New Issue: History of Psychiatry
The latest issue of History of Psychiatry (June 2016) is now online. Abstracts to the articles published can be found below. For the full table of contents, including a classic text by the Italian alienist Eugenio Tanzi, two book reviews and abstracts of recent dissertations, click here.
The emergence of psychiatric semiology during the Age of Revolution: evolving concepts of ‘normal’ and ‘pathological’ (Diego Enrique Londoño and Professor Tom Dening)
This article addresses some important questions in psychiatric semiology. The concept of a sign is crucial in psychiatry. How do signs emerge, and what gives them validity and legitimacy? What are the boundaries of ‘normal’ and ‘pathological’ behaviour and mental experiences? To address these issues, we analyse the characteristics and rules that govern semiological signs and clinical elements. We examine ‘normality’ from the perspective of Georges Canguilehm and compare the differences of ‘normal’ in physiology and psychiatry. We then examine the history and the philosophical, linguistic and medical-psychiatric origins of semiology during the eighteenth and nineteenth centuries (the Age of Revolution). The field of rhetoric and oratory has emphasized the importance of passions, emotions and language as applied to signs of madness. Another perspective on semiology, provided by Michel Foucault, lays stress on the concept of ‘instinct’ and the axis of voluntary-involuntary behaviour. Finally, we analyse how statistics and eugenics have played an important role in our current conceptualization of the norm and therefore the scientific discourse behind the established clinical signs.
Psychiatric governance, völkisch corporatism, and the German Research Institute of Psychiatry in Munich (1912–26). Part 2 (Eric J Engstrom, Wolfgang Burgmair, and Matthias M Weber)
This is the second of two articles exploring in depth some of the early organizational strategies that were marshalled in efforts to found and develop the German Research Institute of Psychiatry (Deutsche Forschungsanstalt für Psychiatrie). The first article analysed the strategies of psychiatric governance – best understood as a form of völkisch corporatism – that mobilized a group of stakeholders in the service of higher bio-political and hygienic ends. This second article examines how post-war imperatives and biopolitical agendas shaped the institute’s organization and research. It also explores the financial challenges the institute faced amidst the collapse of the German financial system in the early Weimar Republic, including efforts to recruit financial support from the Rockefeller Foundation and other philanthropists in the USA.
‘We are all a little mad in one or other particular’. The presentation of madness in the novels of Muriel Spark (Allan Beveridge)
This paper examines the presentation of madness in the novels of the great Scottish writer, Muriel Spark (1918–2006). In her work, there is a large cast of mad characters as well as a succession of psychiatrists and psychoanalysts. Spark suggests several explanations as to the origins of madness. We see mental disturbance conceived in terms of the supernatural, the religious and the Gothic. She also depicts insanity as a form of personality defect, eccentricity or mental enfeeblement. She drew on Romantic notions of the madman as a seer and speaker of truth. In her portrayal of psychiatrists, both the pill-prescribers and the psychoanalysts, Spark is frequently sceptical of the two: medication can erase positive qualities in an individual, and analysts can spout meaningless gibberish.
Neurotoxicity and LSD treatment: a follow-up study of 151 patients in Denmark (Jens Knud Larsen)
LSD was introduced in psychiatry in the 1950s. Between 1960 and 1973, nearly 400 patients were treated with LSD in Denmark. By 1964, one homicide, two suicides and four suicide attempts had been reported. In 1986 the Danish LSD Damages Law was passed after complaints by only one patient. According to the Law, all 154 applicants received financial compensation for LSD-inflicted harm. The Danish State Archives has preserved the case material of 151 of the 154 applicants. Most of the patients suffered from severe side effects of the LSD treatment many years afterwards. In particular, two-thirds of the patients had flashbacks. With the recent interest in LSD therapy, we should consider the neurotoxic potential of LSD.
The DSM and learning difficulties: formulating a genealogy of the learning-disabled subject (Ofer Katchergin)
The article examines the manner in which the learning-disabled subject is created as an object within contemporary psychiatric discourse by means of a genealogical analysis of the learning-disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It investigates how this pathology was formed historically in the text, what metamorphoses it underwent, and their epistemic significance. First, the theoretical underpinnings of the sociological discourse on DSM are presented, giving a brief background of the DSM status in the Israeli context. Many problematic characteristics in the text are unveiled, by means of critiques from sociology, anthropology and discourse studies. Second, the changing definitions and conceptualizations of learning-disorders in the seven editions of the Manual and the accompanying case studies (1952–2013) are examined. It becomes apparent that the disorders have undergone changes that have enabled the biomedical paradigm to triumph. The implications of these transformations are addressed.
‘God grant it may do good two all’: the madhouse practice of Joseph Mason, 1738–79 (Leonard Smith)
Private madhouses made a significant contribution to the development of psychiatric practices in eighteenth-century England. Joseph Mason of Bristol, proprietor of a madhouse at Stapleton and then at nearby Fishponds, was part of a dynasty of successful and respected mad-doctors. A deeply religious man, his Christian ethics constituted the guiding force in his work with patients and interactions with their relatives. He was also an astute man of business, who recognized that comfortable domestic surroundings and the achievement of recoveries would enhance his reputation and attract lucrative middle-class custom. His treatment approaches, illustrated in a 1763 diary, were eclectic and pragmatic, comprising various medicines, dietary regulation, graded social interactions, and the cultivation of individualized therapeutic relationships with his patients.
Max Scheler’s theory of the hierarchy of values and emotions and its relevance to current psychopathology (J Cutting)
The philosopher Max Scheler (1874–1928) set out a hierarchical theory of values and emotions in the early twentieth century. This inspired Kurt Schneider to distinguish two sorts of depressive illness, each conforming to a Störung (disorder) in different levels of Scheler’s hierarchy. No other psychopathologist, except Stanghellini, gave the matter much attention. I believe that Scheler’s theory is a rich source of insight into psychopathology, general and neuropsychiatric. I therefore give an account of Scheler’s scheme, review its extant applications (Schneider’s, Stanghellini’s), and present suggestions as to its continuing potential relevance in a wide range of psychopathological conditions.