ON PSYCHOANALYSIS
413
Even without the use of punishment for improper behavior, total
systems of living are now being experimented with.
In
one state hospital severely disturbed female patients are al–
lowed only bare necessities of living. They are given a bed and three
meals a day.
In
order to have night stands, ground passes, access to
the commissary, privacy through the use of screens around a bed,
psychotherapy or permission to attend church, the patient is required
to use tokens earned through cooperative behavior. The tokens are
earned by making one's own bed, keeping clean, cleaning others, being
obedient and so on. This ward has rapidly become the cheapest in
the hospital to run, though no patients have been released.
In
a
critique of this and similar experiments William Simon has pointed
out that this technique merely creates a very special Adam Smithian
world where all relationships are based on economic exchange,
though the evidence indicates that the schizophrenic disorder is not re–
lated to a lack of economic rationality, but rather to a failure in
social relations. The exchange of tokens is not a human exchange.
In
the face of insoluble problems one is tempted to retreat once
again either to organic methods of treatment disguised as behavior
therapy or to other organic panaceas through which the body is
attacked in order to change the mind. The widespread popularity of
tranquilizing and energizing drugs in our mental hospitals was and is
an expression of the continuing distrust of verbal forms of treatment
and part of a general hope that we can reduce the changing of
human behavior to the taking of a few pills. The mental institutions
where the drugs have had their greatest successes are those where the
least was being done in verbal terms for the patients. Little or no
change has been observed in institutions where a high level of patient
care already existed. Indeed, there is disturbing evidence that the
function of these drugs has, in most cases, been reduced to simple
patient management: tranquilize the overactive, energize the de–
pressed. Assaults on the body in the form of shock therapy (drug or
electric) and brain surgery (prefrontal lobotomies) have also had
their vogue.
Perhaps it would be useful to look outside psychology to see
the result of our mistrust of symbols, language and consequently, the
mind itself. Our literature might be the best indication of where our
