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Oxford University Press, Inc | ISBN 0-19-517668-5 | Pages: 351 | English | PDF | Size: 4.54 MB | RAR-Commpressed : 4.5 MB | No Password
Introduction
Psychiatry is the medical specialty concerned with mental symptoms caused by disorders of the brain and mind. Because medical attention to such symptoms stretches back to the Ancients, psychiatry has a long history indeed, moreover a history thoroughly interleaved with the culture and society of the day. This kind of connectiveness to culture makes psychiatry particularly vulnerable to social changes, and the history of psychiatry is associated with discontinuities that do not necessarily occur in the history of other medical specialties. Yet, this highly eventful nature also gives the history of psychiatry its charm. What are the major moments in the evolution of the discipline?
HE HISTORY OF PSYCHIATRY
The history of psychiatry may be divided into roughly three periods: the asylum period of the years 1770–1870, in which biological concepts held sway; the psychotherapy period of the years 1870 to around 1970, in which Freud’s doctrine of psychoanalysis came increasingly to the fore; and the second biological psychiatry, from the 1970s to the present, in which biology has come rushing back with a vengeance and psychodynamic explanations have largely been unhorsed, psychotherapy sliding from the psychiatrists to the psychologists.1 Inevitably, cutting history at the joints in this manner vastly oversimpli?es, for even as psychoanalysis became all the rage in community psychiatry, the number of patients in mental hospitals continued to rise. And even in the heyday of American psychoanalysis, the 1950s and 1960s when every department chair lay in the hands of an analyst, centers of excellence in psychopharmacology and neuroscience were establishing themselves. Yet, grosso modo the image of the pendulum swinging from biology to psychogenesis and then back to biology does capture the main trend. Psychiatry as a discipline began in the last quarter of the eighteenth century with the founding of a new kind of asylum—the therapeutic rather than the custodial asylum. The world had known asylums since the Middle Ages, hospices in which the insane were thrown together willy nilly with the halt, the diseased, the senile, and the impoverished. Such hospices made no pretense of therapeutics
and existed merely for the convenience of removing psychotic and demented individuals, those whose families were unable to care for them, from the streets of the big cities..........................
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