FQ: At a fairly young age, Britt, the protagonist in Breaking Out, is labeled the “black sheep of the family” for what most would consider innocent, childish behavior. Later his teenage angst, which offended his “parents’ religious piety,” led to incarceration in a mental facility. It’s obvious you have studied why young people might end up is such situations with a misdiagnosis. Was this a common occurrence in the 1960s and if so, can you give us your thoughts on the subject?
As with all novelists, I wasn't drawing on a blank slate. There was a background on which I expanded and created, so that Britt's misdiagnosis may not have been a common occurrence. Britt presented a puzzle to the psychiatrist who admitted him to the sanitarium, in that he didn't hear voices and wasn't delusional, salient symptoms of paranoid schizophrenia. But he was agonizingly self-conscious and sensitive, with regard to both his own feelings and those of others. So the psychiatrist made a snap judgment that Britt was schizophrenic. The medical profession operated in a manner similar to the judicial system: It relied on precedent. The misdiagnosis was forwarded to psychiatrists in the next hospital, who, reluctant to question their peers, propagated the mistake. There probably is no way of knowing how often this kind of thing occurred.
FQ: The Rutgerses were apparently descended from a long line of Calvinists, a group whose theological beliefs apparently hung a continual cloud of “irrational feelings of guilt and shame” over Britt’s head. Can you describe your reasoning for selecting this type of socio-familial background for Britt?
Again, I wasn't drawing on a blank slate. I was familiar with this background.
FQ: Britt and many of his other peers in the hospital lived in fear of electroconvulsive shock therapy (ECT). What made you interested in learning about this process and what types of material did you read before writing about it? In between the lines we read of injuries and learn of the mysterious “disappearance” of a fellow patient.
In college in the early 1960s, I considered a psychology major and took a course in abnormal psychology. Watching an old filming of a prefrontal lobotomy performed on a patient, and then one of a shock treatment, the patient convulsing violently, I was appalled. Though I pursued a career in journalism, through the years my eyes were alert to stories by investigative journalists of patients who had undergone shock treatments, and I discovered that some were rendered unable to perform such skills as playing the piano with as few as 10 or 15 ECTs. Broken bones or vertebrae were another side effect for some patients. And what seems incredible is that psychiatrists admitted they didn't know how the shock treatments worked. Furthermore, despite the abundant accumulation of analytical and anecdotal data to the contrary, they insisted, and still insist, that ECTs don't cause brain damage. ECTs are administered differently these days, but some ECT opponents, notably psychiatrist/author Peter Breggin, still condemn their use as barbaric and harmful.
FQ: After several treatments with ECT, Britt’s painful memories of the incident at the bowling alley had disappeared from his memory. At the time he “broke down sobbing” as he was devastated that his friends had hidden his shoes. Much later he discussed that night with Professor Bregman. Does “shock therapy” wipe out some memories in their entirety or just suppress them for a time? Did this therapy actually damage the brains of those who received many treatments?
Most of the memories eliminated by shock treatments return later, but not all. Each patient is different. Some lose their memories of periods up to several years. For some, as with Britt, their memory tends to be scattershot for the rest of their lives. And, as I already noted, some people have reported permanent loss of ability to perform tasks that they previously executed with aplomb.
FQ: Britt was oblivious to the fact that once he had stepped over the threshold of a mental institution he would be forever branded. It was a stigma that he would unfortunately carry for the rest of his life because of a mistaken diagnosis of schizophrenia. Society now claims that mental illness is no different from any other physical illness. This obviously does not ring quite true. Have we really come very far in our view of the mentally ill since the 1950s and 1960s?
I think there has been a greater openness about mental illness since those dark days of the '50s and '60s. For a time, it even seemed to have become something of a status symbol among intellectuals and artists, especially movie stars, to undergo psychoanalysis, which they would banter about at cocktail parties. A number of prominent persons helped remove the curtain of shame by revealing they had undergone shock treatments: Dick Cavett, Kitty Dukakis, Ernest Hemingway, Carrie Fisher, and many others. A host of luminaries have admitted suffering serious bouts of depression, and Mike Wallace confessed to being nearly paralyzed with it. Nonetheless, I think it will always be regarded differently from physical illness and carry a stigma.
FQ: As a journalist you most likely have written about many diverse topics. What in particular drew you to the fictitious town of Mayfield in Midwest Iowa, a town the Calvinist Christian family, the Rutgers, had settled in?
I happen to have grown up in the Midwest, and the religion also was part of my background.
FQ: The background stories of both Miriam and Milton Rutgers were fascinating and give the reader a lot of insight as to why Britt experienced so many problems with his peers and with his parents. This book could easily be the first in a series, but most authors prefer to delve into another topic. Can you give us a hint as to what you are working on now?
I actually did consider writing a novel based on one of the characters in Milton Rutgers' background. However, the opportunity to write an entirely different kind of novel was more pressing because of a time element involved. In 2001, while working for a magazine, I inadvertently discovered shocking information about the 1976 murder of a prominent Palm Beach man, the most sensational murder in the town's history. What makes it especially stunning is the alleged involvement of a very high-ranking national politician at the time. I don't have proof of that, however, so I am writing a roman à clef. I have just finished the first chapter.
To learn more about Breaking Out please visit our website and read the review at:Feathered Quill Book Reviews.
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