Document 4vLw9rRMYoE192JgRLYo960Mp

Health Policy Advisory Center May 1970 HEALTH / PAC BULLETIN Editorial: very commonly) they are brutalized, dehu- manized, physically mistreated, and kept too The Medical doped up with drugs to resist. For all the rhetoric about how we have learned to give the mentally ill humane treatment, in fact Means mental institutions only provide a more or less humane facade behind which we " put of Repression away " those whose minds we can't control. Psychiatrists and psychologists also serve as part of the repressive apparatus within Psychiatry and psychology have long been such conventionally repressive institutions in vogue among liberal intellectuals as par- as prisons and the armed forces. In these in- ticularly humane disciplines. In the forties stitutions, total obedience without question is and fifties it was Dewey's educational psy- demanded. Many methods, from persuasion chology with its progressive schools and to isolation to physical punishment, may be . Play - Art toys and Gestalt psychology with its dynamic, multi dimensional - view of hu- used on recalcitrant prisoners (or soldiers). The psychiatrist or psychologist is just a man experience. In the sixties it was Reich more refined instrument for obtaining abso- and his sexual politics, Marcuse and his dialectical psychology, and Laing and his lute submission. His therapy or counselling serves one end alone to break the resist- existential psychiatry. For some liberal and ance of those on whom other, more direct, New Left intellectuals, understanding of the methods have failed and to ease the way to individual psyche has seemed to open the doors to new, humane ways of " treating " those incapacitated by mental illness, and " adjustment " (i.e., submission) for all. Even the police use psychology as one of their weapons. Increasingly, police depart- to new tolerance of non conforming - thought and behavior. But while liberals were finding visions of ments are allying themselves with academic departments of psychiatry for assistance in dealing with individual offenders, crowd con- liberation in psychiatry and psychology, the trol, and " conflict resolution. " The use by the society around them was learning to exploit police of methods other than the gun and the the darker sides of these disciplines. Psycho- club, of course, does not change the social logy and psychiatry are increasingly used function of the police. The only sense in for purposes ranging from selling deodorant which it can be seen as a humane advance is to isolating and repressing those who step " that it enables the police to do their repres- to a different drummer " (or worse yet, have sive jobs while breaking a few fewer heads. visions of a better society). Psychiatry and psychology are thus used For starters, psychiatry is used directly to as direct instruments of coericion against in- incarcerate people who can't get along with society. A variety of civil commitment pro- cedures and commitment methods tied to the With this issue, the BULLETIN takes on a new criminal courts, presided over by psychia- trists, serve this end. Parents have " difficult " look. We hope you will find the simplified format and new type face more readable, and children committed to mental institutions. Rel- we welcome your comments or letters on any atives sign in their " cantankerous " aged dependents. Police whisk " disorderly " peo- ple off to Bellevue for a few days'observation rather than bothering with courts and elab- orate legal procedures. Prosecutors seek to of the issues raised in BULLETIN articles. Sub- scriptions are available at $ 7 per year $ (5 for students). Please send payment with your or- der to: HEALTH - PAC, 17 Murray Street, New York, New York 10007. F have defendants against whom they have ee flimsy evidence declared " incompetent " and dividuals. Under the guise of " medical committed. In some cases, of course, the per- methods, " people are pacified, punished, or son sent to a mental institution may be deep- incarcerated. But psychiatry and psychology ly troubled and seriously in need of help. In are also used more generally as an instru- many others, however, he may merely be ment of pacification and control of our entire someone whom parents, relatives, cops, or society. They have become a central ide- courts can't get along with and want to get ological instrument for obscuring people's rid of. In either case, his fate is imprison- understanding of their experience and for ment. Patients in mental hospitals get, at preventing their recognizing the social bases best, comfortable custodial care and an in- and collective nature of their oppression. adequate level of treatment. At worst (and The central mechanism by which psychia- CONTENTS 3 Commitment Through the Courts 6 Prison Psychiatrists 11 Cops and Mental Health 13 NYU Dean Dispute try and psychology achieve this is to reduce all collective experience to a sum of individ- ual experiences, to reduce all social griev- ances to individual pathology. Psychiatrists are trained to try to impose the responsibility for a patient's problems on the patient him or herself, rather than on the patient's experi- ence or environment. The March 1970 issue of Transaction reports on an article by Thom- as J. Scheff on this process: " Most psycho- therapists have been trained to view patients as favorable candidates for psychotherapy if they have'insight into their illness - which is to say that they accept, or can be led to accept, their problems as internal " [Empha- sis ours]. Scheff gives an example from the pages of a textbook on phychiatric practice: A women is irritable, tense, and depressed because of her alcoholic, abusive husband. The therapist is supposed, according to the text, to " reject " that explanation of her trou- bles. But when the patient finally states her problem in psychiatric terms, saying that she came to him because " Maybe I could get straightened out " [Emphasis ours], he should now, according to the text, sound " inter- ested " " And you don't regard your husband as being the difficulty? You think it is within yourself? " When the patient replies: " Oh, he's a difficulty all right, but I figure that even had it been other things, that this state would've come to me, " the therapist should, " eagerly now, " begin to question her on " the factors within yourself. " One of the most pervasive uses of this kind of psychiatric ideology is in supporting the continued oppression of women. A woman's failure to accept her prescribed roles as housekeeper, nursemaid, and husband - pam- perer is explained to her as resulting from her own psychological inadequacies as mother and wife rather than from flaws in the institutions of marriage and the family and in the roles defined within them. If she fails to wipe Con Ed's soot off the window sills every day, she is a " bad " housekeeper; if her child uses dope to escape the empti- ness and despair of the streets, she is a " bad " mother. Whether delivered in person by her psychiatrist, or through the mass psy- chotherapy of Abby, Ann Landers, Rose Franzblau, and the Readers Digest, the mes- sage is clear: your oppression as a woman is your fault, not a social problem; hence it must be met individually and ( by changes in yourself), not collectively. Another use of the psychiatric ideology has been in " explaining " the rise of dissident political movements. Thus, psychiatrists and psychologists have sought to explain the rise of the New Left to the American people in terms of the psychology of the dissenters. Vietnam, racism, poverty, imperialism disap- pear save as triggers of latent psychopatho- logy. Bruno Bettelheim, the well known - psy- choanalyst, describes the new radicals, in a widely quoted interview, as " paranoids, " the necessary outcome of the " permissive " child- rearing practices of Dr. Benjamin Spock. More recently, the New York Times called in psychiatrist David Abrahamsen, a specialist in the study of violence, to explain the poli- tics that led up to the recent rash of bomb- ings. The bombers need not be psychotic, he said. They may be " dissatisfied persons with a grudge... some hurt, some loss, dis- harmony in the family, disappointments, per- sonal grudges. " Somehow the bomber " twists his own personality conflicts into believing something is wrong with society " ".. Bomb- ing is a way to call attention to oneself: " And so, while his inner conflict is person- alized, he directs his aggression at society to displace his anger. " These psychiatric de- scriptions have found expression in the plans of the Nixon Administration for increased sur- veillance and repression of the Left. One " highly placed Nixon assistant " described extreme radicals thus: " It wouldn't make a bit of difference if the war or racism ended overnight. We're dealing with the criminal mind, with people who have snapped for some reason. " The Daily News turns it into laymen's lan- guage spoiled ", self centered - brats " who " hate everything decent and good " and who Much Madnes is divinest sense To a discerning eye- Much sense the starkest madness, ' Tis the majority In this, as all, prevail. Assent and you are sane; Demur, you're straightaway dangerous And handled with a chain. -Emily Dickinson ) have an " urge to destroy. " The psychiatrists give the same theme the respectability of sci- ence. Widely publicized in the mass media, their views help shape the public's consci- ousness of the movement. They help insulate the good TV watching - , Life magazine - read- ing citizens from understanding what the movement is all about, how it relates to the forms of oppression he feels in his own life, and why he should take it seriously on its own terms. Many other examples of the repressive ideological role of psychology and psychia- try can be given. Black riots come from the " instability of the Negro family " according Published by the Health Policy Advisory Center, Inc., 17 Murray Street, New York, N. Y. 10007. (212) 227-2919. Staff: Robb Burlage, Leslie Cagan, Vicki Cooper, Barbara Ehrenreich, John Ehrenreich, Oliver Fein, M.D., Ruth Glick, Maxine Kenny, Ken Kimerling and Howard Levy, M.D. 1970. Yearly subscriptions: $ 5 students, $ 7 others. Application to mail at second class postage is pending at New York, N. Y. 2 to presidential advisor Daniel Moynihan, not from poverty and racism, hopelessness and anger. Absenteeism among the blacks and Puerto Ricans in low paying - dead - end jobs is due to inadequate socialization in the vir- tues of promptness and perseverance not to the inhumanity and pointlessness of the job itself. Acceptance of the status quo is normal and healthy; deviance in thought or behav- ior, whether individual or collective, is patho- logical. People are taught to think of them- selves and to think of the deviations and dissents of others in these terms. A sick so- ciety is transformed into nothing more than a collection of sick individuals. Conceived of in scholarly journals, boiled down by pop psychiatrists and advice columnists, in our society psychiatry and psychology have be- come the pseudo scientific - underpinning for a repressive ideology which promotes aliena- tion, from oneself, from others, and from reality. Do not Pass GO, go Directly to Jail . Back in the 1950's and early 1960's, mental health vied with fluoridation as a pet peeve of the far right. For a bunch of psychiatrical- ly trained " intellectuals " to have the power to put people away for something as undefined as " mental illness " seemed an assualt on the moral character of America and an intolera- ble infringement of personal freedom. Liberals regarded the right wing - anti mental - health buffs as " crackpots. " To the liberals, hospital- ization for the mentally ill seemed to be a humane alternative to more conventional punitive measures taken against those who commit anti social - acts because of mental disability. The liberal tradition honored the efforts of private and public institutions to look out benevolently for the welfare of those who were unable to make it in society (whether due to joblessness, age, or insani- ty). But the right wingers - , regardless of their reasons for opposing the mental health move- ment, may not have been entirely wrong. Both criminal and civil law relating to mental health provide ample opportunity for the suppression of those who behave in ways alien to society or profess a different life style the criminal, the hippie, and the polit- ical dissenter. . In New York State, a recently proposed recodification and revision of the mental hy- giene law, which includes the procedures for civil commitment to mental hospitals, shows clearly the potential for repression in current mental health laws. 1984 may be closer than we think. According to the law, you don't have to be a criminal to be put in jail; the good offices of psychiatry will get you there. Anyone who acts other than in ways ap- proved by the authorities, his family, school, or the police may find himself in a Kafka- esque web of extended incarceration by a " benevolent " Mental Health Establishment. New York State has been in the forefront of the movement to use medical treatment as a cover for repression. In 1966, Governor Rockefeller won reelection by promising to subject drug addicts to compulsory " treat- ment " in State institutions. Although the pro- gram was justified as a humane, non crimi- - nal, " medical " way of dealing with addiction, the program is little more than a way of in- carcerating addicts for up to three years against their will and without benefit of the safeguards of criminal procedure. [See Box, Page 4.] Now Rocky is extending his re- medicine pression - through - technique to en snare other social deviants - those who are or who someone considers to be " insane. " The State Department of Mental Hygiene has presented the Legislature with a " recodi- fication " of the State Mental Hygiene laws. The new law is really more of a revision than a recodification. It amends the state alcohol- ism, narcotics, mental retardation, and men- tal illness laws and puts them all under the jurisdiction of the Department of Mental Hy- giene. The bill is currently before the Joint Legislative Committee on Physical and Men- tal Handicaps, but there are indications that an effort will be made to jam it through the Legislature before more opposition mounts. Governor Rockefeller's Department of Mental Hygiene is the leading protagonist of the bill, because the bill provides a major increase in its power over a diverse set of programs. Other backers of the measure include New York City's Department of Mental Health [see May, 1969, BULLETIN] and the New York Association for Mental Health. The psy- chiatric and psychological professional so- cieties are opposed, largely because the bill contains provisions expanding the powers of the State to license, regulate and investigate private psychiatric practice. The portions of the proposed law relating to involuntary commitment to mental institu- tions are especially threatening, adding a new vagueness, looseness of language, and lack of concern for civil liberties to the exist- ing civil commitment procedures (which themselves have been attacked on civil liber- ties'grounds). Some features of the pro- posed law (some of which are carryovers from the current law) are: M@ The definition of mental illness is pur- posefully vague. " Mental illness, " says the law, is " an affliction with a mental disease. " (Got that? Involuntary long term - commit- ment to a mental instiution requires that the person committed be " dangerous to himself or others, " but no overt act or threat justify- ing the allegation of danger is required. (In California, by contrast, an " imminent threat of substantial physical harm to others, " dem- onstrated by an overt act or threat of an act of violence in the immediate past is a prere- quisite to commitment.) The Department of Mental Hygiene is reportedly pressing to have even this vague wording changed, so that it would be possible to commit a person " for his own welfare or the welfare of others. " The law permits, in effect, preventive de- tention of a person who may be dangerous, if (and only if he is mentally ill. " Our so- ciety, " the New York Civil Liberties Union points out, " is remarkably, though properly, reluctant to confine persons solely because of what they might do in the future. " The Civil Liberties Union adds that an estimated 50 to 80 percent of ex felons - will commit future crimes, and members of other groups such as ghetto residents and teenaged males are much more likely to commit a crime than the average member of society. By contrast, mental patients with no prior arrest records have an arrest rate after release which is less than twelfth one - that of the general pop- ulation. Nevertheless, " of all the identifiably dangerous groups in society, only the'men- tally ill'are singled out for preventative de- tention, and they are probably the least dangerous, as a group, of the groups here mentioned. " @ A person can be committed to a mental institution, under the proposed law, for three days (Sundays don't count), for examina- tion, merely upon the allegation - by anyone - that he is mentally ill and requires ob- servation, care or treatment " for his own wel- fare or the welfare of others. " In particular, a policeman can commit a person who " ap- pears to be mentally ill " [to the policeman] and who is " conducting himself in a manner which in a sane person would be disorder- ly. " The distinction between a sane person who is acting disorderly and an insane per- son who is acting like a sane person acting disorderly - maketh the mind to reel and the brain to boggle. Political demonstrators, watch out! (There are similar provisions in the current law.) After the three days, the person can be held further on the signature of two phy- sicians or one psychiatrist. It's (at this step that the " dangerous " provision applies.) Sometime before five days have elapsed, he must be informed that he is being involun- tarily held (in case he hadn't noticed it) and that he has certain rights. (Again, Sundays are days only to the confined man, not to the course of justice.) The patient then has 60 days to ask that the court review his case. If he does not request a hearing, the hospital can ask the court to order a six month confinement without further ado; there is no absolute requirement for a hear- ing before commitment or confinement. If the patient, however, does request a hearing, it can be put off for five days, and possibly, at the request of the hospital and with the con- sent of the court, for a longer time. committed At the court hearing, the patient can be committed to the hospital for up to six COUNSELORS SAY: JAILERS NO MORE The much publicized - State Narcotics Ad- diction Control Com- mission civil commit- ment program which Governor Rockefeller has called " one of the finest in the country " recently came under fire from its own therapeutic staff. In early March dissident counselors and psycholog ists at the Queensboro Rehabilitation Center, Long Island City (one of 14 detention centers in New York State), charged that the policy of the center was " to keep the addicts off the streets " rather than rehabilitate them. After a fruitless appeal for change to the Center's administration and to the brass in the State Narcotics Commission, two of the six counselors who complained were dis- missed, and the other four were threatened with transfer. (The entire counseling staff con- sists of seven people.) Dr. S. Seymour Joseph, associate commissioner of the State agency denied the allegations of the dissidents and said: " The counselors will be replaced with individuals who are more concerned with the rehabilitation of addicts and less with their own personal ambitions. " One ( of the coun- selors'many demands was that one of their own members be promoted to a policy - mak- ing position. The other demands all con- cerned improved care for the addicts.) A press release issued by the therapeutic staff March 10, just before the Joseph edict, said: " There are over 200 people, mainly Blacks and Puerto Ricans, locked up in a prison right behind us. According to the State of New York as manifest in the New York State Narcotic Addiction Control Commission they are being rehabilitated mainly through the use of therapy. The therapeutic staff demands that the people of this state see the grey build- ing behind us for what it is. It is a jail. There is a warden and there are security guards. There is a detention cell - 6x8. All the ac- coutrements of a prison are there for one good reason - it is a jail. The counseling- therapeutic staff serves as propagandists for this prison. They are the icing on the jail. We and the residents have been fooled. We have been fooled by our desire for a real thera- peutic program. We have been fooled by our belief that such a program - a real therapeu- tic program is possible. We now see that it is not possible in a jail. If the therapeutic staff is guilty of anything, is it guilty of naive- te. It is asserting its maturity in asking that a prison be called a prison and a therapeutic program be called a therapeutic program. The residents have helped us to learn that telling'it like it is'is a necessary condition of good therapy. In compliance with their in- sight and... with our own belief that we can help them, we point to a jail and ask that the people of this state regard it as a jail. " 4 months. The court is required to explain in The criminal courts have also used psy- writing the reasons for its decision, if it de- chiatry as a tool of repression through rul- cides to release the patient, but no explana- ings of incompetence to stand trial and ac- tion is required if it orders his incarceration quittal by reason of insanity. Hearings on in- continued. At the end of six months, similar competence to stand trial are held on the proceedings can result in additional one and motion of either the prosecution or the de- two year - sentences. (The words " incarcera- fense before a criminal trial. The hearing is tion " and " sentence " are used advisedly. held before a judge without a jury. Although State institutions for the insane are notorious- the exact legal definition is in some dispute, ly brutal and " therapeutic anti -. " A 1960 ar- findings of incompetence to stand trial are ticle in the American Journal of Psychiatry based on the policy that a criminal defendant observed: " There is repetitive evidence that should not have to go to trial if he is unable once a patient has remained in a large men- to assist his lawyer in preparing the defense. tal hospital for two years or more, he is quite This legal standard of incompetence is often unlikely to leave except by death. ") confused by the courts and psychiatrists, OE The court " may determine the need, if however, with a more general medical stand- any, for the appointment of counsel for the ard of mental illness. A court psychiatrist not patient " [emphasis ours]. He has no guaran- infrequently will testify that a defendant is teed right to counsel. Moreover, his lawyer, incompetent based on a finding of some form if he has one, cannot get access to the pati- of mental illness, without investigating fur- ent's records except " on the consent of the ther whether this will incapacitate the de- commissioner [of Mental Hygiene] or on an fendant in assisting his attorney. For exam- order of a court of record. " ple, a psychiatrist might testify that an overly OE The patient has no right to confidentiali- paranoid defendant is incompetent because ty or privacy. State Mental Hygiene officials he is mentally ill. However, this paranoia may can freely examine him in private (he has equip a defendant with precisely those in- no right to have a lawyer or his own doctor sights that most assist his attorney, e.g., a present), and are authorized to inspect his minute by minute diary of his life. This con- clinical records and personal possessions. fusion between the legal standard and a medical standard of mental illness can result OE Involuntary commitment gives the State extraordinary powers over the confined per- son. It can subpoena a patient's personal books and papers; fingerprint and photo- graph him; take away permanently a child in a defendant's being institutionalized in a hospital for the criminally insane for the rest of his life without ever being tried for the criminal act in question. born to a patient in the mental hospital; seize Often it is the prosecution which seeks to the patient's funds or other personal property have a defendant found incompetent, al- up to $ 2500 and sell them for his support; regulate his communications with non pati- - ents; and even open his letters to friends or though theoretically it should be the defense attorney who makes this decision, because it is he who must be satisfied or not satisfied his lawyer. with the defendant's ability to help prepare OE Consent is required for surgery on a the case. Sometimes the prosecution desires committed person. From the wording of the to have the defendant ruled incompetent be- law it appears that consent is not required cause it is unable to amass evidence to sup- for electroshock therapy, drug therapy, etc. port its case. Bruce Ennis of the New York Mental health laws, in New York and else- Civil Liberties Union's Project on Mental Ill- where, are unparalleled in their delegation of arbitrary power to a single group of peo- ple the psychiatrists, who, of course, are subject to all the political and social preju- ness reports a case in which the district at- torney asked a court psychiatrist to testify to a defendant's incompetence because the state " wasn't ready to try him. " dices of our society. In a 1969 Florida case, " Incompetence " can easily become a vehi- for example, two psychiatrists testified that a cle for handling the political defendant. " proclaimed self - " hippie'who believed in free, Given the availability of established psy- love, non violence - , and the use of hallucino- chiatrists who are willing to testify to the genic drugs " was on these grounds alone mentally ill and in need of confinement. This particular hippie was luckier than some: his " paranoia " and " schizophrenia " of dissidents, the court would have no difficulty declaring the political defendant incompetent and hav- lawyers found a psychologist to take issue ing him institutionalized for an indefinite peri- with the psychiatric judgment and the ap- pelate court set aside an order of commit- od. Activists who make " political defenses " might be another target. For example, recent- ment. If somone can be threatened with civil ly a militant black was arrested for allegedly commitment merely because of his life style, then those whose behavior and attitudes are assaulting a court officer at a trial of one of his friends. When he became unruly at his more directly threatening to the established order might well watch out. Perhaps never in United States history has a law threatened own hearing, the prosecution had him sent to Bellevue Psychiatric Hospital to determine if he was competent. The court psychiatrist such severe punishment for ideas and atti- testified for the prosecution that the defend- tudes as the proposed New York law. And, ant suffered from severe depression. After a according to the law, it's all in the name of lengthy hearing the New York Civil Liberties " the protection and promotion of the mental Union was finally able to persuade the pro- health of the people of the state. " secution to withdraw its motion and admit that the defendant was competent to stand some form of preventive detention. In most trial. In light of recent events, it is also inter- states after an acquittal by reason of insani- esting to recall that George Metesky, the ty, a finding of " dangerousness " or " present " mad " bomber, was declared incompetent insanity " by the trial judge or by the jury re- and has spent 12 years at Matteawan State sults in an indefinite institutionalization. The Hospital without ever going to trial. vagueness of these standards and the feel- Findings of incompetency more commonly ing that the acquitted defendant is still a involve the indigent defendant. The district criminal make preventive detention more attorney and the legal aid attorney can co- than a possibility, especially in cases involv- operate to arrive at incompetency rulings in ing crimes of violence. While the plea of in- order to help clear the clogged criminal cal- sanity is usually a defense strategy it can be endar. The legal aid society and the district raised by the prosecution. Thus, in a case of attorney's office in New York City already a political " conspiracy " the prosecution may work together so that over 80 percent of all try to prove the defendants insane and have criminal cases end in guilty pleas in an effort them put away for an indefinite term instead to speed the burdened criminal process. How- of the ordinary sentence for this felony. More- ever, the decision to have a defendant de- over, by the process, the political act be- clared incompetent is not necessarily arrived comes branded as the act of insane men and aa at on the basis of saving time alone, but is women. often based on the belief that the defendant needs some type of care. What they fail to Commitment proceedings growing out of a criminal prosecution afford an avenue for re- ns consider is that the individual should deter- pression of political dissent, not so much be- mine the type of care he wants whether it's cause of the judicial procedures themselves civil commitment or outpatient care, and not but because of the perversion of those proce- have to rot his life away in an institution for dures. The perversion is brought about by the criminally insane. the ease with which psychiatrists (and so- While not as threatening as the ruling of ciety in general) use the labels of insanity, incompetence, the use of insanity as a de- and the court's refusal to challenge the " ex- fense provides a common mechanism for us- perts. " Dissent from the majority and you are ing the criminal process in a repressive way. insane; suspect repression because of this The insanity defense negates the criminal dissent and you are paranoid; react to the act by taking away the necessary element of contradictions of a society and you are schiz- voluntariness or conscious intent. Unlike ophrenic; attempt to change that society and other defenses, insanity does not operate to you are institutionalized. - John Ehrenreich free the defendant but usually results in and Ken Kimerling Prison Psychiatrists: the new Custodians mental hygiene clinic personnel were basical- ly allies; other prisoners felt the opposite. The first group of prisoners cooperated with the mental hygienists; the latter did not. It was hoped that a political psychological / delinea- tion of the psychiatrist's role in a prison set- ting might help resolve these polar views and might be of help to political prisoners who were trying to organize other prisoners. The form of this article departs so strikingly from that of previous BULLETIN articles that a word or two of explanation is in order. The author wrote an earlier version from his Prisons Prisons are, to use Erving Goffman's term, " total institutions, " meaning " a place of resi- dence and work where a large number of like situated - individuals, cut off from the cell in Lewisburg Penitentiary Farm Camp. At that time he was less interested in de- scribing prison psychiatry (e.g., number of wider society for an appreciable period of time, together lead an enclosed, formally ad- ministered round of life. " It should be clear psychiatrists per 1,000 prisoners, hours and that institutions other than prisons can be types of psychotherapy offered, etc.) than he thought of as " total institutions. " Indeed, the was in exploring and analyzing the relation- term was first applied to State mental hos- ships and interaction of the psychiatrist and pitals. One could also consider monasteries, the prisoner, and, more specifically, the po- chronic disease hospitals, high schools, col- I litical prisoner. This approach was adopted because he hoped to show a contradiction of serious consequence between the psychia- trists'benevolent aspirations and the real leges and medical schools to be various de- grees of total institutions. Insofar as these organizations are total, or at least, " subtotal " institutions, some of the conclusions reached role required of him by prison authorities. with regard to prison psychiatrists may also The essay was written in an effort to sat- be applicable to psychiatrists practicing in isfy a pragmatic need and not as an aca- them. demic exercise. At the time of the writing, One particular institution, the military, of- political prisoners in the camp were divided fers striking parallels with regard to the role in their evaluation of the role of the prison played by psychiatrists. Not only are prisons psychiatrist. Some prisoners felt that prison and the military total institutions, they are, authoritarian institutions. Of the two, prisons are, of course, the more total and more au- thoritarian. But both prisons and the military have their chains of command, consisting of lieutenants, captains and commanders / war- dens. Prisoners, like soldiers, are given or- ders which demand unswerving and unques- tioned obedience. In both systems, behavior is controlled and directed by a system of re- wards and punishments. In both systems, reality is defined within a frame of reference which includes only the total institution but which ignores the existence of the larger so- ciety. Behavior is evaluated in similar fash- ion. Naturally, " adjustment " is encouraged; " maladjustment " discouraged. However, ad- justment or maladjustment are evaluated only with reference to the needs and de- mands of the institution in question; the re- quirements of the wider society are excluded from consideration. Thus the individual who confines his conduct within the limits set by the authorities is said to be " well adjusted, " and is rewarded for his behavior. Those whose behavior strays outside the bounds set by the authorities are said to be " malad- justed " and are punished for their " failure to adjust. " the victim becomes part of a homogenized mass of humanity, cut off not only from the larger society but even from itself, blending indistinguishably into the concrete walls. In the process of adapting to his environment, the victim sacrifices his self image - and self- conception; he ultimately renounces his self- dignity and manhood. He is emasculated, debased and dehumanized. The victim does have another alternative; he can resist. He can do so by using many forms and methods. He may choose a collec- tive political approach, or, under less favor- able conditions, may resist individually. He may resist for very conscious political rea- sons or simply because his sense of rage will not permit his jailors to imprison and annihi- late his mind as well as his already shackled body. The effort to survive imprisonment is a life death - and - struggle. The longer a man is exposed to the dictates of his captors, the less likely it will be that he will survive with his mind and body functionally intact. In such a setting, one cannot carp too harshly about the politics of the victims'survival methods. The fact is that every act of re- sistance in prison is a political act. We need not concern ourselves with an ex- The analysis in this essay is based upon the proposition that psychiatrists play an essential role in, firstly, defining standards of behavior which serve the needs of repressive institutions and, secondly, in enforcing ad- herence to these standards. The psychiatrist is then very much a part of these repressive institutions. These institutions, of course, do violence to their victims'freedom. They aim at the destruction of their victims'very being and personality matrix. They are, then, in their essence, anti mental - health. The question is why and how the psychia- trist, in particular the prison psychiatrist, contributes to, indeed serves, a pivotal role in the destruction of the mental health and well being - of so many countless victims. We must, in the course of this analysis, explore the psychological / political interplay between the victim and the psychiatrist. For the captured victim, two alternative strategies present themselves: He may 1) passively accept the assaults hurled upon * him, or, 2) he may choose to resist. The first response is by far the most common. His- torically, the oppressed often consent in their own oppression. While there are undoubted- ly many explanations, suffice it for our pur- poses to say that the victim's resignation is due to the rewards which will be offered in tensive recital of the exact methods of prison resistance used. They vary from the complete and total non cooperator - , who refuses to eat, dress, shave, shower, work, etc.; to the man who smuggles books, political tracts and let- ters into and out of prison; to prison organ- izers who struggle for the day when the en- tire prison population will be united to wreak vengeance upon their jailors while toppling the prison walls. The victim realizes that, by resisting, he can attain a measure of free- dom despite his imprisonment, and, by so doing, he can prevent or at least delay his deterioration self - . And, if worst comes to worst, and, despite his valiant resistance, he is finally defeated, he will have succeeded in giving a historical and personal dimension to his defeat. The legacy of past resistors lingers in the dank cells and corridors of prison and helps fortify the next crop of con- demned men. The resistor will be met by institutionally- imposed counter resistance - . Initially, these measures include verbal chastisement and denigration. During this process the resistor is for the first time labelled by his captors. He is called a " kook, malcontent, eccentric, sub- versive or pinko. " He is not " a part of the team; " he is an " oddball and troublemaker. " While still relatively benign, the insidious character of these tactics must not be under- payment for his capitulation. The compliant victim is less harassed, humiliated and phy- sically brutalized. If he is a prisoner, the car- rot of parole is constantly dangled in front of his eyes. The compliant victim, the one who obligingly accepts his " fate, " is allowed to melt into the woodwork and is essentially forgotten. In totally acquiescing, however, a steep price is paid. The institution has been permitted to achieve its total domination over the victim's life. The end result is that estimated. Their intended end result is the acquiescence of the prisoner's spirit in its own destruction. The worth and value of the individual is brought into question; the re- sistor is being emotionally isolated and quar- antined from the larger prison community. Later, when the initial verbal chastisement tactic fails, the resistor will be administrative- ly punished. He will be denied privileges (e.g., use of the library or recreation field); he might be placed in solitary; and he may 7 be placed on a restricted diet. Eventually, if these measures still do not suceed in quelling his urge to resist, physical brutality will be added to the emotional violence which has already been imposed upon the victim - re- sistor. Throughout the attempted " breakdown " process, the resistor is offered " benevolent " advice. He is told that he is " making things hard on himself. " He is advised that the in- stitution is designed to " rehabilitate " him, and that he should gratefully cooperate in this endeavor. Prison officials act as if the victim owes them a vote of thanks for their efforts. Of course, the prisoner owes his jail- ors nothing; they owe him his freedom. And, as far as rehabilitation is concerned, prisons are anti rehabilitative - in the extreme. The resistor victim - is striving purely and simply after self preservation - . This is true of every resistor; the politically - inspired resist- or, however, adds another ingredient - he seeks to destroy the system that is oppress- ing himself, his brothers and sisters. Even if the actors are not political, success cannot be insured because pitted against the victim- resistor is the prison Establishment. The vic- tim resistor - must be suppressed because if he is permitted to survive, the institution perishes, or, contrariwise, for the institution to flourish, the victim resistor - must be scari- ficed. To understand why so massive and awesome a resistance counter - is mounted, it is only necessary to point out that prisons are ultimately the defenders of an entire op- pressive State and society. The victim resist- - or's demise must be achieved because his survival necessarily would compromise the power of society's vehicle of oppression. To do so comes very close to challenging State power itself. Psychiatric Psychiatric science buttresses and _ stabi- lizes this repressive apparatus. In not a few instances, the institution's counter resistance - fails to silence the victim resistor - . The initial measures persuasion - , chastisement, mild administrative punishments_fail because the hostility of the institution's personnel is too overt and their duplicity all too evident for them to be convincing. As a matter of fact, not only do these tactics often fail, but, not infrequently, the individual's determina- tion to resist may be strengthened rather than undermined. At this critical juncture, the forces of science are called upon. The heavy artillery is moved into position - an appoint- ment is arranged with the psychiatrist. The victim resistor - is interviewed in the mental hygiene clinic and shortly thereafter a new, medically sanctioned - and therefore " legitimate " label is affixed to the resistor. He is no longer merely a " kook " or " malcon- tent " but is instead a " aggressive passive -" or " immature personality. " But the funda- mental thrust of these labelling devices is the same: They aim to convince the individual that he, and he alone, is responsible for his " aberrent " behavior. The labelling device ex- onerates the institution and its personnel BRUTALITY It is no secret in IN THE Washington Heights CLINIC CELLAR that if you can afford it and if you have an interesting medical case, Columbia's Presbyterian Hospital will provide the best medical care that money can buy. But those who rely on Vanderbilt Clinic (Columbia's outpatient community fa- cility) confront an enormous, impersonal in- stitution - waiting in line for hour after hour; unconcerned, if not arrogant, medical staff; and, increasingly, police violence in the bowels of the clinic. On the evening of February 24, Ira Heller, a 42 year - - old salesman and a community resident, went to Vanderbilt Clinic's 24 hour - emergency room to have a particle removed from his eye. He waited over an hour to be told by the medical resident on duty at the screening desk that he would have to wait to be seen by an ophthalmologist. Another hour ticked by and still no ophthalmologist ap- peared. It (is not clear whether an ophthal- malogist was even on duty.) Heller com- plained to the screening doctor about the wait and was told that if he didn't like it he could leave. He did not leave but insisted emphatically that it was his right to be seen by a doctor. At this point the screening doctor lost his patience and called in three security guards to remove Heller from the clinic. The following discription of the events that ensued has been pieced together from Hell- er's account, the accounts given by communi- ty people and medical students from the Upper Manhattan Coalition for Community Health who rushed to the scene to interview other patients and clinic workers who were eyewitnesses, and from the report of a doctor in the community who examined Heller later that evening. Three security guards, one armed with a pistol and the others with night sticks, seized Heller and dragged him into an elevator which opens into the clinic waiting room. No ( given location in the street - level waiting room is more than 30 feet from the doors leading to the street.) " They began working me over right away - with gloved fists, billy clubs, kicking.... They knew exactly where they were taking me. When the elevator got to the basement, they took me into a room and locked the door behind us and continued working me over. They said,'We'll show you how we treat troublemakers.'When they fin- ished, they pushed me out through Harkness Pavilion (an adjacent hospital for doctors ' private patients) and threw me into the street. They warned me that if I came back again, ' We'll put a bullet through ya.'" According to people who work in the clinic, this incident was not the first of its kind. The only thing unusual about the beating was that the victim was a white man. According to a worker who heard the screams from the from any and all culpability. The prisoner is especially likely to suc- cumb when, as they always do, the psychia- trist professes impartiality and remoteness from the institution. Generally, the psychia- trist goes even further to court the favor and earn the confidence of the victim resistor - ; he accepts the grievances of the victim and pre- tends to identify with his efforts at overcom- ing his tribulations. But the commiseration is a sham. The vic- tim is vulnerable. He's vulnerable because he is love and reinforcement - starved and in such circumstances even a sham - love and sham reinforcement - is better than nothing. The strong resistor victim - who was able to laugh when he was called a " kook " by a prison official, begins to wonder when he is informed and assured by a respected, white- coated, " degreed multi -" psychiatrist that his behavior is pathological. What, in effect, happens during the labelling transaction is that the psychiatrist attempts to abrogate the resistor's victim - right to define the terms of his own resistance. So the combination of the doctor mystique and the skillful exploitation by the psychia- trist of an element of self doubt - which exists in the minds of nearly everybody, including victim resistors - , weakens the will of the re- sistor to continue his resistance. " The reason that you rebel, " the resistor is told, " is not because of the provocations of the prison. You rebel because of certain unresolved psy- chological conflicts which I will help you re- solve. " Of course, some victims do resist this new ploy, but, for the more vulnerable, an element of doubt enters his mind; the seed has been sown; he is now well on the road to being seduced and reduced to a hollow shell of a man. Prison psychiatrists regard themselves as " objectivists. " They maintain that they ad- here to no institutional line but merely serve as objective therapists who only desire to as- sist those needing help. But they define " as- sisting those needing help " as, assisting the the victims of prisons to " adjust " to an ad- mittedly unnatural environment. It should be stressed that if " adjustment " is the goal, they do meet with a certain measure of success. And this precisely is the evil, for to be " ad- justed " to one's own imminent destruction is to promote the cause of one's victimiza- self - tion; it invites the victim's mind suicide. The psychiatrist's role is to destroy any remnants of the prisoner's resistance, and this is pro- foundly antithetical to any meaningful con- cept of mental health. It is a rare man, indeed, who can freely and openly admit to serving inglorious and evil designs. Evil men can do so, but evil men are themselves hard to come by. The men of whom I write are not evil; they do, however, serve evil designs. But, since they conceive of themselves as being essentially good, it is painful for them to acknowledge the legitimacy of an indictment which insists upon judging all acts in terms of the totality elevator, It " happens all the time * espe- cially to alcoholics and addicts. " And ac- cording to a security guard on another shift. " The guys on the 4 to 12 [PM] shift have a reputation for being fast with their hands. " The administration of Presbyterian Hospital has not made an official statement regarding the beating, brushing it off as a " conspiracy " perpetrated by Heller and other " radicals. " Dr. George Perera, dean of students at the medical school, told medical students that the incident had been designed to " upstage " the birth of the celebrated quintuplets and dis- credit Presbyterian. (Ironically, the quints were catching their first glimpse of an im- maculate delivery room in Presbyterian Hos - ` pital at the very moment that Heller was be- ing kicked around in the basement of the clinic.) A few days after the beating, a group of 200 angry community residents and a sprinkling of health workers and students at- tempted to march on Presbyterian Hospital to meet with the administrator, but were turned back by a solid line of security guards. The New York Times sent a reporter who inter- viewed people at length about the beating and about the role of Columbia in the com- munity, but nothing appeared in the paper. Immediately after he was beaten, Heller attempted to register " official " complaints, but he failed to move public officials to respond. let alone act. The State Department of Health said it was a matter to be taken up with the City - the City Department of Hospitals said Vanderbilt was not a City facility, and therefore not a responsibility of the City - and State Senator Sy Thaler (whose major con- cern has been the conditions that exist in New York's Municipal health facilities) didn't return the call. Heller, who has received several phone calls threatening his life if he doesn't drop. the case, plans to press criminal charges against the Vanderbilt security guards, as well as bringing a civil suit against Presby- terian Hospital. He does not view his case as an isolated one, however, but as a symptom of a much larger problem. He says: " I've seen both sides of Columbia - my children were born there, I've been a patient at Harkness and my daughter had an eye operation at Harkness... but it's a different story if you're poor, or black or Puerto Rican. . . T.h e Columbia administration doesn't acknowledge the community it is situated in. Not only has there been no community in- volvement in deciding what services the hos- pital offers, but they act as if they're doing the community a favor by occasionally treat- ing them. They only take the cases they are interested in.... The guards must have felt their actions were condoned by the adminis- tration, or they wouldn't have beaten me. " The only way to change such attitudes is to make Columbia and the hospital answerable to the community. " of the design these acts serve. Thus, to main- tain his own self image - , the psychiatrist must and does interpose rationalizations and other defensive postures between himself and the indicter. In this way, he tries to justify his actions and extricate himself from a morally ambiguous predicament. One such rationalization goes as follows: " Even if I help only a single individual, I am justified in serving the institution. " To begin with, there is a serious question whether prison psychiatrists are able to help even single individuals, given the way they define " help. " But this rationalization collapses of its own weight in any case, when it is re- membered that for every one individual " as- sisted, " the psychiatrist helps to destroy one thousand others. A more sophisticated second rationaliza- tion is often offered: " By infiltrating the in- stitution and initiating reforms to make it more humane, I can change the system and alleviate the distress of all prisoners. " But the psychiatrist is unwilling to accept the notion that the prime initiator of reforms is actually the agitation produced by prisoner- resistors. Unfortunately, while psychiatrists claim they are reforming and even destroy- ing the institution, is it obvious that, in fact, the psychiatrist's main role is to undermine the efforts of those victims who have the nerve and strength to resist of their own ac- cord. In order to safeguard his own privi- leged sanctuary, the doctor contributes to the sacrificing of the system's victims. Thus his medical and humane rationalizations are un- true and are politically dangerous. A conversation with a prison psychiatrist during my own incarceration perhaps re- veals most clearly that naked cynicism and interest self - is the only real explanation of the functioning of the prison psychiatrist. I asked a psychiatrist whether he had ever thought of his office as a firepoof sanctuary protected from the roaring prison flames out- side. He said he hadn't but that he could agree with the analogy. Nonetheless, it was clear that he felt no regrets and no responsi- bility for helping to consign men to the prison inferno. This particular psychiatrist's motiva- tion for serving as a prison doctor was sim- ple. By his own repeated admissions, he had joined the Public Health Service to avoid military service. He was then a draft dodger - , and, paradoxically, was assigned to the job of subjugating draft resistors - and other po- litical prisoners who chose to confront the State directly instead of opting out for an EDITOR'S NOTE: In the City Column [April, 1970, BULLETIN], HEALTH - PAC stated that Dr. Edmund Rothschild, a recent appointee to the Hospitals Corporation Board of Directors, was the selection of Manhattan Democratic Party boss Frank Rosetti. According to Councilwom- an Carol Greitzer, Rothschild was chosen much more democratically from among a number of candidates who were interviewed by all the Manhattan councilmen. easy draft deferment. One more point of rebuttal to the sympa- thetic, rationalizing psychiatrist must be added. Mental hygiene clinics are important substantiations of the claim that prisons " re- habilitate. " The existence of the mental hy- giene clinics are used by legislators and prison administrators to justify these thor- oughly unjustifiable institutions to the public. Therefore, whether willingly or otherwise, the would - be psychiatrist - subversive lends stability and support to these institutions, and, in so doing, subverts his own would - be goals. Actually, the psychiatrist should be asking himself these questions: " What is this in- stitution and what is my role in it? Is the sick one the man who enters my office seeking help, or is the sick one the institution which pays my salary, gives me a uniform to wear, and provides me with a set of rules and regu- lations I'm asked to obey? " The answers to these questions are rather obvious. The institution is the patient, and the victims who seek the doctor's assistance are the " disease. " In particular, the victim- resistor is the most virulent disease infecting the institution and upsetting its homeostasis. The psychiatrist serves his true patient well indeed. He is asked to combat the infectious agent and he does. Instead of antibiotics, however, words and tranquilizers are used to arrest the causative agent - the victim - re- sister. It is to be anticipated that, were the words and pills to fail, the knife would be tried next. By one means or another, the dis- ease- -the victim resis-t omru s-t be extirpated. The psychiatrist knows quite well that for him to act other than as an agent of the pri- son, would be to run the risk of endangering himself. Prison psychiatrists are unable to envision any alternatives, not because they are so difficult to conceive, but because the psychiatrist is too frightened to even specu- late about what those alternatives might be. As one prison psychiatrist told me: " Let's face it, I'm a coward. " The victim resistor - knows that the psychia- trist is not an " objective " therapist; rather he is a frightened therapist. The victim resistor - further knows that because of his fear, the psychiatrist performs acts which make him equally culpable as the institution itself. Rather than admit the accuracy of this indict- ment and thus compromise his own ego image, the psychiatrist ultimately projects his own inadequacy back upon the victim. The combination of fear, self protection - , and the entire thrust of American psychiatric training facilitates the psychiatrist's adopting the institution's original line of reasoning, lock, stock and barrel: " The fault rests with the resistor victim - and his failure to'adjust. " The institutional psychiatrist may be the possessor of limited power, position and priv- ilege. He is not, however, the possessor of his own freedom. Although the victim resistor - is infinitely more victimized than the psychia- trist, the latter, too, is a victim of the system. 10 Both resistor victim - and doctor victim - are trapped by forces felt to be outside them- selves forces which instill fear and deny both victims their freedom. But it is the psy- chiatrist who is the more alienated of the two victims since his very power, position and privilege prevents his attaining full con- sciousness of his own imprisonment. And, psychologically, insofar as his victimization is not fully conscious, he is the less free of the two victims since he is not yet even in a position to formulate the means by which he might resist. Thus, we have come full circle. Insofar as the therapist is afraid to grasp the totality of the system and confront that system, he becomes, as one commentator has phrased it, the " New Custodian. " The psychiatrist who cannot free himself becomes an instrument for the imprisonment of others. The " New Custodians " mold men's behavior to fit the imperatives of institutions, and, in so doing, mold themselves to the same in- stitutional shape. Even the psychiatrist's power is illusory and will be taken away from him as soon as he takes his first tenta- tive steps towards freedom. What might these first tentative steps be? To begin with, the prison psychiatrist must declare his allegiance unequivocally to the victim resistor - as well as all other prisoners. Once having done so, he must manifest that allegiance in concrete acts. Such acts could include the use of psycho therapy - to strength- en, rather than weaken, the will of the resist- or. It might include the smuggling of political materials into and out of prison - letters, pamphlets, magazines and books. And the psychiatrist could and should publicly ex- pose the realities of prison life, including the utter hypocrisy of the theme that prisons " rehabilitate. " Every victim resistor - is fighting to free all victims everywhere. That struggle has been in progress for centuries. Were the psychia- trist ever to decide to do these things, he would also truly liberate himself. At that point he would be welcome to the larger lib- eration movement. To do so, however, the psychiatrist must be willing to yield his priv- ilege. Until he does so, however, the victim- resistor has no choice but to regard the " New Custodian " for what he really is a police- man. The victim is entitled, and in fact, has no other option than to take whatever action may be appropriate in dealing with this enemy Howard. Levy, M.D. Cops: From Clubs to Couches With a little help from psychiatry, the long arm of the law may become the velvet fist of justice during the 1970's. Increasingly, men- tal health professionals and cops are getting together to consider more " humane " ways of dealing with troublesome city dwellers and, in the course of it, are developing more sub- tle forms of social control. Mental health techniques in the hands of the cop, as in the hands of the mental health professional, deal with the disruptive citizen on an in- dividual basis - by helping him to " adjust " or " communicate " more effectively with the authorities. Though such programs may be more humanitarian than billy clubs, they fail to understand what is justifiable anger at an oppressive system especially - as experi- enced by the black and brown communities. Sensitive to growing complaints of fash- old - ioned brutality, urban police forces are arm- ing themselves with more acceptable, but equally repressive techniques borrowed from the mental health professions. In response to the many " movements " for social change in the 1960's, police began dabbling with the ideas coming out of the community mental health " movement. " With the guidance of mental health professionals, local law enforcement agencies began to launch experimental programs - special training courses in riot control and handling strikers, special recruiting and training pro- grams for teenage policemen, weekends in the country for police officers and juvenile delinquents, sensitivity sessions between po- lice and community leaders and encounter therapy between community militants and cops. Financing for such experiments was as- sured by the passage of the omnibus Crime Control Act of 1968 and the subsequent estab- lishment of the Law Enforcement Assistance Administration as part of the Justice Depart- ment. The attraction of mental health profession- als to fighting " crime in the streets " was pre- dictable. Those in the forefront of the com- munity mental health " movement " were using group therapy in their offices as a means of resolving conflict. By working with the police, they could not only examine the dy- namics of conflict in small groups, but might gain insight into conflicts and antagonism between entire segments of the American so- ciety. And, in the eyes of the more idealistic, if they were successful, perhaps they could resolve grave social conflicts such as those which exist between the police and the ghetto dwellers. Police community / pilot projects are pro- liferating and the mental health professionals are refining the techniques as they go. One of the early, more primitive techniques - the " encounter " -is being pushed in city police departments throughout the country. In the State of Illinois, for example, some enterpris- ing professionals from a private consultant firm, Ebony Associates, have sold the idea to a score of troubled municipalities. Ebony, headed by a black, University of Illinois psy- chologist, has as another executive a black ex cop - who uses his seat on the State Com- mission on Human Rights to extol the virtues 11 of Ebony - brand encounters. A couple of years ago, Ebony convinced the police of East St. Louis, Illinois, that an encounter session would help the local police better understand the local black militants. As in traditional encounters which seek reso- lution of conflict through open, non violent - confrontation, the program directors set up a weekend meeting for cops and militants in a motel on the edge of town. CBS later immor- talized the encounter with an hour - long tele- vision documentary entitled the " Battle of East St. Louis. " After hours of head - on verbal collisions, each participant began to see both his " enemy " and himself as a " human be- ing " with problems. And once he accepted individual responsibility for attitudes and ac- tions, he could begin taking individual steps toward resolving the conflicts which had built up over the years. The camera crews re- visited participants a few months later and found that the weekend encounter probably changed the attitude of several cops who par- ticipated. The blacks of East St. Louis report that certain cops who were considered sad- ists by the community are no longer using third degree - tactics at the station house. How- ever, critics of the mental health approach point out that in a town like East St. Louis - a primarily black community which is ruled by a totally white power structure the prob- lems go deeper than individual antagonisms. The encounter group leaders, they report, not only did not bring up, but openly discour- aged discussion of the role of the police force in the black community. In New York City, encounter therapy has played a relatively minor role in mental health projects being devised for cops and community. In the past, if trouble arose in a community, the local police precinct captain Lif he sought counselling at all would -m ost likely call in a psychologist or psychiatrist on a one shot - consulting basis. Now, mental health professionals from both the universi- ties and the medical institutions are working with the New York Police Department to set up joint mental health demonstration projects. Two programs to sensitize policemen have been designed by the Department of Psy- chiatry at St. Luke's Hospital. The first is a " people who play together, stay together " - style program in which a cop can take a kid to camp for a weekend. At camp (an aban- doned army camp in Queens) " dialogue " is stressed in a professionally designed pro- gram which provides for both play therapy and for a series of T group - sessions. In the summer of 1968, 35 two day - periods were scheduled with 10 policemen and 30 youths taking part each weekend with expenses paid by the Law Enforcement Assistance Ad- ministration and Mayor Lindsay's Urban Task Force. Though the directors of the pro- gram feel that a lot has been accomplished so far as changing attitudes (many youths subsequently expressed an interest in joining the police force), the mental health profes- sionals say the program could be even more effective if they had more control of it. For example, the professionals would like the participants to represent a broader spectrum of youth and the cops who actually work on the beat. Unfortunately, they say, the police control the recruiting and they tend to choose only kids who are " troublemakers " and cops who are already specialists in " community relations " rather than ordinary patrolmen. St. Luke's second program, and the one which seems to have taken root and is now being looked to as a prototype for dealing with ghetto youth, provides ongoing training for young police recruits. A little over a year ago faced with increasing hostility from minority youth - the police department be- gan recruiting 17- to 21 year - - old trainees into its Precinct Service Officer program. The re- cruits are trained to relate to their peers and their problems, often those which are rooted in drug usage. Of the 48 young men in the program, only about one third are black or Puerto Rican. For the New York Po- lice Department, however, this is a high pro- portion of the total. The recruits go through police academy training and upon reaching 21 become regular patrolmen. At St. Luke's, the trainees are required to read such books as Soul on Ice and to con- template such heady subjects as: conflict be- tween blacks and Puerto Ricans, the hostility displayed to policemen by militants and SDS, violence and the psychology of extremism, alienation from " the establishment, " the gen- eration gap, youth power, student power, po- lice and urban community conflict and the role of the police in community change. One young trainee who was attempting to absorb all this psycho - social theory requested that the experts clarify and elaborate on the fol- lowing: " I would like to talk about how to relate to a Hard Core Child... I figure this will be very valuable to me in the field [placement] period. By Hard Core I refer to a Cop Hater - , or one who dropped out of school and is us- ing drugs. From what I see these types usual- ly have a big following of young impression- able children. I feel if they see their'leaders ' turn to the police, instead of against, they will also follow. [The psychiatrist] was a tremendous help in the past and I feel he can clear my mind on this subject. " At the same time that community mental health professionals have been tutoring the New York police force, their counterparts in the university have laid more elaborate plans for extending psychology's impact out of the hallowed halls and into the streets. The Psy- chological Center at City College, under the directorship of Dr. Morton Bard, for example, is heading aggressively for the frontlines. Dr. Bard says that " careful evaluation of the realities of modern social existence suggests that law enforcement and mental health are not such strange bedfellows after all In these days of increasing social tension, increasing crimes (particularly of violence), increasing mental health manpower short- 12 ages, and increasing need for a university- community dialogue, novel approaches to these problems are necessary... " The Psy- chology Center, which is located in West Harlem, has launched a _ research - oriented " community action " program in which men- tal health professionals work with and train the local police. The Center is currently focussing on the New York Housing Authority police, who are employees of the Police Department possess- ing the same powers as regular city police. (There are 1400 housing police patrolling 152 public projects with a total of 600,000 tenants.) This demonstration training pro- gram, which involves police from three hous- ing projects, is an extension of an earlier project which trained policemen for crisis in- tervention during family disturbances. On the basis of the successful crisis intervention experiment, the psychologists developing the housing police project are asking: " Can [] the methods of the demonstration [crisis in- tervention] be successfully extended to hu- man conflicts which do not involve family members? [Can] there be a precise meas- urement of impact upon the community? " Already, community people have been sur- veyed for their attitudes toward police so that the researchers can measure changes of attitudes produced by the latest police train- ing program. They hope that, eventually, changed attitudes will be reflected in in- creased utilization of the police force and a decrease in the incidence of " malicious mis- chief and vandalism... which often reflects a passive aggressive - citizen response toward an authority structure that is seen as wholly repressive and insenitive rather than reason- able and helpful. " Conflict resolution is the goal of the City University program. In a paper presented last month to the annual National Symposium on Law Enforcement Science and Technology, Dr. Bard asserts: " To some observers [conflict] is a disrup- tive and deviant form of behavior which needs to be treated as if it were a disease: to others, conflict is a form of socialization which has positive and constructive aspects. In either case, it is for each society to define the tolerable limits of conflict and to contain those conflicts which go beyond acceptable limits.... Virtually everywhere, it is the police who have been assigned the responsi- bility for monitoring the dimensions of con- flict and for checking excesses.... Unfortu- nately, it may be that the failure to properly acknowledge the increasing importance of these highly complex conflict resolution func- tions [of police] has been partially responsi- ble for the deteriorating effectiveness of the police as a system of social regulation. " [Emphasis ours.] How do the mental health professionals or academicians fit into the picture? Read on, Dr. Bard: "... the present experiment [hous- ing police] suggests further the viability of a collaboration between the social scientist and the police. The research action - model embodied in this experiment is clearly to the mutual advantage of both. For the police, the relationship holds promise of affording in- sights into dimensions of complex social processes of which they are the lonely ar- biters and from which can flow their in- creased safety and job satisfaction. For the social scientist, the association provides an avenue to human interactional data not available to naturalistic study in any other way. And for society, the collaboration holds promise for contributing somewhat to im- proving the conditions of life in these con- fused and complicated times. " [Emphasis ours.] The mental health professionals - whether entrepreneurs pushing encounter sessions in motel rooms or academicians reading to re- cruits from Soul on Ice - all seem to have a mental block when it comes to recognizing oppression. They have yet to ask the right questions: Will a predominantly white oc- cupying police force ever find the struggle of minority groups (no matter what the means) for self determination - to be anything other than hostile? And when the role of the occupying police force is to protect the prop- erty of the privileged classes, can the occu- pying force also provide " equal protection " to the citizens of the occupied community? Or will the kind of protection that the black and brown communities need - from drug pushers, greedy landlords and exploitative businessmen, for example - be provided only when the community controls its own police force -Maxine? Kenny NYU - NY Times: What News is fit to Print? When NYU appointed CBW expert and for- mer Pentagon advisor Ivan Bennett to the post of Dean of the School of Medicine, the medical students used every means possible to make their objections known leaflets - , let- ters and even a protest demonstration. The NYU administration had more dignified means of communication at its disposal. On April 9, NYU printed its rebuttal to the stu- dent protestors in the form of an editorial in the New York Times. NYU ( and the Times have always been very close. Howard Rusk, director of the affiliated NYU - Rusk Institute, serves as a Times columnist and medical consultant: see the February, 1970, BULLE- TIN.) Just in case any of the students might have missed the Times editorial, NYU re- printed it and distributed it to all the medical students. Below we have reprinted the Times edi- torial and a rebuttal written by a fourth - year 13 NYU medical student in the form of a letter to the editors of the Times. (The student's let- ter was never printed by the Times): April 9 Times editorial, entitled " McCar- thyism from the Left ": McCarthyism - this time emanating from elements of the New Left instead of the Old Right - is beginning to reappear on some college campuses. A particularly dismaying case in point is the current offensive against the distin- guished medical scientist, Dr. Ivan L. Bennett Jr., who is New York University's vice presi- dent for health affairs and dean of its med ical school. Charging that Dr. Bennett once did research on diseases that are included in the spectrum of biological warfare weapons, a group of NYU faculty members and stu- dents is now demanding his ouster. The charge in Dr. Bennett's case is ludi- crous in light of his major contribution be- hind the scenes toward persuading the Nixon Administration to abandon biological war- fare techniques and to destroy existing stocks of disease organisms. Opponents of bacterio- logical warfare should be honoring Dr. Ben- nett for his effectiveness in pressing their cause, instead of attacking him. This nation, still remembering the damage done by McCarthyism in the early 1950's, is not going to embark upon any such massive irrationality and injustice in the early 1970's. April 10, letter from David Mendelson to the New York Times: Your invocation of " McCarthyism From the Left " is both a seri- ous misrepresentation of the facts in the Ben- nett case, and also a poor historical analogy. First, the charges against Dr. Bennett are in several different areas. Chemical biological - warfare (CBW) is one; another is the in- volvement of the community in the selection and control of the position he has recently assumed. You insist that we object to him be- cause of his past work in CBW; we do, but we also object to his present stance. His so- called " attempts toward persuading the Nix- on Administration to abandon biological war- fare techniques and to destroy existing stocks of disease organisms " are motivated less by considerations of morality than by military tactics. He stated in November at the Uni- versity of Pennsylvania, " When you examine the concepts of biological warfare closely, you see they don't offer much militarily.. The same can't be said of chemical weap- ons. " Indeed, he lauded the use of the tear gas CS as a weapon in Viet Nam; and de- clared his opposition to Secretary - General U Thant's call to abandon " all chemical, bac- teriological and biological agents (including tear gas and other harassing agents), " say- ing that " any move that might be interpreted as taking an effective weapon away from our forces would surely carry domestic political risks. " And to go even further, the July, 1969, report of the UN Commission on Biological and Chemical Weapons (on which he served), attempted to reclassify bacteriolog- ical toxins as chemicals, thus exempting them from a possible ban on biological weapons. President Nixon several months later termed the Commission's statement an " administra- tive oversight. " This is absurd; a person with Dr. Bennett's expert background in politics and pathology simply does not make " ad- ministrative oversights. " We also oppose him because his dual role as Dean of the Medical School and Di- rector of the Medical Center represents a dangerous concentration of power, without accountability to the medical school faculty or student body, let alone to the Medical Cen- ter workers and members of the community the Medical Center serves. McCarthy, by using smear techniques, sought to destroy people on the basis of prior associations, of past history and of past in- volvements which had no immediate relev- ance to the issues at hand. We seek to re- move Dr. Bennett because of his present positions and his present involvements. His past work is significant only in that it has brought him to his position of power today. His present views on the use of chemical and bacteriological warfare render him morally unfit to direct our medical center, and to di- rect the education of generations of young physicians. His appointment was based on considerations of power. This appointment must be reversed. The New York Times is to be criticized for supporting Dr. Bennett without a clear under- standing of the issues involved, and for in- voking the spectre of McCarthyism, which is totally irrelevant to this entire situation. OUT OF THE STIRRUPS: In a major break- through in doctor patient - communications, Women's Liberation and the Women's Health Collective invaded the Sixth World Congress of Gynaecology and Obstetrics on April 16. Demands for free admission and participa- tion in the Congress as well as immediate public support for free safe abortions on de- mand, free and open communication of med- ical information, and an end to class two - medical care brought a surprisingly sympa- thetic response - the Congress, which had previously conceded only 12 admission passes, " found " time for the women to speak at the inauguration of the new president. Hotel Americana officials, however, had other ideas and tried to keep the women out. After several attempts, the women made it just - in time for the end of the inauguration. While the academic - robed doctors marched solemn- ly off the stage, the women stole the show by raising their signs and marching once around the room and on to the stage. After some fur- ther discussion with interested doctors and with Congress officials, the women were granted time during the afternoon sessions to present their analysis of women's medical care and their demands for changes. 14