Camille Koch

Thèse en cours sous la direction de Felix Rietmann, IHM, CHUV-Unil 

Résumé

This project investigates how the so-called pharmaceutical revolution of the post-World-War II period shaped everyday clinical life and therapeutic approaches in Swiss child and youth psychiatry. It aims to extend existing scholarship in this field by placing children in a network of different professional, industrial, and caregiving actors.
Accordingly, this project will investigate psychopharmaceutical use not as an isolated entity but as a site that connects multiple different actors in a social network of psychiatric practice. To do so, it draws on the concept of “social lives of medicines” from Science and Technology Studies (STS) and asks about knowledge production and knowledge regimes inside psychiatric ideas and practice (Whyte, Geest, Hardon 2003). This means that pharmaceuticals are not understood as uncomplicated objects with undisputed definition or effects. Rather, they are defined according to their prescription and use, as well as to the interpretation of their effects. This project aims to investigate the social life of psychopharmaceuticals in Swiss child psychiatry between 1950 and 1970, a period where pharmaceuticals started to be used widely in psychiatry.
Central to the project is the question of how pharmaceuticals were affecting therapeutic knowledge and practice. When was medicine classified as effective? What changes to a patient’s behaviour was seen as relevant? Which were classified as side-effects and to what degree were they tolerated by whom? How did doctors, nurses, patients and their parents experience treatment and how did their ideas of successful treatment differ? From this perspective, the project conceptualizes pharmaceuticals as a kind of social hub (structure) connecting multiple different forms of knowledge that influenced modes of treatment.
The project follows a microhistorical approach, using case studies of individual patients to explore regimes of prescription and supervision, children’s experiences of pharmaceuticals, as well as questions of efficacy, side-effects and experienced vs. objective ideas of what a successful treatment was. These questions will be addressed through the project will array of written sources such as case files and treatment documentation, correspondences between different actors, institutional reports and medical publications.
The history of psychiatric care is a core aspect of this approach as it allows for the investigation the evolving field of psychiatric caregivers and nurses. The project thus investigates how the emergence of new psychopharmaceutical landscape shaped ideas and practices of child psychiatric care. In addition, it is central to the project to foreground the experiences of patients. Given the nature of the sources (clinical files), “the patient’s voice” is often not directly accessible built rather constructed through the many actors involved in the process of medicating children. This indirect access will partly be supplemented with oral history interviews that allow for a more immediate access to former child psychiatric patients.
Finally, this project explores gendered structures of pharmacological treatment. It asks how gendered ideas shaped diagnostic processes, treatment regimens and, by extension, patient experiences.