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Bob Sandidge and Kathy Smith discuss a mock ward experiment

BROADCAST: May. 17, 1972 | DURATION: 00:52:05

Synopsis

Bob Sandidge and Kathy Smith discuss a documentary film directed by Sandidge about a mock ward experiment at the Illinois State Hospital in Elgin, Illinois. The documentary investigates the experiences of hospital staff who participated in an experiment in which some of them were hospital staff and others were patients. Topics of discussion in the interview include the ways that institutionalization shapes behavior and how the experiences influence the way participants believe patients should be treated. The interview includes excerpts of discussions among study participants immediately following the end of the experiment.

Transcript

Tap within the transcript to jump to that part of the audio.

OK

Studs Terkel What do we learn when we read of an outbreak, at Attica, say, a prison? There's a great deal of writing these days and discussion about the life of a prisoner. In a sense, what do we learn? We hear of someone escaping now and then, or something that happens in a mental institution, one run by a state. What's it like to be confined in a large mental institution? Well, two of my guests are workers at the Elgin State Hospital. Kathleen Smith is a social worker there, and Bob Sandidge is in charge of the audio-visual department, dealing with therapy involving tapes and sound and sight, and there was an experiment recently. What is it like to be an inmate, a patient rather than someone who is working there? Bob, suppose you start, there was an experiment that took place called "Mock Wards."

Bob Sandidge Right. And that's exactly the premise we went into the thing on. What is it like? What does it really feel like? People talk about it and we have some experience of the institution working there. But what does it feel like to be an inmate? The whole idea for the mock ward came from Philip Zimbardo, who is a professor at Stanford University in California. Sometime last year he hired some college people, some volunteers, and paid them to simulate a prison situation. He had people play the role of guards and people who were patients. It was supposed to last for several weeks. At the end of a few days it was called off because the simulated guards were beating up the simulated prisoners. We felt if this kind of thing could happen in that situation then what, what does the institution do to individuals who come into a mental hospital? So a couple of the people went to Philip Zimbardo at Stanford and got the, you know, the setup, the scoop on how to set up a ward simulation. We came back and did it for three days in February, and it was, the ward situation was composed of all the staff people. People who normally are psychologists, social workers, technicians, other staff people around the hospital. And they lived on a ward. They were checked in. All of the conditions were kind of exaggerated to intensify the experience for them. But all were based on some prevalent kinds of conditions that happen in the hospital.

Studs Terkel Now these people [that? who?] took Part, the working people at the hospital, technicians you say, psychiatric case workers, social workers such as Kathy Smith who took part--were they younger, older, many people, had they--people who worked there for a number of years?

Bob Sandidge Right. We had a mixed group. We had quite a few young people, but we did have a good number and I would say probably at least a third of the people were what we'd call older employees, people who had been employed for a good number of years. We had at least one person, I know, who'd been there for 18 years, which I feel was particularly relevant, their reactions to the changes because they've seen changes over a period of time in the hospital. And if this could be an intense experience for them, having been exposed to the situation for a long time, well, possibly it had more relevance than we had first thought.

Studs Terkel Well, the idea, then, is for the person working there, someone like you, what is it like to be a patient there, is that the idea?

Kathy Smith Yes, that was one of the ideas of the experiment. I tend to look at it not so much as what is it like to be a patient, but what does being confined, institutionalized, and put under these kind of conditions do to me personally? I think it's a bit difficult to say what it's like to be like a patient, of course, because their reactions are so varied under those circumstances. But I do know that in my experiences that undergoing this process for that three-day weekend was an experience I had never--

Studs Terkel It was three days.

Kathy Smith Yes.

Studs Terkel Suppose you start it. What happened? How did it work out?

Bob Sandidge Maybe I can set the scene a little bit as I was involved in some of the planning. The way it happened on Friday night, and the people were all volunteers and they were not paid, by the way, by the state for doing this, this was a voluntary project on a long three-day weekend, so people were doing it on their own time. But Friday evening, we had it set up, admission procedure, people were made to wait en masse, people were admitted through normal kinds of procedures, filling out lots of paperwork. People were stripped of their clothing, personal items. They were given, everyone was given a pseudonym, so you were not only stripped of your belongings, but also your personal identity--your name was taken away and you were given another name. The whole situation was really, as I said, accentuated in order to make it more intense for the people. They came onto the ward and we had 29 people who were checked in that Friday evening as opposed to the 50 who were scheduled to show up. Many of the people evidently couldn't make it at the last minute for various kinds of reasons. People milled around the ward a lot on Friday night, there was a general lack of anything to do, as pretty much approximates ward situations normally. People did stay up quite late that night. People were running to the woman's dormitory particularly, and people got up early the next day, and, perhaps at this point Kathy could tell some of what it felt like to go through that process.

Kathy Smith Yeah, that's a good idea because I was just about to interrupt. One of the things that I remember talking to a lot of the other fellow patients and an amazing esprit de corps formulated in this group of people, faster than any other group of people I've ever been involved in in my life. And I can remember feeling, sitting, we had to wait. And this is not too unusual. Very frequently I've been involved in doing various admission work at the hospital as part of my respective duties as a social worker. And I can remember some of the patients telling me, "Oh, we just had to wait. We were so confused. We didn't know what was going to happen next."

Studs Terkel Where were you waiting?

Kathy Smith Well, I was waiting outside the door to the ward on the steps.

Studs Terkel How many waiting with you?

Kathy Smith Oh, about six. There were a group of about six of us waiting to go in.

Studs Terkel Ordinarily with patients, how many are waiting?

Kathy Smith That varies so much, it just depends. Sometimes over at the admissions office at the hospital there's nobody.

Studs Terkel Your regular clothes on?

Kathy Smith Yes, I came in my regular clothes, and oh, I brought little things like books and stationery and things at the last minute because I knew I had to have something, you know, I wanted something to do, I didn't know what I'd be doing for three days. And the thing that--

Studs Terkel Would a patient have the books and the stationery, too?

Kathy Smith Some patients come that way, some don't. It depends on their particular circumstances. Patients, I think, that come on a voluntary basis planning to stay do bring many personal belongings, others that come under an emergency basis just don't.

Studs Terkel Want to ask later on, I didn't mean to interrupt Kathy as to who the patients are generally at the state hospital.

Kathy Smith Yeah, but I remember going in and I, we started out by going into a little room and taking a questionnaire on mental health and that kind of an assessment of our attitudes before we went into the experiment, and then we went into it through a regular admission procedure. We went into an admissions office and we had an interviewing worker asking our name, address, and if we were on any medication and this and that, and when it really struck me, when I first started feeling quite uneasy about what I was getting myself into, was when this admissions officer asked me who they should notify in case there was an emergency and anything happened to me. And that shook me up. It really did. And from there we went--oh, first they, you know, they took things like keys and if we had medicine that we were on, they'd take the medicine and dispense it to us from the ward later on rather than letting us take it ourselves. And they took glasses even, I remember, you know, when I read I use glasses--

Studs Terkel Eyeglasses, you mean.

Kathy Smith Eyeglasses and--

Studs Terkel Why'd they take the glasses away?

Kathy Smith Because the potential use of the glass, I assume, you know, that there's something destructive could be done with the glass--

Studs Terkel To slash your wrist or something.

Kathy Smith Something like that. I don't know exactly what they had in mind. And from there we went and took a shower, and in a large room with the rest of the patients, and were given state clothes to wear. And we were also given name tags with our--my particular name was Glenda Kisher. Glenda Kisher was my ward name, and from then on I was Glenda. And we were told that the people with these dark sunglasses on were either observers or staff members.

Studs Terkel Now, there were people who were there, they were like you, Bob, you were an observer.

Bob Sandidge Right.

Studs Terkel And others played staff members who were staff members, but you were among the staff members who were patients.

Bob Sandidge Right.

Kathy Smith And then we were told we could not talk to the observers. They were for all practical purposes invisible to us, they just weren't there. And the cameramen and so on just weren't there, we were to ignore them, and the others were staff members. But they also wore these dark sunglasses, which was part of the reason for that was breaking down eye contact is one way of breaking down personal contact with somebody else and just kind of making it all that more difficult to relate to them, which it did do. And from there on then we went into the ward, still not knowing what was going to happen. And I can remember all these questions coming to my mind and saying, "Well, what about this and this?" "Well, you'll find out," you know, or "I'm not sure, you'll have to talk to your counselor. You'll be assigned a counselor and you ask your counselor about that."

Studs Terkel When did you get it, before you continue the story and cite chapter and verse, when did you emotionally become caught up with it. When were you non-aware that you were Kathy Smith playing the role of someone named Glenda and were non-aware of the guys with the glasses and all the TV cameras?

Kathy Smith Saturday afternoon.

Studs Terkel Oh. Go ahead, I'm sorry.

Kathy Smith Well, it was after the ward meeting on Saturday. We had a ward meeting late Saturday morning, I believe it was, and it was very, very angry mood at the ward meeting. People--the patients and the staff all sat together in a big round circle in the ward and started hashing things out. And at this point everybody was feeling so confused, so frustrated, so beleaguered of all these things that had been impinging upon them that the mood was a very angry one.

Studs Terkel When you say you got angry, now were pretending to have anger or did you actually get angry?

Kathy Smith Oh, no, I couldn't pretend it even, I wouldn't pretend it, you know.

Studs Terkel When did a group of you become angry?

Kathy Smith Well, I think the group was angry at the ward meeting. Bob might be able to comment on that as an observer, but from being a participant in the ward meeting, I think that that was a [varied?] group of people together in that circle. There was a lot of anger and hostility coming out. And my--you asked going back to your original question, when did I almost, the line start to break? It was after that, because I felt like man, I can't--you know. Even when we sit down and try to talk to each other, we can't, we can't communicate with one another, the staff and patients, and understand one another, and I felt like what the feeling was, was that on Saturday afternoon I remember getting quite upset within myself and not knowing what to do because what happened was I didn't know any more what I valued. It was like my value system had been picked away at so surreptitiously that I wasn't sure what was going on or I didn't even know that that was happening until all of a sudden I thought, "My God, I don't know what I value. I don't know what's important to me anymore," because I found myself thinking and saying things that I just thought I would never think and say or do. Not so much as overt hostility kind of things, although some of the verbal part of it was very hostile and nasty towards the staff, but I'm just thinking in terms more of what I was starting to think about people, about, you know, relating to people, and what's important anymore, or you know, doesn't anybody care, this sort of thing that I really didn't know what I valued anymore and that was very frightening.

Bob Sandidge Yeah, I agree with the thing of Saturday's meeting was really the first time. Up to that time we were kind of wondering if anything was really happening, because people were doing a lot of activities, just kind of bodily movement things, you know, and I guess in some sense to say, "Hey, I'm still alive and it's still okay and I'm still in control of the situation." But Saturday--

Studs Terkel Wait. Saturday is how long after you first were admitted and came in?

Kathy Smith Well, we were admitted Friday night at 6:00 and the ward meeting was Saturday at, I can't remember the exact time.

Bob Sandidge It was just before lunch I believe on Saturday.

Kathy Smith Yeah.

Studs Terkel So within less than 24 hours.

Kathy Smith Right. Right.

Studs Terkel Within less than 24 hours, you also, Kathleen Smith, playing at the role of being a patient, were no longer playing the role, you were the patient, is that it?

Kathy Smith I'm not so sure I can say I was a patient. What I will say is that I had been quite deeply affected by this experience.

Studs Terkel And was this pretty much simulating the way it actually is when a patient is admitted, the routine you described before is pretty much the regular routine. isn't it?

Bob Sandidge It's based on the regular routine, as I said, things were exaggerated somewhat.

Kathy Smith Things were probably accelerated in intensity and in time.

Bob Sandidge But part of what we were trying to get at the thing, and maybe it's important bringing up at this point, is that we're talking about when you take people to a state hospital, of taking them away at a time of crisis in their personal lives, away from their family, their regular social network, and we're putting them in an institution where--that's full of people who are strange, troubled. We're putting them in a very artificial situation. At a time of crisis, human beings are really ready to take on a new identity. They're much more subject to someone saying, "That's who you are," and you believe it. You take an honest part of you. And kind of what we were getting at in the whole thing was trying to separate how much of the troubles that a person take into the institution are what his behaviors look like, and how much the institution elicits certain kinds of behaviors. You following me there? By taking relatively normal people into the hospital, and I say relatively quote normal, because that is a very relative thing, into the situation we were able to isolate one of the factors. That is, we had people who weren't troubled to begin with. So the kinds of things we saw happening were, you know, elicited by the structure of the situation.

Studs Terkel So, really, what the purpose of this experiment that became very real to you, Kathy, and to others whose voices we'll hear in a moment, is that it's not just that you're quote unquote normal, whatever that may mean, going into it, what this institution, what a state mental hospital or a prison, for that matter, some other way, does to a person, what the institution and the structure taking away his being, for one thing.

Kathy Smith Right. Perhaps to make it--to talk in more concrete terms or for clarity or to use specific example of this issue that we're talking about, the type of program that was used in this particular ward was a behavior modification program. Behavior modification is a program by which patients are given tokens. It's a token economy system. Are given tokens for certain behavior which is desired by the staff. Okay? For one reason or another they feel it's best for the patient or in some instances it makes it easier for them or it's--

Studs Terkel What sort of--

Kathy Smith Condoned by the system. Well, we just had little paper pieces of money, similar to like in a game of Monopoly, and the types of behavior that were reinforced with these tokens were things like making your bed when you got up in the morning, taking your medication when you were supposed to, even though I protested and protested against this, because I never saw a doctor. Cleaning the ward, participating in the games--

Studs Terkel By the way, is this sort of reward, token reward, actually done as far as patients are concerned?

Kathy Smith In some areas of the hospital.

Studs Terkel That's what I mean. In other words, you're following through on the pattern.

Bob Sandidge Right.

Kathy Smith Yes. It's not used in all areas, but in some it definitely is. So in other words, to make a long story short, we were under this kind of system. I can remember at the ward meeting that there was a lot of gripes and complaints about this behavior modification system, and what it demonstrated to me was I saw--

Studs Terkel Pardon me, what's the phrase, behavior modification?

Kathy Smith Yes.

Studs Terkel Is that some of the jargon that is used?

Kathy Smith Behavior mod.

Studs Terkel Behavior mod? Meaning what, now?

Kathy Smith Meaning modify people's behavior by a token economy.

Studs Terkel Ah, it's interesting, so--

Bob Sandidge This is equivalent to our cash economy. Outside. Our behavior is shaped by who's holding the dollar bill.

Studs Terkel Who's holding the dollar bill. But also the use of phrases, "behavior modification," this sounds like a, almost B.F. Skinner is talking.

Bob Sandidge Exactly. This is a behavioral--

Kathy Smith Yeah. Right. Reinforcement and all that. So, but what frightened me, going back to the feeling level about all these things and institutions and what they can do to people, I saw people, you know, we discussed this as patients, you know, how do you feel about this behavior modification program and all this, and I don't see why I should be cleaning up this ward, or I don't see why I should take medication, when nobody would tell me what this medication is, when first of all I've never seen a doctor, and this sort of thing, and I can remember seeing people who started out saying, "I'm not going to go through with this. You know, I've got, you know, I'm a human being in my own right and I'm not going to give in to this."

Studs Terkel You're talking about actual patients, you mean now.

Kathy Smith Yeah. That were on the ward with me.

Studs Terkel Oh, no. You're talking about the mock--

Kathy Smith Mock ward patients.

Studs Terkel But what about actual patients?

Kathy Smith I have not worked in your modification program myself, so I don't know.

Studs Terkel But the mock ward patients, now were getting the feel of it. "I'm not going to go through with it."

Kathy Smith Right. Yeah.

Studs Terkel They had, for a number of years now, some ward and others have been working with patients.

Kathy Smith Some of them, yes. You may have even--

Studs Terkel Go ahead. I'm sorry.

Kathy Smith Yeah. But the point I'm trying to make is, you know, you saw these people resist this, and then it was like watching, you know, the little [waves? waifs?] drop by the roadside, bang, bang, bang, one by one, you know, until it got to the point, the big part of the behavior modification was the commissary, which was held in a room off the woman's dormitory and they would sell cigarettes, because we weren't allowed to have cigarettes of our own, Cokes, candy bars, this kind of thing.

Studs Terkel That's the way it is in actuality, too.

Kathy Smith Yes.

Studs Terkel Not allowed to have cigarettes of your own.

Kathy Smith In some places. I can't say that from my own ward, the ward I work in they do have their own cigarettes.

Studs Terkel But some they don't.

Kathy Smith Some they don't. So you know, it got to a point where it--everything revolved around this. You know, people would say, "Well, what time is the commissary going to be open? Oh, we've got another hour. What shall we do 'til the commissary opens? Oh, well, try to read a book. Okay. Try to watch the television." And then when they announce the commissary's open, it's this big gang of people just came and ran to the commissary because that, you know, it was something to do for one thing, because people were dying of boredom and restlessness. But secondly, you know, they could get something they wanted. You know, this is something they want even though it meant that they had to abrogate their own sense of values and what they really felt was legitimate for them to be doing on the ward to the system of behavior modification.

Studs Terkel So far what Kathy's describing, Bob, is the breaking down of the will, is almost though it were a concentration camp, in a sense.

Bob Sandidge Right.

Studs Terkel You know who musclemen are, in Bettelheim's book, musclemen are those who become zombies like, the breaking down of will.

Kathy Smith But I was very much frightened, I was very, very frightened to see this happening, you know, because it was the group. Each time the commissary was open, which was about three times a day, the group of people that were rushing there became larger, and you know, you'd say to people, I'd say, "Well, yesterday, you were saying you never were going to mop that floor, because first of all, it isn't dirty in the first place, and second of all, you know, why should you be doing that when you could be doing more legitimate things?" And the person would just go, "Well, no, what do you do? I've got to survive."

Bob Sandidge The system holds the tokens. And this is one of the generalizations that we're trying to make in taking some of this into the community, and that is, that we all live in institutions. We all live in systems where someone else owns the tokens. And what are we doing to get those tokens? And is it really what we want to be doing and is that the way we want to live our lives?

Studs Terkel Not only is someone else own the tokens, but not something else is involved here too, someone else is defining who we are. Defining whether you are normal or non-normal. Defining whether you are legal or illegal. So we come to that, too. Someone else and, so, basically that's what it amounts to.

Bob Sandidge Someone else sanctions.

Kathy Smith Yeah. I remember thinking myself as a mock ward patient at one point the thought going through my head, "It's not a matter of illness or non-illness, you know. It's not a matter that I'm as a patient are mentally ill and those staff people are studying it, it's just a matter of what's tolerable and what isn't tolerable according to the present power structure."

Studs Terkel How long were you a patient along this mock ward?

Kathy Smith Almost three, two and a half days.

Studs Terkel What happened then to you, what was happening to you then? Were you becoming--did you have violent thoughts?

Kathy Smith I had moments when I wanted to hit somebody in the face, yes. I had no thoughts of killing anybody or anything like that. I found myself very--getting increasingly agitated and, you know, having a lot of nervous energy and channeling this into things like mock baseball games, mock skits, mock--

Studs Terkel Mock church.

Kathy Smith Volleyball, mock church. I did find myself pacing, and I stopped and thought, "My God, I am, I'm actually doing this, just pacing up and down."

Studs Terkel Now, those who took part in this mock ward experiment, those who played the role of the attendants, ward attendants, did they behave as attendants do behave generally?

Bob Sandidge Right. By and large, but again they were doing accentuated kinds of behavior to intensify the situation.

Studs Terkel You know, there's one adjective Kathy used, very rather, Kathy intro-- "accelerated." This was accelerated, she says, beyond that, now it occurs to me, the reality may be even worse because of the waiting. You see? If it's accelerated, earlier you spoke of waiting, see. Then if it's in 72 hours, what happened to you, it might conceivably be even worse than reality since it's there this long--

Bob Sandidge Also it's more subtle than reality. Because we don't know in many situations that we're involved in such a process every day.

Kathy Smith I think, you know, it is entirely much more potently harmful in reality because it's not accelerated for those reasons. First of all, you know, like Bob said, we're not so much aware of it when it's not quite so fast. It's just kind of creeps up on you. Therefore you're not quite so sure. You're not as consciously resisting it. And secondly, if it's done over a long slow process it's integrated into much more.

Bob Sandidge What we're just kind of ending up saying here, I think, is that the hospital as an entity is kind of a back ward for society. And I think that one little phrase that I saw on the wall of one of the wards at the hospital was, it says, "We're all crazy, just some of us got caught."

Studs Terkel Yeah.

Bob Sandidge And I think that's really what we're getting down to.

Studs Terkel Coming back to Dr. Thomas Szasz and R.D. Laing, too, aren't we?

Kathy Smith Yes. It's hard not to come back to them.

Studs Terkel But coming back to the point, what, before we hear voices, voices of some of your colleagues that took part immediately after the session. What finally happened? What was the resolution when you were finally released after 72--this was Sunday night, now.

Kathy Smith This was Monday morning 11:00 when we were freed.

Studs Terkel What was your feeling?

Kathy Smith My feeling was I gotta get out of here and be alone. I've got to be alone and get myself reorganized in my head. So I took a couple of hours and just went to my place and it was a beautiful day and I put on some music on the stereo and I thought, until I felt I could face people again.

Studs Terkel What we as observer, Bob?

Bob Sandidge This--one of the big things that I experienced as an observer was, the observers were invisible people, but we did go on to the ward to man the cameras and to record and do different things, but we were totally invisible to those people, they could not interact to us. We had not just changed names, or had been taken our clothes off and given state clothes, that kind of thing. We were nobody. We didn't exist to them. That was a really super stripping process for us. At the end of that Monday, whenever we heard the announcement, we were so eager for the thing to be over so--Because these were people we knew.

Studs Terkel Hey, wait a minute, something, this is interesting, I hadn't thought about this. Something was happening to the observer. You see, now? You were a patient, but we think of the great many people who are the spectators in this world and so many of us are observing the horrors of Vietnam on television. You know? We--as--it doesn't interfere with our appetite as we're eating supper as we see it, you see. Observers of one another. So you were in that category. So what was happening to you?

Bob Sandidge It was a very intense time. Monday the observes--the tension was so great in the observation room Monday, we--actually, the thing had been planned to be over for Monday, but we had moved it back to before noon so we'd have time to talk things out. But part of that was also the anxiety on the part of the observers. We needed to get back and re-establish contact with the people that we knew. We know most of the people, but we couldn't interact at all, and we had the, the way the thing was set up, we had three television cameras, it was a closed circuit situation, so, in a sense, we were experiencing the thing from three different angles at the same time. It wasn't a single perspective. We--if you're following any McLuhan kinds of things, our nervous system had been expanded to three different locations at the same time. And it was a very intense thing for us. We literally we just were expelled into the ward situation when everything was over, and we rushed in to--

Studs Terkel You know, the obvious question we will hold, and that's what happened to the participants, has their attitude toward the patients changed or their knowledge, insights, perhaps we'll take a slight break for a moment and return to Bob Sandidge, who is audio-visual head at the department at Elgin State Hospital and Kathleen Smith, a social worker at the Elgin State Hospital. We'll return in a moment. Let's resume the conversation now with Cathy Smith and Bob Sandidge. You were saying, Kathy, before the break, about attitudes of the people at the department who are working there after their 72 hours as mock patients.

Kathy Smith Yes, I think that there was definitely, that attitudes were definitely affected by the mock ward, which was brought out a lot by the post-sessions when people sat around and talked, they finally could talk about these things, and a lot of people were saying now they understood the dilemma that patients are put in, which I think, you know, they're saying, "Now I know what it's like, really like to be a patient." But I think what they're really saying is, "Now I understand the dilemma that patients are in." One of the things that I think that people--maybe, I could be wrong and I guess I should only speak for myself on this, but I think what the people felt the most was this horrible barrier in communication that they felt, not only with the staff and their quote counselor, but with each other, because, you know, environment definitely is going to affect the kind and quality of the communication, and I became increasingly difficult to communicate anything with other people around the ward. And one of the things that people kept talking about was that they didn't feel they could ever put a patient off again, meaning it's a very common thing when you walk onto the ward at a state mental hospital to hear, "Well, talk to your counselor," which would be the aide saying this. "Talk to your counselor about that." So the patient trots down the hall to talk to their counselor about it, and the counselor says, "I'm busy. You know, I've got this to do, or I've got appointments," or this or that, "Talk to me later." And it's, you know, the patient keeps going around in a circle and around in a circle, and one of the common things we were saying is, "I don't really think I could ever put off a patient and say, 'Talk to me later.'"

Studs Terkel Now the other thing is, the personal effect on you and on your colleagues, the other thing is, you also come to recognize the nature of the institution itself, what the institution does and the structure of it. As Bob was saying, some--

Kathy Smith I don't know how much the people really came to recognize the nature of the institution as such, but I think they came to recognize the feelings that they felt being in an institution.

Bob Sandidge That certain situations set up because of the way the institution is structured.

Studs Terkel But this could be County Hospital. This could be a welfare station. This could be a prison.

Bob Sandidge This can be a colleges (sic). This can be the family institution. What kinds of behaviors does that kind of relationship elicit, because it has to be set up and structured in a certain way.

Studs Terkel So there's also the isolation, the aliena--by the way, that's a que-- before we hear the voices of your colleagues. That matter of, you said lack of communication. What about you--how many patients were there, you and your

Kathy Smith mock patients? Twenty-nine.

Studs Terkel What contact did you have with them during those 72 hours?

Kathy Smith Oh, we were together all the time except when, you know, when we were sleeping.

Studs Terkel No, I mean spiritual con--I mean, what contact--

Kathy Smith Oh, I--

Studs Terkel Was there a feeling among you?

Kathy Smith Yes, there was definitely a lot of feeling. But I found myself like talking very intensely and very openly and honestly with people. I'll have to clarify this, because it sounds like I'm contradicting myself that we couldn't communicate. What I'm saying is that, like, we really couldn't communicate about the institution and the system we were in because it was so nebulous and vague and we weren't sure what was going on. That kind of thing.

Studs Terkel You know, an image comes to my mind again, before we hear these voices. When I visited a friend of mine at a halfway house somewhere on Wilson Avenue, North, and a halfway house, perhaps to the audience, those who have left the state hospital are now in-between, before they come out into the world. And entering the lobby. Now, the street was quiet, rather dull and drab, and the lobby has a tremendous life and vitality. These were the people, the patients, you know, who were at the halfway house, young people, young girls, older people, old guys, older women, but there was tremendous, super--

Kathy Smith Energy.

Studs Terkel Vitality and energy, far beyond that of the so-called normal people outside. I sensed that. It was very lifting and exciting.

Kathy Smith But, yeah, I'd like to comment directly on this because this is so much goes along with what you're saying. That's true, especially when you're so confined, you've got a lot of nervous energy, which we all felt, and we started, like I was telling you earlier, we started doing things with this energy, creatively, more or less. But every time that we would start to do this, we would be interrupted by the staff saying, "Okay, now it's time to be in our exercise program," or "Now it's time to come and do this," or "You do this." You don't--in other words, "You're not fitting in to what we've got planned, so we don't like what you're doing."

Studs Terkel Ah, they had you pigeon-holed, therefore something improvisational could never happen.

Bob Sandidge Right. Something that

Studs Terkel

Kathy Smith Something wildly improv-- Something that came from within us was

Studs Terkel denied. Something spontaneous could not--spontaneity was denied.

Kathy Smith Yes.

Studs Terkel But suppose--Bob, suppose you said it. Now. The 72 hours have passed. And now everybody's out. You're out now. Now there was a session.

Bob Sandidge We had a post-session immediately following. This was part of the scheduled experience. There was a session immediately following and then we had a session one week later. Now the tape that we brought along today has the first part of it, is immediately afterwards and then later are the reactions from the--

Studs Terkel Who were the people? What were they like?

Bob Sandidge These are the same participants that were on the mock ward. We have staff people, we have people who were patients and who played the roles of staff, we had some observers who were doing some of the questioning--

Studs Terkel I think I asked you this earlier, now some of these people, younger people took part, such as you as an observer and Kathy as a patient, but were there also older people there? Also we hear too.

Bob Sandidge Right. We'll be hearing some of the older people. One of the people who talks about her tremendous hostility is a 45-year-old employee who's been there for some time. We have another woman on the tape who's been there for something like 18 years, in fact she mentions it on the tape, so we've identified her.

Studs Terkel So we hear the gathering. This is the session right after the--

Kathy Smith Yeah. This is the gab session.

Man 1 [Unintelligible] We would like to [sort of account for?] what you people are feeling, like what we want to get out of this meeting, and we can make it pretty brief, is for right now what you're feeling, like you know. We'd like maybe like seven patients, approximately seven patients to get together, and we've got some places for you to go to discuss. Here's what we're sort of asking: What were you feeling in this experiment? Like, what are some of the things that you were feeling, your real gut feelings, and what were some of the situations that brought on these feelings? What other feelings, what were some of the situations?

Woman 1 And I think what really bugged me and made me aware of what we do on the ward, you know, as staff was when we were so thirsty, you know, that first night--

Woman 2 And hot water.

Woman 1 And hungry, and someone came in, the staff came in with a hamburger and a cup of coffee--

Woman 2 And sat down in the

Woman 3

Woman 1 ward. And sat down right there in front of us. I felt like punching her in the mouth, because I really felt like she was, "Elizabeth, how are you tonight?" And I just felt like, you know? And she never said a nasty word to me, you know? But it was just like, wow, I just felt about, when she was talking to me, she was talking down to me and I was this big.

Woman 2 And then someone came and asked me while I was mopping the floor, "How do you feel about mopping that floor? Does it bother you if you have people walk on that?" And I wanted to say, and I don't usually swear, you know, I was, "Damn it, can't you tell that it bothers me, you know? Haven't you got any sense, you know?" I wanted to shake him, you know? Your temper, you know. Everything that you feel

Woman 1

Woman 2 inside-- I got that out of my-- I was really, I was getting more hostility than I've ever felt in my life, I have felt here. I just, I really, I could have, I think if I'd stayed much longer either I would have had to jump, you know, if I thought I was going to be a patient, really a patient, I would either made an escape. I might have even attacked a person. You know, I mean a staff, you know, not a patient. I would have attacked a staff, you know? And enjoyed every minute of it, and they would have had to pull me off, you know? And it would have been worth every second of it, you know. 'Cause I feel, I still have this hostility. I mean, that I can't seem to get off. I'm still shook up, you know? I'm really angry.

Woman 3 And you've got your prime staff members all picked out, don't you?

Woman 2 Yeah.

Woman 4 Just like me. When I took that shower and she talked so nasty to me, so hateful to me, even insinuating that I had something in my hand. I had fell and hurt my hand, I shut my hand because it felt better. And I still got the scar, see? And then she comes the next morning and she says, I said to myself, "Well, she's not wearing glasses, you know. And she didn't have her glasses. "Well," she said, "Matthews, how are you?" I said, "I'm Becky Bomberg." I said, "I don't know how I am."

Woman 2 The glasses. I don't know if this was set up for that, but those glasses made me so hostile. You know?

Woman 1 They irked me.

Woman 2 I wanted to go up and pull them off everybody--you know, everybody that came across my path with them because I couldn't see their eyes, you know, and I felt, it made me feel very insecure, because even if I was on a ward as a patient, I'd be able to see your eyes, and I could see whether they, you know, and whether you kind of close your eyes in anger or something, you know, I'd at least see something.

Woman 1 You know, yesterday I really felt like, you know, I just felt kind of numb, like what was reality because you couldn't go outside. You were just sort of, you know, you were closed in and you were looking at the same walls, you know, and it was really--it was really strange.

Man 2 The thing was you were really afraid of the staff.

Man 3 Really?

Man 2 Really afraid that you were going to do--like, there were a lot of things I wanted to do, but I was afraid I wouldn't get a cigarette, I'd be fined. And when I was fined, I walked into the office and got, I got the volleyball. And I walked in there and asked for it, and the guy gave it to me, and I walked out and I started playing with it, another aide came over, took it away from me, and I kept arguing, but the guy gave it to me, he gave it to me, you know? And he walked into the office, put it down, I walked into the office, picked it up. And then he tried to grab me. "Stop that, stop that!" So I threw the ball out, you know, out of the office, at least to get the ball out of the office because I knew they'd kick me out eventually. So one person turns around and says, "You're fined a token." Flora turned around, Flora turned around and she said, "No, he should be fined three tokens." So I gave him one token, no three tokens. So they took my other tokens away from me. And did I feel, I felt like I had done some really bad crime.

Woman 5 I really felt that they were really doing it just to aggravate us. Because some of the aides, I can't remember anyone's names, but some of the aides, now when you got upset, and you were really getting irritated, they kept it up. Like they wanted to see how far they could push you. How upset they could make you. But then you couldn't really distinguish all the time who was really being straight with you and who was just trying to go off into a fantasy.

Man 3 Among the staff or among the patients?

Woman 5 Among the staff. I mean, you knew who was straight among the patients, 'cause then you're a typical patient. My slip was hanging, my dress was open, my gown was on, you know, I really looked like a patient, and I really felt like one at that point, I felt like a real patient.

Woman 4 Well, by me participating on this mock ward that made me realize how near I almost become a patient once. When my son got killed, all I did was just moped around and cared for nothing. And it got so I couldn't eat, couldn't sleep, so well, then when my alarm'd ring I just had to force myself. Then whenever I got so I just wouldn't get up when the alarm rang, I knew there was something to do then. So I went out and got myself another job. The first three weeks I thought I would die, I just couldn't take it. Then I realized I was beginning to sleep a little more. And then I sort of solved the problem. And then I realized how these patients felt when I got on this mock

Man 4 ward. We can't bring, you know, we can't bring the whole experience that we had across [unintelligible].

Woman 6 And it was real funny that I hadn't talked about the mock ward. And the first time I came on, I said something about somebody, you know, she asked--I said something about Queenie, did you hear about Queenie, and she said, "Yes, don't talk about the mock ward, I don't want to hear nothing about it." So I, no, I didn't say a thing to anybody I worked with, I was in charge, but I didn't say anything to the girl I was working with. So last night I worked with the [board of 12?] and she was really interested in, and I sit there and talked to her, I said [well, let's limit it to?] half an hour, 'cause I said I know some people here don't want to listen to it. I mean, we were sitting around the table. And I just told her at the half an hour, I said, you know, if you're interested I'll tell you more and you can see the notes,

Man 4 but-- I'm curious why someone would be so abrupt as to say, "I don't want to hear anything about it."

Woman 7 All the time. You know, [it's?] something they weren't included on, and you know, it's jealousy, resentment kind of thing, you know, like that's your thing, now don't try to push that on me, 'cause I was--

Woman 8 Maybe they thought it was like game playing or something, it wasn't worth anything.

Woman 9 They came back to me. Well, it wasn't real, you know, they heard all these rumors, they said, "Did this happen? Did this really happen?" You know, the first thing I said, "A few things happened around there," you know, I only spoke of the night shift, I said I couldn't speak for the day shift. And it really was a true experience, and I said, "Well, a lot of things were true experiences." And the question, I think, that people asked me were, "Were the patients really acting, play-acting, you know?" This is the question, the acting out. And I said, "No, I didn't feel they were." At first I felt this, you know, but I soon changed my mind. And then they [thought, well, it really?] isn't true, you know. I think the one thing I felt staff really needs to know, and I really feel older staff, to get some feelings, I mean, that we need some of this. This is one thing I've learned, to be more sensitive to the patients' needs, because I consider myself a chronic old employee, you know what I mean, because I'm going on 18 years.

Woman 7 You know that some of us employees, us older ones with feelings, all--I wanted to really like - I would talk about the experience with them, and they would get this real patronizing, like they wanted me to join in with the patronizing, you know, like baby the patient, you know, which is something I really resented on the ward when I was a patient there. I really hated, you know, being babied. I was sick, you know, and they babied you to death, you know, and now they say, "Well, now don't you think you should go coddle this patient because this patient doesn't feel good?" And, yet, it really, you know, like I felt, well, I didn't like to be coddled. But it seemed to them like trying to explain the experience they thought it was more of a vote for patronizing. This is some of the older ones, anyway.

Woman 2 I talked to Father Becker who was on the ward, you know, and I talked to him afterwards and he has been a psychologist for quite some time, you know, many years. And he was shocked at how much I had learned from it. And he said he learned from it, you know. He was amazed at all the things that actually took place that weren't on a piece of paper. You know, that weren't in a book. Things that you experienced, then I shared it with him. He just was flabbergasted. He said that it was almost like all the psychology books he had read put together.

Woman 1 At the end when we were all sitting around talking about you were giving us the questions we needed to answer and stuff, and I asked a stupid question which I immediately realized was a little dumb, and you answered it for me right away, and then you told her not to get hostile about it? And she said, "Well, she's only staff," or something like that. I was like, just like "Pop!" right between the eyes, you know, and I realized how important it was to me to identify with the patients and not with the staff. But I really felt alienated, and it was very destructive to me in that sense except that when I went back on the ward, I found I was trying more to become a part of the patient group. And I would find myself confiding in certain patients or explain to them, "You know, I'm really tired today and I'm--what you're telling me is getting me so frustrated because I just can't run everywhere at once," and I'd be explaining to them why I wasn't doing it instead of just saying "Later, later," you know. That--it really came home to me and that wouldn't have happened if I hadn't known most people or had seen round the grounds beforehand.

Woman 2 I know what I think it is. They're taking advantages. Because this is one thing that I really sensed when I was on the ward, that there were certain people that you could sense they were with you, you know, even if they didn't do a whole lot, you know. Like even I had one aide that came up to me. She didn't say so much, but she put her hand on my shoulder and I felt secure. You know. Someone knew I was there. You know, I wasn't an old thing that was, you know, I was, I was a person yet, you know? And I feel that the patients have picked up an attitude more than anything. You know? I don't think it's so much, I mean, I've always felt for patients before, but I think that they--I don't know, it's an attitude, that's all I can say. They feel it, because I've been working with this one man, I have never been able to get him to respond before, you know? And I'd go there and I'd plead with him, I'd do all sorts

Man 5 of things, and he'd act like I wasn't even there. And today he went out for a walk with me. And I was shocked to death, you know. I think it's the difference between thinking that you're maybe, you know, as the patient looking at you and saying, "Well, she's just acting out a role, playing pretending nice to me," you know, and now when you feel it yourself, he picks up the vibrations that are really there. Real vibrations that you really care.

Studs Terkel So this is quite revealing. This discussion after, these are the mock patients who were technicians, aides, social workers, who became, talked like patients. And several things come to mind. One is feeling, some wonderful sense of feeling, What then? Has the--oh, many things, of course, occur. The eyeglasses, the sunglasses, the eyeless-ness, so therefore, as though almost a symbol of the attendants and the people working there not looking, not seeing these people. Becoming and being a person, all this. So what's the end result? What, what, if anything, can we conclude as a result of this experiment?

Bob Sandidge Well, I think one of the things that happened immediately, and we could hear from the tapes of the post-session, was people began to perceive the patients in a different kind of way, as the one staff person who played the role of a staff person on the ward was saying there that she, whenever she went back to the ward, wanted to identify with a patient group, rather than the staff group, on the ward where she worked. And it's that kind of building of empathy, I think, was the first big feedback we got. That's what we wanted to do it for. Another thing that we're doing and this gets kind of into another area is, many of the people at these post-sessions we had an intense amount of feeling. I think you could feel some of that, there was really a vibrance. People also had a lot of anxiety going back to the ward because they had felt what the system does to people, and people had trouble being a part of that again. They had trouble going back and doing the things that were required of them to do as part of their job. --some of us have gotten together and formed a community mental health group and what we're doing are educational types of things. We're going around to colleges, schools, clubs, churches, anybody who wants to hear about institutionalization in the mock ward experience, we'll be glad to bring around a program. That's kind of a long-range thing going to happen. There is also a group who is working internally in the hospital to check out personal kinds of civil rights issues that are, concern patients. We have a case right now, and I can't be too specific because I don't know how it's going to come out, but we have a patient who was committed by the state against his will, he was committed by a judge and people who do that. He was institutionalized for some period of time. After he was released he got a bill for $5000. Now, the state can legally go in and take his money from him. This, to me, is one of the things that the, that we're trying to combat, is how the state can take a person against his will to a place he doesn't want to go and then take his money away for having done that to him. So those are some of the kind of immediate concerns that we're dealing with. Community-wise, we found that if we as staff people have some misconceptions about what the process is, then certainly the community has to have a lot of misconstrued--

Studs Terkel The group is

Bob Sandidge called Grow, isn't it? Grow.

Studs Terkel G-R-O-W. So if people to communicate with you, people listening, is to Grow, G-R-O-W, as in grow, and it's 2-6-3 DuPage--

Bob Sandidge Right.

Studs Terkel Elgin, Illinois.

Bob Sandidge Right.

Studs Terkel Kathy, Kathy, your thoughts.

Kathy Smith The results?

Studs Terkel Of all this.

Kathy Smith Of all this? Well, I would agree entirely with what Bob was just saying, as far as is really very difficult to go back and you were just more highly sensitive to what was going on around you. A lot of the things that people were talking about their feelings after the mock ward experiment were some of the things I was feeling before the experiment, but it was just much more highly intensified afterwards. And I found myself, I think, taking more time, you know, just as I was saying earlier and just talking to the patients. I found the patients very curious. You know, they had caught wind of this experiment and knew what I was doing and they wanted to know what it was all about.

Studs Terkel Remember that one old woman there, said she was working with this guy and the guy paid no attention to this patient. But something happened, one of you used the word "vibrations."

Kathy Smith Yes.

Studs Terkel Something happened that, perhaps happened to her without her realizing it. That he, the patient, sensed it, and he went for a walk with her. But overall there's one thing, perhaps, we cannot omit: and that there are the attendants, there are the aides, who many do the best they can. Others don't. But there's the institution. As one aide said, "I can't be in both places at the same time." We come back to the institution itself, what it does to both: the staff working there--

Bob Sandidge The staff Right. You

Studs Terkel

Kathy Smith staff is institutionalized as well as the patients. The staff as well as the patients. Right. You have to find your own particular way of kind of getting around that and still being as effective as you can in your relations with the patients. I think that the most, one of the most important things a staff member can give to a patient is kind of just a good relationship with them to start building from again.

Studs Terkel That's the best he, she as an individual can do, but over and beyond this seems to me, this experiment, the whole thing, has more to it even than that and that's the very nature of institutions. It must be one way or another radically altered to a more humane--again, using the mental hospital as almost a metaphor for everything you've named, every institution you've named, practically, it goes back to the impersonal, to the plan, to the modified behavioral pattern.

Bob Sandidge This is one thing we're trying to communicate to the community, and that is to raise some awareness that we all live in an institution. It's just that we were born in the middle of it. We weren't imported into it, so we don't recognize where the walls are. In the same way that the staff becomes institutionalized in a hospital or a recognized institutional setting, we also become institutionalized because using the behavior modification model, the system holds the power, and we are institutionalized. It also controls our behavior and our lifestyles to a very large extent, and probably we're going to be living with institutions, we're going to have to have institutions. But the thing we--I think we should be looking at is how to make those institutions, reshape them, restructure them, in ways that will make behavior productive and spontaneous and allow us to grow rather than confine us, shove us into places we don't want to be, make judgments, labels, and those kinds of things. So, and I think it's a process we all have to become involved in. It's not something somebody else can make decisions for us about. We all have to become aware of the institutions that affect us daily.

Kathy Smith I think the only reason for an institution to exist is that it helps its members become more self-actualizing. But as they exist now, they're only denying self. And as long as they're denying self, there's no reason for their existence. As I can see it.

Studs Terkel Any other thought comes to mind as we, the hour comes to an end. Very interesting. Grow, you used the word to enable us to grow spontaneously, and Grow is the name of the group. So for those who want to be in touch with Grow, 263 DuPage, Elgin, Illinois. Any other thoughts come to your mind?

Bob Sandidge I would just like to say that if people would like to have us or some other people come around with videotapes and talk about these things, we'd be glad to meet with anyone. If you would like to join us, we're just beginning our study of these kinds of issues, we'd certainly like for people to get in touch with us.

Kathy Smith You know, if you want to be on the mailing list, all people would have to do is just send us a letter with their name and address, and we'd be glad to send them information.

Studs Terkel And so, perhaps as a coda to listeners, to everyone, if you want to know what it is to be in an institution, look in the mirror. And then try to figure out what to do about it. Thank you very much, Bob Sandidge and Kathleen Smith, who both work at the Elgin State Hospital.

Bob Sandidge Thanks.