The contribution of anthropology to the study of Open Dialogue: ethnographic research methods and opportunities.

When Open Dialogue diversifies internationally as an approach to mental healthcare, so too do the research methodologies used to describe, explain and evaluate this alternative to existing psychiatric services. This article considers the contribution of anthropology and its core method of ethnography among these approaches. It reviews the methodological opportunities in mental health research opened up by anthropology, and specifically the detailed knowledge about clinical processes and institutional contexts. Such knowledge is important in order to generalize innovations in practice by identifying contextual factors necessary to implementation that are unknowable in advance. The article explains the ethnographic mode of investigation, exploring this in more detail with an account of the method of one anthropological study under way in the UK focused on Peer-Supported Open Dialogue (POD) in the National Health Service (NHS). It sets out the objectives, design and scope of this research study, the varied roles of researchers, the sites of field research and the specific interaction between ethnography and Open Dialogue. This study is original in its design, context, conduct and the kind of data produced, and presents both opportunities and challenges. These are explained in order to raise issues of method that are of wider relevance to Open Dialogue research and anthropology.

[Psychological events--organic interpretations: concepts of trauma in German psychiatry since 1889]. / Psychische Ereignisse--organische Interpretationen: Traumakonzepte in der deutschen Psychiatrie seit 1889.

This paper examines the debate on psychological trauma in German psychiatry since 1889. A content analysis of five leading German psychiatric journals between 1889 and 2005 is realised. An organic concept of psychological trauma has been prominent in the professional debate until today. Psychiatrists frequently referred to physical traumatisation, constitutional factors and genetic predisposition, exogenous reaction types according to Bonhoeffer, and to biological markers in the context of the PTSD concept. The biological tradition in German psychiatry resulted in a specific adoption of concepts on psychological trauma. However, integrating various models of psychological trauma into a psychiatric tradition focusing on a biological model proved to be difficult and inconsistent.

Psychological injury in the two World Wars: changing concepts and terms in German psychiatry.

This paper describes how German psychiatrists in two World Wars treated psychologically injured soldiers, and the concepts of related illnesses which they developed. The literature is reviewed, and symptomatolgy of patients and therapeutic practice in the wars are compared. By 1916 German psychiatrists had already established a concept of illness that continued to be used until World War II and beyond, albeit with a changing terminology. The vague term 'war neurosis' was commonly used, but covered different, partly overlapping concepts. Psychiatrists considered the disorder as a psychogenetic reaction based on an individual predisposition and denied a causal link between the experience of war and subsequent psychopathology. It may be concluded that psychiatrists developed theoretical models and practical treatment methods in a manner that met the social and military requirements of the time.

[Trauma and psychosis in german psychiatry - a historical analysis]. / Trauma und Psychose in der deutschen Psychiatrie - Eine historische Analyse.

OBJECTIVE: The paper reports an historical analysis of the debate on trauma and psychosis in German psychiatry. METHODS: Content analysis of five leading German psychiatric journals between 1889 and 2005. RESULTS: A substantial number of publications until the late 1960s addressed different aspects of potential links between trauma and subsequent psychosis. Papers exclusively focused on traumatic experience in adulthood. Most papers showed a negative attitude towards the idea of traumatic experiences causing psychosis. CONCLUSIONS: The debate on psychological trauma and psychosis refers to a long tradition in German psychiatry. Whilst the discussion contributed significantly to concepts and classifications of psychotic illnesses, it did not generate a coherent model for the potential association of trauma and subsequent psychotic disorder.

[Psychological trauma in psychiatric textbooks published in german - the dominating view of psychiatrists between 1945 and 2002]. / Psychisches Trauma in deutschsprachigen Lehrbüchern der Nachkriegszeit -- die psychiatrische "Lehrmeinung" zwischen 1945 und 2002.

AIM: The study investigates the concepts of psychological trauma and their changes over time in psychiatric textbooks published in German between 1945 and 2002, assuming that textbooks reflect the established and dominating views of their time. METHOD: [corrected] In psychiatric textbooks, the terminology, concepts of illness, and recommendations for assessment and treatment concerning psychological trauma were analysed. RESULTS: The concept of psychological trauma that had existed since 1916 continued to dominate textbooks up until the 1960s. Findings on holocaust survivors entered textbooks not before the mid 1970s. Since the mid 1990s, the concept of Post-Traumatic Stress Disorder has been widely established in textbooks. CONCLUSION: Changes of dominating views on this issue in textbooks appear to have been extremely slow and occurred with significant delays in the past. The change of the dominating view in the 1970s was linked to the establishment of a new generation of leading psychiatrists. Since the introduction of PTSD, psychiatric textbooks have given up a previously negative attitude towards patients suffering from psychological trauma.