Patient Tales

Book excerpt: A look into communicating psychiatric patient histories, from the asylum years to the clinics of today In this engrossing study of tales of mental illness, Carol Berkenkotter examines the evolving role of case history narratives in the growth of psychiatry as a medical profession. Patient Tales follows the development of psychiatric case histories from their origins at Edinburgh Medical School and the Royal Edinburgh Infirmary in the mid-eighteenth century to the medical records of contemporary American mental health clinics. Spanning two centuries and several disciplines, Berkenkotter's investigation illustrates how discursive changes in this genre mirrored evolving assumptions and epistemological commitments among those who cared for the mentally ill. During the asylum era, case histories were a means by which practitioners organized and disseminated local knowledge through professional societies, affiliations, and journals. The way in which these histories were recorded was subsequently codified, giving rise to a genre. In her thorough reading of Sigmund Freud's Fragment of an Analysis of a Case of Hysteria, Berkenkotter shows how this account of Freud's famous patient "Dora" led to technical innovation in the genre through the incorporation of literary devices. In the volume's final section, Berkenkotter carries the discussion forward to the present in her examination of the turn from psychoanalysis to a research-based and medically oriented classification system now utilized by the American Psychiatric Association. Throughout her work Berkenkotter stresses the value of reading case histories as an interdisciplinary bridge between the humanities and sciences.