Aspects of mental health; New approaches to mental health

The following program is produced by the University of Michigan broadcasting service under a grant of aid from the National Educational Television and Radio Center in cooperation with the National Association of educational broadcasters. New approaches to mental health. 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 unglamorous job of basic research. Research in medicine the physical sciences social sciences and the behavioral sciences. Occasionally you will hear what may seem like strange or unfamiliar SOG. These are the sounds of the participants office his laboratory or clinic where the interviews were first recorded. The people you will hear today are Dr. Edith Vigers psychiatrist of Chevy Chase Maryland Dr. Robert H. Felix director of the National Institute of Mental

Health in Bethesda Maryland. Dr. Lawrence Cobb of Columbia University Dr. John C. Whitehorn of the Johns Hopkins University Hospital and Dr. Harry Levinson of the Menninger foundation in Topeka Kansas. My name is Glenn Philips. Some of the new approaches to mental health research and their applications range from the use of drugs to existentialism drugs we are familiar with but existentialism when used in reference to psychotherapy is not so familiar. Another term is local therapy. This has been called the third Viennese School of psychotherapy following Freud psychoanalysis and Adler's individual psychology Freudian psychoanalysis introduced the will to pleasure principle into psychological research. ADLER stressed the role of the will to power in the formation of neuroses. Existentialism rejects these principles for what is called man's

will to meaning is deep seated striving and struggling for a higher and ultimate meaning to his existence. One of the leading exponents of this theory in the United States is Dr. Edith Vigers a psychiatrist from Maryland. The following few moments is an excerpt of a discussion I had with her regarding her theory. Would you explain just what Existentialism is when used in the frame of reference of psychiatry or medicine Existentialism is a modern form of should also feel that deviates from the academic clones of. His As a female and then it goes back to the fundamental axis tense. Practice of living. Of the human being. Being in the world. This is his environment and was himself. You know the term existentialism goes back to the time of Kirkegaard.

Now has this term the practice of exorcist sensualism been refined since that time. To include more things most of the present system should fuse it existentially so to speak for instance Heidegger speaks does ans analysis kickout is certainly the forerunner of these various film as a first like Heidegger Yes. But Kirkuk was definitely the indigenous oriented personality. So Heidegger mainly atheistic existentialists. Why and there are others like us first and say Oh yeah here who have definitely. Just orientation right is the term or the practice of

existentialism find so much interest all of a sudden in the United States. I think it. Complicated the living conditions of a mass society that is absorbed please and Momus amount of complicated technical problems in which the individual and his ultimate value is get lost. So how does it differ from some of the other fundamental theories of psychoanalysis of psychology and psychiatry. It doesn't contradict and now this is a. Clear sense only of burdening off psychoanalysis which is based on an actual naturalistic biological science and it takes the spiritual needs of the individual for whom As for integration of the

personality in himself and in the world in which he is living into account. Does it discount the theory that is held by some other some most or all. Mental distress and problems find its origin in the chemistry the biology the physiology of the human being himself. The existentialist believes that certainly the biological basis cannot be neglected. But many of the conflicts stem out of their way. Into action and the friction split between human beings and the conflicts that arise from there living together. Would it be safe to say that one of the prime beliefs of this theory is that to use the old cliche that to thine own self be true. That is a very important basis of existentialism because of the existentialist who are there.

The individual feels the need to be in order to be integrated into himself and in his environment. He has to make the Optima due of his endowment coming to clearly sation. I had always thought that this also was a practice or a goal of other types of psychoanalysis and psychiatry doesn't do it for so fundamentally or from the psychoanalysis is only that psychoanalysis puts a greater emphasis on biologic foundation of the individual. You say a biological emphasis. This brings into play something in the terms of perhaps drugs or something they're going to try to control and manipulate behavior through drugs and that just is more psychotherapy in journal or psychoanalysis is more oriented towards instinctual conflicts of the human

being the sexual. Instinct and the anxiety is said to interfere with the food development of the instinctual. Impulses into consideration. But what of the individual placed into the society is as an individual where Must he find his final answer would he be true. I hate to use this term. True it's so trite but true to himself would he be true to the group who to whom would he be. Finally true. You can't be true only to yourself because a human being is an animal if you want to put it that way who lives together with her this is a herd animal who is indignation. The group is a greatest employed family as a clan a nation. And the whole

world population. But so very often the very conflict individual has arises from his conflicts with society. That is true in a society sets boundaries to the album only of persons centric desires. But in reality there is no happiness in being only eco centric because you would. There is a need to be elevated to all of this to come to an exchange with this we are depending in the fulfillment of all our needs. We are depending on each other and the person who feels ostracized from a society is an extremely unhappy and desolate individual. On the other hand when the individual completely who lives only in conformity and trying to

adapt himself to what the people around him one he doesn't come to any feeling of happiness either because he is losing what you are calling his true self. So we are always in the conflict between ourselves and our federal air. How does one really find his true self. Through psychoanalysis Yes through self introspection. If he does not live up to his own ideas of what his true self is what may happen to him when he doesn't live up to the idea that he is going to really commit. Then he feels the prayers to feel security and no amount of nationalisation can free him from these guilt feelings. He would need to try to find somebody in dioxin. How could

I get to that disappeared his energies were always have a nagging doubt about. Himself and a development of this potentiality I'm not surprised at all that he used the term depression when a person does not live up to his own expectations. I am surprised of the term the use of guilt guilt. I think most of us always associate with something in the nature of having failed someone else or having done something that lets someone else down or something of this nature you build up guilt feelings there are frequent use of the word but there is certainly a ords still even letting another person down. There is a feeling of of not being true to yourself because one of the values are. Important for every human being is

that he. Is clear of maintaining worse while relations to others. We touched a moment ago on a current fad as it were drugs. In the. Practice of psychiatry. Do you hold out much hope for drugs or the eventual. Cure for any more prevention or control. I don't think that any eventual cure who is owed more on their turn could eyes as normal from the shock treatment methods on lobotomies. All of these technical supports kind of correction cannot. Legally place the use of the sound limbs. Maybe you never get to vote in states of Scythia panic

and severe dissociation breakdown of a person on a tape to go over a situation over there to see if. That was a portion of an interview with Dr Edith Wagner and with her in her home in Chevy Chase Maryland Dr. Robert H Felix of the National Institute of Mental Health held these views regarding the use of drugs. I asked him how much drugs does or will help medically I think this is been one of the most dramatic developments of our time. My own experience isn't long it goes back only 30 years in psychiatry. But I think I can say without any qualification that this has been the most dramatic event that has occurred in my professional lifetime from both points of view. Let's look at it first from the point of view of treatment. We know that with certain of these drugs given under proper conditions and with proper supervision of the patient that there are many patients who never have to go to hospital.

If they are caught early enough they can be calmed down and brought under treatment in an outpatient or office type of situation so that they do not have to go to a hospital. This means many days otherwise lost which are saved for productive work and enjoyable living in the hospitals we have seen. Patients who have been able to leave earlier than they would otherwise have left because of this. The fact that they are brought in under control if you will are brought in situations been have been created in which they are more amenable to treatment. On the most disturbed wards of the hospital we see patients now who before work were often unmanageable or certainly could not be gotten out about the grounds who now can get out every day we find words on lock or before they were locked wards we find curtains on the windows and flowers and vases in the words or before these things did not exist we find China being used instead of templates and used quite safely. This

kind of environment has an effect on the attitude of the staff toward the patients. Which unit in return has a profound a tremendous effect upon the patient himself. Whether or not drugs are solely the cause or not I would not want to say at this time but we do know all that we have seen something happened over the last four years that. Has never happened before in the hundred odd years in which we've been keeping records on mental hospitals each year for the last four years. The population of our hospitals has dropped under what it was the year before. There has been a drop of four tenths of a percent. In the population of hospitals as of June 30 1959 compared to June 30 in 1958. I don't have a hand here at this moment but the total drop has been. But I think it is been about something like

15000 patients totally. There are about 15000 patients less in public mental hospitals today than there were four years ago. You know I could go on and talk more about the therapeutic but let's look at the other. Of equal importance I think for the long perspective has been what these substances have done and serving as a research tool. Now we speak of psychoactive drugs. There are really three different types of these. Two of them have therapeutic applicability but all three have tremendous research applicability. One of these I mentioned a bit ago was Cycle memetic drugs all the drugs which if given to patients to individuals to normal individuals will produce for a period of a few hours a state of mind which is essentially indistinguishable from a psychosis. Then there are what we call the tranquilizing drugs which are

those of people usually think of which will tend to make calm arch more tranquil individuals who are emotionally disturbed. Then there is another group known as the Energizers. These are drugs which will tend to cheer up or make more active and more normal depressed individuals. Not. As we study these drugs there are questions that we want to have answered. Where do these drugs act in the body. What is the reason the act. Is there some center in the brain that one of these acts upon and another one acts upon another center of the brain. Does it change the biochemical environment in which the brain is babied. Does it do something to some of the glands of the body or on some other or other questions of this nature. For instance if it effects certain centers in the brain and we have evidence now that some of these do then do these centers become deranged in mental illness. Because if these senators are affected by these drugs and

these drugs have an effect on the sick patients so it becomes well. Is it logical to assume that then something goes wrong with these centers. We can't answer these completely yet. We do think that these centers have a role in the production of illness but it's probably much more complicated than this. But you can see how these begin to open up tremendous avenues for further research. Those drugs which produce psychosis. Where do they act how do they act on animals and on man. An interesting thing that came about in the last two or three years which will show something of the way these drugs are used as research tools. There was one of the energizing drugs which was found to be quite effective in depressions. It was found however that this drug were given to a non depressed individual to a normal individual. He would become psychotic for about six to eight hours. But given to a psychotic individual who is depressed not only of this kind not not excited

patients not schizophrenia patients but. Depressed individuals. He became depending upon the degree of depression and many other factors but by and large he became more nearly normal. No. Isn't this an amazing thing. Here is a substance which is a boon. To the sick. And poison to the well. What kind of things going on in the body that cause this. The pope this opens up in terms of studies to understand human behavior in sickness and in health. Was it carried to a further extension giving more of the drug to the psychotic patient they reached a point giving him more to see what would happen. No we would not carry this treatment beyond the point which would be safe for the individual. This is another one of the things that slows down research. You know you don't do things to human beings other than to help them. So you sometimes have to resort to other types of experiments

chemical reactions in test tubes effects on animals and by deductive reasoning try to figure out. Why a drug worked in a certain way. This sort of thing has not been done that is continually getting more and more until you see what happens in the end as a matter of fact with this particular substance. I think before the patient would have developed a psychosis he might well have had some kind of poisoning effect. Also discussing drugs with Dr. Lawrence Cobb of Columbia University brought forth this answer to my question about the use of drugs. Well there isn't any question that the discoveries that have been made in the area of the so-called tranquilizing agents is one of the very great advances of the last few years. We need to go much further however. For the most part these drugs provide the person with a period of quiet in which the

possibilities of the restitution reflection and change may take place. They are not however. Cures in the sense that the individual is from the time he commences to take the drug. Relieved of an illness. He either. Is able to sustain his recovery after a period of tranquility. Or he may be required to continue to take the agent. We know that these agents are not affective in all of the disturbances that. We see. And furthermore we know that certain of them may not be given to particular individuals because of their particular their own peculiar sensitivities. We need much more work in this area. And I would expect that in our efforts to discover how these agents work. These are bits of information that are not propose available to us. The moment we will learn a great deal more about the functioning of the brain.

I wondered if the medical application of drugs were not reversing a chemical process but rather perhaps compensating momentarily. Dr. Cobb stated our understanding of these processes is very clear it's possible that we are interrupting in part. A chemical process occurring within the body and particularly within the brain. We're interrupting or blocking. These processes whether they represent overactive processes or defective processes which is certainly not clear. And from Topeka Kansas at the Menninger foundation Dr. Levinson held these views about the use of drugs and their advancements to mental help in the drug business. And I think that's probably a good way to put it has already made significant contributions. And I think will increasingly make contributions to the development of the tranquillisers is a good case in point. The drug companies have not only developed tranquilizers but they themselves have also financed research

in public mental hospitals on such drugs and other drugs. In addition we have support from the federal government through the U.S. National Institute for Mental Health. To support additional drug research re possibilities of course are unlimited and so long as they are unlimited. The drug companies and researchers who are not connected with the drug companies will continue to work quite steadily on these problems. I think we can expect a good deal of continuing interest from the drug business. Dr. White Horne at the Johns Hopkins Hospital expressed his views on the subject of drugs and their psychiatric uses. I think the early years of the drug use permits the care of acute. Disturbed acutely disturbed patients and better than was the custom

before and by acutely disturbed I mean psychotic patients who were acutely disturbed emotionally. By the same token. I would think that the greatest dangers in the. Large popular usage of drug use or psychiatric conditions are conditions approaching that lays lies in their tendency to prescribe crank revising drugs. For the relief of all anxieties. Even when this is not desirable. And I think there are many people struggling with problems in life who shouldn't have a tranquilizer but should struggle through to get the right answers. Dr. Whitehorn said patients should struggle through sometimes and get the right answers without the use of tranquilizers or other drugs. I asked Dr. Vigers once again how one can learn to deal with daily problems.

First of all you need. Some time unfortunately to think things over. Unfortunately in our modern living is so hasty. As you see you have a very thorough daily and scarcely had time for supper I think you like to think I was thinking. And you want to see her only one. Although human beings have mostly a schedule that is Rush then said time for contemplation and meditation is very much shit to load now think of other periods of history. And human beings have had much more leisure to think. The monks in convents not only but all through the day. The lay person was never in such a rush. This is what it is and I think this Herschel is

largely a. Cause for a lot of. This and living one's purpose not knowing what are you running for you know and just running for the sake of running and own problems get sort of. On confused when you haven't any time in the day or the night to really think the most. Dr. VI good has talked about the individual and how he may adapt to cases of mental illness. Dr. Henry Levinson in Topeka Kansas discussed how the family his friends and also the patient may be taught to live with mild cases of mental or emotional stress. That's a difficult question to answer in the abstract. I think for a lot of us when we become aware of problems it's very helpful to know that the problems we have are similar to problems many other people have. If we can recognize this in

many cases we can live more comfortably with whatever it is we are forced to live with. On the other hand there are many things that we may not have to live with and we may not be aware of the fact that we don't have to live with them in this kind of a case psychological and psychiatric help can be of immense value. One of our problems that is one of the problems for every one of us as human beings is to learn what it is we do have to live with where their strengths and assets are what our limitations are and in the process of psychiatric help we become more aware of those and more willing to accept our limitations as well as more willing to pursue our potentialities which we may not have up to that point developed as fully as we might have. Our thanks to Dr Edith VI get Dr. Harry Levinson Dr. Robert H. Felix Dr. John C. Whitehorn and Dr. Lawrence Cobb for their participation in this

program as they have viewed new approaches to mental health. Next week you will again hear doctors Whitehorn Felix and by Garrett as well as Dr. Levinson will be joined by Dr. Dondi Jackson Apollo Alto California as they discuss research on mental illness on the next program from the series human behavior social and medical research. We extend our special thanks to the Mental Health Research Institute of the University of Michigan for their assistant 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 end of E.B. Radio Network.