{"id":35846,"date":"2013-04-30T00:25:08","date_gmt":"2013-04-30T04:25:08","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=35846"},"modified":"2014-05-05T07:19:35","modified_gmt":"2014-05-05T11:19:35","slug":"all-ears","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2013\/04\/30\/all-ears\/","title":{"rendered":"all ears…"},"content":{"rendered":"\n
The debates about psychology versus biology as either the cause or the treatment of mental illness are probably as old as the topic itself:<\/div>\n
<\/a><\/a><\/div>\n
Actually, that’s not bad, the blind giant<\/font><\/strong><\/em> and the dwarf psychologist<\/font><\/strong><\/em> are often heard modern criticisms – the heavy-handed<\/em> psychopharmacologist and the impotent<\/em> psychotherapist [although the italicized adjectives are sometimes reversed]. This dichotomy [psychology vs. biology] is frequently symbolized using the avatars of the giants of the early 20th century – Sigmund Freud and Emil Kraepelin – contemporaries but hardly colleagues. With these iconic figures, some of the gulf between them can be parsed away by recognizing that they saw a different group of patients – the neurotic outpatients of Vienna and the psychotic, institutionalized patients in Munich. They based their views of mental illness on different prototypic conditions – Conversion Hysteria for Freud and CNS Syphilis for Kraepelin. Of some interest, both conditions are now rarely if ever seen. But there were genuine basic differences beyond their disparate domains. Freud commented about the psychoses, but mainly to explain why they were untreatable by his methods. Kraepelin had little to say about neurotic illness, subjectivity, and he explained reactions to life’s stresses on something like innate constitution – anlage<\/em>: <\/div>\n
<\/a>\"from<\/a><\/div>\n\n\n
\n
an·la·ge<\/font> [änläg]
noun<\/strong><\/sup><\/div>\n
    <\/p>\n
  1. \n
    Biology: The initial clustering of embryonic cells from which a part or an organ develops; primordium.<\/div>\n<\/li>\n
  2. \n
    A genetic predisposition to a given trait or personality characteristic.<\/div>\n<\/li>\n
  3. \n
    A fundamental principle; the foundation for a future development.<\/div>\n<\/li>\n

    <\/strong><\/sup><\/ol>\n<\/td>\n<\/tr>\n<\/table>\n

    So how did I get here on a Monday? Well, the pollen count has fallen and my mind\/brain is finally back. And I was thinking about something. After analytic training and years of teaching a "Freud Course," I can out·criticize Freud with the best of them, but what I realized is that while I am full of comments about the neoKraepelinians, I know very little about Emil Kraepelin himself. In training, I learned the textbook version – about his separation of Schizophrenia and Affective Psychosis, and about his work with Alois Alzheimer on presenile dementia. I’ve always accepted Kraepelin’s implied biological basis of the Major Psychoses. But I don’t know his story, his life and times at all.<\/p>\n

    So I started reading about him. The first thing I read was written by him in 1917 for the opening of a new research institute [100 years of Psychiatry<\/a>, Emil Kraepelin, 1917]. It’s on the Internet, but it’s 174 pages long so I’m not pushing it. I found this nice review, but it’s not online. Here’s a comment and a quote:<\/div>\n
    \n
    100 years of psychiatry [Kraepelin]- 50 years later.<\/a><\/div>\n
    by Hilde Bruch<\/div>\n
    Archives of General Psychiatry<\/font><\/strong>. 1969 21[3]:257-261.<\/div>\n

    The general atmosphere of the book is one of humanistic benevolence and scientific optimism. Some of his ideas sound amazingly modern, even contemporary, such as his emphasis on the need for better education and higher salaries for the auxiliary personnel in order to attract people of high caliber, or his awareness of the importance of the social milieu and of each patient’s position and role in the hospital community for his sense of dignity and well-being.<\/p>\n

    Kraepelin felt assured that nothing in the future would deflect from the progress that had been made. The foundation of the Research Institute indicated a further step forward. Though many things were still unclear and unknown, continued clinical investigations were expected to clarify the causes of mental illness and eventually to afford treatment for cases that thus far had been considered incurable. The Institute would attract scientific-minded psychiatrists in search of reward not afforded by psychotherapy, and give the opportunity for close collaboration of specialists in various fields. His concepts of progress was research in the organic field. He mentioned as shining achievements of the recent past the Wasserman test for the diagnosis of syphilis which had been recognized as the cause of general paresis, the malaria treatment for this condition, and thyroid medication for cretinism.<\/p>\n

    With all this benevolence there is also expression of a fatalistic pessimism. It seems rather tragic that Kraepelin’s name has become associated with this nihilistic attitude rather than his courageous forward-looking optimism. To quote:<\/div>\n