Posts Tagged ‘ asylum ’

Dissertations – Hans Asperger and the Ward for Therapeutic Pedagogy of the Viennese University’s Children’s Clinic

Ina Friedmann: Hans Asperger and the Ward for Therapeutic Pedagogy (Heilpädagogische Abteilung) of the Viennese University’s Children’s Clinic. Concepts and continuities in the institutional treatment of children categorized as ‘maladjusted’ between 1911 and 1977.

MUW-FO-S-004464-0082

Patients at the Ward for Therapeutic Pedagogy, 1920s (Josephinum, Sammlungen und Geschichte der Medizin, MedUni Wien, Sign. MUW-FO-S-004464-0082)

The Ward for Therapeutic Pedagogy of the Viennese University’s Children’s Clinic was a central institution from its opening in 1911 onwards concerning diagnosis and treatment of children and youth, who were labeled ‘difficult’, ‘maladjusted’ or to be in ‘need of education’. Science and institutional care were converging and interacting with socially widespread opinions. The Ward was founded under participation of pediatrician Erwin Lazar (1877-1932), who headed it until his death. He was succeeded by Valerie Bruck (1894-1963), who had been working at the Ward since 1923 and then led it until 1935. In this year, Hans Asperger (1906-1980), best known for describing the Asperger Syndrome, replaced her and stayed in this position until 1957, when Paul Kuszen (*1920) took over until 1985. It was especially Asperger who influenced not only the treatment of so-called ‘difficult’ children by decades of work in therapeutic pedagogy, but also had an impact on how those children and youth were perceived in the public as well as social and medical institutions. Already shortly after the opening of the Ward a close cooperation with the Youth Welfare Office, Juvenile Court, schools, children’s and correctional education homes and similar institutions was established, but also parents soon made use of the possibility of having children examined there.

The reasons for acceptance to the Ward were manifold and besides school and educational problems of any kind also included petty crimes, enuresis, masturbation, (sexual) violence, ‘vagrancy’ and ‘neglect’, but also epilepsy, speech disorders or the clarification of fits. The personnel of the Ward consisted of doctors, nurses, but also pedagogues and, from the 1920s onwards also of a psychologist. This correlated with Lazar’s conception of therapeutic pedagogy, who postulated the equal concurrence of pediatrics, pedagogy, psychology and psychiatry with the task to liberate children of their alleged ‘behavioral problems’ by the means of individually applied pedagogical-therapeutic methods.

This thesis focuses on the concepts which were used in the diagnosis, or rather judgment, therapy and further treatment of the patients. It tries to establish which scientific opinions on ‘social abnormity’ were dominating in the research period of 1911 to 1977, and if and how they changed. Therefore, the medical records of the Ward of the first half of the 20th century are the foundation of the thesis, allowing insight into the institutional treatment of children who were judged as ‘abnormal’ and ‘deviant’. Thus, it is also possible to contribute to the history of ‘institutionalized childhood’ in Austria.

Ina Friedmann is writing her thesis at the University of Vienna and is currently working at the University of Innsbruck.

 

Dissertations – Electroconvulsive Therapy and Its Devices

Max Gawlich: “Electroconvulsive Therapy and Its Devices”

In 1939 a wave of enthusiasm swept through the asylums of Europe. Machines and circuit diagrams originating from Italy, but often only the idea of electrically induced convulsions seized the imagination of psychiatrists. In this dissertation project I study the years of 1938 to 1950 as the period of early adoption and beginning routinization of electroconvulsive therapy (ECT). The history of somatic therapy in mid-century psychiatry remains under-studied, often undervalued as mere precursor of psychopharmacological therapies since the development of Chlorpromazine in the 1950s. On the other hand, next to Lobotomy ECT continues to be the infamous therapy of a disciplining and punishing psychiatric regime, dominating as such the critical discourse about psychiatry since the 1970s. The historical question what ECT was, how the machines were built, what those devices did and how they were adopted in the contexts of asylums remained unanswered.

The study compares three large asylums in Europe which were among the earliest to adopt therapeutic innovations in general and ECT in particular: Eglfing-Haar, south-east of Munich in the German Reich; Münsingen near Bern, Switzerland; and Warlingham Park Hospital in South-London, England. Eglfing-Haar was one of the largest asylums in Europe at the time, infamously known for both its function as relay-station for the transfer of patients into asylums where they would be killed as well as its establishment of so-called starvation units in which patients were murdered through neglect and overdoses of opiates. Münsingen was an internationally acclaimed centre for the so-called somatic therapies like insulin-coma therapy or sleeping-therapy and served as a hub for medically trained refugees fleeing the persecution in the German Reich or Italy. Warlingham-Park Hospital was the first British asylum to adopt ECT besides the Burden Neurological Institute. Its Super-Intendent Thomas P. Rees was famous for his reformist zeal opening the gates of his clinic in 1936.

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Siemens Konvulsator II – booklet

The source-material of my project is structured mainly by two institutional contexts. First there is the archival material from asylums, meaning mostly patient-files and therapy-registers. The second group are files, correspondence, brochures, and circuit-diagrams created in the development-process either at the Ediswan Co. in Britain or the Siemens-Reiniger-Werke in Erlangen. The opportunity as well as challenge was to develop a framework in which both kind of source materials complement each other and enable new questions and perspectives on clinical therapy with machines in asylums. To achieve this, I focus on 1) records and inscriptions of ECT, 2) the technical evolution of ECT-Devices in the period from 1938 to 1950, and 3) the therapeutic practices utilizing those devices. I further argue that with somatic therapies also the evaluation of those therapies was introduced. Contrary to previous research, my dissertation will show how psychiatrists involved in somatic therapies developed methods to record therapy, add up data and present statistical evidence supporting their claim of clinical success. Not only were the development and utilization of devices deeply entangled, but also questions of dosage, security, or wanted and unwanted effects were technically as well as practically addressed. Institutional settings, personal preferences and the design of ECT –devices produced specific adaptations of ECT in the local spaces of each asylum. The Second World War hindered the exchange of ideas and concepts of ECT, and rather strengthened the position of Swiss psychiatrists as intermediaries in the international transfer of knowledge. The War created a situation of largely isolated developments, producing specific technical and therapeutic solutions, which demands a comparative perspective and explicative approach.

Illustration: SRW Erlangen Technische Entwicklung, Konvulsator II für die Elektrokrampfbehandlung von Psychosen. 1949, in: Veröffentlichungen a.d. Technischen Entwicklung Bd. 4. SRW 1948-1961 p54, Siemens MedArchiv Erlangen, Nr. 71. (Reproduced with the kind permission of the Siemens MedArchiv, Erlangen)

Max Gawlich is a PhD Candidate at the Historical Institute in Heidelberg, were he also studied history and Jewish studies.

Contact: @MaxGawlich on Twitter or max.gawlich@googlemail.com

Dissertations – The Ottoman State and the insane, 1856–1908

Mental Patients inside Toptaşı Mental Asylum. (From the private collection of Cengiz Kahraman)

Mental Patients inside Toptaşı Mental Asylum. (From the private collection of Cengiz Kahraman)

Cihangir Gündoğdu: “Are there no asylums?”
 : the Ottoman State and the insane, 1856–1908

The present study seeks to contribute to and expand our knowledge concerning the nature and scope of the Tanzimat reforms by bringing to our scholarly attention a relatively understudied matter, the mental asylum reform that took place between 1856 and 1908. This study begins with Luigi Mongeri’s appointment to the Süleymaniye Mental Asylum in 1856 and ends with the 1908 revolution, which inaugurated a period when the mental asylum would undergo a new reformist trend at the hands of Unionist elite. Although the objects of asylum reform were, obviously, the “insane”, this work does not primarily focus on their stories. It rather explores the professional, legal, political, and economic processes that accompanied the mental asylum reform in the second half of the nineteenth century in the Ottoman Empire. It is accordingly organized around certain themes and problematics, such as the definition and quantification of madness, its regulation, the proposals and initiatives to institutionalize the treatment of the insane, and the financing of such initiatives.

Cihangir Gündoğdu did his Ph.D. at the University of Chicago’s Near Eastern Languages and Civilizations Department. He defended his dissertation on 4 September 2014 and currently teaches history classes at the Istanbul Bilgi University in Turkey.

Book announcement: “With the mad. A social history of psychiatry in the 20th century” (Benoît Majerus)

H-Madness co-editor Benoît Majerus has a new book out entitled Parmi les fous. Une histoire sociale de la psychiatrie au XXe siècle (“With the mad. A social history of psychiatry in the 20th century”).

The challenge of this book is to tell the story of psychiatry in the 20th century not through psychiatric handbooks or nosological controversies, but through the daily life of one asylum. This approach enables to discover  actors that are still largely excluded from the traditional narrative on psychiatry be it patients but also nurses, social workers… This historiographical gaze gives new readings of classical themes in the field such as the spatial settings of enclosure or the link between knowledge and power. It also questions the chronology by revisiting the so-called chemical revolution in the 1950s or the deinstitutionalisation from the 1960s on.

Patients’ records are a fascinating material to get access to psychiatric practice. The organisation of work, the forms of knowledge, the medical gaze, the experience of mental illness by the patient or the physician are all topics that are too often described and analysed through medical reports or through the published literature in psychiatric journals. Considering these questions from below offers an intriguing insight in the tensions between discourse and practice, between representation of a field and its actual functioning.

This book is part of a larger narrative that goes beyond a historiography of psychiatry still too often entangled in a dichotomous narrative: medical progress or disciplinarisation. Combining micro-history and sciences studies, it hopes to participate in the historicisation of a topic difficult to grapple, but particularly rich for a history of the 20th century through the margins.

To get the two first chapters, click here.

Grands reportages : “Dans les corridors de l’Institut Philippe-Pinel” (RDI, Québec, 5 septembre 2013)

La chaîne de télévision québécoise RDI diffusera ce soir, jeudi 5 septembre, un documentaire sur l’institut psychiatrique Philippe-Pinel dans le cadre de l’émission Grands reportages. Le documentaire, en lice pour le Prix du public Télé-Québec lors de sa projection aux Rendez-vous du cinéma québécois l’hiver dernier, présente des malades internés ayant commis des crimes dangereux, mais aussi des psychiatres et intervenants de ce milieu encore méconnu.

Pour plus d’informations, voir deux articles récents publiés dans le journal Le Devoir et sur le site de Radio-Canada (ce dernier contenant une entrevue radiophonique avec la réalisatrice,  Hélène Magny).

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.

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