The Crazy from the Sane


The Crazy from the Sane, by Peter Breggin, New York: Lyle Stuart, Inc., 1971

Subtle violence is often more difficult to deal with than overt physical attack. Violence can be institutionalized and so routine that it is overlooked; or it can be so carefully woven into the context of experience that its identity remains unperceived. Violence so completely integrated into a system may "disappear".

Institutional Psychiatry, the organized psychiatric profession, and the majority of practicing private psychiatrists in this country, constitute a system of repressive social control. Government has, through legislative enactment, provided commitment laws which legally permit the involuntary incarceration and "treatment" of any citizens chosen by the psychiatric profession.

Though several books, for example, ONE FLEW OVER THE CUCKOO'S NEST by Ken Kesey, have conveyed an accurate picture of what the systematic violence of institutional psychiatry does to its victims, to my knowledge THE CRAZY FROM THE SANE by Dr. Breggin is the first to depict what it does to psychiatrists.

Upon completion of medical school and one year of internship, specialization in psychiatry requires a minimum of three years resident training. THE CRAZY FROM THE SANE is a story of what often happens to many psychiatric residents during their third and final year of training. The story corresponds so closely to my personal experience, that reading the book evoked a strong and poignant reaction. Although a novel, the book conveys an accurate picture of the realities of psychiatric residency. Dr. Almquist's transition from idealist to cynic, and Dr. Clement's continual battle with his supervisors seem to me like mirror images superimposed on memories of my colleagues and friends in the days of my residency.

As a novel, however, the book has some severe shortcomings. For example, Dr. Clement's explicit awareness of the coercion built into Institutional Psychiatry is presented as a given, as if there had never been a process of growth and he had not had to struggle to identify the facts which gave rise to his awareness. For this reason, his characterization lacks reality. Also, Dr. Almquist's sudden change from admiration for the spirit and perceptiveness of Clement, to fear and betrayal of his friend for daring to challenge the ideas and values of his superiors, is too abrupt, and more development and evolution here also would have improved the book.

Even with its shortcomings as a novel, however, this book is enlightening reading. Although anyone would enjoy the story and gain a perspective on the psychiatric profession, I particularly recommend the book to psychiatric residents, psychiatrists and psychotherapists.

Dr. Henry E. Jones is a psychiatrist in practice in Los Angeles, California. During the course of his training, he has worked at state and county hospitals in Louisiana, Pennsylvania and California. He is an active member of the American Association for the Abolition of Involuntary Mental Hospitalization.


Dr. Peter R. Breggin, author of THE CRAZY FROM THE SANE, has become the country's leading crusader against the apparent return to popularity of "psychosurgery"—lobotomy and other surgical techniques for altering behavior by selective destruction of brain tissue. His article "The Return of Lobotomy and Psychosurgery" was inserted into the CONGRESSIONAL RECORD (24 February 1972) by Rep. Cornelius Gallagher, and his "Return of the Lobotomy" (with Daniel S. Greenberg) appeared in the WASHINGTON POST on 12 March 1972. He may be reached at the Washington School of Psychiatry, 1610 New Hampshire Ave., NW, Washington, DC 20009. REASON will explore the subject of psychosurgery in a forthcoming issue.