Kraepelin's psychiatry in the pragmatic age.

Abstract

The movement of a pendulum is often used as a metaphor to represent the history of twentieth century American psychiatry. On this view, American psychiatry evolved by swinging back and forth between two schools of thought in constant competition: somatic accounts of mental illness and psychodynamic ones. I argue that this narrative partly misrepresents the actual development of American psychiatry. I suggest that there were some important exchanges of ideas and practices in the transition from German biological approaches to American psychodynamic approaches. In particular, two kinds of pragmatism played an important role in this transition: Kraepelin's methodological pragmatism, and pragmatic values present in the American psychiatric context, due in part to the influence of William James. From a historical standpoint, I suggest that the metaphor of the pendulum doesn't capture the full complexities of this shift in psychiatry at the turn of the century; from a philosophical standpoint, my discussion brings to light two strands of pragmatism salient to scientific psychiatry.