William Sargant
Encyclopedia
William Walters Sargant was a controversial British psychiatrist who is remembered for the evangelical zeal with which he promoted treatments such as psychosurgery
, deep sleep treatment, electroconvulsive therapy
and insulin shock therapy
.
Sargant studied medicine at St John's College, Cambridge
, and qualified as a doctor at St Mary's Hospital, London. His ambition to be a physician was thwarted by a disastrous piece of research and a nervous breakdown, after which he turned his attention to psychiatry. Having trained under Edward Mapother at the Maudsley Hospital
, he worked at the Sutton Emergency Medical Service during World War II
. In 1948 he was appointed director of the department of psychological medicine at St Thomas' Hospital
, London, and remained there until (and after) his retirement in 1972, also treating patients at other hospitals, building up a lucrative private practice in Harley Street, and working as a media psychiatrist.
Sargant co-authored a textbook on physical treatment in psychiatry that ran to 5 editions. He wrote numerous articles in the medical and lay press, an autobiography, The unquiet mind, and a book entitled Battle for the mind in which he discusses the nature of the process by which our minds are subject to influence by others. Although remembered as a major force in British psychiatry in the post-war years, his enthusiasm for discredited treatments such as insulin shock therapy and deep sleep treatment, his hatred for any form of psychotherapy
, and his reliance on dogma rather than clinical evidence have left him as a controversial figure whose work is seldom cited in modern psychiatric texts.
. His father was a City broker, his mother, Alice Walters, was the daughter of a Methodist minister from a family of wealthy Welsh brewers. Five of his uncles were preachers. He had two brothers—human rights campaigner Thomas Sargant
and bishop of Mysore Norman Sargant, and five sisters. Sargant went to the Leys School in Cambridge and then studied medicine at St John's College, Cambridge. He did not excel academically but played rugby for St Johns College, was president of Cambridge University Medical Society and collected autographs of famous medical men. Sargant obtained a rugby scholarship to complete his medical education at St Mary's Hospital. His father lost most of his money in the depression in the late 1920s and the scholarship allowed Sargant to continue his medical education. After qualifying as a doctor he worked as a house-surgeon and house-physician at St Mary's and looked set for a successful career as a physician. But in 1934—four years after qualifying as a doctor—a nervous breakdown and spell in a mental hospital put paid to his plans. Sargant would later attribute this period of depression to undiagnosed tuberculosis, although research which he conducted on the use of iron
, in very high doses, for the treatment of pernicious anaemia was not well received and this disappointment may have contributed to his breakdown.
On his recovery, Sargant worked as a locum at Hanwell Hospital
, and then for a while helped his brother-in-law at his Nottingham general practice, before deciding on a career in psychiatry. In 1935 he was offered a post by Edward Mapother at the Maudsley Hospital. In his autobiography Sargant describes how Mapother’s views coincided with his own: 'the future of psychiatric treatment lay in the discovery of simple physiological treatments which could be as widely applied as in general medicine'. Soon after he arrived at the Maudsley Sargant was involved in testing amphetamine
as a new treatment for depression and took it himself while studying for the diploma in psychological medicine. Sargant would take a variety of drugs to treat his depression throughout his life. Another treatment introduced at the Maudsley while Sargant was there was insulin shock therapy.
In 1938 Sargant was awarded a Rockefeller Fellowship to spend a year at Harvard Medical School
in Boston, Massachusetts, under Professor Stanley Cobb. Whilst there he did some experiments on over-breathing and developed a theory that the difference between normal and neurotic people is that the latter have lost their suggestibility. On a visit to Washington he arranged to meet Walter Freeman and see three of his patients who had undergone psychosurgical operations. Although the results were not altogether successful, Sargant resolved to introduce the operation into Britain.
On the outbreak of war in 1939 Sargant returned to Britain to find that the Maudsley had been evacuated and divided into two—one half going to Mill Hill school in North London and the other half setting up a hospital in the old Belmont
workhouse near Sutton, Surrey. Sargant was sent, along with H.J. Shorvon, clinical director Eliot Slater
, and medical superintendent Louis Minski to Belmont workhouse—renamed the Sutton Emergency Medical Service (in 1953 the name of the hospital would revert to Belmont). The hospital, which took both civilian and military patients, was jointly controlled by the Ministry of Health and London County Council
. Sargant described his frustration when London County Council medical advisors tried to curb his experimentation with new treatments such as electroconvulsive therapy
and psychosurgery
(also called leucotomy) but, as he said "we generally got our own way in the end". They were, for example, only allowed to carry out individual psychosurgical operations with the approval of the Council advisors. When the doctors advised against operation, Sargant got round this by sending patients to be operated on by Wylie McKissock
at St George's Hospital
, (where Eliot Slater was temporarily in charge of the psychiatric department). It was, he said, 'doing good by stealth'. But critics saw him as someone of extreme views who was cruel and irresponsible and refused to listen to advice; some suggested that he was motivated by repressed anger rather than a desire to help people. Sargant selected neurotic patients, especially those with obsessional ruminations, for operation, which carried with it a significant risk of death, personality deterioration, epileptic seizures, and incontinence.
After the Dunkirk evacuation the Sutton Emergency Medical Service received large numbers of military psychiatric casualties and Sargant developed abreaction
techniques - patients would relive traumatic experiences under the influence of barbiturates. He also used modified insulin treatment, electroconvulsive treatment and sedation in the treatment of military patients.
During the war Sargant wrote, together with Eliot Slater, a textbook - An introduction to physical methods of treatment in psychiatry, which was to run to 5 editions and be translated into several languages. In 1940 he married Peggy Glen whom he had met when she worked as a volunteer in the laboratory at Belmont. (There were no children.)
. He returned to England in August 1948 having been offered the position of head of the department of psychological medicine at St Thomas’, a teaching hospital in London. At that time the new department consisted of a basement with no in-patient beds, and no requirement on students to attend lectures on psychiatry. Sargant was to stay at St Thomas’s for the rest of his career, and he built the department up into an 'active treatment, teaching and research unit'. The basement was refurbished to use as an out-patient department (for electroconvulsive therapy, modified insulin treatment, methedrine injections, etc.), while the amalgamation of St Thomas’ and nearby Royal Waterloo Hospital
provided Sargant with a 22 bed ward for his in-patients (this was to become his ward for continuous narcosis or deep sleep treatment). Sargant's work at St Thomas' was funded by the NHS with support from the endowment funds of St Thomas' Hospital and gifts from private individuals.
Both at Belmont Hospital and at St Thomas', Sargant subjected patients to up to three months' combined electroconvulsive therapy, continuous narcosis, insulin coma therapy and drugs. He said in a talk delivered in Leeds
: "For several years past we have been treating severe resistant depression with long periods of sleep treatment. We can now keep patients asleep or very drowsy for up to 3 months if necessary. During sleep treatment we also give them ECT and anti-depressant drugs". Sargant used narcosis (sleep treatment) to overcome a patient's refusal of electroconvulsive therapy, or even deliver it without their knowledge. He wrote in his standard textbook An introduction to physical methods of treatment in psychiatry: "Many patients unable to tolerate a long course of ECT, can do so when anxiety is relieved by narcosis ... What is so valuable is that they generally have no memory about the actual length of the treatment or the numbers of ECT used ... After 3 or 4 treatments they may ask for ECT to be discontinued because of an increasing dread of further treatments. Combining sleep with ECT avoids this ...". Sargant also advocated increasing the frequency of ECT sessions for those he describes as "resistant, obsessional patients" in order to produce "therapeutic confusion" and so remove their power of refusal. In addition he states: "All sorts of treatment can be given while the patient is kept sleeping, including a variety of drugs and ECT [which] together generally induce considerable memory loss for the period under narcosis. As a rule the patient does not know how long he has been asleep, or what treatment, even including ECT, he has been given. Under sleep ... one can now give many kinds of physical treatment, necessary, but often not easily tolerated. We may be seeing here a new exciting beginning in psychiatry and the possibility of a treatment era such as followed the introduction of anaesthesia in surgery".
Sargant's methods inspired Australian doctor Harry Bailey
who employed deep sleep treatment at Sydney
's Chelmsford Private Hospital, eventually leading to the death of 26 patients. Bailey and Sargant were in close contact and apparently competed to see which of them could keep a patient in the depest coma. The death rate among Sargant's patients was lower than that among Bailey's, largely thanks to the nursing skills of the 'Nightingales' (St Thomas' nurses). Each sleeping patient was allocated a nurse or student nurse who would monitor their sleep every 15 minutes and wake them every six hours to feed and wash them and take them to the toilet. Some of the nurses disliked working in the narcosis ward, but a former ward sister defended the treatment, recalling patients as 'being pleased to be helped'. There were, however, several deaths.
It was Sargant's firm belief that anyone with psychological problems should be treated early and intensively with all available methods - combined if necessary. He referred to himself as "a physician in psychological medicine". The available methods, which Sargant also referred to as "modern" and "active" treatments, were drugs in large doses (antidepressants, amphetamines, barbiturates, tranquillisers, neuroleptics), electroconvulsive therapy, insulin coma therapy, continuous narcosis and leucotomy. Failures in treatment were put down to the patient's lack of a "good previous personality". (Sargant was fond of saying that you can't make a silk purse out of a pig's ear.) Such failures were sent from St Thomas' to the wards of mental hospitals.
The part-time nature of Sargant’s NHS contract at St Thomas' allowed him time to treat patients at other hospitals and establish a private practice on Harley Street (when he died he was worth over £750,000). He also wrote articles for the medical and popular press, appeared in TV programmes, and published an autobiography, The unquiet mind, in 1967. He was president of the section of psychiatry at the Royal Society of Medicine
in 1956-7, and was a founding member of the World Psychiatric Association
. In 1973 he was awarded the Starkey medal and prize by the Royal Society of Health for work on mental health.
A second bout of tuberculosis and depression in 1954 gave Sargant time to complete his book Battle for the mind (and also an opportunity for giving up his 30-year heavy smoking habit). He spent his convalescence in Majorca, and Robert Graves
helped him edit the book. Battle for the mind, published in 1957, was one of the first books on the psychology of brainwashing
. While this book is often referred to as a work on 'brainwashing', and indeed it is subtitled a physiology of conversion and brainwashing, Sargant emphasises that his aim is to elucidate the processes involved rather than advocate uses. In the book he refers extensively to religious phenomena and in particular Christian methodism
, emphasising the apparent need for those who would change people's minds to first excite them, as did the founder of Methodism, John Wesley
.
Sargant connected Pavlov
's findings to the ways people learned and internalized belief systems. Conditioned behaviour patterns could be changed by stimulated stresses beyond a dog's capacity for response, in essence causing a breakdown. This could also be caused by intense signals, longer than normal waiting periods, rotating positive and negative signals and changing a dog’s physical condition, as through illness. Depending on the dog's initial personality, this could possibly cause a new belief system to be held tenaciously. Sargant also connected Pavlov’s findings to the mechanisms of brain-washing in religion and politics.
Some of Sargant’s former colleagues remember him with admiration. David Owen
worked under Sargant at St Thomas' in the 1960s, before embarking on his political career, and recalled him as "a dominating personality with the therapeutic courage of a lion" and as "the sort of person of whom legends are made". But others, who preferred to remain anonymous, described him as "autocratic, a danger, a disaster" and spoke about "the damage he did".
Patients, too, recall their treatment at the hands of Sargant in very different terms. One man who consulted Sargant at his Harley Street private practice for depression in the 1960s later recalled "Will" with affection and respect. Visiting Sargant for a brief consultation every six months, he was given large doses of drugs and had a course of electroconvulsive therapy; he remembered his relief at being told that his depression was caused by chemical and hereditary factors and could not be resisted by an effort of personal will. But a woman who had been admitted to St Thomas' in 1970 with post-natal depression, and was left with memory loss after treatment with narcosis and electroconvulsive therapy, recalled her experience with anger.
British actress Celia Imrie
was admitted to St Thomas' Hospital when she was fourteen for the treatment anorexia
under the care of Sargant. She was given electroconvulsive therapy
and large doses of the anti-psychotic drug Largactil
and insulin. Imrie has written that her eventual cure was nothing to do with Sargant and his bizarre techniques.
broadcast a programme researched and introduced by James Maw entitled Revealing the Mind Bender General dealing with Sargant's activities and concentrating on his Sleep Room treatments at St Thomas's Hospital. Among the interviewees were his one-time registrar
David Owen, and a number of patients from St Thomas' as well as a survivor of the Porton Down experiments, who testified that their lives had been shattered by Sargant's treatments. Among the points that were brought out were the routine violation of patients' rights as regards giving consent for treatment; the fact that Sargant admitted in correspondence with an Australian lawyer that patients had died under his deep sleep regime; and the circumstance that all patient records at St Thomas's and the related health authorities relating to Sargant's activities have been destroyed, making it difficult - if not impossible - for patients to seek redress through the courts.
has suggested that Sargant's experiments with deep sleep treatment were part of British involvement with the CIA MKULTRA
programme into mind control
. Donald Ewen Cameron
was experimenting along similar lines in Canada, and it later emerged that his work was in part funded by the CIA. Cameron often sought Sargant's advice and on one occasion Sargant sent Cameron a note saying: "Whatever you manage in this field, I thought of it first". Books about Cameron's experiments have commented on links between the two psychiatrists. Although Sargant acted as a consultant for MI5, no evidence has emerged that his work with deep sleep treatment at St Thomas' hospital had any links with intelligence services.
"Though men are not dogs, they should humbly try to remember how much they resemble dogs in their brain functions, and not boast themselves as demigods. They are gifted with religious and social apprehensions, and they are gifted with the power of reason; but all these faculties are physiologically entailed to the brain. Therefore the brain should not be abused by having forced upon it any religious or political mystique that stunts the reason, or any form of crude rationalism that stunts the religious sense." (p. 274)
History of psychosurgery in the United Kingdom
Psychosurgery is a surgical operation that destroys brain tissue in order to alleviate the symptoms of mental disorder. The lesions are usually, but not always, made in the frontal lobes...
, deep sleep treatment, electroconvulsive therapy
History of electroconvulsive therapy in the United Kingdom
Electroconvulsive therapy is a controversial psychiatric treatment in which seizures are induced with electricity...
and insulin shock therapy
Insulin shock therapy
Insulin shock therapy or insulin coma therapy was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks...
.
Sargant studied medicine at St John's College, Cambridge
St John's College, Cambridge
St John's College is a constituent college of the University of Cambridge. The college's alumni include nine Nobel Prize winners, six Prime Ministers, three archbishops, at least two princes, and three Saints....
, and qualified as a doctor at St Mary's Hospital, London. His ambition to be a physician was thwarted by a disastrous piece of research and a nervous breakdown, after which he turned his attention to psychiatry. Having trained under Edward Mapother at the Maudsley Hospital
Maudsley Hospital
The Maudsley Hospital is a British psychiatric hospital in South London. The Maudsley is the largest mental health training institution in the country...
, he worked at the Sutton Emergency Medical Service during World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...
. In 1948 he was appointed director of the department of psychological medicine at St Thomas' Hospital
St Thomas' Hospital
St Thomas' Hospital is a large NHS hospital in London, England. It is administratively a part of Guy's & St Thomas' NHS Foundation Trust. It has provided health care freely or under charitable auspices since the 12th century and was originally located in Southwark.St Thomas' Hospital is accessible...
, London, and remained there until (and after) his retirement in 1972, also treating patients at other hospitals, building up a lucrative private practice in Harley Street, and working as a media psychiatrist.
Sargant co-authored a textbook on physical treatment in psychiatry that ran to 5 editions. He wrote numerous articles in the medical and lay press, an autobiography, The unquiet mind, and a book entitled Battle for the mind in which he discusses the nature of the process by which our minds are subject to influence by others. Although remembered as a major force in British psychiatry in the post-war years, his enthusiasm for discredited treatments such as insulin shock therapy and deep sleep treatment, his hatred for any form of psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
, and his reliance on dogma rather than clinical evidence have left him as a controversial figure whose work is seldom cited in modern psychiatric texts.
Early life and medical career
Sargant was born into a large and wealthy Methodist family in HighgateHighgate
Highgate is an area of North London on the north-eastern corner of Hampstead Heath.Highgate is one of the most expensive London suburbs in which to live. It has an active conservation body, the Highgate Society, to protect its character....
. His father was a City broker, his mother, Alice Walters, was the daughter of a Methodist minister from a family of wealthy Welsh brewers. Five of his uncles were preachers. He had two brothers—human rights campaigner Thomas Sargant
Thomas Sargant
Thomas Sargant was a British law reformer who campaigned for the promotion of human rights. He was educated at Highgate School.Sargant, for much of his life a businessman and politician, became increasingly concerned with the impact of the law and legal services upon ordinary people...
and bishop of Mysore Norman Sargant, and five sisters. Sargant went to the Leys School in Cambridge and then studied medicine at St John's College, Cambridge. He did not excel academically but played rugby for St Johns College, was president of Cambridge University Medical Society and collected autographs of famous medical men. Sargant obtained a rugby scholarship to complete his medical education at St Mary's Hospital. His father lost most of his money in the depression in the late 1920s and the scholarship allowed Sargant to continue his medical education. After qualifying as a doctor he worked as a house-surgeon and house-physician at St Mary's and looked set for a successful career as a physician. But in 1934—four years after qualifying as a doctor—a nervous breakdown and spell in a mental hospital put paid to his plans. Sargant would later attribute this period of depression to undiagnosed tuberculosis, although research which he conducted on the use of iron
Iron
Iron is a chemical element with the symbol Fe and atomic number 26. It is a metal in the first transition series. It is the most common element forming the planet Earth as a whole, forming much of Earth's outer and inner core. It is the fourth most common element in the Earth's crust...
, in very high doses, for the treatment of pernicious anaemia was not well received and this disappointment may have contributed to his breakdown.
On his recovery, Sargant worked as a locum at Hanwell Hospital
Hanwell Asylum
The County Asylum at Hanwell, also known as Hanwell Insane Asylum, and Hanwell Pauper and Lunatic Asylum, was built for the pauper insane and is now the West London Mental Health Trust ...
, and then for a while helped his brother-in-law at his Nottingham general practice, before deciding on a career in psychiatry. In 1935 he was offered a post by Edward Mapother at the Maudsley Hospital. In his autobiography Sargant describes how Mapother’s views coincided with his own: 'the future of psychiatric treatment lay in the discovery of simple physiological treatments which could be as widely applied as in general medicine'. Soon after he arrived at the Maudsley Sargant was involved in testing amphetamine
Amphetamine
Amphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
as a new treatment for depression and took it himself while studying for the diploma in psychological medicine. Sargant would take a variety of drugs to treat his depression throughout his life. Another treatment introduced at the Maudsley while Sargant was there was insulin shock therapy.
In 1938 Sargant was awarded a Rockefeller Fellowship to spend a year at Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
in Boston, Massachusetts, under Professor Stanley Cobb. Whilst there he did some experiments on over-breathing and developed a theory that the difference between normal and neurotic people is that the latter have lost their suggestibility. On a visit to Washington he arranged to meet Walter Freeman and see three of his patients who had undergone psychosurgical operations. Although the results were not altogether successful, Sargant resolved to introduce the operation into Britain.
World War II
On the outbreak of war in 1939 Sargant returned to Britain to find that the Maudsley had been evacuated and divided into two—one half going to Mill Hill school in North London and the other half setting up a hospital in the old Belmont
Belmont, Sutton
Belmont is a village in the London Borough of Sutton in southwest Greater London, England. It is located off the A217 road and near to Banstead Downs in Surrey. It is a suburban development situated 10.8 miles south-southwest of Charing Cross....
workhouse near Sutton, Surrey. Sargant was sent, along with H.J. Shorvon, clinical director Eliot Slater
Eliot Slater
Eliot Trevor Oakeshott Slater MD , was a British psychiatrist who was a pioneer in the field of the genetics of mental disorders. He held senior posts at the National Hospital for Nervous Diseases, Queen Square, London, and the Institute of Psychiatry at the Maudsley Hospital...
, and medical superintendent Louis Minski to Belmont workhouse—renamed the Sutton Emergency Medical Service (in 1953 the name of the hospital would revert to Belmont). The hospital, which took both civilian and military patients, was jointly controlled by the Ministry of Health and London County Council
London County Council
London County Council was the principal local government body for the County of London, throughout its 1889–1965 existence, and the first London-wide general municipal authority to be directly elected. It covered the area today known as Inner London and was replaced by the Greater London Council...
. Sargant described his frustration when London County Council medical advisors tried to curb his experimentation with new treatments such as electroconvulsive therapy
Electroconvulsive therapy
Electroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...
and psychosurgery
Psychosurgery
Psychosurgery, also called neurosurgery for mental disorder , is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under the Swiss psychiatrist Gottlieb Burckhardt...
(also called leucotomy) but, as he said "we generally got our own way in the end". They were, for example, only allowed to carry out individual psychosurgical operations with the approval of the Council advisors. When the doctors advised against operation, Sargant got round this by sending patients to be operated on by Wylie McKissock
Wylie McKissock
Sir Wylie McKissock, OBE was a British neurosurgeon. He set up the neurosurgical unit at the Atkinson Morley Hospital, was Britain's most prolific leucotomist , and president of the Society of British Neurological Surgeons.McKissock was born in Staines, Surrey. His parents were Alexander Cathie...
at St George's Hospital
St George's Hospital
Founded in 1733, St George’s Hospital is one of the UK's largest teaching hospitals. It shares its main hospital site in Tooting, England with the St George's, University of London which trains NHS staff and carries out advanced medical research....
, (where Eliot Slater was temporarily in charge of the psychiatric department). It was, he said, 'doing good by stealth'. But critics saw him as someone of extreme views who was cruel and irresponsible and refused to listen to advice; some suggested that he was motivated by repressed anger rather than a desire to help people. Sargant selected neurotic patients, especially those with obsessional ruminations, for operation, which carried with it a significant risk of death, personality deterioration, epileptic seizures, and incontinence.
After the Dunkirk evacuation the Sutton Emergency Medical Service received large numbers of military psychiatric casualties and Sargant developed abreaction
Abreaction
Abreaction is a psychoanalytical term for reliving an experience in order to purge it of its emotional excesses; a type of catharsis. Sometimes it is a method of becoming conscious of repressed traumatic events....
techniques - patients would relive traumatic experiences under the influence of barbiturates. He also used modified insulin treatment, electroconvulsive treatment and sedation in the treatment of military patients.
During the war Sargant wrote, together with Eliot Slater, a textbook - An introduction to physical methods of treatment in psychiatry, which was to run to 5 editions and be translated into several languages. In 1940 he married Peggy Glen whom he had met when she worked as a volunteer in the laboratory at Belmont. (There were no children.)
St Thomas' Hospital
After the war Sargant found it difficult to settle at the re-united Maudsley Hospital and applied - unsuccessfully - for positions elsewhere. In 1947 he was invited to spend a year as a visiting professor of psychiatry at Duke UniversityDuke University
Duke University is a private research university located in Durham, North Carolina, United States. Founded by Methodists and Quakers in the present day town of Trinity in 1838, the school moved to Durham in 1892. In 1924, tobacco industrialist James B...
. He returned to England in August 1948 having been offered the position of head of the department of psychological medicine at St Thomas’, a teaching hospital in London. At that time the new department consisted of a basement with no in-patient beds, and no requirement on students to attend lectures on psychiatry. Sargant was to stay at St Thomas’s for the rest of his career, and he built the department up into an 'active treatment, teaching and research unit'. The basement was refurbished to use as an out-patient department (for electroconvulsive therapy, modified insulin treatment, methedrine injections, etc.), while the amalgamation of St Thomas’ and nearby Royal Waterloo Hospital
Royal Waterloo Hospital for Children and Women
The Royal Waterloo Hospital for Children and Women was a hospital located on the corner of Waterloo Bridge Road and Stamford Street near Waterloo Station in London, England.- History :...
provided Sargant with a 22 bed ward for his in-patients (this was to become his ward for continuous narcosis or deep sleep treatment). Sargant's work at St Thomas' was funded by the NHS with support from the endowment funds of St Thomas' Hospital and gifts from private individuals.
Both at Belmont Hospital and at St Thomas', Sargant subjected patients to up to three months' combined electroconvulsive therapy, continuous narcosis, insulin coma therapy and drugs. He said in a talk delivered in Leeds
Leeds
Leeds is a city and metropolitan borough in West Yorkshire, England. In 2001 Leeds' main urban subdivision had a population of 443,247, while the entire city has a population of 798,800 , making it the 30th-most populous city in the European Union.Leeds is the cultural, financial and commercial...
: "For several years past we have been treating severe resistant depression with long periods of sleep treatment. We can now keep patients asleep or very drowsy for up to 3 months if necessary. During sleep treatment we also give them ECT and anti-depressant drugs". Sargant used narcosis (sleep treatment) to overcome a patient's refusal of electroconvulsive therapy, or even deliver it without their knowledge. He wrote in his standard textbook An introduction to physical methods of treatment in psychiatry: "Many patients unable to tolerate a long course of ECT, can do so when anxiety is relieved by narcosis ... What is so valuable is that they generally have no memory about the actual length of the treatment or the numbers of ECT used ... After 3 or 4 treatments they may ask for ECT to be discontinued because of an increasing dread of further treatments. Combining sleep with ECT avoids this ...". Sargant also advocated increasing the frequency of ECT sessions for those he describes as "resistant, obsessional patients" in order to produce "therapeutic confusion" and so remove their power of refusal. In addition he states: "All sorts of treatment can be given while the patient is kept sleeping, including a variety of drugs and ECT [which] together generally induce considerable memory loss for the period under narcosis. As a rule the patient does not know how long he has been asleep, or what treatment, even including ECT, he has been given. Under sleep ... one can now give many kinds of physical treatment, necessary, but often not easily tolerated. We may be seeing here a new exciting beginning in psychiatry and the possibility of a treatment era such as followed the introduction of anaesthesia in surgery".
Sargant's methods inspired Australian doctor Harry Bailey
Harry Bailey
Harry Richard Bailey was a controversial Australian psychiatrist. He bore the primary responsibility for treatment of mental patients via Sledge hammers, and other methods, at a Sydney mental hospital. He has been linked with the deaths of a total of 85 patients...
who employed deep sleep treatment at Sydney
Sydney
Sydney is the most populous city in Australia and the state capital of New South Wales. Sydney is located on Australia's south-east coast of the Tasman Sea. As of June 2010, the greater metropolitan area had an approximate population of 4.6 million people...
's Chelmsford Private Hospital, eventually leading to the death of 26 patients. Bailey and Sargant were in close contact and apparently competed to see which of them could keep a patient in the depest coma. The death rate among Sargant's patients was lower than that among Bailey's, largely thanks to the nursing skills of the 'Nightingales' (St Thomas' nurses). Each sleeping patient was allocated a nurse or student nurse who would monitor their sleep every 15 minutes and wake them every six hours to feed and wash them and take them to the toilet. Some of the nurses disliked working in the narcosis ward, but a former ward sister defended the treatment, recalling patients as 'being pleased to be helped'. There were, however, several deaths.
It was Sargant's firm belief that anyone with psychological problems should be treated early and intensively with all available methods - combined if necessary. He referred to himself as "a physician in psychological medicine". The available methods, which Sargant also referred to as "modern" and "active" treatments, were drugs in large doses (antidepressants, amphetamines, barbiturates, tranquillisers, neuroleptics), electroconvulsive therapy, insulin coma therapy, continuous narcosis and leucotomy. Failures in treatment were put down to the patient's lack of a "good previous personality". (Sargant was fond of saying that you can't make a silk purse out of a pig's ear.) Such failures were sent from St Thomas' to the wards of mental hospitals.
The part-time nature of Sargant’s NHS contract at St Thomas' allowed him time to treat patients at other hospitals and establish a private practice on Harley Street (when he died he was worth over £750,000). He also wrote articles for the medical and popular press, appeared in TV programmes, and published an autobiography, The unquiet mind, in 1967. He was president of the section of psychiatry at the Royal Society of Medicine
Royal Society of Medicine
The Royal Society of Medicine is a British charitable organisation whose main purpose is as a provider of medical education, running over 350 meetings and conferences each year.- History and overview :...
in 1956-7, and was a founding member of the World Psychiatric Association
World Psychiatric Association
The World Psychiatric Association is an international umbrella organisation of psychiatric societies.-Objectives and goals:Originally created to produce world psychiatric congresses, it has evolved to hold regional meetings, to promote professional education and to set ethical, scientific and...
. In 1973 he was awarded the Starkey medal and prize by the Royal Society of Health for work on mental health.
A second bout of tuberculosis and depression in 1954 gave Sargant time to complete his book Battle for the mind (and also an opportunity for giving up his 30-year heavy smoking habit). He spent his convalescence in Majorca, and Robert Graves
Robert Graves
Robert von Ranke Graves 24 July 1895 – 7 December 1985 was an English poet, translator and novelist. During his long life he produced more than 140 works...
helped him edit the book. Battle for the mind, published in 1957, was one of the first books on the psychology of brainwashing
Mind control
Mind control refers to a process in which a group or individual "systematically uses unethically manipulative methods to persuade others to conform to the wishes of the manipulator, often to the detriment of the person being manipulated"...
. While this book is often referred to as a work on 'brainwashing', and indeed it is subtitled a physiology of conversion and brainwashing, Sargant emphasises that his aim is to elucidate the processes involved rather than advocate uses. In the book he refers extensively to religious phenomena and in particular Christian methodism
Methodism
Methodism is a movement of Protestant Christianity represented by a number of denominations and organizations, claiming a total of approximately seventy million adherents worldwide. The movement traces its roots to John Wesley's evangelistic revival movement within Anglicanism. His younger brother...
, emphasising the apparent need for those who would change people's minds to first excite them, as did the founder of Methodism, John Wesley
John Wesley
John Wesley was a Church of England cleric and Christian theologian. Wesley is largely credited, along with his brother Charles Wesley, as founding the Methodist movement which began when he took to open-air preaching in a similar manner to George Whitefield...
.
Sargant connected Pavlov
Pavlov
-People:*Pavlov *Ivan Pavlov, a psychologist famous for his experiment in classical conditioning.-Places:*in the Czech Republic:**Pavlov **Pavlov **Pavlov **Pavlov...
's findings to the ways people learned and internalized belief systems. Conditioned behaviour patterns could be changed by stimulated stresses beyond a dog's capacity for response, in essence causing a breakdown. This could also be caused by intense signals, longer than normal waiting periods, rotating positive and negative signals and changing a dog’s physical condition, as through illness. Depending on the dog's initial personality, this could possibly cause a new belief system to be held tenaciously. Sargant also connected Pavlov’s findings to the mechanisms of brain-washing in religion and politics.
Some of Sargant’s former colleagues remember him with admiration. David Owen
David Owen
David Anthony Llewellyn Owen, Baron Owen CH PC FRCP is a British politician.Owen served as British Foreign Secretary from 1977 to 1979, the youngest person in over forty years to hold the post; he co-authored the failed Vance-Owen and Owen-Stoltenberg peace plans offered during the Bosnian War...
worked under Sargant at St Thomas' in the 1960s, before embarking on his political career, and recalled him as "a dominating personality with the therapeutic courage of a lion" and as "the sort of person of whom legends are made". But others, who preferred to remain anonymous, described him as "autocratic, a danger, a disaster" and spoke about "the damage he did".
Patients, too, recall their treatment at the hands of Sargant in very different terms. One man who consulted Sargant at his Harley Street private practice for depression in the 1960s later recalled "Will" with affection and respect. Visiting Sargant for a brief consultation every six months, he was given large doses of drugs and had a course of electroconvulsive therapy; he remembered his relief at being told that his depression was caused by chemical and hereditary factors and could not be resisted by an effort of personal will. But a woman who had been admitted to St Thomas' in 1970 with post-natal depression, and was left with memory loss after treatment with narcosis and electroconvulsive therapy, recalled her experience with anger.
British actress Celia Imrie
Celia Imrie
Celia Diana Savile Imrie is an English actress. In a career starting in the early 1970s, Imrie has played Marianne Bellshade in Bergerac, Philippa Moorcroft in Dinnerladies, Miss Babs in Acorn Antiques, Diana Neal in After You've Gone and Gloria Millington in Kingdom...
was admitted to St Thomas' Hospital when she was fourteen for the treatment anorexia
Anorexia nervosa
Anorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight. Although commonly called "anorexia", that term on its own denotes any symptomatic loss of appetite and is not strictly accurate...
under the care of Sargant. She was given electroconvulsive therapy
Electroconvulsive therapy
Electroconvulsive therapy , formerly known as electroshock, is a psychiatric treatment in which seizures are electrically induced in anesthetized patients for therapeutic effect. Its mode of action is unknown...
and large doses of the anti-psychotic drug Largactil
Chlorpromazine
Chlorpromazine is a typical antipsychotic...
and insulin. Imrie has written that her eventual cure was nothing to do with Sargant and his bizarre techniques.
BBC Radio Documentary
On 1 April 2009, BBC Radio 4BBC Radio 4
BBC Radio 4 is a British domestic radio station, operated and owned by the BBC, that broadcasts a wide variety of spoken-word programmes, including news, drama, comedy, science and history. It replaced the BBC Home Service in 1967. The station controller is currently Gwyneth Williams, and the...
broadcast a programme researched and introduced by James Maw entitled Revealing the Mind Bender General dealing with Sargant's activities and concentrating on his Sleep Room treatments at St Thomas's Hospital. Among the interviewees were his one-time registrar
Specialist registrar
A Specialist Registrar or SpR is a doctor in the United Kingdom and Republic of Ireland who is receiving advanced training in a specialist field of medicine in order eventually to become a consultant...
David Owen, and a number of patients from St Thomas' as well as a survivor of the Porton Down experiments, who testified that their lives had been shattered by Sargant's treatments. Among the points that were brought out were the routine violation of patients' rights as regards giving consent for treatment; the fact that Sargant admitted in correspondence with an Australian lawyer that patients had died under his deep sleep regime; and the circumstance that all patient records at St Thomas's and the related health authorities relating to Sargant's activities have been destroyed, making it difficult - if not impossible - for patients to seek redress through the courts.
MKULTRA
In recent years writer Gordon ThomasGordon Thomas
Gordon Thomas is a Welsh author who has written fifty-three books. The total sales of his works exceed 45 million copies. Thomas divides his time between his homes in Ireland and England, with his wife, an interior designer...
has suggested that Sargant's experiments with deep sleep treatment were part of British involvement with the CIA MKULTRA
Project MKULTRA
Project MKULTRA, or MK-ULTRA, was the code name for a covert, illegal CIA human experimentation program, run by the CIA's Office of Scientific Intelligence. This official U.S. government program began in the early 1950s, continued at least through the late 1960s, and used U.S...
programme into mind control
Mind control
Mind control refers to a process in which a group or individual "systematically uses unethically manipulative methods to persuade others to conform to the wishes of the manipulator, often to the detriment of the person being manipulated"...
. Donald Ewen Cameron
Donald Ewen Cameron
Donald Ewen Cameron , commonly referred to as "D. Ewen Cameron" or "Ewen Cameron," was a twentieth-century Scottish-born psychiatrist who was involved in the United States Central Intelligence Agency's research on mind control and served as President of the Canadian, American and World Psychiatric...
was experimenting along similar lines in Canada, and it later emerged that his work was in part funded by the CIA. Cameron often sought Sargant's advice and on one occasion Sargant sent Cameron a note saying: "Whatever you manage in this field, I thought of it first". Books about Cameron's experiments have commented on links between the two psychiatrists. Although Sargant acted as a consultant for MI5, no evidence has emerged that his work with deep sleep treatment at St Thomas' hospital had any links with intelligence services.
Quotes
"What would have happened if they [new methods of physical and chemical psychiatric treatments] had been available for the last five hundred years?... John Wesley who had years of depressive torment before accepting the idea of salvation by faith rather than good works, might have avoided this, and simply gone back to help his father as curate of Epworth following treatment. Wilberforce, too, might have gone back to being a man about town, and avoided his long fight to abolish slavery and his addiction to laudanum. Loyola and St Francis might also have continued with their military careers. Perhaps, even earlier, Jesus Christ might simply have returned to his carpentry following the use of modern [psychiatric] treatments.""Though men are not dogs, they should humbly try to remember how much they resemble dogs in their brain functions, and not boast themselves as demigods. They are gifted with religious and social apprehensions, and they are gifted with the power of reason; but all these faculties are physiologically entailed to the brain. Therefore the brain should not be abused by having forced upon it any religious or political mystique that stunts the reason, or any form of crude rationalism that stunts the religious sense." (p. 274)
Books written by William Sargant
- 1944 (with E Slater) An introduction to physical methods of treatment in psychiatry. Edinburgh: E & S Livingstone. 2nd edition (1948) Edinburgh: E & S Livingstone. 3rd edition (1954) Edinburgh: E & S Livingstone. 4th edition (1963) Edinburgh: Livingstone. 5th edition (1972) Edinburgh: Churchill Livingstone, ISBN 0-443-00868-X. Published in the US (1944) as An introduction to somatic methods of treatment in psychiatry. Baltimore: Williams and Wilkins
- 1957 Battle for the mind: a physiology of conversion and brainwashing. London: Heinemann. Reprinted in the US (1997) Battle for the mind: a physiology of conversion and brainwashing.Cambridge, MA: Malor Books, ISBN 1-883536-06-5
- 1967 The unquiet mind: the autobiography of a physician in psychological medicine. London: Heinemann
- 1973 The mind possessed: a physiology of possession, mysticism, and faith healing. London: Heinemann
External links
- Sargant's papers at the Wellcome Library
- A review of 'Battle for the mind'
- Extract from the chapter on insulin coma treatment in An introduction to physical methods of treatment in psychiatry (1st edition, 1944)
- Audio of 'Revealing the Mind Bender General'
- A website about Sargant's continuous narcosis experiments, set up by former patients