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Foreword Jerry Frank was a great human being, a man I was privileged to know. Just how splendid he was will become evident to readers of these essays on facets of his life and career. As a medical scientist, he legitimized research on the effectiveness of psychotherapy, a field many thought it impossible to undertake. His creativity and methodological elegance set psychiatry out on a multidecade endeavor that culminated in the development of reliable and valid psychological treatments, treatments that have been shown to be equal and sometimes superior to drug- and device-based interventions. As a political activist, he was a leader in the international effort to create a sane nuclear policy in a world a button-press away from the extinction of all life. As a caring and nurturing human being, he mentored and fostered the careers of countless young men and women. He was unstinting in making himself available to others whenever a problem, large or small, arose. Michael Gelder, professor of psychiatry emeritus at Oxford University, attested to Jerry’s stature as an intellectual leader in psychiatry. He was asked by the British Journal of Psychiatry to “select ten books that had a significant impact on his professional life.” Gelder (2003) included Frank’s Persuasion and Healing (Frank and Frank 1991) in his list, along with such other classic authors as Kraepelin, Jaspers, Beck, Brown and Harris, and Goffman. Gelder singled out Jerry’s demonstration that “the shared features of the various methods of psychological therapy are more important than those by which they differ. At the time, this was a controversial message, although it is widely accepted today” (pp. 270–71). I came to Johns Hopkins as a fellow in child psychiatry not long after Jerry’s return from the Pacific Theater in World War II. Sheer good luck enabled me to meet Jerry and his research coworkers, Stan Imber and Earl Nash (psychologists ), Otto Kernberg (psychiatrist), and Tony Stone (social worker). They were not only good friends but also a continuing source of intellectual stimulation and academic instruction during my fifteen years at Hopkins. x Foreword In the decades when Frank “et al.” were in full flower, their research was by all odds the most outstanding scholarly contribution from Johns Hopkins psychiatry. The State of American Psychiatry in the 1940s and 1950s When Jerry Frank completed his residency, American academic psychiatry could well have been characterized as “monotheistic,” with Sigmund Freud as the Mosaic lawgiver. The dominant sect, psychoanalysis, subscribed to an orthodox belief in the biblical inerrancy of Freud’s Collected Works. Within this frame, Jerry was a “doubting Thomas.” But, like Thomas, he was not an atheist; he was an agnostic. He wanted to believe in psychotherapy but needed proof. His search for the evidence opened the path to evidence-based psychiatry before the term evidencebased medicine was coined. Jerry was not alone in raising questions about psychoanalysis; many of his contemporaries, I among them, had serious reservations about its hegemony. I wrote about my dismay that “in some centers . . . almost all the residents enter personal analysis . . . [and] in my observation, it has been the bright and not the incompetent, the curious and not the unimaginative, residents who have been attracted to psychoanalysis and thus lost to research, university teaching and public service” (Eisenberg 1962, pp. 787–88). Why were they “lost”? Psychoanalytic training restricted the resident’s geographic mobility for the duration of his didactic analysis (often five years or more). Many residents engaged in after-hours private practice to pay for the analysis. They acquired, at great cost (and great effort), a therapeutic technique altogether inappropriate for public service. Worst of all, such training ate away at any intellectual curiosity: analytic trainees were given answers instead of being encouraged to raise questions. Although Johns Hopkins under John Whitehorn was eclectic in its theoretical orientation, many psychiatric residents signed on as candidates at the local psychoanalytic institute. Few read Jerry’s work, so intent were they on their assigned readings at the institute (and so sleep deprived were they by their after-hours practice). It may be hard for those who were not in Baltimore during that period to believe how many Hopkins psychiatric residents of the 1950s and 1960s dismissed Jerry as a therapeutic nihilist, when the opposite was true. Jerry had seen most psychiatric outpatients improve with psychosocial care. It was the apparent successes of the psychotherapies, not their failures, that at- [52.14.168.56] Project MUSE (2024...

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