Patient Memoir
How does John utilise language which underlines the power imbalance between him and Gillman's character?
"'What is it little girl?' he said. 'Don't go walking about like that - you'll get cold." The use of infantile imagery to describe PG suggests that she is under John's power; and there is thus a sense of reliance which is conferred, and a notion that she is starved of agency.
Illustration of the first patient's account in American Journal of Insanity (confused syntax not detracting from underlying message)?
"Come, hurrah boys, for a room full of bread and milk! All the property I have in this world is a pair of black oxen, one buck and the other bright... All I want in this world is a log house, in the woods, keep bacherlor's hall, have a family, clear off some land, and make a living." Also consider "I is about two years old... I was born of one of my aunt's when I was about nine years old. She was an old maid of about six years old when I was born" versus "Oh what a happy man I is going to be when I gets home to my family" THERE ARE CONTINUING LUCID THEMES THROUGHOUT THIS MAN'S "DERANGEMENT" - and see later point about how that derangement might be managed and influenced by notions of "expectations" to "perform" for the interviewing psychiatrist.
Quote illustrating Perkins Gillman's obsession with the wallpaper, and the significance of the woman who supposedly is "trapped" in it?
"I know she was studying that pattern, and I am determined that nobody shall find it out but myself!" There is an interesting admission from one of the 'external characters' - Jennie - that the paper "stains everything it touches" - PERHAPS IDEA OF INDELIBLE IMPACT OF MADNESS? Perkins Gillman increasingly takes on the character of the woman 'trapped' in the wallpaper - "It is the same woman, I know, for she is always creeping, and most women do not creep by daylight." ..."I always lock the door when I creep by daylight. I can't do it at night, for I know John would suspect something at once."
What was Gilman's purpose for writing the Yellow Wallpaper, in her own words?
"It was not intended to drive people crazy, but to save people from being driven crazy, and it worked." Perhaps a sentiment taken up by future movements such as anti-psychiatry.
Quote referencing the culture of fear and self-examination which potentially characterises asylum environment?
"John is a physician, and PERHAPS -(I would not say it to a living soul, of course, but this is dead paper and a great relief to my mind)- PERHAPS that is one reason I do not get well faster."
How is John presented as archetypal physician?
"John is practical in the extreme. He has no patience with faith, an intense horror of superstition, and he scoffs openly at the talk of things not to be felt and seen and put down in figures."
How does the Taxi chapter also suggest that the process of diagnosis is damaging for the mind (perhaps more so than "madness" itself)?
"You need a rest", he announced. / I did need a rest, particularly since I'd gotten up so early that morning in order to see this doctor."
How does Agnew argue that her ailments were now - for the first time - understood?
"my unhappy condition of mind was understood, and I was treated accordingly." Agnew interestingly seems to view the diagnosis of madness as extremely comforting - she writes that "I too, was treated as an insane woman, a kindness hitherto not shown to me.... "...Dr Hester being the first person kind enough to say to me: 'Am I insane?' 'Yes madam, and very insane, too!" Again, is the justification / normalisation of madness within the memoir a way to siphon off the "mad" self from the recovered and writing "self."
Pryal's argument for how psychiatric disability effects room for expression?
"the psychiatrically disabled are not trusted to exercise reason or judgement; as a consequence, civic exclusion often yields rhetorical exclusion as well." I.e. the stigma of mental illness narrows the potential for the patient to express themselves. Can it also effect the posthumous quality of texts - i.e. we create a genre of PATIENT literature.
Quote demonstrating Perceval's heavily class-based view of incarceration in Asylum?
"to prove how cruel the situation of a lunatic, and particularly a lunatic gentleman, may be"
What does Cooter argue is the catalyst for change in valuing patient memoir?
Like Crossley, argues that the Anti-Psychiatry movement was a significant driver for legitimising patient experience - coupled with declining authority of psychiatric professionals.
Primary Sources for this topic?
Agnew - From Under a Cloud American Journal of Insanity Perkins Gilman - Yellow Wallpaper / Why I Wrote the Yellow Wallpaper Kaysen - Girl, Interrupted
How does Agnew's memoir perhaps access a similar theme to Perkins Gilman argued by Herndl (i.e. the destruction and reconstruction of self)?
Agnew argues that the asylum space represents somewhere in which she was able to reinvent herself - she argues that only within the environment of the asylum was her disposition fully understood. Her description of her state before entering the asylum - in which she bore "upon my body suggestive marks, silent witnesses of blows, not given alone by the tongue" - THERE IS A SENSE (link to dignity) THAT AGNEW'S BODY HAS BEEN VIOLATED - THE NOTION OF THE MIND-BODY CONNECTION IS INTERESTING HERE; SHE SUSTAINS BODILY BLOWS, IS BROKEN IN MIND AND BODY - AND REQUIRES 'PATCHING UP' BY THE INSTITUTION.
Gendered aspects in Agnew's narrative?
Agnew argues that the hostile nature of the female ward represents the environment of one group of repressed females at odds with another (notes that the asylum is a male institution). "I don't believe men are ever so cruel to men."
What about Agnew's account issues a problem when considering patient memoir?
Agnew does not consider herself as mad within the narrative, noting that "I immediately asked permission of Dr Hester to sleep in a room by myself, since I was afraid of insane people." This notion of lucidity perhaps raises the question of whose voices are heard and whose are obscured - can we only hear the voices of the recovered rather than the mad? Is recovery how one gains credibility?
How does Agnew's memoir play into potentially Cooper's statements about the close overlap between "genius" and "madness"?
Agnew openly claims that she spoke with two spirits during her internment in the asylum - one of which was the dead spirit of her friend (in the asylum) who had committed suicide, and the other was her father, who she claimed "was with me constantly, for months!" Agnew states that "I am not a believer in any form of spiritualism that I have ever read of, or heard spoken of, but I have a theory that insane persons are brought directly under spiritual influence not to be explained." CONFLATION OF MADNESS, SPIRITUALITY, ENTHUSIASM ETC seems to anticipate anti-psychiatric movements somewhat (THUS SHOWS TO THE HISTORIAN THAT SUCH "ACADEMIC" OR "INSTITUTIONAL" TRENDS CAN SIMPLY BE REARTICULATED SENTIMENTS FROM OTHER ASPECTS OF PSYCHIATRY.
Why is Agnew's reasoning regarding decision to articulate force feeding interesting?
Agnew writes that she attempts to draw attention to force feeding in order to show support for those patients who suffer in similar ways to herself (i.e. attempting to gain traction / recognition regarding the practice). THE NOTION THAT SHE HAS TO JUSTIFY ITS INCLUSION IN THE FIRST PLACE - "even at the risk of offending sensitive, fastidious readers" - SHOWS THAT THE PROCESS OF PUBLISHING AND MAKING PUBLIC EXPERIENCES OF INSANITY ARE MARRED BY CENSORSHIP. One should consider how publicisation as well as class might effect the way in which experiences of mental health are communicated (THIS PLAYS INTO FOUCAULT'S IDEA THAT MADNESS IS SILENCED AND CANNOT FUNDAMENTALLY ARTICULATE ITSELF).
How does Agnew's account potentially suggest an alternative view of asylums to Browne and Conolly?
Agnew's account notes that "they seemed, by the glancing light of their lanterns, as they flitted along with almost noiseless step, like 'guardian spirits'" Seems to suggest that asylums can be seen and presented as protective institutions by those within them. HOWEVER THE NOTION THAT AGNEW WAS CONSTANTLY WATCHED BY ATTENDANTS DURING NIGHTLY ROUNDS, AND HAD CLOSE ACCESS TO THE DOCTOR, PERHAPS QUESTIONS THE DEGREE TO WHICH ONE CAN TAKE HER EXPERIENCES AS TRULY REPRESENTATIVE (her experience of the attendants may be redolent of her class; she notes that she still converses with one of the attendants after her discharge from asylum, which suggests that these "guardian spirits" are of a similar class).
How is Lynch and Hacking's ideas about memero-politics and the debate about memory relevant to historiography?
Allows one to question Foucault's notion of the "architecture of silence" - if one considers that madness indelibly effects the remembrance of events, then one should not consider "recovery" the same as "post-madness."
What are the conventions of mood memoir which Pryal highlights?
Apologia Moment of Awakening Criticism of Doctors Normalises Illness and amplifies author's authority to consider topic of mood.
Why is Hacking and Lynch's study important to patient memoir?
Are Agnew, Perceval and Perkins' Gilman's memoirs a form of "memero-politics" in their own time? Perceval's perhaps is, as he was leader of Lunatics' Friends' society, seeking social change. Does classing memoir as a form of "memero-politics" subvert and potentially devalue experience as being part of a grand narrative? I.e. is Perkins' Gillman's work not also therapeutic?
How does Herndl argue female memoirs play into wider feminine culture and modes of depiction?
Argues that female memoirs are incongruous with the wider world of literature in which women are written "for" (literature is not "by" them). SO GILLMAN MAKES LITERATURE MOVE FROM OPPRESSIVE TO EXPRESSIVE - and she differs from Foucault here.
How does Hodgkin argue that study of memoir is representative of a wider trend in studies of selfhood?
Argues that it is representative of moving from notions like "Renaissance individualism", "Protestant Ethic" (i.e. identity conferred by the group), to things like autobiography and biography, to moving to a more "restrictive" view of selfhood based on individualism. ALLOWS US TO REDEFINE HOW ASYLUMS ARE VIEWED AS INSTITUTIONAL STRUCTURES. However, Hogdkin argues that these studies should not be separated totally from studies of culture.
What does Pryal argue is the result of mood memoirs and their solidification into a literary genre?
Argues that this has changed the ethos of mental illness, and that the mentally ill are now seen as able to express themselves. This is a move away from previous ethos of exclusion.
What does Herndl argue about the use of infantile language in the "Yellow Wallpaper"?
Argues that this is reflective of the anonymous woman (who is therefore an object not a subject) becoming more the possession of John, and under his spell - i.e. retreating more into the realm of the "object" not the "subject."
How does Hodkgkin use Wharton's account?
Argues that though he explains phenomena that appear strange to the modern reader, his peers did not consider him as mad - HE KEPT THESE "eccentricities" TO HIS PRIVATE LIFE AND WAS ABLE TO HAVE A NORMAL PUBLIC LIFE ALONGSIDE THEM. The memoir challenges the historian's "gaze" over works of memoir - i.e. one should not necessarily oppose Perceval's claim that he is not "mad" based on our assessment of what madness is. ...For Perceval, his assessment of himself is grounded in socio-cultural - and potentially unknowable - maxims.
What is the problem with attempting to assign classification to patient accounts?
As Pryal notes, classifying what counts as "mood memoir" depends to some extent on how the DSM defines what a mood disorder is, and thus what a mood memoir can be from that. These medically based classifications may also inform the discourse through which, ironically, the patients attempt to find an avenue of liberation.
What is the Apologia of mood memoir?
Attempts to being legitimacy to the narrative and brings a desire to help others to forefront. Emphasises seriousness of mental illness by comparison with more well-known ailments.
How does Perceval's and Gilman's accounts potentially challenge the notion of archaeology of madness?
Both are accounts considering periods of madness - Perceval's account is especially important because it includes a letter which he apparently wrote when in the asylum; though Foucault's account still stands because Perceval only justifies its inclusion on the grounds that he was 'not mad' when he wrote it.
How does Hacking begin to oppose (in a postmodernist way) debates over memory?
He argues that the debate between "true" and "false" memory is fallacious - all memory is a process of editing and often of misremembering; so the "true" rendering of memory is not necessarily a sign of madness - AND AGAIN THIS BREAKS DOWN FOUCAULT'S ARCHITECTURE OF SILENCE BETWEEN THE "SANE" AND "INSANE"?
How might one glean from Perceval's account that he was actually treated favourably?
Care for him was attempted at home. He was given aid by doctors (one "Doctor Piel") His brother supported him, at least during his period of care at home.
How is the format of the "taxi" chapter significant, and how does this reveal the power of the patient memoir?
Chapter includes the case file of the patient, and demonstrates that the story is contextualised in the records. Gives something which was originally the tool of the psychiatrist agency, and allows us to uncover the voice of the patient within it.
How are treatments criticised in etiology chapter?
Chemical treatments ("Thorazine or Stelazine") grouped with more invasive treatment from various ages ("purging" "electric shock" "removing the uterus" "cold sheets wrapped tight around the body." Seems to rubbish the notion of contemporary treatment as a treatment pattern which is more "humane."
How does Cooter sketch out the historiography of considering the patient in historical works?
Cites Porter as central to historiography, and notes that E.P. Thompson influenced him and his work.
How does Agnew's account immediately touch on themes seen in other patient memoir (notably Percival)?
Cites her seclusion into the asylum as an act of "cruel Fate, aided and abetted by heartless brutality within my own immediate household." Argues that she was mentally abused by her sister who fashioned her as a scapegoat for family troubles. Is this how one might interpret Agnew's time within the asylum as a form of "refuge"? Is this presentation of the home environment characteristic of Pryal's description of "apologia" or "moment of awakening"? HOW FAR IS AGNEW'S COMMENT ON THE "DOMESTIC" SIMILAR TO A PATIENT SUCH AS PERKINS GILLMAN? How far does the notion of "home" serve a similar purpose in their narratives?
How do the accounts from the American Journal of Insanity illustrate the gendering and classification of the asylum environment?
Comparison of attitudes towards "acrostic" from female patient and the poem from "a gentleman of education." The author seems to dismiss the acrostic as "what she calls poetry", yet the gender and class of the male patient is drawn to mind (and the poem is not criticised) when his poem is considered. Class and gender important in expression of memoir.
What is the "Awakening" which Pryal highlights?
Continual description of moment of awakening which shows author's reliability as a writer and a historical witness (e.g. Trosse and his spiritual awakening). Yet does the notion of awakening anyway still serve to demean the innate value of the expressions of the mentally ill?
What does Cooter argue about the quality of histories and the possibility for patient analysis within them?
Cooter argues that each history is always a product of the historiography of the time in which it is written. Argues that one can never truly understand the patient experience, as the ways of seeing between the historian and the patient are now too different. The best we can do is recreate the circumstances within which patients were historically defined.
How does Porter approach the patient, and how did this change?
Cooter argues that though Porter was supposedly patient-centric, this was still used in a top down model, to show how social structuring of power occurred. Notes that in Porter's work, the definition of what the patient is is presupposed - it is not questioned or seen as an object for study in its own right. This changes with later works.
Give three examples of Perceval's state of mind before entering the asylum?
Discussed the Row miracles at length, and provides supposed "proof" for his "own divine authority." (he is apparently directed by a spirit in 1830 to stare at a clock - following discussing Row miracles - and then throw himself to the floor). Perceval notes hearing "articulate voices", yet argues he was not mad, as he deliberated carefully around what they commanded of him. Questions the religious standpoint of his doctors, and attempts to reverse the direction of his head without breaking his neck. ("Dr. Piel was, I believe, an unitarian; therefore, as I conceived, an infidel concerning the Holy Ghost.")
When considering why Gilman wrote the Yellow Wallpaper, how does her gender perhaps play into the diagnosis she receives?
Doctor instructs her to "live as domestic a life as far as possible" and "to have but two hours' intellectual life a day" and "never to touch pen, bush, or pencil again" The notion of domesticity here is consistently strong, and perhaps plays into the idea of enforcing supposedly "acceptable" gender roles.
How might one argue that memoirs aid in the doctor-patient relationship?
Doctors begin to actively seek out patient material and see the therapeutic value in it (patient art movement etc). These accounts perhaps present doctors with details which the patients may otherwise be unwilling or unable to tell them themselves. THOUGH the problem of ethics arises with this - should doctors read private expressions of patients?
How could one interpret the role of the doctor in patient memoir?
Doctors might be said to have an active hand in the manipulation and definition of illness? Is the praising of doctors in Agnew an example of active manipulation, or simply a reflection of the position of the doctor (and the doctor as a male professional) in Agnew's society. Note that Kaysen and Gilman present doctors very differently. Could creating a persona of a "nice doctor" be a deliberate ploy by medical professionals to continue medical observation - is the dichotomy of good doctor, bad attendants a deliberately cultivated one?
Give three examples of abuses Perceval suffered in the asylum (first asylum in Bristol)?
Due to "delusion" he apparently sang Psalm 100 aloud, and was beaten over the ear for doing so - apparently so fiercely and often that he suffered an "internal haemorrhage." Apparently continually 'tied down' / restrained when in bed. Writes that he "made water of a morning" because of this (i.e. wet his bed). Plunged into cold baths continually for treatment (also beaten, strangled).
What message does the "etiology" chapter attempt to give?
Etiology is in the form of a psychiatric and medical report, yet attempts to suggest the vacuous nature of medical knowledge. Blends ancient and contemporary medical thinking - Gods and Devil.
Why is the conversation between Dr Everts and Agnew interesting?
Everts discusses with Agnew the notion of "restraint." For Everts, restraint moves beyond the notion of simply physical restriction, but he argues that the institution is designed to 'restrain' Agnew's will and recast her into a new person. "Look at that window. Could you break one of those bars? See those locked doors? For the first time, probably, in your life, your will is brought directly in opposition to stronger wills." THE INSTITUTION IS A RECONSTRUCTIVE SPACE; Agnew's old will is broken and a new one emerges in its place; Note that this is the exchange which gives the memoir its title (from under a cloud).
What does Perceval's stated purpose suggest about how we should view the memoir?
Firstly the notion that he has supposedly been ignored is quite an interesting one - again raises the question as to how closely accounts of mental illness can ever totally be separated from sensationalism. And this memoir in itself is an interesting one for the historian, as it shows Perceval attempting to self-construct an idea of self (through rearranging memory and establishing a different perception of selfhood to that which society ascribed him).
What does Hodgkin highlight as an important problem to overcome when considering study of memoir?
Foucault's ideas of an "archaeology of silence" which exists across patient memoir - i.e. madness is continually silenced and can only be unsilenced when patient moves from realm of madness to sanity.
What does Pryal define as the "mood memoir"?
Genre of patient literature written by those with mood disorders. Used as a narrative response to attempted rhetorical exclusion - a way to restore power.
How is the memoir used as a tool in Gilman's narrative?
Gilman presents two characters within the narrative - the character within and without the memoir - the memoir is presented as therapeutic in the narrative (and interestingly is detested by John). "There comes John, and I must put this away - he hates me to write a word."
How do Hacking (and Lynch) consider the effect of memory and remembering on diagnosis and the psychiatric discipline?
Hacking highlights the notion of "memero-politics" - the idea that the remembering of events can have distinct impact on the social and historical narrative. Lynch argues using Hacking that medical diagnoses reflect prevailing social discourses and cultures - HACKING ARGUES IN LINE WITH THIS THAT A RISE IN SEXUAL LIBERATION INTO THE LATER 20TH CENTURY LED TO A RISE IN "MEMERO-POLITICS" IN PSYCHIATRY. There were greater attempts to draw attention to issues of abuse (childhood and sexual abuse) which constituted memero-politics - the majority (90%) of cases were women, and many of these were diagnosed as suffering from multiple personality disorder based upon the Freudian notion that memory resulted from repressed memory.
How does Perceval relate to his memoir in a similar way to Perkins Gilman?
He also uses the memoir as a form of "escape" - in this case not fictionalised. He pens his memoir as an attempt to preserve his sense of identity which he argues is being eroded as part of the asylum environment. "Fearing that these causes, in process of time, may break my spirits and render me foolish, or tempt me to acts of retaliation, and expressions of resentment which may be distorted, and looked upon as additional reasons for persisting in the line of conduct that produces them" THERE IS A SENSE HERE THAT ACTS FROM THE INSANE WITHIN THE ASYLUM CARRY A DIFFERENT SENSE OF MEANING - could one argue that in that way Foucault could be right to assert that the asylum is a "heterotopia."
What is Perceval's purpose for writing this account (/ memoir)?
He argues that he has already published a previous volume that was either not circulated widely enough or was not taken seriously by those who read it. Perceval here intersperses his 'recovered' sections of text with LETTERS HE WROTE AT THE TIME, IN THE ASYLUM. He intends specifically to show the reader "the FACT, that I was then of sound mind; which was DENIED, and no reason given me for the denial." (his use of capitalisation here - seems to convey significant degree of emotion).
How does Perceval argue that the views of those in his domestic community worsened his madness?
He argues that part of his "lunacy" was caused by being afraid to speak freely for fear of being disciplined / restrained etc. THERE IS A SENSE HERE - REPEATED OFTEN - THAT THE ASYLUM SYSTEM CAN AGGREVATE AILMENTS (not however that Perceval is writing in 1840, and asylums continued in full swing until c. 1990s - people don't really seem to take notice!)
What does Porter argue - in a Lacanian / linguistic turn way?
He argues that the insane can speak using their own "discourses", idioms symbols etc (Lacan - language confers and constructs a mode of understanding), and Porter argues that this is essentially a 'parallel' to their mode of understanding. HODGKIN WOULD OPPOSE THIS - and this is where the field has changed - she argues through analysing an 'underanalysed' period in 17th century that the idea of "madness" needs to be re-evaluated, and that though someone like Wharton was considered by some as insane, he was nonetheless expressing ideas that formed part of the linguistic framework of his own time. ...he was not accessing a different framework.
How does Herndl treat the notion of "cure" in the Yellow wallpaper?
Herndl argues that the Yellow wallpaper allows Perkins Gilman to 'retreat' from linguistic discourses and find modes of expression through metaphor which are not tied into the patriarchal linguistic system. Gilman is actually the woman behind the wallpaper - she is not the narrator; she is eventually released through the medium of retreating from oppressive forms of language. PERKINS GILLMAN WAS ABLE TO RETAIN HER SUBJECTIVITY BY PLACING HER TRAUMA ONTO A CHARACTER WHO - IN THE COURSE OF THE NARRATIVE - BECOMES ONE WITH THE WALLPAPER AND THUS THE "WOMAN" OF THE WORLD OF OBJECTS. The woman in the narrative finishes as an object (not a subject) so that Perkins Gillman does not have to.
How has feminist historiography traditionally treated the role of female literature, and how does Herndl move away from this (Herndl is writing in 1988 note)?
Herndl argues that traditional feminist historiography (Dianne Hunter 1983) has argued that there is no such thing as the "female voice", as subjectivity for the female is merely a case of learning how to express themselves in a masculine way, and thus moving past the barrier of silence. This is a Lacanian analysis which sees subjectivity as a form of reconciling with dominant linguistic and discursive hegemonies. Herndl argues - using Irigaray and Montrelay - that hysteria becomes a way for women to retreat from linguistic structures in which they are constantly "castrated" (i.e. seen in a Freudian-masculine context).
What does Hodgkin argue about analysing madness through autobiography, and how might Perceval's account be useful in this regard?
Hodgkin argues that writing autobiographies of periods of madness is to encounter a "challenge to memory" in which selfhood could be "absent." Perceval's account moulds social conferring of madness combined with RETAINING SENSE OF SELF - Perceval's identity is carried through his mad periods as well as his sane ones - allows us to challenge Hodgkin's view potentially.
How does Hodgkin's study build on debates between Porter and Foucault about "Great Confinement"?
Hodgkin's study in many ways builds on Porter's problematisation of Foucault's arguments about 'confinement' - HODGKIN ATTEMPTS TO USE MEMOIR TO ATTREMPT TO UNPICK FOUCAULT'S STANCE ON THE "GREAT CONFINEMENT" - E.G. SEE INDIVIDUAL VARIATIONS IN THE MACROSTRUCTURE.
How could one criticise Herndl's view of the Yellow Wallpaper?
If Perkins Gillman's desire was to displace the breakdown of subjectivity onto a literary character to aid her own recovery, then why did she publish? and why should she see that she should publish?
Why might engaging with patient memoirs be useful in the face of historical developments in the field?
In a context of increasing postmodernist approaches to what "madness" means, latching on to patient memoirs - in which patients consider themselves as 'mad' or 'not mad' perhaps allows madness to have a definitory quality which can change across time and between people. I.e. madness can still have substance if viewed in an individual context, even if its value transhistorically is reduced.
Give an example of the distortion of meaning in the American Journal of Insanity.
In the first account, the patient is described as "quite demented" by the author, yet though the syntax of the account given is indeed confused, the message of seeking to establish a life outside of the asylum is abundantly clear. Does the diagnosis of the patient as "mad" perhaps invalidate these wishes?
How might the American Journal of Insanity be useful to the historian?
Interesting to consider the different variations of those who are considered "mad". The man described as living in an "imaginary world" interestingly espouses political ideas not too different to those we would now consider normal (talks of de-escalating political debate and ending political parties for one neutral body). Is this mad, or ahead of his time?
How is a notion of power imbalance expressed through Kaysen's "parallel universe"?
Kaysen argues that madness is something which "you find out about later" - insinuating that it is ascribed by wider society rather than innately "mad." The process of calling one mad confers power.
Who is John in the Yellow Wallpaper, and how is the initial use of language when describing him significant?
John is presented as the archetypal physician in the narrative, acting as the paternal influence in the house - reflects gendered relationship again. Use of parenthesis and "PERHAPS" perhaps represents the culture of fear, isolation and self-examination which characterises the asylum environment.
How does Perkins' Gillman's increasing alignment with the woman (/women) behind the wallpaper effect her relationship with the other characters?
John's veneer seems to slowly be broken down - "He asked me all sorts of questions, too, and pretended to be very loving and kind. As if I couldn't see through him!" PERKINS GILLMAN INCREASINGLY SEEMS TO BECOME MORE LIBERATED AS SHE IS "ISOLATED" IN THE ROOM WITH THE WALLPAPER. Her final statement that "'I've got out at last', said I, 'in spite of you and Jane. And I've pulled off most of the paper, so you can't put me back!'" The writing style has now changed, too - it has gone from an internalised monologue to a third person narration - SUGGESTS THAT - AS HERNDL ARGUES - PERKINS GILLMAN HAS NOW "TAKEN ON" ANOTHER CHARACTER.
Example of Agnew illustrating her class?
Like Perceval, she bemoans the class status of the attendants, noting that "Kitchens, from which most of them came, call loudly for their return to more suitable employment." Are only those of a certain demographic able to be heard through the medium of the memoir? (also see above point about her view of the attendants).
Give three examples in Perceval's account which demonstrates that his experience was heavily regulated by class?
Notes that Perceval's family continued to fund his upkeep (e.g. washing at eight pounds or guineas per annum) - even if he complained that what they contributed was not enough. Also complains that he is kept in same space as those "below him" in social ladder. "I was also degraded to keep company with the lunatic, the blasphemous, the indolent, the idle, and the profane! With vulgar persons below me in society" YET, THERE IS AN INDICATION THAT HE HAD A SEPARATE "BEDROOM" WHILE BEING KEPT IN BRISTOL ASYLUM, WHICH AGAIN SEEMS TO SUGGEST THAT HE WAS AFFORDED SOME DEGREE OF PRIVILEDGE - his family wealth ensured that he was sent to some of the most expensive institutions in the country. A lower class experience of the asylum may have been considerably different (one should note that Perceval is later moved to a private institution for the middle classes in Bristol later on).
How does a comparison of Peterson's 1982 work and Hogdkin's 2007 work demonstrate change over time?
Peterson defined some as mad who were not considered as such by those around them at the time (Marjory Kempe e.g.) / WHEREAS HODGKIN LET CONTEMPORARY DIAGNOSIS LEAD WHO SHE INCLUDED IN HER HISTORY. This shows her building on Porter's assertion that the sources should "speak for themselves" and the historian should not be too involved in trying to radically project order onto them.
What is interesting about Agnew's portrayal of the attendants in her account of their attack on her?
Notes again that they originate from the "back wards" - implication of class difference - and that they refer to her as "'Old Agnew' (omitting the Mrs.)" - NOTE THE PATENTHESIS USED BY AGNEW THERE.
How might the character of "Miss P" in Agnew's narrative, illustrate the difference between memoir and psychiatric analysis / report?
Notes the close personal relationship which developed between Miss P and Agnew - humanises the asylum and makes it a series of relationships rather than a place of incarceration. Miss P apparently opposes Agnew's mistreatment by other attendants ("four great, strong girls from the back wards") = DOES THIS IMPLY THAT THESE ATTENDANTS USUALLY ATTEND TO THE "LOWER CLASS" PATIENTS? Could a psychiatrist be able to analyse the institution in this way?
Example of the psychiatrist's "literacy" (or maybe orality) replacing that of the patient's?
One description of a man does not give him any speech / text at all - THE ONLY ASPECT OF THE PATIENT'S ACCOUNT WHICH IS REPRODUCED IS THAT WHICH IS CONSIDERED BY THE PSYCHIATRIST TO BE HIS "SYMPTOM OF MADNESS." "When excited, he is disposed to ask questions constantly, but never waits for an answer. Thus he will enquire for half an hour: 'Did you ever see an elephant? Where's your wife? Did you ever see a horse? Have you got any squash? How many children?' etc. etc."
What does Perceval's statement about his own experiences seem to suggest in relation to standards of wellness?
PERCEVAL'S ACCOUNT IS USEFUL FOR THE HISTORIAN, AS IT REVEALS DEGREES OF DEFINITIONS OF WELLNESS OUTSIDE OF CLINICAL CATEGORIES. Perceval counts his experiences as lucid because - for him - they are "real." Perceval writes that "men who do not think of, or believe in the word of life, call the expressions of a believer, in a world and body of sin and death, delusions or madness." This shows the difficulty defining madness as "other" creates. PERCEVAL WOULD HAVE BEEN DEFINED BY CONOLLY AS ONE OF THOSE MEN WHO COULD BE CONSIDERED AS "ECCENTRIC."
How does Perceval's consideration of his treatment perhaps reflect Agnew's in some way?
Perceval again (perhaps related to class) highlights the indignity of his treatment as a key reason for his disaffection. He details - for example - those caring for him at home attempting to administer a clyster (enema) without his consent (on account of the fact that he was deluded). And argues that often sufficient materials were not provided for patients to adequately use the toilet (writes that he saw one patient "defile his trousers."
How does Perceval's case illustrate that the problem asylums are involved in extend beyond the walls of the institutions?
Perceval also focuses on corruption from magistrates, the neglect of his family, and the misguided nature of his doctors as equally pressing matters to his actual treatment within the asylum. The account is an account of Perceval's social experience, not only his treatment. "I was to be found in that madhouse, contesting the right of others to treat me as they did - and appealing in vain to the Magistrates... against my mother, and my physician."
What is interesting about Perceval's relation of his own divine "experiences" (which one could certainly class retrospectively as a kind of religious delusion)?
Perceval cuts short writing about his experiences (this is when he is in the asylum) noting that "I dare not, in a lunatic asylum, express my feelings as my nature requires, for fear of misconstruction or calumny, from dread of being called lunatic." HE MAINTAINS THAT WHAT HE HAS JUST RELATED IS NOT AN ACCOUNT OF INSANITY - any reader reading this would arguably see the paradox behind it (he is unable to express supposed symptoms of his delusions in an asylum) and so this in itself could lead to a belief that repressive environment of asylum is not fit for purpose.
Why is Perceval's text difficult to deal with?
Perceval's description of his state of mind and actions before entering the asylum do seem to suggest that he was experiencing mental instability - how do we then interpret his own claims that he did not deserve to be in the asylum? Should this be viewed in the wider context of the conflict he endured with his family? Is he deliberately seeking the reader's pity to sell copies?
How might one argue that Gilman takes an effective line of action with presenting her experiences as a fictional short story?
Perhaps one may argue that fiction reaches a wider number of people - there may be those who are drawn to the text as a work of literature in itself, rather than simply because it is an account of madness (which may attract both sensationalism and a smaller target audience).
How could Agnew's assertion to Dr. Hester (compared with her later acknowledgement of her - at least occasional - derangement) be interpreted?
Perhaps shows that - for Agnew - the process of moving into the asylum was one of acculturation / character 'development'? Shows that she was once a member of "normal" society; though she suffered from delusions, her view of "the insane" was just the same as everyone else. ...yet this changes over time as she assimilates into asylum "system."
Examples of historical studies which move away from traditional narratives of madness = social / asylum?
Porter - he attempts to let the "patient" speak for themselves and argues that he does not attempt to analyse their surroundings. Malone - attempts to analyse colonial psychological relations with the state outside of asylum structures (and emphasises the agency of the colonial subject in some cases - e.g. Ndonye). Hodgkin - attempts to centre physicality into experiences of madness.
What does Porter argue about the study of the mad (or how does he argue about it) and how does this compare to other historians I have read?
Porter opposes the idea that the writings of the insane are meaningless - he argues that there is "method" in the madness. HOWEVER, HE STILL DOES SEE THE MAD PERSON AS EXISTING IN SOME KIND OF "OTHER" CATEGORY - AND AS COOTER STATES, HE DOES NOT PROBLEMATISE THE ROLE OF THE "PATIENT" OVER TIME. Unlike Hacking, he does seem to think that there is some notion of 'inaccessibility' about the voice of madness (though not to the extent of Cooter).
Which party in the asylum system may we be unable to understand at all through memoir and documents?
Potentially, doctors. Though we have medical records, we must remember the influence of academic discourse and practice colouring their expression - reputation and protocol are important. Can we understand the doctors AS PEOPLE in the same way that patients attempt to express themselves as people in their memoirs?
How might one potentially undermine the purpose of writing memoirs?
Producing the memoir may be done out of sensationalism / sense of pride to be considered to have a mental illness / recovered from one? Potentially Munchhausen's Disease comes to mind here (people pretend to be sick in order to garner attention from those around them).
Secondary Sources for this topic?
Pryal - The Genre of Mood Memoir and the Ethos of Psychiatric Disability. Cooter - The Neuropatient in Historyland Herndl - Perkins Gilman. Hodgkin - Madness in 17th century autobiography. Lynch - Writing of Memory Porter - Social History of Madness Reaume - Perspectives of Mad People.
Which secondary writer could be used to support my argument surrounding the replacement of patient orality in American Journal of Insanity?
Reaume - he makes the point that ANTHOLOGIES OF PATIENT ACCOUNTS WERE NOT MEANT TO VALIDATE OR UNDERSTAND PATIENT WRITING, BUT TO ILLUSTRATE THE VERACITY AND USEFULNESS OF WRITINGS IN PROVING DIAGNOSIS. ...and previous historians used these - attempting to find patient voice in this is difficult (and it is thus not surprising that Porter writes his 'madness and their institutions' at roughly the same time as he is writing his work on individual patient.
How does Perceval condemn his experiences in the asylum in his introduction?
Refers to those who were responsible for his care as "swindlers." Also states that the first establishment in Bristol he was committed to (under one Dr. Fox) prior to being moved to Sussex (for middle class inmates) was "one of those places called in mockery an asylum."
How does Hogkin's use of the memoir reinvent her perception of what "madness" is?
She analyses the memoir of Wharton and argues that his example leads the historian to realise that they should re-evaluate what "madness" means - it is not a transhistorical ideal, but rather is culturally and socially dependant. Responds to Cooter's call to define what the "patient" actually is.
How does Hodgkin's analysis support the arguments of Porter and potentially question the statement of Foucault (that madness is socially constructed and silences the historical agent's voice)?
She argues that madness is a bodily phenomenon as well as a socially constructed one, and that both aspects need to be considered. THIS PERHAPS EXPLAINS THE GENERAL MOVE AWAY FROM "TRADITIONAL NARRATIVES" OF ASYLUMS.
How does Perkins Gillman illustrate her deepening fascination with the wallpaper as the narrative progresses?
She becomes increasingly obsessed with various aspects of it - for example she continually refers to "the wall-paper, as I said before, is torn off in spots" - referring to the wall-paper being "torn" is one strand of her fascination. The switches between Perkins Gillman's consideration of events 'outside of' the room and wallpaper become more abrupt and contain less exposition - adds to unsettling character of wallpaper.
Why was Agnew admitted to the asylum?
She claims that she was both mentally and physically abused, which (over the course of three days) led to her lashing out and murdering her abuser.
How is Herndl influenced by the linguistic turn in her analysis of Perkins Gillman?
She notes Lacan's idea about people existing in the "world of the symbolic" - Gillman pushes back against a world in which women are "expected to remain silent." Herndl argues that Gillman reinvents the discursive world around her through her use of the metaphor of the "second woman" in the wallpaper = she emphasises her role as a "speaking subject" and therefore increases in power.
What does Pryal note is the danger of considering patient experience based upon memoir?
She notes that those who are able to put their experiences to paper do not form part of the norm - rather their recovery from disability is an exception to the rule. May make simply using patient memoir difficult to substantiate - other sources are still required.
How does Kaysen characterise the "parallel universe"?
She seems to detail this as the experience of madness, but crucially she does not present this as mad, but rather presents it as an alternative way of seeing. Normality of the person who falls into madness, and the ease with which they enter into the parallel universe seems to normalise experiences of madness and attempts to present them as less sensational.
How does the room of Gilman's confinement reflect the damaging nature of the asylum environment?
She states that she "must not think about" stimulating matters outside of her room, yet then goes on to discuss in detail the yellow wallpaper, which increasingly becomes the object of her fascination, reflecting her growing instability due to her confinement.
How is Agnew's discussion of class difference between her and the attendants extended?
She then makes this into an issue of POWER - notes that "boss" was a "favourite expression" among the attendants, and argues that many lower class attendants gained significant gratification from being able to command higher-class women to wash stockings. JUST AS AGNEW'S EXPERIENCE AND SELF IS RECONSTRUCTED IN THE ASYLUM, HOW DOES THIS WORK FOR ATTENDANTS? And this links to the later consideration of the experience of attendants perhaps being filtered through Agnew's eyes.
Issues / considerations one could make surrounding the inclusion of poetry in the American Journal of Psychiatry?
Similar to considerations regarding the reproduction and display of patient art (Museum of the mind). Does poetry allow for a greater degree of agency for the patient than a text which adheres to a pre-determined classification? Though also consider the question of ethics - was this poem designed to be read? Are we placing some kind of special significance on the poem in order to glean historical understanding?
How does the "Fire" chapter challenge social norms, and again challenge the traditional definitions of madness and sanity (anti-psychiatric influences)?
The passage upholds the girl who has set herself on fire as a beacon of hope and as a source of inspiration. Obviously the veneration of suicide (or attempted suicide) is an alien concept and one which challenges the notion of madness as a "wrong" code of behaviour.
How does the Article in American Journal of Insanity strip the patient of power?
The article is a compilation of letters and accounts designed to illustrate characteristics of insanity. Suggests that there will be an agenda to the account (indeed, each one begins with an introduction from the writer which details the ailments one will be able to "detect"). The meaning of the accounts is coloured by this, and the original meaning perhaps distorted.
What development / conflict has grown out of the debates surrounding memero-politics, and what does this suggest about how the historian has used / can use memoir?
The conviction of former associates through revelation of repressed memories under hypnosis lead to formation of FMSF (False Memory Syndrome Foundation) - mid 1990s - which questioned the validity of memory and claimed it was symptomatic of continuing madness. This shows that memoir has led to the problematisation of what the "patient" means? Is the cured mad person still a "patient"? Does their memory constitute a remaining form of their madness? Can one look at people like Gillman, Agnew and Perceval putting their madness to paper and still potentially see them as "mad"?
How can memoirs be helpful in understanding the "characters" of attendants and doctors?
The example of "power" and "class" of attendants shows how their characters in the asylum are constructed as much as the patients'. In addition, the accounts of Dr Hester and Dr Evert in Agnew's narratives contrast anti-psychiatric / Foucauldian notions that the asylums are automatically "cruel" institutions - THEY SHOW THAT 19TH CENTURY ASYLUM SHOULD MAYBE BE VIEWED "OF ITS TIME" RATHER THAN INNATELY CRUEL (indeed, how far was anti-psychiatric criticism borne out of its own specific social milieu?) I.e. Dr Hester and Dr Evert are not cruel characters - they are up front about Agnew's madness, but they do not communicate this in a way that suggests that they intend to be intentionally "cruel."
Which example in Agnew's narrative seems to raise the issue of perspective within patient memoir?
The example of the two "back ward" attendants who attack Agnew when she is unable to fold her bed spread (claims that a "spirit (what was it)" was controlling her and rendering her unable to make the bed). There is an insinuation that the attendants are under coercion from their superior, and are tied into the hierarchical character of the institution - yet, this is not referred to directly in the passage, rather we are drawn to Agnew's interpretation, where the attendants are ignorant, unfeeling brutes. While we can discern the character and conflict of the attendants, we cannot totally hear their voice. Would they need their own account? This is a similar example to Peceval's presentation of his family.
How is power imbalance presented in Gilman's narrative?
The female character's experience in the narrative is filtered and regulated by the character of John - the female's interior world is a world which John approves of and which he regulates. Reflects the power of the physician in traditional asylum environment.
How does the account of the second patient raise issues regarding the reproduction of patient encounters in the Journal?
The man is described as a "violent and dangerous maniac" who "manifests at times strong religious feelings." YET THERE IS A SENSE IN THE ACCOUNT THAT ONLY ONE SIDE OF THE CONVERSATION HAS BEEN INCLUDED / WRITTEN IN: "...or I'll slew you under the left rib - what horse - yes, I know you, I understand." (there is the implication he is answering someone here, but their "part" is not recorded).
How does the "Taxi" chapter in Girl, Interrupted demonstrate the faults of the psychiatric diagnosis process?
The patient is shown as having a lack of power (they do not have speech in the account, and can only express themselves fully through the medium of the narrative addressing the reader. Otherwise they "nod." Interestingly, nodding does not confer truth, merely it confers submission or acceptance of the agenda presented by the physician, which may not in fact be true.
What has been a thrust of recent scholarship on memoir and the mad "person"?
The question of race. This however becomes more difficult than knowing the memoir of those from the West, as multiple layers of "silencing" are added - especially if it occurs within the colonial system.
What seems to be a feature of all of the patient memoirs?
The role of the doctor is present in each - in Agnew, the doctor Hester plays a continuously central role, and Agnew seems to present him as genuinely compassionate. In American Journal of Insanity, several of the accounts similarly refer to Doctor Brigham, who similarly seems to be a man of trustworthy authority.
What is a significant theme throughout Agnew's text?
Theme of dignity - the preservation of dignity is an important aspect for Agnew within the asylum - argues that her consultation before the application of restraints would have made them acceptable. Protests the indignity of force feeding. SHE ARGUES THAT - LIKE RESTRAINTS - IF SHE HAD BEEN ASKED POLITELY TO ENTER THE DINING HALL TO EAT, SHE WOULD HAVE DONE SO. How is the process of writing a process attempting to redignify the asylum experience?
What must one remember about the patient voice?
This is not only detectable in narratives written by patients themselves. As Pryal notes, the patient memoir exists in a literary space also competing with medical accounts by doctors, law-makers' accounts and trials, and also popular media. The patient voice competes with other voices, and while not always primarily at the forefront, can often be discerned.
What is the process whereby Pryal argues that the Genre of Mood Memoir is constructed?
Uses Tadorov's definition of genre always emerging from combination of pre-existing genres. Argues that the mood memoir genre emerged from traditional autobiographical conventions, combined with preexisting avenues for airing the voice of the oppressed. Gives slave narratives as an example (I would argue that patient memoirs by women are also heavily influenced by feminist movement).
What are the problems with considering the recorded speech examples in the American Journal of Insanity?
We do not know how the patients would react to dictating to a psychiatrist in a room with them - is this different to their usual behaviour activities? Note Brookes' statement about patients being aware of "how" they should act to fit a diagnosis. What is presented as an account may be a conversation - how do we know what has been written, and more crucially, what has been left out by the psychiatrist in writing the account?
How does Gilman present an altered version of wellness in the Yellow Wallpaper?
Wellness seems to be interchangeable with "submissiveness" - "I really do eat better, and I am more quiet than I was." Seems to represent defeat rather than cure.
What is important to consider regarding the definition of a patient memoir?
Who decides what a patient memoir is? Does the patient have any say? Consider the influence of DSM and medical discourses, as well as the influence of publishers and those who circulate the memoir as part of its creation.
Give three examples of mood memoir which have served to change the "ethos" of mental illness.
Wurtzel - Prozac Nation Styron - Darkness Visible Radfield-Jamieson - An Unquiet Mind
