Building Places of Madness

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Dr. Thomas Kirkbride, courtesy National Institutes of Health

Dr. Thomas Kirkbride, courtesy National Institutes of Health

In the early part of the 19th century,  moral treatment (see May 18, 2010 post) included the idea that patients’ surroundings could contribute to their treatment and healing .

Dr. Thomas S. Kirkbride (July 31, 1809-Dec. 16, 1883), one of the founders of the Association of Medical Superintendents of American Institutions for the Insane (which later became the American Psychiatric Association), developed a building plan that he felt would improve the asylum experience for patients. It consisted of a centralized administration building with a wing on either side, one for males and one for females.

Kirkbride believed that careful building design could help with treatment. Each ward was set back a little from the previous one so that every room would have fresh air and sunlight. Grounds were lushly landscaped, and the buildings themselves were set in rural environments to give nature a chance to heal tired minds.

Unfortunately, these huge buildings became victims of overcrowding, which then led to many abuses. They fell out of favor by the end of the century. Below are two examples of the “Kirkbride Plan” for asylums.

St. Elizabeths, (1909-1933?) courtesy Library of Congress

St. Elizabeths, (1909-1933?) courtesy Library of Congress

Danvers State Lunatic Hospital

Danvers State Lunatic Hospital

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Some Treatments Were Moral

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Dr. Philippe Pinel

Dr. Philippe Pinel

Early treatment of insanity generally embraced a view that insane persons had lost their reason, and though not responsible for their actions, could only be housed until they either somehow got better or died. Such treatments as existed were typically physical: bleeding, whipping, spinning, chaining, isolating from others, etc.

In the early 1800s, reformers such as Dr.  Philippe Pinel began to view the insane as people who had lost their reason because of exposure to severe stress or shocks. Victorians had terms like brain fever and shattered nerves to describe this kind of condition. Patients were seen as needing protection from society for a time so they could recover, and many alienists began using fewer restraints and stressful physical treatments. They believed that patients could be helped by moral treatments. These included friendly discussions of the patients’ problems, chores or occupations to discipline their time, and guidance for their interactions with others.

Glore Patients Out For a Stroll, 1902, courtesy Glore Psychiatric Museum

Glore Patients Out For a Stroll, 1902, courtesy Glore Psychiatric Museum

Though popular for several decades, the movement lost favor as medicine became incorporated into treatments, asylums became overcrowded, and money to pay for moral treatment (which required more attendants because patients received more than custodial care) became issues.Depiction of Dr. Pinel Intervening to Unchain a Patient

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A Female Crusader, Part Two

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After Dorothea Dix visited a jail in 1841 and discovered the appalling conditions that mentally ill people suffered there, she began to gather information to present to legislators. She visited every jail and poorhouse in Massachusetts (her home state) and compiled a graphic report. Dix described a woman who was tearing her skin off, bit by bit, with no one to stop her. She had seen a man confined to an outbuilding (presumably at a hospital) next to the “dead room” so that he saw only corpses. Others she had seen were locked into rooms without heat, daylight or fresh air.

She was immediately called a liar, but newspapers reprinted excerpts of her report. She persuaded a group of men to take up her cause, and they were able to persuade the legislature to appropriate more money for the state hospital for the insane.

During her lifetime, Dix played a direct role in founding 32 mental hospitals. One in particular, the Government Hospital for the Insane, (later named St. Elizabeths) provided “the most humane care and enlightened curative treatment of the insane of the Army, Navy, and the District of Columbia.”

From 43rd Congress, First Session, courtesy Library of Congress

From 43rd Congress, First Session, courtesy Library of Congress

One of St. Elizabeths’ doctors became superintendent of the Canton Asylum for Insane Indians.

Men Working in Broom Factory at Oak Forest, IL Poorhouse, circa 1915, courtesy Library of Congress

Men Working in Broom Factory at Oak Forest, IL Poorhouse, circa 1915, courtesy Library of Congress

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A Female Crusader, Part One

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Dorothea Dix, circa 1840

Dorothea Dix, circa 1840

Though she was born in an age that didn’t value education for women, Dorothea Dix (April 4, 1802 – July 17, 1887) learned to read and write as she cared for the siblings her mentally ill mother and alcoholic father all but dumped on her.

She was extremely unhappy and left home to live with relatives when she was twelve years old, but social consciousness had rooted itself in her soul. She began a lifetime of fighting for the downtrodden by opening a school for female children. These “little dames” were not permitted to attend public schools because of education laws, but could be taught privately by a female. Dix was only fifteen when she taught her first class.

When Dix was 40, a friend asked her to teach a Sunday School class in a jail. When she arrived, Dix was appalled to find that “feeble-minded idiots” had been incarcerated with hardened criminals in an unheated jail room. From that moment, she was determined to help the mentally ill, who too often wound up in such places because there was nowhere else to put them. Below is a picture of the Lombard Farm Poorhouse, where Dix reported finding women chained and kept in pens.

Lombard Farm Poorhouse, Barnstable MA, courtesy Library of Congress

Lombard Farm Poorhouse, Barnstable MA, courtesy Library of Congress

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A History of Hurting

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Mental illness has been recognized for thousands of years, and various innovative treatments were developed for it. Most were violent: doctors in ancient civilizations bored holes in the patient’s head to let demons out, and lobotomies (surgery to sever nerve tracts in the brain’s frontal lobe) were performed in the U.S. until 1951. One doctor, Walter Freeman, used to perform several in one session with an instrument like an ice pick.

Roman remedies for madness included flogging, fetters, and starvation. Other tried and true cures through the years were bleeding, purging, and forced vomiting. Herbal remedies abounded as well. St. John’s Wort was used by the Greeks to calm anxiety, while medieval practitioners believed that tying a bag of buttercups under someone’s neck would cure the person’s insanity.

Buttercups

Buttercups

Instruments Used to Bore Holes in Skull

Instruments Used to Bore Holes in Skull

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Kill the Indian, Save the Man

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“A great general has said that the only good Indian is a dead one[….]In a sense, I agree with the sentiment, but only in this: that all the Indian there is in the race should be dead. Kill the Indian in him, and save the man.” –from a paper read by Carlisle Indian School founder, Captain Richard H. Pratt, at an 1892 convention.

Pratt’s words sound terrible to us today, but in his own time, his theory that Indians could be assimilated into American culture–rather than massacred out of it–was more humane than many of his contemporaries’ ideologies.

Pratt was an Army officer in the 10th Calvary,who commanded a unit of African American “Buffalo Soldiers” and Indian scouts  in Indian Territory after the Civil War. In 1875 he escorted 72 Indian warriors suspected of murdering white settlers to Ft. Marion in Florida. Once there, he took off his prisoners’ shackles, put them in uniforms, and drilled them like soldiers. Curious locals offered to teach them English. Pratt agreed, feeling that he was “civilizing” his charges. Eventually the Indians’ military guards were dismissed and trusted prisoners were allowed to act as guards, instead.

Pratt’s accomplishments drew positive attention and he gained permission from the Secretary of the Interior to establish a school that would take Indian children far away from their homes and immerse them in American culture. He got permission to use the Carlisle Barracks at a deserted military base to begin his experiment in civilizing the Indian nations through their children.

Richard H. Pratt

Richard H. Pratt

Richard Pratt With Prisoners, Ft.Marion, 1875

Richard Pratt With Prisoners, Ft.Marion, 1875

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Reading, Writing, and Arithmetic–Not

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The BIA, of course, knew what was best for Indian children–vocational training that would help them become useful members of society. Before they began their lessons, though, students had a host of chores to perform (cooking, cleaning, weeding the garden) that helped keep the school running.

After chores were out of the way, the children had a chance to learn academics like English, music and U.S. history. Children also participated in sports like football and baseball, which many enjoyed. However, they marched to class, marched to their meals, marched to inspections and roll calls, marched to wherever they needed to go, and always by the regimented ringing of a bell to tell them when to go.

Since the government considered education a primary way to help its Indians wards earn a living, the emphasis was put on vocational training. Girls learned nursing and office work, while boys learned animal husbandry, carpentry, blacksmithing, or shop. In addition to formal classes, students swept and scrubbed, painted, sewed, milked cows, maintained gardens and buildings, and performed an abundance of unpaid labor.

Chiricahua Apaches Four Months After Arriving at Carlisle Indian School, 1886, courtesy Library of Congress

Chiricahua Apaches Four Months After Arriving at Carlisle Indian School, 1886, courtesy Library of Congress

Wood Chopping at Tulalip Indian School, circa 1912

Wood Chopping at Tulalip Indian School, circa 1912

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A New Life

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Graduating Class, Carlisle Indian School, 1894, lcourtesy Library of Congress

Graduating Class, Carlisle Indian School, 1894, courtesy Library of Congress

A host of cruel practices were committed in the name of “civilizing” Indians. Though many children endured a hardscrabble life growing up on reservations, many others went to government boarding schools. Sometimes children were forcibly taken from their parents and put on trains without any preparation for leaving.

When they reached their schools, children were both brainwashed and miserably treated, because boarding schools had a mandate to cut the ties students felt to their homes and families.  They were told that their race was inferior to the white race, that their practices were savage, and that even their religion was worthless.

Children were often not allowed to go home to visit their families. The schools were purposely far away from reservations so that it would be a great hardship for families to visit their children. By the time some of the students came home, they had forgotten how to speak their own language.

Boys often wore uniforms and learned to march. Showing homesickness was forbidden. Letters were sometimes intercepted and destroyed or censored. Runaways were a problem, so many children were locked in their rooms at night, or their windows were nailed shut.

Children who conformed to the new way of living  were called “good Indians.” Those who resisted, ran away, spoke their native language, or complained were called “bad Indians.”

Indian Children on Flathead Reservation, 1907, courtesy Library of Congress

Indian Children on Flathead Reservation, 1907, courtesy Library of Congress


Three Lakota Boys Arriving at Carlisle, courtesy National Anthropological Archives, Smithsonian

Three Lakota Boys Arriving at Carlisle, courtesy National Anthropological Archives, Smithsonian


The Same Three Boys Beginning Civilized Life at Carlisle, National Anthropological Archives, Smithsonian

The Same Three Boys Beginning Civilized Life at Carlisle, National Anthropological Archives, Smithsonian

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Other Indian Prisons

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Indian School at Pine Ridge, courtesy Library of Congress

Indian School at Pine Ridge, courtesy Library of Congress

Commitment to an insane asylum would be a horrific experience for any Indian, but fortunately that happened to only a few within the population as a whole. What happened far more often, and affected more people, was the BIA’s invasion into Indian family life. Continue reading →