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Questions for Tues. September 7, 2021

1.	Tomes tells us that Lasch and Katz felt that asylums were instruments of social control that fostered a “single standard of citizenship” which worked well in a rapidly industrializing society. She also explains how they felt asylum treatments were nothing more than “scientific rationalizations of middle-class morality.” (10) It seems that Foucault, Lasch, and Katz all believed asylums were not necessarily good innovations. What do you think? Where asylums an integral part of 19th century America or just a way to “warehouse” social deviants?

2.	Tomes Introduction calls asylums: “institutions sanctioned by the whole society to meet certain commonly perceived needs.” (12) To what needs is she referring?

Submitted by Bonnie Akkerman     I pledge…

1. Throughout Chapter 1, Tomes makes the vague argument that "optimism" was a driving force for the success of hospitals in curing/dealing with mental disorders in the 18th century. Do you believe there are any counter-arguments to this simple line of thinking? Should the previously-held idea that "insanity" was related to a deficiency of one's soul have made mental-health workers more or less optimistic?

2. Reading through Tomes' Chapter 4, it appears that the Kirkbride model revolved around a similar paradigm as the "Great Man Theory" of History, in that it recommended authority be held by an all-powerful superintendent whose individual qualities would determine the welfare of an asylum. Given that theory's divisiveness, do you see any of the critiques against it taking form in the failings of the asylums this chapter follows?

3. What do you think of the idea of a separate Men's (and Women's) section, as proposed by the Kirkbride model? Tenable today?

Submitted by Theron Gertz.    I pledge...

1) According to Tomes, more than 50% of women patients were married at the time of admission, while only 31% were single and 19% were widowed (pg. 28). We have mentioned in past discussions how women were often institutionalized for expressing ideas, being too forward in their opinions, or simply because their husbands didn't want to be bothered by them. Taking this into consideration as well as the knowledge that Pennsylvania Hospital had skewed from its original design of helping the poor in favor of wealthier clientele, I'd like to discuss the implications of these statistics and the moral ambiguity that comes with the institutionalization of people who aren't necessarily in need of treatment from asylums. After all asylums were seen as places to "secure the insane" in order to "seclude" them away from proper society (pg. 35). Furthermore, I'd like to discuss the social and economic motivations associated with this in the context of the 19th century.

2) There are many things the early lay people got wrong concerning mental illnesses, however there are many things they surprisingly got right. Though they do not use the modern psychological terms we are familiar with, they did manage to explain many causes and symptoms in simple terms. I'd like to discuss what these early asylum keepers managed to get right, what they got wrong, and how we feel from a modern perspective about this.

Submitted by Lyndsey Clark.    I pledge...

1. In the very beginning of Chapter 1, I noticed that Kirkbride found that without the lack of restraints or harshness towards the patients, they actually handled themselves pretty well and maintained their appearance to a decent standard (pg. 21). Regardless if whether or not they were just being good for the gingerbread, how come we don't hear about these kinds of cases? Although I do know that not every asylum is run decently, especially not throughout the time period that we are studying, was there ever anything mentioned about the good cases, if there were any?

2. What was considered "Moral treatment"?

3. I was definitely drawn to the statistics as to what a "real lunatic/inmate" was. In Chapter 1, Tomes briefly explains how in order to be qualified to be in an asylum, "lunatics had to disrupt the familial or communal order in some very serious fashion." (pg.26). With that being said, would these actions be fabricated by family members to possibly "rid" themselves of someone? Were there any cases of such?

Submitted By: Erica Banks     I pledge....

1.	 Tomes cites Pliny Earle as saying that Americans of his day suffered from “nervous exhaustion” due to the increased uncertainty that comes along with greater progress in society (80). Is what he called “nervous exhaustion” what we would call depression or anxiety, or a combination of the two? The “strengthening regimen” he recommends using narcotics and tonics seems to complicate the picture (83).

2.	Tomes’ statement that the rise of neurology complicated the asylum referral process by providing an alternative method to treat those who suffered from nerve-related ailments (107). Patients would often go to neurologists first before committing family members to an asylum. This suggests that American society was unsure as to whether mental illness was best treated by medical or psychological methods. At what point would neurologists and/or families decide that their mentally ill were better treated at an asylum? Alternatively, were there instances of asylum doctors referring patients to neurologists?

Submitted by Chris O'Neill

1. Do you think writing the history of a mental hospital is hard because there isn't much written on it or does the political discourse have more to do with it?

2. If Kirkbride's family have chosen to go to the Hicksites, how do you think he would have run his asylum? Would he even have become a doctor?

Submitted By Audrey Schroeder

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