|unpublished manuscript from January 31, 1992
On Not Having Had The Experience
Pioneer Dialogues at South Florida State Hospital
First I want to thank Gayle and the panelists for the privilege
of participating in this truly unique gathering. Psychiatry has
usurped the term hysteria and uses it to label the expressions
of women in distressthey forgot that the original meaning
of hystereia in Greek meant "having the last word."
So I feel particularly honored for being asked to speak at the
end of this panel. But I will not put a wrapper around the words
of my predecessorsobviously they speak for themselves.
Mental health professionals like me suffer from a serious condition:
most of us have never experienced the kind of agony and trauma
we have just heard about. This is indeed a serious liabilitynot
having had the experience makes it more difficult to accept people
who have, respect them for who they are, and see them as anything
other than "chronic mental patients." Not having
had the experience makes it easier to diagnose, restrain, medicate,
dismiss, avoid and forget people like Dian, like Sally and like
Peter who have had the experience. But instead of wondering how
we could make up for this liability, we spend a great deal of
time securing our positions, barricading ourselves behind "therapeutic"
armaments and tools; we spend a lot of energy on avoiding any
emotional involvement with our clientele and on developing bureaucratic
structures designed to perpetuate our way of life and to keep
them in their placewhere patients belong.
What would happen if we started to ask ourselves why it is that
we perpetuate this stance? What if we took the mandate of our
psychoanalytic forefathers seriously and really dissected our
"countertransference"? Would we be reduced to neurotic
descendants of a fading Central European intelligentsia, to Jewish
doctors who fear the sight of blood, to anxious do-gooders whose
egos subsist on Samaritan acts? Or would we disappear, vanish
behind the mirrors we wield, drown in the vortex of diagnostic
confusion and therapeutic nihilism? OR MIGHT WE EVEN GO MAD? Is
all of our professional veneer, our approach to "patients"
merely a defense against our fears of going insane?
To argue that we might indeed be using "our patients"
to avoid a fate worse than theirs, is truly scandalous. And yet,
there might be some truth to it. Let me instead of wrapping up,
unravel a bit right before your very eyes. My mother is a survivor
of Auschwitz. She was 14 when she lost her parents, her only sister
and all her friends. Twenty years after the war, I was in my teens,
she urged me to become a doctor, so that I could cure her many
ills. At first I said no and decided instead to become a biochemist,
trying to decipher the secret code of the mind. By the time I
was 18, I changed my mind again and entered medical school. For
the next 15 years I spent no time thinking about my mother's
wartime experience. I graduated, had a quick brush with cardiology,
came to the U.S. and became a psychiatrist without knowing why.
Strangely, I could not follow the rules instilled by my professionhated
the hospital, wondered about the drugs, formed friendships with
ex-patients and forgot about being a doctor. About three years
ago I found out why. When Laura Ziegler, an advocate, survivor
and close friend, told me that her grandmother was killed by the
Nazis in a mental hospital in Berlin, I suddenly understood my
strange interests and behavior. My main motivation was NOT HAVING
BEEN THERE, never being able to tell what my mother actually experienced
in the camp; never being able to fathom what it is like to suffer
from major depression, from mania, or from other altered states
of mind. Never being able to truly understand the terrible privations
suffered as a consequence of having been "psychiatrized."
My mother talks very little about her experience during the war.
A few weeks ago my father and I were walking on the beach in Delray
when he told me my mother's story for the first time in my life.
What does all this have to do with psychiatry, with empowerment,
with the experience of madness? I'm not quite sure. One thing
it taught me for sure is that psychiatrists and mental health
professionals will never have the last word. The final, the ultimate
authority comes from the repositories of personal experiencefrom
the memories, stories, oral histories, interpretations of Peter,
Sally, Dian and the many millions of others who have been through
the experience of madness.
I apologize for taking the liberty of sharing with you my experience
of not having been there. Maybe turning the mirror against ourselves
will help us to see the people across the way clearer. And seeing
them for who they really are is a good startthat's when we
can begin to rebuild our relationships. That's when we can begin
to forge ahead towards a world defined by all the people who live
in it and not by those who think they are doing their job. Maybe
we can begin to work together to prevent the torture and damage
still done by psychiatry unto thousands who enter its halls in the
midst of their most trying experiences.