For the second installment of the “How I became a historian of psychiatry” series, Edward Shorter, Hannah Professor in the History of Medicine and Professor of Psychiatry at the University of Toronto, author among others of A History of Psychiatry from the Era of the Asylum to the Age of Prozac (1997) and From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era (1992), kindly shares his intellectual biography with the H-Madness community:

This story began in 1967 when, a fresh young history PhD graduate, I came to the University of Toronto.  I had been trained as a social historian and after several projects far away from the history of medicine, in 1975 I wrote a general history of the family, not that it was such a medical contribution – but it called my attention to a number of medical issues in the lives of women historically:  infected abortion, weariness from overwork, and iron-deficiency anemia.  This led to a history of women’s health care (Women’s Bodies) in 1982.  This was full-blast medical history, but researching it made me aware that I knew almost nothing of medicine.  So I went to medical school for two years, taking all the basic medical sciences.

I now felt better equipped to take on a big problem: the history of psychosomatic illness, especially “hysteria,” mainly in women, over the centuries.  Knowing something about medicine was helpful here because of the difficulty in sorting out symptoms that are psychogenic (“hysteria”) from those that are organic-medical, such as endometriosis, often dubbed “hysterical” in the past.  This research resulted in From Paralysis to Fatigue (1992).

I was now thoroughly enmeshed in psychiatry, and went on to write a general history of the discipline, which appeared in 1997 and was read by a number of psychiatrists.  I became friendly with several whose work I greatly admired, and who subsequently influenced the direction of my own studies, in particular David Healy, Max Fink, Bernard Carroll, Tom Ban, Tom Bolwig, and Gordon Parker.  Animated email exchanges with this group produced a sharp research interest on my part in two themes: the history of diagnosis (nosology), and the history of psychiatric medications (psychopharmacology).  This led to a string of publications: A History of Shock Therapy, with David Healy (2007), Before Prozac (2009), and Endocrine Psychiatry; Solving the Riddle of Melancholia (with Max Fink) in 2010.  My latest book, The Rise and Fall of the Nervous Breakdown – And How Everyone Became Depressed, will be published by Oxford early in 2013.  I should say that among contemporary historians of psychiatry there are also several whose work I have learned from, in particular Patrizia Guarnieri and Ian Dowbiggin.  Everyone in our field learned from Roy Porter.

There are two points of more general interest in this cascade of self-esteem: (1) Historians of psychiatry have a real contribution to make to clinical psychiatric diagnosis, subject as it is to the buffeting of fashion and fad; that contribution lies in surveying the enormous historical experience of psychiatry to see which diagnoses seem to correspond most closely to natural disease entities.  (2) Psychiatric historians also have a contribution to make to therapeutics, because many past therapies have been discarded not because they were unsafe or ineffective, but because the patents expired!  Or because (as in the case of electroconvulsive therapy) society turned against them for non-scientific reasons.  Or because, as in the case of the barbiturates, makers of newer drug classes scorned them in advertising as old-fashioned and risky.

Among my current interests are pediatric catatonia and self-injury behavior in autism, and the extent to which they have been relieved in the past with ECT; the early “tranquilizers” and sedatives, discarded as effective treatments largely because of psychiatric urban myths of various kinds; and melancholia as a distinctive illness in its own right with characteristic biological markers.  I find this research tremendously exciting, and hope that historian colleagues will become involved. 

Many thanks, Edward Shorter, for sharing this story!