walkitout (walkitout) wrote,
walkitout
walkitout

Leo Kanner _Child Psychiatry_,

I'm not entirely sure which edition this is. It's a 1942 3rd printing; Kanner produced at least two later _editions_.

I picked up the one book by Kanner that I could get through the local library system (without resorting to ILL). He seems like a really sensible man, even from the perspective of 2012 and to say that about _any_ psychiatrist from the 1930s seems almost incomprehensible to me.

I haven't read the whole thing; I started by sampling some areas of particular interest to me. The section on epilepsy separates out "pyknolepsy" from absence or petit mal seizures but it seems Kanner had some reservations about it as a separate category and shows some opposition to actually diagnosing it except retrospectively. His treatments list for epilepsy includes a section on dietary management that includes a ketogenic diet which has been in the news again recently.

Immediately before the section on epilepsy is a section on sexual disorders in children, which leaves me with mixed emotions. On the one hand, the last section ("The Child as an Object of Sexual Practices"), while short, would be tough to improve on, right down to the last two prescriptive sentences (sex ed will make kids wary of sexual predators and parents should know who their kids are around -- this after pointedly saying that parents and teachers _need_ to be aware that this kind of thing can happen in any neighborhood). On the other hand, the section entitled "Homosexual Activities" is less positive. Not freaking out about a same-sex crush in childhood, well, that's probably good. A couple of rather harrowing examples (an older boy sexually abusing younger boys after seeing other boys do the same, and a man sexually abusing a boy) later, Kanner directly addresses the born-this-way question:

"In these two and many other cases the theoretical question [ouch!] as to whether there exists such a thing as a congenital homosexual tendency is certainly of much less practical significance than the concrete facts which obviously led up to the boys' performances." *sigh* The balance amounts to, a well run home/family will identify "such influences" early and deal with them without freaking out. He doesn't _say_ that'll prevent all homosexuality but the reader is certainly invited to assume that. Probably this was the safest thing to say at the time?

This sentence, "Fellatio (immissio membri in os) is a surprisingly frequent form of boys' overt homosexual activities" suggests all kinds of entertaining things about (a) how sheltered Kanner was growing up as well as (b) just how many stories he heard along these lines as soon as he started his practice.

The last example in this section is a true mess and while it's clear Kanner wished he could have extracted the kid from the situation, it's less clear how Kanner thinks the kid should have been directed if he could have been removed from his stepmother (who also wanted him gone).

Kanner's attitude in "Fetishism" is deliciously low-key: he thinks nobody should get too worked up about it, even if some adults with fetishes say they started in childhood.

Kanner's description of thumbsucking and its treatment is notable in its skepticism of the typical approaches AND correct understanding of how those approaches can take an existing real problem and add to that something else even worse.

I'll continue to read this on and off; I'm surprised at just _how_ readable it is. I'll also take a look around and see if I can find any of his later work, perhaps a later edition of this book.

ETA:

Here's a review of the 3rd edition.

http://ajp.psychiatryonline.org/article.aspx?Volume=115&page=952&journalID=13

Link to full pdf can be found on the page.
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