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This student in Dr. Diana Eidson’s class is focusing on discrimination asylum patients
faced in the 18th – 20th centuries. In this description of her research-in-progress, she
discusses her research questions, research methods, and the lens through which she plans
to examine her subject.
Student
Dr. Diana Eidson
ENGL 1127
The Theory and Methodology of Institutionalized Discrimination in
the Treatment of 18th-20th Century Patients
Origin and Context
After much deliberation—and several topic changes—I decided to base my paper
around the discrepancies in the care of patients in 18th-20th century asylums and other
such mental institutions. Though this has not been an easy topic for me, I feel an
obligation to shed light upon the people who have been hidden by shame and history.
However, I soon realized that not all patients received the same standard rate of care. In
fact, their treatment varied based upon their gender, race, and sexual orientation.
Therefore, if one did not fit into majority groups (those dominant in the population—in
this case, those groups would be made up of men, white people, and heterosexuals), then
they would receive even less adequate treatment based upon their membership to those
designated minority groups. So, women would receive different care than men; people of
color would receive different care than white people; and those in the LGBTQ+ spectrum
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(from now on noted as MOGAI—see footnote 2) would receive different treatment than
heterosexuals. There is a certain societal bias present in the way the patients were treated.
That bias reveals an important area of the past. And it is that area which will affect our
future if we do not understand it.
During my only visit to the Auburn Archives and Special Collections, I found a
small line in the 1892 Alabama State Board of Health Review that intrigued me: while
there was a higher population of white patients in an asylum, patients who were POC had
a significantly higher rate of death— 15.5% to white patients’ 4.8%. With my interest
piqued, it suddenly dawned upon me that not all patients were treated equally. With that
understood, it made sense to research the further injustices of those patients.
Though this is not normally a foremost topic in the minds of others, mental illness
and its sufferers are never far from my heart. Ever since I was very young, I have dealt
with mental illness, and so I feel a draw to others who have suffered from it as well.
However, considering my proximity to the subject, I must practice ethical research and
prevent my personal bias from tainting the information. Nonetheless, I believe my
passion will lend itself to creating the necessary rhetorical engagement— my language
used to describe the subject (Gaillet and Eble “Defining and Engaging with
Communities” 21)— to hook and accurately inform the audience.
Finally, this topic binds together my personal and academic interests (Gaillet and
Eble 33): the treatment of mentally ill people and the progression, as well its regression,
over time.
Research Questions and Rationale
Once I encountered the discrepancy in the treatment of asylum residents, I
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gravitated towards the concept that some patients were considered worthier than others. It
is a surviving notion—certainly not a relic of the past. Human society consists of
minority and majority groups, each of whom scramble for the same resources, all of
whom possess advantages or disadvantages due to the institutionalized arrangement of
power. In order to understand current social struggles, one must also look at the faulty
foundation of the past. Otherwise, one may forget that social justice is an ongoing process
and a very important one.
In social rights struggles, one must always account for intersectionality1. When
considering intersectionality, one must then understand that the treatment of the mentally
ill did not just depend on their illness—it also depended on their race, gender, sexual
orientation, and social class. Therefore, I ask the following research questions:
1. How did treatment and perception vary among minority groups?
2. In that vein, how did treatment and perception vary for women?
3. How did treatment and perception vary for different races (those in the minority)?
4. How did treatment vary for MOGAI2 people?
In answering these questions, I hope to bring attention to the current struggles of
the mentally ill by illustrating those of their predecessors. If one considers the past
“The complex of reciprocal attachments and sometimes polarizing conflicts that
confront both individuals and movements as they seek to navigate among the raced,
gendered, and class-based dimensions of social and political life” (University of
California: Center for New Racial Studies n.p.).
2
MOAGI stands for Marginalized Orientations, Gender Identities, and Intersex. It is a
simpler and more inclusive acronym used to represent the LGBTQIAP+ population.
However, as it is a newer term, it is less popular and used. For simplicity’s sake, I shall
be using it throughout my research.
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sufferers of mental illness, finding compassion in their hearts, then they will apply that
compassion to the afflicted modern day people.
Positionality Statement
While I was not in a 18th-20th century asylum, I was in a psychiatric facility for a
brief amount of time when I was thirteen. Because of that, I think very much about what
would have happened to me had lived in the past.
I have a very personal identification with the subjects, as both a patient myself
and as a woman. Both groups are a part of my community (Gaillet and Eble. "Identifying
a Research Topic and Thinking Like a Researcher." 21) Therefore, I may be especially
sensitive. In order to overcome that sensitivity, I must be especially aware in conducting
ethical research—I cannot manipulate the research in order to create the picture that I
wish to see. I must go out of my way to cover all areas of the subject, finding both grim
truths and positive facts, if possible. In other words, I must look at the research through a
neutral lens so I do not see myself reflected in it. My experience is not pertinent to the
research and as such, should not be included. I owe the subjects of my project a fair and
unbiased representation; therefore, I must conduct my research so it results in such an
account.
I must also ensure that my privilege as a white person does not distort my
research. All people must be represented with care and consideration, and so I have an
especially important duty to recognize and accurately record the stories of those with less
privilege than I. So, multicultural awareness and the etiquette of equality (Sohn 3) ought
to be practiced.
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Lastly, I must not view the past with a contemporary lens. Presentism (Spoerhase
49) must be avoided entirely; in conjunction, I must discard my preconceived values and
history in order to truly understand and represent the world in which my subjects existed.
Methodology
Thankfully, there are several sources with which I can triangulate data. First, in
order to conduct primary research (Gaillet and Eble "Introduction to Primary Research."
7), doctors’ journals— such as that of George Cheyne (Franz and Selesnick 115)– and the
works of social reformers— such as Johann Heinrich Pestalozzi (Franz and Selesnick
114)– shall prove invaluable. There are also several tools with which I can conduct
secondary research, such as medical journals and census records (Gaillet and Eble
"Introduction to Primary Research." 8).
Physical artifacts, such as the suitcases left by patients in the Willard Asylum
(Zennie n.p.), could provide amazing detail into the minutiae of the patients’ lives,
showing what they held dear. In other words, those suitcases would present a personal
picture of their owners, not just cold facts. Additionally, photographs of patients (such as
those found in The History of Psychiatry: An Evaluation of Psychiatric Thought and
Practice from Prehistoric Times to the Present) would illustrate the subjects. From those,
one could glean their physical condition (how clean they were, what clothes they wore,
whether or not they had injuries and how those injuries were faring, and onwards).
Furthermore, photographs could depict the places in which the patients stayed, therefore
allowing one to understand both the conditions and where they occurred.
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However, using surveys and interviews will not be feasible. The subjects which I
wish to depict have long since passed away, and as I possess no psychic powers, I may no
longer speak with them. Considering such, I must ensure that I rely on strong primary
sources, as they will function as my last possible communication with the past.
Operational Definitions
Though I have introduced a possibly less well-know term (MOGAI), there are
very few new concepts brought into this project. Instead, I shall elaborate on older ones.
In the project, discrimination refers to the carried-out actions and prejudices that
affected the patients depicted. The patients, therefore, will be represented as the group
who has been acted upon. They will serve as the subjects I present.
Institutionalized power is the concept that people born into certain dominant
societal groups (such as men, heterosexuals, and white people—those are the ones
typically in power in the western world) automatically possess power and benefits just
because they are in those groups. So, society rewards them for simply existing. Sadly, the
opposite is true for minority groups—they suffer and face discrimination simply for
existing.
Minority groups will be those who are not institutionally in power—those who
face discrimination due to their race, gender, and sexual orientation.
Bias will mean the implied and institutionally confirmed discrimination against
patients in the minority.
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Preliminary Findings
In my research so far, I have found several important primary sources. Among
them are doctors and activists. However, finding primary sources from the patients
themselves is proving to be the challenge, so I hope that as I dig through accounts in
medical journals and accounts, I will find the stories of patients as well.
I consider The English Malady Or, a Treatise of Nervous Diseases of All Kinds,
as Spleen, Vapours, Lowness of Spirits, Hypochondriacal, and Hysterical by George
Cheyne to be a particularly important example of a primary source. Cheyne was an 18th
century activist who also suffered from the illnesses upon which he wrote. He believed
that neurotic behavior—or, the behavior of the mentally ill—was entirely common and
hardly obscure (Franz and Selesnick 112).
Benjamin Rush’s rather disgusting volume, Medical Inquiries and Observations,
upon the Diseases of the Mind conveys the institutionalized racism that affected patients
of color at the time. Though it is not directly from the aforementioned patients
themselves, it gives an inkling as to how the medical community may have operated at
the time, and the prejudices that the treatment entailed.
Perhaps the most fascinating primary sources would be the suitcases left at
Willard Asylum, which contain the abandoned or lost possessions of patients in the 20th
century (Zennie n.p.). Through them, one could view the lives of patients in a way that
medical journals may not always provide, for the items within give humanity to the
patients.
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As for a secondary source, the 1892 Alabama State Board of Health Review
created the spark that ignited the passion for my ultimate area of interest. Its statistics can
lead to further questions to ponder, such as the terrible effects of institutionalized racism
and how many patients of color suffered from them. Similar inquiries can be based
around the discrimination against women and MOGAI patients.
Additionally, I have located The History of Psychiatry: An Evaluation of
Psychiatric Thought and Practice from Prehistoric Times to the Present by Franz
Alexander and Sheldon T. Selesnick. It has detailed an incredibly solid foundation upon
which I may build my paper. From it, I have found detailed information about the history
and context about the eras on which I am writing. Even better, it samples a multitude of
primary sources, and so I may then use this book as a leaping point. Already it has led me
to several primary sources.
Thanks to all of these sources, I have crafted my primary thesis: Institutionalized
oppression in the 19th-20th century caused a discrepancy in the care of minority patients.
I argue that patients of color, women, and MOGAI people faced discrimination
and specialized cruelty based on those aforementioned characteristics. I will note,
however, that as these are broad groups of people, I may have to narrow my focus to only
one of them.
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Bibliography
Alabama State Board of Health Report 1 (1892). Print.
Alexander, Franz, and Sheldon T. Selesnick. The History of Psychiatry: An Evaluation of
Psychiatric Thought and Practice from Prehistoric Times to the Present. 1st ed.
New York: Harper & Row, 1966. Print.
Cheyne, George. The English Malady Or, a Treatise of Nervous Diseases of All Kinds, as
Spleen, Vapours, Lowness of Spirits, Hypochondriacal, and Hysterical
Distempers. London: Printed for G. Strahan, and J. Leake at Bath, 1733. PDF.
Foerschner, Allison M. "The History of Mental Illness: From ‘Skull Drills’ to ‘Happy
Pills’" RSS. Student Pulse, 1 Jan. 2010. Web. 16 Oct. 2014.
Gaillet, Lynee Lewis, and Michelle Eble. "Defining and Engaging with
Communities." Primary Research and Writing: People, Places, and
Spaces. S.l.: Routledge, 2015. PDF.
Gaillet, Lynée Lewis and Michelle Eble. "Introduction to Primary Research." Primary
Research and Writing: People, Places, and Spaces. New York: Routledge, 2014.
Digital Galley PDF. 1-63.
Gaillet, Lynee Lewis, and Michelle Eble. "Identifying a Research Topic and Thinking
Like a Researcher." Primary Research and Writing: People, Places, and Spaces.
S.l.: Routledge, 2015. Print.
Greger, Michael. "Appendix 20 - Homophobia." Appendix 20 - Homophobia. United
Progressive Alumni. Web. 20 Oct. 2014.
Greger, Michael. "Appendix 42 - Women." Appendix 42 - Women. United Progressive
Alumni. Web. 20 Oct. 2014.
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Greger, Michael. "Appendix 43 - Drapetomania." Appendix 43 - Drapetomania. United
Progressive Alumni. Web. 20 Oct. 2014.
"MOGAI." Abbreviations.com. STANDS4 LLC, 2014. Web. 20 Oct. 2014.
<http://www.abbreviations.com/MOGAI>.
"Race/Gender/Class Intersectionality." University of California: Center for New Racial
Studies. 1 Jan. 2011. Web. 10 Oct. 2014.
<http://www.uccnrs.ucsb.edu/intersectionality>.
Rush, Benjamin. Medical Inquiries and Observations, upon the Diseases of the Mind.
Philadelphia: Kimber & Richardson, 1812. PDF.
Sansone, Tina. "Women and the Insane Asylum." Women and the Insane Asylum.
Tennessee Genealogical Society. Web. 22 Oct. 2014.
<http://www.tngs.org/library/asylum>.
Sohn, Katherine Kelleher. Whistlin' and Crowin' Women of Appalachia: Literacy
Practices since College. Carbondale: Southern Illinois UP, 2006. Print.
Spoerhase, Carlos. "Presentism and Precursorship in Intellectual History [full Text]."
Academia.edu. Routledge, 15 Apr. 2008. Web. 20 Oct. 2014.
Zennie, Michael. "The Chilling Pictures of Suitcases Left in a New York Insane Asylum
by Patients Who Were Locked Away for the Rest of Their Lives." Mail Online.
Associated Newspapers, 9 June 2013. Web. 8 Oct. 2014.
<http://www.dailymail.co.uk/news/article-2338714/The-chilling-picturessuitcases-left-New-York-insane-asylum-patients-locked-away-rest-lives.html>.
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Level of detail/inclusion of all required elements: A
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