Captain Brain versus Mister Mind. Une histoire américaine

Abstract

ObjectiveVery often, the brain and the mind are objects of controversy in the world of psychiatry. The history of American psychiatry is instructive in this respect. From an early date, the United States embraced psychoanalysis, invented behaviorism, promoted biological psychiatry, used biometry and produced a highly successful classification of mental disorders. The objective of this paper is the study of this history. MethodThe paper proposes a detailed study of the theories, practices and ideological debates in the field of American psychiatry since the 18th century, and of federal mental health policies. ResultsPsychiatry in the United States has distinctive features linked to the concept of manifest destiny, Protestantism and pragmatism, to the manner in which the nation was constructed (slavery, conquest of the West, economic liberalism) and to the ceaseless wars, from the War of Independence to the Middle Eastern wars, not forgetting the Civil War and two World Wars. As the nation succeeded in integrating its immigrants, it also assimilated their different cultures and their discoveries in the field psychiatry. Many theories and practices that later diffused by globalization were instigated by the nation, among others the DSMs, part of the cultural, scientific, economic and political development of the nation. Lay people were early protagonists in the constructive shifts, conflicts and anti-psychiatry tendencies. DiscussionThis paper examines the growing success of psychoanalysis in the 1950s and the causes behind its loss of influence in the 1970s. It does not attribute this loss to the DSM-III, but to the psychoanalysts themselves. It sets out to demonstrate that the DSM-III and later DSMs did not result in a paradigm shift in the meaning of Thomas Kuhn. ConclusionThe history of American psychiatry proves that there is little chance of seeing an end to the conflicts between advocates of the brain, still poorly understood, and upholders of the mind, often poorly defined, as long as our knowledge in the field of mental disorders remains as slim as it is today.