History of Psychiatry in the 20th Century

The June 2011 issue of History of Psychiatry has just been released online. This is a special issue edited by Volker Hess (left) and Benoît Majerus on the history of twentieth century psychiatry. Among the articles included in the special issue are ones on post-WWII psychiatric changes, chlorpromazine trials in Heidelberg in the 1950s, and the deinstitutionalization of the history of twentieth century psychiatry. Titles, authors, and abstracts follow below.

“Writing the history of psychiatry in the 20th century,” by Volker Hess and Benoît Majerus. The abstract reads,

As editors of the special issue, we try to summarize here the historiographic trends of the field. We argue that the field of research is accommodating the diversity of the institutional, social and political developments. But there is no narrative in sight which can explain the psychiatry of the 20th century, comparable to the authoritative coherence achieved for the 19th century. In contrast, the efforts to extend these narratives to the 20th century are largely missing the most impressive transformation of psychiatric treatment — and self-definition.

“‘Therapeutic community’, psychiatry’s reformers and antipsychiatrists: Reconsidering changes in the field of psychiatry after World War II,” by Catherine Fussinger. The abstract reads,

In addition to outlining some core characteristics of the therapeutic community — an approach developed during World War II — this article describes the achievements of reformist psychiatrists in the field of the therapeutic community during the 1950s and also discusses the appropriation of this model by the antipsychiatrists during the 1960s. By emphasizing the proximity of their respective contributions, rather than their generally accepted radical differences, this article is an invitation to renew the way historians consider the dynamics of change in psychiatry after WWII.

“Reforming psychiatric institutions in the mid-twentieth century: A framework for analysis,” by Nicolas Henckes. The abstract reads,

This article develops an analytical framework of processes of institutional reform in psychiatry in Western countries during the last century. It discusses explanations of social change based on deinstitutionalization and proposes instead to put reform practices themselves at the centre of the analysis. Thus, central to this framework is the historicity of the idea of reform itself. Taking the case of France as an example, the article shows how the diffusion of a reformist ethos within psychiatry in the post-World War II period can be accounted for by a change in medical expertise during the first half of the century. It concludes with a discussion of the changing relationship between psychiatrists and the State in the twentieth century.

“Terra incognita: An historiographic approach to the first chlorpromazine trials using patient records of the Psychiatric University Clinic in Heidelberg,” by Viola Balz. The abstract reads,

Psychiatrists have often referred to the discovery of new psychopharmaceutical drugs in the 1950s as a ‘therapeutic revolution’, which allowed physicians to observe und measure therapeutic effectiveness easily. Contrary to this view, this article will argue that psychiatrists needed the patient’s subjective voice to evaluate the effects of the drugs. In a micro-analysis of hospital records of the first patient to be treated with chlorpromazine in the Heidelberg clinic in 1953, I show the different perspectives of doctors and patients on the diagnosis and treatment. The analysis points up how difficult it was to get an impression of the drug’s effectiveness. The article emphasizes the importance of the new perspective that includes the patient’s voice in the history of psychotropic drugs after 1945.

“Deinstitutionalizing the history of contemporary psychiatry,” by Greg Eghigian. The abstract reads,

While contemporary mental health services have been marked by the burgeoning of outpatient and preventive care, the historiography of psychiatry remains largely tied to the study of custodial and palliative treatment. The work in which contemporary psychiatry has been involved cannot be adequately understood as a singular, autonomous enterprise based in a residential facility. It has become a technoscience that operates in numerous settings and alongside multiple sciences, technologies and decision-makers. This paper explores what it might mean to ‘deinstitutionalize’ the history of contemporary psychiatry by examining the case of social therapy for sex offenders in West Germany.

“‘In good times and in bad’: Boundary relations of psychoanalysis in post-war USA,” by José Brunner and Orna Ophir. The abstract reads,

This paper suggests writing the history of psychoanalysis by focusing on the manifold ways in which its practitioners may relate to the boundaries dividing it from its neighbouring professions. This approach is illustrated by two loosely interrelated examples: the 1950s debate among leading US psychoanalysts on whether borderline patients can be analysed, and the 1990s responses of psychoanalysts to psychopharmacological treatments of schizophrenia. A close reading of psychoanalysts’ journal publications reveals in each instance multiplicity (of voices), instability (of boundaries), duality (of defence and dialogue) and simultaneity (of internal and external addressees). At the same time, a common rhetorical stance emerged in each period, serving as a shared discursive frame while allowing a plurality of boundary relations.

“The Rodewisch (1963) and Brandenburg (1974) propositions,” Volker Hess. The abstract reads,

The Classic Text presents two documents of the development of modern social psychiatry. Both show the early beginnings of the reform movement in the GDR — in contrast to the FRG where the reform did not take place until the late 1970s. Adopted in 1963, the Rodewisch propositions formulate for the first time the central issues of the German reform debate in psychiatry. The Brandenburg propositions (1974) document how the reform movement was shifting from a political to a more individual perspective in the GDR.

Book Reviews

Arne Pfau, Die Entwicklung der Universitäts-Nervenklinik (UNK) Greifswald in den Jahren 1933 bis 1955 (Abhandlungen zur Geschichte der Medizin und der Naturwissenschaften, 101), Matthiesen Verlag: Husum, 2008. Reviewed by Maike Rotzoll.

Robert van Voren, Cold War in Psychiatry: Human Factors, Secret Actors, Rodopi: Amsterdam & New York, 2010. Reviewed by Dan Healey.

About Jacy Young

Jacy Young recently completed a Social Sciences and Humanities Research Council (SSHRC) of Canada Postdoctoral Fellow at the University of Surrey in the UK. She earned her doctorate in the History and Theory of Psychology at York University in 2014.