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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 70:


But such a point, if raised at all, must of course be made without that direct proof which can come only from the man guilty of an act which in the sane world is regarded as odious and criminal. If a crime in the sane world, surely it is doubly a crime when its commission injures a person already stripped of most of his privileges by the laws of the State.


My experience in this respect was not exceptional. I know in my own heart that during the past year thousands of the inmates of our asylums have been subjected to like unjust treatment, and during the past century, tens of thousands. At this very moment many patients quite capable of writing fairly lucid, even sane, letters, are, for any one of a number of reasons, kept out of touch with relatives and friends. These sympathizers would gladly keep in closer touch with the afflicted ones, if they were advised to do so by the hospital authorities. But, instead of encouraging such beneficial intercourse, doctors, with few exceptions, at least tacitly discourage it. Occasionally those in authority frankly advise against it. When such advice is given the doctors explain at plausible length that the receiving and reading of messages from home tends to excite the patient -- especially when the patient first enters an institution. To my mind this procedure is wrong. It is, indeed, worse than an error of judgment. It is a positive cruelty. The patient when committed has enough to contend against without being forced to fight for his life and liberty unsupported by messages from those he loves -- or, for that matter, even temporarily hates. The first weeks of exile are the ones which determine the patient's attitude toward his new and distressing environment. If to a patient's sense of loneliness there be added the suspicion or belief that his relatives and friends have forsaken him, does it not stand to reason that his recovery will be retarded, if, indeed, the consequent dejection does not forever render recovery impossible?


I do not exaggerate when I say that this interference with a privilege which is part of the birthright of every American citizen causes more anguish among the insane than physical abuse. One can suffer an incredible amount of physical abuse, and forget and forgive. But the opening and illegal confiscating of letters is nothing short of dishonorable in the eyes of men and women brought up to respect the sealed messages of others. The moment a patient proves to himself -- and the proof is seldom wanting -- that his mail is being tampered with, that moment he loses all confidence in the doctors. As insanity itself in a majority of cases is characterized by an inordinate suspicion of others, is it sensible or scientific for a management to forever undermine the very grounds of belief that must be established if a recovery is to be hastened, or ever secured?


I will admit that there may be an occasional instance where messages from home might prove detrimental, but such cases are so rare as to justify my contention that every patient, from the moment of commitment, should be allowed a high degree of liberty in the matter of correspondence. His letters, both incoming and outgoing, should not be subjected to the scrutiny of officials whose burdensome duties so often render impossible anything like a fair inspection of the patients' mail. Indeed, the only type of physician that deserves to be invested with powers of censorship is that, I regret to say, rare type of man who is so interested in his work that he desires to read letters for the purpose of judging, with scientific precision, a patient's state of mind at a given time. Without question, written thoughts furnish an invaluable basis for diagnosis, and to deprive a high-minded psychiatrist of the privilege of scientific scrutiny of mail-matter -- which term I use in contradistinction to scrutiny of the more common, self-protecting sort condemned -- would no doubt work an injustice to all concerned. Nevertheless, in view of the fact that comparatively few physicians working among the insane seem able to censor mail in the right rather than the wrong spirit, I feel safe in recommending that a letter written by a patient should be sent without censoring, or not be sent at all. Inasmuch as a psychiatrist genuinely interested in the welfare of a given patient will, perforce, be on the best of terms with his conservator, and, in most instances, with the patient himself, it will be an easy matter for him to secure copies of a patient's letters -- or the originals -- simply by stating his reasons to the conservator and asking for what he wants. In this way, freedom of communication with the outside world may be maintained and the interests of the patient -- and physician -- conserved. In contending that letters written by a patient should be forwarded unopened, unread, I do not mean that the inmate of an asylum should be permitted to write to any and all persons. For his own protection, and the protection of the public, he should be allowed to write only to those designated by the persons who effect his commitment, provided the list contain at least one other name besides that of his appointed conservator. This second person should be one who is interested in the welfare of the patient, for it frequently happens that the legally appointed conservator is derelict in his duty. A committed person should be permitted to write at will to his conservator, and to the one other person selected by himself -- or selected for him, should he himself express no choice. In addition to these two persons, as many other relatives and friends should be placed on the list as the conservator may see fit to designate.

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