Psychiatry, Psychology and the Progressive Movement Author(s): John Chynoweth Burnham Source: American Quarterly, Vol.

12, No. 4 (Winter, 1960), pp. 457-465 Published by: The Johns Hopkins University Press Stable URL: http://www.jstor.org/stable/2710328 . Accessed: 01/04/2011 00:47
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BURNHAM CHYNOWETH JOHN Foundations' Fund for Research in Psychiatry

and the Psychology Psychiatry, Movement Progressive

RECENT

Much topicsin Americanhistory. era one of the mostinteresting pre-1917 the search of modernliberals for their of thisnew scholarshiprepresents reinterpretation a more thoroughgoing Currently own political identity. are studyingsocial who historians of group a by is being undertaken action.1 This into it put visualized it and control as the Progressives ranges far beyond what is essentially latest research on Progressivism political history. dealing with the human psyche,psyA study of the two professions before World War I, contributesto a broader chiatryand psychology, the hypothesisthat the Progressive by suggesting view of Progressivism was not limited to politics,economicsand social philosophy, movement Americans.If the phybut pervaded all of the endeavorsof middle-class an examination of of the mind were prototypical, sicians and scientists the rest of national life-as it is ordinarilysubdivided-will also show Americans in their occupations and other that early twentieth-century on "Progressive"assumptionsor at least were social capacities operated activities to "Progressive"ends.2 The their aware of the relevance of in psychiatry fact that reformers is the striking basis for the hypothesis in politics and economicsa set of shared with reformers and psychology themall as Progressives. thatindentified social assumptions From the more traditionalresearchon the subject we already know The essence of the movementwas the the suppositionsof Progressivism.
1 For a partial treatment of social control, see Stow Persons, American Minds, A History of Ideas (New York: Henry Holt & Co., 1958), chap. xxv, and Henry F. May, The End of American Innocence, A Study of the First Years of Our Own Time, 1912-1917 (New York: Alfred A. Knopf, 1959), pp. 154-58. 2 Each area also had its conservativesanalogous to Aldrich and Taft.

INTERPRETATIONS

HAVE MADE

THE PROGRESSIVE

MOVEMENT

OF THE

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"firmbelief that to a considerabledegree man could make and remake did not all believe thatman his own world."3 Althoughthe Progressives good, theyagreedat least thatthehuman being is malleable. is inherently largelyor for the ills of the world rested,therefore, The responsibility in which the individual lived.4Alupon the social environment entirely the grew out of Darwinian thinking, thoughmodem environmentalism and so believed thatman could changehis own environment Progressives both societiesand individuals.5 reconstruct The most elusive element in the basic social thinkingof the Progresand so foreordain sives was-who should tamperwith the environment the fatesof his fellow men? It turnedout, inevitably,that the Progresarbitersof man's destiny. were to be the self-appointed sives themselves They were able, literateand largelyprofessionalgroups,accustomed to the role of leadershipand, like Theodore Roosevelt,unafraidof it.6 were consciouslymotivated by altruism. Direction The Progressives his own was to come fromthe Man of Good Will who had transcended The Calvinistic he governedby rightof his moral superiority.7 interests; indicated a directrelationshipas well backgroundof many Progressives of the leadershipand the stewardship as an analogybetweenProgressive inspired in many Progressivesa feeling of elect. Social responsibility guilt forall of the evil that a faultysocietyhad caused, and the sophistiwith social cated with New England consciencesequated righteousness reform.8
3 George E. Mowry,The Era of Theodore Roosevelt, 1900-1912 (New York: Harper & Bros., 1958), pp. 17-18, 37. 4 Ibid., pp. 49-51. David W. Noble, The Paradox of Progressive Thought (Minneapolis: Universityof Minnesota Press, 1958), summarizes the views of the high priest Herbert Croly, on the subject, p. 62. of Progressivism, 5 Eric F. Goldman, Rendezvous with Destiny, A History of Modern American Reform (New York: Alfred A. Knopf, 1952), p. 94; Mowry,Era of Theodore Roosevelt, p. 50. Such thinkingwas not far distant from other doctrines of the times, such as of history. an economic interpretation 6 Richard Hofstadter, The Age of Reform, From Bryan to F. D. R. (New York: Alfred A. Knopf, 1955), has been pre-eminent in suggesting as a major factor in Progressivism the changing status of certain middle-class groups, chap. iv; and Mowry,Era of Theodore Roosevelt, has documented the middle-class nature of Proand psychologistsin general belonged to gressive leadership, pp. 85 ff. (Psychiatrists this dominant part of the middle class.) The Progressivereliance on the executive and the cult of the strongman were notable contemporaneousdevelopments; ibid., p. 88; Goldman, Rendezvous with Destiny, p. 80; Noble, Paradox of ProgressiveThought, p. 74. Even the Progressives'faith in democracy was dependent upon their providing a proper environmentfor that democracy. See the sophisticated discussion of Progressivism in May, End of American Innocence, pp. 21-29. 7 Hofstadter, Age of Reform, p. 258; compare the summary in Mowry, Era of Theodore Roosevelt, pp. 104-5. 8 Ibid., p. 87; Hofstadter, Age of Reform,pp. 204-6,208-12.

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environThese, then,were the elementsof Progressivism-optimism, mentalism,moral fervorand leadership by an enlightenedelite. None of themwas new in American thought,but at the time theytook on a with which theyappeared and special meaningbecause of the frequency because of theirapplication to social control.Althoughmost obvious in the psychofirst, political and social thinking,they also characterized, the revolt second, that day and, of the psychiatry in movement therapy In case it turned each psychology. contemporaneous in of the behaviorists a out that an autonomous historical developmentwithin science contained the same elementsas a new political and social movement. (which at that time included neurology) provides a nice Psychiatry physicianswho dealt with the example. In the late nineteenthcentury, to scientific mentallyill usually were "organicists"who adhered strictly materialism. They believed that behavior and thinkingwere but the of the nervous systemand that physical expressionof the functioning defects or diseases were at the bottom of all mental diseases. The autopsieson the brainsof deceased mentalpatients, performed organicists forevidenceof lesionsor brain damage. The workof thisgroup searching was vindicated by the discoverythat a common type of insanitywas of as the literature caused by syphilis. Yet nothingis quite as depressing around the turn of the century-endlessreportsof psychiatry-neurology examinations of demented brains and discussions of the post-mortem was problems of keeping and managing the insane. The psychiatrist expected to do little more than deliver a prognosisof the melancholy courseof the disease and thensupervisethe housing,feedingand restraining of the patient.9 Well into the twentiethcenturythe three main alcohol and syphilis.10 causes of insanitywere thoughtto be heredity, By the 1890's a great deal of discussionof hysteria(disease symptoms and faithhealing, in the absenceof physicaldisease),hypnotism occurring routineof prognosisand commitment, plus a rebellionagainstthe dreary led to a revivalof attentionto so-called"moral treatment."Everyexperienced physicianknew the importanceof the patient'sstate of mind for the treatment of illness, and early in the firstdecade of the century, followingdevelopmentsin continentalEurope, American medical pracIn large part the psychotitionerstook up the fad of psychotherapy. therapymovementwas a formalrecognitionof the medical value of a
9 The cure rate was about twentyper cent; A. I. Noble, "The Curability of Insanity,"American Journal of Insanity,LXIX (1913), 715-17. 10 E.g., H. M. Swift, "Insanity and Race," American Journal of Insanity, LXX (1913), 154.

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constructive intellectual and emotional environment, especially in the treatment of what we would now call neuroticdiseases." Strictorganicistswho believed that insanitywas caused by heredity, alcohol and syphiliswere not necessarily outside of the Progressive movement. There were reformgroups dedicated to the elimination of the baneful effects of all three. The eugenics movement,advocating the and criminalpersonsin orderto improve sterilization of insane,defective the race, representedthe Progressive attemptto deal with that part of man whichwas not malleable.'2 Many psychiatrists supportedthe efforts to remove fromcommercewhat theyregardedas of the prohibitionists was social poison. And one of the lasting reformsof Progressivism effected by the crusaders(many of them physicians)who opposed both with the powerfulargumentthat only preand promiscuity prostitution ventioncould controlvenerealdiseases.'3 These were typicalProgressive but Progressive reform movements, psychiatrists foughttheirfinest-and most fundamental-battles in the name of psychotherapy. who employedor advocated psychotherapy in Basically the physicians to the were any of its many forms unwilling accept pessimistic attitude of currentpsychiatry and neurology. Under the competitive pressureof ChristianScience and otherfaithcures that were demonstrably effective, these physiciansignoredmaterialismand undertookto cure patientsby whatever method worked. Effectivepsychotherapy required hopeindeed, faith in the patient's ability to cure himself. C. P. Oberndorf, in the United States,later one of the first psychoanalytic psychotherapists to his enthusiasmand to his attributedhis early successesin treatment in the new tools with which he worked. Others using quite confidence likewiseshowed an optimismthatset different methodsof psychotherapy in the psychiatric them apart fromconservatives profession.14
11 See Walter Bromberg,Man Above Humanity, A History of Psychotherapy (Philadelphia: J. B. Lippincott Co., 1954), chap. viii. 12 Mark Hughlin Haller, "American Eugenics: Heredity and Social Thought, 18701930" (Ann Arbor: UniversityMicrofilms,1960), especially pp. 4, 157-58, shows how Progressives' assumptions of environmentalism did not deter them from supporting the eugenics movement. 13 For somewhat different views, see Louis Filler, Crusaders for American Liberalism (2d ed., Yellow Springs, Ohio: Antioch Press, 1950), chap. xxii, and Harold Underwood Faulkner, The Quest for Social Justice,1898-1914 (New York: The Macmillan Co., 1931), pp. 159-62. 14 C. P. Oberndorf, A History of Psychoanalysis in America (New York: Grune & Stratton, 1953), p. 152. E.g., see the revealing paper, Charles W. Burr, "The Prevention of Insanity and Degeneracy," American Journal of Insanity, LXXIV (1917), 409-24,and especially the discussion,422-23.

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The basis for the new hope was the convictionthat an individual's behavior was determined-to a large extent-by his environment. A "as people who, for Boston physicianin 1909 defined psychoneurotics one reason or another,are not well adapted to theirenvironment."The observed in 1911, "If the conclusion was obvious; as one psychiatrist of an individual are largelyresponmental habits and the surroundings to accomplishments we can look forward sible forthe onsetof a psychosis, 15 whichmayrival thesuccessachievedin thecrusadeagainsttuberculosis." primaryobjective became, then, to re-educate The psychotherapists' adjusted himthe patientso that he adapted himselfto his environment, self to the realitythat surroundedhim. Thoughtful physiciansquickly perceived that the largest part of the environmentthat required the patientto changehis conductwas the societyin whichhe lived,including reported in 1913 that his family. A New York asylum superintendent "The patient is no longerregardedsimplyas a separate individual, but also as a social unit, whose cure cannot be consideredcompleteuntil he At the same has been restoredto social adaptability and efficiency."'IO time physicianssaw the possibilityof alteringnot just the patient but was social, the also his environment.Since the importantenvironment found themselves committed to social forward-looking psychiatrists indeed.'7 were Progressives and therefore meliorism, of children was especially a target for the socialThe environment of earlyFreudian ideas, they Under the influence reformer psychiatrists. importancein assertedthat childhood experienceswere of overwhelming of thesepsychiatrists was William Healy, later life. The most influential trained specialist in nervous and mental diseases,who a conventionally gave up his practice (at considerable sacrifice)in 1909 to work with juvenile delinquents in Chicago. Through his own experiencewith the motivationsof youthfullawbreakers, psychoHealy came to a strongly with case interesting analyticpoint of view. His works(richlyillustrated histories)persuaded untold numbers of persons that favorable changes
15 Richard C. Cabot, "The Analysis and Modification of Environment," Psychotherapy, III, No. 3 (1909), 5. James V. May, "The Modern Trend of Psychiatry," InterstateMedical Journal,XVIII (1911), 1098. 16 E.g., see the systematic work of Morton Price, "The Subconscious Setting of Ideas in Relation to the Pathology of the Psychoneuroses,"The Journal of Abnormal XI (1916), 1-18. William L. Russell, "The Widening Field of Practical PsyPsychology, chiatry," American Journal of Insanity, LXX (1913), 460. E.g., William A. White, The Principles of Mental Hygiene (New York: The Macmillan Co., 1917), p. 316. 17 E.g., C. C. Wholey, in The Journal of the American Medical Association, LXII (1914), 1036. Thomas W. Salmon, "Some New Fields in Neurology and Psychiatry," The Journalof Nervous and Mental Disease, XLVI (1917), 90-99.

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in the social environments of youngsters could preventdelinquencyand promotenot only mental health but social progress.18 The presumptuousness of psychiatrists in deciding how the world should be run was not different from that of other Progressives.Like Dr. George Van Ness Dearborn of Boston, physiciansappealed to "the sound principle of noblesse oblige." Moreover, as doctors they dealt with mattersof life and death, and as psychotherapists in daily practice theyundertookto interfere in and changethe attitudes and waysof lifeof of theirpatients. They were,therefore, accustomedto the responsibilities leadership. As earlyas 1907 E. W. Taylor of Boston pointed out that the role of the physicianwas expandingand thathe had to look afterthe sosaid cial as well as the physicalwelfareof his patients. He was becoming, LewellysBarkerof JohnsHopkins, the "moral director"of his patients.19 in rationalizing A numberof theories wereused by thepsychotherapists the world. A New York theirattemptsto recast neurologistwho advocalled cated a type of psychotherapy suggestionproposed in 1912 that infections of civilization-noxious suggesphysicianscombat the psychic thatwould foster what that is, withsuggestion tion-with psychotherapy, elements an cultural he believed to be the better (surely ambiguous goal and forsocial control).20Most Americanswere not strongon systematics, of their those who used to nourish many hope sufficed opinions; only invoked a fairly the most radical of the psychotherapies, psychoanalysis, consistent theoryto justifytheirreformism.2' whose alleged commitment to a so-called"sexual" The psychoanalysts,
18 E.g., William Healy, The Individual Delinquent: A Text-Book of Diagnosis and Prognosis for All Concerned in Understanding Offenders (Boston: Little, Brown & Co., 1915); William Healy, Mental Conflictsand Misconduct (Boston: Little, Brown & Co., 1917), especally chap. xvii. Healy's case affords evidence of a situation in which political Progressiveshad a direct influenceon the development of psychiatry. In an interview with the writer Dr. Healy remarked that the method of studying children (integrating medical, social, psychometric and psychiatric studies of a single individual) which yielded him such rich results was suggested in large part associated with Hull House and led by Jane Addams by a group of social reformers and Julia Lathrop, two of the best-knownProgressives. The Hull House reformers found financial support for the work and invited Healy to undertake it. 19 George Van Ness Dearborn, The Influence of Joy (Boston: Little, Brown & Co., 1916), p. 35. E. W. Taylor, "The Attitude of the Medical Profession Toward the PsychotherapeuticMovement," Boston Medical and Surgical Journal, CLVII (1907), 845-46. Lewellys F. Barker, "On the Psychic Treatment of Some of the Functional Neuroses," International Clinics, I (17th ser., 1907), 13, 15, 17. 20 George W. Jacoby, Suggestion and Psychotherapy (New York: Charles Scribner's Sons, 1912), chap. ii, especiallypp. 207, 218-19. 21 E.g., J. T. W. Rowe, "Is Dementia Praecox the 'New Peril' in Psychiatry?" American Journal of Insanity, LXIII (1907), 389, 393, Even most American psychoanalysists in this early period, it must be admitted, had less regard for theoretical than theirEuropean counterparts. consistency

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the intense view of the world was notorious,illustratedmost strikingly By means of sublimationman's psychiatrists. moralismof the Progressive evil would be turned into good, theyasserted; even the grossestsexual would become artisticcreations and love for fellow man. perversions JamesJacksonPutnam, scion of the Puritans,married to a Cabot, and of neurologyat Harvard, wrote: "It may well be urged that professor does not take the cultivationof social ideals as an end for psychoanalysis which it should directlystrive. Technically, this is true. But psychoof personal analystsknow well the evils that attend the over-assertion and the impordesires,cultivatedtoo exclusivelyin and for themselves, tance of the opposite coursefollowsby inference."In theirlong, conventional textbook on nervous and mental diseases, two of the leading and William A. White, Smith Ely Jelliffe of the country, psychiatrists of psychotherapy. ends" useful of "socially the their readers reminded advanced intellectual as the most and wrong about right sophisticated As found altruism medically of psychiatrists the time, Progressive rebels justifiable.22 who had abandoned were psychologists Some of the psychotherapists thesemen tended the Like psychiatrists, psychology. strictly experimental to be lay preacherswho sought to reformthe world by means of reof Boston, L. E. education and retraining. The scholarlypsychologist Emerson,for example, repeatedlypointed out the ethical and reform were likewise possibilitiesof Freudianism. More orthodoxpsychologists to led, when dealing with mattersoutside of experimentalpsychology, the "higher aspirations" of men dilate on the possibilitiesof fostering The best example of the and psychoanalysis.23 throughpsychotherapy is the famousbook of E. B. Holt of Harvard on The Freudian foregoing Wish and Its Place in Ethics.24 Holt assertedthat Freudian psychology justifiedthe ancient belief thatknowledgeis virtue,with the implication that evil need not be always with us. Holt saw man as an individual utilized not only interactingwith his environmentand, significantly,
22 James J. Putnam, "The PsychoanalyticMovement," ScientificAmerican Suppleon Putnam's inclinament, LXXVIII (1914), 391, 402. Freud commented regretfully tion to make psychoanalysis"the servant of moral aims." Sigmund Freud, An Autobiographical Study, trans. by James Strachey (2d ed., London: Hogarth Press, 1946), and William A. White, Diseases of the Nervous System,A p. 94. Smith Ely Jelliffe Text-Book of Neurology and Psychiatry (2d ed., Philadelphia: Lee & Febiger, 1917), p. 98. James J. Putnam, "On Some of the Broader Issues of the PsychoanalyticMovement," The American Journal of the Medical Sciences, CXLVII (1914), 397-402. 23 E.g., Ernest K. Lindley, in The Journal of the Indiana State Medical Association, IX (1916), 7; Stephen S. Colvin, "What Dreams Mean," The Independent, LXXII (1912), 847. 24 Edwin B. Holt, The Freudian Wish and Its Place in Ethics (New York: Henry Holt & Co., 1915).

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but also behaviorism. For within orthodox psychology psychoanalytic were those who adhered to experimentalpsychologythe Progressives behaviorism.25 and discontentin had been aware of ferment For years psychologists centeredaround the factthatdry, theirprofession.Most of the criticism was not useful. Then John B. Watson descriptiveacademic psychology took leadership of the revolt of the behavioristicpsychologists.They methodsand studied the and introspective dispensedwith consciousness human organism in its environment,using the methods of animal psychology.Watson began his behavioristmanifestoin 1913 by making as the behavioristviews it the purpose of the revoltclear: "Psychology is a purely objective experimentalbranch of natural science. Its theoretical goal is the prediction and control of behavior."26 Here was usefulnesswith a vengeance. had observedthat animals' innate patternsof action The behaviorists could be modifiedby training,and the young Turks soon tended to more or less embrace a radical environmentalism.Most psychologists such as that of William covertlysubscribed to an instinctpsychology Jamesor William McDougall. Now out of the laboratoryitselfcame a challenge to essentiallyconservativenativism.27One would misunderstand behaviorismif he overlooked the explicit meliorisminvolved in the movement. Watson himself took pains to clarifythe relation of behaviorismto social control,and the more alert membersof the profession also realized what was involved.28The goal of behaviorismwas, of the classical purpose of any science after all, merelya restatement including psychology:to predict. And prediction,to the Progressive involved control.29 behavioristsas to other scientists, thus appeared as conspicuous features The elementsof Progressivism and psychiatry.The mass of of reformmovementswithin psychology
25 The social psychologiesof men such as G. H. Mead and J. Mark Baldwin were too close to social philosophy to be properly included here. A case might be made, however, for including G. Stanley Hall and the genetic psychologyof that time. 26 John B. Watson, "Psychology as the Behaviorist Views It," The Psychological Review, XX (1913), 158; see also 168-69, 177. Italics added. For an interestingvariation with Freudian elements, see John B. Watson and J. J. B. Morgan, "Emotional Reactions and Psychological Experimentation," The American Journal of Psychology, XXVIII (1917), 163-74. 27 E.g., see M. E. Haggerty, "The Laws of Learning," The Psychological Review, XX (1913), 411; Howard C. Warren, "The Mental and the Physical," ibid., XXI (1914), 99. 28E.g., see John B. Watson, "An Attempted Formulation of the Scope of Behavior Psychology,"ibid., XXIV (1917), 329-52; A. P. Weiss, "Relation Between Functional and Behavior Psychology,"ibid., pp. 353-68. 29 See John Dewey, "The Need for Social Psychology,"ibid., pp. 274-75.

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descriptive.But materialin both sciencesremained,as before,primarily of the two disciplinesled the social attitudesof some of the practitioners just and psychology, to profoundchangesin the verynatureof psychiatry leftitsmarkon Americanpoliticaland social institutions. as Progressivism Progressive psychiatryand Progressive psychology were uniquely was devoid literature Americanphenomena. The European professional of the New World versionsof these of the optimisticsocial reformism epitomizedthe situationin Carl Rahn shrewdly disciplines. Psychologist his observationabout psychoanalysis:"Where the European followerof of the symbolis indicaFreud emphasizesthe point that the formulation tive of a 'renunciationof reality,'" wrote Rahn, "the Americandisciple sees it as a 'carrier of energy' exquisitely fittedfor increasing man's controlover his environment...."30 and the rise of One can easily account for the rise of psychotherapy and psycholbehaviorismin termsof the internalhistoriesof psychiatry coincided in time with the Proogy. But the fact that these movements and the fact that social controlwas an movement, gressivesocial reform in both politics and science,can be accounted foronly aim of reformers and psychology and in all by treatingthe developmentsin psychiatry moveendeavorsas part and parcel of the Progressive othermiddle-class ment itself.3' The historianwill discoverthe full dynamicsof Progressivism only when he examines not just politics, economics and social but all aspectsof Americanlife.32 philosophy,
30 See Edwin G. Boring, A History of Experimental Psychology (2d ed., New York: Inc., 1950), pp. 642-43. Carl Rahn, in a review of W. A. Appleton-Century-Crofts, White, Mechanisms of Character Formation, in The Psychological Bulletin, XIV (1917), 327. The absence of a British counterpart is especially striking in view of movementthere. the nearlycontemporaneousreform 31 The intellectual spokesmen for Progressivism were well aware of the possibilities of the new movements in psychiatryand psychology; e.g., see Walter Lippmann, A Preface to Politics (New York: M. Kennerley,1913). 32 Even though not focusing on Progressivism, May, End of American Innocence, gives an idea of the light that can be shed on the movement by an approach such as the one suggestedhere.

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