Mental Health in the Victorian Age

Factual Questions
1

I’m re-reading “Titan”, Ron Chernow’s biography of John D. Rockefeller. I’m about halfway through the book, and Rockefeller spent about a half-year in seclusion due to “nerves”, his oldest daughter is completely nuts and secluded from society, his wife is a “professional invalid”, his next daughter is halfway nuts with bouts of seclusion, and a half-dozen other characters outside the family are partly or fully loopy.

I recall from other accounts (fiction and nonfiction) of this period many other persons of that time suffering from “nervous exhaustion” and the like. Being a professional invalid seems to have been particularly common among upper-class females. Mental illness seems to have been almost fashionable, and certainly more public than it is today. Any scholars on the history of mental illness or treatment (psychohistorians?) out there to give the Straight Dope?

V.

2

A related thread of interest would be “Fashionable Psychological Problems” in this General Questions board. (sorry I don’t know how to link)

3

In the Victrorian age, mental illness (and any illness, for that matter) was fashionable, because women were encouraged to be fragile, weak, and slightly unstable. Also, being ill was just about the only socially acceptable way to draw attention to one’s self. The sheltered Victorian woman had little excitement in her life, and being an invalid gave her the tea and sympathy of her friends and neighbors, much the way some elderly people complain endlessly of their ailments. Conversation was somewhat limited in the Victorian era, since there were a hell of a lot of things that “one just doesn’t talk about.”

The “medicines” given to them for their nervous conditions often contained opiates, which gave the skin a fashionable pallor, and often kept the woman in the state it was supposed to cure. They could languish in a limbo of constant nervous exhaustion for the rest of their lives, and no one thought much of it, unless the woman defied convention, and then she could be shipped to an insane asylum. It didn’t take much to get one committed. Any unconventional behavior put one at risk, which could range from true insanity to sassing one’s husband, masturbation, dressing oddly, expressing independance of thought or lifestyle, or not following the social norms. There would be a hearing in which a doctor, or the woman’s relatives tesified that she was off her rocker, and in she would go. The woman was not allowed to present a defense. (Look at what happened to Mary Lincoln.) This was generally a last resort for families, considering there was a good deal of shame involved in having a relative in the loony bin. Having an “insane” sister lowered a woman’s value on the marriage market, so a lot of families simply kept the relative locked away in their homes, away from society.

I’ve read a couple of books that linked nervous breakdowns to sexual frustration, but that’s another thread.

4

In Virginia, the process for involuntary committment involved obtaining a “Green Warrant.” The process for getting one was remarkably easy. While doing some genealogical research I leafed through a few volumes of “Green Warrants” and one man had his wife committed to Western State Mental Hospital “Because she talks back to me, she must be out of her mind.” My great aunt suposedly suffered a mental breakdown and was in Western State from 1928 to 1950 (she stabbed her husband after catching him in bed with another woman - sounds like a pretty lucid moment to me). Given the state of the art of psychotherapy in the late 1800s and early part of this century I can only imagine the horros the poor woman endured.

5

Here is “Fashionable” Psychological Problems.

6

Surprisingly insightful and it was written during the period in question.

7

Rockefeller had daughter who would have fit right in with today’s modern society, in that she was strong willed, independent, fought against the traditional role of women of the time and would not kowtow to her powerful father – which was her fatal mistake. Rockefeller, like most of the super rich of the time, was an egomaniac, used to getting his way and having people defer to him.

When this daughter failed to do so, plus decided to fall in love with a man the old fart did not approve of, he flexed his rich muscles, had a doctor declare her incompetent – an easy thing to do if you had millions back then – and bundled off to an institution. Over his wife’s feeble protests, the old man had her given a frontal lobotomy. Today, not only would no doctor do this, but jail time would be guaranteed afterwards for the doctor and the old man.

A frontal lobotomy of the time consisted of knocking the patient out, lifting up the eyelid and pounding something like an ice pick through the skull up in the orbit. This went into the frontal lobes of the brain. The ‘doctor’ then waved the pick from side to side, ripping the lobes free from the rest of the brain. Afterwards, the patient was left with temporary black eyes and was much calmer. It was used to control violent patients. (See One Flew Over The Cuckoo’s Nest.) Depending upon how much of the frontal lobes were ripped up, the person could respond with virtual drooling stupidity, or functional passivity.

His daughter was the latter. Gone was her spark, her spunk, her independence, and her fun. He killed her just as thoroughly as if he had stopped her heart but he had a nice, quiet, passive daughter who obeyed him. Shortly afterwards, his wife started going into institutions for ‘nervous breakdowns’. I think she never forgave him for mutalating their daughter.

A movie was made about it years back, but I can’t recall the name.

Years ago, psychotherapy consisted often of ECTs (Electro Convulsive Therapy), insulin shock therapy – they inject insulin into one to cause the body to go into shock, then they inject glucose to bring the person around, and cold wrap therapy. Cold wrap consisted of being wrapped tightly in layers of wet sheets until one could not move, then left of a gurney in a room for hours, shivering and confined. They also used psychoanalysis, some drug therapy and confinement as necessary. It was pretty primitive in comparison with today.

8

I have heard Doctors lament that patient are so set against it and that it is simply a misunderstood treatment. They still don’t understand what it does. It scares the bejeezus out of me.

9

PRISM - which daughter was this? From your description, it sounds like Edith - she was the spunky one. However, she married Harold McCormick of International Harvester fame, who JD Rockefeller thoroughly approved of, at least before the marriage. Edith did have mental problems - mebbe later she was lobotomized - I’ll get back to you as I read on.

Bessie went nuts on her own, again after marrying a man her father approved of.

Alta was the one who kept falling in love with men JD didn’t like. He generally was able to get rid of them using financial pressure or in some cases, fatherly trickery (one wimpy guy he got rid of by paying for a several-week long skiing outing. The guy couldn’t keep up with Alta, and Alta lost interest). She married an attorney, whom JD approved of. Of the gang, she seems most like to get a lobotomy, but not because of the reasons you described. Again, after I complete the biography, I’ll get back to you.

V.

10

We’re STILL all crazy, but nowadays we try to keep it to ourselves.

11

Electro Convulsive Therapy

It is believed that some segments of mental illness, like depression, are learned patterns in that, if the mind has been depressed for a long period of time, it learns to be and act depressed.

ECT sends a low electrical current through the frontal lobes of the brain, kind of like jumbling everything in there – sort of like a real mild surge through your computer. The regular processes of the brain are unhurt, but the newly laid down behaviors are scrambled. A side effect is that the jolt puts one into a convulsion, which is why they now sedate one, often install a combination breathing tube and bite brace and require the doctor and a nurse to be present.

The effects vary, but the normal range is that the patient, upon recovery, experiences a temporary loss of memory and hopefully, a permanent loss of knowing how to be depressed – or some of it. The therapy used to come in a series of two or more treatments. Each time the treatment is given, with a day of recovery in-between, the memory loss is more pronounced, while recently laid down memories, like those from a day or so ago, are often wiped out. It is hoped that after the last treatment, the client will recover the majority of their long term memories but will have forgotten how to be depressed.

In some cases, they have success. The therapy was considered brutal years ago because of the violent convulsions and because they did not figure people needed anesthetic. Plus, for a time it was used for many inappropriate conditions and can kill a person if they have a bad heart. (No doctor will give ECT if the patient fails a checkup.)

It is much easier now days, with mouth braces of silicone, partial length breathing tubes, drugs, soft beds and much better training on the device. Nonprofessionals used to be able to administer it, and in the old mental hospitals, many of the attendants were selected for strength and not empathy or intelligence. Needless to say, if the attendant was pissed off, higher voltage than necessary was used and the convulsions could break bones.

There are still controversial opinions as to whether or not it is actually as effective in treating depression as medication is.

12

of a truly hilarious book I read some time ago, dealing with the (late) Victorian’s obsession with sex. In those days, masturbation was thought to lead to insanity, and some poor girls were subjected to unspeakable operations to remove the cause of this “vice”. I also believe that the Victorians had a morbisd streak-they loved to build elaborate tombs and memorial services were much in vogue. It is amazing to reflect on how absurd some of these people’s ideas were, but then again, they accomplished a lot of other things.

13

I have read account of people who underwent extensive ECT. Although they were restrained and did not suffer much physical trauma, but the memory loss can be extensive and become an ongoing terrifying problem.

If ECT were so effective in erasing long term mental habits one would think it would be used more extensively in a wider range of disorders. I don’t care what the doctors say about it being humane, It still scares the bejeezus out of me.

Go back and read some of the most recent prolobotomy literature. I have read stuff that makes it seem like a simple, effective, humane treatment to mental illness. Compare the tone of that literature with the current literature on ECT and drug therapies.

Some of the psychoactive drugs are fairly well understood compared to either ECT or lobotomies, some are not. Some, like thorazine are modern day equivalents of the opiate cocktails used to placate troublesome women in Victorian times.

Still, even the best ones are sometimes over prescribed. I just had an pal tell me her gynecologist prescribed the latest and greatest antideppressant for her. She does not feel depressed, but he assured her that her brain chemistry is out of whack and this will help. He has seen her twice and has prescribed this medication on the basis that she has trouble sleeping and a few answers to a questionaire ( not a big test like the MMPI either.) He says if these don’t work he will take test to see if she has thyroid problems.