Roy W. Menninger – American Psychiatry After World War II, 1944-1994

Автор: Roy W. Menninger
Название книги: American Psychiatry After World War II, 1944-1994
Формат: PDF
Жанр: Психология
Страницы: 679
Качество: Изначально компьютерное, E-book

A project of this size is possible only with the help of a great many people,
chief among whom, of course, have been the contributors themselves. They
have variously tolerated repeated requests for clarification, successive manuscript
reviews, nit-picking syntactical queries, and “arbitrary” sentence revision
and deletion. But perhaps most taxing of all, they have endured a long
gestational process that generated understandable fears that this project
would be stillborn, never to see the light of day.We salute their steadfast commitment
to the task and the quality of the work they brought to the endeavor.
That this book is finally published also reflects the dedicated help of some
invaluable souls. First among them have been our editorial colleagues, Mary
Ann Clifft (Director of Scientific Publications, Menninger Clinic) and Phil
Beard (Managing Editor, the Bulletin ofthe Menninger Clinic). Through the
dark of night and the fog of professional obfuscation, with inspired acts of
editorial surgery, they have accomplished wonders. They meticulously
reviewed virtually every word, every line, every citation, every reference for
accuracy, literacy, and especially clarity. There can be few authors or editors
who have had such conscientious support. Without them, this book indeed
might never have appeared.
Directly supporting their work have been the talented and perspicacious
staff members of the Menninger Clinic Professional Library: Mary Austin,
Alice Brand Bartlett, Lois Bogia, Nancy Bower, Andi Burgett, Krista Comly,
Judy Kash, and Linda Nelson. No citation or reference proved too obscure,
too scanty, or too old to escape their vigilant attention. Their willingness to
respond to repeated requests for yet another literature search was itself an
inspiration. Of particular assistance as well was Paul Arrigo, the reference
coordinator and government documents librarian at the Washburn University
School of Law Library, whose familiarity with the legal literature proved
invaluable.
Bringing this work to fruition would certainly not have been possible
without the expertise, encouragement, patience, and support of the editorial
staff of the American Psychiatric Press, Inc., from Carol Nadelson to Claire
Reinburg to Pam Harley, as well as many others who labored to ensure its
completion.
Lastly, Rosemary Hall Evans warrants a special tribute of appreciation for
her bounteous New England hospitality, an encouragement that nourished the
muse during several long periods of this protracted “work in progress.”
We gratefully acknowledge that publication of American Psychiatry After
World War II was made possible in part through a grant from the American
Psychiatric Foundation.
History plays a signal role in the clinical work of psychiatrists. Attending to a
patient’s presenting complaints brings hints and reminders that the current
symptoms are expressions of events that have gone before, often a long time
before. For this reason, few clinicians undertake treatment without an initial
scrutiny of the patient’s history. For some clinicians, such an examination may
be a perfunctory review of behavioral change or symptom appearance and
evolution. More experienced clinicians, however, regularly undertake extended
study of their patients’ life stories: their earliest experiences, feelings,
and memories; descriptions of their parents, siblings, and relationships among
them; their educational, social, and work history—in short, a comprehensive
longitudinal survey of the patient’s life. For most practitioners, the history of
the patient’s problems or illness is an essential ingredient for an adequate
understanding of the origin and evolution of a clinical problem, even as our
understanding of etiology evolves from earlier presumptions of single-agent
causes, from “constitution,” to “biology,” to “psychodynamics,” to “neurobiochemistry,”
to “genetics,” and perhaps ultimately to a grudging recognition
that it is all of the above and more. History—the patterns of events and
related thoughts and feelings—provides the context in which diagnosis and
treatment proceed; history illuminates critical motivations, delayed maturational
issues, and unresolved conflicts. To practice clinical psychiatry without
extensive history taking is to set off on a journey without a map.
The history of the discipline of psychiatry, however, is a different matter.
To many, it seems little more than an accumulation of information that is terribly
outdated or misguided or just plain wrong, only potentially interesting
in a “quaint” way, and, in any case, irrelevant to the fast-paced patterns of
today’s world. The history of the discipline does not seem especially helpful
in the management of clinical problems confronting the average practitioner.
It does not contribute to a better understanding of the diagnostic and therapeutic
options in the field.
Consequently, the history of psychiatry is relegated to a dusty corner of
the intellectual work world of the practicing professional, briefly appearing as
part of a celebratory presentation for the opening of a new building, or the
marking of an institutional anniversary. A few professional training programs
and some thoughtful senior clinicians offer occasional history lectures to
beginning residents in the field, intended to give them some sense of the
antiquity of the problems we address and the complex evolution of treatments
that have emerged. Even this brief exposure to the past is in jeopardy as the
magnitude of information to be taught increases geometrically; history, it is
argued, is no longer useful. Perhaps so, but there remains a strong sense that
recording what we have done and why we did it has value apart from any purported
usefulness