Aspects of mental health; Research on mental illness

The pummelling program is produced by the University of Michigan Broadcasting Service undergrad made from the National Educational Television and Radio Center in cooperation with the National Association of educational broadcasters research on mental illness a program from the series human behavior social and medical research produced by the University of Michigan broadcasting service with special assistance from the Mental Health Research Institute of the University of Michigan. These programs have been developed from interviews with men and women who have the too often on glamorous job of basic research. Research in medicine the physical sciences the social sciences and the behavioral sciences. Occasionally you will hear what may seem like strange or unfamiliar stuff. These are the sounds of the participants office his laboratory or clinic where the interviews were recorded. The people you will hear today are Dr. John C. Whitehorn. Doctor Don Jackson Dr. Robert H. Felix. Dr. Edith Raggett and Dr. Harry Levinson. My

name is Glenn Phillips. During preliminary discussion in preparation for this series and during the interviewing for the individual programs I would ask a question that was usually worded something like this. What do you consider to be the most pressing problem that needs basic and immediate research in medical science and the behavioral sciences. I think with few exceptions the answers would always come back in terms of mental health or emotional health. That then is the subject of this program. An all too brief glimpse at the current research in this area. Dr. John C. Whitehorn of Johns Hopkins University said when asked to describe research at his university area which has been most media personally interesting to me a has been. Concern with. Interesting discrimination between doctors who don't bother with Skeeter clinic patients and those who don't do so well.

It appears from our studies that there's a marked difference here between doctors in fact already in our first publication. We reported upon a group of doctors who had 75 percent improved rates compared with a group that had a 27 percent improvement rates in their sketch of twenty persons. There's a bigger difference than you get in considering any other special category of illnesses like. Conversion reaction to your depressive reaction or. Obsessive compulsive patients. We studied these doctors in order to try to find out what it should be. So that. Doctors some of them did well with schizophrenia patients and some did not. We also studied the patients to see maybe these good doctors were luckier than others. We didn't find discriminating differences between the patients.

In these two groups so we looked for that among the doctors but there is evidence that the regular doctor goes in. It has jar with the patient. Reveals something of himself and his own approach to life. And how he so between sweets there's you know to what he thinks the patient would need. Roughly speaking. Those doctors that tend to think in terms of roofs rights and wrongs rather mechanical make. The world with kids are going to question. What I would make a statement on the basis of a. Rather specific ways of characterizing these doctors when here is paper and pencil tests particularly the strong location literacy test to get an empirical way of characterizing the doctors I was giving you a rough impressionistic picture of the kind of a doctor as brought out by these tests who doesn't do well with Skeeter clinic

patients on the other hand we could characterize them. Kind of a doctor who doesn't do well. As one who has a more problem solving approach less rule of thumb for right and wrong. Who are. Sick to understand what the Dr situation the problem and the issues are in the life of the patient. And to understand what the patient is droll he had. Maybe he had difficulty because a patient hasn't formulated what it is he's driving. Having a life. So you need assistance here. But this more freewheeling approach to try to know what one wants and then how one can get into why this seemed to be characteristic of the doctors who did well with schizophrenia patients. I think he had a moment of a paper that was sent me here a couple three weeks ago by one other doctor who was a psychiatrist. It in that paper he said to me that he felt psychoanalysis for the psychiatrist was not necessary for your research here

it would indicate in a way that it may well be very necessary in selecting the doctor. In dealing with particular patients. What would your reaction be to that remark. We have had the opportunity here to comparators. Actors who have been analyzed are going to know this was not so. Kind if you knew your material imperiously speaking this is make a difference to whether they have improved rates high rollers capering patients puts it easiest way to hit your person in these terms superior to a second houses would seem to make any difference. Dr. White Iran and his associates have conducted research on schizophrenia I asked he has just described to Johns Hopkins University. But also in Palo Alto California Dr. Don de Jackson and his associates at the Mental Health Institute have also been involved with research in this area. He commented to me I'm interested in schizophrenia in general because it is one of

the most appalling medical disorders. Even. Comparable to heart disorder in cancer. In terms of the amount of people. It affects. And the age group particularly that effects which is. Largely the age group of the 20s. But specifically I have focused on the communication aspects of schizophrenia. Which is a attempt to analyze. What this gets a frantic said as how he says it and what is possible meaning is. This work was begun some years ago. In collaboration with Gregory Bateson. We found that the. Best place to study the. Communication of the schizo frantic was in his natural surroundings which would not be the state hospital but. His family. So we over a period of time since. 1954 have

been. Interviewing. The families of schizophrenia IX with the patient. And. Since. About 1950. To 56 we have started families in treatment where we see the whole family as a group. Use Are you for an hour and a half once a week sometimes more frequently. The patient the mother and father being the primary family the siblings. Brothers and sisters being present. If they're willing to attend in some cases they are for a time but they will. Pull out after a while. In this context we're trying to do research which. Asks this question. Are the symptoms of schizophrenia. The things that most people when they witness it would label as crazy. Are these adaptive to the family. That is do they make sense in the family context.

And are all over. By no means near any thing. Quibble and the proof. Is that yes they do make contacts. In the family. The way this gets a frantic behaviors is a way that is. Adapted. He. Protects the mental health of the family. Right his being the main symptom bearer. And. He keeps his symptoms going because nothing becomes clarified since the peculiar statements. Or peculiar behavior that he exhibits can always be labeled as crazy and not explore where family members. That's a kind of a. General statement. I asked Dr. JACKSON What role if any heredity might play and gets afraid to reply. I want to note no lies in my position on this is not. The position of the majority of psychiatrists so that what I say has to be taken

with a whole ton of soil. I've had the privilege of reviewing the literature on the genetics of schizophrenia during a sabbatical and I was also able to visit a number of the people who are working on this problem. It's my impression that the current notions about schizophrenia being essentially hereditary disorder are ruining us. I say this for several reasons. One is that the. Family incidence of schizophrenia as. Shown in the work of these gentlemen indicates a preponderance of females. The interesting thing is that there's no. Hereditary reason why this should be so. Nor do state hospital figures show an increase of. Females over males as far as admissions. On the other hand there is a disorder which has the unfortunate title of

meaning the sense of a madness of two which is a condition in which two individuals. Influence each other so that both become crazy. That is they share the same abnormal or unusual unrealistic thoughts. It so happens that four is four times more common in SR's. Than in any other group and its next commonest in mother and daughter players. It is least common. In father. Or brother pairs. I think that there are reasons to believe that in the selection of patients some. Of the genetic work has been. Misleading but they have. For example focused on identical twins and asparagus. Schizophrenia is much higher medical command of a schizo from a patient than a fraternal twin.

Without taking into account the relationship of the identical twins which can be a very intense and very close one. For other examples of research work in mental health. I asked Dr. Robert Felix who is director of the National Institute of Mental Health at Bethesda Maryland for comment. He said there are two phases to the research with which we are concerned. Here at the niceness to the mental health. There is that research which is carried on in our own laboratories here at the institute. And then there was that much larger body of research which is being supported by grants from the Institute two scientists working in laboratories throughout the country. Here in our own laboratories. Our concern is rather broad. We have research that's being carried on at the level of the physiology of the nervous system. Function of the brain in various portions of the brain and its relationship to human behavior.

We have research it's being carried on in the area of biochemistry. The end. They in fact of various substances which the body elaborates. In health and in disease upon thought and behavior. Research in the area of pharmacology neuro cycle pharmacology that is the effect of various drugs on thoughts emotions behavior. We are concerned and are carrying on research in the area of genetics. That is the effect of various inherited characteristics and traits upon one's behavior and the possibility of becoming ill. We have considerable research going on in various areas of psychology ranging all the way from comparative studies in animal behavior to studies of the learning process. And the studies of the psychological aspects of aging. We have research going on here

in the so-called clinical area that is studies of certain types not all types because this would be a too large a program for us to carry on at any one time but a study of certain types of mental illness and the effects of various types of treatment both psychotherapy and drug therapy upon the course of these illnesses. What I've said about the work being carried on here is true on a much larger scale and in much more detail throughout the country as a result of the grants for the Institute makes each year to support scientists working in these fields. And then it one of the best known institutions in the nations for mental health research. The many go Foundation at the peak of Kansas. I asked Dr. Henry Levinson of that institution for a description of the research work being conducted there. He commented to me when we are working on a project in the

strain in which we're trying to learn something about prevention prevention of mental illness or to frame it another way. What can we learn about how to keep well people well. We're doing this by interviewing the numbers hold people on the job when working in one study in the Kansas Power and Light Company for the past three years. And in this case we've interviewed some eight hundred seventy five people who have gone out with them on their jobs on the trucks and interviewed them in the ditches where they were working in hot weather and cold. And what we're trying to find out as we talk with them is what happens to them in the course of their work life. How do they relate to other people on the job. What makes possible better relations. What is the relationship between a man at work and the former organizational structure in the company. What happens in small group relationships and what kinds

of things are operating in an organization which tend to enhance people's well-being well or to detract from it. To find out something about the age groups of the persons that came to seek psychiatric care I asked Dr Edith VI good of Chevy Chase Maryland what the age groups were that came to see her for consultation. Her reply was I have patients of all age groups I have at present a new set of children in younger years and her photo worked with children and but otherwise I have patients of all age groups. I would think then perhaps I don't know this person in the beginning 2013 has the greatest flexibility and can make the best Cumulus of psychoanalysis he is still in the process of development to

such a degree that one can give him decisive up here in his screwed up act of overcoming his conflict. But I have been almost so surprised homework shit. How do people even in the age groups of 50 60 and even older can profit from a psychoanalysis. There may be in the older age group. Particularly interested in their own existential stick approach because the question of who am I where my googling the question of. Financing of the ultimate death is politically on the other hand there is clearly a life experience and a certain degree of wisdom that makes the word a person completely quite accessible

to such deliberations. I wondered what the greatest problems were in her practice. Doctor if I go to gun Commons the greatest problem seems to me in how to deal with this anxiety. I mean not so much with do you find fear and I look at allies on the specific issue. And I think if a person knows what he is afraid of. And has in the can mobilize his courage here why it made the problem head on and deal with it. But human beings very frequently so under are unclear and me and undefined anxieties. Extremely disturbing. The anxiety is in small doses a stimulant. There you see a certain processes. If you are anxious you have not

only accelerated respiration heart activities. You are thinking fast. Many ideas drummed into your mind and sometimes overwhelmed by many ideas of. How to Save yourself. But excessive anxiety is we speak about panic. Has such a dissociative effect. Would be becomes more or less hopeless. And needs other people to assist. I have frequently been told that there is difficulty in showing the families of many cases of the great medical need that exist in mental and emotional health. Again I asked Dr. Donald E. Jackson of Palo Alto what his problems were in reaching the unsophisticated family. He commented thusly we have had almost exclusively.

Middle class family is a few upper class families all of whom have had rather high education. We had just a few lower class families families who whose socio economic status is relatively low and who have a high school education or use a less with those families we haven't made out too well. The thing to consider here is not only the family and what they are willing to be told. But also the therapist himself who may find it more difficult to relate to a lower class family since he himself comes almost always from a middle class or better environment. I think if we ever discover that we are on solid ground in attributing a. Fair amount of the symptoms of schizophrenia to family interaction then we could proceed to study lower class families and see if we can translate.

Our findings to their particular situation. One area of research is that of family therapy and psychiatric education of family members. Dr. Jackson spoke of this recent interest in family therapy and in the therapy of married couples rather than in the therapy of individual patients. Has been so tremendous that it is an obvious need for it and it reflects an obvious to satisfaction on the part of many psychiatrists with their results. And with the economy of their time. Certainly psychoanalysis as an early practice is not economical. It requires a tremendous amount of time and money. Per psychiatrist per individual patient. And the results have to be weighed against this time and money. We haven't done enough family therapy even though we've been doing it for. Five years

to be able to say that it will turn out to be an effective therapeutic method for largely interested in research. But our hunch is that it isn't indeed a an effective therapeutic method and that changes brought about in the family situation can benefit family members in a way that discussion as an individual rather is a kind of trust might take some time to bring about. If people treat each other differently they feel differently about each other. And I think the emphasis on action which necessarily is a part of family therapy is a new dimension in psychiatry. It's a dimension that has always been present in those who have tried to do recycle therapy. Two of Freud's early. Followers. Fronts in wrong. Broke ran from him when they advocated active psychotherapy A. Departure in which they took every active part with patients rather than trying to be

the reflecting screen. I think that there is such an interest in family. Been in therapy with married couples that the next 10 years will see a great many psychiatrists learning these techniques so our experience in the Ponto area has been that the mental Research Institute has been submerged with. Requests by a. Psychiatrist to learn these techniques to come and watch interviews and. So on. We're not prepared to handle these because we are such babes in the roads ourselves currently. Dr Henry Levinson and Dr John Whitehorn told me what they felt were the greatest advances in mental health research first. Dr Levinson I think in my judgment the most significant experimental work which has come about has to do with. So-called isolation studies letters some interest began and what happens to people when they become isolated after the brainwashing experiences of the Korean War. Following on that there been a number

of experiments in various places in which people have been isolated from all kinds of external stimulation. That is they may be put in dark rooms where there which are soundproof where there is no stimulation they may be placed in. The tubs of tepid water where there is no or very little stimulation. And we've learned from those experiments that when outside stimulation is removed when people have no contact or limited contact with other people with sounds with things they can see and touch that all of us. The implication is that all of us can break down that. Some of the conscious thoughts are present in all of us which I controlled by our contacts with the outside environment begin to come forth and people can and do develop delusions. That is the belief that something is true which is not true or hallucinations hearing voices and things of

that sort. This to my mind is the most significant kind of research which is going on in the last 10 years especially and it gives us a lot of promise for future research. I think it tells us one. What are some of the circumstances under which people can break down and to rule of us given the right kind of circumstances can break down. Now Dr. Whitehorn I would think the study of the social implications of mental illness both in terms of group dynamics. In terms of social rehabilitation medio third group the. Study of the social situations in which illness arises. Possibilities of better mental care within the family group. These are all problems in social interaction. Freud had some thoughts about

this but. His contribution. I think would be usually classified as. More on the level of the individual courage to conclude this program May I refer to a quote Dr. George L. beads of Cleveland. He said in the last few years there has been a wave of enthusiasm for the chemical approach to mental disorders. The tranquilizing drugs are showing real promise as an aid to speedier and more effective therapy. These early reports are encouraging indications that research can be productive even at the present low rate of expenditure. However the memory of previous enthusiasms for new treatment methods that fail to fulfill their promise bids us to be cautious in this matter. Still if the new approaches to treatment fulfill a sizable proportion of their promise we will continue to be in trouble. Manpower wives because nearly everyone agrees that the new drugs are effective only in combination with increased attention and psychotherapy. We are faced with the prospect of larger

numbers of hospitalized patients who formerly did not see a psychiatrist for a long period of time. They are now lining up outside the doors. That is the prospect and the challenge for research in mental illness. We have heard Dr. John C. Whitehorn psychiatrist in chief of the Johns Hopkins Hospital in Baltimore Maryland Dr. Edith braggart a psychiatrist from Chevy Chase Maryland Dr. Henry Levinson of the Menninger foundation in Topeka Kansas Dr. Robert H. Felix who is the director of the National Institute of Mental Health in Bethesda Maryland. And Dr. Don Jackson of the Palo Alto medical clinic here in Palo Alto California as they have discussed research on mental illness. Next week you will hear Dr. Paul Dudley white of Boston Massachusetts. And Dr. Leonard J duel of Bethesda Maryland as they discuss safeguards against

mental illness. The next program from the series human behavior social and medical research the consultant for this program was Dr. Raymond Wagner of the University of Michigan Medical School and director of the university's Department of Psychiatry. We extend our special thanks to the Mental Health Research Institute of the University of Michigan for their assistance. Glenn Phillips speaking asking that you join us next week and thanking you for being with us at this time. This program has been produced by the University of Michigan broadcasting service under a grant in aid from the National Educational Television and Radio Center in cooperation with the National Association of educational broadcasters. This is the NEA ybe Radio Network.