Dorothea Dix: A Unitarian Pioneer for Mental Health Treatment
Sermon by Steve Edington
October 24, 2010
In 1988 the movie sensation of that year was Rain Man, a really outstanding film which swept the Oscars winning Best Picture, Best Director, Best Screenplay, and - for Dustin Hoffman - a Best Actor award. The other lead actor was Tom Cruise. The story line, which was very loosely based on a real-life situation and person, was quite captivating.
I'm guessing many of you have seen it, but I'll give it a quick once-over. Tom Cruise plays Charlie Babbitt, a self-centered and opportunistic Los Angeles based automobile dealer, dealing in high end Lamborghini-type cars. He learns that his father, from whom he's been estranged most of his life, has died at the family home in Cincinnati, leaving a considerable estate. Cruise's Charlie assumes the estate will be his, thinking he's his father's only offspring. Upon arriving in Cincinnati, however he learns that his father's three million dollar estate has been given to a mental institution in that city. Charley gets his father's Buick Roadmaster and some rose bushes.
One of the residents at the institution that is the recipient of the elder Babbitt's estate is Raymond Babbitt - the Dustin Hoffman character - and the brother of Tom Cruises's Charlie; a brother Charlie didn't even know he had. Raymond is severely autistic. In addition to be stunned to learn he has a brother - a brother with autism, no less - Charlie also feels he being cheated out of his share of the father's estate, and is determined to get what he considers to be rightfully his. He decides to take Raymond back to Los Angeles to meet with his attorney, get a court appointed psychiatrist, and see what can be done.
Charlie wants half of their father's estate, with the other half going to the mental hospital in Cincinnati with the understanding that they will also maintain custody of Raymond. The story line of much of the film is about their cross-country trip, which they take by train since Raymond is afraid of flying, and of the relationship that develops between the brothers as they travel.
At first Charlie treats Raymond as something of a necessary nuisance who is preventing him from getting what he wants of the father's estate. He's not mean or cruel to Raymond, he just wants to take care of this piece of business, get what he feels is rightly his, and get on with his life. Then when he learns that Raymond has an amazing memory, and that that memory can be channeled in specifically directed ways, he teaches his brother how to play blackjack and how to count cards. They make a stop in Las Vegas where they make a killing at the blackjack tables before getting caught at card counting and sent on their way, albeit considerably richer. For Charlie, then, Ray goes from being a nuisance to having a skill he can exploit.
But as their journey goes on a bond develops; and by the time they get to Los Angeles to meet with an attorney and a court-appointed psychiatrist, Charlie's primary concern has shifted away from the money involved and to a genuine care and concern for his brother. He decides he wants custody of his brother, and wants to take care of him, if that's what Ray wants. But Ray, in a session with the psychiatrist, is unable to make that decision. When asked if he wants to stay with Charlie he says 'yes.' But when asked if he also wants to go back to the facility in Cincinnati, he also says 'yes.'
Charlie finally decides the most humane thing to do is to have Ray go back to the safety and familiarity of the mental hospital in Cincinnati, and not pursue any further claim to their father's estate. In the last scene Ray boards a train for Cincinnati and Charlie promises he'll see him in two weeks. Where their relationship will actually go is left to the viewer's speculation.
Although the movie received largely favorable reviews, it got panned in places for taking a patronizing, or romanticized, view of the mentally ill or mentally challenged. I guess that case can be made; but what I saw in it was a story of someone, Charlie in this case, who was leading a largely self-centered life coming to see the humanity in someone for whom life had dealt a very different hand. In connecting with that person--who also happened to be his brother--Charlie discovers his own humanity as well. Reaching out to a brother made him more human. The greater human message is that it is in reaching out in whatever ways become available to us, to our brothers and sisters--especially when they are "different" from us--that makes each of us more human.
While she was hardly living the same kind of life as Tom Cruise's character in Rain Man, the story of Dorothea Dix's life is also that of one who saw the humanity and the dignity in persons whom the society and culture of her day had written off in a kind of wholesale, broad brush way, as being untreatably insane, however great or small their degree of mental illness or emotional instability may have been. She's not only a heroine in the annals of our treatment of, and attitudes towards, persons termed mentally ill, she's also a heroine in our faith tradition of Unitarian Universalism. Had the admittedly fictitious Ray Babbitt character been living in the United States when Ms. Dix was a young woman, and unless he was from a family of considerable means, he may well have found himself confined to a jail cell instead of the facility he was portrayed as being in.
Over the past several years I've come to use the fourth Sunday in October as a time to lift up the life and legacy of a man or woman from our greater Unitarian or Universalist, or UU, story. I use the Sunday that is closest to October 27. This is the date of the execution by burning at the stake of Michel Servetus in Geneva, Switzerland in 1553 at the behest of John Calvin.
The reason for his execution was Servetus' supposed heretical views that rejected the Christian doctrine of The Trinity. It was also Calvin's way of establishing his "doctrinal credibility," and correctness, as it were, as the titular head of the Protestant Reformation. Servetus, who was a physician and a theologian, is regarded as the first Unitarian martyr. In a broader sense he's an example of the use of reason and critical thought in determining one's religious stance, and the danger such free thinking has put persons in over the course of human history. I began this tradition in 2005 with a sermon on Servetus, and have continued it with a UU History sermon ever since on this Sunday.
You heard some of Dorothea Dix's story earlier in my Conversation with the Children. She was indeed born into an impoverished, and abusive, family setting in rural Maine. Her father, Joseph, was most likely an alcoholic, even though he was also an itinerant Methodist preacher. Her mother suffered from a variety of illnesses and was largely an invalid. Joseph Dix, the father, was actually from a family of considerable means in Boston; but one from which he'd been basically exiled as the family ne'er do well. Young Dorothea, though, had been in touch with her Boston paternal grandparents. Her Dix grandfather, whom she loved dearly, died when she was seven. The story of how she ran away at age 12 to live with her Dix grandmother in Boston, is apparently true--silver dollar and all.
Her grandmother, as noted, did have stern and often harsh ways, even as she provided for her granddaughter's overall well being. This grandmother also provided for Dorothea's education at a time when such was generally unavailable to young women, who were expected to marry, raise children, and not much more. Grandmother Dix's severe ways were also reflected in her strong Calvinist beliefs, which were in turn reflected in the church to which Dorothea was sent.
As she approached young adulthood, however, Dorothea discovered Unitarianism, as it was being preached in the 1820s and 30s by the minister who is regarded as one of the founders of American Unitarianism, Dr. William Ellery Channing. His pulpit was that of the Federal Street Church, now Boston's Arlington Street Church, on the corner of Arlington and Boylston Streets. In something of a chicken and egg situation, Ms. Dix's basic humanitarian instincts were nurtured by the liberal Christianity preached by Rev. Channing which in turned heightened those instincts, and also served to enhance Dorothea's other interests in science, literature, and religion.
In the preachings of Channing she found not a Jesus who had had to die an excruciating death to redeem her from an inborn state of depravity--as taught by the Calvinists--but one who lived a life of love and service and compassion and called upon human beings to do the same. She found herself drawn to the early 19th century Unitarian belief that salvation is found in emulating the life and teachings of Jesus, rather than being dependent upon his death to save one from the curse of original sin.
Even at the age of 14, as we also saw, Dorothea was able to convince her grandmother to allow a part of the Dix mansion to be used as a school for impoverished children in Boston. Dorothea was already in fragile health, as her mother had been, to the point that the Grandmother may acceded to her granddaughter's wishes figuring she might not long for this world anyway.
Grandma was almost right. Even as she worked tirelessly at her school for the indigent, and wrote a number of children's books, Dorothea's health continued to fail to the point that at age 32 she had a complete physical and emotional collapse and an onset of tuberculosis. Though some of Rev. Channing's contacts, she was sent to England to recover under the care of a couple who were especially adept and caring in treating persons with both physical and emotional difficulties and challenges.
It was when she returned to America and to Boston, with her physical and emotional health reasonably restored, that she had her life defining moment at the age of 39. By now she had turned down an invitation of marriage, choosing to devote all of her energies instead to the causes in which she believed.
As told in my story with the children, she was asked, in 1841, to lead a Bible Study class for women at the Cambridge House of Corrections. It was here that she discovered, to her horror that mentally ill persons--from the severe to the less than severe--were being thrown into prisons with criminals, and were subjected to all manner of inhumane treatment. That became her defining moment and the cause to which she devoted nearly all of the remaining forty six years of her life. With Rev. Channing's support she enlisted the help of her fellow Boston Unitarians Samuel Gridley Howe--the husband of Julia Ward Howe and the founder of the Perkins School for the Blind; and of Horace Mann, the father of public schools in America.
Her efforts in time went well beyond Boston, as she traveled throughout New England and the South in both the pre- and post-Civil War years, advocating for legislation to build mental hospitals where the mentally ill could be treated as human beings with worth and dignity of their own. She wrote books and delivered countless lectures on behalf of the cause that was her primary passion. In just the first seven years since her experience in Cambridge she traveled some 60,000 miles, visited numerous existing mental institutions, and attended the groundbreaking or the expansions of many others that were undertaken largely at her instigation with various State legislative bodies. The nature of these institutions and many of their treatment methods might be considered crude and backward by today's standards; but they were remarkable steps forward in the mid-nineteenth century.
In time she took her crusade to the Federal level and convinced both houses of Congress to pass a bill that would have set created a perpetual fund and set aside millions of acres of land as sites for the treatment of the mentally ill. Her greatest disappointment was when President Franklin Pierce, New Hampshire's only President, vetoed the bill declaring that such expenditures were not the rightful purview of the federal government. (Or perhaps he wanted no part of that "government run health care.")
During the Civil War Ms. Dix organized an Army Nursing Corps of female volunteers and was granted a commission as the Superintendent of the United States Army Nurses as she approached the age of 60.
What I find really remarkable in all this is that Ms. Dix was doing what she did at a time when women not only did not have the vote, but were not expected, and indeed were discouraged from having any role and any voice in the shaping of any kind of public policy. That was men's work. My sermon on this Sunday one year ago was on Dr. Benjamin Rush, a Philadelphia based Universalist, an early shaper of American Universalism, and the man regarded as the Father of American Psychiatry. Benjamin Rush was a well-connected man of prestige and learning and political power. He was a signer of the Declaration of Independence. I find it all the more admirable of Dorothea Dix that a woman without the kind of social and political clout that a man like Dr. Rush had was, in effect, his peer when it came to mental health reform.
Dorothea Dix died in Trenton, New Jersey at the age of 85. She'd been given an apartment on the grounds of the New Jersey State Hospital--one of the first institutions she'd been instrumental in founding in the early days of her reform efforts, and which she called her "first-born child." Having no children of her own she considered the hospitals she helped establish to be her offspring.
Dorothea Dix's legacy is one still in the process of being fulfilled today when it comes to our attitudes towards and treatment o f mentally ill persons. I'm also quite aware that the term "mentally ill" covers a very wide range of behaviors and conditions. While, as just noted, the treatment methods of Dr. Rush and the types of institutionalization for which Ms. Dix advocated would be greatly lacking by today's standards, they were pioneers in their day. Among the prejudices they had to deal with was a religiously based notion that persons dealing with any kind of mental illness were doing so because they'd found disfavor from God and were being condemned for personal weaknesses.
I feel my predecessor in this pulpit, and our minister emeritus, the late Rev. Donald Rowley, was clearly standing in the tradition of the Unitarian, Dorothea Dix, and the Universalist, Benjamin Rush, when he played an instrumental role in this community in establishing both the Community Council and Harbor Homes. As these two fine organizations demonstrate, the treatment of mentally ill, or mentally and emotionally challenged persons, is moving away from institutionalization. As positive a move as I believe this is, there still remains and probably always will be the need for institutions - in their 21st century version - for which Ms. Dix advocated and fought.
One more point before I close: For all of the advances that have been made in the treatment of mentally ill or emotionally disturbed persons, practically any family who had had to deal with the more mild to the more severe forms of mental illness know what a stress and strain on the whole family system such a situation can be. Within our congregational family this past year we found ourselves dealing, on more than one occasion, with the tragically extreme and painful outcomes of chronic depression, resulting in persons taking their own lives. Even to this day we cannot fully be aware of the extent of the mental and emotional turmoil some of those even closest to us experience. In the aftermath of such tragedies, all we can really do is "love one another," be kind to ourselves, and continue to be bearers of compassion.
Moving quickly on, even as I strongly support granting the most appropriate levels of personal autonomy to persons with mental and emotional maladies, I'm also aware of how the refusal of treatment, including medication, can push those family stresses to very high levels. We've moved from a time when, as in Ms. Dix's day, mentally ill persons had practically no personal autonomy at all, to a time when such autonomy is given a priority. Finding the right, and most just, balance between mandated treatment and personal choice on the part of the mentally ill remains an ongoing challenge and an ongoing struggle. However one feels about how that balance is properly struck, we have Dorothea Dix, along with Benjamin Rush, to thank for getting that conversation to the point where it now is. This woman and this man from our Unitarian and Universalists faith traditions still merit our praise today.
Finally, I see in the life and dedication of Dorothea Dix yet another example of how one's religious convictions can inform and direct him or her living a life of devoted - and in Ms. Dix's case, a life of passionate - service to one's fellow human beings. She shows what it means to be a passionate advocate for social justice for the sake of a greater human good. I know that the case can be well made as to how religion has been, and continues to be, a force for all manner of human misdeeds and evil and ignorance. I do not contest that case. But such a case is only half of the equation, if that. What I see in the life of a woman like Dorothea Dix is that of a well educated and deeply dedicated humanitarian - a strong advocate for a particular kind of social justice - who was also a very devout religious person.
When she reached for what she regarded as the ultimate motivation for how she lived and dedicated her life, it was found in the image of the loving and compassionate Jesus she heard preached from the Unitarian pulpits of her day. The message from her life to ours, as I see it, is not that we necessarily embrace her type of religion, but that we continue to explore and dig every more deeply into our own lives as we seek out the most authentic and caring ways of living our lives. This, indeed, is one of the many reasons as to why we are in community here; so that we may continue to grow a life and grow a soul that will be a blessing to all the other lives we encounter.
Stephen Edington
October 24, 2010
