A Kansas psychologist's view of this film

The following (with minor changes) is a copy of the response I made to the topic "what is Deanie's mental illness"(mine was the last of scores of other replies). I'm posting it here hoping to get a few readers' responses.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

To me, this is a VERY interesting movie for a number of reasons:

#1 I'm a PhD clinical psychologist (now retired) who worked in the Kansas Mental Health (MH) system (Topeka) for a little over 20 years beginning in 1962 -- my first 10 on a team serving a couple wards @ Topeka State Hospital. (TSH @ that time was rated one of the best state MH hospitals in the country). The last 2 of those years, when we were short of psychiatrists, I was the full-time "treatment director" of/on a 60 bed TSH ward (w/a part-time MD to prescribe meds). And during the 1st 10 of those 20 years, because it was so highly valued in Topeka, I went through a 5 1/2 years psychoanalysis at near-by and VERY influential TMF (The Menninger Foundation) also in Topeka. Their doctors gave excellent supervision of the TSH staff's psychotherapy & treatment. After gaining much experience, I was also employed by TMF as therapy supervisor to several of their psychiatric residents.

For years 12-16 of those 20 years I was the "chief psychologist" of our Kansas MH system (4 MH hospitals, 3 DD institutions, 3 adolescent residential facilities, 32 Community MH centers), on a team w/a psychiatrist & social worker overseeing and evaluating those facilities' clinical practices/adequacy and implementing changes. Then I spent 20 more years in private practice. And my last 4 yrs. (of that 20) as Clinical Director of a Community MHC.

#2 - Regarding diagnoses -- Doctors differ in their biases toward this or that. When you're the doctor deciding on most effective treatment, you rely on those biases. Some have a strong bias to meds; for some others, non- or low dose medication approaches such as Activity Therapies and psychotherapy. If you're inclined to see Schizophrenic or Bi-polar symptoms, meds are certainly warranted. But, IMO, neither of those were warranted by Deanie's symptoms as shown. (I'd give her the diagnosis of "depressive reaction" plus "adjustment reaction of adolescense." But those are much more modern diagnoses.)

Remember, this movie is NOT a documentary but a fictionalized version of how life was supposedly lived in 1928-30. I suspect that at Menningers', (the "Menninger Sanitarium" began admitting mental in-patients in 1925), Deanie would've been seen as having depression caused by conflict between societal & family standards on the one hand and biological urges on the other.

BUT there was NO clear, universal standard for diagnoses until the advent of the "Diagnostic & Statistical Manual" of American psychiatry which was first published in 1952. So Deanie could have been diagnosed whatever her doctor(s) decided. But 2 1/2 years of hospitalization for her symptoms (IMO) is VERY L---O---N---G. Certainly in the 1960s, at TSH and TMF, I think 5-6 months would have been typical with possibly as much as 11-14 months in exceptional cases when there were other contributing causes (e.g., especially a continuing suicidal ideation).

#3 In 1928 (at the time of this film's action), MH hospital treatment in the USA was usually abominable. There was NOTHING in Wichita, KS, even REMOTELY resembling the treatment Deanie "got there". Instead, her "Wichita treatment" was extremely similar to and obviously patterned after the good -- BUT VERY RARE FOR THAT TIME -- treatment that TMF (The Menninger Foundation in Topeka, KS) provided in the 1950s & 1960s.

But Inge, apparently? thinking a Topeka location wouldn't make sense for residents of Independence, KS (150 miles from Topeka), switched "TMF's 1960s type of treatment" to a fictional 1930 facility in Wichita, much closer to Deanie's Independence, KS, family. Topeka State Hospital/TSH (the Kansas state MH hospital to which Deanie could've gone alternatively) was TERRIBLE at that time, more like prisons from which one is rarely released, until its reformation in the 1950s.) [[TMF was largely responsible for that reformation; it was following that and with further huge help from TMF that TSH became--for a time--such an outstanding model of state mental hospitals.]]

The type of relationship shown between Deanie and her doctor would have been roughly similar to that in the 1960s between TMF Drs. and patients AND the occupational therapy Deanie had (art therapy, etc.) also would have been similar to mid-20TH century TMF (as well as at TSH where we had many TMF supervisors of ALL our treatment choices & probabilities).

FWIW, the type of "art therapy" featured in this film "...as a profession began in the mid-20th century" -- Wikipedia So Inge took many liberties with reality.

#4 This film certainly captures the general moral code of the 1920s-->1940s, i.e., that "nice girls don't do 'IT'." According to a compendium of changing behaviors covering the 1900s ("The First Measured Century") slightly less than 19% of 19 year old unmarried white girls were sexually experienced at the time of marriage in 1928 while, by 1991, it was 74%. This curve accelerated so greatly from 1970 on that it well could have been in the 90% range for sexually experienced unmarried 19 yr. old white girls by 1990 or 1999. I grew up in rural Vermont, graduating from HS in 1945 in a class of 91. One girl in our class, "J---," was known as a "slut" because she didn't hide sufficiently that she'd had sexual relationships with 2 or 3 boys.

I suspect more than a few girls who married their HS boyfriends had intercourse only with them before their marriage ceremony. I recall in Vermont, there was a well-known saying that 'the gestation time for one's first child is 6 months but that for all later children it's 9 months.'

While the moral principles in this movie were true for that time, most of us found ways around them. With several HS girls that I "seriously went with" (successively over 4 years) we found "ways around" the prevailing code -- in the back seats of cars, bras undone + easy access to below-both-waists, occasionally in bed near nude, using fingers and hands to accomplish with/for each other that which we'd prefer & dreamed of doing otherwise. And I have to think that this kind of "work-around" was typically true for many adolescents for many? years previously (including this film's 1928 setting). It was certainly true for a 19 yr. old girl I went with (1947) in Wash., D.C., plus the girls in the adjacent Stephens College that I went with in 1949-51 when I attended the U of MO in Columbia, MO. (That same statistical source book shows that, in those years, slightly less than 30% of 19 yr. old unmarried white women had sexual experience in contrast to the maybe 90+% by the year 2000.)

But, by about 1952 (in my experience), ways of avoiding pregnancies had advanced enough and were broadly enough accessible that most serious (or intense) relationships easily advanced beyond those "DON'T do IT!" restrictions in those preceding decades to a state fortunately beyond hands & fingers with bras undone + easy access to below-both-waists.

==========================================================

I enjoyed this film, thinking it captured many elements of a previous era although it certainly (IMO) overly exaggerated certain aspects and "mixed up" eras. I've heard that Inge was gay and, if so, possibly that limited his reality perception of adolescent sexual experiences? Nevertheless, a very enjoyable film.