Over the Edge
‘Absorbingly interesting’, wrote Bertrand Russell to William Sargant in 1957, on reading an advance copy of his book Battle for the Mind; ‘I have not enough medical knowledge to form a critical estimate of your theory but it is the kind of theory I feel inclined to accept’. He was a little puzzled, however, as to why Sargant had included a foreword stressing that his book was not an attack on religion. ‘There is no more materialism involved’, he wrote, ‘than in the generally accepted truth that alcohol intoxicates’. But Sargant was anticipating greater resistance. He replied: ‘We shall find out how many are still terrified by the thought that they may be ruled by their brains rather than their souls!’.
Battle for the Mind was the public showcase for Sargant’s claim to have discovered a universal truth: that the human brain has a hidden back door through which its programming can be hijacked and overwritten. When subjects are driven over the edge by relentless stresses or stimuli such as drumming, dancing or drugs, their rational faculties and willpower are disabled; the mental slate can be wiped clean, and the most bizarre beliefs imprinted so deeply that they are powerless to doubt them. Although this mechanism had lain undiscovered through history, the techniques and practices that induce it had controlled humanity, in Sargant’s words, ‘from the Stone Age to Hitler’.
Sargant’s theory caught the wave of Cold War paranoia about ‘brainwashing’ that began with the Stalinist show trials of 1936-8 and had been heightened during the 1950s by the mysteriously glazed confessions of the Hungarian Cardinal Mindszenty and the US pilots shot down over North Korea. His chilling descriptions of Pavlovian conditioning dovetailed with rumours that Stalin had extracted from Pavlov techniques for human manipulation that he had never committed to print. His status as a leading psychiatrist both drew on and enhanced the profession’s postwar mystique, and the book’s startling photographs of orgasmic trance states, from bare-breasted voodoo ceremonies to Appalachian serpent-handling cults, combined sensationalism with clinical authority. Sargant’s reduction of faith to mental programming – describing John Wesley as ‘the greatest brainwasher of the last two hundred years’ – presented a stark image of a modern world that had outgrown religious consolation but was not yet mature enough to resist the new forms of control rising up to replace it.
Sargant’s vision was endorsed by the top ranks of the British intelligentsia. Even more enthusiastic than Bertrand Russell was Aldous Huxley, who had already explored the extremes of religious fanaticism and possession in The Devils of Loudun (1952). In its appendix he had drawn chilling parallels with the modern age of brainwashing: ‘Herded into mobs’, he wrote, humanity en masse is liable to ‘fall into a state of heightened suggestibility, resembling that which follows an injection of sodium amytal…while in this state they will believe any nonsense bawled at them, will act upon any command…’. Huxley welcomed Sargant’s ‘enlightening book’ in his Brave New World Revisited (1958), and spread its influence considerably through his lectures and broadcasts. The following year Sargant noted with delight that ‘Aldous Huxley mentioned the book on television and this had the immediate result of selling over 1000 copies the next week!’.
Sargant’s transition from psychiatrist to populist was aided by his collaboration with the poet Robert Graves, who reworked his original manuscript extensively, adding classical and Shakespearian references that, in Sargant’s archly Pavlovian phrase, ‘certainly make the saliva flow’. Along with literary gloss, Graves contributed the preface that Bertrand Russell found too apologetic: both he and Sargant were concerned that without it the book would be seen simply as an attack on religion, and its deeper message lost. This was also the reason Graves gave for keeping his co-authorship ‘as much as possible in the shadows’, as he put it: ‘I am Public Enemy No. 1 to the churches’.
Battle for the Mind brought together researches from within and outside Sargant’s psychiatric career; it was both highly idiosyncratic and unmistakably a product of its times. He came from a family of devout Methodists, and although he had long rejected their faith he had their missionary zeal. From the beginning his career had been a crusade for mental illness to be viewed and treated as a physical disease of the brain. It was characterised by the search for the magic bullet: a drug potent enough to ‘wipe the slate clean’ and allow the brain’s deep structures to be reprogrammed. Whenever a new drug or physical therapy emerged, he would be among the first to try it – and if it failed, to double the dose, or the voltage.
Throughout his career, Sargant’s defense of his extreme methods would return to the horrors of Hanwell Mental Hospital, where he first worked as a locum in the early 1930s: a grim Victorian asylum where the majority of patients had been ‘put away’ for life, kept docile by bromides and straitjackets. The latest therapeutic ideas revolved around the theories of Freud and his associates, but it was abundantly clear to Sargant that talking cures would never heal more than a tiny percentage of these chronic cases. At the same time, evidence was emerging from the wider medical world that so-called ‘mental illness’ could be responsive to physical treatment. The dementia of tertiary syphilis was now treatable by the new ‘magic bullets’ of salvarsan or the malaria ‘fever cure’. Other experimental therapies, such as electric shock treatment for depression, seemed poised to reduce further intractable categories of mental illness to treatable brain disorders, and establish psychiatry on a solid bedrock of clinical medicine.
When he joined the staff of the Maudsley Hospital in 1935 Sargant found a regime receptive to these ideas. The superintendent, Edward Mapother, was an old-time Victorian neurologist distrustful of intellectuals and their theories and open to practical experiments. Sargant, who by his own account revered Mapother ‘to the point of hero-worship’, joined battle with him against both the Freudians and the left-liberal proponents of ‘community therapy’ who saw the roots of mental illness in poverty and social exclusion. Together they pioneered aggressive interventions such as ECT and huge doses of barbiturates and insulin.
Yet in his many tellings of the Hanwell story, there was one crucial fact Sargant always omitted: he himself had been institutionalised there as a patient. He had originally wanted to be a teaching hospital physician, and his first job was as a medical superintendent at St. Mary’s in Paddington. He began researching pernicious anaemia, then a chronic condition that could only be treated by eating liver; almost immediately, he announced a dramatic breakthrough, claiming it could be more effectively treated with massive doses of iron. He wrote papers that were published in the British Medical Journal and the Lancet, but his theory was conclusively shot down: it turned out it was not the iron in liver that made it effective, but the complex of chemicals that would later be known as Vitamin B-12. Sargant subsequently fell into a severe depression and was hospitalised for several months.
His depressions, which would recur throughout his life, complicate the no-nonsense certainty of the persona Sargant projected. For some colleagues (such as his one-time registrar David, now Lord Owen) his sensitivity to depression, though concealed behind a carapace of bullish optimism, gave him a profound insight into his patients and their needs. For others, his hidden story revealed him as a physician manqué: drummed out of his chosen profession, he was determined to demonstrate that psychiatry, despite its lower prestige, was ‘proper medicine’ in its own right. His lifelong contempt for talking cures could be seen as an insistence that there was no hidden story to be uncovered; his heroic therapies and extreme doses take on a darker tinge as expressions of frustration or rage at stubbornly persistent mental conditions that mirrored his own; and his reductive physical theories could be read as a lifelong quest to wipe away the stigma of mental illness, for his patients and for himself.
It was during the Second World War that Sargant discovered the power of drugs to push the mind over the edge and allow the psychiatrist to reorder its contents. In 1940 his Maudsley department was reassigned to the Sutton Emergency Hospital, an old workhouse and tramp hospice in Surrey, and tasked with treating the sufferers of ‘war neurosis’ flooding in from Dunkirk, the Battle of Britain and the Blitz. Sargant, along with his friend and superintendent Eliot Slater, began experimenting with injections of sodium amytal, barbiturates and pentothal: sedatives that some in psychoanalysis and the military had begun to refer to as ‘truth drugs’. With large doses, Sargant discovered, some soldiers would begin to talk about their experiences, return to the source of their trauma and even, with prompting, relive it in all its emotional intensity. He discovered that ether was the best drug for ‘artifical excitement of mounting degree’: he would strap subjects down and hold the mask over their face while telling them urgently that they were trapped in a burning tank or exposed behind enemy lines. ‘Physical restraint’, he noted, ‘adds to their excitement’. If more stimulus was needed, he would inject them intravenously with methamphetamine. In a series of papers crammed with dramatic case histories, he claimed that by the end of the war he had treated 10,000 casualties, with many spectacular testimonies of success (‘I feel fine. I am a different fellow!’).
Sargant described this process as ‘abreaction’, a term adopted from Josef Breuer and Sigmund Freud’s technique of relieving hysteria by ‘talking it out’. During the First World War it had been attempted with hypnosis; Sargant’s heroic version, predicated on powerful physical and chemical stimuli, positioned him at the cutting edge of medicine, a position cemented by the textbook he co-authored with Slater that appeared in 1944, An Introduction to the Physical Methods of Treatment in Psychiatry. It would remain a standard work for decades, its last edition emerging in 1981; over the years its list of abreactive drug treatments would swell to include everything from carbon dioxide to mescaline, psilocybin and LSD. Sargant’s pharmacopeia was in constant flux, his treatment modalities always peppered with caveats such as ‘may increase instability’ and ‘many patients are unsuitable’. Breakthroughs were announced in each new edition, but the studies to support them emerged more rarely, and those discredited were quietly dropped.
After the war Sargant was invited to spend a year as a visiting professor at Duke University in North Carolina, and it was here that his ideas took on dimensions that carried them beyond the confines of psychiatry. Shortly after the Normandy invasion he had met an American military psychiatrist, Major Howard Fabing, who had pressed on him with the zeal of a convert a series of lectures entitled Conditioned Reflexes and Psychiatry, delivered by Ivan Pavlov shortly before his death in 1936.
In Pavlov Sargant found his master theorist, an anti-Freud for the biopsychiatry vanguard. Pavlov’s experiments with dogs had shown that reflexes could not only be conditioned but, under particular forms of stressful stimulus, broken down and reprogrammed. Some character types were more resistant to stress than others but, animal or human, all would eventually be driven through the same stages of collapse: exhaustion would be followed by a breakdown in conditioned behaviour, succeeded by negative or opposite forms of previously established traits. From this point Pavlov’s ungainly terms for the stages of this process – ‘equivalent’, ‘paradoxical’ and ‘ultraparadoxical’ – took on a prominent role in Sargant’s work, setting it apart from the psychiatric mainstream and giving his writings a hermetic aura, alluring to some and exasperating to others.
His discovery of Pavlov awoke his curiosity about the phenomenon of religious conversion, with its similar power to erase and rewrite all previous conditioning. Five of his uncles had been Methodist preachers, and his childhood had been populated by adults who ‘had been suddenly and spiritually changed, as it were in the twinkling of an eye’. Re-reading John Wesley’s Journals, he was struck by how closely the hysteria whipped up by his sermons paralleled his own chemically-enhanced abreaction sessions at the Sutton Emergency Hospital. Delving into William James’ The Varieties of Religious Experience, he was astonished to discover that the distinctive markers of the conversion experience could be recognised throughout history, from Mohammed to Saint Teresa to born-again Baptism. He took advantage of Duke University’s location to attend the services of North Carolina’s backwoods revivalists, where he witnessed the congregation handling live poisonous snakes and surrendering to hysterical twitching fits that they called ‘exercises of the spirit’. He took photographs to document the facial expressions of mounting tension and terror that preceded the collapse into the arms of God.
Sargant returned to London with his star in the ascendant. He left the Maudsley to become head of the department of psychological medicine at St. Thomas’ Hospital, where he began training up a cadre of junior psychiatrists and developing therapies such as ECT, insulin coma and methedrine abreaction. In public lectures, Sargant hailed his regime as ‘an exciting new beginning in psychiatry’, comparable to the introduction of anaesthesia in surgery. His duties to the newly established NHS left him plenty of time for private practice on Harley Street, for which he was in great demand (he would even, for a suitable fee, undertake talking cures, at which he was quietly rather good). Moving into a Regency apartment behind Lord’s cricket ground alongside publishers, actors and politicians, he felt he had finally attained the status of the senior doctors at St. Mary’s whose Daimlers he had admired and envied as a medical student.
But in 1954 his career was interruped by a recurrence of the tuberculosis that, as a teenager, had put an end to his promising rugby career; his slow recovery was dogged by a severe, though unacknowledged, recurrence of depression. The new drug streptomycin cured the TB, but there was no such magic bullet for his mental condition (he turned down offers of psychotherapy). Instead he reluctantly gave up smoking and went to recuperate in Majorca, where he met Robert Graves and shared with him his convalescent reading on Pavlov and religious conversion.
Graves, who was enthusiastically working Gordon Wasson’s theories about ancient mushroom cults into his new edition of The White Goddess, was equally quick to interpolate Sargant’s ideas into his classical visions of Corybantic rites, Dionysian dithyrambs and oracular possession. He offered to help Sargant turn the material into a popular book against the advice of his friend George Simon, a radiologist at St. Bart’s who told him that Sargant was ‘a charming man known for his eccentric views on lobotomy and hallucinogenic drugs’. Flat broke, Graves ignored Simon and asked for a third of the royalities, which turned out to be considerable.
After Battle for the Mind, Sargant’s energies began to ebb away from psychiatric practice and towards popularising his theories. He loved public speaking and broadcasting, and the entrée that his fame gave him to worlds beyond his professional life. Over the following decade he became a global media figure: filming documentaries, travelling to international conferences and networking with the elite of the emerging consciousness-expansion movement. Although his response to the sixties counterculture was cartoonishly reactionary – he wrote newspaper articles warning that ‘drug traffickers in central London watch for ecstatic dancers to find their prey’, who have made themselves suggestible by ‘hyperventilation and rhythmic head movements’ – he was intensely curious about the hidden world of the swinging sixties. Sexual orgasm, he believed, produced a similar state to trance and possession, and he researched its use in spiritual traditions from tantric Hinduism to the group orgiastic rites of Aleister Crowley.
The swinging sixties were a congenial environment for a media-friendly psychiatrist whose theory of abreaction gave him a specialist interest in sex, drugs, trance, possession and voodoo. Popular interest in the extremes of human experience was fed by journals such as the partwork encyclopaedia Man, Myth and Magic; Sargant was invited onto its editorial board, and in turn invited its editor Richard Cavendish to perform Robert Graves’ role in polishing his follow-up book, The Mind Possessed.
Psychedelic drugs were, naturally, a subject of particular interest, and one where he regarded the counterculture as ignorant gatecrashers, having worked with LSD and psilocybin in the fifties. He was dismissive of the claims now being made for the psychedelic experience, which he regarded as intrinsically meaningless: its true significance was its ability to impress any belief, no matter how absurd, with religious certainty. These drugs were a potent tool for indoctrination, whether in the hands of shamans, psychiatrists or hippie priests.
Yet while he was making this global lap of honour at the climax of his career, the foundations of Sargant’s world were being turned upside down. In anthropology, a new generation of ‘participant-observers’ were championing the primitive against the civilised: he was shocked to discover at a conference on ‘Possession States’ at Paris in 1968 that ‘some of the anthropologists present had acquired a semi-belief in the gods whose cults they studied’. For Sargant, this was missing the point on an epic scale: throughout history these suggesible states had been manipulated by the priestcraft who allowed access to the trance, and who had exploited the power it gave them to control the minds of their community. There was no spiritual wisdom to be found here, only a functional glitch in the brain, and a sleep of reason from which humanity was finally waking.
Closer to home, his profession was becoming less friendly. Psychiatry had been revolutionised since the mid-fifties by chlorpromazine (Largactyl), the first of the antipsychotic drugs that had proved more effective and far less damaging than ECT and lobotomy. Sargant hailed it as the promise of his physical therapies fulfilled and the beginning of the end of mental illness, yet he persisted with therapies such as a ‘deep narcosis’ regime of continuous sedation, where severe depressives were kept asleep twenty hours a day for up to three months, taken from their beds only for toilet visits and ECT sessions. The gusto with which he played his role as Cold War alarmist made him a figure of fun to a new generation of psychiatrists who found his heroic therapies ethically dubious and his reductive theories ever less plausible. Despite having built his department from a rat-infested basement to a dynamic teaching clinic, he was never offered a professorship at St. Thomas’. Outside the hospital, the voices of the emerging anti-psychiatry movement were becoming more strident: the likes of Sargant, and not his patients, were the true psychopaths.
Sargant came to see his mission in ever grander perspective. ‘The whole process of civilisation’, he wrote in 1973, ‘depends almost entirely on a number of people being born in each new generation who have important new beliefs and ideas, and hold on to them with obsessional tenacity’. The modern world was adrift, its population swayed and manipulated by forces that were understood only by a handful of specialists. Its future depended on humanity summoning its powers of reason, but ‘the last dread paradox’ was that the power of reasoned argument was severely limited: minds ‘can only be changed radically and swiftly by the methods we have been considering’. People could be manipulated to do most things, but not to choose freedom.
In 1975 he was offered the biggest stage yet on which to play his role: the trial of Patty Hearst, the heiress kidnapped by the Symbionese Liberation Army and filmed two months later carrying out a bank robbery together with them, armed with an M1 carbine. When she was finally captured a year later she gave her occupation as ‘urban guerilla’; her defence team claimed that she had been brainwashed. The trial was a global sensation, and the defining legal test for the reality of brainwashing; Sargant was contacted by the defence attorney Al Johnson, conducted five lengthy interviews with Hearst and prepared an expert witness statement. In it he wrote that Hearst’s state of mind, and her ‘nervous over-breathing’, reminded him of the battle exhaustion he had witnessed in World War 2. He testified that her initial confinement by the SLA had been enough to force a conversion to anything: ‘Had I personally been subjected for nine weeks to such mental stresses, I should have been unable to resist’. He concluded that her renunciation of her bourgeois life had been an involuntary ‘ultraparadoxial’ conversion, comparable to the moment when ‘the fleeing exhausted rabbit suddenly turns and runs into the mouth of the pursuing stoat’.
But this defence was problematic from the start. In correspondence with Johnson, Sargant suggested that juries might prefer the term ‘conversion’ to ‘brainwashing’, with its now dated resonances of the McCarthy era and the Red Scare. The prosecution offered a contrasting picture of Hearst as the child of a new era: one characterised, at least for privileged members like herself, by expansive personal freedoms and restless self-fashioning in search of new identities. Against Sargant’s image of a brainwashed and broken victim were set the defiantly posed photos of Patti in beret and army fatigues, toting her sawn-off rifle in front of the SLA’s blazon of a seven-headed cobra. As the trial progressed it became ever more plausible that Hearst was unrepentant, and the brainwashing defence had been the idea of her family who were unable to believe she might have chosen voluntarily to become a terrorist. Sargant was never called to testify, and the jury agreed with the prosecution that Hearst’s robbery was an act of free will. The battle for the mind was over, for all but the determined few.
Originally delivered as a lecture at Altered Consciousness, Queen Mary College, 17/11/2013