Changing American Psychiatry: A Personal Perspective

436 Pages·2008·9.54 MB·English

by  Melvin Sabshin

Changing American Psychiatry
A Personal Perspective
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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
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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.
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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
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