Le branle-bas général à Saint-Jean-de-Dieu : Expérience de la désinstitutionnalisation, 1930-1976

Expérience de la désinstitutionnalisation à Saint-Jean-de-Dieu

Le branle-bas général à Saint-Jean-de-Dieu: Expérience de la désinstitutionnalisation, 1930-1976

Conférence de Marie-Claude Thifault

Le mercredi 03 juin 2015 – 19 h à 20 h 30

Institut Universitaire en Santé Mentale de Montréal

Conférence grand public

«Ouvrir les portes de l’hôpital, débarrer les portes de l’hôpital», selon le psychiatre Denis Lazure, n’était pas une façon d’imager sa pensée, mais bien un geste concret nourri par le vent de changements qu’insufflait la révolution psychiatrique des années 1960. Certes, la Commission d’études des hôpitaux psychiatriques et les conclusions de son rapport (Bédard, 1962) permettaient de croire à un vaste projet de désinstitutionnalisation psychiatrique au Québec. Nous jugeons qu’il est à propos de déplacer le point de vue sur la question de cette grande réforme pour s’intéresser à celui du patient lui-même. Cela afin de nous demander quelles sont ses propres inquiétudes quant à l’avenir suite au processus institutionnel de mise en liberté définitive? Ce questionnement propose une réévaluation des résultats peu concluants qu’a connus la première vague de désinstitutionnalisation psychiatrique au Québec, cette fois-ci, attachée à relater et prendre en compte l’expérience des patients.

Cette présentation sera tirée du livre Désinstitutionnalisation psychiatrique en Acadie, en Ontario français et au Québec (PUQ, 2014)

Conférencière

Marie-Claude Thifault, professeure agrégée
Titulaire, Chaire de recherche sur la francophonie canadienne en santé
Directrice, Unité de recherche sur l’histoire du nursing, Faculté des sciences de la santé, Université d’Ottawa, Canada

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Article in The Guardian: “The Truth About Psychosomatic Illness”

The London-based neurologist Susanne O’Sullivan has just published a piece in The Guardian about psychosomatic illness. Entitled “You Think I’m Mad?”, this article examines the case of a woman who went blind and whose symptoms could not be attributed to neurological causes. Towards the end of the article, the author mentions the ways in which this echoes the seminal work of nineteenth-century philosopher and psychologist, Pierre Janet (1859-1947).

To read the article, click here.

Peter Gay Dies at 91

It is another sad week for historians of psychiatry: Peter Gay — perhaps most famous in this field for his biography of Freud — has passed away at 91 years old.

An article on his life and work was published today in The New York Times. It starts thus:

Peter Gay, a German-born historian whose sense of intellectual adventure led him to write groundbreaking books on the Enlightenment, the Victorian middle classes, Sigmund Freud, Weimar culture and the cultural situation of Jews in Germany, died on Tuesday at his home in Manhattan. He was 91.

His death was confirmed by his stepdaughter Elizabeth Glazer.

Mr. Gay, a refugee from Nazi Germany, devoted his long career to exploring the social history of ideas, a quest that took him far afield from his original area of specialization, Voltaire and the Enlightenment. “He is one of the major American historians of European thought, period,” said Sander L. Gilman, a cultural and literary historian at Emory University.

It was his work on the 18th century that sealed Mr. Gay’s reputation as one of the pre-eminent historians of his generation. “Voltaire’s Politics,” published in 1959, was followed by “The Enlightenment: An Interpretation,” a monumental two-part study whose first volume, subtitled “The Rise of Modern Paganism,” won the National Book Award in 1967. The second volume, subtitled “The Science of Freedom,” was published in 1969.

“That is the last great work to provide a synthetic account of the philosophes and their world,” said Margaret Jacob, a professor of history at U.C.L.A. “It was canonical. He just had an encyclopedic grasp of the subject.”

A longstanding interest in Freud’s ideas led Mr. Gay to train at the Western New England Institute for Psychoanalysis and motivated him to write a revisionist psychohistory of the Victorian middle classes, “The Bourgeois Experience: Victoria to Freud,” whose five volumes were published in the 1980s. He also wrote the highly acclaimed “Sigmund Freud: A Life for Our Time” (1988), the first substantial Freud biography since the three-volume one by Ernest Jones from the 1950s.

To read the full New York Times article, click here.

New Issue – Guerres mondiales et conflits contemporains

GMCC_257_L204Hervé Guillemain et Stéphane Tison, auteurs de Du front à l’asile, 1914-1918, viennent de publier un numéro de la la revue Guerres mondiales et conflits contemporains, dédié aux “psychoses de l’arrière“. Le numéro rassemble historiens et psychologues.

Introduction parHervé Guillemain et Stéphane Tison

Loin du front, la folie ? Les civils internés à l’asile durant la Grande guerre par Stéphane Tison

Angoisses pour le sort des proches, deuils de guerre, crainte des combats : la Grande Guerre, par sa durée et l’implication de l’ensemble de la population française a suscité bien des troubles psychiques chez les civils. Toutefois, les aliénistes sont restés silencieux sur ces phénomènes. La plupart pensent comme leurs prédécesseurs du siècle précédent, que la guerre a tendance à suspendre les maladies mentales et que ces troubles s’inscrivent dans la biologie et l’hérédité. L’étude des statistiques réalisées par les directeurs d’asile montre une baisse de la population asilaire due à la réduction des séjours et à l’expérimentation de services ouverts. La guerre ne bouleverse pas la pensée médicale pour les civils mais diffuse progressivement la conception de l’assistance pour les « petits mentaux », en médicalisant angoisses et troubles mineurs qui n’étaient pas pris en compte avant guerre.

La psychose est-elle le fruit de l’Histoire ? À propos de la crise de septembre 1938 et de l’exode de mai-juin 1940 par Hervé Guillemain

Pour les malades entrés à l’hôpital psychiatrique durant la Seconde Guerre mondiale ou sortis peu après celle-ci, et pour leurs familles, il ne fait aucun doute que les événements de la guerre ont joué un rôle majeur dans le déclenchement de la psychose dont ils souffrent. Au premier abord les discours médicaux qui paraissent nier ce fait montrent que la controverse scientifique sur les liens entre guerre et folie ne s’est guère enrichie depuis la Grande Guerre. Pourtant en nous appuyant sur les effets psychiatriques de deux événements de l’histoire contemporaine française – la panique de septembre 1938 et l’exode de mai-juin 1940 – il est possible d’affirmer que ces événements et les travaux médicaux qui sont liés à eux permettent de consolider la notion récente et très discutée de « psychose réactionnelle » – pensée en tant que point de contact entre le terrain et l’expérience vécue, entre l’Histoire et l’histoire individuelle.

Permettre aux morts de mourir. Psychopathologie et prise en charge des séquelles de la shoah par Nathalie Zajde

L’auteur, enseignant-chercheur à l’Université de Paris 8, responsable de la cellule psychologique dédiée aux survivants et descendants de survivants de la Shoah du Centre Georges Devereux, rappelle l’évolution du statut du survivant des camps de concentration dans le corpus psychiatrique, elle remet en cause certains préjugés sur l’usage de la parole et sa fonction dans les familles de survivants, enfin, en s’appuyant sur des vignettes cliniques, elle présente l’intérêt et la singularité de l’approche ethno-psychiatrique.

Une mission syrienne. Témoignage par Caroline Leduc

Quelle valeur donner aux dispositifs de prise en charge psychologique qui interviennent dans le temps même de la guerre, alors que les civils auxquels ils s’adressent continuent à en subir les effets délétères ? Que peut-on en attendre, au-delà de l’affichage politique vertueux qui initie souvent de telles interventions ? On tâchera d’en faire l’épreuve au travers de la présentation d’une mission au sein d’un hôpital militaire français situé dans le camp de réfugiés syriens de Za’atari, au Nord de la Jordanie. Les modalités atypiques de cette opération humanitaire ont conduit à construire un dispositif expérimental, défini à partir de ses limites : fonction non médicale du psychologue, temporalité spécifique, différence des cultures et des langues. Des vignettes cliniques permettront d’articuler les enjeux et les visées du dispositif aux effets qu’il a produit.

Special Issue of Science in Context: “Of Means and Ends: Mind and Brain Science in the Twentieth Century”

The latest issue of Science in Context, guest edited by Stephen T. Casper, deals with the mind and brain sciences in the twentieth century. Its essays cover a range of topics relevant to H-Madness readers, from the Thematic Apperception Test to Edgar Adrian’s Thermionic Vacuum Tube, from Hugo Münsterberg’s Psychotechnics to the Minnesota Multiphasic Personality Inventory, and from the Psychosurgery Controversy of the 1970s to the Intersecting Histories of Psychiatry and Psychology in Twentieth-Centuy US.

Titles and abstracts below:

Of Means and Ends: Mind and Brain Science in the Twentieth Century

Stephen T. Casper

What role does context play in the mind and brain sciences? This introductory article, “Of Means and Ends,” explores that question through its focus on the ways scientists and physicians engaged with and constructed technology in the mind and brain sciences in the twentieth century. This topical issue addresses how scientists, physicians, and psychologists came to see the ends of technology as important in-and-of themselves. In so doing, the authors of these essays offer an interpretation of historian Paul Forman’s revisionist and highly contextualist chronology of the twentieth century, which presents the comparatively recent tendency to aggrandize the ends of technology as evidence of a major, epochal transformation in the epistemic culture of twentieth-century American science. This collection of papers suggests that it was in the vanguard of such fields as psychology, psychiatry, and neurophysiology in North America and Europe that the ends and applications of technology became important in-and-of themselves.

Dredging and Projecting the Depths of Personality: The Thematic Apperception Test and the Narratives of the Unconscious

Jason Miller

The Thematic Apperception Test (TAT) was a projective psychological test created by Harvard psychologist Henry A. Murray and his lover Christina Morgan in the 1930s. The test entered the nascent intelligence service of the United States (the OSS) during the Second World War due to its celebrated reputation for revealing the deepest aspects of an individual’s unconscious. It subsequently spread as a scientifically objective research tool capable not only of dredging the unconscious depths, but also of determining the best candidate for a management position, the psychological complexes of human nature, and the unique characteristics of a culture. Two suppositions underlie the utility of the test. One is the power of narrative. The test entails a calculated abuse of the subjects tested, based on their inability to interpret their own narrative. The form of the test requires that a subject fail to decipher the coded, unconscious meaning their narrative reveals. Murray believed the interpretation of a subject’s narrative and the projection contained therein depended exclusively on the psychologist. This view of interpretation stems from the seemingly more reasonable belief of nineteenth-century Romantic thinkers that a literary text serves as a proxy for an author’s deepest self. The TAT also supposes that there is something beyond consciousness closely resembling a psychoanalytic unconscious, which also has clear precedents in nineteenth-century German thought. Murray’s views on literary interpretation, his view of psychology as well as the continuing prevalence of the TAT, signals a nineteenth-century concept of self that insists “on relations of depth and surface, inner and outer life” (Galison 2007, 277). It is clear the hermeneutic practice of Freud’s psychoanalysis, amplified in Jung, drew on literary conceptions of the unconscious wider than those of nineteenth-century psychology.

The Birth of Information in the Brain: Edgar Adrian and the Vacuum Tube

Justin Garson

As historian Henning Schmidgen notes, the scientific study of the nervous system would have been “unthinkable” without the industrialization of communication in the 1830s. Historians have investigated extensively the way nerve physiologists have borrowed concepts and tools from the field of communications, particularly regarding the nineteenth-century work of figures like Helmholtz and in the American Cold War Era. The following focuses specifically on the interwar research of the Cambridge physiologist Edgar Douglas Adrian, and on the technology that led to his Nobel-Prize-winning research, the thermionic vacuum tube. Many countries used the vacuum tube during the war for the purpose of amplifying and intercepting coded messages. These events provided a context for Adrian’s evolving understanding of the nerve fiber in the 1920s. In particular, they provide the background for Adrian’s transition around 1926 to describing the nerve impulse in terms of “information,” “messages,” “signals,” or even “codes,” and for translating the basic principles of the nerve, such as the all-or-none principle and adaptation, into such an “informational” context. The following also places Adrian’s research in the broader context of the changing relationship between science and technology, and between physics and physiology, in the first few decades of the twentieth century.

Screening the Psychological Laboratory: Hugo Münsterberg, Psychotechnics, and the Cinema, 1892–1916

Jeremy Blatter

According to Hugo Münsterberg, the direct application of experimental psychology to the practical problems of education, law, industry, and art belonged by definition to the domain of psychotechnics. Whether in the form of pedagogical prescription, interrogation technique, hiring practice, or aesthetic principle, the psychotechnical method implied bringing the psychological laboratory to bear on everyday life. There were, however, significant pitfalls to leaving behind the putative purity of the early psychological laboratory in pursuit of technological utility. In the Vocation Bureau, for example, psychological instruments were often deemed too intimidating for a public unfamiliar with the inner workings of experimental science. Similarly, when psychotechnical means were employed by big business in screening job candidates, ethical red flags were raised about this new alliance between science and capital. This tension was particularly evident in Münsterberg’s collaboration with the Paramount Pictures Corporation in 1916. In translating psychological tests into short experimental films, Münsterberg not only envisioned a new mass medium for the dissemination of psychotechnics, but a means by which to initiate the masses into the culture of experimental psychology.

Of Psychometric Means: Starke R. Hathaway and the Popularization of the Minnesota Multiphasic Personality Inventory

Rebecca Schilling and Stephen T. Casper

The Minnesota Multiphasic Personality Inventory (MMPI) was developed at the University of Minnesota, Minneapolis, in the 1930s and 1940s. It became a highly successful and highly controversial psychometric tool. In professional terms, psychometric tools such as the MMPI transformed psychology and psychiatry. Psychometric instruments thus readily fit into the developmental history of psychology, psychiatry, and neurology; they were a significant part of the narrative of those fields’ advances in understanding, intervening, and treating people with mental illnesses. At the same time, the advent of such tools also fits into a history of those disciplines that records the rise of obsessional observational and evaluative techniques and technologies in order to facilitate patterns of social control that became typical during the Progressive Era in the United States and after. It was those patterns that also nurtured the resistance to psychometrics that emerged during the Vietnam War and after.

The Surgical Elimination of Violence? Conflicting Attitudes towards Technology and Science during the Psychosurgery Controversy of the 1970s

Brian P. Casey

In the 1970s a public controversy erupted over the proposed use of brain operations to curtail violent behavior. Civil libertarians, civil rights and community activists, leaders of the anti-psychiatry movement, and some U.S. Congressmen charged psychosurgeons and the National Institute of Mental Health, with furthering a political project: the suppression of dissent. Several government-sponsored investigations into psychosurgery rebutted this charge and led to an official qualified endorsement of the practice while calling attention to the need for more “scientific” understanding and better ethical safeguards. This paper argues that the psychosurgery debate of the 1970s was more than a power struggle between members of the public and the psychiatric establishment. The debate represented a clash between a postmodern skepticism about science and renewed focus on ultimate ends, on the one hand, and a modern faith in standards and procedures, a preoccupation with means, on the other. These diverging commitments made the dispute ultimately irresolvable.

Contending Professions: Sciences of the Brain and Mind in the United States, 1850–2013

Andrew Scull

This paper examines the intersecting histories of psychiatry and psychology (particularly in its clinical guise) in the United States from the second half of the nineteenth century to the present. It suggests that there have been three major shifts in the ideological and intellectual orientation of the “psy complex.” The first period sees the dominance of the asylum in the provision of mental health care, with psychology, once it emerges in the early twentieth century, remaining a small enterprise largely operating outside the clinical arena, save for the development of psychometric technology. It is followed, between 1945 and 1980, by the rise of psychoanalytic psychiatry and the emergence of clinical psychology. Finally, the re-emergence of biological psychiatry is closely associated with two major developments: an emphasis that emerges in the late 1970s on rendering the diagnosis of psychiatric illnesses mechanical and predictable; and the long-term effects of the psychopharmacological revolution that began in the early 1950s. This third period has seen a shift the orientation of mainstream psychiatry away from psychotherapy, the end of traditional mental hospitals, and a transformed environment within which clinical psychologists ply their trade.

Epilogue: The Redux of Postmodernity

Roderick D. Buchanan

The essays in this topical issue illustrate the changing cultural form and function of the biopsyche disciplines – disciplines that are both sciences and technologies of selfhood. To varying degrees, each essay actively engages Paul Forman’s thesis on modern and postmodern cultural valuations of science and technology. Forman invites those who read his work to view the cultural space framing science and technology in new ways (Forman 2007; idem 2010).

For more information, click here.

The Controversial Diagnosis of “Excited Delirium”

9780849316111Journalist Justin Jouvenal has written an article for The Washington Post examining the debate swirling around a syndrome dubbed “excited delirium.” Proponents have applied the term to what is believed to be a syndrome affecting certain individuals “Influenced by mental illness or the use of such stimulants as cocaine and methamphetamine” who, when in “its grip often have extraordinary strength, are imperviousness (sic) to pain and act wildly or violently. Then, suddenly, some die.” Critics, however, have noted the popularity of the diagnosis in cases involving suspected excessive force by police in the United States, concerned that it is providing cover for abusive policing practices.

According to Jouvenal’s sources, the concept dates back to the mid-19th century, but started to gain currency more recently in the mid-1980s. Medical examiners in Miami at the time began applying the term in the midst of the cocaine epidemic spreading across Florida.

New network on Madness Studies

Screenshot from 2015-05-05 19:16:13 At the University of Oulu, Finland, a network to coordinate research in the Nordic countries on Madness Studies has been created recently. This group is now keen on expanding the network beyond this rather small geographical area.

The main purpose of Madness Studies is to provide a useful platform for communication, cooperation and collaboration across national borders and disciplinary boundaries. At this early stage, the primary goal is to compile data about scholars, doctoral students and research groups involved in research activities, as well as inform about conferences, journals, books and primary sources. Potential future forms of activities include a founding of a society and organization of meetings devoted to the multidisciplinary aspects of madness.

To get more information visit their homepage.

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