Knowledge and Power: Perspectives in the History of Psychiatry (review)

Eric J. Engstrom, Matthias M. Weber, and Paul Hoff, eds. Knowledge and Power: Perspectives in the History of Psychiatry. Selected papers from the Third Triennial Conference of the European Association for the History of Psychiatry, 11-14 September 1996, Munich, Germany. Berlin: Verlag für Wissenschaft und Bildung, 1999. 234 pp. Ill. DM 68.00 (3-86135-770-4).

This smorgasbord of twenty papers selected from a 1996 conference of historians of psychiatry offers the reader a variety of morsels to choose from. Some whet the appetite, others leave the palate flat, and a few are difficult to swallow. The offerings include announcements of research projects, reports on current work in progress, puff pieces in psychiatric biography, and completed articles derived from earlier publications or ready for refereed journals. They range chronologically from the early modern period through to the mid-twentieth century, and are confined geographically to Western and Central Europe.

The editors take their title from the theme of the conference. Despite its Foucauldian intimations, however, the book as a whole is mercifully out from under the French philosopher's shadow. As the editors write in their brief preface, "Those seeking definitive pronouncements on these issues [of methodology and analytical perspective in the history of psychiatry] will thus undoubtedly be disappointed by this volume. We have no synthetic master narrative to offer our readers" (p. 10).

The book is divided into five categories: people, institutions, therapies, psychiatry and National Socialism, and psychoanalysis. Among the people the reader encounters, there is the inevitable Pinel, but alongside him the enigmatic Dutch psychiatrist Bouman, trying to fashion a psychiatry that is compatible with Calvinism. Similarly, the institutions visited include those mandated by the well-trod English Poor Law of 1834, but also the less-traveled Spanish asylums and nineteenth-century Swiss hospitals. The therapeutic pickings are slim, with two entries: one showing the complexity and vitality of sixteenth-century Galenist practice regarding lunacy, the other a confusing essay on the uses of electrotherapy in Germany in the nineteenth century.

When the reader arrives at the six papers on psychiatry and National Socialism (five in English, one inexplicably in the original German) he is ready for richer fare, and is not disappointed. Geoffrey Cocks's excerpt on his subject of the Göring Institute sets the tone of historical depth and moral disturbance that the history of psychiatry under Nazism requires. The subsequent contributions follow his lead. Armin Schafer's essay on the role of psychiatrists in the treatment of homosexuals under the Third Reich, with its discomforting intertwining of psychiatry and endocrinology, is especially noteworthy. Paradoxically, although this group of essays turns the stomach, it also whets the appetite for a fuller knowledge and, if possible, deeper understanding of how and why the medical and psychiatric professions implicated themselves in the Nazi regime.

The final section, on psychoanalysis, is confined to one paper on the "scientific" status of psychoanalysis—which adds nothing new to the debate—and two essays reassessing Freud's relationship to Meynert and Krafft-Ebing. The history of psychoanalysis has grown well beyond Freud studies, but unfortunately this is not reflected among these papers.

The history of psychiatry now claims its own professional journals, its own international conferences (of which this volume is an expression), even its own scholarships and academic positions. Will its professionalization lead to its sequestration from broader currents within the history of medicine, the history of science, and general history? So long as workers in the field—some of whom are represented in this book—continue to grapple with the larger social, political, and moral matters posed by madness, deviance, and scientific knowledge, there is hope that it will not.