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Challenging research assumptions

The three papers (Birtchnell, 1973, 1974 and 1978) represent a turning point in my approach to psychiatric research. Together, they expressed a disillusionment with the approach upon which, up to that point, I had exclusively relied. A number of colleagues experienced these papers as a criticism of, if not a direct assault upon, them. Whilst, in part, they may have been this, much more they were a criticism, if not a direct assault upon myself. How could I have been so naive as to believe that meaningful connections could be made between such simple and easily measurable variables as death of a parent or order of birth and the development of psychiatric symptoms later in life? Life is much more complicated than that.

The problem was, of course, if I abandoned this approach, what could I replace it with? If every person's life is unique, how is it possible to gather together numbers of individuals who have a common experience that would amount to a single variable? Over the next few years, I spent much time cataloguing individual life histories. In particular, I studied the case records of women (identified from the North Est of Scotland Psychiatric Case Register) of a large number of early bereaved women. Eventually, I chose a middle way, and decided to collect more detailed data on selected samples, but much of these data have remain unanalysed. (See the next two sections).

The (1983) paper on the life histories of suicidal patients (see previous section on suicidal behaviour) and even the (1975) analysis of the art productions of a dysmorphophobic patient (see section on Art and Art Therapy) were the result of this more detailed approach.


Birtchnell, J. (1973) How appropriate is the epidemiological approach to the investigation of the familial causation of mental illness? British Journal of Medical Psychology, 46, 365‑371.

Birtchnell, J. (1974) Is there a scientifically acceptable alternative to the epidemiological study of familial factors in mental illness? Social Science and Medicine, 8, 335‑350.

Birtchnell, J. (1978) The peculiar problems of psychiatric research. British Journal of Medical Psychology, 51, 113‑118.

Birtchnell, J. (1981) The use of the computer in life history research. Behaviour Research Methods and Instrumentation, 13, 624‑628.

Birtchnell, J. (1983) Verbal description versus numerical analysis in psychiatric research. In Calhoun, J.B. (Ed.) Environment and Population: Problems of Adaptation. Praeger: New York.