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Wednesday, 01.12.2021

Thomas A. Ban: The Ewen Cameron Story

 

Barry Blackwelll’s comments

 

         Towards the end of a distinguished career as a neuropsychopharmacologist, historian and editor Tom Ban has offered us a key to a long locked door that began in a dialogue with David Healey, “The Ewen Cameron Story,” published almost a quarter century ago in The Psychopharmacologists Volume 1 (Healey 1996).

         Tom was the closest but publically silent observer of events that created an unresolved enigma of the mid-20th century involving a vast inventory of speculation among psychiatrists, historians and conspiracy theorists that is still displayed and debated today on the Internet.

         It concerns how to understand and reconcile the brilliant and apparently unblemished career of Canadian psychiatrist Ewen Cameron against virulent allegations of undertaking and colluding with the U.S. Central Intelligence Agency (CIA) in unethical “brainwashing” experiments on unwary and uninformed patients.

         My own analysis and attempted resolution of this seemingly irreconcilable paradox is presented in three parts: a synopsis of Cameron’s persona, professional life, ideology and accomplishments; an account of the hospital environment where the disputed events ended and the small staff involved (including Tom Ban); and finally an attempt to reconcile the two conflicting views of Cameron and thus resolve the paradox.

Ewen Cameron: Professional and Personal

         Ewen was born on Christmas Eve 1901 in Scotland, the oldest son of a Presbyterian minister. He graduated as a physician from Glasgow University in 1924 and began his psychiatry training at Glasgow Royal Mental Hospital in 1925. The following year he moved to America on a scholarship to work under Adolf Meyer at the Phipps Clinic at Johns Hopkins Hospital in Baltimore from 1926 to 1928. He left Baltimore for the Burgholzli Clinic in Zurich but after only a year migrated to Canada and became Physician in Charge of the Reception Unit of the Provincial Mental Hospital in Brandon, Manitoba. During his seven years there he worked in a typical asylum setting. Before effective drugs he also established a community mental health model with 10 outpatient units.

         In 1936 he became Director of the Research Division at Worcester State Hospital (Blackwell 2014) and in the same year obtained his Doctoral Degree in Medicine with distinction from Glasgow University and published his first book,“Objective and Experimental Psychiatry” (Cameron 1935).

         In 1938 Cameron moved to Albany, NY, to become Professor of Neurology and Psychiatry at Albany Medical College and Russell Sage School of Nursing where he trained both physicians and nurses in  the British and European model of descriptive psychiatry on disorders which were assumed to be somatic in origin, determined primarily by biological not social or psychological factors. He became particularly interested in age-related memory loss.

         When World War 2 erupted in 1939 Cameron became a consultant to the U.S. Office of Strategic Services (OSS). In 1945         he was invited  to participate in the Nuremburg Trials to evaluate Rudolf Hess’ alleged memory impairment and fitness for trial.

         Meanwhile 1943 marked a major turning point in Cameron’s career. His reputation in both biological psychiatry and neurology was considerable and he was invited by Canadian neurosurgeon Wilder Penfield to accept the dual positions as the first Chair of Psychiatry at McGill University in Montreal and Director of the newly endowed Allan Memorial Institute, established by a grant from the Rockefeller Foundation and the gift of Sir Hugh Allan’s mansion at Mount Royal.

         Despite Cameron’s biological bias, at McGill he set about recruiting a diverse talented faculty that represented experts in the social and psychological domains, including several psychoanalysts from different schools. In doing so he created an Institute comparable to those of Jean Delay in France and Aubrey Lewis in England.

         The Allan Institute would become the focus of Cameron’s research interests after 1949 in non-drug related spheres. As new drugs arrived in droves they were the purview of McGill faculty member Heinz Lehmann at the Verdun Hospital.

         In less than a decade Cameron’s reputation and role in North American and world psychiatry became dominant. In 1952 he became President of the American Psychiatric Association (APA). In 1958 he was elected APA President and in the same year President of the Canadian Psychiatric Association. Two years later in 1961 he was elected President of the World Psychiatric Association, serving until 1966. Finally in 1965 he was elected President of the Society of Biological Psychiatrists. Cameron’s popularity with a plurality of psychiatrists of all persuasions is  remarkable and probably unique given that in the two decades from 1950 to 1970 psychoanalysts had established almost total control and hegemony over academic psychiatry in America; almost every chair and most faculty members were analysts. Psychoanalysis became a rigid ideology to the detriment of both clinical practice and education.

         Among the many attempts to reconcile Cameron’s dichotomous views the analysis by Rebecca Lemov, a Harvard Professor, is perhaps the most compelling. Her 20-page essay, supported by 71 references (Lemov 2011), is prominent on the Internet and examines the nuances of Cameron’s professional life and persona culled from a range of sources which “evoke a man not only respected but adored.” A postmortem appreciation  notes, “To anyone who knew Ewen Cameron intimately it became obvious that he was a man who was vitally concerned  with the well-being of man everywhere. He had a genuine disregard for national barriers, racial variations and religious differences. He had a world perspective on social, economic and political problems” (Cleghorn and Silverman 1967).

         Speaking on behalf of the psychiatric profession Francis Braceland (1967) noted: “His worldwide success in his profession was, of course, due principally to his great knowledge and brilliance. But surely a great factor also was the softness – one is tempted to say loveliness – of his personality. Those who were privileged to know him, even briefly, will not soon forget the warmth and kindliness of this understanding man.”

         In order to reconcile the public professional persona of Cameron with the vicious allegations associated with his “brainwashing research” Lemov adopts a metaphor from Hindu mythology; she bestows the title of “avatar” on Ewen and in the title of her essay. An avator is a secondary manifestation of the self, sometimes a false interpretation in the “eye of the beholder.” Lemov employs this both to explain how Cameron shaped his own image as well as how a fellow faculty psychiatrist, Robert Cleghorn, used this device to minimize his own concerns about Cameron when he substituted for him at the Allan Institute.

         Lemov’s depiction of Cameron as avatar portrays him as “a tinkerer, a lover of the neat gadget, a rigger of devices. He uses an array of technology based methods as a way of thrusting forceful change over older therapeutic practices such as the slow and humanistic pursuit of psychological healing via psychotherapy. Cameron sought nothing less than the automation of psychotherapy.” She supports this characterization with a detailed description of the technology, drugs, ECT and protocols Cameron used to prolong therapy and suppress resistance from days to weeks often when the patient was immobilized or isolated. “Cameron took deliberate steps to thwart avoidance.” In substance, “Methodological  fixation allowed him to ignore the lack of significant results and to continue his unabated quest to solder together a grand all-purpose cure for mental disease… what was psychic driving, aside from Cameron’s bid to win a Nobel Prize for curing schizophrenia.”

         Separate from Cameron’s projection of his own persona from malignant to benign, from technologic to humanitarian, Lemov analyzes comments made by his colleague Robert Cleghorn. Displaying his analytic insights Cleghorn notes: “Cameron never allowed his personal warmth to become intimate. He never socialized with his professional acquaintances… his genial personality was a thin overlay. He could be intemperate and abusive. He had a blind eye for psychopathic personalities at least two of whom he hired as laboratory assistants. He inspired awe and admiration but no affection or identification in his students.”

         Lemov also notes that prior to the concern suddenly roused in 1964, “Cameron has not been the subject of academic writing… his work may pose a mystery, but it is not a mystery that has been of interest in academic circles.” She suggests that this tendency of colleagues is a form of depersonalization, “…structured forgetting within which his research went forward. His colleagues associates, underlings and funders could and did see without seeing, watch without knowing and remember while forgetting. Events could go on and not really be happening.”

The Allan Memorial Institute: People, Programs and Problems

         When Cameron assumed the role of the first Director of the Allan Memorial Institute he made it the focus of his research and teaching at McGill. Tom Ban describes the result as he encountered it in 1960: “The Allan was a truly eclectic place with facilities, such as a day hospital and specialty clinics, which were very much avant-garde those days and with one of the largest and most respected training programs with residents from all around the world. All of this was of Cameron’s making. What most impressed me was that Cameron ran the largest clinical service with the most difficult patients. Every day he walked around and talked to each patient and every other day we had rounds with him when we sat around a table. He kept the cleanest and most precise records I had ever seen with all the information given on each patient to the smallest details. He dictated his notes in front of his team in his characteristic Scottish burr and whatever he dictated was typed in the record by the next day.”

         Tom summarizes Cameron’s long-term research program as “…based on psychodynamic principles and learning theory designed for patients refractory to traditional approaches to therapy… It was a combination of  de-patterning using drugs, sleep, sensory isolation and regressive ECT to get rid of pathologic beliefs and behaviors followed by psychic driving to rebuild things from scratch again using a variety of drugs, including psychedelics and tape recorded  therapeutic instructions.” Tom describes Cameron as being “impatient and taking short cuts in the application of multiple modes in succession or simultaneously.”

         The research team helping implement Cameron’s research was relatively small, consisting of only three others: two psychiatrists and a technician. Both psychiatrists were relatively junior – Leonard Levy was a former chief resident and Tom Ban was completing his diploma requirement for graduation – “Conditioning and Psychiatry” (completed in 1961 and published three years later) (Ban 1964). At the time he had been working with Lehmann doing research on phencyclidine when Ewen requested a transfer to his own research program at Allan to take advantage of his knowledge of conditioning. In fact, Tom was only marginally involved, first because he was working with his own patients and also because his primary interest in psychopharmacology would lead to increasing involvement with Lehmann developing a drug program at Verdun where they would both become co-directors of an Early Clinical Drug Evaluation Unit funded by the NIMH.

         The third team member was a technician named Leonard Runbenstein whose responsibilities included the filming of patients and the building of a sensory isolation chamber. Although Tom had not been invited to interview him or review his credentials he clearly had links to the CIA and worked closely with Cameron on technical aspects of the program. Tom found him “strange” and difficult to work with.

         Tom found his work at Allan “terribly frustrating” for a several reasons. First because Cameron employed a number of gadgets for “everything for which a gadget was available” and Tom was responsible for keeping them in working order. The rationale for treatment seemed sound but Cameron tacked “too many issues together, trying to answer too many questions simultaneously. Some of these had important theoretical implications such as whether a pathological pattern could be erased by physical means.” Tom’s efforts to better understand such things were also frustrated: “Cameron spoke little and even when he did I frequently felt he said things tongue in cheek.”

         Shortly before Tom moved to Verdun to join Heinz Lehmann there was a sudden dramatic turn of events. News about CIA involvement in Cameron’s research  became public leading to allegations he had been treating patients inhumanely. Almost immediately both Cameron and Rubenstein left Allan unceremoniously, without explanation and the entire record of more than 20 years of research disappeared overnight (Ban, personal communication).

         Cameron transferred his research to the Albany Veterans Hospital but confined it to resuming his previous attempts to find biological measures and markers for mental illness. Tom never asked for or received any explanation of events at Allan before Cameron’s untimely death while mountain climbing in 1967.

         After Cameron’s departure Robert Cleghorn took over Allan Memorial: “…it shifted the department into a psychodynamic mode at a time when the rest of the world was shifting in the opposite way.”

A personal attempt at reconciliation

         Seeking a better way to understand the genesis of Ewen Cameron’s thinking and modus operandi I obtained a copy of his book Life is for Living, published in 1948, written five years after he became Chair at McGill and Director of Allan Memorial (Cameron 1948).

         The book is a philosophical tour de force in which he dissects the contemporary problems confronting the human race, largely in social and psychological terms. The prose is lucid and elegant, and each challenge is illuminated by case vignettes from his own clinical repertoire. Strangely, the components are entirely without mention of the biological dimension with no attempt to define a unifying clinical model to address the complex issues facing humanity. There are, however, a few prescient topics relevant to the issue under consideration. He asks the question: “What is pattern living? It is the doing of things in a given way because we have always done them that way; everybody does it. We don’t do it that way because it is the most effective or most reasonable way, or even the most pleasant way; but simply because it is sanctioned.”

         Later he notes: “…the almost inevitable tendency to repeat a pattern once it has been established… Pavlov’s dogs drooling to a bell.” Anticipating his future research efforts but not mentioning them he continues: “New ideas must insinuate themselves through cracks in this continuous system, or by brute force or blood letting  (my italics). We have no organizing machinery for scrapping the old, the outworn, for taking dangerously antique concepts off the highway of living.” In a nutshell he is anticipating his future clinical experiments and the pain they might inflict. Finally: “It is the business of the invention of reasoning to break up the old patterns and set the fragments together in new ways.” An orthopedic metaphor?

         Cameron’s analysis of what he calls “the great running mates or curbs to action, pain, anxiety and guilt” make fascinating reading as he discusses the need to reform the criminal justice system, eradicate misogyny from the culture and re-conceptualize marriage.

         Cameron’s reflections on the benefits and problems of research are worth noting in the context of his own future behavior: “In totalitarian countries research is becoming a state function.” He expresses concern: “…whoever controls research controls tomorrow… If research is to acquire full status as a function of society, it must be a partner and not an employee. It must have a seat on the planning board. It must have a position guaranteed and present as we struggle to guarantee and preserve equality before the law, freedom of speech and the rights of habeas corpus.” Research programs must be “protected by public opinion  crystallized into law, against political  or other manipulation.” This sounds like the rationale for Institutional Review Boards and informed consent that were still two decades away but might have saved  his own programs and individual fate when the CIA and MKULTRA revelations came in the early 1960s.

         Both in his book and during the Second World War Cameron epresses concerns about the destructive influence of hostility and aggression, clearly nurtured by wartime experiences consulting for the OSS and postwar as an expert at the Nuremberg war crime trials. Paradoxically, his belief about ingrained hostility and dominance in the German population led him to propose remedies to control reproduction and restrict access to positions of  authority. One wonders if such radical opinions might have influenced his co-operation with the CIA against America’s enemies during the Vietnam War.

         In understanding the terminal events at Allan Memorial the literature tends to imply Cameron’s involvement with the CIA was almost incidental, haphazard or back door; that he hardly knew or cared where the money came from.

         Events suggest otherwise. By the early 1960s Cameron had been pursuing his twin theories of depatterning and psychic driving without notable success, scientific publication or arousing academic interest or attention for almost 20 years.

         Co-operation with the CIA offered a number of assets: increased technical support, a sense of collaboration in helping to defeat a hostile foreign enemy and perhaps even an opportunity to broaden the scope or speed up his own research. We know Cameron had become “impatient and prone to taking short cuts”; perhaps allowing him to seek tougher measures to reach his treatment goals – the “brute force and blood letting” necessary to confront patterns he foretold in “Life is for Living.”

         Such an interpretation will not be popular; we know that Cameron was endowed with an aura of charm and charisma that dispelled criticism and gave rise to Rebecca Lemov’s concept of an avatar.

         In conclusion an historical analogy may help. In America at Yale University, also in the early 1960s, a comparable scenario was occurring around the research and philosophy of Spanish scientist Jose Delgado (Blackwell 2013). His innovative and ground-breaking research involved the invention of a technique for electrical stimulation of the brain, first in animals and then humans to elicit changes in behavior and affect.

         A renowned philosopher invited Delgado to contribute a book to a series, World Perspectives, whose editorial board comprised many of the world’s Nobel Laureates. The title he chose for his book was Physical Control of the Mind; Towards a Psychocivilized Society (Delgado 1969). His philosophical speculations went far beyond the data and aroused the ire and attention of the Scientologists, led by psychiatrist Peter Breggin, and allied with the same opposition to the CIA and MKULTRA program, as in Canada. This group succeeded in lobbying Congress to cut off all funding for brain research ending Delgado’s career in America.

         Delgado returned to Spain and led a distinguished career into his 90s, continuing animal research and philosophical writing. His last book was titled Happiness  and went through 14 editions.

         Ewen Cameron’s life came to an early and sad end, his philosophy and research unreconciled.

         While Ewen’s philosophy of life lives on in the pages of his book, Life is for Living, Cameron’s attempt to render his beliefs scientific and therapeutic largely failed and the records were destroyed.

 

References:

Ban T. Conditioning and Psychiatry. Aldine Pub. Co. 1964.

Blackwell B. A distinguished but controversial career: Jose Manuel Rodriguez Delgado. inhn.org.biographies. May 30, 2013.

Blackwell B. Asylum: A mid-century madhouse and its lessons. inhn.org.biographies. April 10, 2014.

Braceland FJD. Ewen Cameron 1901-1967. Amer. J. Psychiat. 1967:860-861.

Cameron, D.E. Objective and experimental psychiatry. New York, NY, US: MacMillan Co. 1935.

Cameron DE. Life is for Living. Canada, Mcmillan Co. 1948.

Cleghorn RA, Silverman BD. Ewen Cameron, M.D., F.R.C.P.[C]. Can Med Assoc J. 1967;97(16):984–986.

Delgado JMR. Physical Control of the Mind. Toward a Psychocivilized Society. Harper and Row, New York. 1969.

Healy D. The Psychopharmacologists Volume 1, Chapman & Hall, London, 1996;599-606.

Lemov R. Brainwashing’s avatar. The curious career of Dr. Ewen Cameron. Grey Room. 2011;45.

 

September 12, 2019