New issue: History of Psychology

hist psychThe February 2011 issue of History of Psychology is out and includes, among others, and article by Donna Trembinski entitled “Comparing premodern melancholy/mania and modern trauma: An argument in favor of historical experiences of trauma”.

The abstract reads:

Historians and psychiatrists have repeatedly looked to both real and imagined individuals of the past, like Achilles and Samuel Pepys, and found evidence that they were suffering from symptoms of trauma and posttraumatic stress disorder. The assumptions that allow such historical “diagnoses” have, however, recently been called into question by philosophers such as Ian Hacking, anthropologists like Allan Young and psychiatrists such as Patrick Bracken. These scholars have all suggested in various ways that experiences of trauma could not have occurred until the diagnosis of trauma and its symptoms had been formalized and the language of trauma had been developed in the late 19th century. This article attempts to resolve this bifurcation of opinion on the universality of the mind and historical experiences of trauma in two ways. First, it argues for the necessity of applying modern categories of analysis to further present understandings of the past. Second, it considers discussions of “melancholia” and “mania” in premodern medical literature and argues that there are enough similarities between the causes and symptoms of these premodern disorders and modern trauma to suggest that experiences of trauma may not be wholly culturally bound to the modern world, as the above scholars have suggested. While melancholy or mania cannot simply be understood as premodern names for trauma, and it is not always correct to “diagnose” a premodern person who exhibits symptoms of these illnesses with trauma, such an assumption is not always ahistorical or incorrect either.

More information on this issue can be found at http://psycnet.apa.org/index.cfm?fa=browsePA.volumes&jcode=hop

New Issue of PSN

A new issue of PSN (Psychiatrie Sciences Humaines Neurosciences) has just been released online. Included in this issue are two pieces that may be of interest to h-madness readers. Titles, authors and abstracts listed below:

Interview with Alain Ehrenberg: social signification of narcissistics pathology in France and United States of America by Bernard Granger

Anxiety disorders in the history of medicine Second part: from neurasthenia to generalized anxiety disorder by T. Haustgen

The last “great neurosis,” described by general practitioners before the Freudian classification, the neurasthenia (Beard, 1869, 1880; Charcot, 1887) originated between 1870 and 1900 in the USA and in Europe. It was then dismembered and annexed by the psychiatrists, through psychasthenia (Janet, 1903) and mild depressive states. It declined slowly at the beginning of the 20th century, but is still alive in the textbook of P. Guiraud (1956) and in the ICD-10 (1992). Helped by the works of E. Brissaud (1890) and E. Hecker (1892), Freud’s “anxiety neurosis” (1895) remains, however, the most famous clinical entity resulting from the dismemberment of neurasthenia. It includes anxious expectation, anxiety attacks, and somatic equivalents. Diffused in France by Hartenberg, Lalanne (1902), and then Heckel (1917), it was contested by G. Ballet, Pitres and Regis (1902) and F. Raymond (1911) — successor of Charcot at the Salpêtrière Hospital. After 1910, the hereditary “emotive constitution” of E. Dupré tended to gather the manifestations of anxiety neurosis, several hysterical symptoms, some depressive disorders, and post-traumatic disorders resulting from the lst World War (Devaux and Logre, 1917; De Fleury, 1924). But many French authors separated psychical anxiety and somatic anguish — later named panic disorder, (Brissaud, 1902; Claude and Lévy-Va1ensi, 1938; Ey, 1950). After 1945, the emergence of several somatic entities such as stress, vagotonia, and spasmophilia can be seen as new attempts by general practitioners for the annexation of anxiety disorders. After 1960, two opposite clinical orientations can be described: those inspired by psychoanalysis maintain the autonomy of anxiety neurosis; others separate, from psychopharmacological criteria, generalized anxiety and acute anguish. This last, named “panic attack” (D. Klein, 1962), gathers in fact the symptoms of paroxysmal anxiety (Brissaud), anxiety attack (Freud), emotive attack (Dupré), emotive or anxious crisis (Devaux and Logre), and the mental paroxysmal form of anxiety (Heckel). Though the clinical dichotomy between generalized anxiety and panic disorder has been emphasized by DSM-IV and ICD-10, a dimensiona1 approach of mental disorders would include most anxious and “neurotic” symptoms, beyond anxiety neurosis.

Book Review – Siri Hustvedt. The Shaking Woman, or A History of My Nerves (Picador 2010)

By Mikhal Dekel

Siri Hustvedt begins to shake uncontrollably when she delivers a talk in honor of her father two and a half years after his death. She shakes violently from the neck down (her mother later tells her it looked like an electrocution) but manages to deliver her talk without a flaw, her linguistic faculties and facial expression apparently unaffected. The seizure is followed by a few subsequent seizures, followed by an overwhelming dread of more seizures. In what Hustvedt describes as “a quest for mastery” over the foreign assault on her otherwise highly composed, non-anxious, linguistically sophisticated self, the novelist embarks on an intellectual journey in search of a diagnosis. But the questions she asks on this journey soon turn larger and larger, pushing her towards the philosophical: What is the relationship between body and mind? Is there an unconscious? How different are dreams and flashbacks from explicit memories? Is she “the shaking woman,” or is the shaking woman external to her, a double, or a cut-off part of her contained, core self? Need the shaking woman be reckoned with or must she be obliterated with medical treatment?

Hustvedt’s deft quest for answers sends her traveling across a slew of disciplines: psychiatry, neurology, psychoanalysis, pharmacology, philosophy, and narrative medicine. She visits each discipline, citing famous case studies and considering a possible diagnosis (Hysteria? Conversion disorder? Repression? Epilepsy?), then quickly moves to expose the blind spots that fall outside the scope of each epistemological framework. As a non-specialist, Hustvedt (who holds a PhD in English and has published several novels and essays) is the highly intelligent lay explorer who isn’t bound by the yoke of any single discipline or point of view. She allows herself to transgress the boundaries between and within disciplines, traversing not only horizontally but also diachronically to what Foucault had called their “point-zero,” the moment in which neurology is forever dissociated from psychiatry (the first would heal the brain, the latter the mind) and psychoanalysis turns from the science that the young neurologist Sigmund Freud had first envisioned it as into a “talking cure.” This bird’s eye view allows Hustvedt not only to critique the limited scope of the highly specialized disciplines, but also to salvage the reputation of the late nineteenth century giants that have fallen out of favor with the medical establishment: Freud, Janet, Charcot. Freud, Hustvedt maintains, took the fateful turn towards psychological explanations of the mind only after he decided that the knowledge of neural processes available to him at the time was insufficient for developing a biological model of the mind; but the scientific origin of Freud’s thought has been forgotten (repressed?) by practitioners of psychoanalysis, as well as by neurologists and psychiatrists who, exposed to not a word of Freud in the course of their training, are prone to adopt Freud’s popular image as a mystic thinker whose theories emerged out of the decidedly un-empirical air of his imagination.

Hustvedt sets out to critique the specialized disciplines but also to make peace between them. She is at her best when she draws original links between seemingly unrelated doctors, patients and theories, situating types of dissociative conditions like multiple personality disorder and traumatic flashbacks side by side, fancying the case of Janet’s famous patient Irene as a precedent to her own case, or identifying the brain-damaged patient at the center of the Russian neurologist A. R. Luria’s The Man with a Shattered World as the unacknowledged precedent to a paper published in a 1994 issue of Brain. Her flexible, wide lens, it is implied, allows Hustvedt to see links that the highly professionalized contributors to Brain cannot.

The glue that holds all of this intellectual heavy-lifting together – though occasionally parts do not quite stick – is Hustvedt’s personal story: the progression of her shaking condition, early childhood memories that had shaped her, the history of her migraines, and her relationship both to her deceased father and to her (barely mentioned) mother, the big elephant in the room around which Hustvedt circles but never explores at length.

Something of an inherent contradiction underlies this fascinating, challenging and at times moving book, a contradiction which is symptomatic of our age: Hustvedt’s quest into the far reaches of medicine and psychology is driven both by fascination with and a deep distrust of the medical and psychological professions. Reportedly reading Freud since she was sixteen, she has never been in analysis; in lieu of medical attention to her seizure, she visits an imaginary psychoanalyst (summarizing the imagined course of treatment in one paragraph), then an imaginary neurologist, who sends her for an imaginary CAT Scan (no noticeable change in the brain is detected). In place of a doctor Hustvedt reads and reads and reads all those books and specialized journals that once were accessible only to the white robes but are now available at the stroke of a keyboard to a New York based novelist or any grandmother in Texas. When reading fails to bring about a conclusive diagnosis or end the shaking episodes, Hustvedt turns to a psychiatrist “friend”; the friend refers her to a neurologist, who refers her to a pharmacologist, with whom she finally makes an appointment. But then she cancels, choosing instead to self-medicate on the beta-blocker Inderal, which suspends the external shaking but does not alleviate her inner tremor. In the last pages of her memoir, Hustvedt decides to begin analysis, but this is where the book tellingly ends.

It is striking in this respect to consider the stark difference between the hermeneutics of suspicion, and the rapid transitions and conjunctures that characterize this work by a contemporary American writer, and the lengthy, painstaking recording of thirty years worth of minute observations, which makes up the Russian Luria’s 1973 study. At times her expansiveness works against Hustvedt: one cannot, after all, read everything (she overlooks, for example, Richard McNally’s recent study of trauma memory, which contradicts much of what she says about fragmented, involuntary memory). At times she also hammers her critique a bit too hard (as when she launches, near the end of the book, an intense critique of constructivism, a dead horse for sometime now). Nonetheless, Hustvedt offers the reader a unique and impressive synthesis of multiple intellectual threads, woven into the story of her shaking with lucid, exquisite prose (“Over time [Freud’s] thoughts about the psychic apparatus would both change and evolve, but he would never be able to sink his theories into the nervous system, where he knew its processes originated”). In passionately arguing for a holistic, humane take on the individual as body and soul, consciousness and unconsciousness, composure and abandon, Hustvedt situates herself within a lineage that dates back to earlier female critics of rationalistic practices like Martha Nussbaum and Patricia Williams, but also, going even further back in time, to Freud and Janet.

Mikhal Dekel is an Associate Professor of English at the City College of New York, where she teaches courses on trauma, memory, emotions and culture. She is the author of The Universal Jew: Masculinity, Modernity and the Zionist Moment (Northwestern UP, 2010)

Mémoire et avenir : controverses autour de la psychiatrie et de l’antipsychiatrie

IUHMSP, Lausanne
Musée de la Main,Fondation Claude Verdan, 21 rue du Bugnon, CH-1011 Lausanne

Une série de quatre symposiums organisés par l’Institut universitaire d’histoire de la médecine et de la santé publique (IUHMSP), avec la collaboration du Département de Psychiatrie et de l’Association Le chiffre de la parole.

Ces rencontres partent de la constatation qu’il existe encore peu de recul, en termes de mémoire vivante, de récits et de transmission, quant à l’émergence d’expériences singulières relevant du champ de la psychiatrie ou de l’éducation au cours du XXe siècle et à leur rapport avec les institutions officielles. On pensera en particulier à Maud Mannoni, Fernand Deligny, François Tosquelles ou Claire-Lise Grandpierre pour ne citer que quelques exemples, surgis dans le sillage de ce qu’il est convenu d’appeler l’« antipsychiatrie ».

Assurément, ce terme, et l’ensemble des pratiques, institutionnelles ou alternatives, qu’il a suscitées demande réflexion : historique d’une part, institutionnelle et politique d’autre part. Les questions soulevées articulent en effet vies individuelles singulières, familles, organisations et institutions, collectivités, pouvoir politique. En termes d’avenir, il convient de réfléchir aux nouvelles alliances entre l’ensemble des acteurs et des décideurs, afin que soient valorisées des pratiques à différentes échelles.

Lors de ces rencontres, où interviendront historiens, psychiatres et soignants spécialistes de santé mentale, membres d’associations alternatives de soin et de lieux de vie, ces questions seront abordées à la fois sous l’angle historique et prospectif, lors de conférences, projections de documents filmés et débats.

Pour plus d’information, cliquez ici.

Call for paper – L’éclatement des dispositifs de santé mentale. Regards croisés France-Angleterre

L’objectif de la journée d’étude est de réunir des chercheurs venant de différentes disciplines des sciences sociales et travaillant sur les conséquences sociales des troubles psychiques. Si de nombreux travaux ont contribué à une meilleure compréhension des politiques de déhospitalisation psychiatrique en France et en Angleterre, ils sont le plus souvent centrés sur les recompositions professionnelles qui en découlent. Peu se sont intéressés à la multiplication des dispositifs de prise en charge et à l’imbrication complexe des pratiques de soin et des pratiques d’insertion sociale. Si des travaux récents
ont étudié le quotidien des personnes souffrant de troubles psychiques, ils ne visaient pas à interroger systématiquement les nouvelles articulations avec le secteur de l’action sociale et avec les nouveaux acteurs concernés. La journée entend donc fournir un lieu de réflexion collective autour de ces nouvelles configurations des politiques psychiatriques et d’action sociale.

L’organisation sociale de la prise en charge des troubles psychiatriques s’est considérablement transformée depuis un demi-siècle, et ce, dans la plupart des pays qui avaient developpé comme solution l’internement asilaire. Parmi les nombreuses raisons de cette transformation se trouvent les critiques, notamment provenant des sciences humaines, du traitement et de la place sociale donnés aux malades qui étaient amenés à vivre de manière chronique dans les établissement de soins. Les politiques de déhospitalisation ont transformé la place sociale des personnes souffrant de troubles psychiques. Celles-ci ne sont plus éloignées de manière definitive de la vie sociale. Les troubles psychiques et leurs conséquences sociales sont dès lors régulés autrement, non seulement par des professionnels de la psychiatrie, mais aussi par de nombreux autres acteurs de la vie sociale. Pour autant, la question de la place sociale des personnes souffrant de troubles psychiques demeure plus que jamais problématique. La multiplication des dispositifs de prise en charge a une importance considérable dans la vie des personnes confrontées à  ces troubles qui se rencontrent bien souvent dans les différents mondes sociaux qu’ils traversent, des “mini-institutions” ou des lieux semi-institutionnels censés leur apporter une aide, mais qui de fait participent plus à une multiplication  des formes de stigmatisation. Comment alors saisir cette nouvelle configuration de l’articulation des politiques psychiatriques, sociales qui expriment non seulement des recompositions affectant les acteurs de la psychiatrie, mais aussi et surtout des évolutions dans la place donnée aux dépendances et à l’autonomie des personnes?

Les transformations observées sont concomitantes dans différents pays, alors même que les contextes culturels et sociaux varient. Pour appréhender ces recompositions, la journée entend faire place à trois types d’approches :
– Une approche comparative – En raison du contraste fort dans le rôle de l’Etat dans les politiques sociales et de santé, et des transmissions de pratiques existent entre les deux pays, les comparaisons France/Angleterre seront particulièrement privilégiées, notamment la discussion du rôle et de la portée des notions de “sectorisation” et de “community care”;
– une approche socio-historique – Si le contexte des politiques de déhospitalisation est connu, la progressivité de leur mise en oeuvre l’est moins.  On s’interrogera ici sur le devenir pratique des politiques de déhospitalisation en observant particulièrement  comment elles se sont confrontées aux politiques d’insertion (emploi, logement, etc.), aux différents acteurs concernés (les proches, les familles), à l’importance prise par les “usagers”, mais aussi à la politisation des enjeux sécuritaires;
– une approche ethnographique – Les questionnements sur la place sociale prise par les personnes souffrant de troubles psychiques passe par une observation du vécu des personnes confrontées à ces multiples institutions et à l’usage qu’elles en font dans leur parcours.

Afin de décentrer le regard, les échanges entre praticiens, usagers et chercheurs seront d’ailleurs encouragés par l’invitation pour chaque session de la journée d’un discutant scientifique et d’un témoin.

Pour plus d’information, cliquez ici.

International Conference on the History and Heritage of Psychiatry – Dangerously young

The 3rd International Conference on the History and Heritage of Psychiatry (28 and 29 April 2011)

Dr. Guislain Museum, Ghent, Belgium

Dangerously young – Child and Adolescent Psychiatry from a Historical Perspective

Children and youth take up a special position in today’s society. On the one hand they are described as ‘the future generation’, on the other hand they are increasingly regarded as a threat and a danger to society. As a result, children are constantly examined with an incessant question in mind: ‘Is this child normal?’.

The 3rd International Conference wishes to place this topic within a historical perspective with lectures on the history and evolution of child and adolescent psychiatry. Internationally renowned speakers from various disciplines will share their insights from a historical, medical, pedagogical, psychological and cultural angle.

The Dr. Guislain Museum opens the debate during a two day conference in Ghent. The museum owns a fascinating compilation on this theme, including: a medical collection, a photo collection and a collection of outsider art.

Lectures will be simultaneously interpreted in Dutch, French and English.

For more information, click here.

Jacques Côté – Dans le quartier des agités

Une nouvelle série policière choisit l’histoire de la psychiatrie à la fin du 19e siècle comme cadre. L’éditeur présente la série et le premier volume comme suit:

La série

Cette série se déroule de 1885 à 1918. Elle a comme personnage central le docteur Georges Villeneuve, un aliéniste montréalais qui fut l’un des pionniers de la médecine légale au Québec. La série met en scène le lieutenant Lafontaine, policier de la ville de Montréal, qu’on retrouvera, tout comme le docteur Wyatt Johnston, dans quelques enquêtes. Chacun des romans met l’accent sur une affaire principale, mais le lecteur découvre également ce qu’est la vie asilaire, les morgues du XIXe siècle, les avancées et les lacunes de la médecine en matière médico-légale, la vie à Montréal durant la Belle Époque, etc.

Le premier tome

Dans le quartier des agités Paris, juillet 1889. Villeneuve a complété ses études en médecine. Désireux de se spécialiser en médecine légale des aliénés, il se rend à l’asile Sainte-Anne de Paris pour étudier sous Magnan et à la Salpêtrière avec Charcot. Il en profite pour assister au cours de Brouardel à la morgue de Paris et suit les formations de Mégnin en entomologie judiciaire.

À la veille d’un congrès de médecine mentale, le docteur Magnan confie à son jeune interne le suivi d’un malade que l’on croit être l’égorgeur d’une prostituée, et qui se réfugie dans le silence et refuse de s’alimenter. Magnan, qui a la réputation de protéger les aliénés contre une justice expéditive, doit freiner les ardeurs du commissaire Goron qui croit détenir l’assassin surnommé le coupeur de nattes. Villeneuve se met en quête de l’identité de l’aliéné, mais aussi du bon Samaritain qui a conduit l’homme à l’asile et qui en sait peut-être beaucoup sur le meurtre. Cette enquête le mènera sur le chemin d’un être fascinant et décadent…

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