Saturday, December 29, 2007

The Cobweb

William Gibson, who was married to the psychoanalyst Margaret Brenman-Gibson, spent some time in Topeka, Kansas, while she was associated with the Menninger Clinic in the early 1950s. The Cobweb, published in 1954, is a novel set at a psychiatric hospital located in a mid-western town. In this novel Gibson, who won fame for writing plays such as The Miracle Worker, tells a tale of institutional politics and infidelity that reads somewhat like the script for a 1950s B movie. His descriptions of clothing and cars as well as drinking and smoking habits create a vivid sense of the period. Attitudes towards race and gender are painfully, but not judgmentally, presented. What I enjoyed most, however, is the snapshot that Gibson takes of hospital based psychiatry at that moment when psychoanalytic treatment and milieu therapy were on the cutting edge. Seen from the 21st century optimism about the therapeutic value of patient government seems quaint. I think it is important, however, to revisit all those moments of false optimism that litter the history of psychiatry. Gibson's book provides an enjoyable way to visit at least one of them.

Sunday, December 16, 2007

Menninger Madhouse

Lawrence J. Friedman's 1990 book Menninger: The Family and the Clinic is an absorbing tour through much of twentieth century American psychiatry. Personally it connected the dots between many of the names that were floating around when I was doing my psychiatric training in the early 1970s. What struck me reading this book was the extraordinary hubris involved in the creation of hospital based psychoanalytic treatment facilities. I was reminded of Andrew Scull's book Madhouse with its caustic treatment of Henry Cotton's focal infection theory and incredible damage that resulted from its arrogant application. One of the most moving parts of Scull's book were the vignettes that allowed one to imagine what it was like for families to have someone treated by Cotton. While I do not want to draw too close a comparison between the Cotton's often lethal methods and the Menningers' subtler mind games, they do have one thing in common: psychiatrists claiming great expertise with very little evidence to back it up. If only Friedman had been given access to case records so that one could have a more vivid sense of what being subjected to treatment at the Menninger Clinic was like. I wonder if ther are first hand accounts.