Madness in its Place

Narratives of Severalls Hospital 1913-1997

Diana Gittins

• Publisher: Routledge
• Year: 2006
• eBook ISBN: 9781134670635
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

This fascinating study presents a unique history of psychiatry in the twentieth century. It brings together the memories and narratives of over sixty patients and workers who lived, or were employed, in Severalls Psychiatric Hospital, Essex, UK. Personal accounts are contextualised both in relation to wider developments and issues in twentieth-century mental health, and in relation to policies and changes in the hospital itself. Organised around the theme of space and place, and drawing upon both quantitative and qualitative material, chapters deal with key areas such as gender divisions, power relations, patterns of admission and discharge, treatments, and the daily lives and routines of patients and nurses of both sexes.

1

INTRODUCTION

Space, time and madness

A few weeks after Severalls, Essex County Council’s second lunatic asylum, opened its doors in May 1913, the first radio signal was beamed across the world from the Eiffel Tower. A symbol and portent of impending collapse of earlier notions of space and time, it established world time and would also make the earth a ‘global village’. In that same year, Henry Ford began the first assembly-line production of cars, heralding both mass-production on a huge scale and a revolution in transport. Just over one year later, the First World War would shatter old beliefs about madness and psychiatry, religion, nation, gender. Prior to this, of course, myriad changes had already come about and were still in process, but the rate of change varied enormously, and though the industrial world had long been ruled by the invariant measure of clocks, it could still be said that in some areas of the world, particularly remote areas, different ways of experiencing time still existed.

Rural Essex at this time still operated in ways that had changed only slowly over the past century; the majority of patients who filled Severalls’ wards, at least until well into the twentieth century, came from rural areas and agricultural work where their lives were dominated by time that was as much determined by seasons, moons, frosts, rains, planting and harvesting cycles as by clocks. The rural population was still travelling by foot, bicycle, horse and cart. Towns such as Colchester, Chelmsford, Clacton and Harwich, which were also part of Severalls’ huge catchment area ¹ were different, and those who worked in the manufacturing industries and shops would be used to a rigid clock-dominated way of life and work. Temporalities shift and vary according to people’s lives and experiences.

The world was rapidly speeding up, becoming a smaller and increasingly more accessible place, but the rate and the pace at which it did so varied enormously from country to country, region to region, hamlet to town, and town to city. Such changes meant a more extended reaching-out to other cultures, other places, a process begun with colonisation and one which accelerated dramatically during the course of the First World War, to a large extent as a result of the new ‘world time’ and the revolutions in communication and transportation.

While on the one hand new developments reached outwards, parallel developments resulted in an increasing tendency to look inwards, to seek to understand and analyse the invisible interior. Rutherford’s work on the atomic nucleus was a looking-within which would in time have, literally, earth-shattering repercussions. The discovery of X-rays by Roentgen in 1895 meant, among other things, that for the first time the interior of the human body could be scrutinised. The writings of Joyce, Proust, Woolf and Richardson were all both exploring a more interior world of the individual and challenging old notions of temporality, linearity and realism. Much of this had been influenced by Freud’s theory of psychoanalysis, another prime example of a quest for the unseen, the unknown, the invisible darkness, a quest that was in many ways represented in Conrad’s Heart of Darkness and, of course, acted out in reality in colonial quests, expeditions and adventures generally.

Freud’s theory challenged prevailing ideas of psychiatry, dominated by the ideas of genetics and a ‘faulty-machine’ model, by claiming that much, if not all, mental illness can be seen as a result of childhood trauma. This model was to become known as a ‘functional’ model and the two models, or discourses, would vie uneasily for dominance throughout the twentieth century. Freud’s ideas were to have, of course, much wider influence on the world, and on the arts and literature in particular. The famous Armory show in New York in 1913 brought together art by Picasso, Matisse, Brancusi, Braque, Klee, de Chirico and Kandinsky, all of whom were challenging old realist ideas of perspective, space, realism and dimension and were much influenced by the idea of the unconscious. Yet these were, at least initially, metropolitan developments, changes at the core that were, in time, to reverberate through peripheries, but which in 1913, in rural Essex, were probably noted by only a small handful of local middle-class professionals. Most probably the walls of small agricultural workers’ cottages in Great Horkesley or Boxted or Elmstead Market would display an old sampler proclaiming ‘Bless this House’.

As the new atonal music of Schoenberg, Bartok and Berg was blowing apart old ordered patterns of narrative in music in concert halls in New York and Paris and Berlin, agricultural workers in north-east Essex would still be singing folk songs going back a hundred years or more, dancing to melodic tunes played on a fiddle at a Harvest Home in the local barn. Indeed, the farm workers and patients who worked on Severalls’ two farms were still celebrating Harvest Homes after the Second World War. In 1913, when D.H. Lawrence’s Sons and Lovers was first published, challenging Victorian ideas of morality, sexuality and secrecy, illegitimacy and pre-marital sexual relations were still considered shameful among the Essex population at virtually all class levels, and remained grounds for certifying wayward daughters as ‘morally insane’ for many years to come. Many such young women were brought by their families to Severalls and left there, their very existence denied by their kin, for thirty, forty or fifty years. Many of them died in Severalls, some very recently.

Chaos was increasingly seen by philosophers, artists and writers as characteristic of the new, modern world, a view to which, at least until 1914, probably the majority of the population, going on about their work and lives, trying to make ends meet and survive, gave little thought. Unemployment and poverty were rising in Essex. Times were hard. In 1911 30 per cent of the entire population of Essex was classified as paupers. Though people might marvel at a new steam threshing machine, theories of chaos or modernism were almost certainly not burning issues to the thousands of people who would soon come through Severalls’ gates both as patients and as workers. Yet modernism was at its peak in 1913. Not easy to define, it is generally taken to encompass, along with fears of chaos, parallel beliefs in, and a veneration of, objective science, rationality and the possibility of universal laws and morality: ‘Generally perceived as positivistic, technocratic, and rationalistic, universal, modernism has been identified with the belief in linear progress, absolute truths, the rational planning of ideal social orders, and the standardisation of knowledge and production.’²

Integral to the belief in rationality and the potential of scientific progress was medical practice and discourse. Psychiatrists desperately wanted to be part of the strengthening trend towards medicine-as-science, yet during the course of the nineteenth century they had worked and practised almost exclusively as ‘alienists’ within asylums. As such they were more custodians than doctors and were regarded by the rest of the medical profession as poor cousins, Cinderellas of medicine. The track record of cure in psychiatry was very poor indeed; some treatments, such as bromides, paraldehyde, continuous baths and physical restraint by straitjackets, helped to alleviate, sedate and control, but at this point there were no more real ‘cures’ in evidence than there had been a hundred years previously, or indeed, a thousand years previously.

A PLACE FOR MADNESS

Severalls Hospital was constituted as a specific set of buildings in time and space. Between 1913 and 1997, the years of its opening and closing, although there were additions and alterations,³ the infrastructure of the hospital remained very much as it was built, covering a specific area and space. Severalls as a material place therefore continued in apparently the same way over time. Yet between those years many things changed and altered within the hospital’s routines, staffing, population, rules, divisions,

Figure 1.1 Aerial photograph of Severalls, 1978

Source: Picture by courtesy of Essex County Newspapers

regulations, administration and management. To try and account for the history of the hospital thus demands consideration of both space and time, and the interstices and intersections between them.

Space, as Foucault argues, is a metaphor for a site of power which usually constrains but can also liberate. The way in which space is organised constrains, limits and divides can, and frequently did, oppress and repress. Class, gender and categorising of illness were literally built into the hospital infrastructure and thus operated as primary determinants of power relations and a way of life. Through these, Severalls’ inhabitants’ notions of identity and self were to a great extent constructed, or re-constructed (indeed, de-constructed in the older sense of the term), imprinted and defined.⁴ It thus formed a representation of the world that was, or some thought should be, a mental hospital and all those who lived and worked inside it. It was, in a sense, a ‘realised myth’ ⁵: a myth of what an elite group wanted to represent as madness, and madness contained and controlled.

Material space, however, is not the only space, and try though authorities may to define, delimit and contain mental illness within material confines, there still remains another space: the space of imagination, vision, madness, or what Bachelard calls ‘poetic space’.⁶ Patients I interviewed often described their experiences of visions/delusion/epileptic fits as if they were quite distinct landscapes they inhabited at times, landscapes for which, and in which, the lines and grey routines of the hospital were but hazy, one-dimensional unrealities. One woman, who has been in and out of Severalls since the 1960s, described her experiences of manic-depression to me:

It was like—like being put into a glass case, and gradually the lid was lowered, the sound was blocked out. Then the glass was scoured, so you could see less and less through it. And somehow the temperature was dropped. The worst of it is, when it starts, when the glass case is first on you, the lid being put over, and the first scratches on the side, you know what’s happening and you know how it’s going to develop. That is the worst part. When I get to smashing windows, I’m getting better. That’s coming out of the glass. But this knowing how it’s going to develop, knowing you’re powerless to stop it, is the worst part of all. People keep saying, ‘Oh — it was so bad seeing you in the hospital and — you know, this, that or the other was going on’, and I can’t, can’t get over to them that by then it was actually better. It was the weeks and months before, when it’s closing down …

I’ve been on walks when I could see the black beast, which is my name for it. But I could actually see it. I’d turn my head, I’d see it behind me. I’d hear it and smell it. I can’t really say what it looked like, except it always had claws, which would land on me or grab me, or whatever. I can smell it and hear it as well as see it. In fact, the smell is — the first symptom, always. I start smelling things that aren’t there. Usually burning.

And then you come out, and the rooms are small, and there’s all these self-contained little human beings, apart from the one or two really close to you, all the others are all sort of wrapped up in polythene, little layers of it. You can’t get, you can’t get hold of them. There’s no way to make contact with them. It’s a reverse of — for me, when I’m going into the illness, there’s the glass case which gets more and more scratched, but when I’m coming out, everyone else is in a glass case.

Colour was more Intense, and blacks and reds and blues in particular — very very strong. And coming out, there doesn’t seem to be that. And coming, actually, I was last in in 1990, and it’s only this summer [1995] that colours and people are beginni...

Table of contents

• Cover
• Half Title
• Full Title
• Copyright
• Frontmatter
• Dedication
• Contents
• List of illustrations
• List of tables
• Acknowledgements
• 1 Introduction: space, time and madness
• 2 At the gate
• 3 The corridor of power
• 4 The great divide
• 5 On the female side
• 6 On the male side
• 7 The space and pace of treatments
• 8 Conclusion
• Notes
• Bibliography
• Index