This is an article
written regarding ‘Experiences of an Asylum Patient’, a document written by
Rachel Grant-Smith and published in 1961. The document largely takes the form
of an eyewitness account over 12 years of incarceration in what were then
called ‘asylums’ in The North-West of England. The writing in itself is an
attempt for Ms Grant-Smith to argue against what she regarded as her
mistreatment and the misconstruing of her mentality – to the extent which she
was prepared to come in front of a Royal Court. It is through the exploration
rather than examination of the lives of those like Rachel Grant-Smith who were
not given a voice at a time of mental anguish, that an important history of
mental health treatment can be uncovered.
As Virginia Woolf
once reflected:
“I can only note that
the past is beautiful because one never realises an emotion at the time. It
expands later, and thus we don't have complete emotions about the present, only
about the past.”
It could be seen that
in taking the emotions of the past into account, we can make better preparation for emotional
care in the future, the history of mental health uis often kept secluded,
patients involved in the ‘asylums’ often viewed as fading into some
undocumented existence. However, through careful research and the account
‘Experiences of an Asylum Patient’ this article seeks to highlight especially
how we can, in regards to mental health especially, learn from the language of
the past, to shape the terms of the present.
It is my belief that language and its usage can be used constructively
within mental health care. For example, as this piece highlights, although the
term ‘asylum’ was once used, now ‘psychiatric unit’ is appropriated. The
changing of language use and the discussion of mental health is important – a
point Grant-Smith urges in her writing itself.
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| A model of the old infirmary - Piccadily Site |
February has seen the growth of incentives to encourage the
discussion of mental health – such as the ‘Time to Talk’ campaign launched by
the charity, Mind. This is partly, and rightly, in response to a history of mental
health discussion thwarted by stereotypes and false classifications. In this
case, words can be both culprit and constructive. Through words we can limit
people, yet they also serve as vehicle for expression. In turn, in order to elaborate on the factor of
history and mental health, this article will explore the words of Grant-Smith who was interned at what
was called ‘ Manchester Lunatic Asylum’ (later ‘Cheadle Royal Asylum’) and how
her writing holds such relevance today.
Manchester Lunatic Asylum opened in 1766, with the hospital database
suggesting an ‘unknown location’ from 1763 to 1850. A common suggestion in regard
to situation is Manchester Piccadilly,
part of the same site as the Infirmary which existed there from 1752 to 1909. After
all, a letter from 1804 by a James Jackson is addressed to the ‘trustees of the
Manchester Infirmary, Dispensary, Lunatic Hospital; & Asylum’ suggesting
that the infirmary and psychiatric services thus shared the same site. In 1850
the ‘Lunatic Asylum’ diverged to
location of what is now 100 Wilmslow Road, Cheadle SK8 3DG, though
ultimately kept many of its Lancashire connections and patients. By 1870, George W. Mould was the Cheadle
Superintendent.
In 1900, a patient was admitted as a boarder under the name
of Rachel Grant-Smith. Yet it is interesting that her location on census in
1902, despite her being in the hospital, is described as ‘Musgrove’ – a pseudonym.
This use of language highlights an attempt to disguise the reality of mental
health problems and services. It is interesting that there could be considered a slow extent
of progress over the next 50 years, in terms of an article by W.V Wadsworth in
the Lancet, part of conducting investigations into mental health units. "In 1959 he [Wadsworth] invited
Gordon Cross to come from the Bristol Day Hospital to open a similar one at
Cheadle. This developed as a therapeutic community and in association with the
industrial unit helped in the rehabilitation of both neurotic and psychotic
patients." (Munks Roll)
Yet in Rachel’s’ case, not only is her location ‘Musgrove’ a
pseudonym, but her name itself. It is
this name which signs the haunting ‘Experiences of an Asylum Patient 1922’
based on her mental health treatment in
the North-West from 1900. The document
now contains an introduction, which presents the ‘Experiences of an Asylum Doctor’,
by Montagu Lomax. Initially, this writing proceeding Rachel’s invites an extent of scepticism – is this the
assertion that those deemed ‘medical professionals’ at the time still held the
ultimate authority when it came to written expression? After all, who gave
Rachel her name, attempted to construct her identity? Interesting them, is how
the doctor appears to defend Rachel’s writing
itself, asserting the ‘Truth’ which lies within it – quite definitive
language for the time. A particular point of language is that Lomax writes ‘the personal pronoun ‘I’ looms
very large in all lunatic asylums’ – suggesting an awareness that is the
patients themselves and their words, which form their identity.
Words contribute to identity and can be used constructively.
For those suffering from illness, mental or physical, words can often appear
like a condemnation or a fetter – in the form of diagnosis or a letter. However,
this piece of medical literature is especially important in regards to mental health
and its history as highlights the beginning of awareness that words can be used
for constructive expression – like discussion. It is in the main body of ‘The
Experiences of an Asylum Patient’, that Rachel describes her difficulty as ‘once
tainted with a certificate of madness.’ This includes grotesque mistreatment which she alludes to
‘terrible acts of brutality’ in a ‘vicious circle’ over ‘twelve long years incarceration’.
Although Lomax in the introduction suggests that Rachel provides a ‘simple’ narrative
– this statement perhaps does not appear altogether accurate. After all, the
pathos of Rachel’s writing as just aforementioned conveys an extended articulation of human suffering.
Her writing opens
with an account of her life prior to internment. It was the death of her husband
in 1900, which Rachel alludes to as leading her to ‘nervous breakdown’ with
overwhelming feelings of ‘anxiety’. It is with the support and suggestion of
her family, interestingly, that she entered the Cheadle Royal asylum
voluntarily. Yet here we see a dramatic shift in tone, hence why the writing is
so important and haunting. She alludes to glimpses of positivity before the internment
as she sought the company of her family ‘it was good with me, being with my
people and without drugs’ - the repetition of ‘with’ suggesting that Rachel was
making real effort to sustain connection
with society. This was a connection significantly compromised as her brother encouraged
her to in effect, sign herself over’ to the hospital with the ultimatum ‘it is
too late’ before she had even signed. Rachel’s citing of this particular phrase
is interesting, highlighting an environment in which even the autonomy of her signature,
her identity, was removed from her. In this light, her effort of writing her
‘Experiences as an asylum Patient; could be seen as a triumph and suggestive of
the restorative power of writing. Importantly also, the profundity with which
she emphasizes the phrase ‘it is too late’, highlights the importance and lasting
effect of language, especially in regards to mental health. It can only be
imagined how this triggered the constant anxious questions – too late for what?
Rachel’s account of her time incarcerated is composed of a
combination of narrative and reflection.
Her comments such as ‘I should
have as a sensible woman, be able to reason with myself’ shows reason in
itself, yet also a guilt – a cruel sensation which often still goes under-addressed
in mental health care. Here was not only a woman blaming herself for her
confinement, but blaming herself for what she
feels she ‘should’ have done. In terms of writing ‘should’ screams in
its modality – it is selective, it indicates choice. This is what could be considered
especially important in mental health care – that people have both choice and a
voice, a seemingly appropriate rhyme. It appears Rachel, and doubtless many
others, lacked this at a time they were meant to be receiving ‘treatment’.
Phrases may appear simple on the surface, but the
implications they hold can be profound – ‘it is quite easy to get into an asylum,
but terribly difficult to get out’. Here the
compound sentence expresses a concision of reason. And Rachel’s writing
provides the haunting evidence – especially in regards to how mental health was
made inaccessible by language. In retrospect, she alludes to her situation as
‘monstrous’, trapped by the terms of a doctors combined verdict that she was ‘melancholy
and depressed’. As this was the time following the death of her husband, it
could be anticipated that Rachel would feel low I mood – a logical emotional
reaction to personal trauma. Here she writes of an experience which still
pervades in unhelpful stereotypes today – that ‘depression’ is treated as a
feeling, a reaction. In many cases, depression is alienating, a lack of
feeling, a sense of suspension away from the world.
That Rachel’s writing highlights misconceptions which still
continue today in regards to mental health is both shocking and illuminating.
In turn, I have been driven to write about in the awareness that writing can
change things, an awareness Rachel seemingly shared as she went before a Royal
Commission in an attempt to draw attention to
her treatment.
An interesting link in regards to writing, especially in
terms of mental health, is the poetry of Edna St Vincent Millay, a poet active,
although in America, at the time Rachel was living. It is Rachel’s narrative
that she berates not knowing who the ‘’visitors’’ are – the exaggerated
apostrophes highlighting an environment in which people were ascribed with
names rather than holding them intrinsically. This is often still the case in
mental health treatments, people allocated as ‘’experts’’ or ‘’working in your
best interests’’ when the actuality of those statements are potentially very
much debatable. In Millay’s poem ‘A Visit To the Asylum’ a speaker is employed
who appears to reflect upon her childhood experiences of the inmates of an asylum,
and her lack of understanding of the reality of people’s internment. For
example, the final stanza ends with "Come again, little girl!" they
called, and I/ Called back, "You come see me!" – highlighting how
quickly dialogue can be exchanged, without understanding. Rachel likely felt
subject to this position – at the end of treatment from people who did not
understand the reality of her situation. And this tragically still continues in
regards to mental health. For example, the lack of distinction between using
‘depressed’ as a feeling and ‘depression’ as illness leads to people placing
exaggerated expectations on people suffering from mental health problems –
varying from ‘they are not bad enough’ to ‘they cannot do anything at all’. Making
valid judgment involves facts and facts require listening and evidence.
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| Cheadle Royal Infirmary |
It is the appropriation of limiting language terms to
people, pressing them into categories, which creates a fight for identity. What
is particularly evident is that Rachel’s writing is fraught with this friction,
profoundly unfair, as seen in the imagery she uses to express it. The
description that in a ‘drugged condition
I appeared before my mental execution’ highlights that institutionalisation of
people for mental health problems was often treated as a kind of incrimination.
It in turn makes one hope profoundly that such attitudes have changed, both
inside and outside the treatment of mental health. Rachel alludes to how she
was greeted with the phrase ‘You would like to go to bed’ – nurses assuming an
identity and autonomy for her in language, This is enough to make anyone all
the more passionate that this is why
today, every day, we should see language is essential to the autonomy with each
individual.
People should be allowed to express themselves, converse – whether
through reading, writing, speech, or action. So many in the past were denied
this opportunity, and it is from the incredible accounts of those who
incredibly kept up the strength to write – showing not only needed to change
now, but what even now can be changed for the better. During her internment at Cheadle,
upon which this article focuses, Rachel did not understand the definition of the
‘’Visitors’’. Perhaps it is our task, as readers of the future, to make ourselves
as ‘visitors’ felt – to highlight our experience, however brief or intense,
with mental health. Talk about it, encourage others to talk about it, write it
down, read about it. It is through words which change can happen.
Thank you.
Bibliography
Grant-Smith,Rachel.
Experiences of an Asylum Patient. London: George Allen & Unwin Ltd.,1961 - https://archive.org/details/39002028421130.med.yale.edu
http://studymore.org.uk/mhhtim.htm#RachelGrantSmith1922
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