HHH Column: Psychiatrists’ Historical Self-reflection by Vincent Korbee
The HHH column is a monthly blog in which History, Health & Healing members share their thoughts on research, current affairs, or anything to do with medical history. Each edition is written by a different member — in due time, we hope to offer everybody a chance to publish a contribution. This month, the floor is for Vincent Korbee, research master student History at Leiden University. In his research he focuses on the history of nineteenth and early twentieth-century psychiatry in the Netherlands. This interest recently led him to a conference on the history of psychiatry in London. In this column, he shares his thoughts on the event and reflects on the dynamic between historians and psychiatrists.
Psychiatrists’ Historical Self-reflection
By Vincent Korbee
Scholars in the humanities often suffer from an inferiority complex. At least, they tend to feel a strong need to prove the societal relevance of their research. For historians of psychiatry, I have good news: psychiatrists themselves desire historical research about their discipline. We are, frankly, wanted. This has been my banal conclusion after attending the After Kraepelin: Ambitions, Images, Practices and the History of Psychiatry 1926-2026 conference in London on the 6thand 7th of March.[1] What initially drew me to this conference was the fact that it focused on the history of psychiatry, but was organised by psychiatrists. Though some speakers had a background in the humanities, many of them, in fact, did not. As such, the main question I had going into the conference was why historical knowledge would be deemed important by psychiatrists? Historians – including me – obviously find their own work very important, but what benefit does the knowledge they produce have for medical professionals? Psychiatrists seem to recognise the benefit.
Members of the Royal College of Psychiatrists, the main organiser of the conference, have the option of joining a special interest group (SIG). Among many, one of the SIGs is the ‘History of Psychiatry’ SIG (HoPSIG). It was established in 1988 on the initiative of professor of psychiatry G.E. Berrios, who has written many conceptual histories of different mental dispositions. The use for HoPSIG was motivated by Berrios in 1985 writing the following. ‘Suffice it to say that current scholarship (to which I have contributed) shows that historical studies play a fundamental role in the calibration of psychiatric concepts and in the understanding of psychiatric institutions.’[2] In other words, historical research helps psychiatrists to review their work and workplace. However, the archival records suggest that this ‘fundamental role’ was not always recognised.
HoPSIG was not active between 1997 and 2003, dissolved in the latter year, and only ‘resurrected’ – in the words of the archivist – in 2015. The records do not indicate why this was the case. Nevertheless, the After Kraepelin conference in 2025 shows a recognition for historical knowledge again. Many presentations, even those focused on psychiatric genetics or brain imaging, made the link to late nineteenth and early twentieth century psychiatric work. Wilhelm Griesinger (1817–1868), Carl Wernicke (1848–1905), Theodor Meynert (1883–1892), and Arthur Kronfeld (1886–1941) were some of the names that featured in different talks. In constructing arguments about the state of psychiatry and brain research, or the extent to which these fields have developed, comparisons were made with the historical antecedents. The value of historical work seemed to be well-established.
Cue the historian (Mariusz Turda) and philosopher (Francesca Brencio). In the second session of day one, these scholars made numerous attendants of the conference uncomfortable. As the title and online header of the conference suggests, Emil Kraepelin is considered as ‘probably the single most significant figure in the history of psychiatry.’[3] Besides the fact that historians have already shown that Kraepelin’s work was heavily criticised over the years and many elements of the upsurge of biological psychiatry from the 1970s onwards were unjustifiably accounted to him,[4] the figure himself was not particularly uncontroversial either. In fact, Kraepelin mentored three Nazi psychiatrists. Additionally, as Brencio points out, psychiatric diagnoses have been used as socio-political tools to reinforce certain norms.[5] Quasi-anthropologically, I observed the unease with which psychiatrists received this historical information. One mental healthcare professional commented that the historian and philosopher painted a very grim image of psychiatry’s past. Applause followed. Hence, although psychiatrists are interested in and embrace the worth of historical studies, the information that emerges from these studies is often uncomforting – and rightfully so.
Retrospectively, it makes sense to me why this is the case. One of the reoccurring themes during the conference was the instability of the professional identity of psychiatrists. This identity is threatened by clinical neuroscience and the social sciences, as Paul Hoff for instance indicated in his talk.[6] Furthermore, critical perspectives on psychiatry remain prominent, such as in the relatively new perspective Mad Studies, presented by Peter Beresford on day two. Historians, with their supposedly annoying reflections, add to this criticism as well. There is thus a large tension. On the one hand, historical studies often include critical perspectives on psychiatry. On the other hand, psychiatrists are interested in historical knowledge. Its benefit is to compare past and present and to gain new insights for psychiatrists’ practice. During one discussion, it was even argued that psychiatrists should be more confident in going ‘backwards in time’ to more phenomenological diagnostics. This, however, would again lead to risks regarding professional identity because other medical professionals might comment on the un-medical or un-scientific character of psychiatry: ‘see, you were incapable of diagnosing after all.’
It seems, therefore, that Berrios’ 1985 motivation for the historical study of psychiatry by psychiatrists is insufficient 40 years later. Psychiatrists are not just looking to calibrate their concepts and institutions, but also the discipline’s identity itself. Looking back in time, psychiatrists have played multiple roles as therapists, brain experts, and even socio-political actors. At the After Kraepelin conference, it appeared that ‘the psychiatrist’ is currently all of these things. The question is whether this is durable and desirable. There is a task for both historians and psychiatrists. The former can aid the latter by studying the ways in which the professional identity of the psychiatrist has developed over time and showcase how history can help with constructing the contemporary identity – taking into consideration questions of exclusion and the differentiation from other disciplines.[7] Psychiatrists, in their historical self-reflection, should not be too wary of the ‘negative image,’ since it is exactly this image which both historians of psychiatry and psychiatrists should use to challenge psychiatric wrongs.
[1] https://www.rsm.ac.uk/events/psychiatry/2024-25/pyt02/
[2] Royal College of Psychiatrists Archive, no. GB 2087, Record of Special Interest Groups of the Royal College of Psychiatrists, Records of History of Psychiatry Special Interest Group, no. RCPSYCH/J3, [1987–2003].
RCPSYCH/J3, History in Psychiatry Special Interest Group, 1987 – 2003, P. 37
[3] Read the opening paragraph of the conference description: https://www.rsm.ac.uk/events/psychiatry/2024-25/pyt02/
[4] Kenneth S. Kendler and Eric J. Engstrom, ‘Criticisms of Kraepelin’s Psychiatric Nosology: 1896–1927’, American Journal of Psychiatry 175, no. 4 (April 2018): 316–26; Eric J. Engstrom and Kenneth S. Kendler, ‘Emil Kraepelin: Icon and Reality’, The American Journal of Psychiatry172, no. 12 (December 2015): 1190–96.
[5] Valeria Bizzari and Francesca Brencio, ‘Psychiatric Diagnosis as a Political and Social Device: Epistemological and Historical Insights on the Role of Collective Emotions’, The Humanistic Psychologist 52, no. 1 (2024): 70–82.
[6] See his work: Paul Hoff, Arthur Kronfeld Und Die Identität Der Psychiatrie: Denkwege Vom 18. Bis Zum 21. Jahrhundert (Stuttgart: Kohlhammer, 2023).
[7] I am currently developing a research proposal that tackles this question.