| A case study of one mental health field in a medium-sized, steel-belt city over a 50 year period is presented. Through interviews and archive data, the narrative elucidates the transitions that occurred in regards to which professions are dominant, and which services count as mental health services, in different eras and under different science and governmental regimes. The dissertation focuses on four professional categories in particular: psychoanalytic psychiatrists, neurological psychiatrists, research psychologists, and clinical psychologists. It also focuses, primarily, on three institutions: a large psychiatric research hospital, a university psychology department, and a psychoanalytic institute. Through tracing the dynamics of the professional transitions undergone by these professions and institutions, four major conclusions are reached: (1) The transitions in mental health were not just scientific advancements, but changes in the "object" over which mental health professionals are considered to have expertise. (2) Sidestepping the "total person" has resulted in a radical transition in the very hierarchy of the mental health system of professions. (3) The problem of the "total person" continues to complicate efforts in mental health, despite having ostensibly been "sidestepped." (4) "Totality" has become an area of technocratic expertise for those working in private practice psychotherapy. However, totality is no longer exclusively conceptualized through a psychoanalytic lens, while the ground to make a claim on "totality" is still grounded in "clinical experience."... |
