Significant changes began in the early 1900s in terms of medicine and psychiatry. Laboratory science allowed scientists to explore the brain for causes of mental illness. Neurologists and microbiologists concluded that mental illness was a disorder of the nervous system. With this information, psychiatric illnesses were now viewed as medical problems. Psychoanalysis, developed by Sigmund Freud as a method of analyzing people’s lives, was used as an effective way to determine how stresses stemmed from negative influences of childhood events.
Although there were positive new developments, an admission to a State Hospital was scary, shameful to the family, and various methods of treatment were used in the hope of treating mentally ill people. These included electroconvulsive therapy (which was first called electroshock therapy), insulin therapy (which induced comas in patients by the injection of insulin), induced seizures, hydrotherapy (the wet sheet pack, the continuous bath), fever therapy, and for some people, a lobotomy. These mentally ill people were many times labeled as “lunatics.” It was no wonder then that mental illnesses were kept a secret. I know if I had to go through that in the early part of the 20th century, I would have been scared to death myself.
Women and children were still treated as property. Women couldn’t vote and had no real control over their lives. Women and children were beaten, molested, raped, and threatened with further violence if they said anything – just like they are today. So, the thought of studying the impact of violence in the home, a man’s private castle, was not a possibility.
It would have been helpful if the psychiatric community had learned from the earlier studies on multiple personalities and the combat experiences of WWI, but those studies had little impact on psychiatric thought. Prior to the war, psychoanalysis had focused on the denial or repression of unacceptable inner drives. Denial of external reality was considered to be indicative of severe psychopathology or a weak ego. The war experience, however, showed that denial could be used by normal persons in an adaptive-or maladaptive-fashion. Dissociative states such as feelings of depersonalization, derealization, and detachment from one’s body, and amnesia and fugues, which, like denial, were commonly associated with trauma.1
After WWII in the 1950s, almost 40 years later, the public still viewed mental illness as a stigmatized condition. The public was not particularly skilled at distinguishing mental illness from ordinary unhappiness and worry and tended to see only extreme forms of behavior – namely psychosis – as mental illness. In fact, mental illness was linked with unpredictable and violent behavior.2 But at the same time, people discounted the unpredictable and violent behavior of the bullies, alcoholics, and child molesters in their families which contributed to mental illness. That was all kept a secret just like it is still kept a secret today.
With no understanding of the psychological effects of trauma, especially attributed to the internal stressors on young victims of child abuse, the film The Three Faces of Eve starring Joanne Woodward burst upon the scene in 1957 and sensationalized the diagnosis of Multiple Personality Disorder. The average American had no frame of reference to understand the effects of trauma or that of dissociation. The medical community did nothing to explain the diagnosis to the public, and to this day, having multiple personalities/alters is still believed to be a rare aberration among very sick people.
In 1961, Dr. C. Henry Kempe, then president of the American Academy of Pediatrics, held a conference on the “battered child syndrome” in which he outlined a “duty” to the child to prevent a repetition of trauma.” The Battered Child Syndrome Conference resulted in many states passing laws to protect children from physical abuse. The work is generally regarded as one of the most significant events leading to professional and public awareness of the existence and magnitude of child abuse and neglect in the U.S. and throughout the world. In response to The Battered Child, the Children’s Bureau held a symposium on child abuse, which produced a recommendation for a model child abuse reporting law. That was over 50 years ago, and the long-term impact of child abuse is STILL not addressed as a high national priority.
1 “Conversion Disorders,” by Edwin A. Weinstein M.D., War Psychiatry, Office of the Surgeon General, Borden Institute, Walter Reed Army Medical Center, Washington, D.C. 1995
2 “Mental Health: A Report of the Surgeon General,” U.S. Department of Health and Human Services, 1999