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Inconvenient People: Lunacy, Liberty and the Mad-Doctors in England Paperback – July 15, 2014
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"This might seem morbid reading, but Wise's research is rigorous, her writing is lucid and witty, and this book is engaging, although disturbing. A must-read for those who work in the mental health industry, I think most people will find it both eye-opening and provocative." The Guardian
Ms. Wise delves deeply into her unsettling subject, finding bizarre humor in it as well as tragedy . . . She extracts richly detailed material from the archives and animates it with great narrative flair.” The Wall Street Journal
"Wise’s meticulously researched study adds a fresh perspective to current scholarship on insanity and offers a chilling reminder of 'the stubborn unchangeability of many aspects of the lunacy issue.'" Publishers Weekly
Praise for the UK edition of Inconvenient People
"Wise is a terrific researcher and storyteller. Here she has woven a series of case studies into a fascinating history of insanity in the 19th century." Kate Summerscale, Guardian, Books of the Year 2012
"I was thrilled read to Sarah Wise's Inconvenient People, an enthralling study of those who fell foul of Victorian mad-doctors and greedy relatives." Philip Hoare, Sunday Telegraph, Books of the Year 2012
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Ms. Wise clearly exposes the shenanigans and hypocrisy of the "alienists" (psychiatrists/psychologists) in cahoots with members of the judiciary who facilitated the confinement of many victims based solely on greed. Many examples of the so-called `lunatics' were simply eccentrics who did not toe the line within the culture, or held alternative religious beliefs, or resisted their families' wishes, or were an inconvenience or impediment to their relatives' acquisition of wealth or property, or were simply an inconvenient burden on the family.
Often the victim would be declared insane and imprisoned in the family's home, or in one of the myriad privately run madhouses, run by an alienist, for a fee. In most cases, the `lunatic' would forfeit his/her possessions to the relatives (who are "caring" for them) or to the adjudicating Lunacy Board to pay for their upkeep. The majority of the funds were diverted to the trustees' personal coffers in most cases.
The diagnosis, incarceration and overall brutal treatment of the insane often bordered on the criminal.
Public asylums and lunatic wards in workhouses meted out the worst abuse of the inmates, including beatings, heavy metal shackles, bed restraints, dunking in ice-cold water baths etc. But it was the upscale, private, genteel and expensive asylums that characterize these times; they were prisons, nonetheless, with bars on the windows, locked doors and "straight waistcoats, iron whole-leg hobbles, handcuffs, finger confining instruments and manacles" used to control unruly patients.
Readers of Jane Austen, Wilkie Collins et al may get the impression that the majority of `lunatics' were hysterical women locked up in the attic or young damsels falsely imprisoned by nefarious relatives; but the reality was that the majority confined to asylums were males.
The definition of insanity was very vague at best, and `alienists' and asylum keepers were prepared to commit almost anyone for money. Eventually there was an outcry against these abuses when anyone can be accused of insanity, imprisoned without a trial and with no recourse of appeal or knowledge of the accuser.
In 1845, the Lunacy Commission was established for the purpose of regulating and prosecuting doctors and asylum owners for abuses; but collusion, complacency and corruption allowed exploitation and mistreatments to continue, until Parliament intervened and passed the Lunacy Acts in the 1860s. It was not until 1930 that the Mental Treatment Act was enacted to allow involuntary, voluntary and temporary confinement.
The book includes many known personalities of the time; Charles Dickens, Lady Rosina Litton, John Percival, Charles Lutwidge Dodson (Lewis Carroll) in various cameos. No spoilers here.
The author concludes on a somewhat depressing note that depicted the extreme abuses of the mid-twentieth century when youthful unruly behavior, rebellious attitudes or illegitimate pregnancy could land a teenager in an asylum for several years. In spite of the many advances in medical research and treatment of mental illness, the stigma remains.
This is a well-researched, detailed book based on primary sources and original archives, presented in a clear well-organized narrative. It is replete with details and minutiae, but is never boring. It is certain to appeal to mental health professionals, students of social and medical history and buffs of the Victorian era. The lay reader will find many areas of the book interesting and informative.
I was initially expecting something a bit more sweeping - along the lines, say, of Scull's excellent Madness in Civilization - but Wise's focus on the precise details of every case presented brings the tragedy and horror the victims of Britain's system endured into sharp relief. If there's a weakness here it's in the underplaying of what are clear instabilities in some of the patients covered - Wise's point is well made that people who managed to recover while in care had a nearly impossible time getting out, but she seems to gloss over the fact that in some (not all) of the cases she covers there were clear inciting incidents that seemed to warrant putting the patient under supervision.
Inconvenient People, with its exacting detail, might not be for everyone, but fans of Gothic fiction and Wilkie Collins should flock to it, as should students of the history of psychiatry, or anyone who wants to feel significantly better about the modern mental healthcare system.
This book alternates between an outline of various lunacy laws with explanations that put those laws in context, and carefully detailed case histories that result from those laws or cause a change of the laws.
We get to see past the sensationalist accounts of the press and public hysteria to what was actually happening. I found it fascinating to learn the truth behind the myths, so to speak.
Well worth reading if you have any interest in the subject at all, with a useful collection of sources listed for further study.
This book reminds me of Koven's "Slumming: Sexual and Social Politics in Victorian London" in that it takes on an area of Victorian history, debunks an accepted wisdom that didn't add up to me, and replaces it with something that makes more sense.