Archive for November, 2011

Question from a reader on Native Americans

Kathryn McKay from the Simon Fraser University sent the following question:

Hello,

I am looking for articles from the late 19th or early 20th century that describe the mental conditions of Native Americans and First Nations peoples from a medical perspective, rather than from an anthropological one.  The earliest I have found are Dr. Hummers'”Insanity among the Indians” from 1911, Dr. A.A. Brill’s “Piblokto or Hysteria among Peary’s Eskimos,from 1913” and Dr. I Coriat’s “Psychoneuroses among primitive tribes”from 1915.

Please let me know if you know of anything earlier. I am particularly interested in dementia praecox, but am more generally interested in any discussion of “insanity.”

I can be reached at mckay@sfu.ca

New issue: History of Psychiatry

A new issue of History of Psychiatry is now available online and contains the following articles:

“Alexandre Brierre de Boismont and the origins of the Spanish psychiatric profession” (Enric J Novella and Rafael Huertas)

This article examines the influence of the French alienist Alexandre Brierre de Boismont in the first development of the Spanish psychiatric profession during the third quarter of the 19th century. As an outstanding figure of French psychological medicine, Brierre enjoyed great scientific prestige among Spanish doctors, but he also took an active part in promoting and legitimizing the cause of alienism in Spain. For instance, he was involved in projects for the reform or creation of new mental hospitals, supported the admission of some Spanish colleagues into the Société Médico-Psychologique and made a decisive contribution to the social recognition of the professional and medico-legal expertise of alienists in Spain. His case is thus an excellent example of the important role played by international relations and the scientific and professional networks of European alienism in spreading the discourses and practices of the emerging psychological medicine.

“The peculiarities of the Scots? Scottish influences on the development of English psychiatry, 1700–1980” (Andrew Scull)

This paper examines the multiple influences Scottish psychiatrists have exercised over the shape of English responses to mental illness during nearly three centuries, beginning with George Cheyne and ending with R.D. Laing. Scotland’s distinctive response to mental illness was largely ignored until recently, as though it had simply followed the English path. The neglect has begun to be rectified, but the powerful influence of the Scots on developments south of the border requires more sustained attention than it has received hitherto.

“Institutionalization of mentally-impaired children in Scotland, c.1855–1914″ (Iain Hutchison)

This article examines two institutions which were established in Scotland specifically for the accommodation of mentally-impaired children: Baldovan Asylum near Dundee and the ‘Scottish National Institution for the Education of Imbecile Children’ in Larbert, Stirlingshire. It surveys the aims and agendas of the institutions in the spheres of residential childcare, mental health, and education and training. It compares the admission regimes of these institutions and considers whether they complemented one another in serving an unsatisfied demand for places, or whether they were in competition for admissions, staff and charitable support. The survey covers the period from the opening of both institutions to the implementation of the Mental Deficiency Act of 1913 which required the (re)certification of all children.

“‘Him Bi Sona Sel’: psychiatry in the Anglo-Saxon Leechbooks” (Christopher Pell)

Classical Greek and Roman writers documented the diagnosis and treatment of psychiatric illness in ancient times. Following the fall of the Western Roman Empire however, we find little writing on the topic in early Medieval Europe. Yet in Britain, medical texts survived and were complemented by local traditions and treatments. This article explores the best-known Anglo-Saxon medical texts, the Leechbooks and Lacnunga, for evidence of psychiatric illness and the treatments employed by physicians in the tenth century. The difficulties encountered when working with sources translated from Old English and speculations about the supernatural aetiology ascribed to these illnesses are detailed. The efficacy of the leechdoms (treatments) described are also investigated for both their placebo and potential pharmacological effects.

“Women and melancholy in nineteenth-century German psychiatry” (Lisabeth Hock)

This study examines depictions of the relationship between women and melancholia in German psychiatric textbooks published between 1803 and 1913. Focusing in particular on how these texts present the female life cycle, nineteenth-century views about female ‘nature’ and gender traits, and women’s familial and professional roles, it reveals how nineteenth-century psychiatrists were caught between the scientific demand for objective clinical observation and the gender norms of the culture to which they belonged. On the one hand, psychiatrists carefully and sensitively describe female melancholia with evidence obtained through the scientific methods of clinical observation, anatomical investigation and self-questioning. On the other hand, language choice contributes to the naturalization of gender difference by assigning cultural meaning to clinical observations.

“The fight for ‘traumatic neurosis’, 1889–1916: Hermann Oppenheim and his opponents in Berlin” (Bernd Holdorff and Dr Tom Dening)

The concept of traumatic neurosis conceived by Hermann Oppenheim (1858–1919) located post-traumatic nervous symptoms between hysteria and neurasthenia, considering them a consequence of physical reactions to fright and a cause of molecular tissue changes. As early as 1890, his concept was criticized at an international congress in Berlin. In February 1916, there was a significant debate of the issue in Berlin, and eventually Oppenheim’s concept was completely defeated at the war meeting of German neuropsychiatrists in September 1916 in Munich. In the Berlin debate, a range of views on war neurosis was presented. Partly as a result of this, but also due to the powerful position of Oppenheim himself, it was not until after the end of WWI that traumatic neurosis was excluded from medico-legal assessments. The differing views of physiological brain-mind relations from that time do not differ greatly from present concepts. However, Oppenheim’s traumatic neurosis with its more quasi-neurological picture should not be equated with PTSD.

The issue also contains as its classic text the second part of August Wimmer’s ‘Psychogenic Psychoses’ (1936) commented by Johan Schioldann, an essay by Neil Vickers entitled “Literary history and the history of neurology“, as well as two book reviews.

For more information, click here.

New Book Announcement: Guérir la vie by Jacob Rogozinski

Jacob Rogozinski, professor of metaphysics at the University of Strasbourg has written a book on the link between madness and artistic creativity, taking Antonin Artaud as a case study.

For an engaging review, click here.

History of Madness : fifty years after

HISTOIRE DE LA FOLIE : CINQUANTE ANS APRÈS

Jeudi 15 décembre 2011, 9h30-17h30

Université Paris-Est Créteil

61, av. du Général de Gaulle, Créteil, bâtiment i, salle 222

Matinée –

Président de séance : Frédéric Gros (Université Paris-Est Créteil)

9h30 Daniele Lorenzini et Arianna Sforzini : Introduction au colloque

  • 10h00 Jean-François Bert (EHESS) : Histoire d’un succès philosophique. L’Histoire de la folie à l’âge classique
  • 10h30 Kojiro Fujita (Université Paris-Est Créteil) : La naissance du cogito chez Foucault

11h00 Discussion

11h15 Pause

  • 11h30 Jérémy Romero (Université Paris-Est Créteil) : La folie et la mort chez Foucault : éléments pour une pensée du dehors
  • 12h00 Emmanuel Gripay (Université Bordeaux III) : La perception morale de la folie : une appréhension néantisante ou objectivante ?

12h30 Discussion

Après-midi –

Président de séance : Daniele Lorenzini (Université Paris-Est Créteil/Università « La Sapienza » di Roma)

  • 14h30 Arianna Sforzini (Université Paris-Est Créteil) : La présence du théâtre dans l’Histoire de la folie à l’âge classique
  • 15h00 Caroline Mangin-Lazarus (psychiatre, revue Superflux) : Ignorer la démence dans le droit pénal : une voie politique au moment de la Révolution française ?
  • 15h30 Roger Ferreri (psychanalyste et chef d’un service de psychiatrie infanto-juvénile) : Du fou à la folie, histoire de la folie ou question à la démocratie ?

16h00 Discussion

For more information, click here.

BPS History of the Psychological Disciplines Seminar Series

British Psychological Society History of the Psychological Disciplines Seminar Series

Organiser: Professor Sonu Shamdasani (UCL)

 

Wednesday 30 November 2011, 6pm

Dr. Egbert Klautke, UCL School of Slavonic and East European Studies – “The Repudiation of Völkerpsychologie in Germany”

My talk will focus on the ‘last’ representative of the once honourable discipline of Völkerpsychologie in Germany, Willy Hellpach. I will present his contribution to the field — his textbook Introduction to Folk Psychology (1938) — as part of his personal strategy to adapt to the conditions of the Third Reich, despite later claims to the contrary by Hellpach and some of his sympathetic interpreters. In the second part of the paper, I will outline the conditions and results of the slow repudiation of his Völkerpsychologie after World War II, and outline the problems which academics critical of ‘national character studies’ encountered.

 

Wednesday 14 December 2011, 6pm

Thibaud Trochu (University of Paris 1, Sorbonne) – “Psychological Experimentation in the Nineteenth Century: James John Garth Wilkinson (1812-1899), Physician, Mystic and Radical.”

Though quite forgotten nowadays, Dr. J. J. Garth Wilkinson was once a widely known intellectual figure in Victorian Britain. Praised by his contemporaries as a fine scholar, a first-rate writer, and a highbrow public ethicist, he was notorious for stirring controversy and debate — most often against the grain. His personality and thinking revolved around two passionate feelings: deep-seated religious yearnings — though quite unorthodox ones — on the one hand, and on the other, an inclination to mistrust and to defy all forms of established authority – be they religious, medical or political — which he accused of narrowing the horizons of self-conscious practitioners and free citizens. His medical career, strongly entwined with his “spiritual”‘ quest, was thus colored by a radical political tone. This led him to carry out numerous experiments in his daily practice of the art of healing such as homeopathy, hypnotism and other forms of “psychological analysis,” whilst establishing himself as an opponent of what he saw as the dominant trend of medical materialism, “dogmatic objectivism” and autoritarism. At a time of triumphant scientist medicine, Wilkinson saw himself as — in his own words — “smashing its institutional structure.”

Time: 6pm

Location: UCL Department of Clinical, Educational and Health Psychology, Room 544, 5th Floor, 1-19 Torrington Place, London WC1E 7HJ Directions: From the main reception, go through the double doors at the back and turn left, walk the length of this corridor and at the very end turn left again – you will find yourself in front of the ‘West’ Lifts. Take these to 5th Floor. On exiting the lift, turn right through double doors and then left through single door, walk the length of this corridor pass through another door and then turn right – you will see a marble table ahead. Room 544 is straight ahead.

For more information, click here.

Andreas Killen: “Hypnosis and Medical Ethics”

Apparatus for measuring hypnotically-suggested arm movements. Clark Hull (1933). Hypnosis and suggestibility: an experimental approach (New York: Appleton-Century-Crofts). Image from: http://www.hypnose-kikh.de/museum_en/saal9.htm#a

Hypnosis and Medical Ethics

by Andreas Killen

Andreas Killen is Associate Professor of History at the City College of New York and the CUNY Graduate Center. He has held fellowships at the UCLA Humanities Consortium and the Max Planck Institute for the History of Science. He is an editor and co-founder of H-Madness.  This essay was posted earlier for Psychiatric Times.

When Leo Alexander, the psychiatrist who served as advisor at the Nuremberg doctors’ trial, helped draft the articles of the Nuremberg code, his attention was drawn to two earlier episodes in German medical history. One of these occurred in 1931, when, following the deaths of 75 children in Lübeck by means of a contaminated TB vaccine, the Reich Health Council issued guidelines spelling out the principle of voluntary consent. Galvanized by the Lübeck affair and others like it, prominent physician Julius Moses had publicly condemned the “experimental mania” in German medicine, and by the time it met to discuss Moses’ charges, the Health Council was responding to considerable public outrage. Noting widespread popular belief that experimentation served the interests of scientific knowledge rather than those of healing, Council members agreed on the necessity of clearly defining the boundaries of permissible human experimentation. Yet these boundaries were by no means self-evident to the Council.

In an effort to clarify the issue, Council member Alfons Stauder suggested that the distinction between experiments for therapeutic purposes and those purely for research purposes could be illustrated by reference to the practice of hypnosis. In the hands of a trained physician this method of treatment was invaluable, although it exercised such a “profound influence over the patient’s mental life” that it could only be used with due caution. Very different, Stauder continued, was the use of hypnosis by lay-practitioners, whether for the purpose of healing or for the sake of gratifying public interest in mysterious or unconscious forces. He stressed the danger such experiments posed and the disrepute such practices could bring to medicine.

On the face of it, Stauder’s illustration of the general problem addressed in this session by reference to hypnosis seems surprising, even bizarre. Why did hypnosis appear in these deliberations? And why was it seen as so transgressive? Closer examination shows that, however seemingly tangential to the controversies surrounding the Lübeck affair, Stauder’s comments allude to a wider history of debates concerning the ethical and professional boundaries of medicine, in which hypnosis figured as a recurring theme.

Another key moment in this history concerns an earlier scandal that erupted in 1898, when several people experimentally injected with serum from a syphilitic patient contracted the disease. One participant in the resulting controversy was Albert Moll, a specialist in neurology and hypnosis, whose book Medical Ethics (1902) Leo Alexander cited as a key source. Moll argued that this case was not an isolated one but indicative of wider abuses, including frequent instances of experimentation on patients in public hospitals. He identified several possible causes of such lapses: medical overspecialization and the resulting narrowness of doctors’ outlook; the growing knowledge-gap between doctors and patients as medicine was revolutionized by the natural scientific method; the greater prestige accorded research over treatment. He also suggested that physicians’ social status blinded them to the power differential between them and their often poor, under-age, or mentally handicapped patients. To prevent abuses, Moll suggested the need for a contract between physician and subject-patient spelling out, among other key issues, the principle of voluntary informed consent.

Not surprisingly, given his own professional interests, Moll referred often to hypnosis in his discussion of medical ethics. Indeed it is quite central to his treatment of the doctor-patient relationship. The opening pages of his text included a warning concerning the dangers of hypnosis at the hands of lay practitioners, illustrating these dangers by citing the case of a woman who had to be institutionalized following treatment by a Hungarian hypnotist. Though he regarded such occurrences as unusual, Moll conceded in his text Hypnotism (1898) that the hypnotized subject was in fact “completely devoid of a will of his own,” and reiterated this view in his book on medical ethics. In Moll’s eyes, the hypnotic procedure carried clear risks, involving not just its apparent ability to penetrate deeply into the subject-patient’s psyche, but, in effect, to turn the subject into an object. A corollary to this was the great power it placed in the doctor’s hands.

Hypnosis thus raised significant issues concerning the doctor-patient relationship. A precondition for the contract between doctor and patient, he wrote, was the existence of a relationship of trust: a consent given by the patient or patient’s guardian. This was precisely what hypnosis, by disabling the will and thus the very basis of voluntary consent, called into question. This special feature of the hypnotic procedure, therefore, was symptomatic of a larger problem plaguing modern medicine: that patients all too often were treated as objects — a fact raising questions about “the so-called voluntary nature of the consent that patient-subjects gave their physician-researchers.” In touching here on the issue of physicians’ treatment of their patients, Moll linked the problem of ethical violations to larger questions of public trust. Absence of trust harmed hopes of medical progress both by hindering public health policies and by strengthening the popularity of alternative medicine.

Moll’s effort to find a middle ground between the patient’s interests and those of science initially found little resonance. Meanwhile, the critique of the natural scientific orientation in medicine spawned a lively medical counter-culture of alternative and esoteric healing, against which German doctors campaigned vigorously. This proved, however, no easy task, and became less so as a result of subsequent developments. During World War I, thousands of shell-shocked soldiers were treated with hypnosis. German military doctors’ discovery of its therapeutic properties gave hypnosis new validity. At the same time, the war amplified many of the issues that had surfaced in earlier debates. In some hands, the hypnotic treatment took on authoritarian features, making the patient’s submission to the physician’s absolute authority a part of the cure, and leading to conflicts between medical authorities and soldiers. Such conflicts were re-enacted in postwar films like The Cabinet of Dr. Caligari (1919), which portrayed the hypnotist as a figure of intense fear and fascination.

During the 1920s, debates about hypnosis proceeded along several tracks. On the one hand, many doctors incorporated it into their clinical practice. On the other, controversies persisted concerning its still poorly understood workings, benefits, and risks. Malpractice charges were not infrequently filed against the many unlicensed hypnotists who flourished in the war’s aftermath. The campaign against lay medicine, or quackery, continued throughout the Weimar period. At the same time, in the polarized political climate of this era, many politically conservative physicians cultivated an image of themselves as charismatic leaders, claiming the right to administer ambitious, and sometimes radical, solutions to many social problems. Moreover, doctors continued to resist encroachment on their prerogatives, resisting efforts to impose stricter guidelines on experimentation, claiming that – as opposed to the problem of quackery, where intervention was justified – prospects for scientific progress demanded complete freedom.

It was in this context that Julius Moses launched his attacks on the “experimental mania” in German medicine. In referring polemically to the Lübeck case as an instance of “medical quackery,” Moses challenged the claims of physicians like Alfons Stauder, the doctor who brought hypnosis into the 1930 Health Council deliberations, that German medicine stood on solid scientific foundations. Stauder was the head of two leading medical associations who had long used his position of influence to campaign against lay-healers. Convinced that his profession had adequate safeguards in place, Stauder argued that the worst abuses occurred in natural medicine circles. Nevertheless, in the outcry following the Lübeck affair, the Health Council issued new guidelines spelling out the limits of permissible experimentation and the principle of voluntary informed consent. These guidelines, however, had limited impact before the Nazis repudiated them in 1933. With the passage of laws legalizing involuntary sterilization of the mentally handicapped, the systematic violation of patient’s rights became institutionalized under the rapidly Nazified medical profession.

What conclusions may be drawn from this story about hypnosis and its place in the history of debates about medical ethics? Though the issues surrounding hypnosis do not warrant comparison with the Lübeck case or the crimes tried at Nuremberg, the persistence with which German doctors wrestled with them over a period of decades suggests that these issues touched a deep nerve in the medical community. Hypnosis represented a special category, one that threw several problems confronting the profession into relief. Debates about hypnosis exposed a general lack of clarity surrounding the boundaries between treatment and experiment, as well as the boundaries between science and non-science, in other areas of medicine. Perhaps more importantly, hypnosis raised significant questions concerning the relationship between doctor and patient. Efforts to establish this relationship, and the wider relation between medicine and public, on the basis of the principle of voluntary, informed consent proved, in the deeply fractured political climate of the early 1930s, short-lived. It would take the verdict of the Nuremberg doctors’ trial, and the subsequent efforts of the psychiatrist Leo Alexander, to establish this principle at the center of modern medical ethics.

New issue: Journal of the History of Medicine and Allied Sciences

jhmasA new issue of the Journal of the History of Medicine and Allied Sciences is now available online and includes the following articles dealing with the history of psychiatry:

“Female Same-sex Desires: Conceptualizing a Disease in Competing Medical Fields in Nineteenth-century Europe” (Chiara Beccalossi)

This article examines the ways in which female same-sex desires were represented across a range of nineteenth-century European medical writings. While recognizing the conceptual innovations of the late-nineteenth-century psychiatric idea of “sexual inversion,” it argues that the category of “sexual invert” was positioned alongside other medical representations of same-sex desires, such as gynecological descriptions of women with hypertrophy of the clitoris and socio-cultural analyses of the tribade-prostitute. These representations complicate current historical accounts of sexual inversion, which emphasize conceptual ruptures within the history of medicine.

“Making Up Koro: Multiplicity, Psychiatry, Culture, and Penis-Shrinking Anxieties(Ivan Crozier)

Koro is a syndrome in which the penis (or sometimes the nipples or vulva) is retracting, with deleterious effects for the sufferer. In modern psychiatry, it is considered a culture-bound syndrome (CBS). This paper considers the formation and development of psychiatric conceptions of koro and related genital retraction syndromes from the 1890s to the present. It does so by examining the different explanations of koro based on shifting conceptions of mental illness, and considers the increased recognition of the role culture has to play in psychiatric concepts. Conceptions of culture (deriving from colonial psychiatry as well as from anthropology) actively shaped the ways in which psychiatrists conceptualized koro. Cases under consideration, additional to the first Dutch descriptions of koro, include the ways in which koro was identified in white western cases, and the 1967 Singaporean koro epidemic. Following a number of psychiatrists and psychologists who have addressed the same material, attention is also paid to the recent genital-theft panics in sub-Saharan Africa, considering the implications of the differences between koro and other genital-theft panics. Finally, the paper addresses the role played by koro in the development of the concept of CBSs, which was first presented in the DSM IV in 1994. This is explored against the backdrop of emerging ideas about culture and psychiatry from the late colonial period, especially in Africa, which are central to modern ideas about transcultural psychiatry.

“Shell Shock, Trauma, and the First World War: The Making of a Diagnosis and Its Histories” (Tracey Loughran)

During the First World War, thousands of soldiers were treated for “shell shock,” a condition which encompassed a range of physical and psychological symptoms. Shell shock has most often been located within a “genealogy of trauma,” and identified as an important marker in the gradual recognition of the psychological afflictions caused by combat. In recent years, shell shock has increasingly been viewed as a powerful emblem of the suffering of war. This article, which focuses on Britain, extends scholarly analyses which question characterizations of shell shock as an early form of post-traumatic stress disorder. It also considers some of the methodological problems raised by recasting shell shock as a wartime medical construction rather than an essentially timeless manifestation of trauma. It argues that shell shock must be analyzed as a diagnosis shaped by a specific set of contemporary concerns, knowledges, and practices. Such an analysis challenges accepted understandings of what shell shock “meant” in the First World War, and also offers new perspectives on the role of shell shock in shaping the emergence of psychology and psychiatry in the early part of the twentieth century. The article also considers what relation, if any, might exist between intellectual and other histories, literary approaches, and perceptions of trauma as timeless and unchanging.

“‘An Object of Vulgar Curiosity’: Legitimizing Medical Hypnosis in Imperial Germany” (Heather Wolffram)

During the late nineteenth and early twentieth centuries, German medical hypnotists sought to gain a therapeutic and epistemological monopoly over hypnosis. In order to do this, however, these physicians were required to engage in a complex multi-dimensional form of boundary-work, which was intended on the one hand to convince the medical community of the legitimacy and efficacy of hypnosis and on the other to demarcate their use of suggestion from that of stage hypnotists, magnetic healers, and occultists. While the epistemological, professional, and legal boundaries that medical hypnotists erected helped both exclude lay practitioners from this field and sanitize the medical use of hypnosis, the esoteric interests, and sensational public experiments of some of these researchers, which mimicked the theatricality and occult interests of their lay competitors, blurred the distinctions that these professionals were attempting to draw between their “legitimate” medical use of hypnosis and the “illegitimate” lay and occult use of it.

The issue also includes articles by Hans Pols, Peter Cryle, Chiara Beccalossi and Peter Cryle dealing with various aspects of the history of medicine more generally.

For more information and a complete table of contents, click here.

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