Devereux] MOHAVE ETHNOPSYCHIATRY AND SUICIDE 239 



to which John had been subjected made it impossible for him to rest. He 

 suffered from severe insomnia and became more and more disturbed and con- 

 fused. A very observant Mohave described his state at that time as follows: 

 "He seemed to withdraw from people and did not talk, drink, or eat anything 

 for several days in a row. Even after he began to eat and to drink once more, 

 he was still quite confused and refused to speak to anyone." 



John's condition so distressed the members of his immediate family that, 

 despite the objections of their more conservative relatives, who — suspecting an 

 ahwe: illness (pt. 4, pp. 128-150) — wished to consult a shaman, they decided to 

 have John hospitalized. 



Admission. — After considerable efforts, John was admitted to a reputable 

 public psychiatric hospital, which, like nearly all public psychiatric institutions, 

 was both overcrowded and understaffed. Since John's mutism prevented him 

 from giving the admitting official the necessary information, he was placed for 

 several weeks in a ward for deteriorated schizophrenics. 



The milieu. — The Mohave who visited John in the hospital were horrified by 

 the atmosphere of this "back ward," though this ward was infinitely better than 

 what one sees in many public institutions. As for John, he was so depressed 

 by his environment, that when he began to talk once more, he asked one of his 

 visiting Mohave relatives : "What have I done to be put in such a place?" 



Psycliotherapy. — Since John did not respond to the ward psychiatrist's initial 

 attempts to obtain a case history from him and since many Western hospitals 

 appear to operate on the assumption that it is impossible to communicate with 

 Indian psychotics, including even those who, like John, speak English fluently, 

 he was given no formal psychotherapy. This decision appears to have been 

 both injudicious and overly pessimistic. Indeed, when a kindly hospital em- 

 ployee — who held an advanced degree in one of the auxiliary medical professions, 

 but was not a qualified psychotherapist — took an interest in him and encouraged 

 him, day after day, to ventilate his problems and anxieties, John proved to be 

 quite accessible, although he continued to remain aloof from the ward psychiatrist. 

 It is extremely probable that John's recovery was largely due to the effort of 

 this interested and kindly employee. 



Other "therapy." — Like most not immediately accessible psychiatric patients, 

 John was subjected to a type of "therapeutic" intervention that is routinely 

 used in all but the very best — and most expensive — psychiatric hospitals." 

 Fortunately for John, he does not appear to have been given a so-called "full 

 course" of this type of "treatment," since he emerged from it without any 

 flattening and discoloration of his personality. 



Visitors. — While in this hospital, John was periodically visited by certain 

 members of his family and it is to the credit of the hospital that these visits 

 were facilitated and encouraged by the staff in every way." A Mohave who 

 visited him during this period reported that John could not accept the reality 

 of the disappointment which had precipitated his breakdown ; i.e., in psychiatric 

 terms, John dealt with this trauma by denial, "not remembering" it. 



Remission. — After a relatively short period of hospitalization John began to 

 improve quite rapidly, and, according to an observant Mohave visitor, "seemed 

 to be himself most of the time," although he was still somewhat confused at 

 times and occasionally still attempted to deal with the precipitating trauma by 

 means of denial. However, a few weeks later he ceased to be confused, ac- 

 cepted the reality of the traumatic occurrence, and recovered sufficiently to 



■^ For a critical evaluation of tliis type of treatment see tlie section on Diagnosis, below. 



'2 Indian patients, especially if they do not speak English, rapidly deteriorate in mental 

 hospitals, due to the impossibility of forming real relationships with the staff and with the 

 other patients (Case 65). 



