The title page of Remaking a Man identifies Baylor as a representative of the Emmanuel movement. This is certainly true. Baylor, the former patient who became one of its leading therapists, was closely tied to Emmanuel until Worcester retired in 1929. Worcester and Baylor then launched a foundation to continue their work. Both men were strongly influenced by the emergence of the new science of psychology. But there were differences between them. Worcester never lost his faith in the importance of religion in helping men and women recover from illness. But God is not mentioned in Remaking a Man. In 1919, Baylor estimated that he had treated over a thousand patients, mostly alcoholics, and claimed to have helped two-thirds of them. There had not been such an effective counselor of drunks since Albert Day of the Washingtonian Home. But the kind of spiritual assistance that Baylor provided did not require belief in a higher power. What was needed were strategies for addressing the alcoholic’s serious psychological problems.
The Emmanuel movement started something important. Americans were already fascinated by the idea of the mind cure when Worcester announced his plans in 1906. But the partnership between orthodox ministers and distinguished doctors gave mental healing a legitimacy that it lacked when it was practiced by Christian Scientists, who many considered religious fanatics. Newspapers around the country provided extensive and often sensationalistic coverage. (One claimed that Worcester had brought a woman back to life, when, in fact, she had only fainted.) Ladies’ Home Journal paid the minister a princely sum to write a series of articles. His book Religion and Medicine was an instant best seller that was reprinted eight times in seven months. The United States Surgeon General included it in a list of the three best books on psychiatry. Ministers from around the country traveled to Boston to study Worcester’s methods. Similar programs were started by churches in New York, Cleveland, San Francisco, Detroit, Philadelphia, Baltimore, and Seattle. But Worcester could not sustain his movement. He had too many enemies. Doctors didn’t like the idea of laymen, even well-intentioned ones, practicing medicine. Many ministers also attacked the Emmanuel experiment, believing that it had nothing to do with religion. The opposition grew so strong that Worcester decided it was pointless to defend his idea and focused on his work in the clinic.
Interest in psychology continued to increase as Freud’s ideas revolutionized the practice of psychiatry. Freud was very critical of the Emmanuel movement when he visited the United States in 1909. A reporter asked him to comment on claims by “several psychotherapeutists” that they had cured hundreds of alcoholics “by hypnotism.” Freud doubted that the drunks would stay sober for long. Suggestion depended on planting an idea in the patient’s unconscious. The goal of Freudian therapy was to discover the underlying cause of neurosis. “The analytic therapy . . . does not wish to inject any thing; but to take away, to get rid of, and for this purpose it concerns itself with the origin and progress of the symptoms of the disease, with the psychic connection of the diseased idea, which it aims to destroy,” Freud explained.30
Freud may have disagreed with the proponents of mind cure over theory and methods, but his claim to be able to cure illness by destroying “the diseased idea” was no less sweeping—or exciting. Doctors were both shocked and attracted by his theory that neurosis originated in the frustrated sexual desires of children. Many were eager to learn his methods for uncovering and resolving these conflicts, especially the analysis of the hidden meaning of dreams.
It wasn’t just doctors who were fascinated. The middle class was growing rapidly in cities of the United States during the first decade of the twentieth century. These men and women hungered for an understanding of the economic, social, and political problems of their day, and they found many of their answers in a new genre of “muckraking” magazine that challenged the platitudes of the previous generation. The muckrakers recognized the revolutionary nature of the new psychology and rushed to explain it to their readers. It provided a new way of looking at the problem of mental illness, including alcoholism. A number of magazines featured articles in which drunks explained how they had been cured through the new Freudian therapy—psychoanalysis.
In September 1917, McClure’s Magazine published an article, “Is This Why You Drink?,” by an anonymous author who claimed he had stopped drinking following several months of psychoanalysis. The author explained that he had been a successful attorney, but in his early thirties, he began to encounter problems. “At pretty regular intervals I drank flagrantly, arrogantly, without regard to the advice of anybody else in the world,” he wrote. After eight years of hard drinking, he realized he couldn’t stop. He sought advice from doctors, read temperance literature, and tried various “cures.” Nothing worked. “[T]here was nothing to indicate why I, an otherwise sensible and industrious man, should inevitably at certain periods, embark on a debauch.” Finally, a friend gave him the name of a well-known psychiatrist in another city. He traveled to the doctor’s home. The psychiatrist was reassuring. “There are many thousands of others like you,” he said. “You are a neurotic. I can straighten you out and set you on your feet if you will give me the required time and will live here in this city.”31
The lawyer agreed and met with the psychiatrist every day for several months. During one of the first sessions, the doctor told his patient that all drunks shared one quality:
Every drunkard is a moral coward, because, in getting drunk he runs away from the workaday world with all its problems and burdens and enters into the world of phantasies, a world where the imagination makes things seem the way you want them to be. Drunkenness is flight, a running away from reality.
He analyzed a dream the lawyer had during the previous night. The man was working in his law office, but he was distressed because his secretary, a dark-skinned Hindu man, had left open the transom above the office door. Eventually, the secretary disappeared through the transom, closing it after him. The psychiatrist interpreted the dream as an expression of the lawyer’s tendency to be shut up emotionally. Discussion of the Hindu, who was not really his secretary, brought up a painful memory of his mother’s rejection of a request he made when he was five. “The long and the short of that dream was that its analysis by the doctor showed me the folly of attempting to live within myself, that I was selfish and that I had become morbid many years before,” the author wrote.32
The lawyer continued to drink during the early weeks of his therapy. The psychiatrist had never told him that he should stop. “He knew, it seemed, that, as the burden of the thing that had troubled me was lightened, the liquor would have less and less attraction for me,” the lawyer said. That was what happened. At the end of the first month, he was drinking less. “I had not been really drunk for a week!” He had stopped completely by the end of the third month. By then, his whole attitude toward life had changed. “I was amazed by the degree in which my appreciation of the beautiful things of the world, the flowers, pictures, good books and good plays had taken the place of the ‘charm’ of whiskey,” he said. He moved home full of enthusiasm for his new life and the therapy that had made it possible. He even tried to psychoanalyze five of his acquaintances, four of whom were drunks.33
While the lawyer’s experience sounded promising, it is not clear whether he was an alcoholic or someone with a drinking problem who found it relatively easy to stop. Whether psychoanalysis could help many drunks was also an open question. The author of “Is This Why You Drink?” could afford to move to another city for several months of intensive therapy. Freud himself had raised doubts about how many people could benefit from psychotherapy. “The psycho-analytical cure . . . makes difficult demands on the patient and on the physician,” he told the Boston Daily Transcript in 1909. “Of the patient it requires great frankness, occupies a great deal of time, and is therefore expensive.” Wealth and education appeared to be prerequisites. Perhaps even more important was a willingness on the part of the patient to explore his or her deepest emotional conflicts. What could it do for those who didn’t have th
e money or the time? Was there any hope for the alcoholic who did not think his drinking was a problem?
Slowly, answers began to emerge. Alcoholism had long been recognized as one of the major problems plaguing urban life, and progressives believed that it was reaching crisis proportions. Bellevue Hospital in New York City treated 6,453 drunks in 1906. A psychiatrist on the hospital staff believed that 40 percent of his insane patients had abused alcohol. Many of these drunks had been repeatedly picked up by the police. The city workhouse became almost home to men and women who returned as often as eighteen times per year. Homer Folks, a leading social worker, saw alcoholism as the root of many social problems:
The drunkard’s family has ever been the insoluble problem in home relief, public and private. The drunkard’s children have ever been the despair of child-caring agencies. . . . General hospitals . . . find the alcoholic ward a source of ever recurring trouble. The conscientious almshouse superintendent finds his best plans miscarried. . . . The lower courts are close with habitual drunkards.
Folks believed something had to be done and that it was up to government to do it.34
Advocates had been calling for the creation of state institutions for alcoholics since the early nineteenth century, but little had come of it. The New York State Inebriate Asylum was a private institution. There were plans for government-run institutions for drunks in Connecticut and Minnesota in the 1870s, but these were never realized. When the Minnesota legislature passed a tax on liquor sales to pay for a Minnesota Inebriate Asylum in Rochester, angry saloon keepers descended on the state capital, forcing both the repeal of the tax and the cancellation of plans for the asylum.
The political climate during the Progressive Era was more receptive to the idea of a role for government. In 1909, the Minnesota Supreme Court recognized that the attitudes were changing:
The trend . . . of legislation is to treat habitual drunkenness as a disease of mind and body, analogous to insanity, and to put in motion the power of the state, as the guardian of all of its citizens, to save the inebriate, his family and society from the dire consequences of his pernicious habit.
Homer Folks persuaded the New York legislature to create a New York City Board of Inebriety to investigate cases of public drunkenness and determine how the offenders should be treated. Men and women who had been arrested for the first time were to be released without further court proceedings; repeat offenders would be punished with fines and probationary sentences. If the drunks continued to drink, they could be sent to a proposed state farm for inebriates or, failing that, the workhouse or penitentiary. (Workhouses, also known as poorhouses, were established by local governments in the nineteenth century to provide care for those who were unable to support themselves; residents worked in return for their room and board.)35
New York City, Minnesota, and Connecticut established inebriate farms between 1912 and 1915. Considering the magnitude of the problem they were meant to address, they were all small facilities. The Minnesota Hospital Farm for Inebriates in Willmar had room for only fifty men; the New York farm opened sixty miles outside the city in Warwick with twenty-five beds and eventually housed a hundred drunks; the Connecticut facility had a capacity of sixty. The superintendents of the inebriate farms took seriously their responsibility to rehabilitate the men in their charge. Many of the drunks had been locked up in an insane asylum or hospital. Henry M. Pollock, the superintendent of the Norwich State Hospital and Farm in Connecticut, made every effort to provide a “normal” environment. The patients were
subject to simple rules that differ but little from those observed in the usual household, the inmate enters and departs as he pleases. He rises to have breakfast at six-thirty, is employed during the day, and after an evening spent in reading or employed in games or writing goes to bed at nine. On Sunday he attends church in the village where he receives a cordial welcome from both the pastor and people.
The goal of the farms was to help the drunk regain his health and develop a skill that would support him once he was released. “As far as possible, he is strengthened physically and morally,” Pollock said.36
Advocates for a new approach to alcoholism were aided by a rising concern about the public health threat from drunks. Discoveries in the field of genetics led some scientists to sound an alarm about the threat that “defectives,” including epileptics, the retarded, the mentally ill, and alcoholics, posed to future generations. The purported science of eugenics claimed that these disabilities were hereditary and called for measures to block their transmission by eliminating the right to beget a tainted offspring. In 1907, Indiana enacted a law providing for the compulsory sterilization of defectives. The US Supreme Court later upheld a Virginia law requiring the sterilization of patients in its mental institutions. By then, most states had adopted similar laws.37
The popularity of eugenic ideas provided an impetus for government treatment of alcoholism. In Iowa, Josiah F. Kennedy, the secretary of the state board of health, argued that reformed drunks would father healthy children and urged the creation of a state hospital for alcoholics. The legislature continued to resist the expense of a separate institution, but it approved the creation of a separate ward for alchoholics at two state mental hospitals in 1902.
Sixty-nine alcoholics soon moved into the Mount Pleasant State Hospital, while others were assigned to a second hospital in the northwestern part of the state. The new arrangement proved unworkable. Some of the mental patients thought they were better than the drunks. One of them complained loudly to John Cownie, a state official who was touring the facility. “Mr. Cownie, I want you to know I’m no drunken sot. I’m here for my health,” he said. The hospital administrators also had a low opinion of the new patients. “Usually they are dirty and lazy. . . . They won’t work. All they do is sit around and spit tobacco juice all over everything, making their rooms dens of filth,” one official said.38
In 1904, the Iowa legislature finally appropriated $100,000 to renovate an abandoned building in Knoxville that opened two years later as the State Hospital for Inebriates. It was no Garden of Eden. Most of the patients had no desire to get sober. Many had been committed by the courts and were resentful that they were being held against their will. Others were so damaged by drinking that they had lost the ability to recover. Those who could escape did so with the aid of relatives who had been glad to see them locked up briefly but needed their labor during harvesttime.
The drunks were given no good reason to stay. After the initial sobering-up period, treatment mainly consisted of work that was supposed to instill discipline in the men. Rather than teaching skills that might have given them confidence, they were assigned menial tasks. State officials also felt a need to show the voters a return on their investment. They even considered employing the recovering men in local coal mines, producing fuel to heat government buildings. It would also make it harder for the men to escape since they would be underground during the day and too tired to try anything at night. The idea of turning drunks into miners was never implemented. Instead, they were given “the wheelbarrow cure,” doing landscape work around the hospital and hired out to neighboring farms. The work was punitive as well as menial. A state official explained:
Our wheelbarrow cure for dipsomaniacs is working wonderfully well . . . [and] is the best thing we have found yet. . . . I tell you when the men get through with that cure they will hesitate a long time before they touch whisky again and have to go back to the wheelbarrow.
Without any statistics, this is a dubious claim, but the hard physical labor required of drunks certainly helps explain why they escaped at every opportunity.39
Massachusetts was having more success with its Hospital for Dipsomaniacs and Inebriates in Foxborough, which treated more than twelve hundred alcoholics by 1919. During the early years, the hospital faced many of the same problems as the Knoxville facility. The staff was deluged by men in the late stages of alcoholism who had been arrested so many times that judges sent th
em to Foxborough because they didn’t know what else to do with them. The hospital became overcrowded, and the escape rate soared. Administrators had tried to provide mental stimulation. Patients had been offered a variety of entertainments, including educational lectures, variety shows, poetry readings, and musical performances. But these were dropped and new restrictions imposed in an effort to reestablish discipline. Wards were locked, and the hours of physical exercise and work were extended.40
In 1908, Foxborough made a radical change of course. A thirty-nine-year-old psychiatrist, Irwin H. Neff, took over as superintendent in the spring. Neff was deeply committed to the progressive view that institutions could improve the lives of individuals and create a healthier society. As a result, Foxborough began to focus on the importance of “reeducating” alcoholics. The goal was to help drunks become hard-working, independent citizens. There was no fixed curriculum. “We must appreciate that the personality of the inebriate is an individual personality and cannot be expressed by a composite picture,” Neff said. This meant that therapy must be tailored to the individual. Therefore, the relationship between the doctor and his patient became key. Neff demonstrated his commitment to this idea by hiring a business manager to give him more time to work with the men.41
Neff recognized that the reeducation process extended beyond the doctor-patient relationship. The recovering drunk had to be reconciled with his family, the community, and the law. To promote this process, he created an outpatient department with offices around the state. When a patient was discharged, his case was referred to a counselor in the office nearest his home. The counselor worked with the alcoholic’s family, teaching them about his illness and how to be supportive. The outpatient department also helped the patient find a job and provided food and clothes when necessary. The counselor visited the recovering man periodically to monitor his progress. Foxborough also worked to educate the public about alcoholism. A trustee of the institution published a pamphlet that addressed the misconceptions of probation officers and judges. Neff helped organize one of the earliest state-sponsored conferences about the social and mental problems caused by alcoholism.
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