Unearthing the ‘clinical encounter’: Gartnavel Mental Hospital, 1921-1932.

Hazel Morrison successfully defended her thesis in mid-September, 2014. Her full thesis title and abstract are as follows:

Unearthing the ‘clinical encounter’: Gartnavel Mental Hospital, 1921-1932. Exploring the intersection of scientific and social discourses which negotiated the boundaries of psychiatric diagnosis

Thesis Abstract

Charting the trans-Atlantic movement of ‘dynamic’ psychiatry from The Henry Phipps Psychiatric Clinic, Baltimore, to Gartnavel Mental Hospital, Glasgow, my thesis throws light upon the resultant ‘dynamic’ case note records, produced in Gartnavel during the 1920s.  By undertaking an in-depth, qualitative analysis of Gartnavel’s case note records and corresponding archival materials, I explore the polemical question, posed, amongst others, by Foucault, of how psychiatry achieves its distinct status as a science of the individual.  Foucault, most notably in Discipline and Power, ascribes to the psychiatric profession the power to fashion individual patient histories into cases, cases which simultaneously emphasise the individuality of a patient, while condensing, i.e. ‘fixing’ their identities that they may be constituted ‘an object for a branch of knowledge and a hold for a branch of power’.  This thesis, while recognising the validity of this argument, explores how the clinical practices and philosophical outlook of dynamic psychiatry in the early twentieth century enabled both patient and psychiatrist to negotiate the construction of the psychiatric case note record, and consequently of patients’ individual identities.

D. K. Henderson, physician superintendent of Gartnavel between 1921 and 1932, was one of the first, if not thefirst psychiatrist fully to incorporate dynamic principles into the working practices of a British mental hospital.  Initiating methods of case note taking and staff meeting consultation (now integral components of modern day psychiatric practice) he transported the teachings of his mentor, the Swiss émigré psychiatrist Adolf Meyer, to the everyday clinical practices of Gartnavel.  The dissemination of dynamic psychiatry through Henderson’s published works and medical teachings is recognised as having integrally shaped the practices of Scottish psychiatry in the twentieth century.  However, the significance of the unpublished case note records, produced under his superintendence of Gartnavel during the 1920s, as sources of historical enquiry has gone largely unrecognised.  A near-unique archive of ‘dynamic’ case note records is used in my thesis to reveal, what Roy Porter termed, a ‘history from below’ of clinical practices and examinatory processes.  For as Henderson employed stenographers and clinical clerks to record verbatim and semi verbatim the dialogues that passed between patients and psychiatrists within staff meetings and mental examinations, I, as Porter himself aspired to, take as the focus of my research a history of the ‘two-way encounters between doctors and patients’.

By employing an interdisciplinary research method, one that incorporates Foucauldian, literary, critical medical humanities, as well as more traditional forms of medical history scholarship, I establish a history of dynamic psychiatry set within clinical encounters.  Engaging with current debate, evolving primarily within the interdisciplinary sphere of the medical humanities, I argue these records reveal a history of medical humanism, one in which both patients and psychiatrists actively shaped the history of twentieth century Scottish psychiatry. 

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