Never a boring day for a clinical psychologist

Alan Smith’s book called From Tests to Therapy is a personal diary which takes the reader on a rollercoaster ride through the changing face of psychology, presenting a unique glimpse into a secret world of strange obsessions, delusions and phobias, including life inside the walls of Powick Hospital.

This is the real-life One Flew Over the Cuckoo’s Nest where Mr Smith, aged 66, of Newland, near Malvern, looks over a 30-year-career probing the dark recesses of mental illness.

Describing his research on delusions, he writes: “This morning they said there is an old lady in one of the long-stay wards who thinks she is Queen Victoria, so I went to see her. ‘Be careful, she can be a bit dangerous’, warned the nurse.

“Fortunately, old ladies don’t move too fast so when she came after me waving a walking stick I retreated fairly swiftly. Not suitable for my research, I thought.

“More luck this afternoon, however. There’s a man called Albert Johnson who says that he is a divine being of some sort, with control over the universe. He is allied with God and his task is to fight evil in the form of beings called Them who are trying to destroy the universe.”

Mr Smith joined the staff at Powick in September 1971 after the hospital was emerging from something of a cloud, having featured in the TV programme World in Action in 1968 where there were some shocking scenes filmed on the long-stay female wards where 78 elderly patients were living in cramped and unsavoury conditions.

After the scandal Powick was chosen as the pilot project for closing all mental hospitals in the UK and replacing them with general psychiatric units.

When Mr Smith joined the staff he also stumbled on some other surprises – LSD was being used to treat mental illness under pioneering work by Dr Ronald Sandison.

The treatment continued between 1964 and 1972 when 680 patients were given the drug before this method fell into disrepute and the LSD unit was closed.

Years later, some patients mounted compensation claims on the grounds they still suffered flashbacks, most of which were rejected, although some claims were settled out of court by the health authority in 2002.

Also of local interest is his description of the move from Powick to Newtown Hospital, Worcester, in December 1978, a world away from the old-style Victorian asylum where he had spent his early career.

He writes of Newtown: “Sometimes I do wonder if One Flew Over the Cuckoo’s Nest is not so far from the truth. I am having a running battle with one of the consultant psychiatrists and his registrar.”

In the book, Mr Smith, who writes as G Alan Smith (so as not to be confused with the footballer), writes about his training at the Maudsley Hospital in Camberwell, South London, and his meeting with the famous psychologist Hans Eysenck in a canteen. He first inspired Mr Smith’s interest in psychology when he stumbled across one of his books in Gateshead Library next to the much larger witchcraft section.

Mr Smith writes about how he was sent to Bethlem Royal Hospital in Bromley, South London, in May 1970. The name of the hospital is the source of the word “bedlam”

which we now understand to mean uproar, confusion and even hell on earth.

Mr Smith writes in his book: “In the 1700s people used to go to Bedlam to stare at the lunatics as if it were a zoo. Even worse they were allowed to poke the inmates with long sticks. However, in modern times Bethlem Royal Hospital has an advantage in comparison to the old Victorian asylums in having a more modern building, together with its connection to Maudsley.”

Mr Smith also writes about his discomfort at using a “shock box”

(aversion therapy) to help a man overcome his homosexual urges – his habit of going out at night to public toilets looking for sex with men.

Homosexuality had only been legalised a few years before but police were cracking down on gay men meeting up in public toilets for sex and the man had asked for help.

Another interesting part of the book is his use of the psychological stress-evaluator – or lie detector – appearing with the machine on TV’s Pebble Mill in May 1974 which created something of a media frenzy at the time, especially after he was asked to use to machine to test whether George Davis was responsible for an armed robbery at the Ilford branch of the London Electricity Board.

The man himself was not available for the test but the test was performed at Powick on people who had provided him with an alibi.

The Sunday Times headline at the time was “Lie detector okays George Davis alibi” and he was later released over doubts about the police evidence, although he was caught red-handed in a later robbery and Mr Smith remains unconvinced about the merits of these tests.

One of Mr Smith’s greatest successes was to help win independence from psychiatrists, who are often described as somewhat pompous and elitist.

Patients began to be referred to him directly by GPs in October 1985 and he saw about 25 patients a week.

Much of the role of the psychologist was to try out new measures and approach mental illness in a scientific way – and often that meant coming headlong against more traditional methods and ideas.

Mr Smith said: “We started out with this scientific approach of looking for evidence, trying things out, testing things, rather than doing what we had always done before. Psychologists have always challenged the medical dogmas.

You have to be unafraid of offending the powerful.”