Patients and power struggles

Medical History has a brief but good article on the political wranglings and scientific battles between psychiatry, psychoanalysis and clinical psychology in 20th Century America.

It’s by history of psychiatry ninja (not his official title) Andrew Scull, who tracks the events behind the waxing and waning of mental health fashions and how they have played out among professionals of different camps.

Psychoanalysis had managed initially to contain the potential threat posed by the drugs revolution, but by the mid-1970s, that resolution was threatening to break down. Antipsychotic drugs had proved to be an enormously lucrative market, and questions were beginning to be raised in many quarters about precisely what therapeutic advantages accrued from adding seemingly interminable and expensive psychoanalytic treatments to the mix.

A decade earlier, virtually every academic department of psychiatry was led by a psychoanalyst or a psychoanalytic fellow-traveller, but increasingly, the sums on offer to conduct laboratory research on potentially therapeutic compounds were exercising a powerful appeal, one bolstered by the critical importance of funded research in establishing pecking orders in large research universities.

It’s worth noting that quite a different story played out in Europe, where the fashion for psychoanalysis never really caught on and the success of mental health treatment were much less determined by the whims of insurance companies.

Link to ‘Mental Health Fight Club, 1940–2010’ (not the official title).

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