Tuesday, October 4, 2016

Æther Salon - Asylums! (Edited Transcript)

Most of you know me as Beryl Strifeclaw.  I keep the asylum here in New Babbage afloat when I'm not off on some insane quest or other unexpected madness.

Let me begin this by saying how this journey began for me and the reason that I began taking an interest in asylums and mental hospitals, long before I joined SL. It had nothing to do with a fascination with the past.  I met someone who actually worked in a hospital treating those in need.  I would soon learn something from them that you aren't going to see in a history book or a newspaper.

Everyone probably has or had a friend, or at least seen depicted on TV, where someone cannot stand how their profession is depicted on screen.  Real lawyers who hate how slimey they are represented, Doctors who despise being compared to their television actors (Patch Adams), Cheerleaders as the brainless bullies, and soldiers complain the truth is never accurately depicted. My friend had similar complaints about mental institutions, except theirs was that in all forms of media the asylum or hospital was never there to actually help anyone.  It was always a backdrop for some twisted location where no one listened, people experimented uncarringly upon patients, or delighted in torturing their victims.

To them every asylum or mental hospital represented in stories was always the backdrop of a 'torture porn' where those who worked there had no redeeming qualities at all.  The most recent examples of these I've spoken to them about was American Horror Story: Asylum and the psychiatrist in American Horror Story: Murder House. She despised both of these depictions as it only further serves the negative perception in the public mind toward mental health facilities.  The worst part for her was when the psychiatrist in Murder House called therapy a sick joke and no one was ever helped by it. She found that offensive to everything she represented. Often when people speak of mental hospitals and asylums this picture of torment and torture is brought to mind first.  Sadly it is just another thing, like the social stigma and mockery surrounding medication or needing therapy, that adds to the anxiety that make many people forgo the help that they could get.There is no getting around that terrible things happened in these places, and the manner of their corruptions might still surprise you.

However, if you take nothing else out of this, I hope it will be to realize that there are still people working in these facilities, which have much better practices today than even twenty years ago.  For every uncaring individual wanting their pay-check, or corrupt practitioners, there are people who want to help those in need and nothing I say today should stop you from seeking them out.
With that said lets go back to the earliest asylums...

In 872, Ahmad ibn Tulun built a hospital in Cairo that provided care to the insane, which included music therapy.  Bimaristans were Islamic institutions that were later described by European travellers who wrote about their wonder at the care and kindness shown to 'lunatics'. Despite this medical historians would say, "They were a drop in the ocean for the vast population that they had to serve, and their true function lay in highlighting ideals of compassion and bringing together the activities of the medical profession."  (Roy Porter 1997 The Greatest Benefit to Mankind: A Medical History of Humanity)

In Europe during the medieval era, the 'mad' were housed in a variety of settings. Monasteries, towers (fools' towers), hospitals and more. The ancient Parisian hospital Hôtel-Dieu also had a small number of cells set aside for lunatics, whilst the town of Elbing boasted a madhouse, the Tollhaus, attached to the Teutonic Knights' hospital. Dave Sheppard's Development of Mental Health Law and Practice began in 1285 with a case that linked "the instigation of the devil" with being "frantic and mad". The level of provision for the care and control of the insane remained extremely limited at the turn of the 18th century. Madness was seen as a domestic problem, with families and parish authorities central to regimens of care. Parish authorities would often provide financial support, the provision of parish nurses and, where family care was not possible, lunatics might be 'boarded out' to other members of the local community or committed to private madhouses or workhouses.

In the late 17th century, this model began to change, and privately run asylums for the insane began to proliferate and expand in size. Already in 1632 it was recorded that Bethlem Royal Hospital, London had "below stairs a parlor, a kitchen, two larders, a long entry throughout the house, and 21 rooms wherein the poor distracted people lie, and above the stairs eight rooms more for servants and the poor to lie in".  (Allderidge, Patricia 1979 Management and Mismanagement at Bedlam). Inmates who were deemed dangerous or disturbing were chained, but Bethlem was an otherwise free roaming building. Its inhabitants could wander around its confines and possibly throughout the general neighborhood in which the hospital was situated.  In 1676, Bethlem expanded into newly built premises at Moorfields with a capacity for 100 inmates. Practices such as leeching the patients and restraints such as the 'Tranquilizer chair' were used during this era.

This, is the tranquillizer chair. The idea was that they couldn't see, hear or otherwise get any stimulation. The bucket was for what you think it was for. The mad were more likely to go more insane in these conditions. But that was because they weren't interested in treating the patients. Privately run asylums quickly got a reputation for caring more about profits than care for their patients.  The August 19, 1858 edition of The Times printed an editorial about three cases of wrongful confinement. The editor used those accounts, which were filled with detailed descriptions of greed and corruption leading to these confinements revealed the subpar regulations in place. People were bribing doctors to wrongfully commit relatives in order to receive their inheritances early among other things.

According to the editor any man or woman could, without much difficulty, be incarcerated in a Private Lunatic Asylum when fully within the realm of reason.  Private asylums like these would have been employed by the upper class, as they were expensive, but in the case of inheritance it was sometimes worth the cost. The corruption went further.  Sometimes Asylum directors were bribed to ensure better care was given to one specific patient. Someone who wanted to lock up their sister or mother but ensure nothing bad happened to them.  The fear of abuse made the Doctors even more influential because even judges and politicians had to use their services for members of their family.

By failing to place a relative who was thought to be insane or problematic to the status quo into an asylum, families were opening up the possibilities of “immediate danger, disgraceful scenes, and exposures” to the public and ruining their family image. (Monroe, Henry Articles on Reform in Private Asylums. Deviance, Disorder, and the Self.) In this era where your image was everything, incarcerating anyone who shamed your family on the surface was important to your own welfare. There were asylums for 'hysterical women' and 'drunkards' and women who were guilty of 'infidelity'.  Here are just a few things that could get one involuntarily committed:  Insanity caused by anxiety, Epilepsy,  Insanity caused by childbirth, Insanity caused by overwork, depression, inebriation, and infidelity (known as 'Moral Insanity')

Even their opinions were enough to get women incarcerated.  The men who were in charge of these women, either a husband, father, or brother, could send women to mental institutions stating that they believed that these women were mentally ill because of their strong opinions.  Between the years of 1850-1900, women were placed in mental institutions for behaving in ways the male society did not agree with. "These men had the last say when it came to the mental health of these women, so if they believed that these women were mentally ill, or if they simply wanted to silence the voices and opinions of these women, they could easily send them to mental institutions. This was an easy way to render them vulnerable and submissive."  (Packard, E.P. (1873). Modern persecution, or, Insane asylums unveiled as demonstrated by the report of the Investigating Committee of the Legislature of Illinois.)

However, not everyone was corrupt.  And even the corrupt ones did not stand in the way as things were changing for the better as the world was getting ready for Sigmund Freud's theories.  Even decades before his studies into psychotherapy things were becoming more humane during the Enlightenment and 'Optimistic' asylum periods. Attitudes towards the mentally ill began to change. It came to be viewed as a disorder that required compassionate treatment that would aid in the rehabilitation of the victim. When the ruling monarch of the United Kingdom George III, who suffered from a mental disorder, experienced a remission in 1789, mental illness came to be seen as something which could be treated and cured.

Therapeutic Optimism in asylums ran from about 1830 to around 1860 and were at its height in the 1840s. Asylums built under the 1808 and 1828 County Asylums Act tended to be left to the management of doctors. As the theories and techniques of managing lunatics in asylums developed, so did the belief that this asylum treatment itself was the correct, scientific way to cure 'lunacy'. Signs of the therapeutic change can be seen in the changing legislation. The 1828 Madhouses Act, unlike the 1774 Act, was concerned about conditions in asylums. These included the 'moral conditions'. Official visitors were required to inquire about the performance of divine service and its effects. In 1832, this inquiry was extended to include "what description of employment, amusement or recreation (if any) is provided". This was not much, but it was a start.

In May 1839 John Connolly visited Lincoln Asylum where Robert Gardiner Hill had abolished mechanical restraint of patients in a small asylum. On appointment to Hanwell, Connolly proceeded to abolish it in a large asylum. Several English asylums were practising non-restraint by 1844. Doctors were already recognizing that chains and restraints were worsening the patients conditions instead of helping them recover.  To paraphrase the friend I mentioned at the beginning, 'because real life isn't a horror story where doctors are soulless monsters, they did what scientists are supposed to do and changed their practices to fit the science.'

Iron chains, mercury pills, and Tranquillizer chairs were being abandoned for more humane treatments and eventually most were discontinued completely in the 1850's as a failed experiment along with bleeding the patients. Outdated treatments, there were many: Instead they began to utilize actions and the freedom to move around their tiny rooms.  When left with nothing to do but live in the tiny space patients often went mad even when they were sane before but activities were being introduced.  Painting, reading, and game activities. So while you might have found devices like the tranquilizer chair in the old asylum in Babbage, the Dunsany, it was considered archaic to Professor Rance or Solsen 'today'.  However, we would be starting to use Steam boxes, hydrotherapy, lobotomies, and radium therapy instead.

The steam box. Basically using water and sweat to calm people. The science showed them it might work and for some it did, especially in inebriates asylums.  But...In our era, 188X, focus had shifted from incarceration and chains to treatments.  Some of these treatments were misguided or fundamentally flawed.

Treatments would continue to improve after Freud as people tried different techniques in their quest to help.  However conditions were still far from perfect and corrupt practices still had rational, innocent people taken away to private asylums. Journalists would soon begin exposing this world in more depth.  Unsurprisingly there were very few who would check themselves in during the era of the Tranquillizer chair.  Now exposes would become more frequent as more journalists began to feel safer committing themselves to get their stories, and the rampant abuse, terrible conditions, and corruption would be exposed.

The Victorian era, our era, actually set the stage for modern mental hospitals with the advances we made. Reforms would continue and eventually bedlams would abandon some of their morals due to overcrowding and more unstable patients.  Asylums would eventually fall out of favor and be replaced with mental hospitals

To cover everything that covers asylums would take far more than an hour could possibly contain, so here are a few resources you can use:

http://studymore.org.uk/mhhtim.htm
https://en.wikipedia.org/wiki/Moral_treatment
http://www.dailymail.co.uk/home/you/article-2141741/Sent-asylum-The-Victorian-women-locked-suffering-stress-post-natal-depression-anxiety.html

But really it takes only a few seconds of research these days to find the abuse.  It's much harder to find the humanity hidden in there.

I will finish off by saying this. There is help, and you should not let anything I say or reveal during this salon stop anyone from seeking assistance should they need it.  Even if some psychiatrists got their license from a cracker jackbox, and others mock those who need help or medication, do not let that stop you from seeking needed assistance. Unless someone is a mental health specialist themselves, they have no right to comment upon your mental health in any way.

Fin~




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