Criticism of the 'Mental Illness' paradigm


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The testing of Alan Turing


The testing of Alan Turing

The Providentia blog has a brilliant three partseries on Alan Turing, focusing on how his homosexuality was treated at the time both as a mental illness and a criminal act.

As with all of the posts of Providentia it’s wonderfully written and captures the sad circumstances leading to the death of one of the world’s artificial intelligence pioneers and breaker of key German codes in the Second World War.

The piece places Turing’s ‘treatment’ in the context of how homosexuality was conceived and dealt with by the medical establishment of the time

In a 1949 paper, F.L. Golla and his colleagues presented the results obtained from a sample of thirteen convicted homosexuals and concluded that “libido could be abolished within a month” with sufficiently high dosages of female sex hormones. The authors concluded that “in view of the non-mutilating nature of this treatment and the ease with which it can be administered to a consenting patient we believe that it should be adopted whenever possible in male cases of abnormal and uncontrollable sexual urge”. Politicians and newspaper editorials alike praised the potential value of hormonal therapy. While critics warned that there was still too many unknowns involving the treatment, the potential gain was felt to be worth the risks involved. Controlling “unnatural” sexual urges with hormone treatments fit in well with the radical advances being made in other areas of psychiatry. Considering other types of experimental treatment being tried (including aversive conditioning, lobotomies, and electroconvulsive therapy), such treatment seemed relatively benign.

A highly recommended read about an exceptional man who was sadly let down by the country for whom who worked to protect.

The Turing Problem

When Alan Turing's house was burglarized on January 23, 1952, it didn't seem all that serious.  As Turing himself would later write in a lettter to a colleague:

I have just had my house broken into, and am still every few hours finding some fresh thing missing. Fortunately I am insured, and little has gone that is really irreplaceable. But the whole thing has had a very disturbing effect, especially as it followed shortly on a theft from me at the University. I go about expecting a brick to fall on my head or something disagreeable and unexpected anywhere.

Prophetic words.  When Turing reported the crime to the local police, he quickly began to suspect that a young lover of his, Arnold Murray, was involved.   He had met Murray earlier that month and they spent several nights together at Turing's house.   On being accused by Turing, Murray became agitated and threatened to tell the police everything about their relationship.  Given that homosexuality was still a criminal offense at the time, Turing knew perfectly well that what Arnold's confession would mean.  Despite the risk, Turing  simply told him to "do his worst" and Murray 225px-Alan_Turing_photo[1]settled down.    Murray admitted knowing the burglar (an acquaintance he had told about Turing's house) who had probably decided that Turing was a good target since he would be unlikely to report the robbery.   Although Turing was reassured enough to resume his relationship with Murray, he decided to go to the police with the information.   While he did his best to conceal Murray's identity and the exact nature of their relationship, he was eventually forced to confess the truth.  His fate was sealed at that point.

The police were struck by Alan Turing's lack of shame in admitting his homosexuality.  He minimized the seriousness of his lifestyle and even protested that a Royal Commission was being planned to legalize it (he was wrong).   Under Section Eleven of the 1885 Criminal Law Amendment Act, homosexual conduct was classified as Gross Indecency.  Only applying to males ( all lesbian references were removed from the act although the actual reasons for theexclusion remain murky),  the act made no distinction between public or private sex acts and permitted no exceptions.  While the 1885 legislation replaced earlier, more religion-inspired, laws classifying homosexuality as a "crime against nature", the days of convicted homosexuals serving prison sentences were hardly over by Alan Turing's time.  For all that his unconventional lifestyle was an open secret to many who knew him personally, Turing's failure to keep his life out of the public eye meant the he could be charged and convicted.

On February 27, both Arnold Murray and Alan Turing went on trial  At the urging of his brother, John Turing, he pleaded guilty to the charge against him . No other verdict would have been possible since the written statement that he provided to police was used as evidence against him at his trial.   In many ways, Turing's arrest and conviction were typical for the time.  Between 1931 and 1952, prosecutions for homosexual conduct had increased by 500 per cent as a reaction to the increasing visibility of homosexuals in British society.  Despite Alan Turing's eminence in scientific and government circles, public exposure as a homosexual meant being classified as a sexual offender - the "lowest of the low" as far as "polite" British society was concerned.  It also took an emotional toll on Alan Turing's family.  In addition to his brother, he was also obliged to tell his elderly mother the truth about his personal life.    While Ethel Turing stood by him, his brother didn't hesitate to tell him that he considered homosexuality "disgusting and disreputable".

Several of Turing's  colleagues from his Bletchley Park days also supported him.  His mentor, Max Newman, and fellow cryptanalyst Hugh Alexander acted as character witnesses during his trial.  This was a courageous  stand for them considering the "guilt by association" mentality that often tarred anyone who supported convicted sex criminals.   Many of Turing's friends, homosexuals themselves, felt obliged to distance themselves out of fear that they would be suspected as well.   Others stood by him although they felt distressed by the nature of the charge he was facing.   Since Alan Turing had a long history of outrageous behaviour,  his colleagues shrugged it off as being "typical Turing".  The ones who avoided him before had even more reason to avoid him.   Through lobbying by Newman and others, Turing kept his fellowship at King's College, Cambridge but it was allowed to expire and was not renewed.    Turing remained active as  a mathematician throughout the trial and even attended an important conference on March 21.

The case of Regina vs Turing and Murray was heard on March 31, 1952 with Judge J. Fraser Harrison presiding.   There were twelve charges in all focusing on the acts of Gross Indecency committed between Alan Turing and Arnold Murray.  Although they both pleaded guilty, the judge commented on Turing's lack of remorse for his actions but the various testimonials on his behalf helped ensure leniency.  While prison sentences for convicted homosexuals had become rarer (only 174 of the 746 men  convicted of 'gross indecency' in 1951 received prison sentences-typically less than six months),  other options were available by that time.   Arnold Murray received a conditional discharge (Turing defended him in court) but Alan Turing was placed on probation with the condition that he "submit for treatment by a duly qualified medical practitioner at Manchester Royal Infirmary".

His punishment had only begun..

While the first Diagnostic and Statistical Manual of Mental Disorders (DSM-1) was only released that year, the classification of homosexuality as a mental disorder was already firmly in place.  Although  psychoanalysis had shown little value in the treatment of homosexuality, advances in medical science made more radical alternatives possible.   The existence of sex hormones such as estrogen and testosterone had been known since the 19th century but it was only when they were first chemically synthesized in the 1920s that true hormone therapy began.   Despite physical castration of convicted sex offenders (including homosexuals) having a long history, the use of hormone therapy for treating undesirable sexual practices was far more experimental.  Known as "chemical castration" (a very misleading term by the way), the first study in using sex hormones to control homosexual behaviour was conducted by a team of American researchers in 1940.   After examining testosterone and estrogen levels in convicted homosexuals, the researchers concluded that homosexuals had significantly lower male sex hormones than heterosexuals (although the numbers varied widely in the small sample used).  In the paper they released that same year, the researchers noted that "if a biologic etiology were established, this would lead to investigation of therapeutic possibilities from a much wider perspective than now exists".    In other words, sex hormone therapy could provide the long sought-for "cure" for homosexuality.

Based on these initial findings, the lead researcher, S.J. Glass, conducted further research involving treatment of eleven homosexuals using male hormones "kindly supplied"  by pharmaceutical companies.   The use of the experimental treatment was compulsory for many of the subjects in the study (three were underaged boys) and the results, published in 1944, were not considered successful.   According to Glass,  "Only three of the subjects reported benefit from this therapy. Five reported an intensification of the homosexual drive.'  It did not help in 'the clinical management of the male homosexual."   Since testosterone showed no benefit, researchers hit on the bright notion of using female hormones instead.   A 1940 study had already shown that estrogen treatment of males resulted in an almost total suppression of libido.  Physical castration for sex offenders was already  accepted practice in many U.S. states (by 1950, there were an estimated 50,000 castrated sex offenders on record) but British law banned the use of castration for punitive purposes. Given the existence of a chemical equivalent, authorities considered it to be  an intriguing option for dealing with convicted homosexuals.

In a 1949 paper,  F.L. Golla and his colleagues presented the results obtained from a sample of thirteen convicted homosexuals and concluded that "libido could be abolished within a month" with sufficiently high dosages of female sex hormones.   The authors concluded that "in view of the non-mutilating nature of this treatment and the ease with which it can be administered to a consenting patient we believe that it should be adopted whenever possible in male cases of abnormal and uncontrollable sexual urge".    Politicians and newspaper editorials alike praised the potential value of hormonal therapy.  While critics warned that there was still too many unknowns involving the treatment, the potential gain was felt to be worth the risks involved.  Controlling "unnatural" sexual urges with hormone treatments fit in well with the  radical advances being made in other areas of psychiatry.  Considering other types of experimental treatment being tried (including aversive conditioning, lobotomies, and electroconvulsive therapy), such treatment seemed relatively benign.

In Alan Turing's case, taking female hormones to control his sexual urges was actually voluntary.  When his lawyer explained the different legal options open to him (including imprisonment), Turing decided that taking the medication was the best way to stay out of jail and continue his research.   Given his status as a prominent mathematician and a member of the Order of the British Empire (which he retained despite his conviction), there was considerable media coverage of his case.  After he was placed on probation, local newspapers carried headlines such as "University Reader Put on Probation:  To Have Organo-Therapeutic Treatment".   If Turing was bothered by the publicity, he made little mention of it to his friends.  The probation order required him to stay on the medication for only one year.  In a letter to fellow mathematician, Philip Hall, he wrote that:

I am both bound over for a year and obliged to take this organo-therapy for the same period. It is supposed to reduce sexual urge whilst it goes on, but one is supposed to return to normal when it is over. I hope they're right. The psychiatrists seemed to think it useless to try and do any psychotherapy. The day of the trial was by no means disagreeable. Whilst in custody with the other criminals I had a very agreeable sense of irresponsibility, rather like being back at school. The warders rather like prefects. I was also quite glad to see my accomplice again, though I didn't trust him an inch

The conviction also meant a permanent ban on his traveling to many countries, including the United States ( "moral turpitude" was considered grounds for denying entrance).   Turing's security clearance was also revoked which ended his cryptographic work.  Although Alan Turing took these various obstacles in stride, he was especially disturbed by the side effects of the medication he was taking during his probation.  Along with the impotence, which he had been assured was only temporary, he also began experiencing other side effects.  Gynecomastia (breast swelling), mood changes, and overall "feminization" are common symptoms in men taking estrogen supplements.  Despite the hardships, Alan Turing continued with his professional work (and even managed a brief affair with a Danish man he had met on holiday).   Despite the distress over the various medical issues stemming from the medication, he completed his probation year without incident.

By early 1953, his future seemed bright.   Not only did the probation period end in April and the medication discontinued, but the University of Manchester voted to create a formal five-year Readership position just for him.  His private life seemed secure and homosexuality in general appeared more tolerated than ever.

Which was why his suicide on June 7, 1954 came as a shock to everyone who knew him.

The exact circumstances of Alan Turing's death remain a mystery.  A cleaner found him in his home on June 8 and an autopsy determined that he had died of cyanide poisoning.  A half-eaten apple was next to his body although it was never tested for cyanide.  Since there were no warning signs and no suicide note left behind, the reason for his suicide baffled friends and family.    When an inquest was held on June 10, the coroner stated that "'I am forced to the conclusion that this was a deliberate act. In a man of his type, one never knows what his mental processes are going to do next".  He ruled that Alan Turing had committed suicide "while the balance of his mind was disturbed".

John Turing, who had attended the inquest, chose not to contest the verdict.    The national press carried respectful obituaries of Turing's life and achievements and left out any mention of the 1952 conviction.    Ethel Turing  refused to accept the suicide verdict and maintained that her son's death had been due to his careless use of chemicals.  There may actually be some truth in that considering that Turing was in the habit of running chemical experiments in his home and she had warned him in the past about accidentally poisoning himself.    Many of his working papers were left in disorder at 51YXCHY4KQL._SL500_AA300_[1]the university and he had reserved time on the university's Mark II machine as usual.    While he had made a new will earlier that year, there was no other sign that he was preparing to end his life.  Alan Turing's body was cremated at Woking Crematorium on June 12.   His mother, brother, and longtime friend, Lyn Newman, attended the ceremony.  His ashes were scattered in the gardens, near where  his father's ashes had been scattered years before.  Despite there being no marker on the site, the city of Manchester has constructed numerous memorials to Alan Turing in and around the city.

What reason could Alan Turing have had for suicide?   Biographers have speculated that he may have killed himself due to lingering medical problems relating to the medication that he had been forced to take.  Again, though, he gave no sign that any residual side effects had remained by the time of his death.   There was also speculation about the possibility of blackmail or simply his increasing awareness of how his homosexuality was viewed by the government that he had helped to win World War II.   By 1950, intelligence agencies in the United States and the United Kingdom had singled out homosexuals as representing a security threat.  As the Cold War intensified, a loose cannon like Alan Turing seemed unacceptable and even his informal consulting work with government agencies was ended.  If anything, he was fortunate to die when he did given the massive witchhunts of the later fifties and early sixties which led to the purging of suspected homosexuals from most Western governments.    Considering that much of the cryptoanalysis work that he had done was still classified,  intelligence agencies would hardly have overlooked Turing for fear that he might be recruited by foreign governments (particularly the Soviet Union).

It seems ironic that the man whose groundbreaking work in mathematics and artificial intelligence should die just as the computer age was beginning.  Early computers were already in existence (including a Mark II machine at the University of Manchester) and Alan Turing would certainly have been in the forefront of new technological advances as they occurred.  Many of the papers that he had been working on at the time of his death were published posthumously.  His name remains legendary in scientific circles and the numerous recognitions and tributes to Turing's achievements are too numerous to mention here.   As for his other legacy as a victim of the anti-gay hysteria of that era,  there seems little evidence that Turing's death had any immediate impact.  Despite numerous other high-profile cases and the publication of a 1957 government report recommending decriminalization, homosexuality remained a criminal offense in the United Kingdom until 1967 (1980 for Scotland and 1982 for Northern Ireland).  Even with the passage of the 1967 Sexual Offences Act, government prohibitions on certain forms of homosexual acts remained in place for years afterward and it wasn't until 1994 that the last laws used to convict Alan Turing and Oscar Wilde were finally removed from the books.  Many other countries followed suit (including most Western nations) although homosexuality remains a criminal offense in far too many countries around the world.

In addition to no longer being considered a criminal offense in most jurisdictions, homosexuality ceased to be classified as a mental disorder with the 1973 revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM).   A compromise diagnosis termed ego-dystonic homosexuality persisted despite heavy criticism until finally being removed in a 1987 version of the DSM.   As for the use of hormonal therapy in the treatment of convicted sex offenders, that continues to be used in cases of paraphilias (especially pedophilia).   As an alternative to physical castration, hormonal treatment has shown benefit in curbing sexual recidivismalthough its use remains controversial.  While estrogen therapy is no longer the practice for sex offenders, specific anti-androgen agents such as cyproterone actetate (Androcur) and medroxyprogesterone acetote (Provera) remained the standard  for decades.  Due to frequent complaints of adverse side effects (including liver and kidney damage),  leuprolide acetate (Lupron) has become the medication of choice in recent years.   In addition to suppression of libido, common side effects include weight gain, lethargy, dizziness, mood swings, and, in extreme cases, loss of bone density.   Despite being voluntary in many cases, court-ordered hormonal treatment is common practice in many countries across North America and Europe and is likely to continue for the forseeable future.

On September 11, 2009, U.K. Prime Minister Gordon Brown issued a formal posthumous apology to Alan Turingfor the "appalling" way in which he had been treated for being gay.  The apology comes in response to a petition which was signed by thousands of supporters.  In welcoming the apology, gay activist Peter Tatchell said that a similar apology was also due to the estimated 100,000 British men who suffered similar treatment.  "Singling out Turing just because he is famous is wrong".

Alan Turing would certainly have agreed.

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