The December 2017 issue of History of Psychiatry is now online. Articles in this issue explore connections between psychology, psychiatry, and philosophy, nineteenth century insane acquittal policy, LSD experiments in the United States Army, the use of ECT for mass killing by the Nazis, and much more. Full details below.
“Con Drury: philosopher and psychiatrist,” by John Hayes. Abstract:
Maurice O’Connor Drury (1907–76), an Irish psychiatrist, is best known for his accounts of his close friendship with the eminent twentieth-century philosopher, Ludwig Wittgenstein. His only book, The Danger of Words (1973), was well received by those who had an interest in the relationship between psychiatry, psychology and philosophy. This article concentrates on Drury’s experiences, studies and writings in these fields.
“Insane acquittees and insane convicts: the rationalization of policy in nineteenth-century Connecticut,” by Lawrence B Goodheart. Abstract:
A current situation in Connecticut of whether a violent insane acquittee should be held in a state prison or psychiatric facility raises difficult issues in jurisprudence and medical ethics. Overlooked is that the present case of Francis Anderson reiterates much of the debate over rationalization of policy during the formative nineteenth century. Contrary to theories of social control and state absolutism, governance in Connecticut was largely episodic, indecisive and dilatory over much of the century. The extraordinary urban and industrial transformation at the end of the Gilded Age finally forced a coherent response in keeping with longstanding legal and medical perspectives.
The Saskatchewan Mental Hospital at Weyburn has played a significant role in the history of psychiatric services, mental health research, and community care in Canada. Its history provides a window to the changing nature of mental health services over the twentieth century.
Built in 1921, the Saskatchewan Mental Hospital was billed as the last asylum in North America and the largest facility of its kind in the British Commonwealth. A decade later, the Canadian Committee for Mental Hygiene cited it as one of the worst institutions in the country, largely due to extreme overcrowding. In the 1950s, the Saskatchewan Mental Hospital again attracted international attention for engaging in controversial therapeutic interventions, including treatments using LSD.
In the 1960s, sweeping health care reforms took hold in the province and mental health institutions underwent dramatic changes as they began moving patients into communities. As the patient and staff population shrank, the once palatial building fell into disrepair, the asylum’s expansive farmland fell out of cultivation, and mental health services folded into a complicated web of social and correctional services.
Managing Madness examines the Weyburn mental hospital, the people it housed, struggled to understand, help, or even tried to change, and the ever-shifting understanding of mental health.
Revisiting the history of postwar LSD (lysergic acid diethylamide) research illuminates how the work of a chemist at the Rockefeller Institute contributed to the development of a biochemical paradigm for mental functioning. Dilworth Wayne Woolley proposed one of the first theories of the biochemistry of mental illness based on empirical evidence. His research with LSD and serotonin had wide-ranging repercussions for pharmacology and fit neatly into the emerging medicalization of mental illness. Reevaluating Woolley’s ideas and the fruits of psychopharmacology leads to possible new approaches toward mental health and illness when considered alongside lessons learned from past research with psychedelic substances, and exemplifies a broader paradigm shift in cultural studies toward a biopsychosocial model that acknowledges the intersections between biology and culture.
The June 2016 issue of History of Psychiatry is now online. Articles in this issue explore psychiatric semiology, the German Research Institute of Psychiatry in Munich, madness in novelist Muriel Spark’s work, LSD as treatment in Denmark, the DSM and learning disabilities, Joseph Mason’s madhouse, and the work of Max Scheler. Full titles, authors, and abstracts follow below.
“The emergence of psychiatric semiology during the Age of Revolution: evolving concepts of ‘normal’ and ‘pathological’,” by Diego Enrique Londoño and Professor Tom Dening. The abstract reads,
This article addresses some important questions in psychiatric semiology. The concept of a sign is crucial in psychiatry. How do signs emerge, and what gives them validity and legitimacy? What are the boundaries of ‘normal’ and ‘pathological’ behaviour and mental experiences? To address these issues, we analyse the characteristics and rules that govern semiological signs and clinical elements. We examine ‘normality’ from the perspective of Georges Canguilehm and compare the differences of ‘normal’ in physiology and psychiatry. We then examine the history and the philosophical, linguistic and medical-psychiatric origins of semiology during the eighteenth and nineteenth centuries (the Age of Revolution). The field of rhetoric and oratory has emphasized the importance of passions, emotions and language as applied to signs of madness. Another perspective on semiology, provided by Michel Foucault, lays stress on the concept of ‘instinct’ and the axis of voluntary-involuntary behaviour. Finally, we analyse how statistics and eugenics have played an important role in our current conceptualization of the norm and therefore the scientific discourse behind the established clinical signs.
The Canadian Broadcasting Corporation (CBC) has just aired a piece on the controversial history of Oak Ridge, the forensic mental health division of the Waypoint Centre for Mental Health Care in Penetanguishene, Ontario. (The Oak Ridge building officially closed in 2014, but Waypoint continues to house Ontario’s only maximum security forensic hospital.) “The Secrets of Oak Ridge” aired March 1st, 2016 as part of the CBC’s national news program The National and is described simply as: “Allegations of treatment with LSD, sleep deprivation, torture. The painful legacy of an Ontario psychiatric facility. Reg Sherren reports.”
The 15-minute piece, driven by the narrative of one man’s experiences in the institution in the 1970s, describes some of the treatment practices at the institution at this time and questions the ethics of those involved. A provocative indictment of the institution and its doctors, the segment unfortunately lacks any counterpoint regarding the ethics of the therapeutic practices employed at the hospital. Absent any discussion of the greater context of psychiatry at this time, the treatment of patients at Oak Ridge is presented as unequivocally cruel, unusual, and unethical. This is certainly the experience of the former patient featured in “The Secrets of Oak Ridge.”
And from our present-day vantage point we may well feel similarly. Taking the context of 1960s and 70s psychiatry into account, however, the ethics, or lack thereof, of the program are less clearcut. At the time, Oak Ridge’s use of LSD and other psychopharmaceuticals – alongside other therapies – was seen as a positive form of treatment and a promising advance in the field. Where the CBC segment is most successful is in presenting the patient’s voice, as he recounts his experiences at the hospital. Respecting this patient’s experience, while putting that experience into historical context is a fine balancing act, one, unfortunately, “The Secrets of Oak Ridge” does not attempt. Contextualizing these treatment practices does not mean invalidating the experiences of this or any other patient, but it is necessary for a more complete understanding of what transpired at this hospital in this moment in time.
As we’ve reported previously on AHP, the recently launched Remembering Oak Ridge Digital Archive and Exhibit produced by former AHP contributor Jennifer Bazar, is an excellent and under-utilized source for this much needed information. Details and fuller context for the social therapy program discussed in the CBC segment can be found on this page of the site. (It should also be noted that a class action lawsuit against the hospital and the program’s doctors, on behalf several patients, is as yet undecided.)