Schizophrenia was 20th century psychiatry’s arch concept of madness. Yet for most of this period, schizophrenia was both problematic and contentious. This new history explores changes in the concept of schizophrenia across the 20th century. It provides a broad map of the concept’s mutating symptoms, fluctuating subtypes, social uses, and changing definitions.
This research reveals and cites a long tradition of critical unease towards schizophrenia – by numerous mainstream psychiatrists, psychologists, and schizophrenia authorities. This critical stance is shown to have existed in addition to complaints by so-called anti-psychiatrists (also documented). The book therefore explains how and why North American Psychiatry eventually sought to stabilize its disease concept at an institutional level – through the use of operational definitions in its DSM series.
Among its many remarkable offerings, the research unearths accounts of children being experimentally kept on LSD for over one year, and demonstrates that the stigmatising idea of schizophrenia as a split personality actually stems from Swiss Psychiatrist Eugen Bleuler – the concept’s creator. But its principle aim is to serve as a useful introduction to schizophrenia that guides the reader through a complex history of rejection, negotiation, and transformation, in this most contested of 20th century concepts.
This historical contribution to our understanding of schizophrenia draws extensively on primary sources from the schizophrenia literature, and builds on the research of recent historians of psychiatry and related disciplines.
The June 2015 issue of History of Psychiatry is now online. The issue includes articles on the symptoms of schizophrenia, British colonial lunatic asylums, and “senile dementia” in the decades before 1979. Also in the issue is a classic text on symptoms in psychiatry by Hans W. Gruhle (right). Full titles, authors, and abstracts follow below.
“First rank symptoms of schizophrenia: their nature and origin,” by J. Cutting. The abstract reads,
Kurt Schneider’s insight nearly 80 years ago that schizophrenia could be demarcated from other psychoses by a small set of particular delusions and hallucinations powerfully influenced diagnostic practice. The theoretical status of such ‘first rank symptoms’ as a whole, however, has rarely been addressed. But if they are sensitive and specific to the condition, it is about time that their essential nature and potential origin be considered. This is the purpose of the present paper. I argue that these psychopathological phenomena are indeed relatively sensitive and specific to the condition, that their nature can be formulated within a Schelerian model of what constitutes a human being, and that their origin fits anthropological and neuropsychological notions of the make-up of contemporary human beings.
The journal History of Psychiatry is celebrating its 25th anniversary. A special issue marking the occasion has just been released. Among the articles in the issue are ones addressing the history of nostalgia, the treatment of shell shock at the Maudsley Hospital, masculinity in Victorian asylums in New Zealand and Australian, the distinction between passion and emotion, and much more. Full titles, authors, and abstracts follow below.
Editorial: “The first 25 years of History of Psychiatry,” by German E Berrios.
“Some reflections on madness and culture in the post-war world,” by Andrew Scull. The abstract reads,
This article examines the treatment of madness as a theme in drama, opera and films, concentrating its attention for the most part on the period between World War II and the 1980s. These were the years in which psychoanalysis dominated psychiatry in the USA, and so Freud’s influence in the broader culture forms the central though not the sole focus of the analysis.
In her reading of it, the book can be situated at the boundary between the history of psychiatry, the history of psychology, and the public understanding of science:
The public was introduced to dementia praecox by a 1907 piece in the New York Times that recounted the testimony in the murder trial of architect Stanford White. The superintendent of an asylum in Binghamton, N.Y. testified that the murderer, Harry Kendall Thaw, might’ve been suffering with dementia praecox.
In the late 1920s to the 1930s, dementia praecox started making its exit, replaced by Eugen Bleuler’s “schizophrenia.” At first, Noll says, these terms were used interchangeably in both clinical practice and research (which, naturally, made things very confusing). But these disorders had distinct differences.
Although he didn’t use the word, Noll—in a recent interview posted at the blog run by Harvard University Press—explained the overlap as being a consequence of schizophrenia’s “indigenization” into the American context. This then wrought changes in meaning:
By 1927 schizophrenia became the preferred term for inexplicable madness, but the Americans reframed Bleuler’s disease concept as a primarily functional or psychogenic condition that was caused by mothers or maladjustments to social reality. When Bleuler visited the United States in 1929 he was horrified to see what the Americans were calling schizophrenia. He insisted it was a physical disease with a chronic course characterized by exacerbations and remissions of hallucinations, delusions and bizarre behaviors.
As we reported in early October, the British Psychological Society‘s History of Psychology Centre, in conjunction with University College London’s Centre for the History of the Psychological Disciplines, has organized a Fall Seminar Series. The next speaker in the series is Joanna Moncrieff (left), of University College London. On Wednesday, November 9th, Moncrieff will be speaking on “Magic Bullets for Mental Disorders: The Evolution of Ideas about the Nature of Drug Treatment for Scizophrenia.” The abstract for the talk reads,
When ‘antipsychotic’ drugs were introduced into psychiatry in the 1950s, they were thought to work by inducing a state of neurological suppression, which reduced behavioural disturbance, as well as psychotic symptoms. This view was reflected in the name ‘neuroleptic’. Within a few years, however, the idea that the drugs were a disease-specific treatment for schizophrenia or psychosis, and that they worked by modifying the underlying pathology of the condition, replaced this earlier view, and they became known as ‘antipsychotics’. This transformation of views about the drugs’ mode of action occurred with little debate or empirical evaluation in the psychiatric literature and obscured earlier evidence about the nature of these drugs. Drug advertisements in the British Journal of Psychiatry reflect the same changes, although the non-disease-specific view persisted for longer. It is suggested that professional interests helped to facilitate the transformation of views about the nature of these drugs.
Full details on the seminar series can be found here.