Providentia

The Problem with Robert Schumann

On March 6 1854, when Robert Schumann first became a patient at a private sanatorium located in Endenich (now part of Bonn), he assumed that entering as a voluntary patient would count in his favour when he eventually decided to leave.  Instead, he would spend the rest of his life there.

Already famous for his prowess as a pianist and a composer, Schumann's seemingly idyllic life, including his marriage to Clara and the eight children they had together, was marred by his lifelong problems with depression.   By late 1853, he began developing new and even more worrisome symptoms, including auditory hallucinations of angelic voices (which may have been linked to problems with tinnitus).   This soon progressed to his experiencing visions of angels and, as his condition deteriorated, of demons as well.   The demonic voices continually told him he was a sinner and that they would be throwing him into Hell.   He also screamed at times due to the belief that he was being savagely attacked by wild animals. 

In the first months of 1854, he began worrying about the possibility of harming himself or his family and he warned Clara that he posed a danger to her.n On February 27, he eluded the family members keeping watch on him and proceeded to a bridge overlooking the Rhine river near his Dusseldorf home.   Then, after throwing his wedding ring into the river, he jumped in himself.  Fortunately, two fisherman witnessed his jump and managed to reach him in their boat and bring him to safety (despite his attempting to throw himself into the river a second time).  

When the fishermen brought Schumann home, he was placed under the constant care of two physicians (Clara didn't learn about the suicide attempt until some time later).   After being kept in isolation for several days, he asked his doctors to arrange his transfer to a mental institution "because only there would he recover."    Since the Schumanns were relatively well-off, the decision was made to send him to the private sanatorium at Endenich where he would receive far better treatment than in a public hospital.    Though Clara was distraught by her husband's condition, she was helped by her mother, children, and family friend, Johannes Brahms, all of whom were present when he was transferred to Edenich with only one physician to accompany him.

The asylum at Edenich certainly had a good reputation and its director, Dr. Franz Richarz, was considered one of the top experts in his field.  Located on a seven-acre estate which had originally been built as a summer residence, it had been purchased just two years before by Dr. Richarz who had then converted it to a hospital.   Retaining much of its original splendor, including extensive gardens, the hospital seemed like an ideal setting for recovering patients.  Certainly its policies were unusually progressive for that era with patients being allowed to walk on and off the grounds for exercise (though Schumann was constantly supervised due to his suicidal history).    Unfortunately, treatment was also extremely expensive and, despite offers of help from Brahms and other friends, was a major financial concern for Clara Schumann.

She was also concerned about the weekly reports she received from the hospital about her husband.   The doctors had asked her not to visit or communicate with her husband directly since they thought this would help him recover faster.   Even the few visitors he received weren't allowed to talk to him, only to observe from a distance.   Whether or not this made good medical sense, it certainly contributed to his feeling of isolation, especially from Clara and his beloved children.   

While the doctors continued to report on his progress, any hope for a speedy recovery was dashed by Robert's frequent relapses, not to mention his constant guilt over something that happened prior to his marriage to Clara (historians are divided over what exactly this was).   Despite his relapses, he definitely improved over time and often went on walks through the hospital's gardens.   Though he was eventually allowed visitors, his improvement was still rocky.   

The hallucinations slowly subsided but he was still prone to paranoid delusions, including the belief that his wine was poisoned.  He was also distressed over not hearing from Clara at all and he apparently didn't realize that the doctors had instructed her not to write to him directly.   After a few months, the doctors relented and asked Clara to write to him but she was still asked not to discuss any topics that might distress him.

While Clara tried to write as often as possible, her own life was going through a profound change.   While she had largely been overshadowed by her husband before his hospitalization, raising her children alone allowed her to establish herself as one of Europe's finest pianists.   As a result, she was kept busy going on frequent musical tours to help pay for Robert's care as well as to support herself and her children.   Despite her worries about Robert's condition, she definitely enjoyed all the public attention she was receiving and, ironically enough, her success as a pianist allowed her to earn far more money than Robert would likely have earned at his regular music position in Dusseldorf.  

As for Robert himself, he continued to recover and, while his letters to Clara were sporadic, he also wrote to many of his other friends, including Brahms.   In these letters, along with what he told friends during visits, Robert seemed apprehensive about his doctors and the treatment he was receiving at Endenich.    When one of his close friends, Joseph Joachim, visited Schumann December, 1844,  Robert told him that he wanted to leave Edenich because "the doctors there completely misunderstood him".   There was no evidence that Joachim told Clara about this but Robert later sent her a letter in which he wrote, "My Clara, ” he wrote, “I feel as if something dreadful lies before me. What sorrow—if I never see you and the children again!”  Though his doctors took this to mean that he was considering suicide, it seems more likely that he was afraid that he would never be allowed to rejoin his family. 

Though Clara herself didn't visit Edenich, she arranged for several friends to see her husband and investigate other possible clinics.  One friend, Bettina von Arnim, visited Robert and later told Clara that she would do everything she could "to free poor Schumann as soon as possible from his imprisonment."   She was also extremely critical of the hospital and the doctors themselves, many of whom she thought were even more disturbed than their patients.

Despite Bettina's urging, Clara was reluctant to take her husband out of the hospital and, instead, met with Dr. Richarz who assured her that everything was fine and that Robert should not be moved.   This was apparently enough for Clara and she agreed to keep him at Edenich for at least another year.  Unfortunately, Robert had apparently regarded Bettina as being his last hope and his condition quickly deteriorated when nothing changed.   

By 1856, he had become much worse as Brahms noted in his two visits that year.  After one of these visits, Brahms reported that Robert was largely incoherent and that "often he only babbled, something like bababa—dadada" and that he showed little sign of understanding his friend when he tried to talk.   

In June of that year, Clara received a telegram from Edenich while she was touring in England.   The telegram said that Robert was "totally debilitated" though he was still apparently conscious.   She finally went to Edenich herself on July 27 after receiving word that her husband was dying.    Even though Brahms and the doctors had tried to stop the visit (to spare her the shock), Clara was still stunned by what she saw.    As she would later report, "He smiled at me and, with great exertion placed his arm around me. I will never forget it...He spoke with spirits, so it seemed, and would not permit anyone around him for long, or he would become restless.   It was nearly impossible to understand him any longer."  

Robert Schumann died in his sleep on July 29 at 4 pm.   Clara came to his bedside a half-hour later to see her husband one last time.  "I stood by the corpse of my dearly  beloved husband and was at peace; all feelings went in thanks to God that he was finally free."  The funeral was held just four days later and the general consensus among everyone present was a sense of relief that his "miserable existence" was over.   Clara Schumann never remarried and spent the rest of her life as a concert pianist who helped to popularize Schumann's work worldwide.

As for the exact cause of  Schumann's death, that continues to be a mystery even today.   While h was only forty-six when he died, the autopsy report itself was largely inconclusive.  In an article Doctor Richarz wrote on Schuman in 1873, he claimed that Robert suffered from "incomplete general paralysis" resulting from a "slow,  but irreversible and progressive deterioration in organization and strength of the entire nervous system."   Along with his "melancholic depression",  Richarz attributed Schumann's early death to his refusal to eat and the emaciated state of his body when he died.  

Other medical historians have also suggested that Schumann suffered from schizophrenia or bipolar depression based on the bizarre symptoms he often displayed.  In recent years, another explanation that seems more widely accepted was that he suffered from tertiary syphilis (also called general paresis in those days).   Certainly he had numerous symptoms linked to advanced syphilis, including hallucinations, speech and movement difficulties, and an eventual mental collapse.   Schumann himself apparently believed that he had syphilis due to a previous affair (which contributed to his delusios of being sent to Hell due to his "wickedness").   Still, no traces of the brain degeneration commonly seen in tertiary syphilis turned up in his autopsy, something that would have been evident if he really had the disease.   Certainly there was no indication that he passed it on to Clara or that any of his children developed congenital syphilis afterward (though one son was committed to a psychiatric asylum years later).   

Ironically, it may well have been the treatment received at Edenich that truly led to Schumann's death.   In his own article, Doctor Richarz displayed a total lack of empathy towards his patient that reflects Schumann's own sense of despair at not being allowed to leave the hospital and rejoining his beloved wife and children.   Though he had recovered significantly between 1854 and 1855, his plea that he be allowed to return home was largely ignored by his friends and family.  Though his hopes were raised by visits from friends such as Bettina von Arnim, his condition only deteriorated when he felt abandoned and he began starving himself as a result.   As it happens, other patients also engaged in hunger strikes, largely in protest to the treatment they were receiving at Edenich, though little is known about what later happened to them. 

So,  was Robert Schumann's death due due to despair at being abandoned or because of a still-undiagnosed medical condition?   We may never know for sure.  Despite the mystery surrounding Schumann's death, the love affair between Clara and Robert, as well as their friendship with Brahms continues to be commemorated.  With numerous books and movies written about the three of them, not to mention the musical works that Johannes Brahms and Robert Schumann completed between them, has become the stuff of legend.

 

After Little Albert

For all the controversy surrounding John Broadus Watson and his famous Little Albert study,  it was what was happening behind the scenes at the time that ultimately cost him his position at John Hopkins University.  During the winter of 1919-1920, all of the work that he did with eleven-month Little Albert was conducted with the help of his bright young graduate student, Rosalie Rayner.   Their collaboration continued for months and he spent more and more time away from home and in his assistant's company.  Whatever suspicions that Watson's wife had of what was happening between her husband and Rayner seemed confirmed when she found a passionate note in his coat pocket.  The note was from Rosalie Rayner to her husband and Mary Watson had good cause to question her husband's fidelity (he had strayed before, after all).

Knowing that she needed more evidence, Mary took advantage of a dinner invitation at the home of Rosalie's parents to investigate further.  After pretending that she had a headache and needed to lie down for a while, she sneaked into Rosalie's bedroom and found love letters that John Watson had written to Rosalie.  The letters were  graphic enough to give her all the proof that she needed.   Mary Watson confronted her husband and threatening to ruin his career if he didn't end his relationship with Rosalie immediately.  When he refused, she decided on a very public divorce.

Not only did the divorce proceedings become front-page news in Baltimore, but copies of the love letters were sent to the president of the university, Frank Goodnow (whether the letters were sent by Mary herself or her brother isn't known).   Even today, an affair between a faculty member and a graduate student is considered improper but back then it was unforgivable.  Goodnow demanded that Watson resign his position and John Watson, up to then a rising light in psychology, would never work as an academic again.   Once his divorce from Mary was finalized, John and Rosalie were married in 1921 and they would eventually have two sons together. 

Although his academic career was over, John Broadus Watson was still very much a psychologist and the behaviourist school that he had spearheaded was just beginning to gain force.  Bitter over the lack of support from the university and his fellow psychologists, John and Rosalie moved to New York City where he used the contacts developed by fellow psychologist E.B. Titchener to become resident psychologist for the J. Walter Thompson advertising agency.   Still one of the largest advertising agencies in the United States,  the Thompson Agency (now known as JWT) provided Watson with an opportunity to merge psychology and advertising to create new and innovative new campaigns to sell a wide variety of products.  During his time with the agency, Watson developed some of the most successful campaigns in the agency's history including ads for Pond's Cold Creams (he obtained testimonials from the Queens of Spain and Romania praising the product), Johnson and Johnson baby powder, and Maxwell House instant coffee.   Watson is now considered to be one of the pioneers of modern advertising and continued to draw an enormous salary even at the height of the Depression.  He and Rosalie settled down on a large hobby farm in Connecticut and he devoted his time puttering on the farm when he wasn't working in New York.

Along with his extremely lucrative advertising work, John Watson also became an author of popular books and magazine articles on psychology.  Most of his books and articles focused on behaviourism, particularly in using behavioural principles to raise children.  Using the slogan of "not more babies but better brought up babies",   he also became famous (or infamous depending on your perspective) for his outspoken support of nurture over nature in child-rearing.   In his classic book, Behaviorism, he provided his famous "Twelve Infants" quotation:

Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select – doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. I am going beyond my facts and I admit it, but so have the advocates of the contrary and they have been doing it for many thousands of years.

The last sentence is often omitted from the quote giving Watson a more radical reputation as a behaviourist than he likely deserves.  

Still, his theories about child development must have seemed radical enough at the time.  Though politically conservative, he considered behaviourism to be the ideal way to mold a child's personality and to counteract the dominant hereditarian views of the time (racial theories inspired by Francis Galton and other eugenics writers were still very much in favour).  In his 1928 book, Psychological Care of Infant and Child (co-written with Rosalie Rayner),  Watson insisted that children be treated as young adults and that mothers refrain from providing too much love and affection to their children.   Since society as a whole didn't provide adults with unconditional love and support, parents needed to prepare children for their place in society by not giving them unrealistic expectations.  He also advised against letting children sit on their parents' lap or otherwise encouraging emotional dependence.   The book became extremely popular and American parents regarded it as the de facto reference manual for child-rearing for decades afterward.

By all accounts, he was a stern and unemotional father who had no difficulty putting his own behaviourist theories of upbringing into practice.  His two children by his first wife included a daughter, Polly and a son, John, who were both plagued with lifelong emotional and medical issues.    Whether that was due to Watson's unemotional parenting or the scandalous breakup of his marriage to Mary seems open to question.  

As for his two sons from his later marriage,  how they were raised often led to disagreements between him and Rosalie.  A 1930 article that she wrote in Parent's Magazine reflected the issues that she had with her husband's ideas about child-rearing.  Titled, "I Am The Mother of a Behaviorist's Sons",  the article  showed only lukewarm support for her husband's stern behaviourist principles.  She even went so far as to suggest that her children be raised with an appreciation of art and music (which her husband often dismissed as frivolous).   Rosalie added that "In some respects I bow to the great wisdom in the science of behaviorism, and in others I am rebellious. ... I like being merry and gay and having the giggles.  The behaviorists think giggling is a sign of maladjustment."    Unfortunately, her positive influence on her sons would be brief.   After a bout with dysentery which grew worse despite treatment,  Rosalie Rayner Watson died at the age of 35 leaving John Watson to raise their children alone.   Devastated by Rosalie's death, he would never mention her name in his children's presence again.  As William and James Watson would later describe, his announcing to them that their mother had died was one of the few times that he had ever hugged them. 

Aside from advertising work (from which he eventually retired after a few years),  John Watson became a virtual recluse on his farm.   While he would be involved with other women, he never remarried and began to neglect his personal appearance and hygiene as he grew more eccentric.  In 1957, he was surprised when the American Psychological Association told him that he would be awarded a gold medal for his contributions to psychology.  Despite going with his sons to New York to receive the award,  he asked one of them to stand in for him at the last moment out of fear that he would burst into tears during the public ceremony.  The inscription on the medal read:

To John B. Watson whose work has been one of the vital determinants of the form and substance of modern psychology.  He initiated a revolution in psychological thought and his writings have been the point of departure for continuing lines of fruitful research.

Considering that Watson's academic contributions had been overshadowed by later theorists and even his staunchest defenders had since rejected his extreme behaviourist position, it was a magnanimous tribute.  He died a year later at the age of eighty.   His older son William, who suffered from longstanding emotional problems despite becoming a successful Freudian psychoanalyst (which likely grieved his behaviourist father),  eventually committed suicide four years after his father's death.   Ironically,  William Watson's suicide may have led to a persistent urban legend surrounding  the supposed suicide of B.F. Skinner's younger daughter Deborah due to her spending part of her infancy in an Air Crib designed by her father  (Deborah Skinner Buzan has since devoted many years of her life debunking that particular rumour). 

As for his other son, James Watson did relatively better in life.  In a 1981 symposium at the annual meeting of the American Psychological Association in Los Angeles, he would say that:

Both dad and mother, although she died when I was still a child, rigorously pursued the foundation teachings of behaviorism. Frankly, I think that a better end product would have resulted if the process of growing up had been [tempered] with some measure of affection -- it certainly would have made growing up less like a business proposition where one is judged by bottom-line performance.   It is my hope that the teachings of his disciples and others who have followed him have tempered the emotionally spartan upbringing that he espoused. His behavioristic theories on child development unquestionably have value in terms of life's preparation through the setting of standards and developing an understanding of the parameters of acceptable and responsible behavior, but they could have been much improved if one were permitted to mix in a big helping of parental affection. I believe to do so would provide a better psychological foundation for all of us who, at one time or another in life, are ultimately put to the test of weathering the emotional storms that often topple people because of the frail egos and low levels of self-esteem, which usually result from a childhood diet that lacks a deeper sense of human connection.

Although James Watson would later backtrack on his criticism of his father's ideas, other members of John's family would be less generous.  The most well-known of John Watson's descendants is his granddaughter, actress Mariette Hartley (of whom I happen to be a long-time fan).    In her 1990 book, Breaking the Silence, she described her own emotional problems growing up with her mother, John Watson's daughter Polly.   While Ms. Hartley eventually survived her mother's alcoholism and suicide attempts as well as many of the other tragedies that nearly overwhelmed her, the consequences of John Watson's theories definitely had an influence.  As Ms. Hartley would state in her book: 

Grandfather's theories infected my mother's life, my life, and the lives of millions. How do you break a legacy? How do you keep from passing a debilitating inheritance down, generation to generation, like a genetic flaw?

While John Watson died believing to the end that the psychological revolution that he had helped bring about would change psychology forever, he was largely mistaken.   Even in his lifetime, neo-behaviourists such as Clark Hull and B.F. Skinner would demonstrate that the radical behaviourism endorsed by Watson was far too simplistic to explain something as complex as behaviour (whether in humans or animals).   As new models of cognitive, motivational, and biological psychology came along, Watson's old theories seemed increasingly out of step with the more diversified view of psychology favoured today.  

Despite his extreme behaviourism falling out of favour, John Broadus Watson is still considered to be one of the central figures in psychology's history.   From the "Little Albert" experiment to his highly controversial theories on raising children, he may well be remembered more as a showman for his own special brand of psychology than as a scientist.  Whatever his impact, both personal and professional,  he remains larger than life.

And that may well be the legacy he would have wanted most.

Is Distracted Walking Due to Smartphone Addiction?

Distracted walking is an ever-increasing problem. Studies have already shown that using a smartphone while walking impairs attention and increases the risk of accidents. A new study in the journal Addictive Behaviors seeks to determine if smartphone-addiction proneness magnifies the risks of using a smartphone while walking. In an experimental design, participants, while walking on a treadmill and engaged in a smartphone task, were required to switch tasks by responding to an external stimulus, i.e., determining the direction of movement of a point-light walker. Participants were chosen to cover a range of smartphone-addiction proneness. Four smartphone-use conditions were simulated: a control condition with no smartphone-use, an individual conversation condition, a gaming condition, and a group conversation condition.  Results show that using a smartphone while walking decreases accuracy and increases the number of missed stimuli. Moreover, participants with higher smartphone-addiction proneness scores were also prone to missing more stimuli, and this effect was found regardless of experimental condition. The effect of the smartphone task on accuracy and the number of missed stimuli was mediated by the emotional arousal caused by the smartphone task. Smartphone-addiction proneness was positively correlated with a declared frequency of smartphone use while walking. Furthermore, of all the smartphone tasks, the gaming condition was found to be the most distracting. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

For the abstract

Bipartisan Suicide Hotline Bill Approved By U.S. Senate

A bill designating 988 as a 3-digit dialing code for a National Suicide and Mental Health Crisis hotline is close to becoming law after being unanimously approved by the U.S. Senate this week.   The bill, which was introduced in January by Senators Tammy Baldwin (D-WI), Cory Gardner (R-CO), Jerry Moran (R-KS) and Jack Reed (D-RI) is also co-sponsored by a bi-partisan group of 28 senators. Intended to replace the existing 10-digit National Suicide Prevention Lifeline and Veterans Crisis line,  the new 3-digit number will be available in all geographic locations of the United States and will ensure that all calls will be re-routed to a nearby crisis centre where callers may get immediate assistance.   The new line will also include the Veterans Crisis Line for veteran-specific mental health support. The legislation also authorizes states to collect fees to ensure local call centers are able to support increased volume in callers.  

“In America, we lose about 45,000 people every year to suicide, including more than 6,100 veterans, making it one of the leading causes of death in this country,” stated Senator Baldwin in a news release. “We need to do everything we can to prevent suicide and that means improving the tools we have to help people who are suffering from depression or other mental health issues. I’m very proud my bipartisan legislation has passed the full Senate so we can make it as quick and easy as possible for Americans in crisis to get the help and support they need through the National Suicide Hotline.”

This legislation has been endorsed by over 50 organizations including the American Legion, National Federation of Families for Children’s Mental Health, NowMattersNow.org, United Suicide Survivors International,the American Association of Suicidology, the American Counseling Association, the American Foundation for Suicide Prevention, the American Psychological Association, Suicide Awareness Voices of Education, Mental Health Colorado, Depression and Bipolar Support Alliance, and The Trevor Project.

The bill came into existence following a lengthy review process, including extensive consultation with mental health groups across the country.  Public support for the bill has been bolstered by the current pandemic and the mental health toll that isolation and job loss are having on Americans.   During debate on the bill, the Senate heard testimony describing the rising suicide rate in rural areas as well as the increased risk of suicide in indigenous and LGBT youths.  

 

 

 

 

 

The Reporter in the Madhouse

It began with a cryptic telegram received by a guest at a New Orleans hotel on July 10, 1872.   The guest, who was registered as "Felix Somers" opened the telegram which was written in a rather elaborate cipher he decoded on the spot.   The message in full read:  "Will you feign insanity; enter Doctor Baldric's mad-house as a patient, and write expose?  If you accept, come to New York.  Answer."   It was signed "W.F.G.S."   Despite the hidden message, the guest had no difficulty decoding the message and replying with a single word, "Yes".  And so he began making arrangements for what would be one of the most challenging assignments of his career.   

In reality, "Felix Somers" was 22-year-old Julius Chambers, one of the world's first investigative journalists, and the assignment was nothing less than to have himself committed to Bloomingdale Asylum, a private hospital for the mentally ill located in New York on the site where Columbia University now stands.

As a private hospital, Bloomingdale Asylum was reserved for those patients who had families able to afford their care (the very poor went to the asylum located on Blackwell's Island instead).   Despite its reputation for humane care, there were still allegations of patient abuse which led to the Julius Chambers' rather unusual undercover assignment.   Ironically, the idea for the assignment had come from the asylum's head who had suggested that a reporter be sent in to see that the allegations were false.  Chambers' editor had decided to take the doctor at his word, but not in the way that he had intended. 

Not only would the reporter be committed, but it had to be done in a way that would make him seem like a regular patient in need of psychiatric care.   To make this happen, Chambers had to do things just right.  That involved careful research into different symptoms that mental patients might display and then recruiting friends and colleagues who would play their part as well.   After spending the next week "cramming" for what would be his best performance, he then traveled to New York to put his plan into action.  

Along with researching the role, Chambers also prepared himself physically as well.  As he would later write: 

"Up to this moment, if I have made myself clear, you have taken the best care of your bodily health.   You have lived the regular, laborious life of an enthusiast.  Now cast all regularity of life to the winds.  Stop your hearty dinners: substitute for the ale two large cups of black coffee or strong green tea.  If four cigars have been your daily allowance, now smoke fourteen - so that the sudden abandonment of tobacco three days later will, at the end of forty-eight hours' abstinence, smash your nervous system into fragments.  Any regular stimulant, taken in excess for a short time and then suddenly stopped, will produce the same result.  Never for a moment lose confidence in yourself, or in the power of your constitution to sustain all the shocks from which it is to suffer.  There is no danger from a temporary and systematic overstrain:  the human mind can endure severe trials under which the physical frame would be shattered forever."

On August 13, 1872, a doctor was called to an upscale hotel in New York City to see one of the hotel guests who had been acting strangely.   The guest, a young man named Felix Somers, looked exhausted at being up for eleven hours straight, sitting next to the open window in his room.   According to hotel staff,  Somers had spent the entire night demanding that the hotel porters bring boiling water up to his room (hot water apparently being his preferred drink).   By morning, he had made dozens of these strange requests.  

That same morning, Somers was visited by a friend  who came to  his room along with a hotel clerk.    At least, it appeared to be a friend, though Somers claimed not to know him.   That, along with the glazed look in his eyes and general unkempt appearance, led to a doctor being called in to make a medical examination.  When the doctor arrived, things got even stranger.   Though Somers claimed not to know his first visitor, he greeted the doctor (whom he had never met) as a long-lost friend.   "Sampson," he exclaimed, "How's Delilah and the baby?"   The doctor, who happened to be named Dromio Johnson, consulted with the friend, Dinfor, and learned that Somers had been recently ill.   He also learned that he had an uncle in town though he had apparently decided to stay in a hotel rather than go to the uncle's house.    Dr. Johnson recommended that Somers be placed in a nurse's care and that the uncle be called at once. 

The "uncle" (actually a confederate named Foster) arrived that afternoon and spent some time with the two other men until the doctor returned.   At this point, Chambers resumed his "mad" act by pretending to talk to himself and not taking notice of anyone else in the room.   When the doctor examined him and noticed that his pulse was racing, he concluded that his patient "presents all the visible symptoms of mental aberration."    After arranging for a nurse to tend him through the night, the doctor concluded that the patient be sent to an asylum if he failed to improve.  Along with the nurse, a burly man named McFinn, Chambers was transferred to a larger hotel room to wait until morning.

Chambers then spent the evening feigning madness (since the nurse needed to be fooled as well).   In his book, he describes his bizarre antics that night including ribald singing, covert exercise to boost his pulse, rambling to himself, and even leaping on and off his bed.     The noise was enough to rouse other guests and hotel staff who all came to his door to see what was wrong.   At one point, the poor nurse pleaded with the doctor to have another nurse sent in to help him since he was fearing for his own safety.   A medical student was sent for and Chambers was obliged to continue his mad act for him. 

By the next morning, Dr. Johnson and Chambers' two confederates met to discuss what had happened the previous evening.   Then came the biggest challenge since Doctor Johnson arranged for a medical expert on lunacy to examine the patient.  At that time, there were certain standard "tests" of insanity that were given to patients though the most extreme of them were usually reserved for prisoners suspected of feigning insanity to avoid execution.  Chambers had prepared himself to pass all of them, either on his own or with help from one of his confederates.  To his relief, the expert didn't carry out any tests but simply relied on the statements from people who had been dealing with "Felix Somers".    Based on this evidence, the expert agreed that Somers/Chambers should be sent to an asylum.

After a trip to a police courtroom to arrange for a judge to sign the commitment papers,  a sanity hearing was quickly held.  With testimony from the two physicians along with the that of Chambers' two confederates, the judge agreed to have Chambers transferred to Bloomingdale Asylum.  Again, there was little actual debate and the warrant the judged signed concluded that "Felix Somers is INSANE, and by reason of this Insanity, is so far disordered in his senses as to endanger his own person, or property of others, if permitted to go at large."   According to Chambers, "It was only a matter of ten minutes, two affadavits, and two legal blanks."   With the signed warrant in hand, Chambers and his two confederates traveled by coach to Bloomingdale Asylum and the undercover assignment could finally begin. 

Though probably more pleasant that what someone who couldn''t afford private care could expect, the asylum that Julius Chambers intended to infiltrate wasn't a particularly inviting place.   Despite being located on very spacious grounds that were well-maintained, much of the hospital complex was made up of dingy brownstone buildings.   On Chambers' admission to the asylum, the first thing the admitting doctor verified was whether the patient's family could afford to pay for his stay.  Though $52 for thirteen weeks boarding (paid in advance) doesn't seem that much by today's standards, it was still well beyond what most New York families could afford at the time.  As well, this was an era before psychiatric medications were available and most people committed to asylums tended to stay there for the rest of their lives (or until their families could no longer afford their care).. 

Once the doctor received the money and examined the commitment warrant, he then gave the new patient a very brief examination (basically, he just took Chambers' pulse).   No questions were asked about his condition or why he had been admitted.   After his two confederates left, Chambers was on his own but there seemed little risk of his being discovered.   In his book, he described the hospital as "three doctors, ten attendants, and nearly two hundred patients - all more or less deranged."    During his stay in the hospital, Chambers would conclude that long-time association with mental patients had an adverse effect on doctors and attendants causing them to acquire a "morbid state of mind"  (today, we would call this burnout). 

From the moment patients entered the asylum, they were systematically cut off from the outside world.   Not only were most people on the outside completely indifferent to what was happening in the asylums, but the doctors and staff seemed determined to keep their patients as quiet as possible.  Though Chambers had gone to elaborate  lengths to get himself committed, he scarcely needed to make any pretense after he was inside.  Once two doctors signed the commitment papers, no asylum doctor seemed at all interested in reversing that decision regardless of how normal the patient seemed to them.   Even if a patient pleaded to be released, that would simply be considered as evidence of their mental instability.

After being admitted, Chambers began taking notes using scrap paper taken from the New York Herald in which he pricked holes to hide what he was doing from staff (he would later smuggle this paper out in the toe of his shoe.)   To ensure that he would get the full asylum experience, he acted up enough to be sent to the "manic wards" located in the back of the buildings where the padded cells were kept.   Though the asylum had many attractive features, including beautiful gardens and a bowling alley, only the least troublesome patients were allowed to go there.   As for Julius Chambers, he was placed in a small cell six feet by nine feet in length with only a small iron cot and a straw mattress.  There were only a tiny grated window and the only real lighting available came from the open doorway.  This meant that the cell was completely dark whenever the door was locked (as it usually was).   And please remember that this was the asylum for patients from well-off families.  You can probably imagine what it must have been like in the public asylums. 

Julius Chambers' words describing the conditions under which he was kept are as true today as they were then:

No means was ever resorted to which proved so effectual in breaking the will, destroying hope, and inspiring madness as solitary confinement in a cell whose walls or ceiling were bare of a single object to direct the thoughts or the attention of the unhappy prisoner.  The dungeons of feudal Germany, revolutionary France, or inquisitorial Spain, were no better calculated for these results than was the cell in which I found myself immured.

Along with the usual sounds and smells of the asylum, Chambers could also hear the screams of other patients throughout the night which added to the general sense of terror.  

When he was finally allowed to interact with other patients, he noted that many of them seemed unable to understand what was happening.   To get them to enter the dining-hall for their meals, the attendants often resorted to slapping them on their ears or simply shoving them in the right direction.  Those patients who could understand seemed too apathetic to offer much resistance and simply did what they were told.   Presumably, these were the patients considered well enough to be allowed out with minimal supervision.   As for the food, it was served in an eating-room that seemed substandard even for a prison.   Not only were the knives and forks completely filthy but the entire room was dingy.  As for the food itself, it was barely edible and the attendants were openly mocking at anyone who asked for larger portions (shades of Oliver Twist!). 

Chambers discussed his fellow patients at some length in his book.   Though many of them were lifelong mental patients, others came from distinguished families and had been important members of society before coming to the asylum. Despite many of them being fairly high-functioning, even to the point of being entrusted with helping to care for other patients,  there were also some who seemed downright catatonic.   Chambers focused on a few of them in his book with names such as "the Count", "the Professor," "the Senator," etc.   One of them had been a professor at an eminent European university while another was heir to one of the wealthiest families in America.  There were millionaires, elected politicians, and former Wall Street brokers but all of them were simply asylum patients when Chambers saw them.   

And these were the relatively well-treated patients.  As for the worst patients, they were kept in padded cells from which they were never allowed to emerge.  Not only were they fed through grates, but the attendants also hosed them down whenever they got too filthy.  Whatever they had been on the outside, they were largely just left to themselves in their squalid cells.   Chambers was able to watch as one attendant "fed the animals" (the attendant's own words) though he took careful notes all along.   As for their symptoms, they ranged from delusions of grandeur, paranoia, and extreme violence at times (Chambers saw one of them bite off another patient's nose).    Many of these symptoms of mental illness are seen in psychiatric hospitals even today.

The attendants were also quick to slap patients who acted out in any way and they showed very little patience for patients who were in distress.  Though there were differences between them in terms of abusiveness and general attitude, the long-term attendants were also the ones who appeared the  most uncaring.   Any time Chambers asked to be allowed to communicate with the outside world, or even to read a newspaper, he was put off and even mocked by more than one attendant. 

The only time conditions improved was when the Board of Trustees came to visit.   Not only were the wards scrubbed but many of the walls were whitewashed prior to their arrival.  The Board was made up of a panel of distinguished businessmen and politicians and Julius Chambers was especially careful not to meet any of them.   As a reporter, he had dealt with all of them and he was afraid  that one of them might recognize him.  This was never a real danger since the Board hardly spent any time interacting with the patients.   This meeting with the Board, and the yearly report the hospital was obliged to submit to the State Legislature, was the only real oversight into what was happening in Bloomingdale Asylum.  Again, this was a private hospital where patients supposedly received better care than the patients sent to public asylums. 

All told, Julius Chambers was only in the hospital for ten days though this was long enough to turn him into a lifetime advocate for psychiatric reform.   On that tenth day, his confederate Dinfor returned and questioned the doctors about the condition of "Felix Somers".   Although the doctors were reluctant to allow him to talk to Chambers (since he wasn't a relative), they finally agreed.    Though careful not to be overheard, Dinfors managed to let Chambers know that his newspaper was working on his release.  Unfortunately, that involved having him return to court to overturn the commitment order.

Interestingly enough, Chambers wrote that his treatment at the hospital improved dramatically during his last two days there, largely because the doctors and staff members knew that people were arranging for a legal writ for his release.  Even the other patients seemed to treat him differently.  

Doctor Baldric  emphatically insisted that his patient wasn't fit to be released.  He went so far as to speak with the man he thought was the patient's uncle to prevent this from happening.  He even asked that the writ be withdrawn so they could release him without involving the courts at all.   This was after they had told Dinfor that Chambers would need months of treatment before his release.  Since Baldric had no luck with the two confederates on the outside, he went to work on Chamber/Somers directly (along with trying to discover how he had managed to arrange the writ in the first place).   When that failed, all that remained was to go to court and what would prove to be a complete debacle for Doctor Baldric and his hospital.

It was during his sanity hearing that the lawyer for "Felix Somers" argued that his client was perfectly sane and that there had been no reason to commit him to an asylum.  Though Doctor Baldric became visibly upset when the lawyer reported similar cases of false imprisonment who had been "victims of a persecution worse than the Inquisition,"  there was even worse to come.  Not only did the lawyer present numerous affidavits verifying that the client was sane, but he also described the horrors that he had been forced to undergo while in the asylum.    It was only then that he threw in the real revelation:  that the client was actually a journalist who had deliberately infiltrated the asylum as a test of the Lunacy laws and that none of the doctors involved, including Dr. Baldric himself, had any idea that he was really sane. 

Doctor Baldric's lawyer didn't speak at all.   What could he really say at that point?   The lawyer and his client simply left the courtroom while a group of lawyers and journalists surrounded Chambers to congratulate him on a magnificent performance.   When the judge restored order, and it took a while, he simply declared Chambers to be sane and released him.   After the court adjourned, news of what had happened spread throughout the courthouse.    

Though rival newspapers promptly announced what Chambers had done, it was still up to him to tell the complete story.   Going straight to the Tribune's editorial offices, he began writing up what he had experienced based on his memory and the notes he had managed to smuggle out of the asylum.    The expose was released in installments over the course of the next two weeks though the public response seemed muted at best.   Still, it says something about the impact of Chambers' revelations that, within thirty-six hours of the events in court, twelve out of the one hundred and eight-six patients in the asylum were released into the community as cured.  

Chambers would also write about how the doctors at the Bloomingdale Asylum responded after his expose came out.  Part of this expose including confidential information that had been leaked by a staff member describing the hospital's annual income.  This revelation apparently outraged the doctors and hospital board who then arranged for Chambers to be followed by a private detective for a few months afterward.   Chambers described one innocent encounter with a released patient he named "Staunton" who greeted him on the street to express his appreciation for the expose.   Shortly afterward, Staunton, who had been functioning perfectly well in the community after his release, was reportedly kidnapped and forcibly committed to an asylum in another part of the state.    What became of him afterward, Chambers was never able to determine.

Despite the hospital's attempts at punishing the ones responsible for the expose, the damage was already done.  A few days after the expose come out, then-Governor of New York, John T. Hoffman, appointed a Commission to investigate the allegations of abuse that Chambers had brought to light.    The Commission was charged with investigating Bloomingdale Asylum as well as several other private and public asylums in the New York area.    Julius Chambers appeared at the first meeting of the Commission to give a verbal report of what he had experienced in the asylum and his own recommendations for improving patient care.  The members of the Commission met at the asylum shortly afterward and verified all of the details that Chambers had provided.    Though the staff were on their best behaviour (they knew better than to hit the patients with observers watching), the Commission members saw for themselves what conditions at the hospital were really like.

Based on the Commission's findings, which were reported directly to the New York legislature, a new act was drafted to improve conditions in the asylums and to appoint a Commissioner of Lunacy who would oversee mental health care in every asylum in the state of New York.  As Chambers pointed out in his book however, there was only so much that new laws could accomplish.  Ultimately, it would be up to the medical profession to reform itself and develop better ways of dealing with mental illness and for dealing with  doctors who provided substandard care for patients. 

Along with his groundbreaking expose, Chambers included all of his experiences at Bloomingdale Asylum in a book, A Mad World and Its People, which was published in 1876.   His book provided full details of his undercover assignment and still remains one of the classic works in the history of investigative journalism.   Though he would continued to be an advocate for psychiatric reform, Julius Chambers worked as a journalist, editor, and travel writer up until his death in 1920.   

Did Chambers' expose and later crusading for reform creating lasting change for mental patients?   That likely depends on who you ask.   Certainly allegations of abuse continued at other asylums, even with the supposedly more stringent laws that Chambers helped bring about.   When journalist Nellie Bly carried out her own daring undercover assignment by posing as a mental patient at the Blackwell's Island Insane Asylum for female patients in 1887, she found many of the same abuses that Chambers had reported years earlier.     Her own book, Ten Days in a Madhouse, would also lead to a grand jury investigation and greater funding for mental health care.

Through their pioneering work as journalists, Julius Chambers and Nellie Bly continue to be powerful inspirations for the countless journalists who came after them.    Their exposes also demonstrated the important role that investigative journalists could play in ensuring that people unable to speak for themselves would get the treatment they deserve.   While skeptics may argue that many of the issues surrounding mental health care are still with us today, focusing public attention on abuses within the system is still the only real way that true reform can happen.

Weeding Out The Immigrants

“Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tossed, to me:
I lift my lamp beside the golden door.”

While the famous lines by Emma Lazarus inscribed on the Statue of Liberty continue to proclaim the welcome offered to immigrants coming to the United States, the reality has always been somewhat different.  

Even though potential immigrants traveling in first- or second-class often managed to enter the country with only a rudimentary assessment, passengers traveling in steerage were processed through the immigration station at New York Harbour's Ellis Island.   First opened in 1892, the inpection stations of Ellis Island acted as the central processing point for  millions of immigrants arriving from Europe and other parts of the world    Thorough medical  examinations by physicians appointed by the Public Health Service were required to check for contagious diseases or other medical problems  and immigration officials often relied on medical evidence to weed out "unsuitable" candidates. Based on an 1882 immigration law, any immigrant deemed to be "likely to become a public charge" could be blocked from entering the United States.    That included any medical deformity or condition that would make an immigrant unable to earn a living.   While many physicians objected to their medical findings being used to screen potential immigrants, immigration officials often justified their decision to exclude "unsuitable" immigrants.

In that same legislation, "imbeciles" and the "feeble-minded" were included as being unfit to enter the United States.   Not only were the feebleminded considered to be prone to various social problems including drug abuse and crime, but they also pose a daner to the genetic health of the nation (due to their inferior genes being passed on to future generations).   Immigrants from southern and eastern Europe were regarded as a particular concern for Americans worried about the eugenics of immigration.  

Due to widespread concerns about "feebleminded" immigrants,  having the physicians who examined immigrants test for low intelligence seemed to make good sense to the immigration officials and politicians imposing limits on who could be allowed into the countery.  Except for the problem of how to test for intelllectual problems, that is.  Though early intelligence scales had already been developed for use with children needing special education, providing something equivalent for rimmigrants, many of whom could not even speak Enlish. was more difficult.

It was psychologist, Henry Goddard, who first  traveled to Europe in 1908 to learn how to use the new intelligence test first developed by Alfred Binet and Theodore Simon.  After returning to the United States, Goddard translated and revised Binet's test for use at the training school where he worked.  He also developed an early classification system for the intellectually impaired children at his school, i.e., any children with an intelligence quotient (IQ) of less than 70.   For children with a score between 51 and 70, the term moron was used.   All children with scores btween 26 and 50 were labelled imbeciles and any child with an IQ of 25 or less was labelled an idiot.   Though these are considered offensive terms today, Goddard's classification system matched his own theories about eugenics andhow low intelligence should be dealt with. 

Goddard also established his credentials as an authority on feeble-mindedness through two well-known books highlighting  the genetic risks associated with allowing people of low intelligence to breed.   His 1912 book, The Kallikak Family, traced the genealogy of two branches of a single family, one "feeble-minded" and the other normal.    Though modern reevaluation of Goddard's findings suggest that Goddard understated the role of environmental factors, his book proved to be highly influential, especially with early eugenicists such as Madison Grant and Charles B. Davenport.  

Given the concerns over allowing potentially feeble-minded immigrants into the country, it was not surprising that Henry Goddard was invited by the Commissioner of Immigration at Ellis Island to advise staff on the best way of assessing immigrant intelligence.  Though Goddard's initial impression was that concerns about feeble-minded immigrants were likely exaggerated, he conducted tests of his version of Alfred Binet's test for use with immigrants.   Comparing his own test results with what immigration doctors were reporting, Goddard concluded that his own trained assessors were more accurate in detecting immigrants with low intelligence.   On that basis, he recommended that Congress allocate funds to provide Ellis Island with staff trained in measuring feeble-mindedness. 

Many of the immigration doctors themselves objected to the use of Goddard's intelligence tests to weed out low-IQ immigrants.   One of them, Howard Andrew Knox, published an article in 1913 in the Journal of the American Medical Association which pointed out how inappropriate it was to use tests developed for schoolchildren on immigrants with limited English skills.   As he pointed out:

To the uninitiated using routine tests for defectives nearly all the peasants from certain European countries appear to be of the moron type; but of course this is a fallacy. If these peasants are questioned about conditions existing in the land from which they come most of them will show average intelligence.

But Knox and his colleagues were still eugenics supporters themslves and endorsed the political call to week out the "feeble-minded".  As he stated in another article  published that same year, it was more important to identify morons than people who were insane since morons would "immediately start a line of defectives whose progeny, like the brook, will go on forever, branching off here in an imbecile and there in an epileptic, costing the country millions of dollars in court fees and incarceration expenses."     All that remained was to come up with a reliable method of identifying these mental defectives.

When Goddard's researchers visited Ellis Island in 1913 to test 165 immigrants, they still had to decide how to interpret those results.   When Goddard finally published his findings, he stated that a disproportionately high number of immigrants were identified as mentally defective.    In talking about his findings, Goddard stated that "one can hardly escape the conviction that the intelligence of the average ‘third class’ immigrant is low, perhaps of moron grade."  He charitably suggested that this was due to the poor environments from which they had come rather than their genetics though.

After the researchers visited Ellis Island in 1913 to test 165 immigrants, it was still up to Goddard to decide how to interpret those results.   When he finally published his findings, Goddard stated that a disproportionately high number of immigrants were identified as mentally defective.    In talking about his findings, he stated that "one can hardly escape the conviction that the intelligence of the average ˜third class immigrant is low, perhaps of moron grade" though he charitably suggested that this was due to the poor environments from which they had come rather than their genetics.

Despite the controversy, there was enough political support for the idea of  IQ screening for immigrants, except for the pesky problem of language.   Since the Binet scales were primarily verbal in nature, using them for immigrants with limited English was a challenge that needed to be overcome.   Even relying on interpreters proved risky as the interpreters themselves often had difficulty understanding the concepts used in testing.

Fortunately, there was already a potential solution available.  Psychologists working with hearing impaired patients and children with language deficits had developed specialized performance tests relying on nonverbal skills.   Many of these tests involved form boards requiring test-takers to fit geometric figures into similarly-shaped impressions in the board.   The most famous of these was developed by Edoard Seguin and it was already being used for nonverbal performance testing in children with language needs.   Other tests included jigsaw puzzles and picture formboards that attempted to reduce verbal testing as much as possible. 

The doctors stationed at Ellis Island  incorporated many of these non-verbal tests into the battery used with new immigrants and also developed several new tests as well.  Howard Knox developed two non-verbal tests which he described in as 1913 article.  The first of these was a Visual Comparison Test  using line drawings to match for size and complexity.  The second one, the "Knox Cube Imitation Test", required test-takers to tap a series of cubes in a sequence shown to them by the tester.    

In a 1914 paper, Knox wrote that he had conducted the tests on "over 4,000 suspected defectives in the last eighteen months and many more made by my associates ... all were considered sufficiently near the required standard to be allowed to pass, except 400 certified as feeble-minded and (in a few cases) as imbeciles."    Different versions were used including an "Imbecile test" for people with a  a mental age of less than six.   There was also a "Moron test"  which could only be solved by someone with a mental age less than ten.    Knox recommended that these tests be given several times to ensure that immigrants didn't pass the test by accident.

Since the number of potential immigrants identified as feeble-minded was far greater than what the doctors had detected before the intelligence testing began, this was regarded as proof for the value of psychological testing at Ellis Island.   Still, Howard Knox repeatedly stressed the difficulty involved in testing immigrants due to their limited English skills and cultural differences.   To minimize these problems, he developed a test procedure to be used on immigrants which included a careful interview to ensure that they had basic cognitive skills.   In most cases, immigrants received only a cursory examination with only those failing the interview being passed on for more in-depth testing.

Though Knox had left Ellis Island by 1916, he continued to publish in various eugenic and public health journals and played a role in expanding the definition of mental deficiency to include paupers, criminals, epileptics, and other "persons possessing stigmata and deformities."   He also argued that male immigrants should meet fitness standards at least equal to what would be demanded by the U.S. Army.    His tests, which were later produced by commercial test publishers, would become  standard use in screening immigrants.

By 1921, the U.S. government established a quota system and shifted responsibility for immigrant screening to U.S. embassies or consulates around the world.   While Ellis Island continued to be used for immigrant detention and deportations (including thousands of "enemy aliens" being held there during World War II), the facility was finally closed in the 1950s.   It eventually reopened to visitors as a tourist site in 1976 and the Ellis Island Immigration Museum opened in 1990.   Visitors to the museum can still see many of Knox's intelligence tests on display, along with other reminders of the thousands of immigrants who passed through the system during its heyday.

So what can I say about Howard Knox?   While his intelligence tests had a significant influence on the early history of intelligence testing, his name has been largely forgotten except by psychology historians.   Many of the nonverbal test elements he developed continue to be used in different intelligence tests and he is rightly regarded as a pioneer in non-verbal intelligence testing.  Still, while some of his ideas about how language and cultural barriers can interfere with intelligence testing are valid enough, his beliefs about eugenics are hard to defend.   He was certainly not the only eugenicist of that era though but the critical role he played in how potential immigrants would be screened made him one of the most influential.

As for the human cost of Knox's work, that is harder to determine.   We will likely never know what became of  the immigrants identified as feeble-minded by Knox and his fellow testers.   Certainly many of these same "feeble-minded" immigrants were routinely allowed into the country before intelligence testing became the norm and without the dire predictions of the eugenicists coming to pass.   That a disproportionately high number of immigrants regarded as being inferior came from non-English speaking backgrounds and cultures only helped reinforce the prevailing belief in the genetic superiority of "true" Americans.   

Along with rigid quota systems in place for potential immigrants, the eugenics movement would claim other victims as well.   Many of the same policies advocated by Knox and his fellow eugenicists would be used to implement compulsory sterilization on thousands of "inferior" men, women, and children in the United States and Canada.  It would take decades, and the horrendous example of the Holocaust in Europe, to eventually overturn the eugenics laws although some still remained in place until the 1960s or later. 

The price of these laws, including restitution payments made to the victims, would ensure that their influence would continue even today.   In an era of anti-immigration furor and calls for deadly force to to prevent even immigrant children from entering the country,  the xenophobia that turned Ellis Island into a proving ground for racial  politics a hundred years ago is still alive and well today.

When Does The Present End and the Future Begin?

Through the process of prospection, people can mentally travel in time to summon in their mind’s eye events that have yet to occur. Such depictions of the future often differ than those of the present, as do choices made for these 2 time periods. Conceptually and semantically, this research tradition presupposes a division between the 2: At some point in the progression of time, the present must yield to the future. Still, the field to date has offered little insight by way of defining the division that separates the present from the future. The basic scientific appeal and practical implications of prospection beg 2 related questions: When do people believe that the present ends and the future begins, and do such perceptions affect decision-making?  A new article in the Journal of Experimental Psychology: General describes a series of experiments examines these questions.   For the first question, perceptions of when the present ends vary across people (Study 1) and are reliable over time (Study 2). To the second, when people believe that the present ends sooner, they are more likely to make future-oriented choices in correlational and experimental contexts, even when controlling for potentially related constructs (Studies 3–5). Finally, the researchers identify a psychological mechanism underlying this relationship: A shorter present is associated with a sharper division from the future (Study 6a), and this sharp division accounts for future-oriented behavior toward both hypothetical (Study 6b) and incentive-compatible (Study 6c) outcomes. This research sheds light on a foundational but unexplored prerequisite for thinking and acting across time. (PsycINFO Database Record (c) 2020 APA, all rights

For the abstract

Indonesian Lawmakers Seek to Pass Anti-LGBT "Rehabilitation" Law

Human rights critics are condemning a new "Family Resilience" law tabled by conservative  lawmakers which has been condemned as sexist and homophobic.   Under the new law, gay and transgender people would be forced to undergo “rehabilitation” — an catch-all term likely to include exorcisms and other “conversion treatments” to purge the country of "sexual deviancy".     “Conversion therapy, such as exorcisms, amount to violence against LGBT people,” said Budi Wahyuni, a former commissioner at the Indonesian women's commission in discussing the new legislation.  

Despite being the world's most populous Muslim majority nation, homosexuality is  legal in Indonesia except for conservative Aceh province (which adheres to Sharia law).  In Aceh, the backlash against sexual minorities is especially severe with public whippings being a common punishment for people convicted of same-sex relations.  In 2018, police  rounded up a group of transwomen and publicly humiliated them by cutting their hair and forcing them to dress in male clothes. 

But even outside of Aceh, anti-gay and transgender persecution remains extremely common throughout the country.   Since homosexuality is widely believed to be caused by possession by "evil spirits", many gay and transgender people are forced to undergo exorcisms conducted either by Muslim imams as well as animist shamans to "cast  out" their inner demons.   If the new law is passed, exorcism is expected to be one of the most widely-applied conversion techniques used.

Exorcisms are already extremely common and are used to treat everything from mental illness to hauntings.  One prominent exorcist speaking of the new law told reporters that he anticipated a boom in demand once it is passed.   Boasting of "curing" ten clients in the previous decade alone, he says that his exorcisms consist of him reading from the Quran as he places his hands on clients and then watches for signs he believes suggest evil spirits are being expelled.  “It's usually a strong reaction but that means they'll be cured quicker,” he explains, adding that he's witnessed vomiting and screaming in the process.   Numerous clinics in Jakarta also offer exorcisms to cure same-sex attraction though they rarely advertise such services openly.

But that may be changing since surveys show a sharp rise in radicalism and intolerance among most Indonesians.  According to a 2017 survey, more than 80 per cent of Indonesians now support the country adopting strict Islamic law, including harsh punishments for same-sex attraction in line with other Islamic countries.   At present, many gay men, lesbians, and transgender people are being forced to undergo exorcisms arranged by their own families in the hope that they would somehow be "cured."

One 31-year-old transgender woman, identified only as "Andin" in an AFP story, reported that she has endured harassment and abuse from her family for nearly two decades.   She remains traumatized by the various "treatments" she was forced to endure, including being bombarded with Quranic verses while trapped in a locked room for days as well as being doused with freezing water by an imam promising to purge the “gender disease”.   On another occasion, she was forcibly taken to an unknown religious guru who showed her a burial shroud and given a harsh choice: Relinquish life as a woman, or go to hell.    "Nothing changed after the exorcism. I'm still LGBT, but my family didn't give up easily,” she said.  "It's traumatising — the horror of that memory stays in my head.”   

Still, despite the rising intolerance, there is a vocal minority opposing the new legislation and they have succeeded in blocking similar laws in the past.   Last year, lawmakers tried to push through a criminal law overhaul that would have made premarital sex a criminal offence, but a sharp backlash led to the bill being dropped.   But people like Andin remain pessimistic about future persecution of sexual minorities in Indonesia, especially when much of that persecution comes from members of her own family.   

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A Shocking Discovery

The 1930s was a turbulent decade for Italian psychiatry, largely due to widespread interest in "physical therapies" for treating asylum inmates. Use of Insulin coma, barbituate narcosis, and other medical interventions represented an exciting alternative to the psychoanalytic movement of the time in treating the untreatable. Given the widespread perception that mental patients represented an economic burden on society, Italy's Fascist government (likely inspired by the Erbkrank movement in Nazi Germany) began funding different research projects investigating somatic therapies for mental illness. At the forefront of this research was the medical team led by Ugo Cerletti.

Born in 1877, Ugo Cerletti had studied with the most eminent neurologists of his time before graduating with twin specialties in neurology and neuropsychiatry. By 1935, he had become the Chair of the Department of Mental and Neurological Diseases at Universita Di Roma 'La Sapienza". After visiting Vienna to study insulin coma therapy under Manfred Sakel, Cerletti formed his own research program into chemical convulsion treatments. After observing the use of electrical stunning on hogs being prepared for slaughter however, Cerletti was struck by an inspiration. Since epileptic-type seizures induced by insulin and metrazol were already being used to treat schizophrenics in many countries, could electrically induced convulsions be used as well?

As part of his long-term research project, Cerletti used dogs as test subjects to induce seizures electrically. Although half of the animals died as a result of shock stopping the heart, Cerletti and his research assistant Lucio Bini discovered that electric current could be safely administered if the electrodes were applied to the dog's temples. The dog experiments continued (with the dog catcher's wagon making weekly stops at the clinic) and the bodies were autopsied to examine the effect of electric shock on their brains.

Despite perfecting the technique on dogs, testing the procedure on a human subject was very different. Cerletti was extremely hesitant about taking this next step for obvious reasons. As primary researcher, he would bear full responsibility for any death or serious injury that resulted. Still, his research team (Bini, Ferdinando Accornero, and Lamberto Longhi) developed an experimental device that would develop 80 to 100 volts of electricity for a fraction of a second.

And then...

On April 15, 1938, a 39-year old engineer from Milan was arrested while wandering about the railroad station in Rome. The patient (identified only as "S.E") was found to be actively hallucinating and complaining about being "telepathically influenced".   Diagnosed with schizophrenia, S.E. became the first test subject for the new treatment (which Cerletti named electroshock). Exactly who provided the informed consent for the use of this experimental procedure on a human patient isn't recorded.

There are different versions of what happened during that first session (the actual date is disputed although it occurred in April, 1938). In addition to Cerletti and his team, there was also medical observers and a male nurse to tend to the patient. S.E. was reportedly very docile as he lay on the examining table while the electrodes were attached to his temples. The first trial was at 80 volts for a tenth of a second and all that happened was that the patient contracted suddenly and then relaxed. His vital signs were carefully monitored with no apparent problems.

After a second trial with the voltage raised to 90 volts with no apparent reaction (although the patient did start singing), the team debated whether to try again. It was at this point when the patient stated in a calm voice, "Careful, the first is pestiferous, the second mortiferous". Although the researchers were puzzled by what he meant, they continued on to the next stage.

On the third trial, with the apparatus turned up to the maximum voltage, S.E. had a classic grand mal epileptic seizure. He became pale, turned blue, and then stopped breathing. The doctors found that his heart was racing and, after forty-eight seconds, S.E. began breathing again on his own (so did the doctors). The patient then sat up calmly and asked what they wanted from him. According to Cerletti's account, S.E. denied any memory of what had just happened. And so ended the first electroshock treatment session.

After ten additional electroshock sessions, S.E. was considered well enough to be discharged from the hospital on June 17, 1938. Cerletti later reported that the patient was "in good condition and well oriented" and could return to his engineering job in Milan. A follow-up assessment a year later found the patient reporting that he was "very well". His wife added her own concerns about her husband's condition, however. She reported that her husband became increasingly paranoid and jealous just a few months after his release. She also mentioned that "sometimes during the night he would speak as though in answer to voices”. While electroshock was no cure for schizophrenia, Cerletti continued to use it with countless other patients and his discovery would soon be adopted around the world.

For better or worse, a new era had begun in psychiatry.  But, if Italy's fascist government played a role in the invention of electroshock therapy (also called electroconvulsive therapy or ECT for short), it may very well have been the Nazis who played the largest role in its spread around the world. Three clinicians who had trained under Dr. Cerletti left Europe to escape Nazi persecution and brought ECT with them.

Lothar Kalinowsky had originally trained in Berlin before fleeing the Nazis and earning his second MD degree in Rome under Cerletti. As the Nazis advanced, Kalinowsky fled to France and then to England and introduced ECT to both countries.  Immigrating to the United States in 1940, he helped launch ECT at the New York State Psychiatric Institute while Renato Amansi (Cerletti-trained refugee number two) did the same at the Columbus Hospital in New York. Victor Gonda (refugee number three) introduced ECT in Chicago at the same time and there continues to be some controversy over who was the original "godparent" of electroconvulsive therapy in the United States.

While asylum psychiatrists were enthusiastic about the potential for the use of ECT, psychoanalysts were far more skeptical. Washington psychoanalyst, Harry Stack Sullivan, was an early critic of ECT and the biological model of mental illness which ECT supported. Despite this resistance, by 1946 when Kalinowsky and Paul Hoch published Shock Treatments, Psychosurgery and Other Somatic Treatments, ECT had become widely used across North America.

While there were warnings as early as 1947 by the Group for the Advancement of Psychiatry about the "promiscious and indiscriminate use of" ECT, psychiatrists were eager for new treatments to deal with the chronic overcrowding in psychiatric hospitals. The end of World War II and its aftermath led to thousands of psychiatric casualties (including returning veterans) and drastic reductions in hospital staff. A 1942 survey of 305 state psychiatric hospitals found that 93 percent of them had adopted some form of ECT (although medical standards varied widely). An estimated 7000 patients were treated within the first two years of ECT's introduction.

The first machines tended to be "in-house" creations made by local technical staff or hired electricians following directions provided by Cerletti and his assistants. As different designs and innovations began to proliferate, manufacturers offered their products to hospitals and the familiar ECT machine started sporting brand names such as Offner, MedKraft, Rahm, and Lektra. There were active marketing campaigns with ads in psychiatry journals and psychiatrists began favouring some manufacturers and brands over others.

The use of ECT replaced all other forms of somatic treatment (except for the continuing use of lobotomies but that's another story). Patients suffering from any form of psychosis, depression, dementia, personality disorder, psychopathy, or even homosexuality (it was still considered a mental illness at the time) were considered for the new treatment. New organizations sprang up including the Electroshock Research Association in 1944 and the Society for Biological Psychiatry in 1945.

Clinical literature was filled with post-treatment validity studies testing ECT in different psychiatric populations. A typical research study in 1945 reported a 67-70 per cent remission rate for first-episode schizophrenics compared to a 25-30 spontaneous remission rate. Studies of longer-term improvements tended to be far less optimistic though and it was increasingly recognized that ECT was a treatment rather than a cure. ECT even entered the popular culture with a prominent appearance in the 1948 classic film The Snake Pit (based on Mary Jane Ward's semi-autobiographical book). The sight of Olivia de Havilland being subjected to ECT in the movie helped shape popular attitudes of the time.

Despite the eagerness associated with ECT use there was one important stumbling block: nobody knew exactly why it worked. Ugo Cerletti proposed that ECT caused the brain to produce beneficial chemicals which he termed "acro-amines" although his arguments were unconvincing. Other critics suggested that ECT produced selective brain damage due to trauma (and pointed out the short and long-term memory impairments that often resulted from its use) which affected emotional responsiveness. ECT advocates suggested that ECT stimulated neurotransmitter production but experimental studies were (and still are) inconclusive.

With research came more innovations to deal with the serious dangers associated with ECT use. Patients receiving electroshock often developed broken bones due to their thrashing about on the table. Nerve blockers and general anesthetics made ECT less risky although patients still complained of memory loss afterward.

Although he was nominated, Ugo Cerletti died in 1963 without ever receiving his long-cherished Nobel prize in medicine. Given that the only other Nobel prize ever awarded to a psychiatrist was for the invention of the lobotomy, you do have the sense that the Nobel Committee shied away from recognizing another potentially controversial breakthrough.  As it was, Cerletti was lucky enough to miss the backlash against ECT that would come later but he lived long enough to see a marked decline in ECT use during the 1950s and early 1960s. The availability of antidepressant and antipsychotic medications that were safer and more effective made ECT less popular with therapists and patients.

One of the most well-known psychiatric patients to undergo ECT was Ernest Hemingway.  In the last years of his life, the eminent writer became increasingly despondent due to chronic pain, alcoholism, health problems, and his failing literary career. By 1960, Hemingway underwent a series of ECT sessions to treat his depression and paranoia (of course the FBI had been watching him ever since he left Cuba so there may have been reasons for the paranoia). While the ECT was meant to control his depression, it actually seemed to make things worse.

In addition to his other problems, Hemingway began experiencing serious memory loss as well. Talking about his ECT sessions, he said that "Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient." Following his first suicide attempt in 1961, Hemingway received further ECT treatments before finally succeeding in killing himself on July 2 in that same year. While a clear link between Hemingway's ECT use and his suicide can't be established, his tragic experience has made him a poster child for the anti-ECT movement.

The counterculture movement that took shook psychiatry in the late 1960s and early 1970s was driven by a renewed activism by former psychiatric patients rebelling against the perceived authoritarian culture in psychiatric hospitals. Hemingway, Silvia Plath (who committed suicide in 1963), and other writers who wrote movingly of their experiences with ECT helped shape the popular perception. Combined with the writings of Thomas Szasz, R.D. Laing, Michel Foucault, and Erving Goffmann, psychiatrists came to be seen as increasingly sinister figures who used ECT and other treatments to modify unwanted behaviours rather than treating disease.

Ken Kesey's 1962 book One Flew Over the Cuckoo's Nest and its 1975 movie version helped shape public awareness of ECT and it was during that same period that a massive revolution in how psychiatric patients were treated got underway. With newer and better medications came a rapid deinstititutionalization of psychiatric patients Mass closing of psychiatric hospitals and the dumping of patients into communities that were often ill-equipped to handle them made the need for better treatment options all the more acute.

Questions concerning the appropriateness of ECT use and accusations of involuntary treatment spurred the rise of antipsychiatry groups and and patient's rights organizations began to challenge psychiatric hospitals in court. Neurologists also began questioning the potential role of ECT in causing brain damage in patients. John Friedburg published Shock Treatment Is Not Good For Your Brain in 1976 in which he stated that ECT produced amnesia through selective brain damage.

As former patients such as Mark Vonnegut and Leonard Frank came forward with their own negative experiences with ECT and the public awareness of its dangers grew, more and more patients came to refuse it altogether. Anti-psychiatry groups such as the Network Against Psychiatric Assault (founded in 1973), the Committee for Truth in Psychiatry (founded in 1984) and the Church of Scientology began to agitate against ECT use (especially on involuntary patients). ECT became increasingly rare, especially since psychiatrists using it found themselves receiving sharp rises in their professional liability insurance premiums as a result.

Given that not all cases of depression and bipolar disorder responded to medication, ECT continued to have a role in treatment however. My own graduate mentor, Norman Endler, credited ECT with helping him recover from serious bipolar disorder and even wrote a book on his experiences, Holiday of Darkness. Other former psychiatric patients including Kitty Dukakis, Thomas Eagleson, and Andy Behrman have come forward with their own positive experiences although they tend not to be as well-publicized as the negative accounts.

I won't try to do justice to the hundreds of pro- and anti-ECT research studies that have been carried out over the past four decades. Government and non-government organizations including the National Institute of Mental Health (NIMH) and the American Psychiatric Association have released reports confirming the value of ECT in certain circumstances as well as imposed more stringent guidelines concerning informed consent and training of ECT staff. It was in 1985 when Max Fink, a protege of Lothar Kalinowsky launched the Journal of ECT which remains the primary publication of its type and helped restore some of ECT's lost credibility.

The political debate over ECT use has become increasingly polarized over time with harsh denunciations on both sides. Even a brief Web search can turn up numerous anti-ECT sites that denounce the treatment and its providers. Attempts at a reasoned debate on ECT use tend to degenerate into anti-psychiatry arguments. And there we stand at present.

Ironically, ECT may well be moving into a new direction altogether. The use of deep brain stimulation procedures to treat depression by implanting electrodes to stimulate the subcalossal cingulate region of the brain has been found to relieve treatment-resistant depression with few of the negative side effects associated with ECT or anti-depressant medication. Whether this new form of electrical stimulation will replace its predecessor, only time will tell.

The Case of Dorothy Talbye

What could cause a mother to kill her child?

Though cases of mothers committing filicide are likely as old as history itself, the kind of punishment these women receive afterward has varied across time and in different societies around the world.  Even today, public reaction over stories such as that of Susan Smith and Andrea Yates has ranged from shock and disbelief to calls for their execution.  While postpartum psychosis and mood disorder are being increasingly recognized in these cases, treating filicidal mothers as mental patients rather than as murderers is still a relatively recent phenomenon.

Which brings us to the case of Dorothy Talbye...

Life tended to be hard for women living in 17th-century Massachusetts.  Along with the widespread belief in witchcraft and demonic possession shared by the deeply religious residents of cities such as Salem and Boston, laws provided little protection for wives dealing with overly brutal or dominating husbands.  Women who dared to criticize their husbands or resist their authority in any way risked being placed in stocks or even publicly whipped as "common scolds" or "shrews."    Part of the problem was the widespread belief that women were especially vulnerable to being led astray by Satan, something clergymen frequently declared in their regular sermons. 

Even many of the religious books published in that era spoke about how women were responsible for "original sin" (thanks, Eve).  William Perkin's 1596 book, A Discourse on the Damned Art of Witchcraft, was downright lyrical in condemning women.  "“In all ages it is found … that the devil hath more easily and oftener prevailed with women than with men," he wrote.  "T”he more women, the more witches.”

Relatively little is know about Dorothy Talbye's early life though she was later described as being "of good esteem for godliness."  Along with her husband, she was a regular church goer and lived an unremarkable life.  But everything changed in 1636 when her daughter, Difficulty, was born.  For reasons that remain lost to history, Dorothy Talbye suddenly began experiencing emotional problems which made her increasingly moody and aggressive.   According to the diary of Massachusetts Governor, John Winthrop, Dorothy's bizarre behaviour put her at odds with her husband and her church.   She was described as "falling at differences with her husband, through melancholy or spiritual delusions, she sometimes attempted to kill him, and her children, and herself by refusing meat saying it was revealed to her, etc."  

Since she failed to improve despite efforts by her church leaders, she was formally "cast out" of the church.   If anything though,  learning that she had been excommunicated made her even more uncontrollable.  After several more incidents involving her husband and children, Dorothy was then charged to appear before the magistrate in 1637 after being accused of assaulting her husband.   She was initially sentenced to be bound and chained to a post and later that same year,  was sentenced to be whipped over new offenses directed at her husband.   The flogging appeared to do the trick and Dorothy began obeying her husband again, at least for a while. 

In November 1638, Dorothy Talby killed her three-year-old daughter, Difficulty by breaking her neck.  Though she freely admitted committing the horrific crime when first arrested, she refused to say anything at her arraignment hearing.   Colonial law being the way it was at the time, the governor eventually grew tired of her refusal to speak and threatened to have her pressed to death unless she confessed.  Realizing she had no alternative, Dorothy admitted to the murder and stated that she killed her daughter to "free it from future misery."   Throughout her trial, she said nothing more in her defense and mostly refused to cooperate with the court for any reason. 

At the time of the trial, there was no such thing as an insanity defense though it would be adopted under Massachusetts law not long afterward.  While people with severe mental illness were typically locked up in asylums to prevent them from harming themselves or anyone else, Governor Winthrop seemed disinclined to show any kind of mercy for Dorothy Talbye.  As he later wrote about her in his journal, she committed the murder, not due to insanity, but because "she was so possessed with Satan, that he persuaded her (by his delusions, which she listened to as revelations from God) to break the neck of her own child." 

In the eyes of the Governor and the court, the death sentence was the only acceptable option in Dorothy's case.    By all accounts, she showed little real emotion on being told she would be hanged for her crime and said nothing to suggest that she was sorry for what she had done.  She did ask to be beheaded instead of hanged, arguing that it would be less painful or shameful, but her request was denied.   On the day of her execution, Dorothy Talbye had to be dragged to the gallows where she refused to stand.   Her pastor and several other clergymen went with her hoping to provide some sort of comfort at the end but she refused any last minute rites.  She even refused to wear the black hood that was standard for condemned prisoners.  Instead, she took off the hood and used it to make the noose more comfortable for her.    The actual hanging was a horrible sight since this was long before the use of the "Marwood drop" in which the gallows simply broke the condemned person's neck.   Dorothy Talbye was fully conscious as she slowly strangled to death (she even tried to grab the gallows ladder as she was swinging).   She was then declared dead.

So, why was Dorothy Talbye punished so severely?  While infanticide is a horrible crime, the courts have always had a fair bit of latitude in sentencing.  When Mercy Brown of Wallingford, Massachusetts killed her son in 1691, she also went on trial for her life but was treated much more humanely than Dorothy was.   Not only was sentencing delayed because of her "distracted" state, but she eventually received a prison sentence since she was regarded as mentally unfit.  In Mercy Brown's case however, she was openly remorseful and she also cooperated fully with the court, something Dorothy Talbye refused to do. 

Instead of recognizing that her crime was due to mental illness, the courts saw her execution as an opportunity to "educate" other women about the consequences of acting "improperly", i.e., failing to be submissive and obedient as a good wife should.    Dorothy Talbye's fate was sealed by her long history of "unwomanly" behaviour and her refusal to abide by the teachings of her church.   Much as in the Salem witch trials which would take place years later, women of that era were expected to know their place.