History of profession
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Historical biographies of professionals in the field of German-speaking psychiatry
Burkhart Brückner (2015)
There has always been an abundance of biographies in the medical field. The long-standing tradition of doctors’ biographies is reflected in numerous articles and edited volumes, in the international Journal of Medical Biography and in popular science literature. All these texts link the history of science to the actions of individuals. The “individual” is a core term in therapeutic practice, be it in acknowledging patients as the subjects of their own life stories, be it in training therapeutically efficacious “personalities”. Psychiatric practice in particular depends on interpersonal encounter and support, on dialogue and congruent action. It is against this ethical background that many professionals have told their own biographies (cf., e.g., the compilations in Schneider 2012; Wilkinson 1993; Pongratz 1977; see also Dörner 2001). On the other hand, the term “burnout” was initially coined with regard to the psychosocial professions (Freudenberger 1974) – and, more often than not, good practice was defined solely in terms of what is beneficial to the patient, while the professionals themselves were rarely seen as subjects with their own needs, expectations and life histories (except in psychoanalysis) (Dreier 1987).
The history of psychiatry is, of course, always also the history of its formative agents. However, the representatives of a structural and social historiography have argued decades ago against the aggrandisement of single individuals. Kurt Kolle’s 1956 (1963) compilation Große Nervenärzte (Great Psychiatrists) might serve as a vivid example of this tradition (Depkat 2011; Hähner 1999). In contrast to this focus on the individual, a number of influential authors shed critical light on the daily professional practice in mental institutions during the heyday of the sociology of professions in the 1970s and 1980s (cf. Goffman 1961; Fengler & Fengler 1984; Zaumseil & Keupp 1978). However, as long as the professional actors were regarded merely as agents of institutional systems (e.g., as the agents of labelling processes), their subjectivity remained a blind spot as well. Alma Kreuter (1996), author of the most comprehensive German-language biographical and bibliographical compilation on the history of psychiatry, suggested that such material also be collected on the less-known and “unnoticed” members of the profession – the “minor psychiatrists”, as she called them with ironical reference to the eminent leading figures portrayed by Kolle (cf. Hippius & Hoff 1996: vii).
At the beginning of the 21st century, the field of medical professions saw its own “biographical turn” with studies employing hermeneutics and qualitative social science methods (Rickard 2004; Honegger, Liebig & Wecker 2003; Chamberlayne, Bornat & Wengraf 2000). There are a number of contemporary individual studies that combine the traditional sociology of professions with biographical research, but also with the historiography of gender or everyday life (e.g., Milligana, Kearnsb & Kylec 2011; Ostermann-Vogt 2011; Witte 2010; and more general: Pundt 2012; Ahlheit & Dausien 2009; Fabel & Tiefel 2004; Kraul, Marotzki & Schweppe 2002; Come & Helsper 1996).
Theo Payk (2000) sought to present a comprehensive historical review of the psychiatric profession in Germany. Methodologically satisfactory studies, however, are rather rare (e.g., Lohff & Kintrup 2013; Schuster 2010; Bewley 2008; Hess 2008; Germann 2003; Bucholz 1999; Berrios & Freeman 1991). An inspiring example is Eric Engstrom’s Clinical Psychiatry in Imperial Germany (2003), a study on the development of the profession during the early 20th century. Yet, we still see publications that follow the (more developed) traditional path of writing individual biographies (Hippius, Schliack & Holdorf 2006; Hippius & Schliack 1998). Other projects have turned to combining their biographical research with approaches borrowed from structural history and take into consideration the influence of the social – and sometimes also of ideology – in forming the personality. The history of the DGPPN (Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde), Germany’s largest expert association in the field of mental health, for instance, reveals the dramatic as well as problematic development of professional careers in psychiatry during the Nazi era, owing especially to the quest for professional recognition (Schmuhl 2013; Roelcke 2013; cf. Lockot 1994; Greuter 1988).
The attempt to combine profession-centred and patient-centred biographical historiography is thus based on a range of solid research traditions. A viable concept of the biographical subject facilitates the integration of approaches, methods and trends originating from the medical humanities, social research (Brückner 2008), patient-centred historiography and disability studies (Bösl 2010). We thus draw on well-established resources and address issues such as deprofessionalisation and the limits of the discipline as well as more recent participatory models (e.g., “trialogue” forums or peer work).
The Biographical Archive of Psychiatry builds on the foundations of cultural and social history and the sociology of professions, incorporates patient-centred historiography and takes a multi-professional perspective of the field of mental health care. In including the perspective “from below”, our approach to the history of the psychiatric profession is essentially participatory. We also consider transdisciplinary influences and contributions made by historians, sociologists, journalists, politicians and administrators. The actual focus can differ depending on our authors and their respective perspectives and research interests: some strongly focus on the history of a professional’s work, while others place more emphasis on biographical aspects, on the politics of the persons portrayed or on their conception of the relationship between therapist and patient.
Literature
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