This review psychiatry has been used in ways other than was discussed
here a few days ago. The reviewer's credentials (Department of Defense)
may be suspect. He seems to imply that the problem lies with the
specific German application. It reminds us that supposedly
non-totalitarian society's have misused psychiatry, but also suggests
that it can be a very dangerous sort of approach since there are no
scientific bases for grounding it.
H-NET BOOK REVIEW
Published by [EMAIL PROTECTED] (January, 2004)
Paul Lerner. _Hysterical Men: War, Psychiatry, and the Politics of
Trauma in Germany, 1890-1930_. Ithaca and London: Cornell University
Press, 2003. xi + 326pp. Photographs, notes, bibliography, index.
$39.95 (cloth), ISBN 0-8014-4094-7.
Reviewed for H-German by Brian E. Crim <[EMAIL PROTECTED]>,
Department of Defense
Putting the Front Generation on the Couch
Historians continue to explore the First World War and its
influential and contested legacy during the Weimar era for insight
into National Socialism and the Holocaust. Omer Bartov suggests
that something so seemingly incomprehensible as the Holocaust was
unimaginable before the First World War. The generation responsible
for perpetrating the Holocaust either survived the war at the front
or was inundated by the constant representation and memorialization
of the war during the interwar period.[1] The criminal acts of the
National Socialist regime relied heavily on the support of two
professions most often associated with progress and
modernity--medicine and law. Understanding how these professions
evolved between the _Kaiserreich_ and the Third Reich is not only
important in its own right, but it prevents historians from
embracing the _Sonderweg_ theory too easily without accounting for
context.
Paul Lerner contributes an impressive study of the German
psychiatric profession in which he describes its development and
political, social, and economic orientation between 1890 and 1930.
Not only does Lerner write an impressive history of German
psychiatry, he reveals the degree to which the relatively new
profession influenced and was influenced by the rest of German
society. Lerner writes: "psychiatry in World War One had less to
do with the murderous initiatives of the next generation than with
the economic discourses of its own time" (p. 4). Lerner's study
engages successfully a myriad of issues including the
historicization of hysteria and trauma and the pathologization of
the November Revolution of 1918 by politically conservative
psychiatrists.
Male hysteria was a diagnosis fraught with political and social
significance. Once considered a phenomenon restricted to women,
German psychiatrists detected symptoms of hysteria in German men
soon after industrialization. Psychiatrists associated male
hysteria with an inability or unwillingness to adapt to the modern
age. More significantly, Lerner reveals that most psychiatrists
viewed male hysteria as a sign of weakness, even corruption. In the
eyes of many psychiatrists, men who behaved hysterically because
they suffered some sort of trauma simply took advantage of Germany's
newly instituted insurance laws by collecting pensions instead of
contributing to the economy. This bias continued into the First
World War when psychiatrists, now pressed into the war effort,
generally dismissed the legitimacy of combat trauma and attributed
hysterical symptoms to "a pathological lack of male behavior" and
pre-existing nervous conditions (p. 8). During the revolution of
1918-1919, psychiatrists diagnosed "a national nervous collapse"
and, according to Lerner, "used the language of psychiatry to
describe political events and to pathologize revolutionary actors,
equating war hysteria with political radicalism, unpatriotic
behavior, and biological inferiority" (p. 194).
Lerner begins _Hysterical Men_ by discussing the status of
psychiatry in Wilhelmine Germany and the defeat of the traumatic
neurosis theory by the male hysteria diagnosis. Most psychiatrists
supported the male hysteria diagnosis because they suspected many
men suffering from symptoms of trauma were milking Germany's
accident insurance laws. Chapter 2 reveals that German
psychiatrists initially welcomed war as a healthy alternative to the
perceived decadence of peacetime industrialized Germany. Lerner
then delineates the debate between psychiatrists over the cause of
the war neurosis crisis. Psychiatrists like Hans Oppenheim failed
to convince his colleagues that the crisis was legitimate and that
patients required long-term care. Instead, German psychiatrists
attributed mental collapse to weakness and sloth and treated the
symptoms without investigating the illness. Lerner describes in
detail some of the disturbing treatments employed by psychiatrists
in the field hospitals and special clinics devoted to the war
neurosis crisis. The last three chapters are the most interesting
for Germanists because Lerner places psychiatry within the context
of the political, social, and economic tensions confronting both
wartime and post war Germany. Most German psychiatrists adapted
what may be called "rationalized psychiatry." Under this system,
patients' mental health was considered less important than their
economic productivity. Lerner includes an interesting chapter on
how psychoanalysis responded to the war neurosis phenomenon and the
external pressures to return patients to the field or war
industries. It seems psychoanalysis was more influential within the
medical profession than Freud suspected. Lerner relates how the
mostly conservative and patriotic psychiatric profession politicized
war hysteria in the November Revolution by declaring revolution and
Social Democracy the work of mentally ill degenerates. Lerner
concludes his study by analyzing the formation and debate of
"individual and collective memories of war and trauma in Weimar
society, psychiatry, and culture" (p. 11).
The key to understanding the psychiatric profession in Germany
during the time period studied by Lerner is its embrace of
rationalization. The organization of psychiatric facilities and
treatment emphasized "therapeutic speed and efficiency." If
hysterical patients could not return from the front, wartime
planners used them for the war economy. Lerner discovered,
"[m]edical power created a system to serve economic needs" (p.126).
Lerner wisely avoids determining the validity of the hysteria
diagnosis versus trauma by treating these psychiatric concepts as
historical actors. Lerner also avoids drawing direct connections
between the behavior of the medical profession during the First
World War and the Third Reich. However, Lerner is on safe ground
when speculating that "an approach to mental health that prioritized
the needs of the nation over the welfare of the individual patient
[...] may have contributed to the mentalities that made possible the
path from 'mass well-being' to 'mass annihilation'" (p. 247).
Lerner's source base is as impressive as his writing and
organization of ideas. He draws from a combination of federal and
state archives in Germany, university archives holding personal
papers from influential psychiatrists, and hundreds of published
sources from medical journals and newspapers. Strangely absent from
the bibliography are the military archives in Freiburg, which
include record groups from medical services. Despite Lerner's best
efforts, it is sometimes difficult to keep track of the parade of
personalities discussed in his narrative. _Hysterical Men_ will be
of interest to anyone interested in modern German history and would
make an excellent graduate seminar selection.
Note
[1]. See Omer Bartov, _Murder in Our Midst: The Holocaust,
Industrial Killing, and Representation_ (New York: Oxford University
Press, 1996).
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--
Michael Perelman
Economics Department
California State University
michael at ecst.csuchico.edu
Chico, CA 95929
530-898-5321
fax 530-898-5901
