THE SOCIAL AND HISTORICAL CONTEXT:

Values, Faith, and the Helping Professions

. historians of the future will point out that we too lived by myths. -Herbert J. Muller What needs to be stressed is the intimate relationship between the philosophy o! man prevailing in a given historical period and the assumptions concerning the deviant person. What is of importance is the relationship between these assumptions and the institutionalized practices that have developed for coping with deviance. -Jules D. Halzberg

It is common to begin textbooks with a chapter placing the current view of a tield of study into sequential historical perspective. That was in part the aim of Chapter I. The aim of this chapter is slightly different in that it is less concerned with a time line of historical "fact" and reporting of specific events. Chapter I is misleading if it makes the history of the h<:lping professions appear to be orderly and rational. Some events become historical fact as a function being remembered, recorded, written about, and interpreted. Other events are ignored and do not become facts. The recent emergence of Black American history, regarded for so long as nonhistory, is one good example. The way events are put together is as much a function of the interpreter and the community of historians as the events themselves. Such a view is similar to the one presented book called What is own question is that different from truth. by Carr (1961) in a little History? His answer to his historical fact is something This account will be no dif-

scribe how the social sciences and the helping professions are influenced by faith, social forces, and values. This chapter presents the following points:

1. All of man' squest for understanding, including science, and particularly social science, can be shown to be influenced by social forces, mediated through personal values and beliefs. We shall consider several analyses as examples of that theme, leading to the inevitable conclusion that the helping professions are so affected by current social forces that there is little sense in the argument that direct political action on the part of social scientists is .. unprofessional." The passive acceptance of status quo social forces is viewed as equally politicalas active intervention aimed at social change. The alternative presented here is not to deny such influence, not to condemn it, but rather to recognize that applied social science and the human service professions are inherently polit.ical. This requires scientist-professionals to examine their own values, and to present

ferent. It will express a point of view rather than a set of truths. 1t is expected that the viewpoint will have heuristic value. That is, it will de-

26

_.-

.~J;:""'. -"""

.~

these ~ thought of as 'l~gely political in I,111:"'~ ture, 'separate from the.work of scienfists,.]{ is7i",~' j'w'ish"iO :serv.e}ff1" . often th~ught to be deiriean~ngfQr sCie!ltis)sM'';:' ~.,fJ"Althougp't traditional view is that the tHe engage in ~ttempts t<H,!uiicfpate'lri th~'shapmg"'"'\ of these forces, or to be influenced by them.-Th~/,; : .~f+< nonappli~d psychologisHs less influenced by soCialtforces,"the fact is.that both "b~sic':,;" argument is that scienti~f~may pmticipate in)~J.;~~ ~nd?appliedp~yc.hologyhave been 'influenced cial policy debate as citizens, but notas sden"'~;.~;. tists, and that their aclual w6fk as Scientists is,it" , <~dii'ettly a-nd'indireCtfyby historical events, .";. ,"~ not: influenced by, other :ithal!""scientific,,,ll~ culturn,l biase.s,llnd values. ;'}" c-3:,We' n{view,some "historical notes" on the method." In fact, scieiitists~'like~other'members, ,f"f'i: of mental health. practices .,; ,,/";'determinantSo' of society, are shaped bY-Social otces,regafdle.~'~ ~:~<r f :;which,'wIIl demonstrate that the actual conof their willingness, and;as' they participa~;{i~ '+?$.::'i'~;+.J :'tent' o( the "best scientific and professional society they al~o help to~shapeit;'This paJ!ici,p~::.:1f'~~f;:~ -\ praCtiCes"is'" otten influenced by soCial tion can be actIve (usually toch~ge,orcreate'a"~':\-;:;':l . forces~ fads, and biases of influential leaders, social policy) or. passive, (usually toaccept~~::~~~~r~j~i ; as muth ~::by' scientific advancement. existing social policy): Because'it is difficult t~'. ;,i", ~gjJ see outside of one's.own(time,_peopte~~;:~~~~ 4., Corrmlunity'~psychology can best deal with the moral, ethical, and value questions of shaped by social forces eveihwhen .they are ;jJft.,:;~~; human welfare' through an appreciation of aware of them, History is usually dearest (if nOt "",,f the multiple cortmlunities that make up a sonecessarily acc;urate) in retrosPect rather than in\i~:t,ta, ciety. Such anappreeiation requires the culcontemporary historical ,;accounts. phenom7::';" enologically it is difficult for people torecogtivation of diversity and strength building, nizethe social forces influencing their behavior",- -\ two themeS that are repeated throughout this . book~'tThe scientific methods used:by com- ' attitudes, and beliefs because these forces are<~;! often diffused and are ri1i~ed'with the common-. ~, j, , munity psychology are most likely to keep the'moral and ethical questions in mind when sense beliefs of the time;'.:Wecarinot easily be-." they are-seen through a perspective ba:sedon come" unstuck" in time~and Wepay little atteri~f~'). tion to the importance of when we iive on how~, . cultural relativity and an ecological view, of human behavior, 'both of which are con" we think. In the unwritten code of the scienti~t there is a belief that deniesthis influence.~Sci.t: . cerned ,with person~environnient fit, rather ence deals with "objective truth,'; or at least'the ~. , than with evaluative labeling of people or '. ~~~ environinents~ search for it, and science is therefore supposedlyabove the influence, of contemporary events::~. Social Forces, Values, and Belief, The "leap offaith"'taken by Christians'who in Science believe in God and the Jeachings of Christ as ' . recorded in the Bible later permits a number of.. ',' Science and the professions it supports are quite logical conclusions about how to live,'fin4 . influenced by social forces both within the truth, happiness, justice, and so on. The "leap' community of scientists and within the larger of faith" of the social scientists who have all society. For the purpose of this discussion,sobeen trained in similar places, have read similar textbooks, and who have viewed the world for cia/forces'are defined rather lOOSely aspolitica/, 'social,' cultural: and, economic f.actors and their many years from a common perspective, such. omp/ex interaction extant in a society, or a that most accept a number of common assumpsegment of society, at a given moment in histions,' including mathematical and statistical tory; These forces-are mediated to scientific beprocedures as a way to make sense of complex havior by way of personal values and beliefs of information about humanity, also permits certain' 'individual scieQtists. There are both local and "logical" conclusions, But they are only logical national aspects of social fOn:;es,and sometimes if the basic assumptions are accepted. Within a
.-~;'
..::"

"Therri'dearly and explicitly so as not to de-.. . cclve themSelves or the community they

C'

'"

..

--:'

...

\.

'

...

'

';J

28

THE SOCIAL AND HISTORICAL CONTEXT

given science or profession there are frequently conflicting sets of theory and interpretation to . explain" the same data. "Schools" with par. ticular biases develop, especially in the social sciences. Sects of scientists proliferate like sects of religion. Each sect tends to view the world of concern with somewhat' different .. assumptions." Sc ientists prefer to call biases and values .. assumptions," but the terminology should not disguise the fact that they are beliefs. The history of science is scattered with such discarded beliefs. Today's truth is tomorrow's phlogiston. It is not often admitted that the choice of science as a system in which one has faith must be seen as simply that: a choice based on faith. Science is one system for ordering the world. It seems to work well for the natural sciences, and perhaps less well for the social sciences. Social science, despite its effort to be empirical, may actually involve new ways of viewing things already known. at least as much as new discoveries. If that is true, then there are, of course, a number of ways outside of science to help humanity view itself. A writer such as Kafka may say as much about us as a scientist studying alienation and anxiety. Does Shakespeare's literature say any less about us than Freud or Skinner? The choice between methods of understanding lies in a "leap of faith" to science, religion, art, or some other system. Once the leap is made each has its own logic. Today most psychologists believe in science. The rules of science therefore govern many of the conceptions and actions of community psychologists. However, this should not hide the fact that the issues of concern to psychologists are basically those of human welfare. The American Psychological Association prints each month the following statement on the title page of its official publication, The American Psychologist: "The purpose of the APA is to advance psychology as a science and as a means of promoting human welfare." The statement means that while the method endorsed is science, the questions addressed are necessarily moral, ethical, and value questions. What constitutes human welfare cannot be viewed in any other way. It is impossible to escape this fact, even when it is disguised by scientific language

which calls value judgments "assumptions" or . is hidden in laboratory research which is less open to public view than applied research. As psychology moves from the biological to the social, and from the theoretical to the applied, the questions dealt with (and the answers given) are increasingly more obvious as value positions. All views of how people ought to be are by nature value statements subject to the beliefs of their advocates. When one moves from theory to application they also become action statements, again subject to the beliefs of must openly admit this influence, try to make their values, beliefs, and cultural biases as clear as theirpossible, and Consequently, advocates. try to understand the social psychologists forces influencing their work. Much of applied psychology, which includes community psychology, is concerned with how best to implement those things already known. Thus, applied psychology is in a kind of "double jeopardy." On the one hand its "facts" are subject to cultural biases, values, and beliefs. On the other hand the methods and

aims for application of these "facts" are also subject to values, beliefs, and cultural perspectives. For example, if a social scientist observes, by collection of empirical data, that children who do well in public school tend to have a positive self-concept, that "fact" may have more to say about how positive self-concept is defined by the psychologist than it does about the child or the process of feeling good about one's self. If an applied psychologist takes this fact and tries to implement a program which aims to improve the self-concept of children by helping them to do well in school, he implicitly accepts the notion that positive self-concept should be a function of doing well in school. Although he may justify his work with children on the basis of the scientific fact of a relationship between positive self-concept and doing well in school, in so doing he often tends to ignore the basic value position this reflects, that is, selfconcept and school performance ought to covary. Trimble (1974) has made the same point more concrete in reporting on the self-image of native American Indians who are observed to

THE APPLIED VERSUS "BASIC"

DICHOTOMY

29
sense,

have high rates of alcoholism

and suicide.

As he

own

values.

culture, the values

and

"common

notes, Illany psychologists assullle that American Indians have a low sense of self-esteem hecause native found of their association However, their Americans that from reported with such "negative" 1000 he live major tribes, behaviors. in his survey of over self-esteem

Sometimes quently consistent

are explicit. When

more

freare

they are implicit. with a prevailing

the values

status quo they are as value judgments an established way of

less likely to he recogniz,ed than when they challenge viewing the world. Community psychology dedicated challenge settings, open to a challenge is to applied Community

is quite

high. In interpreting these results, Trimble concludes that the native American culture may not label as ne~ative the same behaviors whIch tlie _ c mainstream haviors. culture calls negative. Other oesuch as couragl' or the I,;;::k of it. may

is hy its very nature of the status in more quo, The as teston One controlled

work in public settings psychology and leaves "you requires

well as to science

practiced

be more important to self-esteem than drunkenness or the lack of it. Although these are rather straightforward holds. examples, the same process for less are frl'as we shall see in this chapter. social scientists

ing in the real world, to the claim values personal rather

its practitioner

that

are operating

than on science."

aim of this chapter.

and other parts of this book.

obvious examples. It is ironic that

is to present the view that values and science are not conlrauictory. That is, a scientist has values, no more right than anyone ues influence the scientist's thennore. this is else's, and these valwork and ideas. Furespecially in and

quently less willing than physical scientists to admit to being influenced by the very pnll'esses which social science is ahout' Yates (1\.)7.:+). for examplc. in reviewing a recent book on 131'I1m'io/' IlIflllclle' ulld Pn,\ollulilr (K rasner & Ullmann, 1\.)73). takes issue with till' au'thors' contention psychology. that sCIence. and particularly than absolute, is relalive, rather

unavoidable.

applied activities based on social science. should he made public rather than hidden.

The more the sl'ientist operates in the real world the more dii'1icult it is to hide the influel1l'e of values and bl'lids, Perry London (1\,)65) has

and that the scientist current methodology calls th is "dangerous

fullills a role by folloV\ing a and a valul' system, Yates nonsense" and argues

argued that psychotherapists cannot help but influence the values of their clients and that they have a responsibility biases more and bdore often social concerned systems to inform them with than entire about their psychology, populations is even the fact. Community

that there can be a universally valid body of knowledge by citing work from the physical sciences such as NeWlon's laws of motion. Although he means this to concern psychology. since it is a review of a book about psychology in a journal does edge" written for psychologists. of "universal sciences, recognize the influence of Yates knowlnot cite an example from the social

individuals,

more public. anu the practitioner will similarly need to clarify his or her values to those affected by an intervention. laboratory scientists biases explicit. social science. tist simply mode I. It i~; less to make usual their to expect values and

yet it is their data and interpretaserve as a basis for applied social scienas a theoretical The totally objective

tions that presumably to straightforwardly social forces and not be apologetic about having

does not exist except

values or participating in the political process, It {It is important is impl1l1ant community PSYChOlogistS! for for community psychologists to recognize, to popular practice and to tell nonscientists, belief. scientists, are subject of science, that contrary the in any biases, and therdore to values,

and faith, just as are any people engaged form of human endeavor. acting human judgments No person. in the role of scientist.

The Applied Versus "Basic" Dichotomy As It Affects the Psychologist Interested in Social Change
There is, within the social sciences, a kind of so-called hierarchical scientists distinction and drawn between The

even when hy one's

can avoid making

that are influenced

practitioners.

practitioners,

30

THE SOCIAL AND HISTORICAL CONTEXT

while they presumably base their interventions on knowledge of research, must also deal with problems for which the data are at best inconclusive, and activities are often based on hypotheses rather than fact; at worst research may be almost nonexistent. In applying psychology, researchers and practitioners are necessarily responding to the press of current events. This is almost a definition of applied psychology. Consequently, there must be an obvious influence of contemporary needs, values, beliefs, as well as political and economic aims. Applied psychology is a servant of these aims. This open responsiveness to contemporary issues creates a conflict in values which one sees repeated over and over again within the profession of psychology. Because psychology has developed out of an academic and research tradition based in philosophy and physiology, even those who apply psychology to contemporary problems see themselves as "scientist-practitioners." The ideal of this model is one of objective tester of reality, with the data of a value-free investigation objectively gathered and applied dispassionately. Applied psychology is frequently thought of as not different in its ideal from experimental psychology, but simply as a means of going the next step. This ideal is popular not only among the applied scientists, but among laymen as well. Within psychology the bias of the scientific establishment leads to a kind of

proposed a set of methodologies called progmm evaluation (Shulberg, Sheldon, & Baker, 1969; Struening & Guttentag, 1975; Weiss, 1972). But ultimately the applied researcher is always in a "one-down" position when judged by the criteria of "pure science." Unfortunately, testing in the real world frequently requires so much compromise of the experimental model a,s to always be in a weak il}ferential position. On the other hand, laboratory researcb is often so far removed from the real world as to be in an equally weak position when application is required. There seems to be an inverse relationship between scientific "rigor" and relevance to the real world. Clinical psychology has dealt with this problem since its existence; community psychology, which has a considerably broader scope and far fewer traditions is, with little question, in a "one-down" position with regard to these issues, even when compared to research in clinical psychology, let alone experimental psychology .. When a psychologist performs an experiment in the laboratory there are few questions with which he or she must deal outside of those that other psychologists of similar interests, background, and biases raise. This creates the illusion of objectivity. The further away one moves from the safety of the laboratory the more open one is to questiollsfrorita wider audience who do not necessarily share one's assumptions. To do research in a mental hospital there are a number of ethical and procedural standards that must be met. But again the reviewers are usually of like mind with the researcher. As one moves

hierarchy of scientific respectability which places experimental science at the top, descriptive science somewhere below, and application art he bottom. Applied social scientists are now to other social systems, such as schools (educain a peculiar position. Although the physical tional research has its own set of rules), and as scientist, who serves as the model of objective one moves out to less traditional settings in the science, can apply many of the neccessary connatural environment, the rules and assumptions' trols for a truly experimental science, and the " , become less clear and a number of legitimate psychologist who confines his work to the questions can be raised by an increasing number laboratory can presumably approximate this, the of people affected directly or indirectly by the" applied psychologist is forced to make a number work. There are no fewer biases held by of compromises with the ideal model in order to psychologists doing laboratory research than conduct research, and even more to apply it. there are by those in community psychology. There are various means for approximation, The difference lies in the publicness of the remany detailed by Donald T. Campbell and Jusearch, the number of people and special inlian Stanley (1966) under the rubric of "quasiterests touched upon, and in the potential for experimental" research designs. Others have immediate social influence.

WHEN IS A SCIENTIST POLITICAL?

31

than the laboratory, eVl'n if it is descriptive dal<1, and When one collects datais in till' to field" r,lther pal1icularly when il data .. l'valuate an attempt
10

change

Ihings,

Ihe

inl'luenee

of

I grams,

eommunilY, depending on what sort of pmL'lll1lined sellin~ such as Toschool or in thc lar~er a ill/llll'lI/ClIl grams he is proposing, new proas well as 10 invent them, is seen as Ihe responsibility (Fairweather. of Ihe l'\lInmunily psychologisl 1<)74). Sanders, & Tornat/.ky,

political-slll'ial forces bel'omes mosl apparent) Not only docs the researcher 11L'edto ,ICl'\lmmOdate to varillus predetermined more obvious, influenced life are laboratory tial. simply effects asked more inlluential flll'Cl's quite directly in order 10 he permitll'tl to do rl'sl',lrch, but also thl'

When Is a Scientist

Political?
anu Sl'ient ists veractiYl' and to of society is this alhistory. coneeds

biases of the researcher become The ways in \\hich he has heen him all his is doing apparl'nt apparent. who she \\ants has to examine Ihis the in ,I and competition is rarely Iahoralory Ih,ln if he

A It hough most psyd)ologists hally respond to Ihe immediate

by sOl'ial fOI'Cl's ,tnlllnd research, more

state that 10 he polilil'ally

TIKY arl' nllt nHlrl' infllll'n-

inappropriate to the scientilic enlerprise. titude is not rellected in our actual Rohert Reiff (1<)7Ia) has argued gently when Ill' pointed the hehavioral scientist's and puhlic policy

A psyd)ologisl of cooperation whal right

this point

III study

out that the history of involvemenl in politics States shows

social-psYl'

holog iell ,

small-group

in the United

experiment. But the same psychologist. if she wishes 10 do research on the c1lects of cooperation in schools, will need to estahlish a school that operates hy the pril1l'iples she "'anls to examine, This will require political behavior at the local level. because she will have to ereate the program politically that shape

inereases during war lime, or when there is a of society. threat 10 the perceiYl'd well-heing During entists they military World were considereu personnel War II. many of the "pure" willing the to become need for In times applied assessment when scientists sciwhen of argue they do

vital.

lx' fore

she can l'vailiale

it. II' she

nol perceiYl'

a erisis these same

stays in the laboratory

she may 11L'ver have to he

active. and her own political hiases her research l',tn he kepI quill' to her-

for nonpolitical involYl'ment in public policy. Who (which sl'ientist) gets involved in political inlervent ions and publ ic pol icy depends sees the problems action as suflil'iently uemand willingness as opposed on who to The is in imptlJ1anl

self. She would. of course. have 10 give up the test of her ideas in the real world, unless she were lucky where who would experiment" What psychologist enough to lind a reformer someapproximated her ideas and who her
10

to rel1cction, in such action

to he involved

allow

conduct 11)6<)). is Ihat in social

a the chongI'.

quasiapplied or in

(Campbell. this means interested

more a scientist !'eels personally concerned with an issue, the more likely he is to act rather than pari a function of the values one holds. psy Thl.:J re Ilec\. During World War II. most chologists did not refuse to uo applied work on the basis of elhics situation affecled identify minority lems, many or lack of data, Ihem directly. The political Those who

examining the effects of a program not already in exislence. is not only in a one-down posilion because researcher. he is an applied but he must rather than a "pure" enter the also openly

with the problems of the poor and groups are more likely to be involved and scientific Ihe laIc system, work 1960s Some with such proband early 1<)70s in joined for changes professors During

political market place in order to test his ideas. He must make his values clear. and he must be politically active if he is to be permitted the

in political

studenls

went on "strike"

oppol1Lmity to test Ihem out. The alternative is to never test his ideas, Since. in American society. policy the right is under to tryout political new control. ideas for social

the university for a pro!'essor

them and others argued

that it was inappropriate in such political

to be involved

the community

psychologist who wants to obtain empirical data will necessarily be a political activist. either in a

activity, As funds for salary raises to professors have been reduced in the 1970s more seem willing to join unions and threaten strikes them-

32

THE SOCIAL AND HISTORICAL CONTEXT

selves. If the political issue is relevant to the scientist, he is more likely to participate. It has far more to do with values than with data.

Although social forces and values affect the viewpoints, interpretations, and models of basic .. trom the Eugenics Research Association, a committee of scientists, " ... in an effort to take as well as applied social science, this is always the national debate over immigration 'out of more obvious in the work of the applied pol itics' and to place it on a .scientific basis,' psychologist. However, even within applied began to support relevant research" (cited in psychology those who are involved in programs Kamin, 1974a, p. 4). They sponsored the work of for social change are more likely to be labeled as Carl Brigham who reanalyzed the army data on "political" than are those who work for prointelligence of immigrants. Brigham found that grams of social control. In some measure, the immigrants who had been in the country 16-20 scientist who works with grass-roots people, or years were as bright as native-born Americans. from the bottom up, rather than with the govHowever, those who were recent arrivals wele ernmental or established agencies of social conclassified as feeble-minded. Brigham argued trol, is viewed as more political than his govthat he was measuring native intelligence, and ernment agency counterpart. The real difference the reason for the better showing of the longer may be in their status quo versus change poliresiding immigrants was that most had come tics, but they are both political. from England, Scandinavia, and Germany, Even avowedly antipolitical social scientists whereas the more recent were from Southeastern have been influenced in their scientific work by their personal value system and by contemporEurope. The decline was seen as due to a decrease in "Nordic blood." As Kamin notes, ary social forces. Leon J. Kamin (l974a),1 in a recent paper on "Heredity, intelligence, poliBrigham went on to add, in a classic disavowal of political activity, that: tics, and psychology," has noted the political involvement of some of the most esteemed of American psychologists early in this century. He reviews, for example, some of the activities of the renowned psychologist. Henry Goddard, who became involved in the effort to limit Euro-

of Blacks, but were used in the most important political battle of the day, the debate over admission of immigrarits by quota. Under Yerkes' leadership and with the assistance of scientists

I I
I I
\

pean immigration to the United States. Goddard used "mental tests" to examine large numbers of immigrants and concluded that 83 percent of Jews, 80 percent of Hungarians, 79 percent of -,italians, and 87 percent of Russians were "feeble minded." Congress used his data in 1924 to limit immigration of .. undesirables." Under the direction of Robert M. Yerkes. a psychologist renowned in the annals of experimental psychology and social science, the Army's World Warl testing program results were published by the American Academy of Sciences in 1921. Kamin notes that the results not only provided evidence for the low intelligence

We are incorporating the negro into our racial stock, while all of Europe is comparatively free from this taint ... The steps that should be taken must of course be dictated by science and not by political expediency ... and the revision of the immigration and naturalization laws will only afford slight relief ... the really important steps are those looking toward prevention of the continued propagation of defective strains in the present population (Carl Brigham, cited in Kamin, 1974a, italics added).

'Kamin has recently expanded on his observations in a book. The Science and Politics of lQ. Potomac. Maryland: Lawrence Erlbaum Associates, 1974b.

Not only does Kamin show, by citing Congressional testimony from scientists, how this and other similarly value-laden interpretations of scientific research helped establish immigration quotas, but he notes, not incidentally, that Brigham later became an important office holder in the American Psychological Association, and served on the College Entrance Examination Board where he devised and developed the Scholastic Aptitu_de Test. If men like Yerkes, Goddard, and Brigham had decided that the intelligence test data used to justify limited immigration were actually so cul-

'c

- turally biased as to be uhfair and unscientific, and had used their considerable influence to ~gue for more ppportunities;. for immigrants, .'.one wonders whaLtheir fate ip the history of s~ial sclen~e might have been. The ,fact that the~ supported the dominant political viewpoint oftheir tirnt;does no! make their actions any less political, but they &re remembered as experimental. scientists, not as political polemicists. This same point has been well made by opporient~;of' military research who have taken ilniversity scientiststo task for accepting "de. fense .contracts" which support improved war machines in the name of science. Unfortunately, because it is more. disguised, it is less often re~ized that those who receive grants from the bepartment of Health, Education, and Welfare, induding this aut~or, have' also worked for the government and consequently are oftel1 agents pf social control. . This argument does not state that social control through health, education, and.welfare programs is necessarily wrong, but simply notes that .suchScientific and applied work is just as much in the realm of politics and values as work with grass-roots groups who seek direct political change. To support a status quo political sys- tern, or a psychology of adjustment to things the way they are, is just as political, even if less obviously-so, as supporting a change,in political ~. and social systems. Is work with a grass-roots group of Black youth who want to organize and protest their treatment in school any more political than consulting with the school. system to' develop a plan to control those same children by use of behavior modification aimed at social
<
-

Psychiatry was never an ethically or p6liifCallyneutrai<~~{ profession. Value, systems,' usually. implicit'>ijd'~r;'~:' than explicit, have always dominated.t~:p~Jic~s of~>;' different schools of psychiatry ;.';'. 'TIii'Peoollwt\o;li', .,
,--r" ,-.--

preoccupied with int~ma,!p!pbI~mscis,likejy:tq:bele~ inclined to confront social~systems.~";:. so:.~OIi~ as'''. treatment does not encourage the patient to'ex~~ or;;: confront his environment ;and. so long as treatment~. protects those who have adversely.affec~ that p~tient"~..f'. from considering their own behavior;ihlnet effect r~Ii?: . of treatment is to strengthenthe status.quo~' . ; there 'is no ,c
..1

~'!_

way in which the psychiatrist

ca1fd~al with behavior._.

''' ... ;0 . , ". __

,I

that is partly generated by a'sol!icil sysfem~withOut either' strengtheningoralieringttluit Systent." Every encounter with a psychiatrtst.'therefore; has Political implications

--

..

"

....

once this fact is appreciated, the,~; .. , ... psychiatrist's search.for ~litical neutrality beginS}O,/; .. ~ appear illusory (Halleck, 1971, pp. 34-36, -italics in~,. of " original). :). ~

control, or therapy groups which give them some place other than the public domain to vent their anger? Albee (1969) has noted that as long .~ mentalhealth deals with therapies-it is not threatening to the existing social structure. But when the problems are conceptualized as a result of inadequate, unequal, and destructive social systems it becomes a threat to the existing political-economic.system. Thus, tho~ who re~'jpond ~politiCal, to contemporary problems are often seen and thQsewho ignore theJIl are not. Actually, all human serVice professionals are

Some (Szasz, 1970) have argued that institu-t :, tional psychiatry, which involves involuntary ": . hospital commitment: is 'politically, motivated:' and repressive in the same sense that the' inquisition repressed religious deviance. Halleck ( 1971 ) goes further to argue that - all of psychiatry is a political weapon. He notes that:
In treating a patient (or-in the case of communit)' psychiatry-in dealing with any mental health prgb- .; lem) the psychiatrist chooses his o,wnmodes of treatment; he is not required to explain either the values or political philosophies that govern his choice; Some psychiatrists are conservative; most are liberal, and a few are radicals. The extent to which a psychiatrist' s . political or moral belief systems affect his choice ora particular therapeutic approach is rarely acknowledged or appreciated. He merely insists that his primary goal is preventing mental illness (p. 88).

, THE SOCIAL AND HISTORICAL CONTEXT

Ronald Leifer (1969) has also argued that the human service professions have always been agents of social and political control "in the name of mental health." He calls psychiatry social control disguised as medicine, and notes that the factors that are usually credited with leading to community psychiatry are merely historical events that have not been causati ve. The events that are usually cited, as was noted in Chapter I, include increased public recognition of mental health needs, the increasing role of the federal government in health care, and new developments in medicine and psychiatric practice. Community mental health has, Leifer notes, focused on programs for improvement or abolition of mental hospitals, construction of ,mental health centers to serve geographically proximal communities, and programs to prevent "mental illness." He interprets these activities as manifestations of a " ... social movement with a long history. Its development is related to profound changes in the character of modem social and political Iife-danges in national

political biases and values in 'favor of social contro!. The way in which Leifer views community psychiatry and community mental health is as a movement directed by the state to control its deviants, and he shows how this is hidden by medical or sociological terminology. lnterestingly, many of the mental health workers who participate in the community mental health system would view themselves as apolitical, or certainly not as political activists. If Leifer's view is adopted they, just as much as an organizer in a radical grass-roots movement, or a conservative policeman, must be viewed as agents of political mission, regardless of their avowed interest in mental health rather than politics. Anyone who has ever tried to implement a new program of mental health service not consistent with the status quo, or who has engaged in the delicate game., of'" gnintsrrienship" (a euphemism forthepolitics'of economic support for research or serVice programs), will recognize that current political forces are influential in de-

character, national purpose, and public policy" _ J.irIDJning success. The actual content and feasi(p. 214). ~iTlty of mental health service programs are Leifer's essential argument is that the ~{necessarily affected by the economics and polichange of emphasis in psychiatry from hospital _~ tics of health, education, and welfare, at least as confinement to community treatment is a reflec~ much as they are affected by scientific merit. tion of a change in governmental public policy <:) Funding agencies 'set priorities. These priorities the poor to welfare programs, rather than a change in basic medical knowledge. He note from treatment of the mentally and in America and that obvious maltreatment ill oppression Of~ vidual scientists are usually selected to serve as consultants on grant applications, and, not SUfare a function have biases, beliefs, and values. prisingly, they of governmental policies. Indi-

Europe has always been hospitals the control of~~ Usually those selected to serve on review profesdeviance. Public mental through evolved from ~re well-known, established scientists or panels prisons and poorhouses, and policies for operasionals whose position is therefore most often tion of public hospitals have always been a funcrepresentative of the status quo prevailing betion of public policy toward the poor, not scienIiefs. New ideas, particularly if they challenge tific discovery. The same system has evolved those in power, be it the scientists, the mental into the modem welfare system of which comhealth professionals, or the political administramunity mental health programs are a recent extion, are difficult to finance. Anthony Graziano tension. Leifer views the localization of com(1969) has illustrated this reality in a detailed munity mental health programs as an extension of social control over deviants by means of surveillance, rather than true medical advances. He sees danger not in the expression of such political values, but rather in disguising these values as medically and scientifically based, and advocates frank admission by psychiatrists of their case history of an attempt to establish a new mental health program based on what he viewed as recent advances in psychological research. Graziano describes the experience of a group who wanted to provide new mental health services in a community already controlled by a mental health establishment. By applying the

ground' niles of currently" acceptable sCientific . 'dedsion making, if this new ,approach had be,en '.i;compared with the success. of the established "approach, theL\Veightof evidence would have "JJeen stibngly;' in favor of th~new approah. ,"lJ()weve.r, the.skills ~fpOlitics! rath<;:rhan those t ~f sc~ence or medicine were necess",ary obfor' 'tiun:irig fund'il].gto 'establish' the neW program. J'he 'gc)'\:,emmental gents,did not ask for rational a ,scientific ,cgmp'arison. Rather, power and so<;ial G6ntrorwere the determining f~tors~The estaQlishdt "ProfesiiPnals \Vhose\-con~l:'w~ being ',dill1ifnged' Were c~U~d u~t(as tne .only i~gitiof nqte 'evaJuatO~~ the progrIDnpr0I'OSetlbY-this, 'new grouP. The new service was automatically referred to the control of those whom they challenged, since.the established professionals were 'd:>nsidered'tobe the best judges, apparently on the basis of theirsdcial position. Despite outside and independent positive evaluation, the new program was rejected for funding because, argues G,raziano, it threatened the status quo continuation'of; the local ,mental health establishment.', Graziano has drawn some general conclusions from this experience. The maj~r lesson he pre~nts is that turning innovativ~ideas into in,novative programs requires "a good deal more than humanitarian.beliefs and scientific objectivity" (1969; IJ., 13). Rather, he argues; political knowhow is essential. Here we see the link betWeen social science and development of human resources; politics. To implement a program requires political action, p'articularly if that program is one which challenges existing power relationships in a community. Graziano argues that tM'mental health power,stnictufe (and this, . could be generalized to any soCiaI system) spends the 'inajo{ portion of Its 'efforts in main'tainingitself. He gives it the motto "Innovation without change," and describes the typical established power as supporting words that sound like innovation, and actions that do not lead to it.'To challenge the controlling system one must become political. '''Contemporary American mental health professions base their major decisions neither on science nor humanitarianism, and certainly not on honest self-appraisal, but on everyday politics of bureaucratic survival in

The Influence of Contemporary and Historical Forces'on;-:'/' " ,"Basic" Psychology'

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, ;>

It may be argued that the rea,llybasic proce~ures" of science and verifiability\ are different particular theories. AU scientists tend to agree, on the "rules of science" even when they differ in their interpretation of data. But even the pro- , cedures which are said to lead to verifiability are>\' based on faith and tradition. The continued replication of an experiment which finds results "statistically significant" such that the chances are one in twenty that the result is random con- ' vinces us that the result means something, in that it is generally reproducible under the same conditions. Unfortunately, not only are there few such consistent replications in the social sciences, but those found frequently account for only a small portion of the data, and are offen': suspect beyond the specific (usually laboratory) conditions under which they were obtained;'

36

THE SOCIAL AND HISTORICAL CONTEXT

Recently a small number of psychologists have emerged who question the adequacy of scientific aims borrowed from the natural sciences as appropriate to the social sciences. The major issues raised center on the observation that, unlike the physical universe, social behavior changes quite rapidly over a relatively short time span, and may make "universal behavioral laws" impossible to find. This position has been well presented from three entirely different and independent perspectives by Lee Cronbach, Kenneth Gergin, and Klaus Riegel.

Cronbach's Analysis of the Quest for Universal Laws

In 1957 Lee J. Cronbach presented a very influential paper which argued for the combination of experimental and correlational research in what he calls aptitude by treatment interactions. The question such research asks is "how do the same experimental treatments affect people with different individual characteristics?" Today this is a very common sort of research design in psychology. In 1975, coming back to his earlier suggestion in an address to the APA on receipt of a Distinguished Scientific Contribution Award, Cronbach noted that looking at these simple interactions is probably an insufficient means of understanding since behavior is so complicated that many other uncontrolled factors are usually operative in an experiment. In Cronbach's (1975) words, "An ability by treatment interaction can be taken as a general conclusion only if it is not in turn moderated by futher variables ... However far we carry our analysis-to the third-order or fifth-order or any other-untested interactions of still higher order can be envisioned." Going further, he argues that laboratory experimentation may not even be a good first approximation of real world relationships in that experimental generalizations assume that, .. all other things being equal," a treatment effect accounts for a given result. However, in the real world other things are rarely equal, and most fre'queTltly we are not even aware of what the "other things" are. Finally, Cronbach notes what he calls' 'time as a source of interactions."

Over time, empirical relationships change, For example, DDT is no longer effective because mosquitos have adapted to it. As the economy and community attitudes change, social psychology changes. Even the position of the stars change over time. Culture changes, and "the more open a system the shorter the half-life of relations within it are likely to be." The argument that psychological reality is not fixed over time, nor is it independent of cultural and attitudinal changes, is one which is emerging here and there among psychologists, although it is contradictory to the standard model of science as a search for enduring empirical relationships. Cronbach now suggests that psychology may be> realistically thought of as interpretation in a social context, rather than as a search for timelessgenequizatien; Again, in his words: Social scientists are rightly proud of the discipline we draw from the natural science side of our ancestry. Scientific discipline is what we uniquely add to the time-honored ways of studying man. Too narrow an identification with science, however, has fixed our eyes upon an inappropriate goal. The goal of our work ... is not to amass generalization atop which a theoretical tower can someday be erected ... The special task of the social scientist in each generation is to pin down contemporary facts. Beyond that, he shares with the humanistic scholar and the artist in an effort to gain insight into contemporary relationships, and to realign the culture's view of man with present realities (Cronbach, 1975, p. 126). It is not much of a step from this contextual view of psychology to recognize that even the publication of dfl!a is influenced by values, biases, and social influences. The tradition, for example, of publishing only results that are positive tends to bias the journals that scientists read in favor of data that support a prevailing status quo. In the same way, since journal reviewers are typically those already well established in a field, the tendeQcy is to accept articles for publication, that support the existing rather than new paradigms. That is in part why each new school of psychology finds it necessary to create its own journal. Likewise, the social meaning and interpretation of data, once published, are also functions of current social values.

-- -

--- --------------~-

, A few simple examples will clarify this latter point; If Blacks are consistently found to score
16.;we{ thanwl1ites onjntelligence measures used by AplericaD psyc hologists fQ~rnost of the twentieth ceqtHry: wijat does that 'Peal!, and what social pollcy--does it imply?.:There have been ,'many ~iifferent answe~s,to that question, often put forth by scientists who share a respect for the b,asie procedures pf science. These answers range from refusal to offer any policy (which is t2e sam~,as sayi.!'1g,,"do what ha.s traditionally been done") to radical, proposals for change, ranging from' eugenics through cultural enrich. ment and educational reform, to banning the use, of tests. The soc:;ialpblicies 'offered are more a
,.,~~ .io

function of values and beli~~ _~ha~9fdata. The policies most popular are 'a function of the'times in 'which one lives, 'such that, the same data can. _ . be used to -support genetic inferiority, environ, mental causality~ or invalidity of tests, depend-, ing on ~:me's politics and on current popular beliefs.The beliefs are rationalized by data, bur they remain rooted in values . . A recent e~ampl~ of the~same p~enomenon was presented by the AmericanPsychiatrrc Association which has now determiI!ed by popular vote of its membershjp that homosexuality is no lorger to be considered a.disease. The sudden "curing" of many heretofore" sick" people is a consequence of the Gay, Liberation ,Movement and current liberal, sexual attitudes, rather than scientific advances. This is .not an isolated example. "More than a century ago Dr. Oliver Wendel Holmes observed that 'meq.icine, professedly founded on observation, is as sensitive to' outside influence, political, religious, . philosophical, imaginative, as is the barometer to the changes of atmospheric density. Theoretically it ought to go on in its own straightforward inductive path, without regard to changes in government or to fluctuation of public opinion. ,:aut [actually there is] a closer relation between Medical Sciences and the condition of society and the general thoug~t of the time than would at first be suspect' ." (cited inGrobb, 1973). There is danger in saying this if it is interpreted to mean that scientific method has no place in psychology. Psychology must operate within the best scientific methodology available.

r--

Gergin's View of Sodal Psychblogy as Contemporary History

Kenneth Gergin (1973), a consulting editor for the Journal of Personality and Social Psychology at the time, has argued that although methods of research in social psychoiogy, ap:~. area which aspires to the model of the natural sciences, are scientific iil character, its theories and ideas about social behavior are essential!y , reflections of contemporary histc?ry. "ltis the rare social psychologist whose value's do not' influence the subject of his resear<;:h, 'his,

38

THE SOCIAL AND HISTORICAL CONTEXT

methods of observation, or the terms of description" (p. 311). Individual difference research, for example, places those most like the researcher in the best light. The more similar the subject is in education, sex, and values to the psychologist, the more positively he is described. Models of social interaction as well as individual personality variables are based on value judgments. Conformity, authoritarianism, aggression. and other such concepts are not , value-free, and are either highly regarded or not depending on the culture. As Gergin notes. the authoritarian personality is looked down upon in American psychology, but has been praised in German society (Jaensch, 1938). Wiggins, Jones, and Wasserman (1975) recently found that Whites and Blacks view the term "aggressive" quite differently, with Blacks rating it more positively than Whites. Further examination showed that Whites view the term to mean physical aggressiveness, and Blacks see it to mean gaining active control over one's environment. The meaning of such words is always culture bound. Unless psychologists recognize this they may reify the meaning and make improper inferences about people. Even when careful methods are used to collect data the discussions of results often employ words as if they have a meaning that is not culture-bound. Gergin gives some excellent examples: ... self-esteem could be termed egotism. need for approval could be translated as need for social integration; cognitive differentiation as hair-splitting; creativity as deviance; and internal control as egocentricity ... if our values were otherwise conformity could be viewed as pro-solidarity behavior ... (1973. p. 312). Gergin goes on to argue that social psychology does not operate in a vacuum; as it influences humanity's view of itself via dissemination of theories of social behavior the very nature and influence of the variables described change the way they affect its behavior. To know that psychologists think that people repress sexuality leads to attempts to deal with it openly. To know about reinforcement as a way to control behavior leads them to resist such control. The more powerful a theory of social behavior, the more aware people become of it, and

paradoxically, the more they change in reaction to the previously understood social influences. Gergin argues that this is most true in areas of concern to the public. Learned ways of behaving in social situations are a function of culture. As culture changes so must these ways of behaving. Gergin, like Cronbach, argues that the study of social psychology is essentially an historical account of contemporary affairs. He asserts that although the prejudice of academic psychologists is against applied research because it is assumed to be of only transient value, and "pure research" is seen as contributing to "basic and enduring knowledge," this is false, and he argues for a change of the intention of social psychological research from prediction and control to "sensitization." "Whether it be in the domain of public policy or personal relationships, social psychology can sharpen one's sensitivity to subtle influences and pinpoint assumptions about behavior that have not proved useful in the past" (Gergin, p. 317). Because the processes of social psychological concern are not locked into the biology of the organism they are subject to what Gergin calls "enlightenment effects." Making people aware of their current behavior patterns and' social influences on them:, he argues; will aid in changing the influence itself. A good example is the mu.::h noted practice of institutional racism. Raising the consciousness of people with regard to the subtle ways social institutions discriminate against minority groups is an important step in changing this fact. Social psychology, argues Gergin. should study changing patterns over time, as the major share of the variance of social behavior is due to historically dependent dispositions. Basically, what Gergin is saying is that even social psychologists opposed to applied research are culture-bound and influenced by the social forces around them. These forces change over time, and the psychologists themselves, even as their subjects, are products of their time and their history. He urges social psychologists to embrace this fact and not only admit it, but make use of it to better understand their own data in light of political, economic, cal reality. and histori-

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Gergin' s(1973) paper has not been accepted witho~t criticism. Typical is Schlenker's (1974) ,'re~Ponse'apPeanng in the same journal. His coun~er-argument is essentially a srn.:tement sa sertin~ the possibility of a soci~ science with enduring laws and abstract generalizations that are,nottim.e~ or culture-bound. Schlenker's position IS that a nontime-bound science of social behavior,..is not illogical and could be con" structed, ~espite the fact that social science difJersfrom'natural science in a,nurnber of ways. ,'Forexample~ he shows that the nature of the open" systems affecting social behaviormeans only, that' experimentation is difficult, not that thert:.are no regularities. He also makes a useful " ,distinctiQn, between empirical generalizations and.higher.,order abstract theories which shows that the former are possible as a me'ansof avoid) ing'the culture-boundness 'of the latter. ,Regardless of one's position as to the possibility of timeless and universal laws of behavior, Gergin's paper makes it clear that much of social psychology has in fact been culture- and , time~bound. To recognize this one need not re'ject}he possibility of finding" or the desirability ,',of a search for, universals. It does, however, ,focus on the problem' of cultural and historical relativitY. This is a particularly acute problem when on~. applies, social science, since it is in application that one must deal with c~rrent reality rather'than theoretical possibility. But it is not lim~ted to applied social science. The cultural arid, historical biases, imposed by social forces ont'basic" as well as applied science are considerable.

evolved as' a consequence '~f JW:<!;,,~tg' politica1-economictr~di!igns: t~",:c~p]taIistiS':\~rl1t pO~ular in the Anglo-AInerlc~ world, ~ . ~~ ' ~ Continental, European ~"me~an~c~Sqf~}:~ istic." , " ~ ,,".;.c' The capitalist tradition, 6u!()byhich'~ . ,,~. '. Darwin's notions ofthe:~'struggle for:survival,~~ was supportive 'of a 'reemergen(:~ of,~;,,' philosopher Hobbes' argumen! thatman 'is eS;i~F sentially competitive,' 'arid establi~hed'Soci~~~' , " .-::.:- ';',' 1-71~~' order only as a means for protection'of self an~'~~ property. The result o(t~ese two line~ Of:tb~"~f~i ;";~: ~r~j ing in what cametobe k~own'as "SociatRar-Y' " winism" (Spencer,' 1897)'Wit'hits~mpha.~:i~oii "successful survivors': \yas the natUral COhchi~ sion by capitalist societies that, the best of 'm!n: are "white middle-dassadults, most likely ep::' , gaged in manufacturing or businessenterprlses" , (Riegel, 1971, p. 130).-InshQit; ids a ratiop~r:~ zation of wl1y the ruling class rules.]{iegel ar: ' gues that this philosophy was perfect fora soc'b,::,,tj ' ety such as England with' its history of\'entre~~~t>"'''~ preneurial competition, manufacturing, huntingri'" -. , and breeding, and led t6, a view of deviance ~(~, /; '" any kind from the standdas inferior. ". :e{;,~~ children are regarded' as'incomplete' adults; old.;;\ persons as deficient;' criminals', mental defec;~'. tives, colonial subjects and non-whites as fai' below the rank of white middle-class adults:t.:< , "it , (Riegel, 1972, p. 130);; ",' , ,;:; " " In psychology, aswe have seen in Chapter I. ,'q" this view has been expressed through the tradi-'"i", \

Riegel's Vietp of the Influence of Sodal Forces on Basic Psychology

, A third analysis, similar in some ways to Cronbach',s and to Gergin's, but more sweeping in its historical scope, has been offered by Riegel (1972) to demonstrate the "Influence of Economic and Political Ideologies on tha Development of Developmental Psychology.;' His general theSISis that the economic and cultural conditions of society provide a basis for the direction and growth of its science. Specifically, Riegel argues thattw0'E0nsidet;ably different vieW~ (!f.' developmental' psychology have

,,~i~' tion of individual difference research, 'stim&~,,1t:";:,; lated in England by' Francis Galton~s eugeriic~)~j:,;,2~~'-' and Pearsons' psychometrics.G. Stanley Hall; in America early Inthis century, while accepting the idea of inheritance of acquired characteris~ tics, emphasized environmental rather thari genetic factors, and helped to shift explanations of deviance from totally genetic explanations'to socially malleable differences. Nevertheless, the' , essential tradition established in both England"; and America, regardless of attributed causality't is one of comparison of groups to a single standard or ideal. The interpretation of Hall's idea that each person "recapitulates" evolution in his own in- - " dividual development, but is malleable, particularly during adolescence, led educatIonal reformers in America to a psychological jus.

40

THE SOCIAL AND HISTORICAL CONTEXT

tification of the need for assimilation of immigrants to the standard, largely through forced public education. " ... boys clubs (stimulated by Hall's psychology) and public school athletic directors, conceived of sports, quite explicitly, as a modem means of indoctrinating alien lower-class youngsters with conventional American pieties on patriotism and mobility ... " (Schlossman, 1973, p. 147). Functionally, the explanation of differences as caused by either gen~tic or environmental factors matters little so long as differences from the standard continue to be regarded as inferior. Riegel (1972) sees this tradition of comparison to a single, dominant-group ideal, expressed in psychology by individual and group difference research, as in large measure a function of the competitive-capitalistic tradition in which it has developed, and which it in turn helps to justify. If the poor and other deviants do badly on psychological tests, it is no wonder that they are poor. They simply have either bad genes or bad environments. We shall see later in this book,

of the "noble savage." Men are seen as basically good and as born equal. Civilization creates group differences. Out of the tradition of preserving the child's qesirable natural state for as long as possible grew the educational traditions of Montessori (1870-1952), Pestalozzi's (1746-1827) child-centered "kindergarten," and the "youth" or "back to nature" movements which, unlike the American scouting programs, were totally youth operated. Spranger (1882- 1963), an influential developmental psychologist who emphasized sympathetic understanding of deviance, was a participant in this movement, and Riegel sees him as typical. Piaget's developmental'psychology grows out of this tradition emphasizing stages of development, each to be understood in its own terms, rather than in comparison with other stages. Finally, Riegel notes the recent influence of continental European psychology in America, which he interprets as supportive of a more individual appreciation of deviance and subculture, with a diversity of standards. He cautions, howparticularly in Chapters VII and VIII, how perever, that in its extreme, this view can be supvasive this point of view still is. portive of classes and castes, and argues for a combination of the two traditions of developA different type of developmental psycholmental psychology through an "interaction or ogy grew out of the political-economic traditions relational model." He cites some attempts to which Riegel calls "mercantilistic-socialistic." His analysis of political-economic life in develop such an "interaction paradigm" in ecology and in the social psychology of Kurt Europe, particularly France and parts of GerLewin (1936). Basically, this idea is an attempt many and Italy, sees these countries as essento separate the specific content of development tially land powers dominated by land-owning from the process of development. It is an ataristocrats. Their large armies and courts made tempt to understand development in a context, manufacturing necessary, but it was supervised rather than by analysis of its elements. In short, by the state. Merchants who were too successful were suppressed, but as manufacturing inpeople may differ with regard to what they know and do as a function of their social context, but creased, a middle class was added to the social the assumed meaning of those differences may classes of aristocracy and peasantry. Neverthesay more about the observers than about the obless, they were less well off than the aristocrats, served. and eventually this helped lead to the French Revolution. Riegel sees the existence of specific The essence of Riegel's viewpoint, in his words, is that: classes, and the absence of cross-class competition, as creating conservative attempts to justify ... our sciences, as much as our children, do not that particular social order; consequently, unlike develop in a sociocult~ral vacuum; ... it is naive, England, a social and educational philosophy irrelevant, and irresponsible to anchor our efforts upon which emphasized multi-cultural differences an abstract truth criterion traditionally conceived as developed. Riegel notes that Rousseau, for ineither .. god-given" or as provided by "scientific stance, outlined an educational philosophy in facts" and "nature itself." Truth and knowledge are also functions of the actions taken and of the actions which a child is compared only to his peer they demand. These actions are determined by the group, and gave support for the romantic notion

tf..

eConomiCand political ideologies Of the societies in I which 'we-live (Ri~gel, 1972, p. 140).
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; The foregoing analy~s by Cronbac,h, Ger-. gin., and Riegel lay open to question'the argum~nt that Wcial3, science is ever free from the . ':': influ~nce oftiplt~" his!ory, politics, economics, audcpltural tradition. Although the influences are wmewhaHndirectand serve to Set certain ~: " tones: limits, anf! broad ideological guidelines for ......~ so-called "basic" - reSearch, the influences
.~ JUS! as powerfui, even if more subtle, than . tPose,9I} th~ applied scientist. .
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The early nineteenth-centuiy practitionerS: .. eager to manipulate facets of both extraxmIfaland)~:._ ~ stitutional life in order to encourage' optiniUII,1ondE c tions for the prevention of mental disorder; for earlY'S' case finding, and rapid treatment, and, for avertiI!g relapses axnong discharged patients. They tended)') reach these objectives fuStin progn!1llSdirected t():,~: ward the lay community, ~ond in ~'organiz.ation ~f;~

/~e~~:

Historical Notes on the Determinants of Mental Health Practices

Exiuni,ning the historical events of, the mental health professions allows us, in various ways, to understand the profession's current activity. We have .seen in Chapter I that. a chrQnology of events is one way to view history. A second has been to examine the influence, .. f social forces, o mediated through values and beliefs. We have discussed how the content of scientific and professional belief is influenced by politicai at, titudes (avoring or rejecting the status quo (Halleek;' Liefer). We have seen now contemporary eve~ts chang~ "truth'; (Gergiti); how.economic systems influence psychqlogical method (Riegel); and' how professional practice is influenced ,by the tende.ncYito ,prest;"rve power and control, rather than to be 'scientific and humanitarian (Graziano). There remains at least one other historical perspective to further muddy the,Waters of objectivity: how the actual conte.nt ofthe "best scientific,professional, and mental health practices" change with the winds of fad, the whims of political leaders, and the current views of "proper" behavior, rather than the ore derly flow of scientific advancement.

institutions, and third in '~e interfaceo(the~:t\\1Q, . milieux (Caplan, 1969, p.lO). ;~'\ ,', The obvious similarity between this and tb~ cur,.i'" rent view of community mental heaith cent~rj' ,c, _ :",0 (see Chapter III) is so close as to-'~be inter,,- ~
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changeable. N ineteenth-century-';:. psys_l!!atris\}3~ were particularly conceritectwith_c~ilareil aillli' therefore sough! preventio,n' of ilIne'ss: t~ug1i public ~ucation. Parent groups, based on cuIHvation of "intellectual and moriil character" be; '"~, '. --'I, ,~

,
:"

lieved to directly affect the brain;were popula( , "Defective education and injudicious early 1 training" were thought to be the' prime cauSes of insanity. The major reference groups for.American psychiatry during this period were lawye~, doctors, clergymen, and educatedmerchahts who composed the upper-middle-class society.F' Parents were warned against leaving their c~ildren in the care of others, and early education at home was considered paramount. In general, t~e advice of the period' favored clean,' regul~ ' habits of life, and the Puritan Ethic of the tim~.,f"" The recent interest in early education, in day' care, and in preschools shows the same concern today, only the proper contents, agents., and targets for such education are changed. The agents are now professionals as well as parents, ' and education is aimed at the lower classes rather than exclusively at the middle class (See Chapters VII and VIII). More important is that the content now reflects current views of what makes a child worthwhile-that is, doing well in academic school work rather than the earlier "moral training." In Ruth Caplan's view of nineteenth-century psychiatry, based on the beliefs and practices of those in the medical professions, the physician's .belief in environmental factors as a cause of

"

Fads, Political Leaders, and Scientific , "Breakthroughs"

Ruth Caplan (1969), in detailing the history of Americ~n psychiatry in nineteenth-century America, presents the view that psychiatrists, even as today, were concerned with the role of

42

THE SOCIAL AND HISTORICAL CONTEXT

mental illness ultimately led to confinement as a means for dealing with insanity. Although it was rationalized that isolating the mentally ill in environments which removed them from pressures of the world that might" bruise the brain," such treatment also served a social purpose in justifying the removal of undesirables. In the early days of the nineteenth century insanity was believed to be curable by means of "moral treatment" and the provision of smallgroup social interaction in a relaxed environment. Later, disillusionment with such treatment came as a function of the unwillingness of American society to apply the expensive procedures of moral treatment to an increasing population of lower-social-class immigrants. Throughout the nineteenth century mental diseases, although considered to reflect brain damage, were believed to be envionmentally determined, yet specific ideas for treatment came and went and seemed to have less to do with their actual value as treatment than with their cost and social utility as a means of isolation and punishment (treatment) of deviants. . After the middle of the nineteenth century, when large numbers of immigrants and the poor began to fill the mental hospitals, there was a corresponding decrease in funds available for such services. "Moral treatment had been created to serve an elite group of patients. well-mannered, clean, self-supporting Protestant artisans and farmers who shared their superintendent's adherence to the gospel of work and to the value of worship and education" (Caplan, 1969, p. 73). In the years 1839 to 1844 nearly 80.000 immigrant German and Irish poor entered the United States. Many wondered if the Irish were not more prone to disorder than other "races." Not only did they have to deal with ethnic prejudice when they encountered psychiatry, but there were few who understood their culture. Isaac Ray, a renowned physician and hospital superintendent wrote of them in 1863 (cited in Caplan. 1969): In endeavoring to restore the disordered mind of the clodhopper. who has scarcely an idea beyond that of his manual employment. the great difficulty is to find some available point from which constructive influences may be projected. He dislikes reading, he

never learned amusement, he feels no interest in the affairs of the world, and unless the circumstances allow some kind of bodily labor, his mind must remain in a state of solitary isolation, brooding over its morbid fancies, and utterly incompetent to initiate any recuperative movement (p. 74). In the 1950s Hollingshead "and Redlich (1958) published their famous study of differential psychiatric treatment and diagnosis by social class. They fouride tharC,'-th?se diagnosed as schizophrenicwere'/more likely 'to be lowerclass people, and that these lower-class clients were most often hospitalized and treated with physical methods rather than with psychotherapy, which was the preferred method for middle-class clients. Grobb (1973), in a review of mental institutions in America, found that the same phenomenon occurred over one hundred', years earlier. Many American psychiatrists, among them, not surprisingly, Isaac Ray, supported the idea of differential treatment by separation of paying and nonpaying clients: ... patients from the "poor and laboring class" required less attention than those from "educated and affluent" backgrounds. The former were used to working and were content with simple pleasures such as a walk in the country or performing small tasks. The latter, on the other hand, could only be satisfied by long and repeated interviews with the superintendent. Each class, therefore, required different forms of therapy (Ray, cited in Grobb, 1973). This reasoning led to support for" separate but equal" facilities. Eventually, as foreigners were overrepresented in hospitals, there was a loss of public support for psychiatry, and consequently, a loss of resources and difficulty attracting good young physicians to its practice. In the latter nineteenth century the rise of social darwin ism and the continued influx of immigrants led psychiatry in two directions. One was to support mental institutions as a means of removing the undesirables from the community. The second was to encourage reform activities to prevent the spread of alcoholism, tobacco, and masturbation, believed to be a cause of insanity. Many medical scientists lobbied for legislation and worked for "public education" on these matters. Like the

~,.,,7;:i:;::~ . ~~

mQdem community mental health reformer, the _S<i:iald~inist-psychi~rist sought to work on two front&-on the one hand to hospitalize those deviantsalreadysic;k, and on the other to clean up the en~ironm~nt. Although they belIevedthat poor environments were passed on biologically, _and today,'s envi~nmental reformers believe in cultural tran~mission, the similarity is obvious. Many who now advocate parent education in child_-reating practices and proper assimilation of the lower c1~ses to. middle-'c1ass culture, so as to eradicate differences from the mainstream culture, <,10 so on the grounds of ment'!t health. Caplan, ,in summarizing much of the failure' of ninet~enth-century psychiatry, points to sev--era! "traits" characteristic of psychiatry which

to have been subject to periods-h( jn~iiy;, frequent occurrences of .tjiz~ 'behavi~F...ManY~,, ; physicians of the time who wouI4Jlot~h~vebeen~ ","'}... . ,. ,.," "l~';.w;' otherwise concerned abo!lUhetl!-tme'!.~:or~in~' curable disease" were attracted 10 its 'stlldy, parL, ticularly since all' sort~ of notable- pe6ple s~ _'. denly began to hear about and,manife_s~ ,similari,'b,'f,r-" .
~:~

symptoms. Even the specific t~atrnenbthat"the': " King received became aJad~ong 'phsida~~:1~~. His doctors, influenced "y tbe ~liefthiit removing the patient from all- famfliar sights imd sounds cuts off the possibility .girumitJ3.~g :ort'" _ disturbing matters, -p,rescri~~.,a,,"c9mp\rS change of sce-ne;This wassoo:i!o beqome preferred mode of treatment'fOftlle fashion~!>lf insane. From this idea the '-;notiorr~ oh i~ stitutionalization .is not far. remov~({C.apl~, 1968a). '~V'.,"" "f,'c~v, . ~i Some two hundredyearsafter$ing~:':!. Geof~J' "'.~ ~ 1II, the then President of theUnjted Sfa~es,:Jdhn F. Kennedy, was.to have a widespreclc1ffect ,on "' e the mental health movementin/his\:-couhtry:" Quite by accident of history: ~ man~~:O durinlh his short stay in the White, Hou~ (1960-19 . ~ , reached, through his personal 'appeal, alu,---,. ...

seem t9 .. ecur ~podically, even today. One is r thetendtilCY ,t(),~pPort_pai1ac-easrid1.9oversdl a ',a~give'niatmeni:;'only'to ~ disappointed -by-its later failure. For example, in 1874 the Association of Hospital Superintendents endorsed the use of chloral hydrate in mental institutions, without regard -for many of its detrimental effects. Even the. use of "cautions" i!l the endorsement was .eliminated. A second tendency was to support particular treatments by investing legendary status, had a siste~.~ho. is-~e. ' .". huge amounts of manpower and resource's, even retarded. Kennedy's personaJ.uiteresLin.retard~l :"~ , when they. were untested. This recurrent tention research and programs rather tllan .. scientific breakthtougilst'.>J'llrbfoundJY dency, which remains operative in the mental health movement, seems to operate through the influenced levels of funding'ana'research"iil re; tardation during the I960s. Much, of this- re~"' occurrence of fads, or what are frequently called . 'priorities." A priority is a euphemism which search has been a search for medk~cause~' of ,enaQles a granting agency to 'say .do this if you retardation, although there is me ~ason to_beL _want money:""Frequent,ly -the "this~' is' the lieve'such programs may be' fruitless (AI~:' -".I 1968 a) .. _, latest.panacea or research problem-'thAtis curBenjamin Rush, a signer _oftbe Am~rican. rently embarrassing the political administration. Government leaders, particularly those in Declaration of Independence, is_oneofthe most positions of high symbolic value (e.g., kings, influential men in the, history,. of Amerkan presidents) can influence the practices of mental . psychiatry and provides anotller exaJ11p1ef per-_' o health by both direct (with financial support) and sonal influence. He represents the enlightened indirect means (through the weight of their opinmedical-psychiatric thought of the late eight-. ions and concerns in public statements). This eenth and early nineteenth centuries, as well as.: influence is easily translated into "priorities." an important early linkto government. In PaT!asTW9 very good, yet very different examples of a function of his political influence, as well as .,'j his intellectual leadership, many of his ideas' .. this phenomenon can be drawn from England and the United States some -two hundred years were widely accepted and implemented by: American psychiatry. If all men were created. apart. "King George lU, who reigned in Britain at equal, as stated in the Declaration of Indepen-,'i , the time of the American Revolution, is known dence, it must follow that their environment- .

0F~~!~, .

sQ. ,

-.

/'>i.\

44

THE SOCIAL AND HISTORICAL CONTEXT

molded them to their differential status in society. However, this view was functionally not so equalitarian as it may first appear. Throughout the nineteenth century, either through belief in the inheritance of characteristics acquired as a function of the environment and culture of one's fore bearers, or later through belief in one kind of social darwinism or another, the assertion was held that through natural selection one reached one's place in society. Much of the impact of these views was to mute the implications of environmental determinism and to justify social class inequality while sounding equalitarian. Rush, for example, like his contemporaries, was faced with a peculiarly difficult contradiction in the beliefs expressed by the Declaration of Independence and the simultaneous existence of slavery in America. Thomas Szasz (1970) is enlightening in his description of how Rush managed to deal with the contradition. As Szasz shows, Rush was a master at interpreting social, political, and moral beliefs in terms of medicine. He presented a view which accepted the Black man as a person, but at the same time stigmatized him as a carrier of hereditary disease. In 1792 Rush encountered a Black man who was suffering from a disease now known as vitiligo, which causes loss of pigmentation, such that some areas of the skin appear white. Believing this to be a spontaneous "cure " of his blackness, Rush wrote a paper on the cause of the "disease." In his view of "Negritude" Rush rejected the popular belief that God made the Negro black as indication of his inferiority; or that he is black by nature; but rather argued that he suffers from a disease. Both his facial features and skin color are a function of the affliction of his ancestors with leprosy. It is a symptom, now passed on by inheritance, and no longer infectious to others, except by producing children. Here, Szasz notes, was the perfect scientific-medical model of illness which enabled the physician to justify a social evil and support a status quo while appearing to be humanitarian and scientific. It is similar in function to today's sociological explanations of inferior Black culture. Today, by attributing many of the problems of living which Blacks face to poor mothering or bad environments, the

behavioral scientist is able to deny genetic inferiority, but functionally justify the societal scapegoating of Black Americans. Rush's conelusion from his "medical ana!ysis" was that although Whites should. not intermarry with Blacks, they should be humanitarian and should attempt to cure the disease! .. It must be recalled that Rush was a leading scientific as well as a political figure of his day. His textbook Medical Inquiries and Observations upon Diseases of the Mind, published in 1813, was the most influential book in American psychiatry during the nineteenth century. Many of his medical methods of care, such as blood letting, dunking, and confinement, were quite popular and hailed as scientific advances over earlier religious practices for mental treatment. One of the most striking examples of treat- ( ment fads occurred at the beginning of this century and is described in a full chapter by Caplan (1969). The superintendent of Manhattan State Hospital on Ward's Island, New York, fearing an epidemic of tuberculosis, erected tents on the hospital grounds in order to alleviate overcrowding. All living and dining facilities for a group of twenty patients were moved to the tent. There was great attention paid to this experiment, ineluding regular scrubbing and spraying, and the provision of an excellent set of meals. Although intended to be a preventive measure against tuberculosis, the physicians were surprised to find improved behavior among the small group of patients. Only after patients were returned to the hospital wards did many relapse. Case histories and publications followed, lauding the newly discovered treatment. Improvement was attributed to sunlight, open air, and the change in environment. The hospital began to remove other patients from the overcrowded wards to tents of twenty or so inmates. They were even given the opportunity to decorate and participate in designing their new environment. Staff were assigned so that patients now had more frequent and easy contact with doctors. Photographs were taken, and the outside world acknowledged them. Patients housed in the wards were soon also given more opportunity to get ."fresh air," considered to be a major factor in the recovery. They began to be sent out for long

HISTORICAL

NOTES ON THE DETERMINANTS

OF MENTAL HEALTH PRACTICES

45

walks. spread.

More Thc

puhlicat ions idea bcgan

followed. to takc hold

t he word in otllL'r

misused weather fully when: homes" aration concept

as their

adoption

increases, a number

As Fairthese In setcases of care-

(see Chapter administered patients without disaster have

IX) has shown, require been charaL"leristics. released

places including Illinois. Ohio. and California. Tents were lauded for the ir low cost as a means of setting thusiasm idea small tion lost. up new units. With customary and misunderstanding. it was also misused excitement. the camps routine. however. overenas the

tings. to be successful.

to "group

spread group.

such that the participawere overstall to large. thc camps necessary

proper administration or prephas resulted, Sometimes the persons) "hotels" to live IX

and patient hecame with

is so m isappl ied that pat ients have heen As we shall see in Chapter

in setting Eventually and

up and running

sent to large (200-500 on their own, many patients ronment started toward

crowded. shortagL's.

can live on their own if the enviscl up so as to get them living, out But the topatients to live true independent letting

and the entire

atmosphere

reverted

is properly

the style of the huildings. Tent treatment was soon found to be indkL"live and disappeared. Since then there have heen other fads. sometimes surgery tury. lauded Shock as panaceas. treatments The use of brain cen-

fad of simply

gether. unprepared after years of connnement. and without resllurces. ereates chaos. What the
Nell'

was extensive

in the mid-twentieth continue

York Tillles

was seeing.

of course.

was a

to be used tll-

reaL"lion to that L'haos whiL'h will likely lead to a return to the wards of hospitals. vision of proper Similar frequently. mental misused. The Behavior supports. of promising idea of (see Chapter modification ideas occurs as nonprokssionals (see misuse rather than pro-

day. Drugs arc frequently administered in large and rout ine doses as "maintenance" for chronic patients despite their failure as treatment (c.g .. Anthony 1'1 lIf .. ILJ72: see also chapter IX). The advent movement. llf the ulmmunity has focused mental health whidl in part lln llpen-

health workers

Xl) is often Chapter

ing up the hack wards lease chrllniL' patients. many tients recent which hospitals have

of large hospitals to rehas. tll the extent that suddenly "dumped" pain been unf())1unate

IV) is another modern example. Initially shown to be c1lective in maintaining sOL'ially acceptable behavior ullllercardully administered conditions of hospital living. the fad has caught on, Many hospitals now have such" behavior-mod" units which arc only that in name, The general ideas of reward and punishment arc sometimes applied without proper training of stall in administering a system which only on the face of it seems easy to apply, The techniques have spread to schools and prisons as well. and are pubfrequently so misused as to properly arouse

into the community.

years. Interestingly. the same hllspital developed tent treatment was recently reYork Tillles (Oetoher 20. to maintain the free movehoused mental there. health

ported in the Nell' 1974) to he unable

ment of a large patient population As a function of the community

movement many patients had heen let out of locked wards to move freely about the community, Many were found to get into various kinds of difnculty and the staff was calling for more "security," again some. means that is. locked wards. guards. report. and Here so on. according to the newspaper

lic anger and prohibition (Murphy. 1974: Time. 1974). Fads of the mental health movement continue to he uncritically professions (1969) applied even notes by the so-called "age other of scihistorical helping ence, " in the several

seems to he the misuse of an idea. To release to the commun ity apparently simply opening the doors and not providresources, The halfway houses. can live

Caplan

ing preparation or necessary same phenomena occur as places together effective living, where small groups in the community. means to return There is danger

characterist ics of the he Iping professions, One is the tendency to meet public criticism by denial, defensiveness. being ply sionals patients witnessed today's may along and "truths." once again withdrawal. This hospitals is again misapprofestheir of as our mental retreat. behind

of patients

are shown to be an them to community will he

If it continues.

and take

that such settings

with them.

the walls

46

THE SOCIAL AND HISTORICAL

CONTEXT

institutions where the public cannot see them. Altho'ugh emptying the mental hospitals and getting community input in mental health programs are the current stated goals of community mental health, the consum~rstill has little real impact on psychiatry ahdrnen~a1health practice. Local community control of mental health programs has never really been implemented for several reasons, some of which are discussed in later chapters. Here we simply note that the realities of the situation do not match the rhetoric. Rather, there is a tendency to accept secondary goals and to confuse ends and means. Clean hospitals, quiet wards, and correct staff procedures are settled for. Finally, Caplan notes, there has been a neglect of the social history of psychiatry. Rather than understandillg the social and political forces that have shaped its history, psychiatry has tended to view itself from the eyes of its great men and their "scientific advances" (e.g;, see Zilboorg, 1941). This view has prevented modem psychiatry from understanding its relationship to the social environment with which it has been theoretically concerned. Recently, others have attempted to understand the mental health movement from a broader perspective of social history (Foucault, ]965; Grobb, 1973; Rothman, 1971; Szasz, 1970). A]though Caplan began in that direction, her view is largely focused on developments within the mental health profession itself, and centers on the beliefs and practices of psychiatrists. Daniel J. Rothman (1971) approaches some of the same events from the perspective of American history, and focuses particularly on the question "Why did Americans in the Jacksonian Era suddenly begin to construct and support institutions for deviant and dependent members of the community?" He notes, with the irony of historical perspective. that the builders considered the asylums to be instances of reform in the care of mental patients and to be based on scientific and medical advances. He questions why American society was ready to adopt such measures as asylums and prisons when in earlier days there had been none. The answers he finds are less a function of science or of the advances of medical treatment than a function of socia] values.

Asylums were a means to restore a kind of social balance to the newly founded American society. Like today's community mental health centers, which became popular in the 960s during times of considerable social unrest, the

asylum,

in the 1800s~);Was'A~'melUls'of'socia:J

control. The comI!lynttYfiJTle~t~,jhealth; center movement of today W.~sgiven tremendous support by its temporal association with the War on Poverty, which would help to assimilate the deviant poor into mainstream American society. The theories of insanity in the early 1800s, Rothman notes, also had more to do with social and political conditions than with medical discovery. The society which was trying to establish itself and its republican form of government in the eyes of the world neededarneans of social control whichappearedJ'rationaland humani? iarian. The medical reformers of the day, in an effort to prevent epidemics of insanity," tried to establish a kind of utopian environment which became the mental institution. Despite its obvious failure, the asylum has survived, partly as a means of keeping the poor and deviant away from the community at large, and partly through the ability of its proponents to protect and maintain themselves in the only way feasible-as a custodial institution.
Just as state-supported institutions boasted of keeping the paupers clean so too private ones found satisfaction in making the rich comfortable .... Once it gave up the claim of cure or rehabilitation, the asylum could concentrate on the "fai]ure proof task of care for the chronic" ... and thus maintain itself as an institution even if it lost its original aims (Rothman, pp. 278-282). 1971,

The Manufacture Outgroups

of Madness

and Other

The use of asylums as a convenient place to incarcerate immigrants, paupers, and undesirac bles is not new to America. Foucault (1965) has argued, in a review of the social use of the concept of insanity in Europe from 1500 to 1800, that society has always needed a scapegoat. For modem man the insane are the equivalent of lepers of the Middle Ages. He notes that the "great Reform" in Europe which eliminated jailing of the emotionally disturbed on the basis

i,

"

")~:

,!.

>,'

'

:',

' "

~~~.

'}:.

of"uemQri~~iY Or rilnihaliiy 'was followed by., ,.ifthei'g..eatCQrlfhlement'.' on the basis of-disease;' , Thomas S .. Sza,~ (1970) presents a similar analysis in The Manufacture 'of Mlulness. His , treatmen( of. ti!.e ~ial' history of madness is ,perhap~' the nicistpointed and critical study to date. It requires one to ask serious questions of bur most' ch~rished beliefs'in the helping professions; -it ~verses our images and calls th~ '''helper',' tbe CIl<atot.of puidness who is rewardedc,b)U its:.cieationand by~its puni~tun.ent, (treatment} iven', as were' witch-hunters" and' 'exorcistS. ~To be sure,'Szasz does not consider the individual psychiatrist to be evil in intention, but ra~her a well-meaning believer, a modem transformatiOIi of the religious zealot. 2 To rid , the world of mental illness)s equivalent to ridding the world, of heresy. Both aims serve the purpose of scapegoatingand protecting society symbolically as well as literally, by means of, control of-deviance., , Of all the social critics of the helping professions reviewed thus f~, it is Szasz WllO leaves onl< most ~FPmfortable, It is easier to under~ stand'anda~e with S~ast intell~ctUlllly tqanit is to follow the implicatibns'ofhis arguments to. their logicalconcJusion. He, like Leifer, Halleck, Caplap, Graziano, Rothman, and Foucault, raises intellectual arguments which question the social purpose of the helping professions; he points out their vested interests, their history of misguided beliefs, and their support for the status quo. Szasz also gives new ways to interpret the meaning of one's common sense belief i,n those whoSe ideas are in ,ascendance: But Szasz goes further. His arguments raise moral as well'as intellectual questions for tho,se who, are in the professional practice, of "helping." His analysis requires close examination by community psychology, for he questions if the aims, of "community" can ever be recon" ciled with those of individual freedom. The most striking thing about Szasz's work is the way he traces the history of the Inquisition and the mental health II10vement as one unbroke,n line of events, each movement serving the

same function at different timeS- fu -history:,People have always, since societies.haye"been organized, needed a scapegoat to,serve asbOtli'" symbolic and literal validation of t~~,group'JTh~

f deviant is the scapegoat: ,Ritual ge~,cti?nof humans ,and animals-are~ foundamoIlg', all " societies. Symbolically this is the w~y;in \\,hi~l1 ,
people have shifted the burden of e~i1;guilt, arid suffering from the grol!P to, a nomll,e!l1ber.'The Jewish custom of the sacrificial~'gbat: i~ hiter shifted to the story ofJes,us as !he ~~peg<?aJ wh<t;,,' . died for all the sins of man. On.c~ iP,asseildance, , Christianity found scapegoat$~i9!h?~ who'~id,'S, .', _ not believe-Jews and heretics. IncGreece, -'''~,' theiJi~'it . -, " practice of sacrificing a deformed person in t.ime,. ,"'", 'y:' of famine was common. In earlier !imessaC~ ' rifices were for religious reaspns;j~aymei are _ rationalized by medical-sC'ientifig t~rminology,'i but serve.. the same purpose: ix(>u,lsiop of eviL-' through th~ sacrifi~e of one' ~ho"ii~ttb~~_n~t a", '"1i:',f1.; group member or IS defined a!! an.-optcast The . -'1.'3 justification is always technical (scientific), but ,r the basis lies in a magical.belief-in expulsion of evil. The witch-hunter, the anti-Semite, the psychiatrist who confines deviants against their will, drugs them, and shocks' ,them 'are, each fighting evil. The ends justify the means; Society is "improved" through their work. In all cases the oppressor is, unable to accept human differences. Everyone must be the same or tQe. group is threatened. According to Szasz, by use . of medical terminology the moral questions in ' such practices are avoided. By religious conversion Jews are saved, by treatment (social conversion) the "mentally ill" are saved. }nboth cases the group is unwilling to accept the de-, . viant. The crux of Szasz's argument lies~in his'be-~, lief ,that mental illness is a social Invention useCl' to stigmatize deviants. He is particularly concerned with the social function of institutional psychiatry, which is seen as an agent of the state to control the society even as the religious esta~lishment did in earlier times. Psychiatry is the new priesthood, able to diagnose mental illness just as the witch-hunters diagnosed witches, and , for the same reasons, now in medical rather than , religious terms. Szasz's idea that mental illness is a myth is" often not well understood. That is, he does not

'Although he writes specifically about psychiatry. Szast's arguments are'intended to encompass the mental health professions more generally,

48

THE SOCIAL AND HISTORICAL

CONTEXT

deny that some people are unhappy and unable to cope with their environments, but when this happens they are often condemned, stigmatized, and locked away against their will. This is even, or perhaps especially, the case for those who do not want "help." They are seen as "out of their mind," otherwise they would be just like us, or at least they would want to be. Using Sartre's discussion of anti-Semitism as an exemplar of the process, Szasz points out that for some deviants there is no need to "diagnose" their difference; Blacks, for example, are readily identifiable in a white society, but for others-Jews or mental patients-the identification requires a social act on the part of others. His discussion of Sartre' s analysis of antiSemitism is instructive:
Although Sartre recognizes that Jews exist in the same way as homosexuals or depressed people exist, he asserts that "The Jew is one whom other men consider a Jew: that is the simple truth from which we -must start .... It is the anti-Semite who makes the

rights of the Jew, and of the more obscure but equally indispensable rights that are not inscribed in any code, he must enjoy those rights not as a potential Christian but precisely as a French Jew. It is with his character, his customs, his tastes, his religion ifhe has one, his name, and his physical traits that we must accept him." To apply this attitude to the so-called mentally ill is not an easy task. Present-day American society shows not the slightest interest in even seeing the problem in this light, much less in so resolving it. It prefers the model of conversion and cure: As Benjamin Rush sought the solution of Negritude in vitiligo, we seek the solution of fear and futility, rage and sadness in Community Mental 'Health Centers (Szasz, pp. 273-274).

Szasz is specifically concerned with the involuntary patient-the homosexual, the drug addict, the alcoholic, the idiosyncratic .person who is called schizophrenic and locked away against his will under the fallacious argument of physical dangerousness. He sees this to be a rationalization for the inability of society to tolerate differences that are a moral rather than a physical threat. This is the classic conflict be-

Jew." Now, of course, Sartre knows as well as anytween individual freedom and communal values one else that Jews may exist without anti-Semites. In and beliefs reenacted since the beginning of saying that the anti-Semite "makes the Jew," he civilization. To see it in other terms than this, means the Jew qua social object upon whom the antiSzasz feels, obscures the real challenge for Semite proposes to act in his own self-interest. This society-to accept pluralism and individual difpoint cannot be emphasized too strongly about mental ferences, and to live in harmony with them. illness. It is one thing for an observer to say that These same concerns must be faced as commusomeone is sad and thinks of killing himself-and do nothing about it; it is quite another to describe such a nity psychology approaches questions other than person as "suicidal" or "dangerous to himself"mental illness per se. and lock him up in a hospital (to cure the disease of The history of the mental health movement depression, of which he considers suicidal ideas but a finds an ever-increasing definition of the scope symptom). In the former sense, mental illness may be of mental illness (Zax & Cowen, 1972). The said to exist without the intervention of the psychiamovement toward concern with the "welltrist; in the latter, it is created by the psychiatrist. As being" of all members of society has served as in the case of anti-Semitism, moreover, the psychiatjustification for large-scale "helping prorist creates mental patients as social objects so that he grams." Many of these programs are adminiscan act upon them in his own self-interest. That he conceals his self-interest as altruism need not detain us tered by professional middle-class people who here, as it is but a fresh "therapeutic" justification of have little contact with or understanding of the interpersonal coercion. people they presumably seek to help. To the extent that people have characteristics that Operationalized in the community mental health set them apart from others, the truly liberal and movement, and through various welfare prohumane attitude toward these differences can only be grams, including those for early education such one of acceptance. Sartre describes this in terms as Head Start, mental health consultation to equally applicable to so-called mental patients. "In schools, and extension of public health concepts societies where women vote," he writes, "they are to social phenomena, the network Of people not asked to change their sex when they enter the defined as in need is sometimes seen to be as voting booth .... When it is a question of the legal

f
CULTURAL RELATIVITY AND THE NEED FOR AN ECOLOGICAL VIEWPOINT

~
49

hi~h as om~-third to one-h,M or the population (Cowen. Gardner. & /,1\. IlJ(7). The poor arc special tar~ets or such drorts. ror which they they have a say. pro~rams arc to or standard orten tar~Lled ror "pro~rams" neither volunteer nor in which Many sociali/e or the aims or to such everyone

middle-class arc socially ror the poor,

people mar~inal. the

who. Black

for various man. the

reasons. oppressed

He oIlers

no assist,lI1ce

minorities. or the unhappy who cannot allord the services he oilers. and ror whom those services may be largely sympathy irrelevant because they ;Ire inappropriate SI.<ISI oilers equal social system. to their problems in livin~. of an un-

a sin~1e

"model man" as dclined hy the mental health and the educational estahlishments. Even when people volunlLer 1'01' such pro~rams the values. aims. and ideolo~ies or those in control arc rarely the ohvious. pro~rams This arc. is not surprisin~ on the race or which parents hel'ause it. ror the

to the victims

but lillie else. He would not

have us sti~mati/e them, but at the same time he otlers no clue as to how to work 1'01' the social chan~l's th<lt arl' necessary to truly have ideologiprecisely. a

"good" or the people. tification. When poor child ror the opportunity

needs lillie jusvolunteer their ror school in

pluralistic society. Sl.asl. is essentially cal and not act ion oriented. Community psyeholo~y. or more

to preparl'

a presl'lHlol pro~ram. the ima~e is usually a raise one presentin~ the road to success in America. Actually. values guarantee for those either or nothin~ sOl'iali/ation occurs. and to middle-class there is lillie

a psychology ror the members of diverse COIl1munities, demands more. Passivity will not do, The lesson to he learned rrom Sl.as/. is to recognilL' the traditional sions as agents role or the helpin~ quo. This profesmeans. or the status

or success in later school or life even who hecome soci,di/ed. These issues nHlre rully in l,iter chapters.

(lIlce <lg;lin. ;1 willingness to l'xamine one's values and to advoc<llL thl'm even when they arc ror social chan~e rather than social stability. A to tll community psycholo~ist need nol work coniine deviants. nor need he limit himselr individual ing himselr psychotherapy. with various Rather. stigmatil.ed grass-roots

arc discussed

It is important to note here that the COlll'epts of mental illness arc inereasingly he ing ex tended to emhrace cational all rorms or deviance includin~ edu(to be a hi~h school dropout is as mUl'h

by identiry-

a sti~ma as to be sid;). Thl' education estahlishment is now coming to~ethcr with the menwl health establishment to roster this extension. Those who arc deviant American middle-class tally ill. surfering which makes by not filling in to the school arc. if not mena social-intellectual

groups the community psycholo~ist can work ror social chan~e together with those ~roups. II' L'llmll1unity is delined "other." ~roups representative some or whom ues and powers. and <lssistance not as a monolithic valas a set of subtheir place in the only or prevailin~

hut is dclined in establishin~

rrom

arc in need or resources

patholo~y ronment.

because or their inferior envithem at least stupid and unagain their" place" in society Bec,luse the he

social i7.ed. Once

society. then the community psychologist may be free to work ror social cllan~e. This requires a view of the relativist-ecological neither inferior (cultures). world through perspective nor inferior a cultural which sees environment

is justified in humanitarian terms. Docs Szasz have a solution'? writes from the perspective of

private-

people

practicing psychodynamically oriented psychiatrist. his solution is essentially a "hands off" policy. Psychiatry should not be used to further for psychiatry." individual wherein treatment the aims of the state. but only to be available what he calls "contractual individual patients seck from a private practitioner.

The Emergence of Cultural Relativity and the Need for an Ecological Viewpoint
Others have also argued that the helping been responsive conditions of society, services and his-

This places the menhave always economic to the political In a recent

tal health professional in the role of agent only for those who seck him out. What Szasz docs not deal with are the large number of non-

50

THE SOCIAL AND HISTORICAL

CONTEXT

torical analysis of the settlement-house movement, Levine and Levine (1970) detail the beginnings of social work in America. Their analysis has been cited as historically important for an understanding of current community psychology (Zax & Specter, ]974), community mental health (Hersch, 1972), and helping services for children (Mora, 1972). The idea of the settlement house, a place where well-off and idealistic social service volunteers could live and work to provide services for the workingclass poor, was based on the notion that one had to live in a given community in order to understand its people.' Neighborhood organization was seen as an important means of socialization. In America, during the late nineteenth and early twentieth centuries, frequently with religious aims, and often with the paramount idea of assimilation of immigrants into the American mainstream, many young,' economically and educationally advantaged women became crusaders for social reform through this movement. The workers in the settlement houses they established not only provided neighborhood social, medical, and recreation services, but also joined in political activity for neighborhood improvement, improvement of labor conditions, and legal rights of children. Although early efforts were based on reaching the children through volunteers who provided socioenvironmental opportunities such as education and recreation, eventually the settlement houses came to be operated by professionals. As the child guidance movement developed, concurrent with the widespread acceptance of Freudian psychology, individual counseling of an intraphysic nature gaIned precedence over socioenvironmental reform activities. In describing this history the Levines discuss the relationship between the political tenor of the times and the kinds of explanations and solutions offered for social problems by members of the helping professions. They see two classes of theory and help-giving activity which have alternated in popularity. One is the intrapsychic or individual explanation and intervention, the other is the environmental or situational. Each of these approaches is based on a social value system which dictates the activity of the profes-

sional service deliverer.: In the context of the individual approach, activity focuses on problems believed to be idiosyncratic to the person in question. The individual's particular background, experiences, learning history, genetic makeup, intrapsychic processes, _.personality, and so on, are attributed the major share of the cause for problems in living. In essence, it is a belief in the individual as totally responsible for his own actions. The environmental or situational view emphasizes the social and environmental causes of problems in living, quite apart from individual makeup. The environmental view leads to activity aimed at reforming the social conditions, rather than the individual. Similarly, the Levines note, the political tenor of the times may~~d~sc~,bed as generally. conservative, or ge.!lerally. reform-oriented. They argue that the heIpin& ()rientation, dominant during a given era, is "aJunction of which political ideology has seHhe tone for.the times. Although not a one-to-one correspondence, they document this relationship for the social history of the helping services which they have reviewed. During' times of political conservativism the intrapsychic orientation is most popular, whereas during times of political reform the environmental approach is in ascendance. Ira Goldenberg (1971), in the context of a description of his own program for social action (see Chapter X), has reflected similarly on the relationships between the tenorofthe times and the history of clinical psychology, which, as we have seen in Chapter I, emerged as a profession just after the end of World War II. At that time there was an increasingly felt need for psychological services to be available to the many returning veterans, and there was a concerted effort to develop clinical psychology to assist the psychiatric profession. Goldenberg characterizes the development of clinical psychology in the 1940s,and 1950s, and 1960s as passing through three respective stages which mirrored the times: "frantic," "silent," and "action-oriented." Psychology had been called to the front during the war and, like the rest of the country, responded to the needs of war. As Reiff (1971 a) noted, the cautious scien-

i
f

I I

l'

.-----------

----------

"_~:; :j;,'

~t~~:.
-":_t

,.;).,

tively short American history .' ThoSe, who jee ",,,,,,,, themselves as first and most basically' }\~~ri[anf' sity and ,joined other helpIng professionals jn making decisi0!ls and providing service with, are left out of the diversity.trend. To. recall and " explore the recent Pa,sCill styl~ ~d xc,~nt~pt' less'than cer:tain knowledge. In the 19~Qs we' seems to be an alternative 'to ~Jhni~)d~rilifica. became; alOh~, with Eisenhower, stabilize,d, conservative, angqui~t.ln the 1960s, aroused tion. In any case, it appears that tIle.~970;~~ a time in our social history when djversity '~and, ' first by KeI!nedy's call to action and later by Jo.hnson',sWar on Poverty, we agaiil took up the; tradition are both being h()noied.agliiri,: It i~,a " call to~arms with less than caution. The times time when one's belonging to a grou~with a had shifted from poli~ical conservatism to. re- , past is honored.. j.~~ ,. ,~. form. anq psXcholo~ica!intervention became, as In ~t~ acadef!1icsa~d pOliti~;;~ ~~f~,~~~~y&, a ,senous' challenge' to the; "Afuencant'as-" s, . the Levine~' historical analysis would predict, focusedon environinental change. lt was during siinilationist ideology. Many do to . ,.the 196QsJha~;c~mmunitY psychology was born. enter a melting pol and lose their 0~,ti~9iversity.::,:rt: There appears to be an~increased'iolerance, for CO!llffiunity.psychology will be a "teenager" ip the late :1<)70s and early 1980s. The, people (as it is expres~djn the"~p'ular s!artgj outcome of it~,inevitable search for identity will "doing their own thing."Gre~IY:;(l97p.sees in part be det~rmined by the temper of the times. ' this in terms of cuIturalpluralism:\!h,ich.defives We already know that this decade is less openly out of. what Edward Shils (1957). calls "pri-.~, action-oriented;and,more reflective. Conflicting mordia-Iattachments" 01' likind of:n~u~ S~ii~ groups have turned inwarq. In the 1970s anew of belonging out, of whi~~~1f-:-e~t~e~l'.isawareness of our past has emerged which may developed. Recogniiing the traditionaL Amerhelp cOII1h1unity, p~ychol9gy to break with the ican (and academic) dislike fpr -diversity, idea that either persons or their culturaL enviGreely is an advocate for ethnic pluralism,, ronmeI}ts are to "blame"for their problems in He views the American' assimilationis! ethic, living. The concept of person-environment which calls for everyo11;etobe the .s~e in order' to live in harmony, as a kind of white, middle"fit" rather than inferi()r or superior people or class, Protestant imperialism. Sifnilarly, he is cultures is beginning to take hold. Recognition of and support for diversity is emerging. A critical of the Marxi!it thought ,which views. major political-social question for the rest of this ethnicity as a mask for class opp~ssion.IHe arcentury wiII involve the ability of diverse groups gues that ethnic pluralism is healthy, and in fact, to "live and let live," and this will mean underthose Americans who have a strori~ identificastanding that there are neither sick persons (in tion with an ethnic group are not anti-BIack,!ls the social-psychological sense) nor inferior culthey are painted in popular newspaPer account~.. tures. ' Rather, he argues, according to survey research, American Blacks have helped to make all'of they are more pro-integration. than the general population. Furthermore, j1ecites considerable , . the ethnic groups, as well as themselves, aware of the importance of diversity. There is now an 'data to support the argument that "ethnics are inward and reflective atmosphere with a new more. likely to be politically liberal than Anglorespect for difference .. Difference is even Saxon Americans of comparable social class, and the more ethnic a person is, the !Ilore hecis flaunted by ~ome. The interest in nostalgia and likely to be 'liberal' " (Gre.ely, 1971). ,looking back to the 1920s and 1930s in dress, Arguing further that Americans live in relastyle, movies1 and television has been interpreted as a search for the simpler days; but it tive peace among diversity, Greely concludes may also be seen ils a search for our roots and that it may well be that the answer to such peace our traditions. is universal affluence. In other words, diversity Many Americans who do not identify with is healthy in that it allows each individual a sense of personal identity, and it is workable, an ethnic or a minority group, a European coungiven enough physical resources to allow their try of family origin, or a religion" have it rela,_ -0 __ _~.

tist became a self-proclaimed expert by neces-

rOf

:a.;

~'C

"h~i:~~ .

52

THE SOCIAL AND HISTORICAL CONTEXT

equitable distribution. The popular picture of "ethnics" in conflict with Blacks is newsworthy, but occurs only when by accident of geography or political maneuver they are thrown into direct competition for limited resources. Greely believes that pluralism works in America because of denominational pluralism in religious tradition, supported by the American Constitution. He sees diverse groups in political, cultural, and social style living together in relative harmony. He goes so far as to view minorities, even Blacks, as better off in America than minorities in other countries " ... diverse groups live together with at least some harmony and if not with justice, still at least with the conviction that justice (is) a reasonable expectation" (Greely, I97 I). He sees the current interest in diversity, bolstered by the arrival of Black ethnicity, as legitimate. This leaves other. groups who support (or oppose) this ethnicity, freer to admit and support their own diversity. "It has now ... become official: it is all right for Blacks to have their own heritage, their own tradition, their own culture. If it is all right for the Blacks, then it ought to be all right for everyone else" (Greely, 197]). If it is true that diversity, expressed in reverence for the traditions, skills, and experiences of the past, is the social theme of the ]970s, then there are several possible outcomes. On the one hand, appreciation of diversity may lead to a fairer amd more equitable distribution of psychological resources that is, self-esteem. But this need not necessarily lead to equitable distribution of physical resources. If the two distributions continue to be disparate, as indeed they are in the ]970s, as appreciation for diversity increases and power and economic relationships remain the same, then one might expect efforts to balance the psychological and material scales. The way this appears to be attempted in the ]970s is through internal efforts of ethnic, social, and religious groups to build their own strength. In the past, attempts to obtain resources involved largely assimilationist strategies, and the willingness to give up diversity to attain them. To build a society in which material resources and power are distributed in fair share to ethnic and minority groups, without

the loss of psychological identity and respect for diversity, requires a turning inward and solidarity among group members. They must take and not be given, they must do it in their style, not anyone else's. Social change no longer can exclude preservation of tradition and the contents of ethnic identity, but must retain such identity while seeking reorganization of the political, economic, and social relationships among groups. For community psychology this signals several implications. Progress in the ]970s will depend on a recognition of the strengths of special groups and support for diversity. A social view that is culturally relativistic and eschews comparison of all to a single standard must be developed. The political temper of the times demands control by diverse groups over their own destiny, rather than by a monolithic authority. For community psychology, Greely's (197] ) analysis is a step in the direction of the "rediscovery of di versity," but it falls short on several grounds. His analysis leads him to the conclusion that the attempt to organize "ethnics" is silly because they are already organized. Unfortunately, his use of the term "ethnic" is restricted to those groups who are traditionally identified as such by sociologists. That is why he appears to be satisfied with the way diversity works in America. Greely does not carry his analysis of diversity to its logical end point. Diversity implies that in order to truly have a society that both tolerates difference and does so with justice, there needs to be room for more than traditional ethnic difference. New groups of people who are different on other than an ethnic basis must be allowed to emerge. The so-called "mental patients" who Szasz is so concerned about need the right to their individual differences without loss of their legal rights or the physical resources of society. Homosexuals may not be an ethnic group, but they certainly are different from the standard. They too need political, legal, and psychological resources. The individual "odd" mental patient needs the opportunity to live in a community which provides him the resources to which he is entitled as a member of the human race, even if he is a group of one: The alcoholic and

r
CULTURAL RELATIVITY AND THE NEED FOR AN ECOLOGICAL VIEWPOINT

53
the drug rights group addict must not haw a minority. their individual psychology Community responsive treatment, with sources. Greely psychology relativity. based which ond. or resources. of communities. must support. psychology is at its best when it is to grass-roots cure. The social. groups who require hut and psychological for not reor re-edueation. perspel"l ive support

violated. and

Women.

although a "new

not an ethnic may now apminority." Ricans.

not even

propriately

he considered

Greely does not ewn ment ion Puerto Mexican-. or Native Americans. In discussing the Black American.

political.

community for cultural distrihution must he secviews in their value which system

must he one of support diversity. and equitahle and ethical perspective Community psychology

(1971) smooths over the unjust and inequitahle distrihution or resources to which they are subjected. He. ironically. does not even touch on to asthe pervasiw consider the similationistterms. cans. sometimes inahility or White Americans Black man in other than

lirst on a social recognizes on an ecological

the right to be different:

It is these groups or Americalled the "new minorities." in order to he a true

all people to material

and all ~'ultures as worthwhile and psychological resources.

own right: and third.

on a belief in equal access

that cOl1ll1lunity psychology.