CURED Film Project. Used with permission.

A review of award-winning documentary Cured.

Cured premiered on PBS on 11 October to coincide with National Coming Out Day. The documentary chronicles the years-long campaign which led the American Psychiatric Association (APA) to remove homosexuality from its manual of mental disorders.

Featuring rich, newly unearthed archival footage and incisive interviews with key players, Cured has already won an award from the American Historical Association. The British Film Institute called it “one of the best documentaries of this or any year.”

The first part made me sick to my stomach. In one scene, shot in 1966, an assembly of children are warned, “If we catch you with a homosexual… the rest of your life will be a living hell.” In another scene, a psychiatrist publicly opines that homosexuals cannot “remain happy for long.”

Homosexuality had once been in the purview of the Church, but people no longer believed so much in sin, and homosexuality came to be rebranded as something more credible for the times. In the first edition of its manual of mental disorders (DSM-I), published in 1952, the APA included homosexuality as a “sociopathic personality disturbance.” In the second edition (DSM-II), published in 1968, it reclassified it as a “sexual deviation.”

By the 1960s, a large majority of Americans believed homosexuality to be a mental illness, and many looked upon gays with varying mixtures of disgust, discomfort, and fear. People who were denounced as homosexual were unable to work as a teacher or judge or civil servant, or even to retain the custody of their children. Most gays had little choice but to remain closeted. Many bought into the narrative that they were mentally defective: some hoped that marriage might cure them; others sought treatment or were coerced into it.

The most common “treatment” at the time was talk therapy, but many gay men and women were subjected to more aggressive interventions such as aversion therapy and electroconvulsive therapy—even, in extremis, castration or lobotomy.

One, now elderly, victim described it as “like a horror movie.”

The fight-back

Small, isolated protests began to take place from 1965, with activists putting their livelihoods and families and friendships on the line. This gay liberation movement began to snowball after the 1969 Stonewall Uprising, in response to an arbitrary police raid in Greenwich Village, New York.

In 1970, activists infiltrated and disrupted the National Convention of the APA. At the 1971 convention, astronomer Frank Kameny demanded that psychiatrists provide scientific evidence for their claim that homosexuality is a mental disorder. In 1972, Dr John Fryer—who, like Kameny, had lost his job after being outed—addressed the convention under strict anonymity, complete with mask and wig and voice-distorting microphone. He began: “I am a homosexual. I am a psychiatrist… What is it like?” Hearts were warming, and minds shifting on the meltwater. In 1973, activist Ronald Gold received a standing ovation for his talk entitled, “Stop it, you’re making me sick!”

 Photo by Kay Tobin @Manuscripts and Archives Division, The New York Public Library. Used with permission.
Dr Anonymous addressing the 1972 APA Convention, with Frank Kameny and Barbara Gittings. Photo by Kay Tobin @Manuscripts and Archives Division, The New York Public Library. Used with permission.

In December 1973, the APA board voted unanimously (with two abstentions) to remove homosexuality from the DSM. But psychoanalysts who objected to that move forced the APA to hold a referendum. In 1974, the APA asked its membership to vote on whether to affirm the board’s vote: 5,854 psychiatrists voted in favour, 3,810 against. The APA then compromised, removing homosexuality but replacing it, in effect, with “sexual orientation disturbance” for people “in conflict with” their sexual orientation. Not until 1987 did homosexuality completely drop out of the DSM.

Meanwhile, the World Health Organization in Geneva only removed homosexuality from its International Classification of Diseases (ICD) with the publication of ICD-10 in 1992, although ICD-10 still carried the construct of “ego-dystonic sexual orientation.” In this “condition” the person is not in doubt about his or her sexual orientation, however, “wishes it were different because of associated psychological and behavioural disorders.”

As I discuss in The Meaning of Madness, the evolution of the status of homosexuality in the classifications of mental disorders highlights that concepts of mental disorder can be rapidly evolving social constructs that change as society changes. Today, the standard of psychotherapy in the US and Europe is gay affirmative psychotherapy, which encourages gay people to accept their sexual orientation—although some licensed professionals still conduct so-called “conversion therapy.”

Further thoughts

The early successes of the gay liberation movement are not ancient history but well within living memory. Gay marriage has been legal for some years now, but the old notions of sin and mental illness, of guilt and inadequacy, live on in the collective consciousness, including the substance of gay people born long after the 1970s. While the documentary is All-American, there are many countries in which homosexuality remains illegal, in some cases punishable with life imprisonment or even death. In many parts of Africa, conditions for gay people are in fact getting worse. Some important battles have been won but the war is far from over, and this documentary is good ammunition.

I think it’s also worth asking why attitudes to homosexuality, at least in America and Europe, have shifted so far and so fast after centuries of stasis. We flatter ourselves that we are more enlightened and tolerant than our forebears, but progress in one area is often tied to progress in other areas, and it must have helped that gender roles are now less defined and childbearing no longer the imperative it used to be.

But that is not to diminish the achievements of heroic activists like Frank Kameny and John Fryer, who carried the hand of history.

In the U.S., Cured is available to stream for free through November 30 at pbs.org and on the PBS video app. The film is streaming in the UK on Sky and NOW through 2024.

Zacharias Diamantakis in his element.

The first advanced civilization of Europe, the Minoans, were already making wine on Crete four thousand years ago. In the second century, Crete was known in Rome and beyond for a sweet wine called protropos. In the Middle Ages, under the Venetians, the sweet Malvasia di Candia (as Crete was then known) was traded far and wide.

Wine production went into decline under the Ottomans, and, until recently, Crete was mostly known for bulk wine. Still today, the island accounts for around a fifth of Greece’s total area under vine. Phylloxera came late, from 1974, and many of the old vines that were lost were replaced with olives or international varieties such as Chardonnay and Syrah. Happily, in recent years a new generation of winemakers have been busy reviving ancient indigenous varieties, and their wines are starting to make a mark on the palate if not yet on the wallet.

Crete is the largest island of Greece, forming the southern boundary of the Aegean Sea. It is about 260 km long and from 15 to 60km wide. The capital Heraklion, on the central northern coast, is more southerly than Tunis, but soaring mountains along the length of the island make for cooler, wetter conditions than might be expected, especially in the western Chania [pronounced ‘Hania’] region. In fact, Crete is a powerhouse of agriculture as well as tourism, and one of the richest regions of Greece.

Most of the vineyards are on the northern side of the mountains, where they are sheltered from the hot Libyan winds and exposed to cooling Aegean and mountain breezes. Unusually for Europe, they tend to face north, like the Cretans themselves, who are strongly attached to Mother Greece. The green and rolling foothills behind Heraklion (pictured) account for over 85% of total production, and include the PDOs of Dafnes, Peza, and Archanes—although, with Crete, it is wise not to get too embroiled with appellations. There is also some quality production in Chania and around Sitia in the east. Soils are predominantly limestone-rich calcareous clay, quite unlike in nearby and volcanic Santorini.

The varieties that are attracting the most interest and enthusiasm are Vidiano and Liatiko, which might be thought of, respectively, as the Cretan Viognier (or Roussanne) and the Cretan Pinot Noir. Vidiano is beginning to eclipse the serviceable Vilana, which had once been encouraged. Liatiko is light and pale and liable to bronzing, but also fresh and floral and haunting. In my limited experience, both Vidiano and Liatiko seem to benefit from a bit of bottle age. The two other notable red varieties, Mandilari and Kotsifali, are often blended, with Kotsifali playing Merlot to Mandilari’s Cabernet Sauvignon—although the wines themselves are more redolent of Northern Rhône crus than of Bordeaux. Indigenous varieties are often blended with international varieties, which is a shame insofar as it obscures their Cretan identity. Another notable variety, native to Chania, is Moscato Spinas, a thin-skinned clone of Muscat Blanc that makes for fresh and elegant wines.

Leading producers include Diamantakis, Doulofakis, Idaia, and Lyrarakis in the centre, Manousakis in the Chania region, and the iconic and idiosyncratic Yiannis Economou near Sitia. Lyrarakis is credited with rescuing three ancient indigenous varieties: Dafni, Plyto, and Melissaki. Dafni, like Portugal’s Loureiro, means ‘laurel’: it is bright and fresh with notes of bayleaf, sage, pine, ginger, quinine, and citrus fruits. Plyto on the other hand seemed to be more about length, structure, and minerality, with high acidity and a saline finish. Lyrarakis’ Voila Assyrtiko, from Sitia, is the best Assyrtiko from outside Santorini and Tinos that I have tasted, and a real bargain to boot.

I look forward to following these wines.

Neel Burton is author of The Concise Guide to Wine and Blind Tasting.

Seneca’s timeless advice for dealing with noise. 

Odysseus and the Sirens, by John William Waterhouse. Public domain, via Wikimedia Commons.

In my previous post, Hate Noise? You Might Be a Genius, I discussed the relationship between sensitivity to sound and creative thinking. Many great minds, from Kant to Kafka, and Darwin to Proust, are known to have been atrociously sensitive to sound. The philosopher Arthur Schopenhauer (1788-1860) in particular wrote an essay, On Noise, in which he linked misophonia [“the hatred of sounds”] with intellect and creativity—an association that modern science seems to be confirming.

There was, however, one singular genius, often mentioned in the same breath as Socrates, who managed to make his peace with noise: Seneca (c. 4 BCE-65 CE), the famous Stoic philosopher and infamous tutor and advisor to the mad emperor Nero. In the end, Nero forced his hapless mentor to commit suicide, which Seneca did unflinchingly according to the model that had been set by Socrates.

If you think that Manhattan is noisy, that is nothing to Ancient Rome, with its criers and hawkers, chariot wheels on uneven roads, and lack of window glass let alone double glazing and other soundproofing. Not even Seneca, who has been described as the first-ever investment banker and might have been the richest man in the Roman Empire, could insulate himself from the hubbub.

In the Letters to Lucilius, which he wrote in a (successful) bid to become immortal in the months leading to his death, Seneca claims to be living in lodgings right over a bathing establishment: “So picture to yourself the assortment of sounds, which are strong enough to make me hate my very powers of hearing!” He paints a vivid picture of the soundscape and, by extension, of first century Roman life: the grunts of the weightlifter, the slaps and pummelling of the masseur, the splashing of the enthusiast who bombs into the pool, the ceaseless chatter of the hair-plucker who makes his victims yell…

Despite the din, Seneca remains able to read and write, assuring Lucilius that “this racket means no more to me than the sound of waves or falling water.” Still, he recognises that some noises are worse than others. Intermittent noises, he says, are more upsetting than steady ones. Spoken words are more distracting than mere sounds, in that they demand our attention: compared to speech, even the saw-sharpener is easier to bear. Yet Seneca is able to force his mind to concentrate and “keep it from straying to things outside itself.”

More than that, Seneca sees this as a test of his Stoicism, mental fortitude, and even virtue. Ultimately, he reasons, noise only disturbs us insofar as it resonates with our own emotional turmoil. If our mind is still, no amount of noise can unsettle it; but if our mind is angry or fearful, or burning with greed or envy, no amount of silence can still it: “For of what benefit is a quiet quarter or neighbourhood if our emotions are in an uproar?”

In Virgil, as Aeneas flees burning Troy, he says, “I, whom of yore no dart could cause to flee… Now shake at every sound, and fear the air, Both for my child and for the load I bear.”

We tend to associate sleeping with resting. But unless we are able to still our mind by the use of reason, the night merely changes the form of our worries. Real tranquillity, in contrast, “is the state reached by a rational mind when it is at rest.”

For if we have sincerely retired… and have scorned outward attractions, then… no outward thing will distract us; no music of men or of birds can interrupt good thoughts, when they have once become steadfast and sure. The mind which starts at words or at chance sounds is unstable and has not yet withdrawn into itself; it contains within itself an element of anxiety and rooted fear, and this makes one a prey to care… You may therefore be sure that you are at peace with yourself, when no noise reaches you, when no word shakes you out of yourself, whether it be of flattery or threat.

I think there is a lot of truth in that. When overwhelmed by noise, I find it very helpful to ask myself, “Is my annoyance more to do with me or my prejudices than with the noise itself?” But I would contest that even if we are able to concentrate in a din, our concentration is less profound or complete than it would otherwise have been, and more wearing too.

Seneca readily admits that, having tested ourself, is it simpler to avoid the uproar, or block it out, just as Odysseus blocked his ears and had the Argonauts row faster to get past the sirens. According to lore, the sirens were fated to die if someone ever escaped their singing, and after Odysseus were never again to be seen or heard.

Ketut Subiyanto/Pexels

I am excruciatingly sensitive to noise: I always carry earplugs and fantasize about living in the middle of the woods. Is the problem with me or with the world?

As a misophone [“hater of sounds”], I’m in pretty good company. Kant hated noise, as did Proust, Kafka, and Darwin—and even, ironically, Wagner. Kant fled his lodgings on account of a crowing rooster, and Proust went so far as to line his bedroom with cork. Plato, Aristotle, and Epicurus secluded themselves in large private parks, and had only to contend with the baby-like cries of hedgehogs and maybe the murderous screams of vixens. The sounds of nature, I find, are always more bearable: I onced toured Cophenhagen Zoo—the only thing open on a Monday—and noted that the most disturbing cries came from the human children.

Young children scream and cry all the time because they haven’t yet learnt how to read. That’s how I’d be without books.

The philosopher Arthur Schopenhauer (1788-1860) wrote an essay, On Noise, in which he linked misophonia with intellect and creativity:

Certainly there are people, nay, very many, who will smile at [my predicament], because they are not sensitive to noise; it is precisely these people, however, who are not sensitive to argument, thought, poetry or art, in short, to any kind of intellectual impression: a fact to be assigned to the coarse quality and strong texture of their brain tissues.

Schopenhauer railed hardest against the cracking of whips in narrow resounding streets (the 19th century equivalent of revving motorbikes): “Hammering, the barking of dogs, and the screaming of children are abominable; but it is only [his emphasis] the cracking of a whip that is the true murderer of thought.” To him, the cracking of whips was all the more unbearable for being unnecessary and, worse than unnecessary, useless.

Not every sound is noise. I enjoy certain natural sounds such as birds singing, a stream burbling, or waves lapping or breaking; but not, say, an air conditioner humming (unless it is very hot outside), children crying, or people shouting or talking without saying anything useful, interesting, or amusing. If I believe that something is important or meaningful or beautiful, the sound that it makes is much less likely to constitute noise; and contrariwise if I think that it is ugly or meaningless or destructive. Noise, then, is whatever I don’t think is worth hearing, and exists on a spectrum. In the final analysis, it is whatever ends up dissipating rather than concentrating or conserving my energies.

For Schopenhauer, genius is precisely this: the ability of the mind to concentrate itself on a single point and object. But as soon as this bunched-up mind is interrupted or distracted or dispersed, it is no better than an ordinary mind. It is, says Schopenhauer, as with a large diamond, which, if shattered, loses most of its value; or as with an army, which, if dispersed, loses most of its power. It is not merely a matter of genius but also of happiness, because, as every creative person knows, there is no happiness greater than that of the mind at play. Aristotle famously conceived of God, the traditional fount of all reason, as a mind that turns blissfully upon itself. In contrast, people who are too frightened to put two and two together, or are unable to, use noise to help occupy and numb their minds (see my related post on the psychology of music in restaurants). 

Was Schopenhauer being fanciful in linking misophonia with intellect and creativity? In recent years, researchers at Northwestern University have found that real-world creativity (although not, interestingly, academic test scores) may be associated with a reduced ability to filter “irrelevant” sensory information. “Leaky” sensory gating may help our brains integrate ideas that are outside the focus of our attention and thereby promote associative and creative thinking. But if these extraneous ideas are, well, noise, it can also cripple us. The geniotic brain is like a high-compression engine, which knocks if fuelled with lower octane gasoline, i.e. nonsense. Even if he might have overstated his case, Schopenhauer, it seems, was on to something.

There was, however, one singular genius who was not disturbed by noise: Seneca, the famous Stoic philosopher and infamous tutor and adviser to the mad emperor Nero, who, in the end, obliged his hapless mentor to commit suicide.

In my next post, I will look at Seneca’s timeless advice for coping with noise.

References

  • Schopenhauer, A (1851): Parerga and Paralipomena, Vol 2, Ch 30, On Din and Noise.
  • Zabelina DL et al (2015): Creativity and sensory gating indexed by the P50: Selective versus leaky sensory gating in divergent thinkers and creative achievers. Neuropsychologia 69:77-84.

Is Psychiatry the New ‘Opium of the People’?

Picture credits: Atlantic Books/James Davies/Neel Burton

Dr James Davis is a medical anthropologist and trained psychotherapist who is perhaps best known for his book of 2013: Cracked: Why Psychiatry Is Doing More Harm Than Good.

Cracked is a forensic examination of our increasing reliance on psychiatry and psychiatric drugs, in which Davis essentially argues that psychiatry ‘in the name of helping others, has actually been helping itself’.

His latest book, Sedated (March 2021), is broader in scope, looking at the social and political underpinnings that facilitated and enabled this state of affairs.

Since the early 1970s, the number of mental disorders listed in the DSM, the American classification of mental disorders, has risen from 106 to 370. Antidepressant prescribing in the U.K. surged from 25 million prescriptions per year in 2002 to nearly 75 million in 2020. The coronavirus pandemic has only accelerated the trend—while more benign and empowering psychological treatments are ever harder to access.

In Sedated, Davis puts it to us that psychiatric interventions, including superficial psychological interventions principally aimed at returning people to productivity, merely create the illusion of care while leaving the structural causes of distress intact. More than that, by shifting the blame or responsibility onto the sufferer, they serve to obscure these structural causes and, thereby, to preserve and entrench the neoliberal status quo.

The interventions favoured by the government, including even the psychological interventions, are those that involve internal rather than external change, because internal change promises to increase economic productivity and so cost-effectiveness, which is the preferred criterion for endorsing one treatment over another. If we are suffering, we are simply to stiffen ourselves to the social problems created by successive policies aimed solely at the bottom line.

Karl Marx famously said that ‘religion is the opium of the people’. The social institutions responsible for understanding and managing suffering are critical to the preservation of vested interests. With the waning of religion in the West, priests may have been supplanted by psychiatrists. The idea that a pill can make us happy ought to be inherently suspicious but fits perfectly with our materialistic and mechanistic worldview.

Thus, according to the prevailing narrative, suffering is rooted in individual rather than social or existential causes, while well-being is whatever best serves the economic imperative. Behaviours that disrupt economic activity are labelled as mental disorder, and this mental disorder presents yet another money-making opportunity.

If so many of us are ill, if a quarter of us are taking a psychiatric drug, this is because our suffering, having been stripped of its deeper purpose and meaning, is no longer being heeded. It is no longer being interpreted as a vital call to change, or to protest against harmful or inhibiting conditions. 

On the contrary, once we identify as mentally ill, we become disempowered in the belief that the problem lies solely with us, or, more precisely, with misfiring chemicals in our brains. While we are at the clinic, we are not at the barricades.

And while we work to grow the economy, we are not working to grow ourselves.

This is very big picture stuff from James Davies, who weaves our worst fears into a coherent, compelling, and damning narrative.

Neel Burton is author of The Meaning of Madness.