The horrors of the Holocaust were preceded in Nazi Germany by the conversion of five asylums and an abandoned jail, which were transformed into gas chambers, killing tens of thousands of patients.

That’s a story that Susanne Paola Antonetta tells in The Devil’s Castle, a book that started with the Nazi massacre of the disabled, she said. “The subtitle, Nazi Eugenics, Euthanasia, and How Psychiatry’s Troubled History Reverberates Today, grew with the book,” stated Antonetta. ”Euthanasia grew out of the 19th-century eugenics movement, the drive to remove ‘tainted’ hereditary lines from society. Eugenics flourished in the United States before and after the war. It hasn’t ended,” she stated.

Antonetta focuses on several people in the history she provides for a book she said took eight years to compile. “I even had to learn another language: German,” she stated. Two of Antonetta’s “heroes” are Paul Schreber, a German judge who was able to make his own case to force his release from an asylum, and Dorothea Buck, a longtime activist who wrote lucidly of her own psychotic episodes.

“Buck had a vision in 1936 of Hitler’s coming war proving ‘monstrous.’ Buck’s mother took her to a doctor, the vision of monstrous war a symptom, like the loony cartoon prophet’s apocalypse sign. If only millions of people had had her symptom,” noted Antonetta.

Buck died in 2019 at the age of 102, said Antonetta, who “found her book, her talks, her letters.” “I followed her star with her during my own psychotic break,” said the author, who’s had to deal with her own bipolar condition.

Another major figure in the book is Emil Kraepelin, a German psychiatrist who was both eugenicist and anti-semite. Kraepelin believed Jews had a natural connection to mental illness, and he trained some of the worst Nazi doctors, noted Antonetta. Kraepelin, who died in 1926, remains popular, even considered “the father of modern psychiatry,” having devised an elaborate system of psychiatric classification, she said.

The title of the book refers to what the asylum known as Sonnenstein later became called. Once a castle-fortress dating back to the Middle Ages, the buildings were renovated in the 15th and 16th centuries. In 1811, the Prussian government established an asylum at one end of the sprawling fortress. Antonetta noted that a study of how society treats mental problems shows that ideas on finding a cure often change over time.

Under its first director, Ernst Pienitz, Sonnenstein became Europe’s pinnacle asylum, said Antonetta. Pienetz released a quarter of his patients, fully cured, within a year of their entry, remarkable for that time and that patient population, she said.

The reputation made Sonnenstein a teaching hospital, the destination for hundreds of doctors to learn how mental illness could be treated humanely , said Antonetta, noting that less than a century later, the once-fabled institution had become a killing ground “where patients died by gas and were thrown in the river below in the form of ash.”

While stressing the failures in the treatment of mentally disabled people, Antonetta sees progress being made despite a reliance on drugs for treatment. She looks to the future and calls for change. “It’s time to end the use of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in psychiatry,” she said. “This work is the fruit of the poisoned tree, in its Kraepelinian roots and in its development by those with a financial stake in finding people ill.”