Damaging the Body: Gendering The Physical in Victorian Psychiatry

Damaging the Body: Gendering The Physical in Victorian Psychiatry

September 24, 2010

Location: The Wellcome Trust Centre for the History of Medicine, 5th Floor, 183 Euston Road, London, NW1 2BE

The aim of the workshop is to bring together experts from a variety of fields, including literature, history of medicine, psychology and gender studies to provoke interdisciplinary discussion of the ways in which the creation of more diverse histories of bodily damage in the nineteenth century might open up wider concerns.

Please click here for the program.

Syllabus: Lerner, “Madness, Science, and Society in the Modern West”

The following is the first installment in our series on university and college courses dealing with the history of madness, mental illness, and psychiatry.  For the next two weeks, we will be posting syllabi from courses across the world, along with the comments of their creators and instructors.  If you teach a university or college course about the history of mental disorders and their treatment, please contact Greg Eghigian (gae2@psu.edu) with details.  We will be happy to post all relevant submissions.

Paul Lerner is Associate Professor of History at the University of Southern California (USA).  He is a historian of nineteenth and twentieth-century Germany and Central Europe with particular interest in the history of the human sciences, Jewish history, gender, and the history and theory of consumer culture. He has written on the history of psychiatry, specifically on hysteria and trauma in political, cultural and economic context in the years around World War I in Germany, and he is now working on the reception and representation of department stores and modern forms of marketing and consumption in Germany and Central Europe. This project pays particular attention to the notion of the “Jewish department store” and the ways that various movements deployed images of Jews to critique excessive consumption or mass consumer society. Lerner is also part of a long-term project on gender in German Jewish history and is co-editing a volume of essays entitled: “Jewish Masculinities: German Jews, Gender and History.” Lerner’s books can be found at: here and here.

Let me note that the course is part of the Thematic Options program, an honors track alternative to the university’s regular General Education curriculum.  Most of the students in the class were majoring in psychology, neuroscience, or biology and this served as a history/philosophy of science course for them.

What worked well:  the films, powerpoint presentations with pictures of asylums, and artistic renderings, readings such as S. W. Mitchell, Charcot, Pinel, W.A. F. Browne, in short, accessible primary sources that the students could really get into it.  Discussion of ECT and especially leucotomy generated intense discussion and debate.  They had some difficulty digesting Metzl, but it led to good discussions. Lecture on Nazi psychiatry provoked strong reactions as did a guest lecture on eugenics in the US.  The class also produced a number of creative and thoughtful final projects.

What didn’t work so well:  students complained, as usual, about Freud and I was disappointed that our discussions remained somewhat shallow. The Healy book on Mania was a flop.  It would have been nice to do something on non-Western societies or colonial madness – still looking for good teaching sources on these topics.  Presentism is always a danger with this class, especially when I have so many psychology majors and pre-meds.  On the whole, enough students understood the historical approach that we were able to keep the presentism in check.

New Issue of Neurosurgical Focus

A new issue of Neurosurgical Focus has been published online. Included in this issue is an article by Marwan I. Hariz, Patric Blomstedtand Ludvic Zrinzo on Deep Brain Stimulation between 1947 and 1987. The abstract reads:

Deep brain stimulation (DBS) is the most rapidly expanding field in neurosurgery. Movement disorders are well-established indications for DBS, and a number of other neurological and psychiatric indications are currently being investigated.

Numerous contemporary opinions, reviews, and viewpoints on DBS fail to provide a comprehensive account of how this method came into being. Misconceptions in the narrative history of DBS conveyed by the wealth of literature published over the last 2 decades can be summarized as follows: Deep brain stimulation was invented in 1987. The utility of high-frequency stimulation was also discovered in 1987. Lesional surgery preceded DBS. Deep brain stimulation was first used in the treatment of movement disorders and was subsequently used in the treatment of psychiatric and behavioral disorders. Reports of nonmotor effects of subthalamic nucleus DBS prompted its use in psychiatric illness. Early surgical interventions for psychiatric illness failed to adopt a multidisciplinary approach; neurosurgeons often worked “in isolation” from other medical specialists. The involvement of neuro-ethicists and multidisciplinary teams are novel standards introduced in the modern practice of DBS for mental illness that are essential in avoiding the unethical behavior of bygone eras.

In this paper, the authors examined each of these messages in the light of literature published since 1947 and formed the following conclusions. Chronic stimulation of subcortical structures was first used in the early 1950s, very soon after the introduction of human stereotaxy. Studies and debate on the stimulation frequency most likely to achieve desirable results and avoid side effects date back to the early days of DBS; several authors advocated the use of “high” frequency, although the exact frequency was not always specified. Ablative surgery and electrical stimulation developed in parallel, practically since the introduction of human stereotactic surgery. The first applications of both ablative surgery and chronic subcortical stimulation were in psychiatry, not in movement disorders. The renaissance of DBS in surgical treatment of psychiatric illness in 1999 had little to do with nonmotor effects of subthalamic nucleus DBS but involved high-frequency stimulation of the very same brain targets previously used in ablative surgery. Pioneers in functional neurosurgery mostly worked in multidisciplinary groups, including when treating psychiatric illness; those “acting in isolation” were not neurosurgeons. Ethical concerns have indeed been addressed in the past, by neurosurgeons and others. Some of the questionable behavior in surgery for psychiatric illness, including the bygone era of DBS, was at the hands of nonneurosurgeons. These practices have been deemed as “dubious and precarious by yesterday’s standards.”

Book announcement: Joost Vijselaar – The asylum, single fare or return

Joost Vijselaar, Het gesticht, enkele reis of retour (Amsterdam 2010; Uitgeverij Boom); The asylum, single fare or return

Based on an extensive qualitative analysis of patient records, this book studies in great detail the social patterns of admission, stay, treatment, care, and discharge in three Dutch psychiatric hospitals in the period 1890-1950. In line with other recent research, it demonstrates that families did in fact cope and care for their disturbed relatives, sometimes for extended periods of time and even in cases of serious mental illness. In general, two major factors contributed to the referral of a patient to an institution: first, escalating, disruptive behavior that threatened the patient’s social integration; and second, the weakening of the capacity of the family to cope with and care for the patient. The intensity of treatment in these hospitals was conspicuously low, the emphasis laying on care rather than cure, and on the regulation of disturbing behavior, with internal transfer between wards for the quiet and the (half)disturbed being the most important social tool. Labour and bed rest constituted the backbone of the regime in Dutch asylums during the entire period, covering the functions of cure, care, and the management of unrest. Therapeutic innovations, such as the famous somatic cures (e.g. ECT), did not characterize the regime in a significant way, but were rather adopted in only a quarter of all cases. Patterns of discharge mirrored the process of admission: with a psychiatrist assessing improvement by social criteria (such as the measure of social integration), and families exerting a clear influence on the discharge of their relatives, the probationary discharge being the instrument of choice for doctors to test the adaptive power of both family and (former) patient. Families did exert a significant ‘pull’ on the asylum, benefiting those with a social network in society. In all, the asylum was less high-walled than its general image would have us believe, and its population had a more dynamic character than is often assumed. Admission to an asylum did amount to a ‘return fare’ for a considerable number of patients suffering from manic-depressive or psychotic disorders.

Willard Suitcase Exhibition, Film, and Lecture Series (Pittsburgh, USA)

The online exhibit is available here.

Cornell University Richardson History of Psychiatry Seminar Fall 2010

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 15
Patricia Everett, Ph.D., Private practice, Amherst, MA Stevens-Barchas Lecture
“The Correspondence between A.A. Brill and Mabel Dodge Luhan, 1916-1944″
October 6
Elizabeth Lunbeck, Ph.D., Vanderbilt University
“Heinz Kohut, American Psychoanalyst”
October 20
Howard Kushner, Ph.D., Rollins School of Public Health & Graduate Institute of Liberal Arts, Emory University
“Psychoanalyzing the Psychohistorian: Erik H. Erikson’s Identity Crises”
November 3
Aude Fauvel, Ph.D., Postdoctoral Research Fellow,
Max Planck Institute for the History of Science
“‘Le Femmes Violeuses:’ Crime, Sex, and Medicine in 19th Century France” /div>
November 17
Deborah Weinstein, Ph.D., Brown University, Program in Gender and Sexuality Studies
“Visions of Family Life: Observation and the History of Family Therapy in Postwar America”
December 1
Eslee Samberg, M.D., & Elizabeth Auchincloss, M.D., Weill Medical College of Cornell University
“Psychoanalytic Lexicography: Notes from two ‘harmless drudges'”
December 15
No Seminar – Holiday Party
* PLEASE NOTE: Space is limited. Attendance by permission only.

The Cushing Collection at Yale University

The New York Times has a piece and a slide show presentation about the collection of brain samples stored at Yale University by Dr. Harvey Cushing.  Cushing, who died in 1939 and donated the collection to the university, was a well-known neurosurgeon, who helped lead the field toward respectability in the early 20th century.  The Cushing collection in the Cushing/Whitney Medical Library at Yale University at 333 Cedar Street, New Haven, is open to the public Monday through Friday, 8 a.m. to 8 p.m.; Saturday, 10 a.m. to 8 p.m.; and Sunday, 9:30 a.m. to 8 p.m.

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