Deep Sleep Therapy

A very psychiatric scandal.

My training in psychiatry in West Australia in the 1970s was totally dominated by people who had trained in the Institute of Psychiatry, at the Maudsley Hospital in London. Partly that was because, until a few years before, there was no post-graduate training in psychiatry in the state, so everybody had to go interstate or overseas to qualify. Mainly, however, it was because “Maudsley men,” as they liked to call themselves, were convinced that anything worthwhile in psychiatry came from their alma mater and unless it was to agree with them, nobody else had anything interesting to say. Their party line was unleavened biological psychiatry, drugs, drugs and more drugs, then ECT and, even though it was rapidly going out of fashion at the time they dallied with the idea of psychosurgery. They had no time for “talking cures” and in particular, despised Freudian notions, except when they detected an opponent using ego defences such as projecting, which invited much scornful laughter. Very early, I noticed how they liked to get themselves on committees and into various official positions where they acted as a gang and always supported each other. To challenge one of them was to challenge them all, and they didn’t like being challenged one little bit.

Most of the time, they talked about the people who had trained them with the same air a parish priest talks of the bishop. One name that popped up from time to time was Dr William Sargant (1907-1988), from London (of course). It was clear that he wasn’t a Maudsley man but he was on their side in the battle against the Freudian influence in American psychiatry, only a bit more extreme. Where they liked to give 12 ECT as a starter, Sargant gave 20 or 30 and had no hesitation giving hundreds in all. Where they gave one antidepressant plus one or two other drugs, Sargant gave two, routinely mixing tricyclics such as amitriptyline and monoamine oxidase inhibitors, which we were taught was dangerous, with antipsychotics and barbiturates in what they called “heroic doses.”

In particular, he had developed what he called narcosis therapy, in which patients were heavily drugged for weeks on end and given massive doses of ECT to “rest their brains.” If this didn’t “work,” they were subjected to brain surgery. He had written a couple of books which were sometimes mentioned but as he wasn’t one of their tribe, never recommended. At about that time, Australian psychiatry was in turmoil due to the exposure of the “deep sleep” scandal at Chelmsford Private Hospital, in Sydney, in which psychiatrist Dr Harry Bailey (1922-1985) used massive doses of drugs to keep people in a coma for weeks or months on end, resulting in up to 88 deaths. Bailey claimed he was following Sargant’s methods for treating intractable mental disorders. About ten years later, 3 years after Bailey had committed suicide, the NSW Government established a Royal Commission to investigate his activities at Chelmsford.

In Andrew Scull’s excellent history of psychiatry [1], and even though he was a major figure in post-War British psychiatry, Sargant gets only two brief mentions (Harry Bailey gets none). Was Scull being led astray by mainstream psychiatry which, as the two did a lot to bring psychiatry into disrepute, doesn’t want to talk about them? It’s possible, so I was interested to see a recent article by an author who has just published a biography of Sargant. The picture he described was much worse than I’d been led to believe many years ago so, rather reluctantly, I got the book and read it over the weekend. It was also election weekend here, in which the colourless and clueless Labor prime minister, Anthony Albanese, faced the Liberal-National opposition led by the thuggish, Trump-loving and even more clueless Peter Dutton. If Dutton had won, it would have been a grim weekend but sanity prevailed and he lost his seat. Buoyed by that uplifting news, I was able to get through the book because the story it tells is very, very bad.

Jon Stock’s The Sleep Room [2], subtitled A Very British Medical Scandal, is enormously detailed but I think it should be required reading for anybody working in the field of mental health, or anybody in law, or humanities, parents … pretty well everybody, in fact. He has obviously done a huge amount of work to get all his sources together because most of it would have been scattered around in various archives or simply not known. He describes Sargant’s privileged background and his education, including how he liked to be in charge of everything, and then his early medical training. For him, World War II was a godsend as it let him take charge of a hospital long before it would normally be possible, and provided thousands of mentally-troubled troops for his experiments in a very biological sort of psychiatry. This started his rise to the top, accelerating when he was appointed medical director of the psychiatry unit at St Thomas’ Hospital, from where he soon reached a dominant position in British psychiatry.

Sargant was big, loud, domineering and aggressively intolerant of other opinions. Anybody who dared question him was shouted down. He believed fervently that all mental disorder is a brain disorder and can only be treated by physical means, for which he avidly took up narcosis, ECT, insulin treatment and then psychosurgery (lobotomy), and drugs, drugs, drugs. He moved in the highest social and political circles in the UK, US and Canada, including the shady world of espionage. He drank a lot, took a lot of psychiatric drugs and was sexually aggressive and promiscuous, including, it seems, with trainee nurses, patients and anybody else who didn’t move fast enough. In other words, he was a psychopath (Stock doesn’t use the word). He was not a sociopath, the modern term, because that was redefined to include a criminal record, which meant that all the psychopaths in politics, business, the military and police, academia, religion, the professions, the arts, sport and entertainment and everything else, could sleep a little easier, not that they ever give a shit about other people’s opinions. In his dealings with patients, Sargant was utterly ruthless, not least as there was never any notion of informed consent for his “treatment.” Patients who had the misfortune to be referred to him ended up as drugged and shocked zombies who, if they didn’t smile on cue, were in danger of having their brains cut.

Despite Sargant’s reigning supreme over the scene for decades, there was no enquiry or recriminations until just before his death at 81. This is bizarre as what he was doing was beyond horrific, it was only a few steps removed from Nazi “race science.” In fact, as Stock shows, he was very close to Dr Eliot Slater, former long-time editor of the British Journal of Psychiatry and former student and close friend of Dr Ernst Rüdin. Rüdin was the inspiration and supervising architect of the Nazi T4 program that murdered about 300,000 mental patients in Germany, Austria, occupied Czechoslovakia, Poland, France and everywhere else they were able. I didn’t know of this connection, nor of Sargant’s close friendship over many years with the monstrous Harry Bailey. That’s bad enough but the part that made me feel quite ill was the lengthy section on his relationship over decades with the infamous Dr Ewen Cameron, director of the Allan Institute for psychiatry, McGill University, in Montreal. The Scottish-born Cameron gets two pages in Scull’s history, which isn’t much as he eagerly took psychiatry into the netherworld of espionage, torture and drug-induced “confessions.” If Sargant was a few steps away from Dr Mengele, then Cameron was breathing over his shoulder. A lot of Cameron’s “research” led directly to what the Americans call “enhanced interrogation,” i.e. torture, in which some psychologists have been eager participants.

What’s the point of this? As I’ve repeatedly pointed out, there are bad people in every walk of life, and that includes medicine, both general medicine and psychiatry. There’s never been a shortage of psychopathic psychiatrists, and Sargant, Cameron and Bailey were right down there with the worst of them. Psychiatry, however, differs from mainstream medicine as psychiatrists aren’t fenced in by a firmly defined scientific model that sets limits on what they do. Advances in medicine are theory-constrained: you can’t take medicine for intestinal worms or drink bleach to kill Covid because medical theory forbids it. Granted, “deep sleep” therapy is now banned, psychosurgery severely restricted and patients can’t be given 360 ECT in 30 days as Cameron was apparently doing, but that’s only come about because of the horrors Stock describes. These monstrosities were pushed by rogues and unprincipled adventurers until society itself recoiled; the restrictions didn’t come from psychiatric theory or, for that matter, through any ethical qualms among the mainstream.

Sargant never missed a chance to broadcast his activities, publishing books and speaking at conferences or on TV whenever he could. He travelled a great deal and kept close to his many thousands of well-placed supporters. At the time, his blizzard of propaganda and his vast web of influential connections kept critics at bay. For example, in 1953, Harold Bourne, a junior medical officer (registrar, resident) in London published a paper showing that insulin treatment was pure placebo [3]. As one, the establishment turned on him and savaged him. He was denied jobs in London and eventually went to Otago University in New Zealand where he was very popular. Even in the 1970s in Western Australia, Sargant was rarely mentioned and then not in the same dismissive manner as Freudians were.

It is clear from Stock’s biography that throughout, mainstream psychiatry did nothing to restrain Dr Sargant. Since he died, the walls of silence have closed over the whole affair as mainstream psychiatry has carefully airbrushed him from the record. Is this a conspiracy? Not in any active sense. I see it as absolutely typical of psychiatry, a widespread, tacit agreement that gentlemen don’t criticise each other in front of the servants. Once Sargant retired from hospital practice in 1972, he was out of the public eye and, following his death, well, we don’t speak ill of the dead, do we? As Orwell said: “Everything faded into mist. The past was erased, the erasure was forgotten, the lie became truth” (1984, p68).

Two points are salient. In the first place, everything Sargant did and said was pseudoscience. A paper he published in the BMJ in 1951 [4], describing states in which people suddenly convert to the opposite point of view, is gobbledygook but it served his purpose of silencing his opponents. However, it didn’t silence all the angry letters that flowed into the journal in the next few weeks after readers saw the connection between Sargant’s methods and torture. Tellingly, the mainstream did not react to his bizarre paper as they reacted to Bourne’s exposé, which was first rejected for publication barely a year later. As I have seen hundreds of times over the years, it is easier to get nonsense published in psychiatry than it is for a rebuttal to see light of day.

The reason Sargant could get away with this 75 years ago was that psychiatry didn’t have a model of mental disorder, or a theory of mind, or anything. Thus, when a very forceful person started trumpeting that mental disorder is biological and needs dramatic biological cures, nobody could tell him he was wrong. They had no intellectual legs to stand on and thus no way of policing the boundary between “reasonable treatment” and what many of Sargant’s patients described as “torture.” In Australia, Harry Bailey was, quite literally, getting away with murder but the RANZCP was mute, as they were with the odious Dr Selwyn Leeks in New Zealand.

The second point is this: Nothing has changed. The line between valid and invalid psychiatric treatment is still just a faint line in the sand that’s periodically blown away by the wind. The latest blast of hot air blowing out from the centres of biological psychiatry, knocking everything else over, is hallucinogenic drugs in psychiatry. After decades of “It’s serotonin all the way,” suddenly, that’s forgotten (see Robert Whitaker and Joanna Moncrieff in this week’s MIA). Psychotherapy is back in vogue, pushed by people who have no training and have never practised it. However, they always forget to mention what brand of psychotherapy or what it actually is (such as a model of mind-brain interaction) but we can trust them, can’t we. They’re doctors, after all. That’s the advantage of never tying yourself to a single model: if the old one becomes too embarrassing, you can quietly rewrite the manuals of “intellectual correctness”. Orwell again:

At any given moment there is an orthodoxy, a body of ideas which it is assumed that all right-thinking people will accept without question. It is not exactly forbidden to say this, that or the other, but it is 'not done' to say it, just as in mid-Victorian times it was 'not done' to mention trousers in the presence of a lady. Anyone who challenges the prevailing orthodoxy finds himself silenced with surprising effectiveness. A genuinely unfashionable opinion is almost never given a fair hearing, either in the popular press or in the highbrow periodicals (From "The Freedom of the Press", unused preface to Animal Farm (1945), published in Times Literary Supplement 15 September 1972)

So why was this A Very British Medical Scandal? Presumably how everybody covered it up and pretended nothing was going on when they all knew of the ghastly ethical breaches and, in fact, crimes that one of their own was committing. But, of course, that’s not just British, that’s universal. That’s what power hierarchies do. That’s why the overwhelming majority of Sargant’s victims, sorry, patients, were women and girls. Hysterics, one and all. Don’t take any notice of them, just keep pressing the ECT button.

References:

1. Scull A (2022) Desperate Remedies: Psychiatry and the mysteries of mental illness. London: Penguin.

2. Stock J (2025). The Sleep Room: A Very British Medical Scandal. London: Bridge St Press.

3. Bourne, H. (1953). The insulin myth. Lancet. ii. (Nov 7 ) 265 (6798): 964–8.

4. Sargant WW (1951). The Mechanism of “Conversion.” British Medical Journal Aug 11 1951, p4727.

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