by John E. Mack, M.D.
An autobiographical essay written in April 1994 for publication in Ellen L. Bassuk’s 1996 book The Doctor-Patient Activist: Physicians Fighting for Social Change. Several quotes from this essay appear in Ralph Blumenthal’s 2022 biography of John Mack, The Believer.
“Those who dream by night in the dusty recesses of their minds wake in the day to find that all was vanity; but the dreamers of the day are dangerous men, for they may act their dream with open eyes, and make it possible.”
— T. E. Lawrence, Seven Pillars of Wisdom, 1935
An invitation to write of the facts of one’s life and the forces that have driven and shaped them presents for me, at 64, a special challenge and opportunity. Any attempt to provide coherence to events and experiences that seemed, while they were being lived, not only to lack unity and clear direction but to feel at times quite random or chaotic must to a degree represent a false imposition of order. Yet, I suppose, all learning and teaching must to some extent be like that. For if we are to pass our experience – and, yes, lessons – on to others we must make them tangible and give them form, creating, if we can, a story from which meaning might be derived.
This is a book about physicians who have fought for social change. I am pleased to be identified that way and can see that such struggles have been an important part of my life. But at the same time, the assignment has piqued a certain curiosity, a self-questioning. It has made me wonder about the roots of these efforts and inspired a desire to look inward and explore the soil from which they have grown.
In order for social actions to be effective, they must, I, think, grow out of some context or tradition that enables others to recognize their own desires and potentialities, some undercurrent of larger purpose with which they may connect. Otherwise actions that are directed toward social or political change may appear as isolated behaviors, outside of or appropriate role or competence. In the course of their education and specialty training, physicians are consciously and unconsciously drawn into an ethos of healing, a commitment to trying to reduce suffering, and a dedication to human betterment. But the expression of these purposes may occur at the individual or the collective level, as in the field of public health.
Participants in the physicians’ antinuclear movement, for example, represented by groups such as Physicians for Social Responsibility and International Physicians for the Prevention of Nuclear War, were always quick to connect their efforts to public service and public health traditions and described the nuclear arms race in the language of those disciplines. This would be, we said, “the last epidemic,”(1) and one of the most effective arguments that we could present to the public concerned the fact that only prevention was possible. Treatment after a nuclear war was utterly beyond our capability, we showed, at symposia that were attended by hundreds of thousands of anxious citizens. Although this approach was seen by conservatives who were unhappy with the political implications of the message to be stretching the limits of the medical mandate, it was important to maintain a link to our professional base. When we were seen as too nakedly political, our efforts were easier to discredit.
But this outlining of professional traditions, and the derivation of actions from them, does not say much about what makes a particular person at specific moments in history engage in certain issues of the time. For this we need to know about that person, his or her cultural background, formative influences, and private motivations, what is called, in the shorthand of our time, his identity. But a word of caution is needed here, a reminder of the incompleteness of retrospection and reflection. A mystery will remain, and explanations are inadequate. We can wonder and examine, but, finally, there is much that we do that seems beyond our ability to understand.
The expansion of the scope of social commitment has paralleled the evolution of my own psychospiritual development. As I have come increasingly to see myself as connected beyond human relationships and have grown to feel a kind of oneness within the expanse of creation, I have become increasingly interested in the dangers of ecological devastation and, finally, in the problems of consciousness that have restricted human ability to experience life and meaning beyond the boundaries of the Earth. I have come to see the major social problems of our time – economic inequality, environmental destruction, and ethnonational conflicts that might escalate to a nuclear holocaust – as deriving from a too narrow definition of ourselves, a kind of psychospiritual bankruptcy that permits, and even encourages, exploitation at every level of existence. But more of that later.
I wonder if any subculture has developed the use of the intellect – some say at the expense of other faculties – further than the German Jewish people from whom I am descended. Freud, Marx and Einstein were German Jews, and there was never any doubt that my English professor father and economist mother expected me to become some sort of an academic. But there are other traditions among the German Jews of collective responsibility and community service, well exemplified by my father’s family, who settled in Cincinnati, Ohio in the mid 19th century. Over several generations these forebears devoted themselves to a remarkable variety of charitable and cultural activities in the fields of child care, art, music, and religion, including the founding of a temple, hospital, and orphanage. My great grandfather was an ophthalmologist who pioneered the use of anesthetics in eye surgery, and a great uncle, Joseph Aub, was one of the first Jewish professors of medicine at Harvard Medical School.
The image of medicine was actually too activist for me when I was growing up, not as intellectual a profession (there would certainly be some profession) as I expected to enter. Furthermore, my mother, in her authoritative way, seemed to boss our pediatrician – the only doctor I really knew – around like the tradesmen who came to the house to fix the plumbing or the stove. Yet there was also a part of me that protested secretly against the heady, wordy discussions of books and plays at the dinner table. The social issues of our times were endlessly talked about, especially the events in Europe that culminated in World War II and the Holocaust, leaving me with a terrible feeling of helplessness. For no one ever seemed to do anything about the problems that were so richly and excitedly discussed. This was, of course, unfair for both of my parents were involved in various charities, and teaching and research were certainly respectable ways of contributing to human well being. At the same time, too, my parents, while avoiding with disdain (I now suspect out of anxiety) what they called “administration,” were passing on values of social commitment so that I might some day be able to live a few of their unlived lives.
Then there was my mother’s brother, Julius (“Bud”) Prince, whose attendance in medical school when I was a small boy seemed to carry a certain worthy mystique. Uncle. Bud later became a famous public health doctor who battled for the development of health care systems in Ghana and Ethiopia. He is the most indefatigable activist doctor I know and surely, though I did not know it growing up, became some sort of role model. When I was 20, my sister, Mary Lee (also an academic, with a Ph.D. in economics and a masters in public health), married Sidney Ingbar, who became perhaps the world’s leading thyroidologist and one of Harvard’s most eminent professors of medicine. Sid became like a brother to me – I had no other – and though he was not a social activist my nearly daily contact with him before and especially during medical school (at Harvard, where Joe Aub helped me get in) allowed me to appreciate ever more profoundly the range of possibilities that medicine offered.
Throughout my adolescence and continuing up to the present time, my uncle Saul Scheidlinger (my mother’s sister’s husband), an internationally known expert in group process and psychotherapy, has been a caring mentor and important influence. Saul, a holocaust survivor, has helped me to see the powerful interplay of individual and collective forces in every aspect of human life.
An event that occurred at the beginning of my first year in medical school reified the intellectual (read ineffectual)/activist dichotomy I had established in my mind. The class that entered Harvard Medical School in September 1951 included about 45% Jewish students, many of whom had graduated from Harvard College. Evidently, whatever quotas there had been for admitting Jewish students to the medical school had been quite completely relaxed. It quickly became established that we – the Jewish students – were regarded by the “jocks” among the gentile students, who included several outstanding college football players, as eggheads if not wimps, even though Philip Isenberg, who had just been captain of the Harvard football team, was a member of our class.
So, to establish our athletic prowess and assert our masculine dignity, we, the Jewish students, did something that would probably be regarded now as too politically incorrect to be even contemplated. We challenged the gentile students to a softball game, to be played in the field behind the student dormitory (long since replaced by the Boston English High School building and parking lot). The outcome of the game, which went on until dusk, did not really matter. It all ended good humoredly in a tie. We Jewish intellectuals, from my distorted point of view, had certainly proved our activist credentials.
Then there is the matter of psychology. From childhood – age 12 sticks in my mind – I was searching out books in my elementary school library (it was a progressive school: Lincoln, later Horace Mann Lincoln, founded on the John Dewey principle of learning by doing) on psychology. The curiosity was driven, I think, by the restless hurt I felt inside. Like all explorers of the inner life, I suppose, the drive was to find out about others in order to make sense of my own raging uncertainties. But there is a problem in psychology for any would be activist. As Freud turned from his thwarted political ambitions to do the politicians one better by understanding their motivations, psychology by its very nature is about analysis, not action.
There is a built-in suspicion of action in psychoanalysis, and perhaps psychology generally, which the inescapably pejorative though sometimes accurate term “acting out” implies. Activism may follow analysis through deliberate choice as problems are identified in the outer world that impact peoples’ lives. But action for a psychologist (or a psychoanalyst as I later became) is not, I think, as close to his or her professional tradition as for physicians. Perhaps this is why, finally, after considering social psychology, I chose to become a medical psychologist or psychiatrist rather than follow a more purely academic path.
There is more to be said, I think, about the relationship between wound and action, at least in my own life. Partly to heal the pain connected with early losses, especially the death of my biological mother at 8 months (my father blamed the surgeon for not attending promptly enough to the peritonitis that followed a ruptured appendix), I embarked on a course of psychoanalytic treatment during medical school. A second analysis would later be required as part of psychoanalytic training. I am deeply grateful for the caring and meticulous understanding that my analysts offered. But I have come to feel that this process is too remote, too distant, too analytic, to reach and repair the wounds that reside in the deeper levels of the psyche, especially those associated with the losses and wounds of infancy. Something more powerful, more experiential, is essential, I think, and I have been exploring alternative therapeutic methods in recent years.
But even the most powerfully healing therapeutic approaches do not necessarily translate into social action, although there are in some psychological traditions, especially those like Buddhism that have a strong spiritual base, an emphasis on service and caring for others as an essential part of the transformative process. Here also I came to feel, beginning in my 30s, that depth psychology by itself was too self oriented and incomplete in its therapeutic approaches. Something more was needed, a giving to others, taking on, if not slaying, the collective dragons, the institutional pathogens, that often seemed to be as much the source of human misery as our historical interactions with hurtful or depriving individuals. Like 12 step work in AA, which follows the work of abstinence and repair in alcoholism with a commitment to community service, some effort to contribute to human well-being outside of one’s immediate family I now believe is an essential dimension of the therapeutic process. Thus, social action and inner healing have become, for me, inseparably linked.
My youth seems to have been consumed with an endless credentialing. Get this or that “ticket” so that you can do what you really want to do later, as if one ever can fully know. College followed high school; medical school followed college; and various house officerships followed one another (internship, adult psychiatric residency, child psychiatry fellowship) in a sequence of relentless preparations broken only by two crucial years in Japan working as a psychiatrist in the US Air Force. I think of how my children have taken time after high school before college, and after college before graduate school, to travel, to work and play, and to learn about themselves and the world. This was unthinkable to my career minded family, where even the traditional college junior year abroad was considered an indulgence.
But why did I comply with this constriction of life and vision? I like to think that the 1950s and early 1960s were like that, but I believe now that there was also a failure of imagination, a fear of breaking with my subculture’s program for fulfilling ambitions and acquiring prestige. Things could have happened then that were different. When I complained as a junior staff person to Jack Ewalt, my boss at the Massachusetts Mental Health Center, that I did not have enough time to spend with my family, he made it clear that the work (to go up the career ladder) came first, and I should make appointments, as he had done, to see my small children. Mercifully for children and parents, all that is changing now. Psychoanalytic training should have helped, but it didn’t. For psychoanalysis contributes more to understanding than to liberation. It can point the way to the experiences needed for personal growth, but it can also instill a certain self consciousness, an overemphasis on an obsessive kind of self reflection.
One of the most challenging areas for psychology is the study of how identity both changes and remains the same throughout a person’s lifetime. We can identify a kind of core, containing in my case a reformist zeal, a certain pleasure in shaking things up. Even as a psychiatry resident, I was trying to replace the inpatient services at the Massachusetts Mental Health Center (MMHC), formerly the Boston Psychopathic Hospital, with partial hospitalization programs. But what has changed, at least for me, has been the size of the playing field. The scope of what I have undertaken seems continuously to have widened. In my writings, and in more direct social action, I have always been trying in some way to change the way people see or define themselves first as individuals, later in relation to other groups, and, most recently, within the cosmos itself.
In the fall of 1958, I went to Washington to speak with the consultant to the Surgeon General about where I might be assigned for the 2 years of obligatory military service that lay ahead – doctors could do that then. I had hoped to be assigned to a base near Boston so I could simultaneously pursue psychoanalytic training. Colonel Paul Eggertson would hear none of this. Wearing a colorful California type print shirt, he showed me in his characteristic breezy manner a map of the world with pins stuck where the Air Force (I had chosen the Air Force because it seemed more romantic) had assignments for psychiatrists. He seemed determined to send me overseas whether I liked it or not. Wiesbaden in West Germany was the plum for career officers, and Wheeler in Libya was out for a Jew, which left France, England, and Japan. Eggertson had loved his tours of duty in Japan, and I should have suspected what was going to happen. If he insisted on sending me out of the country, I preferred England or France. My orders for Japan came a few months later. I believe now that Eggertson knew this would be good for me. If he is still living and ever reads this, I want him to know that he has my eternal gratitude.
I was married in July 1959 to Sally Stahl shortly before leaving for Japan, and the 2 years there were crucial for all that has followed. Tachikawa Air Force Hospital, 20 miles west of Tokyo, was the “tertiary care” (base) hospital for the Air Force and Army in the Far East. Although 1959-1961 was a period between wars, I learned about the stresses of service for young men, the ruthlessness of military institutions, and the emotional trauma of cultural displacement for men, women, and children. Above all, this was my first experience of living in a foreign culture, and I came to realize how profoundly ethnocentric my view of the world had become.
In some ways Japan was a 2-year honeymoon. Sally and I lived in part of a large, old Japanese style house in the village of Akishima near the base, and my first son, who was born there, was treated by our Japanese helpers and other friends with the reverence that only this complex and contradictory people bestow on infants and small children. I learned enough Japanese to speak with my neighbors, and life in Akishima taught me how fanatically ethnocentric and ecologically destructive we Americans can be. My first lesson on that score came when I discovered to my horror that the energy load created by our electrical appliances and 60 watt light bulbs required that the entire village be rewired.
We returned to the United States in the summer of 1961 with our 15 month old son Danny, whose irritability and diarrhea reflected his separation from Japan, especially from Fujimoto-san, our devoted housekeeper who had loved him as if he had been her own child. I soon began a child psychiatry residency at the Massachusetts Mental Health Center, followed later by training in child analysis. Work with children has, in a sense, kept me honest. Children can hold us closer to the worlds of myth and imagination. They invite us to get down on the floor with them and make it difficult for the therapist to escape into his head. Working with children clinically, like raising them, can keep our spontaneity alive. Children live in a world of feeling and action and remind us of the continuity of generations. It is often with the threats and possibilities for their futures in mind that we work to create a better world.
During my child psychiatry residency, with the encouragement of psychoanalyst Peter Knapp at the Boston Psychoanalytic Institute (where I began training in the fall of 1961), I undertook a study of children’s nightmares, which led to several articles and my first book, Nightmares and Human Conflict, first published in 1970.(2) Nightmares and night terrors, as I understand them now, are profound expressions of human vulnerability. They occur when the psyche is threatened both from within and without and reflect the struggle to confine the terrors of existence to the nighttime. When this is not possible, when the center does not hold, psychological fragmentation can occur, and, as Mark Twain once wrote, the fears of the night can become the madness of the day.
Some time in the fall of 1964, my brother in law, Sidney Ingbar, told me that Harvard Medical School, where I was now a junior faculty member, was developing an affiliation with the Cambridge City Hospital. This community facility, less than a mile from Harvard Square, had fallen on hard times and could not maintain the quality of its services in a metropolitan area where teaching hospitals were attracting the best trained physicians, nurses, and other personnel. In response to initiatives of town physicians and Cambridge officials, the Medical School arranged with the hospital administration to assign full time chiefs of medicine, surgery, and pediatrics to begin in the summer of 1965. These chiefs would report to “parent” department heads at the Boston City (then a Harvard teaching hospital) and Massachusetts General Hospitals. The school was acting out of a combination of motives. On the one hand, there was the opportunity to develop a model of community based primary health care. At the same time it was embarrassing for the university to have a derelict city hospital virtually in its own neighborhood in an age of expanding academic medicine.
Feeling somewhat restless in my middle management position in charge of an inpatient service at the Massachusetts Mental Health Center, then Harvard Medical School’s central psychiatric teaching facility, I asked Sid Ingbar what was planned for psychiatry at Cambridge City Hospital. He was based at Boston City and was in on the initial planning, having been asked by his chief, Dr. Maxwell Finland, to be the first Harvard chief of medicine at the newly affiliated hospital (which he declined). Sid told me that psychiatry was under medicine at Cambridge, and we discussed the possibilities for developing unique mental health services based at the hospital. In a note to myself dated December 28, 1964, I wrote “virgin area – exciting.” Over the next few months I had conversations with a number of people who were responsible for the development of the Cambridge affiliation and persuaded Jack Ewalt, my chief and chairman of the Harvard Department of Psychiatry, that he should form a direct affiliation with the Cambridge City Hospital and permit me to oversee the development of the services and teaching program there. He agreed, and residents began a rotation in Cambridge as consultants on the medical and surgical wards in the summer of 1966.
Federal laws passed in the framework of the 1963 Kennedy Mental Health Act provided funding for staffing and construction of mental health facilities throughout the United States. In order to be eligible for these funds, the states had to come up with plans that involved creating regions or “catchment areas” within which mental health and retardation programs would be developed. In 1965, the cities of Cambridge and Somerville, with a total population of nearly 200,000, were designated as one such catchment area. Community leaders in the two cities considered the possibility that the Cambridge City Hospital might become the central facility of a potentially outstanding community mental health center, affiliated with the Harvard Medical School through the Department of Psychiatry.
After 2 years of planning for mental health services in Cambridge and Somerville from the Massachusetts Mental Health Center, I moved in July 1967 into an office in the former nursing school that was once connected with the Cambridge City Hospital (renamed the Cambridge Hospital in the late 1960s to remove the onus of the word “City”). This seemed at the time like a lonely journey into a foreign jungle, for when it came to public psychiatry, Cambridge was a new frontier despite its proximity to Harvard and the many citizens in Cambridge and Somerville committed to the development of high-quality community services. At the same time, what made this opportunity so exciting was the chance to put together city, state, and private resources with the backing (if it could be secured) of Harvard Medical School to create a mental health service system that cared for all the citizens in our area, especially, as my dear late colleague and friend Lee Macht phrased it, “those unable to take care of themselves.”
Those of us who worked together in the 1960s and 1970s to create the Department of Psychiatry at the Cambridge Hospital and the Cambridge/Somerville Mental Health and Retardation Center shared a vision, which seems still to endure despite the medicalization of psychiatry generally and the dehumanization of mental health systems in this country. It is hard, like anything deeply felt with which one’s life has been intimately associated, to put this into words. It has something to do with holism and spirit, building an institutional system that combines the intellectual riches (the academic resources of Cambridge have been important for this effort) with a dedication, quite fierce at times, to serving others relatively selflessly.
Power has been important, especially for the enrollment of local, state, and national political leaders in the department and hospital’s mission. But it has been power used in the context of love and service. It is striking to me after 30 years of association with the Cambridge Hospital that people with “big egos,” who use their work too unthinkingly for personal ambition and advancement, or become trapped in hierarchical forms of professionalism, do not last there very long.
The Cambridge “system” has its ways, sometimes gentle, sometimes tough, of putting people out on the sidewalk with a one way ticket home. The Cambridge Hospital straddles geographically and psychologically the junction of the city’s town and gown communities. Perhaps it is the more than 350 years of working out this accommodation that has provided the background for the hospital’s culture. For it seems to be those who can bridge the hard edged, sometimes detached, requirements of the academic teaching hospital (albeit one primarily devoted to basic, hands on services) and the rough and tumble directness of city and community life and relationships that appear to survive best in our setting.
Furthermore, psychiatry in the best sense means the capacity to suspend one’s personal ambitions in order to be able to perceive and identify with the needs of others at both the individual and organizational levels. The success of the psychiatry department at the Cambridge Hospital has resulted, it seems to me, from just this quality. Our department, beginning with the work of its pioneers, has been appreciated in the city for its responsiveness to the community’s needs and for the willingness of its members to put aside personal agendas in the service of a larger purpose.
In my leadership role, what I sought to help create was a structure that was truly sensitive to individual human needs within a caring institutional context. I wanted to develop a model for mental health services that placed the knowledge of neuroscience and psychopharmacology within a psychosocial, humanistic, and even spiritual context. My style of leadership – easier perhaps for others to define than for me – has been to enroll people in a shared vision of possibilities that stretch their imagination while at the same time encouraging maximum freedom and responsibility taking within the limits of personal and organizational realities. This has applied to everyone from junior mental health workers or other paraprofessional levels to senior medical faculty.
The years 1967 to 1971, when we began our own psychiatric residency at the hospital, were heady years for those of us involved in developing the department and the Mental Health Center. It was an experiment in building neighborhood and community based services in an academic context that seems to have worked. The late 1960s was a time of crisis and opportunity for psychiatry in particular and Cambridge Hospital in general. I cannot acknowledge adequately the enormous contributions that so many dedicated people made to the development of the Cambridge and Somerville health system during those years, for the realization of organizational possibilities depends almost entirely on the commitment of individuals and the willingness of those people to submerge their private agendas within the context of a larger, shared purpose. I fear even to mention my colleagues and friends of those times lest I offend someone whose contribution was essential or vital but whose story does not intertwine quite so directly with my own.
Edward Ehantzian, one of the residents in my training group at MMHC and a warm aristocrat of working class Armenian background who has never lost the common touch, began to go to Cambridge Hospital at the beginning of 1966 to supervise the rotating residents and begin the development of consultation/liaison (CL) and emergency services. The late Peter Reilly moved with me to Cambridge in July 1967 as the first chief resident and helped to set limits with me to the services we could provide while planning for the future. My secretary and assistant, Patricia Carr, was the only other person who crossed the river with me to Cambridge that summer. The creative and supportive part she has played over three decades has been central to the whole enterprise. Robert Reid, who had pioneered child and community services in Cambridge since 1955, became the first director of the mental health center, while I was in charge of its clinical services. The trust he had built among citizens and community leaders throughout Cambridge was essential to the success of our work. Along with William Ackerly, who developed the Somerville Mental Health Center in the 1960s, we worked as a kind of trio in putting together the pieces of the larger Cambridge/Somerville Mental Health Center structure.
In the summer of 1968 I was joined at Cambridge Hospital by James Beek and Lee Macht, former trainees of mine at MMHC, both of whom had completed 2 years of a military service equivalent at the National Institute of Mental Health in Washington, and by Susan Miller (later Susan Miller Havens), who had been a student and staff nurse at MMHC. While still in her mid 20s she developed the psychiatric nursing services in Cambridge. Sue went on to obtain an Ed.D. at Harvard and has become a national leader and expert in the field of adoption studies, services, and policies. The savvy of Beck and Macht about the mental health grant process from the other side – Jim had actually worked in the federal office that awarded the grants and knew how to write applications for them – greatly facilitated the process by which Cambridge and Somerville were awarded a $900,000 staffing grant, the largest given up to that time to any area. This grant, which provided for inpatient, outpatient, partial hospitalization, emergency, alcohol, drug, child, mental retardation, and other basic services, went into effect in July 1969 after many community meetings and late night calls to key Cambridge and Somerville state legislators to be sure that the item was not deleted in the logrolling that still accompanies the political process.
The role of Lee Macht, after whom the former nursing school building that houses the psychiatry department offices (which now occupy more than three floors) was named after his death in 1981, can hardly be described. He was my closest colleague and ally in the struggles of the early years. There was nothing we did not talk over, and the combination of wisdom and caring that he brought to the clinical and political work of building the department was unique, especially in someone so young. Lee, along with many of the early founders of the department, including Bob Reid and Bill Ackerly, was a child psychiatrist, which probably contributed to the strong developmental, family, and neighborhood orientation of the organization. His specialty, however, was neighborhood psychiatry, the provision of services in the locations where people lived that took into account the local realities that affected people’s lives. The extensive system of neighborhood health clinics connected with the Cambridge Hospital owes a good deal to Lee’s influence.
Lee succeeded me as chairman of our department in 1977, and his sudden death in 1981 at age 43 of food aspiration connected with an omental anomaly (the omentum is a fibrous membrane that protects the organs of the upper and midabdomen) was a profoundly tragic episode in the history of the department and the hospital. The former nursing school that housed our department was modernized in a renovation program effected by Myron Belfer, who succeeded Lee as department chairman, and Michael Greene, his chief administrative assistant. The building was named in Lee’s honor – the Lee B. Macht Community Health Center – in a ceremony presided over by Harvard’s President Derek Bok and city officials. In addition to the psychiatry offices, the building now houses the administrative offices of the Cambridge Health Commissioner and the Departments of Medicine, Surgery and Pediatrics.
A central figure in the organization and development of health services in Cambridge was James B. Hartgering, who was recruited in November 1967 by Leona Baumgartner, a pioneer in American public health, to become Commissioner of a newly reorganized Department of Health and Hospitals. A former army colonel, Hartgering had been an advisor on health science matters to President Johnson. He was a harddrinking, no nonsense, bear of a man whose warm but gruff ways, abrasive at times, got the job done. When he resigned in 1974, remarried, and retired to Cape Cod to live with the secretary who had worked with him at the hospital, he left behind a well-functioning health system that has since become a national model of excellence in service to its community.
I liked Jim Hartgering and worked well with him. Soon after we met, the Commissioner decided, as he wrote in a letter of recommendation for my professorial promotion in 1970, that I was “the person most committed to stabilizing the hospital and its internal programs.” As a result, we met frequently one on one or with others to address the endless succession of town-gown, academic, personality, organizational systems, and other administrative problems that were constantly surfacing. Although there is no question that psychiatry benefited from my close relationship with Hartgering, which was itself subjected to criticism and even attack by jealous individuals at times, he had always seen the importance of strong mental health services in a complex and varied community such as Cambridge. My greatest challenge was to remain as disinterested and nonpartisan as humanly possible in addressing non psychiatric problems with the Commissioner, especially those involving the Department of Medicine, while at the same time functioning as head of our department.
With Hartgering’s insistence, we opened, in September 1968, an 11-bed inpatient psychiatric service, the hospital’s first, on the fifth floor next to a self-care unit in the newly opened main building of the hospital. In retrospect, this may have been a bit premature. We did not yet have federal and state funding, and our thin staff was dependent on city money. Safety precautions were incomplete, and we paid for this when a Harvard law student, recently hospitalized for depression, swallowed some Clinitest tablets that a diabetic self-care patient was using to monitor her urine for glucose and ketones, pried open an inadequately secured window, and dropped himself out, landing on a grassy ledge three floors below. The patient survived the fall with broken vertebrae, but the Clinitest tablets contained lye, which eroded through his gastrointestinal system, causing a severe peritonitis from which he finally died at the Massachusetts General Hospital 4 weeks later.
The young man’s father, who turned out to be a well-connected, wealthy lawyer, sued the psychiatric staff at the hospital. The suit turned out to be a kind of trial for the new service from which we learned many lessons, especially the importance of working closely with bereaved family members after a suicide, which I and other staff members, responding to bad advice, had failed to do. The case was finally settled out of court in 1975.
A dramatic experience in learning to cover my flanks occurred in November 1968, when Dr. Hartgering invited me to a meeting of the Cambridge City Council to address neighborhood anxieties about the new inpatient and community psychiatric services. Despite the fact that the law student was lingering near death at MGH, I was proud and cocky as I listed the benefits of the new unit, especially in preventing patients from having to go to the Westborough State Hospital, 35 miles to the west, which had been the previous fate of the mentally ill in Cambridge and Somerville. I had arranged for Mayor Walter Sullivan, an influential figure in Cambridge, to speak of how pleased one of his constituents had been with the new service, which made a strong impression at the meeting.
I was spiking, effectively I thought, the rumors flying around about what our unsavory patients were doing to themselves or to others in the hospital neighborhood. Things were, indeed, going well, and the Commissioner was pleased until veteran Councilor Alfred Vellucci, known for his ability to go to the heart of any matter, especially when it involved skewering someone or something connected with Harvard, bellowed at me, “Dr. Mack, I heard that a patient of yours jumped out the window of the fifth floor of the hospital. Was that a rumor?” Realizing my balloon was burst, I answered meekly that no, Councilor, that was not a rumor but a fact and explained the matter as best I could. Vellucci would bellow at me many more times in the years to come, but he and his son, Al Jr., who is still very actively involved in the hospital’s administration, became among our strongest allies. Although politically conservative, Vellucci’s caring for the welfare of his constituents is legendary, and we, in turn, were able from time to time to provide support as needed to members of his extensive family. That has been, always, the Cambridge way. In 1977, after I won a Pulitzer Prize for a biography of T. E. Lawrence,(3) Vellucci, who was then Mayor, arranged a ceremony at City Hall in which I was made an honorary citizen of the City of Cambridge.
The development of the Psychiatry Division, which did not become separated from Medicine as a distinct department until 1969, depended largely on the fate of the hospital itself and, above all, on the stability of the Department of Medicine. Indeed, the success or failure of the entire Harvard affiliation, and, in turn, the future of the hospital and its associated health system depended on the medical service – which is probably true for any hospital. It is not surprising then that the most severe crisis that the hospital has undergone in my 30 years of association with it occurred following the resignation in 1968 of Dr. George Nichols, the first permanent medical chief, whose Yankee patrician ways did not mingle well with the give and take of Cambridge’s multiethnic health politics.
The responsibility for selecting Dr. Nichols’ successor resided with Dr. James Jandl, an internationally renowned hematologist and the hand picked successor, as head of Harvard’s Boston City Hospital service, of the legendary medical giant William Castle. Jandl was tailor made not to be able to do this job. Research and specialty oriented himself, he could not really value the primary care mission of the hospital.
As the months went by, the crisis deepened. Senior internists came over from the Boston City Hospital for 1-month stints as acting chiefs of medicine at Cambridge. Supervision of medical house officers became thinner and thinner as senior medical physicians withdrew from the leaderless department. This had the effect of leading the other Harvard Chiefs of Medicine (at the Massachusetts General, Peter Bent Brigham, and Beth Israel Hospitals) to threaten to withdraw their rotating residents on whom the hospital’s basic care depended. Even Jandl threatened to withdraw his own residents. The chiefs gave the end of 1969 as a deadline for Cambridge to obtain a chief of medicine, or they would withdraw the residents. But this created an impossible catch-22 situation, as finding a chief of medicine was the responsibility of one of Harvard’s medical chiefs, Dr. Jandl.
The end of December 1969 was a dark time. The Commissioner, Sid Ingbar (who, partly as a favor to me, had signed on for a longer rotation as acting chief at Cambridge), and I were able to persuade Dean Robert Ebert, who was unable to control his feudal medical chiefs, to order them at least to continue the residents until June 1970. The crisis was temporarily averted, but as the spring of the year arrived, this deadline loomed large, and something had to be done.
An opportunity to resolve the problem presented itself in May. Sid Ingbar, again in cooperation with me, agreed, at Dean Ebert’s request, to take over the chairmanship of the search committee for Dr. Nichols’ successor, as by this time it was clear to everyone involved that Dr. Jandl could not do the job. But there remained the impossible obstacle that any chief would still have to report to Jandl, and Dean Ebert simply did not feel he had the power to change the lines of affiliation. The break came when Dr. John Knowles, then Director of the Massachusetts General Hospital, offered to take over the administration of the entire Cambridge Hospital, including the Department of Medicine.
Such a loss of autonomy was unthinkable to the City of Cambridge and all of us involved with the hospital. But we did not tell Knowles that. Instead, we used his grandiose offer (highly ambitious and able, Knowles would later become president of the Rockefeller Foundation) as an opportunity to resolve our smaller, more specific problem. Such an offer could be interpreted as creating a policy crisis that could be dealt with only at the highest level. Tucking the Cambridge Hospital into MGH, after all, was a matter that could only be decided by the City Government and, appropriately, with the participation of Harvard’s highest official, its President. So Commissioner Hartgering discussed the matter with Dean Ebert, who invited Harvard’s mild mannered President, Nathan Pusey, soon to leave office, to a meeting in the hospital cafeteria. This historic gathering took place on May 26, 1970. It was chaired by the commissioner and was also attended by the City Manager of Cambridge, (then) Mayor Vellucci, members of the Cambridge City Council, Dean Ebert, all the Harvard chiefs of medicine, John Knowles, and all of the Cambridge department heads.
The first 2 hours of the meeting were spent in reviewing in detail the history of the problem and the looming catastrophe, as the medical residents were scheduled to depart at the end of June. As it became clear to Dr. Knowles that the real agenda for the meeting was not his proposal to take over the hospital but the problem of breaking the impasse in medicine, he gracefully subsided. The meeting came to a definitive conclusion when President Pusey turned to Dean Ebert and, in his soft voice, instructed him, according to my notes (I took virtually verbatim notes, which, when typed up, ran to 7 1/2 pages, single spaced), “to call a meeting of the chiefs of the Departments of Medicine with Dr. Ingbar, the Dean, and Dr. Lee [Sidney Lee, Associate Dean for Hospitals] in order to resolve the problem of obtaining a chief [of medicine for Cambridge].”
For me this was the turning point, a decisive moment in the hospital’s history, for it enabled a workable restructuring of the search process to occur and placed on record Harvard’s commitment at the highest level to support the hospital in a time of major crisis. No crisis of this magnitude has occurred in the intervening 25 years, in part, perhaps, because of the implicit availability of the power of Harvard’s President and his willingness to get involved if things got bad enough at this sensitive hot spot of town-gown relationships in the university’s backyard.
President Pusey’s words empowered Dean Ebert to remove the Cambridge Hospital’s Department of Medicine from Dr. Jandl’s jurisdiction. Within a few weeks Arnold Weinberg, a brilliant, charismatic infectious disease specialist, was selected by Dr. Ingbar’s committee to be Chief of Medicine. During his 5 years at Cambridge, Weinberg laid the groundwork for a first rate department of medicine. Alcohol services (administered jointly by medicine and psychiatry) and other essential mental health programs could then grow rapidly.
Over the last 25 years the Department of Psychiatry at the Cambridge Hospital has been fulfilling its potential as one of the outstanding psychosocially and humanistically oriented departments in the country. Residency positions with Dr. Leston Havens as residency training director are highly coveted, as are training slots in psychology, social work, and nursing. The medical student rotations under Dr. Alfred Margulies’ leadership receive top ratings. The department has benefited from the able leadership, after Lee Macht’s death, of Myron Belfer, Malkah Notman, and Deborah Moran. Meanwhile, the hospital itself has emerged as one of most distinguished community service institutions in the United States, especially under the wise and strong guidance of its present administrator, John O’Brien. In 1993 it won the prestigious Foster McGaw award for excellence in community service, a $75,000 prize that recognized the vast array of people sensitive hospital and neighborhood based services. These include health care for the homeless, a multidisciplinary AIDS program, school based child and teenage health centers, house calls for the homebound elderly, and linguistic minority programs as well, of course, as various drug, alcohol, and mental health services.
For me the Cambridge Hospital experience lies at the core of my work as a physician. All that I have done since the pioneering years of the late 1960s and early 1970s has derived, at least in part, from what I learned in the trenches of the Cambridge health system. These have been simple principles that begin with community service and the understanding of the psychological and political forces operating in group systems. In any planning process, I have discovered, it is essential to identify and include all those who have a stake in the outcome. People can share in a vision if they are able to participate in its fulfillment. Individuals who feel excluded will undermine what you are trying to achieve, even when they do not consciously know or acknowledge that they are doing so. A common ground of shared interest can almost always be found, as I discovered with the McGovern family of obstetricians. The McGoverns – the late Philip Sr. and his sons Philip Jr., head of obstetrics at the Hospital, and Arthur – had delivered a good proportion of the babies of Cambridge over several decades. Initially skeptical about our services, they recognized the value they had for their patients and the community and became among our staunchest allies, opening political doors we could not have passed through on our own.
Another principle concerns the use of power. As physicians, we are always engaged in power relations of one kind of another, although we may not recognize this. At the same time, we have little understanding and surely no training about how power works or how to use it. For me this was a big part of the learning on the job in Cambridge. I found that I had to discover where decision making power resided in the city, state, medical school, and other institutions involved in Cambridge/Somerville health care, find a way to communicate with these individuals, and bring them into an evolving shared vision of an exemplary health care system. The use of power can be frightening, especially when we deny that we are dealing with it. But this fear generally relates to the egoistic aspect, to relating the project to oneself. The best antidote, I have learned, for this anxiety, which can enable one to proceed, is the realization that we are simply playing a role that is a vehicle for serving a larger purpose.
The stakes often seemed high during the years when the Harvard affiliation in Cambridge was becoming established, and I found myself deeply identified with the project and the success of the venture. This made for some highly worrisome times, especially when one or another vital program was threatened because of competing economic and political priorities. I began this work in the relatively prosperous times for mental health of the 1960s. I think I would have found the economic and bureaucratic savaging of menial health care since the 1970s personally intolerable and admire the administrators who endured and prevailed in these difficult times.
My work in Cambridge came to parallel a strong interest in the life and psychology of T. E. Lawrence (“Lawrence of Arabia”). In September 1963, when Sally was 8 months pregnant with our third son, Tony, we went to see the film Lawrence of Arabia. We came late and ended up in the second balcony. The theater was hot, the desert scenes were hot, and Sally was very hot. But I was excited by the character of Lawrence despite the inevitable Hollywood distortions (T. E. Lawrence, for instance, was 5 feet 4 and Peter O’Toole well over 6 feet). Until then Lawrence had been for me a romantic, heroic figure, vaguely tainted with perversion. The film stimulated me to learn more about him, for he seemed to embody the tension between inner purpose and action and the possibility that an individual might live out a creative vision on the world’s stage. I read everything that I could lay my hands on about Lawrence and wrote to his two then living brothers to see if they would talk with me about him if I came to England. This led to interviews in 1964 with T. E.’s older brother, Robert, in Dorset and youngest brother, Arnold, in London. Two other brothers were killed in World War I.
Arnold, an archeologist as T. E. had been, was only 64 when I met him. He became a lively, witty, and helpful collaborator who grasped well my various notions about his brother’s psychology and motivation. It was he, more than anyone else, who made the book possible, for he led me to many unpublished sources, including embargoed family documents, as well as to family friends, service companions, and a variety of other friends and colleagues of his famous brother. My research was a kind of treasure hunt in search of people and papers that took me all over the British isles, to Majorca (to interview Robert Graves, who wrote, after Lowell Thomas’s popular potboiler, the first real biography of Lawrence), and, of course, to the Middle East, where I was still able to find Bedouin Arabs who had fought with Lawrence during the years of the Arab Revolt.
I learned several important things in this study, which was published, finally, in 1976 as a book, A Prince of Our Disorder: The Life of T E. Lawrence,(3) that won a Pulitzer Prize for biography. First, I developed a strong distrust of popular representations of controversial figures. For Lawrence was far from being just a romantic impostor, as he was often described. Rather he turned out to be, for me, a complex figure who, despite a number of psychological problems, was the principal force in galvanizing and supporting the Arab revolt against Turkey and had a fair amount to do with shaping the map of the contemporary Middle East. Second I developed a profound respect for what a human being can do with, or in spite of, a great deal of personal conflict and psychopathology if an avenue for individual personal expression, including political involvement and action, is available. Indeed, I have become forever deeply suspicious of any psychological analysis that looks only at pathology and overlooks the creative enactment that a person has pursued in his world.
Finally, from Lawrence himself, I learned about working as a stranger in a community or culture that is not one’s own. In his case, his illegitimacy and the marginality of his family background and birth contributed to the fluidity of identity that may be a prerequisite of special creativity in this area. My search for T. E. Lawrence in Europe and the Middle East seemed to parallel my own more modest work in Cambridge, where I often felt like, and was, pretty much of an outsider, at least for many years.
Lawrence’s “Twenty Seven Articles,”(4) published during the war among his dispatches from the Middle East, set down basic principles for working with his Arab allies. They contain many psychological principles of leadership that apply when one is not directly in charge but must work through others in positions of authority, as was true for him among the Arab chieftains and, of course, for me in Cambridge. In Article 8, for example, he wrote,
Your ideal position is when you are present and not noticed. Do not be too intimate, too prominent, or too earnest. Avoid being identified too long or too often with any tribal sheikh, even if C/O of the expedition. To do your work you must be above jealousies, and you lose prestige if you are associated with a tribe or clan and its inevitable feuds. (p. 464)
In 1966, when I was in the early stages of the Lawrence project, I consulted L. Carl Brown, who was then a young professor of political science at Harvard specializing in the Middle East, about some of the things I needed to know if I were to venture into the history and politics of that tortured region. Six years later, by which time Carl had moved to Princeton, he invited me to talk about Lawrence at a huge international conference he was planning on the psychology of the Middle East. The conference, which took place in May 1973, was followed by several smaller meetings at Princeton that addressed specifically the psychopolitics of the Arab Israeli conflict. At these meetings I met psychiatrists William Davidson, Rita Rogers, and Vamik Volkan and foreign service officer Joseph Montville, who were engaged in looking at the emotional (we rather neglected the spiritual elements in those secular days) forces that were driving the Middle East conflict.
Over the next 8 years I participated with Egyptians, Palestinians, and other Arabs, Israelis, and Americans (including prominent American Jewish leaders) at many conferences and problem-solving workshops in the United States, Europe, and the Middle East. The purpose of these meetings, some of which were held under the auspices of the American Psychiatric Association, was twofold: to bring together unofficially representative protagonists of parties to the Arab Israeli conflict in a safe setting who might otherwise be prevented from meeting by the political realities of the conflict (Montville has called this process “track II” diplomacy to distinguish it from official or “track I” diplomatic relationships); and to evolve a body of analytic principles that might be applied usefully in the amelioration of this and other ethnonational conflicts. Interactive conflict resolution is a growing field whose recognized value has not been matched by the hoped for results, primarily because leaders determined to exploit for personal and nationalistic ends the historic hurts in their geographic regions have often been unwilling to permit the conciliatory principles of track II diplomacy to play a significant part in the political process.
My participation in the Middle East peace process involved me in a number of private, behind the scenes efforts to communicate between parties to the conflict. One of these involved a meeting with Yassir Arafat in Beirut in April 1980, arranged by Walid Ehalidi, a Palestinian professor and leader who had become a friend at Harvard. Beirut was then in the midst of the anguish of its prolonged civil war. I had been invited to speak about Lawrence and related matters at the American University of Beirut (AUB) and to consult to the dean of the AUB medical school, who was trying, despite the wartime conditions, to improve the psychiatry department.
I was picked up at my hotel by armed Palestinians at night, taken through the darkened city and various checkpoints to a home in the Beirut district of one of Arafat’s friends, where the meeting, which included other Palestimian leaders, would take place. The “Chairman,” also referred to by those close to him as the “Old Man,” arrived shortly after I did. Of relatively small stature, Arafat wore army clothes and a black and white kaffiya and showed the thin beard that is familiar to us. In my notes right after the meeting, I wrote, “He is a bit paunchy and yet there is a sympathetic quality to the man, a kind of directness. He meets you eye to eye, and you feel a determination and a clarity of mind.”
The meeting, which lasted several hours, was concerned with a detailed review of the facts of the conflict, the legacy of resolutions proferred, neglected, or broken, his personal grief over the Palestinian diaspora and losses sustained in the conflict (Hammami, one of Arafat’s closest associates, had just been murdered by Iraqi extremists), and the deep sadness on all of our parts that greater trust and reason had not prevailed. Specifically, Arafat hoped that I would convey to the American Jewish leaders with whom I was then in contact his willingness to settle for a Palestinian homeland on the West Bank and Gaza and to do my part in dispelling the notion that such a step would be but the first stage in taking over the whole of Palestine, i.e., the destruction of Israel. As I left, there were about a half dozen armed PLO gunmen outside the apartment whom I had not noticed before. The same car was waiting, and I was driven efficiently back to my hotel.
Ethnonationalism serves a wealth of deep individual and collective needs, beginning with survival but including as well the desire to belong to a body or entity larger than oneself and the sense of positive or negative self esteem, power or powerlessness, that accompanies the fate of one’s ethnic group or nation. But at root, ethnonationalism is a matter of identity – of mistaken identity in my view. The fact that many millions of people have died for ethnonational causes, voluntarily or at the hands of leaders who have manipulated their minds, coerced their participation in the slaughter of nationalistic wars, or murdered them outright with the justification of one or another genocidal ideology is perhaps the lead story of the century now coming to a close. The only way to avoid the final omnicidal convulsion, it seems to me, would be to discover a different, expanded, human identity, what the Cherokee Nation has called our “original instructions.” This would involve a redefinition of who we are at a human level, a species that has unique ethnonational subgroups within it perhaps, but one that is connected fully to all human groups on a planet in which we discover ourselves to be, once again, connected spiritually and nondenominationally at a cosmic level.
At one of the Princeton meetings in November 1973, I met Rita Rogers, a child psychiatrist from California, who was there to present a paper on David Ben Gurion, one of the founders of the state of Israel. Born Rita Stenzler, she grew up in the town of Radauti in the province of Bukovina in northern Romania. Her parents were living in Haifa in 1973, and she had made frequent trips to visit them. Her most recent trip had been a mission of mercy to tend the wounded of the recent October or “Yom Kippur” war, where she found in a Haifa hospital among the injured men the as yet to be identified son of one of her friends who, unable to speak until he had recovered from surgery, was convalescing from a shrapnel wound to his head. I was impressed then with Rita’s determination and courage. As we became friends over the next few years through our common efforts as psychiatrists addressing the psychological aspects of ethnonational conflict, she told me stories of her idyllic haute bourgeois childhood in Romania, the years with her family in a Romanian/German concentration camp, and the odyssey of her escapes from several communist regimes in the years after the war.
When I was asked in 1979 if I would contribute to the Harvard/Radcliffe biography series on American women, I thought I would like to write about Rita,(5) if she would qualify as an American, since she was 28 when she came here in 1953 to train in psychiatry. Deane Lord, director of the Harvard News Office, and Merloyd Lawrence of Addison Wesley publishers, were in charge of the series and agreed to my proposal. Rita’s and my researches together in the early 1980s took us to the Ukraine, Prague, Vienna, and, of course, the Bukovina – the places that had figured prominently in her life. We found the tragic remnants of the decimated Jewish communities of Eastern Europe, and yet Rita’s story became as much one of transformation and community as of tragedy and suffering, although there was so much of both. For she had been fortunate and, through her wiles and strengths had been able to save her family and to emerge from the war and her years of flight relatively unscarred.
Rita’s life became for me an example of the triumphant human spirit, of the possibility of transcending malignant ideologies without bitterness. She had become a leading figure in political psychology, translating her personal experiences into public commitment. Her personal example, together with her writings, bear witness to the possibility that destructive human divisions, what Erik Erikson has called pseudospeciation, can be overcome and that a shared human destiny may yet be discovered.
Of the many stories that we shared, one seems to capture best for me what my collaboration with Rita was really about. In June 1981, we brought with us to Eastern Europe her daughter Sheila, now an eminent young journalist, and my son Kenneth, now studying international relations at Columbia University, then respectively 20 and 19. On a train from Bucharest to Vinnitsa in the Ukraine, from which we were to go on to Mogilev Podolsky where the camp had been, we were awakened at the Soviet (Moldavian) border town of Ungheni in our four person couchette at 4 am – this kind of thing always seems to occur at 4 am in Eastern Europe – by three or four customs officers. The man in charge wore a gray civilian suit and spoke English. The others wore khaki military looking uniforms and did not say much. We had been bumped off the train on which we had originally been booked and transferred to this train, so evidently they did not have us on any list. Suspicious and confused about the purposes of four people, including an unmarried man and woman, traveling with passports under two names, the man in the gray suit instructed the other officials to dump all of our tape recording and camera equipment into several bags, which they removed from the train.
Rita, remembering her anxious year as a nomad in Bessarabia and northern Bukovina (taken by Stalin in a 1940 pact with Hitler and reclaimed in 1944) after liberation of the camp in April 1944, was afraid to reveal her history to Soviet officials and insisted that I represent our group and declare our purpose to be “tourism.” This story did not go down at all with the man in the gray suit, who interrogated me in the corridor of the sleeping car as Sheila, Ken, and Rita remained in the couchette. He wanted to know how Rita and I had met, the kind of “medical” work we were doing in the Soviet Union, and the real purpose of this visit. The situation grew increasingly tense, for it was clear to him that tourists did not travel this way.
By the time of this trip I had become active in Physicians for Social Responsibility (PSR) and the physicians’ antinuclear movement, but Rita had warned me not to talk about that because of the political aspects. Our plight on the train, however, seemed rather grim to me, so I decided to take a risk. I asked the man if he had heard of the physicians anti nuclear movement and particularly of International Physicians for the Prevention of Nuclear War (IPPNW), whose first congress had recently been held at Airlee House in Virginia, an hour outside of Washington, D.C. I knew that the Soviet copresident of IPPNW, the eminent Russian cardiologist Evgeny Chazov, had spoken extensively after the congress on Soviet television about the dangers of nuclear war, the necessity of prevention, and the warm collaboration that was developing between the Soviet and American representatives. When he indicated his familiarity with IPPNW, I told my interrogator that not only had I attended this congress, but I had sat at Dr. Chazov’s table and given a toast for peace with vodka brought by our Soviet friends. Immediately the man’s demeanor changed, for evidently he had seen and heard Chazov on Soviet television. “You drank vodka with Dr. Chazov?!” he exclaimed warmly and enthusiastically. “That’s wonderful!”
He told me then that everything would be fine. We were to go into the station building for some routine formalities, consisting, as it turned out, of brief questioning by another customs official, after which we were taken back to the train and our belongings promptly restored to us. Needless to say, Sheila and Ken had been wondering if they would see their parents again, and, as the train got under way again, I had to explain to Rita as well what had happened, for there had been no chance to tell her in the station. For me this experience was a sharp lesson in the necessity of being able to disobey instructions (in this case Rita’s) when necessary. But more importantly, the incident testified to the vital importance of human connection and warmth, which alcohol has often facilitated, for transcending the dangerous separations that borders and boundaries create artificially between human beings.
In 1977, social psychiatrist Perry Ottenberg asked me to join a task force he was organizing under the American Psychiatric Association to examine what was then euphemistically called the “Psychosocial Aspects of Nuclear Advances.” Also included in the group were Jerome Frank, a pioneer in our profession in looking at the destructive human forces that were driving the nuclear arms race, and child psychiatrist William Beardslee, with whom I would collaborate over the next few years in a number of studies of the impact of the threat of nuclear war on children and adolescents. Rita Rogers was its chairperson. In addition to examining the effect of the arms race on children, the task force also considered the psychology of the Soviet/American relationship, nuclear terrorism, and the emotional fallout from the 1979 accident at the Three Mile Island nuclear power plant in Pennsylvania.
At the end of the 1970s my oldest son Daniel, who was then a student at Berkeley, was taking part in demonstrations against the Diablo Canyon nuclear power plant in California, and I remember saying to him that the nuclear arms race represented an infinitely greater threat to life than nuclear energy. His reply was telling, for he said that the political and military structure and secrecy surrounding the creation and deployment of nuclear weapons made that world seemingly impenetrable. It was precisely the political and psychological penetration of the nuclear weapons creating structure that was the principal enterprise of the physicians antinuclear movement, led by cardiologist Bernard Lown, the American copresident of IPPNW, and pediatrician Helen Caldicott, president of its American component, Physicians for Social Responsibility (PSR), which reached its peak effectiveness in the early 1980s in response to the escalation of the threat of nuclear war in the early years of the Reagan administration.
Our message through PSR, delivered in countless articles and major symposia around the country, was a simple but telling one: an actual nuclear “exchange” (one of the many euphemisms used to lull us into obliviousness in relation to the actualities of the nuclear threat) would bring destruction of human life on such a scale that no realistic medical response was possible. The only sane approach was prevention, we said, but that, of course, meant effective deescalation of the confrontation between the United States and the USSR. So, inevitably and, I thought, rather reluctantly, the leaders of the physicians’ movement were drawn into the political arena, and our work received major media attention. Dr. Caldicott met with President Reagan, and Dr. Lown formed a positive relationship with Mikhael Gorbachev when he came into office in 1985.
Needless to say, all this was not well received by the conservatives in the White House and Congress, who challenged our legitimate right as physicians to become involved in political and military policy matters. Perhaps the most important outcome of the physicians’ antinuclear movement, outside of whatever contribution it may have made to the reduction of the nuclear threat, was the clear establishment of the fact that the nuclear weapons problem was not the preserve of a secret government, scientific, and military elite. It was, rather, a crisis of human identity, an outcome of extreme ideological passion and conflicting nationalisms, a fundamental impasse in the ordering of group relationships on the planet. It was, therefore, a matter that was then, and remains, every citizen’s responsibility.
At its peak in the early to mid 1980s PSR had 40,000 physician and nonphysician members, and IPPNW reported that physician participation in the more than 50 nations who were represented in its international congresses reached the hundreds of thousands. In 1985, IPPNW was awarded the Nobel Peace Prize for its work in reducing the threat of nuclear war. At the “heart” of this organization was the longstanding personal relationship of two cardiologists, Bernard Lown and Evgeny Chazov. Their vision of peace had grown out of a friendship cultivated in the course of many meetings at medical conferences in the years before they thought of starting IPPNW in 1980. My own work in PSR and IPPNW was focused on the emotional impact of the nuclear weapon competition and the threat of nuclear annihilation on children and adolescents and later on the psychosocial and psychospiritual roots of the arms race itself.
In October 1980, Rita Rogers invited Jack Ruina, an MIT professor of electrical engineering who had worked on defensive ballistic missile systems, to consult with our task force. Ruina made no secret of the fact that he considered the arms race to be irrational at its core. Hearing this from someone who had, himself, been one of the nuclear insiders, a group that social scientist Carol Cohn called “defense intellectuals,”(6) emboldened the task force, and me especially, to look at more fundamental psychosocial causes of the nuclear weapons competition. With Ruina’s encouragement and contacts he and colleagues of mine at the Kennedy School of Government of Harvard provided, I was able to interview nuclear weapons decision makers in the Congress and executive branches of government, the weapons labs, and private industry. These included Robert McNamara, Robert McFarland, David Jones (former Chairman of the Joint Chiefs of Staff), Jimmy Carter, and Edward Teller. The purpose of the study,(7) which was originally to have included Soviet weapons makers, was to understand how each of these men understood his role in the nuclear weapons acquisition or policy process in order to reveal how the nuclear war system as a whole was propelled.
What struck me most powerfully was the fragmented nature of responsibility in relation to the nuclear threat that permitted each individual to do his particular job with a minimum of actual belief in the Soviet menace. Even Jimmy Carter felt that his efforts to put into practice his own desire for a better relationship with the Soviet Union was curtailed by the Congress and his need to make so many compromises to achieve the most modest of his objectives. For a number of these individuals, professional responsibility and competence took precedence over the vast potential consequences of the project in which they were engaged.
Of the 20 bomb makers whom I interviewed, only Teller, whom I met with at the Cosmos Club in Washington in 1986, was a driven ideologue. But perhaps it only required a few such men to provide the emotional fire and evoke the fear that propelled the competition on the American side. Teller’s demonization of the Soviet Union, which was fused in his mind with the Nazi regime and the Holocaust, was unquestioning and, it seemed to me, quite irrational. When I asked him if he really believed that his invention, the Strategic Defense Initiative (SDI or “Star Wars”), could really work, he replied that it might save the State of Israel. The study taught me above all the danger of technocratic expertise and its associated fragmentation of responsibility in a world filled with instruments of mass destruction, what I have called “malignant professionalism.”(8)
Studies conducted by Beardslee, me and others of children’s fears of nuclear war, though methodologically flawed, touched a raw nerve in the culture and were used politically by Caldicott and the media. Headlines such as “Your Children Are Afraid” were blazoned across the country in the early 1980s, and letters of children to President Reagan led him to say in a November 1982 speech how troubled he was to learn of the fears and nightmares of children related to the nuclear threat, which seemed to be a factor in beginning his initiatives toward Soviet leaders. In 1984, I testified about this work before the House of Representatives Committee on Children and Families. The political impact of the not surprising finding that children and adolescents in this and other countries ranked high among their worries the possibility that they would not have a future because of the danger of nuclear war lay in the fact that the arms buildup was failing in its fundamental purpose – the provision of security, which is, at its root, a subjective, emotional matter. Furthermore, children and adolescents, when interviewed, would inevitably cut through the adult denial, euphemisms, and acronyms by speaking of burned bodies, mass death, and wasted landscapes.
In the fall of 1981, following the lead of the city of Cambridge, my son Kenneth decided to spearhead a campaign to provide truthful information about the realities of nuclear war for his home town of Brookline to counter the lying sanitization contained in the civil defense plan that was then being circulated by the federal government. This resulted in the publication of a booklet that Ken wrote with a little help from his parents and consultation from several experts; Ken had to raise private funds in order to have it widely distributed (unlike Cambridge, which had paid for its own pamphlet).
At a meeting of the Brookline Selectmen in January 1982, at which Ken’s proposal was to be discussed, I met Brookline teacher and assistant principal Roberta Snow, who had recently founded Educators for Social Responsibility in order to create curricula for schools that would provide solid information about the realities of nuclear war, the arms race, and the Soviet Union itself. Bobbi and I became comrades in arms, and together with psychiatrists Robert Jay Lifton, Eric Chivian (who had helped to found IPPNW), Richard Chasin, and William Beardslee and theologian Dorothy Austin, founded the Center for Psychological Studies in the Nuclear Age (later called the Center for Psychology and Social Change). The purpose of the Center, which is affiliated with the Harvard Medical School through the Department of Psychiatry at the Cambridge Hospital, has been to conduct studies and provide public education about the psychological and spiritual forces that underlie human behaviors that are destructive on a mass scale. As the immediacy of the nuclear threat has lessened with the end of the cold war, the Center’s focus has shifted to the problems of ethnonationalism, corporate responsibility, and environmental destruction.
In the early 1980s the concentration of my psychopolitical interests shifted from the Middle East to the US/Soviet relationship and its role in driving the nuclear weapons competition. To be politically effective in this dialogue it was not sufficient to underscore the demonization and dehumanization of the other side, whose irrationality and one-sidedness had become quite apparent to sensitive people by the early 1980s. It was necessary, in addition, to sort out the elements of real threat from those. that were the product of our own political behavior or ideological distortions. But, above all, the task of the physicians and other groups working to reduce the nuclear threat was to make clear the collective arrogance, the primal madness, that underlay our and the Soviets’ apparent willingness to destroy life on the planet as we know it over a difference of political perception and social values.
My work with Soviet colleagues through IPPNW, especially psychiatrist Marat Vartanian, led to several trips to the Soviet Union on one or another “track II” mission. In the summer of 1983, with Vartanian’s help, Eric Chivian was able to arrange an extensive series of interviews with boys and girls ranging in age from 11 to 16 at the Black Sea youth camp Orlyonok. To our surprise (we expected control and censorship), the children were allowed to speak freely with us and talked movingly, as American children had, of their fears of nuclear bombs and of not growing up. The film that we made with the help of a Russian film crew was shown on US national television, including excerpts on Nightline, and in communities throughout the United States. It seemed to help to show the common humanity of young people and cut through the anti Soviet stereotyping that was rampant in the United States at that time.
On my first trip to the Soviet Union in October 1979, my wife and I met in Tbilisi, Georgia, a young Russian, Mikhael Meylakh, then a romance language student in Leningrad. The conference, the first to be held in the Soviet Union on the unconscious and psychoanalysis since before the Stalin era, was organized, not surprisingly, by the independently minded Georgians. Meylakh, excited by the chance to meet Western psychiatrists and intellectuals, traveled to Tbilisi, where he came to symbolize for me the as yet unfulfilled opportunities for connection and exchange between American and Russian citizens. I was considering studying Russian, and Meylakh told me that he had a sister, Mirra, living in Boston who gave Russian lessons.
I failed to contact Mirra when I returned, and it was not until I had found myself traveling relatively frequently to Moscow that I looked her up in 1986. To my great dismay I discovered that Mikhael had been imprisoned for 3 years in a camp in the Ural mountains, where he was doing hard labor for no crime other than the exchanging of papers and ideas with Western colleagues and friends and his too great friendliness with people like me. Needless to say, I was outraged and joined the forces that were engaged in trying to get him and other political prisoners released by the Gorbachev regime that had come into power the previous year. The matter came to a head in January, 1987, when Richard Chasin and I were invited by Vartanian to attend an international conference in Moscow on forming partnerships and overcoming enmity.
At one point in the conference someone in the audience went on a one-sided tirade about the unjust American tendency to maintain an enemy image of the Soviet Union. I lost my temper and, as the television cameras rolled, gave a short speech, which I felt encouraged to continue by the approving gestures and faces of the journalists and other Soviets in the audience. I said that their country could go a long way toward changing its image in the United States by releasing unjustly imprisoned people, and I talked specifically about my friend Meylakh. The next morning Chasin and I were to meet with Vartanian, and I was afraid that I might have embarrassed our host, who had reached a high position by treading a fine line with several Soviet regimes. When he greeted us he said, pointing at the ceiling, “John, they liked what you did yesterday up there.” Noticing his gesture I asked if he meant the Central Committee or God. “Here it is the same thing,” he replied. A week or so later Meylakh was released along with a hundred or so other prisoners. I hope that my effort may have contributed to the outcome.
In June 1986, I was arrested with my wife and three sons, together with nearly 150 other people, for crossing the boundary into the nuclear weapons test site in Mercury, Nevada. Without testing, the nuclear arms race could not be maintained. This was my first experience with direct civil disobedience and came about as a result of the fact that the Reagan administration was continuing weapons testing despite a long Soviet moratorium. Daniel Ellsberg, who was one of the leaders of the action, also pointed out how troubled and disappointed I (and they) might feel if I chose, fearing for my reputation, a “support” instead of a more active role. Ellsberg’s words were instrumental in pushing me, psychologically and literally, over the edge.
Ken served 6 days in jail in Goldfield Nevada, and Sally 5 days in Tonopah. Danny, Tony, and I paid our fines and did not go to jail. The example of a whole family getting arrested received wide national media coverage, and Sally organized a group of families against nuclear testing, which resulted in bringing more people to the test site for protests and arrests in 1988 and 1989. It is difficult to know what contribution this nonviolent civil disobedience made to the eventual US moratorium on nuclear testing in 1991. We were told that these actions, which at their peak involved many hundreds of arrests, were effective in influencing congressional opinion against nuclear testing.
I was criticized by a number of my colleagues for moving beyond the role of psychopolitical analysis to direct action. This would, they said, undermine my credibility as an objective academic and might interfere with the funding of studies related to the arms race that we were then undertaking. I thought deeply about this and came to the conclusion, after reading Thoreau and others, that such actions were altogether consistent with the principles of academic freedom, and the idea that any research on human issues could be totally objective and dispassionate was an intellectual myth. Ideas, feeling, and action constitute a kind of unity, an inseparable totality of human expression. I wrote about these issues in an article entitled “Action and Academia in the Nuclear Age” that appeared in the February 1987 issue of Harvard Magazine,(9) which, not surprisingly, received a range of responses from the alumni readership.
In the winter of 1979-1980 my oldest son, Daniel, then 19, came home from a weekend workshop, spread his arms wide, and declared to his startled parents, “I love you.” Danny had been a somewhat competitive teenager who usually had to be right about most things. Such open expressions of loving feelings had been rare until then, and although we wondered what was going on, we were not going to look this gift horse in the mouth. He persuaded Sally and me to take the workshop, an est spinoff that was conducted by Robert and Cynthia Hargrove. The effect of the workshop on me was to begin a process of questioning about so many of the invisible assumptions that stand in the way of loving relationships and keep us trapped in restricted world views. Danny’s initiative, his taking on full strength the process of personal transformation (from which he has never turned back), helped to start me on a path of personal self-questioning and consciousness exploration that began with est and related workshops.
Over the next years I participated in many human transformational activities, worked closely with the Esalen Institute in California in their Soviet American exchange program, developed a halting meditation practice, and became aware of the missing development in the spiritual dimension of my nature. In September 1987 I attended a large conference at Esalen on frontiers of health, which represented the culmination of a several year Soviet American health project in which I had participated that was directed by Dulce Murphy, wife of Esalen’s founder Michael Murphy. Papers presented included talks by Dean Ornish on reducing coronary atherosclerosis through healthful diet and living, Robert Gale on his work at Chernobyl, and Candace Pert on the immunology of AIDS. I spoke on the nuclear war imagery that had emerged in my clinical practice with adults and children.
Stanislav Grof and his wife Christina, were in residence at Esalen at that time. Grof, a Czech born physician and psychoanalyst, had pioneered the development of a new cartography of the mind based on his analysis of several thousand protocols of LSD experiences in patients at the Spring Grove Hospital in Maryland. These experiences revealed a deeper substrate of personality than the biographical motivational structures developed in psychoanalysis. Grof discovered that the several stages of the birth experience left a powerful imprint upon the personality and that we were also affected by what he called “transpersonal experiences,” the capacity of consciousness to separate from the body and identify with any person, object or entity in the universe. Grof moved to Esalen in the 1970s to escape the restrictions on his LSD research imposed by the federal government.
With Christina, Grof developed the holotropic breathwork method, a drug-free technique for reaching the perinatal and transpersonal levels of the psyche that involves deep, rapid breathing with the eyes closed, evocative music, focal body work and mandala drawings(10) practiced in a safe, protected environment. Many thousands of individuals have attended breathwork workshops or experienced individual sessions. In addition to the profound inner healing that can occur, the breathwork method enables people to relive birth or birth related traumata and to have powerful spiritual openings as a result of the deepening of consciousness that is associated with transpersonal experiences.
Grof offered to demonstrate the breathwork method at the end of the conference, and I eagerly, and rather anxiously, decided to participate. This experience, and many subsequent breathwork sessions, persuaded me that classical psychoanalysis was too limited a method for reaching the deeper levels of the psyche. In the first breathwork session (there were 11 of us who breathed, including two Soviet physicians who attended the conference), not much happened for about 30 minutes. But then I found myself beginning to recall images and feel powerful emotions relating to my biological mother’s death, which I had not been able to access in many years of psychoanalysis, and identified deeply with my father’s grief during the time thereafter, allowing me to be more forgiving of his sometimes distant ways during my early childhood. I also found myself “becoming” – not imagining exactly, but something more like being transported into another consciousness – a Russian father in the 16th century whose 4-year-old son was decapitated by Mongol hordes. The effect of this experience was to enable me to feel more empathy for the Soviet doctors at the conference and for the Russian historical experience generally. This, in turn, allowed me to be more effective in my psychopolitical work with Soviet physicians and others, as I felt more capable of seeing the Soviet/American conflict from the other side’s perspective.
The creation of a nonordinary state of consciousness as occurs, for example, in hypnosis, yoga, with the judicious use of psychedelic agents, Grof breathwork, with some forms of meditation, and in shamanic journeys, I have come to feel is a vital aspect of therapeutic work that aims at achieving deep healing and personal change. Increasingly psychotherapists appear to be including some form of non ordinary state work in their practices. My own peninatal and transpersonal experiences in the breathwork session at Esalen affected me profoundly and led me to contact the Grofs in order to become trained and certified in the use of this method. As time permits, I continue to lead breathwork workshops and to explore how this and other non-ordinary-consciousness work relates to more traditional psychotherapeutic approaches.
Beginning in 1987, I have participated in workshops of what has come to be called the “men’s movement.” I have attended conferences with Robert Bly, Michael Meade, Mark Gerzon, Justin Sterling, Aaron Kipnis, Brian Muldoon, and other leaders of this movement. Contrary to the popular caricaturing of these gatherings, which would reduce them to a kind of foolish wildness, there is behind this effort a need to counter destructive trends in American society. One is the mindless competitiveness into which men are driven by the corporate culture at the cost of their health and humanity.
The men’s movement in its most constructive sense is enabling men to rediscover their own identities and specific needs, their brotherhood with other men, their appropriate responsibilities as protectors at every level of society, and, finally, new ways of joining in an authentic partnership with women from a place of greater personal clarity to address the problems and grievances that beset our culture. For me personally, the contact with other men that has resulted from this participation has brought much needed companionship, closeness, and support in sometimes difficult times. I have been able to develop friendships and close bonds at a time in my life when I did not think this was possible. I wonder now how men survived in this brutalizing society without something equivalent to this movement. Perhaps in the fullest sense they haven’t.
In March 1989, Stan Grof gave me a draft of a chapter on UFOs written by Keith Thompson that was soon to appear in a book edited by the Grofs on spiritual emergencies, of which a UFO encounter, in their view, might be one. I had little acquaintance with the field, but as I read Thompson’s intelligent view of UFO contact as a kind of mythic crisis of transformation I kept asking myself, “But what is going on? Is it real?” A few months later, at the urging of a psychologist friend in the Grof training group, I visited Budd Hopkins, who had pioneered research in the alien abduction phenomenon. When she first told me of Hopkins’ work, I had thought that the idea of humanoid beings taking people into spaceships and performing various procedures on their bodies and minds was altogether preposterous.
But the people whom Hopkins described were not, as far as I could tell, mentally disturbed, were telling stories that were highly congruent one with another, had come forth reluctantly, expressed a great deal of self doubt, were report ing their experiences with intense distress, and provided consistent details that were not in the media. Only something that is “really” happening to people behaves like that. But if this phenomenon was in some way real, then what was its source?
This question was to occupy me for the next 4 years and resulted in the publication of a book, Abduction: Human Encounters with Aliens, published by Scribners in April, 1994.(11) This work was based on detailed case studies of thirteen of the more than 70 people I had interviewed before completing the manuscript who fulfilled my criteria for an abduction experiencer. These include the recollection with or without hypnosis of encountering humanoid beings, being taken forcefully into a UFO or other unfamiliar enclosure, and subjected to various intrusive procedures – all reported with affect and incredulity appropriate to what was being related and occurring in the absence of a psychiatric condition that might explain the strange account. Among these cases I had done one to nine hypnosis sessions with more than 50 individuals, for although many details of the experiences are recalled without the use of a nonordinary state of consciousness, a relaxation exercise is helpful in filling out details and in recovering the intense stressed feeling that accompanies the abduction experiences.
As I pursued this work, it became increasingly evident to me that no conventional psychiatric or even “psychosocial” explanation would be forthcoming. Whatever abductions were, they were not fantasy, dream, a new form of psychosis, or a displacement from some other kind of trauma (although, of course, the experiences themselves were often traumatic). They were what they were, i.e., in some way real, whatever that might mean. In fact, none of the now many hundreds of abduction reports in the literature has revealed behind it something else, i.e. any other condition. Abductions appear to be just what they look and sound like – a visitation of some other form of intelligence that enters people’s lives in strange ways. As I first began to realize this, it seemed shocking, and, indeed, I was frequently warned not to let on, especially publicly, that I took the reports seriously and that they represented an authentic mystery. But after a time this seemed less than truthful, and I began to say in conferences, media interviews, interviews, and, of course, in the book that there seemed no logical explanation for the phenomenon other than that another intelligence was, in fact, reaching into our reality and manifesting physically as well as psychologically, even if this could not be “proven” to the satisfaction of mainstream science.
Although my work has received a great deal of interest and support, I was unprepared, even though I had been warned, for the backlash of cynicism, snide tones, and even ridicule that would greet my book, especially from some of the mainstream print media. I found myself portrayed sometimes as a kind of gullible, too-easy-to-believe Harvard professor who had taken leave of his senses. Behind this attitude lies a structure of belief, I have come to think, that regards human beings as the preeminent intelligent creatures in the cosmos, and that it is likely, if other intelligence might exist, it would behave rather like us, traveling through space by our physical laws and responding to radio signals. The notion that another intelligence might demonstrate behaviors and possess technologies and means of travel that do not follow our gravitational and other physical laws seems far fetched to these critics, and the perception by abductees of intrusive alien beings into their lives is discounted or assumed to be some sort of hallucination, although these experiences are not at all like hallucinations. The egocentrism of this attitude, this discounting of the possible varieties of intelligence that might inhabit a multidimensional universe, seems to me to be the acme of arrogance yet achieved by our species.
As I have explored the abduction phenomenon more deeply and pondered the bitter, sometimes almost violent, resistance with which this work has been met, I have come to realize that to accept its reality means to experience that the world is altogether different than the one we, at least those of us who are the products of Western, materialist culture, assumed it was. Wars are fought not just over land and material resources but over ideas or systems of thought – religious, political, and economic – that structure how we are to live and relate to one another and to nature itself. The UFO abductions invite a war of sorts, but it is not a military conflict fought with weapons of mass destruction. Rather, it is a struggle of fundamental worldviews, a “paradigm” war.
The ideological lines in this struggle are quite sharply drawn. The differences are philosophical, but the implications are pragmatic. In the materialist worldview, the universe is essentially lifeless or devoid of intelligence and meaning. If intelligence is experienced as inhabiting the cosmos, this is a product of subjectivity or a projection of consciousness, which is believed to be an epiphenomenon of the human brain. If the Earth is not experienced as part of a larger, perhaps delicate, intelligent system, then it becomes the potential property of any species physically and technologically powerful enough to appropriate it for its own purposes. This is, in effect, what the human species has been doing in this century, with catastrophic results for human life and the Earth’s living systems.
But the appreciation that the universe is filled with intelligence, and the realization that one of its infinite forms, the entities we perceive as “aliens,” has found a way to enter our physical reality, possessing the capacity for interdimensional travel and the power to render us helpless, must inevitably shatter the official worldview. For among the implications of this reality is the ego-destroying notion that far from being the preeminent intelligence in the universe, we are to these beings as a domestic animal is to us (although at least they do not eat us). The Earth, then, far from being our oyster to devour at our pleasure, must, in this emerging worldview, take its place within a cosmic design we have lost the capacity to perceive.
A practical outcome of this paradigmatic shift will be the realization that the only chance for our collective survival lies in a radical turn of direction, which, at its core, requires an expansion of the idea of who we are. In the sense that we become identified with a cosmos that is filled with intelligence and spirit, we are much larger. But insofar as we discover our lack of control and power over nature, the end of the Baconian era, we are smaller. Living in that paradox, it seems to me, can only be healthy. For then we can devote ourselves to finding a way to live in harmony with one another, other life forms on Earth, and within the vast material and spiritual actuality of the universe.
In the short preface to Abduction I looked back on how this study related to other themes of my life’s work:
An author embarking on a venture as manifestly novel as this one must inevitably ask if some link may be found with his previous work. For me, the connection resides in the matter of identity – who we are in the deepest and broadest sense. In retrospect, this focus has been with me from the beginning, driving my clinical explorations of dreams, nightmares and adolescent suicide, my biographical researches, as well as the studies of the nuclear arms race and ethnonational conflict and, more recently, transpersonal psychology, with which I have been involved. The abduction phenomenon, I have come to realize, forces us, if we permit ourselves to take it seriously, to reexamine our perception of human identity – to look at who we are from a cosmic perspective.
This, it seems, is what my physician-activist life has been about, the discovery of identity, who I am in a personal, human, collective, and spiritual sense. That task is, at root, a psychological or inner one, and, when the suffering becomes too great, even psychiatric. Action seems called for where values are involved, when there is the experience that one’s self-discoveries become generalizable and can translate into a process of transformation for others. Great joy and a good deal of suffering have, for me, been an inevitable accompaniment of the task of expanding identity. For as we break the boundaries of the self, there is both discovery and loss, richness and emptiness. Each step along the way involves an element of terror, I think, for the process involves paradox, mystery, and the unknown.
In this evolution I have come to redefine faith, which always used to mean for me blind, unfounded belief. Now it means that there is a magnificent, unfolding design within the cosmos, and, if we do the work of discovering our potential place and purpose in it, that is the best we can do. This requires, however, a continuing surrender, a letting go of the illusion of control, while asking, in whatever language we have, what the divine consciousness might ask of us. This is an active process, for insofar as we experience that the evolutionary outcome is not foreordained, then we cannot escape the possibility that the next step just might depend on what each of us does.
Postscript
Dr. John Mack continues to investigate alien abductions, focusing on how the phenomenon manifests itself in nonWestern cultures. He is exploring whether the core elements of the phenonmenon are psychologically or culturally determined. “If they are neither,” states Dr. Mack, “the implications of our sense of ourselves are great indeed.” He is developing an outline for a book on human identity over the life span, drawing on his clinical and psychopolitical work as well as his study of human encounters with extraterrestrial beings.
References
1. Chivian E (ed.): Last Aid: The Medical Dimensions of Nuclear War. San Francisco: W. H. Freedman, 1982.
2. Mack JE: Nightmares and Human Conflict. Boston: Little, Brown & Company, 1970. Reprinted with a revised preface, New York: Columbia University Press, 1989.
3. Mack JE: A Prince of Our Disorder: The Life of T E. Lawrence. Boston: Little, Brown & Company; London: Weindenfeld and Nicholson, 1976.
4. Lawrence TE: Twenty seven articles. In Mack JE: A Prince of Our Disorder: The Life of T E. Lawrence. Boston: Little, Brown & Company, 1976:463 467.
5. Mack JE, Rogers RS: The Alchemy of Survival. Reading, MA: Addison¬ Wesley, 1988.
6. Cohn C: Slick ‘ems, glick ‘ems, Christmas trees, and cookie cutters: Nuclear language and how we learned to pat the bomb. Bulletin of Atomic Scientists 1987; June:17 24.
7. Mack JE: Ideology and technology: Lessons from the Nazi doctors for the nuclear age. In Tuttman (Ed): Psychoanalytic Group Theory and Therapy: Essays in Honor of Saul Scheidlinger. New York: International University Press, 1991 45 66.
8. Mack JE: The risks of malignant professionalism in our time. Presented at the American Psychiatric Association Annual Meeting, New York, May 15, 1990.
9. Mack JE: Action and academia in the nuclear age. Harvard Magazine 1987;89(3):25 31.
10. Grof C, Grof S: The Holotropic Mind. San Francisco: Harper, 1992.
11. Mack JE: Abduction: Human Encounters with Aliens. New York: Charles Scribner’s Sons, 1994.
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John E. Mack, M.D. was a Pulitzer Prize-winning author and professor of psychiatry at Harvard Medical School.
© 1994 John E. Mack, M.D.
Written in April 1994 (and revised in July 1994) for publication in Ellen L. Bassuk’s 1996 book The Doctor-Patient Activist: Physicians Fighting for Social Change.