Narrative Survival: Personal and Institutional Accounts of Asylum Confinement

Introduction

The concepts of narrative and of genre share a family resemblance in the sense that there are many sorts of narrative genres that run across the various spheres of human activity from literature to anthropology, to history, law, medicine, and psychiatry. In particular, in the field of narrative, non-literary memoirs have become the object of considerable scrutiny.¹ While not a review of this literature,² this essay seeks to enhance scholars’ understanding of the “illness narrative” as a genre by going backward in time to a period in 19th century British psychiatry when clinical narratives in asylum casebooks were central to the practice of psychiatry. These casebooks were essential to psychiatry as an emergent professional field because patient histories constituted the raw material basis of observation leading to diagnosis.

Because casebooks were consulted by magistrates and lunacy commissioners who visited England’s asylums regularly, the patient case histories were essential to insane asylum record-keeping and accountability. Yet, institutional case histories were not the only narrative genre existing to document illness and its treatment. Indeed, “counter-narratives” began to appear at the beginning of the decline of asylums for psychiatric treatment in the second half of the 19th century. Written by former asylum patients, these texts documented the often cruel practices or neglectful treatment at the hands of insensitive keepers, and they were of considerable interest to the Victorian reading public as “survivors’ narratives,” which, along with journalistic exposés and novels, shaped public opinion as well as English law regarding the treatment of the insane. These “survivors’ tales,” that is, personal experience narratives written by those who had been released from the asylum, were met with resistance from psychiatrists, the representatives of the asylum system, who relied on institutional accounts of the patients’ confinement to justify treatment choices or other professional decisions. It is not surprising, then, that institutional documents, such as certificates of insanity, admission records, and case histories often tell a different story than the one proffered by patients who were seeking justice, redemption, and/or catharsis.

In the following essay we focus on two intimately connected cases from the archives of Ticehurst Asylum, England.³ Herman Charles Merivale and Walter Marshall, both patients at Ticehurst in 1876 and 1877, found common ground in the shared belief that neither was mad. Each man, after leaving Ticehurst, produced a narrative—Merivale, a memoir, Marshall, an oral testimony—that challenged the status quo ante of the medico-legal institutional authority that existed at Ticehurst Asylum.⁴ By “status quo ante,” we mean the practice of basing confinement on “certification” by physicians, surgeons, and apothecaries untrained in psychiatry; the institutional case history of each patient; and the Lunacy Laws⁵ as a whole. Merivale and Marshall produce interdiscursively linked narratives in which they identify themselves as “survivors” of the experience of asylum incarceration for a period of several months. Merivale’s experiences at Ticehurst are described both in the asylum records and in his memoir, My Experiences in a Lunatic Asylum by a Sane Patient, published first in serial format in the magazine The World in 1878 (a year after his discharge), and as a book in 1879.⁶ Marshall’s confinement can be pieced together from three sources: institutional records, his oral testimony in front of the Select Commission on Lunacy Laws in 1877, and Merivale’s memoir. (Indeed, Marshall’s story is recounted by Merivale as a cautionary tale and a nutshell version of his own.) At the core of both former patients’ narratives is a brief for sanity, supported by the argument that to place a person suffering from nerves, fatigue, hypochondria, etc., rather than actual “madness,” in an asylum with the truly insane, is to insure that the sufferer will descend into insanity. Seen together, the two narratives corroborate each other and raise the issue of the need for a better system of checks and balances to guarantee protection for individuals who were eccentric, but not necessarily mad.

Our primary goal in this essay is to compare both Marshall’s and Merivale’s...