Sailing between Scylla and Charybdis: invited response to ‘Blame or discovery?’
Claire Hilton

TL;DR
This paper discusses the challenges of fairly representing psychiatrists in historical research without bias or blame.
Contribution
It offers a balanced perspective on the dual risks of hagiography and accusations in psychiatric history.
Findings
Historical research risks hagiographic portrayals of psychiatrists.
Accusations of self-interest and oppression can distort historical narratives.
Balanced approaches are needed to navigate these dual dangers.
Abstract
This brief commentary reflects on navigating two dangers of historical research into psychiatry: hagiographic representations of psychiatrists; and accusations of their self-interest and oppression of vulnerable people.
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Taxonomy
TopicsHistorical Psychiatry and Medical Practices · Mental Health and Psychiatry · Neurology and Historical Studies
I would like to focus on two of George Ikkos's comments:^1^ ‘Although fairness is undoubtedly a foundational value in both history and psychiatry, arguably the key driver in historical enquiry should be discovery rather than praise or blame’ and ‘Consistent with her institutional position, Hilton presses repeatedly her legitimate anxiety lest psychiatrists be unfairly criticised or blamed’.
As a historian, I aim to understand and explain the past as impartially and objectively as possible. Historical research is a voyage of discovery, but when seeking out psychiatry and psychiatrists, one needs to navigate cautiously to avoid the dangers of Scylla and Charybdis.
On one side are hagiographic representations: Festschriften; biographies; eponymous donations, bequests, lectureships or terminology; obituaries which follow the aphorism De mortuis nil nisi bonum (‘Of the dead, nothing but good’). Their messages often originate from psychiatric colleagues and institutions. On the other side, widely quoted historical analyses by Michel Foucault,^2^ Andrew Scull,^3^ Elaine Showalter,^4^ Akinobu Takabayashi^5^ and others have dominated the landscape, often featuring psychiatrists as seeking to benefit themselves while oppressing vulnerable people whom they were meant to be helping.
The polarities of these Scylla and Charybdis sources are hard to reconcile, and we may become enmeshed in either at our peril. Incredulity at what others had written about psychiatry and psychiatrists of the past drew me into researching the subject, well before taking up my ‘institutional position’.
Steering cautiously and critically with an open mind as to what one might find are prerequisites for a successful voyage of historical exploration. ‘Praise and blame’ about past generations are by-products of historical research, not motivations or goals for it. Understanding what happened in the past, however, may contribute to avoiding psychiatry and psychiatrists being ‘unfairly criticised or blamed’ in the future.
The reference list from the paper itself. Each links out to its DOI / PubMed record.
- 1Ikkos G. Invited commentary: blame or discovery? Walter Benjamin's Jetztzeit, Purdue Pharma LP and ‘our values and our historical understanding of psychiatrists’. BJ Psych Bull [Epub ahead of print]. Available from: 10.1192/bjb.2023.40.PMC 1098572237282592 · doi ↗ · pubmed ↗
- 2Foucault M. Madness and Civilisation: A History of Insanity in the Age of Reason. Random House, 1965.10.1192/bjp.bp.115.16527426527668 · doi ↗ · pubmed ↗
- 3Scull A. The Most Solitary of Afflictions: Madness and Society in Britain, 1700–1900. Yale University Press, 1993.
- 4Showalter E. The Female Malady: Women, Madness, and English Culture, 1830–1980. Pantheon Books, 1985.
- 5Takabayashi A. Surviving the Lunacy Act of 1890: English psychiatrists and professional development during the early twentieth century. Med Hist 2017; 61: 246–69.28260566 10.1017/mdh.2017.4PMC 5426304 · doi ↗ · pubmed ↗
