History of Child Psychiatry
Posted by Dr. Vollmer on September 25, 2013
It turns out the field is less than one hundred years old. Who knew? James McCracken MD, chief of child psychiatry at UCLA, gave a wonderful presentation of how child psychiatry, a field in its infancy, has evolved, largely through the prowess of some key researchers, many of whom, cut their chops at, what was then called, the UCLA Neuropsychiatric Institute, and now called the Semel Institute. Given that I trained in the 80’s, I have lived through over a quarter of that history. Dr. McCracken reminded us, painfully, that historically speaking, autism was thought to be secondary to “refrigerator parents” and not to the bad wiring, which we have now come to understand. The ugly history that child psychiatrists “blamed parents” for what is most likely, to be a brain disease, is particularly painful. Parents of disabled children struggle with disappointment, guilt and the life-long worry that these children may never be able to be independent. The idea that child psychiatrists exacerbated these negative feelings by wrongly telling the parents that it was their emotional limitations that caused their child not to have friends. Like with any historical exploration, I, as a child psychiatrist in 2013, must accept that my fore-fathers (there were few women in the field at the time), had theories which hurt families. The lesson to be learned, as psychoanalysts like to promote, is that uncertainty should be tolerated and so not-knowing should create a position of humility in the physician, rather than the certainty of a harmful theory. In essence, we are moving to a greater biological understanding of mental illness in children, but our movement is slow, and the field still depends on a great deal of subjectivity in the physician. I wonder what the next hundred years will bring.