On June 1, a landmark decision was handed down by Justice
Paul Perell of the Ontario Superior Court of Justice against the defendants the
government of Ontario and two former Oak Ridge psychiatrists—Dr. Elliott
Barker, who is hailed as the mastermind behind Oak Ridge’s therapy program, and
Dr. Gary Maier—Barker’s successor. This suit (for damages) was launched by 31 of
the men who had been “patients” (read: inmates) at Oak Ridge during the years
1966-1983. According to the ruling of the judge, three of the programs to which
the “patients” were subjected constitute torture (see https://www.theglobeandmail.com/news/national/doctors-at-ontario-mental-health-facility-tortured-patients-court-finds/article35246519/),
and as such, there was a violation of fiduciary responsibility.
As one of the many
activists who fought to get the horrors at Oakridge stopped over the years and indeed
kept finding remnants of the horror persisting long after the 1983 date (see
Burstow, 1986), I am relieved that at least a few of the victims have lived to
see a modicum of justice —nonetheless, given the extent of what transpired, additionally,
the possibility of appeal, I am caught between cheering and crying.
So what is Oak Ridge?
What is this judgment all about? And what are the lessons to be gleaned here?
Starting
in 1933, for 81 years Oak Ridge was the maximum security forensic unit of
Penetanguishene Mental Health Centre (Ontario)—a place where Ontario men were
incarcerated who were found “criminally insane” or “unfit to stand trial”. What
was wrong with this place was more than just the bad treatment and human rights
violations typical in institutions of the ilk—not that the “usual” is remotely
acceptable. Beginning in the early 1960s, largely at the direction of Barker, Oak
Ridge introduced and developed what it called the STP (Social Therapy Program).
And it is precisely the ingredients of this “therapy” that have been deemed
torture—three central aspects of it specifically named so.
Touted by its creators as the height of enlightenment and dubbed
“Buber Behind Bars”, in a 1968 article of that same name published in The Canadian Psychiatric Association Journal
(http://www.oakridgeclassaction.ca/document/vol%203/Vol%203%20%20sec%20%201.pdf),
two of the program’s initial architects described and defended it as follows: “Psychopathology”
is a disturbance in communication, and accordingly, forcing the “patient” into
non-stop encounter with others (also called dialogue)—a central feature of STP—would
force them to examine themselves, thereby cure them. Despite the Buberian overlay,
seemingly recognizing some resemblance to Third Reich doctoring here, Barker
and Mason went on to state, “If the process were one of eradicating a set of
disapproved ideas . . . then we would be committing offences as grievous as
those involved in The Third Reich . . . On the other hand, if our patients did
not choose to deviate from society’s norms but rather were driven to such deviations
by internal unresolved conflicts, then we should have them resolve such
conflicts by every means at our disposal, including force, humiliation, and
deprivation . . . And this force will not be lifted until he changes his
behaviour.” A gut-wrenching bit of reasoning, to say the least, and yet the
world welcomed this development with open arms!
So what were the primary components of “Social Therapy”? Besides
solitary and sleep deprivation, which were pervasive (both of which the judge deemed
tortuous), were three subprograms, all of which the justice ruled to be
torture. While a detailed overview of the programs is beyond the scope of this
article [for such detail, see my 1986 article “Oak Ridge before and after the Hucker
Report”] (http://www.psychiatricsurvivorarchives.com/phoenix/phoenix_rising_v6_n2.pdf), in short, the subprograms in question were: 1)
Defence Disruptive Therapy (DDT); 2) Motivation, Attitude, Participation (MAPP),
and 3) the capsule.
DDT consists of forcing hallucinatory drugs on “patients” to
break down their defences and hypothetically force them to confront their
unacceptable behaviour. Patients subjected
to this “treatment” for obvious reasons, walked around delirious.
Far more extensive, and arguably even more torturous was the
Motivation Attitude and Participation Program, in which “patients” were kept for
hours at a time one day after another generally for fourteen days on end, typically
on the floor, not allowed to move a muscle, often chained to one another while
being overseen by “patient teachers” who had authority over them, would punish them
for the slightest movement, even force them to take drugs, all of this
transpiring in a confine which McGuire describes as “three square feet” (see https://www.thestar.com/news/canada/2017/06/08/treatment-at-ontario-mental-health-facility-was-torture-judge-rules.html)
This hyper-surveillance and disciplining by “patient-teachers”, I would add,
continued on for some time after MAPP was officially cancelled.
Finally, nothing compares with the horror of the capsule,
the part of “social treatment” ironically that seems to have inspired Barker to
call STP “Buber behind Bars”. In a tiny room, patients were kept chained to one
another, naked, forced to “encounter” each other for hours on end, day after
day—and with the only food which they imbibed during the “treatment” being
liquid, which was fed to them via straws emerging through tiny holes in the
walls. Herein we appear to be witnessing Barker’s understanding of “healing dialogue” and “total encounter”,
though clearly what was happening was torture.
Is it any wonder that those subjected to this “treatment” were
severely traumatized?
Now eventually, after decades of scandal, the most gruesome
features of STP were discontinued. And recently, the Oak Ridge site itself was
closed. Would that such torture had never been allowed in the first place! And
would that at least some semblance of justice for the victims (the 31 litigants
represent but a fraction of the victims) had been meted out decades ago! All of
which brings me to ponder what has materialized here—and I invite readers to do
the same.
There are of legions of questions that cry out to be answered:
With reports of the horrid abuse at Oak Ridge surfacing frequently over the
years, and with Barker’s own articles conveying a sense minimally of profound
violation, how could this travesty have continued unabated for so long? What is
wrong with the world and with the “therapeutic” community in particular that what
happened here was hailed as a major advance? If STP was called “punishment”
instead of “help”, could anything remotely this invasive have been practiced? And
while what happened is an extreme, given that extremes “write large” the
typical, and in so doing illuminate it, what does this tell us about the
relationship between “mental health” practices and social control generally?
A few more questions, to bring the focus squarely into the
here-and-now: Why is the current and laudable protest against the use of
solitary in prisons not being coupled by an equally voracious protest against
its use in “mental health facilities”? Can anyone really believe that solitary is
“torture” for one population and “necessary treatment” for another? Correspondingly,
in light of the flagrant abuse that went on in Oak Ridge for decades, how is it
that the University of Toronto and Waypoint have recently mounted a digital
commemorative archive of Oak Ridge, which is up for all to see on the internet
now, moreover, which is more laudatory than not (called “Remembering Oak Ridge,
see https://historyexhibit.waypointcentre.ca/). Indeed the impression created is that what
Barker introduced was good and the problems leading to the Ridge’s closure were
simply created by his successor Maier, who, being hippy-like, overdid the use
of psychedelic drugs! Contrast this with the tenor of the various archives dedicated
to Third Reich atrocities—the reference point that the Barker himself
introduced—and the problem with our response to our own human rights violations
becomes crystal clear.
That noted, there is indeed something to celebrate today—not
only the Perell verdict per se, which is decidedly enlightened, but the wording
accompanying it. Note in this regard, after stating that “torture is torture”
irrespective of either intent or how it is seen at the time, Justice Perell went
on to say, “It is a breach of a physician’s ethical duty to physically and mentally
torture his patients even if the
physician’s decisions are based on what the medical profession at the time
counts for treatment for the mentally ill [my emphasis] (see https://www.theglobeandmail.com/news/national/doctors-at-ontario-mental-health-facility-tortured-patients-court-finds/article35246519/)
What in essence this means is that the fact that something
is accepted “medical practice” does not legally absolve practitioners of
wrong-doing. Herein we have ruling by a judge that can be cited as precedence. Moreover
one that willy-nilly invites society to re-examine current practice.
Is not all seclusion torture—whether it happens in a prison
or something called a “hospital”? What about involuntary treatment itself? Moreover,
given that no less reputable an organization than the United Nations has
declared that forced psychiatric treatment could be considered torture (see
Minkowitz, 2014), and given that every state in the world is blithely ignoring
such pronouncements, should these states not be held accountable, beginning
with our own?
Correspondingly, if hallucinatory drugs can be ruled torture
and a breach of fiduciary responsibility even though it was accepted at the
time, how about the current use of “electroconvulsive therapy” or ECT, what with
the grand mal seizures produced, the eradication of memory, the terror instilled,
the profound interference with ability to navigate life? (for details on these
ECT realities, see Burstow, 2006); alternatively, examine survivor testimony at
https://coalitionagainstpsychiatricassault.wordpress.com/articles/personal-narratives/).
More generally still, are not both biological and
institutional psychiatry to a degree at any rate inherently torturous?
Be that as it may, the bottom line is that not only is torture
still happening, it remains rampant in the “mental health area”; and it has to
stop. The good news is that we now have a verdict that can serve us. Let’s start utilizing this ruling, this
precedence to penalize and in the process begin putting an end to current abuse—tortuous
practices, that is, that pass as acceptable largely because they constitute “standard”
practice. Lawyers, survivors, advocates, let’s put our heads together on this.
Meanwhile, psychiatrists, be forewarned. And if for no other
reason than self-protection, give some thought to what you yourself may be complicit
in.
References
Burstow, B. (1986).
Oak Ridge: Before and after the Hucker Report. Phoenix Rising, Fall, 1986: pp. 25-29.
Burstow, B. (2006). Electroshock as a
form of violence against women, Violence
Against Women, Vol. 12, No. 4: pp. 372-392.
Minkowitz, T. (2014). Convention on the Rights of Persons
with Disabilities and liberation from psychiatric oppression. In Bonnie
Burstow, Brenda LeFrançois, and Shaindl Diamond, Psychiatry disrupted (pp. 129-144). Montreal: McGill-Queen’s
University Press.