Address to the American Psychiatric Association

"Address to the American Psychiatric Association" is the title given to a speech to that group given in Philadelphia on October 5, 1988. It was first printed in the collection Fates Worse Than Death and reprinted in the third volume of the Library of America's Vonnegut set in 2014.

Summary

Elie Wiesel, 1987

Recognizing that it's difficult to make unhappy people happier unless they need something basic like food, shelter, companionship, or liberty, Vonnegut thanks the association for honoring the trade of storytelling by inviting both him and the writer Elie Wiesel to address them. Dr. Nancy Andreasen at the University of Iowa Medical Center once interviewed members of that institution's Writers' Workshop and found that many writers were depressives from families of depressives. At one time it seemed that only alcoholics like Sinclair Lewis, Eugene O'Neill, John Steinbeck, or Ernest Hemingway could win a Nobel Prize in the field, but that truth holds less certain now. Vonnegut opines that this is because artistic endeavors are no longer socially seen as feminine, which required men who engaged in them to be perceived as violent drunks to demonstrate their heterosexuality.

Both Wiesel and Vonnegut made their literary reputations with works about the Second World War against Germany. Both also—like Dr. Dichter, who issued the invitation to speak—have German last names, as do many of the pioneering figures of psychiatry. Vonnegut guesses that a plurality of attendees, Jewish and Gentile, have ancestors from the German or Austro-Hungarian Empires which produced so much art and science and "whose remnants gave us a nightmare from which... there can never be an awakening". While the Holocaust defines much about who Wiesel is and what he writes about, Vonnegut says the firebombing of Dresden defines nothing about him, since he was an outsider and mere witness to this rather quick event rather than the victim of a prolonged tragedy directed at him, his loved ones, and the world he thought he knew. Wiesel's father, whom he failed to save from this horror, did not require pharmaceuticals to cure his depression, but basic needs like food, rest, and care.

Vonnegut's training in anthropology taught him to seek explanations for human behavior in culture, society, and history, which are often the villains in his books and also are not affected by pharmaceuticals. In an unfinished book of his entitled SS Psychiatrist, a camp doctor at Auschwitz had the job of treating the depression of staff members with talk therapy. The point of the story was that mental health professionals are often tasked with making healthy people happier in societies that have gone insane. The United States is not in such a dire situation yet, since our goal, especially in politics, primarily seems to be to train intelligent people to sound stupid so they can be more popular.

Vonnegut surmises that he was invited because his son Mark went insane for a while and after his recovery wrote a book about it, The Eden Express. He suggests that they should have invited him instead, since he actually knows what he's talking about in the field and costs less. Often when addressing mental health professionals, Mark asks if any of them have taken Thorazine and recommends they try since it won't hurt them. He was diagnosed with schizophrenia and his behavior looked far more animated than Vonnegut's idea of depression. Now a graduate of Harvard Medical School, Mark has learned that he and many other like him are now considered misdiagnosed and that they were in fact depressives. He addresses this in a new afterword to his book, where he also states he's less convinced that his cure was attributable to megavitamin therapy, but still sees "more hope in biochemistry than in talk".

Central Indiana Hospital for the Insane, c. 1903

Vonnegut himself in his stories already insisted that mental illness was caused by chemicals rather than events or other people. He was taught this by a family friend when he was a child, Dr. Walter Bruetsch, who was then head of the Indiana state mental hospital. Thus did Vonnegut attribute his mother's mental illness and eventual suicide to chemicals more than to her terrible childhood. At least two of those chemicals were external, alcohol and phenobarbital, the latter of which was prescribed by their family doctor for her insomnia. His mother's mental illness and suicide were both kept secret since it would make her children less attractive for marriage. Had there been a branch of Alcoholics Anonymous, it may have helped her but the first Indianapolis chapter wouldn't be founded until 1955 by Vonnegut's uncle Alex, who was an alcoholic, another family secret. Groups such as A.A. provide an extended family, as necessary throughout history to human health as vitamins and largely lacking in modern, rootless, mobile American society. None of this is probably news to the audience, who deal with unhappy people constantly, and probably all of them would rather prescribe their patients a warm life-support system like an extended family instead of pills.