Proposals for the Joint Application of Technique As Between Psychiatry and the Social Sciences
MR. WILLIAM I. THOMAS. — Mr. Chairman and Gentlemen : I will say that this was not a voluntary matter at all, that I was to lead off. I was very strongly urged and I very strongly resisted it.
It is evident that all the sciences dealing with man have their attention at present on behavior problems and are more or less concerned with data which may lead to the prediction and ultimate control of behavior manifestations. This is true in the biological, anthropological, psychological, educational and social science fields.
There is also a common standpoint involved in this attitude, namely, that whatever may be the rôle of constitutional and hereditary factors in the determination of the personality and the behavior reactions, the situations in which the subject finds himself, the life experiences, are factors of great and usually of determining weight.
This appears to be also at present the dominant standpoint in psychiatry. If, as Sullivan has expressed it, schizophrenia is considered as "an evolution of the life process in which some certain few motivations assume extraordinary importance," the consequent maladjustment is evidently one of habit-formation, experience, situation. It is interesting to find also in the literature of psychiatry that even in encephalitis, where the organic structure is obviously damaged, the tendency is to seek the cause of the consequent disorders in the life experience and habit system of the subject and, if I understand the matter, to regard the organic injury as a precipitating incident. The non-specificity of mental disease, as indicated by Strecker and Rosanoff, among others, is an impressive emphasis of the situational standpoint.
In this connection also the line between the normal and the abnormal tends to disappear so far as techniques are involved, and the abnormal manifestations are to be viewed merely from the standpoint of their undesirable implications.
Occupying, therefore, the same standpoint and working on the same problems from different angles, conditions seem ripe for the formulation of schemes of collaboration and interchange between the sciences interested in behavior, and I shall indicate as far as I am able what might be some of the concrete procedures in bringing this about. Speaking as a sociologist, it may be that I shall express to the psychiatrists what I should wish to see them do rather than what they would wish to undertake.
To illustrate the procedures which have been followed up to the present from the standpoint of situation, I may refer to some examples. Freeman and his associates in Chicago, in order to test the effect of situation on intelligence, placed boo children in foster homes and observed the results of the changed situations. Comparisons were made between results on intelligence tests which had been given before adoption, in the case of one group, and the results after they had been in the foster home a number of years. Another comparison was made between children of the same family who had been placed in different homes, the home being rated on a scheme which took into consideration the material environment, evidence of culture, occupation of foster father, education and social activity of foster parents. Both of these comparisons had held heredity constant, letting the situation vary. A third comparison held environment constant, letting heredity vary; that is, concerning itself with a comparison of the intelligence of the own children of the foster parents and of the foster children. The results, stated in a word. show that when two unrelated children are reared in the same home, differences in their intelligences tend to decrease, and that residence in different homes tends to make siblings differ from one another in intelligence. This study is limited to the question of intelligence as measured by
(6) intelligence tests, hurt it is obvious that a fundamental study of behavior and of psychoneurotic behavior could be made by the same method.
Healy and Bronner and their associates in Boston have, in fact, just completed a study of the effect of foster homes on the behavior of a large series of juvenile delinquents containing a rather heavy proportion of psychopaths. This experiment showed (1) that it was possible to treat children without mental deficiency or psychopathic traits with a high degree of success in these situations (90 per cent) ; (2) that a certain period of time was necessary for retraining, and that return to the old home and community was disastrous unless there had been a change for the better there in the meantime; (3) that a transfer of the child from family to family, until a suitable situation was found, was often advisable; and (4) that the method was not successful with psychopathic children. At present Healy and Bronner are planning a comparative study of juvenile delinquents, including the mentally deficient and psychopathic in foster homes and institutions of various types.
I may also refer to the interesting work of Esther Richards in moving psychopathic children from one situation to another until they make a successful adjustment, of the experiments of Sullivan at the Sheppard and Enoch Pratt Hospital, and of Ambuhl at the Children's Village, in forming associations of psychopaths among themselves, and of Krasnogorski and other associates of Pavlov in the production of neuroses in dogs and children by making the discrimination tests too difficult and delaying the reaction.
The Chicago sociologists and their derivatives have used the situational approach in two ways. They have divided the city into regions and followed the behavior manifestations along radii from the center toward the suburbs. Working from the standpoint of the boy-delinquency rate and taking the boy population between 11 and 17 years, they found 443 delinquents per 1000 in the first mile unit, 58 in the second mile, 27 in the third mile, 15 in the fourth mile, 4 in the fifth mile, and none in either the sixth or seventh mile. In the first two â-mile units of the central business district, over half the boys were brought into the juvenile court in an 18 months' period, whereas in other regions none were. That raises, however, the question of what are the experiences within these regions, and they therefore have interested themselves in the development of life histories, personality documents and records with reference to the concrete trains of experience which in these particular regions lead to these results. Among the disclosures made up to the present by the more particular exploration of these regions is that gang life is strongly developed in the regions of a high delinquency rate and that in 90 per cent of the cases of stealing by boys brought before the Chicago juvenile court two or more boys participated. A similar study of the regional incidence of psychopathic traits has not been undertaken and would evidently result in something different, but I believe I can say that the sociologists would participate in such a study under the guidance of psychiatrists.
These random items I have presented as representative of what I am calling a situational approach. With reference to the particular alliances which the psychiatrists may wish to undertake or emphasize, it is my impression that the most profitable immediate working connection and the one most ready to hand is with the Child Research Institutes. I have in mind particularly the work of these Institutes in Minneapolis, Iowa City, Toronto and Columbia University. These Institutes have very favorable set-ups for cooperation with psychiatry. They control a number of young children. They study behavior in terms of behavior manifestations, not in terms of " instincts," body-chemistry or internal mechanisms. They are in the main sociological rather than psychological. They realize that behavior study is a long time job and are going about it in this way.
In Minneapolis, for example, two studies of dominance and subordination have been under way, one controlled and the other observational. A number of children were paired in all possible combinations successively and placed in a room together with an interesting toy. The experimenter retired but observed the children behind a screen and made a record for each child in terms of his behavior as directed towards securing the toy—whether he screamed, pleaded, bargained, threatened, pulled it away deliberately, slapped, pinched or pulled the other child, or relinquished the toy passively ; in terms of the type of domination of the successful child, after the outcome of the conflict; i. e., whether he played with the toy alone, controlled it but let the other child participate, or controlled it but let the other child have his turn or share it, and in terms of the unsuccessful child's reactions; in terms of the subsequent behavior of both children—whether the dominant child relinquished the toy, and, if so, whether he still directed the activity, whether either child made a suggestion, and whether it was accepted or rejected by the other child. In two behavior charts it is shown that one of these children used pleading as behavior directed towards securing the toy over two hundred times, the other child not ten times, but the latter child used commanding about as often as the former used pleading. When we consider the great number of combinations from which these computations came, the consistency of behavior is amazing. The pleading child pleaded consistently, whatever other child he happened to be with ; the commanding child commanded all other children.
In the observational experiment, which consisted in recording the participation in activity during the play period of each child with all other children, taking them in rotation, it was found, for instance, that one child talked 90 per cent of the time; another not at all. It was found also that a given child might be leading or dominating in 95 per cent of the play situations, whereas another child was in the leading position only 5 per cent of the time; that is, within a constant period one child was getting twenty times as much practice in meeting social situations in a given way as a second child.
In the Research Institute at Columbia the main approach has been somewhat different. Behavior has been observed not from the standpoint of psychological categories — dominance-subordination, introversion-extraver-
(8) -sion, etc.—but by observation and recording of the reactions of the children to the multiform stimuli of the environment appealing to their attention. It appears, for example, that there are children who select objects or materials for attention, others who select persons, and others who select themselves. One of the objectives is the study of the modifiability of these attitudes through experience and maturation. All activities of the child are recorded elaborately and objectively, without reference to what may appear eventually to be their significance, but methodologically it has been found necessary to observe these activities seriatim; for example, all physical contacts with other children for a given period and all language content for another given period. The language activity of the child for a period of twelve hours, or four school days, may fill as much as 12o typewritten pages.
I have elaborated this point partly because representatives of this work are not here and partly because I think it is a very important place, perhaps the most important, for the psychiatrist to tie in.
I am sure you will agree that there are in psychiatry many obscure and perplexing points, questions of idiotropic and syntropic, schizoid and cycloid dispositions, the causation and the age-level of the possible onset of schizophrenia, ambivalence, etc., the psychoanalytic theories and claims concerning pan-sexualism, anal-eroticism, the Oedipus, Electra, castration and inferiority complexes, the birth trauma and uterine regression, the trafficking of the Ego with the Id, etc., which would be greatly illuminated if they could be incorporated in the objective, controlled and comparative set-ups of these Behavior Research Institutes. I think I speak for my associates when I say that we realize that we cannot solve our problems without the aid of psychiatry, and we would welcome a rapprochement between yourselves and these Child Research organizations. They are at present concerned with the development of their techniques and you are, I know, concerned with the development of yours. In their set-ups they could include your problems, and in your procedure you could recognize theirs.
Another important contact for the psychiatrists would be with the anthropologists and sociologists, with reference to the incidence and character of mental disturbance among the races and nationalities. The anthropologists are planning at present studies of cultural areas, a section of the sociologists is specializing in human ecology and another section is already experienced in the technique of the smaller regional surveys. The literature on the psychopathology of races is extremely scanty and I have in mind the problem of the individual behavior reactions as they present themselves in different great social frameworks and cultural configurations, with their varying stresses on social values. There are anthropologists present who will doubtless have opinions on this topic. Some of these questions bear upon some of the points I have just enumerated. For example, the feeling of guilt among these different groups must vary enormously, whereas among the Arunta there is no recognition of the relation of children to copulation, and a Blacksnake woman visiting a Kangaroo group and feeling a child move within her would return home, and when the child was born would return it to the group where she was visiting and on whose territory one of
(9) the Alcheringa ancestors entered her person. I don't know how much that would affect these parent-child relations as represented in psychoanalysis, but it certainly is a very different situation with reference, say, to incest, or i f a Witchety Grub man does not cat that animal but takes a small portion of it, so to speak, sacramentally, in order to bring himself into rapport with his totem and at the same time has an understanding with an Emu man that the Emu man shall kill the animal and eat him completely, you certainly have opportunities for mental conflict. The question of homosexuality and its racial distribution and causation, and so forth, taken by the anthropologists and the psychiatrists in a joint manner, I think represents what I have in mind.
Two other highly important questions are the relation of crime to psychopathology and of psychopathology to the occupations. These questions offer an excellent opportunity for cooperative situational studies. It appears, for example, that in a given critical situation one person may readjust on a higher level of efficiency, another may commit a crime and another may go to a hospital for the insane. And with reference to the occupations, it is important to know whether there is a high incidence of the psychoneuroses in given occupations, what neuroses in what occupations, and what experiential or constitutional preadaptations are involved. I cannot expand upon these points here, but hope they will come up in the discussion, and also the relation of psychopathology to the law and to legal procedure, and to the moral code. It is unnecessary and not suitable that I should attempt to expand upon these points, as they could be better represented by those whom I see before me.
I will mention two further items which seem to he of interest to everybody. I have referred to record making and life histories. The juvenile court and child guidance clinics, voluntary organizations like the White-Williams Foundation, and the sociologists have prepared valuable but inadequate materials. It is true that life-records are inferior factually to the records of the Child Research Institutes. They cannot represent factual reality adequately ; they contain much phantasying, but they nevertheless represent effective reality. If, for example, in the field of psychopathology, a man with a delusion of persecution shoots men on the street who have the unfortunate habit of talking to themselves, imagining they are calling him abominable names, the man's delusion is effective reality. Those of us who are particularly interested in this matter would welcome the organization of a group of persons to work on the techniques of record making, with special reference to getting your psychopathic records to the front. I understand you have among you very important materials, but the reading, for example, of McCurdy's volume, where he leans so heavily on the good but old cases of Hoch, is rather disappointing. It would be advisable also to organize on some basis for the systematic publication of behavior records, perhaps in a series of behavior monographs.
Another point is the character of our journals, and their lack of critical and factual materials. I am sure the sociological journals suffer from a metaphysical-philosophical holdover and contain too much speculative essay
(10) writing. It is my impression also that some of your journals contain a considerable proportion of irresponsible, fantastic and incredible statements.
It has been suggested that I say something of the biochemical, physiological, morphological type of approach as related to this conference, and I hesitate to do this not only because of lack of competence and lack of time, but because I feel that conditions are riper for profitable cooperative enterprises on the basis of a sociological rather than a biological approach, and I should regret to see the attention and discussion of this brief conference divided between the two. I will say that I believe too per cent of those present would agree that behavior reactions are conditioned by both the social environment and by what Claude Bernard has called the inner environment. I have the greatest respect for workers like Scammon, Baldwin, Bardeen, Prescott, Boas and others who are working without prepossessions on the problems of population norms as related to the growth and differentiation of the human body and its various organs, on indices of anatomical age, etc., and other work of this character, hurt I am very skeptical of all procedures which weight and make responsible for deviate behavior any single factor or limited set of factors. We have a long history of these claims—Lombroso's anatomically stigmatized criminal type, destroyed by Goring; the theory of mental deficiency as almost the exclusive cause of crime, destroyed by many hands ; the more recent psychopathic personality as numerically dominant in crime, destroyed by Healy, Slawson and others ; Cotton's claims of focal infection as the cause of mental disease, destroyed by Kopeloff and Kirby. Just now the Jaensches are at the front with claims of the eidetic disposition and crumpled as against upright capillaries as concomitants of feeble-mindedness and the psychoneuroses, and arc rating races and nationalities on this basis. Some of the endocrinologists are grossly overweighting their material and giving it a criminalistic as well as a psychopathological bearing; anthropometrists have constructed disease races, as against anthropological races, making many and minute measurements and using few of them in their conclusions.
Certainly some of these claims contain values (and I am especially impressed with the general position of Kretschmer, which may be a weakness on my part), but we do not know what they are. In addition to a perhaps unconscious selection (through which, according to William James, it would be possible to show that all poets are blue-eyed and born on a Thursday), a main defect of all these overweighted theories is that no control groups are used whereby it would be possible to determine what proportion of given traits in the subjects handled occur in the general population. It is assumed that the general population is normal, or rather, ideal, and that deviations from the experimenter's conception of the ideal are abnormal. It is, for instance, quite useless at the present time to make elaborate measurements of any group of behavior deviates because these same measurements have not been widely applied to the general population. We cannot tell to what extent physical deviations are associated with behavior deviations until we have some physical standard from which these deviations may be measured, or until we know to what extent the ideal
(11) physical status corresponds to the normal or average. It is quite useless, for instance, to subject a group of criminals or psychopaths to an elaborate series of physical measurements because so little is known about the " normal " development of non-criminal groups of the same age, sex, nationality, etc. Association of physical defect with crime and insanity cannot be determined until the amount of physical defect in non-criminals is known. " Normal " physical development and growth must be objectively determined before we can trace out and measure the degree of association of various physical states with various behavior manifestations. It may he said to the merit of Scammon and workers of that type that they are occupied with the determination of at least the physical norms.
In this connection, therefore, I should say that the most desirable affiliations for the psychiatrists would be with the statisticians and psychologists. It is true that the psychiatrists and physiologists have sometimes been betrayed by the psychologists. Conscientious men like Starr and Rich have studied the chemistry of the blood and saliva by the most painstaking and accurate techniques with reference to the psychoneuroses and have then correlated their accurate measurements with the very unscientific results of a personality rating scheme proposed by the psychologists whereby teachers or other observers make reports on the behavior tendencies of the subjects. It is also true that statisticians are responsible for some of the items I have just criticized, but there are statisticians who know the limitations and applications of their art. The situation here is similar to the one above, where I suggested an interaction between the psychiatrists and the Child Research Institutes, with a view to setting and regulating one another's problems and procedures.
My experience with conferences leads me to suggest also that, whatever shape your projects may assume, their consummation would be greatly facilitated by the designation of a liaison person whose sole function would he visitation, exploration, organization. Perhaps you may be able to divert Dr. Sullivan from a brilliant psychiatric career and convert him into this liaison person.