Contested Jurisdictions: Psychiatry, Psychoanalysis, and Clinical Psychology in the United States, 1940–2010
نویسنده
چکیده
American psychiatry on the eve of Pearl Harbor was a small, stigmatised, and isolated specialty, for the most part confined as surely inside the high walls of its barrack-asylums as the patients over whom it exercised near-autocratic powers. The number of mentally ill patients incarcerated in state and county mental hospitals had grown sharply, from 150,000 at the turn of the century to 445,000 in 1940. The fiscal crisis of the states that accompanied the Great Depression had produced a steady deterioration of conditions in these institutions, a deterioration that would intensify as a result of the exigencies of total war. In the immediate aftermath of that prolonged conflict, conditions had degenerated to such a parlous state that a number of outside observers compared America’s asylums to Nazi death camps. Yet the size of the psychiatric profession essentially doubled during the war years, from 2,295 to almost 5,000. More importantly, the intellectual centre of gravity of the profession shifted equally dramatically. Through the 1930s, the bulk of the profession had embraced biologically reductionist accounts of mental illness. Correspondingly, they had also engaged in an orgy of experimentation with somatic treatments for mental disorder: surgical evisceration in pursuit of hypothesised septic causes of mental illness; fever therapy, first for general paralysis of the insane (or tertiary syphilis) and later for other forms of psychosis; efforts to put patients into prolonged comas, originally using barbiturates and subsequently using injections of insulin; convulsive therapies using metrazol or electricity; and direct surgical assaults on the frontal lobes of the brain. Led by Brigadier-General William Menninger, who had
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عنوان ژورنال:
دوره 55 شماره
صفحات -
تاریخ انتشار 2011