Houston Psychoanalytic Society
Evening Speaker Series
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Almost Half a Century Since it Was Expelled From the DSM, Why is Psychoanalytic Thought Still in the Wilderness? |
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Hannah Decker, PhD, Historian |
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Thursday, January 12, 2023
7:30PM – 9:00PM Central Time
Live via Zoom
*Pre-Registration required for Zoom invitation
Registration Fees
HPS Members: Free
Non-Members: $20
CE/CME/CEU (1.5 hrs) Fees
HPS Active/Student Members: Free
HPS Friend Members: $20
Non-Members: $20
Instructional Level: Beginner - Advanced
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After World War II ended in 1945, psychoanalysis began to dominate American psychiatry. But keep in mind that almost all the members of the American Psychoanalytic Association were psychiatrists. Thus, even as psychoanalysis rose to prominence, there was a growing threat to America’s psychiatrists. In an era of reform, there was increasing outrage in the 1950s and 1960s that the over 500,000 Americans in the nation’s state mental institutions were housed in deplorable and often shocking conditions. America’s psychiatrists were attacked for not treating the seriously mentally ill, while simultaneously criticized for exerting social control over their patients. There arose a vociferous anti-psychiatry movement, emerging from both the political right and left, and fueled by sociologists and the legal profession. In this state of crisis, the American Psychiatric Association (APA) desperately sought to convince the nation that psychiatry was a trustworthy and skilled medical specialty by publishing a new diagnostic manual of mental disorders that would be seen as scientific and thus silence the anti-psychiatry voices. This manual—DSM-III—appeared in 1980. Gone were the psychodynamic principles that had underlain the diagnoses found in DSM-II. In DSM-III unconscious ideation was nowhere to be seen.
Professor Decker's presentation will illustrate the strength of the anti-psychiatry movement, a part of the Vietnam era’s many protests. The anti-psychiatry’s influence became so deep that the APA continues today to be motivated to keep that movement at bay. The second part of her talk will deal with the anti-psychoanalytic animus of the DSM-III Task Force, who were dedicated to bringing about the fall of psychoanalysis. The Task Force was dominated by members or offshoots of the biological psychiatry department of the Washington University in St. Louis whose prejudice against psychoanalysis influenced the editor of DSM-III, Robert Spitzer.
However, there were other reasons for the monumental conceptual shift in psychiatry. In what ways did the analysts themselves contribute to their downfall? Moreover, as the psychoanalytic presence has dimmed over time, where does that leave its practitioners and organizations?
In a world of increasingly difficult challenges and limited resources does a field such as psychoanalysis have a future? Will there continue to be a clinical base on which to construct theoretical innovation? Or, more positively, has psychoanalysis sufficiently entered the realm of psychotherapy to continue to be meaningful?
LEARNING OBJECTIVES
At the completion of this activity, the learner will be able to:
- Describe the major roots and strengths of the anti-psychiatry movement.
- Explain the anti-psychoanalytic animus of the DSM-III Task Force.
- Describe ways in which psychoanalysis contributed to its decline.
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Hannah S. Decker is a cultural historian of psychiatry. She earned her doctorate in German history from Columbia University and completed a fellowship in the history of psychiatry at the Cornell University College of Medicine. Currently she is Professor of History at the University of Houston and Adjunct Professor in Medical History in the Menninger Department of Psychiatry at the Baylor College of Medicine. She has also taught at the Center for Psychoanalytic Studies in Houston. At the University of Houston, Professor Decker has received awards for excellence in research and teaching. She has also received fellowships from the National Science Foundation and the National Endowment for the Humanities. She has published widely in the histories of psychiatry and psychoanalysis. Her books include Freud in Germany: Revolution and Reaction in Science; Freud, Dora, and Vienna 1900; and, most recently, The Making of DSM-III: A Diagnostic Manual’s Conquest of American Psychiatry. This last book was awarded a Special Presidential Commendation by the American Psychiatric Association. In 2007 Professor Decker received the Carlson Award from the Cornell University Medical College for "extraordinary contributions to the history of psychiatry and psychoanalysis."
REFERENCES
Decker, H.S. (2010) “A Moment of Crisis in American Psychiatry: The Fight Over the making of DSM-5, 2007-2010," History of Psychiatry Website, April 2010.
Decker, H. S. (2013). The making of DSM-III: A diagnostic manual's conquest of American psychiatry. Oxford U. Press.
Klerman, G. L. (1990). The psychiatric patient's right to effective treatment: Implications of Osheroff vs.Chestnut Lodge. American Journal of Psychiatry, 147: 409-418.
Kendler, K. S., Munoz, R. A. & Murphy, G. (2010). The development of the Feighner criteria: A historical perspective. American Journal of Psychiatry, 167: 134-142.
McWilliams, N. (2020). The future of psychoanalysis: Preserving Jeremy Safran's integrative vision. Psychoanalytic Psychology, 37: 98-107.
McWilliams, N. (2021). Diagnosis and its discontents: Reflections on our current dilemma. Psychoanalytic Inquiry. 41: 565-579.
Szasz, T. S. (1961). The myth of mental illness: Foundations of a theory of personal conduct. Harper & Row.
DSM image from Shutterstock
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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of American Psychoanalytic Association and the Center for Psychoanalytic Studies, as a co-sponsor of Houston Psychoanalytic Society. The American Psychoanalytic Association is accredited by the ACCME to provide continuing medical education for physicians.
The American Psychoanalytic Association designates this Live Activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
IMPORTANT DISCLOSURE INFORMATION FOR ALL LEARNERS: None of the planners and presenters for this educational activity have relevant financial relationship(s)* to disclose with ineligible companies* whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
*Financial relationships are relevant if the educational content an individual can control is related to the business lines or products of the ineligible company.
-Updated July 2021-
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Houston Psychoanalytic Society is approved by the American Psychological Association to sponsor continuing education for psychologists. Houston Psychoanalytic Society maintains responsibility for this program and its content.
HPS, through co-sponsorship with the Center for Psychoanalytic Studies, also offers approved CEs for social workers, licensed professional counselors, and marriage and family therapists.
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1302 Waugh Dr. #276, Houston, TX 77019
(713) 429-5810
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