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Oscar Janiger

could break into the problem of premenstrual depression. I took this woman and I presented her case to my residents when she was depressed. I said, “I’m going to allow you to ask her any question you want, except one, which I’ll keep to myself.” At the end of the presentation I asked the group, “Well, what do you make of this woman?” These residents, who knew quite a bit of psychiatry said, “There’s no question that she has classical clinical depression.” Since pure progesterone is not absorbed through the gut, you have to give it either by injection or vaginal suppository. So I devised an experiment. I double-blinded my progesterone. I injected the material randomly and didn’t know which was which. Then I charted the symptoms and found, when I broke the code, that progesterone had an extremely salutory effect in relieving these women of premenstrual symptoms. I began to see clear evidence of a substance in the body that, in short supply, was markedly influencing the behavior of these women. I gave a talk before the Medical Society and outlined what I had done. I said that premenstrual depression could best be treated by looking at this as a hormonal problem, and that it had certain implications for the way the body influences the mind. The people in the group were skeptical and some said, “How do you know that it isn’t some unconscious factor that’s still operating regardless?” They said, “You haven’t proven that she still isn’t worried about her castration fears. You’ve only proven that if you give her progesterone, that could be modified, but you haven’t attacked the basis of the problem.” How could I do that? Psychoanalysis has an answer for everything. I went to two of my brightest women medical students, and I asked, “How would you like to spend the summer in Europe? I want you to go to all the primate centers there, and find out, do great apes have a menstrual cycle similar to humans? I want you to talk to the keepers and find out if they have any reason to suspect that their behavior is any different during their menstrual cycle.” For the next three months I had letters from all the European zoological gardens. We were excited to discover that in the Berlin zoo, Fritz, who took care of a female gorilla named Olga said, “A week before her period I can’t get near Olga, she’s just a mess. All she does is throw all kinds of shit at me.” (laughter) At my next opportunity to present I said, “Ladies and gentlemen, I have discovered that the gorillas have feminine identification problems, and they also have castration fears, (laughter) because they can get very upset before their period.” Everyone applauded and started to laugh. That was the beginning of my understanding of how mental and emotional difficulties could be correlated with one’s biochemistry. This is the basis for the treatment of depression by altering one’s neurochemistry.

DJB: So part of the problem was that people were locked into the idea that the mind could only be affected by the body and not the other way around?

OSCAR: Yes. I think the over-emphasis on psychodynamics, in deriving everything from psychological theory, retarded us from reaching the same conclusions that the British made. For a long time this perspective stale-mated progress in American psychiatry. In fact, it was difficult to achieve any academic status in psychiatry without having taken psychoanalytic training. At present, psychiatric residents are less inclined to enter psychoanalytical training programs, which may reflect their opinion on pscyhoanalysis as an effective treatment.

JEANNE:: So, in Amercian psychiatry, there was an initial reluctance to use drugs to treat emotional problems?

OSCAR: Right. In that sense European psychiatry was much more progressive. In fact, most of the innovations in psychiatry came from Europe. And you would wonder why, considering the status of American medical research and the abundance of psychiatrists. The British were making strong gains with psychotropic medication that we adopted later on. When you come to think of it, Freud was European, as well as Jung. Menduna in Hungary and Bini and Cerlucci in Italy were the first to use insulin and electro-shock therapy. Neuroleptic drugs were first developed in France. Psycho-drama and Gestalt therapy had European and South African origins. The basis for Behavioral therapies originated in Russia. It’s quite remarkable how little innovation we have brought to the field. We’re good at taking what they give us and grinding it out, but we have a poor record at innovation in the field of psychiatric treatment. Also, psychiatrists have been more locked into their therapeutic systems with little flexibility. In my LSD experiments we ran close to a thousand people, and we found that psychiatrists tended to have negative experiences. The ministers were next. The artists had

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