[Announcer:] Wyeth Laboratories is privileged to present Out of Darkness,
produced in consultation with the American Psychiatric Association
and the National Association for Mental Health,
with Dr. William C. Menninger as Medical Narrator and starring Orson Welles as The Reader.
[Reader:] A tree, as it stands isolated on the plain, no companion like thousands in the forest,
bears within its bark all the materials for rapid combustion.
For all so cool and green as it looks, the elements of its destruction are circling through it,
through branch and trunk, leaf and roots.
Between the tree and the fire, and man and madness, a close analogy exists,
and then they part.
The fire must come to the tree.
Man can go and seek madness, can toil and pray and suffer,
and, as it were, go a-courting this fearful bride.
And numberless are the paths which lead to the region of darkness in which he dwells.
[Music: Mournful female vocal rendition of "Greensleeves"Out of Darkness]
[The Reader: Orson Welles]
[Medical Narrator: Dr. William C. Menniger]
[A CBS Public Affairs Program]
[Produced in consultation with the American Psychiatric Association
and the National Association for Mental Health]
[Out of Darkness is an actual filmed record of three months in the life of Doris L.,
a patient in a mental hospital largely photographed through one-way glass.
It is a story of new hope and promise for the mentally ill.]
[Reader:] On the program you're about to see, there will be no actors,
with the possible exception of myself, and I'm not going to do any acting.
I'm just going to read to you a few pages from a book now and then.
We're going to make a journey through the world of mental disorder.
It's a world which is unknown and feared by most of us,
but not nearly so desolate of hope as we might imagine.
One of our guides will be this book that I'm going to read from.
It's quite a remarkable book, written over a hundred years ago by an unknown man,
a former patient in a mental hospital in Glasgow, Scotland.
Our other guide will be a doctor, Dr. William Menninger,
one of America's foremost psychiatrists.
Through these two voices, one from the present, one from the past,
perhaps we'll be able to gain some measure of insight into one of the most urgent health problems of our time,
into that vast and greatly misunderstood portion of humanity, the mentally ill.
And now from the book.
I am not a medical man.
My claim to be heard is founded not upon education or position,
but solely upon what I've seen and what I've suffered.
For seventeen years, I have been in communication with insanity,
and for a long time I've been impressed with the idea that could this disease be rendered more familiar
and of course less repulsive to the public mind,
its chance of being checked and subdued in the first stage would be much greater.
In the hope of dissipating this dread and freeing the bright spirit of hope from the talons of despair,
I've written this little book.
And while keeping truth in view, I've endeavored to strip lunatic asylums of all imaginary terrors
and to render them familiar to the public view.
[Sign: Metropolitan State Hospital]
Lunacy, like rain, falls alike upon the evil and the good.
And although it must forever be a fearful misfortune,
yet there is no more sin or shame in it than there is in rheumatism or a fever.
[Sign: Ward 29]
Had I the certainty of an attack of insanity before me and the power to prescribe for myself,
I'd say, "Put me in a place where I can do no harm to myself or any other person.
And let that place not be a prison in which penance must be undergone and punishment suffered,
but let it be a place of refuge, an asylum."
[Patients and healthcare workers murmuring]
[Intake nurse:] I'm glad you came in because I've been wanting to talk to you about your wife's illness.
Did you notice when her illness started?
[Patient's husband:] Yes, I did, about three months before I'd taken her to the hospital.
I noticed strange things happening around her and, uh, I...
It got so bad that I was afraid to leave her by herself while I was working, you know.
[Intake nurse:] What did your wife do when you first noticed she was getting upset?
[Patient's husband:] I noticed her doing strange... uh... strange things such as, uh...
sitting at the window from morning till night and not dressing, uh, at all.
And, uh, I would talk to her, and she wouldn't answer,
and then in fact, one day, that, uh, the neighbors told me that she went out in the nude.
And one of the neighbors caught her just in time as she was crossing the street and brought her back in,
and they, uh, was kinda ashamed to let me know anything about it, and uh...
When I went to the pay the rent to my landlady, why, she told me about it.
And that's when I really began worrying.
And another thing that, uh, made it seem strange that she was...
had the Bible in her hand from morning till night, which she never did do before,
and I would come home at night, and she'd point out verses to me.
And she would write notes, you know, and lay in the... uh, different pages of the Bible that she'd written down.
And she would, uh... She was always talking about the stars and moon and stuff like that, you know.
And, uh, I knew then that something was wrong, but I didn't... couldn't catch it right away.
[Intake nurse:] I understand Doris is mute now, that she won't talk to anyone.
Was she a talkative person before her illness?
[Patient's husband:] Very talkative.
She used to be pleasant and... and, uh, joyful, you know, and... and always singing around the house, you know, and, uh...
Well, she always done something to occupy her mind. She could make friends with anybody.
She had some friends that, uh, came to the house quite often, and she would just sit there and have a wonderful time with them.
And, uh, when I noticed her getting into this stage,
uh, she didn't recognize these same people that she had had a lot of fun with and talked to earlier.
[Intake nurse:] It was a hard decision to decide on sending her to this hospital.[Patient's husband:] I'll say it was.
And I was just wondering if that should, uh... if that will be held against me when she does come home.
[Intake nurse:] Many patients when they come here have some resentment about coming,
but as they begin to feel better, quite often they realize that coming here was for their own good
and their own happiness in the long run.
[Patient's husband:] Yes, ma'am.
[Intake nurse:] I know you'll worry about it, though, until that time comes.
[Patient's husband:] I do.
[Murmuring]
[Typewriter keys click as someone types: "9-2 PATIENT CONTINUES TO BE MUTE AND WITHDRAWN"]
[Murmuring]
[Conversation and sounds of pots and dishes in the kitchen as staff prepare food]
[Woman 1:] All right, you girls just stand and just wait until I find a place for you.
The rest of you, sit down.
[Murmuring, conversation]
[Typing: "9-12 INDIVIDUAL PSYCHOTHERAPY RECOMMENDED"]
[Mrs. Murphy:] There's nothing to be afraid of in here. Let's just look around.
Would you like to look at some of the books?
Why don't you just sit down and be comfortable?
Does it make you feel better to hold my hand?
You can if you want.
Don't be so frightened.
[Dr. Cholden:] Doris, I'm Dr. Cholden.
I'm your doctor.
And you and I will meet together three times a week.
This is your time.
You can do whatever you want during this time.
If you want to be quiet, that's fine with me.
If you want to talk, that's fine with me.
I'm perfectly satisfied to spend this time in any way that you want to spend it,
because I'm your doctor, and I want to help you.
[Dr. Cholden:] Doris, would it be all right if Mrs. Murphy waited for you in the hall?
[Mrs. Murphy:] I'll give you a cigarette before I leave.
I'll be right out in the hall. I'll wait for you there.
[Doris nervously smokes her cigarette]
[Dr. Cholden:] You're wondering, "What does he want to do to me?"
I only want to understand you and to help you while you try to understand yourself.
And this is a place where you can't hurt anyone, and no one can hurt you.
A safe place.
A place where you can do what you want, and I will understand.
Try very hard to understand, that is.
Doris, we'll meet again on Monday, in three days.
[Reader:] There is a root from which these symptoms spring,
a reason so powerful in its irrationality as to shake the sufferer almost beyond endurance.
And there is a long chapter in the book of human nature, unread by one who would judge an insane person
solely by her behavior.
[Dr. Menninger:] From a technical point of view, we know that all of us do have mental devices,
tricks in a sense, that work automatically to try and relieve us when we have a feeling of fear or anxiety or tension.
We all of them you... We all of us use these tools.
When the road going gets rough for many of us, we at times all use one or two major
methods of combatting the situation.
One of them is flight.
We take flight from it in one way or another by procrastination or forgetting, or neglect,
or perhaps going to sleep, or running off physically, sometimes maybe getting sick.
Or the other reaction is the fight reaction,
a reaction in which sometimes we threaten and even destroy the situation that we want so much to save.
We get angry. We blow our top.
We get so mad that we don't think what we're doing when we destroy the situation.
All of us do that sometimes.
Life's full of stress for all of us.
But for some people, it goes on too long and there's too heavy,
they begin to bend, and they break.
And that's what happened to these patients.
As we see them here, their action and behavior seems bizarre and strange to us.
But really, it's just their attempt at solution, using the same devices that we use,
to find a happy way out, but it's so unhappy.
And now the job is to help them find a better solution.
And that's the assignment that the doctor and the hospital takes on when they come to us.
[Reader:] As a flood of fire from the bosom of a living volcano sweeps down the verdant slope,
turning flower and fruit into smoke and ashes,
so does insanity sweep over laughter and happiness.
And where those glorious attributes once flourished,
we find only desolation and darkness.
Yet I may add, for the consolation of the afflicted and their friends,
that the coming of insanity need not permanently injure either the feelings or the intelligence.
In a great majority of cases, provided proper treatment is resorted to at the outset,
it is curable.
[Dr. Menninger:] If there was room for optimism a hundred years ago,
there's room for much more optimism now about the cure of mental illness.
I don't beleive any group of illnesses have the potential recovery rate that mental illness does.
The tragedy is that because of the lack of doctors and facilities,
that many patients don't have a chance to have the right treatment.
What do I mean by the right treatment?
Well, those that know a little about it have heard of shock, electric, and insulin.
These are applicable in perhaps five to ten percent of cases.
And then a new door has been opened with the advent of drugs, the so-called tranquilizing drugs.
Pray, they hold much promise too, but they're not a cure-all.
They're not going to radically change the situation, because at best, they just help the patient become accessible to help.
Help him able to talk, help him participate in the program at the hospital.
Actually, they're... Both the drugs and the shock treatment are comparatively unimportant
to the role of the hospital as a whole.
The hospital has to provide, in a sense, protection for a patient, protection sometimes from himself,
certainly protection from those waves that have engulfed him.
It has to do this in various ways in its physical setup.
It has to do it in a program of activities, opportunities where the patient can express his interests
and perhaps learn new interests.
And that's why in psychiatric institutions,
we have to have a program that includes classes, perhaps in music and art,
and maybe even typewriting, social events, games of all kinds, lots of different crafts.
Quite apart, though, from the hospital in its physical setup,
the most important thing are the people that work in that hospital.
Those people have to be trained.
They have to be taught the meaning of mental illness
so that they have a rationale to be patient and tolerant and helpful.
Most of all, if the patient gets well in the mental institution, it's because of personalities that surround him,
the people that will help him.
The doctor is kind of the captain of the crew.
He's the fellow that's got to find out what's wrong with the individual
and what ought to be done about it, what ought to be prescribed for the patient, and plan the program in the hospital.
More important perhaps are his personal contacts with the patient.
His contacts as a guide, as an interpreter,
as a person who understands and will help the patient understand.
The individual who has got to guide the patient, if he can, back to health.
And very often, this occurs in frequent, regular sessions with a patient
that technically we call psychotherapy.
[Dr. Cholden:] Doris, you may sit down whenever you like.
I really can't help you to decide.
When you're a little less afraid in here, it will be easier to decide.
At the moment, it seems to me, Doris, you're feeling tight, frozen,
holding yourself in so you won't get hurt anymore.
I think you know, Doris,
that I want to help.
But I think you can't be sure if you can trust me.
If I'll stand by you when you need me
and if I'll remain with you, to help. I will.
[Sign: "Visiting To-Day"]
[Reader:] During the whole period of my residence in the asylum,
my wife visited me upon a stated day each week.
And no week passed without her seeing me.
Though I was often unable to let her know at the time, these visits gave me something to think upon.
Being, as it were, a solid spot in a troubled ocean whereon the spirit could occasionally rest.
[Background conversation]
[Doris' husband:] Doris, did you like the magazines I brought you?
Will you read some more if I bring you some?
[Murmuring]
[Background conversation]
[Doris' husband:] Won't you talk to me, honey? Huh?
How do you think I feel when I hear your voice talking?
Don't you think it makes me happy?
Don't it?
Don't you think it makes me happy to hear your voice?
You gotta make up your mind, Doris.
You gotta make up your mind, angel, to get your mind off these other people, and you've got your life to live. Don't forget that.
Haven't you?
Now, whose life are you living?
Maybe that's the trouble. You're not living your life, you're living somebody else's life.
Doris, I'm gonna ask you and I'm gonna tell you something now.
You oughtta see the little place I got now. It's the only damn reason in the world I got it, Doris.
You could come home with me, and I'd fix it up so nice.
I got a nice old living room,
and I've got a bedroom, twin beds,
and I got a nice bathroom and a nice kitchen.
And I bought a television set.
Who do you think I'm doing that for? Not for me, honey.
I'm not doing it for me. I don't give a damn, well, I'd just have a...
a floor to sleep on.
I want you to get well and come home.
Will you get well? Will you get well?
[Dr. Cholden:] Sometimes, Doris,
I get the feeling that you're very angry with me.
And that's all right.
And part of that anger is because you're not sure you want to come here.
Sometimes you feel I'm forcing you.
It's as though you decided to take a rest from the world, a retreat.
And somebody is trying to pull you out of that retreat, and I am that somebody.
But I'm not pulling you. It's your decision.
But if you decide to come out of your retreat, maybe I can be of some help.
Doris, would you like to use my comb?
It must be very hard to decide whether you want a doctor
and whether you want me to be that doctor.
All I can do is to offer my help,
put it on the table, so to speak.
And you can decide whether to take it or not.
Like the comb, I'm available and my help is available.
You must decide whether you want that help.
[Announcer:] Wyeth Laboratories is presenting Out of Darkness,
produced in consultation with the American Psychiatric Association and the National Association for Mental Health,
with Dr. William C. Menninger as Medical Narrator and starring Orson Welles as The Reader.
We continue now with part two of Out of Darkness.
[Reader:] No position can be more honorable than that of a conscientious and humane physician
who devotes his time and talents to the treatment of the insane.
And what a fearful responsibility clings to the office which he has assumed.
For in many cases, it rides with him
whether the patient be saved or lost.
[Clicking sounds as a reel-to-reel tape recorder is set up]
[Dr. Cholden:] Progress Summary, Doris L., third week of treatment.
The patient's acceptance of my comb and her desire to take it back to the ward with her
are clear indications that she accepts the idea of help and of a doctor.
Her previous terror is gone and in general she seems to be much more relaxed and comfortable.
However, there is still a considerable amount of anxiety present.
Each effort of mine to achieve closer contact presents a new threat to her.
And in this formative stage of our relationship,
there are still many things which she is not yet prepared to accept.
Would you be less frightened if I held your hand?
Don't take my hand if it will make you uncomfortable.
It's too hard now. I understand.
[Sign: "Ward 29"]
[Music]
[Man:] Here we go!
[Singing:] Oh, give me a home/Where the buffalo roam/
Where the deer and the antelope play/
Where seldom is heard/A discouraging word/
And the skies are not cloudy all day/
Home, home on the range/
Where the deer and the antelope play/
Where seldom is heard/A discouraging word/
And the skies are not cloudy all day
[Dr. Cholden:] Progress Summary, Doris L., sixth week of treatment.
Well, the most significant development over the last few interviews
has been an increase in the patient's response to the external environment.
Doris, the other side of the cigarette.
Doris, the other side of the cigarette.
As Doris becomes more alert to her surroundings,
I find that I am beginningto get a clearer sense of the woman beneath the illness.
[Music: Guitar/ukelele rendition of "Greensleeves"]
[Reader:] There are people here enjoying the twilight and the beauty, and the fragrance of the trees,
who in other places would still be lying in bonds and darkness.
[Dr. Cholden:] Doris?
And now we are friends.
[Woman 2:] Oh you did get one!
[Reader:] Activity of almost any kind cannot fail at being beneficial,
especially if attendants or other sane people can be involved in the enterprise.
It breaks up that stagnation of the mind, consequent upon the monotony
which must ever reign within these walls.
[Overlapping conversations]
[Nurse:] Almost.
Hundred... You've got a hundred and fifty. Two hundred. Two fifty.
Mary! Three hundred.[Woman 3:] Oh, marvelous!
[Reader:] Activity soothes the excited, cheers the desponding,
and turns the mind aside for the time from the corroding task of contemplating its own sorrows.
[Background conversation]
[Dr. Cholden:] Progress Summary, Doris L.,
tenth week of treatment.
Non-verbal contact has been firmly established.
It is now time to encourage her to talk.
And now, this attack on the defense of muteness will undoubtedly increase her anxiety,
and it may lead to a setback.
However, I feel it's a risk worth taking.
I'm trying to understand.
But sometimes I can't understand unless you tell me in words.
I want to help answer your questions, if you feel that you can ask them now.
Questions that you may have about being in a hospital.
You know you're in a hospital, Doris.
This is a hospital.
And I'm your doctor.
It's not easy when you decide to remove yourself from people.
But once it's done, it's even harder to get close to them again, isn't it?
I somehow feel that there are things you would like to let me know.
But you don't know how.
You still have to prevent yourself.
Do you remember why they brought you here, Doris?
Doris, would you feel more comfortable if you whispered in my ear?
Maybe you're fearful about saying things.
You're afraid of what might happen if you talk.
Are you afraid of all that?
Hmm?
Take it.
[Doris:] Pretty pearl. Is that a real pearl?
[Dr. Cholden:] I don't know.
Do you like pretty things, hmm?
[Doris:] Mm-hmm. I had some pearls at one time.
[Dr. Cholden:] Where did you get the pearls?
[Doris:] They were a present.
[Dr. Cholden:] From whom?
Hmm?
Who gave you the pearls?
[Doris:] Oh...
[Doris:] A friend of mine.
[Dr. Cholden:] What happened to the pearls?
[Doris:] [Gasps] I lost them.
[Gasp]
[Blowing her nose]
[Dr. Cholden:] It makes you want to cry to think about the things you've lost.
[Doris:] [Sigh] I've lost quite a bit.
[Dr. Cholden:] Is it hard to remember?
You took a rest.
And you kind of...
went inside yourself and held yourself quiet.
I get the feeling now that you're ready for a change.
Ready to finish your rest
and talk to people.
Thirteenth week of treatment.
With the emergence of the patient into reality, the first major stage of treatment is over.
We're ready now to utilize our relationship in order to help her understand herself and her illness,
and also to give her support as she moves into new areas of experience.
[Music: Guitar/ukelele rendition of "Greensleeves"]
[Reader:] I know some who will say, "Though she appears pretty well now,
were she to leave this, who knows, but she might relapse.
No doubt she would like to return to the world, but many there would distrust and despise her.
No one does so here.
However, it is in the busy avenues of men, not in the solitude and shelter of the asylum,
that the cure must be perfected.
[Music]
[Music]
[Out of Darkness]
[The Reader: Orson Welles]
[Medical Narrator: Dr. William C. Menninger]
[A CBS Public Affairs Program]
[Produced in consultation with the American Psychiatric Association]
[and the National Association for Mental Health]
[With the cooperation of the Department of Mental Hygiene, State of California]
[and the patients and staff of Metropolitan State Hospital, Norwalk, California]
[Therapist: Dr. Louis Cholden, Department of Psychiatry, U.C.L.A. Medical School]
[Cameraman: Fred Dieterich;Mr. Welles' Photography: Arthur Ornitz]
[Editors: Arthur Swerdloff, John Hoffman; Associated in Production: Lewis Jacobs]
[Production Manager: Harry Robin;Production Coordinator: Arthur Swerdloff]
[Executive Producer: Irving Gitlin]
[Produced, Directed, and Written by Al Wasserman]
[Dr. Menninger:] This was an amazing experience.
We watched a real patient with a real doctor in a real hospital with a real husband get well,
a seriously mentally ill patient.
But in a sense, this has created an illusion maybe,
an illusion that I'd like to try to correct if I can,
because I feel so deeply in my heart the suffering and the unhappiness
of 750,000 patients in our hospitals in this country, and not a handful of them are getting the treatmen that this patient did.
Why? Because in that big population, the size of the city of Pittsburgh,
there's only one doctor for every 311 patients.
What chance would Doris have had if she was one patient
among 310 others with one doctor?
We're trying to run these hospitals on the ridiculous sum of two dollars and a half a day, per patient.
And that includes the board and the room and the clothing and the medical attention.
You and I know that it costs ten times this amount, fifteen times this amount to go to a general hospital.
What we can... What can we expect in this field of mental health
if we're going to try to do that kind of a job at two and a half a day?
And furthermore, we're starving to death in our field of psychiatry for more knowledge.
We ought to be able to help these people more quickly.
We ought to be going much further in how do we prevent mental illness?
And yet research in psychiatry's a drop in the bucket to the needs.
It's the biggest cost of all the health problems, a billion two hundred million dollars a year.
And we don't spend one-half of one percent learning how to do our job better.
In this rich land across the country,
would that we could enlist people's understanding of how big this problem is,
how neglected, how backward we are, in our knowledge of what ought to be done
so that many, many girls like this could get well.
The facts are that six out of every ten people that go to a mental hospital never leave it.
And that doesn't have to be.
We've got proof now and can show it, that at least eight out of every ten could go home
and again be happy and useful citizens.
This is a universal problem.
It affects us all.
It ought to be a concern of every individual as to what can we do about it.
So many places need help.
They need financial support. They need clear and better understanding.
And only as more people do understand is there going to be change.
I have a deep conviction that when people know and understand, it will be changed.
[Announcer:] Wyeth Laboratories has been privileged to present Out of Darkness,
a CBS Public Affairs Program, produced in consultation with the American Psychiatric Association
and the National Association for Mental Health.
[The EndMCMLVI Columbia Broadcasting System Inc.All rights reserved]