Category: Remembering

In the 1950s, three delusional Messiahs were gathered to live together in the same mental hospital. This is one of the most remarkable experiments in the history of psychology and I’ve written about it in an article for Slate.

I’ve had this tale told to me many times, but in a hazy way almost like a myth. I’ve been asked it as a question (“what would happen if three delusional Christs met each other?”) other times it appears as a trite abbreviate anecdote (“did you hear about the three delusional Christs? One decided he was the Father, the other the Son and the other the Holy Ghost!”).

It was, however, a genuine experiment, carried out by psychologist Milton Rokeach in the 1950s, and written up in the sadly out-of-print book The Three Christs of Ypsilanti.

As Rokeach realised years later, the whole setup was entirely unethical and thankfully we have moved beyond manipulating patients’ lives for academic curiosity, but it remains a fascinating chapter in psychiatric history and I tried to capture the essence of it in the Slate piece.

These tales are surprising because delusions, in the medical sense, are not simply a case of being mistaken. They are considered to be pathological beliefs, reflecting a warped or broken understanding that is not, by definition, amenable to being reshaped by reality. One of most striking examples is the Cotard delusion, under which a patient believes she is dead; surely there can be no clearer demonstration that simple and constant contradiction offers no lasting remedy. Rokeach, aware of this, did not expect a miraculous cure. Instead, he was drawing a parallel between the baseless nature of delusion and the flimsy foundations we use to construct our own identities. If tomorrow everyone treats me as if I have an electronic device in my head, there are ways and means I could use to demonstrate they are wrong and establish the facts of the matter‚Äîa visit to the hospital perhaps. But what if everyone treats me as if my core self were fundamentally different than I believed it to be? Let’s say they thought I was an undercover agent‚Äîwhat could I show them to prove otherwise? From my perspective, the best evidence is the strength of my conviction. My belief is my identity.

Link to Slate article ‘Jesus, Jesus, Jesus’.

A 1999 article about ‘Mental disorder among the Incas in ancient Peru’ in the History of Psychiatry journal has a listing of mental illness recognised by the Inca empire.

The name on the left is in Ancient Quechua, the language of the Incas, and the translation is on the right.

Chayapu oncuy – Frenzy, madness
Chayapuy – Frenzy, madness
Chayapuyniyoc – Frenetic
Chayapuyok urek – Lunatic
Cupaypa yaucusccan – Possessed by the devil
Haucha utek – Furious fool
Llakiy – Addiction, sadness, anxiety
Manchay Ilakllay – Fear
Manchay utek – Furious fool
Muzpaycachak – Fool madman
Poqques – Innocent fool who knows nothing
Pputirayay huaccanayay vnccoy – Melancholy
Putirayay – Melancholy
Putiy – Sadness
Soncconnak – Fool without common sense
Utek chanak – Madman
Utek chanaynin – Insanity
Utek cay – Insanity
Utek – Fool or madman without common sense

Interestingly, the translation is only approximate, not because the original terms were necessarily hard to understand but because we no longer know the meaning of the Spanish words which they were translated into.

Apparently, the the conquistadores had their own vocabulary for mental disorder which has now been lost to time.

However, it seems the Ancient Incas not only had a complex classification system but they also had a wide range of psychoactive plants which they used to try and treat mental problems.

Clearly there are some conditions mentioned that we wouldn’t recognise today but as soon as someone on the DSM committee gets hold of the article you can assured they’ll be proposed for the next edition. Probably alongside an academic article telling us that the condition is poorly recognised and woefully under-diagnosed.

I discovered the article via the excellent Spanish-language psychiatry blog Desde El Manicomio which also comes highly recommended.

Link to PubMed entry for Inca article.
Link to Desde El Manicomio.

I just watched a thought-provoking BBC documentary called Mental: A History of the Madhouse which follows the history of British psychiatric treatment in the 20th century from the monolithic mental hospitals inherited from the 1800s to the development of ‘care in the community’ at the end of the century.

If you’re based in the UK you can watch it on the BBC’s streaming service but I also notice that it has appeared on various public torrent servers. *cough*

It’s definitely a dissenters look at history as the professional commentators, such as psychiatrist Joanne Moncrieff and psychologist Rachel Perkins, hail from the most critical end of mental health.

It’s probably true to say that 20th century psychiatry was not exactly a litany of success stories, although it would have been useful to hear some of the more positive angles as well.

However, I was interested to hear that one of the major figures in the removal of the old mental hospitals was conservative politician Enoch Powell who secured his place in history with his rabidly anti-immigration 1968 ‘Rivers of Blood’ speech (synopsis: ‘we fought the war and now there are darkies everywhere!’).

Years earlier, however, he gave a speech that cemented his determination to dismantle the old hospital system and he didn’t mince words.

They imply nothing less than the elimination of by far the greater part of this country’s mental hospitals as they exist today. This is a colossal undertaking, not so much in the new physical provision which it involves, as in the sheer inertia of mind and matter which it requires to be overcome. There they stand, isolated, majestic, imperious, brooded over by the gigantic water-tower and chimney combined, rising unmistakable and daunting out of the countryside – the asylums which our forefathers built with such immense solidity to express the notions of their day. Do not for a moment underestimate their powers of resistance to our assault. Let me describe some of the defences which we have to storm…

The speech reads very strangely today as it was clearly the beginning of huge reforms while openly talking about ‘sub-normals’.

The documentary is well worth checking out. It largely focuses on the story of one hospital, High Royds, in West Yorkshire.

Interestingly, the hospital has had two rock tributes to it. The Kaiser Chief’s song ‘Highroyds’ and Kasabian’s album named ‘West Ryder Pauper Lunatic Asylum’, riffing on its original name.

Link to info about the documentary.

Medical journal Neuropsychological Rehabilitation has a fascinating article on Phineas Gage’s years after his dramatic injury, updating previous accounts and suggesting he made a remarkable recovery after his initial change in character.

The piece is co-authored by Malcolm Macmillan, author of the definitive Gage book An Odd Kind of Fame and can contains many important updates and corrections on the story since the biography was released.

Unfortunately, the article is locked behind a $30 paywall (harsh, bit it keeps the plebs out) which is a pity as it carefully dsicusses Gage’s post-injury life and notes that while he seemed to have a marked change in character and behaviour shortly after the tamping iron was blown through his frontal lobes, in the long-term, he seemed to recover very well.

Reviewing Phineas’ post-accident history we note:

1. He resumes work on the family farm within four months of the accident, and seeks his old job as foreman within another four.

2. He adapts within two or three years to the vocation of “exhibiting”, possibly managing his appearances, advertising, and travel independently, and probably re-learning lost social skills.

3. He works for Currier during 1851-1852, where he possibly learns stagecoach driving and builds on his social re-learning.

4. He is settled and reliable enough in his behaviour for an employer to take him to Chile as a coach driver.

5. He works in Chile for 7 years in a highly structured occupation (possibly for just one employer) where he adapts to the language and customs, and uses the complex psychological and cognitive-motor skills required by his job.

6. Eventually his mental faculties are such that a doctor who had known him well sees “no impairment whatever” in them.

7. He is “anxious to work” after recovering from illness in San Francisco, and finds farm employment.

8. He continues to work even after his first seizure. Only now does he become unsettled and dissatisfied with a succession of employers.

We see in all of this how consistently Phineas sought to readapt.

On this summary, Phineas Gage made a surprisingly good psycho-social adaptation: he worked and supported himself throughout his post-accident life; his work as a stage-coach driver was in a highly structured environment in which clear sequences of tasks were required of him; within that environment contingencies requiring foresight and planning arose daily; and medical evidence points to his being mentally unimpaired not later than the last years of his life. Although that Phineas may not have been the Gage he once had been, he seems to have come much closer to being so than is commonly believed.

By the way, did you know a second photo of Gage has been uncovered. You can see it above. Apparently after the publicity surrounding the first the Gage family of Texas found this one in their family collection.

UPDATE: Thanks to Avicenna for noting that the full text of the article is available online here.

Link to PubMed entry for Neuropsychological Rehabilitation article.
Link to awesome Wikipedia article on Gage.

The Edwin Smith papyrus is one of the oldest medical texts in the world and is an Ancient Egyptian treatise on surgery, particularly after head injuries. In contains perhaps the first ever recognition that a part of the brain can be linked to a specific function as it describes how someone can be left ‘speechless’ after a penetrating wound to their temple.

The Egyptian tourist board has put the full translation of the document online. It seems to be taken directly from the 1920s translation of James Breasted so the language is a little arcane but case twenty is the one we’re most interested in:

Case Twenty: Instructions concerning a wound in his temple, penetrating to the bone, (and) perforating his temporal bone.

Examination: If thou examinest a man having a wound in his temple, penetrating to the bone, (and) perforating his temporal bone, while his two eyes are blood shot, he discharges blood from both his nostrils, and a little drops; if thou puttest thy fingers on the mouth of that wound (and) he shudder exceedingly; if thou ask of him concerning his malady and he speak not to thee; while copious tears fall from both his eyes, so that he thrusts his hand often to his face that he may wipe both his eyes with the back of his hand as a child does, and knows not that he does so…

Diagnosis: Thou shouldst say concerning him: “One having a wound in his temple, penetrating to the bone, (and) perforating his temporal bone; while he discharges blood from both his nostrils, he suffers with stiffness in his neck, (and) he is speechless. An ailment not to be treated.”

Treatment: Now when thou findest that man speechless, his [relief] shall be sitting; soften his head with grease, (and) pour [milk] into both his ears.

I’m not sure if I’d be too pleased to wake up after a serious brain injury to find someone pouring milk in my ears, but then again, I’m not an Ancient Egyptian.

However, the case seems to be a clear case of a type of speech impairment, aphasia, caused by damage to the temporal lobe.

If you’re interested in some background on the discovery and significance of the papyrus, one of the most important in the history of medicine, there’s an excellent article from a previous incarnation of Neurophilosophy that you shouldn’t miss.

Link to Wikipedia on the Edwin Smith papyrus.
Link to complete translation.
Link to Neurophilosophy on the papyrus.

Sex Madness was a curious 1938 sexploitation film that claimed to warn of the dangers of syphilis but was really an excuse to show risqué sex scenes that would have otherwise been banned by the film censors of the time.

As you might expect, watching the film now it seems remarkable that anyone would see anything in it worth censoring, but the concern about ‘sex madness’ was not entirely fictional.

Untreated syphilis typically leads to neurosyphilis where the disease attacks the nervous system and leads to dementia and madness.

It has been with us for possibly thousands of years and there is a rule of thumb that for any famous figure who died ‘mad’ before the 1950s someone will have suggested they died of syphilis.

However, it was truly a nasty way to go and a genuine danger considering that the first safe and effective antiobiotic treatments were not widely available until after World War Two.

For a long time before then, the most effective treatment was to be infected by malaria which would give you a fever so strong that the syphilis bacteria would die in your body due to the high temperature. The hope was that the malaria could be treated by quinine before you died from that. The discovery won Julius Wagner-Jauregg the Nobel prize in 1927.

So when the ‘sex madness’ film was made there was a genuine need to warn people about syphilis although the ‘madness’ angle gave the producers an excuse to show people acting ‘crazily’ and going ‘wild’ while melodramatising the effects of syphilis and ‘immoral behaviour’.

The whole film is now in the public domain and it is remarkable as a historical document, for the appalling acting and for its awesome film poster.

Link to ‘Sex Madness’ on YouTube.
Link to ‘Sex Madness’ on archive.org

The UK’s Science Museum has a special online exhibit about the history of mental health and illness that is packed full of fascinating photos and stories.

This rather unpleasant photo from the ‘mental institutions’ section particularly caught my eye. It is labelled “Elderly man in restraint chair, from a series of photographs taken of patients at West Riding Lunatic Asylum, Yorkshire, c. 1869.”

It’s interesting because it bears an interesting resemblance to a famous picture of James Norris, an ‘insane’ US marine who was found by the press to be permanently restrained in Bethlem Royal Hospital (the ‘Bedlam’ asylum) in 1814.

His condition so outraged the public that it was instrumental in a number of reforms to ‘madhouses’ including the 1828 Madhouses Act and the 1845 Lunacy Act.

However, the photo of the elderly gentleman is dated 1869, after both reforms, suggesting that this was either a temporary measure to restrain ‘unruly’ patients, or that the London-centric reforms just didn’t have much effect in the distant provinces of the United Kingdom.

On an unrelated point, the man is described as being a patient at ‘West Riding Lunatic Asylum’ the short name of the ‘West Riding Pauper Lunatic Asylum’.

British rock band Kasabian recently named their award winning album after the hospital but managed to mangle the name, entitling it ‘West Ryder Pauper Lunatic Asylum’.

Link to Science Museum mental health exhibit (via BPSRD).

As well being one of the most influential neurologists in the history of medicine, Georges Gilles de la Tourette, led a very colourful life.

The journal Clinical Neurology and Neurosurgery has an engaging article about his work on hypnotism and how he became involved in a debate over the possible criminal uses of hypnotism.

At one point, he took part in a celebrated trial where a murderer claimed she had been hypnotised to commit the crime, but most strikingly Gilles de la Tourette was shot in the head by a likely-psychotic patient who claimed he was ‘hypnotising her from a distance’.

The event was so striking it made the front page Le Pays Illustré.

On 6 December, 1893, at 18:45, at Gilles de la Tourette’s domicile, 39 rue de l‚ÄôUniversit√©, a young woman asked for him, and since he was not back from the hospital, she said she would wait for him. When he arrived fifteen minutes later, she immediately followed him and told that she had been hypnotized many times, being now without resources and asking for 50 francs. He vaguely remembered to have seen her (and indeed she had participated to several hypnotism sessions), and told her to give her name and address. Since she asked for money again, he went to the door, when he heard a shot and felt a violent shock in the back of the head.

Two new shots followed, but he could leave the room, feeling blood pouring down to his neck. This story was shortly reported in Le Progr√®s M√©dical by Georges Guinon, who arrived a few minutes later, and saw the woman quietly sitting in the waiting room, apparently satisfied. Guinon’s article was published with the purpose to stop the already spreading rumors of an assault perpetrated under hypnosis, since this would have been a major challenge to the La Salp√™tri√®re school theories that no crime could ever be accomplished during a hypnotic state.

The wound was not severe, and the same evening, Gilles de la Tourette was able to write to his friend the journalist Georges Montorgueil: “What a strange story”. Previous mentions of the event inaccurately reported that it led to a famous trial, while there was no trial at all. The woman, named Rose Kamper (born Lecoq, on 23 June, 1864, in Poissy) indeed was recognized to be insane. She had already spent time at the Sainte-Anne asylum, and was known to have written threatening letters to the administrator of the École Polytechnique Mr. Rochas. She later told that she suspected Gilles de la Tourette to be in love with her, but also that she had been hypnotized without her consent, with the consequence that her will had been annihilated.

She reported that she had been hypnotized “at distance”, and that there was another person in her, who had pushed her to shoot. She was examined by Brouardel, Ballet and Jules Falret, who concluded to what nowadays corresponds to paranoid schizophrenia, so that she was sent back to Sainte-Anne and other hospitals, from which she was intermittently released. Interestingly enough, a couple of days before the assassination attempt, Gilles de la Tourette and Montorgueil had published an article in L’Éclair on hypnotism contesting the Nancy school.

Gilles de la Tourette lived on for more than a decade after being shot although towards the end of the century his behaviour started to become a little bizarre.

In 1899 he published a famous article on recognising and treating the neurological effects of syphilis but when writing the paper he noticed the symptoms in himself, realised he had neurosyphilis and became profoundly depressed.

He was forced to leave his job in 1901 owing to his increasingly delusional behaviour and was admitted to the Lausanne Psychiatric Hospital in Switzerland when he eventually died in 1904.

Link to PubMed entry for article on Gilles de la Tourette.

RadioLab discusses how the final novels of Agatha Christie subtly reflected the early stages of dementia as her written vocabulary and her ability to use the nuances of language slowly began to diminish.

The discussion is based on a linguistic analysis of her books by English professor Ian Lancashire who found in his study [pdf] that the range of vocabulary in her final works markedly declined and her use of indefinite words (like ‘something’ or ‘anything’) greatly increased, indicating that her striking ability to manipulate the English language was fading as she began to develop dementia.

This is not the first analysis that has looked at the literary output of a great author as she declined. A 2005 study analysed the text of three Iris Murdoch books, who famously lost her literary abilities as Alzheimer’s disease began to take hold, and found a similar pattern in her later writing.

In the case of Murdoch, and probably in the case of Christie, both of these analyses were on books completed before the authors were diagnosed with the condition (although we don’t know if Christie was ever formally diagnosed owing to the secrecy of her family).

In fact, we know that this is a common pattern, in that years before people get diagnosed with Alzheimer’s disease there is a slow but steady decline of mental function that is a little beyond what we would expect from normal ageing but not so severe that it is clear the person has the condition.

The RadioLab programme also discusses the well-known ‘Nun Study‘ project which has studied the relationship between biological and life-style factors and the risk of getting Alzheimer’s disease in a group of nuns.

In one of the studies from the project, the researchers found a link between getting Alzheimer’s and the linguistic skills of the nuns that they demonstrated in an essay they wrote when they first entered the convent as young women – those who wrote the more complex essays were less likely to develop the dementia later in life.

This reflects an idea in dementia research known as the ‘cognitive reserve‘ which suggests that your mental ability is a bit like a fuel tank and when wear-and-tear on the brain drags your ability below a critical point in later life, you start going into the rapid decline of dementia.

Those with more mental ability are therefore more resistant (although not immune) to dementia. While level of education has been consistently linked to protection against dementia, it could just be that those who have more natural mental capacity study more, but there is some recent research that suggests education may help ‘top up’ the cognitive reserve fuel tank to help protect against the disease.

Link to RadioLab piece ‘Vanishing Words’.

The journal Memory has a remarkable case study of a man who began memorising the whole of John Milton’s epic poem Paradise Lost at the age of 58. The researchers tested him at age 74 and found they could pick any part of the 10,565 line poem and he could successfully remember the next 10 lines.

JB is an active, articulate septuagenarian who began memorising Paradise Lost at the age of 58 in 1993 as a form of mental activity to accompany his physical exercise at the gym. Although he had memorised various poems in earlier years, he never attempted anything of this magnitude. JB stated that he wanted to do something special to commemorate the then-upcoming millennium. ‚ÄúWhy not something really challenging like, oh, ‘Paradise Lost’?‚Äù he said. He began by walking on a treadmill one day while trying to memorise the opening lines of the poem. After those lines were committed to memory, he extended the task over successive sessions to see how far he could go. JB, who regards himself as a theatre person, reflected on this process this way:

“The real challenge was just not to memorise it, but to know it deeply enough to really tell Milton’s story. As I finished each book, I began to perform it and keep it alive in repertory while committing the next one to memory. ‚Ķ The goal eventually became not just a series of performances, but to do all twelve books on the same occasion.”

Nine years later, JB achieved his goal. He recited Paradise Lost in its entirety over a 3-day weekend. Since that 2001 performance JB has given numerous public recitations, although for many of these performances, due to the time it takes to recite the poem (approximately 3 hours for Books I and II), he limits his performance to several books, rather than all of the books in their entirety. Typically, he moves and expresses emotion during a performance to help signify changes in characters, and he gives copies of the poem to the audience so that they can follow his memorised recitation.

Psychologist John Seamon discovered JB after attending one of his performances where he recited the whole of Books I and II from memory.

Seamon and his team asked JB to take part in tests regarding the epic work where they cued him with two lines selected from anywhere in the poem and asked him to recall the following 10 lines. In one part they picked out lines as they went through the books in order, in another they just chose books at random.

He seemed to stumble on a couple of books when they were tackled sequentially, but generally his verbatim recall was generally above 90% and seemed more consistent when the books were picked out randomly. The team also video-taped one of his live performances and found his average accuracy was between 97% and 98%.

Although not formally tested, JB’s everyday memory is apparently normal for his age, with his exceptional memory for Milton’s poem apparently arising from his relentless practice and dedication.

This is a common pattern in mental practice or ‘brain training’ style scenarios where we get better at the tasks we repeat but that improvement doesn’t seem to carry over very effectively into other areas of mental life.

If you’re interested in seeing JB in action he has his own webpage, mentioned in the scientific article, where he advertises his performances and where you can watch video of him reciting the poem.

Link to PubMed entry for case study.
Link to JB’s website.

The latest All in the Mind from ABC Radio National has a fascinating discussion about how the definition of schizophrenia shifted throughout the 20th century in the USA as it morphed from being a disease of the withdrawn middle class female to being the affliction of the aggressive black man.

The program is an interview with psychiatrist Jonathan Metzl who discusses his new book The Protest Psychosis: How Schizophrenia Became a Black Disease.

Unfortunately, discussions about mental illness and race can quickly starting going round in circles. As we’ve discussed previously, the fact that an ethnic minority has higher rates of mental illness, does not, in itself, provide strong evidence that the mental health system is racist – as this could easily be a reflection of poverty or immigration, both of which have been shown to have been linked to mental illness independently of the skin colour of the peoples concerned.

However, Metzl’s critique is somewhat more subtle and he suggests that in mid-20th century America there were attempts, implicit or otherwise, to pathologise the civil rights movement by shifting the diagnosis for certain conditions – most notably, schizophrenia.

In fact, in 1968, an article in the Archives of General Psychiatry even proposed what was called ‘protest psychosis’, “a special type of reactive psychosis” that affected “American Negroes” which was caused by “the stress of asserting civil rights in the United States”.

At the time, the excessive and ad hoc use of the diagnosis of schizophrenia in the USA led to the famous ‘US-UK Diagnostic Study‘ where the States was brought in line with the standards and definitions used in Europe.

By the way, if you’re a regular All in the Mind listener don’t miss the extra audio that turns up on the blog. Sadly, you can’t download the extra audio directly because it is embedded in a playing widget, but if you mouseover or ‘View source’ you can see the whole URL for the extra mp3s and download by pasting this into your browser.

Link to AITM on ‘protest psychosis’.

I’ve just discovered the powerful story of the German psychiatrist Alice Ricciardi-von Platen. She refused to take part in the growing eugenics movement in the 1930s Germany that targeted people with mental illness for sterilisation and euthanasia, resisted the Nazi party and wrote a book documenting Nazi medical abuses of psychiatric patients after being asked to observe the Doctors Trial at Nuremberg.

As a result, she was ostracised from the German medical community and her book was repressed. It wasn’t rediscovered by German historians until thirty years after it was published in 1948.

Afterwards she became highly respected for her work developing group therapy and worked in Britain and Italy right into her late nineties.

There is surprisingly little about her online or in the academic literature although she received two glowing obituaries in the British press when she died in 2008.

We like to think that each of us would stand up to human rights abuses even if everyone else around us was involved but we know from countless social psychology experiments that it is an incredibly difficult thing to do. Consequently, I always have immense admiration for people like Ricciardi-von Platen who did so in the most difficult of circumstances.

We also like to think that the Nuremberg trials put an end to the political abuse of psychiatry but a recent article in Schizophrenia Bulletin tracked the history of these abusive practices noting that they have been regularly used throughout the 20th century and into the 21st.

From the Soviet use of sluggishly progressing schizophrenia to silence dissidents, to the Nazi’s incorporation of psychiatry into eugenics, to psychiatrists’ collaboration with torture during dictatorial regimes in Latin America, to China’s use of psychiatric hospitals to persecute Falun Gong members and to the collaboration with ‘war on terror’ torture in the US (albeit in the light of outright condemnation from the American Psychiatric Association).

Sadly, psychiatry has been co-opted many times over as a tool of oppression. Complacency is the enabler of these abuses and people like Alice Ricciardi-von Platen are a reminder that even the most powerful forces can be resisted.

Link to obituary from The Times.
Link to obituary from The Guardian.

I’ve just discovered the joy of searching Flickr for photos of psychiatric ward corridors which turns up some amazing images of hospitals past and present, and photos of institutions that are slowly, and sometimes beautifully, decaying.

The great numbers of abandoned hospitals are mostly due to the shutting down of the old monolithic psychiatric hospitals in the second half of the 20th century.

As the buildings were often built as large permanent structures, often with great architectural finesse, many are difficult to knock down or sell, and so have just remained to fade away. Needless to say, they’ve become a regular destination for urban explorers.

There are many striking photos to check out, but there’s one interesting historical shot. It’s a photo of the main corridor in the now closed down Friern Barnet psychiatric hospital on the edges of North London.

The place was built in 1853 and was originally called the Colney Hatch Lunatic Asylum and the building had, so they say, the longest corridor in Europe, which is captured in the image.

As with many institutions of the time, the building, at least on the outside, was very beautiful. It has now been converted into ultra luxury flats called Princess Park Manor, which, as you can see, has a swish website to match.

So swish, it seems, that despite lauding the architectural heritage the building, it neglects to mention that it used to be one of London’s biggest asylums.

Link to photo of psychiatric hospital corridors.

It’s not often that historians are described as kicking ass, but the latest issue of the The Lancet has a barnstorming piece by Andrew Scull that gives an uncompromising history of psychiatry from the mad house to Big Pharma.

It must be said that the article is oriented more toward American psychiatry. Although similar influences have been present in European psychiatry, it has been much less subject to, shall we say, the mood swings that have tended to pull the American psychiatric community from one extreme to the other over the last century.

Nonetheless, it is a rollicking read from one of the most respected historians in the field. This is where Scull discusses the rise of neurobiology:

The US National Institute of Mental Health proclaimed the 1990s “the decade of the brain”. A simplistic biological reductionism increasingly ruled the psychiatric roost. Patients and their families learned to attribute mental illness to faulty brain biochemistry, defects of dopamine, or a shortage of seratonin. It was biobabble as deeply misleading and unscientific as the psychobabble it replaced, but as marketing copy it was priceless. Meantime, the psychiatric profession was seduced and bought off with boatloads of research funding. Where once shrinks had been the most marginal of medical men, existing in a twilight zone on the margins of professional respectability, now they were the darlings of medical school deans, the millions upon millions of their grants and indirect cost recoveries helping to finance the expansion of the medical-industrial complex.

One of the best articles on the history of psychiatry I’ve read for a very long time. No stone is left unscorned.

Link to Lancet article ‘A psychiatric revolution’.
Link to PubMed entry for same.

There is a long-standing myth that before the Enlightenment, all the experiences and behaviours we would now classify as madness were thought to be due to demonic possession.

This idea has been comprehensively debunked and it is now clear that both of these concepts have run side-by-side and medieval courts often went to great lengths to try and distinguish the two ‘states’.

I’ve just read a fascinating article about ‘Demonology, Neurology, and Medicine in Edwardian Britain’ from the Bulletin of the History of Medicine that showed that this tendency continued well into the modern age.

Evangelical demonologists, some of them qualified doctors, incorporated medical advances into their theories – even using the dramatic discoveries of the ‘father of neurology’, John Hughlings Jackson, as a way of better ‘explaining’ our susceptibility to malign influence:

The Jacksonian hierarchy of higher conscious levels, the sensory midbrain, and the lower reflex centers was mapped onto the Pauline division between spirit, soul, and flesh and the psychological division between the supraliminal, the subliminal, and the body (cf. 1 Thess. 5:23 and Heb. 4:12). As Penn-Lewis argued, the lower nervous centers of the midbrain and the medulla could be seen as corresponding to habit and nature, “the law of the organs,” which frustrated man’s attempt to serve God.

This association of the soul with unconscious animal instincts revealed its vulnerability to the possibility of demonic infection. Indeed, many late-Victorian authors had argued that the newly discovered subconscious or unconscious mind provided the perfect medium for demonic activity: connected in psychology and literature to dreams, instincts, passions, and madness, it was seen as a gaping wound in the human personality through which invasive agents could undermine their hosts. Certainly many demonologists believed that invading spirits possessed a natural appetite for nervous tissue as they sought to recapture the nourishing somatic form they had lost.

This is a common pattern, of course. Carl Sagan’s book famously described science as “a Candle in the Dark” against a “Demon-Haunted World” but less attention is paid to the fact that every new illumination casts a whole new set of shadows for people to misinterpret.

Link to PubMed entry for demonology and neurology article.

Childhood amnesia is the phenomenon where we are generally unable to remember the earliest years of childhood. This is often assumed to be purely because the brain is too underdeveloped to successfully store and organise memories but an interesting study from 2000 reported that the extent of childhood amnesia differs between cultures and sexes.

Cross-cultural and gender differences in childhood amnesia

Memory. 2000 Nov;8(6):365-76.

MacDonald S, Uesiliana K, Hayne H.

In two experiments, we examined cross-cultural and gender differences in adults’ earliest memories. To do this, we asked male and female adults from three cultural backgrounds (New Zealand European, New Zealand Maori, and Asian) to describe and date their earliest personal memory. Consistent with past research, Asian adults reported significantly later memories than European adults, however this effect was due exclusively to the extremely late memories reported by Asian females. Maori adults, whose traditional culture includes a strong emphasis on the past, reported significantly earlier memories than adults from the other two cultural groups. Across all three cultures, the memories reported by women contained more information than the memories reported by men. These findings support the view that the age and content of our earliest memories are influenced by a wide range of factors including our culture and our gender. These factors must be incorporated into any comprehensive theory of autobiographical memory.

This doesn’t mean that brain development plays no role, of course, but it raises the question of how many of the things we recall from childhood are influenced by culture.

For example, memories that seem genuinely to be from the early years may appear that way due to us being brought up with the retelling of family stories or from seeing photographs and subsequently absorbing them as our own memories thanks to source amnesia.

It could be that this form of social remembering differs between cultures or is influenced by the sex of the child which may encourage people to report earlier or later memories, or alternatively, may actually strengthen genuine memories as they are re-told during our early years.

pdf of full text of culture and childhood amnesia study.
Link to PubMed entry for same.