Appointments After returning from Germany, Southard interned in pathology at
Boston City Hospital and became an instructor at Harvard Medical School in 1904. From 1906 to 1909, he was an assistant pathologist at
Danvers State Hospital. Socially, he participated in the
Wicht Club with other young Harvard scholars beginning their careers. In 1909 Southard was named assistant professor of psychology at Harvard University and Bullard Professor of Neuropathology at Harvard Medical School, titles he held until his death. That year, he also became a pathologist for the Massachusetts Commission on Mental Diseases. and Southard developed
lymphangitis in his arm, undergoing aggressive surgery and recovering over several months. Although he wrote an outline of his autobiography and traveled extensively in Europe during his convalescence, he felt unable to concentrate on research and referred to this period as "the wasted year". Southard led the
Boston Psychopathic Hospital, which had opened as a department of
Boston State Hospital, from 1912 until his death. Southard was a past president of the
American Medico-Psychological Association, and was president of the Boston Society of Psychiatry and Neurology at his death. Other professional memberships included the
American Genetic Association, the National Epilepsy Association, the American Association of Pathologists, the
Massachusetts Medical Society and the Society of Experimental Biology. He served in an editorial capacity for several publications, including the
Journal of Nervous and Mental Disease. Led by biologist
Charles Davenport, the ERO lobbied for state sterilization laws and restrictions on U.S. immigration. Public approval of the office waned during the 1930s (when eugenics became associated with
Nazism), and the ERO closed in 1939. Southard coined the word "
cacogenics" for the study of racial decline.
Professional contributions Southard studied the organic basis of mental illness at a time when two camps of professionals (known informally as "brain spot men" and "mind twist men") debated the biological and behavioral origins of psychiatric disorders. His neuropathological perspective was eclipsed after his death by the "mind twist" hypothesis of mental illness promoted by the
dynamic psychiatry (or
psychobiology) of Adolf Meyer and the psychoanalytic perspectives of
Sigmund Freud,
Carl Jung and
Alfred Adler. Although physiological theories of "autointoxication" were explored in U.S. psychiatry before 1940, Southard had rejected them many years earlier. During the World War I era, Southard conducted early studies of
shell shock. He believed that shell shock resulted from the mind's inability to align the sensory experiences of war with other life events. Southard said that this process, which could also have physical causes, resulted in disorientation and transformed the events of war into a mental condition. In
Shell Shock and Other Neuropsychiatric Problems, he called the term "shell shock" advantageous because it "compared with the more acutely terrible and life-in-the-balance thing we know as traumatic or surgical shock." The condition initially captured public interest, at least in part because it was said to be caused by a traumatic force to the head. Once shell shock was no longer thought to result from physical injuries, patients were stigmatized and arguments over its cause interfered with effective treatment. Southard delineated several priorities for his scientific work and writing. He hoped to publish four books; the first would cover observations from his research laboratory made between 1906 and 1919. The second book, on clinical work he had done at Boston Psychopathic since 1912, he hoped would increase enthusiasm for psychiatric hospitals. The third would report on the expansion of psychiatric social work, and the final work (a requirement of his academic post) would be an overview of neuropathology. In 1924, a bronze table by sculptor
Bashka Paeff was installed in the reception of the hospital in his honor, Although Southard expressed a great deal of interest in research, he was most inclined to work on the classification, nomenclature and definition of psychiatric and philosophical concepts. He said he realized that such work was ridiculed by many, but a "psychiatric dictionary (to include definitions of every near-lying psychological and philosophical term also) would do more to push mental hygiene on than any other single thing I can think of." Southard proposed an eleven-category classification system for psychiatric diagnoses, which was not adopted. He was particularly interested in
dementia praecox (which he favored renaming
schizophrenia), and found diffuse anatomic differences in the brains of schizophrenic patients. Shortly before his death Southard wrote and presented
Non-dementia non-praecox: note on the advantages to mental hygiene of extirpating a term, but did not live to see it published. Southard and Mary Jarrett founded the field of psychiatric social work, applying psychiatry to industrial employees.
The Kingdom of Evils, a book on psychiatric social work by Southard and Jarrett, was published after his death. In his introduction to the book, physician
Richard Cabot wrote that it highlighted the collaboration between doctor and social worker; the physician excels at diagnosis, and the social worker is better able to provide resources for treatment.
Influence At Danvers State Hospital Southard met
Myrtelle Canavan, with whom he worked and published in neuropathology for the next few years. When Canavan received a tempting job offer from the
Pennsylvania Hospital for the Insane, in his capacity with the Massachusetts Commission on Mental Diseases, Southard petitioned the board to create a position for her as his assistant, and her salary was enough for her to refuse the Pennsylvania offer. Southard had considerable influence on the early career of comparative psychologist
Robert Yerkes. and Yerkes received a half-time appointment at Boston Psychopathic with Southard from 1913 to 1917. Shortly afterwards, Yerkes was elected president of the
American Psychological Association and developed the U.S. Army's mental testing program during World War I. In his autobiography, Yerkes called Southard "my master of psychopathology." ==Personal life==