The upcoming PBS documentary Cured begins by compelling us to experience, at a visceral level, just how much Americans hated and feared homosexuality. Not that long ago, there was no public outcry directed at governments that had declared homosexuality a crime, churches that had declared homosexuality a sin, and psychiatry—the focus of Cured—that had declared homosexuality a sickness.
Cured is the story of how gay activists forced the American Psychiatric Association (APA) in 1973 to rescind its declaration that homosexuality is a psychiatric illness and, ultimately, to remove it from their DSM manual of disorders. Cured is a powerful piece of filmmaking, and I suspect that even if one has neither a personal reason to be thankful for the bravery of these gay activists nor a personal reason to be appalled by the arrogance and barbarism of psychiatry, one may still well be touched by filmmakers Bennett Singer and Patrick Sammon’s documentary, scheduled to be broadcast on PBS’s Independent Lens on October 11 (National Coming Out Day).
Barbaric is a strong word, but Cured viewers will not consider it to be an unfair description of psychiatry’s “treatments” for homosexuality, which included talk therapy but did not stop there. Cured graphically details the use of electroconvulsive therapy (ECT), commonly known as electroshock, to “cure” homosexuality,” as filmmakers pull no punches showing just how traumatizing and brain injuring ECT was for its victim patients. Another commonly used “treatment” was “aversion therapy,” in which electric shock to the genitals and/or nausea-inducing drugs were administered simultaneously with the presentation of homoerotic stimuli; and psychiatry also attempted to “cure” homosexuality with castration and lobotomy.
Beyond the emotional experience of disgust and horror that one feels in viewing psychiatry’s homosexuality “treatments,” on an intellectual and political level, Cured is an important film for two reasons. On the surface, Cured describes a pivotal event in the movement for LGBTQ equality, rights, and de-stigmatization. Below the surface, Cured will help critical viewers understand why this gay activist victory over the APA remains such a pivotal event for individuals today who may not be LGBTQ but who feel dehumanized by psychiatric diagnosis and treatment.
There have always been normal human variations that have caused fear and rage in the majority of society; and institutions such as government, organized religion, and psychiatry have been charged with reducing such societal tension. What is particularly irrational about society today is that so-called “well-educated” individuals continue to persist in their belief that labeling individuals with such variations as “mentally ill” will eliminate societal stigma for them. Recent history tells us not only does such mental illness labeling maintain and even increase societal stigma, but that for those who accept their sickness branding, what ensues is a crippling belief that their fundamental humanity is defective. This is a truth that gay activists brought to public attention in their battle against psychiatry, as journalist and gay activist Ron Gold famously scolded the APA, “Stop it, you are making me sick!” Gold then offered some common sense to a psychiatry profession lacking any: “The worst thing about your diagnosis is that gay people believed it. Nothing makes you sick like believing you are sick.” Sadly, this is a truth that has been re-buried.
In the battle to liberate homosexuality from a psychiatry profession that claimed it was capable of “curing” it, we see astronomer Frank Kameny, one of the most influential gay activists in U.S. history, declaring psychiatry to be a “shabby, shoddy, sleazy pseudoscience masquerading as science.” As a scientist, Kameny was a powerful figure insisting society recognize that mental illness declarations were the result not of any kind of science but of politics, and as such, could only be abolished by political activism.
Gay activists such as Ron Gold and Frank Kameny are heroes today not only in the LGBTQ community. They are also heroes for other individuals who today feel that they too have been made to feel defective by a non-scientific psychiatric label for their tension-producing normal human variations. I know these individuals well.
When DSM-III was published in 1980, homosexuality was no longer listed because brave and well-organized gay activists—assisted by a changed cultural climate—had enough political clout to intimidate psychiatry into abolishing this insult to their humanity. However, psychiatry quickly turned to an even larger population, one with little potential for organizing and no such political clout—children and teens.
In the 1960s and 1970s, not all that radical was the idea that it is quite normal for many young people—especially critical thinkers and artistic souls—to feel alienated and oppressed by standard schools; but beginning in the 1980s, this commonsense wisdom had begun to be replaced by the psychiatric wisdom that a failure to adapt to one’s schooling is a symptom of mental illness. Today, young people who refuse to pay attention in the classroom are diagnosed with “attention deficit hyperactivity disorder” and put on Adderall or some other such speed; shy school-resistant youngsters are diagnosed with “social anxiety disorder” and put on Paxil or some other such antidepressant; stubborn noncompliant young people are diagnosed with “oppositional defiant disorder” or some other such “disruptive behavioral disorder” and placed on a variety of drugs. And what would have been completely bizarre fifty years ago is the now increasingly popular psychiatric illness of “pediatric bipolar disorder,” in which even five-year olds are placed on antipsychotic drugs based on their failure to “regulate their moods” in a manner that doesn’t put adults out of control.
In my clinical practice, I talk to Gen Xers and Millennials who, when children, were given these mental illness diagnoses and drugs, and they, similar to Ron Gold, tell me that the worst thing about their diagnosis was that they believed it. No psychiatrist told them that it is perfectly normal for many children and teens to feel alienated and oppressed in school and to behave in the manner that they did. As adults, they routinely forgive their parents for being frightened by society into believing that without psychiatric treatment that their lives would be unhappy ones, but they do not forgive psychiatry for exploiting their parents’ fears.
There is today another population who are as angry with psychiatry as those earlier gay activists who defeated the APA; but unlike children and teenagers, this group is increasingly politically organized and utilizing gay activists’ successful model of resistance against psychiatry. This population consists of “voice hearers,” whose voice hearing is deemed by psychiatry as a major symptom of schizophrenia, but deemed by themselves as a meaningful human experience. If you want to get a sense of the damage created by psychiatry’s standard treatment for voice hearers and the meaningfulness of such voices for them, check out the Eleanor Longden TED talk “The Voice in My Head” (which currently has received more than five million views on that site alone).
Dutch psychiatrist Marius Romme, in contrast to the overwhelming majority of his colleagues, has championed the idea that hearing voices is a normal, albeit unusual, human variation, and he has challenged the notion that it is a characteristic of serious mental illness. Romme along with journalist Sandra Escher and ex-psychiatric patients have created the Healing Voices Network. Similar to how gay activists depathologized, normalized, and destigmatized homosexuality with the help of Alfred Kinsey’s studies that showed gay fantasies and experiences are more widespread than previously acknowledged—Kinsey is discussed in Cured—the Healing Voices Network reports there is a great deal of research showing the widespread nature of voice hearing, which is termed by psychiatrists as “auditory verbal hallucinations” (AVH). A major 2013 review of these studies concluded: “Epidemiological studies have estimated the prevalence of AVH to be between 5 and 28% in the general population.” Most importantly, among those who hear voices, the difference between those who are diagnosed as ill and “treated” versus those who never encounter psychiatry is highly related to how positively (e.g., a meaningful experience) or negatively (e.g., a symptom of schizophrenia) voices are experienced.
There are two opposite models of how to destigmatize people whose human variations have caused fear, rage, and extreme tension in the majority of society. There is the model promulgated by the APA and the major institutions of psychiatry—one of viewing these variations as an “illness like any other” with the belief that societal acceptance of “illness” diminishes stigma. In contrast, there is the model asserted by the gay and voice hearer activists—a model that depathologizes and normalizes human variations. History tells us which model works. Specifically, diagnosing homosexual thoughts and behaviors as illnesses to be treated did not reduce stigmatization but instead routinely worsened it. What has majorly reduced stigmatization of homosexuality is society viewing it as a normal human variation.
When I heard that a film was in the works that was fiercely critical of the APA’s treatment of homosexuals, I wondered if it would ever get seen, and when I heard it was to be broadcast on PBS’s Independent Lens, I became curious as to how the filmmakers had pulled this off. After all, in contemporary American culture, critics of the psychiatry-pharmaceutical industrial complex are routinely branded as “pill shamers,” and—in the manner analogous to anti-war activists being red-baited as communists—coupled with goofy Scientology cultists.
So how did Cured filmmakers get their documentary aired? On the Cured website, at the bottom of its homepage is the following: “Outreach and Engagement Sponsorship Provided by the American Psychiatric Association Foundation” (the “Corporate Alliance” of the American Psychiatric Association Foundation lists as its “Grand Patrons” and “Patrons” several pharmaceutical corporations, including those that manufacture psychiatric drugs). From the looks of Cured, its filmmakers received the message that the only way they could show just how unscientific, arrogant, and barbaric psychiatry was in its treatment of homosexuals fifty years ago was to paint a picture of current psychiatry being a completely different institution, one that includes openly gay psychiatrists in leadership positions in the APA.
I have no idea whether Cured filmmakers merely sensed the heavy hand of the APA or if they were in fact slapped into line with it, but I suspect that in at least one instance, it was the latter. Specifically, at film’s end prior to the roll of credits, a disclaimer states: “Electroconvulsive therapy is no longer used to ‘cure’ LGBTQ people in the United States, but it continues to be used as an effective treatment for severe forms of depression.”
The question many film viewers may ask is “Why was that disclaimer inserted?” After all, the film makes it obvious that the APA abolished homosexuality as a mental illness, and thus obvious that electroconvulsive therapy (ECT) is no longer used by psychiatry as a “treatment” for homosexuality. Obvious, at least to me, necessary for the APA—which continues to promote ECT—is the phrase in that statement that ECT “continues to be used as an effective treatment for severe forms of depression.”
Given the focus of Cured, I have a difficult time believing that the filmmakers, on their own, felt obliged to proclaim that ECT is an “effective treatment for severe forms of depression.” This claim is, at best, a controversial distraction to the message of their film, and worse, a claim that is disputed by the research. A 2019 review of the research on ECT effectiveness for depression reported that there have been no randomized placebo-controlled studies (ECT versus simulated/sham ECT) since 1985. The reviewers assessed those studies that were done prior to 1985 (five meta-analyses based on 11 studies) are of such poor quality that conclusion about efficacy are not possible. The authors concluded that given ECT’s uncontroversial adverse effect of permanent memory loss (and its smaller risk of mortality) that the “longstanding failure to determine whether or not ECT works means that its use should be immediately suspended until a series of well designed, randomized, placebo-controlled studies have investigated whether there really are any significant benefits against which the proven significant risks can be weighed.”
Psychiatry today parades public testimonials for ECT, but keep in mind that when ECT was used to “cure” homosexuality, some of these “treated” patients privately thanked their psychiatrists. All testimonials, pubic and private, are what genuine scientists call “anecdotal evidence,” which is not considered to be scientific evidence.
Given the amount of gut-wrenching footage in Cured devoted to the traumatizing and brain-damaging ECT “treatment” for homosexuality, it would not surprise me that the APA communicated to the filmmakers, directly or indirectly, the following: either remove that ECT footage in Cured, or put in that disclaimer, or we will diagnose your film as “irresponsible.”
If in fact this is the way it played out—and I have absolutely no idea what actually did transpire—I am glad that the filmmakers chose what I consider the “lesser evil” option of the disclaimer, as Cured with its ECT footage needs to be seen. Had the filmmakers asked me what the hell they should do, I would have suggested inserting a “wink” in the disclaimer that would have made it clearer that a gun had been pointed at their heads, something like this: “Electroconvulsive therapy is no longer used to ‘cure’ LGBTQ people in the United States, but it continues to be used as an effective and lovely treatment for severe forms of depression.”