Aug 1, 1982
The Canadian Journal of Psychiatry
were more readily applied to non-white patients, psychotherapy was person-oriented and aimed at making the patient adjust to the system without analyzing or denouncing it. At the same time, totalitarian and dehumanizing structures and policy are related to staff segregation, abuses of psychological testing and of medical legal reporting, overdosing patients with psychotropic drugs, the use of ECT as malpractice and of therapy as punishment. This type of abuse of psychiatry may be observed anywhere in the world where it isjudged to be wrong and where staff and administrative personnel try to correct it. But in South Africa, weare told, it is a symptom of the system: it is standard tolerated practice, and part and parcel of the training given to psychiatrists and psychologists. Nowhere is the systematic abuse of psychiatry and medicine more obvious than in the use made of the Valkenburg Hospital by the security police. We are informed that, sometimes, Coloured or African persons who are politically active are apprehended by the police. Instead of being arrested and charged, the "trouble-makers" are injected with drugs, certified by a cooperative police surgeon and taken by ambulance to Valkenburg Hospital for "treatment." There, further drug and shock treatment is administered. In 1977 a new building was allegedly erected with a 15to 20 foot high wall, along the lines of a maximum security prison for dangerous psychopaths, but intended, in this instance, for Coloured and black psychiatric "problem patients." In fact, it was designed to be used for political dissenters or to "re-educate offenders against the pass laws. We are also told that in the middle 1970's the Department of Health became the central mechanism of the government for dealing with mental health affairs. The South African Board of Psychology is largely comprised of government nominees. We are reminded that in the Steve Biko case the three medical doctors who attended the prisoner before his death in September 1977,while he was detained without trial by Port Elizabeth Security Police, were themselves under the influence and political control of the police. Dr. Lambley interrupted his research and left South Africa in 1978, but it is a matter of record that subsequently: I) the three doctors at the inquest of Biko's death were criticized by the presiding magistrate; 2) that in June 1980 the South African Medical and Dental Council decided there was no evidence of professional misconduct by the three doctors; 3) that subsequently the Medical Association of South Africa sided with the Council; and 4) that this created such a protest among South African doctors, including Dr. Christiaan Barnard, the heart surgeon,. and Professor D.J. du Plessis, ViceChancellor of the University of Witwatersrand, Johannesburg, that finally the Federal Council of the Medical Assocation of South Africa, in November 1980, wrote a statement to the press to the effect that Mr. Biko "had received inadequate treatment" and that "the doctors attending Mr. Biko did not appear to have complete clinical independence and that this could have contributed to unsatisfactory management." (The Lancet, September 27, 1980 and November 29, 1980). Clearly, The Psychology ofApartheid, like the thread of Ariadne, leads far beyond the standard practice of psychological testing with matched samples control design to an open socio-political arena for a personal and historical encounter. One wishes, however, that findings and interpretation were more clearly separated, that tables with the results of testing and analysis of data were included and that the "F" scale were added as an appendix. As it is, the book is very comprehensible, although not for the squeamish. Among the cases of schizophrenic patients who were not schizophrenic, the unqualified psychologists and the pompous and repressive Superintendent of Valkenburg, the Broederbond lurks like a morally insane Spectre of the James Bond series, with Verwoerd, Vorster and Botha as the successive villains. In spite of its methodological difficulties and limitations, this book is indeed a much needed example of a scientific study of what is very complex social behaviour. It is also, by its direct approach to professional ethics, a reminder of what human rights are all about and of the necessity to cherish and protect them and our professional freedom and responsibility. The book can be recommended to social psychologists and anthropologists and to all clinicians and individuals working within the health care system.