that people who struggle mentally were born with a brain that needs lifelong medication to fix a chemical imbalance is a lie. A simple dopamine excess model of schizophrenia is no longer credible. The drugs actually turned normal brains into schizophrenic ones, but that was never told to the public. The studies featured abrupt withdrawal, which is very harmful. People were dropping out of the studies due extreme problems caused by the process.

In 1968, George Crane of NIMH sounded the alarm about tardive dyskinesia, (uncontrollable movements cause by psych drugs), but he was gaslit within his community. Finally, he talked about how the drugs had turned into cash cows. Psychiatrists compete with psychologists and didn't want to lose their standing. European doctors, however, did not go along with this lie that the drugs were "like insulin for diabetes."

India, Nigeria, and Colombia have much better long-term outcomes than in developed countries such as the U.S.A. that treats with antipsychotics as the centerpiece of care. Whitaker doesn't have good things to say about antidepressants or benzodiazepines either. Many people are documenting their horror stories with psych drugs. A paradigm shift and call for revolution is needed.

Some positive alternatives include medication free wards and de-prescribing practices. Also, below I list some hopeful approaches, (which have asterisks), in this timeline of significant events.

*1800s Quakers: moral treatment, treated people as Brethren, produced remarkably good results.
*1971, Soteria House in Santa Clara gave care to residents. They were present with them.
1980s, NAMI embraced the biological model and focused on drugs (boo)
1984 Borison and Diamond fabricated results about Thorazine - storytelling re: atypicals
*1987, Hearing Voices Groups
1990, Clozaril by Sandoz bundled with blood tests at $9,000 year
1990s, Clinical researchers serving drug companies boomed
*1992, Swiss Scientists replicated Soteria care
1998, 92 percent of schizophrenics in American were on antipsychotics.
*2012, Open Dialogue Therapy

Again, this book is fantastic! One of the most informative books I’ve ever read. I also recommend the documentary. ( )

This book blew my mind. ( )

This book is probably one of the most disturbing books I have ever read. It tracks the history of psychiatry in America over the last 200 years, from the gruesome physical abuse of days gone by, lobotomy and the shambolic, corrupt trials of modern times. A huge amount of research went into this book. I think that it should be on the reading list of anybody intending to study medicine.

What is so scary about it? I don't think anything has changed. ( )

This was my first read for 2021 and what a start!

The almost 200 years of psychiatric treatment in America, from swinging chairs and drowning tubs, to the emergence of eugenics, to insulin induced comas, to electroshock therapy and lobotomy, to the rise of neuroleptics, atypicals and for-profit research sites. The only reprieves in this horrific timeline are the Quakers' Friends Hospital in 1813 and their belief in truly humane and compassionate care, and Loren Mosher's Soteria House which followed the same ideal. Of course, both of these successful experiments were dismissed in their time. It's all a disturbing mark on our history but one that everyone should know.

The author remains unpolitical in their writing, which I greatly appreciated, sticking to only to patient testimonies, published results, private studies and investigations. I cannot recommend this one enough! ( )

Basically the history of psychiatry in America. Shocking and gruesome and incredibly useful. I already think of psychiatrists as quacks, but I didn't know they had such a violent history of quackery. Wow. ( )