Special Issue in Honour of Gerald Grob

The January 2019 issue of Journal of the History of Medicine and Allied Sciences is a special issue in honour of historian of American psychiatry Gerald Grob. Full details below.

“Introduction,” by Nancy Tomes; Kathleen W Jones. Abstract:

This article offers an overview of the life and work of Gerald N. Grob. As part of a generation of scholars intent on overturning the old “Whig history” of medicine, Grob pioneered the use of institutional history as an analytical tool. His work on American psychiatry combined a formidable command of archival sources with a strong commitment to putting medical practice in social context. Grob’s personal and political views put him at odds with other scholars of the asylum; he conducted some very public feuds with David Rothman and Andrew Scull. At the same time, he showed a more benevolent side to younger historians interested in psychiatry; he took particular pains to encourage women (including the authors of this introduction) to enter a historical specialty then dominated by men. To honor Grob’s legacy as a scholar and a person, this special issue features articles written by several generations of scholars influenced and inspired by his work.

“New Directions in the Historiography of Psychiatry,” by Deborah Doroshow; Matthew Gambino; Mical Raz. Abstract:

Gerald Grob’s work in the history of psychiatry over the course of almost fifty years created a model for how historians might successfully situate mental health in its social and political context, and how inseparable it was from this context. Over the last twenty years, the field has grown tremendously. Historians have incorporated categories of analysis like gender and race, methodologies like cultural history and intellectual history, and sought to continue Grob’s quest to understand American mental health history as a critical component of American history writ large. In this piece, we suggest several potential areas for future study. Building on Grob’s work on the asylum, we focus on the continued need to explore the texture of lived experience for both practitioners and those experiencing mental illness, both within and beyond the institution. In an era when the politics of deinstitutionalization continue to shape the modern mental health enterprise, we suggest that further examination of the consequences of deinstitutionalization is both inherently rich and relevant to contemporary mental health practice. Finally, we discuss opportunities for historians to engage with policymaking and social justice, pointing to incarceration and juvenile justice as two especially relevant areas for further study.

“Homosexuality and Psychoanalysis Meet at a Mental Hospital: An Early Institutional History,” by Naoko Wake. Abstract:

Psychoanalysis and homosexuality in the United States were both largely in flux between 1910 and 1935. This article sheds light on this unique historical moment by first exploring scholarly discussions of the era’s psychoanalysis and homosexuality, both of which emphasized the transitional nature of therapy and sexuality. By putting two bodies of scholarship into conversation, I also suggest how the historiography might move beyond two oft-cited arguments—that the psychoanalysis of the era had the power to form a person’s sexual identity negatively, and that sexual minorities formed their identities affirmatively by staying away from medical interventions. I argue that, instead, psychoanalysis was part of modern sexual identity-formation in surprisingly open-ended ways. The second half of the article continues to explore the interplay between therapy and sexuality by closely examining clinical practices at one of the leading mental hospitals of the era: Sheppard and Enoch Pratt Hospital in Towson, Maryland, where an eclectic mode of psychotherapy was actively employed to treat homosexuality. In particular, the work of Harry Stack Sullivan (1892-1949), a gay psychiatrist well-known for his interpersonal theory of mental illness, shows how male patients who experienced same-sex sexual relationships nurtured productive interdependency among men in their articulation of sexual identity. By carefully delineating this process, the article shows how analytic practices could, and sometimes did, offer a crucial space for self-reflection and articulation of male sexuality.

“Pathologizing the Crisis: Psychiatry, Policing, and Racial Liberalism in the Long Community Mental Health Movement,” by Nic John Ramos. Abstract:

The community mental health movement has been generally regarded as a benevolent movement that replaced old notions of psychiatric racism with new ideas about the normality of race. Few studies, however, have explored the movement for its active support for new surveillance and policing strategies, particularly broken windows theory, a policing approach partly responsible for the expansion of prisons in the United States after the 1970s. Looking to racially liberal approaches to psychiatry in the 1960s and 1970s crafted by integrationist psychiatrist Louis Jolyon West and black nationalist psychiatrist J. Alfred Cannon at the University of California, Los Angeles, this essay demonstrates that cultural and biological explanations for racial violence in civil rights and black nationalist discourses renewed surveillance on poor people of color that resulted in increased forms of incarceration, segregation, and discrimination for them by the 1980s. Rather than forward racial justice, I argue that psychiatric discourses arguing for the racial sameness of white and black minds in the 1960s and 1970s relied on scientific and cultural narratives centered on child development, gender, and sexuality that obscured the processes of racial capitalism that continued to produce poverty and sickness in black communities.

“Psychiatric Jim Crow: Desegregation at the Crownsville State Hospital, 1948–1970,” Ayah Nuriddin. Abstract:

The Crownsville State Hospital, located in Maryland just outside of Annapolis, provides a thought-provoking example of the impact of desegregation in the space of the mental hospital. Using institutional reports, patient records, and oral histories, this article reconstructs the three phases of desegregation at Crownsville. First, as a result of its poor conditions, lack of qualified staff, and its egregious mistreatment of patients, African American community leaders and organizations such as the NAACP called for the desegregation of the care staff of Crownsville in the late 1940s. Second, the introduction of a skilled African American staff created unprecedented and morally complex issues about access to psychiatric therapeutics. Last, in 1963, Health Commissioner Dr. Isadore Tuerk officially desegregated patients in all Maryland state hospitals. Though desegregation brought much needed improvements to Crownsville, these gains were ultimately swamped by deinstitutionalization and the shift towards outpatient psychiatric care. By the 1970s, Crownsville had returned to the poor conditions that existed during segregation.

“The Final Years of Central State Hospital ,” by Ellen Dwyer. Abstract:

There is a rich literature on the deinstitutionalization movement in the US but few, if any, parallel histories of state mental hospitals. Under attack from the 1950s on, state hospitals dwindled in size and importance. Yet, their budgets remained large. This paper offers a case study of one such facility, Indiana’s Central State Hospital, between 1968 and 1994. During these years, local newspapers published multiple stories of patient abuse and neglect. Internal hospital materials also acknowledged problems but offered few solutions. In 1984, the US Department of Justice intervened, charging Central State with having violated patients’ civil rights, the first such action filed under the 1980 Civil Rights of Institutionalized Persons Act. Although Indiana signed a consent decree promising major reform, long-lasting change proved elusive. Civil and criminal lawsuits proliferated. In 1992, as Central State continued to attract negative attention, Indiana Governor Evan Bayh ordered the troubled hospital closed. His decision promised to save the state millions of dollars and won plaudits from many, but not all, mental health advocates. Even as the last patients left in 1994, some families continued to challenge the wisdom of eliminating Indiana’s only large urban mental hospital, but to no effect.

The Trials of Psychedelic Therapy: LSD Psychotherapy in America

Now available from Johns Hopkins University Press is Matthew Oram’s The Trials of Psychedelic Therapy: LSD Psychotherapy in AmericaAs described by the publisher:

After LSD arrived in the United States in 1949, the drug’s therapeutic promise quickly captured the interests of psychiatrists. In the decade that followed, modern psychopharmacology was born and research into the drug’s perceptual and psychological effects boomed. By the early 1960s, psychiatrists focused on a particularly promising treatment known as psychedelic therapy: a single, carefully guided, high-dose LSD session coupled with brief but intensive psychotherapy. Researchers reported an astounding 50 percent success rate in treating chronic alcoholism, as well as substantial improvement in patients suffering from a range of other disorders. Yet despite this success, LSD officially remained an experimental drug only. Research into its effects, psychological and otherwise, dwindled before coming to a close in the 1970s.

In The Trials of Psychedelic Therapy, Matthew Oram traces the early promise and eventual demise of LSD psychotherapy in the United States. While the common perception is that LSD’s prohibition terminated legitimate research, Oram draws on files from the Food and Drug Administration and the personal papers of LSD researchers to reveal that the most significant issue was not the drug’s illegality, but the persistent question of its efficacy. The landmark Kefauver-Harris Drug Amendments of 1962 installed strict standards for efficacy evaluation, which LSD researchers struggled to meet due to the unorthodox nature of their treatment.

Exploring the complex interactions between clinical science, regulation, and therapeutics in American medicine, The Trials of Psychedelic Therapy explains how an age of empirical research and limited government oversight gave way to sophisticated controlled clinical trials and complex federal regulations. Analyzing the debates around how to understand and evaluate treatment efficacy, this book will appeal to anyone with an interest in LSD and psychedelics, as well as mental health professionals, regulators, and scholars of the history of psychiatry, psychotherapy, drug regulation, and pharmaceutical research and development.

Aeon: Collective Psychiatry

AHP readers may be interested in a recent piece published in Aeon: “Collective psychiatry: Chinese psychiatry remains committed to the political ideal of mental hygiene, long after its discrediting in the West.” As Emily Baum writes in the piece,

If we look back in time, the continued influence of mental hygiene in China is hardly surprising. When the discipline first made its way there in the middle of the Republican period (1911-49), it coincided with an extensive interest in the concept of ‘hygiene’ more broadly. At the time, hygiene, or weisheng, had only recently entered the Chinese imaginary. Although the particular characters that constituted weisheng had long existed in the Chinese vocabulary, they were used to refer to various dietetic and meditative regimens. But in the early 20th century weisheng was imbued with more modern connotations, including scientific progress, racial fitness and state control over public health. Believing that individual and national strength were linked, successive government regimes implemented hygienic measures to both improve the health of the population and shore up political power.

Read the full piece online here.

‘Every expression is watched’: Mind, medical expertise and display in the nineteenth-century English courtroom

Now available from Social Studies of Science: “‘Every expression is watched’: Mind, medical expertise and display in the nineteenth-century English courtroom,” by John Carson. Abstract:

The growing presence of medical experts in the English courtroom during the early nineteenth century presented new challenges with regard to how those experts would exert their authority in an adversarial setting. This article examines the ways in which mental science practitioners responded when confronted with the need to testify as to the soundness or unsoundness of mind of an individual in the context of a legal proceeding. It argues that they often engaged in ‘a double act of self-fashioning’. On the one hand, they attempted to fashion their personae into representations of truth-telling beings; on the other hand, they sought to present testimony in such a way that the judge or jury could diagnose the individual’s alleged soundness or unsoundness of mind for themselves, and they sought to do this without leaving any trace of their own efforts. The procedures and presumptions of the English courtroom thus created an epistemic space in which physicians (and other scientific experts) were frequently presented with the puzzle of how to translate determinations arrived at on the basis of often recondite professional knowledge and years of experience into manifestations that could be made visible to a lay audience. Moreover, they had to do this in a setting in which every significant claim was likely to be disputed by adversary counsel and rival experts.

Special Issue: Histories of Data and the Database

AHP readers may be interested in a special issue, “Histories of Data and the Database,” recently published in Historical Studies in the Natural Sciences. Full details below.

“Introduction: Scrutinizing the Data World,” by Soraya de Chadarevian, Theodore M. Porter. No abstract.

“Data as Word,” by Daniel Rosenberg. Abstract:

The history of what we today call “data” extends to the ancient world, yet our contemporary terminology of “data” is modern. This article examines the history and significance of the term “data.” It argues that a historiography of data that is self-conscious about the historicity of its own categories can illuminate the specific materiality of data, distinct from the things in the world it claims to represent.

“Datafication and Spatial Visualization in Nineteenth-Century Census Statistics,” by Christine Von Oertzen. Abstract:

This essay argues that the explosion of visual graphics in nineteenth-century population statistics was closely linked to a shift in statistical epistemologies and practices of data collection. Taking German census statistics as a case in point, I illuminate concepts and practices that referred to data as a category of the here and now, enabling spatial representations of current phenomena. I argue that seeing and abstracting the world as data opened new avenues not only for producing tables with multiple variables, but also for forging such refined results into graphical visualizations of data. These in turn made empirical relationships in the social order evident and thus modifiable through intervention and reform.

“Data in Time: Statistics, Natural History, and the Visualization of Temporal Data,” by David Sepkoski. Abstract:

One of the best arguments for approaching the history of information processing and handling in the human and natural sciences as a “history of data” is that it focuses our attention on relationships, convergences, and contingent historical developments that can be obscured following more traditional areas of focus on individual disciplines or technologies. This essay explores one such case of convergence in nineteenth-century data history between empirical natural history (paleontology and botany), bureaucratic statistics (cameralism), and contemporary historiography, arguing that the establishment of visual conventions around the presentation of temporal patterns in data involved interactions between ostensibly distinct knowledge traditions.

“Observations, Narrative, and Data in Nineteenth-Century Asylum Medicine,” by Theodore M. Porter. Abstract:

French asylum doctor Ludger Lunier’s effort to measure the causal force of war and revolution in the production of insanity involved reasoning from data in an unfamiliar form. Lunier built up what we can call a medical database from an accumulation of about four hundred compact case narratives, some of them based on his direct experience. Although the conclusions he sought were purely quantitative ones, he returned repeatedly to these elemental accounts of the genesis of madness.

“Making and Unmaking Populations,” by Staffan Müller-Wille. Abstract:

Statistics derives its power from classifying data and comparing the resulting distributions. In this paper, I will use two historical examples to highlight the importance of such data practices for statistical reasoning. The two examples I will explore are Franz Boas’s anthropometric studies of native American populations in the early 1890s, which laid the foundation for his later critique of the race concept, and Wilhelm Johannsen’s experiments in barley breeding, which he carried out for the Carlsberg Laboratory around the same time and which prepared the ground for his later distinction of genotype and phenotype. Both examples will show that the manipulation of data depended on complex classificatory practices: the distinction and articulation of “tribes,” “races,” and “family lines” in the case of Boas, and the selection and construction of “populations” and “pure lines” in the case of Johannsen. They also reveal a fundamental difference between data practices in the human and the life sciences: whereas the latter are relatively free to construct populations in the laboratory, the field, or on paper, the former have to rely on social categories shaped by historical accident and self-perception of the subjects under study.

“Me and My Data,” by Sarah E. Igo. Abstract:

This article examines a recent, unexamined turn in the history of personal data in the last half century: the era when it was re-envisioned as a possession of the individual whom it described or from whom it was obtained. Data—whether scientific, commercial, or bureaucratic—had often been treated as confidential or protected, but it had not typically been conceived in terms of individual ownership. But starting in the later 1960s, more and more people in the industrialized West questioned whether they or the authorities who collected or maintained their data properly had claim to that information. This question was sparked as much by political and economic developments as it was by scientific and technological ones. Citizens’ move to shore up their proprietary claims would prompt new regulations around access, control, and consent that continue to undergird contemporary ideas about personal data. A product of social movements and civil rights reforms as well as market thinking, this bid for authority over one’s “own” information would however reveal its limitations by the turn of the twenty-first century, particularly in the context of a big data economy.

“The National Data Center and the Rise of the Data Double,” by Dan Bouk. Abstract:

A mid-1960s proposal to create a National Data Center has long been recognized as a turning point in the history of privacy and surveillance. This article shows that the story of the center also demonstrates how bureaucrats and researchers interested in managing the American economy came to value personal data stored as “data doubles,” especially the cards and files generated to represent individuals within the Social Security bureaucracy. The article argues that the United States welfare state, modeled after corporate life insurance, created vast databanks of data doubles that later became attractive to economic researchers and government planners. This story can be understood as helping to usher in our present age of personal data, one in which data doubles have become not only commodities, but the basis for a new capitalism.

“An Episode in the History of PreCrime,” by Rebecca Lemov. Abstract:

This article traces the rise of “predictive” attitudes to crime prevention. After a brief summary of the current spread of predictive policing based on person-centered and place-centered mathematical models, an episode in the scientific study of future crime is examined. At UCLA between 1969 and 1973, a well-funded “violence center” occasioned great hopes that the quotient of human “dangerousness”—potential violence against other humans—could be quantified and thereby controlled. At the core of the center, under the direction of interrogation expert and psychiatrist Louis Jolyon West, was a project to gather unprecedented amounts of behavioral data and centrally store it to identify emergent crime. Protesters correctly seized on the violence center as a potential site of racially targeted experimentation in psychosurgery and an example of iatrogenic science. Yet the eventual spectacular failure of the center belies an ultimate success: its data-driven vision itself predicted the Philip K. Dick–style PreCrime policing now emerging. The UCLA violence center thus offers an alternative genealogy to predictive policing.

“Things and Data in Recent Biology,” by Soraya de Chadarevian. Abstract:

There is much talk about data-driven and in silico biology, but how exactly does it work? This essay reflects on the relation of data practices to the biological things from which they are abstracted. Looking at concrete examples of computer use in biology, the essay asks: How are biological things turned into data? What organizes and limits the combination, querying, and re-use of data? And how does the work on data link back to the organismic or biological world? Considering the life cycle of data, the essay suggests that data remain linked to the biological material and the concrete context from which they are extracted and to which they always refer back. Consequently, the transition to data science is never complete.

“Open-Access Genomic Databases: A Profit-Making Tool?,” by Emmanuel Didier. Abstract:

A database organizes information, but since information is produced by actors, it also coordinates the different actors involved with data. Here, focusing on the newly created ClinVar, a genomic clinical variant database, we will see how it helps the government, academia, and industry (represented mainly by the company Illumina) find their positions relative to one another.

“How We Became Instrumentalists (Again): Data Positivism since World War II,” by Matthew L. Jones. Abstract:

In the last two decades, a highly instrumentalist form of statistical and machine learning has achieved an extraordinary success as the computational heart of the phenomenon glossed as “predictive analytics,” “data mining,” or “data science.” This instrumentalist culture of prediction emerged from subfields within applied statistics, artificial intelligence, and database management. This essay looks at representative developments within computational statistics and pattern recognition from the 1950s onward, in the United States and beyond, central to the explosion of algorithms, techniques, and epistemic values that ultimately came together in the data sciences of today.