Dear Carrol,

I don't think one can make any blanket statement that psychiatry at the
time was wrong.  Many psychiatrists today use Freud, and Freud was well
known then at least among medical and philosophical circles, though until
about 1920 his was not the dominant model.  But so were other theories
that still have important influence.  I am not saying it was right because it
is not much more likely to be right now,  maybe less since chemical mood
control is increasingly displacing the "talking cure." It also was not simply
"wrong."  Much of it then and now was awful, but there were also
therapists who got some results then as now.  It is not an exact science
that has simply started from falsehood and progressed.  Someone
mentioned Septimus Smith.  Interestingly, he kills himself to save himself
from the psychiatrists and from the incredible places then called hospitals
for "lunatics."  But awful as those were, there were also doctors who wrote
against them and theorists who were very knowledgeable and who had
different views about how to treat people.

My point is that it was a mixed bag--as it is now.
Cheers,
Nancy


Date sent:              Sat, 28 Sep 2002 16:37:37 -0500
Send reply to:          "T. S. Eliot Discussion forum." <[log in to unmask]>
From:                   Carrol Cox <[log in to unmask]>
Subject:                Re: Some Queries, was Re: Deluge...
To:                     [log in to unmask]

Nancy Gish wrote:
>
> I'm sorry, but if you want a long list of medical articles from the
> period that say quite differently, let me know.  At the turn of the
> century and up to and through the war, "hysteria" was a broad term that
> did indeed include shell shock and what we would call post-traumatic
> stress.  I only said "neurasthenia" was hard to distinguish, and there
> is a long text making that claim and giving charts of differences that
> then got quoted by many doctors.  On this you are factually wrong as to
> what the terms meant then. As I spent many, many weeks reading on this
> at the Bodlian last year, I am quite certain of my terminology.

Nancy, the proposition here is not that you are/were wrong; the
proposition is that the psychiatry of the time was wrong. I would go
further and say our present psychiatry is almost certainly incoherent and
incomplete. The psychiatry of 1920 (with some qualification) has the same
kind of interest that the psychiatry of 1850 or (before it was called
psychiatry) of 1714 had:

                Here sighs a Jar, and there a Goose-pye talks;
                Men prove with Child, as pow'rful Fancy works,
                And Maids turn'd Bottels, call aloud for Corks.
                                (Rape of the Lock, iv, 52-54)

And this lack of knowledge (on the part of both professionals and the
general public) would have radically transformed the symptoms. Let me
illustrate what I mean by a recent experience of my own. I haven't
suffered from what I call "plain vanilla depression" since early 1999 --
but apparently I am permanently afflicted with acute anxiety whenever I
make a promise to do something or when events impose such a choice. I
had
a (surprise) extraction a 10 days ago, and it was right next to a bridge,
which fell out in the process. They glued it back in temporarily and made
an appointement for this last Wednesday to have pins put in to hold it. A
couple hours after I got home, the bridge fell out. I did the sensible
thing. I put it in a baggie to take with me the next week. That was
Wednesday evening. Then on Thursday I wondered if perhaps I should call
the dentist's office and inquire. The sort of thing that, as I said in an
earlier post, made Pound's "mortal fatigue of action postponed"
reverberate for me, set in, and I didn't call. The office was closed on
Friday, and by Thursday evening I was frozen and had talked myself into
believing that it was essential to have called. I _knew_ otherwise, but I
couldn't believe otherwise. Neither could I call on Monday or Tuesday, and
for those five days (Friday through Tuesday) I couldn't read, couldn't do
simple business, etc. etc. etc. Of course when I went in Wednesday, the
technician merely chuckled and said, "I didn't think it would last."

That is semi-acute anxiety. Some friends have it much worse. But at
least, even when it is wracking me, I know abstractly what it is, and my
wife knows enough not to laugh at me or try seriously to convince me of
what I already know. And friends in the Depressive & Manic Depressive
Support Group will know exactly how I felt. Now suppose that happening in
a context in which _no one_, not professionals and not friends or
relatives or the sufferer him/herself, could see such behavior or such
feelings as anything but a serious character flaw or real hallucination --
just plain crazy and idiotic -- shameful! Clearly for many it would spin
out of control: you would end up with the sort of "madmen" and
"madwomen"
who supplied Sunday-afternoon entertainment at Bedlam for visitors in
mid-18th century London.

So whatever names they gave, and whatever symptoms they described, the
"mental illnesses" of 1920 would have been in substantial ways
_different_, for mental illness is not like a broken arm, or even a case
of TB, for each case is a constant interplay between "it" and the
responses of those around, the whole life history of the sufferer.

Fifty years from now "Depression" (if they still call it that) will be a
quite different condition than Depression now. And in fact, the "Shell
Shock" of a WW 2 soldier, the combat fatigue of a soldier in France in
1944, and Bob Summer's PTSD are both the same and not the same. (For
example, very few of the earlier 'victims' could have spoken of it (even
in the semi-anonymity of a listserv) as Bob has done, or as I have done
just now of my illness. That makes it different.

Carrol

> Cheers,
> Nancy
>
> Date sent:              Sat, 28 Sep 2002 12:13:58 -0700
> Send reply to:          "T. S. Eliot Discussion forum."
> <[log in to unmask]> From:                   Francis Gavin
> <[log in to unmask]> Subject:                Re: Some Queries, was
> Re: Deluge... To:                     [log in to unmask]
>
> Both neurasthenia and hysteria are considered quaint antiquated terms in
> medical circles. Hysteria is sometimes used in a very limited way to
> describe disassociation in personality formation, neurasthenia not at
> all. Neither one has anything to do with battle fatigue or PTSD, which
> are in turn, two different things.
>
> GAVIN
>
> on 9/28/02 10:26 AM, Nancy Gish at [log in to unmask] wrote:
>
> > "Shell Shock" is what they called hysteria and we
> > would probably call post-traumatic stress disorder.  In any case,
> > there was a very extensive literature on it that actually goes back a
> > couple of thousand years to ancient Egypt.  Vittoz specifically wrote
> > on "neurasthenia."