Dr. Anne Harrington is the Franklin L. Ford Professor of the History of Science and the Director of Undergraduate Studies of that department. She has twice served as the Department Chair, first between 2007-2010 and again from 2012-2013. An alumna of Harvard College, she concentrated in History and Science before receiving her Ph.D. in the History of Science from Oxford. Her research interests include the History of Psychiatry, Psychology, and the Neurosciences, areas in which she has published extensively and written four books. In addition, she and her husband, a Professor at MIT, have served as the Faculty Deans of Pforzheimer House since 2013.
RS: When you came to Harvard as an undergraduate, did you have an interest in the brain sciences, and how did you explore it?
AH: I did have an interest in the history of the brain sciences. I was an undergraduate in the History of Science program, just as you are, and I joined the History of Science department with a lot of big questions, some of which had to do with the brain sciences. These particularly had to do with my discontent with the brain sciences, discontent not in the sense that I didn’t think they had fascinating things to offer, but that they offered me a view of our humanness that was at such variance with the view of what it means to be human that I had absorbed from my classes in the humanities. I felt either both disciplines were wrong, or they both had a piece of the truth, but I didn’t know how to put it all together. I started off more a humanities person, and from my humanities classes, I believed in taking seriously the claims of meaning and striving and agency and free will and purpose as important parts of our humanness. In the brain sciences courses I took, and I also took classes in biological anthropology and related disciplines, humanness seemed to come down to evolutionary advantage and physiology. So, I embarked on a mission to understand the fractured nature of thinking about our humanness, that seemed to be embodied in these disconnects. That led me into the History of Science department, because clearly there must be some historical root to this fractured nature. But there weren’t courses offered about this idea back then. The courses in the department that I took involved fields like the history of biology, and in general were much more classical back then. Although, there was a fair amount of political science in my courses, too, many of which I took, because I was quite interested in the social problems raised by science. But no courses in the area of the history of brain sciences. We didn’t have any faculty in that field, and in fact, when I was tenured in the History of Science department, it was a radical thing that someone who worked in the field of mind, brain, and behavioral sciences could achieve tenure. But I wrote my senior thesis in an area that dealt with the history of the brain sciences and human consciousness. It was from there—being able to write a project that had not been a focus of any of my classes, but that the department tutorial program allowed me to pursue—that I decided to do my PhD in that area, and things went on from there. So, yes, the roots lie quite deep, but they rely on this existential crisis that I had—what it means to be human—rather than a single course that I took in the history of the brain sciences.
RS: Why was it considered radical to be studying the history of the brain sciences, and in your experience in academia, have you ever encountered opposition, or perhaps derision, from colleagues?
AH: Well, that’s a fair question given how I just described my appointment as “radical,” but my answer is I did not particularly feel I experienced hostile opposition. I think, though, it was more a function of how the field itself—the field of the History of Science—started off very much about the physical sciences. It didn’t, at least in the early years, embrace technology and medicine, either. The fact that the field was embracing the life sciences was bold enough! By the time I came back to the department as a faculty member, first as an assistant professor, I think that the scope of the department was expanding. So, no, I don’t feel like I was disrespected or prejudiced against, it was more that there wasn’t a lot of company for a while. There is something exciting, though, about trying to establish and broaden the discipline that you care about in new directions. There’s an advantage, too, in that it’s not a very crowded playing field. It was more a little bit lonely rather than feeling disparaged or undermined.
RS: In those early days, did you find that many students were interested in the history of the brain sciences, or was it a smaller group? I recall that at one point, your class Madness and Medicine had over 300 students enrolled. But was this popularity present from the start?
AH: I originally started off as someone who worked in the brain sciences, but I also taught courses in evolutionary theory and human nature. So, going back to my original existential question, I brought that into the classroom. My interest in psychiatry started as a kind of service course. It didn’t start off as my primary interest, but I developed it out of a desire to contribute to the history of medicine course offerings. But then it took on a life of its own because people were drawn to that course for different reasons. Not explicitly because they couldn’t wait to learn about what was going on in 19th century mental hospitals, but more because they were looking for perspective on their own world and the mental health challenges that they, family members, or other people in their circles might experience. They were confused about why we think about our mental suffering in the ways that we do. The course became very large, I think at one point 500 students in that course. Not every year, but it did become a very big class. I took very seriously the responsibility of providing some kind of perspective and service for the students, knowing that many of them were not in the class because they were passionate about history as such. I sought to persuade them that there is power and merit in bringing in a historical lens to their own moment. I would tell people in the class, sometimes in my intro, something like “in a sense, there are no more important questions that anyone can ask than, ‘how did I end up in the world I ended up with, why am I in this world, why are these the assumptions, why are these questions I’m supposed to ask, but these others are not appropriate or already considered?’” When you ask those types of questions, like “why have I ended up in this world, and not some other?” you’re asking a historical question. You’re saying that your world was made, and it could have been different. Once you see that, and you see the forces that created your world, you also can decide, in a more informed way, the extent to which you’re contented with the choices that have been made. You can see more clearly where there are points for intervention, and so on. That’s, I think, how I thought about Madness and Medicine, but I should also say that undergraduates had the effect of turning me into a historian of psychiatry. I became a scholar and historian of psychiatry as a consequence of becoming a teacher of that field for Harvard undergraduates. I think it’s usually the other way around in academia.
RS: Did your experience as a professor who taught undergraduates in this discipline influence your scholarly work?
AH: I wrote a book that came out in 2019 called Mind Fixers, and it attempts to understand why American psychiatry, about 30 or 40 years ago, after having been so psychotherapeutically and psychoanalytically oriented, why in an astonishingly short period of time we pivoted to biological understanding of the brain. The reason I ended up writing that book is because, in my course Madness and Medicine, when it came time to tell this recent part of the history, I didn’t feel like I was doing a good job. I didn’t really know because it’s not like it’s a difficult puzzle here. The history of psychiatry was ticking along up until the ’70s, and then you blink, and everything that people were saying in the ’70s is now being declared completely wrong, and nonsense. Scholars in the 1980s then claimed that psychiatry is only about the brain, and about drugs, and the biological revolution. But see, there was no scientific reason for these claims. There had been no revelations from brain imaging, or pharmacology or on any other front. Scholars claimed that there was a revolution, but that’s a description being adopted by people at the time, and not an explanation. So, Mind Fixers was an attempt to get behind what led to this kind of talk, and why it was possible to declare a revolution, without any actual revolutionary science. This motivation for me to write came as a result of teaching. I dedicated my book to my Harvard undergraduate students.
RS: I’ve spoken before with Professor David Jones, one of your colleagues in the History of Science department and trained as a psychiatrist, about the sometimes bitter disputes between the medical specialties of psychiatry and neurology. How do you think this history of animus influences—and will continue to influence—the relationship between the two fields?
AH: I would first probe this idea that the history of neurology and psychiatry are marked by bitter animus and that’s all there is to say. There have been moments, particularly early moments—and I’m not sure what era you and Professor Jones were discussing—of this type of relationship. In the mid-to-late 19th century, this relatively new field of neurology was established. Neurology is considerably younger than the field that we would call psychiatry, which has not always called itself that. Neurology was the upstart, new discipline, and its scholars began to question why asylum superintendents only seemed to care about the facility’s flower gardens, and how that asylum did at the country fair with the peach harvests, but had no knowledge of the brain and how it works. But neurologists had made the association between mental illness and the brain, and thought that they should supervise this area of practice and research. There was an attempt at a takeover, which largely failed in the U.S., and partially succeeded in parts of Europe. There’s nuance there, but that’s a roughly fair approximation. It did lead to animosity between the fields. But I don’t think that’s the entire history at all. I think that’s a dramatic piece of the story. Some people have said that if a brain disorder becomes understood—although it rarely happens—it becomes part of neurology, and psychiatry is left over with all the disorders that are not really understood. The prime example of that would be general paralysis of the insane, which is a disorder psychiatry understood reasonably successfully, but then lost control over to neurology. Maybe Alzheimer’s, too, although it is now squarely in the world of neurology, and before, the dementias used to be part of psychiatry. There are other ways to think about the worlds of psychiatry and neurology other than about political battles between representatives of the two disciplines. That view becomes essentially office politics, of who has the status, and who should get access to the resources. I think a more interesting way to think about the relationship between these two fields is at the level of the patients, and the forms of suffering and disability, and how patients are partitioned out between practitioners. What happens when patients are moved between the frameworks of one field into the frameworks of another?
RS: Looking ahead, what are your current research projects and what areas of the history of the brain sciences do you think are particularly ripe for further study?
AH: My next book is going to be an attempt to write a different history of neurology, that will be patient centered. In another example of what I was discussing earlier with Madness and Medicine, I’m going to try to teach this idea before writing the book. I’m planning to offer a new lecture class in the fall possibly called Brain Stories: A Patient Centered History of Neurology. I learn so much more from having to justify what I’m saying in front of 150, or however many, critical undergraduates, than I would sitting in a library trying to do it on my own. It’s terrifying, but in all the right ways. So is it a world of animosity and battle between neurology and psychiatry, if you look at another level, in terms of individual patients? It depends on whose story is important. If you decenter yourself from the assumption that it’s all about what the prominent doctors are doing and how they’re fighting it out, and ask who else is involved, it might look quite different.
RS: Finally, you’ve been a central figure in this field for long enough to see it grow and evolve and a host of ways. What changes have you noticed in terms of whose voices are heard and whose are silenced—intentionally or unintentionally—in academic research?
AH: This is one of the things that I’m most exercised by, and it’s related to what I was saying earlier about decentering. So, this is just the right question to ask. I talk about this a lot in [History of Science] Sophomore Tutorial as well—who aren’t we paying attention to is so important. It’s like, “but, wait, there were all these other voices that weren’t heard.” Like patients. So, in the history of neurology, let’s go back to that since this is for The [Harvard] Brain. We think about the history of neurology as only about the neurologists themselves, right? Same etymology, similar word. But neurology is the clinical arm of neurosciences. Neurologists engage with their patients for the initial diagnoses, and they may engage with them longer if the patient is scientifically interesting. But what happens when a patient is no longer scientifically interesting? Where do they go? So, here’s an example of what I mean. There was a point in time where aphasia was the most interesting research area in neurology. This might seem surprising, because today aphasia is not really a big deal. It was a really big deal for a number of generations, partly because language is simultaneously such a high order human capacity, unique to humanness, and appears to be localized, or associated with certain parts of the brain. The idea that something so high level could have a focal spot in the brain—it’s almost like discovering the seat of the soul, or the seat of rationality. So, it energized the field for a number of generations, from the 1860s right through the first World War, in a range of ways. But then, it stopped being of interest. But people still suffered from language loss. What happens if we don’t follow the neurologists to their next research interest, but follow the aphasia patients? It turns out, the neurologists were much more interested in the implications of language loss than helping the people who suffered from language loss improve. They were not very interested in rehabilitation. But, of course, patients don’t really care about being interesting cases. They want to have a life, and go to work, have a family. So, who ends up actually driving the story of rehabilitation? It turns out that there were people that came out of elocution schools, who were very low level, mostly female workers. Some of them had training in elementary school education, because the view was the aphasia patients had become like children. And there’s a whole story about these women, who are barely characters in most histories of aphasia, actually creating a field of rehabilitation. Why isn’t that important? Why isn’t that part of what we think about? What the field is interested in is the Broca brain in a vat at a museum in Paris, with a big hole in it where the famous patient Tan had the stroke. Now, I’m not saying that’s not a story. But what if it’s not the story?
About the Author
Raj Sastry is a sophomore at Harvard College concentrating in History and Science with a secondary in Global Health and Health Policy.
RS: When you came to Harvard as an undergraduate, did you have an interest in the brain sciences, and how did you explore it?
AH: I did have an interest in the history of the brain sciences. I was an undergraduate in the History of Science program, just as you are, and I joined the History of Science department with a lot of big questions, some of which had to do with the brain sciences. These particularly had to do with my discontent with the brain sciences, discontent not in the sense that I didn’t think they had fascinating things to offer, but that they offered me a view of our humanness that was at such variance with the view of what it means to be human that I had absorbed from my classes in the humanities. I felt either both disciplines were wrong, or they both had a piece of the truth, but I didn’t know how to put it all together. I started off more a humanities person, and from my humanities classes, I believed in taking seriously the claims of meaning and striving and agency and free will and purpose as important parts of our humanness. In the brain sciences courses I took, and I also took classes in biological anthropology and related disciplines, humanness seemed to come down to evolutionary advantage and physiology. So, I embarked on a mission to understand the fractured nature of thinking about our humanness, that seemed to be embodied in these disconnects. That led me into the History of Science department, because clearly there must be some historical root to this fractured nature. But there weren’t courses offered about this idea back then. The courses in the department that I took involved fields like the history of biology, and in general were much more classical back then. Although, there was a fair amount of political science in my courses, too, many of which I took, because I was quite interested in the social problems raised by science. But no courses in the area of the history of brain sciences. We didn’t have any faculty in that field, and in fact, when I was tenured in the History of Science department, it was a radical thing that someone who worked in the field of mind, brain, and behavioral sciences could achieve tenure. But I wrote my senior thesis in an area that dealt with the history of the brain sciences and human consciousness. It was from there—being able to write a project that had not been a focus of any of my classes, but that the department tutorial program allowed me to pursue—that I decided to do my PhD in that area, and things went on from there. So, yes, the roots lie quite deep, but they rely on this existential crisis that I had—what it means to be human—rather than a single course that I took in the history of the brain sciences.
RS: Why was it considered radical to be studying the history of the brain sciences, and in your experience in academia, have you ever encountered opposition, or perhaps derision, from colleagues?
AH: Well, that’s a fair question given how I just described my appointment as “radical,” but my answer is I did not particularly feel I experienced hostile opposition. I think, though, it was more a function of how the field itself—the field of the History of Science—started off very much about the physical sciences. It didn’t, at least in the early years, embrace technology and medicine, either. The fact that the field was embracing the life sciences was bold enough! By the time I came back to the department as a faculty member, first as an assistant professor, I think that the scope of the department was expanding. So, no, I don’t feel like I was disrespected or prejudiced against, it was more that there wasn’t a lot of company for a while. There is something exciting, though, about trying to establish and broaden the discipline that you care about in new directions. There’s an advantage, too, in that it’s not a very crowded playing field. It was more a little bit lonely rather than feeling disparaged or undermined.
RS: In those early days, did you find that many students were interested in the history of the brain sciences, or was it a smaller group? I recall that at one point, your class Madness and Medicine had over 300 students enrolled. But was this popularity present from the start?
AH: I originally started off as someone who worked in the brain sciences, but I also taught courses in evolutionary theory and human nature. So, going back to my original existential question, I brought that into the classroom. My interest in psychiatry started as a kind of service course. It didn’t start off as my primary interest, but I developed it out of a desire to contribute to the history of medicine course offerings. But then it took on a life of its own because people were drawn to that course for different reasons. Not explicitly because they couldn’t wait to learn about what was going on in 19th century mental hospitals, but more because they were looking for perspective on their own world and the mental health challenges that they, family members, or other people in their circles might experience. They were confused about why we think about our mental suffering in the ways that we do. The course became very large, I think at one point 500 students in that course. Not every year, but it did become a very big class. I took very seriously the responsibility of providing some kind of perspective and service for the students, knowing that many of them were not in the class because they were passionate about history as such. I sought to persuade them that there is power and merit in bringing in a historical lens to their own moment. I would tell people in the class, sometimes in my intro, something like “in a sense, there are no more important questions that anyone can ask than, ‘how did I end up in the world I ended up with, why am I in this world, why are these the assumptions, why are these questions I’m supposed to ask, but these others are not appropriate or already considered?’” When you ask those types of questions, like “why have I ended up in this world, and not some other?” you’re asking a historical question. You’re saying that your world was made, and it could have been different. Once you see that, and you see the forces that created your world, you also can decide, in a more informed way, the extent to which you’re contented with the choices that have been made. You can see more clearly where there are points for intervention, and so on. That’s, I think, how I thought about Madness and Medicine, but I should also say that undergraduates had the effect of turning me into a historian of psychiatry. I became a scholar and historian of psychiatry as a consequence of becoming a teacher of that field for Harvard undergraduates. I think it’s usually the other way around in academia.
RS: Did your experience as a professor who taught undergraduates in this discipline influence your scholarly work?
AH: I wrote a book that came out in 2019 called Mind Fixers, and it attempts to understand why American psychiatry, about 30 or 40 years ago, after having been so psychotherapeutically and psychoanalytically oriented, why in an astonishingly short period of time we pivoted to biological understanding of the brain. The reason I ended up writing that book is because, in my course Madness and Medicine, when it came time to tell this recent part of the history, I didn’t feel like I was doing a good job. I didn’t really know because it’s not like it’s a difficult puzzle here. The history of psychiatry was ticking along up until the ’70s, and then you blink, and everything that people were saying in the ’70s is now being declared completely wrong, and nonsense. Scholars in the 1980s then claimed that psychiatry is only about the brain, and about drugs, and the biological revolution. But see, there was no scientific reason for these claims. There had been no revelations from brain imaging, or pharmacology or on any other front. Scholars claimed that there was a revolution, but that’s a description being adopted by people at the time, and not an explanation. So, Mind Fixers was an attempt to get behind what led to this kind of talk, and why it was possible to declare a revolution, without any actual revolutionary science. This motivation for me to write came as a result of teaching. I dedicated my book to my Harvard undergraduate students.
RS: I’ve spoken before with Professor David Jones, one of your colleagues in the History of Science department and trained as a psychiatrist, about the sometimes bitter disputes between the medical specialties of psychiatry and neurology. How do you think this history of animus influences—and will continue to influence—the relationship between the two fields?
AH: I would first probe this idea that the history of neurology and psychiatry are marked by bitter animus and that’s all there is to say. There have been moments, particularly early moments—and I’m not sure what era you and Professor Jones were discussing—of this type of relationship. In the mid-to-late 19th century, this relatively new field of neurology was established. Neurology is considerably younger than the field that we would call psychiatry, which has not always called itself that. Neurology was the upstart, new discipline, and its scholars began to question why asylum superintendents only seemed to care about the facility’s flower gardens, and how that asylum did at the country fair with the peach harvests, but had no knowledge of the brain and how it works. But neurologists had made the association between mental illness and the brain, and thought that they should supervise this area of practice and research. There was an attempt at a takeover, which largely failed in the U.S., and partially succeeded in parts of Europe. There’s nuance there, but that’s a roughly fair approximation. It did lead to animosity between the fields. But I don’t think that’s the entire history at all. I think that’s a dramatic piece of the story. Some people have said that if a brain disorder becomes understood—although it rarely happens—it becomes part of neurology, and psychiatry is left over with all the disorders that are not really understood. The prime example of that would be general paralysis of the insane, which is a disorder psychiatry understood reasonably successfully, but then lost control over to neurology. Maybe Alzheimer’s, too, although it is now squarely in the world of neurology, and before, the dementias used to be part of psychiatry. There are other ways to think about the worlds of psychiatry and neurology other than about political battles between representatives of the two disciplines. That view becomes essentially office politics, of who has the status, and who should get access to the resources. I think a more interesting way to think about the relationship between these two fields is at the level of the patients, and the forms of suffering and disability, and how patients are partitioned out between practitioners. What happens when patients are moved between the frameworks of one field into the frameworks of another?
RS: Looking ahead, what are your current research projects and what areas of the history of the brain sciences do you think are particularly ripe for further study?
AH: My next book is going to be an attempt to write a different history of neurology, that will be patient centered. In another example of what I was discussing earlier with Madness and Medicine, I’m going to try to teach this idea before writing the book. I’m planning to offer a new lecture class in the fall possibly called Brain Stories: A Patient Centered History of Neurology. I learn so much more from having to justify what I’m saying in front of 150, or however many, critical undergraduates, than I would sitting in a library trying to do it on my own. It’s terrifying, but in all the right ways. So is it a world of animosity and battle between neurology and psychiatry, if you look at another level, in terms of individual patients? It depends on whose story is important. If you decenter yourself from the assumption that it’s all about what the prominent doctors are doing and how they’re fighting it out, and ask who else is involved, it might look quite different.
RS: Finally, you’ve been a central figure in this field for long enough to see it grow and evolve and a host of ways. What changes have you noticed in terms of whose voices are heard and whose are silenced—intentionally or unintentionally—in academic research?
AH: This is one of the things that I’m most exercised by, and it’s related to what I was saying earlier about decentering. So, this is just the right question to ask. I talk about this a lot in [History of Science] Sophomore Tutorial as well—who aren’t we paying attention to is so important. It’s like, “but, wait, there were all these other voices that weren’t heard.” Like patients. So, in the history of neurology, let’s go back to that since this is for The [Harvard] Brain. We think about the history of neurology as only about the neurologists themselves, right? Same etymology, similar word. But neurology is the clinical arm of neurosciences. Neurologists engage with their patients for the initial diagnoses, and they may engage with them longer if the patient is scientifically interesting. But what happens when a patient is no longer scientifically interesting? Where do they go? So, here’s an example of what I mean. There was a point in time where aphasia was the most interesting research area in neurology. This might seem surprising, because today aphasia is not really a big deal. It was a really big deal for a number of generations, partly because language is simultaneously such a high order human capacity, unique to humanness, and appears to be localized, or associated with certain parts of the brain. The idea that something so high level could have a focal spot in the brain—it’s almost like discovering the seat of the soul, or the seat of rationality. So, it energized the field for a number of generations, from the 1860s right through the first World War, in a range of ways. But then, it stopped being of interest. But people still suffered from language loss. What happens if we don’t follow the neurologists to their next research interest, but follow the aphasia patients? It turns out, the neurologists were much more interested in the implications of language loss than helping the people who suffered from language loss improve. They were not very interested in rehabilitation. But, of course, patients don’t really care about being interesting cases. They want to have a life, and go to work, have a family. So, who ends up actually driving the story of rehabilitation? It turns out that there were people that came out of elocution schools, who were very low level, mostly female workers. Some of them had training in elementary school education, because the view was the aphasia patients had become like children. And there’s a whole story about these women, who are barely characters in most histories of aphasia, actually creating a field of rehabilitation. Why isn’t that important? Why isn’t that part of what we think about? What the field is interested in is the Broca brain in a vat at a museum in Paris, with a big hole in it where the famous patient Tan had the stroke. Now, I’m not saying that’s not a story. But what if it’s not the story?
About the Author
Raj Sastry is a sophomore at Harvard College concentrating in History and Science with a secondary in Global Health and Health Policy.