Barry Blackwell: Pioneers and Controversies in Psychopharmacology
The International Neuropsychopharmacology History Network (INHN.org) was founded in 2013 by Tom Ban and a few like-minded colleagues, including me. The material for this volume, 21 biographies of selected pioneers and six significant controversies were penned and posted on INHN.org in five years between 2013 and 2017. Together they provide a colorful portrait of some of the organization’s early activities in its historical context.
Technically, this is a convenience sample which raises the question of how representative it is of the larger population of pioneers and range of controversies. By definition most, if not all, controversies are unique with little content in common so this question may be moot. Nevertheless, all six controversies touched my own 50-year career in some manner or degree (Blackwell 2012).
Controversies were also sometimes imbedded in the individual biographies. The anti-psychiatry agenda touched the careers of Jean Delay, Jose Delgado, Heinz Lehman and Karl Rickels. Squabbles about the priority, significance or methodology of a discovery are evident in the biographies of Thudichum, Cade, Smythies and Charalampous.
The selection of pioneers was dictated by several considerations. If we define pioneer as activity in the period 1949-1970, age and mortality winnowed the field. Joel Elkes was 101 years old when I interviewed him and many who merited a biography were deceased. Five biographies are a synopsis extracted from personal memoirs of Callaway, Berger (post-mortem), Smythies, Rickels and Varga (in part). Two are derived from post-mortem biographies by other authors of Cade and Delay. Three are based on in depth personal interviews of Elkes, Varga and Charalampous and two from detailed literature reviews and other material about deceased pioneers, Lehman and Delgado.
A general familiarity with the careers of pioneers, available for reflection and comparison, was obtained between 2008 and 2011 working with Tom Ban on the Oral History of Neuropsychopharmacology (OHP) for the 50th anniversary of the American College of Neuropsychopharmacology (ACNP). I edited Volume 7 (Neuropsychopharmacology) and Volume 9 (Update) in the 10-volume series and also wrote 57 mini-bios (dramatis personae) published in Volume 4 (Psychopharmacology) and Volume 7 (Special Areas; Desiderata).
Further details about each biography or controversy and its place in the chronology are provided in the text.
A diversity of cultural origins is displayed in the chronology beginning in the 19th century with Thudichum, who trained in Germany and migrated to Britain. The onset of the modern era began halfway through the 20th century with Elkes in England and Cade in Australia. Following, in a flourish of creativity and serendipity, were Delay in France, Lehman in Canada and Berger in America from Germany via Britain. He was joined by Delgado from Spain and Elkes from Britain. Later arrivals in America were Rickels from Germany, Varga from Hungary and Charalampous from Greece. The only pioneer born and raised in America was Calloway.
We can compare this convenience sample with a control group of 57 mini-bios (dramatis personae) written by me for the OHP, volumes 4 and 7. There were 13 immigrants (28%) and 10 women (18%) in this cohort. The oversampling of immigrants or foreigners in the convenience sample is partly explained by a chronological difference in time frames. The convenience sample is from the first 15 years of the modern era (1949-1964) while the control cohort covers a lengthier period. The high incidence of immigrants from Europe in the convenience sample is contributed to by scientists fleeing the Nazi and Communist regimes in the pre-and post-World War II years.
The absence of women in the convenience sample compared to the control cohort is due to the fact that the golden era of psychopharmacology was also a time of a cultural phenomenon -misogyny. The organizing committee of the ACNP (1961) included no women. The first women council members were not elected until 20 years later (1981). Eva Killam became the first woman President in 1988 and there were only two other woman presidents in the next 20 years.
However regrettable the absence of women in the convenience sample, it is compatible with the ACNP’s organizational and recruitment policies. There are several women members in the control cohort born between 1920 and 1940 (almost all of the pioneers in both genders were born in that time), whose careers clearly merit a biography and seven of their stories are told in Chapter Eight, taken from Volumes 5 & 7 of the OHP that I edited.
The biographies and controversies are intermingled in conformity with the time sequence and interspersed with chapters that highlight the differing points of view between Early Optimism and Ambiguity (Chapter 9) as opposed to Cautious Appraisals and Skepticism (Chapter 10).
The four final chapters discuss broader considerations affecting the entire field including changes in medical education and practice (Chapter 17), corporate corruption in the psychopharmaceutical industry (Chapter 18), Keith Conners in his own words (Chapter 19) and an epistemological conundrum about what to believe (Chapter 20).
The volume ends with an Epilogue by the author placing the golden era of psychopharmacology in its historical context (1949-2017).
December 7, 2017