Wednesday, 1 April 2009

Dietary Discipline & Other Aspects – A reader’s Account and Another in the ‘Truth Stranger than Fiction Vein’

Hi readers!...Only me!
Its been a while again, but while I am now fully recovered from my drinking binge I am putting most of my energies into getting the long delayed INSTITUTIONALISED volume 2 finally finished - the rest of the time is currently being dedicated to improving my fitness levels in the gym in preparation for the London to Brighton cycle ride later this year. I have to admit to lacking a little enthusiasm now and then (particularly at the moment) but then along comes something and I am all fired-up again. For a time that inspiration centered around the 'monster experiment' (the stuff I came across regarding the deliberate induction of stammering in test subjects by a speech therapist). But more recently I was sent this intriguing account (see below) and the sparks began to fly once more. While obviously I cannot vouch for its accuracy, nor its authenticity, I hesitantly (but enthusiastically, it must be said) categorise it in the 'truth-stranger-than-fiction vein. What really caught my imagination was the mealtime discipline - all that 'spoon tapping' used as a conditioning aid, the carefully prescribed number of times a food item has to be chewed, the use of the metronome to prescribe the tempo...what a wonderful level of control, what exquisite discipline. And it is so beautifully written that I just had to share it with you (anon of course) - I hope the writer doesn't mind, but I just couldn't wait for you all to read it. I have done a little editing here and there and added a couple of suitable pics (I think it deserves it) but that is about it.
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"Dear Mr. Toyntanen,
I was surprised to find the snippet, about girls in an experimental mental hospital, from your upcoming book. It reminded me all too vividly of the time I spent in a semi-private hospital when I was a teenager being cured of my supposed homosexual tendencies. I say supposed because I don't believe I ever was a lesbian, but the more I denied it, the more convinced the 'professionals' were that I was lying. Apparently a classic symptom of my sickness!

There is nothing good I can say about my time in that place. If I behaved I was allowed to 'recreate' - though I was always kept separate from the others because I was considered a sexual deviant and therefore dangerous to my 'fellow' patients. So if I was lucky I spent my days in the day-room, comprehensively strapped to a heavy chair that even Dr. Rush would have been proud of [Dr. Benjamin Rush 1745 – 1813, Known as the Father of American Psychiatry, see on left for his famous chair – Garth].

I was not happy and was glad to let everyone know it - so more often than not I sat there gagged with a couple of pillowcases over my head - which did nothing to improve my demeanour.

It seems to me that they spent a lot more time 'controlling' us than they ever did 'treating' us. Supposedly justified by the idea that you can't have a bunch of teenagers running around doing whatever they want - so their first order of business was to make us behave and obey their every order like a bunch of automatons. They tried to tell us that out treatment would not begin until we became pliant, but like most other things they told us, it wasn't really true. I know because they began my treatment, or at least testing, before they finally calmed me down.

They inserted some kind of device into my vagina - which was a very painful and embarrassing procedure (did I mention that continual embarrassment was one of the things I remember so well - and I think a tool that the staff used to its fullest - they were always making belittling comments) and then they would make me watch a slide show of dirty pictures and supposedly measure my sexual response. Later I did some research and found that the device, I think they were using, was extremely unreliable.

Anyway, after the first couple of sessions my therapist would berate me for not cooperating and trying to evade their 'scientific' testing. I had no idea what she was talking about. Then she'd shout at the nurses that did the testing. She must have yelled at the ward nurses too because I always 'got it' from them too. This carried on for a while, but eventually it seems that they were getting the results they wanted - which then just made her yell at me for what she called my 'perversions'. Honestly I'm sceptical that either I or the apparatus began to give different results - I'm more inclined to think that the nurses responsible for administering the tests would somehow fake them so that the therapist wouldn't yell at them anymore. I don't think the machine produced any kind of chart - the nurses just read my 'response' from a dial and note it on a clipboard - so it would have been easy enough to fake. Anyway, I don't remember feeling aroused by any of the dirty pictures, whether they had two women or a man and a woman in them. maybe I was just too mortified and embarrassed. Or maybe women just aren't stimulated by pictures the way men are.

When I went there I didn't know anything about sex - nothing about what went on between a man and a woman and even less about two women. It just never occurred to me. And nobody explained it to me when I went to the hospital either. They just assumed that I knew everything because I was meant to be a lesbian. I had to piece together what was going on from the pictures they showed me and things the therapist said.

But I digress. What really prompted me to write was your description of the girls being fed. When I was admitted they asked me a lot of harmless questions, like what I liked to eat, what I didn't like to eat. I remember the nurse asking the questions was very friendly and seemed to understand that I really hated some foods. She even volunteered that she absolutely detested some foods too - so I felt very comfortable telling her all my likes and dislikes. And my list of dislikes was very long indeed. Perhaps I should have been suspicious when she categorized my degree of hatred of each food type, but without saying so she encouraged me to believe that answering the questions would result in me getting the foods I like. After all, what else was I to think?

But my illusions were shattered when I was categorized as a 'fussy eater' and was put on a special regimen at meal times. We fussy eaters were not trusted to eat our food - they thought that we would hide the food, or somehow get rid of it without eating it. And their fears were probably right, at least in my case, because my diet was suddenly limited to all the foods I hated the most - and the nurses bringing in the food and putting it down in front of us were careful to mock me - presumably because I was the latest patient to join their merry band of 'fussy eaters'. Of course I dare say the idea behind it was to help us overcome our 'fussiness' and was no doubt meant to be a gradual introduction of 'disliked' foods accompanied by kindness, understanding and encouragement - but the way it was implemented in practice was purely vindictive and punishing. Besides the spiteful words the food was presented in the most unappetizing manner possible. Desert and main course foods, cold and mixed together - lumps of wobbly fat coated in the rice pudding and semolina that I hated so much. Yechhh!

Of course they warned me that I would be 'force fed' if I didn't eat everything on my bowl-like plate. But it didn't matter. No matter what they threatened I wouldn't have been able to eat it. I remember trying, but my stomach rebelled and I'd heave every time I put some of it in my mouth. I just knew that I would vomit everything up if I tried to swallow it.

Well, they had ways to 'encourage' me. They called them aversives - but they were just torture. And after they had broken my spirit in that regard they didn't just let me go back to eating food with everybody else - in absolute silence - even a glance at a neighbour would earn you a whack about the head. No I ended up on what they euphemistically called a 'special' food regimen. Like the girls in your book I would be hand-fed by a nurse - not in bed, but in the equivalent of an adult high chair where I could be fastened during the feeding, just like in the day-room. And there was no evading the spoon - the forehead strap saw to that.

No doubt some kind of bib is a good idea whenever somebody is being spoon fed and especially when the person being fed is not particularly appreciative of the service being rendered - but I'm sure a less humiliating procure could have been developed. First we were dressed in a tight canvas 'smock' that covered us from neck to ankles, [tightened] from behind with tapes - not tapes to close the opening, for there was no opening except at the neck - just tapes to make it snug all the way down - but especially at the neck where the high collar was always cinched up just a little too tightly for comfort. Then after we were properly strapped into the feeding chair a large rubber bib was fastened over us, covering us from neck to floor once more; no doubt a practical thing, but humiliating when the nurses would say something [along the lines of] 'a babies bib for you then'. But they weren't satisfied at that because then a large white bib was also fastened about our necks. And heaven help us if we dropped or dribbled anything on this pristine white bib during out feeding. And at the end of the meal when the sister would come round to inspect our charts and our bibs you can be sure we were grateful if the nurse had not deliberately stained our bib as we ate - or started us out with an already stained bib - most probably pointed out to us with some glee as it was fastened about our necks.

Besides the stomach-churning 'food' that we were required to eat, we were required to eat it in a particular manner - no doubt to impress upon us that we were now part of a well regimented group - or some such rubbish. Maybe [it was] just to let us know that they now controlled every aspect of our life. The nurse would tap us on the left side of the mouth with the spoon to signal us to open our mouths. She would then insert the spoon and we were required to close our mouth in a 'polite' manner and wipe the spoon clean as the nurse withdrew it. Again heaven help us if there was any vestige of the 'food' on the spoon as it was withdrawn. We had to hold the food until the nurse inspected the spoon and tapped us on the chin with it to indicate that we should begin chewing - something hardly necessary since the food was always ground up into a foul-smelling paste. But despite that we were required to chew each mouthful a certain number of times - the exact number dictated by the therapist - and usually a high enough number to greatly annoy the nurse and us. A low number might be 50 times, and a high number might be 200 times. And we had to chew in a particular rhythm. Not too fast and not too slow. Beginners had a metronome placed behind them until they got it right. And each chew had to be exactly the same as the previous and the next. If the chew was not uniform then the chew didn't count and the nurse would mark you down on the clipboard for insufficient chews for that mouthful. And each mouthful insufficiently chewed or over-chewed would result in a demerit and subsequent loss of privileges - if you were lucky enough to have any. Once you had chewed the mouthful the requisite number of times, adding on an extra chew or two if you thought that some chews might have been disallowed, and hoping that the nurse had excluded them from her count also, you were required to hold the well masticated mess in your mouth until further instructed. Another tap on the chin meant 'display' and you had to open your mouth and 'display' the 'food' to demonstrate that you had not swallowed any of it - something hard to avoid given the mushy consistency and the seemingly unending chews we were required to perform. With or without the tap on the chin to 'display', a tap on the right side of the mouth meant swallow."
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Pheeew! Well, if you were intrigued by the above account - then I have to say that one of the finest fictional pieces I have read in this vein was called 'Committed' and did much to influence the direction of some of the story arc in my INSTITUTIONALISED series (Click on the title, in blue, to read). For myself, it opened up more questions and avenues to explore than anything else - as I wrote in reply. For example, questions that immediately popped into my mind when I first read it included:

Whether or not spoken orders were given to accompany the spoon-tapping signals, or whether perhaps they were initially but were no longer required after some time? (The use of the metronome I found interesting; in my mind's eye I could see a line of girls all chewing in unison to its tick-tock rhythm - perhaps glassy eyed?). In a similar vein; was hypnosis in any form applied?
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Then there is that intriguing term she uses, 'aversives' - one's imagination runs riot with possibilities as to what that might allude to - what was the effect each time they were applied, what did they consist of? Was any form of corporal punishment in use to maintain order and enforce compliance?
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Judging from what she says about the canvas smocks worn for meal times, I doubt it was permitted to retain their own clothes or much in the way of personal belongings - or were night-dresses taken from home allowed, for instance? If not, what sort of thing was issued by the hospital and was any attempt made to enforce a uniform appearance? I'm just wondering whether nightdresses were worn at all times, for example, or whether other clothing was available for other times of the day, in which case (and assuming all hospital issue) was there a disciplinary aspect to it - for example was it necessary to look a certain way, to appear smart, perhaps, even though the circumstances seem to make such concerns obsolete? (After all it's a nice way of asserting control).
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Related to the above - as an issue of compliance (and also a security issue – see below) - is the question of toiletry arrangements: In the average small hospital ward (and I imagine this to be quite a compact ward we are talking about here) there are usually only one or two (if that) toilet cubicles. A weird subject I know but one with many disciplinary connotations, particularly under the circumstances you describe, as once in a cubicle the patient could be out of sight for example and might choose to regurgitate an unpleasant meal. And bearing in mind the regimentation of the dietary procedures that are described one can't help wondering whether such toilet visits were regimented in a similar way (I make mention – in both INSTITUTIONALISED volume 1 and 2 - of bedpan use, both for convenience but also for ' medical ' reasons - to allow for easy monitoring of waste output, shall we say (humiliating for the patient, I know, but perhaps necessary in a research setting or where compliance needs to be monitored / enforced).
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Then we come to what security measures were in place: under the circumstances the writer outlines - and given your average rebellious teenager (and particularly taking into account the time scale that seems to be implied) - the temptation must have been to simply walk out. I imagine, therefore, all this would have taken place in a secure, locked ward. In which case I, for one, would be fascinated to learn of the security precautions taken. The possibility of the nurses having manipulated the results of the tests performed adds a particularly interesting dimension to this. Along with denial being virtually taken as a symptom of proof, particularly when backed up by test results guaranteed to prove the point - and assuming that the length of stay is dependent on a cure (of a condition not present in the first place) - it would be quite difficult to acquire release once admitted. One can't help but wonder as to whether one or two inmates (for want of a better term) might simply have been admitted as a matter of convenience (or even amusement, perhaps) for some individual.
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Finally: In terms of the original concern over the subject's alleged lesbianism - was aversion therapy, in any form, in use? On the other hand, considering the manipulated results and dubious diagnosis - was there any evidence of 'negative' therapy being given, perhaps as part of an experimental probe into the origins of the development of such 'deviant' sexuality? Here I am drawing a parallel with the so-called 'monster study' that I've talked about in the blog before and in which - in the 1930s - speech deficits were deliberately induced using a mixture of suggestion and constant reinforcement by therapists and teachers.
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So many questions: we await the answers with excited anticipation...but perhaps you...yes, you, out there ... have your own ideas about the conditions that you might imagine would be in place - or would be in place if you were running the unit? Then share them with us! In the meantime, I'm going back to writing - its nearly there, now!

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