The Peculiar Institution: Race, Gender, and Religion in the Making of Modern Psychiatry

Wendy Gonaver (PhD, American Studies, College of William and Mary) was a Research Fellow of the Consortium in 2015-2016. Read more about her Consortium-funded research below. My research examines and analyses the role of race and slavery in the emergence of moral treatment for mental illness in the late eighteenth and early nineteenth centuries, and its demise after the U.S. Civil War. I pay particular attention to two nineteenth-century Virginia asylums, The Eastern Lunatic Asylum in Williamsburg and the Central Lunatic Asylum in Petersburg. Central Lunatic Asylum was created after the Civil War to treat African Americans exclusively. Prior to that, the Eastern Lunatic Asylum was the only U.S. institution to accept free blacks and slaves as patients and to employ slaves as direct attendants. Enslaved attendants were routinely entrusted with a remarkable degree of authority over patients of all races, making it possible for administrators to implement total non-restraint. Similarly, the example of slaves hiring out and inadequate funding for free black patients contributed to early and successful experiments with outpatient care. Despite contemporaneous European criticism of American asylums for reliance upon corporal restraint and its alleged connection to slavery, I argue that slavery served as a model for liberal innovation in asylum care. I am currently revising my manuscript, which is under contract with the University of North Carolina Press. With the support of the Consortium for the History of Science, Technology and Medicine, I found sources to strengthen two key topics: the reactions of northerners to southern asylums, and changes in mental hospital administration and patient population during and after the Civil War. The Superintendent of the Eastern Lunatic Asylum, John M. Galt, graduated from the University of Pennsylvania’s medical school and went on to co-found, in 1844, the organization that eventually became the American Psychiatric Association. I looked at the University’s administrative records to learn what medical school was like in the 1840s. I was curious about the number of southern students who enrolled, and the extent to which they asserted their regional identity through thesis topics and social networking. It was especially amusing to encounter a letter of recommendation from a professor at the College of William and Mary asking faculty in Pennsylvania to overlook an applicant’s suspension for dueling. I also looked at Civil War materials at Special Collections in search of northern soldiers’ accounts of their experiences in Virginia, particularly their encounters with and impressions of former slaves. Both sets of materials suggest that northerners believed that the South was insufficiently modern despite the fact that Virginia’s asylums provided for the indigent mentally ill decades earlier than did Pennsylvania’s hospitals. Nevertheless, one of the most prominent nineteenth-century institutions was The Pennsylvania Hospital for the Insane. Unfortunately, patient records have been inaccessible to scholars since 2003 because of strict privacy laws. Archivist Stacey Peeples was able to show me correspondence between Pennsylvania’s renowned Superintendent Thomas S. Kirkbride and John M. Galt, as well as letters Kirkbride exchanged with influential reformer Dorothea Dix about Galt. These fascinating letters reveal behind-the-scenes opposition to Galt’s advocacy of interracial institutions and outpatient care by two leading figures of asylum reform. Dix wanted Galt to replace enslaved attendants with nuns. Her concern was not exploitation, but whether slaves were sufficiently refined to interact with patients allegedly in need of exemplary moral discipline. The association of slaves with enthusiastic Protestantism and abolitionist “fanaticism” also contributed to objections about their job as caregivers and admission as patients. I was, therefore, intrigued to find a book at The College of Physicians by a British author who argued that successful missionizing among slaves in the West Indies proved the merit of similar efforts among the insane in England. Librarian Beth Lander also showed me minutes from the annual meetings of the Association of Medical Superintendents of American Institutions for the Insane, annual reports from an array of institutions, and rare pamphlets and treatises on other relevant topics such as the therapeutic propriety of corporal restraint. Debates about the necessity of restraints at asylums resonated with similar controversies about the proper treatment of slaves. Asylum Superintendents believed that authoritative benevolence encouraged most patients to control aberrant behavior without the use of restraints just as defenders of slavery argued that a paternalistic master controlled slaves without punishment. Although most Superintendents were unwilling to entirely forego mechanical restraint, the defense of restraints in the United States intensified with slavery’s demise. Administrators now insisted that these new patients were so violent and excitable as to require separate institutions and the abandonment of moral means. At The Library Company of Philadelphia, I read pamphlets from the 1870s and 1880s that advocated this point of view. The Library Company also has every edition of the American Journal of Insanity, making it possible to chart changing attitudes towards outpatient cottages, colonies, and farms for asylum patients judged to possess superior self-control. Outpatient care was so controversial when Superintendent Galt first proposed it in the 1850s that he was ostracized until his death just after the Battle of Williamsburg in 1862, but similar plans received plaudits by the 1880s. The medical and humanitarian crisis brought about by the Civil War led to many changes in hospital care, including the segregation by race of asylums in Virginia and the creation of new facilities in other states for mentally ill African Americans. Although employees of the Freedmen’s Bureau encountered resistance from southern Superintendents over admission of African American applicants, de facto segregation was the norm in northern asylums despite significant numbers of African Americans in northern prisons, jails, and almshouses. At the American Philosophical Society, I examined proposals for the treatment of the “insane poor” in Pennsylvania, annual reports from Philadelphia’s Eastern State Penitentiary, and other essays about mentally ill convicts and prison discipline. I also read excerpts from the fascinating diary of a plantation overseer in Jamaica who wrote about the labor and religious lives of former slaves immediately after emancipation in 1838. This overseer complained about religious radicals who encouraged freedmen and women to strike for better wages and working conditions. Authorities in Virginia made similar complaints about individuals who were ultimately committed to the asylum. I am grateful to the archivists, librarians, and staff for their expert assistance. I thank the Consortium for the History of Science, Technology and Medicine for financial support and intellectual community.