Monday, December 13, 2010
December 13, 2010: The Definition of Insanity
In March 1841, a thirty-nine year-old teacher and social worker named Dorothea Dix visited East Cambridge Jail in Massachusetts. She was there to teach a Sunday School class for female prisoners, but what immediately and entirely drew her attention were the conditions in which all of the inmates—but most egregiously, to her sensitive perspective, the mentally ill and disabled, who were held there not because they had necessarily committed a crime but because the facility doubled as an asylum, as almost all American prisons in the era did—were held. Among other things, the facility was entirely unheated and had been kept that way throughout the New England winter; when Dix inquired about this policy, she was told that “the insane do not feel heat or cold.”
That falsehood represents just the tip of a very sizeable iceberg of misinformation that constituted the vast, vast majority of public and even medical thinking about the mentally ill in the first half of the 19th century. But Dix was not one to accept conventional or traditional wisdom, no matter how widespread or entrenched it might be. She took it upon herself to visit virtually all of the state’s jails and almshouses (the latter a more charitable but often no more suitable space in which the mentally ill were housed), talked at length with all those who worked in them as well as (when she could) some of those who were housed there, and wrote up incredibly detailed and thorough notes on the eerily similar conditions she observed throughout her travels; she turned those notes into a document for the Massachusetts legislature, and won as a result a significant state outlay of funds to expand the Worcester State Hospital and make it into a much more appropriate home for the state’s mentally ill wards.
That successful journey was only the beginning of an epic quest that would encompass much of Dix’s remaining forty-odd years of life; she would eventually travel across every state east of the Mississippi and even numerous European nations, visiting facilities constantly and working tirelessly to improve conditions in those facilities, to advocate for the opening of better facilities, and, perhaps most significantly, to change fundamentally the way society viewed these individuals and communities. Dix once wrote, as evidence for why she knew that many can be “raised from these base conditions,” of a young woman who “was for years ‘a raging maniac’ chained in a cage and whipped to control her acts and words. She was helped by a husband and wife who agreed to take care of her in their home and slowly she recovered her senses.” This woman represents only one individual among the untold millions who were positively influenced by Dix’s work and perspective, but of course even one individual’s live so radically changed for the better is a significant achievement; to contemplate how many people around the world were given the opportunity to go from unheated cages and brutal beatings to sensitive care and treatment by Dix’s efforts is to truly understand how much one inspiring American can do and transform in a life’s work.
Yet as much good as Dix’s efforts accomplished, it would do her memory no honor to pretend that we have adequately shifted our perception or, most importantly, our social and communal treatment of the mentally ill; a late 20th century text like One Flew Over the Cuckoo’s Nest highlights (in fictional but not at all inaccurate form) just how far from desirable our mental institutions often remain. The definition of insanity, the phrase goes, lies in doing the same thing over and over again and expecting different results. Dorothea Dix’s redefinitions are still, it seems, very much needed. More tomorrow, on the alternative and deeply democratic visions of family in two great indie films.
PS. Two links to start with:
1) Good short bio of Dix that frames her through the lens of the Unitarian church in which she was raised and to which she remained connected throughout her life: http://www25.uua.org/uuhs/duub/articles/dorotheadix.html
2) It’s a bit tough to read, but a scan of one of Dix’s influential early works, Remarks on Prisons and Prison Discipline in the United States (1845): http://www.archive.org/stream/remarksonprison00dixgoog#page/n4/mode/1up