Buber behind Bars

Abstract

This paper describes the structure and conceptual foundations of an intensive treatment program operated at the Ontario Hospital, Penetanguishene, a 304-bed maximum security institution which receives patients from the courts, reform institutions, and other mental hospitals. The philosophy of treatment includes the following assumptions: 1) Mental illness is fundamentally a breakdown in the communication between persons. 2) For a sick person, the most helpful experiences are acts of genuine communication — direct encounters — as defined by Martin Buber, in which each turns to the other in his present and particular being, and addresses him without pretence. 3) The patient is the principal agent of therapy. He is equipped to help his peers better in some ways than the professional whose role is seen as an administratively supportive one creating the space in which direct encounter can occur. 4) Every event in a total institution should enhance the treatment goals. 5) The use of force is legitimate in treating patients for illnesses which they do not recognize, in settings where they will be incarcerated until they change. An outline of the eighty-hour per week compulsory program describes the variety of group interactions, planned and sustained by patient committees with minimal staff supervision. The establishment of fixed pairings for an hour a day, seven days a week indefinitely as a device of confrontation; the use of video tape equipment as a device of observation; the intensive use of hyoscine hydrobromide, methamphetamine hydrochloride, imipramine hydrochloride, dextroamphetamine sulfate, amobarbital sodium, lysergic acid diethylamide as ‘demystifiers’ are sketched. Experiences in the simultaneous treatment of schizophrenic and psychopathic personality types are examined, and the need for the objective evaluation of results is affirmed. The value of this program is felt to be primarily for those settings where patients are held for long periods of time.