The past century has witnessed substantial changes in mental health care in America. In 1909 Clifford Beers founded the National Committee for Mental Hygiene and Sigmund Freud made his only trip to America, fostering the spread of psychoanalysis. Forty years later, in 1949, the National Institute of Mental Health was established. In the span of 100 years mental health in America has unfolded against a backdrop of social, political, and economic changes. This two-day conference brings together leading experts in the field to examine where we have been, where we are, and to speculate on where we are going.
The program includes invited talks by Ludy Benjamin and Gerald Grob. In a recent email sent to the members of the Society for the History of Psychology, Baker (pictured right) explained the details as follows:
The event will take place on Thursday, April 23 and Friday, April 24, 2009 at the University of Akron. We have assembled an outstanding group of scholars and leaders in mental health policy, practice, advocacy, and history. This conference is made possible with the generous support of the Margaret Clark Morgan Foundation.
Her fiction makes use of the discipline’s discourse with and against the grain, creating micro-narratives of the mind’s surface level and present moment which contrast sharply with more familiar psychoanalytic perspectives. Narrative form in Darrieussecq, I argue, can be characterized as a stream-of-consciousness, which, while failing to conform to the literary model set by Dujardin and Joyce, is in fact closer to the original psychological conception of the term. (p. 429)
The article’s literary aspects are interesting. What will ultimately be more important for the readers of AHP, however, is Kemp’s short discussion of a contemporary dispute in French psychological scholarship: CBT vs. psychoanalysis.
National Public Radio (NPR) in the US has posted an episode of its program “On the Media” centered on the debate over the contents of the forthcoming 5th edition of the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association. The episode is entitled “The Art of Diagnosis.” The issues discussed focus mainly on the social acceptance or stigmatization of people complaining of particular clusters of symptom and not, perhaps surprisingly, on access to insurance payments or pharmaceutical company windfalls.
Among the politically-charged syndromes under review are “Gender Identity Disorder,” an extreme form of PMS called “Premenstrual Dysphoric Disorder” (for which a specific pharmaceutical, Sarafem, has already been marketed), and “Social Anxiety Disorder” (better known as shyness). Questions about this sort of “diagnostic bracket creep” are discussed on the program. Continue reading DSM-V Debate on NPR→
Breaking News: The University of Groningen has announced that a 4-year research grant will be provided for a student of non-Dutch nationality to study the history of Asperger’s Syndrome. The position, leading to a dissertation about “the proliferation of Asperger’s Syndrome,” will be in the Theory & History of Psychology section of the Faculty of Behavioral and Social Sciences. Application details are here. (The deadline is October 27.)
In this keynote address, Professor Thomas Szasz appeals to the history of psychiatry in making his argument against the labeling of children as having, for example, ADD/ADHD. (In the speech, he calls this “stigmatization not diagnosis.”) But does the history to which he refers simply show progress in the medicalization of moral treatment? Or is it, as he claims, evidence of something more sinister?
This video has been edited, but not by us. (The full text of this speech, or one very much like it, can be found here.)
Professor Szasz is famous for, among other things, his anti-psychiatry bias. That, however, is not what’s on display for our purposes here.
AHP has covered similar issues in the past, most notably here (on changing the DSM), here (on how psychiatry is financed), and here (on the removal of homosexuality from the DSM). A bibliography of readings related to Professor Szasz’ comments, for interested students, is appended below the fold. Continue reading Thomas Szasz on diagnostic malpractice→
The June issue of Brain, 131(6), includes an “occasional paper” by Marjorie Perlman Lorch that reexamines the supposed debate between Paul Broca and John Hughlings Jackson at the 1868 meeting of the British Association for the Advancement of Science (BA).
This meeting hasbeen identified as a turning point in favour of Broca’s positionon the cerebral localization of language. A return to originalsources from key witnesses reveals that the opinion of the Britishpractitioners was generally against Broca’s views. Close examinationof contemporaneous materials suggests that no public debatebetween Jackson and Broca occurred. However, the public discussionafter Broca’s presentation records notable concerns over boththeoretical issues of localization of function and the statusof exceptional clinical cases. A significant stage in the developmentof current views on the organization of language in the brainis revealed in the accounts of the BA meeting in August 1868and successive responses to these events in the British pressover a period of years.
Perhaps it is now too late to give as a holiday gift, but the fine blog Mind Hacks has just published a review of what sounds to be a most interesting book: War of Nerves: Soldiers and Psychiatrists (Harvard, 2001), by the British journalist Ben Shephard. Although military psychology does not usually play a prominent roll in the history of psychology (apart, perhaps, from the intelligence testing of American conscripts during World War I), this book argues that it was the phenomenon of what was then known as “shell shock” during World War I that made physicians rethink their exclusively neurological view of the mind. Continue reading History of Shell Shock, Battle Fatigue, PTSD→
Celebrating its 25th anniversary, Psychotherapy Networker magazine partnered with Columbia researchers to chart the recent trends in Clinical Psychology. They found that Carl Rogers is still the #1 most influential figure, just as he was when American Psychologist first did the study in 1982.
In other words, the therapist who became famous for his leisurely, nondirective, open-ended, soft-focus form of therapy 50 years ago remains a major role model today, even with the explosion of brief, “evidence-based” clinical models, a psychopharmacological revolution that often makes medications the intervention du jour, and a radically altered system of insurance reimbursement that simply won’t pay for the kind of therapy Rogers did.
As for methods, however, the top therapeutic approach of the past quarter-century is cognitive-behavioral therapy (CBT). Over two-thirds of the 2,598 survey respondents use it, compared to just under a third following a “Rogerian/client-centered/humanistic” approach.
“The number of mental disorders that children and adults in the general population might exhibit leaped from 180 in 1968 to more than 350 in 1994.”
Lane, who spent time in the archives of the American Psychiatric Association, uses social anxiety disorder (first dubbed social phobia) as the lens through which to analyze American psychiatry’s extraordinary shift in the last 30 years from a psychoanalytic orientation relying on talk therapy to its current emphasis on neuroscience and drugs.
He draws on letters and memos written by the framers of the new disorders to argue that DSM revisions to social phobia or social anxiety disorder placed the diagnostic bar too low, turning social anxiety into a mental illness common enough to be considered, according to recent studies, third only to alcoholism and major depression. Continue reading Alterations to DSM “unscientific and arbitrary”→