New issue: History of Psychiatry

The June 2012 issue of History of Psychiatry is now online and contains the following articles:

R.D. Laing’s theological hinterland: the contrast between mysticism and communion (Gavin Miller)

Contrasting elements in R.D. Laing’s psychiatry can be traced to two kinds of Christian theology: mystical theology and corporate theology. On one hand, Laing’s mystical theology combined with psychoanalytic theory, to provide a New Age psychotherapeutic account of the recovery of authentic selfhood via metanoia. On the other, his incarnational, corporate theology promoted social inclusion of the mentally ill, particularly via therapeutic communities. For Laing, as for other post-war British Christians, a turn inwards, to mysticism and the sacralization of the self, and a turn outwards, to social and political activism, were ways of negotiating with the decline of traditional Christianity.

Psychiatric case notes: symptoms of mental illness and their attribution at the Maudsley Hospital, 1924–35 (Edgar Jones, Shahina Rahman, and Brian Everitt)

Case notes of patients treated at the Maudsley Hospital during the interwar period provided data about diagnosis, symptoms and beliefs about mental illness. In the absence of effective treatments, patients were investigated in detail in the hope that connections between disease processes might be revealed. We analysed a randomly-selected sample of 700 patients taken equally from 1924, 1928, 1931 and 1935. Eight groups (three representing psychosis and five indicating psychological disorders) were identified on the basis of symptom clusters. Formal diagnosis did not correlate with clusters. Although there was a measure of agreement between patients and doctors about the cause of mental illness, stigma may have inhibited discussion of some themes. Psychiatric diagnosis was informed by symptoms but not determined by them. In an era before classification systems were tested for reliability, diagnosis was fluid, reflecting changing hypotheses about causation, pathology and treatment. Attributions were associated with diagnosis rather than symptoms.

Limited to no responsibility: addiction, alcoholism and the law in modern Germany (Jonathan Lewy)

In Germany, a perpetrator had to be of sound mind to be convicted of a crime throughout the nineteenth and twentieth centuries. The criminal code was clear, but reality was not. From the moment that physicians accepted alcoholism and drug addiction as diseases of mind and body, the question of what to do with alcoholic and addicted criminals troubled legal theorists. How were judges to maintain the balance of justice if, on the one hand, a potential perpetrator chose to be of unsound mind by drinking or using drugs, but on the other, he was sick, unable to control his actions? As this article demonstrates, the legal system was lenient towards inebriated perpetrators as a by-product of the insistence of German doctors that alcoholism and addiction were diseases.

Between phenomenological and community psychiatry: the Comprehending Anthropology of Jürg Zutt (Peter Schönknecht and Tom Dening)

Phenomenological and existential philosophical approaches to mental illness have had great influence on psychiatric research and theory in European psychiatry (Berrios, 1992: 309). Among them, the work of Jürg Zutt (1893–1980), Professor of Psychiatry at University Hospital Frankfurt 1950–63, closely relates to the anthropological psychiatry of Ludwig Binswanger, Victor von Gebsattel and Erwin Straus. Since both anthropological psychiatry and social psychiatry are based on a person-centred approach, it was hypothesized that common roots are to be detected in what is called humanistic psychology. The main finding of the present paper is that there is a strong relationship between Zutt’s concept of Comprehending Anthropology and the biopsychosocial model on which social psychiatry is based. However, it cannot be concluded from the existing evidence that the reform of psychiatric services necessarily resulted from the anthropological approach.

Psychology during the expeditions of the heroic age of Antarctic exploration (HR Guly)

The psychology of Antarctic explorers and groups in Antarctic bases has been much studied in recent years, and current knowledge has been summarized in a review by Palinkas and Suedenfeld (2008). There was no formal psychological research during the heroic age of Antarctic exploration, but a number of the doctors and non-medical personnel on the expeditions were keen observers of the psychological aspects of the expeditions and wrote about them. In this paper, I describe their understanding of the psychology of Antarctic exploration. By comparing this with current knowledge, it is clear that most of what has been found by formal study was known to the explorers of the heroic age.

Psychiatric illness and suicide in the heroic age of Antarctic exploration (HR Guly)

During the heroic age of Antarctic exploration, a number of the early explorers developed psychiatric illness either in the Antarctic or shortly after leaving it. Most of these were psychotic illnesses and stress reactions. At least six explorers committed suicide either in the Antarctic or after their return. These cases are described, and possible reasons for the apparent high incidence of psychiatric disease and suicide are discussed. There are also examples of the possible misuse of psychiatric labels.

Victor Kandinsky (1849–89): a pioneer of modern Russian forensic psychiatry (Vladimir Lerner, Jacob Margolin, and Eliezer Witztum)

The paper describes Victor Kandinsky’s professional achievements within nineteenth-century Russian forensic psychiatry. A thorough review of nineteenth-century Russian psychiatry is presented, followed by a short biographical account of Kandinsky’s personal life. Within the backdrop of Russian forensic psychiatry toward the end of nineteenth century, Kandinsky’s pioneer innovations in psychopathology and classification as well as his contributions to Russian forensic psychiatry are reviewed. These are exemplified by two of his forensic case studies relating to forensic responsibility and malingering, which are included in his famous book ‘On Irresponsibility’.

The issue also contains a comment on Frederic Rowland Marvin’s classic 1874 text ‘The Pathology and Treatment of Mediomania’ by Carlos S Alvarado and Nancy L Zingrone; the full text of Richard Noll’s Dementia praecox, 1886: a new turning point?, as well as book reviews of Waltraud Ernst and Thomas Mueller (eds), Transnational Psychiatries: Social and Cultural Histories of Psychiatry in Comparative Perspective c. 1800–2000; Paul E Stepansky’s Psychoanalysis at the Margins; Alfred I Tauber’s Freud: The Reluctant Philosopher; Jan Goldstein’s Hysteria Complicated by Ecstasy: The Case of Nanette Leroux; and Marco Conci’s Sullivan Revisited – Life and Work: Harry Stack Sullivan’s Relevance for Contemporary Psychiatry, Psychotherapy and Psychoanalysis.

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