Psychiatric Annals

Personal Reflections 

Symposium in Honor of a Distinguished Colleague

Francis J Braceland, MD

Abstract

The symposium, held on October 30, 1976, was in tribute to Dr. Howard P. Rome. Thé occasion was his retirement from the Mayo Clinic. The distinguished president of the World Psychiatric Association had graced the Clinic for more than 30 years. The sessions were introduced by Dr. M. J. Martin, the present head of the Mayo psychiatric section. The participants, all well chosen, gave knowledgeable presentations, which are to be found in this issue of Psychiatric Annals.

Judge David Bazelon expresses regret that more and more distinguished psychiatrists are proclaiming that they have nothing to contribute on the issue of criminal responsibility and are studiously avoiding court appearances. He sees it as tragic if simple misunderstanding or embarrassment were to deny the courts present-day knowledge of human behavior. The distinguished jurist then gave his view of the law, seeing it not as a static order built on certitude but as a dynamic order built on process. In a wellreasoned presentation he elaborated upon his thesis and concluded, among other things, that "the tragedy may be that too many of us ignore what we do know in order to postpone present needs while awaiting the day of certainty." As his thesis unfolded, this listener really understood his ideas for the first time and regretted that he had been so slow in comprehending them.

Gene Usdin gave a relaxed, pleasant, folksy talk, and it was soon evident that he was comfortable and at home with psychiatry and the law. He saw no reason for psychiatrists to build anxiety in courtrooms, and he believes that a competent psychiatrist OMi of court is a competent psychiatrist in court, provided that he participates as a psychiatrist and does not try to be a lawyer. He gave a number of tips as to proper conduct and, like Judge Bazelon, warned against the use of jargon. He warned, too, against becoming an advocate and told how, when he was asked if he could be wrong, he answered, indeed, yes, he could be wrong. Among the excellent bits of advice he gave were not to overstate, oversell, or overkill your opinion. Interestingly enough, he has had seven judges in psychotherapy; it was an informative experience for him and might even make the rest of us more comfortable.

Dana Famsworth undertook the very difficult topic of "dangerousness" and concentrated on the potential for harm to self or others by persons who are considered mentally ill. He recalled that predictions regarding dangerousness in mentally ill persons are notoriously unreliable and that some researchers have found most predictions of dangerousness to be inaccurate.

Dr. Farnsworth broke down the term "dangerousness" into four component elements: (1) magnitude of harm, (2) probability that harm will occur, (3) frequency with which the harm will occur, and (4) imminence of the harm. He gave illustrations from his own experience. He believes it would be highly desirable if some system could be devised to permit the lawyers, the judge, and the psychiatrist involved in a case to discuss questions informally. He maintains that physicians and lawyers could solve problems by collaboration rather than by an adversary process. Wisely, he also points out that it is never known whether or not violence has been prevented, "for if one prevents something he destroys the evidence that he has done so."

Frank Ty ce presented a wellresearched report on imprisonment and reported that the system and the prisons are all so antitherapeutic that effective psychiatric intervention with prisoners is no longer possible. Apparently we have learned little in the past 200 years, and modern prisons, like their counterparts two…

The symposium, held on October 30, 1976, was in tribute to Dr. Howard P. Rome. Thé occasion was his retirement from the Mayo Clinic. The distinguished president of the World Psychiatric Association had graced the Clinic for more than 30 years. The sessions were introduced by Dr. M. J. Martin, the present head of the Mayo psychiatric section. The participants, all well chosen, gave knowledgeable presentations, which are to be found in this issue of Psychiatric Annals.

Judge David Bazelon expresses regret that more and more distinguished psychiatrists are proclaiming that they have nothing to contribute on the issue of criminal responsibility and are studiously avoiding court appearances. He sees it as tragic if simple misunderstanding or embarrassment were to deny the courts present-day knowledge of human behavior. The distinguished jurist then gave his view of the law, seeing it not as a static order built on certitude but as a dynamic order built on process. In a wellreasoned presentation he elaborated upon his thesis and concluded, among other things, that "the tragedy may be that too many of us ignore what we do know in order to postpone present needs while awaiting the day of certainty." As his thesis unfolded, this listener really understood his ideas for the first time and regretted that he had been so slow in comprehending them.

Gene Usdin gave a relaxed, pleasant, folksy talk, and it was soon evident that he was comfortable and at home with psychiatry and the law. He saw no reason for psychiatrists to build anxiety in courtrooms, and he believes that a competent psychiatrist OMi of court is a competent psychiatrist in court, provided that he participates as a psychiatrist and does not try to be a lawyer. He gave a number of tips as to proper conduct and, like Judge Bazelon, warned against the use of jargon. He warned, too, against becoming an advocate and told how, when he was asked if he could be wrong, he answered, indeed, yes, he could be wrong. Among the excellent bits of advice he gave were not to overstate, oversell, or overkill your opinion. Interestingly enough, he has had seven judges in psychotherapy; it was an informative experience for him and might even make the rest of us more comfortable.

Dana Famsworth undertook the very difficult topic of "dangerousness" and concentrated on the potential for harm to self or others by persons who are considered mentally ill. He recalled that predictions regarding dangerousness in mentally ill persons are notoriously unreliable and that some researchers have found most predictions of dangerousness to be inaccurate.

Dr. Farnsworth broke down the term "dangerousness" into four component elements: (1) magnitude of harm, (2) probability that harm will occur, (3) frequency with which the harm will occur, and (4) imminence of the harm. He gave illustrations from his own experience. He believes it would be highly desirable if some system could be devised to permit the lawyers, the judge, and the psychiatrist involved in a case to discuss questions informally. He maintains that physicians and lawyers could solve problems by collaboration rather than by an adversary process. Wisely, he also points out that it is never known whether or not violence has been prevented, "for if one prevents something he destroys the evidence that he has done so."

Frank Ty ce presented a wellresearched report on imprisonment and reported that the system and the prisons are all so antitherapeutic that effective psychiatric intervention with prisoners is no longer possible. Apparently we have learned little in the past 200 years, and modern prisons, like their counterparts two centuries ago, "still systematically destroy human beings."

Dr. Tyce is not content to simply bewail the inhumanity of the system; rather, he sets forth a plan that, while much more humane, is also effectual, having been tried in his own area. The plan warrants careful consideration by others, though it might be difficult to install in large cities.

The speakers then assembled as a panel and cleared up any loose ends they might have left.

The symposium ended with a general tribute by Karl Menninger, who was present and who has been witness to the gyrations of laws and lawyers and psychiatrists for more than half a century. Dr. Menninger's remarks were both warm and apposite, and this brought the symposium to a close on an upbeat note and with sincere encomiums to the honoree.

10.3928/0048-5713-19770601-03

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