Tag Archives: alienists

Insanity and Stereotypes

Patient With Acute Melancholia

I believe that one reason insane asylums became popular–initially–is that they broke down traditional stereotypes about what it meant to be insane. For years, people viewed insanity as both incurable and hereditary. As views changed in the 1830s, hope became possible for families dealing with insanity. Alienists believed the condition could be cured, especially if it were nipped in the bud during what they called the acute phase. Asylums were looked upon as “hospitals for the mind” and alienists held out the possibility of curing diseases of the mind just as they did for diseases of the body.

At the same time, alienists began moving away from the idea that insanity was heredity. This belief shows itself in the many Victorian-era novels where heroes/heroines refuse to marry because of the “tainted blood” they might pass on. Alienists began to think that at most, heredity only gave a predisposition toward insanity, just as it might give a child a predisposition toward certain physical conditions. But, just as “weak lungs” might be prevented through fresh air and exercise, a predisposition toward melancholia, for example, might be thwarted by brisk mental activity, interesting hobbies, social involvement, and so on.

This new thinking was so encouraging for families who had a member with mental health issues!

What Next?

Trans-Allegheny Lunatic Asylum

Writers need to keep busy with writing projects, even though there’s a lot out there to distract us. I’ve been wanting to write a book about insane asylums in general for a long time, and after Vanished In Hiawatha was published, got busy with an outline and some thoughts on how to present the information.

Next came a round of reading and researching, and then the re-immersion into the writing process. It can be a real chore to write again once you take a break from it, but I find that I always enjoy it once I make myself sit down and get started. I finished a couple of chapters and wrote a proposal, hoping to send it out with a quick turnaround–approved, of course!

That hasn’t happened yet, so I am staying busy with an e-book on insane asylums. This will be quite different from the history that I have in mind for a hardback, but it will still give readers a lot of interesting information. I’ve been writing a blog about the Canton Asylum for Insane Indians for several years, and I’ve included many snippets of information about insane asylums in general, their history, and some of the practices and routines followed by many alienists (early psychiatrists). I hope that many readers will gamble on exploring a new topic or diving more deeply into one they’re already interested in with this e-book, since this format is so inexpensive.

Here’s hoping!

The Incurable Insane

Chapin House at Willard Asylum for the Chronically Insane

Alienists believed that early intervention in recent cases of insanity led to high cure rates–at least 40% and perhaps higher. However, patients who did not receive treatment until their cases were advanced or of long standing, were much less likely to recover. (See last post.) These latter were exactly the kind of patients that most families eventually wanted to turn over to asylums, and superintendents were eventually faced with the dilemma of how to use their limited resources most effectively.

Some of those who were interested in this growing problem suggested that special asylums just for the incurably insane be built. Caretaking for such individuals would be cheaper than including them in an establishment that were designed for more acute cases, and wouldn’t drain the staff manpower away from patients who stood a better chance of being cured. Though asylum superintendents didn’t like to spend their resources on the incurably insane, some of them were quite vocal about not building asylums just for these patients.

An article in the American Journal of Insanity (1844) made one superintendent’s position very plain:

— No one can predict which patients might be cured; of the people in that particular asylum, fully one-third couldn’t really be placed into one category or the other.

— Many incurables were simply “monomaniacs” (deranged only on one or two subjects) and sane on all others. Why should they be denied the comforts and amenities given to those who are hopeful of being cured?

— It would be impossible to make sure incurables weren’t abused or neglected. The author of the article said in particular: “In all Asylums, the fact that some are well and soon to leave the Asylum is the greatest safeguard against abuse.”

— If asylums for incurables didn’t have proper staffs of doctors and other appropriate caretakers, how would they be any better than poorhouses?

Others pointed out that to send someone to an asylum for incurables would destroy the individual’s last shred of hope and might well cause him or her to never be cured.

Considered With Care

County Asylum for the Insane, Appleton, Wisconsin

When asylums first became accepted in the U.S., all aspects of their construction came under review. Experts looked for designs that gave good ventilation, access to sunlight, and provided safety. They also considered the asylum’s location very important. Alienists–men trained in mental health care–were convinced that city living contributed to the rise of insanity in the population. They believed that siting an asylum in the calm, restful countryside would help patients get well. It was important, then, that windows in bedrooms or sitting rooms look out on lovely, peaceful views.

Though it’s true that some patients came to asylums simply because it was convenient for their families, many other patients truly needed help of some kind. For women who were distraught or overwhelmed with the care of eight to ten children and all the physical work that fell to housewives in that day, a stay in a country setting might be very beneficial. Patients who were mildly depressed (melancholy) were often helped by a change of scenery and some of the light occupation an asylum offered. Others who had become stressed to the point of mental breakdown by the cares of business or family could get away from the source of their turmoil.

Asylum superintendents came to feel strongly that proper architecture and a small patient population would allow doctors to provide the kind of individual care that would help patients most. Sadly, asylums just got bigger and bigger, and the personal touch began to fade. Asylums turned into warehouses rather than “hospitals for the mind.”