Archive for June, 2010

Review – Anton Kaes, Shell Shock Cinema: Weimar Culture and the Wounds of War (Princeton 2009)

What part do movies play in making psychological trauma visible? This is the question Tony Kaes poses at the outset of his new book on the cinema of Weimar Germany. While this cinema has generated enormous scholarly interest ever since Siegfried Kracauer’s landmark From Caligari to Hitler (1947), Kaes’ study represents a major departure from earlier approaches. Drawing on a growing body of work on trauma, the history of psychiatry, and World War I, he places this crucial chapter of modern cultural history within an entirely new analytic framework.

For historians of medicine and psychiatry, the central interest here will lie in Kaes’ claim that shell-shock holds the key to unlocking Weimar cinema’s complex narratives, images, and themes. The experience of trauma, he argues, was Weimar’s “historical unconscious”, and its films re-enacted the effects this experience had both on individual combatants and on German society as a whole. Just as traumatic events are repressed and yet return involuntarily in the form of flashbacks and other symptoms, so too Weimar cinema returned obsessively to the invisible wounds of the war. In making this claim, Kaes argues against the grain of Kracauer’s book, which treats Weimar films as a series of ominous variations on the rise of Nazism. Shifting the focus to the Great War and its aftermath, Kaes pulls together a wide variety of sources in weaving his account of how the cinema of the Weimar period worked through the shocks and aftershocks, both psychic and social, of this conflict.

A key moment in Kaes’ exposition concerns the encounter between one of the foremost representatives of wartime psychiatry – the Viennese physician Julius Wagner-Jauregg (later awarded a Nobel prize for his discovery of the malaria cure for progressive paralysis) — and the founder of psychoanalysis, Sigmund Freud. Serving as expert witness at Wagner-Jauregg’s postwar trial, on charges that he had overseen the use of a punitive form of electrotherapy against soldiers suspected of malingering, Freud criticized the manner in which wartime practitioners had become entangled in an irresolvable conflict between their duties to the state and to their patients.

In an ingenious reading, Kaes traces the way that this encounter and the issues it raised are re-enacted in the narrative and structure of one of the most celebrated films of the Weimar era, Robert Wiene’s The Cabinet of Dr. Caligari (1920).  The story concerns a fairground hypnotist, Dr. Caligari, whose medium, Cesare, murders several inhabitants of a provincial town. Through its use of expressionistic sets and its themes of crime, somnambulism, and hypnosis (which, like electrotherapy, had been widely used to treat war neurotics) the film creates a fractured, hallucinatory landscape of terror and madness. This is further accentuated by its use of a frame-device: the story is narrated as a series of flashbacks by a young man, Francis, who relates his discovery that Caligari is actually the director of the local insane asylum, who has fallen under the spell of a manuscript written by an 18th century experimenter with hypnosis. In a final twist, the unreliability of the narrative is exposed at the film’s end by the revelation that Francis is himself a patient in the insane asylum. The film concludes with the asylum’s director promising to cure Francis.

If on a thematic level, the Caligari figure stands in for the Wagner-Jaureggs of the wartime psychiatric establishment, Kaes suggests that on another level the film itself doubles as a psychoanalytic session. Freud’s disciple Ernst Simmel, who by the war’s end was treating soldiers with a combination of psychotherapeutic methods, likened the recovery of traumatic memory through hypnosis to the “unrolling” of a filmic narrative. Francis’ narrative is in this sense a form of talking-cure: as if under hypnosis, the film of his traumatic memory “rolls again.” Kaes thus situates The Cabinet of Dr. Caligari in a context shaped by debates about military psychiatry, shell-shock, and malingering, as well as by questions about the perception and representation of a world in which traditional norms and values have been radically overturned.

In subsequent chapters he follows a related set of concerns through his analyses of several other major films of the era — Nosferatu, The Nibelungen, and Metropolis — many of them populated by psychologically disturbed, amnesiac, or violence-prone characters, and marked by a paralyzing concern with death. Though he sticks for the most part to canonical films, Kaes also devotes space to a handful of lesser-known movies, most of them now lost or surviving only in fragmentary form, including Towards the Light (1918), an account of hysterical blindness and its cure; and Nerves (1919), a drama depicting the people of Munich in the grip of a postwar epidemic of nervous panic. Kaes’ analysis works best when he is dealing with these early films; at times in his discussion of other films the connection to the war becomes too indirect. Yet he is persuasive in showing how the “unabated presence of trauma in German society” shaped not simply the content of the era’s films but their formal repertoire as well. In its search for a new means of expression capable of capturing the “post-traumatic” world of Weimar Germany, the cinema of the period, he argues, contributed decisively to the birth of modern film language.

Andreas Killen, City College of New York and the Graduate Center

Diagnostic Ambivalence and Psychiatric “Workarounds”

The Science, Knowledge and Technology section of the American Sociological Association has awarded this year’s Hacker Mullins Student Paper Award to Owen Whooley (NYU) for his paper “Diagnostic Ambivalence: Psychiatric Workarounds and the Diagnostic and Statistical Manual of Mental Disorders” (Sociology of Health & Illness, vol. 32, 2010: 452–469).

Abstract

In 1980 the American Psychiatric Association (APA), faced with increased professional competition, revised the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric expertise was redefined along a biomedical model via a standardised nosology. While they were an integral part of capturing professional authority, the revisions demystified psychiatric expertise, leaving psychiatrists vulnerable to infringements upon their autonomy by institutions adopting the DSM literally. This research explores the tensions surrounding standardisation in psychiatry. Drawing on in-depth interviews with psychiatrists, I explore the ‘sociological ambivalence’ psychiatrists feel towards the DSM, which arises from the tension between the desire for autonomy in practice and the professional goal of legitimacy within the system of mental health professions. To carve a space for autonomy for their practice, psychiatrists develop ‘workarounds’ that undermine the DSM in practice. These workarounds include employing alternative diagnostic typologies, fudging the numbers (or codes) on official paperwork and negotiating diagnoses with patients. In creating opportunities for patient input and resistance to fixed diagnoses, the varied use of the DSM raises fundamental questions for psychiatrists about the role of the biomedical model of mental illness, especially its particular manifestation in the DSM.

New Collaboration with Psychiatric Times

The scholarly blog Psychiatric Times has invited H-Madness to share a monthly guest blog with their readers.  You can follow the monthly contribution here. (Note: You must first register with Psychiatric Times before you can have access to the series.  Registration, however, is free).  This month, Greg Eghigian discusses some of his thoughts on learning lessons from history.

Colloquium on the History of Psychiatry and Medicine (Harvard)

The Colloquium on the History of Psychiatry and Medicine offers an opportunity to clinicians, researchers, and historians interested in a historical perspective on their fields to discuss informally historical studies in progress.  Below you will find an announcement of this year’s unusually rich Colloquium (note meeting rooms for specific dates).  Please join us.

David G. Satin, M.D.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Department of Postgraduate and Continuing Education, McLean Hospital

And

Center for the History of Medicine, Francis A. Countway Library of Medicine

present

COLLOQUIUM ON THE HISTORY OF PSYCHIATRY AND MEDICINE

David G. Satin, M.D., DLFAPA Director

Open to students of history and those valuing a historical perspective on their professions.

———-Fall, 2010———-

September 16

“Anomalous Sensations and Astounding Disclosures’: Nineteenth-Century American Narratives of Asylum Experience”

Kathleen M. Brian:  Ph.D. Candidate in American Studies, The George Washington University

October 21

“Reforming Mental Health Via Hollywood:  ‘The Snake Pit’ (1948) and Its Audiences”

Benjamin Harris, Ph.D.: Professor of Psychology and Affiliate Professor of History, University of New Hampshire

November 18

“German-speaking Psychiatrist and Neurologist Émigrés to the U.S. After WWII”

Frank W. Stahnisch:  Associate Professor, AMF/Hannah Professorship in the History of Medicine & Health Care, Department of Community Health

Sciences and Department of History, University of Calgary, Member of the Hotchkiss Brain Institute

December 16

“Asylum:  Inside the Closed World of State Mental Hospitals”

Chris Payne

4:00 P.M.—5:30 P.M.

Minot Room, fifth floor, Countway Library of Medicine

Harvard Medical Area

For further information contact David G. Satin, M.D., Colloquium Director, phone/fax 617-332-0032, e-mail david_satin@hms.harvard.edu

New Issue of History of Psychiatry

The second issue of the History of Psychiatry for 2010 has been released online. Included in this issue are six articles. It is a special number dedicated to Hundred Years of Evolutionary Psychiatry (1872-1972)

Titles, authors and abstracts are listed below.

The evolutionary turn in psychiatry: a historical overview by Pieter R Adriaens (University of Leuven, Belgium)

Ever since Darwin, psychiatrists have been tempted to put evolutionary theory to use in their efforts to understand and explain various aspects of mental disorders. Following a number of pivotal developments in the history of evolutionary thought, including degeneration theory, ethology and the modern synthesis, this introductory paper provides an overview of the many trends and schools in the history of ‘psychiatric Darwinism’ and ‘evolutionary psychiatry’. We conclude with an attempt to distinguish three underlying motives in asking evolutionary questions about mental disorders.

Schizophrenia, evolution and the borders of biology: on Huxley et al.’s 1964 paper in Nature by Raf De Bont (University of Leuven, Belgium)

In October 1964, Julian Huxley, Ernst Mayr, Humphrey Osmond and Abram Hoffer co-published a controversial paper inNature, in which they tried to explain the persistence of schizophrenia from an evolutionary perspective. This article will elucidate how the reputed authors composed this paper to make it a strong argument for biological psychiatry. Through a close reading of their correspondence, it will furthermore clarify the elements which remained unspoken in the paper, but which were elementary in its genesis.The first was the dominance of psychoanalytical theory in (American) psychiatry — a dominance which the authors wanted to break. The second was the ongoing discussion on the boundaries of biological determinism and the desirability of a new kind of eugenics. As such, the Huxley et al. paper can be used to study the central issues of psychiatry in a pivotal era of its history.

‘This excellent observer …’: the correspondence between Charles Darwin and James Crichton-Browne, 1869-75 by Alison M Pearn (Darwin Correspondence Project, University of Cambridge)

Between May 1869 and December 1875, Charles Darwin exchanged more than 40 letters with James Crichton-Browne, superintendent of the West Riding Pauper Lunatic Asylum, Wakefield, Yorkshire. This paper charts their relationship within the context of Darwin’s wider research networks and methods; it analyses the contribution that Crichton-Browne made to the writing of Expression, arguing that the information he provided materially affected Darwin’s thesis, and that it was partly the need to assimilate this that led Darwin to publish Expression separately from Descent. The letters help to reconstruct Crichton-Browne’s early research interests, and document Darwin’s little-explored role as a patron. Both men are revealed within a collaborative scientific network, with each of them at various times a beneficiary or a promoter.

‘Birdwatching and baby-watching’: Niko and Elisabeth Tinbergen’s ethological approach to autism by Chloe Silverman (Penn State University)

Biographers have largely dismissed Nikolaas ‘Niko’ Tinbergen’s late research into the causes and treatment of autism, describing it as a deviation from his previous work, influenced by his personal desires. They have pointed to the incoherence of Tinbergen’s assertions about best practices for treating autism, his lack of experience with children with autism, and his apparent embracing of psychogenic theories that the medical research community had largely abandoned. While these critiques have value, it is significant that Tinbergen himself saw his research as a logical extension of his seminal findings in the field of ethology, the science of animal behaviour. The reception of his theories, both positive and negative, was due less to their strengths or faults than to the fact that Tinbergen had inserted himself into a pre-existing and acrimonious debate in the autism research community. Debates about the relative role of environmental and hereditary factors in the aetiology of autism, and the implications of both for the efficacy of different treatments, had political and material significance for the success of parent organizations’ lobbying efforts and financial support for research programmes. Tinbergen’s approach was welcomed and even championed by a significant minority, who saw no problem with his ideas or methods.

The evolution of Harry Harlow: from the nature to the nurture of love by Marga Vicedo (University of Toronto)

Harlow deserves a place in the early history of evolutionary psychiatry but not, as he is commonly presented, because of his belief in the instinctual nature of the mother-infant dyad. Harlow’s work on the significance of peer relationships led him to appreciate the evolutionary significance of separate affectional systems. Over time, Harlow distanced himself from the ideas of John Bowlby and Mary Ainsworth as well as from Konrad Lorenz’s views about imprinting and instincts. Harlow’s work did not lend support to Bowlby’s belief in an innate need for mother love and his thesis that the mother was the child’s psychic organizer. Nor did Harlow agree with Lorenz’s view of instincts as biological, unmodifiable innate needs, unaffected by learning.

‘Racial differences have to be considered’: Lauretta Bender, Bellevue Hospital, and the African American psyche, 1936-52 by Dennis Doyle (Mississippi State University)

This paper examines one US psychiatrist’s engagement between 1936 and 1952 with a racialist strain of evolutionary thought. When Lauretta Bender began working with Bellevue Hospital’s disproportionately black population, the psychiatric literature still circulated the crude evolutionary proposition that blacks remained stuck at a more primitive stage of development. In the 1930s, drawing insights from holistic, mechanistic and environmentalist thinking on the relationship between mind and body, Bender developed her own more circumspect racialist position. Although she largely abandoned her underdetermined version of racialism in the 1940s for an approach that left out race as an active factor of analysis, this paper contends that she probably never wrote off black primitivity as a theoretical possibility.

For more information, click here.

On the Lighter Side: Darth Vader’s Diagnosis

Both the British Psychological Society’s Research Digest Blog and The Guardian feature a story on Eric Bui and his colleagues at Toulouse University Hospital in France.  They have written an article arguing that the Star Wars character Darth Vader most likely meets the diagnostic criteria for borderline personality disorder.  Bui and his colleagues see such arm-chair diagnosis as a way of teaching young people about the disorder and, in turn, helping to undermine the stigma associated with it.

Psychiatric Epidemiology and Depression

La journée d’études s’intéressera à la façon dont les outils, les designs, les définitions et les modèles de l’épidémiologie psychiatrique, d’une part, et les évolutions dans les classifications et les significations de la dépression, d’autre part, se sont réciproquement influencés. Elle traitera également des différents modèles de recherche utilisés dans les campagnes récentes contre la dépression. Enfin, elle abordera l’apport des neurosciences et des recherches en génétique dans l’épidémiologie psychiatrique et la clinique, ainsi que les images et les représentations du public concernant la dépression.
Ce colloque est gratuit, ouvert à tous, en particulier aux étudiants en sciences sociales, en santé publique et en psychiatrie, ainsi qu’aux chercheurs, aux enseignants, et aux membres des instituts concernés par la dépression en population générale.

Coordination scientifique Anne M. Lovell

9h00-9h30 : Accueil et café

9h30-9h45 : Mot d’accueil de Françoise Parot , Professeur de Psychologie, Université Paris-Descartes

Matin

Présidence : Pierre-Henri Castel , Directeur de recherches, CNRS/CeRMeS3 – CESAMES et responsable du Projet ANR PHS2M

9h45-10h00 : Introduction, Anne M. Lovell , Directrice de Recherches INSERM/ CeRMeS3-CESAMES

10h00-10h45 : « L’épidémiologie et la transformation des catégories liées à la dépression », Jerome Wakefield , Professeur d’Université, NYU School of Medicine

10h45-11h00 : Pause café

11h00-11h45 : « Les thèses de Jerome Wakefield à l’épreuve de l’épidémiologie britannique », David Goldberg , Professeur Emérite, Institute of Psychiatry et King’s College, Londres

11h45-12h30 : « La dépression et les outils épidémiologique en Europe », Viviane Kovess-Masféty , Professeur de Santé Publique, École des Hautes Études en Santé Publique

12h30-13h00 : Discussion

13h00-14h30 : Pause déjeuner

Après-midi :

Présidente de séance : Anne Lovell , Directrice de Recherches CNRS/CeRMeS3-CESAMES

14h30-15h15 : « L’épidémiologie psychiatrique à l’épreuve des neurosciences de la dépression », Philippe Fossatti , Professeur des Universités – Praticien Hospitalier, service de psychiatrie d’adultes (Pr Allilaire), Groupe Hospitalier Pitié-Salpétrière

15h15-15h30 : Discussion

15h30-16h30 : Table ronde, modérée et présidée par Bruno Falissard, Professeur de biostatistique – Praticien hospitalier, Directeur de l’unité INSERM U669 (santé mentale de l’adolescent) « Nosologie, outils, épidémiologie psychiatrique et santé publique de la dépression » :

  • François Beck , Directeur des Sciences Sociales, INPES ;
  • Xavier Briffault , Chargé de Recherches CeRMeS3-CESAMES ;
  • Stéphanie Wooley , Présidente de l’Association France-Dépression ;
  • Anne Lovell, Directrice de Recherche CeRMeS3-CESAMES

16h30–17h00 : Réponses de J. Wakefield et débat avec la salle, modéré par Steeves Demazeux , Doctorant en philosophie, IHPST

For more information, click here.

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