克利福德·比尔斯：现代心理健康政策的起源(续一）

肖申克的救赎

比尔斯的成功开始于他的自传《一颗找回自我的心灵》

    比尔斯的成功在于发展起一个国家的，最终也是一个国际的运动，这一切开始于他的自传 《一颗找回自我的心灵》。他希望这本书能同《汤姆叔叔的小屋》一样能给读者以强烈的影响。在这本书中他追溯着他得病的历程。他是耶鲁大学毕业生,在商界有着前程远大的事业，在他事业刚起步的时候,他的一个兄弟死于癫痫，之后他患上了一种精神崩溃强迫性恐惧症。他变得非常绝望，试图去自杀。这导致了他独自渡过了一段糟糕的岁月，自愿地住进康涅狄格州的医院，最终他康复了，他决心改革对患有心理疾病的人的治疗。

    尽管在比尔斯之前也有其他的揭发事实，但没有一件像比尔斯叙述的那样影响深。Norman  Dain, 比尔斯的传记作者，评论道：“…其他揭发事实…描叙精神病院里的治疗是残酷的和不近人情的，但是大多数不太容易让人相信，因此它们没有起到有效的宣传作用”。

    比尔斯的自传抓住了感情这根敏感的弦和事情的因由。当他在揭发虐待事实时，他透露出大量的他内心的痛苦和迷茫，还有他在住院时的过激行为。他谴责护理人员那该诅咒的行为和医院里缺少内科医生的监督，因为他们会伸出援手保护他和其他不能遵守失去人性的医院常规的病人，但是他也承认他自己的病并显示出对内科医生的知识和能力相当多的尊敬。

    平衡的声音和《一颗找回自我的心灵》的主旨毫无疑问地增加了它的力量。Robert  Coles 曾建议到它也是一部文风有艺术质量的作品，从而使它有如此的效果。在1980年版本的序言里，Coles说道大多数揭发事实“唤起同情…或者也许是一种客观的理解，但是都没法比得上像这部能使道义上的敏感性拓宽的艺术作品那样引起更大的反应。”

   《一颗找回自我的心灵》毫无疑问的在道义上是有说服力的。读过它的大多数人都被书中透露出的痛苦而感到震惊，都被促使我们的社会行为对患有严重心理疾病的人变得仁慈博爱而感动。


                  比尔斯吸引重要的支持者是为了他的事业


    一开始比尔斯就能够吸引到非常重要的支持者。第一个是William  James, 他那个时代最重要的心理学家和美国哲学实用主义的奠基者之一。在比尔斯的自传出版之前，James为比尔斯打开了许多方便之门，包括他的出版人和一群有资源能发起一场运动的人。另外，在自传出版之前比尔斯赢得了Adolph  Meyer 的注意，那个时代最重要的精神病学家之一。当 Meyer 正在开设一家精神病院的时候,他被比尔斯的一些关于医院的大部分糟糕供述而震惊，他也相信医院也需要作较大的改革并认识到比尔斯有潜力能产生带来这种改革需要的一种公共支持。他和比尔斯形成了一种伙伴关系，他们给国家心理卫生委员会制定了最初的方向。

    比尔斯联合了一群对国家心理卫生委员会的成功不可缺少的有领导素质的人。他还使之在州和当地社区大量产生。

    ·他有一个清晰的，有力量的远见。

    · 他有很强的能力进行书面上的沟通和面对面的交流 .
     
    · 他有不断的决心意识到他的远见甚至要付出相当大的个人代价。（他积欠了一笔可观的私人债务来维持国家委员会的运行。）

    ·当他竭尽全力去缔造和维持联盟时，他能灵活地折衷各种关系，但是他也有勇气坚守自己的观点当他认为是在被批评的时候。

    ·他有敏锐的商业头脑。他能理解他设想的这个重要的事业不是一个人能完成的。从一开始他的目标就是建立一个统一的拥护社团。

    ·他知道他需要来自那些重要的非专业人士的道义和资金上的许诺，同时他也需要那些德高望重的心理健康专业工作者尤其是内科医生的支持。促使比尔斯心理健康运动的发展和扩大的那些非专业人士和心理健康专业工作者是一个名副其实的美国之家。(待续）


       Clifford Beers: The Origins of Modern Mental Health Policy

An Essay by Michael B. Friedman, CSW
First published in The Mental Health News, Fall 2002



Beers' Success Began with His Autobiography, A Mind That Found Itself


Beers' success in developing a national, and ultimately an international movement, began with his autobiography, A Mind That Found Itself. He hoped that it would have an impact on the scale of Uncle Tom's Cabin. In it he traced the course of his illness. He was a graduate of Yale University at the beginning of a promising career in business when he developed an obsessive fear of mental collapse subsequent to the death of a brother from epilepsy. His despair became so great that he attempted suicide. This led to the terrible years he spent in private, voluntary and state hospitals in Connecticut and eventually to his recovery and his determination to reform the treatment of people with mental illnesses.

Although there had been other exposés before Beers', none had the impact that Beers' account did. Norman Dain, Beers' biographer, comments,

"…other exposés…described treatment in asylums as cruel and inhumane, but most went beyond credulity, so that they were not effective propaganda…".
Beers' autobiography has the ring of truth and reason. While exposing abuses, he revealed a great deal about his inner suffering and confusion and about his provocative behavior when he was in the hospital. He condemns the abusive behavior of attendants and lack of supervision exerted by the physicians who should have helped to protect him and other patients who could not comply with dehumanizing hospital routines, but he also acknowledged his own illness and showed considerable respect for the physicians' knowledge and abilities.

The balanced voice and substance of A Mind That Found Itself unquestionably contributes to its power. Robert Coles has suggested that it is also the artistic quality of the writing that makes it so effective. In the Preface to the 1980 edition, Coles says that most exposés "prompt compassion…and maybe a kind of clinical understanding, but not the larger response that a work of art commands-a broadened moral sensibility."

A Mind That Found Itself is, unquestionably, morally compelling. Most people who read it feel horrified by the suffering it reveals and are moved to help to humanize our society's actions towards people with serious mental illnesses.

Beers Attracted Prominent Supporters for His Cause
From the beginning Beers was able to attract very prominent supporters. The first was William James, the most important psychologist of his day and one of the founders of American philosophical pragmatism. James helped to open many doors for Beers prior to the publication of the autobiography, including to his publisher and to a number of people who had the resources to help to found a movement. In addition, Beers won pre-publication interest from Adolph Meyer, one of the most prominent psychiatrists of the era. While Meyer-who ran a psychiatric hospital-was disturbed by some of Beers' most troubling allegations about hospitals, he too believed that hospitals needed substantial reform and recognized that Beers had the potential to generate the kind of public support that was needed to bring reform about. He and Beers formed a partnership which gave the National Committee on Mental Hygiene its initial directions.

Beers combined a number of leadership characteristics that were essential to the success of the National Committee on Mental Hygiene and of the state and local societies that it spawned.

He had a clear, powerful vision.
He had remarkable ability to communicate in writing and face-to-face.
He had unending determination to realize his vision even at considerable personal cost. (He ran up a significant personal debt to get the National Committee going.)
He had the flexibility to compromise when he had to in order to forge and preserve alliances, but he also had the courage to stick to his own views when he thought it was critical.
He had sharp business acumen. And he understood that an enterprise of the magnitude that he imagined could not be the work of one man. From the start his goal was to build a unified advocacy community.
He knew that he needed the moral and financial commitment of prominent lay people and that he also needed the support of the most highly regarded mental health professionals-particularly physicians. The laypeople and mental health professionals who joined Beers in the development and expansion of the mental health movement were a veritable who's who of America.(to be continued)

http://mhawestchester.org/advocates/beers802.asp