Education: Essay

Listening to Patients: The Opal as a Source

by Dr. Benjamin Reiss, Emory University

In the 1850s, patients at the New York Lunatic Asylum in Utica were given an unusual, but not unprecedented, platform to address the public. The Opal, the patients’ literary journal, grew out of a school for patients run by the doctors; its first issue in 1850 was pen-printed and distributed only within the asylum. The next issues were sold at an asylum fair, and by 1851, the journal was published on the asylum’s printing press, which also published the American Journal of Insanity, the professional forum for early psychiatrists (or asylum superintendents, as they were called). It was published quarterly, modeled in style after such popular periodicals as Graham’s, Godey’s Ladies Book, and the Knickerbocker, as well as several other asylum journals published in Vermont, Connecticut, and Scotland. By the end of its first year it had over 900 subscribers and an exchange list of 330 periodicals, which went into the asylum’s considerable library. Its run extended until 1860, when it fell victim to the demise of the moral treatment movement that promoted it.

The journal’s title refers to the precious stone’s “singular power of preventing sickness and sorrow”; its purpose was ostensibly to “indicate some phases of the mind” of patients and “to exhibit… the effect of the discipline of this cherished institution in promoting the objects of intellectual benefit.” In these rationales, we can see numerous functions: the journal advertised the restorative powers of the institution, it gratified the public’s curiosity about the minds and lives of the inmates, and – as opals were supposed to do – it was meant to be an element of cure itself. The need for advertising and display are fairly obvious: administrators of this public asylum needed to convince the public and the state government to continue funding their massive investment in public mental health. As such, the articles tended to present a relatively rosy picture of asylum life, with paeans to doctors, accounts of patients’ poetic reveries in wandering the grounds, summaries of the educative and refining lessons learned in schoolrooms, lectures, and libraries. Occasionally, more frank portraits of the patients’ struggles with insanity, with their keepers, or both, peek through the placid surface. An example is the “Second Day” of the article “Life in the Asylum, Part 1,” where the author complains bitterly of being “ruled by the Doctor” and dreams of setting her fellow “poor captives” free; nonetheless, by the end of the piece she learns to acquiesce in “deep submission” to the doctor’s wishes, and sees him as her “champion knight.” In an unusually clever, even teasing piece also reprinted here, “A Dialogue, Between Two Southern Gentlemen and a Negro,” the author implicitly parallels the situation of patients to that of slaves, but by the end has the slave express contentment with his confinement. These were squelched expressions of discontent, which, of course, could never find full expression, as the journal in which they were published was meant to maintain the image of the asylum as a humanitarian space of care, rather than a den of horrors.

But the Opal was not just a showcase for the benefits of life in the asylum; it was also an important element of treatment, which could go a long way toward “preventing sickness and sorrow.” As part of the extensive cultural and pedagogical programming at the Utica Asylum (including fairs, theatrical shows, debating societies, lecture series, and the like), the journal played no small role in furthering one of the major medical goals of the asylum. As Amariah Brigham, the asylum’s first superintendent put it, much insanity could be overcome by “diversion of the mind from morbid trains of thought” and “arousing and calling into exercise the dormant faculties of the mind.” His assumption was that patients were capable of leaving behind their deliria, their hallucinations, their fixations, and their demons; lying “dormant” was a capacity for rational, orderly, polite expression, which needed to be coaxed out and encouraged by trained professionals. (Drugs, burly attendants, and isolation chambers could pacify or restrain those whose furious minds did not respond immediately to the cultural offerings.) And so the journal is less a record of the patients’ collective state of mind than of their efforts to suppress the disorder that had landed them in the asylum. In order to come into print, patients had to replace their visions or their intransigence by a polite, learned, cultivated voice – the perfecting of which was itself a part of the cure.

It is not always clear whose voices we are hearing, as most of the articles were published anonymously or pseudonymously. (Using the asylum’s case notes, scholars have, however, identified several authors.) Men and women seem to have participated in roughly equal number, with male patients writing more clearly on politics and other public issues, while women tended to write poetry, romantic fiction (sometimes with asylum themes), and messages to family members. Compared to the overall patient population, contributors were well-educated, came from comfortable backgrounds, and lived in the “first ward” of the asylum, which was reserved for non-violent residents and convalescents, and was disproportionately occupied by paying patients. As in many public asylums, the Utica managers promoted the idea that their institutions were not simply glorified poorhouses, and so they allowed well-off patients to occupy more comfortable accommodations than others. Additionally, these first-ward contributors seem generally to have been spared the more onerous kinds of labor that many other patients performed: working on the asylum’s farm or its blacksmith shop, sewing clothes and linens, maintaining the ground, even operating and maintaining the press. Writing for the Opal, then, was a privilege – both in that it was often a reward for good behavior and medical progress, and in that it seems to have been more available to paying patients than to wards of the state.

The journal, then, was an outlet only for those patients whose voices were deemed appropriate; even then, those voices only partially captured the experiences and thoughts of the authors, who always had to self-censor in order to find their way into print. And yet they offer powerful clues to the historical experience of those confined within America’s first generation of institutions for the psychiatrically disabled. Reading between the lines of their praise for their doctors and their acceptance of their treatment, we can hear complaints, insecurities, longing for lost loved ones, shame, self-doubt, and even hints of rage and rebelliousness. An image of the moral treatment’s legendary founder, Philippe Pinel smiles benevolently from the cover; the pages inside wear a smile that is more forced.

How to cite this essay in a Chicago Manual of Style footnote: Benjamin Reiss, “Listening to Patients: The Opal as a Source,” Disability History Museum, http://www.disabilitymuseum.org/dhm/edu/essay.html?id=71 (accessed date).