This blog follows the history of psychiatry

The new issue of Social History of Medicine includes at least two articles that could be of interest to H-Madness readers:

Katariina Parhi and Petteri Pietikainen, Socialising the Anti-Social: Psychopathy, Psychiatry and Social Engineering in Finland, 1945–1968.

This article argues that in Finland during the two decades after the Second World War, the diagnosis of psychopathy represented a failed attempt to adjust ‘difficult’ individuals to the social order. Discussing the social and medical character of the diagnosis, we examine psychopathy using the analytic and historical framework of social engineering in post-war Finland. We utilise patient records, official documents and psychiatric publications and analyse the diagnostic uses of psychopathy and its associations with social maladjustment. We also address the question of how mental health care in the less-developed northern part of Finland grappled with behavioural deviance, and especially with behaviour deemed ‘anti-social’. Contextualising psychopathy as a marker of individual disorganisation within the development of social organisation, this article contributes to historical scholarship that maps mental disorders onto the historical development of the nation.

Concepts used by historians are as historical as the diagnoses or categories that are studied. The example of Munchausen syndrome (deceptive presentation of illness in order to adopt the ‘sick role’) is used to explore this. Like most psychiatric diagnoses, Munchausen syndrome is not thought applicable across time by social historians of medicine. It is historically specific, drawing upon twentieth-century anthropology and sociology to explain motivation through desire for the ‘sick role’. Ian Hacking’s concepts of ‘making up people’ and ‘looping effects’ are regularly utilised outside of the context in which they are formed. However, this context is precisely the same anthropological and sociological insight used to explain Munchausen syndrome. It remains correct to resist the projection of Munchausen syndrome into the past. However, it seems inconsistent to use Hacking’s concepts to describe identity formation before the twentieth century as they are given meaning by an identical context.