This article presents a historical analysis of the origins, rise, and demise of theories of stratification (Schichtentheorien). Following their roots in the ancient metaphysical idea of the “great chain of being,” Aristotle’s scala naturae, the medieval “Jacob’s ladder,” and Leibniz’s concept of the lex continua, I argue that theories of stratification represent the modern heir to the ancient cosmological idea of a harmonious, hierarchical, and unified universe. Theories of stratification reached their heyday during the interwar period within German academia, proliferating over a vast number of disciplines and rising to special prominence within personality psychology, feeding the hope for a unitary image of the world and of human beings, their biological and mental development, their social organization and cultural creations. This article focuses on the role of visuality as a distinct mode of scientific knowledge within theories of stratification as well as the cultural context that provided the fertile ground for their flowering in the Weimar Republic. Finally, the rapid demise of theories of stratification during the 1950s is discussed, and some reasons for their downfall during the second half of the 20th century are explored.
Follow the rise and fall of the mental asylum and explore how it has shaped the complex landscape of mental health today. Reimagine the institution, informed by the experiences of the patients, doctors, artists and reformers who inhabited the asylum or created alternatives to it.
Today asylums have largely been consigned to history but mental illness is more prevalent than ever, as our culture teems with therapeutic possibilities: from prescription medications and clinical treatment to complementary medicines, online support, and spiritual and creative practices. Against this background, the exhibition interrogates the original ideal that the asylum represented – a place of refuge, sanctuary and care – and asks whether and how it could be reclaimed.
Taking Bethlem Royal Hospital as a starting point, ‘Bedlam: the asylum and beyond’ juxtaposes historical material and medical records with individual testimonies and works by artists such as David Beales, Richard Dadd, Dora García, Eva Kotátková, Madlove: A Designer Asylum, Shana Moulton, Erica Scourti, Javier Téllez and Adolf Wölfli, whose works reflect or reimagine the institution, as both a physical and a virtual space.
Monday 11th July
Dr Martyn Pickersgill (Usher Institute for Population Health Studies and Informatics, Edinburgh Medical School): ‘On infrastructure and ontology: Shifting dynamics of knowledge production and application in mental health’
Infrastructures proliferate within mental health. Services are developed and instantiated both through and as particular socio-material configurations. These are underpinned by diverse kinds of infrastructure, as well as serving as the underpinning for therapeutic encounters. The knowledge drawn upon, ignored or un-encountered by psychological therapists is itself produced through a range of infrastructural arrangements, which are impacted and directed by research funders in varying ways. In this talk, I take considerations of infrastructure as a departure point for discussing two Wellcome Trust-funded projects on the sociology of mental health. The first represents an analysis of the social dimensions of initiatives to enhance access to psychological therapy in England and Scotland; the second is a new study interrogating innovation in psychiatric diagnosis across the US and the UK. I will discuss the forms of normativity that (are claimed to) structure both of the cases I explore, and consider the infrastructural arrangements my respondents imagine and enact in response to these. In turn, I want to reflect on what (drives to develop) infrastructures do to the ontologies of pathologies, patients and professionals working in mental health research and practice.
Location: Arts and Humanities Common Room (G24), Foster Court, Malet Place, University College London
Directions: From the Torrington Place entrance to UCL, enter the campus on Malet Place. After fifty metres, you will find Foser Court on the right hand side. Turn right under the underpass, and enter via the second door on the right. The common room is straight ahead.
““The Glamour of Arabic Numbers”: Pliny Earle’s Challenge to Nineteenth-Century Psychiatry,” by Lawrence Goodheart. The abstract reads,
A well-established interpretation associates the nineteenth-century psychiatrist Pliny Earle’s deflation of high cure rates for insanity with the onset of a persistent malaise in patient treatment and public health policy during the Gilded Age. This essay comes not to praise Earle but to correct and clarify interpretations, however well intentioned, that are incomplete and inaccurate. Several points are made: the overwhelming influence of antebellum enthusiasm on astonishing therapeutic claims; the interrogation of high “recovery” rates begun decades before Earle’s ultimate provocation; and, however disruptive, the heuristically essential contribution of Earle’s challenge to furthering a meaningful model of mental disorder. In spite of the impression created by existing historiography, Earle, a principled Quaker, remained committed to “moral treatment.”
“Constitutional Therapy and Clinical Racial Hygiene in Weimar and Nazi Germany,” by Michael Hau. The abstract reads,
The paper examines the history of constitutional therapy in Weimar and Nazi Germany. Focusing on Walther Jaensch’s “Institute for Constitutional Research” at the Charité in Berlin, it shows how an entrepreneurial scientist successfully negotiated the changing social and political landscape of two very different political regimes and mobilized considerable public and private resources for his projects. During the Weimar period, his work received funding from various state agencies as well as the Rockefeller foundation, because it fit well with contemporary approaches in public hygiene and social medicine that emphasized the need to restore the physical and mental health of children and youths. Jaensch successfully positioned himself as a researcher on the verge of developing new therapies for feeble-minded people, who threatened to become an intolerable burden on the Weimar welfare state. During the Nazi period, he successfully reinvented himself as a racial hygienist by convincing influential medical leaders that his ideas were a valuable complement to the negative eugenics of Nazi bio-politics. “Constitutional therapy,” he claimed, could turn genetically healthy people with “inhibited mental development” (geistigen Entwicklungshemmungen) into fully productive citizens and therefore made a valuable contribution to Nazi performance medicine (Leistungsmedizin) with its emphasis on productivity.
His vision for Google’s role in reforming mental health care creates an unprecedented intersection between the fraught social politics of public surveillance, ‘philanthrocapitalism‘ and the psychological industries:
“Google’s strength in data analytics could be leveraged to identify patterns such as changes in cognition and behavior that are difficult to detect in the early stages of psychosis, he says. In many cases, people who were eventually diagnosed with the disease went undiagnosed for years because their initial symptoms masked themselves as traditional adolescent behavior, such as isolation from others and difficulty with academics, Insel says. Smartphones, for example, could collect speech data that would be plugged into an algorithm that detects disorganized speech patterns indicative of psychosis.”
Read the full article here. Conversation on the topic welcome and encouraged.
The November 2015 issue of Social History of Medicine includes several pieces of interest to AHP readers. Articles in this issue include ones that explore the modern construction of human subjects, madness during voyages to New Zealand during the Victorian and Edwardian eras, and the use of case records of early 20th century Eastern European emigrants as sources. Full titles, authors, and abstracts follow below.
“Migration and Madness at Sea: The Nineteenth- and Early Twentieth-century Voyage to New Zealand,” by Angela McCarthy.
This article draws on a range of sources—including surgeon superintendents’ reports as well as asylum records—to examine the mental health of migrants and crew on the voyage to New Zealand during the Victorian and Edwardian eras. It examines key themes such as relations between crew and passengers, the emotional dimensions of insanity, attempts to export the insane, and collaboration between doctors and relatives in adhering to mental health legislation in order to repatriate the insane, all of which facilitate assessment of wider debates about medical authority. While surgeon superintendents documented actions rather than causes for unusual behaviour, asylum doctors and family members were more likely to attempt to explain mental disturbance at sea. Additionally, this article examines the beliefs of medical officials who paradoxically argued that the voyage was beneficial, rather than detrimental, to health.
“Making up ‘Vulnerable’ People: Human Subjects and the Subjective Experience of Medical Experiment,” by Nancy D. Campbell and Laura Stark.
This paper explores how ‘the human subject’ was figured historically and expands the interpretive range available to historians for understanding the subjective experiences of people who have served in medical experiments in the past. We compare LSD studies on healthy ‘volunteers’ conducted in two experimental settings in the 1950s: the US National Institutes of Mental Health’s (NIMH) Addiction Research Center (ARC) Lexington, Kentucky and the NIH Clinical Center (NIHCC) in Bethesda, Maryland. Sources consist of oral history interviews, transcripts and archival documents including photographs and records. Political priorities and historical contingencies relevant for crystalising the expert domain of modern bioethics, especially the 1960s US Civil Rights movement, were central for producing the ‘vulnerability’ attributed to the modern figure of the ‘human subject’. Using Ian Hacking’s historical ontology approach, we suggest how this figure of the ‘vulnerable human subject’ affected historical actors’ self-understandings while foreclosing paths of historical inquiry and interpretation.
In Under the Strain of Color, Gabriel N. Mendes recaptures the history of a largely forgotten New York City institution that embodied new ways of thinking about mental health, race, and the substance of citizenship. Harlem’s Lafargue Mental Hygiene Clinic was founded in 1946 as both a practical response to the need for low-cost psychotherapy and counseling for black residents (many of whom were recent migrants to the city) and a model for nationwide efforts to address racial disparities in the provision of mental health care in the United States.
The result of a collaboration among the psychiatrist and social critic Dr. Fredric Wertham, the writer Richard Wright, and the clergyman Rev. Shelton Hale Bishop, the clinic emerged in the context of a widespread American concern with the mental health of its citizens. It proved to be more radical than any other contemporary therapeutic institution, however, by incorporating the psychosocial significance of antiblack racism and class oppression into its approach to diagnosis and therapy.
Mendes shows the Lafargue Clinic to have been simultaneously a scientific and political gambit, challenging both a racist mental health care system and supposedly color-blind psychiatrists who failed to consider the consequences of oppression in their assessment and treatment of African American patients. Employing the methods of oral history, archival research, textual analysis, and critical race philosophy, Under the Strain of Color contributes to a growing body of scholarship that highlights the interlocking relationships among biomedicine, institutional racism, structural violence, and community health activism.
The May 2015 issue of Social History of Medicine is now online. The issue includes a number of items that may be of interest to AHP readers, including an article on Irish patients in the Victorian Lancashire asylum system and one on the importance of black celebrity activism in making the mental health of black youth a civil rights issue. The issue also includes a special section, “Focus on Learning from Pain,” where a number of recent volumes on the history of pain are reviewed. Full titles, authors, and abstracts follow below.
A website chronicling the history of the Devon County Mental Hospital (formerly the Devon County Lunatic Asylum) at Exminster has recently launched. The site is an outgrowth of a series of projects undertaken by Nicole Baur and Jo Melling at the Exeter Centre for Medical History at the University of Exeter, along with John Draisey of the Devon Heritage Centre.
Included on the site are sections that detail the history of the hospital’s setting and operation and describe four case studies from archived patient records. The site also features a detailed bibliography of publications related to the hospital, as well as a section of multimedia material and a page soliciting memories from those with some association with the hospital. As the site itself describes,
This website takes you on a fascinating journey through the history of the Devon County Lunatic Asylum at Exminster. Based on archival case notes and supplemented by Medical Superintendents’ and Commissioners of Lunacy’s reports as well as interviews with former staff, we tell the stories of real patients and their journey into, and life within, the asylum, hoping to highlight changes in the legislation and care of people suffering from mental health problems.