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Questions for Thursday Sept. 9, 2021

1. Kirkbride was a big advocate of “routine” (Tomes –pgs. 199-200) with scheduled activities that included physical and mental exercise. He also implemented asylum patients’ daily activities “according to their affluence.” (201) This approach reminds me of how the military trains and sustains internal obedience and self-discipline while carefully maintaining the rank structure of officers and enlisted. Thoughts on Kirkbride’s visionary approach to keeping order?

2. I thought it was so interesting that: “Kirkbride tried to use the shame and guilt that individuals came to feel about their past behavior to increase their determination to resist or overcome their insane impulses.” (218) Apparently, it was sometimes successful. What do you think of this approach to behavior modification?

3. Tomes states, “early asylum therapy might be regarded as a secularized version of the conversion experience.” (222) What does this say about the Second Great Awakening in American Culture? Is this “mortal treatment” more or less humane than the way mental patients are treated in the 21st century?

Submitted by Bonnie Akkerman I pledge…

1. In Chapter 5, we learn that confinement was a regular procedure in the Kirkbride model for those who caretakers deemed “destructive” or capable of self-harm. Was this humane to do? Does Tomes make a stance on this practice?

2. As we have seen in Tomes' book, entire centuries of medical/psychiatric practice were defined by individuals. Why does this not seem to be the case today? How will future historians label our current overarching attitude toward mental health?

Submitted by Theron Gertz I pledge…

1. Did the patients know that they were being given morphine infused tea and other drug remades while in Kirkbride’s care?

2. What was Kirkbride’s view on the Irish immigrant population? since he unlike other superintendents. Did not view them as a reason as to why their staff was incompetent.

-Parker Siebenschuh I pledge….

1. I'm very interested in the early uses of drugs to treat mental patients, especially the use of drugs like opium and hemlock and the potential harmful effects they had on patients. Taking into consideration the way he grouped patients, to what extent do you think Kirkbride's use of drugs on his patients was justified? Is this Kirkbride's way of being humane? I'd like to discuss the ethics behind this, and talk more about how this translates into the current uses of drugs for psychological cases.

2. Chapter 5 demonstrates that Kirkbride was very adamant about his patients having a daily regimen. This makes me wonder if Kirkbride had a psychological disorder of his own. The way Tomes describes him makes it sound like he has a personality disorder characterized by undermining and controlling other people, or a “control freak” for the improper slang term. I'd like to discuss this more with the rest of the class.

Submitted by Lyndsey Clark. I pledge…

1. If asylum workers knew that withdrawing from the world wasn't healthy behavior, why didn't they try to help instead of just tending and housing patients (192-193)?

2. Tome states, “In the first place, Kirkbride was quick to reassure family members that the decision to commit a relative was a wise one” (210). Based on this statement, was Kirkbride more influenced by helping the patients, or did he care more about their families' money?

Submitted by Audrey Schroeder. I pledge…

1. What differentiated early European asylums and American asylums? Were they similar, in any way?

2. One thing that I would like to ask regarding Kirkbride: Do you think that he made the reputation of mental asylums better, or worse? How did his ideas influence the perception of insanity in American society? Do we still see any of these perceptions today?

Submitted by Erica Banks. I pledge…

1. Kirkbride is said to have administered morphine to “75-88 percent of the patients receiving medical treatment” (195). Given that morphine is a highly addictive drug, I’m wondering if morphine addiction ever became a problem in his asylum. If so, how did he treat it?

2. Tomes points out that possibly one of the greatest achievements of 19th century asylums that it was able to treat patients like Eliza Butler and allow them to return to a “reasonably normal life” (235). However, Tomes, cautions, there was a stigma in society of that time (no doubt true even today) against people who had a past of mental illness. To what degree were previously “insane” people stigmatized?

Submitted by Chris O'Neill

Question 1: Tomes mentions that Kirkbride would offer hard-working patients who recovered, jobs at the asylum. How often did this occur and how many employees were recovered, patients?

Question 2: How often did “rebellions” from employees and patients occur in asylums?

Submitted by Griffin Nameroff

1. Why was it justifiable for experimenting with drug therapy on patients? Was this seen as progressive by many patients or were they at all suspicious of the ramifications that came with experimentation?

2. Asylums were said to have equality of opportunity rather than equality of condition, was this something that made asylums inevitable to fail? Would equality of condition be sustainable?

Submitted by Jack Kurz

1. I found it interesting that Kirkbride allowed “individualism” with in his hospital by allowing patients to wear their personal clothing, why did he not instill this same train of thought with individualized treatment?

2. How did Kirkbride handle addiction on behalf of distributing morphine and other opioids?

-Janis Shurtleff

In Chapter 5, Tomes reveals how persuasive and manipulative Kirkbride can be when it comes to preserving his image and smoothing over hairy situations. He also spent a lot of time on rewarding patients with special dinners with him, writing letters to families, etc. Since he was the model for other superintendents, were they also operating their institutions this way?

The idea that increased social stresses were the cause of insanity and reinforced the need for psychological care. Kirkbride set up a class hierarchy as well as a reward system in his facility with punishments for poor behavior. Doesn’t this also create additional stress that would further complicate their conditions? Several patients complained about feeling less than because they were poor, or that they were treated poorly in different wards, so were these systems constructed to only benefit the rich and unproblematic patients?

Submitted by Allison Love (I pledge…)

1) Tomes mentions how Kirkbride permitted the patients to purchase anything that they wished to have in their rooms (202). Wouldn’t this be possibly dangerous to the patients if it was not closely monitored what was sent to them or what they purchased? Couldn’t this also adversely affect other patients’ treatment by making them feel as though since they have less than the other patients?

2) Kirkbride’s marriage to Eliza was one that promoted the effectiveness of medicine to cure insanity and allow the patient to return to a normal life. What happens to the patients who are cured but are unable to return to a normal life due to prejudice or lack of acceptance? Tomes eludes to it but doesn’t go into much detail.

Submitted by Mallory Karnei (I pledge…)

1) Something throughout the sources that we have read that I've realized is how widely known Kirkbride and his methods were. What made him and his time as a superintendent so well known that, “his approach to hospital management profoundly influenced a whole generation of American asylum doctors.” (page 265) Discuss.

2) As we have learned from earlier readings, people could be brought to stay in an asylum for any number of reasons, voluntary or not. In the chapter “The Perils of Asylum Practice,” Tomes mentions that patient-related disputes “contributed to the problem of asylum practice.” (page 274) How serious were these questions being brought up and how were they solved? Who usually “won” the dispute, the institution or the patient?

Carson Berrier (I pledge…)

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