By Sabine Wieber

Shortly after his arrival in 1919 at the Psychiatrische Klinik der Universität Heidelberg, the German art historian and psychiatrist Hans Prinzhorn (1866-1933) petitioned colleagues across Germany, Austria and Switzerland to send him artefacts for the institution’s growing collection of patient art. The response was very positive and Prinzhorn acquired thousands of artworks that formed the foundation for his influential study Bildnerei der Geisteskranken: Ein Beitrag zur Psychologie und Psychopathologie der Gestaltung (1922) and that today comprises the Prinzhorn Collection [1]. In the book under review here, Monika Ankele draws on Heidelberg’s diverse collection to analyze and trace how female patients at three specific psychiatric institutions (Grossherzogliche Badische Universitäts-Irrenklinik Heidelberg, Grossherzogliche Badische Heil- und Pflegeanstalt Emmendingen, and Kuranstalt ‘Bellevue’ in Kreuzlingen/Bodensee) engaged with their highly regulated environments over a period of 20 years (1900-1920).

Ankele’s approach to this material emerges out of a recent shift in cultural history that replaces a more traditional (art historical) focus on object analysis with one that takes into account the practices and processes involved in its production [2]. Although Ankele draws on a long tradition of gender history concerned with the reconstruction of the ‘forgotten’ daily lives of historical women, she is much more interested in the ways in which female patients in the aforementioned institutions used seemingly insignificant and ephemeral acts of everyday practices such as eating, dressing, furbishing their spaces and working to appropriate the structures, spaces and materials of their institutional confinements (25). Taking her cue from Michel de Certeau’s key text The Practice of Everyday Life (trans. 1984), Ankele rehabilitates her female patients as active historical agents who, while confined within the spatial and institutional parameters of the psychiatric institution, left definite material traces of self-empowering acts (de Certeau would call these tactics) in the realms of “Selbstgestaltung” (self-formation) and “Raumaneignung” (spatial appropriation) (24). Ankele thus views the Prinzhorn Collection’s objects as creative, material traces of concrete behaviors by female patients at the heart of her study.

Ankele uses 33 patient records and 88 diverse self-testimonies such as letters, texts, drawings, embroideries, textiles, collages and ‘multi-media‘ scultpures composed of any material available to these women (including blood and excrement) to launch her investigation. The patient files are important historical documents because they not only give insight into the institutional histories and disease patterns of individual patients (mostly diagnosed with dementia praecox) but they also reveal a rich archive of additional self-testimonies such as confiscated letters, photographs, correspondances between physicians and relatives etc. In Chapter 2, Ankele employs these files to flesh out her subjects‘ institutional and medical identities, while unveiling some of the discursive regimes of early twentieth-century asylum-psychiatry which was largely grounded in medical observation and classification. Here, Ankele resists a more conventional interpretation of these patient files and proposes a reading against the grain because she believes that “this method of reading does not negate the determinative effects of ‚powerful’ structures, but proceeds from the assumption that – in the Foucaldian sense – power does not merely govern, but is also productive” (62).

Ankele locates this Foucauldian encounter with institutional power generating patient power within the concrete parameters of the three different psychiatric institutions. Chapter 3 therefore examines Bellevue (private), Heidelberg (university) and Emmendingen (state) as three distinct physical places regulated by normative structures, regulations and functions within which patients conducted their daily lives. If Chapter 3 provided a bird’s eye view into psychiatric institutions, then Chapter 4 offers a worm’s eye into the female patients‘ daily practices and the ways in which they constituted their personal and institutional spaces through a series of interactions and relations. Not surprisingly, this final chapter is less interested in the intentions of Ankele‘s historical actors and focuses instead on the effects of their actions: “effects that resulted in practices as well as effects that either made these practices possible, limited [them] or engendered [them] in specific ways“ (109). At this point, Ankele begins to connect with the material self-testimonies from the Prinzhorn Collection and leads the reader through a series of fascinating and nicely illustrated “everyday practices and forms of appropriation” (the title of Chapter 4). These are grouped in four highly effective categories: “Working – Keeping Oneself Occupied (Arbeiten-Sich Beschäftigen); Living-To Ensconce Oneself (Wohnen-Sich Einrichten); Hair-Dressing Oneself (Haar Tragen-Sich Kleiden); Eating-Nourishing Oneself (Essen-Sich Ernähren).”

Ankele makes a tremendous contribution to the scholarship on patient art (here understood in the broadest sense) by bringing her skills as an art historian and a gender historian to the history of psychiatry. She approaches the Prinzhorn Collection’s material from a highly sophisticated theoretical vantage point that takes into account the number of different historiographic ‘turns‘ (cultural, spatial, material, practical) to ultimately propose a cultural-historical re-assessment of female psychiatric patients as “agents on and in the world” (Caminero-Santanglo qtd. 181). These agents used material culture as a means of “creative appropriation of existing conditions” (23) – circumstances that represented a radical break from ‘ordinary‘ daily lives before their institutionalisation. Ankele’s analysis is sophisticated and elegant in that she not merely maps a theoretical framework onto archival material, but uses her carefully chosen self-testimonies and patient files as material points of access into otherwise ephemeral practices. Ankele categorizes her approach as a “practice-theoretical history of psychiatry (praxistheoretische Psychiatriegeschichte)” which aims to shift attention away from notions of intention and into the realm of practices and their material effects [3].  In this way, Ankele moves beyond Roy Porter’s call for a history of psychiatry from below (“The Patient’s View”, 1985) and problematizes the ways in which their subjectivities were constituted in the first place.

Ankele‘s focus on self-testimonies exclusively by women represents both a strength and a weakness of her book. It is a strength in that it allows the author to draw on a series of well-grounded methodologies from gender studies to develop her analytical framework for the Prinzhorn material. But it also limits the scope of her book because it obviously excludes the everday practices and appropriations of institutional space by male patients. This is not so much a criticism of Ankele’s carefully selected and clearly justified range of materials and methodologies, as it is a bemoaning of a missed opportunity. A recent exhibition at the Wellcome Collection attempted to problematize the potentially differing institutional experiences and responses of female and male patients, but the format of an international loan exhibition proved too limiting to fully explore this complex topic [4]. Viewed from this perspective, Ankele’s book raises the problematic question about the difference between a dissertation and a monograph. This work originated as a dissertation at the University of Vienna (2008) under the same title and of virtually equal length. Including at least a problematization of male “Alltag und Aneignung” in relation to the central topic of female self-testimonies might therefore have imbued the book with an even stronger disciplinary authority and intellectual identity. And yet, this is a beautifully written and convincingly argued piece of work that has been awarded several prizes by the Austrian government, and it should maybe be left to the reader to judge for herself [5].

Sabine Wieber is Lecturer in Art History at University of Glasgow. Previously, she worked as a post-doctoral research associate on the project ‘Madness and Modernity: Architecture, Art and Mental Illness in Vienna and the Habsburg Empire, 1890-1914.” She is currently working on a book project investigating central European salon culture between 1850 and 1918.

Notes

[1]. For a history of the Prinzhorn Collection see www.prinzhorn.uni-hd.de.

[2]. For example, Bettina Brandt-Claussen and Vila Michely. Irre ist Weiblich: Künstlerische Interventionen von Frauen in der Psychiatrie um 1900. Heidelberg:  Wunderhorn, 2004.

[3]. For a fascinating interview with Ankele on this topic consult

http://stimmen.univie.ac.at/2010/10/ankele_psychiatriegeschichte/

[4]. Gemma Blackshaw and Leslie Topp. Madness and Modernity: Mental Illness and the Visual Arts in Vienna 1900. Farnham: Lund Humphries, 2009.

[5]. Käthe Leichter-Preis für Frauen- und Geschlechterforschung (2009); Doc.Award der Stadt Wien (2009); Michael Mitterauer-Preis für Gesellschafts-, Kultur- und Wirtschaftsgeschichte (2010).