In Conversation With a Sigourney Award Winner: The Intersection of History, Humanities, and Psychoanalytic Thought

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Q&A

Psychiatric Times® spoke with Daniel Pick, PhD, recipient of the 2023 Sigourney Award, about his work exploring how the intersection of history, humanities, and psychoanalytic thought can help us understand the challenges of our modern political environment.

Psychiatric Times: Your work has been commended for seamlessly integrating history, humanities, and clinical psychoanalytic practice. How has this interdisciplinary approach enhanced our understanding within the field of psychiatry, and what implications might it hold for psychiatric practice in addressing complex mental health issues?

Daniel Pick: To delve into the history of psychiatry is likely to be troubling, and salutary, for anyone working in the mental health field today. No doubt psychiatry and psychoanalysis can offer valuable insights in certain forms of historical inquiry. But history also can serve to challenge or complicate assumptions made by contemporary clinicians about their own craft. History can suggest, for instance, the different ways that psychiatric language has reflected and reshaped cultural and political assumptions—assumptions about what it means to be human and to live a flourishing life.

For anyone grappling with complex psychological health issues, it can be useful to compare and contrast past and present approaches in the psychological sciences, and shifting ethical boundaries. We may want to consider, for instance, the history of debates on and treatments of hysteria—or to investigate post-war experiments, conducted by psychologists, involving sensory deprivation and overload, lysergic acid diethylamide (LSD), induced comas, repetitive messages, etc.

Such experiments, involving numerous scientists, oftentimes covertly funded by intelligence organizations, were conducted at times with remarkable insouciance and sometimes zeal. They were inflicted on patients without informed consent. It is salutary to explore, furthermore, the vogue for “lobotomies,” especially prevalent in the United States.

To confront the past is also a means to question current orthodoxies—for example, the scale of current prescribing of antidepressants, or the various medications routinely now offered to children diagnosed in ever larger numbers with conditions such as attention-deficit/hyperactivity disorder (ADHD).

The aim of historicization is not automatically to argue that we ought to junk the categories in current use, but to invite consideration of how they are constituted, and why, and to what effect. By investigating how particular concepts emerge, and then circulate in society, one of my aims has been to encourage clinicians, be they psychiatrists or analysts, to think about and contextualize their working assumptions.

Glaring examples from history can be eye-opening, and relevant, even if we do not share the same crude models as previous generations may have believed in. Much has now been written about “conversion” endeavors by prominent clinicians, for example, when working with gay patients in the past. Dagmar Herzog, PhD, has written of this powerfully in her book Cold War Freud.

I first got involved in thinking about the history of psychiatry in the 1980s. It was a time when a remarkable range of research and debate was emerging, inspired in good measure by the pioneering work of Michel Foucault, PhD, over the previous 30 years. This invited consideration of the malleability of the idea of the self and also the malleability of the categories of pathology.

I became increasingly interested in that kind of exploration. All societies may have had their own notions of madness, but any precise account of what madness—or, for that matter, criminality—consists in, historians show, have changed radically over time.

While studying the Victorian period, I was struck at the ready acceptance by numerous commentators of terms such as “degeneration” and “atavism.” I showed how these ideas were put to work in consequential debates and policies. Some spoke of “the born criminal” and saw no need to await the actual committing of crime—they sought “preventive detention” to protect society. Others contested this claim.

I have also written on “shellshock” and other theories about the breakdown of soldiers during the Great War. Those who work with diagnostic categories now such as posttraumatic stress disorder (PTSD) do well to explore the history of debate about trauma in times long ago. In my research on the Cold War, I have also mapped the rapid and widespread adoption of other terms we may now take for granted, such as groupthink, mind control, and brainwashing. These terms all merit scrutiny.

I can see, looking back, various threads running through my historical research, including an interest throughout in psychoanalysis. This informed my focus upon shared cultural anxieties and fantasies, as well as individual dreads and desires. My first book, for example, based on my doctorate, explored “degeneracy,” a prevalent theory, and diagnosis, as I have noted already. This idea developed in Europe and was widely disseminated. The image of the “degenerate” ricocheted between medical tracts, theater, novels, and paintings. I think it can be helpful for anyone working in mental health to note how ideas may move back-and-forth between fiction and science, for better or worse.

The term degenerate was applied in psychiatry as well as in criminology, sexology, and crowd psychology, and loomed large in later Victorian culture.¹ Ideas of racial degeneration were also taken up widely, with hideous consequences. I have written of that history, and of social Darwinism and eugenics, and traced where this led.

After my Faces of Degeneration, I published a separate book mapping various modern theories about war and human nature, from Darwin to Freud and beyond.² Later, I explored animal magnetism, hypnotism, suggestion, and crowd psychology. I was intrigued by how debate on hypnosis intersected with anxieties about race, class, and gender at the fin de siècle. The central figure in my study was a fictional Jewish hypnotist, Svengali, who appeared in George du Maurier’s extraordinarily popular 1890s novel, Trilby.³

Since then, alongside my clinical practice and teaching, I have undertaken several inquiries into the history of psychoanalysis and psychiatry, including a general brief account of “the talking cure” for non-specialists,⁴ and have looked at several 20th-century encounters, or arguments, between British historians and psychoanalysts. Moreover, I have contributed as best I can to contemporary dialogues between commentators in these disciplines.

I completed a book—admittedly rather a meandering diffuse study, which I would write differently if I had the chance now—about the challenges and problems of pursuing “psychobiography.” This book, Rome or Death, explored, among other things, a forgotten tale in which General Garibaldi, hero of Italian unification, became enormously preoccupied with moving the course of the Tiber from the Eternal City.^5,6 I asked readers to consider why he did so, and what are the limits of our knowledge about the motives, rather than the stated intentions, of the dead.

With fellow historians, I have also edited collections and features on dreams, psychoanalysis and totalitarianism, and the role of denial in history.^7-9

In sum: Various psychiatric and psychological accounts I explore in my work, I hope, suggest the potential valency of drawing upon our repertoire of ideas about the mind in the study of the past, but also the risks of “wild analysis,” of anachronistic interpretations, and of labelling people glibly. In addition, they illustrate how patients are not just recipients of psychiatric discourse but also active agents who are reframing narratives and theories in countless ways.

PT: Delving into the historical consequences of Freud’s “revolution in mind,” how do you perceive the historical context influencing psychoanalytic principles and their relevance to psychiatric practices?

DP: I can only give a rather impressionistic answer to this enormous and challenging question. But suffice first for me to say there have been many historical contexts for psychoanalysis since its inception. Psychoanalysis has responded in diverse ways to those contexts. It has also affected how many of us think about those contexts, for instance, regarding the crises of liberalism, the history of empire and decolonization, phases of capitalism and communism, war and cold war, totalitarianism, and in our own times, new forms of populism and the gathering evidence of climate breakdown.

Freud’s theories were part of a wider “revolution in mind” in the late 19th century. He was a remarkable figure, but not the only pioneer, of course, to transform modern ideas about the unconscious. That transformation in understanding of mind shaped and was shaped by the epochs in which psychoanalysis developed. It has been around now for a century and a quarter.

Like Darwin (one of his heroes), Freud deeply troubled his readers and raised profound new questions for psychiatry, too. He cast into doubt prevailing assumptions about normality and pathology, and about the relationship of the psyche and society. Psychoanalysis emerged in and spoke to an age, increasingly too of mass politics, mass mobilization, and mass communication.

He sought to create general theories valid for all and unbound by history. Yet his ideas also resonated powerfully with and responded to crises in his own time—for instance, as he contemplated, from Vienna, amid the turbulent politics of the Hapsburg Empire, the nature of an intolerant internal “censor” in the mind, or, as explored during or shortly after the First World War, an array of new ideas about the denial of death, mourning and melancholia, repetition, narcissism, the death drive, the superego, and group psychology. I think these ideas require historicization but, in my view, also remain enormously useful in and beyond the clinic.

At the risk of departing from your question here, I would like to mention a further project, which I hope is also relevant to psychiatrists. Between 2014 and 2021, thanks to generous funding from the Wellcome Trust, I led a group of researchers interested in investigating the history of thought about brainwashing. That work, I believe, offered another context for thinking about post-war psychoanalysis. My own take on this field can be seen in my book Brainwashed.¹⁰

The larger project, of which this was part, is of relevance to psychiatrists and other mental health workers, as it shows, among other things, the nature and extent of psychological experiments on captive [participants] during the Cold War, to which I alluded briefly earlier. Second, it explores how that Cold War context affected the psy professions, and how the globalized conflict between 2 systems—communism and capitalism—came to be understood at least in part through competing visions of mental health.

This body of work also illuminates a plethora of fears, realistic or otherwise, about mind control that emerged at that time and had an impact on the reputation of the psy professions, and in fueling the anti-psychiatry movement.

The Hidden Persuaders project, as it was known, was an avowedly cross-disciplinary endeavor, albeit primarily based in history. We involved academics in several fields from around the world, as well as clinicians, educators, filmmakers, and numerous students. Some of the results can be seen on a free-access website, along with a list of the team’s publications, documentaries, blogs, interviews, etc.

PT: You have discussed applying Freudian thought to understand mass conflict, war, and human destructiveness. How can insights from psychoanalysis help psychiatrists comprehend and address the psychological impacts of political trauma on individuals and communities? And is psychoanalysis still relevant?

DP: It is true that I have been especially interested, as a historian, in the darker side of Freudian thought. His writings on war and more generally on human destructiveness have come up in various ways. I do recommend Freud as a rich resource still of value in addressing present dark times, which is not to say he holds some master key.

As to trauma, that has, of course, been a theme in psychoanalysis from the beginning, and I will not attempt here to rehearse debates and critiques that have ensued since Freud made his first hypotheses. He remains, for me, both an object of study and a writer “to think with,” as well as the founder of the clinical approach in which I work as an analyst.

At its worst, psychoanalysis made untenable claims about war and mass conflict, as though it would be possible to treat communities, and even states, as though they were simply individual minds writ large. Freud himself was of course interested in many disciplines and thought that those training in analysis required a wide education, including in many branches of the humanities.

In studying history, psychoanalysis is weakest when it seeks to jettison dialogue with other methodologies. At best, psychoanalytic resources enrich the way we understand history and politics, without claiming some masterful authority. Indeed, psychoanalysis could be seen as the discipline that makes us more wary, not more sweeping, in claiming to understand the deepest motives of those who are not “on the couch.”

Moreover, even when working in the consulting room, analysts may be as much concerned with enhancing a capacity for the patient to tolerate doubt and uncertainty as endorsing some new casual explanation of how things ended up as they did. Analysts, hopefully, are alert to what may drive manic convictions, as well as neurotic doubts, in themselves and their patients; intent upon exploring preconceptions and longings; and interested in how sometimes the patient may long for the analyst to explain things away and become some kind of guru or leader—an auxiliary ego or superego claiming omniscience.

The demise of psychoanalysis has been predicted for well over a century. Depending on your viewpoint, this may be lamented or celebrated. But news of that death has been greatly exaggerated despite the advent of the pharmaceutical revolution in psychiatry, the remarkable spread of cognitive behavioral therapy (CBT), “mindfulness,” and other modalities.

Psychoanalysis is enormously varied, of course, as a body of theory and a range of practices. It is not a static thing. As therapy, it helps some individuals, but of course not everyone. Not everything Freud wrote stands the test of time, nor can any past thinker in the psychoanalytic tradition of the 20th century simply be wheeled out now as “the answer” to the crises of the 21st.

Psychoanalysts, admittedly, can get as caught up as anyone in what Freud described as group psychology, with all its unconscious dynamics, or in the reverential approach to their own movement, which he challenged obliquely in works such as The Future of an Illusion.

We have tended to group ourselves around revered figures—for instance, Klein, Bion, Winnicott, and Lacan. These figures were indeed second-wave pioneers and highly creative thinkers. It is astonishing to think how much creative work was produced by the first and second generation of psychoanalysts, and we should indeed treasure what is most alive in their contributions.

But much further work and development has come in their wake. Neither they nor the third generation that followed spare us from the painful task of thinking afresh what works for whom, and what ideas are salient in addressing human suffering or more generally exploring politics and society in the new millennium.

Much of the canonical literature, I think, remains relevant, nonetheless, as a springboard for discussion and thought today. We need a continuing dialogue with that canon, and a questioning and expansion, or sometimes debunking, of the canon (for instance, recognition of all that may be occluded by the largely European provenance and focus of the Freudian movement, at least before 1939).

We might want to return to all these writers afresh in thinking today. Great literary and philosophical texts in the past, after all, can generate “contrapuntal” readings, as Edward Said famously argued. They emerge in a particular context, of course, but are not dead letters frozen in time. I find Klein’s ideas of the “paranoid schizoid” and “depressive positions,” for example, interesting to think about historically, but also of enormous value in the consulting room and in thinking about contemporary politics.

We can return with great profit to earlier resonant texts and find new meanings and readings—for instance, Freud’s On Transience or Beyond the Pleasure Principle—and find new things of interest, new possibilities, or difficulties each time we read them, as Jonathan Lear, PhD, shows so finely in his recent book Imagining the End: Mourning and the Ethical Life, and as Jacqueline Rose, PhD, richly demonstrates in The Plague.

PT: Your research explores the impact of clinical involvement in wartime intelligence, denazification debates, and the consolidation of post-war liberal democracy. What insights or lessons can psychiatrists draw from these historical contexts to inform their therapeutic approaches, especially in times of societal stress?

DP: I have written about this extensively in a 2012 book, The Pursuit of the Nazi Mind. I fear I will have to partially side-step your question about how best clinicians might use this history to inform their current practice, but I would argue that we can gain a great deal in looking at how previous generations of analysts and psychiatrists grappled with cognate problems: the role of grievance in individuals and in communities, the propensity for demonization and idealization in the interplay of nature and nurture, the impact of collective as well as individual traumas, intergenerational transmissions of affect, collective delusions, and failures to mourn.

One interesting text to consider by way of introduction to the history of the crisis of liberal democracy in the 20th century is Freud’s Group Psychology and the Analysis of the Ego, which was published at terrifying moment of European history: 1921. This work might be seen as a starting point of the kinds of developments to which you are alluding in this question. It is also of great interest regarding ideas about identification, fantasy, love, hypnosis, the fundamental emotional ties we have with the other, and more. It was an inquiry into groups (inside the mind and in the external world) and into the precarious nature of “the ego.”

Group Psychology, sometimes translated as Mass Psychology, was written on the eve of the age of fascism and Nazism, and so soon after the catastrophe of World War I. It helped inspire conceptual and practical work thereafter—for instance, the advent of group therapy, which really took off, in the 1940s. It was also a catalyst for attempts to think deeply about unconscious identifications at work in authoritarian politics. It inspired, among others, members of the Frankfurt School, such as Adorno.¹¹

Such ideas as Freud explored there, along with those I have mentioned above—including, crucially, the superego in his 1923 study, The Ego and the Id—were soon taken up by other commentators, inter-war. Some of Freud’s followers used these works to seek to address the profound crisis of liberalism that they were facing.

Freudian thought has massively influenced not only modern understandings of mind and therapeutic treatment, but also modernism and many distinct visions of politics. This was powerfully the case in the United States after 1945. Psychoanalysis gained, post-war, a powerful purchase in many Western societies, as I tried to show in The Pursuit of the Nazi Mind.

Daniel Pick, PhD

That is not to say, however, that psychoanalysis was confined to the West. Historians have produced compelling accounts of its distinct trajectories in numerous countries globally—East, West, North, and South.

Dr Pick is professor emeritus of history at Birkbeck College, University of London, and a training analyst and supervisor at the British Psychoanalytical Society.

­­­References

1. Pick D. Faces of Degeneration: A European Disorder, c. 1848-1918. Cambridge University Press; 1989.

2. Pick D. War Machine: The Rationalisation of Slaughter in the Modern Age. Yale University Press; 1993.

3. Pick D. Svengali’s Web: The Alien Enchanter in Modern Culture. Yale University Press; 2000.

4. Pick D. Psychoanalysis: A Very Short Introduction. Oxford University Press; 2015.

5. Pick D. Rome or Death: The Obsessions of General Garibaldi. Random House; 2005.

6. Pick D. Psychoanalysis, history and national culture. In: Feldman D, Lawrence J, Eds. Structures and Transformations in British History. Cambridge University Press; 2011.

7. Pick D, Lyndal R. Eds. Dreams and History: The Interpretation of Dreams From Ancient Greece to Modern Psychoanalysis. Routledge; 2004.

8. ffytche M, Pick D. Eds. Psychoanalysis in the Age of Totalitarianism. Routledge; 2016.

9. Hall C, Pick D. Thinking about denial. History Workshop Journal. 2017;84:1-23fwar.

10. Pick D. Brainwashed: A New History of Thought Control. Profile Books; 2020.

11. Pick D. The Pursuit of the Nazi Mind: Hitler, Hess, and the Analysts. Oxford University Press; 2012.