High Society: Drugs, Mental Health, and the History of Psychiatry

Abstract

Psychiatrists and historians used to exist in a state of mutual mistrust and suspicion. Professional historians of a generation ago, much influenced by the radical epistemology of Michel Foucault (1), the sociological critiques of Erving Goffman (2), the countercultural theorizing of RD Laing (3), or the trenchant libertarianism of Thomas Szasz (4), came to portray the entire enterprise of modern psychiatry as a thinly veiled experiment in social control and professional monopolization. French-language scholars such as Robert Castel (5) and Yannick Ripa (6), as well as Anglo-American academics from David Rothman (7) and Andrew Scull (8) to Phyllis Chelser (9) and Elaine Showalter (10), constructed stinging histories of the rise of psychiatry (and its asylums), ripping into almost every aspect of modern psychiatric theory and practice. Psychiatry was attacked, from the left and from the right, by Marxists, feminists, and libertarians alike, as well as from within its own ranks. Little wonder, as Trevor Turner, the distinguished British psychiatrist-historian, remarked, that many psychiatrists retreated from engaging with their own history when it seemed that historians were preoccupied with framing psychiatry as the culprit responsible for most of modern society's social problems (11). In the late 1980s, however, a leading medical historian, Roy Porter (12), and a philosopher-psychiatrist, German Berrios (13), sought a rapprochement by promoting a constructive exchange of scholarship between academic humanists and clinician-researchers (14). Their project was realized in the British-based journal History of Psychiatry (established in 1990). Psychiatric journals such as the London-based Psychological Medicine soon followed suit, integrating historical articles within their pages. This new collaboration between psychiatrists and historians was also aided indirectly by new research in the philosophy of science that tried to break down the simplistic dualism of biological determinism vs social constructionism. In particular, the former University of Toronto scholar Ian Hacking made a particularly thoughtful case for creating a space for dialogue between the 2 camps (15). His work affirms the existence of psychiatric illness in the face of transtemporal diagnostic discordance. It may come as a surprise to many readers that much of the new scholarship in the history of mental health and psychiatry is home-grown, emerging from Canadian universities. Edward Shelter's eminently readable A History of Psychiatry (16) has been become a standard text on the emergence of the mental health professions in the Western world; Geoffrey Reaume's unconventional history of the Toronto Asylum breaks new theoretical ground by rewriting the history of the mental hospital from the perspective of the patients (17). Thierry Nootens' (18) and Marie-Claude Thifault's (19) exploration of familial responses to madness in 19th-century Quebec have opened up as-yet-unexplored vistas onto the history of care of the mentally ill outside the walls of the asylum (18). A new anthology, encompassing the work of both prominent and promising scholars in the field, will soon be published by McGill-Queen's University Press (20). This issue's In Review section seeks to add to this new and innovative research by exploring one small but vitally important corner of the history of psychiatry: the history of drugs and mental health in postwar North American society. In the first article, Andrea Tone, Professor of History and Canada Research Chair in the Social History of Medicine at McGill University, analyzes the rise of (minor) tranquilizers within North American society as a treatment for anxiety (21). She details the changing social and political context that framed and informed the social practice of drug taking. Tone also emphasizes the role that the media and (ultimately) politicians played in encouraging and then stigmatizing the users of the new anxiolytics. …