{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T07:11:31Z","timestamp":1695798691097},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,2,24]],"date-time":"2016-02-24T00:00:00Z","timestamp":1456272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J History Behavioral Science"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:p>This study examines experiences of individual patients and psychiatrists in the Henry Phipps Psychiatric Clinic at Johns Hopkins between 1913 and 1917. The dynamics of these patient\u2010psychiatrist interactions elucidate the well\u2010known conceptual shift in explanations of mental illness during the twentieth century, from somatic models rooted in the logic of \u201cneurasthenia\u201d and damaged nerves to psychodynamic models based on the notion of \u201csubconscious conflict.\u201d A qualitative analysis of 336 cases categorized as functional disorders (a catchall term in this period for illnesses that could not be confirmed as organic diseases), shows that patients explained their symptoms and suffering in terms of bodily malfunctions, and, particularly, as a \u201cbreakdown\u201d of their nervous apparatus. Psychiatrists at the Phipps Clinic, on the other hand, working under the direction of its prominent director, Adolf Meyer, did not focus their examinations and therapies on the body's nervous system, as patients expected. They theorized that the characteristic symptoms of functional disorders\u2014chronic exhaustion, indigestion, headaches and pain, as well as strange obsessive and compulsive behaviors\u2014resulted from a distinct pathological mechanism: a subconscious conflict between powerful primal and social impulses. Phipps patients were often perplexed when told their physical symptoms were byproducts of an inner psychological struggle; some rejected the notion, while others integrated it with older explanations to reconceptualize their experiences of illness. The new concept also had the potential to alter psychiatrists' perceptions of disorders commonly diagnosed as hysteria, neurasthenia, or psychoneuroses. The Phipps records contain examples of Meyer and his staff transcending the frustration experienced by many doctors who had observed troubling but common behaviors in such cases: morbid introspection, hypochondria, emotionalism, pity\u2010seeking, or malingering. Subconscious conflict recast these behaviors as products of \u201cself\u2010deception,\u201d which both absolved the sufferer and established an objective clinical marker by which a trained specialist could recognize functional disorder. Using individual case studies to elucidate the disjunction between patients' and psychiatrists' perspectives on what all agreed were debilitating illnesses, this analysis helps to illuminate the origins of a radical transformation in psychiatric knowledge and popular culture in the twentieth century\u2014from somatic to psychodynamic explanations of mental illness.<\/jats:p>","DOI":"10.1002\/jhbs.21777","type":"journal-article","created":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T08:30:24Z","timestamp":1456475424000},"page":"124-145","source":"Crossref","is-referenced-by-count":3,"title":["\u201cMY RESISTING GETTING WELL\u201d: NEURASTHENIA AND SUBCONSCIOUS CONFLICT IN PATIENT\u2010PSYCHIATRIST INTERACTIONS IN PREWAR AMERICA"],"prefix":"10.1002","volume":"52","author":[{"given":"SUSAN","family":"LAMB","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/10585-000"},{"key":"e_1_2_10_3_1","first-page":"1894","volume-title":"Psychoanalysis and American medicine","author":"Burnham J. C.","year":"1967"},{"key":"e_1_2_10_4_1","unstructured":"By dual personality new theory of mental disease to be tested here. (1911 January 11).Baltimore Sun p. 14."},{"key":"e_1_2_10_5_1","unstructured":"Curing the blues. (1912).The Washington Post July 31 p. 6."},{"key":"e_1_2_10_6_1","volume-title":"The discovery of the unconscious: The history and evolution of dynamic psychiatry","author":"Ellenberger H.","year":"1970"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2307\/1413001"},{"key":"e_1_2_10_8_1","first-page":"1876","volume-title":"Freud and the Americans: The beginnings of psychoanalysis in the United States","author":"Hale N.","year":"1990"},{"key":"e_1_2_10_9_1","volume-title":"Over the teacups","author":"Holmes Oliver Wendell","year":"1890"},{"key":"e_1_2_10_10_1","volume-title":"L'automatisme psychologique","author":"Janet P.","year":"1889"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM190612061552301"},{"issue":"2","key":"e_1_2_10_12_1","first-page":"243","article-title":"Social, motivational, and symptomatic diversity: An analysis of the patient population of the Phipps Psychiatric Clinic at Johns Hopkins Hospital, 1913\u20131917","volume":"29","author":"Lamb S.","year":"2012","journal-title":"Canadian Bulletin of Medical History"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1353\/book.35552"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0957154X07077749"},{"key":"e_1_2_10_15_1","first-page":"538","article-title":"A short sketch of the problems in psychiatry","volume":"53","author":"Meyer A.","year":"1897","journal-title":"American Journal of Insanity"},{"key":"e_1_2_10_16_1","first-page":"373","article-title":"Anatomical facts and clinical varieties of traumatic insanity","volume":"60","author":"Meyer A.","year":"1904","journal-title":"American Journal of Insanity"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0072906"},{"key":"e_1_2_10_18_1","first-page":"604","volume-title":"The collected papers of Adolf Meyer","author":"Meyer A.","year":"1909"},{"key":"e_1_2_10_19_1","first-page":"117","volume-title":"Proceedings of the Mental Hygiene Conference","author":"Meyer A.","year":"1912"},{"key":"e_1_2_10_20_1","first-page":"155","volume-title":"Studies in psychiatry","author":"Meyer A.","year":"1912"},{"key":"e_1_2_10_21_1","first-page":"95","volume-title":"Studies in psychiatry","author":"Meyer A.","year":"1912"},{"key":"e_1_2_10_22_1","first-page":"202","volume-title":"The collected papers of Adolf Meyer","author":"Meyer A.","year":"1913"},{"key":"e_1_2_10_23_1","volume-title":"Approaching hysteria: Disease and its interpretations","author":"Micale M.","year":"1995"},{"key":"e_1_2_10_24_1","volume-title":"Rest in the treatment of nervous disease","author":"Mitchell S. W.","year":"1875"},{"key":"e_1_2_10_25_1","volume-title":"Fat and blood: An essay on the treatment of certain forms of neurasthenia and hysteria","author":"Mitchell S. W.","year":"1884"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1525\/9780520309937-004","volume-title":"Hysteria beyond Freud","author":"Porter R.","year":"1993"},{"key":"e_1_2_10_27_1","unstructured":"Psychanalysis: A new science. (1911).Chicago Daily Tribune August 20 p. E2."},{"key":"e_1_2_10_28_1","first-page":"1869","volume-title":"Neurasthenic nation: America's search for health, happiness, and comfort","author":"Schuster D.","year":"2011"},{"key":"e_1_2_10_29_1","volume-title":"Doctors and their patients: A social history","author":"Shorter E.","year":"1991"},{"key":"e_1_2_10_30_1","volume-title":"The hysterical woman: Trials, tears, tricks, and tantrums","author":"Thornton R.","year":"1893"}],"container-title":["Journal of the History of the Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjhbs.21777","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbs.21777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T20:55:24Z","timestamp":1695761724000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jhbs.21777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,24]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1002\/jhbs.21777"],"URL":"https:\/\/doi.org\/10.1002\/jhbs.21777","archive":["Portico"],"relation":{},"ISSN":["0022-5061","1520-6696"],"issn-type":[{"value":"0022-5061","type":"print"},{"value":"1520-6696","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,24]]}}}