Sex with mental patients

Sex is a fundamental expression of humanity. In fact, it's a fundamental expression of being alive in a broader context than just humanity. Animals, and even plants, have sex. It's not unreasonable to assume that their sexual expression is as important to their life as human sex is to people like mental patients, social workers and security therapy aides.

Humans have the power to control the sexual expression of less evolved life forms, and we frequently do so just for our peculiar advantage, or if their sexual expression happens to become offensive or inconvenient to us. My dogs are neutered, and my new Ginkgo tree has been genetically engineered to not produce the fruit that would rot and smell bad in October. But why would a fundamental expression of life become offensive or inconvenient? The fact that it clearly does implies some some very basic misunderstanding or disagreement with life itself.

We all want to be as fully alive as we can be. This is the whole impetus of evolution. Human beings developed language, advanced social organization and culture; and we have learned (or at least continuously attempt) to master matter, energy, space, and time itself, in the pursuit of being more alive. That is our game.

But something... maybe about the strategy we are on to win this game, or maybe about the rules, or maybe about an opponent... is mistaken. The facts of sex and our confusions about sex prove this, and urge us to think more carefully.

Why exactly is sex with institutionalized mental patients wrong?

We have so many rules and explanations, and justifications and arguments and theories, which in the end just do not solve the problem: there must be sex but there can't be sex. The problem is nowhere so obvious as at Elgin Mental Health Center and the other nuthouses operated by the Illinois Department of Human Services.

Supposedly EMHC is, "A hospital dedicated by the State of Illinois to the welfare of its people for their relief and restoration, a place of hope for the healing of mind, body and spirit, where many find health and happiness again." That's what it says on the handsome bronze plaque on the wall, right?

Well, certainly sex is part of anyone's version of health and happiness. Why must it be so severely regulated? Why is it banned between patients and staff? Why is it dangerous?

There are people who need to heal mind, body and spirit, and who need to find health and happiness again. In the hospital those people are not supposed to be allowed real sex, and the rules about that are supposed to be helpful to them. There's a whole lot of disagreement though! Most of it is hidden. So what's this complicated story all about?

We create institutions, organizations, social and cultural structures... as evolutionary strategies. Psychiatry, or the medicalized "healing" of human problems in thinking, emotion and behavior, is one such structure or strategy. No strategy is ever perfect by the way, that would make the game be too easy and boring, or it would just be over too quickly. The main point with a strategy is to continuously improve it until the current game is won and a new game becomes available.

All the rules about sex between staff and patients are part of the strategy of medical psychiatry. Other parts of that strategy include the conceptual location of human problems with thinking, emotion and behavior exclusively in the brain and the apotheosis of the brain itself, the use of drugs and other somatic tactics (ECT, etc.), the subordination of other specialized knowledge (psychology, social work, religion) to psychiatry; the prioritization of public funds for what we call "mental health," the shaming of anyone who might be called "anti-psychiatry," and the establishment of legal and financial advantages for pharmaceutical companies and medical enterprises. It's a very big socio-cultural machine, and everybody is supposed to be competent to use it and responsible for getting it repaired when a need arises.

But our civilization has forgotten that this is all a strategy and a machine to be used in the game of life. People believe it's just true. That's why sex is such a big problem: it points insistently to the fact that we sorely need to improve our strategy. Sex embarrasses us. Or maybe (more significantly) it shows that we are missing some of the rules to this game, or that we cannot even identify the goalposts and the opponent.

Of course, we have been repeatedly embarrassed by sex throughout human history. (Think Trump and Stormy Daniels, Mata Hari, Giacomo Casanova, Caesar and Cleopatra, Helen of Troy, and Eve!)

In the more specific history of psychiatry, practitioners were frequently embarrassed. Freud's psychoanalysis was originally billed as science, but it was never popular and available except for repressed rich people who wanted salacious stories. By the 1970s, psychiatry had to renounce libido in favor of neurochemistry to remain a medical specialty that paid well. In the 1980s and 90s, they had to renounce an overwrought minority of their own guys who were pushing a weird theory of multiple personalities caused by satanic, ritualistic sex perpetrated against children by international cannibalistic conspirators supposedly lurking in everyone's neighborhood. (Think Bennet Braun, M.D., and Rush Presbyterian St. Lukes!)

Now they have to disavow state employees proven to have seduced and sexually abused the mentally ill people at their mercy, or other employees proven to have enabled the seduction and abuse. These employees are all supposed to be above suspicion, so they are much more of an embarrassment as professionals who have supposedly dedicated their respective careers to working in mental health facilities, and would never jeopardize their own careers and morals.

It turns out that it's much harder to control the sexuality of human beings than that of house pets or trees. And if we try it's dehumanizing, especially when we fail, which is almost always. We have to pretend that there is no sex between staff and patients at EMHC, or that it's vanishingly rare. Otherwise, this strategy that we call psychiatry has to be seriously questioned.

Psychiatry would be revealed as a fundamental misunderstanding or disagreement with life itself: a bad strategy for the game. We don't want to know that, we have too much invested.

It would be too much work to improve or abandon the strategy.