The Quest for Mental Health
This is the story of one of the most far reaching human endeavors in modern history: the quest for mental well-being. From its origins in the eighteenth century to its wide scope in the early twenty-first, this search for emotional health and welfare has cost billions. In the name of mental health, millions around the world have been tranquilized, institutionalized, psychoanalyzed, sterilized, lobotomized, and even euthanized. Yet at the dawn of the new millennium, reported rates of depression and anxiety were unprecedentedly high. Drawing on years of field research, Ian Dowbiggin argues that if the quest for emotional well-being has reached a crisis point in the twenty-first century, it is because mass society is enveloped by cultures of therapism and consumerism, which increasingly advocate bureaucratic and managerial approaches to health and welfare. Over time, stakeholders such as governments, medicine, researchers, industry, schools, the media, the courts, families, and a public whose taste for treatment seems insatiable have transformed the campaign to achieve mental health into a movement that has come to mean all things to virtually all people. As Dowbiggin shows, if current trends continue, the quest for mental health is likely to make people more miserable before they become happier.
Ian Dowbiggin has taught history at the University of Rochester, the University of Dallas, the University of Toronto, and the University of Prince Edward Island. The author of six books on the history of medicine, he has also published in the American Historical Review , the Journal of Contemporary History , the Journal of Policy History , the Canadian Historical Review , the Canadian Journal of Psychiatry , and the Bulletin of the History of Medicine . He is on the editorial board of the History of Psychiatry .
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The Quest for Mental Health
A Tale of Science, Medicine, Scandal, Sorrow, and Mass Society
Ian Dowbiggin
The University of Prince Edward Island
CAMBRIDGE UNIVERSITY PRESS
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Ian Dowbiggin 2011
This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.
First published 2011
Printed in the United States of America
A catalog record for this publication is available from the British Library.
Library of Congress Cataloging in Publication data
Dowbiggin, Ian Robert, 1952
The quest for mental health : a tale of science, medicine, scandal, sorrow, and mass society / Ian Dowbiggin.
p. cm. (Cambridge essential histories)
Includes bibliographical references and index.
isbn 978-0-521-86867-9 (hardback) isbn 978-0-521-68868-0 (paperback)
1. Mental health. 2. Personality. 3. Emotions. I. Title. II. Series.
RA790.D69 2011
362.19689dc22 2010054413
ISBN 978-0-521-86867-9 Hardback
ISBN 978-0-521-68868-0 Paperback
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Contents
Acknowledgments
This book is the culmination of research, writing, and teaching over thirty years in the field of the history of mental health care. It has been my pleasure during this period to have met and chatted with many of the outstanding historians who have tilled this field. My first training in the history of mental health came at the University of Rochester from the psycho-historian William J. McGrath and the historian of medicine Theodore M. Brown, both exceptional scholars. The list also includes German Berrios, Joel Braslow, Edward M. Brown, John Burnham, Bill Bynum, Eric Engstrom, Toby Gelfand, Cyril Greenland, Gerald Grob, Paul Lerner, Mark Micale, George Mora, Michael Neve, Patricia Prestwich, Roy Porter, Andrew Scull, Edward Shorter, Nancy Tomes, Trevor Turner, and David Wright. In 2002, to my great pleasure, James Moran moved into the office across the hall and became my valued colleague. To all these superb scholars, I dedicate this book.
Like my earlier books, this one would have been next to impossible to write if it had not been for the generous support of the Social Sciences and Humanities Research Council of Canada, the Associated Medical Services, and the University of Prince Edward Islands Senate Committee on Research Grant. I also owe a deep debt of gratitude to Don Critchlow and Lew Bateman for encouraging me in this book project, as well as the many librarians and archivists who have aided me unstintingly over the years at locations such as the Canadian Archives for the History of Psychiatry, the Wellcome Institute for the History of Medicine, the University of Michigans Bentley Historical Library, the Social Welfare History Archives at the University of Minnesota, Harvard Universitys Schlesinger Library on the History of Women in America, and the Harvard Medical Schools Francis A. Countway Library of Medicine. Last but not least, my student assistant, Peter Rankin, pitched in with some invaluable online research.
Part of this book appeared previously in altered form in High Anxieties: The Social Construction of Anxiety Disorders, Canadian Journal of Psychiatry , 54, no. 7, July 2009: 42936. I am grateful to the Canadian Journal of Psychiatry for permission to reproduce copyrighted material.
Introduction
Mental health issues are huge, exclaimed a Canadian official in 2008, an assertion that may prove to be one of the greatest understatements of the twenty-first century. In 2001 the World Health Organization (WHO) announced its intention to raise awareness of mental health issues at the highest level of decision and policy making. The WHOs aim was to mark the beginning of a new era in the field of mental health care.
