The invention of the psychosocial: An introduction (Rhodri Hayward)
Although the compound adjective ‘psychosocial’ was first used by academic psychologists in the 1890s, it was only in the interwar period that psychiatrists, psychologists and social workers began to develop detailed models of the psychosocial domain. These models marked a significant departure from earlier ideas of the relationship between society and human nature. Whereas Freudians and Darwinians had described an antagonistic relationship between biological instincts and social forces, interwar authors insisted that individual personality was made possible through collective organization. This argument was advanced by dissenting psychoanalysts such as Ian Suttie and Karen Horney; biologists including Julian Huxley and Hans Selye; philosophers (e.g. Olaf Stapledon), anthropologists (e.g. Margaret Mead) and physicians (e.g John Ryle and James Halliday).
This introduction and the essays that follow sketch out the emergence of the psycho-social by examining the methods, tools and concepts through which it was articulated. New statistical technologies and physiological theories allowed individual pathology to be read as an index of broader social problems and placed medical expertise at the centre of new political programmes. In these arguments the intangible structure of social relationships was made visible and provided a template for the development of healthy and effective forms of social organization. By examining the range of techniques deployed in the construction of the psychosocial (from surveys of civilian neurosis, techniques of family observation through to animal models of psychotic breakdown) a critical genealogy of the biopolitical basis of modern society is developed.
The pursuit of happiness: The social and scientific origins of Hans Selye’s natural philosophy of life (Mark Jackson)
In 1956, Hans Selye tentatively suggested that the scientific study of stress could ‘help us to formulate a precise program of conduct’ and ‘teach us the wisdom to live a rich and meaningful life’. Nearly two decades later, Selye expanded this limited vision of social order into a full-blown philosophy of life. In Stress without Distress, first published in 1974, he proposed an ethical code of conduct designed to mitigate personal and social problems. Basing his arguments on contemporary understandings of the biological processes involved in stress reactions, Selye referred to this code as ‘altruistic egotism’. This article explores the origins and evolution of Selye’s ‘natural philosophy of life’, analysing the links between his theories and adjacent intellectual developments in biology, psychosomatic and psychosocial medicine, cybernetics and socio-biology, and situating his work in the broader cultural framework of modern western societies.
‘The gut war’: Functional somatic disorders in the UK during the Second World War (Edgar Jones)
Hospital admission and mortality statistics suggested that peptic ulcer reached a peak prevalence in the mid-1950s. During the Second World War, against this background of serious and common pathology, an epidemic of dyspepsia afflicted both service personnel and civilians alike. In the absence of reliable diagnostic techniques, physicians struggled to distinguish between life-threatening illness and mild, temporary disorders. This article explores the context in which non-ulcer stomach conditions flourished. At a time when fear was considered defeatist and overt psychological disorder attracted stigma, both soldiers and civilians exposed to frightening events may have unconsciously translated their distress into gastrointestinal disorders. While the nature of army food was initially identified as the cause of duodenal ulcer in servicemen, the pre-war idea that conscientious and anxious individuals were at high risk gathered support and fed into post-war beliefs that this was a stress-related illness. Diet continued to be employed as a means of management at a time when the nation was preoccupied by food because of the constraints imposed by rationing. The peptic ulcer phenomenon set much of the medical agenda for the war years and conflicted with the commonly held view that the British people had never been healthier.
War on fear: Solly Zuckerman and civilian nerve in the Second World War (Ian Burney)
This article examines the processes through which civilian fear was turned into a practicable investigative object in the inter-war period and the opening stages of the Second World War, and how it was invested with significance at the level of science and of public policy. Its focus is on a single historical actor, Solly Zuckerman, and on his early war work for the Ministry of Home Security-funded Extra Mural Unit based in Oxford’s Department of Anatomy (OEMU). It examines the process by which Zuckerman forged a working relationship with fear in the 1930s, and how he translated this work to questions of home front anxiety in his role as an operational research officer. In doing so it demonstrates the persistent work applied to the problem: by highlighting it as an ongoing research project, and suggesting links between seemingly disparate research objects (e.g. the phenomenon of ‘blast’ exposure as physical and physiological trauma), the article aims to show how civilian ‘nerve’ emerged from within a highly specific analytical and operational matrix which itself had complex foundations.
Glasgow’s ‘sick society’?: James Halliday, psychosocial medicine and medical holism in Britain c.1920–48 (Andrew Hull)
James Lorimer Halliday (1897–1983) pioneered the development of the concept of psychosocial medicine in Britain in the 1930s and 1940s. He worked in Glasgow, first as a public health doctor, and then as part of the corporatist National Health Insurance scheme. Here he learned about links between poverty, the social environment, emotional stress and psychological and physical ill-health, and about statistical tools for making such problems scientifically visible. The intellectual development of his methodologically and epistemologically integrated medicine – a hybrid of biomedical and psychological approaches – was embedded in the context of this practice with its particular medical culture and socio-economic circumstances. Halliday’s ideas are part of the wider, heterogeneous turn towards medical modernism and holism within mainstream medicine in Britain, western Europe and the United States in the inter-war period, and their evolution underlines the varied nature of contemporary anti-reductionist thinking in medicine. It also points to the diversity of the sources of holism and the many routes by which psychological and especially psychosocial discourses about health and illness entered professional and public arenas in Britain in this period.
Political dimensions of ‘the psychosocial’: The 1948 International Congress on Mental Health and the mental hygiene movement (Jonathan Toms)
The Foucaultian sociologist Nikolas Rose has influentially argued that psychosocial technologies have offered means through which the ideals of democracy can be made congruent with the management of social life and the government of citizens in modern western liberal democracies. This interpretation is contested here through an examination of the 1948 International Congress on Mental Health held in London and the mental hygiene movement that organized it. It is argued that, in Britain, this movement’s theory and practice represents an uneasy and ambiguous attempt to reconcile visions of ‘the modern’ with ‘the traditional’. The mental hygienist emphasis on the family is central. Here it appears as a forcing-house of the modern self-sustaining individual. Mental hygienists cast the social organization of ‘traditional’ communities as static, with rigid authority frustrating both social progress and the full emergence of individual personality. Yet mental hygienists were also concerned about threats to social cohesion and secure personhood under modernity. If the social organization of ‘traditional’ communities was patterned by the archetype of the family, with its personal relations of authority, mental hygienists compressed these relations into the ‘private’ family. Situated here they became part of a developmental process of mental adjustment through which ‘mature’, responsible citizens emerged. This reformulation of the family’s centrality for the social order informed mental hygienist critiques of the growth of state power under existing forms of democracy, as well as suspicion of popular political participation or protest, and of movements towards greater egalitarianism.
Democratizing mental health: Motherhood, therapeutic community and the emergence of the psychiatric family at the Cassel Hospital in post-Second World War Britain (Teri Chettiar)
Shortly following the Second World War, and under the medical direction of ex-army psychiatrist T. F. Main, the Cassel Hospital for Functional Nervous Disorders emerged as a pioneering democratic ‘therapeutic community’ in the treatment of mental illness. This definitive movement away from conventional ‘custodial’ assumptions about the function of the psychiatric hospital initially grew out of a commitment to sharing therapeutic responsibility between patients and staff and to preserving patients’ pre-admission responsibilities and social identities. However, by the mid-1950s, hospital practices had come to focus pre-eminently on patients’ relationships with family members, and staff had developed a social model of mental health that focused on the family as the irreducible unit of mental treatment. By the late 1950s, this culminated in the in-patient admission of entire families for mental treatment, even when only one family member was exhibiting symptoms. At the heart of this growing post-war social-psychiatric preoccupation with the family was a new emphasis on the close relationship between mental health and individuals’ successful development toward mature responsible adulthood. The family came to be conceived as the quintessential space where both were forged. This article examines the process through which the Cassel’s social-psychiatric commitment to ‘therapeutic community’ became focused on the family as a key therapeutic site. While the family had become a central point of focus in social, political and psychological discussions of the foundation for stable democratic culture and political peace in post-war Britain, the Cassel Hospital actively experimented with these connections in therapeutic practice. This article thus illuminates the important, but frequently overlooked, role of psychiatric practices in the development of a post-war psychopolitics that established important links between the nuclear family, mental health and democratic social life.
Rats, stress and the built environment (Edmund Ramsden)
From 1942 to 1952, a programme took place at Johns Hopkins to devise new methods of controlling Baltimore’s rat population. This article focuses on three individuals closely connected to this project at various stages of its development: psycho-biologist Curt Richter, animal ecologist David E. Davis, and ecologist and psychologist John B. Calhoun. For all three, the challenges of controlling rat numbers highlighted the significance of stress – a homeostatic mechanism critical to the survival of the animal. This was a process that was analyzed and manipulated by (re)introducing the wild rat into the laboratory. Here the rat not only contributed to new methods of rodent control, but offered new possibilities for the control and improvement of humankind. Yet it was not just the animal, but the physical structure of the laboratory that came to model the world outside. Through examining the experimental systems of the three scientists, this article will trace a series of transgressions between laboratory and field, urban and wild, animal and human. The result was that while animals were used to model the behaviour and pathologies of human city dwellers, the laboratory spaces in which they existed came to model the urban environment. We shall also see how differing perspectives on the value and uses of animal models and environments encouraged and reinforced alternative visions as to the role of science in the service of the city.
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