Fifteen Questions: Anne Harrington on Hist of Sci, Mental Health, and Ice Cream

Anne Harrington ’82 received an undergraduate degree in History and Science from Harvard and then received a modern history doctorate from Oxford. She is the Franklin L. Ford Professor of the History of Science and also serves as the Faculty Dean of Pforzheimer House. This interview has been edited for length and clarity.

FM: Could you tell me about your favorite class that you’ve taught?

AH: The hardest class, but also the class that in some sense, has meant the most to me, was my Gen Ed class on Madness and Medicine. That course probably shaped me, surprisingly, as much as it shaped the students I taught. In the end, it inspired me to write a book that was published in 2019, called “Mind Fixers,” that I dedicated to the students in that Gen Ed class. I became convinced that I was unable to do justice to one of the most important developments in the recent history of psychiatry, and I was inspired by the questions asked by those students to figure out the answers. Why is it that so suddenly, and without much warning, the whole field of American psychiatry pivoted away from previous psychotherapeutic and psychosocial understandings of what mental suffering is? How come, sometime in the 1980s, everyone’s decided, apparently, all together, that it’s all about drugs, it’s all about chemistry, and it’s not about context or biography? There had been no new science and no new treatments to justify it. So there needed to be a different explanation for why we ended up in the world that we did.

FM: Why did that shift happen?

AH: The field of psychiatry had been dominated by the psychoanalysts and the psychosocially oriented thinkers that embraced a very expansive vision of what they were doing that hardly seemed like it had anything to do with medicine at all. That came back as a starting point for a whole wave of radical critiques of the mental health professions, which argued that they seemed more in the business of disciplining people than of curing them, and that there doesn’t seem to be any medical agenda here, so why are they claiming to be doctors?

There was a very major project that they had undertaken that had to do with emptying the mental hospitals and moving people into the so-called community that was inspired by this broad way of thinking. And it was the families of many of the patients that had been moved out of the hospitals and into the so-called community that pushed back and said, “It’s time to re-medicalize.” They provided a space for the biologically oriented psychiatrists who had been out of power to step up and say, well, the field has pushed itself to a point where it’s at risk of making a laughingstock of itself. Of course, there’s such a thing as mental illness; of course there’s a biology to mental illness; we need to get back to brass tacks.

What the general public tended to believe was that there must have been a biological, scientific reason for the shift in power, but it was really more of a rhetorical move. It was one in which they said, put us in power and we will figure out the biological basis of schizophrenia and depression. Give us money, have a “decade of the brain,” give us MRI machines, and we will figure this out, but they really never did.

Right now, the field is in a place where there is a tremendous ambivalence about psychiatry’s ability to really say what it knows or doesn’t know about mental illness. And, I hope, maybe an appetite to pull back from hegemonic ways of thinking about what causes mental illness and bring back voices that got marginalized in the ’80s.

FM: History of science combines two different fields into one. What distinguishes it from history?

AH: There are a lot of universities where history of science is simply embedded in history departments, so it’s a very fair question. We are a university where it’s been decided that there is value in having a separate department. And the benefit of maintaining the separate department is that it allows us to expand the purview of things that can be studied. We offer students this opportunity to combine historical studies with in-depth scientific coursework, to produce social and scientifically literate social scientists.

FM: To be a good historian of science, how much actual science should you know?

AH: It kind of depends on what you’re measuring and what you’re doing. I couldn’t have written my book “Mind Fixtures ” if I hadn’t understood the biochemistry and the pharmacology. I don’t think it’s an ideological position that you have to have a certain amount of science in order to do the field well, because it would depend on the question you’re asking. But I do think you ask more interesting questions as an historian of science, if you really lived in the world of science in some sustained way. There’s something about the hands-on experience of doing science that makes you a more thoughtful historian.

FM: What do you try to do to make sure that you’re up to date on what’s going on in the science world?

AH: For six years, I co-directed Harvard’s Mind Brain Behavior Initiative, which had the wonderful educational value of exposing me on a very regular basis to how scientists think and their understandings of where their fields were going. You embed yourself in a community that pushes you, and that Mind Brain Behavior Initiative was a wonderful way to do that. I also have close colleagues in the psychology department.

FM: How did you get into history of science?

AH: I came as a first-year thinking I had figured everything out and I was going to be an English concentrator. I thought science was just tedious things you had to learn in textbooks, and I didn’t see the beauty.

Then everything fell apart in a really constructive way. Basically, I felt the world was too dangerous to simply become an English person. I continued to love English literature and wrote poetry and did all these other things, but I was very, very worried about nuclear war. I took a Gen Ed class called “The Astronomical Perspective.” The instructor invited scientists who had been involved in the Manhattan Project to come to class. I remember going into Science Center B, and I was very worried about the world blowing up, and these are the people that had done it. So who were these giants who had brought these godlike powers into the world? I came in, and they were these little wrinkly gray guys who basically said that they hadn’t quite appreciated all of the implications of what they had done, and got all caught up in the technical interest of the project, and then they basically said they saw no solution. It was going to be up to us to figure out what to do about all the awesome and horrible powers they brought into the world. I left Science Center B furious with the grownups.

And then it became, well, how do I live with my anger and my fear? And history of science became a kind of responsible avenue for working through my quarrel with science, for trying to understand the disconnect between the scientific developments and moral responsibility. So I kind of went to the history of science initially to try and save the world. But it was a kind of a dark space in the history of science that I moved into, and it actually wasn’t where the love was. The love for me was really about where human beings fit into the universe, and I was fascinated by consciousness. It seemed to me to be the most mysterious thing because everything else was big, empty, silent space and then one infinitesimally tiny bit of the universe woke up and looked around, and I couldn’t wrap my mind around this, and I didn’t think the scientific story made any sense of this.

In the end, I ended up following the love rather than the fear. I got involved with the history of the brain sciences and all the sciences that are interested in the human mind, but then found other ways to connect that interest to the kind of activist impulses that originally brought me into the field, but now focused more on social justice and equity and centering human suffering and looking at ways that the scientists do or don’t do justice to it and alleviate it.

FM: Who’s been a mentor in your life and what impact did they have on you?

AH: As an undergraduate, one of my mentors and sources of inspiration was a now retired but still living emeritus professor of the history of science, Everett Mendelsohn. At this point in time, I decided I wanted to go into academics, I wanted to get a PhD. But I was worried that if I did that, I would lose touch with the social activist instincts and concerns that I had. Wouldn’t I just become part of the ivory tower? But he had been someone who had, throughout his career, maintained a very strong commitment to important social causes and intellectual and scholarly agenda.

I went to him as a senior, and I was very shy back then, so it took a lot of courage for me to ask him, how had he done it? And one of the nicest things happened. He said, “That’s a really good question, and it’s too important a question to just answer on the spot, let’s go have lunch.” And he took me out to Bartley’s Burgers and he talked to me about how he had done it. Basically, he said, you just have to make a commitment. There won’t be time leftover, there’s never enough time, but you make a commitment, and you carve the time out, and you make it part of your life. And that freed me to go to graduate school and become a professor.

FM: Is there anything that you are trying to do now in that activist mindset, bringing that forward?

AH: I think of my book “Mind Fixers” as an intervention and not just a piece of history. I’m in the process of developing a project that will look at the brain disorder, actually, and what would happen if we told stories about say, neurology or the brain sciences in ways that didn’t assume that the only interesting actors were the scientists and the doctors, but centered the neurological patient and their families. There’s this profound ethical and political power in that simple act of re-centering. So, my activism is not as much as it used to be about going out, getting on buses to go to DC. It’s now much more about offering alternative possible ways of making less visible people visible to the people in power.

FM: What lessons do you think that people in modern times should be taking from the history of science to deal with mental health now?

AH: One of the things you notice, if you look at the history of the mental health care system, is the repeated arrogance and the premature claims to victory. I actually have a tremendous amount of respect for mental health care workers. But there are structural factors that have tended to prioritize professional status and profit over less profitable and less prestigious needs of suffering people.

What if it turned out that one of the most important things you could do for a chronically and seriously mentally ill person was not to discover what’s wrong in his or her brain or even find a better medication — that’s not saying that’s not important — but the best thing you could do for that person would be to get them an apartment. That might not feel medical, and then maybe that doesn’t feel like it’s aligned with the professional goals of the field, so then you have to share power.

One of my hopes is that we might be able to move to a world in which there is an ecosystem of mental health care workers, some of which have a medical mission, and some of which have a psychosocial mission and some have much more of a social worker mission, and that there is a mutual respect and sharing of power and understanding that whatever we do in any single moment we center the patient.

I think people will respond to what I’ve just said, by saying, oh, we do that. They’re already social workers and clinical case workers and psychologists. And that’s not wrong, but it tends to be organized within a hierarchy, where the medical mission and the biological vision and the research agenda stands at the top of the totem pole. And I just feel if we could flatten our hierarchies, and deepen our knowledge of what helps on across all of these spectrum of care that patients need, it would serve the patients better.

FM: In a 2018 survey, some 46 percent of Harvard students reported mental health concerns. What do you think needs to be done to support them?

AH: This is a question that universities and colleges across the country are asking. Harvard students are both unique, and also very typical in the sense that it’s been exacerbated, as we all know, by the isolation and the strains and anxieties brought on by the pandemic. I don’t want to give a glib answer like, “here’s what we should do.” What I would say, though, is that not all forms of mental suffering or mental distress are necessarily disease. Suffering from anxiety may or may not always be best served by embedding the understanding of what’s wrong and how to fix it in a medical model. If we allowed that there could be a spectrum of things that could help, some might involve medication, some might involve therapy, some might involve speaking to a chaplain. I think we constrain our ability to help people by prematurely medicalizing all forms of distress.

FM: What is your favorite thing about being Pfoho House Dean?

AH: It gives me an excuse to play. I have to take people snow tubing, it’s my job, what can I do? I have long kind of felt it’s been a not-so-secret excuse to have fun in ways that I probably wouldn’t allow myself otherwise. Not everything always has to be deep. The house system and the things that we do can bring some lightness to everyone’s life, including the faculty deans’.

FM: What’s your favorite Pfoho house tradition?

AH: We have a program called Pfoho Pforays, and they are excursions that follow the arc of the seasons. In that, the thing that has been the most amazing foray we’ve done has been a four-day dog-sledding and winter camping excursion. We take about 20 students to western Maine, right near the Maine-New Hampshire border, and they learn how to mush teams of sled dogs and spend two nights sleeping out in canvas tents by a frozen lake.

FM: Do you have a favorite place on campus that you like going to?

AH: I think the Quad is great, I really do. How can we move people’s minds and hearts a little bit on this issue? You go on to the Quad lawn on a sunny day with Adirondack chairs, and maybe there’s a mom with a baby toddling around, and kids are there doing their homework, and the sky is blue, and it’s so peaceful. It’s just like a home.

FM: What do you tell freshmen who are sad about being Quadded on Housing Day?

AH: I say come up and see us. As a place to live, and as a community in its own right, I think once people get up there and see the amenities and meet the people, they wipe away their tears and they settle in.

FM: On the Pfoho website it says that you think ice cream should be its own food group. Of all the ice cream shops in and around Harvard Square, what’s your go-to?

AH: Partly because I like ice cream so much, I don’t go too much. Honeycomb Creamery is the fancy place. I actually quite like J.P. Licks, that’s my go-to if I’m with friends or family. Toscanini is a little bit out of the way, but when I go kayaking with students, we go to Toscanini. How can you choose? It really depends on the mood, the moment, where you are. Ice cream is always good.

— Associate Magazine Editor Io Y. Gilman can be reached at io.gilman@thecrimson.com.