Tag Archives: history of emotions

Communicating Mental Health, University of Birmingham, 16-17 September 2013

‘Communicating Mental Health, c.1700–2013′ was a workshop held at the University of Birmingham’s Institute of Advanced Studies, aiming to bring together researchers from a range of backgrounds to consider the communication of mental health and illness, both in the past and in the present. Communication took many forms in the papers presented – verbal, written, and visual.

L0028860 Case notes: Holloway Sanatorium Hospital for the InsaneKicking off the proceedings, Louise Hide from Birkbeck, University of London examined letters written by 19th-century asylum patients. Letter-writing by patients was a significant activity, with around 100 letters a day written at London’s Claybury Asylum in 1895. Such letters are complex both in their contents and the ways in which they might be read by the historian – Hide particularly emphasised patient’s use of metaphor as a way of communicating their experiences within the asylum. This was a trend also evident in the spoken words of patients, as I briefly noted in a paper on the role of the patient in diagnosis. As the asylum admission process in the 19th century didn’t involve the input of an asylum doctor (rather, general practitioners and Poor Law authorities), the information provided on admission documents was often re-assessed in the asylum in light of the patient’s own story. One man, who had told the general practitioner certifying him that the ‘flesh was dropping off his bones’, explained to the asylum doctor that he didn’t really think this, but had employed the phrase to describe his feelings of numbness in the toes.

Letters sent by patients were also examined by Jane Hamlett (Royal Holloway University of London), who described how demands for goods from families may have been a way for the patient to assert authority after being placed in an institution. One patient at Bethlem wrote an astonishingly long list of goods that he ‘required’, asking his father to send him – amongst other things – a harmonium and an alarm clock. That letters were a means of maintaining one’s position as head of the household was evident in the letter written by a man to his wife, who declared that she ‘need not send the cake [she had mentioned], as he did not care for it’, but she might send some rashers of bacon instead. In their provision (or not) of foodstuffs and domestic items, then, we can see families engaging in a form of object-based communication.

Inside the padded cell in the Stephen Beaumont Museum of Mental Health.

Inside the padded cell in the Stephen Beaumont Museum of Mental Health.

That objects might be communicative was a possibility also explored in Rob Ellis’s (University of Huddersfield) talk, which examined the Stephen Beaumont Museum of Mental Health – previously discussed on this blog, here. Ellis argued that museum collections are very much bound up with who ‘owns’ the history of psychiatry (the closure of asylums in the late 20th century, for example, prompted some curators to highlight the ‘progressive’ nature of psychiatry).

This much broader issue of ownership was a concern that ran throughout the two days of the workshop. Towards the end of the first day, we were already asking ourselves if historians were part of ‘myth-making’ about mental illness and, if we were, what we could do about it. But was ‘myth-making’ too simplistic a label to put on the issue? Was there, asked Peter Bartlett (University of Nottingham), any area of life where – as humans – we weren’t constantly constructing myths about history, the present, and ourselves? Many of the papers presented at the workshop had highlighted how there was rarely a single narrative of mental health or illness that enjoyed relative hegemony at any one time. In the stories we were telling about past and present mental health practice, we were also adding other voices to an already varied narrative.

Poster from the Birmingham campaign, ‘Don’t Turn Your Back on the Symptoms of Psychosis’.

Poster from the Birmingham campaign, ‘Don’t Turn Your Back on the Symptoms of Psychosis’.

The languages spoken by these voices seemed diverse – historical, medical, psychoanalytical – but displayed some important similarities. That there was an easily discernible line between ‘normal’ and ‘abnormal’, or ‘health’ and ‘illness’, was complicated by many of the speakers present. Katherine Chisholm and Sarah-Jane Fenton both addressed the importance of identifying mental ill-health in adolescence – the point at which many serious psychiatric disorders began and often manifested themselves in ways that made it difficult to determine the lines between ‘mental illness’ and ‘typical’ teenage behaviour. The language used to talk about mental health issues was also a rapidly changing one, so that – as one current practitioner pointed out – an individual might be diagnosed with something that meant little as a diagnostic label years later. How language and the labels we assign to disorders could profoundly affect an individual’s sense of self, then, was a consideration that came through in papers both by historians and current practitioners.

Methodology also turned out to be an area of common experience: though we might lack a methodology that can properly capture the experience of mental illness at different points in time (as Joseph Melling [University of Exeter] noted), there was a clear similarity across the disciplines in terms of research methods employed. Thematic analysis was central for many speakers, whether analysing the letters of 19th-century asylum patients, or in working with young autistic adults (Susy Ridout, University of Birmingham).

300px-Speech_bubble.svgFittingly, the workshop ended with participants reflecting on how we had communicated with each other. Fostering interdisciplinary study was a laudable aim, but something that involved more than simply delivering papers together at the same event. How could the discussion continue beyond that context, and how far were historians, practitioners, and service users really integrated? Whilst we’d been using the same languages and methodologies, there was still a sense of a divide within the room at times – almost that historians were distanced, detached observers with little direct experience of mental health issues. How could we bridge that divide?

This was a big question that I had the chance to explore a little further a few days later, at the Wellcome Trust’s Engaging Science Day, a workshop for grantholders about public engagement. In our session, ‘Are historians human? Communicating medical history’, we talked about the mental health issue directly. Should we, as historians, communicate our own experiences of mental health and illness to make our field of study more accessible to others? The general consensus was no, unless you felt strongly about doing so. There was, though, a case to be made for engaging with medical and psychiatric history on a more personal level as a way of capturing other’s imaginations. Appealing to people’s preconceptions about the history of psychiatry and medicine as a starting point for discussion was one suggestion. Opening up a talk with an appeal to the audience – such as ‘What do you think the first drug treatments used in psychiatry were?’ – was a way in to a subject that the speaker specialised in, but which the audience might also have some knowledge of, going a small way to bridging that gap between speaker and audience, or historian and service user. Maybe the issue wasn’t one of language, of methodology, even of different disciplines, then, but in the very simple way we communicated with others.

‘Communicating Mental Health’ ended with a discussion amongst University of Birmingham participants about taking the dialogue opened up at the workshop further, and we look forward to hearing more about this in due course. You can view the full timetable of speakers and papers here, and Vanessa Heggie (@HPS_Vanessa) has kindly Storified (or Storify-ed?) live tweets from the two days here.

Animals and the Asylum: A comparative approach to the science of mind

This week’s post comes from Liz Gray, who is currently undertaking doctoral research at QMUL’s Centre for the History of the Emotions. Liz also blogs about her work at Tales of Animals Past.

William Lauder Lindsay. © Natural History Museum

During the second half of the 19thcentury the discipline of comparative psychology was a mixture of methods and approaches. Anthropologists, physiologists, and alienists all used the title for their studies of the mind in man and animals. Scottish naturalist-physician and alienist William Lauder Lindsay (1829-1880) had his own interpretation: the study of mind in the lower animals, in particular the mind in a diseased state.

His theory was that the lower animals and man shared a ‘community of disease’ – that physically and mentally all animals (including man) could be affected by the same pathologies. Having begun his experimental career investigating the transmission of cholera between humans and dogs, a topic to which he returned on many occasions, by 1870 he had turned his attention to psychopathology.

The study of the animal mind offered the chance to garner an insight into the human mind, in particular the diseased or insane mind:

‘…their study [morbid mental phenomena] in other and lower animals by the physician or veterinarian, naturalist or comparative psychologist, cannot fail to bring to light many data of the highest interest to man’s knowledge of human insanity.’

By the 1870s this was not a unique idea. In 1873 James Crichton-Browne invited David Ferrier to use laboratory space at the West Riding Asylum, providing him with a variety of animal subjects (pigeons, guinea pigs, cats, and dogs), for his investigations into the pathology of epilepsy. French physiologist and neurologist Charles-Édouard Brown-Séquard also explored the artificial production of epilepsy in small mammals.

What set Lindsay apart from the physiological approach was his method of investigation, and his interest in a moral and mental,  rather than physical, hierarchy of species. Darwinian morality of the 19th century placed the intellectual, upper-class white man at the ‘top of the tree’. In mental and moral terms, dogs (man’s most loyal companion) were ranked below men; women were equal or lower to dogs. Children, ‘savages’ and the mentally ill all occupied lower rungs on this particular evolutionary scale.

One of Crichton-Browne’s photographs of a West Riding patient. © Wellcome Images

Whilst conducting his research for The Expression of the Emotions in Man and Animals, Charles Darwin was struck by the notion that ‘the insane ought to be studied, as they are liable to the strongest passions, and give uncontrolled vent to them.’ He was put in touch with Crichton-Browne, who provided him with ‘copious notes and descriptions’ based on his observations of his own patients. Although the photographs of these patients were not included in the final book, the information they provided were integral to Darwin’s views on the subject of emotional expression. (The Expression of the Emotions is often referred to as a founding text of comparative psychology, even though he doesn’t use the terminology).

Observation of behaviour and expression were the tools that Lindsay and others utilised in their studies – methods of the naturalist rather than the physiologist. What enabled Lindsay to draw comparisons between his patients at the James Murray Royal Asylum in Perth and the animals he observed, was his experience of the insane and ‘idiotic’ who were unable to communicate verbally. In these cases changes in behaviour, facial expression, and vocal noises were seen as indications of mental disturbance. Herbert Major (a contemporary of Crichton-Browne’s, who also worked at the West Riding Asylum) provided Lindsay with a case study where the same could be seen in animals:

‘…a case of association of irritability of temper, with loss of memory and diminished intelligence, including failure to recognise her master, coincidently with the development of fits, apparently of an epileptic character, and with partial paralysis of the limbs, all in an old terrier bitch, these conditions, moreover, being coincident with senile atrophy or degeneration of the brain.’

Head of a dog, from Charles Bell’s Essays on the Anatomy of Expression in Painting (1806). © Wellcome Images

Animals acted as experimental models of disease, as well as providing insights into behaviour and expression as diagnostic tools for mental disease and derangement. Lindsay took this approach one step further. By interpreting these links as evidence of a ‘community of disease’, he turned towards possible environmental factors that could influence the mind.

One of the simplest experiments of Lindsay seems to have been inspired by the saying, ‘Like a red rag to a bull’. By changing the colour of the light in the sleeping rooms of some of his patients, he studied the reaction of the mind to different colours. He was unconvinced by the anecdotal animal evidence of reactions to colour, and his human experiments produced ‘negative conclusions’.

A snarling dog from Darwin’s Expression of Emotions. © Wellcome Images

Metrological data can be found in the medical reports of Perth asylum for a period of almost 5 years. It was used to analyse changes in both the behaviour and physical health of patients. Climatic changes seemed to have little effect on the types of mental disease at the asylum, and physical effects mirrored  the health of the more general population of Perthshire. But the observation of climate was part of a wider area of interest in the causes of mental disease.  Lindsay was well-travelled and wrote papers on the etiology of mental illness around the world. One such study focused on the impact of the colder climate experienced in Norway, Iceland, and other Arctic countries. People and animals, in particular dogs, were affected by both the climate and latitude of these countries. They suffered predominantly from depression and melancholia as a result of the low levels of sunlight, solitude due to sparse populations, and the monotonous scenery.

For Lindsay, the science of comparative psychology was located within the asylum and the research opportunities it offered. His explanations of animal behaviour with their anthropomorphic basis were used in his ideas of human mental disease. Animals were introduced into the asylum as scientific subjects, but not objects of physical experimentation. The asylum patient was seen as an equally valid object for research, although carefully designed as part of the moral treatment approach.

- Liz Gray

Further reading

Charles Darwin, The Expression of the Emotions in Man and Animals (London: J. Murray, 1872).

W. Lauder Lindsay, ‘Community of Disease in Man and Other Animals’, British and Foreign Medico-Chirurgical Review 53 (1874).

W. Lauder Lindsay, Mind in the Lower Animals in Health and Disease, 2 vols. (London: C.K. Paul, 1879).

W. Lauder Lindsay, ‘On Insanity and Lunatic Asylums in Norway: Being the Narrative of a Visit made in the Summer of 1857′,  Journal of Psychology Medicine 11 (1858).

W. Lauder Lindsay, ‘The Causes of Insanity in Arctic Countries’, British and Foreign Medico-Chirurgical Review 14 (1870).

Robert J. Richards,  Darwin and the Emergence of Evolutionary Theories of Mind and Behavior (Chicago: University of Chicago Press, 1987).