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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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Page 43:


During most of this restraint I was in the padded cell. A padded cell is a vile hole. The side walls are padded as high as a man can reach, as is also the inside of the door. The worst feature of such cells is the lack of ventilation, which deficiency of course aggravates the general unsanitary condition. The cell which I was compelled to occupy was practically without heat. As a result I suffered intensely from the cold. Frequently it was so cold I could see my breath. And, though my canvas jacket served to protect part of that body which it was at the same time racking, I was seldom comfortably warm. For, once uncovered, my arms being pinioned, I had no way of re-arranging the tangled blankets. What little sleep I managed to get I took lying on a filthy and hard mattress placed on the bare floor.


Lack of ventilation means vitiated and foul air, and vitiated and foul air was the last thing one in my condition should have been permitted to breathe. I was entitled to an adequate supply of oxygen, for, being two or three times as active as any normal person, I was burning up a proportionately greater amount of tissue. Strangely enough I was able to hold my own while thus subjected to a process of slow poisoning; but I am confident that many a patient, possessed of less stamina, has been seriously affected, if not permanently injured, by confinement in such unsanitary dens. To describe the condition of a padded cell at its worst would violate good taste. As it is likely to be in an unmentionable condition for hours at a time the seriousness of the situation may be appreciated. The condition of my mattress was such that I objected to its use; and nothing so justifies my objection as the fact that it was actually and immediately heeded. It seems to be the prevailing opinion that "anything is good enough for a crazy man." In my opinion, if the sane suggestions and requests of insane patients were complied with, as my suggestion was on this occasion, hospitals for the insane would become model institutions sooner than they will if the needed changes continue to depend upon indifferent persons in authority.


It is to be regretted that many hospitals for the insane maintain such cells -- either padded or unpadded. Like strait-jackets they can be used to advantage only on the rarest occasions. Therefore they should be abolished. They have already been abolished by those doctors who are advocates of Non-Restraint -- except in a few instances where the authorities have not yet given these intelligent superintendents money enough to provide the added attention and equipment necessary to care properly for a patient during a period of intense excitement. (6) "

(6) In a hospital provided with modern bathing facilities mechanical restraint and "seclusion" need never be resorted to; for modern equipment includes the so-called "continuous bath," in which an excited patient may be placed and kept for hours, until his excitability gives way to a fairly normal calm. As a rule, patients enjoy the "continuous bath.


The man who was superintendent while I was undergoing treatment at this hospital had, during his early incumbency, gained considerable distinction by advocating Non-Restraint. But, during the latter years of his life, for some reason unknown to me, he permitted Restraint to be used -- in moderation. Nevertheless, "moderation" means "abuse," as my account surely proves. I attribute this doctor's apparent change of attitude to his advanced age, which made it physically impossible for him to give that attention to the individual case which a proper enforcement of Non-Restraint requires. In saying this, however, I do not wish to seem ungrateful to a man, now dead, who did much for me and would have done more had he at the time known of the conduct of his assistant physician.


The present superintendent of this hospital, a man in the prime of life and a firm believer in Non-Restraint, is placing the institution on a Non-Restraint basis. The vile padded cell, already described, no longer exists, and only once or twice during the past year has a patient been placed in a strait-jacket, and then only by the direct order and in the presence of the superintendent himself. Why use a strait-jacket at all? Simply because methods of treatment in an institution in which mechanical restraint has been used cannot immediately be changed. Not that the doctors advocating Non-Restraint need time to adjust themselves to the new conditions, but the attendants require both time and training; and changes also (though not great ones) in the equipment of the building are necessary. The principle of Non-Restraint is something which has to be absorbed. It is an atmosphere of kindliness. It is not unlike the esprit de corps of the army -- a certain standard to be attained and maintained. When attendants once appreciate the significance and advantages of it they invariably take great pride in proving that they have the faculty for controlling patients without resorting to any other force than that of kindliness -- one of the greatest and least used of all forces.

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