Past Imperfect, Future Conditional: Towards a Historical Grammar of Canadian Psychiatry

Reviews Past Imperfect, Future Conditional: Towards a Historical Grammar of Canadian Psychiatry SHRINK RESISTANT: THE STRUGGLE AGAINST PSYCHIATRY IN CANADA. Bonnie Burstow and Don Weitz, Editors. Vancouver: New Star Books, 1988. MOMENTS OF UNREASON: THE PRACTICE OF CANADIAN PSYCHIATRY AND THE HOMEWOOD RETREAT, 1883-1923. Cheryl Krasnick Warsh. Montreal/ Kings/on: McGill-Queen:S- University Press, 1989. BATTLE EXHAUSTION: SOWIERS AND PSYCHIATRISTS IN THE CANADIAN ARMY, 1939-1945. Terry Cope and Bill McAndrew. Montreal/Kingston: McGillQueen :S- University Press, 1990. THE TWO PSYCHIATRIES: THE TRANSFORMATION OF PSYCHIATRIC WORK IN SASKATCHEWAN 1905-1984. Harley D. Dickinson. Regina: University of Regina, 1989. THE CENTURY OF THE CHILD: THE MENTAL HYGIENE MOVEMENT AND SOCIALPOLICYINTHEUNITEDSTATES AND CANADA. Theresa R. Richardson. Albany: State University ofNew York Press, 1989. A HISTORYOFGREATIDEASINABNORMAL PSYCHOLOGY. Thaddeus E. WeckowiczandHelen P. Liebel-Weckowicz. Amsterdam: North Holland, 1990. In the last three decades there has been a dramatic increase in interest in the history of psychiatry. The outpouring of publications include historical re-evaluations of institutions , movements, specific diseases, famous psychiatrists and the entityof madness itself. What medical historian Edward Shorter has called this "burgeoning industry" is propelled primarily by non-psychiatrists. Historians and socialscientists have found in psychiatry a suitable subject area for the application of Journal ofCanadian S1udies Vol. 27. No. 3 (A111011111e 1992 Fall} modem historiographic methods influenced by social theories. Recently, these techniques have begun to be applied to Canadian practices. Six recent booksstrikingly reveal Canadian psychiatry as a god that has not yet succeeded. Idealistic expectations ofa scientific psychiatry remain unfulfilled. Innovative programs have foundered. The profession is losing its sense of purpose, as it largely ignores the not inappropriate criticisms ofits client population. Canada is not unique among the industrialized nations in finding organized psychiatry at a crisis ofconfidence. Someofthe historical movements referred to in these books have, however, been promulgated in Canada with an unusual energy and determination. Indeed, we can view this country as a crucible oftrends that will have profound and far-reaching implications for the futl.!re ofpsychiatry everywhere. Shrink Resistant, edited by Bonnie Burstow and Don Weitz, demonstrates disturbingly , painfully, and disappointingly the failure oforganized traditional psychiatry to meet the needs ofmany ofthose itsupposedly serves. The book is a collection of"interviews ,joumal entries, poetry, graphics, and personal narratives," in which more than forty individuals "relate theirexperiences inside the walls ofmental hospitals and at the hands of psychiatrists." Today, psychiatry is better equipped technically, more effective in practice , and its exponents recruited from a wider, bettereducated population than at any time in its history. It is shocking, therefore, to find that many people feel they havebeenabused, let down, harmed or dealt with ignominiously by this profession. It would be comforting to think that these accounts refer to the"bad old days."Surely in our time, unenlightened administrative and clinical care in overcrowded old-fashioned asylums has been replaced by individualized, effective approaches. To believe this would permit the consoling pre-Foucaultian vision ofthe continuing advance ofhumane reason to endure. The famous painting that imagines Philip Pine! freeing the inmates of the Salpetriere from their chains exemplifies the optimism of the French Revolution and the Enlightenmentdream. Foucault forces us to reinterpret this myth or, rather, see it as myth 135 (or ideologicalconstruct) and not as a reflection ofthe inevitability ofhistorical progress. Shrink Resistant certainly does include unhappy memories of institutions now widely condemned within psychiatry itself. But it also includes very recent experiences such as those ofNira Fleishmann in a general hospital in-patient psychiatry ward in 1983. She recalls her feelings in restrained, poetic language that echoes the words ofKing Lear: "Denied even the simplest comfort - a language that could communicate the grotesque horror of our being here. Everyday alphabets talk of cold reason, boundaries, lines, definitions - senseless to God's fools, knowing themselves at the mercy ofwanton boys.... Left with labels only"(8 l). Someof the most trenchant criticisms refer to now notorious events in the premier Canadian academic psychiatric institution in Montreal. Th.ese accuse in particular Dr. Ewen Cameron, internationally known chairmanof the Department of Psychiatry at McGill University, Director ofthe Allan Memorial Institute and chief architect of academic teaching and training in Canadian psychiatry. The contributors to...