Come to me, all who labor and are heavy burdened, and I shall give you rest

[austin_dern]

So, my current reading. Tell me this doesn't sound like a sick joke: in the late 50s at the Ypsilanti State Hospital they brought together three people each suffering the delusion of being Jesus Christ and put them in the same room. (Actually, several rooms.)

It wasn't just they were curious to see what the three Christs would do. But that was part of it. They were interested in how people form their beliefs, with personal identity of particular interest because it's such a central one and it's so impossible to argue people out of who they think they are. And there were legends of people who had the delusion of being someone else being shocked out of it by meeting someone else with the same delusion. That didn't happen in this case; the Christs figured out ingenious reasons why they were right and the other putative Christs were just wrong.

Where it gets to the jaw-dropping, ``what were they thinking'', this is what the author apologizes for in the 1980s edition, part is: one of the men believed himself to have a wife (who, being a Yeti, was taken to be imaginary). They began writing letters pretending to be from her to see how far they could manipulate his behavior. You can actually feel --- at least, I can feel --- the researchers realizing that maybe this started out questionable but probably not harmful (maybe beneficial, since they were getting much more personal care than as part of a general mental hospital population) and then stumbled into ``what if anything were you thinking?'' territory.

It is all fascinating stuff, though I did feel like I was being callous when the men's monologues got to ... well, stuff that sounded funny. I mean, when someone claiming to be Jesus Christ says that several years ago besides his duties as God he was also governor of Illinois, it sounds like the sitcom representation of Zany Crazy People. But reading nearly 200 pages of this breaks past that impression. I got to feeling for the people afflicted and hoping for their health, even if they didn't come to thinking of themselves as their pre-Christ personas.

Trivia: Britain's King George III in 1804 attributed his 1801 mental disturbance to worry and concern about public affairs, particularly being called upon to break his coronation oath and consent to the emancipation of Roman Catholics. Source: George III, Christopher Hibbert.

Currently Reading: The Three Christs of Ypsilanti: A Narrative Study Of Three Lost Men, Milton Rokeach.

Comments

[bunny-hugger.livejournal.com]

I may have mentioned this last time you told me about this incident, but the film The Ruling Class involves, among many other bizarre things, trying to "cure" one delusional Christ by confronting him with another one.

My mother once worked at Ypsi State, but of course long after this occurred. Although, come to think of it, not really terribly long in the scheme of things.

[austin-dern.livejournal.com]

There are legends of delusional Christs (or other people) being shocked to normal by meeting someone else claiming the same identity, and that was part of what formed the background material for the project. Unfortunately if this example is representative, it looks like it doesn't work, or doesn't work long. People figure out reasons why their belief is right and everyone else is wrong.

I remember your mentioning that about your mother. I think we got to there talking about the strange project at the children's hospital in Ann Arbor which was curiously contemporary to this, come to think of it.

[bunny-hugger.livejournal.com]

I've visited the children's hospital, Mott Hospital, on a field trip when I was a kid.

Incidentally, The Ruling Class is the sort of savagely satirical film that the British specialize in; it suffers from overstaying its welcome (by the end it's a bit "all right, we get it, we get it already") but is worth seeing for the excellent Peter O'Toole performance.

[austin-dern.livejournal.com]

I've got to remember to look for it either on Netflix Instant or Turner Classic Movies. The two have been doing pretty well at bringing movies to your summoning.

[lexomatic.livejournal.com]

"Man's a rationalizing animal, not a rational one." Why don't the three patients notice the contradiction and amend their mental models? Perhaps their debility is similar to a dream-state: the brain's contradiction-detecting module is disabled. Every new input is rolled into the storyline; nothing is rejected.

(In that vein, after years of carefully observing my own dreams, I recognize why certain twists in Alice in Wonderland are called "dream-logic.")

I don't know what that era's (1930s?) idea of mind-organization was, but it surely predates the Minskyian notion of multiple concurrent specialized agents. Specialized anatomy, yes, as 19cen injury-studies had already given us "Broca's area" and "Wernicke's area" etc. I wonder if practioners recognized the sheer kludginess of the brain, or if they (i.e., with what prevalence) were still stuck in a Biblical mindset of "we're God's creation, it must be a good design"?

[bunny-hugger.livejournal.com]

That doesn't even seem to require any special explanation. Lots of people believe they're right about things and other people are wrong about them when those beliefs are inconsistent; why would this be any different?

[seawasp]

Things like this are of interest to me in my SF novelist profession, because they show how even PROFESSIONAL good intentions can lead to trainwrecks of one kind or another. This kind of thing is *exactly* what caused the development and ultimately fall of the Hyperion Project in Grand Central Arena

[austin-dern.livejournal.com]

I just find it really incredibly interesting how intelligent, competent people can get together with good intentions and come out with a horrible decision. It seems like only unforeseeable outside accident ought to be able to induce that and yet it's all over the place, and is often fed by the group's own dynamics.

(Of course, groups coming to good decisions isn't so visible, and even overcoming slightly bad ones is going to pass without much comment since that's what's supposed to happen. What's left does have to be we-must-write-books-so-this-never-happens-again-class mistakes.)

[seawasp]

True. But for my purposes it's a reminder that Hyperion ISN'T one of the more far-fetched ideas in my novel; it's one that is too terribly possible if you give people the power of little gods and the freedom to use it.

[austin-dern.livejournal.com]

Oh, no, that's not far-fetched at all. I suppose the immersive-virtual-reality sides of it may be, but that's an implementation detail as I see it. The rest is really just sufficient wealth and the right social dynamics away.

[lexomatic.livejournal.com]

Given that we don't (didn't) know how to treat mental disorders of this nature, and the physicians knew what didn't work, experimentation seems justified. Their options include (speaking physically, not necessarily legally):

* Humor the delusional patient while keeping him institutionalized.
* Continually confront/contradict him with consensus reality.
* Euthanize him as inconvenient to society.
* Try something else.

The judgment call would be: when does continued application of "something else" cross the "do no harm" boundary of the Hippocratic Oath? (Which should probably be rephrased as "do no more harm than necessary or the patient is willing to accept," since otherwise how were traumatic battlefield amputations justified?) The issue with mental patients is they're not equipped to give informed consent to expermentation (but I suppose, if you've been institutionalized, someone else has that authority).

[austin-dern.livejournal.com]

Well, that was one of the early warning signs of ethical peril here: the research wasn't experimenting in ways to treat or cure the patients. They'd have been happy if they found one, certainly, but what they were interested in studying was more along the lines of ``why do these guys think they're Christ, anyway?'' and that lead into ``can we shake them out of it?''

Trouble is from there it's not far to start thinking of, ``this one feels the hospital's director is his father/father-figure/authority-figure, maybe we can have letters `written' by him telling the guy to do things'', and then, ``this one has an imaginary wife; if we wrote letters as her ... '' and then you see him standing outside the commissary hoping that maybe this will be the week she's able to come see him, the way she's been half-promising she will.

The guides on psychological experiments with humans, and on experiments with subjects who can't meaningfully consent, pretty much postdate this era of experiments (remember the Milgram shock experiments). I'm not expert on them, but I suspect that anything past the have-the-three-live-with-each-other would make the ethical review board look very, very seriously at just what was being proposed, and why, and what the possible benefits would be. That it wasn't at heart a search for useful treatments would be a major factor, I think.

[lexomatic.livejournal.com]

Aha. So the ethical line is between physician/treatment and psychologist/researcher. Assuming the participants see those as two distinct roles and consider ethics as applicable. Which, in London's hospital/prison of Bedlam (based on my minimal knowledge of the place and the nasty/brutish/short tenor of the times) they probably weren't.

This raises the interesting SFnal story premise of physicians for whom every patient is a potential experiment, and the patients are sufficiently selfless to accept this. Another premise involves "run off a disposable copy"-type milieus (Queendom of Sol, etc.) where you can induce a disorder. It also helps with repeatability.

And why wouldn't we apply ethics to patients? Possibly because we can have very narrow criteria for "behavior that identifies a human." With a physical injury, the patient still has acceptable responses, but with a psychopathology, maybe not. It's sometimes hard enough to accept small children, geriatrics or other cultures. And if the subject is, moreover, uncooperative? There's a reason for the idiom "patience of a saint." Some ethical responses appear to be instinctive but more abstract ones surely require attention, and attention is a limited mental resource.

[austin-dern.livejournal.com]

Well, as psychological experiments go, there are --- these days --- reasonably substantial guidelines given to how to ethically experiment on living subjects. There's no hope of reducing that to a couple paragraphs, but it does amount to a series of potential-harm and potential-risk versus potential-benefit calculations.

For example, deceiving a human patient is a major ``stop and think about the potential harm'' flag. Sometimes it's not possible to do without some element of deception; for example, if you're running a test on perception you might have to tell your patient you want them to count the number of times the basketball is passed when you're really interested whether they notice the guy in a gorilla suit running across the court. But in that case, the potential harm from the deception is so tiny almost no review board would object: none of the subjects are going to be harmed or even embarrassed when they find out what was really going on. Offering the company of an imaginary wife if the right things are done ... oh, that's bad.

Settings where it is possible to run off ``disposable'' copies of people, like the Queendom of Sol [1], would if you allowed that the copies could be maimed or killed allow for considerably more rigorous exploration of treatments for any kind of ailment, mental or physical, given the better ability to set up and maintain controls. Of course, there are enormous problems of morality to be dealt with in such a pretext, which can't be addressed because the only philosophy allowed in the genre of science fiction is utilitarianism cut with whatever brand of solipsism allows the protagonist to do anything he knows Must Be Done because all those other zombies don't care enough to do What's Right.

[1] I recall one of the main characters in the Queendom had made his fortune, uncharacteristically for science fiction, not in the field of having a lot of money but by getting the patent on the filter which filters out all the Bad Stuff from people who've gone through the wellstone plates and run off a fresh copy of themselves. It strikes me there should be a funny, that is, tragic version of this story where the Bad Stuff filter is from the equivalent of Thomas Midgley, full of ideas that are great except a generation later it turns out they're not so great after all.

[bunny-hugger.livejournal.com]

I wouldn't say there are any problems of morality in that scenario. A problem implies difficulty, and I think there is no difficulty at all in morally evaluating the practice of creating people to maim and kill them experimentally.