CfP – Tales from the Asylum: Patient Narratives and the (De)construction of Psychiatry

Tales from the Asylum

Patient Narratives and the (De)construction of Psychiatry

L0025917 Charcoal drawing: head from dissection

What is the patient’s role in shaping psychiatric practice? Thirty years after Roy Porter’s seminal article exhorting historians to turn to the neglected half of the doctor-patient dyad,[1] the time has come to reexamine the state of psychiatry and its history. Time and again (re)defined through a polyphony of narratives, mental illness has gone through a number of important changes over the past two centuries. Patients have played a significant role in these developments. Yet their stories in many ways remain to be told. At times frustrated, at times empowered, these men and women have used various channels to voice their suffering. How has madness been depicted, experienced, told by its main protagonists? How has its understanding been affected by broader socio-cultural developments, and vice versa? How have these changes come to shape and give rise to new identities? Delving into madness and its many narratives reveals a rich and intricate web of stories.

This special issue aims to provide a fresh and novel look into these psychiatric tales by critically reexamining recent historical and historiographical developments. From “outsider art” to clinical diaries, from popular accounts to autobiographical novels and from heated manifestoes to asylum scribbles—patients have cried out their ills in a variety of forms. These real and imagined stories of mental illness shed light on the complex ways in which psychiatry has been construed, explained and fictionalized since its inception. How have individual experiences influenced the construction of clinical categories? How have patients (and indeed their loved ones) come to play a decisive role in effecting medical and extra-medical changes? In what ways have patients chosen to voice their oppression? How have their demands been met by the legal system? And how have various methods of treatment—from the asylum to Freud to the DSM to the psychopharmacological turn—been accepted or rejected by those protagonists in differing social, cultural and political settings? By focusing on psychiatry’s ever-fluid identity, this issue will investigate the varied ways in which the patients’ voices have guided this discipline’s construction, deconstruction and reconstruction from 1800 to the present.

We welcome papers from both early career and more established scholars dealing with the above topics from historical, historiographical, theoretical and anthropological perspectives. Themes include (but are by no means limited to) accounts of mental illness examined through the following lenses:

  • Non-Western patient accounts
  • The impact of class and gender on formulations of mental illness
  • The juxtaposition of views “from above” and “from below”
  • The influence of the anti-psychiatry debate
  • Unedited correspondences between patients and physicians
  • Challenges to traditional (e.g., Foucauldian) theoretical approaches
  • The boundaries between fact and fiction
  • Alternative and little-known modes of representation
  • The impact of changing socio-political contexts on patient experience
  • The role of patients in altering diagnostic classifications and curative methods
  • Family and outsiders’ accounts
  • Particularities of psychiatric (vs. non-psychiatric) patients and their changes over time

Interested prospective authors should send 250-word paper descriptions, along with a tentative title and a short biographical statement, to H-Madness co-editor Alexandra Bacopoulos-Viau at abv233@nyu.edu by 30 June 2014. The full proposal with the selected contributions will be sent to a history of medicine journal shortly thereafter in view of an upcoming special issue.

 

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[1]Roy Porter, “The Patient’s View: Doing Medical History From Below”, Theory and Society, vol. 14, no. 2 (March 1985): 175-198

Image courtesy of the Wellcome Library, London

Seeking graduate student for summer research opportunity (Montreal)

Eugene Raikhel (Comparative Human Development, UChicago) and Stephanie Lloyd (Anthropology/Psychiatry, Laval U/McGill U) are seeking a graduate student to carry out ethnographic and archival research on a Montreal-based brain bank. The position is part of a broader research project examining the ways in which concepts of suicidal risk are being reframed by research in neuroscience and epigenetics. Applicants should be familiar with qualitative research methods in the social sciences, and ideally have a background in medical anthropology, medical sociology, science and technology studies, or the history of science and medicine. Research will be carried out over the course of eight to twelve weeks between June and September 2014, and will be based in Montreal, QC. Fluency in French is preferable. This is a paid position. This project would be particularly appropriate as the basis for a Master’s thesis or its equivalent.

Please contact Eugene Raikhel (eraikhel@uchicago.edu) if interested.

Weill Cornell Richardson History of Psychiatry Richardson Seminars – Fall 2014

Fall 2014

The Richardson History of Psychiatry Research Seminar

Convenes on the 1st & 3rd Wednesdays from September through May

 2:00 PM Baker Tower Conference Room F-1200 

 

September 3                Martha-Grace Duncan, Ph.D., J.D., Emory University Law School

“Morbid Laughter, Proper Tears:  The Demand for ‘Appropriate’ Emotions in Criminal Law”

 

September 17             Liliane Weissberg, Ph.D., University of Pennsylvania

“From Lessing to Freud: The Parable of the Three Rings”

 

October 1                     Mical Raz, M.D., Ph.D., Yale School of Medicine

“Psychiatry, Civil Rights and the Politics of Intellectual Disability”

 

October 15                   Rob Goldstein, M.D., Weill Cornell Medical College

“Balzac’s Addicts: A Literary Endophenotype”

 

November 5                 Diane O’Donoghue, Ph.D., Tufts University

“Freud on the Ring: The Architecture of Everyday Life before Berggasse”

 

November 19                Doron Ben-Atar, Ph.D., Fordham University & Richard D. Brown, Ph.D., University of Connecticut

“Taming Lust: Desire, Anxiety and the Prosecution Sexual Crimes in the Early American Republic”

 

December 3                 Greg Eghigian, Ph.D., Pennsylvania State University

“The Tangled History of Psychopathy in Germany”

 

December 17                No Seminar — Holiday Party

 

For more information, click here.

Investigating the Fate of John Watson’s Famous Experimental Subject

albert1-11

The Chronicle of Higher Education features an article by Tom Barlett – “The Search for Psychology’s Lost Boy” – chronicling the efforts of scholars attempting to discover the fate of psychologist John Watson’s famous experimental subject “Little Albert.” Albert, you may recall, was the baby Watson attempted to condition to be afraid of furry things, and some psychologists have made it their mission to discover the identity and ultimate fate of the youngster in question.

(Note: You may need a subscription to view this article).

A History of Madness Timeline

Madness

This infographic “The History of Madness” has been developed by Nora McAdams from the site Best Counseling Degrees. All your comments are welcome.

Le soin, histoire d’une relation (Europe – XIXe/XXe siècles)

In_a_Different_Voice_(Gilligan_book)

La journée se déroulera le mercredi 4 juin 2014 de 9h à 17h30 à la Sorbonne puis à Sciences Po, sous la présidence de Dominique Kalifa et Paul-André Rosental.

Matinée : salle Marc Bloch, Université Paris1 Panthéon-Sorbonne, 17 rue de la Sorbonne, 75005 Paris

Introduction

9h00. Mathilde Rossigneux-Méheust, Paul Marquis, Anne Jusseaume : « Le soin comme relation sociale : bilan historiographique et nouvelles perspectives ».

Nommer et délimiter le soin

10h00. Fabrice Cahen (Institut national d’études démographiques) : « Le traitement des femmes avortées dans les hôpitaux parisiens (1900-1975) ».

10h30. Benoît Majerus (IPSE, Université du Luxembourg) : « Surveiller et punir (et soigner?). Sur les pratiques psychiatriques au XXe siècle ».

Le soin : relation de pouvoir, pouvoir d’une relation

11h30. Hervé Guillemain (CERHIO) : « Le soin des schizophrènes dans la France des années 1930. Une observation au ras du sol à partir des dossiers de patients ».

12h. Paul Marquis (Centre d’histoire de Sciences Po) : « Soin ou surveillance? Les relations psychiatres-soignants-malades en contexte colonial (Algérie, 1945-1952) ».

Après-midi : Salle Jean Monnet, Centre d’histoire de Sciences Po, 56 rue Jacob, 75006 Paris

La relation de soin : une relation productrice d’identités

14h30. Mathilde Rossigneux-Méheust (Centre d’histoire du XIXe siècle, Paris 1) : « Le rôle du soin dans les opérations d’étiquetage des vieillards parisiens assistés en institution (1840-1914) ».

15h00. Claire Fredj (Université Paris Ouest Nanterre-La Défense – IDHES): « Un patient colonial? Médecins français et soins aux indigènes dans l’Algérie colonisée (fin 19e siècle-années 1930) ».

15h30. Claire Barillé (IDHES), « Le rôle du soin dans la relation médecin malade à l’hôpital : l’émergence du patient (1850-1914) ».

16h00. Anne Jusseaume (Centre d’histoire de Sciences Po) : « Des religieuses soignantes ? La relation sœur-malade dans les hôpitaux parisiens au XIXe siècle ».

17h00. Conclusions d’Olivier Faure (RESEA – LARHRA, Lyon III).

Argumentaire

L’histoire sociale de la médecine s’est largement constituée autour de l’étude des acteurs (médecin, malade, infirmière, personnel religieux), des lieux (hôpital, domicile, asile, dispensaire), des institutions (Assistance publique, médecine militaire, congrégations soignantes), et des pratiques (thermalisme, vaccination, homéopathie, électrothérapie, puériculture). Si le terme de soin y revient souvent, il est pourtant rarement étudié dans sa dimension relationnelle.

Proche de celle du soin, la notion de care a fait l’objet, depuis les travaux de C. Gilligan dans les années 1980, d’un effort philosophique et sociologique de définition et de théorisation. En revanche, la relation de soin reste le plus souvent envisagée en histoire comme un ensemble de pratiques plutôt que comme une forme de rapport social. Le soin est pourtant avant tout une relation intersubjective qu’il importe d’historiciser. Pour explorer cette relation depuis l’avènement de la médecine clinique, cette journée cherche à questionner le sens que revêt le terme de soin (1), puis la dimension sociale et relationnelle qu’il emprunte en se penchant sur les rapports de force (2) et les interactions (3) qui sont à la fois impliqués et produits dans le soin.

Nommer et délimiter le soin

Comment les praticiens envisagent-ils leurs rôles et leurs actes ? Comment trouver le « soin » dans les archives de la pratique médicale ? Ces questions font d’autant plus problème que le terme semble rarement employé dans les archives, et renvoie aussi bien à l’action de rendre la santé que de porter attention à quelqu’un (Larousse du XIXe siècle). Travailler sur la relation de soin (doit-on d’ailleurs en parler au singulier ou au pluriel ?) suppose d’abord de réfléchir à la façon dont on nomme les rapports qui unissent le soignant au soigné, le médecin au malade, le patient au psychiatre, la religieuse au pauvre malade. Dans cette perspective, nous espérons que les cadres de réflexion de cette journée permettront d’identifier les acceptions et les usages de ce mot à différents moments.

S’interroger sur le sens et les mots donnés par les acteurs à la relation produite lors d’une interaction médicale contraint à questionner ce qu’y cherchent soignants et soignés. A quoi sert le soin ? La guérison est l’horizon d’attente de la plupart de ceux qui prodiguent et reçoivent des soins, mais il en existe d’autres, comme la prévention. A ce titre, la dimension morale, politique et religieuse de l’approche médicale du personnel soignant doit aussi être interrogée. Penser la relation de soin permet ainsi de redéfinir la grande diversité d’actes et d’intentions qu’elle peut recouvrir.

Le soin : relation de pouvoir, pouvoir d’une relation

La relation de soin est une expérience partagée dans laquelle existe de façon plus ou moins prononcée une dissymétrie sociale et culturelle. Partir de l’interaction soignante, c’est poser la question de ce qui contribue à instaurer des rapports de pouvoir et des possibilités de négociation entre soignants et soignés. Le médecin s’impose-t-il toujours au malade ? A quelles conditions l’acte de soin peut-il échapper à l’infériorisation du patient, à la réification du malade ? Ces questions sont d’autant plus cruciales que la sollicitude et la volonté de guérir peuvent masquer les dimensions coercitives et autoritaires à l’œuvre. Dépassant la simple perspective médicale, faire l’histoire de cette relation invite à repenser ce qui se joue socialement et moralement dans le soin.

Nous souhaitons pour cela porter une attention particulière aux lieux (lit, salle, cabinet médical) où se produisent les relations de soin, afin de regarder ce qui s’y passe et entendre ce qui s’y formule. Une attention aux attitudes corporelles et aux mots employés permettra de questionner les ambivalences de cette relation. Cette méthode d’observation permettra peut-être d’envisager des périodisations propres à l’histoire du soin.

La relation de soin : une relation productrice d’identités

La période contemporaine est un temps d’accélération sans précédent dans la production des savoirs médicaux et dans la professionnalisation des métiers de soin ; toutefois l’histoire de ces processus ne permet pas à elle seule de réfléchir à la construction de l’identité des soignants et des soignés. Dans une perspective goffmanienne qui fait de l’interaction le moment où se constitue et se donne à voir l’identité des individus, la relation de soin peut être envisagée comme une relation de face-à-face où chacun des acteurs présents voit son rôle défini dans l’instant du soin. Privilégier cette approche conduit probablement à chercher de nouvelles sources pour l’histoire de la médecine. Comment saisir l’expérience des acteurs ? Quel est le rôle de la relation soignants-soignés et soignants-soignants dans la construction de leurs identités personnelles et professionnelles ?

***

A la recherche de ce que soigner et prendre soin veulent dire, nous interrogerons lors de cette journée les méthodes et les sources mobilisables par les historiens pour saisir la relation de soin. Nous aimerions que les communications, qu’elles abordent la relation de soin à domicile ou en institution, fassent jouer différents contextes politiques (colonial, autoritaire, laïque) et scientifiques (de la naissance de la médecine clinique au processus de spécialisation disciplinaire). En partant de l’interaction soignante, nous voudrions montrer que cette échelle d’observation au « ras du sol » permet d’interroger autrement les évolutions d’une histoire sociale de la médecine.

Anne JUSSEAUME (Centre d’Histoire de Sciences Po) : anne.jusseaume@gmail.com

Paul MARQUIS (Centre d’Histoire de Sciences Po) : paul.marquis@sciencespo.fr

Mathilde ROSSIGNEUX-MEHEUST (Centre d’histoire du XIXe siècle, Paris 1 Panthéon-Sorbonne) : mathildemeheust@yahoo.fr

Workshop “Mental Diseases in Ancient Medicine”

Screenshot from 2014-05-21 08:13:11Humboldt-Universität zu Berlin

6-8 October, 2014

Description

While Plato in the Timaeus (86b1-7) formulates a clear distinction between τὰ περὶ τὸ σώμα νοσήματα and τὰ περὶ ψυχήν, and also explicitly speaks of a μανία ὑπὸ νοσημάτων ἀνθρωπίνων in the Phaedrus (265a9-10) the absence, in medical texts of the fifth- and early fourth-century BCE, of comparable conceptualization of insanity as disease is well known. No clear model of ‘mental’ disease as mental is found in these texts: even though certain signs we would identify as psychiatric (e.g., hallucinations), psychological (e.g., suicidal tendencies, sudden fear) or neurological (e.g., spasms or fits) receive much attention, they are not made explicit as being part of a mental disease. Even phrenitis, melancholic affections, hysterical suffocation and epilepsy in its various forms, which appear to display mental implications clearly and with regularity, and to be the best candidates as ‘mental diseases’ in our texts, are problematic and present several serious objections to being attributed to this category. These diseases or syndromes are not isolated as belonging to a definition of psychiatric disease, on the one hand; on the other, with the important if not paramount role played by bodily aspects in them, they are also no easy match for any current categorization of mental diseases.

Later medical texts, instead, are more explicit in this respect. Diseases recognizable as pathologies we currently relate to as psychiatric or psychological are mentioned under clear labels. On the other hand, at different degrees the philosophical tradition on the care of the self, developed in the meantime (Plato, Aristotle, the Hellenistic schools) contributes to a more comprehensive view of health that explicitly includes spiritual and ethical aspects, and has a normative component.

This evolution towards a conceptualization of the psychological and psychiatric in medicine, noticeable for the first time in the taxonomy of the genera insaniae in section 3.18 of Celsus’ De Medicina, finds different formulation in a variety of nosological texts (Aretaeus’ De causis et signis acutorum morborum and De causis et signis diuturnorum morborum; Anonymus Parisinus; Caelius Aurelianus’ De morbis acutis et chronicis; Rufus’ De Melancholia) as well as in the consideration for the insane as specific patients expressed, for example, by Rufus in his Quaestiones medicinales but also perhaps visible in Galen’s patients’ cases, as well as in his philosophical and ethical take on emotions and mental life, which become at full title part of the field of action of the physician.

In this workshop we want to concentrate just on that period of Greco-Roman medical thought, in which the psychological was well established as legitimate part of the domain of the medical practitioner and thinker (i.e., a consideration for aspects of personality and emotions as elements of the pathological picture), on the one hand; and on the emergence of the psychiatric disease or syndrome in the nosological discussions alongside physiological diseases, on the other. This involves discussion of key methodological problems, and close reading of relevant texts that present questions and obscurities.

In this meeting we shall focus on some of the most relevant examples found in later medical sources from Celsus onwards, also establishing, where appropriate, a dialogue with the earlier (fifth- and fourth- century) medical tradition.

 

These are some of the central questions/themes that we shall explore:

What makes a disease a psychiatric disease in the given text?

How do psychological states, such as the emotions or the character of the patient, impinge on his bodily health, and how are they determined, in turn, by diseases of the body?

Can we speak of a form of ‘psychological therapy’ being recognised as part of the care for the insane (evident in Celsus, but also notably, in different forms, in Galen’s De propriorum animi cuiuslibet affectuum dignotione et curatione, De Temperamentis and De Indolentia, or in Rufus’ Quaestiones Medicales, and elsewhere)?

The intersections of ethics, medicine, and philosophy: Galen, of course, but also nosological texts (Aretaeus and Caelius Aurelianus, for example) engage with a broader, eudaimonistic and partly normative view of health as they discuss mental diseases. Discussion of relevant examples.

Which psychiatric (e.g., information about sleep, memory, cognition, disturbances of the senses) and psychological (e.g. emotional, communicative and behavioural data) signs are recognised as part of the semiotic and diagnostic of mental diseases?

In addition, in order to offer a frame to the more narrowly focused discussion on individual texts, two sessions will look at sources other than ancient medical texts: first, the evidence offered by documentary sources, to explore as much as possible the ‘real life’ of the mental patient, his or her social interactions and legal status, and various cultural implications. Secondly, the methodological and taxonomic problems implicit when discussing ancient mental diseases using the terminology and conceptual framework of current psychiatric and psychological categories.

Contact

Should you have any questions, please do not hesitate to contact the workshop organiser, Dr Chiara Thumiger (chiara.thumiger@hu-berlin.de).

For more information and a detailed program, click here.

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