Perspectives
The art of medicine
The psychiatrist who wanted to believe
“Hey, Dr Khantzian—is Dr Mack crazy?” The question,
shouted across the foyer of the Massachusetts Medical
Society, was a measure of how far Harvard Professor of
Psychiatry John Mack, an eminent practitioner, researcher,
and Pulitzer Prize-winning writer, had fallen in the
estimation of some of his peers by the early 2000s. “It is
a tragedy that that’s the tag that’s often put on him”, the
late Mack’s former colleague and friend Edward Khantzian,
Clinical Professor of Psychiatry at Harvard, told me. “He was
not ‘crazy’. He was a man that was guided by his interests,
his searching for all kinds of truths, and I think he got
caught up with a faulty instrument.”
The “faulty instrument”—hypnotic regression—was
a technique that Mack put absolute faith in to help his
patients recover memories more clearly than conscious
recall. It was a view that put him at odds with the weight
of evidence: as Professor Chris French of the Anomalistic
Psychology Research Unit of Goldsmiths College, London,
told me, “the problem with hypnotic regression is you get
pretty much what you expect to get. If you go into a session
expecting to recover memories of alien abduction that’s
most likely what you’re going to get. If you go in thinking
you’re going to recover past life memories of being
Mary Queen of Scots, then that’s what you’ll get.” But, as
AP
John E Mack (1929–2004)
1140
far as both the Harvard administration and the scientific
community were concerned, the problem with Mack was
not just his belief in hypnosis: it was what he did with it.
In the early 1990s, Mack made a startling announcement.
He had been seeing patients who claimed to have been
abducted by aliens—and he believed them. In 1994, he
published Abduction: Human Encounters with Aliens, a book
containing a case series of 13 patients. A sequel, Passport to
the Cosmos, followed in 1999. Mack claimed that Abduction
was a logical development from his earlier work, which
included studies of T E Lawrence, suicide, and the threat of
nuclear warfare: “the connection resides in the matter of
identity—who we are in the deepest and broadest sense”.
The personal account became paramount: “the reported
experience of the witness, and our clinical assessment of
the genuineness of that report, may be the only means by
which we can judge the reality of the experience”.
It was, to his colleagues, an astonishing departure.
“He influenced me in many ways”, Khantzian said, “but
I could not go down that path...It was a painful aspect of
our relationship that I never entirely resolved.” Harvard
instituted a review of Mack’s position in 1994, but
he fought back and retained tenure. His professional
reputation, however, was severely damaged. “He’s not
taken seriously by his colleagues anymore”, Arnold Relman,
Emeritus Professor at Harvard Medical School, told the
Los Angeles Times in 2001. Mack also faced fierce criticism
from outside the academic community: journalist
Donna Bassett posed as a so-called abductee, and made
public details of a session during which Mack apparently
believed her story of being kidnapped by aliens during the
Cuban missile crisis, and witnessing a conference between
Khrushchev and Kennedy held aboard a spaceship.
What happened to Mack that made him believe and
promote such outlandish claims? Reading Mack’s work,
and my conversation with Khantzian, left me with the
feeling that Mack was driven by quite sincere beliefs.
Indeed, it was an aspect of his personality—his wanting
to believe (to paraphrase The X-Files)—that opened the
door to his promotion of the abductee experience as a
real phenomenon. Sceptic Michael Shermer wrote that
Mack’s emotions had led him into a belief system that
was then maintained through an intellectual leap, “giving
up the game of science entirely”. Abduction speaks of a
man easily touched by others’ emotions—indeed, a man
whose perception of others’ emotional sincerity led to a
belief in the reality of the experiences they described. “My
criterion for including or crediting an observation by an
abductee”, Mack wrote, “is simply whether what has been
reported was felt to be real by the experiencer and was
www.thelancet.com Vol 380 September 29, 2012

communicated sincerely and authentically to me.” This was
a surprising mistake for a psychiatrist of Mack’s experience
and standing. As Khantzian said, “if you listened to him,
his rigorous way of critiquing things...there was a true
juxtaposition that seemed contradictory.” What was it that
Mack found so convincing about patients who claimed to
have been abducted by aliens?
When abductees recount their paranormal experiences,
French told me, in general “the emotion that they show
is very, very real...It’s the emotion of the situation that
[observers] get swept up in and find so compelling”.
Writer Paul Cornell, who has woven elements of Mack’s
story into his thoughtful abduction-themed comic book
series Saucer Country, agreed. “Whenever you see these
folk...I think most of them are actually sincere—and
therefore most of them, it must be said, have experienced
something that is upsetting”. Khantzian told me about a
meeting with one of Mack’s abductees in which a panel
of psychiatrists “could find nothing delusional about
her”. Mack was keen to stress that his patients could not
be diagnosed with disorders such as schizophrenia. As far
as Mack was concerned, the treatable mental illness was
the trauma of the alleged encounter, not the abnormal
experience in itself.
If, as a reasonable scientific approach would demand,
we exclude the literal truth of alien abduction, what is
happening to these people? One candidate might be
sleep paralysis: a transient state between REM sleep
and full consciousness, during which the individual
is unable to move, and may experience, according to
French, “other associated symptoms that make it much,
much scarier: you get the sense of presence, you get
visual hallucinations, auditory hallucinations, tactile
hallucinations, [a] sense of pressure on the chest, and so
on.” Whilst French does not think that all those reporting
abduction experiences have experienced sleep paralysis,
“if you get the full Monty repeatedly...you can see how
some people might actually interpret this as evidence for
some kind of supernatural context”.
Sleep paralysis is a common condition—some estimates
go as high as 40% of the general population. The reasons
why a tiny proportion of sufferers might go on to identify as
alien abductees are complex. First, there is the predisposing
psychological profile of the individual—how likely they
are, for example, to attribute a paranormal explanation
to abnormal experiences. Second, there is the role that
culture plays in shaping and filtering one’s interpretation
of events. “In Newfoundland”, French told me, “they talk
about the old hag that comes and sits on the sleeper’s chest
and attempts to suffocate them. In Japan, they talk about
kanashibari, which is a nocturnal spirit attack; in St Lucia,
it’s the spirits of unbaptised children. Back in Europe in the
Middle Ages, it was sex-crazed demons”. In other words,
the basic experience of sleep paralysis remains the same—
www.thelancet.com Vol 380 September 29, 2012
Perspectives
night time visitations by a malevolent force that interferes
with one’s body—but the creatures that populate both the
experience and subsequent waking interpretations change.
In this respect, Grey aliens are a fascinating phenomenon,
described by Cornell as “the only modern monster”—a
popular myth invented and elaborated within living
memory. Their genealogy, Cornell told me, can be traced
back to an experience reported in 1961 by an American
couple called Barney and Betty Hill. “When they met [the
aliens], they were dressed in little biker caps and leather
outfits like the Village People...except that doesn’t feel
right, so the myth-making process has stripped them of
their uniforms.” The cultural elements that informed the
myth in the first place are harder to pin down, but the
appearance and behaviour of the Greys would suggest
they come from the darker aspects of 20th-century
history. “What I say at the start of Saucer Country—that the
Greys [aliens] are shaved lab animals, the dead of Belsen,
aborted fetuses—they do look like all those things, and
it does feel like it’s things we’ve done that are back to get
us”, Cornell said. In Abduction, Mack put a personal spin
on the Grey alien abduction myth, more in line with early
UFO stories in which benevolent superbeings warned
humankind to mend its ways. “The abductee is a modern
Dante”, he wrote. Where others saw horror, Mack saw a
“transformative process” involving beings who shared
many of his own social and political concerns. Naturally,
Abduction puts a positive spin on his interventions, but I
find the book uncomfortable reading: I see a well-meaning
man uncritically elaborating on tales of alien abduction,
and potentially both cementing and constructing false
memories. Moreover, Mack’s work, as Cornell said, spread
“the cultural meme of the Greys further”.
Mack’s story is a troubling one, demonstrating the
difficult boundary psychiatrists must negotiate between
offering comfort, and colluding with unusual beliefs.
Mack stated that with abductees he was “fully involved, Further reading
experiencing and reliving with them the world that they Mack JE. Abduction: human
encounters with aliens. New York:
are calling forth from their unconscious”. His decision to Simon and Schuster, 1994
give this part of his personality free rein whilst suspending Shermer M. Why people believe
his “rational intellect” was his undoing, and would come weird things: pseudoscience,
to overshadow his many admirable qualities. “The legacy superstition, and other
confusions of our time.
should be that he was an ethical, decent, inspiring, gifted, New York: Holt, 2002
enthusiastic teacher, clinician and mentor”, said Khantzian.
French C, Santomauro J.
“He was held in very, very high regard till he got into this Something wicked this way
area. And that part of him that was such a great leader comes: causes and interpretations
of sleep paralysis. In: Della Sala S,
and a great mentor, I never saw it wane in spite of these
ed. Tall tales about the mind
interests.” I believe that Mack was wrong. But he may, at and brain: separating fact from
least, have been wrong for the best of reasons, and with fiction. Oxford: Oxford University
the best of intentions. Press, 2007: 380–98
Cornell P. Saucer country.
New York: Vertigo, 2012
Niall Boyce
For Goldsmiths Anomalistic
The Lancet, London NW1 7BY, UK Psychology Unit see http://
niall.boyce@lancet.com www.gold.ac.uk/apru
1141