YDS: The Clare Spark Blog

November 8, 2009

Is the History of Psychiatry a Big Mess? (2)

Image (90)

Henry Fuseli, “Thor Battling Jormungander, the Midgard Dragon,” (1788)

Since I wrote part one of this blog, there have been several developments. First, a chasm has opened between those who see Nidal Hasan as a mental case, for instance, suffering from “harassment” directed against him as a Muslim, and those who see the Fort Hood event as an episode in radical Islamic jihadism. Second, I have attempted to find out more about “military psychiatry” and its philosophy.

Here is one article from 2002 that lays out its managerial philosophy: http://pb.rcpsych.org/cgi/reprint/26/6/227.pdf. Sociologists will recognize a classical structural-functionalist and behaviorist model. (For the still powerful Talcott Parsons cohort at Harvard and elsewhere see my blog http://clarespark.com/2009/08/25/preventive-politics-and-socially-responsible-capitalists-1930s-40s/. As I understand “functionalism,” society is viewed as a well-oiled machine, all its moving parts integrated to form a harmonious whole: any disturbances will emanate from outside “the system”–”outside agitators” or “Jewish” troublemakers, for instance.) In the explanation of military psychiatry (cited above) I was taken especially by the inception of military psychiatry in Russia diagnosing “evacuation syndrome” following the revolutionary situation of 1905 (the date meant nothing to the authors, apparently; Russian soldiers were joining Soldier’s Councils), and the suggestion that research today (2002) is being conducted in “computer administered cognitive therapy for affective and anxiety disorder.” I may have gone way more libertarian in my latter years, but my mind-management antennae are quivering anew and my head is ringing with alarm bells, notwithstanding the supposed adherence of military psychiatry to the “evidence-based practice [of medicine].” We should all be more attentive to this peculiar medical “culture” as its own advocates describe it, and it promises to be a fine subject for historians of science and investigative journalists, especially those with an interest in robots and their construction.

Third, one Facebook friend believes that Freudian and perhaps other approaches to depth psychology are obsolete and were always grievously mistaken anyway. He is not alone, and I have met few psychiatrists who do not distance themselves from psychoanalysts, even those analysts with medical degrees. Very briefly, I will sketch what contributions of Freud remain interesting, and how he was received in the early 20th century. The valuable part of Freud, for me at least, is that which asks us to piece together a narrative of our lives, first to identify patterned responses to difficult persons and situations, and second to examine our loves and hatreds toward the end of overcoming idealization or its opposite, demonization, of others; finally, to identify traumas and how to manage their lingering effects on psyche and soma, for instance, panic attacks on persistent anxiety. What Freud does not do is paint a rosy picture of life or any kind of “social engineering,” though as Nathan Hale has shown in his Freud and the Americans, he was deliberately turned into a Progressive in the USA. The real Freud would not have drawn a smile on Leviathan, but Henry Murray did (see “Leviathan Altered?” http://clarespark.com/2009/11/08/leviathan-altered/. Murray added a smile to the whale image).

“Where Id was, let Ego be!” As I have mentioned before on this website, Freud wrote a major essay during the Great War describing the difficulty in becoming a civilized person or society, “Thoughts for the Time of War and Death” (1915). Indeed, in his still deeply controversial anti-religion book, The Future of An Illusion (1927), he began by stating that any society that abused many of its less advantaged members deserved to be overthrown: he was ever the moralist. In sum, he demands that we remember every significant detail of our past, and how relationships in the family of origin could have affected later object choices as an adult. No one who attended this call to constructing an accurate narrative would be susceptible to demagoguery or mind-management by others, including those in the press or government.

Those who are anti-Freud should be interrogated as to whether or not they reject the relevance of early childhood experiences and family deficiencies to persistent adult distress or gullibility. Also, whether or not they believe that the artists and writers who inspired Freud are of no consequence today (I include Sophocles, Shakespeare, Milton, Schiller, Goethe, Nietzsche, and many more; certainly Melville, writing in the 1850s, was as interested as Freud in family relationships). But that is not how Freud as historian (and literary critic) was received by the bohemian upper class after the war. Rather, libertines seized upon his theory that sexual repression causes neurotic symptoms and behavior. Let the acting out begin! (See Herbert Marcuse in Eros and Civilization for one of many examples. In Berger and Luckmann’s The Social Construction of Reality (1966), they dismiss psychoanalyst as suitable only for (New York?) Jews, with the implication that only sex-obsessed Jews would benefit from Freud. I was assigned this book in graduate school. )

In the 1970s, radical feminists pounced upon Freud’s cover-up of the sexual abuse of minor girls by male relatives, claiming that he had sold out, contradicting the testimony of his hysterical patients by postulating sexual fantasies in his analysands; these young women were thus made the victims of patriarchy (by the feminists). In that hostile reading, the victim became the perpetrator, i.e., “she asked for it.” I could spend a lifetime studying Freud and his interpreters/misinterpreters (some of whom are blatant antisemites, blasting Freud-the-carnal-Jew, not to speak of his atheism), and all the reasons he remains controversial today, so I apologize for the brevity of this blog on such a momentous subject. My own view is that any psychological treatment 1. must be anchored in the materiality of the human brain; and 2.must respect the autonomy of the patient or client, rigorously opposing brainwashing, interpretations that make sense only to the therapist, or any other type of indoctrination, and 3. cannot ignore the institutional context in which mental illness arises. Idealist (mystical) formulations that fail this test are simply ideological, and deserve the suspicion of their harshest critics. Mystification has no place in an enlightened profession.

As for soldiers, they deserve to know exactly why they fight: as a tight unit, they will give up their individuality, but it should not be a permanent loss of self. It cannot be an easy task to integrate them back into a society (ours) that is viciously polarized, often deceptive in the utterances of its leaders, and divided into fragments defined more by the group-think of race and ethnicity than by loyalty to a set of common democratic principles.* The more honest and capable psychiatrists of the military may have an impossible task on their hands.

*Here, in an excerpt from my article on Bunche and Myrdal,  is what was promised to enlisted men during the second world war:

[From my article:] Louis Wirth’s insistence on wise progressive planning and foresight, including the sighting of threats to order, was reiterated in a Q. and A. booklet from the Office of War Information, “What Do Students Do In The War and After” (numbered M-3227,  slipped into the Ideologies volume in the Bunche Papers at UCLA, though not bound). On page 8 the Committee for Economic Development [business leaders adopting Keynesian economic policies, created in 1942, C.S.] is mentioned as promising “maximum employment and high productivity” after the war. Page 9 quotes Ambassador Winant in a speech to English miners: “Anti-Fascism is not a short term military job. It was bred in poverty and unemployment. To crush Fascism at its roots we must crush depression. We must solemnly resolve that in the future we will not tolerate the economic evils which breed poverty and war. This is not something that we solve for the duration. It is part of the war.”  Page 10 announces “There is a growing sense of social responsibility among business leaders and a wide-spread acceptance of the inescapable duty of business to maintain full production and continuous employment to maintain the purchasing power upon which prosperity depends.” Page 11 ff., states that the curricula for history, the social sciences and the liberal arts will be revised and adjusted accordingly: Education must stress science, interpersonal human relations, and international affairs, the “larger world of other peoples and other cultures with whom we must collaborate in establishing world order.” [end excerpt] In other words, multiculturalism and internationalism were not an imposition by the Left but an upper-class “progressive” response to heightened expectations among soldiers for more equality, peace, meaningful work and education after discharge from the armed services.

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6 Comments »

  1. Reblogged this on YDS: The Clare Spark Blog and commented:

    This piece on military psychiatry sets the tone for all our institutions. The footnote is a must read for those interested in the policies of “socially responsible” business leaders and the promises they made to enlisted men during World War 2.

    Comment by clarelspark — July 26, 2013 @ 1:45 am | Reply

  2. [...] more famous the better.   Another task was the feminist demolition of Freud (see the passage in  http://clarespark.com/2009/11/08/is-the-history-of-psychiatry-a-big-mess-2/ where I mention the attack on Freud as a sell-out to his gender by covering up real sexual abuse of [...]

    Pingback by She Who Gets Slapped: the magic of middle-aged Boomerdom « YDS: The Clare Spark Blog — December 23, 2009 @ 9:42 pm | Reply

  3. “Clare Spark” posted Nov. 12
    on one of the H-NET lists:

    > The recent Fort Hood massacre in Texas has prompted my interest
    > in military psychiatry. I wrote a blog about it here:
    >
    http://clarespark.com/2009/11/08/is-the-history-of-psychiatry-a-big-mess-2/.
    >
    > . . . Initial searches suggest that as a field of inquiry, military
    psychiatry is
    > sequestered from related fields in the mental health professions, and that
    > it may be relatively impervious to oversight from the elected
    > representatives of the citizenry at large.

    2. The medical profession appears even more impervious to
    legislative oversight than the military profession. We can note
    in the case of the USA:
    – desegregation of the US military in the postwar 1940s was
    accomplished by the executive branch of government (i.e.
    the military authorities) alone. It seems likely that, if the
    US Congress had had a voice in military affairs of this type,
    racial segregation would have lasted until a later date.
    – plenty of controversy surrounds the American Psychiatric
    Association’s Diagnostic and Statistical Manual of Mental
    Disorders (cf. Wikpedia et al.) But no one has suggested
    the legislature should or could interfere with professional
    decisions of this character.
    – The best-known occasions of Congressmen’s direct
    participation in military medicine appear to have been the
    location and equipment of veterans’ hospitals after the two
    world wars. Such participation was (later) widely condemned
    as corrupt and in many cases harmful to patients.

    1. More generally, in at least some countries the wartime
    temporary recruitment of civilian medical men seems to
    have done nothing but good. British examples include
    psychiatrist Rivers in the First World War (effective and
    humane treatment of combat fatigue, at least for officers),
    Archibald McIndoe (treatment of burns, WW2), and
    psychiatrist Brock Chisholm (Canadian army, WW2, later
    first director-general of the World Health Organization.)

    Rank probably has something to do with this, because
    rank inhibits personality generally in military life (including
    military medicine) but wartime volunteers are often indifferent
    to military rank and deploy their personalities in uniform no
    differently than in their professional careers. Personality was
    obviously of primary importance in the three cases cited, but
    each brought about permanent reforms in their particular
    branches of military medicine.

    Don Phillipson
    Carlsbad Springs
    (Ottawa, Canada)

    Comment by Don Phillipson — November 13, 2009 @ 1:04 pm | Reply

  4. [...] Is the History of Psychiatry a Big Mess?  [...]

    Pingback by Attack the System » Blog Archive » Updated News Digest November 15, 2009 — November 12, 2009 @ 12:54 pm | Reply


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