15

WARD 11

As Bill shuffled the deck for another round of crazy eights, a miraculous series of events was unfolding a few yards away inside the same hospital on a special unit called Ward 11.

The idea for Ward 11 was sparked in the mountains of Big Sur at Esalen Institute. Most people of a certain age know of Esalen thanks to its notoriety—Naked therapy! Orgies! Drugs! (And, more recently, many may recognize it as the setting of Mad Men’s finale episode, where Don Draper experiences his “I’d like to buy the world a Coke” aha moment.) Two years before Bill’s hospitalization, a Life magazine article skewered Esalen. It reads like satire: “Not only do people publicly neck and nuzzle like teenagers, but they sit on each other’s laps like babies. And they cry a lot. Crying is a sort of status symbol.”

Despite the bad press, Esalen was a key incubator for the growing counterculture and human potential movements as everyone from movie stars, businessmen, and bored housewives tapped into their better selves. Attendees participated in programs like “The Value of the Psychotic Experience.” Bob Dylan visited. R. D. Laing lectured. Joan Baez was basically an artist in residence. Charles Manson showed up with one of his girls and performed an impromptu concert days before the Tate murders. During the heady first decade, you may have rubbed shoulders with anyone from British philosopher and Eastern culture disseminator Alan Watts; to chemist Linus Pauling, one of the founders of quantum mechanics and molecular biology; to writer Ken Kesey; psychologist B. F. Skinner; and quite possibly to social psychologist David Rosenhan. Despite the debauchery and celebrity worship, the goal—to offer a peaceful oasis away from the world’s soul-crushing conformity—was a legitimate one dreamed up by Esalen co-founders Mike Murphy and Dick Price, who had barely survived his experiences on the other side of sanity.

Dick Price was supposed to follow in his successful father’s footsteps: attend a respectable school, major in economics, and settle down with a suitable wife. Instead he pursued a degree in psychology and developed an interest in Eastern religions after taking a class by Frederic Spiegelberg on the Hindu text Bhagavad Gita, which championed the pursuit of a “dharma” or path that each enlightened person is destined to fulfill. He seemed back on the straight and narrow when he enlisted in the air force—if you ignored the fact that he spent his nights at The Place, a nightclub in San Francisco’s North Beach neighborhood, frequently haunted by Allen Ginsberg and poet Gary Snyder. Soon Price met a dancer and fell hard. On the night he met her, he heard a disembodied voice say: “This is your wife.” The two married. It all sounded poetic, even though it was the beginning of Dick’s unraveling.

His behavior grew odder, even within the affectedly strange and drugged-out Beatnik scene. One night at a bar in North Beach he was hit by an urge: “He felt a tremendous opening up inside himself, like a glorious dawn,” wrote political scientist and author Walter Truett Anderson in his book The Upstart Spring. The feeling was: “I’m a newborn, I should be celebrated.” Price began repeating: “Light the fire, light the fire,” over and over, spooking the bartender, who called the cops. Price ended up in handcuffs and woke up in a psychiatric hospital at the Parks Air Force Base, where he fought aides and was sequestered in a padded isolation room. He threw himself against the walls, believing that there was an “energy field” around him that protected him from injury and pain. There he received his first in a series of electroshock therapies.

Dick’s family moved him to a fancier private hospital across the country in Hartford, Connecticut, called the Institute of Living. On the surface, the institute had more in common with a country club than a hospital. A Victorian main mansion, surrounded by cottages and research buildings, stood on ornate grounds designed by Frederick Law Olmsted, the chief architect of Manhattan’s Central Park. Patients could pick from a fleet of chauffeur-driven Packards, Lincolns, and Cadillacs. There was even an in-house magazine, The Chatterbox, which once ran an illustration of glamorous patients wading around the pool.

But these images only told the stories the institute wanted to share. Though the hospital catered to the rich and famous with its putting greens and fancy cars, it also deployed the experimental treatments of the era—lobotomies, ECT, and insulin coma therapy. The institute’s psychiatrist-in-chief, Dr. Francis J. Braceland, had deep attachments to the Catholic Church and admitted priests who had been sent by archdioceses to be “cured” of their “disorders.” Pope Pius XII knighted him in 1956, the same year that Dick entered the hospital, where doctors diagnosed him with paranoid schizophrenia.

At the Institute of Living, Dick lived on the locked ward, his “private prison,” where he was subjected to cutting-edge “treatments.” During his stay he underwent ten electroshock therapies, doses of Thorazine, and what Dick called “the complete debilitator,” insulin coma therapy. Viewed at best as malpractice, this therapy, which involved inducing comas with insulin to cure psychosis, went out of style by 1960 after a series of articles revealed that there was no scientific evidence to back the dangerous, sometimes lethal procedure.

This is what Dick would have faced: After a series of tests—blood work, heart rate monitoring—a nurse would inject the insulin. As his glucose levels fell, Dick would sweat and salivate; his breathing would slow and his pulse quicken. Gradually, unconsciousness would blanket him. Patients would sometimes drool so much that nurses would have to sop up the saliva with sponges. Sometimes the skin burned hot, the muscles twitched, and the patient would jerk. Often a seizure would occur, which doctors saw then as a sign that the treatment was working. Glucose injections followed, administered intravenously or via a thin rubber tube inserted through the nose and into the stomach, bringing the patient back to life (if they were lucky).

During the year he spent at the institute, Dick Price said he underwent fifty-nine of these therapies. The naturally trim Price, a born athlete, put on over seventy pounds, since the insulin treatments caused ravenous hunger. He fell into a stupor, wandering around the halls as if he were in “a pool of molasses” until something clicked inside him: He had to get out. After learning how to successfully cheek his Thorazine, Dick convinced his father to get him off the locked ward and onto an open one. On Thanksgiving Day 1957, he was released. (Another famous Institute of Living resident, screen actress Gene Tierney, would later call her stay there “the most degrading time of my life… I felt like a lab rat.”)

Dick Price returned to California, where he hooked up with Mike Murphy, whose family owned the land on which the two men would build Esalen, their dream retreat, which they opened to the public in 1962. Price envisioned Esalen as a place that “would serve people coming to this type of experience and there would not be the drugging or the shocking—that was my main motivation.” He believed that madness should be taken seriously, probed, embraced, and examined as a path to insight. He saw Esalen as a place to “live through experience” and facilitated this approach by providing treatments like encounter therapy, bodywork (massage, Rolfing, and sensory awareness), and psychedelic drugs. Dick was influenced by the work of Fritz Perls, a German psychotherapist in residence at Esalen, who created Gestalt therapy, which pushes people to focus on the present moment.

R. D. Laing came to Esalen in 1967, speaking in his enchanting Scottish brogue about his work at Kingsley Hall, a house in the East End of London that provided therapeutic supportive housing as an alternative to hospitalization. Kingsley Hall was a utopian place, Laing said, with no de-individualization, no power struggles over keys, no forced meds, where people engaged in twenty-four-hour therapy sessions and meditated. (He didn’t mention the young woman who smeared feces on the walls, the LSD sessions, the drug raids, or the parade of celebrities who gawked at the scene, but that’s a different story.)

That same year psychologist Julian Silverman, a National Institute of Mental Health schizophrenia researcher, arrived at Esalen to teach a seminar on “Shamanism, Psychedelics, and the Schizophrenias.” He wasn’t your typical buttoned-up doctor type. Silverman had befriended the Grateful Dead and followed the teachings of John Rosen, the inventor of “direct analysis,” which used psychotherapy to treat schizophrenia by basically babbling with the patient. (Rosen later lost his license after patients accused him of sexual and physical abuse, landing him on the long list of doctors who exploited people under their care then and now.) Silverman and Price hit it off, and out of their friendship grew Ward 11, a way to scientifically test Laing’s therapeutic housing theories.

Dick Price offered to supply funding from Esalen’s coffers, and the National Institute of Mental Health supplied grants. Somehow they convinced Agnews to allow them access to a ward where they could conduct the experiment. Maurice Rappaport and Voyce Hendrix (yes, he’s a close relative of that Hendrix) joined in to work in “ding dong city,” as Silverman lovingly called it.

They selected a few Agnews staff members, vetted to be young, far out, and open-minded, to travel to Esalen to learn Gestalt therapy. The staff discouraged separation created by “the cage” and set up a quiet vigil room, where anyone who felt overwhelmed could get away and sit and pray or just think. Staff members were to interact with the patients as much as possible. Patients were allowed to roam freely throughout the ward—a big no-no in most hospitals, which steer patients into dayrooms so that they can be watched from the cage. The criteria were simple: Men between the ages of sixteen and forty, recently diagnosed with schizophrenia without prolonged history of mental illness, would live on Ward 11. They wanted patients with no prior hospitalizations—most of them were “first breaks.” Half would receive nine tablets a day of the typical course of Thorazine, a minimum of three hundred milligrams a day, while the other half would receive a placebo. (Interestingly, Bill Dickson himself, who was in a nearby ward, did fit the above criteria. It’s possible that he was considered for inclusion in the study, but he is confident he was never included.)

The beginning was rough, to put it mildly. “The first thing we did was take some patients from the hospital and take them off medication. They broke all the windows the third day,” Alma Menn, a social worker on Ward 11, told me.

The new freedom created some friction, it seemed.

“We only really had one fire,” Alma added.

The fire occurred during a visit by a psychotherapist, who lugged in a bin of toys, dolls, and musical instruments to facilitate playacting with adults. The staff rifled through the props alongside the patients. That’s when the fire department walked in.

“Of course I had been holding my skirt on my head and playing like a mermaid. We all had an instrument and were playing music,” Alma said. “[The firemen] walked around the corner and there was a patient who’d been in bed and was standing at the drinking fountain with a cup trying to put out the fire that he had started on his mattress.”

The result of all this playing was published in the 1978 paper “Are There Schizophrenics for Whom Drugs May Be Unnecessary or Contraindicated?” The paper showed that of the eighty patients studied, the placebo group showed greater improvement than its drugged counterpart, though both groups showed improved long-term outcomes over patients undergoing “typical” hospitalizations.

Rappaport’s study added to the growing backlash against the “take your drugs” approach endemic to the traditional hospital settings. Patient groups, who now called themselves psychiatric survivors, had already started pushing against this refrain by filing class-action lawsuits against Big Pharma as many patients experienced permanent, disfiguring side effects. Suddenly these miracle drugs didn’t seem so miraculous—in some cases they were downright dangerous.

Rappaport et al. gave an alternative approach scientific basis—though mainstream psychiatry successfully dismissed the findings as fringe science, missing the larger picture that the creation of a supportive environment had actually improved clinical outcomes for everyone. Something as simple as sitting and eating together, as listening, as goofing around, as playing dress-up, as being part of a community seemed to help.

Even though mainstream psychiatry ignored it, a series of “med-free sanctuaries” sprouted up around California. The most prominent person to take on the mantle of Ward 11 was Loren Mosher, the head of the NIMH’s Center for Studies of Schizophrenia, who saw an opportunity to take Ward 11 to the next level. He recruited Ward 11’s cast of characters—including Alma Menn and Voyce Hendrix—to start Soteria House, an experiment in communal living located in a twelve-room Victorian house in downtown San Jose. Here a group of six people who would have ended up in an asylum lived together outside of it. The average stay was forty-two days—much shorter than the six-month average in an institutional setting—while the total doses of antipsychotic medications were three to five times lower. Papers published extolled the value of the environment and the success rate of using minimal antipsychotic drugs. As at Laing’s Kingsley Hall, there was neither commitment nor forced medication. One of the board members who helped mold Soteria House—and here it all comes full circle—was David Rosenhan, in the midst of the success of his groundbreaking study whose theories questioned the powers of traditional psychiatry and its hospitals.

Over twelve years the outcomes of people living at Soteria, named after the Greek goddess of safety and salvation, varied. There were a few suicides. Some got worse and had to be hospitalized, but many reported that Soteria House was a transformative and ultimately healing experience. One former Soteria resident I interviewed credits his current life—he is a successful technology salesman with a wife and two children—to Soteria. It’s easy to dismiss Soteria House, as many do (and as I did at first), but its mission captured something essential missing from the institutional model: focusing on the patient, not the illness.

The Soteria model continues in places like Alaska, Sweden, Finland, and Germany. There are echoes of it in the clubhouse model, which predates Soteria but provides similar restorative support, along with housing and employment opportunities to people living with serious mental illness. We see it also in Geel, a small town in Belgium with a long history of providing a safe haven to those with mental illness, where foster families in the community adopt “guests,” not patients. In Trieste, Italy (where a young Sigmund Freud first studied the sexual organs of eels), people are respected as members of the community with access to care across a wide spectrum of needs, along with supportive social networks.

The legacy of Agnews’s Ward 11 is a long one. Sadly, Esalen’s Dick Price probably did not get to bask in the immediate celebrations surrounding the launch of his successful research study. Just before the project commenced in 1969, Price suffered another break. He began ranting about “having more kingdoms to conquer,” believing that he had channeled a whole host of historical figures, including Napoleon and Alexander the Great, and spent ten days in, of all places, Agnews State Hospital. Price did eventually recover and returned to Esalen, where he lived peacefully until his death in 1985.