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Notes chapter one: The Perils of Open-mindedness 1. In this perspective, Meyer was ahead of his time. He applied the public health perspective to disease long before most other leading psychiatrists considered it.One of his students,Aubrey Lewis,led the British school of psychiatry centered around the Maudsley Hospital at the University of London; with his student Michael Shepherd, Lewis brought public health and epidemiology into psychiatry as a key means of understanding mental illness. In their efforts, they were following in the tradition of Meyer. 2. Meyer recommended teeth extraction, almost as an afterthought, in addition to self-help techniques and generally supportive psychotherapy, to a prominent Canadian politician, MacKenzie King, who came to the Johns Hopkins Hospital to be treated for various psychosomatic ailments as well as some clear psychopathology (probably auditory hallucinations) in the late 1910s (before King became famous as Canada’s prime minister in the 1920s). King was impressed by Meyer’s supportive manner, and it seems that Meyer focused on psychological support as the key to King’s treatment, but he also added Cotton’s method of teeth extraction, just in case (Roazen 1993a). 3. Worldwide about fifty thousand lobotomies had been performed by the time the Nobel was awarded for it in 1949. After World War II, while lobotomy was highly common in the West, it was banned in West Germany and in the Soviet Union. The 1949 Nobel Prize spurred interest in the practice. Freeman himself had nominated Antonio Caetano de Abreu Freire Egas Moniz for the Nobel Prize for Medicine and was somewhat influential in the campaign that led to his receiving the award. It is ironic that in that same year, Australian psychiatrist John Cade would discover lithium, an effective treatment that to this day continues to be probably the most effective psychotropic medication ever; yet after the Moniz fiasco, the Nobel committee shied away from giving awards for direct treatment of mental illness, and thus the clinical discoverers of lithium , antipsychotics, and antidepressants have never been duly recognized. chapter two: So Many Theories, So Little Time 1. The only overall“rapprochement”that Williams saw was, as we will see with both Roy Grinker Sr. and George Engel, a reliance on the holistic theories derived from general systems theory (Williams cites the founder of that theory,Ludwig von Bertalanffy). 2. Outside of psychiatry and psychology, warnings about eclecticism have also been made. For instance, in nursing, it has been suggested that the field is “drowning in eclecticism”:“A seemingly unlimited range of theories from multiple disciplines (about a seemingly unlimited range of phenomena) are used throughout the professional practice and scholarship of nurses. . . . Eclecticism—defined as selecting the best or more favored from various sources, styles, or methods—is not, in and of itself, a ‘bad’ thing” (Cody 1996). But it is a problem in nursing when it consists of “constantly borrowing ” from other disciplines rather than “growing the body of knowledge that is nursing’s own.” There is a “miasma of endless, unbridled theory sampling.” Hence “nurses find themselves in effect simmering in a theoretical soup.” This results in “the ‘black bag’approach to selection and application of theories . . . as the modus operandi of many practicing nurses and scholars.”“To maintain in that grab bag a collection of theories for use that are philosophically and logically incompatible with one another is intellectually and ethically indefensible.” The consequences are that “the enforced eclecticism in contemporary nursing reduces the performing art of nursing to imitation and pastiche” (Cody 1996). Clearly, eclecticism can get, and perhaps has gotten, out of hand, not only in psychiatry but in allied disciplines such as nursing. 3. This approach, which has Kantian roots in philosophy of mind, was similarly expressed by Karl Jaspers years earlier (though unreferenced by Yager). 4. This definition is similar to Karl Jaspers’s methodological consciousness, or the pluralistic model I proposed in The Concepts of Psychiatry (Johns Hopkins University Press, 2003). 5. Ibid. 6. Ibid. chapter three: Riding Madly in All Directions 1. Sigmund Freud stated that his usual fee was $25 per hour and that even in his old age he was obliged to continue seeing patients and charging such fees to make a living. Roy Grinker apparently expressed a concern about being able to provide such funds, leading Freud to describe a sliding scale that he could provide as an exception, with no lower than $10 per hour. Freud...


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