Elizabeth Lunbeck

In The Psychiatric Persuasion: Knowledge, Gender, and Power in Modern America, Elizabeth Lunbeck “examines the process by which psychiatrists in the early twentieth-century effected [a] momentous shift in their discipline’s foundations and fortunes” (pgs. 3-4). To this end, she locates “the sources of psychiatry’s cultural authority not in institutions but in the discipline’s conceptual apparatuses,” proposing “that the discipline’s authority instead be located in the spread of a psychiatric perspective that has little to do with psychiatrists’ institutional power. Employing a rough metric of the normal, this perspective would constantly assess individuals’ normality in any number of dimensions (behavioral, sexual, characterological), arraying them on a spectrum ranging from the abnormal to the normal” (pg. 4). Her argument is largely Foucauldian, examining power relationships between psychiatrists and their patients, society and psychiatrists, and authorities legal and medical. To this end, Lunbeck writes that psychiatrists “laid new conceptual foundations for their specialty, delineating a realm of everyday concerns – sex, marriage, womanhood and manhood; work, ambition, worldly failure; habits, desires, inclinations – as properly psychiatric and bringing them within their purview” (pg. 3). Addressing gender, she writes, “Gender conflict, real and rhetorical, shaped day-to-day practice and colored psychiatrists’ and social workers’ reflections upon it” (pgs. 5-6). In this, her work “is the story of the advent of sexual modernity, a modernity that many have suggested psychiatry enabled, even promoted” (pg. 6).

Lunbeck argues, “The sources of psychiatry’s widely noted dominance lie neither in its long-overdue embrace of science, as those writing from within the discipline have argued, nor in its enduring commitment to social control, as many critics of psychiatry have proposed, but here, in psychiatrists’ delineation of a realm of everyday concerns – sex, marriage, womanhood, and manhood; work, ambition, worldly failure; habits, desires, inclinations – as properly psychiatric” (pg. 47). She further argues, “Any normalizing power the discipline enjoys today is premised not on psychiatrists’ authority over insanity, for most are willing to cede them that, but on their turn-of-the-century forebears’ bold appropriation of day-to-day life and their subtle weaving of a psychiatric point of view into its many aspects” (pg. 47). Discussing the rise of testing and statistics, such as the Stanford Binet IQ test, Lunbeck writes, “Constantly invoking the authority of science, with which they claimed their discipline was now allied, they outlined an ambitious professional program aimed at securing them the formal institutional and political power that had eluded their predecessors’ grasp” (pg. 61). As part of this, they sought to secure “a broad, respected role in the public sphere” while also claiming authority over the private sphere (pg. 61). To this end, “nationwide, psychiatrists campaigned successfully for the passage of laws that brought commitment from the legal into the medical arena, transforming it, in their estimation, from a highly charged question of law into a straightforward question of medical judgment” (pg. 82). Discussing psychiatrists’ interests in pathologizing the home life, Lunbeck writes, “Behavioral policing, however, was a function of the family as much as of any other institution” (pg. 107). That said, early psychiatrists focused more on aberrant behavior that was due to ethnic differences, thereby contributing to homogenizing efforts [pg. 101], while ignoring violence within families, such as husbands beating their wives and children (pg. 106).… (mais)