Author Archive

Book Review – Anne Roekens (dir.), Des murs et des femmes. Cent ans de psychiatrie et d’espoir au Beau-Vallon (Presses Universitaires de Namur 2014)

FMProBy Valérie Leclercq

The psychiatric institution le Beau-Vallon was founded at the eve of the first World War by the catholic order of les Soeurs de la Charité de Jésus et de Marie. Located on one of the hills surrounding the Belgian city of Namur and dedicated to the exclusive care of women, Beau-Vallon was designed as the first pavilion asylum of Wallonia and rapidly developed into an imposing near-autonomous structure isolated from what was seen at the time as the poisonous influence of the city. On the day of its official inauguration in 1924, it was already comprised of eleven pavilions housing a total of 740 patients.
Today, the institution celebrates a century of existence with the release of a book entitled Des murs et des femmes: Cent ans de psychiatrie et d’espoir au Beau-Vallon. Edited by Anne Roekens, a professor of contemporary history at the University of Namur and also the (co-)author of five out of the book’s seven chapters, Des murs et des femmes showcases the penmanship of seven additional contributors, among whom three psychiatrists (Xavier de Longueville, Benoît Delatte and Jean-Paul Rousseaux, responsible for the seventh chapter), three young historians graduated from the Catholic University of Louvain (Nathalie Collignon, Lisa Lacroix and Mélanie De Brouwer) as well as historian Benoît Majerus who has published extensively on the history of psychiatry in Europe these last few years. The book also incorporated elements from the work of students from the UNamur history department who in 2012 and 2013 were given the opportunity to delve into the records of the institution.
Thematically structured, Des murs et des femmes explores different aspects of the history of the institution, from the context of its foundation to its present state, from its evolving spatial infrastructures and treatment procedures, to the specificities of its personnel and patient population. The book does a great job at revealing the slow processes behind some of the important changes that radically affected 20th-century psychiatry, such as the apparition of psychopharmacology, the professionalization and secularization of the medical personnel, deinstitutionalization, etc. Surprisingly, the history of Beau-Vallon (which would have been considered a second-class country asylum – ou “asile de province” – by the medical authorities of the capital) parallels that of western psychiatry more closely that one might think. In one instance it even seems to have anticipated change when the institution opened several residential facilities outside the hospital a decade before the launch of the 1991national plan to encourage the development of ‘MSP’ (Psychiatric Care Houses) and ‘IHP’ (Protected Homes Initiatives). This last fact the authors are of course eager to point out. But Des murs et des femmes is far from being the simple celebratory narrative that one might expect. Although never overtly critical of this particular institution, the authors do not shy away from sensible topics such as forced confinement, physical coercion, unresponsive physicians, suicide or social segregation inside the asylum, etc. The tone of the book is globally that adopted by most medical historians today who cautiously navigate between the radical anti-institutional acidity of the 60s/70s and the blind optimism of Whiggish medical-historical writing. This middle way is apparent when the authors expose the mutability of the totalitarian psychiatric space, recontextualize the use of mental therapeutics or brush aside the rigid physician-patient antagonism to highlight what Benoit Majerus in his book Parmi les fous (2013) already deemed the central relationship of the everyday institutional psychiatric experience: that of nurses and patients.
Des murs et des femmes, however, will probably prove a frustrating read for historians of psychiatry due to a somehow limited depth of analysis. It propounds no really innovative thesis. The book might be in this regard illustrative of a certain Belgian francophone approach to history: close to its rich source material but lacking in theoretical background and perspective. The two first chapters (Le temps des fondations & Espaces psychiatriques, espaces religieux) appear the strongest and tightest while the four following chapters, dealing respectively with the two world wars, the patient population, treatment and the asylum personnel, seem a bit more factual and loosely problematized. The last chapter, which is concerned with deinstitutionalization and was penned by the three medical authors, confidently recounts the progressive opening of Beau-Vallon and the evolving Belgian legal context in many interesting and necessary details but without never really questioning the process of deinstitutionalization itself. To be fair, the very nature of the project must have imposed some limitations to the contributors’ creativity. When medical historians decide to work on the records of a single medical institution, it is usually to study some or other aspects of medicine or psychiatry, and they are then usually free to narrow their focus as they think best for the relevance of their subject. In The Psychiatric Persuasion, for instance, Elizabeth Lunbeck used the records of the Boston Psychopathic Hospital to write about the psychiatrization of everyday life, just as a few years earlier Nancy Tomes in The Art of Asylum-Keeping dug through the archives of The Pennsylvania Hospital for the Insane only to reflect about the social significance of mid-19th century asylums [1]. But Des murs et des femmes is ultimately the history of the Beau-Vallon asylum itself, an object uneasily unified around a cardinal analytical argument. The study, as a result, covers the major aspects of the institution’s evolution in a thematic overview that still seems to have a lot of unexplored potential.
It is great, however, to see a medical institution collaborate with historians and work such as this being commissioned. And despite its limitations, Des murs et des femmes seems to achieve its purpose successfully. It is a carefully researched and well written effort that is also accessible for the layperson. This accessibility would seem essential for a centennial anniversary publication. The source material used by the different authors is incredibly rich and varied; it includes congregational and hospital archives, legislative texts, medical literature, private archives, oral history (most interviews have been conducted by Anne Roekens), photographs, etc. Moreover, long excerpts from archival documents are showcased in dark grey sidebars, giving the reader direct access to the words of various actors from the period – whether it be catholic nurses or nursing students, psychologists, a priest or a judge. This makes for an engaging read that will similarly please the general, medical and historian public. It is also worth noting that the history of sciences and medicine in Belgium is still in its infancy. In this regard, any contribution to this field is highly valuable, especially when it points out, as is the case here, the specificities of the Belgian situation (for instance the predominantly religious and hospital-centered character of 20th century Belgian psychiatry), possible archive material and new territories to explore while contributing to building the picture of a larger national historical context that no reference work has yet come to illuminate.
1. Elizabeth Lunbeck, The Psychiatric Persuasion : Knowledge, Gender, and Power in Modern America, Princeton: Princeton University Press, 1994; Nancy Tomes, The Art of Asylum Keeping: Thomas Story Kirkbride and the Origins of American Psychiatry, Philadelphia: University of Pennsylvania Press, 1994 (origin. ed. 1984)

 

Valerie Leclercq is a FNRS doctoral Research Fellow at the Free University of Brussels. Her areas of interest include 19th and 20th-century medicine, the history of patients, psychiatry and medical ethics. She is currently writing her dissertation on the therapeutic encounter at the turn of the 20th century.

Histoire sociale/Social history

The May 2010 issue of the Canadian academic journal Histoire sociale / Social history has just been added to the online MUSE project database.  In this particular issue, you’ll find an article by Danielle Terbenche entitled A solider in the service of his country”: Dr. William Rees, Professional Identity, and the Toronto Temporary Asylum, 1819-1874. The abstract reads:

The first medical superintendent of the Toronto Lunatic Asylum, physician Dr. William Rees, found his tenure from 1841 to 1845 marked by financial struggle, extensive administrative conflict, and physical injury. His personality along with these events have given rise to negative portrayals of Rees as an inept administrator. Less known are his social contributions beyond his asylum work. A more extensive assessment of Rees suggests the value of his biography as a study of Upper Canadian professional and class status. While Rees’s occupational endeavours before 1841 enhanced his status, negative experiences at the asylum changed this pattern and caused an ongoing decline in his social status after 1845.

Deinstitutionalisation in psychiatry as a possible resource

A Romanian – Italian symposium of Psychiatry took place at the University of Medicine and Pharmacy “Carol Davila” (Bucharest) on November 25-26 2010. Here is the program:

DEINSTITUTIONALISATION IN PSYCHIATRY AS A POSSIBLE RESOURCE

Romanian – Italian symposium of Psychiatry

University of Medicine and Pharmacy “Carol Davila”- Aula Magna

(Bucharest, 25th and 26th November 2010)

THURSDAY, NOVEMBER 25th, 2010

8.45 – 10.10

Arrival of participants, introduction speeches

Panel 1

The Romanian and Italian experience of deinstitutionalisation in psychiatry

Chairman: Prof. Dr. Pompilia DEHELEAN, Head of The Romanian Association of Psychiatry and Psychotherapy, Pro-rector and Head of the Department of Psychiatry, UMF “Victor Babes” Timisoara

10.20

Matt MUIJEN, Regional Adviser for Mental Health WHO Regional Office for Europe – Challenges for community based mental health services in Europe

10.40

Prof. Dr. Ileana BOTEZAT ANTONESCU, President of the Romanian Federation of Psychotherapy, Director of The National Centre of Mental Health and Fight against Drugs Bucharest – Deinstitutionalization in mental health services in Romania – between aspiration and reality

11.00

Dr. Lorenzo TORESINI, psychiatrist ASL Merano – Deinstitutionalisation in Italy: Franco Basaglia and the introduction of ethics in the medical treatment

11.20

Prof. Dr. Dan PRELIPCEANU, Medical Director at “Prof. Dr. Alexandru Obregia” Psychiatry Hospital Bucharest – A reformation project of the mental health services – sources, solutions, and limits. A critical approach.

11.40

Prof. Dr. Luigi ATTENASIO, Director of the Mental Health Department of the ASL Rome C, National President of „Psichiatria Democratica Europa”

Dr. Walter GALLOTTA, Director of the psychiatric hospital service unit “Diagnosis and Treatment” S. Giovanni Hospital, Rome

Dr. Angelo DI GENNARO Basaglia theories and practices in a Mental Health Department of a metropolitan city: towards the implementation of international development programmes in co-operation with an NGO (CESVI)

12.00

Dr. Patrizia D’ONOFRIO, psychologist, ASL E Rome – Changes in the role of the care function following the law no. 180: an impressive challenge and a creative engagement

12.20

Dr. Roberto MEZZINA, Director of the WHO Collaborating Centre – Trieste Mental Health DepartmentDeinstitutionalization in East European countries: the role of WHO Collaborating Centre of Trieste in the reform process

12.40

Dr. Bogdana TUDORACHE, President of the Romanian League for Mental Health and Raluca NICA, psychologist, Director of the Romanian League for Mental Health – The role of NGOs in the development of mental health in Romania

13.00

Public debate

13.30

Lunch break

Panel 2

Overcoming contention as a milestone for deinstitutionalisation

Chairman: Prof. Dr. Tudor UDRIŞTOIU, Scientific secretary UMF Craiova

15.00

Dr. Bruno NORCIO, Deputy Director of Mental Health Department of Trieste and former Head of Psychiatric Emergency Service – Overcoming of contention. How can it be done?

15.20

Dr. Gaetano INTERLANDI, psychiatrist Caltagirone Catania – SPDC no restraint in the middle of a decentralised organization

15.40

Prof. Dr. Luigi ATTENASIO, Director of the Mental Health Department of the ASL Rome C, National President of „Psichiatria Democratica Europa”, Dr. Walter GALLOTTA, Director of the psychiatric hospital service unit “Diagnosis and Treatment” S. Giovanni Hospital, Rome and Dr. Angelo DI GENNARO – Reciprocity: against containment and in favour of  the dialogue with madness

16.00

John JENKINS, President of the International Mental Health Collaborating Network (IMHCN) – Whole life-recovery approach in community mental health

16.20

Prof. Dr. Florin TUDOSE, Dean of Psychology and Sociology Faculty, ”Spiru Haret” University Bucharest – Immobilization and contention as an aggression

16.40

Prof. Dr. Mirela MANEA, Head of the Department of Medical Psychiatry and Psychology, the Faculty of Dentistry UMF “Carol Davila” Bucharest – The careful surveillance versus the close observation for the patients with mental disorders

17.00

Public debate

17.30

End of the first day

FRIDAY, NOVEMBER 26th, 2010

8.45

Arrival of participants

9.10

The speech of Prof.Dr. Virgil PAUNESCU, Presidential Counsellor

Panel 3

Treatment through social inclusion. Cooperation, self-support, social assistance.

Chairman: Dr. Gianfranco PALMA, Director of the Mental Health Department ASL E Rome

9.20

Prof. Dr. Aurel NIREŞTEAN, Head of Department and General Chancellor UMF Tg. Mures – Deinstitutionalization and de-stigmatization

9.40

Dr. Gianfranco PALMA, Director of the Mental Health Department ASL E Rome – Changes in the culture and welfare systems in the process of social inclusion

10.00

Dr. Ruggero BRAZZALE, psychologist, Bassano del Grappa – Innovation models in the mental health services in the Mures region: the Marostica project.

10.20

Vasile GAFIUC, President of The Regional Association of Adult Education, Suceava – The role of NGOs in the process of decentralisation of the psychiatric system

10.40

Dr. Ilario VOLPI, psychologist, President of the integrated cooperative “Il Grande Carro” in Rome – Integrated cooperatives and the process of deinstitutionalisation

11.00

Dr. Mircea DRAGAN, Ploiesti Municipal Hospital – Disorganization in mental health from Prahova County

11.20

Coffee break

11.40

Dr. Jean-Yves FEBEREY, Head of Department, Henri-Guérin Hospital (Department of Var, France), doctor at Centre médical de la Mutuelle Générale de l’Education Nationale – Disorganization in mental health in France today

12.00

Prof. Dr. Alexandru PAZIUC, Psychiatric Hospital Campulung Moldovenesc – The role of the mobile team in the process of social inclusion of people with severe mental problems

12.20

Dr. Magda GHEORGHIU, MD Psychiatric Hospital Siret – Attempts to reintegrate people mentally retarded from institutions

12.40

Dr. Luigi LEONORI, psychologist, President of SMES-Europe – Psychic suffering and precariousness: prevention and  participation

13.00

Public debate

13.30

Lunch break

Panel 4

De-institutionalization in Eastern Europe and CIS States

Chairman: Prof. Luciano Sorrentino, Director of Mental Health Department “Franco Basaglia” ASL TO2, Professor of History of Psychiatry, Psychology Department, University of Torino

15.00

Dr. Nermana MEHIC-BASARA, MSc, neuropsychiatrist, Director of the Institute for Alcoholism and Substance Abuse of Sarajevo Canton, Bosnia and Herzegovina – From Centralised Services toward Community Based Psychiatry – Experiences from Bosnia and Herzegovina

15.20

Manana SHARASHIDZE M.D, psychiatrist, Director of the Georgian Association for Mental Health – Opportunities and obstacles for future de-institutionalization in Georgia

15.40

Dr. Markku SALO, Head of Research, The Finnish Central Association for Mental Health – From charity to productivity of persons. The importance of the protagonist in the individual

16.00

Public debate

16.30

Final remarks and conclusions of the symposium

Prof. Dr. Ileana ANTONESCU BOTEZAT

Dr. Lorenzo TORESINI

Dr. Patrizia D’ONOFRIO

To see the pdf of the program, click here.

Dr. Walter Freeman’s photographs of lobotomy patients

A few days ago, the blog Advances in the History of Psychology pointed its readers to the work of Miriam Posner (a Mellon Postdoctoral Research Associate at Emory University) and the exceptional collection that constitutes the central object of her Yale university dissertation: Dr. Walter Freeman’s before and after photographs of lobotomy patients.

Some of these pictures are featured in a slideshow presented by the blog Science and the Arts (a project of NPR’s Science Friday) and narrated by Posner herself. Posner “argues that for Freeman the photographs served as medical evidence of the benefits of lobotomy and provided justification for his focus on external behavior rather than their mental states when evaluating surgical outcomes” (AHP).

The full slideshow can be viewed here.

New Issue of PSN

A new issue of PSN (Psychiatrie Sciences Humaines Neurosciences) has just been released online. Included in this issue are two pieces that may be of interest to h-madness readers. Titles, authors and abstracts listed below:

Les états anxieux dans l’histoire de la médecine Première partie: d’Hippocrate au « nervosisme », by T. Haustgen

The description of anxiety disorders, in their somatic and emotional components, depends on successive pathogenic theories since the antiquity. Evoked by Hippocrates and Galen among digestive illnesses, they are included into hypochondriasis in the 16th and 17th centuries. Sydenham compares this last entity with hysteria. In the 18th century, Blackmore and Cheyne at London, then Raulin and Pomme at Paris, describe the “vapours”, in the continuity of humoral theories. In 1765, Lorry in France and Whytt in Scotland (“nervous disorder”) describe on the contrary an injury of the nerve fibers, clearly differentiated for the first time from hysteria and from hypochondriasis by Whytt. Cullen introduces the term neurosis (1769), propagated by Pinel’s “Philosophical Nosography” (1798). At the beginning of the 19th century, appears the word neuropathy (Pougens, 1825; Cerise, 1841). The term anxiety is used by Cheyne (1733), Boissier de Sauvages, “the Panckoucke’s Dictionary” (1812), J.-P. Falret (1822), and occasionally by the first alienists in their manuscript observations, but as a symptom and not as a clinical entity. In 1822, E. Georget, a pupil of Esquirol working in the Salpêtrière hospital, isolates most symptoms of the later “panic attack,” in his picture of “cerebropathy” (i.e., hypochondriasis). During the 2nd half of the 19th century, several remarkable and synthetic descriptions of anxiety disorders are published separately in France by alienists (délires émotifs: Morel, 1866; “hypocondrie morale”: J. Falret, 1866; “vertige mental”: Lasègue, 1876) and by general practitioners (“état nerveux”: Sandras, 1851; “nervosisme”: Bouchut,1860; “cerebrocardiac neuropathy”: Krishaber, 1873).

L’introduction faussement simple du cognitivisme dans la thérapie comportementale, by D. Ravon

The conflicts within behavior therapy caused by the public advent of cognitive behavior therapy in America are examined. The origins of the latter are sought out within the behavioristic heritage itself (classical conditioning, operant conditioning, and social learning theory), as well as in the rest of the psychological and psychotherapeutical environment of the 1960s and 1970s. Two findings go against a simplificatory speech commonly heard in France. Firstly, the acceptance of cognitive frames of reference in the behavior therapy movement wasn’t and isn’t unanimous, since the Skinnerian radical behaviorists, still active today, dissociated themselves from it. Secondly, the therapy’s cognitive-behavioral integration didn’t happen with reference to the information processing model, but rather through a disparate process of internal and external borrowings in answer to anthropological questionings on the cognitive control of behavior.

Issues in Mental Health Nursing

The October issue of Issues in Mental Health Nursing is available online and includes an article by Philipa Martyr entitled A Lesson in Vigilance? Mental Health Nursing Training in Western Australia, 1903-1958. The abstract reads:

Researching examples of historical hospital-based training can provide some measure of the improvements in mental health nursing education which have taken place over time. Claremont Hospital for the Insane was the only major stand-alone psychiatric institution in Western Australia, and recent research into its mental health nursing training program between 1903 and 1958 provides an example of how nursing training could suffer in the hospital setting. There is much to learn from Claremont’s experience: Not just to measure how far mental health nursing has progressed since that time, but also as a reminder of why and how accountability, supervision, and independent auditing all help to ensure quality delivery of training.

Book Annoucement – Madness in Medieval Law and Custom

TURNER Wendy J. (ed.), Madness in Medieval Law and Custom (Brill, Leiden-Boston, 2010).

This collection of essays opens a new discussion about the mind, body, and spirit of the mad in medieval Europe. The authors examine a broad spectrum of mental and emotional issues, which medieval authors point out as ‘unusual’ behavior. With the emerging field of medieval disability studies in mind, the authors have carefully considered legal and cultural descriptions for insight into the perception and understanding of mental impairment. These essays on madness in the Middle Ages elucidate how medieval society conceptualized mental afflictions. Individually, the essays cover aspects of mental impairment from a variety of angles to unearth collectively medieval perspectives on mental affliction.
Contributors are James R. King, Kate McGrath, Irina Metzler, Aleksandra Pfau, Cory James Rushton, Margaret Trenchard-Smith, and Wendy J. Turner.

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