Bipolar 2 From Inside and Out

Their names were Sarah, Edna, Wilma, and Helen Morlok, but they went down in psychiatric history as the Genain quads, Nora, Iris, Myra, and Hester, thanks to papers and books written about them at NIMH, where they lived for a while. NIMH was interested because all four girls developed schizophrenia.

Born in 1930 in Lansing, Michigan, the quads first became famous for the undeniable fact that they were four identical little girls. Their appeal was irresistible (at least until the Dionne quints came along in 1934). Unlike the five Dionne girls, the Morlok girls were not swept away to an institutional setting—at least not yet. They lived at home with their parents Sadie and Carl (who was appalled at their birth, comparing their mother to a “bitch dog”), under the scrutiny of the inquisitive, possessive townspeople around them. They wore identical outfits, of course, and performed tap dance and comedy onstage.

The girls seemed to provide evidence that schizophrenia was caused by a faulty gene or genes. Now, however, psychiatrists are exploring the effects of trauma in contributing to schizophrenia. And the Morlok girls had plenty of trauma. Nowadays, we would say they probably had C-PTSD. Their father was abusive to them and their mother. The youngest and smallest, Helen, came in for particular physical, emotional, and sexual abuse, along with her sister Wilma. Helen’s propensity for masturbation and sex play with Wilma led to both of them being tied to their beds at night and subjected to clitoridectomies.

The trauma continued into their schooling, when the girls were molested by a janitor and a teacher. Helen was considered slow and never graduated high school, but her three sisters did and went on to hold secretarial jobs. All were victims of attempted or actual sexual assault on the job, but were disbelieved or dismissed. Their schizophrenic tendencies may have begun in their teen years, but by the time they entered the world of work, they were having hallucinations and delusions, as well as the very real perceptions that they were still being abused.

The family members were all relocated to NIMH, the National Institute of Mental Health (part of the National Institutes of Health), where they lived, underwent extensive testing, and eventually were treated with Thorazine and other antipsychotics as they became available. Although the quads’ parents had raised them with an extreme fear of romantic relationships and sexuality, some of them found boyfriends at the facility. They were treated mostly by Dr. David Rosenthal, who formed a bond with the sisters and even visited them in Michigan after they left the institution.

One of the sisters, Sarah, was relieved of her symptoms to the extent that she was able to marry and have two sons. The other three lived at home, or independently at times and sometimes with one of their sisters. As of June 2023, Sara Morlok Cotton was still alive, living in an assisted living facility.

The book Girls and Their Monsters: The Genain Quadruplets and the Making of Madness in America by Audrey Clare Farley goes beyond the facts of the quads’ lives, however. It also explores the societal trends that affected the understanding of brain illnesses and trauma over the years. The book covers topics including structural racism and the civil rights movement. (Malcolm X’s mother, Louise Little, is featured in the book as a contrast to the Morloks. Little was institutionalized for 25 years when she was deemed incapable of caring alone for her eight children during the Depression.)

The gradual realization that incest and sexual abuse were rampant in society and their effects were decried in the book, as were the religiously repressive ideas of child discipline and the anti-feminist/anti-daycare agendas of the “Satanic Panic.” These societal developments as well as “recovered memories” were implicated in the treatment of those with brain illnesses. And, of course, John F. Kennedy’s legislation regarding community mental health and Ronald Reagan’s dismantling of it highlighted the lack of options for those with schizophrenia in particular.

Girls and Their Monsters also follows the development of psychiatry, from the days when schizophrenia was thought to have a biological origin to latter-day genetic theories that fueled the interest in the Morlok quads. The role of trauma in causing schizophrenia was also discussed. There was no treatment available until the advent of Thorazine, Compazine, and other powerful psychotropics. The role of psychotherapy is not mentioned, largely because of the predominately biological approaches to treatment.

The book covers a lot of territory in its brief pages. It makes for fascinating reading, even if there are no definitive answers. The sisters’ stories provide a mixture of tragedy and hope. Debilitated by their disorder, most of them managed to construct for themselves a life apart from the ravages of schizophrenia. None of them became homeless, and they were never permanently institutionalized. Their lives were difficult, but ultimately inspiring. The Morlok sisters’ struggles show the resilience of the human spirit, even while they lived with one of the most feared and misunderstood illnesses of their—and our—time.

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