The effects on mental health of policies regarding self-isolation and small group confinement

[thorbiorn]

Yesterday while listening to NewsReal: The Red Line? Governments Extend Vaccine Mandates to Children there was a clip of an Australian guy who suffered seriously from government imposed self-isolation requirement. There have been many such cases, from the very beginning of the lockdown measures instituted under the official pretext of an urgent need to protect the health of the people.

One paper about the topic of confinement is an overview article:
"Grassian, S. (2006). Psychiatric Effects of Solitary Confinement. Washington University Journal of Law & Policy, 22, 325-384."

This article was prepared from a statement given to the Commission on Safety and Abuse in America's Prisons. As the article is an overview of the psychiatric effects of confinement throughout history it is not fully footnoted

The article is already 15 years old, as such it is unlikely to include much research on how people having access to virtual face to face interactions and electronic messaging are affected. However, observations of the effects on of the lockdown measures on the mental health of some people demonstrate that even the most modern means of communication are not sufficient to mitigate the effects for all people.
Here are a few headings followed by some excerpts:

II. SOLITARY CONFINEMENT CAN CAUSE SEVERE PSYCHIATRIC HARM 333
A. Solitary Confinement Can Cause a Specific Psychiatric Syndrome 333
1. The Specific Psychiatric Syndrome Associated with Solitary Confinement 335
2. This Syndrome has the Characteristics of an Acute Organic Brain Syndrome-A Delirium 337
[...]
C. The Twentieth Century Experience: Prisoners of War, "Brain Washing, "and Experimental Research 343
1. Prisoners of War and "Brain Washing" 343
2. Experimental Research on Sensory Deprivation 345
D. Factors Effecting Response to Sensory Restriction and Solitary Confinement 346
1. Differing Conditions of Isolation 346
2. The Perceived Intent of the Isolation Experience 347
3. Individual Differences in Response 347
[...]
E. Long Term Effects of Solitary and Small Group Confinement 353
III. CONCLUSIONS 354
APPENDIX A: REPORTS OF PSYCHIATRIC DISTURBANCES IN OTHER CONDITIONS OF RESTRICTED ENVIRONMENTAL STIMULATION 356
I. A VIA TION 356
II. SMALL GROUP CONFINEMENT 357
III. POLAR HABITATION 358
IV. EXPLORERS: SOLO VOYAGES 361
V. MEDICAL CONDITIONS 362
A. Eye Patched Patients 362
B . Poliomyelitis 363
C . Cardiac Patients 363
D. Hearing-Impaired Individuals 364
E. Other Medical Patients 365
VI. OCCUPATIONAL SITUATIONS 365
VII. ANIMAL STUDIES 365
APPENDIX B: THE NINETEENTH CENTURY GERMAN EXPERIENCE WITH SOLITARY CONFINEMENT 367

330
This literature, as well as my own observations, has demonstrated that, deprived of a sufficient level of environmental and social stimulation, individuals will soon become incapable of maintaining an adequate state of alertness and attention to the environment. Indeed, even a few days of solitary confinement will predictably shift the electroencephalogram (EEG) pattern toward an abnormal pattern characteristic of stupor and delirium.
[...]
331
An adequate state of responsiveness to the environment requires both the ability to achieve and maintain an attentional set and the ability to shift attention. The impairment of alertness and concentration in solitary confinement leads to two related abnormalities: the inability to focus, and the inability to shift attention. The inability to focus (to achieve and maintain attention) is experienced as a kind of dissociative stupor-a mental "fog" in which the individual cannot focus attention, and cannot, for example, grasp or recall when he attempts to read or to think.
331
The inability to shift attention results in a kind of "tunnel vision" in which the individual's attention becomes stuck, almost always on something intensely unpleasant, and in which he cannot stop thinking about that matter; instead, he becomes obsessively fixated upon it. These obsessional preoccupations are especially troubling. Individuals in solitary confinement easily become preoccupied with some thought, some perceived slight or irritation, some sound or smell coming from a neighboring cell, or, perhaps most commonly, by some bodily sensation. Tortured by it, such individuals are unable to stop dwelling on it. In solitary confinement ordinary stimuli become intensely unpleasant and small irritations become maddening. Individuals in such confinement brood upon normally unimportant stimuli and minor irritations become the focus of increasing agitation and paranoia. I have examined countless individuals in solitary confinement who have become obsessively preoccupied with some minor, almost imperceptible bodily sensation, a sensation which grows over time into a worry, and finally into an all-consuming, life-threatening illness.
[...]
332 There are substantial differences in the effects of solitary confinement upon different individuals. Those most severely affected are often individuals with evidence of subtle neurological or attention deficit disorder, or with some other vulnerability. These individuals suffer from states of florid psychotic delirium, marked by severe hallucinatory confusion, disorientation, and even incoherence, and by intense agitation and paranoia. These psychotic disturbances often have a dissociative character, and individuals so affected often do not recall events which occurred during the course of the confusional psychosis. Generally, individuals with more stable personalities and greater ability to modulate their emotional expression and behavior and individuals with stronger cognitive functioning are less severely affected. However, all of these individuals will still experience a degree of stupor, difficulties with thinking and concentration, obsessional thinking, agitation, irritability, and difficulty tolerating external stimuli (especially noxious stimuli).

[...]

344
In 1956 the Group for the Advancement of Psychiatry (GAP) held a symposium, "Factors Used to Increase the Susceptibility of Individuals to Forceful Indoctrination," to study methods used by the Chinese and Russian Communists to "indoctrinate" and "break the will" of political prisoners and prisoners of war.41 Dr. Milton Meltzer, former Chief Medical Officer at Alcatraz Federal Penitentiary, contributed his observations of psychiatric disturbances among prisoners exposed to punitive solitary confinement at Alcatraz.42 These prisoners were rarely confined for periods beyond one week.43 Despite this, Dr. Meltzer described acute psychotic breakdowns among prisoners so confined; his descriptions closely paralleled the observations at Walpole:

The motor effects ranged from occasional tense pacing, restlessness and sense of inner tension with noise making, yelling, banging and assaultiveness at one extreme, to a kind of regressed, dissociated, withdrawn, hypnoid and reverie-like state at the other....​

​

... [T]he sense of self, the ego and ego boundary phenomena are profoundly affected by the isolation.44​

In the same symposium Dr. John Lilly of the National Institute of Mental Health noted that despite the importance of other factors which tended to "weaken personalities and make them more susceptible to [forced indoctrination]"-such as semi-starvation, physical pain and injury, and sleep deprivation-social and sensory isolation was still the central pathogenic factor in such confinement.45

[...]

350-351
Thus, the medical literature demonstrates that individuals whose internal emotional life is chaotic and impulse-ridden and individuals with central nervous system dysfunction may be especially prone to psychopathologic reactions to restricted environmental stimulation in a variety of settings.

357
II. SMALL GROUP CONFINEMENT
Many studies-both anecdotal and experimental-have been made of individuals confined together in small groups. Groups thus described have ranged in size from two to approximately sixty individuals, the larger groups include reports of men isolated on a Pacific island, in submarines, and on Antarctic expeditions. 71 The most consistent finding was of dramatically increased levels of hostility, interpersonal conflict, and paranoia.72 Individuals exposed to such conditions also tend to become irrationally territorial, staking out "areas of exclusive or special use, [and] acting with hostility to trespasses by others. 73 Confined groups comprising just two individuals may be the most pathogenic of all, associated with especially high rates of mutual paranoia and violent hostility. Admiral Byrd believed it to be extremely unsafe to staff an Antarctic base unit with just two men:

It doesn't take two men long to find each other out.... [T]he time comes ... when even his [campmate's] unformed thoughts can be anticipated, his pet ideas become a meaningless drool, and the way he blows out a pressure lamp or drops his boots on the floor or eats his food becomes a rasping annoyance.... Men who have lived in the Canadian bush know well what happens to trappers paired off this way ... During my first winter at Little America I walked for hours with a man who was on the verge of murder or suicide over imaginary persecutions by another man who had been his devoted friend.74​

Reading about the potentially harmful effects of confinement can help one to understand some of the observations of people who have been asked to self-isolate like in this clip from Australia. Fortunately only few people are so severely affected.