About the Project

This website is the final output of an extra-curricular research project funded by the Undergraduate Research Support Scheme (URSS) at the University of Warwick.

About me and my research interests

I am a recent graduate of the University of Warwick’s History Department and have a keen interest in the history of psychiatry. Specifically, I am interested in exploring the historical definition of ‘mental illness’ in different societies and understanding the cultural and social context of that categorisation. One of the original contributions to this field of historical inquiry which caught my attention was Michel Foucault’s Madness and Civilization. In the preface Foucault writes, ‘madness and non-madness, reason and non-reason are inextricably involved: inseparable at the moment when they do not yet exist, and existing for each other, in relation to each other and in the exchange which separates them’^[1]. Foucault, as this quote illustrates, argued in Madness and Civilization that whatever is categorised as ‘mad’ or ‘mentally ill’, in a society, is closely connected to what is categorised as ‘sane’. Although Focuault’s arguments have been disputed by scholars from multiple disciplines, the concept presented in his book, and encapsulated in the quote above, continues to draw my attention.

Thus far, I have investigated my research interest by analysing the rise of asylums and the introduction of moral treatment in nineteenth century Britain, and the United States. I was drawn to this period because of the rapid changes in mental health infrastructure as a consequence of changes in social attitudes towards mental illness. As multiple scholars have argued, social attitudes towards madness shifted when moral treatment made madness ‘curable’.^[2] In consequence of this shift in social attitudes, political attitudes also shifted and policy reflected the idea that society had a duty to publicly cure the insane. However, notably, the ‘medical’ justification of institutionalisation came later.^[3] Therefore, the rapid construction of asylums as a consequence of changing social ideas about mental illness in the United States and Europe presented as a good starting point for my historical inquiries. The nuance to my research is my methodology as I frame my research around sources which represent the patient’s perspective on their treatment during the described period of change.

A key methodology I have implemented is ‘the patient’s voice’, which was popularised by Roy Porter in 1984.^[4] In 1984, Porter argued that medical ‘history from below’ was necessary to more completely understand historical systems of medical treatment. To incorporate the patient’s voice into historical research historians must use sources written by patients. I have sought to engage with the patient’s voice by analysing patient-run periodicals from the nineteenth century to answer my key research interest: what did patients think about the rapidly changing infrastructure and social ideas of mental illness? I find patient-run periodicals a fascinating source due to the issue of censorship. Patient-run periodicals served as an opportunity to speak with the public when, in the mid-nineteenth century, many patients were restricted from communicating with family and friends while a patient in an asylum.^[5] As such, patient-run periodicals can be used to expose what parts of the ‘world within’^[6] the medical staff of these ‘benevolent’ institutions did not want the public to see. However, as this research will display, asylum attitudes towards patient’s engagement with the public did vary in the mid-nineteenth century. I plan to continue to seek answers to this question at the University of Oxford while reading for a MSc in the History of Science, Medicine and Technology.

^[1] Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason, trans. by Richard Howard (London: Tavistock Publications, 1967), p. xii.

^[2] Peter Conrad and Joseph W. Schneider, Deviance and Medicalization: From Badness to Sickness (New York: C. V. Mosby, 1980); David J. Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic (Boston: Little, Brown and Company, 1971).

^[3] Constance M. McGovern, Masters of madness: Social Origins of the American Psychiatric Profession (London: University Press of New England, 1985).

^[4] Roy Porter, ‘The Patient’s View: Doing Medical History from below’, Theory and Society, 14.2 (1985), 175-198.

^[5] For restrictions of communication at REA see: Allan Beveridge, ‘Life in the Asylum: patients’ letters from Morningside, 1873-1908’, History of Psychiatry, 9.36 (1998), 431-469.

^[6] See: Erving Goffman, Asylums: Essays on the social situation of mental patients and other inmates (New York: Doubleday, 1961).

Aims of the project

This project’s aim was to use the patient-run periodical Morningside Mirror to engage with patient’s opinions on their treatment and the contemporary social understanding of mental illness. Alongside this, I hoped to learn more about the everyday life of those writing the periodical in the Royal Edinburgh Asylum.

Methodology

Methodologically, I placed the Mirror at the centre of my research. Before I entered the archives, I read a wide range of historiography concerning: moral treatment; the rise of asylums in the nineteenth century; the function of the patient-run periodical, and on Royal Edinburgh Asylum.^[1] To begin with, I read all seven volumes of the Morningside Mirror as I wanted to take the source at face value before evaluating to what extent the periodical was censored. This followed the methodology adopted by Roy Porter in his book A Social History of Madness: Stories of the Insane by taking the words of those writing the Mirror at face value without trying to decode or analyse them.^[3] In doing so, I hoped to learn what they believed was important to publish in the Mirror before exploring why they felt it was important.

After reading the Mirror, I consulted the following sources:

Case books from the East House (1844-1853). The case books detail each patient’s medical history upon admittance and their state of insanity throughout their stay. Medical staff wrote updates weekly, monthly or yearly on the state of the patient’s condition. They also recorded the patient’s social behaviours and hobbies, such as writing for the Mirror.
Annual Report of the Royal Edinburgh Asylum (1844-1853). This report is presented by the superintendent to the asylum’s medical board annually and includes statistics such as death rates, social causes of insanity and patients’ previous occupations.
Manager’s minutes (1844-1853). These minutes record the Manager’s administration of the hospital. They include the minutes of the annual general meetings where medical staff and members of the medical board would convene. The meetings predominantly concerned the asylum’s finances.
Daily Register (1844-1845). Only one year of the early register survives. After 1845 the next year to be on record is 1955.

First, I read the Annual Reports and the Manager’s Minutes to understand how the image of the asylum presented in Mirror either complimented or contrasted the asylum’s financial and political situation. Afterwards, I read the Case Books in detail. When reading the Case Books, I was looking for confirmed authors of the Mirror as only one author had been previously confirmed by Allan Beveridge and Michael Barfoot.^[2] I wanted to use the case books to contextualise the writings of authors I could confirm by connecting the patient’s articles to their medical notes.

^[1] See ‘Reading List’

^[2] M. Barfoot and A. Beveridge, ‘Madness at the Crossroads: John Home’s Letters from the Royal Edinburgh Asylum, 1886-87’, Psychological Medicine, 20 (1990), 263-84.

^[3] Roy Porter, A Social history of Madness: Stories of the Insane (London: Weindenfeld & Nicolson, 1987).

Conclusions and future research

Concluding the question of censorship and ‘authenticity’ of the Mirror is a complex matter. First, the lack of attention paid to the periodical’s staffing hierarchy by medical staff, displayed in the lack of awareness that PDM was editor, exhibits that the authors of the Mirror were not constantly under surveillance. However, the consistent use of positive language to describe the the asylum as a benevolent institution within articles (at face value), complimented with encoded criticisms of the asylum, complicate the question of censorship. If the Mirror’s authors were truly dismissed as unimportant, then, why encode criticisms of the medical authority?^[1]

The majority of articles are written with intelligence, style and wit which juxtaposed common conceptions of what a ‘madman’ was as the writers held rational discussions and made convincing arguments. The tone of writing is unsurprising as the authors of the Mirror were private patients of the East House, meaning they had come from affluent and educated backgrounds. Many articles discussed philosophical and scientific issues and, therefore, promoted the asylum as a healing institution because the patient’s voice presented as rational and, therefore, sane. Moreover, many articles praised the asylums plethora of amusements, such as the weekly balls, games of curling and trips to Habbie’s Howe.

Nonetheless, the periodical presents surprising and interesting themes on the definition of mental illness and criticisms of the asylum. The author’s engagement with what constituted mental illness corroborates with Vicky Long’s argument that authors ‘depicted the distinctions between madness and sanity as permeable’.^[2] Articles written by and about Punch corroborate this argument as Punch continually saw himself as above medical authority – an example being when he promised all of the patients a ‘new set of brains’ in Vol 3, No.4.^[3] Consequently, Punch sees a difference between himself and the medical staff – therefore, a ‘sane’ and ‘insane’ individual – because he warrants himself worthy to cure the patients, but not the medical staff. Additionally, the character of ‘Punch’ is an interesting way to understand how stories travelled down generations of patients as Punch’s identity is retold over a known period of twenty years.

Nevertheless, the Mirror did include some expected conceptualisations of madness – one example being that madness was bound with grief. Many authors wrote about their loss of a loved one or the loss of a previous life (for example, the loss of their business which was considered a social cause of insanity at this time). The fact that asylum patients saw themselves as ill because of grief is unsurprising.

An area of future research could be comparing my findings on the thematic content and censorship of the Mirror to other patient-run periodicals published in Scotland. During the mid-nineteenth century Crichton Royal Hospital at Dumfries also published a patient-run periodical entitled New Moon from 1844 until 1937. As historians have largely neglected the development of Scottish psychiatry this would enrich the current historiography.

^[1] See pages ‘Punch’ and ‘Authors of the Mirror’ to read the basis of these conclusions.

^[2] Vicky Long, Destigmatising mental illness?: Professional politics and public education in Britain, 1870-1970 (Manchester: Manchester University Press, 2014), p. 30.

^[3] ‘Punch in his corner’, Morningside Mirror, 3.4 (1848), 34-36 (p. 35).

Life in Edinburgh

I used the Lothian Health Services Archive at the Centre for Research Collections, located at the University of Edinburgh’s Main Library, to conduct this research. I lived in Edinburgh for five weeks over the summer which was an unforgettable experience.