The relationship between prisons and mental illness has preoccupied prison administrators, physicians, and reformers from the establishment of the modern prison service in the nineteenth century to the current day. Here we take the case of Pentonville Model Prison, established in 1842 with the aim of reforming convicts through religious exhortation, rigorous discipline and training, and the imposition of separate confinement in its most extreme form. Our article demonstrates how following the introduction of separate confinement, the prison chaplains rather than the medical officers took a lead role in managing the minds of convicts. However, instead of reforming and improving prisoners’ minds, Pentonville became associated with high rates of mental disorder, challenging the institution’s regime and reputation. We explore the role of chaplains, doctors, and other prison officers in debating, disputing, and managing cases of mental breakdown and the dismantling of separate confinement in the face of mounting criticism.
The December 2017 issue of History of Psychiatry is now online. Articles in this issue explore connections between psychology, psychiatry, and philosophy, nineteenth century insane acquittal policy, LSD experiments in the United States Army, the use of ECT for mass killing by the Nazis, and much more. Full details below.
“Con Drury: philosopher and psychiatrist,” by John Hayes. Abstract:
Maurice O’Connor Drury (1907–76), an Irish psychiatrist, is best known for his accounts of his close friendship with the eminent twentieth-century philosopher, Ludwig Wittgenstein. His only book, The Danger of Words (1973), was well received by those who had an interest in the relationship between psychiatry, psychology and philosophy. This article concentrates on Drury’s experiences, studies and writings in these fields.
“Insane acquittees and insane convicts: the rationalization of policy in nineteenth-century Connecticut,” by Lawrence B Goodheart. Abstract:
A current situation in Connecticut of whether a violent insane acquittee should be held in a state prison or psychiatric facility raises difficult issues in jurisprudence and medical ethics. Overlooked is that the present case of Francis Anderson reiterates much of the debate over rationalization of policy during the formative nineteenth century. Contrary to theories of social control and state absolutism, governance in Connecticut was largely episodic, indecisive and dilatory over much of the century. The extraordinary urban and industrial transformation at the end of the Gilded Age finally forced a coherent response in keeping with longstanding legal and medical perspectives.
Blumenthal offers a historical examination of the jurisprudence of insanity, legal capacity, and accountability from post-revolutionary America through the nineteenth century. Americans struggling to set the boundaries of ordered liberty turned to Common Sense philosophy that held to divinely given rational faculties of intellect, volition, and moral sense. Republican citizenship assumed that a reasonable man, as a legal person, would act accordingly. The market economy of self-made men, the new field of medical psychology, will and contract challenges over wealth and property, tort law and increased liability claims exposed the inadequacy of social and political norms in defining human fallibility, and the limits of responsibility. Litigants, lawyers, judges, and medical experts struggled to find a reliable way to settle issues of mental competency and define the bounds of freedom. The incapacity of married women, children, and slaves provided a means of comparison for the male citizen involving metaphysical, political, social, and economic ideas wrapped up in the concept of self-government. Blumenthal has produced a remarkable piece of intellectual and legal history situated in the rapidly changing market environment of a young republic.
A recent article in the Bulletin of the History of Medicine may be of interest to AHP readers. Exploring the happenings at the New York State Lunatic Asylum, Kathleen Brain describes how the antebellum asylum asserted ownership over the prevention of suicide and the ramifications of this claim. Full details below.
““The Weight of Perhaps Ten or a Dozen Human Lives”: Suicide, Accountability, and the Life-Saving Technologies of the Asylum,” by Kathleen M. Brian. The abstract reads,
By accounting for the law’s productive capacity to structure asylum physicians’ encounters with suicide, this essay argues that the antebellum asylum was a technology for the preservation of life. The essay first shows how suicide’s history as a crime encouraged popular attributions of suicide to insanity. What began as a tactic to protect survivors, however, ended by bolstering the professional claims of asylum medicine. Initially it appeared there was much to gain from claiming suicide as their own, but dominion over prevention in fact rendered asylum physicians and their staffs vulnerable in unanticipated ways: for while agents of suicide were effectively evacuated of legal responsibility, a variety of laws made physicians more accountable than ever. Focusing on medical superintendent Amariah Brigham and his staff at the New York State Lunatic Asylum shows how the anxiety of assuming guardianship over the suicidal created networks of accountability that profoundly affected daily life.
The March 2017 issue of History of Psychiatry is now online. Guest edited by Chris Philo and Jonathan Andrews, this special issue explores “Histories of asylums, insanity and psychiatry in Scotland.” Full titles, authors, and abstracts follow below.
“Introduction: histories of asylums, insanity and psychiatry in Scotland,” by Chris Philo and Jonathan Andrews. The abstract reads,
This paper introduces a special issue on ‘Histories of asylums, insanity and psychiatry in Scotland’, situating the papers that follow in an outline historiography of work in this field. Using Allan Beveridge’s claims in 1993 about the relative lack of research on the history of psychiatry in Scotland, the paper reviews a range of contributions that have emerged since then, loosely distinguishing between ‘overviews’ – work addressing longer-term trends and broader periods and systems – and more detailed studies of particular ‘individuals and institutions’. There remains much still to do, but the present special issue signals what is currently being achieved, not least by a new generation of scholars in and on Scotland.
“A ‘Scottish Poor Law of Lunacy’? Poor Law, Lunacy Law and Scotland’s parochial asylums,” by Lauren Farquharson. The abstract reads,
Scotland’s parochial asylums are unfamiliar institutional spaces. Representing the concrete manifestation of the collision between two spheres of legislation, the Poor Law and the Lunacy Law, six such asylums were constructed in the latter half of the nineteenth century. These sites expressed the enduring mandate of the Scottish Poor Law 1845 over the domain of ‘madness’. They were institutions whose very existence was fashioned at the directive of the local arm of the Poor Law, the parochial board, and they constituted a continuing ‘Scottish Poor Law of Lunacy’. Their origins and operation significantly subverted the intentions and objectives of the Lunacy Act 1857, the aim of which had been to institute a public district asylum network with nationwide coverage.
““The Glamour of Arabic Numbers”: Pliny Earle’s Challenge to Nineteenth-Century Psychiatry,” by Lawrence Goodheart. The abstract reads,
A well-established interpretation associates the nineteenth-century psychiatrist Pliny Earle’s deflation of high cure rates for insanity with the onset of a persistent malaise in patient treatment and public health policy during the Gilded Age. This essay comes not to praise Earle but to correct and clarify interpretations, however well intentioned, that are incomplete and inaccurate. Several points are made: the overwhelming influence of antebellum enthusiasm on astonishing therapeutic claims; the interrogation of high “recovery” rates begun decades before Earle’s ultimate provocation; and, however disruptive, the heuristically essential contribution of Earle’s challenge to furthering a meaningful model of mental disorder. In spite of the impression created by existing historiography, Earle, a principled Quaker, remained committed to “moral treatment.”
“Constitutional Therapy and Clinical Racial Hygiene in Weimar and Nazi Germany,” by Michael Hau. The abstract reads,
The paper examines the history of constitutional therapy in Weimar and Nazi Germany. Focusing on Walther Jaensch’s “Institute for Constitutional Research” at the Charité in Berlin, it shows how an entrepreneurial scientist successfully negotiated the changing social and political landscape of two very different political regimes and mobilized considerable public and private resources for his projects. During the Weimar period, his work received funding from various state agencies as well as the Rockefeller foundation, because it fit well with contemporary approaches in public hygiene and social medicine that emphasized the need to restore the physical and mental health of children and youths. Jaensch successfully positioned himself as a researcher on the verge of developing new therapies for feeble-minded people, who threatened to become an intolerable burden on the Weimar welfare state. During the Nazi period, he successfully reinvented himself as a racial hygienist by convincing influential medical leaders that his ideas were a valuable complement to the negative eugenics of Nazi bio-politics. “Constitutional therapy,” he claimed, could turn genetically healthy people with “inhibited mental development” (geistigen Entwicklungshemmungen) into fully productive citizens and therefore made a valuable contribution to Nazi performance medicine (Leistungsmedizin) with its emphasis on productivity.
Since at least the 13th century, artists have been fascinated by insanity. There are literally hundreds of images, most stylised and stereotypic, of ‘madness’ and ‘the madman’ (or woman). When asylums spread across 19th-century Europe, providing a captive population of mad people, artists began to use actual patients as models for their drawings and paintings. These images are often less extreme than earlier portraits, but their typically grotesque emotionality is just as dehumanising.
Patients are treated as specimens, devoid of any context, like tumour cells in a pathology manual. Even in the works of progressive physicians like Pinel or Esquirol, madness is depicted as brutality or as generalised deterioration. Esquirol’s particular interest in pathological types influenced the thinking of generations of psychiatrists and reduced the patient’s whole life to one main symptom (e.g. mania). Of course, today we take this idea far more literally than Esquirol did in the 1830s – current images of madness don’t even show the person, just their hypothesised brain defect.
The Paris Review currently features a beautifully illustrated piece from historian Andrew Scull. In “Madness and Meaning” Scull discusses the many depictions of mental illness – religious, medical, pharmaceutical – produced through history. Read the full piece, and see all the evocative images, online here.
Yes, we do listen to your suggestions! Earlier this summer, historian of psychology Ryan Tweney left us a comment in response to our post about our roadtrip to the Glore Psychiatric Museum in St Joseph, Missouri. Tweney said we might also enjoy visiting the “Lunatic House” in Bowling Green, Ohio – so we decided to make one last trip before fall was officially upon us.
The Lunatic House in Bowling Green is actually a part of a collection of buildings that now constitute the Wood County Historical Center and Museum. The primary exhibits are located in the oldest and largest building on the property: the infirmary. The displays take you through the rooms, floors, and wings of the building – beginning first with the history of the County Home itself before growing outwards to include medical history, technological developments, and a history of Ohio.
The site is quite unique, as one of the last remaining county poorhouses in Ohio with a majority of the original structures still standing. The poorhouse system dates to the early nineteenth century in the Unites States. Individual counties provided residential institutions (often as part of farm land) to house those who were unemployed or otherwise did not have the financial means to support themselves. Much like other states, every county in Ohio opened its own poorhouse. By mid-century, the Ohio General Assembly ordered these facilities to take in a wider population including the infirm, the elderly, and the mentally ill – renaming the poorhouses “infirmaries.” They later took on the name “county home” in 1919. Continue reading One More Summer Roadtrip: Wood County Lunatic House→
A new issue of History of Psychiatry is now online. Included in this issues are articles on racial issues in psychiatry in China and the United States, the admission of medical doctors as patients in English asylums, the history of the insanity defence in Australia, and much more. Full titles, authors, and abstracts follow below.
“Hebephrenia: A conceptual history,” by Abdullah Kraam and Paula Phillips. The abstract reads,
This paper traces the conceptual history of hebephrenia from the late nineteenth century until it became firmly embedded into modern psychiatric classification systems. During this examination of the origins and the historical context of hebephrenia it will be demonstrated how it became inextricably linked with twentieth-century notions of schizophrenia. The first detailed description of hebephrenia in 1871 by Ewald Hecker, then a virtually unknown German psychiatrist, created a furore in the psychiatric establishment. Within a decade hebephrenia was a firmly embedded concept of adolescent insanity. Daraszkiewicz, Kraepelin’s brilliant assistant in Dorpat, broadened Hecker’s concept of hebephrenia by including severe forms. This paved the way for Kraepelin to incorporate it together with catatonia as a subtype of dementia praecox. We recognize Hecker’s hebephrenia in DSM-IV as schizophrenia, disorganized type. Although DSM-5 will probably abolish subtypes of schizophrenia, characteristic features of hebephrenia will be found within the proposed domains of disorganization, restricted emotional expression and avolition.