Is Basket Weaving Harmful?

Awakened at the crack of dawn for an inhumanly early breakfast, the patient in a typical U.S. mental hospital faces a day of TV watching, pingpong, checkers, and perhaps a bit of dishwashing or floor mopping. Then there is lunch at 11:30, an hour of basket weaving or making leather belts, and dinner at 4:30 to end a day spent entirely in the company of his own sex. Is this routine rehabilitating? On the contrary, says Psychologist Wolf Wolfensberger of the Nebraska Psychiatric Institute, it is Rehabilitating. Writing in the American Journal of Psychiatry, Dr. Wolfensberger pleads for what he calls the principle of normalization: treat a deviant normally and he will behave, if not normally, at least less abnormally.

Mortification Process. To Wolfensberger, normalization can do as much for the mentally ill as for the retarded. It will integrate the patient into society, at least as far as his illness permits, and wipe out or minimize the "subcultures of deviancy" that develop in institutions. To achieve that goal, Wolfensberger advocates specific changes in treatment:

> Patients should not be submitted to a "mortification" process--stripped of clothes and possessions and locked up. They should be free to turn lights off and on, open or close windows, welcome or reject a would-be visitor: "A nurse sweeping abruptly into a resident's room commits an act of denormalization." Patients should also get up, eat and retire at normal hours.

> "Normalization means living in a bisexual world." There should be "at least as much mingling of sexes as in a hotel, a mixed boardinghouse, or a home in which there live adults other than a married couple."

> Patients should not be forced, or even encouraged to take part in endless recreational therapy. "While American society approves of recreation after work, it does not approve of recreation instead of work; the latter is viewed as childlike play activity."

> Since "poverty in a mental hospital is no less dehumanizing than in a slum," patients should have pocket money, not merely scrip or credit.

>There ought to be an annual trip for hospital residents "to the usual tourist and vacation places."

The principle of normalization was first formulated in Denmark and has become part of Danish and Swedish law. Except in extreme cases, a retarded person may not be deprived of his civil rights in either country. Government funds assure him a living standard comparable to that of a typical citizen in his community.

Rare Examples. In the U.S., only a beginning has been made. In Omaha, federal, state and local funds support a center that trains the mentally retarded in simple job skills like assembling hair curlers. The city also has four hostels and three apartments in which retarded patients live. But such examples are rare, and Wolfensberger hopes for much wider acceptance of the Scandinavian approach.

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