Abstract
Henri Ellenberger (1905–1993) wrote the first French-language synthesis of transcultural psychiatry (“Ethno-psychiatrie”) for the French Encyclopédie Médico-Chirurgicale in 1965. His work casts new light on the early development of transcultural psychiatry in relation to scientific communities and networks, particularly on the role of Georges Devereux (1908–1985). The Ellenberger archives offer the possibility of comparing published texts with archival ones to create a more nuanced account of the history of transcultural psychiatry, and notably of the psychological treatment of Native Americans. This paper examines some key moments in the intellectual trajectories of Devereux and Ellenberger, including Devereux’s dispute with Ackerknecht, the careers of Devereux and Ellenberger as therapists at the Menninger Foundation (Topeka, Kansas) in the 1950s, and their respective positions in the research network developed by McGill University (Montreal, Quebec) with the newsletter Transcultural Research in Mental Health Problems. Finally, I consider their ties to other important figures in this field as it transitioned from colonial medicine to academic medicine, including Roger Bastide (France), Henri Collomb and the Ortigues (France and Africa), as well as Eric Wittkower and Brian Murphy (Canada) and Alexander Leighton (United States and Canada).
Keywords
The history of transcultural psychiatry is now the object of a variety of historical narratives. The time of origin stories is over, and it is up to historians to establish facts that are based on the documents bequeathed to us by the past. The 1990s and 2000s have provided several genres of accounts, including portraits of pioneers (Corin & Bibeau, 1988; Murphy, 1983; Prince, 1987, 1996; Prince & Beauchamp, 2001); autobiographies (Devereux, 1978b; Prince, 2010); monographs dedicated to important figures like Henri Collomb (Arnaud, 2006) and Georges Devereux (Bloch, 2012; Cerea 1 ); institutional histories (Collignon, 1978; Kirmayer, 2000; Kirmayer & Minas, 2000; Prince, 1995, 2000, 2006; Zempléni, 1980); reassessments of the field from the perspective of colonial history like Richard Keller’s groundbreaking essay (2007); and biographies of key figures like Franz Fanon (Macey, 2000). There are also studies that take up this history by focusing on geographic or cultural regions (e.g., Ernst, 2010, 2013) or on mental disorders that are locally prevalent (e.g., Crozier, 2011), as well as researchers in the social sciences (anthropology, sociology, political science, etc.) who emphasize the postcolonial stakes of transcultural psychiatry (e.g., Fassin, 1999, 2000; Fassin & Rechtman, 2005). Careful to inscribe these developments in the perspective of longue durée, I will adopt Alice Bullard’s analytic framework (Bullard, 2005a, 2005b, 2007) which describes the professionalization of the field of transcultural psychiatry and its transformation into an academic discipline as a “transition” propelled by intellectual fermentation during the period of decolonization 2 and by policies enabling the integration of postwar immigrants (the period is called “Trente Glorieuses” in French, “Wirtschaftswunder” in German, “Pop Years” in English).
With this framework in mind, I want to revisit a well-known narrative about the development of transcultural psychiatry during the 1950s and to illuminate it using a considerably underestimated body of work. The narrative in question is Reality and Dream: Psychotherapy of a Plains Indian (Devereux, 1951) by the psychoanalyst and ethnologist Georges Devereux (1908–1985), which describes the psychological treatment of a Native American patient. The book was recently adapted to film by Arnaud Desplechin with the title Jimmy P. (2013). The film grippingly depicts a psychological course of treatment, and the actor Mathieu Amalric offers a superb portrayal of Devereux. But rather than being unique, this document can be read alongside other texts documenting patients of a similar ethnic background, treated in the same place and during the same time period. I will draw on a medical encyclopedia which is still largely ignored by historians of sciences: the Encyclopédie Médico-Chirurgicale (EMC), better known under its acronym EMC. A lieu de mémoire for French medicine, the EMC was founded in 1929 by Francis Durieux, a lawyer, and by Professor Amédée Laffont, Dean of the Medical School in Algiers (Delille, 2008). The Juris-Classeurs (1907), a French legal research database, was the model for the encyclopedia: it was made up of thematic binders and detachable numbered booklets sold by subscription that have been regularly updated to this day. It was in this text that Henri Ellenberger (1905–1993; see Figure 1), author of The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry (Ellenberger, 1970), published a clinical observation of a Native American patient that we can now document on the basis of recently assembled archives that are open to researchers but as yet seldom examined. My interpretation of these sources will unfold in three parts: first, I will show how Devereux’s work on Native Americans very quickly created academic controversy. Then I will present Ellenberger’s therapeutic work with Native American patients at the Menninger Foundation, before presenting an excerpt of his “Ethno-psychiatrie.” Finally, in lieu of a conclusion, I will shift the historiographical focus by considering the positioning of these two protagonists within a scholarly network.
Henri Ellenberger (1905–1993) in the 1950s.
Controversy as an analytical framework: Devereux versus Ackerknecht
“Ethnopsychiatrie” (in French) and “transcultural psychiatry” (in English) are the terms that Devereux and Ellenberger most often use in their essays, but other contemporary terms exist, including “cross-cultural psychiatry,” or more simply “cultural psychiatry.” For example, Eric Wittkower (1899–1983), the founder of the world’s first program in transcultural psychiatry in 1955 at McGill University, offered the following definition: Cultural psychiatry concerns itself with the mentally ill in relation to their cultural environment within the confines of a given cultural unit, whereas the term transcultural psychiatry denotes that the vista of the observer extends beyond the scope of one cultural unit to another. (Wittkower, 1970, p. 162)
Devereux was born György Dobó to a Jewish family from the Banat region of the Austro-Hungarian Empire, which became part of Romania at the end of the Great War (Bloch, 2012). In 1926, he set off to study in Paris, where he mixed with the avant-garde and developed literary ambitions. Devereux obtained his diploma in ethnology in 1931, then his degree from the Sorbonne the following year, all the while continuing his training in ethnology under the supervision of Marcel Mauss and Paul Rivet. The same year, he converted to Catholicism. The Rockefeller Foundation awarded him a 2-year fellowship for his first fieldwork experience, with the Sedang people in Indochina. However, it required him to travel to the United States before undertaking this study in order to observe the Hopi tribe in Arizona. He was rapidly recruited by the University of California at Berkeley to write a dissertation, Sexual Life of the Mohave Indians (1935; unpublished doctoral dissertation), under the direction of the anthropologist and psychoanalyst-in-training Alfred Louis Kroeber (1876–1960). At this time, fieldwork in a tribal reservation was an obligatory experience in American anthropology. This major development coincided with policies of the U.S. Bureau of Indian Affairs (Zaballos, 2009) that sought to end the mutual mistrust between traditional indigenous medicine and Western medicine, which had led to a disastrous sanitary situation. We can cite, for example, the well-known case of the American psychiatrist and anthropologist Alexander H. Leighton (1908–2007), a pioneer of psychiatric epidemiology (Waldram & Bibeau, 2006). Leighton’s first book was a health manual (1945) based on his observation of the Navajo tribe in New Mexico.
In 1939, Devereux carried out research at Harvard in the Sociology Department founded by Pitirim Sorokin (1889–1968), and at Worcester State Hospital, with which the Hungarian anthropologist and psychoanalyst Géza Róheim (1891–1953) was affiliated. Devereux then published an article titled “A Sociological Theory of Schizophrenia” (Devereux, 1939), which was well-circulated, especially as he then belonged to the same social circle at Harvard as Robert K. Merton (1910–2003), the founder of the sociology of science. In this article, Devereux defended the theory of the psychogenesis of schizophrenia, which could only emerge from culture.
Devereux’s ideas were far from having unanimous support, and Erwin Heinz Ackerknecht (1906–1988) responded to him in a 1943 article, “Psychopathology, Primitive Medicine and Primitive Culture” (Ackerknecht, 1943). Like Devereux, Ackerknecht had studied ethnology in Paris with Rivet and Mauss. He was born to a German family in Stettin (now Szczecin, in Poland) and began to study medicine in 1924 in Freiburg, where he was active first in a group of communist students and later in the Trotskyist movement. In 1931, Ackerknecht completed his doctoral dissertation in the history of medicine under the direction of Henry E. Siegrist at the University of Leipzig. He then settled in 1932 in Berlin, where he worked as a physician’s assistant and continued to be politically active. In 1933, soon after Hitler’s rise to power, he was threatened and his belongings were seized by the Gestapo. Ackerknecht was nevertheless able to leave Germany and move to Paris. In France, he could not legally practice medicine and had to settle for work in a paramedical field: he took a position as a librarian at the EMC. Disillusioned with revolutionary theories, in 1938 (the year Lev Sedov, son of Leon Trotsky, passed away) he renounced his previous political commitments. While searching for a new theoretical orientation, he began studying ethnology at the Sorbonne (1938–1939). Now stateless, he was recruited as a nurse’s aide in the French army; he left for the United States after its defeat. In January 1942, Ackerknecht was hired by the Institute of the History of Medicine at Johns Hopkins University (Baltimore) to work alongside Siegrist, his former professor and friend. His research now turned to medical anthropology; while working on the history of malaria in the Mississippi region (Ackerknecht, 1945), Acknerknecht authored fieldwork studies about the health practices of Plains Indians (the Cheyennes).
In his 1943 article, Ackerknecht harshly criticized Devereux’s methods. In particular, he accused Devereux of not having been able to move beyond the outdated argument in Freudian psychopathology that religion has the structure of a neurosis (articulated by Freud in The Future of an Illusion [Die Zukunft einer Illusion], 1927). Ackerknecht also attacked Devereux’s model for understanding schizophrenia as a “speculative sociological theory” (Acknerknecht, 1971, p. 82), but conceded that Devereux’s work on primitive psychopathology was otherwise clarifying: It is sad to see—but one reason more to take up the problem—that this statement—apparently an “improvement” of the older slogan that religion is a neurosis—comes from an author who, on the other hand, has done so much to elucidate problems of primitive psychopathology. (Acknerknecht, 1971, p. 61)
To respect the principle of symmetry important in analyzing a controversy, we must emphasize that Devereux responded to the detractors of his 1939 article 30 years later in the preface to the second edition of Mohave Ethnopsychiatry (Devereux, 1969, pp. viii–ix). In it, he characterized Ackerknecht’s critique as an approximation of culturalism, a scientific paradigm whose theories he had always condemned as simplistic. We must nevertheless note that, paradoxically, Devereux fervently supported Margaret Mead, one of the leading representatives of culturalism. In his book, Devereux attacked Ackerknecht’s 1943 article, claiming that using the criterion of social adaptation as a basis from which to differentiate between the normal and the abnormal was ethnocentric. He had already formulated this critique in Reality and Dream (1951).
In the third edition of his history of psychiatry published in 1985, the year of Devereux’s death, Ackerknecht, himself near the end of his life, mocked the enthusiasm for transcultural psychiatry as “trendy” (Ackerknecht, 1985, p. 2). We should note, however, that Ackernecht’s book opened with a first chapter about ethnology’s contribution to history, which was uncommon for a history of medicine and which demonstrates that this is an issue whose stakes are important to grasp for the history of the human and social sciences.
The Menninger Foundation in Ellenberger’s intellectual trajectory, 1953–1959
The Menninger Foundation in Topeka, Kansas, played a key role in the transition toward an academic transcultural psychiatry in the postwar period. It sheltered many professionals who had fled the authoritarian regimes of Central Europe, and who became influential in spreading psychoanalytic ideas in the United States. Over the course of a century, the leadership of the Menninger Foundation was assumed by three generations of the Menninger family (Friedman, 1992), 3 whose central figure is Karl Menninger (1893–1990). Then considered “the mecca of psychoanalysis,” this treatment center was also the largest center for psychiatric training in North America, before being dethroned, in terms of the number of resident psychiatrists, by McGill University’s Department of Psychiatry during the 1960s.
Devereux moved to Topeka in January 1947 to take up a research and teaching position, but his situation was precarious. Indeed, as neither a medical doctor nor a permanent member of a psychoanalytic society, he was not allowed to practice psychoanalysis, even if he had undertaken, the previous year, a didactic analysis with Marc Schlumberger after a first analysis in the United States with Róheim. He therefore could only undertake the psychotherapy of his famous Native American patient under the supervision of another psychoanalyst, Jan Frank, just as he himself was beginning a third analysis at the Topeka Institute of Psychoanalysis, a part of the Menninger School of Psychiatry, with another Jewish Hungarian psychoanalyst, Robert Hans Jokl. Devereux finally obtained the right to practice psychoanalysis in 1952, shortly before his departure. This shows the extent to which transcultural psychiatry is not only a legacy of colonial medicine, but is also linked to the history of scientific migration.
Psychotherapy of a Plains Indian is Devereux’s first book. It is based on the transcription of 30 psychoanalytic therapy sessions that Devereux had with Jimmy Picard (a pseudonym), a Native American from the Blackfoot tribe, who as a World War II veteran was being treated at the Winter General Hospital. Jimmy Picard suffered from psychological distress stemming from a number of factors, including familial conflict, relationship problems, overconsumption of alcohol, and cranial trauma incurred during the war. At the beginning of the text, Devereux introduces his methodology and its guiding principle, the “ethnic personality” that allows him to link psychology and ethnology. In his later academic autobiography, he would define the ethnic personality as “determined not by child rearing techniques but by the mood of the parents while mediating to him, through such techniques, the culture of his tribe” (Devereux, 1978b, p. 397). Devereux also presents a few basic aspects of Blackfoot culture, stressing in particular the importance of dreams. The treatment narrative is interwoven with Jimmy Picard’s family history and the anamnesis of his suffering. Finally, Devereux reproduces the results of psychometric evaluations and projective tests administered by a psychologist.
Devereux’s theoretical positions in the 1940s are rooted in the psychoanalytical interpretation of neurotic symptoms, based on an understanding of Freudian theory as universally applicable. But he tried to avoid psychological reductionism as well. Devereux returned to Kroeber’s concept of a “culture area” (Kroeber, 1930) in order to define “ethnic personality” and “identity.” 4 This demonstrates how important cultural anthropology is in his conceptual framework. Otherwise, Devereux would later develop his theory of “complementarism” between psychoanalysis and anthropology (Devereux, 1967, 1978a). Complementarism is certainly Devereux’s major contribution to the epistemology of social sciences, but it had not yet been formulated as a theory in Psychotherapy of a Plains Indian (1951).
If this book has undeniably marked the histories of transcultural psychiatry and of psychoanalysis, historical perspective now allows us to put it in dialogue with similar documents from the same period. I will therefore establish similarities and differences between this text and those available in the Ellenberger archive; Ellenberger’s work at the Menninger Foundation during this period is less well-known. While their correspondence primarily documents missed connections, Devereux and Ellenberger had shared experiences in Topeka with Native American patients, about which they both published scholarly essays.
Like Devereux and Ackerknecht, Ellenberger was a European who trained in France and then emigrated to North America (Delille, 2006). Born in Northern Rhodesia (a British colony, now Zambia), he had five nationalities in the course of his life: British, French, Swiss, American, and Canadian (Yanacopoulo, 2009). Chronology is therefore important. A descendent of Protestant missionaries of Swiss and French origin, he belonged to a family of prolific intellectuals; his father authored volumes of anthropology and naturalism as well as several translations (Ricard, 2003).
At the beginning of the Great War, when he was 9 years old, Ellenberger was sent by his parents to France for his studies. He began his medical training in Alsace and continued it in Paris in 1932 as a resident in Paris’ psychiatric hospitals (Asiles de la Seine) in order to become a psychiatrist. The Chair of Mental Illness at Paris’s Medical School was then Henri Claude (1869–1946). Among his students at the time were two famous psychiatrists, Henri Ey (1900–1977) and Jacques Lacan (1901–1981), who unlike Ellenberger never received university appointments. Only those who took the path of exile, including Hassan Azima, Maurice Dongier, and Ellenberger at McGill, succeeded in doing so.
In the 1930s, while working in Poitiers as a specialist in nervous disorders, Ellenberger developed an interest in folklore. He published articles on popular tales and legends, in continuity with his father’s work but also under the influence of the great French specialist Arnold van Gennep (1873–1957), before publishing his first articles on the history of psychiatry. Ellenberger became a French citizen in 1939, but because of the Vichy regime’s racist laws, in 1941 he decided to leave France in order to settle in Switzerland with his wife and children, putting them at risk of losing French citizenship.
As a therapist, Ellenberger had a very eclectic practice (Yanacopoulo, 2009). For example, he practiced hypnosis in Poitiers and insulin shock therapy and narcotherapy in Bern, and he tried to develop art therapy in Schaffhausen, where he worked from 1943 to 1953. It is during the time he spent in Switzerland that he trained as a psychoanalyst in Zurich, with Pastor Oskar Pfister, a close friend of Freud and a first-generation psychoanalyst. After the war, in 1952, he trained as a psychotherapist for schizophrenic patients in the United States, after which he was recruited by the Menninger Foundation in 1952–1953, principally to teach. However, like Devereux in the same period, he also practiced psychotherapy.
Devereux’s psychological treatment of Native American patients has become well-known, while Ellenberger’s similar practice—developed soon after his didactic analysis in Switzerland—has been overlooked. We must be precise about the timeline because their activities did not directly overlap: Devereux published his book in 1951 and left the treatment center in 1952, the year Ellenberger first arrived in Topeka. Their correspondence demonstrates that they met in 1952 and formed social and professional ties at the Menninger Foundation, but Devereux had already left Topeka when Ellenberger settled there definitively in 1953. It is possible that they discussed the individual Devereux calls Jimmy Picard, the Native American whose psychoanalysis he was carrying out at the Menninger Foundation, but their ulterior correspondence bears no trace of it. Devereux and Ellenberger would only meet again at a few scientific conferences, far from Topeka.
Ellenberger’s “ethno-psychiatrie,” between psychoanalysis and Janet’s legacy
Faithful to his pose as a thinker with a comprehensive perspective, both eclectic and restrained, Ellenberger cites Psychotherapy of a Plains Indian in his articles as a first-rate scientific study, without critiquing Devereux’s methodology or results. However, in the same publications, Ellenberger discusses different possible psychological interpretations of his own Native American patients’ difficulties, without adopting Devereux’s methodology and while clearly questioning the value of psychoanalytic interpretation. Ellenberger presents at least two cases of Native American patients from the Potawatomi and Kickapoo tribes who originated from reservations close to Topeka. These patients, like Jimmy Picard, were members of Plains Indian tribes whose languages belong to the Algonquian language family and who were traditionally buffalo hunters.
Ellenberger’s most detailed case history appeared in several documents with little variation. The first known version was published in French in 1965, at the beginning of an EMC booklet called “Ethno-psychiatrie” (Ellenberger, 1965). This is the collection which was the first French synthesis of transcultural psychiatry (Delille, 2008). Ellenberger compiled this enormous encyclopedic work with his colleague Brian Murphy (1915–1987), 5 an important pioneer of psychiatric epidemiology. Together they wrote other EMC booklets in 1978. Ellenberger also added new bibliographic entries in a 1978 EMC booklet focused on drug use (Ellenberger, 1978). Paying attention to this framework, which was not central in Devereux’s analysis, reveals a crucial difference between the two Topeka therapists.
The psychoanalyst and historian of psychoanalysis Élisabeth Roudinesco, who compiled a scholarly edition of Ellenberger’s articles, mentioned in a footnote (Roudinesco, 1995, p. 20) Ellenberger’s 1965 synthesis of transcultural psychiatry, which has never been republished. But there are also other published (Ellenberger, 1967, 1978) and unpublished documents to take into account: the Ellenberger archives 6 contain a previously unknown version which was developed for teaching. It is a typed 10-page lecture that presents the two clinical cases, the first as a short introductory vignette and the second as a more detailed case study offered for interpretation. The document is undated, but it contains as a handwritten addendum (“Peyote Addenda”) the supplementary bibliography found in the 1978 booklet about drug use. It therefore seems likely that the lecture was given as part of a course in the Department of Social Sciences at the University of Montreal, where Ellenberger taught from 1963 to 1977.
I will now briefly summarize the two clinical observations. The initial meeting with the Native American patients is identified as having taken place at the Topeka State Hospital in 1957–1958. The first case is that of a Native American from the Mayetta reservation who was hospitalized at the age of 33. Psychological tests revealed an implausibly low IQ; indeed, further tests showed that the results were skewed because the patient had no formal education. Furthermore, the patient did not suffer from an intellectual disability but rather from an organic brain syndrome. Here, psychological tests that were not adapted to the patient’s culture obscured a neurological pathology, which had been overlooked prior to a thorough examination taking into account the patient’s socialization in a reservation where he did not receive a formal education. The second case is that of a man in his sixties who was diagnosed with “alcoholic neurosis.” That this disorder should emerge so late, in an elderly subject, seemed far-fetched to the psychiatrist. Ellenberger wrote in his 1965 booklet: In 1957, a Kickapoo Indian who was about 65 years old was admitted to the psychiatric hospital in Topeka (Kansas). Sober until recently, he had suddenly begun to consume alcohol in excessive amounts after unclear circumstances where disagreements with his wife seemed to play a role. The case was diagnosed as “alcoholic neurosis.” The fact that I knew one of his friends and neighbors well incited the patient to tell me his story. Like many Indians of his tribe, he had a sort of double personality: an American name and an Indian name, an “official” religion and an “Indian” religion. Although nominally Protestant, he belonged to the Peyote religion, to which he had converted approximately fifteen years earlier. He practiced his religion sincerely, but eventually became addicted to peyote (a rare but not unimaginable occurrence). His wife, who belonged to another Indian religion, that of the “Drummers,” was hostile to the Peyote cult. One day peyote was unavailable: our man was overwhelmed by acute distress, which led him to seek relief in alcohol. This was the real origin of this late-onset alcoholism—but it was deeply loathsome to our man to speak of peyote and of his religion, which he considered purely Indian matters that did not concern medical doctors. (Ellenberger, 1965, p. 2 [Trans. by Emmanuel Delille & Marie McDonough])
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This case and Devereux’s famous case have various elements in common: the patients are men struggling with major conjugal conflicts or conflicts with powerful women in their families; 8 psychological tests were carried out in hospitals—which shows that psychoanalysis was not the only psychological treatment practiced in Topeka in the 1950s; alcoholism is a recurrent but illusory pattern which conceals other, more salient diagnostic possibilities, such as neurotic symptoms (Devereux) or anxiety about religious practices (Ellenberger). There is also, of course, a common interest in the patients’ language, customs, and religion. Moreover, far from the stereotypical neutrality that Freudian doctrine requires of analysts vis-à-vis their patients, Devereux and Ellenberger seem to have developed relations of trust and even friendship with their patients.
After this series of similarities, we must also nuance our comparison of Ellenberger and Devereux. First, Ellenberger depicts the presence of Native Americans at the Menninger Foundation as ordinary; indeed, the Menninger Foundation was surrounded by Native reservations, and Mayetta is located less than an hour away from Topeka. Ellenberger also considers drug use a relevant framework for analysis; from his point of view, the relationship between the toxic and the sacred, between drug use and magico-religious rite is interesting, especially as it comes into conflict with Protestant puritanism—a dimension absent from Devereux’s book. Ellenberger ends his clinical observation with a participant observation of the religious practices of the Native Americans whom he discusses, but these religious practices are not explored in Freudian psychoanalysis, which, as mentioned above, introduces a clear theoretical parallel between rituals and neurotic symptoms. Similarly, if Ellenberger calls on his patients to express themselves in drawings (Figure 2), it is neither to represent their mental contents nor to interpret Freudian fantasies, but rather to document magico-religious practices. Finally, Ellenberger is like Devereux interested in dreams, but does not interpret them psychoanalytically; furthermore, he indicates that the visions were caused by the toxic psychoactive substance in peyote, and that they were nightmares, in the metaphorical sense of the term (“distressing visions”). Ellenberger refuses to describe the drug-induced religious experience of Native Americans as pathological: “This experience is not an artificial psychosis,” he writes at the end of his unpublished lecture. His patients were not having hallucinations but rather “pseudo-hallucinations.” He therefore deems the analytical framework of the normal and the pathological irrelevant, insofar as there is no schizophrenic delusion. Here we can see the convergence of Ellenberger’s and Ackerknecht’s critiques of the inappropriate use of concepts of psychopathology.
Patient’s drawing and Ellenberger’s comments.
Ellenberger’s narrative pulls together knowledge from various domains: the social sciences, religious studies, botany and psychopharmacology, but also literature (Huxley, 1954 9 and Michaux, 1966 10 ), and especially psychology. But which psychology? From the start Ellenberger’s interpretive framework comes from classical psychology and its theory of double and multiple personalities, which gave rise to several scientific controversies during the 19th century (Carroy, 1993); this is not the psychoanalytic framework of Freud or of Devereux. Rather, Ellenberger draws on the work of the French psychologist Pierre Janet (1859–1947) and the dissident psychoanalyst Carl Gustav Jung (1875–1961). Indeed, Janet authored an overview of 19th century French psychology focusing on the Salpêtrière (Charcot, Bourneville, etc.) and Nancy (Bernheim) schools, which fed the controversy about the diagnosis of double or multiple personalities. The origin of this diagnosis can be traced back a half century before Freudian psychoanalysis and specifically to the case of Félida, a young woman about whom the Bordeaux physician Eugène Azam (1822–1899) wrote several influential works between 1858 and 1876. This case was so important in the history of psychology that Janet considered Félida the true founder of the Chair in Psychology at the Collège de France! Janet himself is well-known for clinical observations of hysteria featuring women suffering from religious torment and double personalities. The introduction of this diagnosis at the Menninger Foundation as an alternative to psychoanalytic interpretation is therefore not happenstance, as Ellenberger was at the time one of Janet’s first serious biographers (Ellenberger, 1950a, 1950b). Moreover, Ellenberger’s interest in the history of double and multiple personalities never waned: the last article (Ellenberger, 1991) he published, near the end of his life, concerned the history of one of Jung’s case studies about double personality. Like Ellenberger, Jung was the son of a Protestant pastor and was passionate about world religions, and Ellenberger visited him when he lived in Switzerland.
Once these similarities and differences are set out, it is particularly interesting from a historical point of view to notice that Ellenberger did not find it appropriate to offer a Freudian interpretation of his Native American patients—and I insist on this once more—even though he had just completed his didactic analysis in Switzerland with Pastor Pfister, Freud’s close friend and a first generation psychoanalyst. As a historian, in his book The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry (1970), Ellenberger treated Adler, Freud, Janet, and Jung as equally important protagonists. The clinical observation shows that Ellenberger held to the same principle as a psychiatrist and therapist: rather than privileging psychoanalytic explanations in his case study of his Native American patient, he presents several psychological interpretations and accords them equal value. Ellenberger’s lecture ends with an ironic remark drawn from Sandford Unger’s work at the American National Institute of Mental Health (Unger, 1963a, 1963b), jotted down in telegraphic style and then reproduced in the 1978 booklet about drug use: When the drugs were administered by Freudian psychoanalysts, subjects tended to relive childhood memories, with positive results; when they were administered by Jungians, the subjects had transcendent experiences with no less positive results; when they were administered to Harvard students, they grappled with philosophical problems such as determinism and free will, good and evil, etc. (Ellenberger, 1978, p. 5 [Trans. by Emmanuel Delille & Marie McDonough)
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For a connected history: Transcultural psychiatry’s scholarly networks
At the end of 1958, 6 years after Devereux, Ellenberger also left the Menninger Foundation. He obtained a research appointment in the Division of Social and Transcultural Psychiatry at McGill University in Montreal, which confirms that the history of transcultural psychiatry goes as much through Montreal as through Topeka when we reconstruct its development during the 1950s—and especially when we think of it in terms of a network. What is this network? That of the newsletter Transcultural Research in Mental Health Problems, created in 1956 by Wittkower, whose goal was to bring together the medical doctors and researchers around the world who were interested in transcultural psychiatry by collecting and centralizing relevant scientific information for the first time. Ellenberger and Devereux were both early correspondents for the newsletter, as were others who might be deemed pioneers: Roger Bastide, Henri Collomb, Guy Dubreuil, Louis Mars, Edmond and Marie-Cécile Ortigues, and so forth, to cite only Francophones. But the newsletter soon proved controversial as well: we must emphasize that Devereux levelled certain criticisms against the McGill reviewers in the newsletter (Devereux, 1964) and in the preface to the second edition of Mohave Ethnopsychiatry (Devereux, 1969, p. ix). I cannot present other protagonists here, but wish simply to emphasize that in the 1950s, 1960s and 1970s, this newsletter featured, Europeans as well as Americans, and medical doctors as well as researchers in the social sciences.
In short, by challenging a foundation myth featuring an isolated genius, the history of networks offers us the possibility of highlighting the links between actors in a “transition,” in Alice Bullard’s sense. Devereux and Ellenberger are actors in a connected history. Sources for this history are not lacking: in addition to the EMC and McGill’s newsletter, edited volumes were published throughout the 1950s. To cite only one example, we can point to a book edited by the anthropologist Marvin Opler (1914–1981), Culture and Mental Health (Opler, 1959a) which combines our two areas of inquiry: one on hand, it clearly consists in a cultural approach to psychiatry, drawing from psychoanalysis as well as ethnology. On the other, it presents research on the psychological treatment of Native Americans (Opler, 1959b), confirming that Devereux’s and Ellenberger’s practices were not exceptional but rather were inscribed in a particular moment in the history of the human sciences.
Devereux and Ellenberger both continued their academic careers in the 1960s. After Topeka, Devereux moved to Pennsylvania, where he worked at an institute for children with behavioural and/or mental health problems (Devereux School, Devon). In 1956, he became associate professor of Ethnopsychiatry at Temple University (Philadelphia). Then, from 1959 until 1963, he practiced psychoanalysis in New York and also taught at Columbia University. But his principal affiliation remained with Temple, where he eventually became full professor. In 1963, however, he left the United States definitively and returned to Paris. He took a position at the École Pratique des Hautes Études (EPHE), with the support of two eminent anthropologists, Claude Lévi-Strauss and Roger Bastide, who was the head of the Institute for Social Psychiatry at the Sorbonne.
For his part, Ellenberger stayed at McGill University for 3 years before obtaining a Chair in Criminology at the francophone Université de Montréal (1963). Nonetheless, as previously noted, he continued to publish on transcultural psychiatry with Brian Murphy (Murphy, 1965) until the 1970s. He also practiced in several of Montreal’s psychiatric hospitals. Ellenberger and Devereux met at least one more time, at a 1968 conference in Dakar that was dedicated to African psychiatry and psychopathology. They were invited by Collomb, who worked with the Ortigues (Bullard, 2005b). In this way, Topeka, Montreal, Paris, and Dakar are interrelated pieces of transcultural psychiatry’s scholarly networks in transition after the war. But each site and network needs new historical analyses.
Conclusion
Today, it is possible to compare Devereux’s well-known case study “Jimmy P.” with others of Native Americans at the Menninger Foundation, namely those written by Ellenberger in his “Ethno-psychiatrie” for the French Encyclopédie Médico-Chirurgicale, and in his lecture notes for his Montreal courses. Rather than being unique, these texts document patients with a similar ethnic background, who were treated at the same institution but with different methods and theoretical approaches. They clearly demonstrate the diversity of early transcultural psychiatry. Psychoanalysis was not the only method of interpretation used, even if Ellenberger had completed a didactic analysis before his stay in Topeka. Each figure in this academic field in transition had a unique but equally eclectic training, whether it included medicine or not, anthropology or history, psychoanalysis as part of the long tradition of psychology or as new “gold standard.” To emphasize two important differences, Ellenberger’s case histories were clearly developed with the training of new physicians in mind, and they were indexed to the history of psychology from the 19th century on, whereas Devereux’s essays targeted practicing psychoanalysts.
Another obvious conclusion is that these figures were also connected with each other in this period of transition, participating in the same transnational scholarly networks. Indeed, “transition” does not only mean decolonization after World War II but also points to a vast scientific migration. Historical sources allow us to assert that the codification of transcultural knowledge began with scientists who had personal transcultural experience in the context of their academic careers. But the Menninger Foundation was an important stage in the careers of Devereux and Ellenberger not only because of transcultural psychiatry: it was there that Devereux undertook his first psychotherapy with a patient, and Ellenberger, at the request of Karl Menninger, his first teaching on the history of dynamic psychiatry.
Archival materials
Henri Ellenberger’s papers and works are distributed among several collections: Centre de Documentation Henri Ellenberger (Centre Hospitalier Sainte-Anne, 1 rue Cabanis, 75014, France); archives of the Université de Montréal (Division des Archives de l’Université de Montréal, 2900 boulevard Édouard-Montpetit, Montreal, Canada). Georges Devereux’s papers are held at IMEC (Institut Mémoires de l’Édition Contemporaine, Abbaye d’Ardenne, 14280 Saint-Germain la Blanche-Herbe, France).
Footnotes
Acknowledgements
This article emerges from several conference papers given these last few years in Japan and in Europe. I am deeply grateful to Professor TSUIKI Kosuke (Kyoto University), the Japan Society for the Promotion of Science (JSPS), and the Maison des Sciences de l’Homme Paris-Nord (MSH-PN). I also wish to thank the team at CAPHÉS (Laurie Catteeuw and Mireille Delbraccio, CNRS, and ENS-Ulm, Paris), which organized the colloquium “Georges Devereux: au-delà de l’ethnopsychiatrie?” on June 12, 2014, in collaboration with IMEC (François Bordes). I am also grateful to Irène Ellenberger, Michel Ellenberger, Professor Eric Engstrom (Humboldt University, Berlin), Samuel Lézé (ENS-Lyon), and Andrée Yanacoupoulo, who encouraged me to continue my research, and to Christopher Lyons (Osler Library, Montreal), Catherine Lavielle, and Nadine Rodary (Bibliothèque médicale de l’hôpital Sainte-Anne, Paris). I also wish to thank Marie Satya McDonough, who translated this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
