Category Archives: Abstracts

Tracing outsideness

Tracing outsideness: young women’s institutional journeys and the geographies of closed space (2016)

Anna Schliehe

Thesis available via Enlighten

Abstract

Understanding confinement and its complex workings between individuals and society has been the stated aim of carceral geography and wider studies on detention. This project contributes ethnographic insights from multiple sites of incarceration, working with an under-researched group within confined populations. Focussing on young female detainees in Scotland, this project seeks to understand their experiences of different types of ‘closed’ space. Secure care, prison and closed psychiatric facilities all impact on the complex geographies of these young women’s lives. The fluid but always situated relations of control and care provide the backdrop for their journeys in/out and beyond institutional spaces. Understanding institutional journeys with reference to age and gender allows an insight into the highly mobile, often precarious, and unfamiliar lives of these young women who live on the margins. This thesis employs a mixed-method qualitative approach and explores what Goffman calls the ‘tissue and fabric’ of detention as a complex multi-institutional practice. In order to be able to understand the young women’s gendered, emotional and often repetitive experiences of confinement, analysis of the constitution of ‘closed space’ represents a first step for inquiry. The underlying nature of inner regimes, rules and discipline in closed spaces, provide the background on which confinement is lived, perceived and processed. The second part of the analysis is the exploration of individual experiences ‘on the inside’, ranging from young women’s views on entering a closed institution, the ways in which they adapt or resist the regime, and how they cope with embodied aspects of detention. The third and final step considers the wider context of incarceration by recovering the young women’s journeys through different types of institutional spaces and beyond. The exploration of these journeys challenges and re-develops understandings of mobility and inertia by engaging the relative power of carceral archipelagos and the figure of femina sacra. This project sits comfortably within the field of carceral geography while also pushing at its boundaries. On a conceptual level, a re-engagement with Goffman’s micro-analysis challenges current carceral-geographic theory development. Perhaps more importantly, this project pushes for an engagement with different institutions under the umbrella of carceral geography, thus creating new dialogues on issues like ‘care’ and ‘control’. Finally, an engagement with young women addresses an under-represented population within carceral geography in ways that raise distinctly problematic concerns for academic research and penal policy. Overall, this project aims to show the value of fine grained micro-level research in institutional geographies for extending thinking and understanding about society’s responses to a group of people who live on the margins of social and legal norms.

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Thesis: Reconstructing a Twentieth-Century Scottish Psychiatrist

Congratulations to Sarah Phelan on the succesful defence of her thesis: Reconstructing a Twentieth-Century Scottish Psychiatrist: Thomas Ferguson Rodger, “Wartime Psychiatry”, “Eclecticism”, and “Mad Dreaming”

Abstract:

This PhD explores the contribution to psychiatry of Thomas Ferguson Rodger (1907–1978), first Professor of Psychological Medicine at the University of Glasgow (1948–1973) and consultant psychiatrist at several Glasgow hospitals. Rodger is a somewhat neglected figure in the history of Scottish psychiatry, yet his career spanned – and in some measure also shaped – an important period of transformation as traditional asylum-based psychiatry was challenged by emergent general hospital- and community-based psychiatry. Rodger’s personal archive, including lecture notes, patient case notes, correspondence and miscellaneous items, has recently been catalogued by the University of Glasgow Archives through funding from the Wellcome Trust. This study comprises a forensic reading/interpretation of this archive, alongside oral histories with individuals who remember him and his immediate legacy in/beyond the University. Adopting perspectives drawn from the history/geography of psychiatry and medical humanities, it reconstructs Rodger’s life, ideas and practices, set within the changing ‘spaces’ of mid-twentieth century psychiatric medicine.

This thesis reads across Rodger’s papers as well as sources within other repositories, allowing themes to emerge and develop which form the basis for discrete case studies in twentieth-century psychiatry. Rodger’s career, as reconstructed from his archive, provides a compelling aperture into psychiatric developments of the interwar, Second World War and post-war periods respectively. Beginning in the Second World War, it elaborates upon the link between Rodger’s and his fellow military psychiatrists’ endeavours in personnel selection and the inception of the therapeutic community model at Northfield Military Hospital in Birmingham. Foregrounding how the therapeutic ideals of the psychiatrists were subordinated to military aims and tradition, it speculates upon Rodger’s post-war re-envisioning of psychiatry as at least in part a reaction to the limited application of their techniques during wartime. The thesis then moves to the changing post-war therapeutic landscape, situating Rodger’s eclectic psychiatry within the context of deinstitutionalisation and the therapeutic armamentarium of ostensibly divergent physical and psychological methods. It complicates eclectic psychiatry’s straightforward descent from Meyer’s and Henderson’s dynamic psychiatry by positioning it as a response to the challenge of deinstitutionalisation in balancing between contrasting treatment methods, and additionally as a critical acknowledgement of the uncertainty afflicting understandings of mental disorder, especially with respect to the efficacy of physical therapies. Finally, the thesis returns to the earliest phase of Rodger’s career for which archival evidence exists: his times as Deputy Superintendent at Glasgow Royal Mental Hospital in the 1930s, when he was experimentally examining the resonances of psychoanalytic theories in his own work framed by the psychiatric pessimism of the time. Through discussion of dream analytic sessions, it elucidates Rodger’s dissatisfaction with psychoanalysis’ failure to account for environmental difficulties and stresses Rodger’s adoption of a more pragmatic ‘common-sense’ therapeutic attitude. Collectively, the thesis underlines Rodger’s self-critical stance towards his profession and his developing conviction about the significance of social/environmental and cultural factors in the causation and cure of mental distress.

New paper: The (un)habitual geographies of social anxiety disorder

This is Louise Boyle’s first publication related to her PhD research that explores the lived experience of social anxiety. The paper was published as part of a Special Issue on Health and Wellbeing in the journal Social Science and Medicine.

The article is available online.

Abstract

This article investigates experiences of Social Anxiety Disorder (‘social anxiety’) with reference to recent geographical debates on habit. It considers how habit simultaneously captures (un)reflective modes of being in the world and the foreboding disruptive capacity of uncertainty as people attempt to adapt to, negotiate and manage everyday life with social anxiety. Drawing on lived accounts from online questionnaires and online interviews with people diagnosed, or self-diagnosing, with social anxiety, it uncovers the relational and embodied practices-and the inherent spatialities of such practices-that enable individuals to (re)gain control of their socio-spatial surroundings. It also considers the capacity for habits to become disrupted and displaced through pervasive anxieties and persistent rumination and anticipation, situated within the context of participants’ everyday lives. This analysis highlights the social, spatial and temporal dimensions of socially anxious experiences. Overall, by interpreting lived experience in this way, this article introduces a socio-spatial dynamic to otherwise extremely limited accounts of social anxiety found outside of the dominant biomedical framework.

Thesis: Scottish-Jewish ‘madness’?

Cris Sarg successfully defened her thesis in mid-September 2017. The full thesis title and abstract are as follows:

Scottish-Jewish ‘madness’?: An examination of Jewish admissions to the royal asylums of Edinburgh and Glasgow, c.1870-1939. Thesis available on Enlighten

Abstract

This thesis sits at the junction of asylum history and Anglo-Jewish history, specifically Scottish Jewish history, and contributes new perspectives to scholarship on histories of both psychiatry and Anglo-Jewry. It explores the lived experiences of Jewish patients admitted to the royal asylums of Edinburgh and Glasgow between 1870 and 1939 using a range of both quantitative and qualitative archival sources. A discussion of the relevant literature that has focused on ‘Anglo’ asylums and Anglo-Jewry, particularly on Scottish asylums and Scottish Jewry, provides the historical context for the research questions being asked about how Jewish patients admitted to the royal asylums were understood, diagnosed and treated. The quantitative Jewish patient population is presented, discussing: demographic variables such as gender distribution, age at admission and the patient’s marital status at admission; social variables such as ‘class’ as regards a patient’s accommodation within the asylum and their occupation; diagnostic variables such as the mental disorders identified; and finally institutional variables such as a patient’s discharge status and the length of a patient’s stay within the asylum. This Jewish patient profile is compared to control samples of non-Jewish patients to detect similarities and differences between the two groups, providing scope for the qualitative accounts that follow. Qualitative sources are then used, pulling out a number of individual case histories as detailed exemplars of broader claims, spread across three substantial chapters. The first qualitative chapter draws on several of the themes presented in the discussion of relevant literature, such as matters of Jewish demography, migration, family dynamics, social standing, cultural experiences and the like, as these intersect with the ‘asylum lifecycle’, meaning periods spent in and outside of the asylum by these patients. This material opens a door to the Jewish patient experience through the discussion and analysis of several themes, such as: family, community, immigration status, social class, migration histories, big and small and the asylum lifecycle with respect to patients who experienced multiple admissions to asylums. The next chapter’s overarching theme is the Jewish body – all aspects of Jewish embodiment; of embodying Jewishness – in the asylum. This theme is further broken down into specific areas for discussion, such as: the male Jewish body; poisoning, because historically Jews have been associated with the act of poisoning; the diagnostic criteria as it was applied to Jews during the period under investigation; the role of language within the clinical encounter; and troublesome patients. The goal here is to illustrate how the Jewish body was often seen as inherently different from other (British) asylum patients and therefore pathologised because of those differences, such that in certain situations merely being Jewish suggested a likelihood of being mentally unstable and possessing a mental illness due to the Jewishness association. The final qualitative chapter concentrates on Jewish women and their experiences within Scottish asylums, highlighting some of the gendered differences within that experience when compared to the male Jewish experience of madness that was primarily tackled in the previous chapter. This chapter discuses Jewish women and their place within the Jewish community and wider Anglo-Scottish society, and further it addresses the perceived close relationship between Jewish women and mental illness, itself complicated by the extent to which the woman concerned sought to live up to a vision of the perfect Jewish mother while also being judged through an idealized version of domestically content British (middle-class) womanly reserve. Final conclusions are added which summarise the contributions made by the thesis, and speculate about further inquires that might be conducted in this field.

New paper: ‘It used to be here but moved somewhere else’: post-asylum spatialisations – a new urban frontier?

‘It used to be here but moved somewhere else’: post-asylum spatialisations – a new urban frontier?

Ebba Högström

Social & Cultural Geography http://www.tandfonline.com/eprint/YuscFCJhDI43TCExhkrW/full

Abstract

This paper presents a number of spatialisations of mental health care in Sweden, exemplifying these spatialities in three vignettes drawn from the Swedish post-asylum landscape. Working with the notion of a ‘new urban frontier’, I examine: (1) how these landscapes have been transformed by processes of decentralisation and austerity measures; (2) how this transformation plays out within and through physical space; and (3) the new spatial relations that are produced through such transformations. The idea of ‘landscapes of care’ and the concept of ‘multiscalarity’ are used to understand the changing spatialisations evident in mental health care, and the shift we are presently witnessing which replaces the tangible spaces of ‘bricks and mortar’ of the past with, rather, a diversity of settings, localisations and administrations. The empirical material that forms the basis of the analysis derives from a larger study of spatial discourses in Swedish mental health care, which I carried out between 2008 and 2011. The paper concludes with some thoughts on the kinds of spatial relations evident within the post-asylum landscape of formal mental health care in times of austerity and decentralisation, wherein I consider whether these spatialisations can be regarded as a ‘new urban frontier of care’.

Constructing Patient Stories: ‘Dynamic’ Case Notes and Clinical Encounters at Glasgow’s Gartnavel Mental Hospital

New Article

Morrison, H. 2016 ‘Constructing Patient Stories: ‘Dynamic’ Case Notes and Clinical Encounters at Glasgow’s Gartnavel Mental Hospital, 1921–32’, Medical History, Volume 60, Issue 01, pp.67-86.
DOI: http://dx.doi.org/10.1017/mdh.2015.69
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10064468&fileId=S0025727315000691

Abstract:

This article contextualises the production of patient records at Glasgow’s Gartnavel Mental Hospital between 1921 and 1932. Following his appointment as asylum superintendent in 1921, psychiatrist David Kennedy Henderson sought to introduce a so-called dynamic approach to mental health care. He did so, primarily, by encouraging patients to reveal their inner lives through their own language and own understanding of their illness. To this effect, Henderson implemented several techniques devised to gather as much information as possible about patients. He notably established routine ‘staff meetings’ in which a psychiatrist directed questions towards a patient while a stenographer recorded word-for-word the conversation that passed between the two parties. As a result, the records compiled at Gartnavel under Henderson’s guidance offer a unique window into the various strategies deployed by patients, but also allow physicians and hospital staff to negotiate their place amidst these clinical encounters. In this paper, I analyse the production of patient narratives in these materials. The article begins with Henderson’s articulation of his ‘dynamic’ psychotherapeutic method, before proceeding to an in-depth hermeneutic investigation into samples of Gartnavel’s case notes and staff meeting transcripts. In the process, patient–psychiatrist relationships are revealed to be mutually dependent and interrelated subjects of historical enquiry rather than as distinct entities. This study highlights the multi-vocal nature of the construction of stories ‘from below’ and interrogates their subsequent appropriation by historians.

 

Troubling Institutions Conference 2014 – Abstracts


Childhood Institutions – The Orphanage

(Presented by Tom Disney (University of Birmingham)

 The orphanage as an institutional space represents a significantly underrepresented area of study in Geography, both theoretically and empirically. While institutional spaces such as prisons (Moran et al. 2011, Moran 2012) and asylums (Philo 1989) have often been explored to understand how micro-populations are disciplined through everyday life, this research is often adult-centric and fails to consider the ways in which childhood institutions might challenge traditional understandings of institutional environments (see Goffman 1961 and Foucault 1998).

In an attempt to address these issues this paper draws upon ethnographic data gathered while working in an orphanage for disabled children in the Russian Federation. It considers the everyday practices within the institutional environment of the orphanage, in particular exploring the conceptualisations of the disabled orphan’s body as ‘dirty’ and how this is implicated in practices of ‘dehumanisation’ (Goffman 1961), transgressing the borders of ‘normal’ human contact and bodily practices. This paper utilises the work of Douglas (2002) and Kristeva (1982) in to analyse everyday life in the orphanage such as human touch, dirt and washing. Through this analysis this paper addresses the need for further empirical considerations of orphanage spaces, provides alternative theoretical considerations of institutional space through an examination of childhood experiences of such spaces, and finally contributes to cross-disciplinary debates surrounding care practices and orphan well being in institutional spaces.

 ‘Therapeutic Landscapes’ and emotional ties to past settings; salvage and abandonment as considerations in Psychiatric Hospital design.

Presented by Sarah Curtis (Durham University) and Victoria Wood (Newcastle University)

We explore the connections between theories relating to therapeutic landscapes and to emotional attachment with landscapes associated with past experience.  We use these ideas to interpret findings from research on emotional reactions to changes to medical spaces of care. We draw on findings from a qualitative study of the transfer of psychiatric inpatient care from an old to a newly built facility. Our findings show how the meanings attributed to ‘therapeutic landscapes’ from one’s past can evoke emotions and memories, manifesting in ideas about nostalgia, solastalgia, salvage and abandonment, which can impinge on one’s present therapeutic experience in a new hospital setting. We reflect on how consideration of these ideas might contribute to better future built design of psychiatric inpatient facilities and the wellbeing of those using them.

Troubling Institutions: Prisons and the Design of Carceral Space

(Presented by Dominique Moran (University of Birmingham)

Prison design is crucial to the relationship between the ‘carceral’ and the state, in that it is the process which determines, in large part, how the goals of a criminal justice system are materially expressed. However, prison design remains under researched within criminology and prison sociology, and is yet to attract the attention of carceral geography. With this in mind, this exploratory paper overviews the significance of prison design, sketches out the extant research on this topic, and suggests areas of potential intersection between carceral geography, geographies of architecture, and health geographies, in the latter case specifically in relation to the notion of therapeutic landscapes.