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Sailing between Scylla and Charybdis: invited response to ‘Blame or discovery?’

Published online by Cambridge University Press:  07 June 2023

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Summary

This brief commentary reflects on navigating two dangers of historical research into psychiatry: hagiographic representations of psychiatrists; and accusations of their self-interest and oppression of vulnerable people.

Type
Commentary
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

I would like to focus on two of George Ikkos's comments:Reference Ikkos1 ‘Although fairness is undoubtedly a foundational value in both history and psychiatry, arguably the key driver in historical enquiry should be discovery rather than praise or blame’ and ‘Consistent with her institutional position, Hilton presses repeatedly her legitimate anxiety lest psychiatrists be unfairly criticised or blamed’.

As a historian, I aim to understand and explain the past as impartially and objectively as possible. Historical research is a voyage of discovery, but when seeking out psychiatry and psychiatrists, one needs to navigate cautiously to avoid the dangers of Scylla and Charybdis.

On one side are hagiographic representations: Festschriften; biographies; eponymous donations, bequests, lectureships or terminology; obituaries which follow the aphorism De mortuis nil nisi bonum (‘Of the dead, nothing but good’). Their messages often originate from psychiatric colleagues and institutions. On the other side, widely quoted historical analyses by Michel Foucault,Reference Foucault2 Andrew Scull,Reference Scull3 Elaine Showalter,Reference Showalter4 Akinobu TakabayashiReference Takabayashi5 and others have dominated the landscape, often featuring psychiatrists as seeking to benefit themselves while oppressing vulnerable people whom they were meant to be helping.

The polarities of these Scylla and Charybdis sources are hard to reconcile, and we may become enmeshed in either at our peril. Incredulity at what others had written about psychiatry and psychiatrists of the past drew me into researching the subject, well before taking up my ‘institutional position’.

Steering cautiously and critically with an open mind as to what one might find are prerequisites for a successful voyage of historical exploration. ‘Praise and blame’ about past generations are by-products of historical research, not motivations or goals for it. Understanding what happened in the past, however, may contribute to avoiding psychiatry and psychiatrists being ‘unfairly criticised or blamed’ in the future.

About the author

Claire Hilton, FRCPsych, FRHistS, is historian in residence at the Royal College of Psychiatrists and an Honorary Research Fellow at Birkbeck University of London, London, UK.

Data availability

Data availability is not applicable to this article as no new data were created or analysed in this study.

Funding

This work received no specific grant from any funding agency, commercial or not-for-profit sectors.

Declaration of interest

C.H. is a member of BJPsych Bulletin editorial board and did not take part in the review or decision-making process of this paper.

Footnotes

Commentary on… Blame or discovery? Walter Benjamin's Jetztzeit, Purdue Pharma LP and ‘our values and our historical understanding of psychiatrists’ (https://doi.org/10.1192/bjb.2023.39).

References

Ikkos, G. Invited commentary: blame or discovery? Walter Benjamin's Jetztzeit, Purdue Pharma LP and ‘our values and our historical understanding of psychiatrists’. BJPsych Bull [Epub ahead of print]. Available from: https://doi.org/10.1192/bjb.2023.40.Google Scholar
Foucault, M. Madness and Civilisation: A History of Insanity in the Age of Reason. Random House, 1965.Google Scholar
Scull, A. The Most Solitary of Afflictions: Madness and Society in Britain, 1700–1900. Yale University Press, 1993.Google Scholar
Showalter, E. The Female Malady: Women, Madness, and English Culture, 1830–1980. Pantheon Books, 1985.Google Scholar
Takabayashi, A. Surviving the Lunacy Act of 1890: English psychiatrists and professional development during the early twentieth century. Med Hist 2017; 61: 246–69.CrossRefGoogle ScholarPubMed
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