November 8, 2007
Land of the Living Sky With Diamonds: A Place for Radical Psychiatry?
By Dyck, Erika
Dr. Humphry Osmond first published the term "psychedelic" in 1957 as a result of an extensive set of clinical investigations with d- lysergic acid diethylmide (LSD) that took place in Saskatchewan in the 1950s. In the post-World War Two period, Saskatchewan became an attractive destination for medical, and in this case psychiatric, researchers who wanted to pursue theoretical and practical investigations that challenged disciplinary boundaries and critically examined the relationship between medicine and the state. Partly as a result of Saskatchewan's post-war political culture, the province became an intellectual sanctuary for medical experimentation that in some other contexts did not gain currency because it appeared too radical. This essay examines the way that psychedelic psychiatry emerged in that province and argues that the social, cultural and political environment in post-war Saskatchewan played a significant role in attracting researchers and supporting LSD research. C'est en 1957 que le Dr Humphry Osmond publia le terme > pour la premiere fois a la suite d'une serie de recherches cliniques sur le LSD menees en Saskatchewan dans les annees 1950. Durant la periode qui suivit la Seconde Guerre mondiale, la Saskatchewan devint une destination attrayante pour les chercheurs en medecine, et dans ce cas, en psychiatrie, lesquels desiraient conduire des recherches theoriques et pratiques qui remettaient en question les frontieres disciplinaires et qui portaient un regard critique sur la relation entre la medecine et l'Etat. C'est en partie en raison de la culture politique d'apres- guerre de la Saskatchewan que la province devint un sanctuaire intellectuel destine a l'experimentation medicale, laquelle ne fut jamais accreditee dans d'autres contextes parce que jugee trop radicale. Cet article examine la facon dont la psychiatrie psychedelique a vu le jour dans cette province et soutient que l'environnement social, culturel et politique d'apres-guerre en Saskatchewan a joue un role preponderant aupres des chercheurs et qu'il a servi de soutien a la recherche sur le LSD.
In 1955, when asked why medical scientists in Saskatchewan were excited about their jobs, psychiatrist Abram Hoffer responded by claiming that the province offered optimal conditions for scientific research. He attributed this situation to a mixture of governmental support and professional liberty. He boasted that researchers there enjoyed an "unusually fertile climate for research-not in terms of temperature or snow or wind, though Saskatchewan is prodigal with these-but a climate of freedom. He added that the "unique" environment in Saskatchewan would undoubtedly make the province a world leader in medical research through its capacity to attract top scientists and explore fresh ideas. During the 1950s, Hoffer and others working in Saskatchewan became internationally recognized in the mental health community for their investigations of the drug d- lysergic acid diethylamide (LSD).
Hoffer's comments from this period identify the significance of "place" as having an influence on his research, and yet the precise meaning or process by which place affects him remains unclear. An examination of the LSD investigations in Saskatchewan in the 1950s indicates that Hoffer was not alone in his assertion, but there is no particular articulation of how place contributed to these experiments. During the period after the First World War, other medical and psychological researchers joined Hoffer in Saskatchewan and formed part of a dynamic research group whose contributions were pioneering and controversial, but also expressed a slightly different approach to mental health that can be partly explained by the place where the research occurred. Ideas about place shaped the LSD experimentation as place became an intellectual conception, partly ideological and partly about a specific location, with its own historical, political, and social connections to the local environment. The emergence of psychedelic psychiatry in Saskatchewan suggests that the intellectual and geographical climate of experimentation produced a set of conditions that influenced medical research in ways that were not experienced elsewhere.
Western Canada, the prairies, provincial entities, and geographical and social landscapes have received scholarly attention as worthy subjects of study in terms of defining regions, spaces, places, and communities, and attempting to understand the relationship between places and experiences.1 The West is not alone in Canada as a region that has been repeatedly reconceptualized according to competing political and cultural justifications.2 As Gerald Friesen has argued, the very idea of "region" in Canada continues to evolve and exhibits tensions between region and nation, while the growing importance of geography, culture, and memory also contributes to the social meanings ascribed to spatial and temporal relationships (2001, 545). Region, Friesen contends, historically connoted a politically defined relationship within a federal framework, particularly on the Canadian landscape, but this somewhat static definition does not adequately convey the sensations that the more ambiguous term, "place," offers. The vocabulary of place, it seems, has the effect of depoliticizing the analysis and removing the concerns of federalism from the discussion, or at least de- emphasizing their importance. None the less, Friesen and others have questioned the continued utility of region as an analytical tool for exploring political tensions, as regions are increasingly replaced by provincial identities on the political landscape. In addition to this narrowing process, region then continues to convey a political expression, while ignoring the social experiences that may be better understood through analyses of gender, class, and ethnicity; thus, they argue region might be dismissed as part of an older historiographical tradition of political history or parochial investigations (Wardhaugh 2001, 5).
Within the history of health and medicine, social historians and social scientists have provided useful theoretical frameworks for examining the ways in which place, freed from some of its political connotations, influences the process of discovery, the evolution of particular therapies, or the delivery of health services. By combining some of the political characteristics associated with region along with an appreciation for the ways in which place is articulated by inhabitants of a particular location, such scholars have attempted to reconcile regional analyses with cultural histories. For example, Megan Davies applied a regional analysis to a study of the medical profession in nineteenth-century British Columbia, arguing that region is critical for explaining the development of medical services (2000, 7392). Davies moves away from the use of region as a term denoting a community's relationship to nation and instead promotes a more nuanced application of the term as it relates to the ways in which medical services are defined by their communities. Her conscientious use of the term "region" demonstrates an attempt to combine geographical and cultural experiences, while continuing to downplay the political connotations of the term.
Outside of Canada, sociologist Nick Crossley examined two contemporaneous sets of psychiatric experiments and how their intellectual, political, and temporal environments shaped the construction and reception of the research. Crossley argues that R. D. Laing's experimentation with LSD in Glasgow during the 1950s gained him notoriety within the local medical community. The lack of collegial and intellectual support seemed to harden Laing's resolve that LSD offered critical insights into the experiences of psychotic patients, but the unreceptive research environment in which he operated encouraged him to adopt a radical position against the medical establishment, which ultimately characterized Laing as an anti-psychiatrist. Crossley argues that Laing had to struggle conscientiously to cultivate an intellectually supportive environment where he could carry out his studies; according to Crossley, Laing had to build a "working Utopia," a place where "imaginative projections achieve some degree of concrete realization"(1999, 810). Crossley builds upon Thomas More's idea of Utopias as "places 'which have no place/ or perhaps more positively, as places which exist in the imagination" (809-10). As a result of Laing's determination to resist established views on psychiatry and more acceptable approaches to drug experimentation, he became an outsider to mainstream psychiatry. His attempts to generate an intellectual space for exploring new ideas radicalized him, his work, and his reputation as an individual who worked against contemporary psychiatry.
In stark contrast with Laing's experience, researchers such as Hoffer who were engaged in similar kinds of explorations, including conducting LSD experiments as a vehicle for understanding patients' experiences, were never characterized as anti-psychiatrists. They did not have to create a "working Utopia" in order to bring their experimental ideas to fruition in the local medical community. Place, in this context, arose primarily as an ideological and psychological construct, where ties to region, geography, and environment become secondary to the intellectual space that captured the imaginations of medical researchers drawn to the province. During the 1950s, Saskatchewan-based LSD researchers became part of the medical establishment at a time when the province experienced dramatic shifts in its political and social identity. Individuals who moved to Saskatchewan to participate in the medical experiments commented on the political and intellectual attraction of the place. In this case, individuals involved in LSD research acknowledged the importance of place in terms of the supportive research environment, the optimistic intellectual atmosphere, and the receptive medical community. This conceptualization of place as an intellectual space or a psychological construct is infused with older historiographical notions of region and political expressions of identity because it evolved during a period when Saskatchewan was being politically and socially reconceptualized as a region. In October 1929, following the crash of the New York stock market, an economic depression spread across North America. On the Canadian prairies, the crisis was combined with prolonged drought conditions that crippled the staples economy. For nearly a decade, the agricultural sector of the economy suffered under the dual effects of drought and depressed international staples prices. Political scientist David Smith contends that in Saskatchewan "individuals suffered a blow in the 1930s that permanently changed the province's view of itself and its society" (1992, 29). The widespread economic depression in the 1930s compounded existing shortcomings in professional services, particularly those related to health care.
In 1944, Saskatchewan elected a new government. The ruling party, the Cooperative Commonwealth Federation (CCF), led by Tommy Douglas, campaigned as an activist government, committed to radical experimentation in public policy and in the domains of science, medicine, agriculture, and technology. The party remained in power for five consecutive terms until 1964. Throughout its 20-year mandate, the CCF government expressed a commitment to nurturing innovation. In particular, this government became known throughout Canada as the first provincial jurisdiction to enact a program of publicly funded health care, a system that the federal government eventually adopted in 1966 (Mombourquette 1991, 101-16; Shillington 1972; Tollefson 1964; Ostry 1995, 87-105; Badgley and Wolfe 1967; Taylor 1978; Naylor 1986). Although it was not the only region that developed a new political party at this time (Finkel 1989; Morton 1967), the popularity of the CCF demonstrated the willingness with which Saskatchewan residents welcomed change in the postwar period. The shift in political outlook also set the province apart as a region identified by political borders instead of a region characterized by prairie geography or a staples economy.
The CCF government directly contributed to this shift in identity by embarking on a series of policy reforms that it hoped would also create social changes for residents in the province. One of the major planks of its reform platform was to establish a publicly funded system of health care. In addition to the implications of the policy changes, the lead-up to the program's implementation attracted medical researchers. Enticed by research grants, professional autonomy, and an opportunity to participate in the formation of North America's first program of socialized medicine, a number of medical investigators made the province their home, if only temporarily. The erosion of the region's professional class during the Depression had created a professional vacuum. Local residents readily embraced recommendations for new and replenished services in communities that had struggled to retain professionals during the Depression. The CCF government recruited doctors and medical researchers to fill senior positions in the rapid expansion of a provincial civil service, as part of its mandate to build a publicly funded health-care system. This combination of regional memory and provincial government initiative meant that Saskatchewan became a place with an allure for medical professionals who were interested in assuming authoritative positions and curious about the ideological implications of socialized medicine.
For some individuals, Saskatchewan became something of an ideological magnet to people from around the world who came in hopes of participating in the various experiments taking place. During the Depression and the second World War, the population of the province decreased by nearly 100,000 residents, a number which it nearly recuperated by the 1960s, when it reached a postwar height of 955,644 in the 1961 census (Canadian Plains Research Centre 2005, 706). As part of these population changes, medical investigators were drawn to the province. Robert Sommer, for example, came to Weyburn in 1957. Sommer was the first PhD psychologist in the area. He and his family drove to Saskatchewan from Kansas in their Volvo, and they eagerly looked forward to living in the "socially progressive" region. Sommer later felt that the sparse professional population reduced the stifling influence of bureaucracy and tradition. He claimed that there was "a professional freedom for experimentation not found elsewhere"(1961, 26). His colleague in Winnipeg further explained that "Saskatchewan has the reputation for being a place where things happen. It has attracted within its borders a group of vigorous, independent, young psychologists whose style of work may set the pattern for the rest of Canada"(1961, 26). Rhodes scholar Alien Blakeney, who in 1944 was a Dalhousie law student, moved to Regina after completing his law degree because he "wanted to be part of the action "(Blakeney 2003). The region captivated his interests, and in 1971 Blakeney became premier of the province.
The province also appealed to individuals on a less partisan basis. One woman recalled that, upon completing high school in British Columbia, she heard that the Saskatchewan government paid tuition for women who wanted to study nursing. Sold on this idea, she moved from Vancouver to Weyburn where she started nursing school. She remembered this as one of the "most exciting times in [her] life"; not only did she leave home for the first time, but she met people from all over the world who brought with them their ideas, energy, and cosmopolitan influences; in Weyburn, for example, she was introduced to jazz (Munn 2003).3
Despite these anecdotal recollections of the province's postwar appeal, grim reminders of the previous decade made the province unappealing to anyone seeking an abundance of modem amenities or an urban environment. For many people, it remained a "backwoods," rural region, disagreeable to well-established professional organizations or high culture traditions (Sommer 1961,26-29).4 Until the late 1950s, much of the province had only limited access to electricity; in many areas, indoor plumbing was a luxury. Saskatchewan's economy, despite the many changes on the political horizon, remained dominated by agriculture. The development of the province's professional class, even in urban areas, still lagged behind other regions in the country.
The optimism and political stability generated by five consecutive CCF victories, none the less, made Saskatchewan an attractive destination for individuals interested in participating in a culture of experimentation. One observer remarked, "It was an age of bold experiments.... The pioneering spirit went beyond art and Medicare, though, it dared to explore the brain, the psyche and dimensions that passeth all understanding. In the late 1950s, Saskatchewan was home to the largest LSD experiments in the world" (Labounty 2001,43). In the 1940s, the province busied itself establishing the groundwork for reforms that would eventually make Saskatchewan a world leader in psychiatric experimentation.
Health Care Reforms
Throughout the process of reconstruction after the second World War, Premier Tommy Douglas remained committed to the idea that co- operation and commitment to a new publicly funded health-care system was the linchpin that would reform the province. Conscripting the support of all levels of government, Douglas assured the people of Saskatchewan that major health-care reforms would chart a new future for the province. He maintained, "We are on the vanguard of public health on this continent, because we have a health conscious people who regard health as something beyond price, who are convinced that health is a public utility and the right of every individual in the nation "(Douglas 1945). Douglas campaigned for a health-care plan, one that provided access for all citizens and removed dependence on insurers, as a program that would distinguish Saskatchewan as a province capable of taking care of itself. Although he was not prepared to turn his back on the federal government, he remained committed to the idea that Saskatchewan could lead the way in experimenting with public policies on health care.5
Less than three months after the 1944 provincial election that first brought the CCF to power in Saskatchewan, Douglas arranged for a Health Services Survey to make recommendations for the establishment of a system of socialized medicine in the province, which included mental health-care provisions. As proof of his dedication to this program, Douglas also took the unusual step of acting as his own health minister. He then invited the renowned physician and historian of medicine, Henry E. Sigerist of Johns Hopkins University in Baltimore, to conduct the health survey. Sigerist was well known (and controversial) for his support of the Soviet Union's system of socialized medicine, and by 1944 he was a leading international advocate for compulsory health insurance (Fee and Brown 1997, 2). According to Sigerist's diary, he welcomed the opportunity to play a leading role in the province's health reforms. He felt he had become persona non grata in the United States where he was considered "a crackpot" for his socialist sympathies. In Saskatchewan he was regarded with respect (Fee 1997, 216). Douglas's timing and choice of commissioners was deliberate. The swift action indicated the CCF's commitment to moving forward with its promises for reform, and Sigerist signified the CCF's dedication to socialized medicine (Duffin and FaIk 1996, 658-83). Sigerist reported the results of the Health Services Survey on 4 October 1944, offering prescriptions for immediate action.6 His recommendations focussed attention on collecting resources and swiftly planning for the co-ordination of community assessments and service implementation (Sigerist 1944, 325-29). Douglas responded by identifying three prescient themes from Sigerist's report: 1) a critical shortage of trained personnel; 2) a scarcity of equipment and facilities; and 3) inadequate funds. With a total population of 840,000 in 1944, Douglas determined that the province required an additional 400 doctors to fulfill Sigerist's first recommendation (Sigerist 1944, 329). Hospital facilities, including mental hospitals and tuberculosis sanatoria, already suffered from overcrowding, creating demands for additional facilities, as well as for repairs to existing buildings. To begin addressing these concerns, Sigerist recommended the construction of two new mental health facilities, which would bring the provincial total to four. Funds for mental health in general were more difficult to secure, but with intentions to develop a strong program of research, money could be obtained, in part, through research grants available outside the province.
To address the shortage of professionals, the provincial government channelled funds towards the development of a provincial medical school. The medical school eventually opened in 1952 as part of the expansion of the provincial university in Saskatoon. The government hoped that an in-province education would help keep medical students in the region. Too many Saskatchewan-born students who received their medical degrees out of province did not return to practice in their home communities. In addition to these internal solutions to the shortage of health-care professionals, the CCF government also continued to recruit professionals to the province from other parts of the country and from other Commonwealth countries.7
Mental health services held a particular fascination for Douglas. His master's thesis from McMaster University's campus in Brandon, Manitoba, explored social problems associated with mental diseases. The 1933 thesis recommended a variety of community endeavours for addressing what appeared to be increasing rates of mental illness in the twentieth century (Douglas 1933).8 In his study, Douglas examined his home constituency of Weyburn, Saskatchewan, and recommended initiatives in public education, religious instruction, state-supported treatment facilities, and even sterilization to alleviate the mounting stresses of mental illness in the community.9 Although his perspectives altered somewhat by the time he became premier, Douglas maintained a keen interest in mental health programs and ensured that psychiatric services were included in the discussions of health-care reforms.
After the second World War, several jurisdictions faced increases in patient populations, which led to severe overcrowding in mental health institutions. In 1950, for example, the National Department of Health and Welfare in Canada reported that nearly 60,000 individuals resided in mental hospitals across the country. This figure represented an increase of almost 4,000 patients from the previous year and showed a growing trend over the last decade. In addition to the rising need for institutional space that these increases created, the costs of maintaining patients within institutions also rose (Canada Health and Welfare 1952).10 Predictions showed no signs of a reversal and, therefore, political and clinical attention began focussing instead on developing sustainable solutions that did not involve dependence on large- scale institutions. After the second World War, the Saskatchewan government abandoned its earlier plans to construct a third mental health facility in Saskatoon and instead entertained new options, investing in research into the origins and treatment of mental illnesses rather than costly and largely untherapeutic accommodations.
Douglas deplored the tradition of placing individuals with mental illnesses in custodial institutions. He maintained that overcrowded and understaffed asylums produced terrible conditions for therapy. Moreover, where professionals were available they were often too busy attending day-to-day duties to engage in medical research that might produce more satisfying alternatives to institutionalization. He believed that a hospital should be a place of last resort, and that care among relatives and within a familiar community was almost always preferable to long stays in a hospital. Mental health services, according to Douglas, should be provided in a comprehensive manner that emphasized preventative medicine and involved professional collaboration in the community. His strategy for accomplishing this objective relied on a combination of increasing psychiatric research and initiating an aggressive public education campaign. His focus on non-institutional medical intervention set the agenda for mental health reforms that emphasized innovative medical research and new conceptualizations of mental illnesses.
In November 1946, Douglas appointed a commissioner of mental health services who also acted as chief psychiatrist for the province. D.G. (Griff) McKerracher came to Saskatchewan after working in the Ontario health department following his service as a medical doctor with the Canadian Army during the second World War (Mombourquette 1991,109). McKerracher willingly responded to Douglas's offer of a directorship and seized upon the opportunity to effect changes in psychiatric services (Coburn 2003). Psychiatric services also benefitted from an increase in government funding for health initiatives in general. In 1946, the provincial funding for mental health care rose by $600,000, while funding for health care in general increased from a sum of $1,852,079 in 1943-44 to $5,895,141 in 1946-47. In 1947, the province passed a new Mental Hygiene Act, which enacted changes to the admissions policy by shifting authority over asylums from the Department of Public Works to the Department of Health, while simultaneously widening admissions policies at general hospitals in order to incorporate psychiatric services (Mombourquette 1991, 109).
Despite the existence of two provincial mental health facilities, one in North Battleford and the other in Weyburn, many patients were still required to travel great distances to receive psychiatric treatment. Moreover, the numbers of individuals seeking care quickly outpaced provision. When the hospital in North Battleford opened in 1914, its superintendent, Dr. J.W. MacNeill, travelled to it by train for 29 hours with 346 patients who had been staying in an asylum in Brandon, Manitoba (Demay 1973, 24). By the time the Weyburn Mental Hospital opened in 1921, Saskatchewan's Department of Public Health suddenly reported having over 1,500 individuals requiring institutional care (Dickinson 1989, 38). Both hospitals admitted patients suffering from acute and chronic illnesses, in addition to accommodating patients with intellectual disabilities, then categorized as "mentally retarded" (Frazier and Pokorny 1967, 3). It appeared that, as planners reduced the travel distances, the demand for admission rose dramatically. It remained unclear, however, whether this situation resulted from an increase in available services, from changing social attitudes to institutional care, or from more sophisticated diagnostic procedures (Grob 1994, 48).
Part of McKerracher's vision for psychiatric services in Saskatchewan involved recruiting psychiatrists to the region and facilitating the development of an active research program. He felt the criteria for reaching this objective in Saskatchewan's postwar political climate had to focus on scientific research initiatives. One of his colleagues recalled McKerracher complaining that "psychiatry suffered from being alienated from medicine. Medicine tended to be something you could see through a microscope and you can't see anything in psychiatry through a microscope. You can't lay hands on it, it is all ideas" (Coburn 2003). The absence of empirical measures in psychiatry made it a comparably more abstract medical subject and one that McKerracher felt dissuaded students from pursuing careers in that specialty. The fluid and subjective clinical definitions used to diagnose mental disorders discouraged individuals from pursuing careers in psychiatry, which further contributed to a lack of trained personnel in the field. McKerracher strongly urged a reconceptualization of mental health as an area indistinguishable from general medicine, meaning that its treatment would take place in a general hospital and general practitioners would play a more active role in mental health care. Rather than continue to provide health care in separate institutions, which reinforced professional divisions, McKerracher wanted psychiatric medicine to form an integral part of modern medicine, similar to many other medical sub-specialities. Accomplishing this goal required a change in professional and lay attitudes, as well as the development of appropriate care facilities seamlessly integrated into the general health system. McKerracher felt particularly committed to merging mental and physical health care systems because of his underlying belief that attitudes towards mental illnesses were too often shaped by misleading stereotypes. Psychiatric illnesses carried significant social stigmas, ones traditionally suggesting that disordered behaviours resulted from weak characters or a dysfunctional upbringing.11 The shortage of professionals, in combination with social stigmatization, meant that mental health care often languished as a medical specialty and remained a low priority for public spending. The enticement of major health care reforms in the province, Douglas's personal interest in mental health, McKerracher's commitment to administrative reforms, and the promise of new psychiatric research initiatives brought renewed optimism to the field. McKerracher thus took advantage of this political opportunity and began directing a program of research in psychiatric services that nurtured novel perspectives in mental health.12
Within this climate of therapeutic optimism, Dr. Humphry Osmond arrived in Saskatchewan. Osmond was born in Surrey, England on 1 July 1917. His father worked in a local hospital as the paymaster captain and eventually moved the family to Devonshire before Humphry later settled with his aunt and uncle back in Surrey, where he completed the rest of his preparatory schooling. Rather than heading straight into the study of medicine at university, Osmond took a more circuitous route, beginning with theatre writing and a brief flirtation with banking. He credited Hector Cameron, a physician and historian of medicine, with introducing him to the wide variety of possibilities within medicine that eventually captured his academic interests (Osmond 196Oa, 5).
By the outbreak of the second World War in 1939, Osmond had completed his clinical training, but the war interrupted his regular hospital ward practicum and forced him to engage in intermittent fieldwork. In 1940, he returned to Guy's Hospital in London and survived the bombing of the city, which destroyed much of the area but miraculously left the hospital more or less intact. In 1942, he joined the British Navy, and he quickly became acquainted with another part of the war aboard a ship filled with men requiring medical attention while he struggled to provide assistance with limited practical experience and meagre medical supplies. At sea, however, he also learned that the psychiatric emergencies were often quite severe and potentially more damaging than surgical crises (Osmond 196Oa, 19). Through his work with the navy, Osmond met Surgeon Captain Desmond Curran, head of psychiatry in the British Navy, who helped Osmond develop his interests in psychiatry, while his medical colleagues chastised him for abandoning what could have been a promising career in surgery (Osmond 1955b).13
After the war, Osmond took a position as a senior registrar at the psychiatric unit at St. George's Hospital in London. There he worked closely with colleague John Smythies and cultivated a keen interest in chemically induced reactions in the human body. Smythies and Osmond, with the aid of organic chemist John Harley-Mason, examined, in particular, the chemical properties of mescaline, the active agent in the peyote cactus. Nearly two years of research led them to conclude that mescaline produced reactions in volunteers that resembled the symptoms of schizophrenia (Smythies 2004),14 a chronic "disease marked by disordered thinking, hallucinations, social withdrawal, and, in severe cases, a deterioration in the capacity to lead a rewarding life" (Gelman 1999, 1). Further interrogation suggested that mescaline's chemical structure was remarkably similar to adrenaline. These findings led to their theory that schizophrenia resulted from a biochemical "imbalance" in the sufferer. Furthermore, they believed that the imbalance might be caused by a dysfunction in the process of metabolizing adrenaline, which in turn created a new substance that chemically resembled mescaline (Smythies 2004).ls This tantalizing hypothesis captivated Osmond's interests for the next two decades and inspired him to embark on a variety of drug experiments with the supposition that a chemically induced schizophrenia might suggest that the disease had biochemical origins.
Osmond's and Smythies's colleagues at St. George's Hospital were not particularly interested in their biochemical research, but Osmond was intent on continuing this work. One of his colleagues recalled that Osmond wanted to leave Britain where "he had received no encouragement in a largely psychoanalytic environment" (Hoffer 2004, 23). After responding to an advertisement in the Lancet for a deputy director of psychiatry at the Saskatchewan Mental Hospital in Weyburn, Osmond and his family moved to Saskatchewan in October 1951. There he established a research program centring on biochemical experimentation.
Within a year after arriving on the prairies, Osmond met Abram Hoffer. Hoffer was also born in 1917, but grew up in a small farming community in Saskatchewan named after his father, Israel Hoff er.16 He also took a different path into medicine. Abram Hoffer graduated from the provincial university in Saskatoon with a bachelor of science in agricultural chemistry in 1937. Three years later, he completed a master's degree in agriculture, whereupon he received an award allowing him to spend a year at the University of Minnesota conducting research on cereal chemistry. Enamoured with this subject, he continued in this field and in 1944 graduated with a PhD in agriculture and a dissertation that examined B vitamins. His doctoral research introduced him to the study of vitamins and their effects on the human body. The area intrigued him and, after developing a strong background in agricultural chemistry, Hoffer began studying biochemistry as it pertained to medicine. Hoffer completed his medical doctorate at the University of Toronto in 1949, where he had developed a particular interest in psychiatry. On 1 July 1950, Hoffer was hired by the Saskatchewan Department of Public Health to establish a research program in psychiatry for the province (Hoffer 1950,1). His combined areas of expertise in chemical studies and medical practice made Hoffer an attractive candidate for this program.
Hoffer and Osmond soon joined forces and began collaborating on their mutual research interests in biochemical experimentation. Within a few weeks of arriving in Saskatchewan, Osmond had set up a mescaline study. He volunteered to take the first mescaline samples himself, at home. His reaction to the drug confirmed his belief that he might learn a lot about patients' experiences with psychoses. He quickly fixed upon the idea-drawn from Carl Jung-that schizophrenia was fundamentally defined by a distortion in perception. He revisited and refined this concept throughout his work with hallucinogenic drugs. He believed that distortions in perception affected all the senses in psychological and physiological ways. If the senses were thus impaired, he reasoned that an individual with a perceptual impairment was more likely to respond to social and environmental cues in ways that seemed irrational, illogical, or even "sick." This theory was the underlying concept that defined his work on schizophrenia, and it was why he was so intent on trying to explore hallucinogenic drugs and their ability to create what he called a "model psychosis."
In Osmond's inaugural experiment, he went for a walk with his wife Jane, and he felt paranoid and frightened by familiar stimuli:
One house took my attention. It had a sinister quality, since from behind its drawn shades, people seemed to be looking out and their gaze was unfriendly. We met no people for the first few hundred yards, then we came to a window in which a child was standing and as we drew nearer its face became pig-like. I noticed two passers-by, who, as they drew nearer, seemed hump-backed and twisted and their faces were covered.... The wide spaces of the streets were dangerous, the houses threatening, and the sun burned me. (Osmond 1952, 4)17
Astounded by the drug's capacity to suspend his sense of logic, reality, and comfort, Osmond grew more determined than ever to collect others' experiences.
Very soon after his own experiment, Osmond expanded the research program and started using LSD, which had recently become available from the Sandoz Pharmaceutical Company in Switzerland, instead of mescaline. Self-experimentation with LSD convinced him that the drug produced similar reactions to those observed with mescaline, but LSD was more readily available. Moreover, LSD produced a more powerful reaction: minute doses of LSD generated responses from subjects that required much higher doses of mescaline. LSD offered a more suitable and economical choice-which also pleased the CCF government that was supporting this research.
Initial research with LSD also fit neatly into McKerracher's vision for mental health reforms in the province. Early trials indicated that the drug had the potential to improve mental health care by advancing a theory of mental illness that promoted a biochemical explanation. Hoffer, Smythies, and Osmond explained mental illness as a manifestation of metabolic dysfunction (1954). This assertion pointed to the possibility that mental illness was in fact a biological or biochemical entity, and thus could be studied (and ultimately treated) using modern medical technology. It suggested that, similar to physical illnesses, mental illnesses might ultimately and literally be observable under a microscope. Reminiscent of McKerracher, who was frustrated that a lack of observable pathogens generated a stigmatization of mental illness, Osmond welcomed this new and exciting research agenda that promised an observable, measurable explanation. The research possibilities generated by Hoffer and Osmond's theories attracted other individuals to the province, where they eagerly contributed to the expansion of biochemical studies. Osmond, in particular, gained a reputation for attracting graduate students from all over North America to come and study with him in Weybum (Sommer 2007). He purportedly injected a flare of adventure and cosmopolitanism into the small rural community and fascinated others with his "bright ideas."18 Although Hoffer did not generate quite the same draw for students, his superior administration skills prevailed in securing research grants for their work. In addition, Hoffer's association with the provincial university gave him regular access to medical students for teaching and research purposes. The psychiatric research program thus fulfilled two important objectives outlined by Douglas and refined by McKerracher: 1) the biochemical experimentation advanced a theory of mental illness that satisfied McKerracher's vision for a research-intensive program that might eventually transform the image of mental health care; and 2) the allure of the research program attracted more researchers to the region and helped address the critical shortage of health-care professionals.
Psychedelic therapies relied both on a biochemical model of mental illness and the scientific observation of a subjective experience. By combining these two elements in one practice, Hoffer and Osmond presented their approach as a new theory that merged philosophical and psychological traditions with biomedical advances. Importantly, they distinguished themselves from the psychoanalysts, whom they regarded as dogmatic therapists largely concerned with treating middle-class patients, or the worried well. They also differed from psychopharmacologists, who they felt were equally obsessed with the collection of data without consideration for the deeper meanings of personal experience. Armed with their own delicate mixture of biomedical and philosophical influences, the Saskatchewan-based investigators, led by Hoffer and Osmond, promoted an alternative to psychopharmacology and psychoanalysis with a method that incorporated the use of psychedelics as a means for bridging some of the theoretical distance between these two models.
Not everyone, however, expressed enthusiasm for the government attention directed towards drug experimentation. Some of Hoffer and Osmond's colleagues felt that this course of research received too much support and, as a result, other areas of study fell behind (Russell 2003; MacDonald 2003). The concentration on an experimental theory went against mainstream thinking in psychiatry and placed the province at risk of endorsing fruitless research endeavours.19 At the outset, however, LSD experimentation appealed to several psychiatrists and government officials alike as a legitimate scientific endeavour that could lead to major breakthroughs in mental health treatments.
The most publicized and allegedly successful application of these studies existed in the field of alcoholism. Although investigators did not originally anticipate its use as a therapeutic agent, trials with "normals" revealed LSD's capacity to produce feelings of self- reflection, suggesting that it had some therapeutic properties.20 These findings led researchers to apply their psycho-biochemical theory of mental illness directly to alcoholism, which was itself being recast by the medical profession as a disease entity. Psychedelic psychiatrists treated alcoholics using LSD and reported unprecedented rates of success, routinely claiming over 50% recoveries, exceeding the rates of recoveries available from other treatments at the time (Chwelos et al. 1959, 577-90; Hoffer 1967, 343-406).
The medical investigators in Saskatchewan reasoned that alcoholics often resisted social or medical intervention until they began experiencing delirium tremens (DTs), but this stage of the disease was often fatal. If LSD therapy could simulate the psychological experience of DTs, before patients underwent the physiological damages that often accompanied this stage, then perhaps more alcoholics could be helped. The treatment did not simply involve replacing alcohol with LSD, but instead relied on a single mega-dose (between 200 and 1,500 pg), of LSD in a clinical environment. Patients commonly underwent an intense reaction, followed by a period of self-reflection that often resulted in attitudinal changes.
Proponents of this approach believed that this therapeutic regimen incorporated the importance of reflecting upon the individual's reasons for drinking rather than simply focussing on curbing drinking altogether, thus addressing a psychological component of the disease. Regina-based psychologist Duncan Blewett contended that LSD offered a superior form of therapy because it "aid[ed] man in seeing himself, his values and his behaviour in new perspective [sic]; in freeing himself from disadvantageous patterns of thought and action." The reflective aspect of the therapy addressed the frequent complaint from patients that they drank to overcome a feeling that their lives were out of control. In contrast with prevailing trends in psychopharmacological treatments that relied on long-term drug therapy, the use of LSD involved short, intense, treatment sessions. Other methods frequently produced dependence, whether on a chemical or a psychotherapeutic relationship, and did little to assist the patient in resurrecting self-control. LSD treatments for alcoholism brought international attention to the psychiatric investigations taking place in Saskatchewan.
While Saskatchewan offered individuals such as Hoffer and Osmond a supportive environment to conduct experimental investigations, research in other jurisdictions also began developing new psychiatric theories. The ideological context shaped the research program in Saskatchewan as well as its local reception, but that did not mean that Saskatchewan's reforms were necessarily inconsistent with broader developments in the field of mental health. The increasing use of drugs in psychiatry during this period had a revolutionary influence on mental health treatments in the second half of the twentieth century, and this trend relied, to a large extent, on changes in the theory and practice of psychiatry (Healy 2002; Shorter 1997; Montcrieff 1999, 475-90; Valenstien 1998). Psychiatric practice at mid-century has often been described as existing at a crossroads: institutionally based practitioners relied on somatic or bodily interventions that seemed outdated or problematic; and community-based psychoanalysts used approaches that did not seem to work, particularly with severe mental illnesses, and lacked a biological foundation.
LSD research in Saskatchewan fit into these broader developments in psychiatry and pharmacology. Ideas arising out of the LSD trials suggested that mental illness had biological and social precedents and thus required treatments tailored to both sets of needs. LSD treatments offered individuals a conscious experience that initially seemed to support theories from both biochemists and psychoanalysts. Hoffer and Osmond developed a psychedelic therapy that used chemicals to trigger new perceptions of self. The psychedelic experience affected individuals differently: some approached it philosophically, others insisted that the experience invoked changes in spirituality, and still others felt it modified their epistemological world view. Regardless of their interpretation of the treatments' subjective meaning, individuals regularly believed that the LSD experience fundamentally modified their being. In this way, LSD treatments differed from most other psychopharmacological therapies devised to treat a particular disorder. In short, during the 1950s, psychedelic psychiatry promised a consciousness-raising, identity-changing therapy within a medically sanctioned and scientifically rigorous environment. Moreover, psychedelic psychiatry offered an approach to understanding, accommodating, and ultimately treating mental illnesses (and addictions) in a manner that matched the political goals of the region.
Unlike some of the other LSD investigators in the 1950s and early 1960s, however, the Saskatchewan-based researchers did not have to fight an existing medical establishment to develop a supportive intellectual research environment. Instead, they played a role in the contemporaneous political and cultural reforms that contributed to the transformation of the province. Before leaving his post at Weyburn, in July 1961 (Regina Leader Post 1961; Osmond 1961), Osmond wrote a letter to Tommy Douglas describing his faith in the psychiatric research being done in the province. In this letter, he affirmed,
The research is making really encouraging progress. [Ten years ago] it seemed wholly improbable that our idea would last more than a year or so. It is now becoming the centre of more and more attention and gradually confirmation is seeping in.... I could not have done it alone ... I'm not sure what the social implications will be of a measurable, visible, biochemical schizophrenia but it is, I think, (and one can always be a bit premature) very close round the corner. (Osmond 196Ob, 2)
In addition to a justification for his decade-long investigations, this letter also indicated Osmond's appreciation for the political support he received in Saskatchewan.
Like Osmond, by the early 1960s several of the medical investigators central to psychedelic research left Saskatchewan, signifying the slow demise of LSD experimentation in that province. This professional exodus weakened the existing medical research network and the internal support for LSD therapies. By the time LSD became known as a street drug, and later an illegal substance, in the latter half of the decade, many of the psychedelic psychiatrists had dispersed to various destinations throughout North America. In the 1950s, the region provided something of an ideological sanctuary for political and medical experimentation with like-minded colleagues. By the mid-1960s, many of the original medical researchers remained in contact through correspondence, but few continued to work out of the same institutions. The scattering of these individuals left them more vulnerable to attacks, from within the profession as well as from outside the medical community. The political climate in Saskatchewan also began changing in ways that weakened enthusiasm for supporting a culture of experimentation. On 7 November 1961, Tommy Douglas resigned as premier of Saskatchewan to lead the newly formed national political organization, the New Democratic Party. His replacement as CCF leader and premier in Saskatchewan, Woodrow S. Lloyd, continued promoting health-care reforms, but the transition in leadership accompanied a number of personnel changes throughout the civil service and several key individuals left the province.21 After more than a decade of pursuing radical policy innovations, the momentum behind the political experimentation had declined. Gradually, the province sunk into its former routine of losing rather than attracting professionals.
In postwar Saskatchewan, LSD experimentation received significant support as a viable medical technology. As clinical investigations progressed, many believed that studies with LSD offered demonstrable proof that mental illnesses existed and that mental health care should be equal to that available for physical ailments. Hoffer and Osmond used their LSD experiments to bolster a psychobiochemical theory of mental illness, which motivated a series of reforms in the theorization and treatment of mental illnesses. While they were not the only psychiatrists experimenting with this drug during the 1950s, their work benefitted from the local support they received. The political and cultural encouragement allowed them to investigate LSD with sustained attention. Because their experiments formed part of the contemporaneous health-care reforms, their research also had immediate practical applications. Their close relationship with the provincial government provided opportunities that did not exist elsewhere. For these reasons, the location of the experiments facilitated their international recognition as leaders within the field. The stimulation of theories about mental health captivated interests in this region that was politically committed to reshaping attitudes towards health and its care.
I am grateful to Sarah Carter and Krlstin Burnett for hosting the Western Canadian Studies reading group at the University of Alberta where I received valuable feedback on an earlier draft of this essay, to the two anonymous reviewers for their comments, and especially to Peter Twohig.
1. Forexamples, see, Gerald Friesen, "The Evolving Meanings of Region in Canada" (2001); Bill Waiser, "Place, Process, and the New Prairie Realities" (2003); Robert Wardhaugh, ed., Toward Defining the Prairies: Region, Culture and History (2001); Jean Barman, The West Beyond the West: A History of British Columbia (1991); and Acadiensis's "Forum: Roundtable on Re-Imagining Regions" (2006).
2. The East has also received such attention. For examples, see, Margaret Conrad, "Mistaken Identities? Newfoundland and Labrador in the Atlantic Region" (2002), and "My Canada Includes the Atlantic Provinces"(2001); and Ernest Forbes, ed., Challenging the Regional Stereotype: Essays on the Twentieth Century Maritimes (1989).
3. Along with research and educational opportunities, the health reforms in the province created new job categories for women. Saskatchewan developed the first program for psychiatric nursing. A provincial system of loans and bursaries opened doors for nurse training in the province and created unparalleled professional prospects for psychiatric nurses. see Chris Dooley, "'They Gave Their Care, but We Gave Loving Care': Defining and Defending Boundaries of Skill and Craft in the Nursing Service of a Manitoba Mental Hospital during the Great Depression" (2004).
4. Sommer no longer agrees with this assessment. Alien Blakeney recalled that his first accommodations in Regina were not equipped with indoor plumbing.
5. For an in-depth look at how Douglas established a civil service that was committed to implementing publicly funded health care, see A.W. Johnson, Dream No Little Dreams: A Biography of the Douglas Government of Saskatchewan, 1944-1961 (2004).
6. One of the critical recommendations involved dividing the province into health regions. Each region would service its community with a comprehensive team of health professionals. This concept was central to the Sigerist report and became integral to the way that the provincial health reforms developed. For further information on the health regions, see Joan Feather, "From Concept to Reality: Formation of the Swift Current Health Region" (199Ia), and "Impact of the Swift Current Health Region: Experiment or Model?" (199Ib).
7. see Louis Horlick, They Built Better Than They Knew: Saskatchewan's Royal University Hospital; A History, 1955-1992 (2001), and C. Stuart Houston, Steps on the Road to Medicare: How Saskatchewan Led the Way (2002). Some Saskatchewan doctors were Saskatchewan residents who left the province to receive training, most often in Toronto. After the CCF came into power, however, the government actively recruited doctors to come and work in the province. It advertised across North America but was also very interested in attracting British doctors who had experience working in the British National Health Service.
8. Another one of the governmental responses to personnel shortages involved empowering nurses by expanding their authority in health services. Douglas insisted on increasing wages for nurses before adding more services, contending that these healthcare workers deserved to be recognized as professionals, with qualifying examinations and responsibilities befitting their expertise. After identifying mental health as an area with even more severe personnel shortages, he proposed a new category of professional psychiatric nurses separate from Registered Nurses. The new opportunities, augmentation of prestige, clinical responsibility, and secure wages made working in Saskatchewan an attractive destination for many nurses. These measures gradually brought individuals in from outside the province and helped to fill some of the staffing weaknesses in the health-care system.
9. The section in Douglas's MA thesis on eugenics is IV.I.c (there are no page numbers). Douglas's eugenicist ideas have created an awkward subject for many of his biographers. The majority of these authors are sympathetic to his socialism and stress his post- 1944 history, allowing them to ignore this issue. Angus McLaren, in a study of eugenics in Canada, explains Douglas's eugenicist approach as a relatively more popular perspective before the second World War. The issue of Douglas's views on eugenics would benefit from more focussed research, but it is clear that by the time Douglas was elected in Saskatchewan he no longer referred to programs that could be regarded as sympathetic to sterilization. see Angus McLaren's introduction to Our Own Master Race: Eugenics in Canada, 1885-1945 (1990). For examples of Douglas biographies on this issue, see Thomas McLeod and Ian McLeod, Tommy Douglas: The Road to Jerusalem (1987), and Walter Stewart, The life and Political Times of Tommy Douglas (2003).
10. Costs rose from $1.80 per day in 1948 to $1.98 in 1949.
11. These same sentiments are found in a national survey of psychiatric services in Canada, More for the Mind: A Study of Psychiatric Services in Canada, edited by J. S. Tyhurst, F.C.R. Chalke, F.S. Lawson, B.H. McNeel, C.A. Roberts, G.G. Taylor, RJ. Weil, andJ.D. Griffin (1963).
12. For a brief description of the program's research aims and a corresponding list of publications in 1955, see Abram Hoffer's letter of 25 May 1955 to D.G. McKerracher. Among the publications of the program's researchers are Roland Fischer and Neil Agnew, "On Drug-produced Experimental Psychoses" (1954); Roland Fischer, "Factors Involved in Drug-Produced Model Psychoses" (1954); Humphry Osmond, "Inspiration and Method in Schizophrenia Research" (1955a); John Lucy, "Histamine Tolerance in Schizophrenia" (1954); A. Hoffer and S. Parsons, "Histamine Therapy for Schizophrenia: A Follow-up Study" (1955); Abram Hoffer, Humphry Osmond, and John Smythies, "Schizophrenia: A New Approach II: Result of a Year's Research" (1954); Abram Hoffer and Neil Agnew, "Nicotinic Acid Modified Lysergic Acid Diethylamide Psychosis" (1955); and John Smythies, "The Experience and Description of the Human Body" (1953).
13. He had some initial experience in psychiatry as an intern at Guy's Hospital in London in 1942. In 1944, after meeting Curran, he worked as a psychiatrist trainee at the Royal Naval Auxiliary Hospital in Burrow Gurney, Bristol, England, followed by a second navy assignment in Cholmundely Castle at Cheshire. Following the war (1945-47), he worked first as a specialist in neuropsychiatry in Bighi, Malta, then as command psychiatrist in the 90th Military Hospital in Malta. In 1948, he returned to Guy's Hospital as an assistant in the department of neurology before becoming first assistant in the department of psychological medicine at St. George's Hospital at Hyde Park Corner, London.
14. I am grateful to John Smythies for sharing his unpublished manuscript with me.
15. Smythies contends that this was the first biochemical theory of schizophrenia.
16. For further information on Hoffer, Saskatchewan, see Clara Hoff er and Fannie Kahan, Land of Hope (1960). As Hoffer and Kahan make clear, Abram's father came to Saskatchewan as part of a Jewish agricultural relocation program. Hoffer Sr. was sent to Saskatchewan to establish an agricultural community that would absorb Jewish immigrants. Although the program was not very successful, it is likely that Abram developed an interest in agriculture in this context. 17. see also Humphry Osmond and John Smythies, "Schizophrenia: A New Approach" (1952).
18. These sentiments were revealed in a number of oral interviews with the author, including those with psychologist Robert Sommer (2003), psychiatrist and graduate student Neil Agnew (2003), and nurse Joyce Munn (2003). These feelings also match with collegial recollections of Ben Stefaniuk who worked closely with Osmond as a graduate student.
19. Twenty years later, these concerns resonated in a department that had focussed most of its energies on developing biochemical research, much of which involved LSD experimentation.
20. The term "normal" was used to describe volunteers for these trials who were not suffering from alcoholism. The volunteers signed consent forms and were refused if they had any family history of schizophrenia or liver problems. They were often university students or mental health workers.
21. For a more in-depth discussion of the doctors' strike in Saskatchewan that contributed to some of these changes, see Robin F. Badgley and Samuel Wolfe, Doctors' Strike: Medical Care and Conflict in Saskatchewan (1967), and C. David Naylor, Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance, 1911-1966 (1986, 214-43).
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