Treatment Abuse, Behavior Modification, Thought Reform > Daytop Village

Dr. Dan Casriel “A scream away from happiness”

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Inculcated:
Dan Casriel in the earliest days of Daytop expounds upon the beneficial use of fear in therapy, the “parahuman” addict and gives a nod to Synanon:

Therapy of Narcotic Addicts Sparks Psychiatric Theory
[From the Medical Tribune — World Wide Report]

New York. — A psychoanalyst said here that he has evolved a psychodynamic
Theory to explain character disorders by observing and working in the successful rehabilitation of narcotic addicts. The theory is based on the concept that persons whose primary method of defense is withdrawal, not "flight or fight," "fit into the psychiatric classification of character disorder."

Dr. Daniel H. Casriel explained both his theory and the rehabilitation process, which he called "the Daytop phenomenon," at a meeting of the American Society of Psychoanalytic Physicians, of which he is president-elect. The term refers to Daytop Village and Daytop Lodge, addict-reform communities in Staten Island, N.Y., patterned after the Synanon centers, with some modifications of technique.

"Daytop is the breakthrough in the treatment of the drug addict," said Dr. Casriel, who is medical-psychiatric superintendent of Daytop Village. "For the first time, an addict upon entering Daytop sees 100 people who were also addicted but who are living happily and functioning without drugs or the pre-occupation with the thought of drugs."

Daytop Village has been in existence for 6 months. It is an outgrowth of Daytop Lodge, established under a 5-year National Institutes of Mental Health project to compare the results of several alternative probation arrangements for felons of the Second Judicial District, New York Supreme Court, and initially limited to 25 probationers. ,

"People live in Daytop in a pleasant, paternalistic, tribe like, family environment," Dr. Casriel said, paraphrasing his book on Synanon, "So Fair a House."
The members think of Daytop neither as a hospital, a prison, nor a halfway house, but as a family-type club or home — a fraternity of people living together and helping each other to get well * * *. The members are neither patients nor inmates; they are free to leave any time they wish."

ONCE BELIEVED THERE WAS NO HOPE

He said that he himself had once believed there was virtually no hope for drug addicts: "Ten years of contact through community psychiatry with the problem of drug addiction had left me deeply pessimistic * * *. My observations had almost brought me to the conclusion that, once addiction was established in certain predisposed but undefined personalities. A basic metabolic change or deficiency was produced in the addict, manifesting itself in" a craving.

"That was my position until I discovered Synanon 3 years ago," he said, calling Daytop "the amalgamation of the best that was Synanon and the best of the professional understanding and knowhow."

Citing the relative lack of success of psychiatry in the treatment of character disorders, he said that "the question I kept asking myself was, 'Why were nonprofessionals able to stumble upon a rehabilitation and cure of the drug addict, whereas professionals, as a general rule, were completely unsuccessful?' At last I feel I've discovered why.

"After working intensively learning the process of treatment of the drug addict specifically and the character disorder in general, I was finally able to trace
it back and evolve a psychodynamic theory which to me explains why the process works."

The theory, he said, was a modification of the psycho cultural views developed by the Columbia School of Adaptational Psychodynamics.

"A major defect in the adaptational psychodynamic theory," asserted Dr. Casriel, "was its lack of awareness that there are three major methods of coping with pain or stress. * * * They accounted for two of these ways by the mechanisms of defense called flight or fight, using the emotions of fear or rage. What they failed to bring into focus is that there is a major, perhaps more primary mechanism in which one avoids danger or pain. * * * it uses neither the emotions of fear nor rage and may be called isolation or encapsulation. * * * Some people withdraw from the pain of awareness, the pain of reality, what they experience as the pain of everyday functioning, by withdrawing unto themselves."

It was big observation, he said, "that those people whose primary mechanism of defense is withdrawal are those who fit into the psychiatric classification of character disorder."

Once this "intrapsychic world without tension" has been evolved, he continued, "the individual will overtly or covertly fight anyone who attempts to remove him from his prison-fortress. * * * Once the adaptational mechanism of isolation is evolved and becomes a primary mechanism, the standard psycho- analytic techniques using introspections and observation are useless. The individual patient, though he hears, cannot be reached."  

To treat such patients, Dr. Casriel said, "One must first remove the shell and prevent the individual from acquiring or running into any other kind of shell."
Then he must be taught how to grow up emotionally, socially, culturally, sexually, vocationally, and educationally.

On this basis, addicts entering Daytop are given two simple prescriptions: no physical violence and no narcotics or other chemicals — "and by inference no other shells under which to hide." Only one reaction to his stress is left open to the Daytop member — fear. He can leave Daytop if unable to cope with his fears. However, said Dr. Casriel, "We anticipate that at least 80 percent of those who enter Daytop will sooner or later remain to get well."

If he stays, the member is given two prescriptions — go through the motions and act as if. The first means to abide by the rules and follow instructions, like it or not. If a member complains that he doesn't know exactly how to do as he is told, he is instructed to act as if * * * you knew what to do * * * you had the experience * * * you are mature * * * it is going to be successful * * * you are going to grow up and get well * * * you are already well and adult.

"When people go through the motions of acting as if," Dr. Casriel said, "they start thinking as if and finally feeling as if." At the beginning of this process, there is a crucial 90-day hump during which painful underlying feelings come to the surface, he said, but the support of others at Daytop helps the new member.

COMMUNICATION IS TREATMENT

Treatment through communication then helps the member to understand that
the undifferentiated somatic painful feelings that he has experienced on a visceral and emotional level * * * are nothing more than fear, anger, guilt, and depression, emotions experienced by all humanity * * * are not exclusive to what he felt was the mystical “parahuman” called the drug addict.

Tools of communications used at Daytop are a form of group therapy called the encounter, seminars, public speaking, psychodynamic interviews, lectures, and community relations. There are also rituals and rites of passage, including the intake and indoctrination processes, entrance into regular membership after a month's probation, a birthday after a year, and primitive rituals to maintain discipline, called the haircut and the general assembly.

Anonymous:
Is there a link to original source? Date of publication?

Inculcated:
The article above was entered as [Exhibit No. 14(g)]  in the congressional hearings cited and linked on the Narco Farm thread.
Items submitted included his CV and publications:

Curriculum vitae as of testimony(Excerpts)
- Psychiatric consultant, NIMH; grant to study drug addiction in the
U.S. Army. July. August 1962.

- Psychiatric consultant to the Synanon Foundation, August 1962 to June
1964.

- Consultant and therapist for the restoration of young through training
program : A program conducted in cooperation with the New York City Department of Correction, March 1965 to September 1965.

- Cofounder and medical-psychiatric director of Daytop Village, Inc. (a nonprofit therapeutic community and an extension of Daytop Lodge). By January 1970. 300 people in four physical facilities and four outpatient (SPAN) facilities.

- Consultant BAN/ -BAN/LSD (barbiturates, amphetamines and nar- cotics). 1965 to 1968. An ODP clinic, supervised by the New York State Supreme Court. Department of Probation. 2nd Judicial District.

 Group relations Ongoing Workshops, member of board of advisors and
chief, psychiatric services, 1968.

 Board of consultants. Country Place, Warren, Conn.

 SANE, board of consultants, 1968.

 Board of directors. Spruce Institute, Philadelphia, Pa., 1967 to date.

MEMBERSHIPS
(1) New York County and State Medical Association, 1953.
(2) American Medical Association, 1953.
(3) American Psychiatric Association and District Branch, 1952.
(4) Medical Correctional Officers' Association, 1963.
(5) American Society of Psychoanalytic Physicians, 1958 (president, 1966 to
1967).
(6) Association for the Advancement of Psychotherapy, 1962.
(7) Pan-American Medical Association, 1967, member of the council in the
section on psychiatry, January 15. 1969.
(8) ^Member. Royal Society of Health, 1969.
(9) American Public Health Association.

PUBLICATIONS
Book

"So Fair A House." the story of Synanon, Prentice Hall, 225 pages, December
5. 1963.

Articles

(1) "Suicidal Gestures in Occupational Personnel on Okinawa," U.S. Armed
Forces, Medical Journal, vol. Ill, No. 12, December 1962.
(2) "Intramural Psychiatric Service in a Public High School." New York
State Journal of Medicine, vol. 56, No. 12, June 1956.
(3) "A Mental Hygiene Clinic in a High School," the School Review, Summer
1957.
(4) '-Modification of Adaptational Psychodynamics Theory in the Wake of
Successful Rehabilitation of the Drug Addict at Daytop Village," Physicians
Panorama, October 1966.
(5) "The Marathon and Time .Extended Group Therapy," Current: Psychiatric
Therapies, 1968
(6) 'Advice To The Family Doctor,'* Physicians Panorama, February 1970.
..(XT). 'Therapeutic Significance of Peer Interaction," American Public Health Bulletin, (to be published).
(8) -Federal Probation."

TO BE PUBLISHED:

Books

(1) "The Concept." The story of Daytop. Hill & Wang, Spring 1971
(2) "A Scream Away From Happiness." Psychodynamic theory and process of
my new identity process, an accelerated reeducation of emotion, attitude, and
behavior. Spring 1971.

Inculcated:
[Exhibit No. 14(c)]

Significant Therapeutic Benefits Based on Peer Treatment in the Casriel Institute and AREBA  -Daniel Casriel, M.D., New York, N.Y.
EXCERPTS:

“Currently, an ever-growing list of self-help groups are being established.
 Self-help therapeutic communities such as Daytop and Synanon, and more recently, scores of lesser known smaller self-help communities and storefront operations such as Encounter and SPAN are sprouting and growing".


 "Why is this happening? What need are these organizations fulfilling that traditional therapies (medical, paramedical, or religious) failed to fulfill? Who are the people helping and being helped that found no help by professional workers?
How are the incurable and un-helpable being helped by each other? Who are they able to help, and why are they able to help each other? What is the new "magic" ingredient? What can trained professionals learn from all this?

Simply stated, we must examine the process involved with words such as peer relationship, responsibility, concern, involvement, absence of magic and confrontation.”
He then goes on into a really pompous drone about how there is no magic. He really gets repetitive with the "there is no magic" bit. The basis of this section is an assumption that the person on the receiving end of treatment has such expectations or beliefs. In my opinion,this assumption speaks volumes of the reductive perceptions that lead to the concept.

- AREBA : A private therapeutic community for the rehabilitation of middle and upper class drug addicts and other behavioral bankrupts. AREBA (accelerated reeducation of emotions, behavior and attitudes).
“In AREBA, it is assumed that the new entering member knows nothing, has learned nothing but self-destructive, maladaptive behavior, thinking, and feeling. The members and staff of AREBA have in their own growth learned to be truly concerned for the entering member. They enjoy the challenge and will involve themselves with the new member. They know that the more they teach, the more they learn.
There is also the assumption that the emotionally and socially bankrupt member has learned nothing constructive for himself. The staff and senior residents.”

“The humanistic-peer attitude on the part of the therapeutic teacher-leader is essential. Peer relationship on the part of the therapist demands a more personal kind of involvement. It leads to a quicker, more resonant, and fuller human growth for the patient. It is diametrically opposite to the formal, detached, impersonal, nonfeeling therapeutic relationship demanded in our training and experience in psychoanalysis.

The effectiveness of humanistic-peer involvement as a therapeutic treatment
process has several significant implications.”

Hmmm, that kinda reminds me of something.

--- Quote ---Harry G. Levine wrote:
Dr. Deitch claims to have played an important role in calling the lock-em up and bust-em down approach to curing drug addiction a "therapeutic community." But in his interview Deitch reveals that he is unhappy with the name therapeutic community. He regrets not using the term "humanizing community" to characterize these punitive, moralistic, authoritarian, infantilizing institutions. I believe that earnestly using the opposite term to name something is properly called "Orwellian." Since the fifteenth century, "humanism" has been about respect for human freedom, creativity and autonomy. Most American TCs push pretty much in the opposite direction. And Deitch hasn't a clue to the ironies and contradictions in his ideology.”
--- End quote ---
Now we return to this "humanist" expounding on what is required of treating the “untreatables”.  For Casriel this catch all classification subsumes addicts, hysterics and homosexuals.

"The effectiveness of humanistic-peer involvement as a therapeutic treatment
process has several significant implications.

First and foremost is a total change of attitude that professionals have to
develop in order to effectively engage in this type of process.

Second, the obvious empirical observation that a feeling human being, who
has learned for himself as a patient-student the process, and has the capacity, ability, and desire to engage others, can be an extremely effective therapeutic change agent. Previous academic training is of relatively little use, though previous life experiences are of great value as are one's own former neuroses or character-logical problems which have been resolved. In line with this, cured hysterics are most effective with uncured hysterics; cured alcoholics are most effective with uncured alcoholics; cured drug addicts are most effective with uncured drug addicts; and cured homosexuals are most effective with uncured homosexuals.
 However, this does not mean to say or imply that one has to be an ex-hysteric, alcoholic, drug addict, homosexual, to do effective intervention. The peer symptoms identification early in treatment is extremely helpful and in some cases necessary, but within a few weeks all patients, no matter what the variation of symptoms, realize they have the same problems,* that below the symptoms, they are all human beings with the same basic needs and desires and the same basic fears.

Third, psychoanalysis must be returned to the areas where it belongs : as a
highly specialized, very limited fine tool, in the tool chest of psychotherapy.

Fourth, because of the relative ease of treating and training, large numbers
of individuals can be treated and trained at little cost and relatively little time.
This means that large numbers of skilled group leaders can become available to meet a tidal wave of need. Costs are within realistic ranges."

Fifth, it is logical to see the role of the professionally experientially trained psychiatrist, psychologist and S.W. as consultant and trainer of the trainers, as well as being used as the agent of initial interviews, medication, testing or using traditional ancillary roles.

The significance for society is that the large number of untreatables could
now be treated ; the large numbers who could not afford treatment could now
afford it ; the large numbers who wanted treatment but had no available therapist in the area could now find therapists ; a large number who were unwilling or unable to commit themselves to many years of therapy could now look forward to major reparative psychotherapy and reconstructive (major personality change) therapy being done in a matter of months for most, or 1 to 2 years for some. Indeed, this process, if fully applied, could make a significant impact relatively quickly on major portions of our sick society."

Inculcated:
Casriel mentioned in an article that goes on to describe bastardized variants of Encounters within the human potentials movement that reaches out from TCs into religious and corporate retreats. (excerpts below)

Behavior: Human Potential: The Revolution in Feeling:Monday, Nov. 09, 1970

...From a four-story midtown Manhattan brownstone, the sound of screaming can be heard all day long. It comes from patients of Psychiatrist Daniel Casriel, who believes that such release is therapeutic...
To many Americans, these activities typify a leaderless, formless and wildly eclectic movement that is variously called sensitivity training, encounter, "therapy for normals," the bod biz, or the acidless trip. Such terms merely describe the more sensational parts of a whole that is coming to be known as the human potentials movement —a quest conducted in hundreds of ways and places, to redefine and enrich the spirit of social man.

………. Encounter. T groups are now conducted internationally by 600 N.T.L.-trained leaders and are designed to improve corporations, government agencies, churches and other institutions. They differ from encounter groups in that they tend to be less emotional, place more reliance on verbal than on nonverbal communication, and are less concerned with the individuals' growth per se than with his development within his group. T groups improve relationships within organizations by trading what the late Douglas McGregor of M.I.T. called management's "X" approach (do as I say) for the "Y" approach (join with me so that we can work things out together). Obviously, that does not and cannot make equals of the boss and the factory hand; if that is the unrealistic goal, the "Y" approach will fail. But by making the president and the factory hand more aware of each other it can vastly improve the employee's sense of his own value and place...

......The very eclecticism of the human potentials movement has brought it criticism even from within its own ranks. Robert Driver, founder and operator of Kairos, San Diego's human growth center, has compared it to "a tree which is growing too fast without putting down proper roots." The movement also attracts a great many persons who join it for the wrong reasons: "Already," says Driver, "we see some growth experiences that are used merely to blow out the tubes every six months or so."

………There are more disturbing aspects of the proliferating group sessions. Among some 200 Stanford University undergraduates exposed to a wide variety of personal growth workshop experiences, the overall "casualty rate" —those who suffered psychological impairment—was 8%. Perhaps even more significant was the discovery that a so-called charismatic leader, or trainer, within the movement produced a casualty rate of 14%. Psychiatrist Louis A. Gottschalk of the University of California, after participating in one encounter group of eleven, diagnosed "one borderline acute psychotic withdrawal reaction" and "two severe emotional breakdowns with acute anxiety" within that group. Irving D. Yalom, chairman of the American PsychiatricAssociation's Task Force on encounter groups, reports that after one T group session 10% to 15% of the members consulted a resident psychiatrist for such adverse responses as anxiety, depression, agitation and insomnia.
The explanation could lie in the possibility that some leaders themselves may desperately need what they preach. At most growth centers, anyone can join the movement as a trainer with little experience. He learns on the job. Many such trainers are unequipped to recognize the casualties they produce. Their approach tends to be simplistic. "If expression of feelings is good," says the A.P.A. report sarcastically, "then total expression—hitting, touching, feeling, kissing and fornication—must be better."

The movement is also well aware of what it calls the "reentry problem." Writes Jane Howard in Please Touch, the result of a year's participation in the human potentials movement: ………..
.....Re-entry Problem. There is genuine concern as well at the lack of follow-up procedures to determine the long-term effect of the group experiences.

.....Youth's Disaffection. The dangers are real. But the human potentials movement cannot be dismissed as a passing fad. "There is increasing concern for the humanization of organizations," says Dr. Vladimir Dupre, executive director of N.T.L., "an increasing desire by people to feel more connected with each other, to act on their own environment rather than feeling acted upon."

http://www.time.com/time/magazine/artic ... -1,00.html

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