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.
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.