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It is also used in Joseph Conrad's novella Heart of Darkness to describe the doctor in the Company headquarters in Belgium.
It also appears in H.P. Lovecraft's 1927 novella The Case of Charles Dexter Ward to describe the doctors who examine the protagonist during his stay at Dr. Waite's psychiatric hospital, as well as in his story Beyond the Wall of Sleep. It is used by Jim Dixon, the protagonist of Kingsley Amis’s novel Lucky Jim, to insult his adversary, Bertrand Welch.
Although currently not highly used, the term "alienist" is still used in psychiatric hospitals to describe those mental health professionals who evaluate defendants to determine their competency to stand trial. The term first arose in the late nineteenth or early twentieth centuries to describe individuals who aided law enforcement in trying to find serial killers. It is believed the term alienist was used because serial killers were considered somewhat alienated from their emotions. Others believe that the term was used because serial killers and others of their ilk were so "alien" in behavior from what society understood as normal.
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