Archive for December, 2015

Dissertations – Curing the Soul of the Nation

David Freis: “Curing the Soul of the Nation: Psychiatry, Society, and Psycho-Politics in the German-speaking Countries, 1918-1939

     Since the emergence of the discipline, the diagnostic concepts of psychiatry – more than those of any other medical field – have always been closely connected to normative debates about society at large. This link never was more apparent than in the two decades between the world wars. Amidst the political and social unrest, German-speaking psychiatrists attempted to directly interpret, diagnose, and treat society and politics from the perspective of their own clinical experiences. Leading members of the discipline redefined its boundaries and its area of authority to target larger populations beyond the mentally ill, and even the body politic as a whole. While this expansion of psychiatry’s area of expertise in the first third of the twentieth century has been noted by numerous scholars in the field, this is the first study that analyzes this process systematically and comprehensively.

Thesis Abstract FREUS 2015-12-14 IMAGE

Front cover of Erwin Stransky, Subordination, Autorität, Psychotherapie (Vienna: Julius Springer 1928).

     Using the concept of “psycho-politics” to describe the changing relation between psychiatrists and society in the period between the world wars, I maintain that these developments were neither monolithic nor disembodied processes. By situating different approaches in historical context, the thesis demonstrates how the social and political expansion of psychiatric expertise was motivated by very different reasons and took very different forms. I discuss three examples in detail: the overt pathologization of the 1918/19 revolution and its protagonists by right-wing German psychiatrists; the project of professional expansionism under the label of “applied psychiatry” in interwar Vienna; and the attempt to unite and implement different approaches to psychiatric prophylaxis in the German-speaking branches of the international movement for “mental hygiene.”

     Throughout these three interconnected case studies, I make a point for the importance of individual agency in the history of the psy-disciplines. I use the example of a number of eminent psychiatrists to show how the projects mentioned above were linked to their individual biographies and careers, and how their approaches were shaped by individual experiences of the political events in the first third of the twentieth century. Moreover, the study contributes to a broader understanding of the twentieth-century history of the psy-disciplines in at least three ways. First, I unearth the almost forgotten histories of some of the most important scholars and ideas that defined psychiatry in the first half of the twentieth century. Second, I explore the early history of some the concepts that still shape the field to the present day, namely mental health, deinstitutionalization, and psychiatric prophylaxis, as well as the history of psychiatric notions of social and political life that still circulate today. Third, I also examine psychiatry’s utopian promises, and show how the idea that the knowledge of the maladies of the human mind could pave the way to a better society could cut across contemporary political divides. The loftiest promises and the worst abuses of psychiatry were more closely connected than one might expect.

The thesis was defended on 11 December 2015 at the European University Institute in Florence.

David Freis is a research associate (Wissenschaftlicher Mitarbeiter) at the Institute for the Ethics, History, and Theory of Medicine at the University of Münster.

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Dissertations – Genetics, psychiatry and disability

Marion Schmidt: “Genetics, psychiatry and disability: Interdisciplinary approaches to defining normalcy, (mental) health and access to health care.

In psychiatry, the two decades following Wold War II are mostly remembered as an era of deinstitutionalization and first introducing psychotropic drugs. Yet it was also a period in which psychiatrists reoriented conventional mental health care in order to serve disadvantaged minorities such as African Americans, immigrants or the disabled. At the New York State Psychiatric Institute (NYSPI) German immigrant Franz Kallmann in 1955 established the first specialized mental health care services for deaf people that were conducted in sign language. Kallmann was a controversial figure. Often dubbed the founding father of psychiatric genetics in the US, he was a Jewish-born supporter of nationalsocialist eugenics who had been forced into emigration by nationalsocialist racial policies. In the US, Kallmann translated his eugenic psychiatry to a new political framework. Adapting to the goals of Cold War Science, he portrayed genetic psychiatry as a means to achieve a happy family life, a stable democracy and society free of the burden of (mental) illness. The deaf people of New York State became Kallmann’s model population to demonstrate these goals.

Yet in interacting with the state’s large and well-organized deaf community, NYSPI psychiatrists’ perceptions of their target population changed. Engaging with deaf adults, psychiatrists came to ambiguous and multilayered definitions of deaf people’s particular normalcy and (psycho)pathology. This, in turn, informed psychiatric, family and reproductive counseling at the NYSPI. Where before deafness was a tragedy to be avoided, it now became a psychosocial characteristic defining a socially disadvantaged minority. The NYSPI thus translated older eugenic paradigms to the logic and rhetoric of minority rights that permeated the 1960s.

kallmann 63 mental health title

John D. Rainer, Kenneth Z. Altshuler, and Franz J. Kallmann. 1963. Family and mental health problems in a deaf population. New York: Dept. of Medical Genetics, New York State Psychiatric Institute, Columbia University.

 The New York State project is just one example that I explore in my dissertation, a history of 20th century genetic deafness research. This was an area of much interdisciplinary collaboration in which professional alliances were forged and disintegrating throughout the century. Psychiatry and psychology were particularly close allies in the enterprise of determining and preventing so-called genetic abnormalities. With heredity research, psychiatry shared a certain overlap in their target populations. In the early decades of the 20th century, deaf people, against their energetic protests and that of educators of the deaf, were often considered mentally defective or emotionally disturbed and thus came within the reach of psychiatry. This was particularly true for multiply disabled deaf people for which there were few resources and institutions other than mental asylums with their indiscriminate warehousing. In the second half of the century, genetic counseling developed alongside psychiatric and psychological counseling, borrowing much from the emerging concepts of client-centeredness, patient autonomy and non-directiveness. By the 1970s, finally, an activist generation of psychiatrists and psychologists, reflecting on the oppressive or liberating powers of their profession, allied themselves with different patient and disability groups to argue for genetic and cultural diversity.

Drawing from the history of psychiatry and psychology, eugenics and genetics, disability and biomedicine, I explore changing notions selfhood, identity, pathology and normalcy, and trace the growing influence of patient and activist groups.

Marion Schmidt is a PhD Candidate at the Johns Hopkins Institute for the History of Medicine, graduating in spring 2016.


PhD studentships on ‘Living With Feeling’ project

Telemedicine-illustrationThanks to a major grand of £1.6m by the Wellcome Trust for a five-year inter-disciplinary research project entitled ‘Living With Feeling: Emotional Health in History, Philosophy, and Experience’, the Centre for the History of the Emotions at Queen Mary University of London invites applications from outstanding post-graduate students wishing to pursue doctoral research into aspects of the histories of emotions and health. The deadline for applications is 31 January 2016.

For more information, click here.

Obituary: Gerald N. Grob (1931-2015)


We are saddened to report the passing of historian Gerald N. Grob. Grob was Henry E. Sigerist Professor of the History of Medicine (Emeritus) at Rutgers University and its Institute for Health, Health Care Policy and Aging Research. He was a pioneering historian of American psychiatry, the author of such influential works as The Mad Among Us, From Asylum to Community: Mental Health Policy in Modern America, and Mental Institutions in America: Social Policy to 1875. Colleagues and former students remember him especially fondly for his generosity, commitment to teaching, and measured analysis.

In 2012, Grob took part in our series “How I Became a Historian of Psychiatry.” His concluding comments there seeming a fit way to remember him:

In closing I must concede that a series of personal beliefs have clearly shaped my scholarly work. I have never held to the modern belief that human beings mold and control their world in predetermined and predictable ways. This is not in any way to suggest that we are totally powerless to control our destiny. It is only to insist upon both our fallibility and our inability to predict all of the consequences that follow our actions. Nor do I believe that human behavior can be reduced to a set of deterministic or quasi-deterministic laws or generalizations, or that solutions are readily available for all our problems. Tragedy is a recurring theme in human history and defines the parameters of our existence. I have always tried, therefore, to deal sympathetically with our predecessors who grappled–so often in partial and unsuccessful ways as we still do ourselves–with their own distinct problem.

New Issue – History, medicine and health

Screenshot from 2015-12-15 11-08-33The latest issue of History, medicine and health is dedicated to the question of care. Edited by three French historians – Anne Jusseaume, Paul Marquis et Mathilde Rossigneux-Meheust -, the issue contains at least two articles dedicated to the history of psychiatry.

Surveiller, punir et soigner ? Pratiques psychiatriques en Europe de l’Ouest du XIXe siècle aux années 1950, by Benoît Majerus

Le soin en psychiatrie dans la France des années 1930. Une observation à partir des dossiers de patients et des manuels de formation infirmière, by Hervé Guillemain

New Issue – Medical History

MDH60_01The latest issue of Medical History is dedicated to celebrating the thirtieth anniversary of Roy Porter’s article “The Patient’s View. Doing Medical History from Below” (Theory and Society, 1985, vol. 14, no 2, 175‑198). The issue is guest edited by Alexandra Bacopoulos-Viau, one of the editors of h-madness and Aude Fauvel and contains several articles dedicated to the history of psychiatry.

Tales from the Asylum. Patient Narratives and the (De)construction of Psychiatry

Editorial. The Patient’s Turn. Roy Porter and Psychiatry’s Tales, Thirty Years on, by Alexandra Bacopoulos-Viau and Aude Fauvel

This past year marked the thirtieth anniversary of Roy Porter’s seminal 1985 article, ‘The Patient’s View: Doing Medical History from Below’. Few works in the history of medicine have received so enthusiastic a reception. Porter’s call to reclaim the voice of the voiceless has had an extraordinary echo, becoming not only a necessary reference but also a classic trope. This is especially the case among historians of psychiatry. In a field where patient narratives have long formed their own sub-genre, shedding light on these hitherto unheard stories taps into popular fantasies probed by Porter himself—images of gothic madhouses and their gloomy inhabitants; whispers and cries; dark corridors encased in windowless walls, their interiors mirroring the mind gone astray. So ubiquitous is this imagined space that some have recently proposed to create an independent research area dedicated to ‘Mad Studies’. Fetishized, mythicized, ostracised, the psychiatric patient has emerged as an unlikely protagonist, capturing the scholarly, cultural and artistic imagination alike. Yet recent assessments suggest that Porter’s call has not fully been heard. The history of the patient remains ‘curiously underwritten’ in several areas, some have claimed. Others have maintained that on a conceptual level, ‘the history of the patient’s view is as undeveloped now as it was back in the mid-1980s.’ In view of historians of psychiatry’s special love affair with the world of their protagonists, a critical review of these recent developments seems all the more pertinent.

This special edition explores the varied ways in which patients’ voices have guided psychiatry’s construction, deconstruction and reconstruction from 1800 to the present. In this respect, the thirtieth anniversary of Porter’s seminal article acts as an opportune occasion to reexamine the field using fresh historical and historiographical perspectives. In what ways have historians of psychiatry taken on the project of a history ‘from below’? How have they turned such tales into objects of study? What do their works reveal? And how has this focus on patient narratives shaped our understanding of the processes by which mental illness is understood and treated in the twenty-first century?

Animal Magnetism, Psychiatry and Subjective Experience in Nineteenth-Century Germany: Friedrich Krauß and his Nothschrei, by Burkhart Brückner

Friedrich Krauß (1791–1868) is the author of Nothschrei eines Magnetisch-Vergifteten [Cry of Distress by a Victim of Magnetic Poisoning] (1852), which has been considered one of the most comprehensive self-narratives of madness published in the German language. In this 1018-page work Krauß documents his acute fears of ‘mesmerist’ influence and persecution, his detainment in an Antwerp asylum and his encounter with various illustrious physicians across Europe. Though in many ways comparable to other prominent nineteenth-century first-person accounts (eg. John Thomas Perceval’s 1838 Narrative of the Treatment Experienced by a Gentleman or Daniel Paul Schreber’s 1903 Memoirs of my Nervous Illness), Krauß’s story has received comparatively little scholarly attention. This is especially the case in the English-speaking world. In this article I reconstruct Krauß’s biography by emphasising his relationship with physicians and his under-explored stay at the asylum. I then investigate the ways in which Krauß appropriated nascent theories about ‘animal magnetism’ to cope with his disturbing experiences. Finally, I address Krauß’s recently discovered calligraphic oeuvre, which bears traces of his typical fears all the while showcasing his artistic skills. By moving away from the predominantly clinical perspective that has characterised earlier studies, this article reveals how Friedrich Krauß sought to make sense of his experience by selectively appropriating both orthodox and non-orthodox forms of medical knowledge. In so doing, it highlights the mutual interaction of discourses ‘from above’ and ‘from below’ as well as the influence of broader cultural forces on conceptions of self and illness during that seminal period.

‘No “Sane” Person Would Have Any Idea’: Patients’ Involvement in Late Nineteenth-century British Asylum Psychiatry, by Sarah Chaney

In his 1895 textbook, Mental Physiology, Bethlem Royal Hospital physician Theo Hyslop acknowledged the assistance of three fellow hospital residents. One was a junior colleague. The other two were both patients: Walter Abraham Haigh and Henry Francis Harding. Haigh was also thanked in former superintendent George Savage’s book Insanity and Allied Neuroses (1884). In neither instance were the patients identified as such. This begs the question: what role did Haigh and Harding play in asylum theory and practice? And how did these two men interpret their experiences, both within and outside the asylum? By focusing on Haigh and Harding’s unusual status, this paper argues that the notion of nineteenth-century ‘asylum patient’ needs to be investigated by paying close attention to specific national and institutional circumstances. Exploring Haigh and Harding’s active engagement with their physicians provides insight into this lesser-known aspect of psychiatry’s history. Their experience suggests that, in some instances, representations of madness at that period were the product of a two-way process of negotiation between alienist and patient. Patients, in other words, were not always mere victims of ‘psychiatric power’; they participated in the construction and circulation of medical notions by serving as active intermediaries between medical and lay perceptions of madness.

Making Sense of the ‘Chemical Revolution’. Patients’ Voices on the Introduction of Neuroleptics in the 1950s, by Benoît Majerus

The so-called chemical revolution has produced a vast historiographical corpus. Yet the patient’s voice remains surprisingly absent from these stories. Based on the archives of the Institut de Psychiatrie (Brussels), this paper traces the introduction of Largactil as recounted in patient letters, physician records and nurse notes. The paper thus contributes to the history of therapies from below, but also participates in the historiographical debate about whether the introduction of neuroleptics can indeed be considered a revolution.

Constructing Patient Stories: ‘Dynamic’ Case Notes and Clinical Encounters at Glasgow’s Gartnavel Mental Hospital, 1921–32, by Hazel Morrison

This article contextualises the production of patient records at Glasgow’s Gartnavel Mental Hospital between 1921 and 1932. Following his appointment as asylum superintendent in 1921, psychiatrist David Kennedy Henderson sought to introduce a so-called dynamic approach to mental health care. He did so, primarily, by encouraging patients to reveal their inner lives through their own language and own understanding of their illness. To this effect, Henderson implemented several techniques devised to gather as much information as possible about patients. He notably established routine ‘staff meetings’ in which a psychiatrist directed questions towards a patient while a stenographer recorded word-for-word the conversation that passed between the two parties. As a result, the records compiled at Gartnavel under Henderson’s guidance offer a unique window into the various strategies deployed by patients, but also allow physicians and hospital staff to negotiate their place amidst these clinical encounters. In this paper, I analyse the production of patient narratives in these materials. The article begins with Henderson’s articulation of his ‘dynamic’ psychotherapeutic method, before proceeding to an in-depth hermeneutic investigation into samples of Gartnavel’s case notes and staff meeting transcripts. In the process, patient–psychiatrist relationships are revealed to be mutually dependent and interrelated subjects of historical enquiry rather than as distinct entities. This study highlights the multi-vocal nature of the construction of stories ‘from below’ and interrogates their subsequent appropriation by historians.

The Moral Career of ‘Outmates’: Towards a History of Manufactured Mental Disorders in Post-Socialist China, by Harry Yi-Jui Wu

This study focuses on ‘manufactured mentally ill’ (bei jingshenbing, 被精神病) individuals in post-socialist China. In Chinese society, bei jingshenbing is a neologistic catchphrase that refers to someone who has been misidentified as exhibiting symptoms of mental illness and has been admitted to a mental hospital. Specifically, it refers to those individuals who were subjected to unnecessary psychiatric treatment during the first decade of the twenty-first century. Based on archival analysis and ethnographic fieldwork, this study addresses the ways in which the voices of bei jingshenbing victims and those who support them reveal China’s experiences with psychiatric modernity. It also discusses the active role of these individuals in knowledge production, medical policymaking, and the implications for reforming the psychiatric and mental health systems in post-socialist China.

New Book – Houses of Madness: Insanity and Asylums of Bengal in Nineteenth-Century India by Debjani Das

Houses of MddnessDebjani Das, Assistant Professor at the Department of History of Vidyasagar University,  just published a book entitled Houses of Madness. Insanity and Asylums of Bengal in Nineteenth-Century India. The blurb reads:

Houses of Madness is an intriguing analysis of the history of mental asylums in nineteenth-century Bengal. It explores these institutions through several phases of their development, which not only involved changes in medical treatment and its interpretation of the mentally challenged, but also in the social composition of and the spatial distribution within mental institutions. By also locating the asylums both socially and geographically, it explains how mental illness was defined within these confines.

The book compares the medical practices in India and England and shows how changing definitions of insanity led to changes in the social composition of asylum inmates. Through a narration of the inmates daily life inside the asylums of colonial Bengal, Debjani Das addresses critical issues such as inmate labour in asylums and how male and female insanity were defined differently. These questions were directly related to, and also resulted in, the development of different types of treatments for mental illness, which ranged from the medical and moral to physical and mechanical restraint.

Found thanks to Historiens de la santé.


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