vaughanbell

The battleground of remembering

I’ve just discovered a engrossing two-part BBC World Service documentary on ‘oral history’ and how the process of getting everyday folk to relay their memories of important event often challenges the authorised memories of official history.

The programme makes an interesting distinction between public memory, the authorised version of events; individual memory, that we each hold inside us; and collective memory, the process by which we collectively negotiate what we believed happened.

Oral history gets individuals to recount their memories of events, but focuses much more on lived experiences and opinions than names and dates, although can be unsettling to official histories when they contradict politically convenient narratives.

Link to two-part Memory Wars documentary.

Treating the madness of the hippies

In 1972, Colombian psychiatrist Miguel Echeverry published a book arguing that hippies were not a youth subculture but the expression of a distinct mental illness that should be treated aggressively lest it spread through the population like a contagion.

I found the book, called Psicopatologia y Existencia del Hippie (Psychopathology and Existence of the Hippy), in my local library and it turns out to be one of the most surprising psychiatry books I have ever read.

At some point, I suspect the good Dr Echeverry must have been driven to breaking point by a bunch of long-haired youths strumming poorly tuned guitars outside his window, because he is clearly furious.

This is his definition of a hippy, translated from p83, where he is so angry he forgets to use a full stop.

The true hippy is an individual with a frank disposition to hereditary psychopathology, who has abandoned himself, has totally neglected his hygiene and self-presentation, has let his hair and beard grow, is dressed bizarrely, eccentrically and ridiculously, wears a multitude of rings, necklaces, beads and other extravagances, is opposed to all defined and purposeful social and family structures now and in the future, rejects productive and redeeming work, irresponsibly and cynically promotes the cult of free love, aggressively promotes contempt for moral, social and religious conventions, preaches paradoxically about the abolition of private property, harmfully drugs them self with marijuana, LSD, amphetamines, hypnotics, mescaline, psylocybin, sedatives and heroin etc to rebelliously and insanely avoid the sad realities of life.

The author notes with disdain that the ‘hippy threat’ seems to be a particular problem in Bogotá, probably reflecting more than a little regional distrust of the free-wheeling capital.

The book contains not a single reference to any scientific or clinical study, although is happy to wax lyrical about the subgroups of the hippy mental illness. Apparently, there are five: hippies with defective personal relationships and autistic-like problems, aggressive hippies, hippies with defective behaviour and poor family adjustment, emotionally impaired hippies, and those with abnormal, perverted or inverted instincts.

For those worried that he may be getting a little too psychoanalytic, Dr Echeverry makes it clear that there is both a strong environmental and genetic component to hippy psychopathology. Yes, apparently, you can inherit hippidom.

The image on the right is from one of the adverts in the book, all of which advertise the drug Lucidril as a ‘treatment’ for hippies, and it’s no surprise that the book was sponsored by the makers of the medication.

Considering the tone of the book, and the fact that the author concludes that being a hippy as akin to having schizophrenia, it’s interesting that Lucidril is not an antipsychotic, but the trade name for a little known compound called meclofenoxate.

There is weak evidence that the drug boosts memory and is notable largely for its enthusiastic uptake by some sections of the ‘nootropics’ brain hacking crowd.

I suspect the enthusiastic adverts for this oddball drug are largely because the book happened to be sponsored by pharmaceutical company Instituto Bio-Quimico Ltd who were clearly trying to sell the drug as a ‘mental detoxification’ compound for the great unwashed.

But not every bearded girl or guy is a real hippy, says Dr Echeverry, who notes that there are also cases of pseudo-hippies, who are really just weak-minded youths who get swept along with the genuine ‘clinical cases’.

How can you tell the difference you ask? Well, pseudo-hippies are the ones who revert to normality once a psychiatrist pumps them full of approved medication. Simple.

Mind and brain science: an instant overview

A new online tool called brainSCANr visually summarises the psychology and neuroscience literature to give you a network overview of which are the terms most connected to the target concept in scientific publications.

You can see the example for ‘post-traumatic stress disorder’, otherwise known as PTSD, below. Click here to see it full size on the actual website.

The target concept is in the bottom right, marked with a star, and you can immediately see the brain areas, psychological concepts and other disorders most associated with the diagnosis.

The maps are created by looking at how often different words co-occur in the scientific literature, which, as the creators note, is not the same is looking at how concepts are thought of, but it should give a rough approximation.

You can’t just tap any word into it at the moment, as it’s based on a database of concepts, although the searchable list of terms is still quite comprehensive.

However, it’s an inventive new tool which is a fantastic way of getting a quick overview of a field.

Link to brainSCANr.

Post-coma nail trauma

Being in coma could play havoc with your nail care routine.

A 1997 report from the Journal of Neurology, Neurosurgery and Psychiatry notes how discoloured fingernails may be a secondary effect of coma owing to the side-effects of a common medical assessment for consciousness.

The test is nothing more high-tech than giving the finger a hard prod with a pencil to see if there is any reaction to pain, which is a common test on unconscious patients.

In fact, it forms part of the universally used Glasgow Coma Scale. You’ll often hear doctors saying “the patient was admitted with a GCS of…” followed by a number up to 15 which rates how conscious and alert the patient is, depending on their reaction to various prods, pokes and verbal requests.

The brief article reported an unintended side-effect of repeated Glasgow Coma Scale assessments after a patient woke up from coma to find her nails all black and blue.

A 30 year old woman was admitted to hospital with a rapidly progressive decline in level of consciousness and seizures. Neuroimaging studies disclosed thrombus in the superior sagittal sinus, bilateral cerebral venous infarctions, and oedema. She was treated with intravenous heparin and propofol for control of agitation and increased intracranial pressure. She made an excellent recovery.

Three weeks after admission she alerted us to a painless brownish discolouration of many of her fingernails. Bilateral subungual haematomas in different stages of resolution were noted. These lesions had been created by frequent nail bed compression with a pencil to monitor motor response, a common practice of applying noxious pain stimuli in comatose patients admitted to neurological intensive care units.

Obviously, if you’re a Goth, Glasgow Coma Scale evaluations are likely to have much less of an impact on your post-coma nail care routine.

Link to brief JNNP piece on ‘Coma Nails’.

An informal chat about hard data

Scientific American has an excellent article on the sociology of communicating new discoveries and how the relationship between science and journalism has changed over the years.

It’s a remarkably comprehensive analysis that looks not only at science publication but how it relates to our regular patterns of social communication.

This informal style of communication has been deliberately excluded from science in recent decades through the adoption of peer-review and a uniform impersonal writing style, as a way of imbuing the process with a form of institutional trust.

According to the author, online science pioneer Bora Zivkovic, this model is now being challenged by internet science writing where trust is gained through transparency – showing your working and background through links to original source – rather than having an institutional stamp of approval.

I think he’s a little hard on traditional science journalists, but as an analysis of how trust works in science communication, and how that is being affected by the online science community, it’s an incredibly thought-provoking piece.

Link to ‘The line between science and journalism is getting blurry…again’

The plant of human puppets

I’ve made a radio programme with ABC Radio National’s All in the Mind about burundanga, a mysterious street drug used in South America which is widely believed to remove free will.

The name ‘burundanga’ is a popular term and doesn’t refer to a single thing, but its most commonly associated with the brugmansia plants.

They can incapacitate people in high enough doses owing to them being rich in a psychoactive chemical called scopolomine. Criminals spike unsuspecting members of the public and then rob or attack them.

Since living in Colombia, I’ve constantly heard people tell me that the plant removes free will – the affected people just do whatever they’re told. They become, in effect, human puppets.

To me, this always sounded unlikely, and it struck me that, if this was genuinely the case, this might be a hugely important discovery in neuroscience, because free will and agency are two of the most complex and difficult to grasp areas.

But the plant also has hundreds, and probably thousands, of years of history as a psychoactive component of the religious rituals of the indigenous people of the continent, to the point where it holds a central place in some of their founding myths.

Needless to say, the chance to wander round Colombia making a documentary about a psychoactive plant at the intersection of neuroscience, myth and criminal science was too good to miss, so I hope you enjoy the journey.

It sounds wonderful, by the way, but almost entirely due to presenter and producer Natasha Mitchell’s magic at the mixing desk when making sense of my raw materal.

I’ve also written an article about the substance, including the first attempt to use it as a ‘truth drug’ after a gruesome murder, and there’s an image gallery available too.

Link to AITM on the plant that steals your free will with mp3 download.
Link to my article on the AITM blog.
Link to image gallery.

Mind and brain bloggers: wanted for your data

If you are a mind and brain blogger, Dr Alice Bell wants to research you. Alice is at the Science Communication Group at Imperial College, London, and is asking us to complete a survey as part of an investigation into the psychology and neuroscience blogosphere.

Are you wondering whether this is you? Here’s who the research project is trying to recruit:

By ‘brain bloggers’ I mean bloggers who write about the stuff that goes in people’s heads, whatever we think this stuff is. Such bloggers might focus on neurology or psychology, or another field entirely. It might be the history, anthropology or commercial applications of these fields. It might come under ‘research blogging’, journalism, ‘public engagement’ or some form of political activism (or several of these at once, or something else entirely). This focus might be exclusively brain-y, or brain-ish issues might be topics they occasionally blog about in the course of other work.

There are more details at the link below, including all the questions.

Link to Alice Bell’s mind and brain blogger survey.

The brain scanner’s prayer

The brilliant Neuroskeptic has created a version of The Lord’s Prayer for the fMRI generation. It is at once spiritually uplifting, scientifically edifying and very, very funny.

Our scanner, which art from Siemens,
Hallowed be thy coils.
Thy data come;
Thy scans be done;
In grey matter as it is in white matter.
Give us this day our daily blobs.
And forgive us our trespasses,
As we forgive them that trespass onto our scan slots.
And lead us not into the magnet room carrying a pair of scissors,
But deliver us from volunteers who can’t keep their heads still.
For thine is the magnet,
The gradients,
And the headcoil,
For ever and ever (at least until we can afford a 7T).
Amen.

If you don’t read the Neuroskeptic blog, you’re missing out, as it has some of the best mind and brain coverage on the net and, it seems, the occasional request for divine neurointervention.

Link to The Scanner’s Prayer over at Neuroskeptic.
Link to Neuroskeptic blog front page.

2010-12-17 Spike activity

Quick links from the past week in mind and brain news:

The Guardian asks whether the internet encourages insidious and bullying behaviour? Well, does it, punk?

We typically don’t remember our early years but it turns out this amnesia develops over time, as a brilliant piece on ‘The shifting boundary of childhood amnesia‘ at Psychology Today recounts.

BBC Radio 4 had a good documentary on the influence of Freud on British culture. Only three more days to listen – annoying, I know.

There’s a brilliant post on consciousness, mental time travel and the brain over at the consistently excellent Neuroskeptic.

BBC News report on the switch to short-acting barbiturate pentobarbital for the death penalty in the US. “a sedative typically used to put down animals” says the BBC, although they don’t mention it’s also used in the acute treatment of epileptic seizures.

Science News covers a new study on the intriguing but not very pleasant hallucinogen salvia divinorum.

Dan Ariely’s blog Irrationally Yours looks at how perception of value relates to worker effort not results.

The woman with no fear (and no amygdalae). Coverage from Not Exactly Rocket Science and Neurophilosophy outdid all the mainstreams.

The New York Times has a Bayesian take on Julian Assange: “…from the standpoint of Bayesian reasoning, to think we can separate out the merits of the charges from their political motivations.”

Footage of Freud and psychoanalysis – from the 1940s. Advances in the History of Psychology finds two archive gems.

The Guardian science blog covers an interesting study that tested whether sleep deprivation can prevent post-traumatic stress disorder.

For the first time, marijuana use is more common in American kids than cigarette smoking. The excellent Addiction Inbox has a great write-up.

Macleans has a great piece on fashionable paranoias. Nothing to fear but wifi and fluoride.

There’s an excellent analysis of how top flight science journals handle studies on language over at Child’s Play. In brief, they don’t.

The New York Times has a long but rewarding piece on ‘embodied cognition‘ by philosopher of mind Andy Clark.

The top 10 psychology studies of 2011 have been selected with excellent taste by Neuronarrative.

You all know the excellent Brain Ethics blog has just been relaunched right? New pieces on how to teach neuromarketing and whether genes make up your mind.

The Journal of the American Academy of Psychiatry and the Law has a thoughtful piece by a psychiatrist reflecting on Foucault, forensic psychiatry, and committing patients to hospital against their will.

We believe we have more free will than other people. Neurotic Physiology feels compelled to cover this fascinating new study.

The Guardian science blog has an eye-opening piece about the discrepancy between which childhood neurological disorders get the funding and which are most common.

The way in which data is collected for a psychology study affects the sort of people who volunteer. The BPS Research Digest covers the subtle effects of research design.

New Scientist has the best books of 2010 as chosen by neuroscience Steven Rose.

Psychologically inclined filmmaker Adam Curtis finds a social history gem on his BBC blog The Medium and the Message: a 1969 British documentary on the office Christmas party.

Seed Magazine looks at the science of interconnectedness and understanding risk in a connected world.

Contrary to lay wisdom, high trusters were significantly better than low trusters were at detecting lies. Barking up the Wrong Tree covers a counter-intuitive study.

Cannibal cuisine

Cannibalism is a lot more common in human history than you’d guess and an intriguing article in Slate looks at the how a change in living situation might have made the temptations of the flesh all the more appealing.

The piece is by psychologist Jesse Berring who gets his teeth into the scientific debate about whether chowing down on another human may be a genuine biological adaptation, owing to the frequency with with famine-like conditions have appeared in human history.

The bottom line, says Petrinovich, is that when you’re hungry enough, ravenous really, and when all other food sources—including “inedible” things you’d rather not stomach such as shoes, shoelaces, pets, steering wheels, rawhide saddlebags, or frozen donkey brains—have been exhausted and expectations are sufficiently low, even the most recalcitrant moralist among us would shrug off the cannibalism taboo and savor the sweet meat of man … or woman, boy or girl, for that matter. It’s either that or die, and among the two choices, only one is biologically adaptive.

A behavior can be adaptive without being an inherited biological adaptation, of course. But because starvation occurred with such regularity in our ancestral past, and because the starving mind predictably relaxes its cannibalistic proscriptions, and because eating other people restores energy and sustains lives, and because the behavior is universal and proceeds algorithmically (we eat dead strangers first, then dead relatives, then live slaves, then foreigners, and so on down the ladder to kith and kin), there is reason to believe—for Petrinovich, at least—that anthropophagy is an evolved behavior.

The piece isn’t for the feint-hearted, but is certainly a fascinating take on one of the strongest of human taboos.

There is also a link at the bottom to a video discussion between “Robert Wright of BloggingHeads.tv and psychologist Paul Bloom of Yale on what motivates cannibals.”

From the appearance of the screen shot, I think they’ve been practising the look if nothing else.

Link to Slate piece ‘Bite Me: An evolutionary case for cannibalism’.

Ecstasy may bring the love by filtering the fear

Ecstasy users often describe the high as feeling ‘loved up’ and MDMA is frequently described as an ’empathogen’ but until now, little was known about how it genuinely affects the recognition of emotions in other people.

A new study just published in Biological Psychiatry has tested the supposed ’empathy boosting’ effects of MDMA and found that it actually makes people worse at picking up on emotions in the face – but only for threatening expressions.

The researchers, led by psychologist Gillinder Bedi, met the volunteers on three occasions, and on each one they were given either MDMA (‘ecstasy’), placebo, or methamphetamine – the latter to be able to distinguish the effect of feeling ‘wired’ from any ecstasy-specific ’empathic’ effects.

Although everyone had agreed to which drugs would be given, the study was done using ‘double-blind’ conditions, meaning neither the researchers nor the participants knew which they were getting on any particular occasion.

An hour after swallowing the pill, the volunteers were asked to rate their mood and emotional state with standardised questionnaires and to take part in experiments to assess their ability to pick up on others’ emotions.

Two tests involved picking up emotion from the face, one from just the eyes, one from whole facial expressions, and another required participants to do the same for voices.

The volunteers reported that they felt significantly more ‘loving’, ‘friendly’ and ‘playful’ on MDMA, although paradoxically on a higher dose of the drug, it also increased feelings of loneliness.

Methamphetamine also boosted some of these feelings, although to a lesser extent, suggesting that part of the ‘loved up’ feeling is probably down to similar amphetamine-like effects in both drugs (MDMA is often described as a ‘substituted amphetamine’ because of its similar molecular structure).

Strikingly, the emotion tests showed no improvement in the ability to pick up on emotion after taking MDMA, and in fact, people were worse – but only at picking up on fearful, threatening emotions in facial expressions.

This suggests that ecstasy might be causing some of the famous feeling of ‘social connectedness’ by tuning out negative signals from other people faces, rather than boosting our ability to pick up on positive emotions.

Although only a first study, it indicates that the ’empathogen’ label is probably misleading because the drug actually makes us worse at reading others’ emotions.

But because we tend to associate ’empathy’ with positive social interactions, the effects of the drug have been linked to being empathic in popular culture.

Link to PubMed entry for study.
Link to DOI entry for study.

Air on a G thing

Seed Magazine has an absolutely wonderful article on the neuroscience of musical improvisation that looks at how skilled musicians from the jazz greats to the classical masters take us on unplanned melodic journeys.

It’s a brilliantly written piece, a compelling fusion of music and science journalism, that skilfully captures the emerging scientific interest in musical spontaneity.

Aaron Berkowitz, a cognitive ethnomusicologist, who took on the task of demystifying improvisation as the focus of his dissertation work at Harvard, has a theory. He likens the process of learning to improvise to that of learning a second language. Initially, he says, it’s all about memorizing vocabulary words, useful phrases and verb conjugation tables. Your first day, you might learn to say: How are you? I’m fine. “These are like the baby steps beginning improvisers take. They learn the structure of the blues. They learn basic chords and get the form down,” said Berkowitz. But they’re still very limited in what they can do…

The trajectory of acquiring a language, according to Berkowitz, where you begin with learned phrases, achieve fluency, and are eventually able to create poetry mirrors perfectly the process of learning to improvise. In the same way a language student learns words, phrases and grammatical structure so that later he can recombine them to best communicate his thoughts, a musician collects and commits to memory patterns of notes, chords and progressions, which he can later draw from to express his musical ideas.

After reading the piece I wondered if the brain handles musical improvisation in a similar way to how it manages freestyle rap, as they both require unplanned spontaneity but within the restrictions of ‘what works’.

Sadly, so far, science has completely neglected the neural basis of hip-hop, but we live in hope homey.

UPDATE: Mind Hacks posse in full effect. In the comments NT mentioned that neuroscientist Charles Limb has got a freestyle rap study in progress and neuromusic noted that DJ and neuroscientist @djenygma tweeted earlier today he was “Sitting in on #fMRI experiment using local rappers in a freestyle-vs-memorized processing task”.

Link to excellent article on musical improvisation.

Psychologist to the dead

In Havana, even spirits of the dead can have troubled minds.

Although the concept of ‘troubled spirits’ is quite common throughout the world, the Cuban group Sociedad de Estudios Psicológicos Amor y Caridad Universal goes one step further and provides psychologists to treat the conflicted emotions of both the apparition and its possessed human host.

The latest edition of Anthropology and Medicine has a wonderful article that discusses the spiritualist group and their unique take on psychology.

In Havana, the idea that all beings – living and dead – can have psychic and emotional conflicts is common among followers of spiritism (espiritismo), a practice of spirit mediation whose origins are associated with the nineteenth-century mystical teachings of Frenchman Allan Kardec. Spirits too, have lived lives and acquired memories, and often, it seems, accumulated unproductive patterns of thought and behaviour that they are keen to vent on their living counterparts. In the worst of circumstances, believers are expected to seek potent ritual experts to dispatch such beings from the earthly planes of existence they disrupt.

It’s an absolutely fascinating read, as it looks inside the organisation which is at once church, spirit channelling group and clinic. This an amazing part that recounts a session of therapy with a ‘spirit’:

D began suddenly sobbing like a little girl and curling up in his seat like a child. Antonio asked a developed medium next to him to attend to the spirit: ‘investigator, ask her why she is crying, investigate!’ The woman began to talk to the spirit, and attempted to comfort her, but the spirit wouldn’t open up – she only cried incessantly. Antonio asked her directly: ‘what did they do to you? Take this opportunity to get it out of your chest’. ‘They abused me’, the spirit replied immediately.

Antonio turned to the group and explained, in teaching-mode, that this spirit was traumatised, and was reflecting her trauma on the girl (Y). The spirit shook, all shriveled up in her seat. ‘A man abused me’ she managed to say. Antonio kept up his questions, asking increasingly specific ones, and punctuating his investigation with forthright commands of ‘talk, speak!’ He also told the spirit: ‘but all that is over now’, urging it to move on. ‘This is why you took your own life, isn’t it?’ Again out loud to all of us, he remarked: ‘those were the days when virginity was sacred …’

According to the article, the group was founded in the 1950s by Claudio Agramonte who had a complex psychological theory of spirit psychology dictated to him by the spirit of a dead doctor called José de Luz.

Rather appropriately, the article is by a Portuguese academic called, Diana Espirito Santo, which literally translate to Holy Spirit Diana. An interesting case of nominative determinism of which I’m sure the spirits would approve.

The article goes on to discuss how the concepts of the group operate with the social world of Cuba, but is unfortunately locked behind a pay wall, because you’re not old enough to be trusted with anthropology and, anyway, it would probably spoil your dinner.

Link to summary on PubMed.
Link to DOI entry.

The brain isn’t going to take it lying down

The brain may manage anger differently depending on whether we’re lying down or sitting up, according to a study published in Psychological Science that may also have worrying implications for how we are trying to understand brain function.

Anger experiments that have measured electrical signals from the brain (using EEG) or that have altered neural activity with magnetic pulses (using TMS) have found that the left frontal lobe is more active than the right, but studies using fMRI functional brain scans have found no differences.

Psychologists Eddie Harmon-Jones and Carly Peterson wondered whether the brain might be working differently in EEG and TMS experiments because the participant is usually sitting upright, while in fMRI, the person is usually lying flat on their back.

If this seems like a trivial distinction as far as emotion is concerned, it actually has some sound theory behind it. A field of study called ‘embodied cognition‘ has found lots of curious interactions between how the mind and brain manage our responses depending on the possibilities for action.

For example, we perceive distances as shorter when we have a tool in our hand and intend to use it, and wearing a heavy backpack causes hills to appear steeper.

Anger is a prime example where we feel motivated to ‘do something’. In the sitting position we’re much more ready to approach whatever’s annoying us than when we’re flat on our backs, and the researchers wondered whether these body positions were interacting with our motivations to change the brain’s response.

So Harmon-Jones and Peterson asked 46 participants to write a short essay before wiring them up to an EEG that measured the electrical activity across the brain.

The participants then put on headphones and listened as someone else read their essay and rated the author on personal characteristics, such as intelligence and competence. Some participants listened while lying down, others while in the sitting position.

What they didn’t know was that the ‘raters’ were actually pre-recorded audio, and while some heard a benign commentary on their work, other participants heard the other ‘person’ slagging-off them off and harshly rating the participant and their personality.

In line with the ‘ready to respond’ theory, when the participants were angry and sitting up, the left frontal lobe was much more active than the right – but when angry and lying down, there was no difference.

First off, the findings provide evidence that body position interacts with how the brain processes emotion, perhaps depending on which actions are immediately possible.

But more importantly, the experiment might also indicate that different neuroscience techniques may be throwing up varying results because of the differing body positions needed to take the tests.

Although this is only an initial study, it could be a major spanner in the works for cognitive science which often assumes that clumping together evidence from a whole range of techniques gives a better idea of what’s going on.

pdf of full-text of study.
Link to PubMed entry for study.
Link to DOI entry for study.

Fear of one’s own glance

The Australian and New Zealand Journal of Psychiatry has an intriguing article on a Japanese psychiatric diagnosis that doesn’t seem to have a Western equivalent: ‘fear of one’s own glance’ or jiko-shisen-kyofu.

On the basis of the Japanese diagnostic system, phobia of one’s own glance is characterized by a fear of one’s own glance, which they believe assumes an offensive nature and is uncontrollably directed at persons near them. Individuals with phobia of one’s own glance believe that their glance brings others discomfort, and people with this diagnosis convince themselves of the accuracy of their belief by interpreting the trivial behaviour of others (e.g. coughing, laughing, sniffing, sneezing, head turning, etc.) as evidence for this belief. Such patients feel deeply ashamed, demeaned, and unaccepted, and many eventually avoid social situations. A diagnosis of phobia of one’s own glance is not contingent upon whether or not a patient considers his or her thoughts to be excessive; therefore, neither the presence nor a lack of insight is essential for the diagnosis.

The paper gives several case studies that include people who are concerned that their glance made other people feel uncomfortable, was a nuisance or was socially harmful to others, or made the patient themselves feel uncomfortable.

Link to PubMed entry for study.

A visit to San Lázaro

History of Psychology has just published a brief article I wrote about my trip to Hospital San Lázaro in Quito, Ecuador, one of the oldest psychiatric hospitals in Latin America and still a working mental health facility.

…

In the strong morning light, the whitewashed walls of the Hospital Psiquiátrico San Lázaro come alive with lucid sunshine. The beautiful but commanding building looks out over Quito’s old town, set back from the historic centre, where it retains its ambivalent mixture of the modern and medieval. It’s not a welcoming structure and, externally, seems more castle than care facility. Visitors need to enter large metal gates, before climbing an external ramp, and then must announce themselves to reception in the imposing stone gatehouse. I had come, I explained, to visit the hospital, but so far had no luck getting in touch with anyone to organise an appointment.

I had heard of ‘El Hospicio de Quito’ from colleagues in Colombia who had informed me that it was one of the oldest psychiatric hospitals in Latin America, but yet it merits barely a mention in the English language literature and surprisingly little in the Spanish. Determined to discover more, I visited the hospital and, after arranging to return with a letter officially requesting my visit, I was shown round by one of the staff psychologists.

You can see virtually nothing of the hospital from the gatehouse, but after stepping through the iron doors you find yourself in a courtyard of surprisingly gentle beauty, filled with trees and fountains, and surrounded on all sides by the building’s open internal arches. Although built at the dawn of the Renaissance, the hospital feels more like a medieval fantasy and is made up of a collection of multi-level walkways and clinical areas in cobbled courtyards that seem to have been ‘added on’ rather than designed.

The consulting rooms are sparse with high ceilings, while the patient wards, both male and female, consist of large dormitories and both indoor and outdoor communal areas around which patients meander until therapy, mealtime or visits take priority. But despite the antique façade there was determined modernisation programme in progress, with both the historic chapel being restored and the clinical facilities being renovated.

As I discovered at the time, the hospital itself is not the best place to go to research its history and I have learnt in retrospect that there are much better sources for the serious investigator – albeit ones which necessitate a visit to the city. Nevertheless, I managed to find some background in Luciano Andrade Marín’s (2003) La Lagartija que Abrió la Calle Mejía; Historietas de Quito thanks to the assistance of the staff at the Biblioteca Municipal. The hospital lies on the site of a Jesuit seminary originally founded in 1587 as a place of training and spiritual retreat.

Although damaged in the volcano eruption of 1698 and the earthquake of 1755, the building retains many of its Jesuit features including an impressive baroque entrance arch. The building lay empty for some years after the expulsion of the Jesuits in 1767 although by 1785 the Royal Order of Spain (a plaque in the hospital names them the Mercedarians) had converted the seminary into a hospice for the poor, disabled, mad and leprous. By the time of Ecuador’s independence, the hospice was notorious for the brutal treatment handed out to its mentally disturbed residents.

The hospice was taken over by The Sisters of Charity in 1870 who dedicated the institution to the mentally ill and began altering the building to better accommodate its more singular purpose. Patient care was not so forward thinking, however, and a doctor who visited the hospital in 1903, quoted in Andrade Marín (2003), minced no words in describing the conditions: the patients “were treated like animals… writhing in unclean yards, enclosed in dirt and gloomy dungeons, fed like wild beasts… naked and maltreated”.

Sadly, I found out little about the 20th Century history of the institution, but now considerably more humane and caring, the institution is one of the most important psychiatric hospital in Ecuador. Those wishing to investigate further may want to obtain Mariana Landázuri Camacho’s (2008) book Salir del encierro. Medio siglo del Hospital Psiquiátrico San Lázaro, which apparently contains a more complete history, although seems only available from select shops in Quito. The city libraries I visited could only provided limited help but apparently archives relating to the hospital are held in Quito’s Museo Nacional de Medicina.

The building is not open to the public, but the staff were friendly and welcoming, and, at the very least, the exterior is worth a visit for its architectural beauty and evocative location. There are no histories of this important institution in the English academic literature, and Landázuri Camacho’s book is apparently the only serious attempt at historical scholarship anywhere. Clearly, there is still much to be investigated about the history of this important institution.