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European Association of Psychoanalysis |
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European Association of Psychoanalysis |
NEWS
Therapeutic Censorship
Freedom of speech is
one of the most distinctly American political values.
In many European democracies people take for granted that their freedom
requires criminal sanctions against the expression of certain odious ideas,
exemplified by the denial of the Holocaust. In the United States, that would
be a clear violation of the First Amendment.
To be sure there are limits to our freedom of expression, most famously the
prohibition against speech or publication that creates "a clear and present
danger such as Congress has a right to prevent." Except for this criterion
plus the limits placed on the dissemination of "obscene or pornographic speech
and publication," the First Amendment seemingly carves out a very large arena
in which we may freely express and hear the human voice.
I say seemingly because we in the United States take for granted the
government's right, indeed its duty, to prohibit persons to express opinions
deemed to be the products of "mental illness." An American has the right to
deny the Holocaust, but not the right to deny his identity and declare that he
is Jesus.
The person who does that is diagnosed as having schizophrenia, being "dangerous
to himself and others," and incarcerated in a "hospital." This type of
deprivation of liberty is not considered a violation of the First Amendment
because psychiatric commitment is defined as a civil, not criminal, procedure,
its ostensible purpose being therapy, not punishment.
This is familiar territory. Much less familiar is an episode in which
organized psychiatry was responsible for a very different kind of limitation
of free speech, one I call "therapeutic censorship."
The "Titicut Follies"
In the 1960s, documentary film maker Frederick Wiseman received permission to
film, for 29 days, inside the Bridgewater State Hospital, an institution for
the criminally insane. The movie he made there - his first documentary - was
shown to great acclaim at the New York Film Festival in 1967. The
Massachusetts Attorney General proceeded to bar public screenings and the
state's Supreme Court ruled that the movie constituted an invasion of the
privacy of the Bridgewater guards and patients. The film was banned. Today,
The Titicut Follies, if remembered at all, is dismissed as presenting the
kinds of inhumane psychiatric conditions that, thanks to drugs and
deinstitutionalization, we have put behind us.
The Titicut Follies is and was intended to be an exposé, the cinematic
equivalent of investigative journalism. The claim that it violated the privacy
of the guards is as absurd as would be the claim that a newspaper story
exposing the unsavory behavior of a politician is an invasion of his
privacy.
In May 1987, The Titicut Follies was the subject of a forum at the
University of Massachusetts. The reviewer for the New York Times (1987)
reported: "It was a rare screening of the film that, under court guidelines,
can be shown only to professionals in the legal, human services, mental health
and related fields. ... A documentary film ... made 20 years ago and promptly
banned, has proved that its power to provoke debate has not diminished. ... [it]
is the only
American film ever censored for reasons other than obscenity or national
security."
The title of the documentary comes from an annual variety show given by
inmates and guards. After the 1987 showing, Wiseman said in an interview this
week: "If the First Amendment of the Constitution protects anything, it's a
journalist's right to report on conditions in a prison." Nevertheless, the
United States Supreme Court has twice refused to hear Wiseman's appeal. "Blaire
Perry, a lawyer for Mr. Wiseman who was on the panel, said, `In 20 years, not
one patient or his family has ever objected to the showing of the film.'"
Today, the "hospital" is in a modern building. "By all accounts," the Times
reporter assures us, "the staff is better trained and there are more legal
safeguards protecting the patients, many of whom have never been convicted of
a
crime. But the hospital is still surrounded by barbed wire, staffed by 220
prison guards ... There are 25 nurses and 49 psychiatrists, psychologists and
social workers for 436 patients, according to Mary McGeown, a spokeswoman for
the Corrections Department. Bridgewater is still overcrowded, understaffed and
underfinanced." What is the staff better trained for? No matter how many
psychiatrists, psychologists, nurses and social workers are in such a
`hospital,' they are all jailers.
On 6 April 1993 - twenty-six years after it was banned - The Titicut
Follies was shown on the Public Broadcasting System and reviewed by film
critic Walter Goodman (1993) in the New York Times:
Frederick Wiseman's remarkable first documentary, an unsparing visit to the
Bridgewater State Hospital for the Criminally Insane, in Massachusetts, was
banned ... As in all his reports, Mr. Wiseman abjures narration. The pictures
tell his stories, and he has never presented more powerful pictures. The
90-minute film opens and ends with a chorus line from what was evidently an
annual show called "The Titicut Follies." You'll have to guess who among these
costumed performers are inmates, who are guards. ...One man outtalks the
doctors with a fervent yet coherent plea to be sent back to an ordinary prison.
... Many of the encounters have an unsettling ambiguity. A psychiatrist ...
questions an inmate about his sexual proclivities: "What are you interested
in, big breasts or small breasts?" Is he working or just curious? The hardest
scene to watch is of a forced feeding. The doctor smokes a cigarette as he
inserts a long rubber tube into the patient's nostril and pours a liquid into
a funnel; you want to call out to him to flick the lengthening ash onto the
floor before it drops into the funnel.
The Titicut Follies, unlike One Flew Over the Cuckoo's Nest, was
a unique film. It depicted in gripping pictorial detail the psychiatric
invalidation, persecution and dehumanization of so-called mad persons at the
hands of so-called mental health professionals. For that offence, the American
psychiatric establishment, assisted by the American legal establishment,
banned the showing of the film. This unique violation of the First Amendment
has escaped both legal and psychiatric attention.
Today, the Bridgewater State Hospital is a "health care facility" affiliated
with the University of Massachusetts Medical School. In 2003 the National
Commission on Correctional Health Care lauded it as its "Facility of Year." A
2003 essay by Jaime Shimkus, publications editor of the organization, presents
a brief history of the hospital, but does not mention The Titicut Follies
or the conditions described in the film.
In the old days of insane asylums, the truth about psychiatry was apparent:
the madhouse was a snake pit, and snake pits were limited to insane asylums.
Today's snake pits - dispersed throughout society - are concealed by a façade
of pseudomedical diagnoses, therapies, treatment advocacy centers, alliances
for the mentally ill, and the renaming of insane asylums as "health care
facilities."
Thomas Szasz
Szasz, T.S.
(2007).
"Therapeutic
Censorship," The Freeman, 56: 25-26 (May), 2007.
Thomas S.
Szasz Cybercenter for Liberty and Responsibility: _Copyright_ (http://www.szasz.com/copyright.html)
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