The Sordid History of the Asylum

 

The old New Brunswick Asylum

Modern psychiatry considers all major forms of “mental illness” incurable, including chronic depression. All they can do is prescribe pills to reduce the “symptoms.” 

Yet the early mental hospitals, circa the first half of the 19th century claimed cure rates up to 82% (C.M. McGovern, The Masters of Madness: Social Origins of the American Psychiatric Profession. 1985, Hanover Press: University Press of New England.)

What went wrong?

A history of the local asylum here in Saint John, N.B., is instructive. Founded in 1835, it was the first in what later became Canada.

Based on the success of such model asylums as York, England, and Worcester, Massachusetts, the plan was to get the patients away from whatever was causing them disorientation, stress or grief, in a calm and relaxing atmosphere. Dr. Waddell, an early superintendent, wrote that when “the cause of excitement no longer exists and they are confined to one scene and one set of companions, improvements are made.” And not just any scene. There were set principles for asylums: “Every hospital for the insane should be in the country, and within less than two miles of a large town.” “No hospital for the insane, however limited its capacity, should have less than fifty acres of land devoted to gardens and pleasure grounds for its patients. At least one hundred acres … for two hundred patients.”

So when a permanent site was sought for the provincial asylum, the site chosen was one that had previously been used for a summer resort, overlooking a major tourist attraction, the Reversing Falls. At the time, it was a mile outside the city, “commanding a magnificent view of the harbour and city.” “Varied scenery, but near enough to the active and changing scenes of life to arrest the attention and amuse the inmates.”

“The sound caused by rushing water is the music of nature, and is always in harmony with, and soothing in its effects on, the nervous organism.”(Waddell, 1874)

So how did we lose this seemingly effective model?

One mistake was putting these hospitals too close to the cities. Inevitably, the nearby city grew and spread to and beyond the hospital gates. The land reserved for outdoor activities became too valuable and was sold off. No more peaceful natural surroundings. At the same time, with growing populations, the hospitals became overcrowded. Giving out pills and sending them home, back to the conditions that caused their upset, was cheaper.

And there was a second mistake. The early successful asylums were generally run by religious organizations. Or else they were run by romantic idealists with a sense of mission. Staff were often themselves former patients.

Given that the primary cause of “mental illness” is a sense of loss of meaning and purpose, this religious element was probably critical to their success. And it prevented an obvious problem with staffing. Once the state took over, it was just a job. 

And a job likely to attract a certain type of person: someone who likes preying on the vulnerable. For who is more vulnerable than a psychiatric patient?

The first supervisor of the asylum, Dr. George Peters, resigned under a cloud. Seven female employees had accused him of “violating their person,” and having “illicit intercourse” with patients.

This has been a recurring problem, it seems, for psychiatry.

A patient committed in 1868 recorded his experiences. The admitting clerk would not address him, but spoke of him in the third person. “I was searched with as little ceremony and feeling as if they had been examining a horse.” He was then, throughout his stay, “ordered about like a dog.” 

“The keepers,” he writes, “are all very ignorant men and are selected purposely for their brutal and cruel disposition.” He could not of course know this, could not know on what basis employees were chosen. I am sure his assumption is wrong. But lacking any control, bullies would naturally self-select for such a job.  “They are, without exception, the most unfeeling, heatless wretches I have ever met.”

And so the cure for mental illness was lost. Obviously, if, as is currently understood, most or all mental illness is caused by abuse, especially in childhood, the mental hospital as it came to be constituted was in fact the perfect prescription for making the problem incurable. 

And so, supposedly wanting to reform this situation, we now send the unwell off to die on the streets. Causing our “homeless crisis.” The Saint John Asylum was torn down in 1998, and the site is now a popular park.

But have you noticed how much the original, successful asylum concept resembles a Christian or Buddhist monastery? Which were historically not just self-sustaining, but financially highly successful.

You have your solution.

Get Thee to a Nunnery

 

Greg Gutfield and the crew attempt to tackle a growing current problem: what to do about the homeless?

The same issue arises in my current classes on “The Glass Menagerie.” Laura, in that play, is the type: the type who end up homeless. Surely this is her likely fate, once her mother dies. 

How then could she escape her glass menagerie?

Psilocybin is snake oil. I think Gutfield comes closest to the solution when he says, get them out of the cities. Get them out of their current situation, which, as with Laura, is driving them mad. Madness is situational. It is a rational response to an impossible situation.

This would not be a matter of involuntary confinement, a violation of their human rights. You might say, and it would be true, that some people living in tents do not want a proper apartment. Offered shelter, they refuse to move. 

That is because they fear being trapped by “the system.” They want to opt out.

In other words, get them out into the countryside. These tent people are doing their best to simulate that in the city. Give them a bus ticket, and a permanent room in a motel at the edge of some small town, and leave them alone, and they will be delighted.

Consider Tom, in the play. He understands the imperative need to get away—he imagines joining the merchant marine.

Laura, by contrast, seeks to escape into her imagination, with her “glass menagerie.” This is the path to “psychosis”; to imaginary things becoming real. An opting out of the world as a whole.

The immediate need is more specific: generally to escape from a manipulative and narcissistic parent, who views their children as extensions of themself. This, however, develops into a mortal fear of “the system,” as with Tom, or, in Laura’s case, a mortal fear of life in general.

The need is to “get away from it all.”

We used to know this; and we used to have many fewer mentally ill. The original asylums, built at the beginning of the 19th century, were intended to be in tranquil rural settings where the agitated could simply have a restorative rest. In other words, true “asylums.” The New Brunswick Asylum, put up on the 1830s near where I write, was a prime example. It was on a piece of high ground outside the city, within soothing earshot and sight of the scenic Reversing Falls. It had an attached farm which the inmates worked; others did handicrafts. The spot is now a park. In Kingston, the asylum was built along the waterfront, again away from the city. The site is now, again, a park.

These original asylums had a cure rate of something like 80 to 90 percent within a year. Yet they devolved into the supposed “snake pits” that we closed down in the 1960s, in favour of throwing all our Lauras out in the street to freeze or starve.

What happened?

In the mid eighteen hundreds, “scientific” psychiatry began to emerge and to take over the asylums, turning them into “mental hospitals.” Rather than being left alone to sort out their troubles, the inmates of these institutions began to be poked and prodded and ordered about, experimented on and, in effect, tortured, in accordance with the latest “scientific” methods. We got the horrors of hydrotherapy, lobotomy, straightjackets, shock treatments, and the rest. The patients were subjected to the very same sort of bullying, objectification, and manipulation that had driven them mad in the first place. Mental illness became, for the first time in history, incurable. 

Because people stopped getting well, these “hospitals” grew overcrowded, and conditions further deteriorated. As the cities spread to surround and enclose them.

Granted, simply getting people homes out in the countryside is not necessarily going to be enough. This is only removing them from the source of the problem. They will be left with trauma. 

But why did we need to build these large asylums in the 19th century in the first place? What happened to the mentally ill before then?

Before then, we had monasteries and convents in the countryside. A child from an abusive family, or a child rejected by their family, could go there.

Picture Laura again: isn’t this the one plausible happy ending for her? To become a Carmelite nun?

A monastery can replace the faulty programming by a narcissistic milieu with new programming, true programming.

And the postulants are otherwise left alone to sort things out.