112 CHAPTER 5 THE PRACTICE OF PSYCHOLOGY AT THE INTERFACE WITH MEDICINE
research on the experimental induction of neu- roses.
As the new field began to develop, philan- thropies took an interest in the work for its perceived potential to help shed light on social order. As we discuss in more detail inChapter 7, because foundation officers were positioned in such a way that they had contact with a range of trends in medicine and related sciences, they were able to bring together investigators and practi- tioners who might not otherwise have connected with one another. The Josiah Macy Founda- tion did just this in the mid-1930s when it sponsored conferences on ‘‘Problems of Neu- rotic Behavior’’ in New York City. Physicians who were oriented to psychoanalytic and psy- chosomatic approaches attended, along with psychologists, internists, physiologists, and sev- eral other disciplines to formulate a systematic approach to the problems exemplified by psy- chosomatic medicine. The immediate result of the conferences and the collaboration was the establishment of a new journal, called Psycho- somatic Medicine, which began publishing in 1939, with many contributions from psycholo- gists. The field of psychosomatic medicine grew rapidly during the 1940s and was an important source of theory and research for many years. It served as the foundation for the later develop- ment of the specialty of health psychology.
PSYCHOANALYSIS OUTSIDE
SUMMARY 113
wife’s ‘‘devotion to their son, and his rage about the son’s access to the female object of desire’’
(Hartnack, 1990, p. 940). As Bose wrote to Freud, I do not deny the importance of the castra- tion threat in European cases; my argument is that the threat owes its efficiency to its connection with the wish to be female. The real struggle lies between desire to be a male and its opposite the desire to be a female.
My Indian patients do not exhibit castration symptoms to such a marked degree as my European cases. The desire to be a female is more easily unearthed in Indian male patients than in European. The Oedipus mother is very often a combined parental image and this is fact of great importance. I have rea- son to believe that much of the motivation of maternal deity is traceable to this source.
(cited in Hartnack, 1990, p. 946)
Bose nurtured the development of Indian psychoanalysis until his death; for many years, the meetings of the Psychoanalytical Society were held in his home inCalcutta. His correspondence with Western leaders was important, but Bose did not let those relationships inhibit his own theorizing and the development of a distinctive Indian psychoanalysis. Through his influence and the many people he trained, psychoanalysis remained strong in India, with such critical figures in the postwar era as Sudhir Kakar (b. 1938) and Ashis Nandy (b. 1937).
Psychoanalysis in Argentina
Psychoanalysis as a body of theory and practice eventually spread around the world. In each
place, just as we saw in India and the United States, it was modified to fit the culture and the times. After World War II, psychoanalysis diversified into many distinctive expressions. In North America and much of Europe, the two decades after the Second World War marked the pinnacle of the popularity of psychoanalysis.
In most countries, psychoanalysis declined in popularity after 1965, although it has remained an important source of theory in many scholarly fields.
The one exception is Argentina; psycho- analysis has remained the dominant theoretical approach in psychology there. Psychoanalysis gained a following in Argentina in the 1920s and 1930s, when a small group of mental health professionals incorporated psychoanalytic approaches into their clinical work. On a the- oretical level, serious attempts were made to integrate Marxist principles with psychoanal- ysis, much as had been done by such Euro- pean analysts as Wilhelm Reich. However, this attempted integration failed in the later 1930s as the negative pronouncements against Freud and psychoanalysis by Josef Stalin and other Soviet thinkers turned many would-be analysts away.
In the 1940s, a new movement arose that saw psychoanalysis as a way to subvert the mainstream approach and undermine the fascist government. This was also a period when many Jewish analysts fled Germany and Austria to avoid the Nazis. Several of these ´emigr´e analysts ended up in Argentina, where they had a modest influence on the further development of psychoanalysis.
SUMMARY
Psychological thought and practices have had a place in medicine since the early modern period.
As concepts of mental disorders changed with
the advent of Enlightenment ideas, the notion that madness may be due to loss of reason brought a new focus on the mind. Psychological
114 CHAPTER 5 THE PRACTICE OF PSYCHOLOGY AT THE INTERFACE WITH MEDICINE
principles were developed that could, it was hoped, bring not only explanation but also successful therapeutic interventions.
The initial success of such interventions, for example, moral management, seemed to only prepare the way for later disappointment and disillusionment with mental medicine. The sense of failure in understanding and treating mental disorders by the end of the 19th century can be characterized as therapeutic nihilism. In such an atmosphere, an opportunity arose for a new psychological approach. The theory and techniques developed by Freud were received by a significant number of the members of the mental health profession as it existed at the time.
The reception of Freud’s ideas by both pro- fessionals and the public had far-reaching conse- quences. Freud, a figure of the Enlightenment, used reason to show that there were limits to rea- son, and in doing so, he highlighted the critical
importance of the irrational in human moti- vation. His work also introduced the powerful concept of a dynamic unconscious that gives shape to everyday actions and reactions. This notion contributed substantially to the rise of a psychotherapeutic ethos that continues to this day. Rather than measure the truth claims of psychoanalysis against the metric of laboratory science, it is perhaps more important to recognize that Freud’s theories gave people of the 20th cen- tury a language and a conceptual framework for understanding and describing the human con- dition. In this sense, Freud’s work deepened the psychological sensibility of humans in ways that psychological experiments in the laboratory could never accomplish. Freud also gave the 20th century a framework for self-exploration and a language with which people could describe their inner lives. It was his work, it is fair to say, that made the 20th century, and our own time, the age of psychology.
BIBLIOGRAPHIC ESSAY
An abundance of first-rate scholarship is avail- able for the topics covered in this chapter. Roy Porter’s Social History of Madness (1989) gives an excellent account of madness in the Enlight- enment and the failure of therapeutic regimes devoted to it. Nancy Tomes’s fine volume on Thomas Kirkbride,A Generous Confidence(1984) offers key insights into the American use of moral treatment. Mental Illness and American Society, 1875–1940by Gerald Grob (1983) pro- vides a well-researched analysis of efforts to develop a sustainable approach to caring for the seriously mental ill and why those efforts failed.
The literature on Freud is vast. Once again, Roger Smith’s (1997) essay on Freud in his Norton History of the Human Sciences provided our point of departure. Ray Fancher’s essay in the Companion to the History of Modern Science
(1990) was most helpful. We also relied on Peter Gay’s Freud (1988) and Nathan Hale’s Freud and the Americans (1971). On American psychology’s response to psychoanalysis, we found the thoughtful volume written by David Shakow and David Rapaport, The Influence of Freud on American Psychology (1964), useful.
Because the relationship of psychology and psychoanalysis has often been fraught with conflict and misunderstanding, we found the work of Gail Hornstein, ‘‘The Return of the Repressed’’ (1992), particularly helpful.
Many fascinating scholarly accounts have described the emergence and dissemination of mesmerism. We have consulted Adam Crabtree’s work,From Mesmer to Freud (1993), as well as Robert Darnton’s Mesmerism and the End of the Enlightenment in France (1968) and Alan Gauld’s History of Hypnotism (1992).
BIBLIOGRAPHIC ESSAY 115
We also found Alison Winter’s (1998) book on mesmerism in England helpful.
Eugene Taylor’s scholarship on the religious and spiritual roots of psychological practices, such as psychotherapy, is first rate. He has published prodigiously on the topic. We found his bookShadow Culture(1999) and hisAmerican Psychologist article from September 2000 to be particularly useful for this chapter. Eric Caplan’sMind Games(1998) expertly details the development of the Emmanuel Movement and American responses to psychotherapy.
For an analysis of Pappenheim’s journey from being Breuer’s patient to Jewish feminist activist
and social reformer, we drew upon Meredith Kimball’s article ‘‘From Anna O. to Bertha Pappenheim’’ (2000).
For our section on psychosomatic medicine, we drew upon the work of Donna Haraway (1976) and the fine article by Stephen Cross and William Albury (1987). Material on psycho- analysis in India came from Christiane Hart- nack’s scholarship (1990) on the development of Freudian ideas there, as well as Alan Roland’s excellent volume,In Search of the Self in India and Japan (1991). Cecilia Taiana’s work (2006) on psychology and psychoanalysis in Argentina was also helpful.
Francis Galton(1822–1911)
Alfred Binet (1857–1911) John Dewey (1859–1952)
James McKeen Cattell(1860–1944) Galton’s Hereditary Genius(1869)