Psychiatry, a branch of medicine, is a discipline that historically has taken severe mental illness as its object. In the course of the twentieth century, it dramatically expanded its purview, bringing the full range of human behaviors, both normal and pathological, within its domain. By the end of the century, psychiatry dealt with problems in everyday living as well as with schizophrenia and depression. It had become, as psychiatrists sometimes put it, “as broad as life.” In the process, it had also moved into the domain of the social and behavioral sciences. This essay will examine that expansion, focusing primarily on American psychiatry.
Unstably situated between genetics and biology on the one hand and the behavioral sciences – psychology, sociology, anthropology – on the other, psychiatry uniquely bridges medicine and the disciplines. Its practitioners take into account “everything from the molecular level to the most basic social issues.” They disagree, sometimes vehemently, on its goals, practices, and fundamental truths. Equally important to its instability, psychiatry has been thoroughly remade during the twentieth century. This remaking has fostered an eclecticism that is often interpreted as fragmentation, with psychiatrists advocating a broad range of conflicting models of behavior and disease. The remaking has also fostered a curious relationship between psychiatrists and their discipline’s history, with some taking pride in its ancient roots and others willing to jettison them and proclaim their discipline altogether new. “What is psychiatry?” has seemed to many a pressing question throughout the twentieth century.