Emmanuel Movement - Medical Background: Cabot, Pratt, Putnam and Coriat

Medical Background: Cabot, Pratt, Putnam and Coriat

Boston was the center of a local "medical psychotherapy" tradition going back to the 1890s when William James, Josiah Royce, Hugo Munsterberg and Boris Sidis developed individualized techniques for the relief of mental distress. The psychiatric professionals of the 19th century, alienists and neurologists, were primarily concerned with severe pathology such as schizophrenia and mania. Little attention was paid to milder mental conditions. The New England psychopathologists, in contrast, dealt with the problems of those who were more or less functional but unhappy. They treated patients with anxiety or depression or in the grip of compulsive behaviors. James Jackson Putnam (1846–1918), Harvard's first professor of diseases of the nervous system and a founder of the American Psychoanalytic Association, was influenced by this tradition of eclectic therapy. He saw the Emmanuel movement, with its synthesis of psychology and "moral" treatment, as a positive development. His support was important in the reception of the movement by the orthodox medical community.

Dr. Richard C. Cabot, chief of medicine at Massachusetts General Hospital from 1912 until his retirement, was an innovator in both medical education and psychosocial medicine. He introduced the first weekly "Grand Rounds," now traditional in teaching hospitals, and was a pioneer in the integration of social work and medicine. Cabot wrote popular books on counseling, ethics and religion which reflected his continuing loyalty to the philosophy he had learned under Josiah Royce.

Dr. Joseph Pratt (1872–1956) received his degree in medicine (1898) from Johns Hopkins University School of Medicine, where he studied under William H. Welch and Sir William Osler. He joined Cabot's tuberculosis clinic at Massachusetts General Hospital in 1903. From 1927 he served as chief of medicine at the Boston Dispensary and professor at Tufts University School of Medicine. The Pratt Diagnostic Clinic at Tufts Medical Center is named in his honor. Although tuberculosis was then endemic in urban areas, treatments in vogue were labor-intensive and available mainly to the affluent. If there was any hope of offering this sort of care to the poor, Dr. Pratt realized that working with groups of patients and care-givers would be necessary. He also had a lifelong interest in the influence of psychosocial factors on physical and mental illness, so he had confidence in the value of integrated support systems.

Dr. Isador Coriat (1875–1943) was a Tufts neurologist/psychopathologist whose major professional influence was Morton Prince. Unlike most of his medical colleagues, Corait was the son of Jewish immmigrants of limited means. He had entered medical school directly from the public school system and began his medical career at Worcester State Hospital under Dr. Adolf Meyer. As a member of the first generation of American psychoanalysts, he was a link between 19th century experimental psychology and 20th century dynamic psychiatry.