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Written as a cultural weapon and a call to arms,Howltouched a raw nerve in Cold War America and has been controversial from the day it was first read aloud nearly fifty years ago. This first full critical and historical study ofHowlbrilliantly elucidates the nexus of politics and literature in which it was written and gives striking new portraits of Allen Ginsberg, Jack Kerouac, and William Burroughs. Drawing from newly released psychiatric reports on Ginsberg, from interviews with his psychiatrist, Dr. Philip Hicks, and from the poet's journals,American Screamshows howHowlbrought Ginsberg and the world out of the closet of a repressive society. It also gives the first full accounting of the literary figures-Eliot, Rimbaud, and Whitman-who influencedHowl,definitively placing it in the tradition of twentieth-century American poetry for the first time. As he follows the genesis and the evolution ofHowl,Jonah Raskin constructs a vivid picture of a poet and an era. He illuminates the development of Beat poetry in New York and San Francisco in the 1950s--focusing on historic occasions such as the first reading ofHowlat Six Gallery in San Francisco in 1955 and the obscenity trial over the poem's publication. He looks closely at Ginsberg's life, including his relationships with his parents, friends, and mentors, while he was writing the poem and uses this material to illuminate the themes of madness, nakedness, and secrecy that pervadeHowl.A captivating look at the cultural climate of the Cold War and at a great American poet,American Screamfinally tells the full story ofHowl-a rousing manifesto for a generation and a classic of twentieth-century literature.

The Making of DSM-III® chronicles how American psychiatry went from its psychoanalytic heyday in the 1940s and '50s, through the virulent anti-psychiatry of the 1960s and '70s, into the late 20th-century descriptive, criteria-grounded model of mental disorders. Decker's revealing book expertly recreates the stone-by-stone construction of a controversial, conflict-laden diagnostic manual and showcases the remarkable and tenacious handiwork of its creator, Robert L. Spitzer.

Private Practices examines the relationship between science, sexuality, gender, race, and culture in the making of modern America between 1920 and 1950, when contradictions among liberal intellectuals affected the rise of U.S. conservatism. Naoko Wake focuses on neo-Freudian, gay psychiatrist Harry Stack Sullivan, founder of the interpersonal theory of mental illness. She explores medical and social scientists' conflicted approach to homosexuality, particularly the views of scientists who themselves lived closeted lives. Wake discovers that there was a gap--often dramatic, frequently subtle--between these scientists' \"public\" understanding of homosexuality (as a \"disease\") and their personal, private perception (which questioned such a stigmatizing view). This breach revealed a modern culture in which self-awareness and open-mindedness became traits of \"mature\" gender and sexual identities. Scientists considered individuals of society lacking these traits to be \"immature,\" creating an unequal relationship between practitioners and their subjects. In assessing how these dynamics--the disparity between public and private views of homosexuality and the uneven relationship between scientists and their subjects--worked to shape each other, Private Practices highlights the limits of the scientific approach to subjectivity and illuminates its strange career--sexual subjectivity in particular--in modern U.S. culture.

Therapeutic Revolutionsexamines the evolving relationship between American medicine, psychiatry, and culture from World War II to the dawn of the 1970s. In this richly layered intellectual history, Martin Halliwell ranges from national politics, public reports, and healthcare debates to the ways in which film, literature, and the mass media provided cultural channels for shaping and challenging preconceptions about health and illness.Beginning with a discussion of the profound impact of World War II and the Cold War on mental health, Halliwell moves from the influence of work, family, and growing up in the Eisenhower years to the critique of institutional practice and the search for alternative therapeutic communities during the 1960s. Blending a discussion of such influential postwar thinkers as Erich Fromm, William Menninger, Erving Goffman, Erik Erikson, and Herbert Marcuse with perceptive readings of a range of cultural text that illuminate mental health issues--among themSpellbound, Shock Corridor, Revolutionary Road,andI Never Promised You a Rose Garden--this compelling study argues that the postwar therapeutic revolutions closely interlink contrasting discourses of authority and liberation.

The first comprehensive history of \"psychiatry's bible\"—the Diagnostic and Statistical Manual of Mental Disorders. Over the past seventy years, the Diagnostic and Statistical Manual of Mental Disorders, or DSM, has evolved from a virtually unknown and little-used pamphlet to an imposing and comprehensive compendium of mental disorder. Its nearly 300 conditions have become the touchstones for the diagnoses that patients receive, students are taught, researchers study, insurers reimburse, and drug companies promote. Although the manual is portrayed as an authoritative corpus of psychiatric knowledge, it is a product of intense political conflicts, dissension, and factionalism. The manual results from struggles among psychiatric researchers and clinicians, different mental health professions, and a variety of patient, familial, feminist, gay, and veterans' interest groups. The DSM is fundamentally a social document that both reflects and shapes the professional, economic, and cultural forces associated with its use. In DSM, Allan V. Horwitz examines how the manual, known colloquially as \"psychiatry's bible, \" has been at the center of thinking about mental health in the United States since its original publication in 1952. The first book to examine its entire history, this volume draws on both archival sources and the literature on modern psychiatry to show how the history of the DSM is more a story of the growing social importance of psychiatric diagnoses than of increasing knowledge about the nature of mental disorder. Despite attempts to replace it, Horwitz argues that the DSM persists because its diagnostic entities are closely intertwined with too many interests that benefit from them. This comprehensive treatment should appeal to not only specialists but also anyone who is interested in how diagnoses of mental illness have evolved over the past seven decades—from unwanted and often imposed labels to resources that lead to valued mental health treatments and social services.

Fifty years after John F. Kennedy's speech on mental illness and retardation, E. Fuller Torrey's book provides an insider's perspective on the birth of the federal mental health program. Torrey draws on his own first-hand account of the creation and launch of the program as well as extensive research, one-on-one interviews with those involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation.

As the United States rushed toward industrial and technological modernization in the late nineteenth century, people worried that the workplace had become too competitive, the economy too turbulent, domestic chores too taxing, while new machines had created a fast-paced environment that sickened the nation. Physicians testified that, without a doubt, modern civilization was causing a host of ills-everything from irritability to insomnia, lethargy to weight loss, anxiety to lack of ambition, and indigestion to impotence. They called this conditionneurasthenia. Neurasthenic Nationinvestigates how the concept of neurasthenia helped doctors and patients, men and women, and advertisers and consumers negotiate changes commonly associated with \"modernity.\" Combining a survey of medical and popular literature on neurasthenia with original research into rare archives of personal letters, patient records, and corporate files, David Schuster charts the emergence of a \"neurasthenic nation\"-a place where people saw their personal health as inextricably tied to the pitfalls and possibilities of a changing world.

While iconic popular images celebrated family life during the 1950s and 1960s, American families were simultaneously regarded as potentially menacing sources of social disruption. The history of family therapy makes the complicated power of the family at midcentury vividly apparent. Clinicians developed a new approach to psychotherapy that claimed to locate the cause and treatment of mental illness in observable patterns of family interaction and communication rather than in individual psyches. Drawing on cybernetics, systems theory, and the social and behavioral sciences, they ambitiously aimed to cure schizophrenia and stop juvenile delinquency. With particular sensitivity to the importance of scientific observation and visual technologies such as one-way mirrors and training films in shaping the young field,The Pathological Familyexamines how family therapy developed against the intellectual and cultural landscape of postwar America. As Deborah Weinstein shows, the midcentury expansion of America's therapeutic culture and the postwar fixation on family life profoundly affected one another. Family therapists and other postwar commentators alike framed the promotion of democracy in the language of personality formation and psychological health forged in the crucible of the family. As therapists in this era shifted their clinical gaze to whole families, they nevertheless grappled in particular with the role played by mothers in the onset of their children's aberrant behavior. Although attitudes toward family therapy have shifted during intervening generations, the relations between family and therapeutic culture remain salient today.

The high prevalence of mental illness and substance abuse disorders and their significant impact on disability, mortality, and other chronic diseases have encouraged new initiatives in mental health policy including important provisions of the Affordable Care Act and changes in Medicaid. This article examines the development and status of the behavioral health services system, gaps in access to and quality of care, and the challenges to implementing aspirations for improved behavioral and related medical services. Although many more people than ever before are receiving behavioral health services in the United States-predominantly pharmaceutical treatments-care is poorly allocated and rarely meets evidence-based standards, particularly in the primary care sector. Ideologies, finances, and pharmaceutical marketing have shaped the provision of services more than treatment advances or guidance from a growing evidence base. Among the many challenges to overcome are organizational and financial realignments and improved training of primary care physicians and the behavioral health workforce.

Borrowing treatment principles from acute and end-of-life pain care, particularly a focus on pain intensity, has had harmful consequences for patients with chronic pain. Multimodal therapy, by contrast, aims to reduce pain-related distress, disability, and suffering. Pain causes widespread suffering, disability, social displacement, and expense. Whether the issue is viewed from a moral, political, or public health perspective, pain that can be relieved should be relieved. Yet the most rapidly effective drugs for relieving pain — opioids — are caught up in a morass of concerns about addiction. Achieving a balance between the benefits and potential harms of opioids has become a matter of national importance. The United States recently established a national plan to address pain, as Canada, Australia, Portugal, and Malaysia have previously done. 1 This National Pain Strategy grew out of recognition by the . . .