Minds in the Mending

I

EXISTENCE in an insane asylum, far from being the most wretched of any in this vale of tears, can sometimes be distinctly more pleasant than life in the great, wide, beautiful world outside. Mr. Webster’s definition of asylum as ‘a haven of refuge’ is my reason for using that word here, rather than the newer and more generally accepted term, ‘mental hospital.’ We should all be deeply grateful that there are such havens to which we may retreat when the buffetings of life become too much to be borne with fortitude and calm, places where we can be taken care of until we have regained our lost equanimity of mind and soul, which is so necessary in these days of dire stress.

Serene tolerance, I believe, is one of the supreme prerequisites of sanity, and certainly in all but one of the asylums in which I have been there has prevailed a tolerance for all human idiosyncrasies and foibles that was remarkable. More was forgiven and gladly forgotten there than anywhere else I had ever been. The things a person says and does in the throes of any mania would, except in an asylum, be held against him until his dying day. But the trained workers, the nurses, and lastly the patients themselves —unless they are too sick — soon come to understand what is happening, and as a consequence overlook actions and speeches which in ordinary life would result in lawsuits and irreparably damaged friendships. In states of abnormal elation which often follow a profound depression, a person is very apt to say and do things of which he would be dreadfully ashamed once he has regained his senses. These uninhibited pranks and frankly bawdy remarks are never alluded to after he has been promoted to a better hall. All the embarrassing episodes of his extreme sickness are promptly forgotten, and, by this conscious process of forgetting, the patient is hastened on toward permanent recovery.

A remark which I made the other day, to the effect that most of my best friends were in or had just left asylums, was greeted with shouts of wildest mirth by the group with which I was lunching on the veranda of a well-known Southern retreat. I had not meant to be funny, and went on to explain that when one had been ‘locked up’ for the better part of six years it was only natural that the people one was most interested in were those friends found during that enforced exile apart from the friends of yesteryear. I doubt if anywhere else in the world are such deep and enduring friendships made as those cemented by the common bond of fear found among mental patients. Perhaps in the army, during wartime, the same holds true, but there the fear is a tangible reality, and not a ghastly, haunting spectre which pursues its helpless victim inexorably.

Let us consider next the personalities of those who are incarcerated in any sort of mental hospital. The border line between insanity and stable mental health is unbelievably slight. Those of your friends who are eccentric and odd, unstable and queer and wild, are not in asylums only because of the degree of their unusualness. Let them overstep the mark of the behavior pattern required of them in their particular environment, and bang — the doors of some asylum will swing to behind their reluctant forms! But just as the people in your community whom I have listed above are the most interesting and most entertaining, so are the people who have gone them one step further the most diverting and amusing and unpredictable and often the most distinguished persons one could possibly know. Phlegmatic, cowlike, dull individuals do not, as a rule, crack up mentally or emotionally. It is the potential genius who has not been understood or allowed to develop his qualities of greatness — it is the artist who from a pinnacle high above the heads of the multitude has seen visions which he longs to set down in permanent beauty — it is the idealist whose dreams so far outshone the bleak realities which he knew — it is the childlike person of great faith whose belief has been betrayed — these and numerous others like them are the inmates of asylums throughout the land.

Because of the diversity of the temperaments found in confined isolation, there is very little chance of being bored. Unless one is so temporarily incapacitated as to have interest in nothing, one has the opportunity to study human nature in its most uninhibited and often most primitive state. There is literally never a dull moment if one is in the mood for entertainment of an ingenious and often startling variety. This is especially true of the most disturbed halls. Life here resembles nothing so much as a three-ring circus. I do not mean to be unkind or facetious in this allusion. It is true. Disturbed wards are filled, for the most part, with unmanageable cases, elated and utterly unrepressed individuals who do and say anything that comes into their heads; and if one can observe them objectively, and not through a haze of sentimental and maudlin sympathy, he will see things that are devastatingly funny. Remember that these people do not suffer; their feelings are exactly those of a person on a prolonged and intensive jag, and, except for their resentment at the necessary discipline and restraint, they are enjoying themselves tremendously. The cases of mistaken identity alone would make a bookful of entertaining anecdotes. I have myself at various times been confused with Hitler, Clark Gable, and one very attractive woman’s husband, with whom she was not on the best of terms. The mental dexterity involved in playing up to these rôles that have been thrust upon you is something of which any first-rate actor might well be proud!

Then there is the question of all the things that can be learned in modern asylums. In one Maryland institution there is the most efficient and amazing occupational therapy department to be found in any mental hospital in this country. A staff of fifteen or more graduate workers, under the supervision of a charming, intelligent, cultured, and highly gifted woman, teach the patients innumerable arts and crafts. There are dramatics, with plays directed, acted, and costumed by the patients. There are classes in current events and music, and studios where painting, sculpture, ceramics, basketry, weaving, carpentry, metal work, and jewelry are taught. One of the most interesting things about this form of treatment is the number of hidden talents it brings to light. People who have never dreamed they could do anything creative with their hands become surprisingly proficient artisans. A great many of them continue working at the craft they have learned after their dismissal from the hospital, thus filling their leisure with a satisfying outlet which often acts as a safety valve throughout the ensuing years.

Sick people have been likened to children, but I must say that children are a hundred times easier to reach and appeal to than any person suffering from depression, chronic melancholia, or any of the forms of mania which a mental sickness is likely to take. This makes it necessary for the occupational therapist who is really good at his job to be a person of unusual capabilities. He must be kind without being too gentle, sympathetic in the broadest sense of that word, understanding without being officious or smugly superior, and must possess an intelligence of the heart as well as the head. All these qualities and others were found among the workers at this particular hospital, who were tireless in their efforts to interest, stimulate, and divert those of us fortunate enough to be under their tutelage.

II

While I have been speaking wholly of conditions I have found in private asylums, I know from investigation and inquiries that many of the privileges I have mentioned are to be found in the majority of well-run state places, though the occupational therapy departments are of necessity operated on a less elaborate scale. In other words, asylums are no longer the mediæval houses of horror that most people picture them. Moreover, cures are often more quickly effected in state hospitals than in the more luxurious privately owned retreats.

So if you or anyone you love needs the sort of care and specialized treatment which can only be found in a reputable asylum, do not hesitate to take advantage of the protection which is thus offered you. If the treatment is taken in time, months and often years of needless suffering can be avoided. Don’t ignore the many warnings which nature is kind enough and wise enough to send, and don’t, above all, be ashamed of these warnings.

After four years in one of the largest private institutions in the United States I was allowed to return to my native heath, ‘on parole.’ I was in excellent spirits at the time, neither elated nor depressed, and was looking forward to the visit with mingled feelings of joy and distress. Let me say at this point that I have never been the least bit ashamed of having been committed to an asylum, any more than I should have been upset at having tuberculosis and spending the same length of time in some mountain sanitarium. My distress was due entirely to tragedies which had occurred in my private life during my incarceration. Well, I went home — not to the home I had made, which no longer existed, but to the old home of my happy childhood and youth — and proceeded to play around with the first and supposedly best friends of my life. And what, alas, did I find?

I found that while I had been languishing in a place where time seemed so often to stand appallingly still — shut away, as we were, from the world of consequence, action, and achievement — it was I who had grown immeasurably during these years, and they, who had been busy in a normal way, had either retarded or completely stopped developing. My ‘soul stature,’ might I say for want of a better expression, had increased surprisingly. I was emotionally adult, and because of this phenomenon we were wholly uncongenial for the first time in our grown-up lives. I was at first completely at a loss to understand, and then it dawned on me, as I analyzed the situation, that something of this sort had taken place. A concentrated solution of anything is more potent than a dilution. I had for the past four years been getting a concentrated dose of life. Existence in any asylum is a very intensified one. You suffer more, your enjoyment is keener, you drink more deeply of the dregs of human misery and woe; you run such a gamut of emotions in a day as the man outside would know in a month, and every emotion is felt in a higher, sharper key. You learn discipline from a harsh master, for upon your controlled and civilized behavior depend your privileges and all your comforts, and if you are a person of any sensitiveness these experiences are bound to mature you.

Now these friends had been college people; they were the young married crowd of successful, happy, pleasantly well-to-do, averagely intellectual persons who make up so large a part of any good-sized, prosperous American city; and yet they suddenly seemed to me like a group of backward and badly spoiled children whose only conversation consisted of the most tiresome inanities — the feeding of their youngsters, how much so-and-so had paid to have her house done over, constant talk of dieting and clothes, and continual bickering over bridge and golf scores. I was amazed and not a little troubled. What, I asked myself, was the sense of regaining one’s senses if the process did not fit one for happy living in the outside world? I reminded myself of those returned soldiers who had been living such intense drama behind the front-line trenches that life in the normal world seemed indeed ‘weary, stale, flat and unprofitable.’

Another thing that made it exceedingly difficult for me was the obvious reluctance my friends showed in alluding to where I had spent the past six years. If I had been serving time at Sing Sing they couldn’t have been more embarrassed about it, and this didn’t make sense to me. I had no great desire to regale them with the more lurid details of my asylum life; on the other hand, I couldn’t understand why they should be ashamed of my mentioning it. You cannot take six years of a person’s life and politely pretend that those years have never been. As I look back on it now, I believe that it was the length of time I had been shut away that especially bothered them. They seemed to figure that I must have been particularly violent if it had taken me so long to get well. In other words, it was not just a ‘nervous breakdown,’ which would have been quite fashionably forgivable, but I had really been ‘ crazy,’ and that — people simply didn’t talk about!

This time element is another thing that is universally misunderstood with regard to mental sicknesses. Look at it this way for a moment. Within a period of five minutes an accident occurs which sends the victim to bed for five months with a compound fracture. In a mental sickness no one actually knows when the accident or harmful incident took place. One may know the final tragedy or set of circumstances which brought the whole thing to a climax, but even the best psychiatrist has no way of telling how long the patient has been getting sick or for how many dreary years he may have struggled along, fighting both his problems of existence and his encroaching illness. A compound fracture, while a very disagreeable thing, is perfectly definite and a great deal easier to mend than shattered minds and emotions. I have never been out of contact with reality in my sickness; I have never had hallucinations or delusions, nor heard voices, nor been disoriented; but it has taken me six years to recover from a sickness which was probably fifteen years old before it was recognized as such. So don’t be alarmed, or ashamed, or more impatient than you can help, at the length of time required in regaining your mental health. When nerves and emotions are involved, time should not be, and indeed is not, reckoned in the same terms as it is under ordinary circumstances.

III

Since these days of which I have been writing, you will, I hope, be glad to hear that I have made a completely satisfying adjustment to life outside, in a city far removed from the scenes of any previous living. While I don’t feel that this is necessary for every person upon leaving the sheltered life of a hospital, I do think that one must, upon going back into the world, create for himself a new and different pattern of existence. If there hadn’t been something radically wrong with the way we had been living, we should never have got sick. A nervous or mental breakdown is simply nature’s way of saying, ‘You must change your present mode of living.’ In other words, there was some fundamental difficulty in our business, social, or love life, and nature was warning us to take time off and try to discover what the trouble was.

If this should ever happen to you, don’t hesitate to go to some reputable retreat and put yourself in the hands of people professionally equipped to help you. Remember that your family, no matter how loving and how good their intentions, are not trained psychiatrists, and that what they think is best may be the worst possible thing for you in your present state. And don’t be ashamed of your sickness, nor feel guilty about it. Go off to your hospital with as good grace as possible, no matter how much you dislike the idea, and try with every faculty you possess to adjust yourself uncomplainingly to the strange environment. This effort at adjusting will take your mind off yourself, and before long, if you use your head and are coöperative, you will discover innumerable things to interest you.

Once safely sheltered in your haven of refuge, those problems which you have been lying awake nights worrying over will cease to seem so dreadfully significant. In a surprisingly short time, things will slip back into their proper perspectives, and these phantom fears and phobias will no longer assume such outlandish and overwhelming proportions. Then there will come a morning when you awaken refreshed from a deep and dreamless sleep; you will begin noticing things that used to delight you but for a long time have left you quite unmoved — shadow patterns on a spring lawn, the flash of a bird’s wing, the color of an evening sky, or a half-forgotten fragrance. You will be able to laugh once again and converse as though you meant all the things you were saying. On that day you can rejoice, for you will have come a long way on your journey back to health. And by the time you are ready to leave the place where you have been shown the ‘error of your ways’ you will be willing to admit, if you are honest, that life in a well-run asylum is not half bad.