Clare Spark: Is the History of Psychiatry a Big Mess?
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” 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), 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 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?”)
“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. 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 must 2. be anchored in the materiality of the human brain; and 2. 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. Idealist (mystical) formulations that fail this test are simply ideological, and deserve the suspicion of their harshest critics.
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.