Lecture: Handling Psychotics (2)

Author: Hubbard, L. R.
Document date: 1950, 10 November
Document title: Handling Psychotics
Document type: lecture transcript
Event: Professional course
Location: Elizabeth, New Jersey
Document ID: 5011C10
Description: Hubbard classifies psychotics in terms of their accessibility; instructs on how to handle a paranoid schizophrenic who pulls a knife on the auditor in the middle of session; describes the process of psychiatric electric shock; says one of his Dianetics cases was given electric shock and died; describes "basic personality as the part of the individual who always cooperates with the auditor; gives a case history of an institutionalized "howling screaming maniac" who was made sane by Scientologist Homer Lane; discusses notable psychiatrist Dr. Frieda Fromm-Reichmann and her technique for gaining accessibility on psychotics; discusses how to cure catatonic schizophrenics by threatening to kill them with a gun.

The problem here is that of accessibility. The Standard Procedure Chart has right under its heading “(For Accessible Cases).” I have talked earlier about accessibility¹, and the least accessible character of them all is the psychotic. That’s what it means. He is inaccessible. If we modified our terminology to make it a little more workable, we would stop calling them psychotics and start calling them “inaccessibles,” which would be more to the point. When a   person got down to a level of inaccessibility, we could recognize that he was psychotic. It wouldn’t be by any esoteric design of how he wove tapestries; we would just know that he was not accessible, therefore for our purposes he would be immediately classified as psychotic and we would take measures then to increase his accessibility.

The problem is one of keeping your head. If you can do that and keep at it, knowing your Dianetics, you can resolve these psychotics one after the other. But the working of a psychotic is not without its peculiar problems and perils. A paranoid schiz who rolls over and fishes a knife out of his pocket while he’s still in reverie, opens it up and looks fixedly at your throat will not steady your nerves. Actually all you have to do is tell him to put the knife away and go back into the incident and the chances are very good that he will do just that. I’ve worked with quite a few psychotics and have never had one of them actually harm me. I have had them come within an ace of it until I reminded them that I was me and not their Uncle Benny.

The possibility of their actually carrying out these threats is very slight, particularly when they have sensed as basic personality the fact that you are their route to the outside world. Once basic personality really catches on to this, you get nothing but cooperation, no matter how this psychotic looks. He is in dramatisations, the engram is in control, and basic personality is back there taking a back seat. But basic personality will cut through once in a while and keep him in there pitching, enough so that you can work on him.

You have to keep your reason. You also have to resist the demands of families that you permit something to happen to this man immediately. He is a psychotic; he has gone unreasonable. What happens in nature when somebody makes a mistake? You walk down the street, and you make a mistake as to where you put your foot; you put it on the wrong side of the curb and you fall. The punishment for having fallen is receiving pain. Having received this pain and knowing the pain is there waiting, you get up and you don’t fall the next time if you possibly can help it.

So when a person goes irrational, the first reactive thought is to do something to this person to punish him. “He must have something done to him, for he has gone into the field of unreason.” That is not a rational intention but it is actually the reaction underlying some of the weird things done to psychotics, as in the days of Bedlam.

Practically the whole category of treatment has to do with punishment instruments. A human being when he errs receives pain from life. So when a human being errs so far as to become completely unreasonable, other human beings deliver pain to him. People will demand of you that something be done. They will think of the most extraordinary things, such as electric shocks, transorbital leukotomies, prefrontal lobotomies, topectomies, wet packs, and if it weren’t disallowed now, they would also think of whips.

You can say, “Look, he’s in no danger. He’s all right! Just let him settle out for a few days, huh? And then we’ll go to work on him. He’ll stop being violent in a few days, probably, and we’ll pick up a period there where his violence tapers off and we’ll work him.”

“Oh, no!” they say. “He’s got to have an electric shock right away. You’ve got to wait till we give it to him. Oh, we’ve got to give him an electric shock! ”

I’ve had a psychiatrist tell me that, yet what is the matter with having this man be quiet for a few days? “We have got to give him an electric shock. If you do not permit this to happen, today, this afternoon, we are going to throw this man out of this sanitarium!” He spoke with that much heat. Fascinating.

Look over the records of electric shock and you will find this to be the case: A remission takes place, electric shock or no electric shock, in the same amount of time, patient to patient. That’s interesting data, but it is not advertised. Out of a lot of propaganda about electric shock practically none of it is fact. The truth of the matter is that whether a person is given electric shocks or is not given electric shocks, he has about an equal chance of being remitted.

Thousands of records on the subject demonstrate this unequivocally. In other words, there is no point in electric shock.

Probably a layman not used to this sort of thing would be unable to stand in a room long enough to watch a full electric shock given. It is gruesome! It is not just a matter of putting a guy on the table, turning on a little switch and picking him off the table again. There are convulsions and everything you could think of, and it may be attended by a broken spine. One dear old lady was going to get some Dianetic auditing on a Wednesday. So on Tuesday they gave her an electric shock, and she died under that shock. The fact that something else is going to be done will occasionally catalyze people into action. Therefore, working in institutions and with people over whom the auditor does not have sufficient control is not without its liabilities. Things may happen to these people that he knows nothing about, yet he may be blamed. So if the auditor takes over a case of that character, he should receive a full release of responsibility. It would have been bad luck for this one auditor up there if, for instance, he had gone in on Wednesday and the electric shock had been given on Thursday. It required a very hard search of the records to establish that this woman had died under an electric shock. Nobody in the institution would admit it. But they didn’t tear up the electric shock appointment book. It was not on her chart. “She just died frothing at the mouth.” None of these things are nice, none of them are pretty, and your stomachs will be turned the moment you start into this line.

If you just pick up a fresh psychotic and start to work him, you are not going to do so well. They shake you, obviously. But if you stand up to it and just watch one psychotic who is in a thorough spin come out of it because of your auditing, practically nobody will be able to touch you for weeks! We’re dealing here with white and black. It’s a rough job, and no reward compares to it.

I’m telling you this mainly to toughen you up toward the problem. I want you to understand that a psychotic isn’t something from which you should run. But also a psychotic isn’t something that you should expect to rank with a game of jacks. You may be in a room with a psychotic for hours and hours and only succeed in delivering ten minutes of actual processing. Sometimes you have to catch them on the fly, so to speak, as they are sailing around and so forth. I worked one psychotic who, every time he was asked for a phrase or to say something, would throw things–pillows, ashtray, anything of the sort. One just ducks and says, “Go over it again.”

Your assumption that they are reasonable people does a very, very great deal to help psychotics recover, no matter how unreasonable they are. You don’t pay much attention to granting them all the things they ask for, but you talk to them reasonably. You are validating basic personality and you will toughen it up.

Psychotics get worse when they get near institutions because they are treated like unreasonable people, and they continue to be unreasonable. So treat them like reasonable people. Don’t lower your voice the way you talk to a child or a dog, and don’t jump them, or challenge them, or command them and so forth. Just talk to them: “Now let’s go out and get in the car.” The odd part of it is they may gyrate three times in the middle of the floor, but the next thing you know, they will go out and get in the car. It takes a little time for basic personality to get toughened up to it.

There are many, many ways of approaching a psychotic and gaining access to him. Homer Lane, a layman over in England, went into one of the large sanitariums there and asked the superintendent if he could be given the worst psychotic they had in the place. He was told, “Oh, no, we wouldn’t be permitted to do that.”

“Well, just give me one of your very bad, hopeless psychotics.”

“Oh, no, we couldn’t do that. No, he–he–he’d kill you.”

And Lane said, “Well now, I’ll take that responsibility. I’ll give you a release. After all, if he’s hopeless I can’t do him any harm. So let me talk to him for a little while.”

Finally the superintendent gave way. They let Homer Lane, who was not a very big man, into a dark dungeon, and there, naked, dirty and frothing, standing about six foot six and weighing about 250 pounds, was a howling, screaming maniac.

Homer Lane let himself into the cell very quietly and stood there. This shaggy thing looked at him and started to jump. Homer Lane said, “I heard you could help me.”

The maniac stopped in mid-flight and said lucidly, “How did you know?” They released that man in a couple of days.

This gives you a sample of some of the bizarre methods that can be adopted to regain accessibility. Another one is followed by Dr. Frieda Fromm-Reichmann² . She will go into a cell with the toughest, meanest, orneriest psychotics imaginable, and by a process of acting crazier than they act bring them out of it. That’s right. There’s nothing wrong with her nerve. I admire her a great deal. I know of her record, and it is amazing how she has been able to work with practically no tools but her own wits and actually get remissions from these people.

There are just tons of these tricks and ways to do it. But these things never deviate from the principle of getting into communication, by any means whatsoever, with basic personality. Under no circumstances appoint yourself the taskmaster of a psychotic. Never give way to a punishment complex. Have a full confidence within yourself that you are going to produce marked results with this person. If you let your own guts begin to quiver, you are going to fail. These methods, no matter how bizarre, do not depart from this short list. Nobody ever cured psychotics by screaming at them, beating them, or doing other very bad things to them.

You will hear an occasional story about somebody who walked in saying he was going to shoot this catatonic schizophrenic, and then got a gun and the catatonic schiz jumped up. That sounds good but the chances are he might have triggered this fellow further. This is not a 100 percent workable solution. Building a fire under a catatonic schiz is spectacular, but he is liable to lie right there and be burned. He knows you are not going to kill him. You mustn’t overlook these facts.

There are some methods of gaining accessibility which you would not ordinarily expect. Occasionally just by walking the legs off the psychotic, you’ll get him so tired that he will go to sleep, get some rest and wake up accessible.

Hubbard, L. R. (1950, 10 November). Handling Psychotics. Professional Course,   (5011C10). Lecture conducted from Elizabeth, New Jersey.

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