Category Archives: PhD Thesis

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.

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.

Unearthing the ‘clinical encounter’: Gartnavel Mental Hospital, 1921-1932.

Hazel Morrison successfully defended her thesis in mid-September, 2014. Her full thesis title and abstract are as follows:

Unearthing the ‘clinical encounter’: Gartnavel Mental Hospital, 1921-1932. Exploring the intersection of scientific and social discourses which negotiated the boundaries of psychiatric diagnosis

Thesis Abstract

Charting the trans-Atlantic movement of ‘dynamic’ psychiatry from The Henry Phipps Psychiatric Clinic, Baltimore, to Gartnavel Mental Hospital, Glasgow, my thesis throws light upon the resultant ‘dynamic’ case note records, produced in Gartnavel during the 1920s.  By undertaking an in-depth, qualitative analysis of Gartnavel’s case note records and corresponding archival materials, I explore the polemical question, posed, amongst others, by Foucault, of how psychiatry achieves its distinct status as a science of the individual.  Foucault, most notably in Discipline and Power, ascribes to the psychiatric profession the power to fashion individual patient histories into cases, cases which simultaneously emphasise the individuality of a patient, while condensing, i.e. ‘fixing’ their identities that they may be constituted ‘an object for a branch of knowledge and a hold for a branch of power’.  This thesis, while recognising the validity of this argument, explores how the clinical practices and philosophical outlook of dynamic psychiatry in the early twentieth century enabled both patient and psychiatrist to negotiate the construction of the psychiatric case note record, and consequently of patients’ individual identities.

D. K. Henderson, physician superintendent of Gartnavel between 1921 and 1932, was one of the first, if not thefirst psychiatrist fully to incorporate dynamic principles into the working practices of a British mental hospital.  Initiating methods of case note taking and staff meeting consultation (now integral components of modern day psychiatric practice) he transported the teachings of his mentor, the Swiss émigré psychiatrist Adolf Meyer, to the everyday clinical practices of Gartnavel.  The dissemination of dynamic psychiatry through Henderson’s published works and medical teachings is recognised as having integrally shaped the practices of Scottish psychiatry in the twentieth century.  However, the significance of the unpublished case note records, produced under his superintendence of Gartnavel during the 1920s, as sources of historical enquiry has gone largely unrecognised.  A near-unique archive of ‘dynamic’ case note records is used in my thesis to reveal, what Roy Porter termed, a ‘history from below’ of clinical practices and examinatory processes.  For as Henderson employed stenographers and clinical clerks to record verbatim and semi verbatim the dialogues that passed between patients and psychiatrists within staff meetings and mental examinations, I, as Porter himself aspired to, take as the focus of my research a history of the ‘two-way encounters between doctors and patients’.

By employing an interdisciplinary research method, one that incorporates Foucauldian, literary, critical medical humanities, as well as more traditional forms of medical history scholarship, I establish a history of dynamic psychiatry set within clinical encounters.  Engaging with current debate, evolving primarily within the interdisciplinary sphere of the medical humanities, I argue these records reveal a history of medical humanism, one in which both patients and psychiatrists actively shaped the history of twentieth century Scottish psychiatry. 

The Locational History of Scotland’s District Lunatic Asylums, 1857-1913

The Locational History of Scotland’s District Lunatic Asylums, 1857-1913.

Kim Ross

Abstract

This thesis looks into the later ‘Asylum Age’ in Scotland, concentrating on the legislation and construction of Scotland’s district lunatic asylums from the passing of the Lunacy (Scotland) Act, 1857 to the Mental Deficiency and Lunacy (Scotland) Act, 1913. Concentrating on the specific geographies of the asylums, what Foucault refers to as “the space reserved by society for insanity” (Foucault, 1965:251), the thesis weaves a new route between previous radical/critical and progressive/simplistic interpretations of the ‘Asylum Age’, by integrating a Foucauldian interpretation with non-representational theories around the engineering of affective atmospheres. This more nuanced approach, which concentrates on the ‘affective power’ of the institutions across different geographical scales (site and situation, grounds and buildings), recognises the ways in which Scotland’s district asylums, constructed predominantly for pauper patients, were moulded and reshaped as the discourses around the treatment of insanity were developed. The moral, medical and hygienic dimensions to the discourses ultimately outlined the institutional geography, by having a profound influence on asylum location and layout. The ideal district ‘blueprint’ for asylum siting and design, as put forward by the Scottish Lunacy Commissioners, is uncovered and reconstructed by ‘picking out’ the macro and micro-geographies discussed in the annual reports of the General Board. The research then moves to uncover the system ‘on the ground’ as it was constructed in bricks-and-mortar by the various district boards. As asylum location and architecture was a relatively novel concern, questions of siting and design became more pertinent, and indeed central, in institutional planning during the decades after the mid-century lunacy reforms. Thus, despite periods of waning enthusiasm for the institution as a mechanism for ‘curing’ insanity, fitting the building to its purposes continually involved a variety of structural innovations, stylistic refinements and new ways of organising the external and internal spaces of the asylums.