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Recent verdict against 'Oak Ridge Torturers' has major implications for psychiatry

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 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 1983, 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 such institutions -- 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 published in The Canadian Psychiatric Association Journal, 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 confinement 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 (see my 1986 article "Oak Ridge before and after the Hucker Report"), 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" 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 14 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 confined space of about three square feet. 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," although 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. 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 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.

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 -- a reference point that 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. 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" (emphases mine).

What 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, 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? 

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.

The original version of this article can be found here.

Image: York U/ahp

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