Mind Games: American Culture and the Birth of Psychotherapy (review)

Mind Games: American Culture and the Birth of Psychotherapy. By Eric Caplan (Berkeley, University of California Press, 1998) 242 pp. $35.00.

This book argues that the emergence of psychotherapy in the United States during the early twentieth century was neither a response to Sigmund Freud nor the product of internal developments in American medicine. Rather, it emerged out of "a host of interlocking social and cultural discourses endemic to late Victorian America" (8-9). Providing full proof of this assertion in 152 pages of text is nearly impossible, but, by focusing on a number of what he calls "discrete nodal points" (9), Caplan is able to make a number of important observations. His footnotes refer readers to a wide range of primary texts in neurology, psychiatry, psychology, and popular culture, as well as to key secondary works.

The book opens with an exploration of the late nineteenth-century medicolegal debate over what was called "railway spine," a traumatic illness allegedly produced by involvement in a railroad accident. Neurologists testifying on behalf of injured passengers argued that posttraumatic symptoms were somatic in origin; railway surgeons countered that the accident victims' symptoms were expressions of mental, not physical, distress and, as such, ineligible for tort damages. For Caplan, the significance of their disagreements lay not in the legal outcomes (juries almost always favored plaintiffs) but in the railway surgeons' advocacy of what would later be called psychotherapy as the most efficacious response to this particular nervous disorder.

When Caplan turns to neurasthenia, in a chapter entitled "Avoiding Psychotherapy," he describes the insistence of late-nineteenth-century neurologists, such as George Beard and Weir Mitchell, that their prescriptions, whether of hydrotherapy, electricity, diet, electricity, medication, or rest, worked by affecting the body, not the mind, despite frequent evidence to the contrary. Attacking traditional views of this medical episode, Caplan argues that it was the therapeutic limitations of Beard's and Mitchell's somaticism, not their acknowledgment of seemingly subjective mental symptoms, that helped to facilitate the eventual acceptance of psychotherapy by the medical profession.

Caplan claims that the importance of the nineteenth-century American mind-cure movement to the history of psychotherapy has been misunderstood or underestimated by conventional histories of psychiatry. Starting with Phineus Parkhurst Quimby--a one-time clockmaker who developed a highly successful mental healing practice in antebellum Portland, Maine--Caplan moves to Warren Felt Evans and Mary Baker Eddy. Finally, he discusses advocates of a movement known as New Thought, which focused on purely psychological principles, an intellectual strategy more appealing to the medical mainstream than the religious emphasis of Christian Science. By the late nineteenth century, the "more open-minded" and "more progressive" of American physicians (in Caplan's eyes) had begun to take seriously mind-cure strategies and to use them as supplements to somatic therapies (88).

The book ends with a discussion of the Emmanuel Movement, which Caplan sees as "the primary agent responsible for the efflorescence of psychotherapy in the U.S." (10). The Emmanuel Movement began in 1906 in Boston as a medicoclerical experiment designed to legitimate and publicize mental healing. Several prominent neurologists and two Episcopalian ministers, Elwood Worcester and Samuel McComb, gave a series of lectures, which they followed up with more individualized pastoral-healing sessions, which became enormously successful. As a result, the Emmanuel Movement began to spread--first across the East and Midwest and then onto the pages of such varied national magazines as Good Housekeeping and the North American Review. Yet, the rapid success of the Emmanuel Movement produced its almost equally rapid demise. Under attack from conservative clerics, academic psychologists, and a medical profession determined to restrict the practice of psychotherapy to licensed physicians, it was almost totally gone by early 1910. Caplan argues, however, that during its short life, the Emmanuel Movement forced American psychiatrists and neurologists to abandon the rigid somaticism to which they had clung for...