Suspended between science, medicine, religion, art and philosophy, the advent of modern psychotherapies represents one of the distinctive features of 20th-century Western societies, and they are increasing being exported to the rest of the world. However, their historical study glaringly lags behind their societal impact and the role they play in contemporary mental health policies. In recent years, a small but significant body of work has arisen studying histories of psychotherapies in discrete local contexts throughout the world, which is expanding and reframing our knowledge of them. However, little has been done to draw this work together within a comparative setting, and to chart the intersection of these connected histories and transcultural networks of exchange of knowledge and healing practices. This conference takes up these questions, through drawing together scholars working on histories of psychotherapies in Brazil, Europe, Japan, the UK and the US.
Those in our readership oriented towards the intersection of therapy and philosophy will be quite keen on the June 2016 issue of Philosophy, Psychiatry, & Psychologybecause of its theme, existential psychotherapy. The guest editor is Duff Waring. The format taken is featured articles, two commentaries per and then a response from the article authors:
Abstract: This article invites conversation regarding what is seen as a pivotal problem in existential psychotherapy today: the loss of its language of being, its foundational understanding of ontology, Being, and the human being, Dasein. The article begins by introducing the disciplinary challenges of being an existential psychotherapist. This is followed by a systematic, multiperspectival discussion of ontology and its language of being and the challenges an ‘ontological eye’ presents for the theory and practice of existential psychiatry, psychology, and psychotherapy. Historical and cultural factors contributing to America’s conceptual and clinical dispersity and disarray in existential thought and practice are summarized before presenting a brief overview of existential psychotherapy’s present standing, especially with respect to its prospects for developing a regional ontological understanding of the human as human and as a whole.
Abstract: This article attempts to illustrate how an existential ontology has a great deal to offer to psychotherapists. Because this complex interaction may often be difficult to see, three ways in which such philosophical work has been applicable and enriching in the context of a particular psychotherapy practice are presented. These include a) the use of existential themes and concepts in psychotherapy, including the notions of existential guilt, existential anxiety, and bad faith, b) the argument that an existential ontology provides a more suitable philosophical grounding for psychotherapeutic theories and practices, one which better describes the life-world, experiential phenomena in question, and c) the idea that an existential version of the mental status examination, centered around six key dimensions of human experience (derived from an existential ontology) can provide us with a more in-depth understanding of, and better description of, an individual’s experiential world.
Abstract: Heidegger’s existential ontology has greatly influenced existential psychiatry and psychotherapy, yet opinions about the psychotherapeutic utility of an ontological perspective remain divided, especially in light of Heidegger’s negative reactions to misappropriation of his ontological analysis. The present discussion questions the universality of existential ontology, not to do away with it, but, rather, to ‘rehabilitate’ Binswanger’s purported ‘mistaken’ take on ontology and his much critiqued notion of “world-design” with Merleau-Ponty’s ideas of the ontological relevance of “emblems of Being.” The concept of world-design is considered here as a clinically illuminating notion that warrants revision and expansion, which I attempt with the concept of implicit world-projection and its relation to emblems of Being. This reformulation is intended to capture the ontologically world-defining meaning horizon and its relationship to the varying degrees of ontological security and insecurity, ontological robustness, sensitivity, and oversensitivity. This revised notion of emblematic implicit world-projection reaches beyond the confines of the pathological and can be situated within the larger context of relational theorizing. It can also serve as a bridging concept to contemporary reformulations of the unconscious as the “implicit.”
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 September 2015 issue of History of Psychiatry is now online. Among the articles in this issue are ones on Carl Jung (above) and his investigation of his cousin’s mediumship, the epistemological problems of incorporating possession into the DSM, a case study of a museum of mental health care history, and much more. Full titles, authors, and abstract follow below.
“The epistemological significance of possession entering the DSM,” by Craig Stephenson. The abstract reads,
The discourse of the American Psychiatric Association’s DSM reflects the inherently dialogic or contradictory nature of its stated mandate to demonstrate both ‘nosological completeness’ and cultural ‘inclusiveness’. Psychiatry employs the dialogic discourse of the DSM in a one-sided, positivistic manner by identifying what it considers universal mental disease entities stripped of their cultural context. In 1992 the editors of the Diagnostic and Statistical Manual of Mental Disorders proposed to introduce possession into their revisions. A survey of the discussions about introducing ‘possession’ as a dissociative disorder to be listed in the DSM-IV indicates a missed epistemological break. Subsequently the editors of the DSM-5 politically ‘recuperated’ possession into its official discourse, without acknowledging the anarchic challenges that possession presents to psychiatry as a cultural practice.
Claudia Hammond presents the history of psychology series which examines the work of the people who have changed our understanding of the human mind. This week she explores Carl Rogers’ revolutionary approach to psychotherapy, led by the client and not the therapist. His influence can be seen throughout the field today.
Claudia meets Rogers’ daughter, Natalie Rogers, who has followed in her father’s footsteps and developed Expressive Arts Person-Centred Therapy, and hears more about the man from Maureen O’Hara of the National University at La Jolla, who worked with him. Richard McNally of Harvard University and Shirley Reynolds of Surrey University explain how far Rogers’ influence extends today, and Claudia sees this for herself in a consulting room in downtown San Francisco, where she meets Person-Centred psychotherapist, Nina Utigaard.
A call for papers has been issued for a special issue of History of Psychology on the history of psychotherapy in North and South America. Guest edited by Rachael Rosner, the issue will be released in parallel with a special issue of History of the Human Sciences on the history psychotherapy in Europe (guest edited by Sarah Marks). The deadline for submissions is January 1st, 2016. The full call for papers follows below.
The history of psychotherapy is a topic that cuts across disciplines and cultures. In North America, psychotherapy pre-dates Freud in the faith healing and liberal protestant movements of the late 19th and early 20th centuries. Throughout the 20th century and into the 21st century, even as Freud took the limelight, the practice passed through many professions including neuropathology, psychiatry, social work, the ministry and clinical psychology, as well as marriage and family counseling, nursing, and a host of others. Psychotherapy also became the darling of cinema and literature. And yet, psychotherapy has never been a licensed profession. Anyone can hang out a shingle as a “psychotherapist.” Psychotherapy has thus been both a staple of, and a lens onto, medicine, science and culture for nearly 125 years.
How can we make sense of this ubiquitous and yet historically elusive practice? This special issue of HOP opens up the conversation to historians from a broad spectrum of specialties. We welcome contributions on any aspect of the subject in North or South America, but ask contributors to keep within the time-frame of late 19th century (when the term “psychotherapy” originated) to the present. Continue reading CfP: Special Issue of HoP on History of Psychotherapy in North and South America→
“Efficacy and Enlightenment: LSD Psychotherapy and the Drug Amendments of 1962,” by Matthew Oram. The abstract reads,
The decline in therapeutic research with lysergic acid diethylamide (LSD) in the United States over the course of the 1960s has commonly been attributed to the growing controversy surrounding its recreational use. However, research difficulties played an equal role in LSD psychotherapy’s demise, as they frustrated researchers’ efforts to clearly establish the efficacy of treatment. Once the Kefauver Harris Drug Amendments of 1962 introduced the requirement that proof of efficacy be established through controlled clinical trials before a drug could be approved to market, the value of clinical research became increasingly dependent on the scientific rigor of the trial’s design. LSD psychotherapy’s complex method of utilizing drug effects to catalyze a psychological treatment clashed with the controlled trial methodology on both theoretical and practical levels, making proof of efficacy difficult to obtain. Through a close examination of clinical trials performed after 1962, this article explores how the new emphasis on controlled clinical trials frustrated the progress of LSD psychotherapy research by focusing researchers’ attention on trial design to the detriment of their therapeutic method. This analysis provides a new perspective on the death of LSD psychotherapy and explores the implications of the Drug Amendments of 1962.
“Neuro Psychiatry 1943: The Role of Documentary Film in the Dissemination of Medical Knowledge and Promotion of the U.K. Psychiatric Profession,” by Edgar Jones. The abstract reads,
In 1943, Basil Wright produced a documentary film about the treatment of servicemen and civilians with psychological disorders at Mill Hill Emergency Medical Service Hospital. Funded by the Ministry of Information, Neuro Psychiatry was shot to convince influential clinicians and policy makers in North America that the British had developed expertise in the management of psychiatric casualties. By emphasizing novel and apparently effective interventions and excluding severe or intractable cases from the film, Wright encouraged an optimistic sense of achievement. Filmed at a time when victory was considered an eventual outcome, the picture presented a health service to which all had access without charge. Children and unemployed women, two groups excluded under the 1911 National Insurance Act, had been required to pay for healthcare in the prewar period and were shown receiving free treatment from the Emergency Medical Service. However, the therapeutic optimism presented in the film proved premature. Most U.K. battle casualties arose in the latter half of the conflict and follow-up studies failed to confirm the positive outcome statistics reported in the film. Aubrey Lewis, clinical director of the hospital, criticized research projects conducted at Mill Hill for a lack of rigor. The cinematographic skills of Wright and director Michael Hankinson, together with their reformist agenda, created a clinical presentation that emphasized achievements without acknowledging the limitations not only of the therapies offered by doctors but also the resources available to a nation at war.
“The Cost of War—Then and Now: Commentary on ‘Neuro Psychiatry 1943’,” by Heiner Fangerau. The abstract reads,
In his essay “Neuro Psychiatry 1943: The Role of Documentary Film in the Dissemination of Medical Knowledge and Promotion of the U.K. Psychiatric Profession” Edgar Jones provides a detailed case study of a single movie that was made under unusual wartime conditions. From this case, he builds a general analysis of the interpretation and portrayal of scientific expertise that shaped the production, distribution, and reception of this genre of documentary. The paper provides a fresh perspective for the historical analysis of film documentaries, while remaining highly topical and germane to present-day issues in medicine and health care.
The film that Jones studied was produced in a British hospital where war victims (mostly soldiers) were treated for war neuroses. The filmmakers documented the therapies employed and the apparently successful posttreatment reintroduction of patients into military service and civilian work. They hoped to convince informed audiences, especially those outside Britain in the United States and Canada, about the effectiveness of the British Health Care Service in …
Currently streaming on BBC Radio4 for the next 6 days is a program exploring the influence of psychiatric ideas on literature and vice versa. In Writing Madness, literary works by Virginia Woolf (above), F. Scott Fitzgerald, and Charles Dickens are discussed in terms of the development of psychoanalysis and the rise of psychotherapy. As described on the program’s website,
Vivienne Parry takes her diagnoses of literary heroines into the 20th century and the age of Freud, the Great War and the explosion of the ‘sciences of the mind’ focusing on three great works of fiction, mixing contemporary psychiatric and literary insight.
How did modern literary and psychiatric ideas meet and how did each shape the other? Do these heroines show literature of the period to be a critical – and even emancipating – force…or is fiction really medicine’s stooge? Novels on the couch include Scott Fitzgerald’s Tender is the Night and Virginia Woolf’s Mrs Dalloway….interestingly with both novels there’s a tendency to base the heroines on real people – Nicole Diver is based on the case history of Fitzgerald’s own wife Zelda, whereas Woolf’s Mrs.Dalloway comes very close in literary terms to what Freud calls ‘self-analysis’ – one difference is that Woolf sometimes believed ‘madness’ was necessary to be creative, while Scott Fitzgerald depicted it as disastrous drain on creativity (ie. his). And both novels have the dynamic and lucrative new industry of psychotherapy in their sights. Vivienne compares fiction in the age of Freud to literary ideas of mental health in the Victorian age and in Dickens specifically, using Great Expectations’ Miss Havisham as a case study.
Contributors include psychotherapist and essayist Adam Philips, leading psychiatrist Simon Wessely, cultural historian Lisa Appignanesi and Chris Thompson, psychiatrist and medical director of The Priory
The February 2011 issue of History of the Human Sciences has been released online. Included in this issue are six all new articles, a review symposium, and a book review of Roderick Buchanan’s new book, Playing with Fire: The Controversial Career of Hans J. Eysenck. Among the topics addressed in these articles are the placebo effect in psychotherapy, the use of ‘deprivation’ in American psychiatric discourse, and the role of case studies in psychoanalysis. Full titles, authors, and abstracts follow below.
“From medicine to psychotherapy: The placebo effect,” by Stewart Justman. The abstract reads,
If placebos have been squeezed out of medicine to the point where their official place is in clinical trials designed to identify their own confounding effect, the placebo effect nevertheless thrives in psychotherapy. Not only does psychotherapy dispose of placebo effects that are less available to medicine as it becomes increasingly technological and preoccupied with body parts, but factors of the sort inhibiting the use of placebos in medicine have no equivalent in psychology. Medicine today is disturbed by the placebo effect in a way psychotherapy is not. Psychotherapy does not have to grapple with such a disconcerting paradox as successful sham surgery, and unlike those physicians who once pretended to treat the patient’s body while actually attempting to treat the mind, the psychotherapist can treat the mind in all frankness. Perhaps it is because psychotherapy is less burdened by doubts about the placebo effect that it was able to come to its aid when it was orphaned by medicine. It is vain to expect something with so long a history as the placebo effect to disappear from the practices of healing. Continue reading New Issue: History of the Human Sciences→