Archive for the ‘ Dissertations ’ Category

Dissertations – Madness in Early Modern England

Alison R. Brown: “Though Troubled Be My Brain:” Madness in Early Modern England, 1603-1714

This dissertation is a study of madness in Stuart-Era England. Madness was pervasive in early modern England; it was in the streets, performed on stage, discussed in political pamphlets and legal treatises, and physically housed in Bethlehem Hospital. Madness, therefore, serves as a significant lens because in differentiating between madness and sanity, contemporaries regularly drew clear boundaries between acceptable, or “normal” behavior, and unacceptable, or “abnormal” behavior, that was particular to seventeenth-century English culture and society. Specifically, I argue that madness serves as a channel to examine the diagnoses and treatment of mental disorders that contemporaries believed altered the body and mind, the legal repercussions of abnormal behavior at the state and local level, and the use of corporeal rhetoric in political culture.

Ranters Declaration

Frontispiece of “The Ranters Declaration” (1650). The Ranters were a radical religious and political group that emerged during the mid-century crisis in England. Many critics of their movement described them as “The Mad Crew.”

In studying the diagnoses and treatments of diseases that altered the body and mind, we encounter contemporaries negotiating between the boundaries of madness and sanity in familial and community relationships, their choice of medical practitioner, their conception of the mind-body relationship, and the ways in which the interplay between natural and supernatural beliefs affected medicinal practices. In negotiating the boundaries between madness and sanity in gender relations, the law, and political culture, we encounter representations of the mad such as “Tom of Bedlam” and “Mad Bess,” recognizable characters in poems, riddles, and ballads. Representations of the mad and madness itself formed discursive elements in philosophy, religious nonconformity, gendered language, legal statutes, Personal Acts of Parliament, inquisitions of lunacy, the symbolism of “undress,” or nakedness, and in political propaganda meant to delegitimize opposing parties. Therefore, the ways in which contemporaries recognized, interpreted, and managed madness provides insight into aspects of English society colored by divisions between acceptable and unacceptable behavior.

Before public institutions for the insane were founded specifically for that purpose, family or community-based care was the norm for the mad, in addition to the few private madhouses that were founded by private entrepreneurs during the last half of the seventeenth century. With no bureaucratic system of recordkeeping, source limitations seemingly restricted historians to the period starting a century and a half later when public asylums were built. Consequently, this dissertation draws on a wide variety of sources in order to creatively circumvent this problem, including manuscripts, parish records, land commissions, autobiography, spiritual biography, criminal cases, political pamphlets, doctors’ notes, medical guidebooks, and more.

Alison R. Brown is a Ph.D. Candidate at Purdue University working with Professor Melinda S. Zook.

Contact: brown923@purdue.edu

 

Merken

Dissertations – Hans Asperger and the Ward for Therapeutic Pedagogy of the Viennese University’s Children’s Clinic

Ina Friedmann: Hans Asperger and the Ward for Therapeutic Pedagogy (Heilpädagogische Abteilung) of the Viennese University’s Children’s Clinic. Concepts and continuities in the institutional treatment of children categorized as ‘maladjusted’ between 1911 and 1977.

MUW-FO-S-004464-0082

Patients at the Ward for Therapeutic Pedagogy, 1920s (Josephinum, Sammlungen und Geschichte der Medizin, MedUni Wien, Sign. MUW-FO-S-004464-0082)

The Ward for Therapeutic Pedagogy of the Viennese University’s Children’s Clinic was a central institution from its opening in 1911 onwards concerning diagnosis and treatment of children and youth, who were labeled ‘difficult’, ‘maladjusted’ or to be in ‘need of education’. Science and institutional care were converging and interacting with socially widespread opinions. The Ward was founded under participation of pediatrician Erwin Lazar (1877-1932), who headed it until his death. He was succeeded by Valerie Bruck (1894-1963), who had been working at the Ward since 1923 and then led it until 1935. In this year, Hans Asperger (1906-1980), best known for describing the Asperger Syndrome, replaced her and stayed in this position until 1957, when Paul Kuszen (*1920) took over until 1985. It was especially Asperger who influenced not only the treatment of so-called ‘difficult’ children by decades of work in therapeutic pedagogy, but also had an impact on how those children and youth were perceived in the public as well as social and medical institutions. Already shortly after the opening of the Ward a close cooperation with the Youth Welfare Office, Juvenile Court, schools, children’s and correctional education homes and similar institutions was established, but also parents soon made use of the possibility of having children examined there.

The reasons for acceptance to the Ward were manifold and besides school and educational problems of any kind also included petty crimes, enuresis, masturbation, (sexual) violence, ‘vagrancy’ and ‘neglect’, but also epilepsy, speech disorders or the clarification of fits. The personnel of the Ward consisted of doctors, nurses, but also pedagogues and, from the 1920s onwards also of a psychologist. This correlated with Lazar’s conception of therapeutic pedagogy, who postulated the equal concurrence of pediatrics, pedagogy, psychology and psychiatry with the task to liberate children of their alleged ‘behavioral problems’ by the means of individually applied pedagogical-therapeutic methods.

This thesis focuses on the concepts which were used in the diagnosis, or rather judgment, therapy and further treatment of the patients. It tries to establish which scientific opinions on ‘social abnormity’ were dominating in the research period of 1911 to 1977, and if and how they changed. Therefore, the medical records of the Ward of the first half of the 20th century are the foundation of the thesis, allowing insight into the institutional treatment of children who were judged as ‘abnormal’ and ‘deviant’. Thus, it is also possible to contribute to the history of ‘institutionalized childhood’ in Austria.

Ina Friedmann is writing her thesis at the University of Vienna and is currently working at the University of Innsbruck.

 

Dissertations – Soldiers of the Great War in French mental hospitals

Marie Derrien: “La tête en capilotade”. Soldiers of the Great War in French mental hospitals (1914-1980)

The primary objective of this thesis is to observe the functioning of a society plunged into war and faced with one of its consequences: the internment of soldiers suffering from mental illness. The aim is to show that we can contribute to the global history of the war by analyzing the experiences of a small group of people within a mental asylum, though their experiences may seem isolated and unrepresentative of the majority. Contrary to the implications of the purely medical literature, it was not in fact the psychiatrists alone who had an interest in the situation of these men: investigation of various kinds of archive shows that their families, fellow soldiers, senior officers, the representatives of the armed forces and the government at national, regional and local level, as well as asylum directors and their staff, reacted, intervened and took decisions concerning them.

1608 Clinique des Hommes Carte postale

 Asylum of Bron (Lyon, France), psychiatric clinic for men (Postcard, ca. 1900, Archives from La Ferme du Vinatier)

 

Between 1914 and 1918, and subsequently until the passing of the last interned ‘poilus’, the case of soldiers victims of mental illness raises issues of psychological, military, political, economic and cultural nature which transcend their individual particularities. Furthermore, these men’s histories and their voices reveal a long-overlooked dimension of the violence of war and the suffering endured by the soldiers both before and after the armistice. By examining the way in which their conditions were regarded, not only by doctors but by society as a whole, we come to ask ourselves to what extent conflict affects the way in which those who were categorized as mentally ill were perceived. Therefore the second objective of this thesis is to reflect on the role of war in transforming social intervention measures, thereby evaluating the effect of the 1914-1918 period on the evolution of psychiatric assistance during the 20th century.

This thesis was defended on 21th November 2015 at the University of Lyon 2 (France).

Marie Derrien is currently an associate member of the Rhône-Alpes Laboratory of Historical Research in Lyon and a teaching assistant at the University of Savoie Mont Blanc (France).

 

Dissertations –Psychiatry and Society in the German Democratic Republic

Fanny Le Bonhomme: “Psychiatry and society in the German Democratic Republic. Stories of patients from the Charité Psychiatry and Neurology Clinic (East Berlin, 1960–1968)”

Berlin, Krankenhaus, Charité, Psychiatrische und Nervenklinik

Charité Hospital in Berlin, psychiatric clinic (photograph taken on 11 January 1950 by Heinz Funck, located at the Bundesarchiv, Bild 183-S91935 / CC-BY-SA 3.0, Aufn. Illus Funck 5025-50 (3) Mlk 11.1.50)

The patients of the Charité Psychiatry and Neurology clinic (East-Berlin, GDR) during the 1960s are at the center of this study. While taking into account the interpretation provided by the medical discourse, this research aims at reconstructing the experiences and the trajectories of these individuals by inscribing them in the context of the socialist society. Relying on patients’ records – these records being the main source of this study – the goal of this research is to reach a better understanding of underlying tensions in the socialist society in relation to the political and ideological context. As these sources show, when they talk to the therapist, patients can speak according to rules which differ from the rules implemented in the socialist society. Because they may contain traces of speeches that would usually be silenced as a result of censorship or self-censorship, or of the unspeakable, shameful or delirious nature of this speech, the patients’ records prove to be a valuable source for the historian. From marital tensions caused by ideological disagreements to the inner conflicts of an “ardent marxist”, from the pain triggered by the exclusion from the party to the pain caused by the construction of the Berlin Wall, from the “reuniting delirium” to the delusions according to which the West appears as a threat, the individual and singular experiences of the patients allow to reconstruct, through a microhistorical approach, certain tensions inherent to the working of the socialist society.

The thesis was defended on 29 January at the University Rennes 2 (France).

Fanny Le Bonhomme is a post-doctoral researcher at the Centre Marc Bloch (Berlin) and at the Centre for Contemporary History Potsdam (Zentrum für zeithistorische Forschung).

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.

Contact and more information: david.freis@uni-muenster.de / uni-muenster.academia.edu/DavidFreis / twitter.com/monsieurfreis

 

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.

https://johnshopkins.academia.edu/MarionAndreaSchmidt

Contact: mschmi34@jhmi.edu

Dissertations – Electroconvulsive Therapy and Its Devices

Max Gawlich: “Electroconvulsive Therapy and Its Devices”

In 1939 a wave of enthusiasm swept through the asylums of Europe. Machines and circuit diagrams originating from Italy, but often only the idea of electrically induced convulsions seized the imagination of psychiatrists. In this dissertation project I study the years of 1938 to 1950 as the period of early adoption and beginning routinization of electroconvulsive therapy (ECT). The history of somatic therapy in mid-century psychiatry remains under-studied, often undervalued as mere precursor of psychopharmacological therapies since the development of Chlorpromazine in the 1950s. On the other hand, next to Lobotomy ECT continues to be the infamous therapy of a disciplining and punishing psychiatric regime, dominating as such the critical discourse about psychiatry since the 1970s. The historical question what ECT was, how the machines were built, what those devices did and how they were adopted in the contexts of asylums remained unanswered.

The study compares three large asylums in Europe which were among the earliest to adopt therapeutic innovations in general and ECT in particular: Eglfing-Haar, south-east of Munich in the German Reich; Münsingen near Bern, Switzerland; and Warlingham Park Hospital in South-London, England. Eglfing-Haar was one of the largest asylums in Europe at the time, infamously known for both its function as relay-station for the transfer of patients into asylums where they would be killed as well as its establishment of so-called starvation units in which patients were murdered through neglect and overdoses of opiates. Münsingen was an internationally acclaimed centre for the so-called somatic therapies like insulin-coma therapy or sleeping-therapy and served as a hub for medically trained refugees fleeing the persecution in the German Reich or Italy. Warlingham-Park Hospital was the first British asylum to adopt ECT besides the Burden Neurological Institute. Its Super-Intendent Thomas P. Rees was famous for his reformist zeal opening the gates of his clinic in 1936.

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Siemens Konvulsator II – booklet

The source-material of my project is structured mainly by two institutional contexts. First there is the archival material from asylums, meaning mostly patient-files and therapy-registers. The second group are files, correspondence, brochures, and circuit-diagrams created in the development-process either at the Ediswan Co. in Britain or the Siemens-Reiniger-Werke in Erlangen. The opportunity as well as challenge was to develop a framework in which both kind of source materials complement each other and enable new questions and perspectives on clinical therapy with machines in asylums. To achieve this, I focus on 1) records and inscriptions of ECT, 2) the technical evolution of ECT-Devices in the period from 1938 to 1950, and 3) the therapeutic practices utilizing those devices. I further argue that with somatic therapies also the evaluation of those therapies was introduced. Contrary to previous research, my dissertation will show how psychiatrists involved in somatic therapies developed methods to record therapy, add up data and present statistical evidence supporting their claim of clinical success. Not only were the development and utilization of devices deeply entangled, but also questions of dosage, security, or wanted and unwanted effects were technically as well as practically addressed. Institutional settings, personal preferences and the design of ECT –devices produced specific adaptations of ECT in the local spaces of each asylum. The Second World War hindered the exchange of ideas and concepts of ECT, and rather strengthened the position of Swiss psychiatrists as intermediaries in the international transfer of knowledge. The War created a situation of largely isolated developments, producing specific technical and therapeutic solutions, which demands a comparative perspective and explicative approach.

Illustration: SRW Erlangen Technische Entwicklung, Konvulsator II für die Elektrokrampfbehandlung von Psychosen. 1949, in: Veröffentlichungen a.d. Technischen Entwicklung Bd. 4. SRW 1948-1961 p54, Siemens MedArchiv Erlangen, Nr. 71. (Reproduced with the kind permission of the Siemens MedArchiv, Erlangen)

Max Gawlich is a PhD Candidate at the Historical Institute in Heidelberg, were he also studied history and Jewish studies.

Contact: @MaxGawlich on Twitter or max.gawlich@googlemail.com

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