Hudson River State Hospital

[Hudson River State Hospital Old Building Drawin]
When I was first went into the Jesuits over 40 years ago, I lived at the novitiate in Poughkeepsie, NY. Part of our routine as novices was teaching "catechism" to elementary school-aged children in different venues every week. One of the two places I was assigned to teach at was the Hillcrest School for Children at the Hudson River State Hospital, located only about a half-mile down the road from the Jesuit facility. Actually, the Hillcrest School was set in the very back of the property, well away from the main entrance on Route 9 and we had to take a car back and forth for our weekly visits on Saturday afternoons. I suspect that the main reason for our going there, from the point of view of the hospital, was to give the young kids (they were aged about 6 to 14 years old) someone to talk to. My catechism students, as I recall, included two young brothers who had thrown their youngest baby brother out the window and an 8- or 9-year-old boy who heard voices all the time. My most vivid memory of Hillcrest itself was the temperature inside the building. It always seemed to be somewhere between 80 and 85 degrees in all seasons of the year. I was told that the reason for this was to keep the young patients perpetually fatigued and lethargic. Whether that was true, most of the other novices and me attempted as much as possible to go outside with our young charges onto the grounds of the hospital, both to run around the somewhat hilly area nearby, play a few games like catch, and escape the oppressive heat of their institutional home. I further recall a concerted attempt by at least some of the kids in season to search out and pick rhubarb that grew along the grassy knolls near Hillcrest.

Driving onto the property of the Hudson River State Hospital took visitors into a very different world than the one outside the hospital's stone walls. In the mid-1960s, the patient population living on the grounds of the facility could be numbered in the thousands (at its height, the hospital lodged about 9,000 patients in a mostly self-sustained and enclosed "total institution" as Erving Goffman would have termed it). As our car wound its way past the older buildings on the campus (the picture to the upper left is a drawing of the original "Kirkbride" building at HRSH), we would see many groups of patients being led from one place to another by staff members while, in other spots, patients were sitting in chairs or on benches simply staring out at whatever could be found nearby. It was, I recall, a very quiet environment and few of the mostly older and dilapidated-looking residents seem to speak at all to anyone nearby. Nonetheless, the grounds went on and on and occupied many tree-filled acres.

Psychologist Michael Britt, Ph.D. offers a glimpse into the Hudson River State Hospital (HRSH, later renamed the Mid-Hudson Psychiatric Center), in a recently-posted podcast interview on his website, The Psych Files. Dr. Roger Christenfeld, Research Director at a drastically-smaller current facility, discusses the history and therapeutic work of the HRSH in his interview with Britt. During 33 minutes, Christenfeld provides a glimpse of why the hospital was built and opened in 1869, what life was like for many patients in the late 19th and early 20th centuries, and how the notion of a state psychiatric facility changed profoundly after about 1955.

Target Link: Episode 27: From Insane Asylum to Psychiatric Center: A Brief History (33 minutes, the interview is in mp3 format and can be downloaded to your computer)

Associated Resources
  • Historic 51: A website devoted to the history of the Hudson River State Hospital. Includes many images and other information (e.g., a timeline) telling the story of the HRSH
  • Kirkbride Buildings: This website has photos of the "Kirkbride" style building at HRSH, a standard form for psychiatric asylum buildings in the 19th century. As the introduction to this site explains: "Once state-of-the-art mental healthcare facilities, Kirkbride buildings have long been relics of an obsolete therapeutic method known as Moral Treatment. These massive structures were conceived as ideal sanctuaries for the mentally ill in the latter half of the nineteenth century. Careful attention was given to every detail of their design in order to promote a healthy environment and to convey a sense of respectable decorum. Placed in secluded areas within expansive grounds, many seemed almost palace-like from the outside. But growing populations and insufficient funding led to unfortunate conditions that spoiled their idealistic promise."

Out of Body: Sensory Manipulation and the Experience of "Self"

Hermann Grid Illusion
Over the many years that psychologists have studied optical illusions, they have encountered a bewildering variety of strange experiences in the consciousness of their subjects. People saw things that weren't there or experienced the sensation of motion when none existed or found their perceptual set rapidly changing from one configuration to another. These decades of research and the findings of neuropsychologists about the make-up of the central nervous system led psychologists to propose something our "common sense" has difficulty understanding, namely, that our perception of the world is a very, very elaborate construction in which the nervous system builds a sophisticated experience of the world from multiple sources of sensory data. Optical or visual illusions, then, seem to uncover the seamlessness of that construction, to reveal to us how the brain has to weigh or evaluate what it receives from the senses in order to fabricate a meaningful and unified experience of the world and the self within that world. (In the Hermann Grid illusion on the right, we tend to see dark spots at the intersection of vertical and horizontal white lines, an perceptual artifact arising within the nervous system itself.)

In research that was just reported in latest issue of the journal, Science, two different teams of researchers at European universities have manipulated the visual and tactile sensory systems of study participants to induce the illusion that these persons were "out of their bodies". As Sandra Blakeslee reports in the New York Times (August 24, 2007):

Using virtual-reality goggles, a camera and a stick, scientists have induced out-of-body experiences — the sensation of drifting outside of one’s own body — in ordinary, healthy people, according to studies being published today in the journal Science. When people gazed at an illusory image of themselves through the goggles and were prodded in just the right way with the stick, they felt as if they had left their bodies. The research reveals that “the sense of having a body, of being in a bodily self,” is actually constructed from multiple sensory streams, said one expert on body and mind, Dr. Matthew M. Botvinick, an assistant professor of neuroscience at Princeton University. Usually these sensory streams, which include vision, touch, balance and the sense of where one’s body is positioned in space, work together seamlessly, Dr. Botvinick said. But when the information coming from the sensory sources does not match up, the sense of being embodied as a whole comes apart. The brain, which abhors ambiguity, then forces a decision that can, as the new experiments show, involve the sense of being in a different body.

The longer of the two studies (Lennenhager et al., 2007) offers this abstracted description of their findings:

Humans normally experience the conscious self as localized within their bodily borders. This spatial unity may break down in certain neurological conditions such as out-of-body experiences, leading to a striking disturbance of bodily self-consciousness. On the basis of these clinical data, we designed an experiment that uses conflicting visual-somatosensory input in virtual reality to disrupt the spatial unity between the self and the body. We found that during multisensory conflict, participants felt as if a virtual body seen in front of them was their own body and mislocalized themselves toward the virtual body, to a position outside their bodily borders. Our results indicate that spatial unity and bodily self-consciousness can be studied experimentally and are based on multisensory and cognitive processing of bodily information.

These results raise provocative questions about what it means to be a "self" and may actually move clinical researchers more deeply into an examination of neuroperceptual mechanisms in disorders such as schizophrenia. At the recent APA meeting in San Francisco, I heard a fascinating (and very difficult) paper by Louis Sass, Ph.D. of Rutgers (NJ) who presented a phenomenological model of schizophrenia, one which is rooted in defective processing of perceptual experience by the individual.

Target Articles
: (A) Ehrsson, H. H. (2007, August 24). The experimental induction of out-of-body experiences. Science, 317(5841), 1048. (B) Lenggenhager, B., Tadi, T., Metzinger, T, & Blanke, O. (2007, August 24). Video ergo sum: Manipulating bodily self-consciousness. Science, 317(5841), 1096-1099.
Newspaper Report: Blakeslee, S. (2007, August 24). Studies report inducing out-of-body experience. New York Times (Online).

Other Citations: Sass, L. A., & Parnas, J. (2001). Phenomenology of self-disturbances in schizophrenia: Some research findings and directions. Philosophy, Psychiatry, & Psychology, 8(4), 347-356. [LMC Access]

Sass, L. A., & Parnas, J. (2003). Schizophrenia, consciousness, and the self. Schizophrenia Bulletin, 29(3), 427-444. [
Abstract]

APA San Francisco (Fri): The Question of Torture

APA Welcome to San Francisco
Well, the annual APA convention has gotten underway in San Francisco at its usual venue downtown, the Moscone Center South (and West) plus some of the local hotels. I've been out in this area of California since almost the beginning of the month and, for the last week, have been visiting friends in the City. It has been an extraordinary August, so far: the fog has been minimal or absent in the mornings and the rest of the days have been sunny and warm. A rebuke to the supposed remark of Mark Twain ("the coldest winter I ever saw was the summer I spent in San Francisco") which he may or may not have said.
  
The pressing issue of this convention turns out to be the question of the torture of prisoners by the United States government's forces in places like Guantanamo Bay, the involvement of psychologists in developing or advising about interrogation techniques which are torturous, and the ethical lapses or failures of both these psychologists and the American Psychological Association itself in rejecting such activities. My first session this morning involved a symposium/discussion on the topic: "Ethics and Interrogations-Confronting the Challenge: What Does the Research on
Panel on Ethics & Interrogations @ APA
Interrogations Tell Us?" The room for this session was both filled with listeners and a host of people from the media who are here to cover the conference's various sessions on this topic. Indeed, I don't think in the 20+ years I have been attending APA meetings I have ever seen as many reporters and writers as I did today. Mark Costanzo (Claremont-McKenna) led off by describing what we know about coersive interrogation techniques and false confessions in the forensic/criminal justice world. He demonstrated the frequent occurrence of false confessions and the inability of the interrogators to identify when suspects are lying or not. Charles Morgan (Yale Medical School) offered a defense of many techniques and quibbled with notions like "do no harm" or objections to coersion, deception, and other similar issues which, he claimed, physicians routinely carry out in order to help their patients. He was later attacked by an questionner from the audience as a apologist for the government. Shara Sand (Yeshiva) read through the report of the Office of the Inspector General of the Defense Department about the SERE (Survival, Evasion, Resistence, and Escape) program and its supposedly sole use as a defensive, rather than offensive instrument by the American military. She detailed the connection between recent work on programs like SERE and early work (in the 1950s) on brainwashing and mind control by the CIA and DOD under the help and direction of psychologists and other behavioral specialists, the so-called MKULTRA program. Finally, Phil Zimbardo (Stanford) gave an incredibly lively and empassioned talk on the history of interrogation research (including his own very early, but ignored work in the 1950s) and made a sharp distinction between the positive findings of social psychology on how to foster rapport and a willingness to confess by suspects and the uniformly negative findings about interrogations employing coersive and abusive techniques. These, he stressed, regularly result in poor information and are often utterly a waste of time. The moderator/chair of the symposium, Bradley Olson (Northwestern), offered somewhat extended comments after each speaker despite his disclaimer that he would not be an "activist chair" (though he was). And while I agreed with many of his points, the structure of these off-the-cuff comments tended to wander and seemed to be out of place.

Demonstration against Torture @ APA San Francisco Meeting
APA: San Jose Says Stop the Torture

Later in the day, there was a demonstration in the Yerba Buena Gardens across from Moscone South by Psychologists for an Ethical APA. The crowd it attracted seemed to me to consist of about 200-300 pretty committed and enthusiastic. On Sunday morning, the APA Council of Representatives is going
APA Coersion is the Cloak of Cowards APA Psychologists for an Ethical APA APA A.P.A.THETIC traitors, Torture is Wrong
to take up a resolution which moves toward (but not quite endorse) the notion that there should be a moratorium by psychologists cooperating with the government in detainee interrogations (see these documents on this matter submitted to APA). The rest of the convention is going to have programming detailing different aspects of this topic (Ethics and Interrogation) through to Monday afternoon. It will be intriguing to see what the final outcome is going to be. Stay tuned.