The psychological treatment of insanity in France in the first part of the nineteenth century

Welsh author Arthur Machen (1863–1947) wrote his most popular supernatural tales between 1890 and 1900, a period in which European culture felt itself to be on the decline and in which “decadent” art and literature rose up both as a reflection of and a contribution to this perceived cultural deterioration. While Machen's works have received little critical attention, a recent revival of interest in fin-de-siècle decadence has brought his supernatural tales into the literary limelight. Noteworthy examples of this interest include Julian North's treatment of The Great God Pan in Michael St. John's Romancing Decay: Ideas of Decadence in European Culture and Christine Ferguson's analysis of the same work in her PMLA article “Decadence as Scientific Fulfillment.” Indeed, Machen's supernatural tales could enhance and complicate any exposition of decadent literature and culture; they offer a unique vision of descent into the primordial that differs from the moral and psychological treatment of decadence in other popular works of the time, such as Wilde's The Picture of Dorian Gray and Stevenson's Strange Case of Dr. Jekyll and Mr. Hyde. Like Stevenson and Wilde, Machen employs themes of transgression and metamorphosis to illustrate his characters’ deviations from human nature. However, the forces at work in Machen's tales do not arise from the recesses of the human mind in its modern conception, nor do his protagonists sin primarily against society and the arbitrary nature of its morals and values. Instead, Machen locates mythic forces at work within his contemporary society to highlight a much older form of transgression and to challenge notions of degeneration that held currency at the end of the nineteenth century.

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Introduction

Sex, Religion, and the Making of Modern Madness ◽

10.1093/oso/9780195125818.003.0004 ◽

1999 ◽

Author(s):

Ann Goldberg

Keyword(s):

Nineteenth Century ◽

Mentally Ill ◽

Psychological Treatment ◽

Medical Specialty ◽

Absolute Power ◽

Patient Relations ◽

The Mind ◽

The Church ◽

Doctor Patient Relations ◽

At Home

In 1838, an indigent tailor arrived at the Eberbach asylum terrified, dazed, and repeatedly crossing himself. At home before his committal, Martin M. had become violent and been bound and beaten. He had experienced, as he later explained, “an irresistable urge to spit in people’s faces and hit them.” Now, during his eleven-month incarceration, he incessantly begged for “mercy” from the asylum physicians. Rituals of authority and submission were built-in features of doctor-patient relations in an institution where doctors wielded almost absolute power and where acts of submission were a necessity for any patient who wanted to leave the place. Curiously, Martin M. understood this fact in a language foreign to the medical designs of the asylum—a language (“mercy”) of the prisoner or penitent, of criminal justice or the church, not that of the patient. Martin M., it seems, felt he needed either divine salvation or judicial clemency, not medical treatment. The treatment of Martin M. in an insane asylum was an innovation of the nineteenth century. Just twenty-five years earlier, such a man would have been left at home to face the punishments of family and community or placed in one of the multifunctional work-, poor-, and madhouses that housed the castoffs of society—beggars, petty criminals, prostitutes, orphans, the insane, and the infirm. In contrast to these detention institutions, the new asylums of the nineteenth century contained only the mentally ill, with the aim of medically treating and rehabilitating them through methods that affected the mind. The birth of a new medical specialty and a new set of experts—the alienists, later known as psychiatrists—thus accompanied the founding of modern insane asylums in a movement that spread throughout Europe and North America beginning in the late eighteenth and early nineteenth centuries. As a result of these changes, masses of deviant and mentally ill people in the nineteenth century came to be incarcerated and subjected to new kinds of medical and psychological treatment (although their numbers remained limited in the first part of the century). We know that most of these people came from the lower classes; certainly such people made up the overwhelming majority of patients in public asylums.

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The Family in Crisis in Late Nineteenth-Century French Fiction. Nicholas White. Cambridge University Press, 1999 (xii +214 pages) Cambridge Studies in French, 57. £40, hardback, ISBN 0521562740

European Review ◽

10.1017/s1062798700210156 ◽

2000 ◽

Vol 8 (1) ◽

pp. 143-144

Author(s):

Barbara Wright

Keyword(s):

Nineteenth Century ◽

Late Nineteenth Century ◽

Cambridge University ◽

The Family ◽

Late Nineteenth

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Chronic Pain: Fundamental Scientific Considerations, Specifically for Legal Claims

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2013.janfeb01 ◽

2013 ◽

Vol 18 (1) ◽

pp. 1-18 ◽

Cited By ~ 1

Author(s):

Robert J. Barth

Keyword(s):

Health Outcomes ◽

Pain Perception ◽

Driving Forces ◽

Psychological Treatment ◽

Dominant Role ◽

Meta Analysis ◽

General Medicine ◽

Pain Syndrome ◽

Problematic Relationship

Abstract Scientific findings have indicated that psychological and social factors are the driving forces behind most chronic benign pain presentations, especially in a claim context, and are relevant to at least three of the AMA Guides publications: AMA Guides to Evaluation of Disease and Injury Causation, AMA Guides to Work Ability and Return to Work, and AMA Guides to the Evaluation of Permanent Impairment. The author reviews and summarizes studies that have identified the dominant role of financial, psychological, and other non–general medicine factors in patients who report low back pain. For example, one meta-analysis found that compensation results in an increase in pain perception and a reduction in the ability to benefit from medical and psychological treatment. Other studies have found a correlation between the level of compensation and health outcomes (greater compensation is associated with worse outcomes), and legal systems that discourage compensation for pain produce better health outcomes. One study found that, among persons with carpal tunnel syndrome, claimants had worse outcomes than nonclaimants despite receiving more treatment; another examined the problematic relationship between complex regional pain syndrome (CRPS) and compensation and found that cases of CRPS are dominated by legal claims, a disparity that highlights the dominant role of compensation. Workers’ compensation claimants are almost never evaluated for personality disorders or mental illness. The article concludes with recommendations that evaluators can consider in individual cases.

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