Abstract
Transnational Psychiatries is a welcome addition to the serious stable of edited book collections about the diverse and connected worlds of psychiatry of the past. Waltraud Ernst and Thomas Mueller developed this book as a project, with the authors first holding an exciting symposium at Southampton in 2005, and then working with separate contributors to produce an interesting book which sets out to extend existing understandings of the histories of psychiatry in a comparative context. The use of the term ‘psychiatries’ is important here, because these contributions address a much broader set of concerns about the field of psychiatric treatment and the cross-fertilization of the psychiatric profession than many previous collections which mostly – but not exclusively – focus on institutionalization. Therefore, the book has much to offer colleagues and researchers in that it seeks to bring new perspectives to the established field, but it also contains impressive and richly researched single contributions.
Although I have some reservations about the way comparison is itself defined here – with the editors slipping between formal, European understandings of comparative history and more vague definitions such as networks, transfers and entanglements, right through to the much more precise notion of ‘transnational’ – the book presents a new challenge to the many excellent writers in the now global field to address larger theoretical and methodological issues in the quest to write these histories. Indeed, the very point (and general effect) of the slippage described above is to provide some flexibility to older practices of historical and sociological comparison, which were too strict in their application to be useful. Some of these approaches, as the editors also note, are driven by the dynamic discipline of history itself, which has presented, over the past decade, an array of new possibilities for broader conceptions of most topics under the sun.
Histories of psychiatry are part of this larger picture of the new attention to networks and connections in histories of medicine, with one of the most recent additions from Sloan Mahone and Megan Vaughan in their Psychiatry and Empire (2007). Mahone and Vaughan rightly assert that ‘there is no one history of psychiatry and empire’ (p.3). They set out to address a variety of themes which coalesce around the intellectual problem of psychiatry and empire: these include histories of institutions, colonial psychiatrists, race and racism, the colonial subjects as oppressed, as well as imperial networks. Before them, Roy Porter and David Wright also attempted a global study of mental health institutions and the confined in their edited work of 2003, The Confinement of the Insane. However, overall, most edited works cannot fully address a concept such as ‘comparison’ in a very detailed, coherent or sustained way. Instead, we receive glimpses of what it means, for instance, to place inquiries of similar jurisdictions alongside each other, and we might be able to make or draw our own comparisons and conclusions from their juxtaposition.
Ernst and Mueller’s volume goes a little further in that the very notion of ‘comparison’ becomes the central focus of the work. In eleven essays, each addressing a range of aspects of the ‘comparative turn’ in histories of psychiatry and institutions, the book’s contributors set out very different conceptions of what it means to undertake comparison. ‘Comparison’ could be inferred from the geographical scope of the book, which takes readers to Japan, several separate parts of Europe, Argentina, India, and Fiji; and it might also relate to change over time, as the work traverses both the nineteenth and twentieth centuries. It also takes us into the worlds of types of treatments, such as psychotherapy, shock therapies, ‘active-therapy’, among other forms of institutional and extra-institutional measures, therefore asking about competing forms and discourses surrounding psychiatric care, including the roles played by families or communities versus institutions in the past. How were some treatments, accepted in ‘global’ terms, practised locally? Akihito Suzuki subtly disturbs our received wisdom about insulin coma therapy by exploring the economy of treatment in Japan at Ōji Brain Hospital. Ernst’s own chapter examines the practice of ‘modern’ international treatments, embedded in a wider transnational world of psychiatry, in colonial British India. Both chapters show how the world came to locations in specific ways, both tangibly in the form of well-travelled personnel and through ideas.
In the same way, the excellent chapter by Akira Hashimoto about the ‘Japanese Gheel’ opens up the archives of one site to shed light on many places and performances of psychiatric care, including the many visitors to Gheel in Belgium who transported new ways of thinking about extra-institutional care to their various sites. Mueller’s chapter also investigates forms of family or ‘open care’, this time in Belgium, France and Germany between 1880 and 1980, suggesting that the historiography of this topic warrants further investigation. Making links between places, Mueller shows, extends our knowledge about a diversity of practices that were also shared between countries on the continent.
Several chapters convey readers to the dark worlds of past trauma, wartime abuses and morally repugnant forms of institutional ‘care’. We also delve into emotional worlds of depression and the intersecting belief systems of Western and Japanese modes of emotional expression.
Finally, the case of colonial Fiji provided by Jacqui Leckie addresses the methodological questions of comparison head-on, and in this respect it is a superb chapter which makes the important and much-needed connections between the different forms of comparison mentioned earlier. Leckie is able to navigate the debates about networks, entangled histories and comparison in a manner other chapters do not quite achieve. Perhaps this is because historians of the Pacific and Australasia have been at the vanguard of historiographical developments which make meaningful the very notion of comparison. Leckie’s chapter also traces a story of imperial world psychiatry which is transferred into the Pacific, making this a useful way to end this review of the book: it is in the colonial setting that transnational, transcolonial and truly comparative work resonates the most.
The histories of psychiatry told here are rich, innovative and moving. Even read together, and with the Introduction as a guide, the chapters may not fully explain the significance of ‘comparison’ for psychiatry’s history, but the very act of producing this book has elicited some fascinating pieces of writing and scholarship, and has showcased these in a volume of impressive depth and scope.