Wednesday, April 25, 2018

THE EPIDEMIC OF INSANITY

Ladies and gentlemen,

They have decided that by 2000 AD there should be no malaria, filaria, yellow fever, malnutrition, illiteracy, unemployment or misery. By they, I mean all the people who are in a position to advise, decide, publish and print.

It is high time that the psychiatric society boldly declares that by July, 1999 there shall be no hysteria, schizophrenia, dementia, sexual maladjustment, insomnia, psychopathy, accident-proneness or sheer bloody-mindedness. Also, more humbly, that there shall be no war. No effort shall be spared and no stone left unturned, and no one allowed to rest in peace till the decision becomes decided.

I may look at some of these efforts unspared,and the stones turned up over the years with increasing dexterity, sophistry and unquestionable scientific method and dedication.

First, the number of mentally ill to be eradicated must be counted. We have been counting and recounting and continuing to count the number of mentally ill. Lest some might be inadvertently left out, we have also devised ways of trapping those who are liable to catch mental illness. This is not such an easy job as a layman like me might suppose. Large numbers of specialists worked out and continue to work out the definition of what and who is mentally ill. I have gone through this interesting literature printed on increasingly glossier paper, printed in journals which also carry advertisements for cosmetics, contraceptives and car rentals.

Two conclusions stand out:

  1. A definite number of persons are mentally ill. Their distribution in the population varying from 1 in 10,000 to 1 in 1,000, to 1 in 100, to 1 in 50, depending on the year of observation and the admirable bloodhound tenacity of the observer in scenting out the slightest odour of mental illness. There are serious dangers if the figure is increased to one to one of the population. After all, we must not only be scientific but also reasonable. It is quite silly to ask what is reasonable.
  2. This second inference is really an axiom that requires no proof, and no effort of understanding. No definition of what is mental illness fits any psychiatrist dead or living. All those are not psychiatrists are mentally ill.
The king can do no wrong. The psychiatrist is born mentally sound, trained to count, measure and succour the mentally ill on a global scale, and is destined to ascend to heaven in a pristine state of unadulterated mental health.

I hear laughter. So did the Bourbons when reminded of the clay beneath the pedestal of their divine right. “We are not really Divine, but what the hell!” “We know we are not really free from mental illness, but after all we are human. But what the heck!”

The definition is operationally clarified. Having counted the number of the mentally ill, the next question is how to help them. This is being achieved with great tenacity of purpose and much general good heartedness:

  1. To spare no efforts to see that psychiatric help reaches every single man, woman and child and pregnant woman in every nook and corner of this small globe. 
  2. Since a single psychiatrist, poor soul, is likely to be overworked, he is accompanied by a traveling troupe of psychologist, psychiatric social worker, aftercare supervisor etc.
  3. A self-contained ambulance equipped with a condensed branch of May & Baker to supply Largactil; an ECT apparatus - since electricity is freely available to every village; a small section of the biochemistry department to detect the amount of gamma-globulin in those who are likely to be mentally ill, one or two guinea pigs or one higher ape in order to study the effect on their brains and liver when exposed to incipient mental illness. A portable typewriter and statistician are mere peanuts which can always be fitted, information via the satellite to experts at the centre to enable quick decisions, for mental illness must be caught on the spot and eradicated with a speed commensurate with our space age. It will not be difficult to accommodate an anti corruption officer on top of the ambulance to prevent pilferage of petrol and drugs. A representative of Yoga can always find a place near the horn announcing the inherent link between the Vedas and Valium, and how the whole unit is really the traditional outcome of adherence to scriptures.
  4. Since mental illness affects all those who are not psychiatrists, who have a natural immunity to the disease , it is necessary to induce acquired immunity to selected members of the mentally ill, by inducting them into courses for psychiatry and allied subjects. This solves the problem of personnel required for the treatment fo the mentally ill.
The degree of immunity is gradable. With a basic immunity of 15% after MBBS, a person becomes increasingly so after DPM MD, till he reaches undisturbed and undisturbable immunity by the time he becomes senior enough to be a world consultant.

5. Sound health work must be based on sound research. All sound research must be based on animal experiment.


The number and variety of animals sacrificed on the altar of mental health and health - in the drug testing laboratories, in the behavioural laboratories etc. should be sufficient to appease the heart of the most bloodthirsty Kali on earth.

Some Indians still consider smallpox as due to a Goddess and sacrifice goats, cocks and buffaloes. This admirable procedure of finding scapegoats for human failure and sacrificing them is being carried on - the dress and nomenclature of the priest has changed.

In order to understand why human beings commit suicide, it is absolutely, scientifically, objectively necessary to drive chimpanzees to suicide and study their EEGs and brains at various stages in the process.

Bearing these formidable efforts in mind as a mere sample of the gigantic efforts that are really going on, I must say that the decision to eradicate all mental illness by 1999 is too modest and pessimistic an estimate of the milestones set.

If you are amused, it is merely a gratuitous result of my effort at being deadly serious.

Platitudes are merely unpleasant truths of life which you laugh at or laugh off only to meet the tragic consequences of the neglect. If it is a platitude that all are mentally ill to a certain extent, and that mental health specialists can also be mentally ill, and the psychiatrists laugh it off, well and good. But they are also engaged in actively trying to cure and prevent mental illness in others and set the fashion for health. Imagine the result if a number of typhoid carriers were to be engaged seriously in a typhoid eradication program without taking the slightest measure to root out the condition in themselves.

Morbidity increases exponentially to the efforts made to remove it. If an engineering firm were entrusted with the task of plugging a hole in a dam and each effort of this firm resulted in more leaks and holes, and recommendations to multiply the number of like firms and their branches, what would be the reaction of the employers? Yet, by a special blessing, the medical profession seems to be immune from such an inquiry.

I am not a philosopher nor is it my aim to entertain you. It is to raise the question in all its seriousness.

Is it not time that our fundamental assumptions about health and disease are examined in depth? Are not distinguished institutions like yours the very places where some evidence should be given of this concern? I think that there is some evidence of this concern. I speak to those who seriously feel this concern.

What you see as frank mental illness in your hospitals and clinics is only the tip of a colossal iceberg whose base is wide and deep. Much of mental illness goes unrecognised, because many of the minor forms have acquired socially acceptable labels, their results are catastrophic.

The medical student who does not examine the urine for sugar, but cooks up a false report and hoodwinks the professor, whatever be the results on the patient is a hell of a jolly good fellow and the darling of his hostel and family. He is not called a budding psychopath - only a damn clever chap. Next, he copies, crams, butters his bosses and gets his MD, and becomes a professor and gets to be in-charge of a hundred students and thousands of patients, and gets an opportunity to display his cleverness on a larger scale. If quite a few of his students and assistants and families and relatives get duodenal ulcers, or quite a few of the patients die against the background of beautifully recorded and doctored case sheets, what does it matter - for he's a jolly, reckless, clever, successful fellow who can hold his liquor well, and what beautiful lectures he gives on preventive medicine, and has he not also become an international consultant for Lagos or Togos?

There is the other gentleman who eats only pure ghee at home, but delightfully, gleefully sells contaminated masoor dal and mustard oil, and if hundreds get crippled, it is not mental illness. Anything but. He has donated one lakh to charities.

The psychiatrists who conduct group psychotherapy sessions take no account of their own group behaviour at home or office, do not suffer from neurosis. The behavioral therapy is meant for patients. The students who attend whole sessions of lectures on group interactions and field theories of behavior have not a jot of interest in their own behaviour in hostels. There should be an animal laboratory to show evidences of gentlemanliness and rascality in a group of rats or chimpanzees caged in the premises.

By a sly sleight of head and hand, the word average has been made synonymous with ‘normal’. Normal behaviour means the behaviour that is displayed by the largest number of hypothalamic hyenas on the road.

The amount of murderous anger, jealousy, hatred, intolerance and inconsideration shown to one another in even families of the so-called elite is seen to be believed. But these are the cream of society, and most of them are prominent persons and quite a few of them give lectures on peace, prevention of war and the Bhagavad Gita. They absolutely refuse to believe that there is any relationship between their own behaviour at home and the wars they deplore. One member of the family is brought to the psychiatrist with complaints of insomnia, becoming easily depressed and irritable, anxiety and suicidal tendencies, thus adding to the statistics and offering a sacrifice. The systematically cultivated fashionable psychopathy enables the head of the house or office to bring one member to the clinic ignoring his own role in the genesis of the illness, and by drugs, ECT, psychotherapy and by profitable collaboration between informant and psychiatrist, the depression is beaten down to respectable proportions.

Once a father took a son to the senior Sankaracharya - the son was being unreasonable, aggressive and the psychiatrists were getting to be helpless. He was calling the father a rascal and a scoundrel and not at all showing him any respect. The Sankaracharya is reported as having said, ‘It will be a pity if your son is cured of this habit. Then, who will be there to tell you that you are a rascal and a scoundrel? He might be alright when you stop being both!’ This was reported to me by the psychiatrist who attended the interview. The father was being a successful psychopath, perhaps adulterating foodstuffs with muck, and asking the son to be truthful and obedient, and the son unsuccessfully reacting to this becomes classified as being mentally ill.

"Paramacharya" by A Search in Secret India by Paul Brunton. Via Wikipedia 

Medical science is, perhaps, lay opinion and practice confirmed by technology.

Bear with me. I am not engaged in flogging a dead horse or making a rehash of Jonathan Swift’s satires of two centuries ago for your delight. I am searching for an answer.



jaci XIII, Gulliver's Travels 6

Then, people, including medical experts began saying, “Yes, yes! We must all agree that man must change.” Immediately they pursued the matter with great vigour and variety. The religious leaders collaborated with undisguised glee. Research in Yoga, Yoga clinics, place of religion and Yoga in medicine began. Man must be changed. So, the best thing to do is to change the other man. The operational definition of man is every other man, but the man himself. Religion says, serve others, be compassionate, truthful and honest, bathe in cold water, eat moderately, be this and that. Do anything as long as it is advising the other fellow to do it. Do unto others as thou doest to yourself. A man first of all deceives himself, and proceeds inevitably to do the same to others who reciprocate with interest.

Religious attitudes combined with polygraphs is the deadliest combination camouflaging the real subject of the matter, ‘I’, ‘I’, the man whom we are talking about. I am the source, recipient, and reflector of all that is happening to me and inside me. It is my body, it is my mind that is going to dogs every time I do certain things.

If each one of the members of these research institutes considers himself and his body as the main laboratory, and systematically trains himself and his body towards the goals of health he prescribes for others, verifies for himself on himself for at least one hour a week, or at least five minutes of a day, then I would be happy. Whether it will lead to any results, I cannot guarantee, but at least it would be honest.

The verification and modification of your own behaviour in the course of your daily occupation is the essence of the matter. This is also a profession, the profession of self-realisation or auto-piloting. This view is so assiduously preached as a platitude, and equally assiduously flouted in practice, that it is necessary to realise that you deceive yourself and your body, and disease is the name given to this self-deception.

You and your body are the most complex, comprehensive instrument on earth, compared to which all the glossy apparatus in this institute is a village blacksmithy. It is here, you should learn the skills of healthy and harmonious driving. The classroom, the clinic and laboratory are merely subordinate supports. Your life, both with yourself and in the hostels, homes and clubs are the highways and byways on which you test your driving skill, the management of your car and its maintenance. These institutes are not just to preach health, but to produce specimens of health. Health is what you yourself preach to others. This I presume, is what the institute is for.

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