History of Psychiatry: Lobotomies, Therapies, the DSM, and More

The March 2018 issue of History of Psychiatry is now online. Articles in this issue explore the history of lobotomy, moral therapy, the history of the DSM, and more. Full titles, authors, and abstracts below.

“History of lobotomy in Poland,” by Kinga J?czmi?ska. Abstract:

In Poland, there were 176 cases of prefrontal leucotomy performed by Moniz’s method between 1947 and 1951. There were also several cases in which alternative psychosurgical techniques were used: prefrontal topectomy by Bilikiewicz and colleagues, and prefrontal topischemia by Ziemnowicz. This article analyses the following: publications by Choróbski, who performed lobotomy in Poland, and by Korzeniowski, who assessed its short-term results; a report by Bornsztajn, who reviewed general results of the method; and clinical research by Broszkiewicz and by Konieczy?ska, who assessed Polish patients in terms of long-term results of lobotomy. Negative clinical evaluation of lobotomy led to its abandonment in Poland, a decision strengthened by a regulation that forbade lobotomy in the USSR and impacted Polish psychiatry.

“Rotation therapy for maniacs, melancholics and idiots: theory, practice and perception in European medical and literary case histories,” by Sheila Dickson. Abstract:

This article examines the development and use of rotation therapy in the emerging field of psychiatry at the beginning of the 19th century, and the cross-fertilization between British, Irish, German, French and other European proponents of ‘Cox’s Swing’. Its short-lived popularity is linked to prevalent Enlightenment thought, to the development of an industrial and technological society, to the modern medical theories of irritability, and to the new practice of ‘moral management’ of the mentally ill. Case studies documenting the use of the Swing are considered from these perspectives, and are compared with contemporary public reactions in the form of publications in newspapers and of a literary text by German Romantic author Ludwig Achim von Arnim.

“François Leuret: the last moral therapist,” by Edward M Brown. Abstract:

By the 1840s French psychiatrists had abandoned Moral Treatment as an individual psychological therapy, as opposed to an institutional practice. One advocate of Moral Treatment, however, would not go along with this movement. In three books and several papers published between 1834 and 1846, François Leuret (1797–1851) advocated aggressive psychological treatment. Recent commentators have understandably concentrated on the controversies surrounding Leuret’s practices. What such an approach has failed to make clear, however, is that Leuret had a complex, systematic psychological theory supporting his clinical judgements. In addition to reviewing the controversies that surrounded Leuret, this paper spells out Leuret’s psychological theory and shows how he used this theory to think about the individual psychotherapy he provided for his patients.

“Understanding the DSM-5: stasis and change,” by Rachel Cooper. Abstract:

This paper aims to understand the DSM-5 through situating it within the context of the historical development of the DSM series. When one looks at the sets of diagnostic criteria, the DSM-5 is strikingly similar to the DSM-IV. I argue that at this level the DSM has become ‘locked-in’ and difficult to change. At the same time, at the structural, or conceptual, level there have been radical changes, for example in the definition of ‘mental disorder’, in the role of theory and of values, and in the abandonment of the multiaxial approach to diagnosis. The way that the DSM-5 was constructed means that the overall conceptual framework of the classification only barely constrains the sets of diagnostic criteria it contains.

“Strategic voices of care and compassion. Describing the mad, their afflictions and situations in Amsterdam and Utrecht in the seventeenth and eighteenth centuries,” by MA Martje aan de Kerk. Abstract:

Painting a picture of the lives of the early modern mad outside institutions has not yet been done in the Netherlands. However, by looking at notarial documents and admission requests, we can learn more about how the mad were cared for outside the institutions, and the impact their behaviour had on the people close to them. Investigating these sources for both Amsterdam and Utrecht in the seventeenth and eighteenth centuries has unravelled a story of community care in which families played a key role and used their options strategically. Furthermore, it has also revealed a complicated story about the way communities dealt with the behaviour of the mad, involving great personal struggles, breaking points and compassion.

“Health and hierarchy: soldiers, civilians and mental healthcare in Scotland, 1914–34,” by Jennifer Farquharson. Abstract:

During the First World War injured servicemen were constructed as a better class of patient than civilians, and their care was prioritized in social and political discourses. For the mentally disordered servicemen themselves, however, these distinctions were permeable and transient.

This article will challenge the reality of the ‘privileged’ service patient in civil asylums in Scotland. By examining the impact of the war on asylum structures, economies and patient health, this study will explore exactly which patients were valued in these difficult years. In so doing, this paper will also reveal how the lives of institutionalized ex-servicemen and the civilian insane inside district asylums were not quite as distinct as political and social groups would have liked.

“Eugenics, medicine and psychiatry in Peru,” by Santiago Stucchi-Portocarrero. Abstract:

Eugenics was defined by Galton as ‘the science which deals with all influences that improve the inborn qualities of a race’. In Peru, eugenics was related to social medicine and mental hygiene, in accordance with the neo-Lamarckian orientation, that predominated in Latin America. Peruvian eugenists assumed the mission of fighting hereditary and infectious diseases, malnutrition, alcoholism, drug addiction, prostitution, criminality and everything that threatened the future of the ‘Peruvian race’. There were some enthusiastic advocates of ‘hard’ eugenic measures, such as forced sterilization and eugenic abortion, but these were never officially implemented in Peru (except for the compulsory sterilization campaign during the 1995–2000 period). Eugenics dominated scientific discourse during the first half of the twentieth century, but eugenic discourse did not disappear completely until the 1970s.

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.