Posts Tagged 'nineteenth century society'

Nineteenth-Century Society: (Insanity of) Adolescence

In 1892, sixteen-year-old Harry Dearman was admitted to Bethlem with a very specific diagnosis: “Melancholia of Adolescence”. This, the teenager’s first episode of mental ill-health, had apparently commenced just three days before his admission. Harry was described as having become very reticent, refusing food and praying excessively: he had also made an attempt at suicide. The causes of the young man’s illness were thought to be both psychological and physiological: four months earlier, he had been present at the “unusually painful death scene” of a friend and fellow workman which, his relatives noted, he had frequently talked about since. In addition, however, his doctors assumed that puberty was a cause.

In the late nineteenth century, “insanity of adolescence” became a frequent feature of psychiatric texts. Primarily diagnosed by the age of the sufferer (most agreed on a more extended period than we might perhaps have expected, from the age of 14 to 25), the concept emerged from more general attention to adolescence as an important – and potentially difficult – period of development. This interest might appear obvious to a modern audience. However, prior to this period, distinctions between childhood and adulthood had often been drawn without any reference to an in-between, developmental state.

There were several reasons for this new focus within psychiatry, in addition to external cultural shifts, such as the increasing age of marriage. In particular we can see the influence of evolutionary theories of mind and the associated interest in hereditary theories of insanity. Developmental psychology thus assumed a close association between physical and mental development. As T.S. Clouston put it in Tuke’s Dictionary of Psychological Medicine:

At puberty and adolescence … the affective faculties, the social instincts, the altruistic organic cravings, the delight in poetry and romance, the sense of duty, all arise in so different and definite a form as compared with their previous existence, that we must conclude that great tracts of brain substance, which had before lain dormant, have now awakened into activity.[1]

Clouston thus correlated psychological development with physical changes in the brain. These were also thought to be associated with alterations taking place elsewhere in the body, in particular those of sexual development. Similarly, it was assumed that both physical and emotional shocks might arrest mental and physiological development. Sometimes, these might be behaviours under the patient’s control (frequent masturbation, for example, was a common charge). On other occasions, it might include pressures imposed from without, with particular reference to education, work or marriage: “disappointment in love”, for example, was a frequently cited cause for mental illness, in young men as well as women in this period.

Harry Dearman was discharged well after just over four months at Bethlem: insanity of adolescence was widely considered one of the most curable forms of mental illness, with 65% or more deemed to recover. The very existence of the diagnosis, however, points to the increased emphasis being placed on development within psychology in the late nineteenth century, and the introduction of a transitionary phase between childhood and adulthood.


[1] T.S. Clouston, “Developmental Insanities” in Daniel Hack Tuke, ed. A Dictionary of Psychological Medicine (London: J. & A. Churchill, 1892), p. 360.

Advertisements

Nineteenth Century Society: Women, Madness & Marriage 4

Marriage breakdown could cause massive disruption in the lives of married women in the Victorian era. Even in cases where the termination of the marriage had been desired, such as that of Kate Marian Merriman, admitted as a patient of Bethlem Hospital in July 1891, the change in position might be hard to deal with. Suddenly returned to the care of her family after separation from her husband six years ago, 36 year old Merriman “had considerable trouble with her relations over family matters,” most of which seem to relate to her desire for independence for, like Grace Sapsford a decade later, she felt that “I surely have a perfect right at my age to choose my future.”

Kate Merriman told the medical officers a lengthy story of her admission, refuting or explaining most of the issues stated as delusions in her medical certificates. “The night before admission she stayed at a hotel at Henley by herself with no luggage but a travelling bag. She was much upset by the way she was treated there, she says with great want of respect. The people there mistook a razor in her bag for a suicidal instrument, whereas she always carried it to cut her corns. She says nothing in her conduct accounted for the rude way in which she was treated. This bother caused her so much annoyance that she refused her food.”

It is unclear whether the medical officers took the word of Kate’s brother (who connected her illness with her separation from her husband six years before) or herself – for they certainly commented on the lack of clear symptoms of insanity. Moreover, the conversational tone of the letter written by Mrs Merriman to Dr Hyslop after her discharge indicates that she felt he understood her: “as you know, I have not had anything to do with my relatives for some time.” However, as Kate was legally regarded as a dependent of her parents, the medical officers were in a difficult position: they would have to send her back to her parents’ home. This, she wrote, caused her to feel “isolated” in the Hospital, and: “While forgiving as one hopes to be forgiven, one cannot forget the past six & a half years of their life. … I have lived the quietest of lives in rooms with my children before, if necessary I can do it again, & be far happier there, than I could ever be with my own family.”

Ultimately, Kate Merriman managed to achieve her aims. Discharged cured in November 1891, her certificate was signed by a doctor in Penzance – where she had long claimed she wished to move with her children, well away from the family she disliked, in part due to their overbearing views on her marriage. This doctor, Humphry Davy, in fact disagreed with the diagnoses which had led to her certification in the first place. He declared that he had seen Mrs Merriman many times in the last four years and had never witnessed any symptom of insanity: as he saw it, her ideas of persecution at the hands of her family were entirely rational.

Nineteenth Century Society: Women, Madness & Marriage 3

The medical records of an appreciable number of the young women admitted as patients of Bethlem in the late nineteenth century provide evidence of a close interplay of social intimacy, expectation and vulnerability. Nancy Jessie Joy was admitted twice in 1888. Aged 22, Nancy was a Still Room Maid, regarded as suffering from melancholia. She was quickly discharged cured following her first admission, but later claimed to have been simply pretending to be well. After this discharge, while still depressed, she “had the idea that if she became “ruined” a change would come over her mind.” She wandered from home and was “accosted by a gentleman.” Having “allowed him to have intercourse with her,” she “now feels she is going to hell and wants to hurry this on.” In Nancy’s case, conventional gender roles were used to attempt to avoid the stigma that might be associated with her behaviour: the “seduced woman,” Nancy’s actions are interpreted as entirely passive (she “wanders,” and does not instigate relations but simply “allows” it), while the “accosting” gentleman is the active party. Her “seduction” was seen as the reason for Nancy’s re-admission in October 1888 – popular literature in particular frequently associated female insanity and suicidal behaviour with seduction: again, however, she was quickly discharged as recovered, without further comment on her actions.

Yet the role of the Victorian psychiatrist in such cases was complicated – at once physician, moral guardian and spiritual counsellor, indicated by the letter Nancy wrote to Dr Smith three years after her discharge. Having apparently remained well, she begged Dr Smith for advice, for “I feel I cannot ask my mother.” Two things, Nancy felt, might prevent her marrying, as she described her situation to Dr Smith as follows:

“I am engaged to a young man who wishes to marry me & does not mind my having been insane. I could not frame my lips to utter, or I would rather have come & ask you. [sic] Sir, in my sane mind not an impure thought enters my mind. … Am I really ruined or not? If I am I will never marry, no man shall reproach and if you are able to say I am not ruined then one question more, was my insanity of a nature that it would not be right for me to marry?”

There is no indication of Dr Smith’s response to this letter – or whether he even replied at all. However, Nancy was still single when she was admitted to Bethlem in 1899, aged 32, her relapse caused by “mental worry,” presumably due to her “self accusation.” This time, she was discharged uncured.

Nineteenth Century Society: Women, Madness and Marriage 2

Unconventional behaviour was sometimes (but not always) regarded as evidence of insanity. Victorian Bethlem’s medical officers certainly did not appear to think badly of those female patients who chose education over marriage (perhaps unsurprising: obituaries of George Savage hailed him as a champion of medical education for women) – nor, indeed, was this necessarily the case with the patient’s families. Isabella Clemes, admitted in 1892, was a Teacher of Mathematics and graduate of Newnham College, Cambridge; her brother felt that she had shown “no special nervousness” prior to the commencement of her illness – indeed, eccentricity seemed to be predominantly on the male side of the family and, although the maternal grandmother “was carried away a little by “spiritualism” in her old age … up to that time she had been a remarkably able & executive woman.”

“Disappointment in love”, often regarded as a cause of illness in single patients, was thus not particularly associated with women, as indicated in the case of Alfred Freeman and Alice Meeks. Twenty-one year old Freeman’s sentimentality was regarded as part of his apparently troublesome nature; he is “generally annoying everyone” wrote Bethlem’s medical officers in 1894, inserting examples of his love poetry into the casebooks as evidence. Also inserted was the letter he wrote to a female patient, Alice Meeks, after meeting her at one of the regular Hospital dances.

“Dear Dr Hyslop,” Miss Meeks wrote after receiving Freeman’s proposal of marriage. “You will be greatly amused at my letter, also the one which I have enclosed. I must say you won’t be more surprised than I was this afternoon at receiving such a stupid lot of nonsense. I can assure you my ideas of love are very far from that quarter. I don’t suppose in my 22 years of happiness I could ever have thought less about that sort of thing. You remember about my speaking to you about a secret, that even my own Mother & Father know nothing at all about, at the early age of 19 years I had an offer of marriage from a Medical Student, he was very young only 23, but to all outward appearances seemed rather to like my company. He said that in 5 years time he hoped to have a good home for me, but I only laughed at it as I could not & do not understand that meaning love. I fear I am rather a loveless creature. Hoping you will not laugh at me. Yours sincerely, A.G.M. Meeks.”

Seemingly well aware that her behaviour as a “loveless creature” rather defied the expectations of society, the firm and decisive manner of Miss Meeks’ letter is rather at odds with her apparent condition in the Hospital, in which she was generally seen as silent, depressed, and later “stuporous.” Her independent tone, however, was echoed by many other young women in the 1880s and ‘90s: most of whom were working, and often did not live with their families. Those who did might express the opinions of Fanny Hider, a 30 year old governess admitted in 1888, “that if she is allowed to go home she will have her own way, & will do as she likes, she means to be independent.” Shortly thereafter, Fanny was discharged well.

Christmas-Ball-1859-2

A Hospital Dance in 1859