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Last month I spent a fascinating week in the American Psychiatric Association (APA) archives in Arlington Virgina. It was brilliant for a number of reasons, not least of which was that the APA was the perfect host for a humble historian such as myself. I was digging around for material on how the APA viewed social psychiatry and community mental health care during the decades following the Second World War. Many of the presidents of the APA wrote favorably about social psychiatry in the American Journal of Psychiatry, but I wondered if such warm feelings filtered down to the level of personal correspondences and more informal speeches.
Although I found some good material, the real find was unexpected and cast light on how psychiatrists themselves viewed their own history during the post-war period. It was, in short, the uncompleted manuscript of a history of psychiatry from 1945-1970, written by Daniel Blain, a prominent psychiatrist and former president of the APA. Its title was The Magic Years.
If you know anything about the history of medicine, you might be surprised by how excited this box made me. After all, much medical history was written by physicians themselves until the 1960s, when "professional" historians began to take over. One of the criticisms these professional historians had with the amateur physician-historians is that the history written by the latter was to progressivist, that is triumphing medical progress, and tended to focus too much on heroic physicians, rather than experiences of health. In other words, it was too top down and used history as a way of celebrating the present, rather than understanding the past.
Although I can sympathize with such criticisms, examining why physicians used - and sometimes abused - history in this way can nevertheless help us understand the periods in which they were writing. And that's why I was so intrigued. I had been digging around in archives, going through medical journals, and conducting oral history interviews (still am, by the way, so please get in touch if you have a background in social psychiatry or community mental health!), yet here was history from the horse's mouth! What's more, Blain had conducted oral history interviews himself, interviewing many of the movers and shakers of the period to help construct his history. Even his title, The Magic Years, was revealing, demonstrating an overarching optimism about what psychiatrists could do to prevent and treat mental illness. Blain, like many physician-historians, really did see the period 1945-1970 as a period of progress, where patients left psychiatric hospitals in the hundreds of thousands to be treated in the community, where the federal government invested heavily in community mental health, and when new psychiatric drugs became available. I have written in the past about how divided American psychiatry was during this period, but here was Blain telling me that I was wrong.
Putting right or wrong aside, what is really interesting to me is that here was a psychiatrist who lived through this period and saw it largely positively. His work, funded by the National Library of Medicine, was intended for posterity, meaning that he wanted his view of psychiatry to be the accepted one. If he had lived longer (he died in 1981), and completed the project, he might have changed his views, but it is understandable why he saw this period in psychiatric history in the way he did. After all, this was the first time psychiatry was really treated seriously in the United States, particularly at the level of the federal government. Psychiatrists managed to convince politicians - and themselves - that they could tackle the causes of mental illness and even eradicate them. While these ambitions remain unrealized, it makes sense that someone at the heart of the American psychiatric establishment might view the period through rose-tinted glasses.
And that's something historians of medicine - and historian more generally - need to understand: just as other historical sources have to be understood within a specific context, so, too, does historical literature, no matter who writes it. Instead of rejecting the work of physician-historians, we should probably learn more from it.
