Archive for June, 2011

Report on the Joint Conference of ISHN and Cheiron (Calgary, June 2011)

ISHN—International Society for the History of the Neurosciences, and

Cheiron—International Society for the History of the Behavioral and Social Sciences

Joint conference and workshop, Calgary and Banff, June 16-23.

This year, for the first time, ISHN and Cheiron held a joint meeting, in recognition of the research interests shared by members of both societies.  Among the aims of the joint meeting were to spark conversation on areas of shared concern, to encourage cross-fertilization among scholars of clinical psychiatry, psychoanalysis, and neurology, and to mark what many agree is the increasing neuroscientization of psychiatry.  Senior scholars as well as graduate students participated in what many agreed was a very successful experiment in disciplinary boundary-crossing; explorations of topics ranging from gender, race, brain and mind to emotions, neurophilosophy and neuroscience and art proved lively and provocative.  And, the setting—especially for the workshops in Banff—could not have been more stunning.

Here I’ll highlight several of the keynote lectures.  Bryan Kolb of the University of Lethbridge gave a fascinating insider’s account of the evolution of brain-behavior relationships from the 1960s to the present, emphasizing how the foundational work of Karl Lashley and his students limited the field’s ability to assimilate findings inconsistent with it, “misdirecting” researchers for years.  A related panel discussion worried the issue of the relationships among psychology, psychiatry, and the neurosciences—between mind and brain—and explored the tension between the optimism of neuroscientists with respect to the on-going revolution their specialty has sparked in conceptualizing behavior on the one hand and, on the other, the fact that little has changed in the treatment of mental diseases despite the promises of biological psychiatry.  Should the relationship between the fields be conceptualized as complementary, or should they be thought of as one and the same?  Many other panels probed this and related questions from a variety of perspectives—including the visual arts and music—throughout the conference.

Emily Martin of NYU took a fresh look at “introspection” before it was defined out of the experimental field, focusing in particular on the early anthropological field work of W. H. R. Rivers in the Torres Straits.  Rivers and his Cambridge colleagues conducted experiments with islanders as well as on themselves, assuming a malleability of mind that was, Martin argued, compelling to fellow Cantabridgian Ludwig Wittgenstein, a critic of experimental psychology.  Wittgenstein’s later work was not, Martin argued, politically conservative as much as it was deeply materialist, incorporating a familiarity with an evolving anthropological perspective.  In another keynote, Andrew Scull of UCSD gave a masterful overview of the relations between psychiatry and the social sciences in the postwar period in the United States, covering issues ranging from the founding of NIMH, to the rise and fall of psychoanalytic hegemony within psychiatry and its institutions, to the emergence of mental health economics.

A range of other panels offered biographical perspectives on major figures in psychiatry, the behavioral sciences, and neuroscience (Abraham Maslow, Robert Lindner, Hans Seyle); examined paradigmatic experiments and experimental settings; looked into state-sponsored programs of eugenics, especially in Canada;  explored ethics and therapies, across the disciplines; focused on treatments of brain injury and the evolution of neurological surgery; looked at  memory, emotions, empathy, mind and body; and considered how best to teach our students the multiple histories that fell under the capacious rubric of the conference.  Medical, neuroscience, nursing, psychology and history students presented their work on the last day of the conference workshops, the range of their interests and research testifying to the vitality of the fields the gathering brought together.

The conference program may be found here.

– E.L.

Multidisciplinary Perspectives on the Revision of the DSM

The journal Personality and Mental Health features a special issue entitled “The Revision of DSM – Intended and Unintended Consequences:  Multidisciplinary Perspectives“.  Sociological, epistemological, legal, and ethical aspects of the DSM-5 are among the themes discussed.  In looking ahead, the papers invariably look to the past at earlier developments in psychiatric nosology.  Andrea Fossati, for instance, discusses the history of personality disorders in Europe during the 19th and 20th centuries:

ABSTRACT.  A recent focus in Western European research on personality disorders (PDs) has been an attempt to generate an integrative perspective or at least a common framework that could be used by researchers with different theoretical orientation to exchange and integrate their findings. This article discusses 19th and 20th century Western European perspectives on PDs, which led to their conceptualization as separate entities. In particular, we focus on the contribution of three approaches: the psychiatric approach, the dynamic contribution and the individual difference perspective. European tradition suggests revising current PD classification systems to produce PD diagnoses that are close to clinical reality but also grounded in data from scientific studies and characterized by a high degree of transtheoretical acceptance. Copyright © 2011 John Wiley & Sons, Ltd.

Call for Papers – Graphic Medicine: Visualizing the Stigma of Illness. Comics Forum, Leeds Art Gallery. November 17, 2011

This one-day interdisciplinary conference aims to explore medical narrative in graphic novels and comics with an emphasis on the stigma of illness, disease or disability, both physical and mental. A subgenre of graphic narrative known as graphic medicine is emerging as a field of interest to both scholars and creators of comics, and members of the healthcare professions are beginning to turn to comics as a source of illness narratives and documents of the patient and carer experience.

We invite proposals for scholarly papers (20 minutes) or panel discussions (60 minutes), focused on medicine and comics in any form (e.g. graphic novels, comic strips, graphic pathographies, manga, and/or web comics) on the following—and related—topics: notions of stigma in graphic pathographies of illness and disability; the use of comics to explain, highlight and eradicate stigma; the use of comics in patient care; the interface of graphic medicine and other visual arts in popular culture; ethical implications of patient representation in comics by healthcare providers; trends in international use of comics in healthcare settings; the role of comics in provider/patient communication; comics as a virtual support group for patients and caregivers; the use of comics in bioethics discussions and educationContributions are sought from humanities scholars, comics scholars,
healthcare professionals, comics enthusiasts, writers and cartoonists.

300 word proposals for a 20 minute paper should be submitted by
18/07/2011 to submissions@graphicmedicine.org and notice of
acceptance or rejection may be expected by 1/8/2011

Abstracts may be in Word, WordPerfect, or RTF formats, following this
order: author(s), affiliation, email address, title of abstract, body of
abstract.  All proposals submitted will receive and acknowledgement. Abstracts
will be blind peer reviewed.

Drs. Columba Quigley, Maria Vaccarella and Ian Williams

Neuroscience, Free Will, and a New Wave in Criminal Law?

ADRIANNA WILLIAMS/CORBIS

The Atlantic features an article by neuroscientist David Eagleman (Baylor College of Medicine, USA) entitled “The Brain on Trial.”  In it, he argues that neuroscience and genetics today offer a way of approaching criminal behavior that potentially promises to both make society more secure and rehabilitate offenders.  He advocates we adopt a more scientifically nuanced, actuarial-based perspective when considering not only issues like guilt and innocence, but also sentencing.  He is especially critical of the casework and clinical approaches of parole boards and psychiatrists:

So researchers tried a more actuarial approach. They set about recording dozens of characteristics of some 23,000 released sex offenders: whether the offender had unstable employment, had been sexually abused as a child, was addicted to drugs, showed remorse, had deviant sexual interests, and so on. Researchers then tracked the offenders for an average of five years after release to see who wound up back in prison. At the end of the study, they computed which factors best explained the reoffense rates, and from these and later data they were able to build actuarial tables to be used in sentencing.

 

Which factors mattered? Take, for instance, low remorse, denial of the crime, and sexual abuse as a child. You might guess that these factors would correlate with sex offenders’ recidivism. But you would be wrong: those factors offer no predictive power. How about antisocial personality disorder and failure to complete treatment? These offer somewhat more predictive power. But among the strongest predictors of recidivism are prior sexual offenses and sexual interest in children. When you compare the predictive power of the actuarial approach with that of the parole boards and psychiatrists, there is no contest: numbers beat intuition. In courtrooms across the nation, these actuarial tests are now used in presentencing to modulate the length of prison terms.

Eagleman tends to portray all this as the result of recent discoveries in neuroscience and genomics, but students of forensic psychiatry and criminology know that these arguments are hardly new.  They can be traced back to “social defense” theory, the “modern school of law,” and the criminal biology of the nineteenth- and early-twentieth-centuries.  It should also be pointed out that the claim that these methods are proven to be more accurate and effective than clinical assessment is something a number of prominent criminologists have called into question (among them, Bernard Harcourt and Karen Franklin).

Shyness: Evolutionary Tactic?

An Opinion Piece in today’s NY Times on Shyness and DSM by Susan Cain argues that shyness has evolutionary advantages and shouldn’t be unnecessarily pathologized: http://tinyurl.com/64w9exx

New issue: Genèses

genèse

A new issue of the periodical Genèses is now out. Its central theme is “Medicalisation” and it includes three articles dealing with the history of psychiatry:

Lisa Roscioni, “Soin et/ou enfermement ? Hôpitaux et folie sous l’Ancien Régime” (Care and/or Confinement ? Hospitals and Insanity under the Old Regime)

On ne pourrait véritablement parler de « médicalisation de la folie » avant la naissance de la psychiatrie et des asiles, c’est-à-dire pas avant le tournant des XVIIIe-XIXe siècles. Pourtant, certaines recherches récentes soulignent le caractère précoce d’un discours et d’une pratique médicale développée dans des institutions réservées aux fous, qui apparaissent à partir du XVIesiècle. Psychiatre et asile ne sont donc pas apparus à l’improviste, mais constituent au contraire le produit d’un processus de longue durée dont l’origine n’est nullement à rechercher dans un « enfermement », mais bien dans l’ambiguïté constitutive des plus anciennes expériences d’internement et de prise en charge des fous.

We cannot really speak of the «medicalisation of insanity» prior to the birth of psychiatry and asylums, that is, before the turn of the 18th century. Yet recent research emphasises the pre-cocious nature of a discourse and medical practice, developed in institutions reserved for the insane, which arose in the 16th century. Thus, psychiatry and asylums did not appear out of the blue, but were instead the product of a long-term process in no way derived from «institutional confinement», but rather from the ambiguity of older experiences of internment and care of the insane.

Isabelle von Bueltzingsloewen, “Réalités et perspectives de la médicalisation de la folie dans la France de l’entre-deux-guerres” (Reality and Viewpoints on the Medicalisation of Insanity in France during the Interwar Period)

Depuis le vote de la loi de juin 1838 organisant l’assistance aux aliénés, la médicalisation de la folie se confond avec l’internement. Dans l’entre-deux-guerres, les aliénistes imaginent de nouveaux dispositifs de prise en charge. Ceux-ci devront permettre de faire face à la croissance du nombre des internements, interprétée comme une recrudescence des maladies mentales, mais aussi de traiter des malades atteints de troubles légers. Autrement dit de déplacer les frontières de la folie. Freiné par les départements, ce projet médicalisateur ne voit le jour qu’après la Seconde Guerre mondiale.

Since the law of June 1838 organising assistance to the insane, the medicalisation of insanity has coincided with internment. During the interwar period, psychiatrists conceived of new systems for the care of the insane. They were intended to cope with the growing number of people confined to institutions, interpreted as a recrudescence of mental illness, but also to treat patients suffering from mild disorders. In other words, to shift the boundary lines of insanity. This medicalisation project, which was impeded in the provinces, did not come into being until after the Second World War.

Benoît Majerus, “La baignoire, le lit et la porte. La vie sociale des objets de la psychiatrie” (The Bathtub, the Bed and the Door. The Social Life of the Objects of Psychiatry)

À travers la baignoire, un objet évident du traitement, le lit, un objet hospitalier ordinaire, et la porte, artefact passant le plus souvent inaperçu, l’article essaie de porter un nouveau regard sur l’histoire de la psychiatrie au XXe siècle. Prenant en compte la « biographie » des objets, de leur conception à leur pratique, l’article souligne l’interdépendance entre des objets qui déterminent la pratique psychiatrique quotidienne, et la psychiatrie qui transforme ces mêmes objets.

This articles attempts to take a different look at 20th century psychiatry by focusing on the bathtub, an obvious object of treatment, an ordinary hospital bed and the door, an artefact that usually goes unnoticed. Taking into account the «biography» of the objects from their design to their use, the articles emphasises the interdependence between objects that determine every- day psychiatric practice and psychiatry, which transforms these same objects.

More information, as well as a complete table of contents, can be accessed here.

Dangerous Method

David Cronenberg has made a movie about Freud, Jung, Otto Gross and Sabina Spielrein. 
The trailer has just been released:
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