This blog follows the history of psychiatry

This is another installment in our series on university and college courses dealing with the history of madness, mental illness, and psychiatry.

Greg Eghigian is co-editor of H-Madness and Director of the Science, Technology, and Society Program (on leave 2010-11) and Associate Professor of Modern History and Science, Technology, and Society at Penn State University (USA).  He writes and teaches on the history of madness, mental illness, and mental health in the western world.  He is the co-editor and author of numerous books, most recently From Madness to Mental Health;  Psychiatric Disorder and its Treatment in Western Civilization (Rutgers University Press, 2010).

The course I teach is one I designed from “scratch,” so to speak.   By that, I mean that there was no such course on the books at my university when I first started out.  So, I needed to build the course from the ground up.

From the start, I was faced with choices.  What time period should the course cover?  What geographical region or regions?  Would the focus be on medicine and psychiatry, or would it integrate broader social and cultural aspects?  Should the course be for advanced students majoring in history, or should it target non-history majors?

I decided pretty quickly, however, that the course should be an introductory level and one that would attract students from across the university.  It’s important,  I think, that students think about history as more than just the story of kings, queens, wars, political developments, and social movements.  These are all important matters, to be sure, but thematic dimensions of human history can also provide an important window into how and why the world has come to appear the way it does.  But beyond this, I was (and remain) less interested in the prospect of luring history majors to the course than bringing in students majoring in psychology, pre-med, life and health sciences, and the social sciences.  One of my chief purposes, then, is to get future clinicians, caretakers, researchers, and policy makers to consider what an historical perspective might say about the choices made and not made along the way in the development of social and medical thinking about and responses to madness.  This is accomplished institutionally, at least, by ensuring that the course satisfies the “general humanities” requirement that students in non-humanities fields must meet.

Thus, I designed and teach the course as an introduction to the long history of (ancient times to the present) of madness and mental health.  There are restrictions and limitations, however.  I focus exclusively on the “western” world, meaning Europe (including Russia and Great Britain), European colonies, and the United States.  I try to be sensitive to non-western perspectives and global change, but, alas, there is only so much I know and can present.  In the ancient and medieval periods, I make a point of discussing the roles of Judaism, paganism, Christianity, and Islam, but the course has an increasingly secular focus as we move into the modern period.  Developments since the 18th century are the main focus of the course, due, in part, to my own interests, but also due to the fact that I believe students are eager to learn about the 19th and 20th centuries.

The course in its present form is relatively large, ranging in recent years from 140 to 220 students.   At Penn State, this means that the course has a fixed structure: two large lectures a week, combined with smaller discussion sections taught by graduate teaching assistants every Friday.   My lectures are fairly straightforward PowerPoint presentations, punctuated by films now and again.  The focus of the Friday sections is on primary sources.  The graduate TAs and I meet once a week to analyze and talk about the week’s primary sources, flagging the main themes to be addressed on Friday.

Originally, when I taught the course, the primary sources were provided to the students in the form of a photocopied reader.  The course, however, inspired me to “take the plunge” and edit a primary source reader, now being published by Rutgers University Press (thanks to former TA Deirdre Fulton for lighting a fire under me).

Something I later integrated into the book I’ve edited is the periodization of the course. I break the course down thematically as well as chronologically.  The longest period I call the Pneumatic Age (from ancient times to the 18th century) – from the ancient Greek concept of “pneuma” – when madness was seen and treated as both a spiritual and somatic affliction.  The second period, running from the second half of the eighteenth through the 19th century, I deem the Age of Optimism.  Here, the emphasis is on institutional and treatment reforms as well as the growing importance of academic science and research.   The third period – from around 1914 to the 1970s – I refer to as the Militant Age, a period when heroic medicine and radical projects came to dominate psychiatric work.  Finally, a period from around the middle of the 20th century to the present I refer to as the Psychoboom.  This is a time when a wide array of psychotherapies entered the marketplace, coupled with a precipitous rise in the number of mental health professionals.

Without question, there are advantages and disadvantages to covering such a lengthy period of time.  It is difficult to give the most recent developments the time they deserve: student (and instructor) fatigue sets in at the same time that one begins to take on the contemporary period.  And, of course, it is pretty much impossible to delve into any one issue in detail.  In the end, however, I believe much more is gained by spending considerable time on the pre-modern.  By taking students out of the comfort zone of modernity and encouraging them to see the world through ancient, medieval, and early modern eyes, it is perhaps a little easier to think about the present in novel ways.