Posts Tagged ‘ United States ’

The Controversial Diagnosis of “Excited Delirium”

9780849316111Journalist Justin Jouvenal has written an article for The Washington Post examining the debate swirling around a syndrome dubbed “excited delirium.” Proponents have applied the term to what is believed to be a syndrome affecting certain individuals “Influenced by mental illness or the use of such stimulants as cocaine and methamphetamine” who, when in “its grip often have extraordinary strength, are imperviousness (sic) to pain and act wildly or violently. Then, suddenly, some die.” Critics, however, have noted the popularity of the diagnosis in cases involving suspected excessive force by police in the United States, concerned that it is providing cover for abusive policing practices.

According to Jouvenal’s sources, the concept dates back to the mid-19th century, but started to gain currency more recently in the mid-1980s. Medical examiners in Miami at the time began applying the term in the midst of the cocaine epidemic spreading across Florida.

New Book Announcement: Closing the Asylums (George Paulson)

McFarland & Company has just published a new book by George Paulson, Closing the Asylums: Causes and Consequences of the Deinstitutionalization Movement (214 pp. Paperback, $45).

George Paulson is an internationally known neurologist who worked in and about state mental hospitals during the revolutionary movement to close those hospitals. He combines his personal observations with historical scholarship to produce a fresh perspective on a major change in society and medicine.

The press describes the book this way:

One of the most significant medical and social initiatives of the twentieth century was the demolition of the traditional state hospitals that housed most of the mentally ill, and the placement of the patients out into the community. The causes of this deinstitutionalization included both idealism and legal pressures, newly effective medications, the establishment of nursing and group homes, the woeful inadequacy of the aging giant hospitals, and an attitudinal change that emphasized environmental and social factors, not organic ones, as primarily responsible for mental illness.

Though closing the asylums promised more freedom for many, encouraged community acceptance and enhanced outpatient opportunities, there were unintended consequences: increased homelessness, significant prison incarcerations of the mentally ill, inadequate community support or governmental funding. This book is written from the point of view of an academic neurologist who has served 60 years as an employee or consultant in typical state mental institutions in North Carolina and Ohio.

New Book Announcement – After Freud Left (ed. John Burnham)

The University of Chicago Press has just published a new edited volume entitled After Freud Left.  Edited by John Burnham, the volume includes contributions from a number of leading scholars on the development of psychoanalysis in the United States following Freud’s visit to Clark University in August and September of 1909.  The Press describes the book this way.

There has been a flood of recent scholarship on Freud’s life and on the European and world history of psychoanalysis, but historians have produced relatively little on the proliferation of psychoanalytic thinking in the United States, where Freud’s work had monumental intellectual and social impact. The essays in After Freud Left provide readers with insights and perspectives to help them understand the uniqueness of Americans’ psychoanalytic thinking, as well as the forms in which the legacy of Freud remains active in the United States in the twenty-first century.

Table of Contents

Introduction

Part I. 1909 to the 1940s: Freud and the Psychoanalytic Movement Cross the Atlantic

Introduction to Part I: Transnationalizing  Chapter 1: Sonu Shamdasani, “Psychotherapy, 1909: Notes on a Vintage” Chapter 2: Richard Skues, “Clark Revisited: Reappraising Freud in America” Chapter 3: Ernst Falzeder, “‘A Fat Wad of Dirty Pieces of Paper’: Freud on America, Freud in America, Freud and America” Chapter 4: George Makari, “Mitteleuropa on the Hudson: On the Struggle Over American Psychoanalysis after the Anschluss” Chapter 5: Hale Usak-Sahin, “Another Dimension of the Émigré Experience: From Central Europe to the United States Via Turkey”

Part II. After World War II: The Fate of Freud’s Legacy in American Culture

Introduction to Part II: A Shift in Perspective  Chapter 6: Dorothy Ross, “Freud and the Vicissitudes of Modernism in America, 1940-1980” Chapter 7: Louis Menand, “Freud, Anxiety, and the Cold War” Chapter 8: Elizabeth Lunbeck, “Heinz Kohut’s Americanization of Freud” Chapter 9: Jean-Christophe Agnew, “The Walking Man and the Talking Cure”

Conclusion

Resources in the History of Psychiatry at the U.S. National Library of Medicine

The History of Medicine Division of the U.S. National Library of Medicine in Bethesda, Maryland offers some useful resources for historians of madness, psychiatry, and mental health.  For an overview of what the library has on offer, see Dr. Jeffrey S. Reznick’s (Chief, History of Medicine Division, National Library of Medicine of the National Institutes of Health) article “Perspectives from the History of Medicine Division of the United States National Library of Medicine, National Institutes of Health” published in the journal Medical History.

For historians of psychiatry in particular, the following will be particularly helpful if you are considering doing research there.

Emily Martin and Lorna A. Rhodes, Resources on the History of Psychiatry: History of Medicine Division of the National Library of Medicine (2004).  As they explain in their “overview”:

This report introduces scholars interested in the history of psychiatry to the extraordinary collection in the HMD and NLM. This collection is unparalleled for its coverage of time and place in great depth and breadth, for its possession of immense numbers of unique audiovisual and print materials and for its invaluable holdings of manuscripts and oral histories. We have arranged our report in 10 major sections as listed below. Our time frame is primarily from the 19th century to the 1970s. For each major section we have organized items from the library in subsections by topic, date, location, or format. Within each subsection, we have listed only a small selection of materials available in the library, a selection we have chosen to illustrate the large range of sources the collection contains: scientific monographs, federal or state reports, personal accounts, conference proceedings, legal briefs, armed service publications, mass market publications, teaching materials, monographs on psychiatric ethics, treatment, or social effects, manuscripts, audiovisual materials, ephemera, and so on.

Second, there is Mental Disease Moving Images Pre-1950 at the National Library of Medicine prepared by Sarah L. Richards (Curator, Historical Audiovisuals Collection, History of Medicine Division), organized around subject matters, ranging from “catatonia” to “psychiatric nursing” to “stress disorders.”

Finally, there is the catalogue Mind And Body: Rene Descartes to William James by Robert H. Wozniak, which originally accompanied a 1992 exhibition of books from the library’s collection, all in honor of the centennial celebration of the American Psychological Association.

Thanks to Dr. Reznick and Dr. Michael Sappol (Historian, History of Medicine Division, National Library of Medicine of the National Institutes of Health) for drawing our attention to these fabulous resources.

Have American Psychiatrists Given Up on Psychotherapy?

Psychiatric Times recently featured two responses to a 5 March 2011 piece in The New York Times that outlined what it called “the switch from talk therapy to medications” among practicing psychiatrists in the United States.  The New York Times article cites a 2005 government purportedly finding “that just 11 percent of psychiatrists provided talk therapy to all patients, a share that had been falling for years and has most likely fallen more since. Psychiatric hospitals that once offered patients months of talk therapy now discharge them within days with only pills.”

Two psychiatrists and contributing writers to Psychiatric Times, however, expand upon and take issue with at least some of the portrait painted by the news story.   Ronald Pies (editor in chief emeritus of Psychiatric Times and professor in the psychiatry departments of SUNY Upstate Medical University and Tufts University School of Medicine) agrees that “the declining use of psychotherapy in psychiatric practice is unquestionably worrisome,” noting that the shift away from psychotherapy between 1996 and 2005 has coincided with changes in reimbursement, managed care, and medication prescriptions.  What The New York Times article neglected to mention, he argues, however, was that evidence shows that most psychiatrists provide psychotherapy to at least some of their patients.  Moreover, the 2005 study defined “psychotherapy” in such a narrow fashion as to leave out forms of “very brief psychotherapy” (J. Gustafson) as well as other forms of patient contact.

James Knoll IV (editor-in-chief of Psychiatric Times, and director of forensic psychiatry at SUNY Upstate Medical University), in his response, rejects what he refers to as “the implications that psychiatrists must now ‘play the game,’ and resign themselves to a bleak future of harried pill dispensing.” Instead, he encourages colleagues and students to consider taking up the historical mission of caring for those in institutional settings, albeit under the changed circumstances of today:

Many of our patients have been relocated. Jails now house more persons with serious mental illness than do psychiatric hospitals. Perhaps we might consider a return to the original ideals of our path–the care and well being of persons suffering with serious mental illness, and especially the many who are now in our ‘new asylums.’ The fact is that such jobs are plentiful, lucrative and rewarding. One can practice without any false partitions. Medical concerns, medications, psychotherapy-– all may be attended to by the psychiatrist. The patients are grateful for competent care, and time constraints are far less of an issue. Here is a noble calling and return to psychiatry’s roots. There is great honor in following this path that was originally traveled by names such as Rush, Ray, Pinel, and Menninger, among many others.

Keep in mind, you must register to read articles in Psychiatric Times, but registration is free.

The Cushing Collection at Yale University

The New York Times has a piece and a slide show presentation about the collection of brain samples stored at Yale University by Dr. Harvey Cushing.  Cushing, who died in 1939 and donated the collection to the university, was a well-known neurosurgeon, who helped lead the field toward respectability in the early 20th century.  The Cushing collection in the Cushing/Whitney Medical Library at Yale University at 333 Cedar Street, New Haven, is open to the public Monday through Friday, 8 a.m. to 8 p.m.; Saturday, 10 a.m. to 8 p.m.; and Sunday, 9:30 a.m. to 8 p.m.

Dworkin: The Rise of the Caring Industry

Ronald W. Dworkin – Frank Henry Sommer Professor of Law and Philosophy at New York University and Jeremy Bentham Professor of Law and Philosophy at University College London – has a piece entitled “The Rise of the Caring Industry” in the June 2010 issue of Policy Review.  The essay can be accessed online here.  The author of the 2006 book Artificial Happiness: The Dark Side of the New Happy Class considers how the growth of the helping professions (particularly those concerned with mental health) represents not simply an institutional change, but a shift in ethos.  As he puts it:

In this way the caring industry exercises a double fascination — on the one hand as a sounding board for lonely, unhappy individuals, and on the other as emblematic of a new ethos of civilization. The age of caring is a more skeptical age, but also a more tolerant one, expressing a distrust of authority and an antipathy to old enthusiasms that wavers between laughter and disgust. It would be wrong to say that people today deny the world; they simply prefer to ignore it, presenting a blank wall of indifference to how people live and what they believe. They prefer meeting their psychological needs through a therapy session rather than through a community of blood brothers.

The topic has been of particular interest to observers in the United States, and, over the past fifteen years, a number of scholars and writers have written on the subject, including Ellen Herman (The Romance of American Psychology: Political Culture in the Age of Experts, 1995), Eva Moskowitz (In Therapy We Trust: America’s Obsession with Self-Fulfillment, 2001) and Barbara Ehrenreich (Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America, 2009).

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