I believe that humans have an instinct to seek freedom. This instinct was called “drapetomania” when expressed by Black slaves in the USA, who tried to escape. The “treatment’ was to catch them, lock them up and whip them. Whipping was a favourite treatment in the early Australian lunatic asylums too, as well as physical restraints and chemical restraints with an increasing range of toxic drugs. When insulin was discovered in 1921, the first thing they tried was to “treat schizophrenics” by sending them into a coma by injecting them with insulin in 1922. Labouring under the delusion that fevers may cure schizophrenia they tried giving people typhoid and malaria – as a treatment – along with injecting turpentine into the abdomen to cause an abscess, which needed to be drained in theatre. This was all on purpose, with a supposedly “scientific” rationale. Prior to that they tried spinning beds and chairs, convinced that mental illness was caused by too much or little blood flow to the brain, and also developed various methods of immobilization of ‘manic’ or ‘excited’ patients.
During the 1930s and 40s the Nazis subjected people labelled with schizophrenia, manic depression and personality disorder to what they called ‘euthanasia’ or mercy killing under the notorious Aktion T4 program. This was before the mass killing of Jews and Gypsies. Prior to that, several American states established eugenics laws prohibiting the marriage of ‘mentally ill’ people and allowing for the castration of mentally ill and “feeble-minded” boys. Eugenics, initially developed at Cambridge in the 1880s, was also embraced in Australia, where it formed the “scientific” basis for the genocide of Aboriginal people and “breeding out the Black” to create a “White Australia”.
They also used to cause convulsions on purpose, using chemical toxins, as an alternative to electrical shocks, which were given without anaesthetic at first. This resulted in fractures, but was declared to be a successful treatment by its enthusiasts, as were the notorious “ice-pick lobotomies” popularised in the 1940s by Walter Freeman and his followers. There were other atrocities committed under the notorious but still rarely mentioned MK programs of the 1950s and 60s , where the CIA enlisted numerous well-known universities in the USA, Canada and UK to assist in brain-washing and mind control programs, supposedly to counter the “Communist menace”. These included “deep-sleep therapy” and insulin comas, combined with such frequent electric shocks to the brain that the victim was rendered incontinent and unable to talk or walk. They were then “reprogrammed” through various methods including playing repeated loops of audio tapes and other such then modern technology.
The age of lobotomies ended in 1950 with the discovery of the first “liquid lobotomy”, the dopamine-blocking drug chlorpromazine in France. This was the first of the phenothiazines, marketed as Thorazine in the USA and Largactil elsewhere (including Australia). Largactil is credited with ending the era of asylums and allowing mentally ill people diagnosed with “schizophrenia” and previously confined for years to be to be discharged from hospital and treated in the “community”. However, Largactil and the other dopamine-blocking “neuroleptics” or “antipsychotics” (also called ‘major tranquillisers’) were found to have serious side-effects, including irreversible brain damage in the form of “tardive dyskinesia” (TD). TD is characterised by uncontrollable facial, tongue and limb movements; it is hard to imagine a more stigmatising condition, since the limbs writhe uncontrollably, the tongue protrudes in and out, with puffing of the cheeks and facial grimaces. A person with TD looks mad, and this is worsened by the uncontrollable urge to pace up and down and inability to sit still known as “akathesia”, which is also caused by these drugs, presumably due to the blockade of dopamine receptors in the basal ganglia of the brain. They also cause anhedonia (lack of pleasure), reduced creativity and flattened emotions. Cruelly, these side-effects are frequently blamed on the “illness” itself.
Chlorpromazine largely replaced electroconvulsive therapy, hydrotherapy, psychosurgery, and insulin shock therapy. By 1964, about 50 million people worldwide had taken it. Chlorpromazine, in widespread use for 50 years, remains a “benchmark” drug in the treatment of schizophrenia, an effective drug although not a perfect one. The relative strengths or potencies of other antipsychotics are often ranked or measured against chlorpromazine in aliquots of 100 mg, termed chlorpromazine equivalents or CPZE.
According to Wikipedia, chlorpromazine is a “low potency” antipsychotic and less likely to cause tardive dyskinesia than the “high potency” antipsychotics like haloperidol (Haldol) and fluphenazine (Stelazine). I have never had fluphenzine (notorious for causing the ‘Stelazine shuffle’) forced on me, but I have been forced to take haloperidol by mouth and also been injected with long-acting “depot” preparations of the drug. The side effects I developed traumatised me for years after, and long after the actual effects had worn off. This trauma was because of the memory of the incarceration and drugging.
I haven’t yet developed TD, but the condition may develop many years after treatment starts and increases in likelihood the longer it is continued. It may also worsen despite stopping treatment and is itself untreatable. I dread getting this horrible iatrogenic (treatment-induced) condition. I have experienced the other common neurological problems caused by dopamine blockade, namely akathesia and Parkinsonism, with similar symptoms to Parkinson’s Disease, but caused by dopamine receptor-blocking drugs rather than degeneration of the dopamine-producing nerve cells in the basal ganglia (the known cause of Parkinson’s Disease).
I came to the attention of the psychiatric system because of my family, namely my father Brian Senewiratne, sister Shireen Senewiratne and her boyfriend at the time, Robert Purssey. All were doctors working in the public system and my father also got his friend, Dr Chelvarayan Barr-Kumarakulasinghe, to make another referral, in addition to those of Robert and Shireen. My father then wrote a series of letters to the psychiatrist Rajan Thomas and his registrar Noel Barrett, purporting to provide “collateral history”. I have received these letters and Thomas’s own notes when they were provided as evidence against me at the Queensland Health Practitioner’s Tribunal in 2003, but had already obtained some of them in Freedom of Information (FOI) requests I made myself from the Alfred Hospital and Monash Medical Centre and before that from the Formal Hearing of the Medical Practitioners’ Board of Victoria, held in July and August 1996. These documents have helped me piece together the roles that my various family members played in my initial incarceration and subsequent ones. I have long grappled over their motives.
In his first letter ‘framing letter’ to Rajan Thomas, which was hand-written, long and rambling, my father ended it with the revealing line:
“I hope this long dissertation doesn’t result in someone certifying me!!!!”
He evidently knew that being certified as insane is a traumatic experience, which he didn’t want for himself, but was advocating for his much saner son.
Though my sister made a referral to the Junction Clinic in St Kilda on May 18, 1995, she left it to her boyfriend Robert, who was a psychiatry registrar, to make the phone calls to get me locked up. Robert also went through all my things after I’d been locked up at RPH, looking for evidence to substantiate his claim that I had “mania”. When I escaped the first time from Royal Park it was Robert who tracked me down, a task for which he took “compassionate leave” from work! When I escaped a second time and travelled up to Brisbane, not realising my father’s role in my incarceration, Robert flew up from Melbourne, got a mutual friend, Margie Ruddy to invite me out and then stalked me in a nightclub, all the while refusing to talk with me directly. Instead he followed me around and asked the people I spoke to what I had said, warning them that I was mad and could not be believed.
In response to the initial referral by my family the Junction Clinic sent a psychiatry registrar by the name of Noel Barrett to my flat. I had moved in there in January 1995 after separating from my wife Susan the day she arrived from Brisbane after spending two weeks there with our two-year-old daughter Ruby. Sue was furious after being told by Shireen and Robert that I was having an affair with Sara Di Genova, whom they had invited to mind their house in North Fitzroy while they too holidayed in Brisbane (where our parents live). This was untrue. I was infatuated with Sara, something Shireen knew, but we were not having a romantic relationship, though later we did, and ended up living together and having a daughter, Zoe, many years later. Zoe was born on 30th August 2009 at the Mater Hospital in Brisbane, by which time Shireen and Robert had two children but had separated, and Robert had remarried. He has since had two more children and is working as a psychiatrist in Brisbane. He refuses contact with me, and has done since he stopped trying to get me locked up. My father has never stopped trying and is trying to get me locked up again right now.
I thought the registrar Noel Barrett was a strange man. I had no rapport with him. He asked me to come to clinic, which was nearby, the next week to see the psychiatrist Rajan Thomas, who my mother had told me was an expert in autism and known to my uncle Chelvarayan Barr Kumarakulasinghe, who was working as a de-facto psychiatrist (his qualification was a surgeon and he had been professor of surgery in Kandy before coming out to Australia after spending some years in the Middle-East) and is married to my mother’s cousin Nirma, who was my piano teacher when I was a child. Rajan Thomas was a strange man too and not an expert in autism at all. This had merely been a ruse to get me to see him. He saw his task not to discuss my evolving theories with me but to see if I could be “sectioned”, meaning certified as mentally ill and involuntarily confined. He wrote in his notes that “the family wants him sectioned” but that he did not think it could be done legally, and sought a second opinion from the director of the clinic, Tobie Sacks, who I was delighted to hear was a nephew of the famous British neurologist and author Oliver Sacks.
I liked Tobie and was able to develop more rapport with him than I could with Rajan Thomas or the registrar Noel Barrett. After interviewing me for an hour he wrote:
Thank you for asking me to review Dr Senewiratna. A 30+ yr old separated medical practitioner, he presents with mildly elevated mood, slight grandiosity with pseudophilosophical overvalued ideas regarding mental illness, behaviour and motivation.”…
“While it seems very probable, from the recent history, that Dr Senewiratna has been hypomanic, exhibiting elevated mood, grandiosity, flight of ideas and increasingly dysfunctional, uncharacteristic behaviours, and while he is now still mildly elevated in his mood and has several unrealistic, possibly overvalued ideas (his hypothesis) I do not find him to be certifiable/detainable under MHA [Mental Health Act].
There is currently no evidence of flight of ideas, pressure of speech, risk-taking behaviour or impulsivity in his activities. Throughout the interview he remained calm, cooperative and were able to establish good rapport. Affect was reactive and generally appropriate. The overvalued ideas/hypothesis about behaviours/mood etc are fairly firmly held, but not to delusional intensity”.
My hypothesis was that humans have a number of neglected instincts, including communication, curiosity and play, and that these instincts could be used to develop therapeutic strategies individually and as public health programs. I also developed theories about the development of aesthetic appreciation in what we see and hear, that again had practical applications, but the psychiatrists were not interested in my theories other than to determine whether how strongly I held them (and not whether they were justified and rational).
Rajan Thomas has recently been charged with sexually assaulting one of his long-term patients in his rooms and in a Melbourne psychiatric hospital. This came as no surprise to me after his explanation of what motivates people – meaning himself – in March 1995. I asked him, in good faith, what motivated people, something I was developing theories about. His answer is in keeping with the recent charges against him for sexual assault. He said “well, if you see a woman walking down the street (and he put his hands on his chest, simulating breasts) you want to jump on her but you don’t because of the people who are there”. It was a bizarre answer that I was not expecting – my theory was that we are motivated by instincts for communication, curiosity and play!