Friday, December 30, 2005

Jury Award Is Upheld in Firing Case

We continue to debate how to deal with those who have shown themselves to be dangerous and mentally ill. To some extent the Americans with Disabilities Act is leading us to changing our conception of mental illness. In this case it is argued that Mr. Josephs was not mentally ill and therefore not dangerous after treatment. Through the nineteenth and twentieth centuries we held that once a person had an illness they always had it, and presumably the risk associated with it stuck to them. But looking back to colonial times in the U. S. A. people were often locked up when they seemed dangerous, but when the episode passed (obviouslly without effective medication) they were allowed to resume their usual roles in society. As I recall this was true for James Otis one of the signers of the constitution.

Charles W. Socarides, Psychiatrist and Psychoanalyst, Is Dead at 83

He was a man who stuck to his guns if not to his wives. He always seemed to me to be evidence of how one's own experience, mixed with bias, in psychoanalysis can lead to views that resist all forms of public changes in opinion. While most went along with what they knew was a political (and I would say wise) decision about homosexuality by the profession, Socarides knew what he saw through his particular lens on the world.I wonder how many other psychoanalysts in less controversial and public areas also feel that they have seen a truth that the profession denies.

Friday, December 23, 2005

Releasing McElroy a dangerous idea

Here is a response to an earlier post on this issue.

What caused the Mad Hatter to go mad?

I hadn't thought about this question before, but now that you mention it, here is a pretty good answer.

Saturday, December 17, 2005

A Hospital is not a Prison

In this op-ed piece Brandon Krupp, the psychiatrist who resigned over the state of Rhode Island's attempt to extend the incarceration of a sexual offender by placing him in a civil unit of the state hospital, argues forcefully that this is a dangerous misuse of psychiatric hospitals. Historically the inability of psychiatrists to control admissions to state hospitals has been a major factor in the deterioration of care in these facilities. In the nineteenth century, the elderly, poor and homeless were often warehoused in these facilities under the pretense that they were receiving care. Now it appears that we are in the midst of seeing state hospitals used to extend criminal incarceration, under the pretense that care is being provided.

Monday, December 05, 2005

Dire Wounds, a New Face, a Glimpse in a Mirror

In this intruiging article about the first face transplant I was particularly struck by the following:
"Brain-dead patients in France are presumed to be organ donors unless they have made explicit provisions to the contrary, and approval by next of kin is not normally required. But given the delicacy of the case, the donor's family was consulted about the possible harvesting of part of the donor's face during the initial interviews that are undertaken to ensure that the deceased had not given instructions preventing organ donations."
If ever there was an un-American law, this must be it. It certainly demonstrates how cultural and political practices shape what we regard as every day ethical practices.

Thursday, December 01, 2005

Older Antipsychotics Are Found as Risky for Elderly as New Ones

This seems like more reverberations from the pushback against the psychopharm revolution. Was this study sponsored by a drug company?

Wednesday, November 30, 2005

Therapists take on soldiers' trauma in Iraq

This Wall Street Journal Article gives a good summary of the particular issues affecting efforts to deal with PTSD in Iraq.
I was particularly struck by the contrasts with the situation in Viet Nam and some of the similarities with the situation in World War I.

Thursday, November 24, 2005

Wednesday, November 23, 2005

Tuesday, November 22, 2005

Nathaniel's Story: From Juilliard to Skid Row

This is a moving story about a homeless schizophrenic man in Los Angeles.

Saturday, November 19, 2005

Melancholia in Homer

Jean Starobinski in his History of the Treatment of Melancholia, which was originally published in 1960 notes that,"melancholia, like so many painful states tied to the human condition, have been experienced and described before having received its name and medical explanation." As an example he cites the Iliad (ch. vi) where Belerophon submits inexplicably to the anger of the gods: "but when Bellerophon came to be hated by all the gods, he wandered all desolate and dismayed upon the Alean plain, gnawing at his own heart, and shunning the path of man." According to Starobinski Belerophon's desolate wandering is a senseless disaster because he is a courageous and just hero, who has done nothing to anger the gods.

Friday, November 18, 2005

"My Lobotomy": Howard Dully's Journey

Here is the NPR broadcast. It is very well done and worth listening to..

Thursday, November 17, 2005

A Lobotomy That He Says Didn't Touch His Soul

I didn't get to hear this piece, but I am looking for it online.

Saturday, November 12, 2005

Doctor quits over efforts to detain sexual predator

Now that many mentally ill people are being reinstitutionalized in prisons the struggle is on to see if they can be transfered to state mental hospitals. Here is a report from the front lines.

Sunday, October 23, 2005

Newly Discovered Poem Likely Lincoln's

While on the subject of suicide, here is a recently discovered poem about suicide thought to be by Abraham Lincoln.
Joshua Wolf Shenk discusses it at length in his book Lincoln's Melancholy.

Saturday, October 22, 2005

Existentialist Musings, Clinically Pondered in French

In his review of the stage production of Sarah Kane's "4:48 Psychosis" Charles Ishewood notes that Kane's work "may be as close as world literature has ever come to receiving a dispatch from a dead soul. (Ms. Kane committed suicide shortly after finishing it in 1999.) To read it is to feel the dizzying rush of a mind succumbing to the terrible seduction of nonexistence."
Here is a review of the book from Amazon.com:
I've read many of Sarah Kane's plays...and hated them all. However, this specific play of hers hits so deaply at what it means to be truly depressed, it's scary. 4.48 psychosis represents 4:48 am, the time when most people commit suicide. This in itself show how horribly, and yet beautifully, intense this book is. In fact, this was Sarah Kane's last play before she committed suicide, very soon afterwards. The writing of the play is completely manifested to meet with the minds of those who are depressed, with words scattered across the page...repeated phrases...intense images...and much more. If you're trying to do a quick and easy play to this one, forget it. However, if you can ever find a way to make this play come alive on the stage, i'll travel anywhere to watch it. This book is for the lover of vocabulary, the person trying to find the perfect words to describe an intense emotion and sense of mind. This may be the one play that accomplishes it completely. It's short and worth it...I gauruntee it'll interest you. Reviewer: Litost x143

Saturday, October 15, 2005

"Killing Cures" An Exchange

This exchange revolves around Sherwin Nuland's August 11, 2005 review of Andrew Scull's book Madhouse: A Tragic Tale of Megalomania and Modern Medicine and Jack El-Hai's book The Lobotomist. Nuland's review is not available online but the exchange gives some idea of the issues these books have raised.

Sunday, August 14, 2005

Resources on the history of psychiatry

Resources on the History of Psychiatry
History of Medicine Division of the National Library of Medicine
Emily Martin, Professor of Anthropology, New York University
Lorna A. Rhodes, Professor of Anthropology, University of Washington
August, 2004
Overview
This report introduces scholars interested in the history of psychiatry to the extraordinary collection in the HMD and NLM. This collection is unparalleled for its coverage of time and place in great depth and breadth, for its possession of immense numbers of unique audiovisual and print materials and for its invaluable holdings of manuscripts and oral histories. We have arranged our report in 10 major sections as listed below. Our time frame is primarily from the 19th century to the 1970s. For each major section we have organized items from the library in subsections by topic, date, location, or format. Within each subsection, we have listed only a small selection of materials available in the library, a selection we have chosen to illustrate the large range of sources the collection contains: scientific monographs, federal or state reports, personal accounts, conference proceedings, legal briefs, armed service publications, mass market publications, teaching materials, monographs on psychiatric ethics, treatment, or social effects, manuscripts, audiovisual materials, ephemera, and so on.
For a guide to the current scholarly literature on all these topics, the HMD web site contains an extremely useful set of syllabi used in teaching the history of psychiatry in the US and the UK. http://www.nlm.nih.gov/hmd/collections/digital/syllabi/index.html
Since by our reckoning, virtually all the contemporary texts and edited collections cited in these syllabi are available in the general collection of the NLM or the HMD, we have not provided a separate listing of these major contemporary scholarly resources here.
1. Overview…………………………………………….2
2. Prehistory of psychiatry……………………………...3
3. History of asylums…………………………………...6
4. History of psychotropic drugs………………………20
5. Race in psychiatry…………………………………...33
6. Women, children and the history of psychiatry……..36
7. Psychiatry, war, and violence………………………..43
8. Forensic psychiatry…………………………………..46
9. Radical cures: Psychosurgery and ECT……………...54

Monday, August 01, 2005

Treating Lovesickness

In the footnotes of his chapter on the Passions, in his last book Elements of Physiology, Denis Diderot presents a number of cases that he had heard about or read about. For example;
A young man feeling hopeless over not being able to obtain the object of his passion shot himself in the head with a pistol. He did not kill himself, but he remained mad from his wound; during his illness his relatives were advised to have his mistress come to him and to present her to him. When they did this, he raised his eyes, he saw her and he cried: Ah! mademoiselle it is you...and he was immediately cured [Diderot, Oeuvres Compl├Ętes, v. XVII, p. 489; translated by EMB]

another case of Lovesickness

Sunday, July 31, 2005

18th Century Case of Post-Partum Depression ?

In D'Almebert's Dream, the philosopher Denis Diderot presents several case histories of psychiatric disorders. Dr. Bordeu, a well known "vitalist' physician describes them to Julie de l'Espinasse. In the following Bordeu presents a case of a woman with a list of symptoms which occurred following the birth of a child. Bordeu also presents an account of how this woman recovered. In this account one sees an 18th century theory of the mind and its conflicts that that antedates [and perhaps influenced] Philippe Pinel.

Bordeu: There was a woman who had just given birth to a child; as a result, she suffered a most alarming attack of the vapors--compulsive tears and laughter, a sense of suffocation, convulsions, swelling of the breasts, menancholy silence, piercing shrieks-- all the most serious symptoms-- and this went on for several years. Now this woman was passionately in love, and eventually she began to think she saw signs indicating that her lover had grown weary of her illness and complaints and was beginning to break off their affair. That was when she decided that she must either get well or make an end of herself. In this way there began a sort of civil war inside her own consciousness. Sometimes this war would turn to the advantage of the master; sometimes the subjects would get the upper hand. Whenever the two sides were equal, so that the force exerted by the fibers exactly counterbalanced that of the center of the bundle, she would fall to the ground as though dead. Then when carried to her bed, she would lie for hours on end, entirely motionless and almost lifeless. On other occassions the effect would be only one of general lassitude or exhaustion or loss of consciousness from which it often seemed she would never recover. For six months she kept up the struggle. Whenever the rebellion began in her fibers she was able to feel it coming on. She would stand up, run about, busy herself with the most vigorouws forms of physical exercise, climb up and down stairs, saw wood or shovel dirt. She would make the center of her network, the organ of will power, as rigid as possible by saying to herself: You must conquer or die. At the end of a long succession of victoreies and defeats the head finally won out, and the conquered "subjects" had been so throuughly reduced to submission that, although this woman has had to contend with all sorts of domestic troubles and has suffered from various sorts of illness, she has never had the least tendency to the vapors since that time. .
Mlle. De'Espinasse: Good for her! But I think that in her place I could have done as well as she did.
Bordeu. Yes, I think so, because yuou have a firm disposition, and if you were in love, you would not be lukewarm about it.
Mlle. De L'Espinasse. I think I understand. A person will have a firm disposition of the center of the network is able, as a result of education, habit or irgaization, to dominate the various threads. If the center is dominated by the treads, the person has a weak disposition.
Bordeu. And from that proposition one could draw a whole series of further conclusions.
Mlle. De L'Espinasse. First tell us your other case history, and then draw your conclusions.

From Denis Diderot, Rameau's Nephew and other works. Translated by Jacques Barzun and Ralph Henry Bowen [1956] p.156.

Madhouse

May 29, 2005, The New York Times.
The novelist Patrick McGrath reviews the sociologist Andrew Scull's MADHOUSE: A Tragic Tale of Megalomania and Modern Medicine. In this book, Scull, who has long been interested in the abuses of biological psychiatry, presents a full account of the career of Henry Cotton at Trenton State Hospital in New Jersey between 1907 and 1930. Cotton, who believed that major mental illnesses were caused by focal infections, conducted an ambitious program of surgically removing " the infected teeth and tonsils of dozens of his patients, not to mention their stomachs, gallbladders, colons, testicles and ovaries." As a persistent critic of psychiatry, Scull has chosen an exemplary subject to show psychiatry in its worst light.

Saturday, July 30, 2005

Image of Restraint



The strait waist-coat or strait jacket was heralded in the late 18th century as an advance in the management of the insane. Here is an image of the strait jacket from that period. I will upload details about it when I get back to my notes.

Case Histories from the History of Psychiatry

This is a site that I produced a few years ago. It started with case histories that I had used in teaching, where I had asked students to discuss a case based on limited information and then gave them a follow-up. I thought that the hyperlinking capacity of the internet would allow me to present cases in this format. Some of the cases on this site are in that format. As I got going on the site, I couldn't help adding other material and links to other sites. What iscurrently on the site is rather a hodge podge of materials that I have tried to organize so that it might be useful

A collection of classics on the history of psychology and psychiatry

It is increasingly possible to find texts of useful books in the history of psychiatry. Here is a web site that offers what looks like it will be a growing collection of texts. Currently you can find the following:

Havelock Ellis (1927), The Psychology of Sex
Robert Burton (1652), The Anatomy of Melancholy
Sigmund Freud (1920), Three Contributions to the Theory of Sex
Sigmund Freud (1921), Dream Psychology: Psychoanalysis for Beginners
Clifford Whittingham Beers (1921), A Mind That Found Itself