Stories from psychiatry’s past: An introduction
Jennifer Wallis is a doctoral student at QMUL’s Centre for the History of the Emotions. In this, her first post for ThInk, she introduces the subject of her doctoral research and reveals why the history of one asylum in particular caught her attention. As well as being a columnist for ThInk, Jen also runs – with fellow student Mike Finn – asylumscience.com, a blog dedicated to the role of scientific research in the 19th– and 20th-century asylum.
When I tell people that I study the history of psychiatry, I invariably receive one of two responses: “How depressing” or “How fascinating”. In many cases it’s both. Luckily, as I enter the third and final year of my PhD, I’m inclined to say it’s the latter!
Filling in the application form to begin my doctoral studies three years ago, I confidently sketched out a thesis plan that investigated the experience of male patients in the late 19th-century asylum. Having read widely in this area, I was surprised by the relative scarcity of men within the historiography [the written history] of this period. In the 1970s and ‘80s, as feminism began to explicitly inform historical scholarship, the focus was often on the Victorian ‘madwoman in the attic’, and many historical accounts of gender in the asylum remained rather one-sided. I wanted to know what had happened to the men: what was their experience of the asylum?
As any doctoral student will tell you, though, what they plan to do is rarely what they end up doing, and after a few perusals of my archival material my attention was diverted along a slightly different path. There was an element of luck in my choice of case study: the West Riding Lunatic Asylum in Yorkshire. Within its archives were intriguing tales of therapeutic innovation, bacteriological research, and post-mortem examination of the brain. One of the first asylums to be opened under the 1808 County Asylums Act (it opened in 1818), by the later years of the century it was a model of ‘scientific’ psychiatry. In the 1870s it welcomed neurologist David Ferrier into its labs to undertake work on cerebral localisation, some initial results of which he published in the West Riding Lunatic Asylum Medical Reports. The records of the asylum’s everyday work were replete with references to a variety of neurological endeavours. This was far more interesting than the simple social history I’d envisaged at the start!
The life histories of male patients, and the circumstances surrounding their admissions, still remain central to my thesis. It is the men’s bodies inside the asylum, though – how they were interpreted for signs of illness – that has become my key focus. Whilst today we might think of psychiatry primarily in relation to the mind, in the late 19th century the demarcation of the mental and the physical was frequently confused. Many of the men admitted to British pauper asylums at this time suffered from bodily as well as mental illness. The picture was further complicated by those neurological conditions that had a significant impact on the body. Those suffering from ‘General Paralysis of the Insane’ (neurosyphilis), for example, provided a startling illustration of the coexistence of mental and bodily symptoms. In the asylum eyes, teeth, muscles, bones, blood, brains, and cells all came under scrutiny, investigated for what they might reveal about the nature of mental disease.
Whilst many examinations were carried out during the patient’s life, looking at the innermost fabric of the body could only be done after death. As a pauper asylum, the West Riding was able to carry out post-mortem exams in a way that would have been less acceptable in a private institution. Upon admission, a letter was sent to each patient’s family informing them of the protocol for objecting to a post-mortem: it was undertaken unless they voiced their objection directly to the Asylum Superintendent. Not surprisingly, in an age when literacy rates were lower than they are now, many families failed to do this. As a result, the asylum was able to carry out post-mortems on the majority of those patients who died within its walls.
Although it is difficult, and sometimes disturbing to speak of these patients in terms of body parts and post-mortems, as though reduced to mere corporeal objects, there were also instances in which the bodies of asylum patients informed psychiatric practice as much as they were defined by it. Scandals regarding the incidence of bone fractures amongst patients, for example, led to strong critiques of institutional care and informed the advice contained within attendant’s handbooks.
The story of the asylum is, then, rarely a simple one, but the way in which bodies were viewed – how their ‘madness’ was defined and investigated – can, I think, tell us much about both the development of psychiatry and evolving conceptions of mental illness. Over the next few months, I hope to bring you more stories from psychiatry’s past, and I’ll also be investigating how present theories and practices contrast with those of the 19th and early 20th centuries.