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Readers of this book soon become aware that it does not cover the broad field suggested by the title. The text is a painstakingly researched document of the history of psychiatry in Boston from about 1910 to about 1930. The author describes the changes in psychiatry at that time and at that place as they related to changes in the culture: mores, ethnicity of the population, economic strata, gender roles, family structure, sexual practices, moral values, the rise of feminism, the beginnings of the profession of social work, the attitudes of psychiatrists toward their patients, the attitudes of social workers toward their clients, and the professional relationships between the disciplines of psychiatry and social work. Lunbeck is an Assistant Professor of History at Princeton University, and her book is based on the historian's methodology of going to original sources. The data were gathered by a detailed review of Boston Psychopathic Hospital records: patients' clinical records, staff conference notes, psychiatrists' notes, social workers' notes, published articles, newspaper stories, and even some patients' correspondence. Quotations from case histories give the reader a sense of personal review of the clinical material available in the time period under study.
The Boston site is carefully described in detail with geographical and sociological expertise. The author is familiar with research from different disciplines, and the book has many references. She aims to acquaint the reader with the cultural milieu of the patients whose psychiatric treatment will become the focus of her book. It is important to understand her view that psychiatric theory and practice develop within a unique social context. Although she does not say so explicitly, she must believe either that the development of this group of psychiatrists influenced all of