By analysing a collection of documents authored by Thomas Ritchie, founder of the Scottish Union of Mental Patients (SUMP), this study recounts the emergence of mental patient unionism at Hartwood Hospital, North Lanarkshire, Scotland. The discourse and action employed by Ritchie and SUMP are understood and situated in relation to intended audiences, social and material conditions of the asylum space, and transformations in cultures beyond the asylum, including nascent industrial strife, social liberalism, civil rights, the London ‘underground’ and counter-cultures.
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.
This paper analyses the buildings, spaces and interiors of Bangour Village public asylum for the insane, near Edinburgh, and compares these with an English asylum, Whalley, near Preston, of similar early-twentieth-century date. The village asylum, which developed from a European tradition of rendering the poor productive through ‘colonisation’, was more enthusiastically and completely adopted in Scotland than in England, perhaps due to differences in asylum culture within the two jurisdictions. ‘Liberty’ and ‘individuality’, in particular, were highly valued within Scottish asylum discourses, arguably shaping material provision for the insane poor from the scale of the buildings to the quality of the furnishings. The English example shows, by contrast, a greater concern with security and hygiene. These two differing interpretations show a degree of flexibility within the internationalized asylum model which is seldom recognized in the literature.
This paper uses the unique collection of Scottish outsider art, labelled Art Extraordinary, as a window into the often neglected small spaces of asylum care in the early twentieth century. By drawing upon materials from the Art Extraordinary collection and its associated archives, this paper demonstrates the importance of incorporating small and everyday spaces of care – such as gardens, paths, studios and boats – into the broader historical narratives of psychiatric care in Scotland. Examples of experiential memorialization and counterpoints to asylum surveillance culture will be illuminated. The significance of using ‘outsider’ art collections as a valuable source in tracing geographical histories will be highlighted.
This article provides an introduction to the approach of the Scottish psychiatrist Thomas Ferguson Rodger (1907–78), as reconstructed from his archive. Rodger’s contribution has been largely neglected within the history of Scottish psychiatry. This paper amends this neglect through situating Rodger’s eclecticism in relation to both the biopsychosocial approach of his mentors, Adolf Meyer and David Henderson, and psychiatry’s de-institutionalization in the 1950s and 1960s. It is posited that Rodger’s eclecticism was a considered response to the pressures of this transitional phase to balance physical, psychological and social approaches, and a critical acknowledgement of the instability of contemporary psychiatric therapeutics. More psychodynamic than his predecessors, the importance of social relations for Rodger led him to acknowledge psychiatry’s limitations.
Charting a transatlantic movement of so-called ‘dynamic psychiatry’ during the early twentieth century, this paper reads against the grain of established historiographies. Comparing biographical and autobiographical sources with contemporary correspondence, a history is told which considers the evolution of psychiatric knowledge and clinical practices ‘from below’. Revealing a period and place when a ‘dynamic’ counter-culture challenged the established materialist views of Scottish psychiatry, the longevity of this challenge is considered in the concluding paragraphs.
This article examines Scottish provision of psychiatric care in the 1960s and 1970s. It demonstrates that institutional services did not rapidly disappear across the UK following the Ministry of Health’s decision to shut down psychiatric hospitals in 1961, and highlights Scotland’s distinctive trajectory. Furthermore, it contends that psychiatric hospitals developed new approaches to assist patients in this era, thereby contributing towards the transformation of post-war psychiatric practice. Connecting a discussion of policy with an analysis of provision, it examines the Department of Health for Scotland’s cautious response to the Ministry’s embrace of deinstitutionalization, before analysing Glasgow’s psychiatric provision in the 1970s. At this point the city boasted virtually no community-based services, and relied heavily on its under-resourced and overburdened hospitals. Closer analysis dispels any impression of stagnation, revealing how ideologies of deinstitutionalization transformed institutional care.
Puerperal insanity has been described as a nineteenth-century diagnosis, entrenched in contemporary expectations of proper womanly behaviour. Drawing on detailed study of establishment registers and patient case notes, this paper examines the puerperal insanity diagnosis at Dundee Lunatic Asylum between 1820 and 1860. In particular, the study aims to consider whether the class or social status of the patients had a bearing on how their conditions were perceived and rationalized, and how far the puerperal insanity diagnosis, coloured by the values assigned to it by the medical officers, may have been reserved for some women and not for others. This examination of the diagnosis in a Scottish community, suggesting a contrast in the way that middle-class and working-class women were diagnosed at Dundee, engages with and expands on work on puerperal insanity elsewhere.
Combat stress cases were traced in historical texts and military manuals on warfare from the Middle Byzantine period; they were mainly labelled as cowardice. Soldiers suffered from nostalgia or exhaustion; officers looked stunned, or could not speak during the battle. Cruel punishments were often enforced. Suicide and alcohol abuse were rarely mentioned. The Byzantines’ evacuation system for battle casualties was well organized. Psychological operations were conducted and prisoners-of-war were usually part of them. The Byzantine army had ‘parakletores’, officers assigned to encourage soldiers before combat. The leaders dealt with combat stress by using their rhetoric skills and emphasizing religious faith in eternal life. The treatment of the ‘cowards’ was rather similar to modern war psychiatry principles of treatment. No description of PTSD was found.
The University of Padua has many legends about its cultural heritage. One of these concerns a collection of eight skulls still preserved in the Hall of Medicine at Bo Palace, near the old anatomy theatre built in 1545. It is said that some famous professors of the University donated their bodies to medical science, and the skulls were from these bodies. From multidisciplinary research, both historical and anthropological, we have discovered that Francesco Cortese, Professor of Medicine and Rector of the University, started this personal collection of colleagues’ skulls, although they had not donated their bodies to science, so that he could make his own detailed phrenology study.
We recount how Jean-Étienne Dominique Esquirol (1772–1840) gradually changed his position towards what Philipe Pinel (1745–1826) referred to as mania without delusion. Between 1805 and 1838, Esquirol moved from outright rejection, questioning the very idea of insane persons committing motiveless acts of violence without delusion, to relative acceptance. He eventually incorporated the clinical characteristics of mania without delusion in his description of homicidal monomania, dividing them between reasoning monomania and instinctive monomania. We examine this change by detailing each of Esquirol’s points of disagreement, which decreased sharply between the completion of his thesis in 1805 and the publication of his chapter on homicidal monomania in 1838.
This article describes the establishment of psychiatry in Italy’s former colonies during the period 1906–43, in terms of the clinical and institutional mechanisms, the underlying theories and the main individuals involved. ‘Colonial psychiatry’ (variously called ‘ethnographic’, ‘comparative’ or ‘racial’ psychiatry) – the object of which was both to care for mentally afflicted colonists and local people and also to understand and make sense of their pathologies – received most attention in colonial Libya, starting in the first months of the Italian occupation (1911–12) and then taking institutional form in the 1930s; in the colonies of what was known as ‘Italian East Africa’, on the other hand, less was said about psychiatric care, and practical achievements were correspondingly limited.
During the 1860s, Berlin’s exterior physiognomy transformed radically. The city eroded the surrounding rural areas, and the frontiers of the old city centre were abolished. These transformations led to the disappearance of the visible frontiers that once demarcated the limits of the old residential Prussian city. In this context, the description of the clinical picture of agoraphobia by the Berlin psychiatrist Carl Westphal in 1872 marked a turning point, not only in psychiatric theories on anxiety but also in the conceptualization of our experience of space. In this paper, the authors trace the emergence of a new psychology-neurology episteme during the last third of the nineteenth century; and they argue that such an episteme became possible once the relations between anxiety and modern city-scape had been clearly articulated.
Our aim is to investigate two major tendencies in nineteenth-century Brazilian alienism: mentalism and organicism, by conducting a descriptive study of original Brazilian documents on medical health treatments in the 1830s, 1840s and 1850s. Primary sources of Brazilian alienism were theses, memoirs, official reports, and documents written by clinicians and asylum directors. We analysed early mental treatment in Brazilian lunatic asylums, exploring the relative contributions of two main theoretical orientations: moral treatment (based on Pinel and Esquirol) and ‘medical-organicist therapeutic orientation’. Intertextuality was used to assess reports of medical organicist treatment in Brazil. We concluded that contemporaneous textual sources indicate that mid-nineteenth-century alienism in Brazil was predominantly influenced by organicism exported from European countries. Pinel’s mentalist view, nevertheless, remained the reference point for clinical issues associated with the doctor-patient relationship.
This paper addresses philosophical issues concerning whether mental disorders are natural kinds and how the DSM should classify mental disorders. I argue that some mental disorders (e.g. schizophrenia, depression) are natural kinds in the sense that they are natural classes constituted by a set of stable biological mechanisms. I subsequently argue that a theoretical and causal approach to classification would provide a method for classifying natural kinds that is superior to the purely descriptive approach adopted by the DSM since DSM-III. My argument suggests that the DSM should classify natural kinds in order to provide predictively useful (i.e. projectable) diagnostic categories and that a causal approach to classification would provide a more promising method for formulating valid diagnostic categories.
Theory of mind is a prominent, but highly controversial, field in psychology, psychiatry, and philosophy of mind. Simulation theory, theory-theory and other views have been presented in recent decades, none of which are monolithic. In this article, various views on theory of mind are reviewed, and methodological problems within each view are investigated. The relationship between simulation theory and Verstehen (understanding) methodology in traditional human sciences is an intriguing issue, although the latter is not a direct ancestor of the former. From that perspective, lessons for current clinical psychiatry are drawn.
In 1891 the Italian psychiatrist Enrico Morselli (1852–1929) described taphophobia, defining it as an extreme condition of claustrophobia due to the fear of being buried alive. This rare psychopathological phenomenon reflects an ancient fear, and its origin is not known. Taphophobia is closely linked to the problem of apparent death and premature burial. In the nineteenth century, scientists and authors paid particular attention to the issue of apparent death, and special devices (safety coffins) were invented to ensure that premature burial was avoided. Nowadays taphophobia is quite a rare psychiatric disorder; different forms of social anxiety disorders are much more widespread. Its modern equivalent could be the fear of organs harvested from a patient who is still alive.
Kurt Schneider (1887–1967) met Max Scheler (1874–1928) in 1919 when he enrolled in the latter’s philosophy seminars at the University of Cologne. Kurt Schneider was then a junior psychiatrist and Max Scheler a renowned philosophy professor and co-founder of the phenomenological movement in philosophy. We uncover the facts about their intellectual and personal relationship, summarize the main articles and books that they wrote and consider whether Max Scheler did influence the young Kurt Schneider. We conclude that Scheler’s philosophy of emotion impressed Schneider, and that the latter’s notion of ‘vital depression’ as the core element in melancholia was essentially applied Schelerian philosophy. Schneider’s more celebrated contributions to psychiatry – his notion of first rank symptoms of schizophrenia – owed nothing to Scheler or any other philosopher.
Over the 1950s and early 1960s, the use of the hallucinogenic drug lysergic acid diethylamide (LSD) to facilitate psychotherapy was a promising field of psychiatric research in the USA. However, during the 1960s, research began to decline, before coming to a complete halt in the mid-1970s. This has commonly been explained through the increase in prohibitive federal regulations during the 1960s that aimed to curb the growing recreational use of the drug. However, closely examining the Food and Drug Administration’s regulation of LSD research in the 1960s will reveal that not only was LSD research never prohibited, but that the administration supported research to a greater degree than has been recognized. Instead, the decline in research reflected more complex changes in the regulation of pharmaceutical research and development.
This article discusses both the use of graphology in German psychiatry (1870–1930) and the use of handwriting in psychiatric experiments. The examination of handwriting was part of an ensemble of diagnostic tools. Although disorders of handwriting seemed to indicate psychic diseases, graphology did not seem the right method to produce valid observations. Nevertheless, psychiatrists began to incorporate the process of writing into research and diagnosis and to make the process of handwriting an experimental field. Emil Kraepelin invented an apparatus – the so-called Writing-Scale – with which he could measure the dynamics of writing in various dimensions and, in particular, the pressure of movements. The experiments produced a huge amount of data, but the psychiatrists were unable to interpret them in a comprehensible way. Although psychiatrists failed to grasp the psychopathology in handwriting, they discovered a systemic behaviour of the organism controlled by feedback.
Memory is both ubiquitous and persona non grata in the work of Eugène Minkowski. Despite the relevance of memory in the works of those who influenced him, in particular Bergson, Minkowski nonetheless repeatedly overlooked its importance in his writings. To the reader of his work this fact is as much evident as unaccounted for – both by prior research and by Minkowski himself. I shall try to prove that this disregard for memory was conditio sine qua non of Minkowski’s first synthesis of Bleuler and Bergson in a 1921 article, which resulted in his famous concept of loss of vital contact with reality and which he equated with schizophrenia. Moreover, this historical approach will, on the one hand, explain the fragmentary use made by Minkowski of the philosophy of Bergson and, on the other, shed light on central aspects of his Le temps vécu of 1933 that an exclusively philosophical analysis cannot reveal.
This article examines the problematization of sexual appetite and its imbalances in the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in the twentieth and twenty-first centuries. The dominant strands of historiographies of sexuality have focused on historicizing sexual object choice and understanding the emergence of sexual identities. This article emphasizes the need to contextualize these histories within a broader frame of historical interest in the problematization of sexual appetite. The first part highlights how sexual object choice, as a paradigm of sexual dysfunctions, progressively receded from medical interest in the twentieth century as the clinical gaze turned to the problem of sexual appetite and its imbalances. The second part uses the example of the newly introduced Female Sexual Interest/Arousal Disorder in the DSM-5 to explore how the Manual functions as a technique for taking care of the self. I argue that the design of the Manual and associated inventories and questionnaires paved the way for their interpretation and application as techniques for self-examination.
The Ottoman Empire, which encompassed a vast territory, had several facilities for the protection and treatment of the mentally ill. By the late nineteenth century, some wealthy families had begun to send their patients to mental hospitals in Europe for better treatment. During the same period, the process of repatriation of mental patients who were Ottoman subjects also began. These processes, which resulted in complex bureaucratic measures, later found a place in regulations and laws. The Ottoman Empire had an additional incentive to protect mentally-ill patients during the Second Constitutional Era, when discussions about ‘citizenship’ reappeared. This article examines the practices of sending mentally-ill people to Europe and the repatriation of mentally-ill Ottoman subjects from European countries.