Who invented psychiatry

As it turned out, though, none of the subjects became infected, leading the researchers to conclude that the condition arose from previous infection with syphilis. This apparent validation of the biological approach was influential. Neurologists of the time, knowing nothing of brain chemistry, were heavily focussed on what could be observed at autopsy, but there were many mental illnesses that left no trace in the solid tissue of the brain.

Meanwhile, two neurologists, Pierre Janet and Sigmund Freud , had been exploring a condition that affected both mind and body and that left no detectable trace in brain tissue: hysteria. The symptoms included wild swings of emotion, tremors, catatonia, and convulsions. Both men had studied under Jean-Martin Charcot, who believed that hysteria could arise from traumatic events as well as from physiological causes.

Freud believed that traumatic memories were repressed and consigned to the unconscious. Soon, however, the limits of this approach, too, were exposed. During the First World War, men who returned from the trenches apparently uninjured displayed physical symptoms associated with hysteria. Sufferers included soldiers who had not been in the trenches or exposed to bombing. Harrington commends physicians who charted a middle course. In , Bleuler left the International Psychoanalytical Association.

As the century progressed, the schism between the biological camp and the psychoanalytic camp widened. With advances in bacteriology, the biological camp embraced the idea that microbes in the intestine, the mouth, or the sinuses could release toxins that impaired brain functions.

The most notorious mid-century surgical intervention was the lobotomy. Freeman crisscrossed the country—a trip he called Operation Icepick—proselytizing for the technique in state mental hospitals.

On the nonbiological, analytic side of the discipline, world events again proved pivotal. Auden, was clouded by fears about the power of nuclear weapons, the Cold War arms race, and the possibility that communist spies were infiltrating society. Accordingly, American neo-Freudians substituted anxiety for sex as the underlying cause of psychological maladies.

They replaced Freudian tropes with a focus on family dynamics, especially the need for emotional security in early childhood.

In every case history of a troubled child. Start looking for the real enemy. Feminism furnished just one of several sweeping attacks on psychiatry that saw the enterprise as a tool of social control. In , three influential critiques appeared. By the early seventies, such critiques had entered the mainstream. Psychiatry, they argued, labelled people disturbed in order to deprive them of freedom. Challenges to the legitimacy of psychiatry forced the profession to examine the fundamental question of what did and did not constitute mental illness.

Homosexuality, for instance, had been considered a psychiatric disorder since the time of Krafft-Ebing. But, in , the annual A. I am a psychiatrist. I, like most of you in this room, am a member of the A. Homosexuality was still listed as a disorder in the Diagnostic and Statistical Manual of Mental Disorders , even as many psychiatrists clearly held a different view.

In December, , the A. Today, around one in six Americans takes a psychotropic drug of some kind. The medication era stretches back more than sixty years and is the most significant legacy of the biological approach to psychiatry.

It has its roots in the thirties, when experiments on rodents suggested that paranoid behavior was caused by high dopamine levels in the brain. The idea that brain chemistry could offer a pathogenesis for mental illness led researchers to hunt for chemical imbalances, and for medications to treat them. In , the F. The pharmaceutical industry vigorously promoted it as a biological solution to a chemical problem.

Next came sedatives. An alternative, Valium, introduced in , became the most commonly prescribed drug in the country the next year and remained so until One of the first drugs to target depression was Elavil, introduced in , which boosted available levels of norepinephrine, a neurotransmitter related to adrenaline.

Again there was a marketing blitz. The liner notes included claims about the benefits that patients would experience if the drug was prescribed for them. Focus shifted from norepinephrine to the neurotransmitter serotonin, and, in , Prozac appeared, soon followed by other selective serotonin reuptake inhibitors SSRIs.

Yet, despite the phenomenal success of Prozac, and of other SSRIs, no one has been able to produce definitive experimental proof establishing neurochemical imbalances as the pathogenesis of mental illness. Indeed, quite a lot of evidence calls the assumption into question. Clinical trials have stirred up intense controversy about whether antidepressants greatly outperform the placebo effect. But some drugs seem to work well for some people and not others, and a patient who gets no benefit from one may do well on another.

For a psychiatrist, writing a prescription remains as much an art as a science. In America, the final decade of the twentieth century was declared the Decade of the Brain. Even in instances where the discovery of pathogenesis has produced medical successes, it has often worked in tandem with other factors.

Without the discovery of H. Still, the search for pathogenesis in psychiatry continues. Genetic analysis may one day shed light on the causes of schizophrenia, although, even if current hypotheses are borne out, it would likely take years for therapies to be developed.

Benjamin Rush designed two mechanical contrivances to aid in the treatment of the insane. The belief at the time was that "madness" was an arterial disease, an inflammation of the brain. Pictured here is the "tranquilizing chair" in which patients were confined. The chair was supposed to control the flow of blood toward the brain and, by lessening muscular action or reducing motor activity, reduced the force and frequency of the pulse.

Both of Rush's devices were supposed to exert an influence in some way to circulation, which was believed to be essential to the successful treatment of the insane. In actuality, they did neither harm nor good. Rush also believed strongly in bleeding and purging patients to cure diseases. This belief caused a schism in the local medical community during the Yellow Fever outbreaks.

Philip Syng Physick supported Rush's belief and when both contracted yellow fever during the epidemic of , Rush bled himself and his friend. Both men recovered, though we know today that the bleeding played no part in their survival.