Eric J. Engstrom

Emil Kraepelin: psychiatry and public affairs in Wilhelmine Germany

Much has been said and written about Emil Kraepelins psychiatric theories and nosology, but next to nothing about his sociopolitical engagement after assuming the directorship of the university clinic in Munich in 1903. This engagement took various forms, ranging from caustic confrontations in his battles against alcoholism and syphilis, to subversive activities aimed at toppling the German chancellor Bethmann-Hollweg in 1917, as well as to overt attacks on the fledgling democratic roots of the Weimar Republic. This paper explores the origins and extent of Kraepelins public engagement and points toward ties linking it with clinical reality and psychiatric theory.

The Directions of Psychiatric Research by Emil Kraepelin

This classic text reproduces Emil Kraepelin’s inaugural lecture at the University of Dorpat in 1887. It represents one of the most succinct contemporary surveys of German psychiatric discourse in the 1880s. It also outlines Kraepelin’s own research priorities in the early years of his career, providing important historical background to the motives that drove him to place such great emphasis on (and hope in) experimental psychology. Contrary to our contemporary image of Kraepelin as a grand clinical nosologist, this text shows that he was much more of a diagnostician and experimental psychologist than historians have generally assumed. The document also reflects a wider ‘psychological turn’ in German psychiatry, away from patho-anatomic study - a turn that has often been overlooked in the historiographic literature.

Cultural and social history of psychiatry.

Purpose of review The purpose of this review is to highlight recent English language literature in the cultural and social history of psychiatry. It considers publications from 2007 and early 2008, as well as a few important older works that have not yet been reviewed in this journal. Recent findings Cultural and social historians of psychiatry are incorporating a growing number of historical objects into their narratives and developing new methodological techniques that can accommodate the full diversity of psychiatrys hybrid past. Increasingly, these histories are coming to be written in terms of multilateral and multivalent interactions with various other disciplines and organizations. In crafting these new narratives, historians face a confusing panoply of historical agents and events, reminding them that like the discipline of psychiatry itself, theirs too is a heterologic undertaking, grappling to understand and explain the otherness of psychiatrys past. Summary This review surveys the scholarly literature in several specific areas that have attracted the attention of historians of psychiatry in recent years. In particular, it considers work in the history of psychiatric institutions, borderline disorders, 20th-century somatic therapies, military psychiatry, and colonial psychiatry.

History of psychiatry and its institutions.

Purpose of review The purpose of this review is to highlight recent English-language literature on the history of psychiatric institutions. It considers work published since 2010, as well as a few important older articles that have not yet been reviewed in these pages. Recent findings Developments in the last half of the 20th century suggest that psychiatric historiography might finally be able to put the mental asylum behind it. Deinstitutionalization and the diffusion of professional jurisdictions seem to have consigned institutional histories to the methodological dustbin. But these transformations have also opened new perspectives on the institutional history of psychiatry and its methodologies. This review reflects on some of the enduring historiographic potential and importance of evidence drawn from institutional settings. Summary As carceral narratives have begun to lose their paradigmatic status within psychiatric historiography, a much more nuanced picture of asylum culture is becoming visible. The history of psychiatric institutions remains an integral and productive part of psychiatric historiography.

Psychiatry and neuroscience - history.

The ideal of inexorable scientific progress, characterized by expanding knowledge and increased sophistication and complexity, is a defining characteristic of themodern self-image of the natural sciences and can even be objectivelyquantified.Rider (1944) anddeSolla Price (1963), the founders of bibliometrics and scientometrics, notedmany years ago that fromthe 17th century onward thenumberof scientificpublicationshasbeendoublingevery 10–20years, while at the same time citations of earlier literature have fallen off markedly. This finding seems also to be confirmed by publishing developments in the fields of basic psychiatric and neurobiological research.A rough estimate based on the medical subject headings gathered in the National Library of Medicine’s Medline Database shows that in the four decades from 1966 to 2005 the number of essays on psychiatric disorders published in magazines increased from 5400 to 32 000 per year, and in the entire field of neuroscience from 35 000 to 144 000 per year. Does this increase of approximately 4% per year actually reflect inexorable and continuous progress in neuroscience and psychiatry? Among contemporary historians and philosophers of science, this traditional image of progressive scientific development is considered to be naive. This is not to deny that research is shaped markedly by concepts and issues inherent to specific scientific fields – concepts such as “neuron”

Tempering Madness: Emil Kraepelin’s Research on Affective Disorders

This essay examines some of the research practices and strategies that the German psychiatrist Emil Kraepelin (1856–1926) deployed in his efforts to account for the significance of emotions in psychiatric illnesses. After briefly surveying Kraepelin’s understanding of emotions and providing some historical context for his work in the late nineteenth century, it examines three different approaches that he took to studying emotions. First, it discusses his work in experimental psychology and his use of so-called artificial insanity to study affective disorders. It then turns to his clinical research, exploring his particular interest in the course and outcome of psychiatric disorders and then showing how those concerns related to his nosological delineation of manic depressive illness. Finally, it considers briefly how he attempted to expand his “clinical gaze,” turning it outward onto larger, nonhospitalized populations in an attempt to study subclinical forms of affect or temperaments. The article argues that the inadequacies and limitations of his own experimental and clinical research practices contributed to his evolving understanding of affective disorders. In particular, they led him to expand and differentiate his understanding of manic-depressive illness so as to take greater account of premorbid symptoms or temperaments.

'On Uprootedness' by Emil Kraepelin (1921). (Classic text No. 83)

Penned at the height of the debate on national regeneration in Germany after World War I, Emil Kraepelin’s study On Uprootedness sets out his views on social psychiatry. More than just a response to critics of his nosology, On Uprootedness outlines a larger political agenda of social governance and ‘inner colonization’. This introduction places Kraepelin’s understanding of social psychiatry in the broader context of social reform debates in the early Weimar Republic.

Beyond dogma and discipline: new directions in the history of psychiatry

Purpose of review The purpose of this review is to highlight recent literature in the history of psychiatry. It considers publications from 2005 to 2006, as well as a few important older works that have not yet been reviewed in these pages. Recent findings The title of this review essay, ‘Beyond Dogma and Discipline,’ points toward new research that moves beyond the kind of blanket valorizations of psychiatrys past (be they pejorative or laudatory) that had become so commonplace in historiographic discourse. This review surveys new directions of historical research in several important areas (social control, community and family care, sociology of professions, psychoanalysis, nosology, psychopharmacology, and self). Recent work has focused on the multilateral and multivalent interactions of psychiatry with various neighboring disciplines and historical agents, on the integration of psychoanalysis and psychopharmacology into the history of psychiatry, and on the status of psychiatry within broader discourses about the self, identity politics, and the history of emotions. Summary One of the most important contributions that the recent work in the history of psychiatry has to make involves sharpening our awareness of the contingency and cultural embeddedness of psychiatric knowledge and practice across different domains of time and space.

Race, alcohol and general paralysis: Emil Kraepelin’s comparative psychiatry and his trips to Java (1904) and North America (1925):

This article examines Emil Kraepelin’s notion of comparative psychiatry and relates it to the clinical research he conducted at psychiatric hospitals in South-East Asia (1904) and the USA (1925). It argues that his research fits awkwardly within the common historiographic narratives of colonial psychiatry. It also disputes claims that his work can be interpreted meaningfully as the fons et origio of transcultural psychiatry. Instead, it argues that his comparative psychiatry was part of a larger neo-Lamarckian project of clinical epidemiology and was thus primarily a reflection of his own long-standing diagnostic practices and research agendas. However, the hospitals in Java and America exposed the institutional constraints and limitations of those practices and agendas.

History of forensic psychiatry.

Purpose of review The purpose of this review is to highlight recent English-language literature in the history of psychiatry, with a special emphasis on the history of forensic psychiatry. It considers publications from 2008 and early 2009, as well as a few important older works that have not yet been reviewed in these pages. Recent findings The history of forensic psychiatry is a mixtum compositum that challenges historians to reassess their stock narratives in many different ways. Recent studies have demonstrated that the traditional research paradigms of modernization, medicalization, and professionalization fail adequately to capture the historical complexity and contingency of forensic practices and experiences. These deficits have prompted historians to set out in search of new, more hybrid historiographic strategies. Accordingly, their research is turning increasingly to the thresholds of forensic psychiatry where they are exploring how a heterogeneous array of concepts, images, and materials are exchanged and circulated in ways that shape the historical disposition of forensic psychiatry. Summary This review assesses three historiographic domains in which historians have traditionally situated forensic psychiatry. It argues that we need to be cognizant of these different domains and to recognize that enhancing our historical understanding will require us to reflect more carefully on the relationship between them.