Author Archive

CfP Special Issue on the History of Global Psychology and Psychiatry

History of Psychology invites submissions for a special issue on the history of psychology and psychiatry in the global world.

Until recently, historical research in the history of psychology and psychiatry tended to focus on the development of these disciplines in the western world exclusively. When the rest of the world was taken into account, it was often portrayed as the recipient of western insights and not as a place where psychological and psychiatric knowledge originated or where practitioners made genuine contributions to both fields. Over the past two or three decades, historians of psychiatry have devoted ample energy to the history of colonial psychiatry, analyzing developments in the non-western world. Historians of psychology, however, have arguably paid less attention to developments in the non-western world.

In this special issue, we seek to consolidate and extend the historical analysis of psychology and psychiatry beyond the Atlantic or western world. We welcome original contributions on initiatives and developments in the colonial era. In addition, we seek to expand historical interest in the post-colonial era, starting with the Cold War and coming up to the present.

The submission deadline is May 15, 2017.

The main text of each manuscript, exclusive of figures, tables, references, or appendices, should not exceed 35 double spaced pages (approximately 7,500 words). Initial inquiries regarding the special issue may be sent to the guest editors, Hans Pols (University of Sydney) <hans.pols@sydney.edu.au> and Harry Yi-Liu Wu (University of Hong Kong) <hylw@hku.hk> or the regular editor, Nadine Weidman <hop.editor@icloud.com>.

Manuscripts should be submitted through the History of Psychology Manuscript Submission Portal with a cover letter indicating that the paper is to be considered for the special issue. Please see the Instructions to Authors information located on the History of Psychology website.

 

Albert Maysles, pioneering documentary maker, dies at 88

Albert Maysles, pioneering documentary maker, dies aged 88. He made a short documentary on psychiatry in Russia in 1957.

For an obituary see: http://www.nytimes.com/2015/03/07/movies/albert-maysles-pioneering-documentarian-dies-at-88.html?ref=obituaries.

The short documentary on psychiatry in Russia: https://video.search.yahoo.com/video/play?p=youtube+psychiatry+in+russia&vid=f8d7d2c9c60314cec13883877cb6dbc7&l=13%3A39&turl=http%3A%2F%2Fts1.mm.bing.net%2Fth%3Fid%3DVN.608046960190360960%26pid%3D15.1&rurl=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3D3EybtunoiAw&tit=Psychiatry+in+Russia+1957&c=1&sigr=11bv3us6v&sigt=10pf0tidm&sigi=11rnvgk71&ct=p&age=1393712170&fr2=p%3As%2Cv%3Av&hsimp=yhs-001&hspart=mozilla&tt=b.

Abraham Myerson papers available at the Countway Library

The Center for the History of Medicine is pleased to announce the acquisition of the personal and professional papers of Abraham Myerson, M.D. (1881-1948). Myerson, a neurologist, psychiatrist, clinician, pathologist, and researcher, believed in the interdependence of mind and body and a physiological approach in psychiatry and neurology. He had a special interest in the heredity of psychiatric and neurologic disease.

During the first decades of the 20th century, the eugenics movement became prominent and widely supported by lay and professional groups. Myerson was an opponent of the involuntary sterilization of feeble-minded and mentally ill patients. While at Taunton State Hospital, he conducted a study and published his findings in The Inheritance of Mental Disease (1925), which showed that only ten percent of inpatients had a relative who had been confined to the hospital since its opening in 1854. Myerson believed that while there could be a heredity factor involved, social environment also played a major role.

Among his many professional roles, Myerson served as Massachusetts state forensic examiner for eight years. He interviewed Sacco and Vanzetti and later testified at their trial.

The collection contains correspondence with colleagues, peers, and the general public on many topics, including the need and possible uses for Benzedrine, notes of his conversations with Sacco, unpublished writings, and photographs. A subseries contains the inventory of state resources provided for the mentally ill and retarded in the United States compiled by Dr. Harry Best, which later resulted in a publication, and related correspondence with Best.

Born in Lithuania, the son of a schoolteacher, Myerson came to the United States at age five. In 1892, the family moved to Boston, Massachusetts where Myerson attended the Boston public schools. He later attended the College of Physicians and Surgeons of Columbia University and Tufts Medical School; he graduated from the latter in 1908. Myerson held several appointments in Boston-area hospitals and medical schools in neurology, neuropathology, pathology, and clinical psychiatry, including working with Harvard Medical School neuropathologist Elmer E. Southard, joining the first group of residents (with Myrtelle Canavan and Harry Solomon) at the newly opened Boston Psychopathic Hospital (1912), serving as clinical director and pathologist at Taunton State Hospital (1913-1917) and as director of research at Boston State Hospital (1927-1940). He was appointed Professor of Clinical Psychiatry at the Harvard Medical School (1935-1940) and Chair of the Department of Neurology at Tufts Medical School (1921-1940). Myerson was chief of the Department of Neurology and Psychiatry, Beth Israel Hospital, from 1942 to 1945.

Myerson was active in many professional organizations: the American Psychiatric Association (representative to the National Research Council), the American Neurological Association, the Greater Boston Medical Society, the American Psychopathological Society (president, 1938-1939), the Advisory Council for Research in nervous and mental disease for the U.S. Public Health Service, and director of the Mental Hygiene Society. He published ten books, all of which can be found in HOLLIS, and numerous scholarly research articles.

 

https://cms.www.countway.harvard.edu/wp/?p=8424

Review—PTSD before PTSD. The Politics of War Trauma: The Aftermath of World War II in Eleven European Countries. Editors: Jolande Withuis and Annet Mooij. Amsterdam: Aksant, 2010.

by Hans Pols

By now the story of the origin of Posttraumatic Stress Disorder [PTSD] is fairly well known: the diagnosis was the surprising outcome of an unusual set of political circumstances during the 1970s in the USA. At that time, a somewhat unlikely coalition was formed between psychiatrists treating disgruntled Vietnam veterans, advocates for Holocaust survivors, and representatives of the feminist movement demanding public attention for the long-lasting psychological effect of physical and sexual abuse of women. All three groups had observed similar sets of symptoms in the traumatized individuals under treatment. And in all three groups symptoms at times appeared many years after the original event. For all three groups, the PTSD diagnosis provided a medical recognition of their suffering, opened up avenues for treatment, and presented a justification for compensation claims. Accounts on the origins of PTSD generally emphasize the originality and novelty of the diagnosis. The book under review dispels this notion thoroughly: unusually rich and extensive medical and political debates on the sequelae of extraordinary suffering of World War II took place in many European countries after 1945. Physicians who themselves had experienced deportation and life in Nazi concentration camps played a key role in these debates. In all European countries, the public recognition of these horrifying experiences depended on a variety of social, political, cultural, and medical factors, which all changed over time. The essays in The Politics of War Trauma analyze the unlikely political coalitions that made the recognition of war-related suffering possible, which groups were included and which were excluded, and how changes in medical, social, cultural, and political thinking influenced this process.

Central to the formation of medical theories on the health effects of war as well as their social recognition (in the form of pensions, entitlement to compensation, or health care) were the way European nations came to terms with World War II. Politicians, religious leaders, and other opinion makers were engaged in extensive efforts to frame the memory of the war in ways that positioned themselves (and their nations) favorably and that downplayed culpability, guilt, and collaboration. The collective memory of any war is inherently fraught with myths about widespread and heroic resistance and martyrdom at its core (rather than banal collaboration and innocently looking the other way, which was much more common). These myths consist of more or less deliberate acts of forgetting, falsification, obfuscation, fabrication, and confabulation. In many countries, the ranks of the Resistance swelled enormously immediately after the armistice. At the same time government bureaucracies and the armed forces were symbolically purged of a small number of collaborators (while most others remained in their position). Presenting a favorable image of one’s past during the war was particularly necessary for those European countries which sought to hide their official allegiance to Nazi Germany and many acts of collaboration (Austria, Italy, Vichy France, Denmark, and Spain (which is unfortunately missing in this volume)). Austria, as the alleged first victim of Nazi aggression, has always denied any responsibility for its complicity in Nazi atrocities. It referred claims from Austrian survivors of concentration camps to Germany while it paid pensions to all Austrians who had served in the German Wehrmacht or SS Korps. Denmark celebrated a very small and select group of resistance fighters to deflect attention from its less than admirable war record (it surrendered without a fight and its government accommodated the Germans without too much friction). Luxembourg made much of the “pupils of the nation,” a group of orphaned children of killed resistance fighters.

Questions of which individuals were entitled to compensation or war pensions (for suffering, lost income, incapacity, or health problems) were resolved within the context of these sets of narratives to remember the war, commemorate its heroes, and vilify the villains. According to many, resistance fighters and soldiers who resisted the invading Nazi powers deserved recognition. Yet many post-war regimes were loath to acknowledge the contribution of communist resistance fighters and were not eager to include them as potential recipients of pensions. In France, for example, an influential bureaucrat was proud that he personally had made sure that 75% of applications by Communists were rejected (p. 89). In Belgium, Flemish Catholics (who had not been unsympathetic to the Nazis) were upset that the proposed pension legislation would benefit more Walloon then Flemish individuals (because there had been far more Walloon resistance fighters) and insisted on emendations. In West Germany, communist resistance fighters were written out of the historical record and hardly received any recognition and compensation. In East Germany, the opposite happened: only those individuals who had furthered the international interests of the Soviet Union were honored. All the others had to wait until after the wall came down.

Questions remained about individuals who were conscripted to work in German ammunitions factories. They were forced to become collaborators and did not fit the image of heroic resistance fighters. Recognition for them was slow in the coming. During the first two decades after World War II, Jews returning from the concentration camps found it very difficult to get any claims acknowledged (the few who survived the extermination camps felt positively unwelcome upon their return). Before World War II, many Jews did not have the nationality of the country they were living in—which initially excluded them from any consideration for compensation. Veterans’ organizations and other pressure groups were essential in formulating the terms under which recognition for the traumas of war could be gained—conscripted workers had to form their own associations to make their demands known before they were recognized. Until 1965, most countries emphasized the resistance when remembering the war. More recently, the Holocaust and the fate of European Jews has become central to the recollection of the war. That shift had far-reaching consequences for bureaucratic recognition and compensation regimes.

It is one thing for post-war governments to outline who is entitled to compensation and pensions and what conditions have to be met to receive these. It is quite another thing how these rules were interpreted and applied by faceless bureaucrats. And here some striking events occurred. A Jewish Auschwitz survivor, for example, was repeatedly asked by Italian bureaucrats for the medical records during her time there to substantiate that her current incapacity was related to her war-time experiences. I already mentioned the pride of a French bureaucrat in making sure Communists would not receive any compensation. In Germany and Austria, former Nazi physicians often wrote dismissive medical reports of Jewish concentration camp inmates. Laws formulated with the best intentions meant little in the face of bureaucratic obstructionism, which was the exception rather than the rule.

Summarizing the many points that are richly documented in this volume: the cleansing (or whitewashing) of national reputations, the activities of various pressure groups, and the evolving state of medical knowledge contributed to the recognition of war as trauma which constituted grounds for recognition, support, and compensation. European physicians had already formulated the diagnosis the KZ-syndrome (KZ refers to Konzentrationslager, German for concentration camp). When PTSD arrived in 1980, it became yet another element in these discussions without fundamentally altering them. These discussions accelerated in the 1970s. At that time, historical perspectives on the war years became considerably more nuanced while the number of individuals claiming war-related impairments did not diminish, as had been widely expected, but only increased. In the same decade, attention to the fate of the European Jews increased. No longer were the heroic fighters of the underground resistance central to the recollection of the war but the horrifying images of the extermination camps. It appears that a greater acceptance of a psychological approach to life problems, accompanied by a greater acceptance of the public expression of emotions, was a factor in the increase in the number of people who claimed to suffer from war-related trauma. In addition, it seems that the waning of the Cold War and the lesser relevance of a number of national myths about heroes and villains during the war were important factors as well.

Interestingly, the distinction between organic versus psychological disorder, so central in many histories of psychiatry and in psychiatric discussions today, appears to be more or less irrelevant in the medical discussions covered in this book. Critical instead was the issue of causality: could one prove that one’s current level of incapacity was related one’s war-time experiences. This issue became more difficult to assess as the years passed by. Yet, in some countries and for some categories of individuals (those who spent more than 6 months in prison or concentration camps, for example), this causality was assumed; in other countries the burden of proof was with the compensation authorities (that is, only if they could prove that reasonable grounds existed that an applicant’s current condition was not related to the war could compensation be refused). Whether complaints or incapacity were purely psychological or based on physical injury was hardly important. This makes the approach originally espoused by the editors of the volume (to trace the history of the recognition of psychiatric complaints related to World War II) somewhat irrelevant—but it, correctly in my opinion, broadens that question to include a variety of unexplained medical symptoms related to war experiences.

Hans Pols is senior lecturer at the Unit for History and Philosophy of Science at the University of Sydney. He is interested in the history of psychiatry and the mental hygiene movement in North America and Europe, psychiatric war syndromes, and colonial psychiatry, in particular in the Dutch East Indies.

Review – Ethan Watters. Crazy Like Us: The Globalization of the American Psyche. New York: Free Press, 2010.

This book aims to demonstrate how, regrettably, over the last twenty years or so, typically American conceptions of mental illness have been exported successfully to the rest of the world. According to Watters, the often enthusiastic international reception of DSM-III and IV with its standardized descriptions of typical American forms of mental anguish, has homogenized human suffering all over the world. Psychiatry appears to be following the example of McDonald’s, which successfully homogenized (and worsened) the daily diet of humankind.

Watters presents his argument with four case studies. The first one focuses on the tragic death of an emaciated 14-year old woman in Hong Kong, who fainted and fell to her death in broad daylight in 1994. When journalists wanted to report on the case, they quickly found out, using Google, about the symptoms and causes of anorexia nervosa. Soon after, awareness campaigns and prevention programs were organized based on Western insights—and lo and behold, the number of young women in Hong Kong suffering from anorexia nervosa increased dramatically. By way of contrast, Watters describes the research and ideas of Dr. Sing Lee, who had studied a small number of women patients who had deliberately starved themselves. Interestingly, they did not display the symptoms of anorexia nervosa. They did not have a morbid fear of becoming overweight, did not have body image issues, and did not starve themselves to look thin and attractive. It appeared that Dr. Lee had found a rare form of mental illness which might be unique to Asia, and which resembled anorexia nervosa, but was a distinct disease entity. Unfortunately, he was not able to cure this condition with the aid of traditional Chinese medicine and other approaches based on local culture. His only patient with this condition died of starvation.

The second case focuses on the effort to relieve the trauma of the inhabitants of Sri Lanka after the tsunami. The descriptions of NGOs falling over each other and investing significant resources in turf wars are familiar by now. The conclusion that construction materials were needed more urgently than trauma counsellors can come as no surprise. Nevertheless, Watters judges the influence of these counsellors to be relatively benign—ending his chapter with the bemused smiles of young children drawing and painting, not having the faintest idea of what the art therapist who gave the material to them was up to. The third case study focuses on the way an individual with schizophrenia was maintained by his family in Zanzibar. The narrative is moving but because it only involves one individual, it is hard to make any generalizations.

The last study deals with the mega-marketing of depression in Japan. It details the successful efforts of GlaxoSmithKline, the producers of Paxil, to introduce new conceptions of sadness and depression to Japan. Previously, Japanese psychiatry and popular thinking only acknowledged a rare and very severe form of depression, which required institutionalization. Medical anthropologists and open-minded psychiatrists were feted in exclusive holiday resorts and received generous honoraria for their willingness to share their insights with CEOs and marketing experts. A smart marketing campaign then presented new images of depression—after all, experience in the Western world had demonstrated that marketing disease leads to much higher sales that marketing specific cures. The image of depression that was presented to the Japanese public was left deliberately vague, but it was one that could affect almost everyone, in particular the young, the smart, the aspiring, and the successful. Ask-your-doctor commercials appeared everywhere, de-stigmatizing depression and encouraging individuals to take charge of their own condition by requesting prescriptions. At the same time (around the year 2000), as we now know, the evidence in favour of Paxil (and many other SSRIs) remained flimsy, incomplete, and inconclusive. Undesirable side-effects (including, possibly, akathisia, violent behaviour and increased risk of suicide) had been deliberately swept under the carpet. Nevertheless, marketing campaigns do not let questionable science stand in the way of good sales figures.

Of course, it should be emphasized that the pharmaceutical industry is very interested in Japan, because it is a wealthy country. This contrasts with its complete lack of interest in many developing nations, which are often deprived of much-needed medications. The chapter on the mega-marketing of SSRIs in Sri Lanka, for example, would be remarkably brief.

There is much to commend about Watters’ book. It is a page-turner which hardly ever fails to engage its reader. It is significant that recent developments in the history of psychiatry are discussed—after all, we know an awful lot about the asylum by now, but not much about what happened after the 1960s. Studies focusing on the post-World War II world are still relatively rare, even though significant developments in psychiatry and mental health care have taken place over the last sixty years (deinstitutionalization and the development of psychopharmacology, to mention only two). Also appealing is Watters’ discussion of the “rest of the world.” Thus far, most historians of psychiatry have focused on psychiatry in the Western world. Over the past twenty years, colonial psychiatry has received ample scholarly attention, but studies on this topic have often focused on the activities of Western psychiatrists in far-away places (articulating theories in which “race” took the place of “class”). Unfortunately, the reactions, ideas, initiatives, and theories of the original inhabitants of these far-away places are rarely taken into account.  This is exactly what Watters does—although he presents Western (or, more accurately, American) psychiatry as decisively hegemonic. As a consequence, psychiatrists, other mental health care workers, and media types concerned about mental illness in the rest of the world appear almost exclusively reactive. The flow of ideas, however pernicious in its effect, moves from the United States to the rest of the world—and, strangely enough, the rest of the world enthusiastically embraces it, discarding much more refined and interesting indigenous approaches (even though they do not actually work in the examples given in the book—and many more examples of traditional healing methods in the developing world could be mentioned that are inhumane and cruel). The four case studies are sufficiently diverse to compare and contrast responses to mental illness and Western psychiatry.

Nevertheless, a feeling remains that the story fits together too well. Criticizing American initiatives has been a favourite activity of academics for some time now—Watters’ analysis therefore has a familiar feel.  Nevertheless, one could imagine countless scenarios in which psychiatrists and other mental health care workers in the non-Western world maintain a more level-headed approach to the patients they see (in all fairness, Watters’ ire is mostly reserved for uncritical media types and pharmaceutical corporations, rather than for physicians). After all, many American mental health care practitioners often view picking a DSM-diagnosis as a bureaucratic exercise after which the real treatment can begin. The importance of DSM in many developing countries appears to be somewhat overstated.

If the influence of American psychiatric ideas could be diminished, psychiatric anthropologists would be able to conduct more interesting research projects. At least that appears to be Watters’ opinion. His interest in the rest of the world is laudable. Nevertheless, he completely overlooks the fact that in most developing countries, there are hardly any psychiatrists and access to psychotropic drugs is very difficult. As a consequence, many individuals do not receive the care they need and suffer unnecessarily. If Watters’ caution were widely heeded, this situation would likely only worsen.

Lastly, why should we be particularly concerned about the disappearance of various culturally-specific forms of mental suffering? Watters compares the disappearance of exotic forms of mental illness (often described as culture-bound syndromes) to the increasing extinction of plant and animal species, which is impoverishing the bio-sphere. The metaphor of disappearing species is not altogether convincing—who would, after all, advocate preserving the current diversity in suffering? Because Watters often appears to be critical of American psychiatry, his descriptions of reactions to mental illness in the rest of the world are often empathic, generous, and positive, while American approaches only appear in a negative light. Seen that way, the pervasive influence of American psychiatric thinking is easily regarded as pernicious—in particular if it is a poor fit with the experiential world of non-American patients. The often cruel and pointless treatment methods that are still widespread in the non-Western world do not find a place within this book.

Hans Pols, University of Sydney

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