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Changing American Psychiatry: A Personal Perspective PDF

436 Pages·2008·9.54 MB·English
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Changing American Psychiatry A Personal Perspective This page intentionally left blank Changing American Psychiatry A Personal Perspective Melvin Sabshin, M.D. Washington, DC London, England Books published by American Psychiatric Publishing, Inc., represent the views and opinions of the individual authors and do not necessarily represent the policies and opinions of APPI or the American Psychiatric Association. Copyright © 2008 American Psychiatric Publishing, Inc. ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper 12 11 10 09 08 5 4 3 2 1 First Edition Typeset in Georgia. American Psychiatric Publishing, Inc. 1000 Wilson Boulevard Arlington, VA 22209-3901 www.appi.org Library of Congress Cataloging-in-Publication Data Sabshin, Melvin, 1925– Changing American psychiatry : a personal perspective / Melvin Sabshin. — 1st ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-58562-307-5 (alk. paper) 1. Psychiatry—United States—History—20th century. 2. American Psychiatric Association—History—20th century. 3. Sabshin, Melvin, 1925– 4. Psychiatrists—United States—Biography. I. Title. [DNLM: 1. Psychiatry—history—United States—Personal Narratives. 2. History, 20th Century—United States—Personal Narratives. 3. Psychiatry—trends—United States—Personal Narratives. WM 11 AA1 S118c 2008] RC443.S23 2008 616.89—dc22 2008004460 British Library Cataloguing in Publication Data A CIP record is available from the British Library. Contents List of Plates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii About the Author . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi James H. Scully Jr., M.D. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi 1 Post–World War II Scene in American Psychiatry . . . . . . . 1 2 A Pathway to Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 3 Implicit Preparations for a Leadership Role in Psychiatry. . . . . . . . . . . . . . . . . . . . . . 29 4 Reflections During the Search . . . . . . . . . . . . . . . . . . . . . . . 45 5 Clarifying the Mission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 6 En Route to Equity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 7 International Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 8 Psychoanalysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 9 Forensic Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113 10 Evidence-Based Diagnosis and Treatment . . . . . . . . . . . . 127 11 Psychiatric Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 12 Psychiatric Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 13 A Changing Membership . . . . . . . . . . . . . . . . . . . . . . . . . . 173 14 Annual Meetings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 15 Publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 16 Governance and Leadership . . . . . . . . . . . . . . . . . . . . . . . . 219 17 Management of External Relationships . . . . . . . . . . . . . . 235 18 Social and Community Psychiatry . . . . . . . . . . . . . . . . . . .243 19 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253 Appendixes Appendix 1: Selected Papers . . . . . . . . . . . . . . . . . . . . . . . .259 Appendix 1A: Turning Points in Twentieth-Century American Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . . . . .259 Appendix 1B: The Future of Psychiatry . . . . . . . . . . . . . 275 Appendix 2: American Psychiatric Association Speakers of Assembly of District Branches . . . . . . . . . . . . 291 Appendix 3: Presidential Themes for American Psychiatric Association Annual Meetings, 1984–2008 . .293 Appendix 4: Officers of the American Psychiatric Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 Appendix 5: American Psychiatric Association Membership Figures, 1873–2007 . . . . . . . . . . . . . . . . . . . 315 Appendix 6: Presidents of the American Psychiatric Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 Appendix 7: American Psychiatric Association Organizational Chart, 2008 and 1986 . . . . . . . . . . . . . . . . 327 Appendix 8: American Psychiatric Association Joint Commission on Government Relations . . . . . . . . . . 331 Appendix 9: Psychiatry Organizations of Interest . . . . . .333 Appendix 10: American Psychiatric Association Assembly Area Councils by Region . . . . . . . . . . . . . . . . . .349 Appendix 11: Comparison of American Psychiatric Association Area and District Branch Membership, 2002–2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351 Appendix 12: DSM Task Forces and Working Groups . .365 Appendix 13: American Psychiatric Association Medical Directors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375 Appendix 14: American Psychiatric Association Governance System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379 List of Plates Plate 1 Melvin Sabshin, Townsend Harris High School, New York, 1937. Plate 2 Private Melvin Sabshin, U.S. Army, 1944. Plate 3 Melvin Sabshin with his parents, Sonia and Dr. Zalman Sabshin. Plate 4 Dr. Melvin Sabshin, Chairman, Department of Psychiatry, University of Illinois Medical School, Chicago, 1961. Plate 5 Dr. Melvin Sabshin with Mrs. Rosalynn Carter at the 132nd Annual Meeting of the American Psychiatric Association. Plate 6 Dr. Melvin Sabshin with Jay Cutler, Director of Office of Government Affairs, at APA Main Office at 1700 18th Street, 1981. Plate 7 Dr. Melvin Sabshin and wife Dr. Edith Sabshin with Professor Masahisa Nishizono at the 80th Annual Meeting of the Japanese Society of Psychiatry and Neurology. Plate 8 Dr. Melvin Sabshin with Joseph T. English, APA Pres- ident, meeting with Pope John Paul II in Rome, 1992. Plate 9 Dr. Melvin Sabshin with President William Jefferson Clinton, Dr. Jay Scully, and Vice President Al Gore, 1996. Plate 10 Dr. Melvin Sabshin with granddaughters Alisa Sabshin and Renée Sabshin at their graduation from medical school, June 2000. Plate 11 Dr. Melvin Sabshin with granddaughter Drea Sabshin. Plate 12 Dr. Melvin Sabshin at his marriage to Marion Benna- than with granddaughters Brigitte Sabshin and Ella Bennathan, September 2000. Plate 13 Dr. James Sabshin and wife, Mary. Plate 14 Dr. Pedro Ruiz with NAMI President, Suzanne Vogel- Scibilia, M.D., at 2007 APA Annual Meeting. Plate 15 Dr. Melvin Sabshin, September 16, 2000. vii This page intentionally left blank About the Author Mel Sabshin studied medicine at Tulane University after gaining a Bachelor of Science degree at the age of 17 and completing brief service in the U.S. Army. After postgraduate training and a re- search post at Tulane’s Department of Psychiatry, he received an appointment at the Michael Reese Hospital in Chicago, a center of psychiatric research and psychodynamically oriented practice. While at Michael Reese, where he completed psychoanalytic training, Dr. Sabshin became concerned by the schisms in psy- chiatry whereby ideologically based assertions took precedence over evidence-based practice and patient care depended more on the psychiatrist’s theoretical orientation than on a reliable system of diagnosis and therapeutics. In 1961 he was appointed Profes- sor and Head of the Department of Psychiatry at the University of Illinois College of Medicine. During that time, he became an active leader in the American Psychiatric Association (APA), where he was elected to the Board of Trustees, and chaired several of its major committees. By 1974, when the post of Medical Director of the American Psychiatric Association became vacant, there was an effort to find a new leader who could help to unify the badly divided field. Psychiatry needed to become a scientifically respected part of medicine. Dr. Sabshin’s experience and professional perspec- tives—his work on the deleterious impact of professional ide- ologies and his strong emphasis on science and a new image for psychiatry—were seen as fitting him for the job and led to his se- lection. On his appointment that same year he inherited a well-run professional support group with highly dedicated staff and offic- ers. But to inform policy makers, and to convince federal and state legislatures of the importance of proper care for the mentally ill, it was necessary to promote psychiatry with efficient advocacy and to stimulate the research and new education that could produce ix

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