["Norms and autonomy. Southern German clinical psychiatrists' strategies of legitimation and power of interpretation in the first half of the 19th century"].

Abstract

In the present article the Southern German states of Baden and Bavaria are analyzed to exemplify the ways in which during the first half of the 19th century clinical psychiatrists advanced to experts and how they gained within and outside the institutional sphere a psychiatric sovereignty of interpretation ("psychiatrische Deutungsmacht"). One aspect in this development are strategies with which their position as physician was legitimized and ensured. Another aspect analyzed are the conditions under which physicians were able to act. It is to be noted that the rise of the psychiatric profession took place in two phases: Up until the 1820s, during the so called establishing phase of institutional psychiatry, the physician's active horizont was limited to the clinical sphere. Then, a process of "professional self-discovery" set in. Only with the institutional differentiation from the 1830s onwards, clinical psychiatrists also began to appear outside the clinics as experts and critical councellors. However, the fact that there was a gradual gain in autonomy and the establishment of a psychiatric sovereignty of interpretation also within state bureaucracy cannot be explained solely by tendencies toward professionalization. It was rather a multilayered process involving different participants and vested interests. The role of the state is of special importance: Motivated by its interest in solving the problem of deviance through medicalization, the state not only helped to bring institutional psychiatry into being, but also paved the way for the rise of clinical psychiatry.