The Useless Science: A Fine Madness And the Decline of the Mental Sciences

Analyzing A Fine Madness; A Film Deeply Critical of Mental Health Experts

Introduction

Films provide a window into the society where they were made. This week, we continue exploring films that depict psychosurgery. A Fine Madness (1966) was a popular film which used humor to criticize mental health professions and psychosurgery. The movie was written by Irvin Kershner and directed by Elliot Barker. In the film, Sean Connery played Samson Shillitoe, a failed poet who is struggling with mental health. The film is a satirical critique of American society and mental health experts who are depicted not only as ineffective, but as vindictive people who abuse medical interventions to punish rather than to rehabilitate. 

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The Plot

The story narrates the life of the failed poet, Samson Shillitoe (Sean Connery). He is frustrated by his lack of progress on his magnum opus. He was also under pressure to pay his debts. Throughout the film, Samson exhibited aberrant behavior, aggressive tendencies, and was a serial womanizer. Many of the characters in the film do not see his womanizing as a problem. For example, his wife is fiercely loyal despite his indiscretions. 

In the beginning, Rhoda became concerned after Samson lost his job and ruined an opportunity. He worked as an office cleaner and lost his job after getting caught having sex with the office secretary. Later, he squandered a poetry reading because he got inebriated and belligerent. Consequently, and fearing her husband may end his life, she decided to seek the assistance of a psychoanalyst, Dr. West. The Doctor only accepted to see her husband when he learned he was allegedly a poetic genius. Samson was livid that his wife paid the doctor. He went to see him to demand the money back. Rather than accepting, Dr. West proposed to send Samson to a psychiatric institution for specialized study. 

At this institute, Samson is analyzed by a group of psychiatrists, all of which offer different “revolutionary” treatments. Among them is Dr Menken and his Menken Technique, designed to eliminate violent behaviors via lobotomy. The rest of the doctors opposed this approach because they considered it harmful. In response, Menken went directly to Rhoda to persuade her to let him lobotomize her husband. In the meantime, Samson met and seduced Dr. West's wife (Lydia). She had been frustrated by her husband’s focus on his career and subsequent abandonment of their marriage. Dr. West caught them in the bathtub. To avenge his wife’s infidelity, Dr West approved the lobotomy on Samson. In the film, Lydia unsuccessfully tried to stop him (in the book, the lobotomy was interrupted). 

The lobotomy had no effect on Samson, who continued to behave exactly the same way. 

Samson then left the hospital and returned home. Lydia cleared his debts to support him and informed him she had left Dr. West. Lydia left indignantly after Samson invited her to pair with him and Rhoda. Later, Samson accidentally punched Rhoda on their way home, and a turbulent mob began chasing them. Samson and his wife managed to return home and shut the door, thus ending the movie. 

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A Critique of Psychiatry 

The film satirized psychiatry and psychology and portrayed several doctors engaging in medical malpractice. 

At first, Dr. West accepted treating Samson because he found him interesting rather than because he thought therapy would help the patient or if the patient needed help. Second, Samson’s reluctance to accept treatment because of its alleged unreliability and his effort to recuperate the money his wife paid suggest skepticism about these practices. 

In the film, many doctors behaved unprofessionally. When Dr. West discovered that Samson was in his office, rather than being outraged by his space being breached and Samson’s accessing patient records, the physician became fascinated by the poet. He told Samson, “You have a good mind! It’s alive!” This scene highlights a lack of professionalism on the part of the doctor. This scene, like the rest of the film, suggested that psychiatry is full of inefficient, unprofessional charlatans. The film showed that Dr. West is charismatic and media savvy, yet he prioritized his work over his family. Other doctors are depicted with exaggerated traits to emphasize their eccentricity. 

The film suggested that these doctors are not only weird but that there are deep disagreements between them. These differences suggest there is no consensus between experts. Dr. Menken is portrayed as a nervous, obsessive, and shady physician, more interested in promoting his technique (a form of psychosurgery) than in helping patients. Another doctor, Dr. Vorbeck, a Viennese psychoanalyst, is interpreted with a thick German accent, sophisticated manners, and stern expression. This doctor strongly believed in and defended Freudian psychoanalysis. Dr Vera Kropotkin was portrayed as a mysterious woman who also used psychoanalysis. She thought love cured patients, so she engaged in an intimate relationship with Samson. This therapeutic approach failed. None of the interventions depicted in the film help Samson. 

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Source: Youtube

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A Fine Madness mocked psychiatry and suggested it used outdated and eccentric techniques to deal with the issues that society at large has generated. This negative portrayal of the mental sciences coincided with a global movement of counterculture and anti-establishment, which reached its zenith in the 1960s and 1970s. Other pieces of literature published around that time were also harshly critical of mental hospitals. For example, some ten years later, the iconic One Flew Over the Cuckoo’s Nest portrayed professionals abusing technologies, and alleged therapeutic interventions were used to subjugate the will of the patients. 

At Curing Crime, we cover many ways in which science and medicine have caused harm to people. In doing so, we do not mean to suggest that these fields should be discarded. We think that psychiatry and other such approaches are potentially valuable even if we appreciate that mistakes have been made and some therapeutic approaches have caused harm. We believe that films provide a fascinating window into how society understood these developments. 

A Mockery of Lobotomy

The film features a doctor who advocates for the therapeutic value of lobotomy, a procedure that was once popular but was by then largely discredited. The film strongly criticized and parodied this procedure.

The film portrayed the doctor who promoted lobotomy as shifty, nervous, and obsessive. A doctor more concerned with promoting the supposed novelty of his technique rather than the result it generated. When Dr. Menken explained the procedure to a group of doctors; he used a plastic human head as a model of a skull. He presented the transorbital prefrontal approach. During this demonstration the skull’s eye fell out which undermined his assurance of the safety of the process, but also his authority and reliability of him and his practices. He claimed, “the beauty of this technique is that it can be done anywhere, even in the doctor’s office” (01:04:22). Menken claimed that the operation had great success on primates (likely a reference to John Fuller’s work) and on humans. 

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Source: Pexels

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This character was likely inspired by Walter Freeman who proposed a similar approach before lobotomies gained widespread popularity. Freeman was often described as charismatic, likable, and was a well-respected physician. Lobotomies were at first enthusiastically received and used to treat schizophrenics. As their popularity grew and professionals gained awareness about some of its side effects, the operation started to be used to treat a wider set of issues (including violence and behavioral problems). Freeman often argued that the operation allowed patients to return to their homes, and to procure work even if they lost some of their creative faculties. Similarly Menken justified his operation, by saying “To hell with his poetry, I want to make him a useful human being” (01:20:07). The operation grew less popular with the introduction of thorazine and other medicines that made difficult patients docile. In many ways Menken is the opposite of Freeman perhaps because the attitudes towards lobotomy had shifted making a successful, charismatic, and well-respected proponent of lobotomy less believable.

Samson’s lobotomy is also unrealistic. Shortly after his operation, Dr Menken approached to check how he was doing. The doctor removed the bandages revealing no bruises under Samson’s eyes and little, if any, change to his demeanor. Samson muttered and babbled, seemingly unable to form a sentence to, seconds later, stand up, punch Menken, and escape the institution. The poet appeared utterly unaffected by a drastic brain surgery; he remained  “mad as ever” (Merkin, 1966). He recovered fully just a moment later. Contrary to what Dr Menken predicted, he seemed to behave even more violently than he used to. This is in line with what was observed after real lobotomies, which made some patients lose their inhibitions. 

Conclusion

A Fine Madness invited viewers to laugh at the poet but also at “infidelity, psychiatry, psychosurgery, doctors, and the American Club Women” (Cedrone, 1966). The film depicted mental health experts behaving unprofessionally and abusing the tools and technologies at their disposal for personal gain. Further, not only are these tools ineffective, but experts cannot agree on the basic approaches to treating patients like Samson. 

We do not know whether the studio, writers, and actors meant to criticize the state of mental health treatments at the time. Moreover, their intention is irrelevant because the fact that this film was perceived as potentially funny already reveals a lot about the culture in which it was made and released. Just ten years later, there would be an increase in the belief that people could be remade through brain surgery or environmental interactions. Nevertheless, around the early 1960s, lobotomies and other operations were in decline. As the belief that these technologies could be effective grew, so did fear about who could wield them. For example,  Ken Kessey did mean One Flew Over the Cuckoo's Nest to be a critique and expose. 

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Cedrone Jr, Louis. R. 1966. Fine Madness is Fine Comedy. August 23, 1966. The Evening Sun, p.8.

Merkin, R. 1966. Connery Shakes Off His Bonds. August 10th, 1966. The Washington Daily News, p.38.