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A Mind That Found Itself: An Autobiography

Creator: Clifford Whittingham Beers (author)
Date: 1910
Publisher: Longmans, Green, and Co., New York
Source: Available at selected libraries

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It began in this wise: Early in October a man was committed to my ward whose abnormality for the most part consisted of an inordinate thirst for liquor. He did not appear to me to be really insane, nor, according to report, had he ever been so, except as thousands of free men are who have poisoned their systems with strong drink. He was over fifty years of age, well educated, traveled, refined and of an artistic temperament. Congenial companions were scarce where I was, and he and I were soon drawn together in friendship. This man had been trapped into the institution by the subterfuge of relatives. As is common in such cases many "white" lies had been resorted to in order to save trouble for all concerned, -- that is, all except the patient. To be taken without notice from one's home and by a deceitful, though, under the circumstances, perhaps justifiable strategy, placed in a ward with fifteen other men, all exhibiting insanity in varying degrees, is as heartbreaking an ordeal as one can well imagine. Yet such was this man's experience. A free man one day, he found himself deprived of his liberty the next, and branded with what he at the time considered an unbearable disgrace. In justice to the relatives of this man, however, it is but fair to credit them with good intentions. They simply erred through ignorance. Like ninety-nine out of a hundred persons so situated, they did not know that it is not only safe, but advisable, to tell the afflicted one the truth, and nothing but the truth -- after his mental condition has been passed upon by competent authorities and arrangements have been made for his transfer to a public or private hospital. This point I have discussed with physicians who have had placed under their care hundreds of insane persons. Their advice may be summed up as follows: After the relatives of an insane person, or of a person threatened with insanity, have reached the point where commitment of the patient has become inevitable, let them act with decision, tact, and honesty. First complete the arrangements for the transfer of the patient to the hospital; then shortly before the transfer is to be made, tell the patient frankly why such action has been taken or tell him earlier, provided he be kept constantly under the care of a nurse -- this to guard against any overt act induced by that innate and sometimes overpowering dread of confinement in a hospital for the insane. (2) Emphasize the fact that a mental disorder cannot be treated properly at home, and that the patient will stand a better chance for recovery in an institution than out of one, -- which is true. Assure the patient that he will be visited often by relatives and friends, and impress upon him that his every interest will be safeguarded. Then keep such promises to the letter. Experience teaches that a patient who is treated honestly from the beginning usually enters a hospital with comparatively slight reluctance. Further, he is quick to appreciate the advantages of hospital treatment, -- indeed, he frequently appreciates its benefits much sooner than those who effected his commitment. Thus, by a firm, tactful, honest method of procedure, a patient's confidence in his relatives, friends and the hospital authorities is at once established and easily maintained, with incalculable benefit to all; whereas, on the other hand, subterfuge and "white" lies -- which are so often black lies, undermine the confidence of the patient, make him unhappy, delay his recovery, and seriously hamper the hospital officials in their appointed work.

(2) As laws regarding commitment are not uniform throughout the country, it would be necessary in some States to tell the patient, earlier than is here suggested, of his impending transfer to a hospital. Thus do imperfect statutes help to make worse a situation already distressing. Another source of trouble is an ignorant handling of the patient, on his way to a hospital. Trained attendants should be called in at such a time, as is required by law in some States. A general adoption of this law will put a stop to the humiliating, oftentimes cruel, and invariably unnecessary hand-cuffing and binding of insane persons while being transferred to an institution. It seems fair that nurses rather than ignorant, and perhaps unfeeling, officers of the law, should be placed in charge of a person who need plead guilty to no charge other than that of being in ill-health.


Mr. Blank (as I shall call him) was completely unnerved. As he was a stranger in what I well knew was a strange world I took him under my protecting and commodious wing. I did all I could to cheer him up, and tried to secure for him from the attendants that consideration which I deemed indispensable to his well-being. Patients in his condition had never been forced, when taking their exercise, to walk about the grounds with the other patients. At no time during the preceding fourteen months had I seen a newly-committed patient forced to exercise against his will. One who objected was invariably left in the ward, or his refusal reported to the doctor before further steps were resorted to. No sane person need stretch his imagination in order to realize how humiliating it would be for this man to walk with a crowd which greatly resembled a "chain-gang." Two by two, guarded by an attendant -- usually two attendants -- these hostages of misfortune get the only long walks their restricted liberty allows them. After the one or two occasions when this man did walk with the gang I was impressed with the not wholly unreasonable thought that the physical exercise in no way compensated for the mental distress which the sense of humiliation and disgrace caused him to suffer. It was therefore delightfully easy for me to interfere in his behalf; and when he came to my room, wrought up over the prospect of another such humiliation and weeping bitterly, I assured him that he should take his exercise that day when I did. My first move to accomplish the desired result was to approach, in a friendly way, the attendant in charge, and ask him to permit my new friend to walk about the grounds with me when next I went. He said he would do nothing of the kind -- that he intended to take this man when he took the others. Said I, "For over a year I have been in this ward and so have you, and I have never yet seen a man in Mr. Blank's condition forced to go out of doors."

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