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Psychiatry and Eugenics: Keeping America Sane: Psychiatry and Eugenics in the United States and Canada, 1880-1940

Psychiatry and Eugenics: Keeping America Sane: Psychiatry and Eugenics in the United States and... Active support for the eugenics movement during its heyday in the early part of the century is commonly, and often accurately, associated with arrogance and prejudice, though students of the period know that eugenics was also attractive, for idealistic reasons, to a number of progressive thinkers and liberal social reformers. The response of psychiatrists to the movement, however, was much more complex than either of these tendencies, as Ian Robert Dowbiggin makes clear in his valuable and meticulously documented study Keeping America Sane. Psychiatry at the turn of the century emerges from Dowbiggin's description as the Rodney Dangerfield of the medical sciences. Under mounting criticism from the new, more exciting specialty of neurology, unable to profit from the spectacular advances in other areas of medicine, unlikely to attract promising newcomers to a seemingly stagnant (and not particularly well paid) field, often charged with the management of incurable patients in public institutions, and as a consequence faced with the possibility of reduction to the status of an impotent civil service answerable to politicians and bureaucrats, the field of psychiatry suffered from professional insecurity and what Dowbiggin aptly terms "therapeutic pessimism." In this context eugenics was an offer that many psychiatrists could not refuse, promising to rescue them from the frustrations of the asylum and to place them—in the words of one Canadian doctor quoted by Dowbiggin—"in everyday life, ready to apply the ounce of prevention in preference to the pound of cure." Eugenic legislation prohibiting the marriage and authorizing the sterilization of "defective persons" seemed to offer a solution to overcrowded and underfunded institutions. And the debate over immigration policy—an obsession of the eugenics movement—provided an opportunity for psychiatrists to promote their own expertise as the way to stem the influx of "defective aliens." As a president of the American Medico-Psychological Association (forerunner of the American Psychiatric Association) observed in 1908, the time had come "to make ourselves felt in these great public issues which are now pressing upon the country." Psychiatrists saw, in eugenics, not only the potential solution to practical problems, but also the route to prominence and respect. In the face of such irresistible appeal, complete agreement with eugenicist principles was not necessary for psychiatrists to exploit the movement's vocabulary for their own purposes. As Dowbiggin puts it, "They often recommended eugenic measures for noneugenic reasons." Yet particularly in the United States, Dowbiggin convincingly argues, the proximate benefit for psychiatrists that led many to such an enthusiastic embrace of eugenics also contained the seeds of their eventual disillusionment. Initially attracted by the marriage and sterilization laws, which "enabled psychiatrists to sidestep embarrassing questions about their persistent failure to cure their institutional patients," they frequently came to the realization that their support for these same measures constituted an "admission of failure," as the emphasis on prevention inevitably drew attention to their own inadequacies as medical professionals and "raised the prospect of remedial psychiatry's obsolescence." Instead of a path leading psychiatry to respect and recognition as a branch of medicine, eugenics turned out to be an obstacle. In addition, the opinions of some psychiatrists in the United States shifted in accord with changes in their occupational circumstances. G. Alder Blumer, for example, the President of the American Medico-Psychological Association for almost the first quarter of the century, became an outspoken proponent of eugenics while at Utica State Hospital, a public institution in New York filled with the poor and the chronically ill. After becoming the medical superintendent at Butler Hospital in Providence, RI, a well-endowed private institution catering to prosperous New Englanders, however, Blumer found his belief in hereditary taint unacceptable to the patrician families of his clientele, who were busy campaigning for immigration restriction on the basis of their hereditary superiority to the newcomers. "The result," as Dowbiggin humorously describes it, "was a hasty retreat," with Blumer soon recognizing a "neuropathic streak in a genteel family . . . [as] a sign of distinction." Indeed, over the years his comments on eugenics often seemed tailored to fit his audience. In contrast, Dowbiggin describes how Canadian psychiatrists were much less likely to develop second thoughts about eugenic measures, largely as a result of their greater reliance on government support. In a political culture much less dependent on private philanthropy, psychiatrists' enthusiasm for eugenics did not follow the general pattern of eventual diminution characteristic of their colleagues to the immediate south. In both countries, however, Dowbiggin makes clear that psychiatric participation in the eugenics movement was always informed by concern over unfit individuals, not races or nationalities. This laudable emphasis on individuals might seem to exculpate psychiatrists by distinguishing them from the more mean-spirited elements in the movement. It is important, therefore, to keep in mind that, whatever their personal opinion, only a few of these professionals offered any public opposition to the nativists, whose own position was then dignified by the association with a branch of medicine. Thus, the unspoken paradox underlying Dowbiggin's study: in the desire to enhance their own prominence and respect, psychiatrists entered into a symbiotic alliance with eugenics, only to find that their participation conferred increased respect on an approach that they opposed. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Psychiatry and Eugenics: Keeping America Sane: Psychiatry and Eugenics in the United States and Canada, 1880-1940

JAMA , Volume 279 (6) – Feb 11, 1998

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Publisher
American Medical Association
Copyright
Copyright © 1998 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.279.6.477-JBK0211-2-1
Publisher site
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Abstract

Active support for the eugenics movement during its heyday in the early part of the century is commonly, and often accurately, associated with arrogance and prejudice, though students of the period know that eugenics was also attractive, for idealistic reasons, to a number of progressive thinkers and liberal social reformers. The response of psychiatrists to the movement, however, was much more complex than either of these tendencies, as Ian Robert Dowbiggin makes clear in his valuable and meticulously documented study Keeping America Sane. Psychiatry at the turn of the century emerges from Dowbiggin's description as the Rodney Dangerfield of the medical sciences. Under mounting criticism from the new, more exciting specialty of neurology, unable to profit from the spectacular advances in other areas of medicine, unlikely to attract promising newcomers to a seemingly stagnant (and not particularly well paid) field, often charged with the management of incurable patients in public institutions, and as a consequence faced with the possibility of reduction to the status of an impotent civil service answerable to politicians and bureaucrats, the field of psychiatry suffered from professional insecurity and what Dowbiggin aptly terms "therapeutic pessimism." In this context eugenics was an offer that many psychiatrists could not refuse, promising to rescue them from the frustrations of the asylum and to place them—in the words of one Canadian doctor quoted by Dowbiggin—"in everyday life, ready to apply the ounce of prevention in preference to the pound of cure." Eugenic legislation prohibiting the marriage and authorizing the sterilization of "defective persons" seemed to offer a solution to overcrowded and underfunded institutions. And the debate over immigration policy—an obsession of the eugenics movement—provided an opportunity for psychiatrists to promote their own expertise as the way to stem the influx of "defective aliens." As a president of the American Medico-Psychological Association (forerunner of the American Psychiatric Association) observed in 1908, the time had come "to make ourselves felt in these great public issues which are now pressing upon the country." Psychiatrists saw, in eugenics, not only the potential solution to practical problems, but also the route to prominence and respect. In the face of such irresistible appeal, complete agreement with eugenicist principles was not necessary for psychiatrists to exploit the movement's vocabulary for their own purposes. As Dowbiggin puts it, "They often recommended eugenic measures for noneugenic reasons." Yet particularly in the United States, Dowbiggin convincingly argues, the proximate benefit for psychiatrists that led many to such an enthusiastic embrace of eugenics also contained the seeds of their eventual disillusionment. Initially attracted by the marriage and sterilization laws, which "enabled psychiatrists to sidestep embarrassing questions about their persistent failure to cure their institutional patients," they frequently came to the realization that their support for these same measures constituted an "admission of failure," as the emphasis on prevention inevitably drew attention to their own inadequacies as medical professionals and "raised the prospect of remedial psychiatry's obsolescence." Instead of a path leading psychiatry to respect and recognition as a branch of medicine, eugenics turned out to be an obstacle. In addition, the opinions of some psychiatrists in the United States shifted in accord with changes in their occupational circumstances. G. Alder Blumer, for example, the President of the American Medico-Psychological Association for almost the first quarter of the century, became an outspoken proponent of eugenics while at Utica State Hospital, a public institution in New York filled with the poor and the chronically ill. After becoming the medical superintendent at Butler Hospital in Providence, RI, a well-endowed private institution catering to prosperous New Englanders, however, Blumer found his belief in hereditary taint unacceptable to the patrician families of his clientele, who were busy campaigning for immigration restriction on the basis of their hereditary superiority to the newcomers. "The result," as Dowbiggin humorously describes it, "was a hasty retreat," with Blumer soon recognizing a "neuropathic streak in a genteel family . . . [as] a sign of distinction." Indeed, over the years his comments on eugenics often seemed tailored to fit his audience. In contrast, Dowbiggin describes how Canadian psychiatrists were much less likely to develop second thoughts about eugenic measures, largely as a result of their greater reliance on government support. In a political culture much less dependent on private philanthropy, psychiatrists' enthusiasm for eugenics did not follow the general pattern of eventual diminution characteristic of their colleagues to the immediate south. In both countries, however, Dowbiggin makes clear that psychiatric participation in the eugenics movement was always informed by concern over unfit individuals, not races or nationalities. This laudable emphasis on individuals might seem to exculpate psychiatrists by distinguishing them from the more mean-spirited elements in the movement. It is important, therefore, to keep in mind that, whatever their personal opinion, only a few of these professionals offered any public opposition to the nativists, whose own position was then dignified by the association with a branch of medicine. Thus, the unspoken paradox underlying Dowbiggin's study: in the desire to enhance their own prominence and respect, psychiatrists entered into a symbiotic alliance with eugenics, only to find that their participation conferred increased respect on an approach that they opposed.

Journal

JAMAAmerican Medical Association

Published: Feb 11, 1998

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