The Sleep Room: A Sadistic Psychiatrist and the Women Who Survived Him

by Jon Stock

On his first day at the Maudsley, a patient took one look at Sargant, walked out of the hospital and killed himself. ‘It was not a good start,’ Sargant conceded.

It’s easy for his modern critics to dismiss what were once seen as pioneering treatments in an era of experimentation in psychiatry. Much harder to explain is Sargant’s persistence with extreme physical therapies in the face of mounting evidence at the time of their dangers.

As with other ‘miraculous’ cures for mental illness, no one was able to shed much light on why it might work. A few years earlier, another equally bizarre physical treatment had been hailed as a cure for general paralysis of the insane (GPI), a severe mental disorder caused by late-stage syphilis. In 1917, Julius Wagner-Jauregg, an Austrian doctor, had injected blood taken from a malarial patient into two people suffering from GPI. He’d had a hunch that a spiking fever might be therapeutic in some cases of psychosis – the original shock treatment. Some signs of improvement were noted, and it wasn’t long before Horton Asylum in Epsom had become a national centre for breeding malarial mosquitoes, which were duly dispatched to hospitals around the UK.

According to Sargant, ‘One unit went so far as to recommend nurses with big breasts so that when the patient came out of his death-like coma, he or she was greeted on rebirth with this invitingly maternal sight.’

Clinical accomplishments were, at this stage, more important than theoretical foundations. In truth, patients probably just felt better, at least in the short term, because they were the focus of a lot of suggestive attention from a large and dedicated team of doctors and nurses. One conservative estimate at the time suggested that patients were given fifty to a hundred times as much medical care and nursing care, measured by the clock, as non-insulin patients.

‘The Insulin Myth’, a coruscating article in the Lancet in 1953, had concluded that ‘insulin offers the schizophrenic no long-term benefits’. The author was Harold Bourne, a courageous thirty-year-old junior doctor who was subjected to the equivalent of a social media pile-on in the letters page of the Lancet for taking on the insulin coma therapy old guard. Four years later, however, another critical article in the Lancet was (for most people) the final nail in the coffin.

Ladislas Meduna, a Hungarian neuropsychiatrist, observed that if schizophrenics suffered seizures, they were relieved of their psychosis. Similarly, if an epileptic developed schizophrenia, they had fewer seizures. (Today, epileptics are thought to be more, rather than less, prone to psychosis.)

Cerletti proceeded to give Enrico another eleven treatments, each one announced in the clinic with two blasts on a trumpet. Rows of spectators were three deep. As for Enrico, he was allowed to return to his family in Milan three weeks later, in ‘good condition and well orientated; ideation and memory perfect’. In what would become an all too familiar pattern, however, Enrico relapsed two years later, and was readmitted to the Mombello psychiatric hospital in Milan.

Moniz believed that psychiatric problems were caused by ‘fixed’ or repetitive thoughts that had become locked into abnormally stabilised neural pathways in the prefrontal cortex (often described today as the personality centre of the brain). And it was only by cutting these pathways, which connected the frontal lobes with a deeper part of the brain, the thalamus, that those fixed patterns of thought could be disrupted. Thanks to a neurologist called Walter Freeman, who soon adapted and cleverly marketed Moniz’s technique in America (‘lobotomy gets them home’), it quickly became one of the most popular neurosurgical treatments for mental disorders in the Western world.

In one now notorious paragraph, he recommended a lobotomy, instead of divorce or separation, for unhappy wives: ‘A depressed woman, for instance, may owe her illness to a psychopathic husband who cannot change and will not accept treatment. Separation might be the answer, but . . . we have seen patients enabled by a leucotomy to return to the difficult environment and cope with it in a way which had hitherto been impossible.’

Freeman and Watts initially operated on twenty patients. The results were disastrous. One patient committed suicide, another attempted to do the same, and two died within three months. Other patients were left with ‘extreme flattening of emotional life’, ‘a sterile intellectual life’ and ‘frequent convulsions and incontinence’. One woman became ‘fat, jolly and unspoken’. Seventeen out of the twenty patients were female, and eleven of them were housewives, a gender imbalance that was to persist in both the US and the UK. Freeman and Watts soon adjusted their technique, believing that they needed to remove more rather than less brain tissue. (‘Double the dose!’ as Sargant liked to say.) Moniz’s leucotome was swapped for a blade that was used like a butter knife to make sweeping cuts across the frontal lobes. Ironically, they called their new approach a ‘precision’ lobotomy.

psychosurgery that attracted Sargant. He was a performer. The American was an eccentric showman, sporting a cane, Texas sombrero and goatee beard. During his neurology lectures and brain dissections – so popular that students brought along their girlfriends – he often drew on the blackboard with both hands. On Saturday mornings, he would wheel out troubled patients and discuss their neurological diseases in front of them, sometimes even imitating their gait. A few years earlier, in 1933, Freeman had had a nervous breakdown while writing a book on neuropathology. Waking at 4.30 a.m. every day to write, he’d complained his brain was on fire. For the rest of his life, he was on Nembutal, a barbiturate.

Sargant ‘came away in a state of great excitement’, echoing Freeman’s original enthusiastic response to Moniz’s lobotomies, even if the first patient, an alcoholic, had failed to impress Sargant with his boast that he could now get twice as drunk on half the amount of whisky.

was an active member of the British Eugenics Society. Encouraged by Aubrey Lewis, he had won a Rockefeller fellowship in 1934 to Germany, where he studied under Bruno Schulz and Ernst Rüdin at the Psychiatric Research Institute in Munich. Rüdin spearheaded the Nazis’ Rassenhygiene, a programme designed to encourage a ‘pure’ and ‘healthy’ Aryan race by avoiding miscegenation and procreation among mentally ill people. Enforced sterilisation, for example, had been introduced in 1933 to prevent interbreeding between the ‘feeble-minded’ and schizophrenics.

There were, in fact, nine initial operations, but the ninth patient, a twenty-seven-year-old woman, died after a blood vessel was accidentally severed and her case was excluded from the initial report. As for the remaining eight, one died two days after the operation (heart attack), four remained in hospital and three were discharged, two of them with double incontinence.

Sargant argued that the therapeutic goals of a psychiatrist were, therefore, essentially the same as those of the political brainwasher (and the religious leader such as John Wesley): to turn a patient’s unhelpful patterns of behaviour and thought into diametrically opposite ones.

Shock treatments operated on the principle that a tremendous blow to the central nervous system could somehow reset it. The American evolutionary biologist Richard Lewontin once compared the process to a ‘mental enema’.

A more metaphysical broadside was launched by R. D. Laing. A rising star in the anti-psychiatry movement, Laing argued that Sargant regarded man as a machine and that, when it went wrong, he used methods that were similar to giving a radio a smack. ‘The justification of this procedure, with man as with the wireless set, is that “it works”, as indeed it does . . . but has the paradoxical result of regression to barbarism.’

Known variously as the ‘acid Marxist’ and the ‘Mick Jagger of psychiatry’, the Glasgow-born Laing couldn’t have been more different from the pinstripe-suited Sargant. Laing argued that insanity was a perfectly rational adjustment to a mad and dangerous world.

The rivalry between Laing and Sargant would come to a head in 1967 when the BBC broadcast a controversial TV docudrama, In Two Minds. Directed by Ken Loach, it featured a young woman, Kate Winter (played by Anna Cropper), who suffered from schizophrenia. The play, based on Sanity, Madness and the Family, co-authored by Laing and fellow psychiatrist Aaron Esterson, was a direct challenge to Sargant and, in particular, The Hurt Mind, a BBC documentary series on mental health in which Sargant had waxed lyrical about lobotomy, ECT, abreaction and insulin coma therapy.

After In Two Minds was broadcast, Joan Bakewell moderated a lively debate between Laing and Sargant in a special edition of BBC2’s Late Light Line-Up

‘Brainwash’ had first entered the public consciousness in September 1950, when the journalist and CIA propagandist Edward Hunter coined the word in an article for the Miami Daily News. In the first of many anti-communist tracts, Hunter described how Chinese leaders used force to persuade people to convert to communism in a process known as ‘xi-nao’ – literally translated as ‘mind cleanse’.

Brainwashing could not only be used to persuade the masses of the merits of communism; it could also be deployed during interrogation to extract information from individual prisoners, to plant new thoughts – and possibly commands – in their minds, turning people into programmable assassins.

It would take another mental breakdown and a chance meeting in Majorca with Robert Graves to turn that thesis into Battle for the Mind, Sargant’s bestselling book on brainwashing. The media, meanwhile, was already intrigued.

Early in the breakdown of the normal mind under stress, the most fantastic suggestions may start to seem more sensible. What we call a state of increased suggestibility may occur . . . during the “brain washing” itself, previously implanted habits can not only be wiped out, but exactly opposite ones can take their place.’

ECT was initially thought to cure schizophrenia because multiple electric shocks caused such complete confusion, disorientation and amnesia in a patient that schizophrenic symptoms would disappear along with the loss of memory and bladder and bowel control. Everything would be erased – the good and the bad. This process, which Cameron called ‘depatterning’, would wipe the slate clean.

His critics, like Cameron’s, argued that he never knew when to stop, that he was possessed of a furor therapeuticus*

1931, two years after he had arrived at Brandon, a provincial mental hospital in Canada, he conducted an experiment that studied the effect of dehydration on twelve epileptics. The patients became increasingly desperate, eating snow from windowsills, drinking water from vases and stealing food and drink. One died. It was a cruel experiment that proved nothing more than Cameron’s own tendency to put experimental research before patient welfare.

He described a new technique – ‘an adaptation of Hebb’s psychological isolation’ – that involved bombarding patients with recorded audio messages, repeated thousands of times, either when they were in a drug-induced sleep or on LSD. Patients would resist, Cameron acknowledged, but ‘if they are continuously overloaded their breakdown is to be expected’. He then added something that caught the eye of John Gittinger, the CIA’s resident psychologist. ‘Analogous to this is the breakdown of the individual under continuous interrogation.’

had begun to develop it in 1953, when he recorded a forty-year-old French Canadian patient talking about how her mother had threatened to abandon her as a child. Cutting her mother’s words down to a single phrase – ‘If you don’t keep quiet, I’m going to leave you behind’ – he played the recording back to her again and again, continually flicking the tape recorder switch, much to the woman’s distress.

One patient was kept asleep for 65 days.

Da fuq

It also enabled Cameron to push sensory isolation to the limit. While subjecting a patient to negative looped recordings, Cameron would reinforce the message by ‘applying galvanic stimulation to the leg’ at the end of each repetition – an electric shock, in other words. Using $3,500 of the funds, he also built a box, or cubicle, in Ravenscrag’s converted stable block, where he left one patient, Mary C, for thirty-five days of sensory deprivation. She’d already been subjected to other unimaginably intense treatments, including ‘repeated depatterning’ (ECT) and 101 days of ‘positive’ psychic driving, but ‘no favourable results were obtained’. Her condition? She was a menopausal hypochondriac.

The other was a Spanish psychiatrist, Juan José López-Ibor, who would become the second president of the WPA in 1966. During the Franco regime, he had used ECT and lobotomy to ‘cure’ patients of homosexuality. ‘My last patient was a deviant,’ López-Ibor said at a conference in Italy, but he now ‘appears more slightly attracted to women’, even if he had ‘disorders in memory and vision’.

He also liked to use tape recorders during aversion therapy. It was a controversial treatment that tried to associate something unpleasant with a patient’s bad habit: smoking, nail-chewing, drugs, drinking etc. In Anthony Burgess’s 1962 novel A Clockwork Orange, Alex, the teenage protagonist, is subjected to the Ludovico Technique, a form of behaviour modification that bears uncanny similarities to Sargant’s take on aversion therapy. Injected with emetics while watching violent films, he is conditioned to be ill whenever he has an aggressive thought.

Her first patient, Mr Smith, was an alcoholic in his late forties with a heavy beer belly. He was divorced and had little contact with his two children. This was his final attempt to stop drinking. ‘We had to wake him up and give him a tumbler of neat whisky, followed by an emetic to make him throw up, at which point we would play a tape recording. I’m pretty certain it was Sargant’s voice – Sargant made sure he wasn’t actually in the room during the treatment. The voice was rich and low.’ Afterwards, everything that Mr Smith had evacuated from his body was left in the room with him for twenty-four hours. ‘As he was throwing up, he was told on the tape recording to look around, see what a disgusting, unpleasant human being he was.’ Once he had finished vomiting, Julia turned off the recording and let him sleep. Six hours later, the whole routine started again.