Narrative Survival: Personal and Institutional Accounts of Asylum Confinement

Abstract

The concepts of narrative and of genre share a family resemblance in the sense that there are many sorts of narrative genres that run across the various spheres of human activity from literature to anthropology, to history, law, medicine, and psychiatry. In particular, in the field of narrative, non-literary memoirs have become the object of considerable scrutiny.1 While not a review of this literature,2 this essay seeks to enhance scholars’ understanding of the “illness narrative” as a genre by going backward in time to a period in 19th century British psychiatry when clinical narratives in asylum casebooks were central to the practice of psychiatry. These casebooks were essential to psychiatry as an emergent professional field because patient histories constituted the raw material basis of observation leading to diagnosis.
Because casebooks were consulted by magistrates and lunacy commissioners who visited England’s asylums regularly, the patient case histories were essential to insane asylum record-keeping and accountability. Yet, institutional case histories were not the only narrative genre existing to document illness and its treatment. Indeed, “counter-narratives” began to appear at the beginning of the decline of asylums for psychiatric treatment in the second half of the 19th century. Written by former asylum patients, these texts documented the often cruel practices or neglectful treatment at the hands of insensitive keepers, and they were of considerable interest to the Victorian reading public as “survivors’ narratives,” which, along with journalistic exposés and novels, shaped public opinion as well as English law regarding the treatment of the insane. These “survivors’ tales,” that is, personal experience narratives written by those who had been released from the asylum, were met with resistance from psychiatrists, the representatives of the asylum system, who relied on institutional accounts of the patients’ confinement to justify treatment choices or other professional decisions. It is not surprising, then, that institutional documents, such as certificates of insanity, admission records, and case histories often tell a different story than the one proffered by patients who were seeking justice, redemption, and/or catharsis.
In the following essay we focus on two intimately connected cases from the archives of Ticehurst Asylum, England.3 Herman Charles Merivale and Walter Marshall, both patients at Ticehurst in 1876 and 1877, found common ground in the shared belief that neither was mad. Each man, after leaving Ticehurst, produced a narrative—Merivale, a memoir, Marshall, an oral testimony—that challenged the status quo ante of the medico-legal institutional authority that existed at Ticehurst Asylum.4 By “status quo ante,” we mean the practice of basing confinement on “certification” by physicians, surgeons, and apothecaries untrained in psychiatry; the institutional case history of each patient; and the Lunacy Laws5 as a whole. Merivale and Marshall produce interdiscursively linked narratives in which they identify themselves as “survivors” of the experience of asylum incarceration for a period of several months. Merivale’s experiences at Ticehurst are described both in the asylum records and in his memoir, My Experiences in a Lunatic Asylum by a Sane Patient, published first in serial format in the magazine The World in 1878 (a year after his discharge), and as a book in 1879.6 Marshall’s confinement can be pieced together from three sources: institutional records, his oral testimony in front of the Select Commission on Lunacy Laws in 1877, and Merivale’s memoir. (Indeed, Marshall’s story is recounted by Merivale as a cautionary tale and a nutshell version of his own.) At the core of both former patients’ narratives is a brief for sanity, supported by the argument that to place a person suffering from nerves, fatigue, hypochondria, etc., rather than actual “madness,” in an asylum with the truly insane, is to insure that the sufferer will descend into insanity. Seen together, the two narratives corroborate each other and raise the issue of the need for a better system of checks and balances to guarantee protection for individuals who were eccentric, but not necessarily mad.
Our primary goal in this essay is to compare both Marshall’s and Merivale’s “asylum survivor” narratives to the information in their medical admissions records and case notes, as entered in the Ticehurst Asylum...

Full text

Narrative Survival: Personal and Institutional Accounts of Asylum
Confinement
Cristina Hanganu-Bresch
Carol Berkenkotter
Literature and Medicine, Volume 30, Number 1, Spring 2012, pp. 12-41
(Article)
Published by The Johns Hopkins University Press
DOI: 10.1353/lm.2012.0006
For additional information about this article
Accessed 1 Jun 2013 23:01 GMT GMT
http://muse.jhu.edu/journals/lm/summary/v030/30.1.hanganu-bresch.html

 
Literature and Medicine 

Narrative Survival: Personal
and Institutional Accounts of
Asylum Confinement
Cristina Hanganu-Bresch and Carol Berkenkotter

          
            
          
         
          
          
          
            
       
         
        
        
       
       
         
         
         
           
           
          
         
          
        
          


          
          
        
           
        
         
         
           
    
         
 
          

        
       status quo
ante         
           
       
         
          
interdiscursively       
          
        
         My Experiences in a
LunaticAsylum by a Sane Patient      
  The World         
          
          
         
         
             
     
         
           
           
           
           
       
          
        
          

 
      
          
        
           
 invites         
          
           
        
         
   
           
       
        
          
     
          
          
        
          
          
        
         
           
         
           
         
           
          
 
          
         
          
       
           
 Candide   Gulliver’s Travels    
        
         
            
            
      
        


          
        
          
          
         
           
   
         
        
          
            
        
          
          
          
          
         
     
     
       
           
          
          
           
          
           
         
        
          
        
           
         
   
           
  
        
           
         

 
        
           
          
           
       
        
          
         
           
          
       
       
             
            
            
 
        
          
            
             
          
    
         
        
        
          
          
           
            
            
         
       
          
      
          
        
         
          
         
        
         


         
          
          
           
        
       
    
    
       
         
          
        
          
         
           
          
            
         
          
        
          
        
       
         
        
        
          
            
        
 
          
         
          
    
        
          
        
         

 
       
         
          
    
          
            
           
         
       
        
          
           
         
           
        
         
         
   
         
         
    
        
         
          
        
            
            
        
         
   
        
         
         
       
          
       
          
            
      


    
         
            
        
           
       
        
           
            
        
         
       
        
         
 

          
          
           
           
         
                
          
           
  story          
              
  

        
   
        
        
         
           
          
           
         
         
         
        

 
            
       
         
        
    
           
         
         
         
           
          
          
           
          
            
          
         
         
         
          
  
       
  
       
          
  
          
          
             
          
         
          
           
        
           
        
         
          


       
         
       
         
      
        
         
          
      
         
             
     
   
   
             
   
          
           
            
  
           
            
          
           
     
          
           
           
           
          
         
     


          
        
   

 
        
             
         
        
         
          
         
        
       
         

          
  
           
        Still hears voices
  
          
          
   admits hearing the voices, which annoys
him exceedingly.
             
         
     Still confesses to hearing voices.
             
  saying he could hear my (HN) voice and that I was
playing billiards with his father
   Hears voices      
        
         
        
         
            
            
          
         
        
           
         
          


              
      
       
         
           
         
         
          
         
        
    
  
 
           
          
         
       
          
           
           
           
         
            
           
           
        
          
         
             
           
      
         
           
            
       
          
        

 
         
          
         
          
 folie circulaire  olie a la double forme   
     folie circulaire   
           
           
         
          
          
          
            
         
          
          
          
       
         
          
          
           
           
          
            
         
         
   background
 foreground 
       
         
         
          
     
       
  
   
          


          
            
        
          
         
         
         
          
          
         
            
            
          
            
         
           He’s
a Lunatic         
      My Experiences in a lunatic
asylum by a Sane Patient       
         
         
          
             
             
      
  
         
        
            
           
         
         
            
        
            
    
          
        
       
         
            

 
          
         
           
         
   Hard Cash   
    
         
         
           
    lettre de cachet     
        
          
         
           
         
             
           
       
        
  
            
       pathos   
          
          
     
           
            
         
           
           
           
            
             
           
           
  
      
            
            


            
         
         
           
        
          
           
          
           
          
         
       

     
          
         
 
          
       
        
          
             
        

         

          
           
            
          
          
          
          
            
        
          
          
            
         

 
           
        
            
          
       liberavi anima mia, 
          
          
           
             
           
    Bar, Stage, and Platform: Autobio-
graphic Memories        
         
          
          
           
            
        
   
 
            
         
       
          
          
          
           
            
           
  

 
            
          
          
              
          
        
          
           
         


           
        
          
           
         
         
  
      

   My Experiences in a Lunatic Asylum by a Sane
Patient         
          
         
         
        
            
         
      
           
          
              
         
 Hamlet
          
       
         
         
farrago               
           
         
            
             
       
          
          
   
    
      mise-en-abyme 

 
         
             
          
         
  
           

           
         
      
Anatomy of Melancholy. 
        
          
         
 
           
           
        
           
         
          
        
       
        
 
        
       
         
          
         
          
         
          Minutes
of Evidence Taken Before theSelectCommittee on Lunacy Law
            
             
              


            
            
            
          
            
          
               
              
   
           
           
               
            
          
             
           
            
             
           
            
           
    
        
           
         
          
          
         
        
    
             
           
            
              
              
             
           
            

 
        
           
            
           
     
         
           
          
         
     
              
            
            
              
              
             
             
            
  
    
            
           
          
   
        
           
            
            
        
            
         
              
      
            
      
          
         


           
           
        
         
            
         
       
           
             
          
            
             
           
       The Trial 
           
          
          
         
         
        
       
          
   
          
              
     
       
       
           
         
              
          
           
      
        
           
           
       
            

 
          
            
          
     
        
          
          
         
             
              
         
          
         
           
         
         
         
                  
            
         
     
        Book of Common Prayer
       Book of Common Prayer  
           
             
              
            
    
           
          
         
          
          
           
         
     
       
          
          


        
         
         
         
          
           
          
          
       
          
            
          

 
       
          
         
         
         
         
          
           
      
   
          
          
       
  
          
         
        
   Anatomy of Criticism     
          
        
          
         
          
           

 
          
           
            
  
      
         
            
          
         
         
         
          
        
          
         
       
         
         
           
          
        
            
         
      
         
        
          
         
           
          
         
         
        
           
        
           
         
  



 Narrative Medicine Stories Matter
 Constructing Panic  The Illness Narratives   
    Healing Dramas and Clinical Plots 
   Psychoanalysis and Narrative Medicine
   Patient Tales 
          
         
         
          
            
           
              
             
           
         
            
            
           
             
          
            
           
          
             
    Psychiatry for the Rich   A Diagnostic
Analysis
            
          
             
            
           
           
        
          
   dramatis personae        
            
     
  
 
  How to Do Things with Words
      
        
  Narrative Medicine
    
           
              
              
           
      
    My Experiences, 
  

 
           
          
   
           
           
             
  Psychiatry for the Rich
   




  History of Mental Symptoms
         
             
   Psychiatrie    Clinical Psychiatry
   
     
   
   
  The Content of the Form
 Aspects of the Novel 
 Narrative Medicine 
 Narrative Causalities 
   
          
             
           
   fabula   syuzhet     
           
            
              
                 
  
 Explaining People 
    
          
          
   
          
            American
Journal of Psychiatry,            
           
              
            
           
            
             
             
        
           
            
  The History of Mental Symptoms 
      


          
        
   

      
  Psychiatrie: Ein Lehrbuch für Studirende und Aertze  
  
   

 The Woman in White
 Hard Cash
 My Experiences in a Lunatic Asylum     
        Sun and Shadow 
 My Experiences 

              
            
           
           
     The Atlantic       
             
   
 My Experiences 
 
    
 My Experiences 
    
 My Experiences 
 
 
 The Anatomy 

          
            
              
       
 My Experiences 
         
  avant la lettre         
             
            
    
 
            
           
          
      
Minutes of Evidence Taken Before the Select Committee on Lunacy Law 
 

 
 The Trial 
Minutes of Evidence 
   

 
   

 My Experiences 
         
           
       
 
 
 

Manuscript sources.        
          
          
  
   How to Do Things with Words    
 
       The Routledge Handbook of Discourse
Analysis          
  
 Patient Tales: Case Histories and the Uses of Narrative inPsychiatry
       
        
         Written Communication
     
   The History of Mental Symptoms. Descriptive Pyschopathology Since
the Nineteenth Century.      
       Discourse &
Communication      
       A Manual of Psychological Medicine
Containing the History, Nosology, Description, Statistics, Diagnosis, Pathology, and
Treatment of Insanity with an Appendix of Cases.    
     Constructing Panic: the Discourse of Agoraphobia 
     
  Narrative Medicine: Honoring the Stories of Illness   
  
       Literature and Medicine   
      Stories Matter: The Role of NarrativeinMedi-
cal Ethics    
  The Woman in White    
       Medical Times and Gazette 
              
              
   
     He’s a Lunatic. A Farce in One Act.  
  
        Atlantic Monthly Magazine 
 
       Bulletin de l’Académie deMédi-
cine   


 The Rhetoric and Ideology ofGenre: Strategies for Stability
and Change        
     
   Aspects of the Novel      
  The Anatomy of Criticism.     

      American Journal of Psychiatry    
   
  Narrative Causalities      

  The Trial         
 
  The Illness Narratives: Suffering, Healing, and the Human Condition
    
  Clinical Psychiatry: A Textbook forStudents and Physicians  
     
 Psychiatrie: Ein Lehrbuch für Studirende und Aertze     

  Psychiatry for the Rich: A History of Ticehurst Private Asylum,
17921917   
      
     The Anatomy of Madness: Essays in the
History of Psychiatry          
     
  Healing Dramas and Clinical Plots: the Narrative Structure of Experi-
ence      
      Social Science and Medicine 
 
   Bar, Stage & Platform: Autobiographic Memories   
   
 My Experiences in a Lunatic Asylum by a Sane Patient   
 
  Hard Cash: A Matter of Fact Romance     
   
           
    British Parliamentary Papers, 1877
   . Critical Inquiry       
 
           Sto-
ryWorlds: A Journal of Narrative Studies   
        Science    
  
       Psychoanalysis and Narrative Medicine
        
  A Diagnostic Analysis of the Casebooks of Ticehurst House Asylum,
Psychological Medicine,  
   
       Speech Acts in Argumentative Discus-
sions    
  The Content of the Form: Narrative Discourse and Historical Representa-
tion      