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The aim of my research, funded by a Summer Undergraduate Research Fellowship (SURF), was to contribute a modern perspective to the existing scholarship on gender and insanity. Most of the research on this topic is outdated, with the latest publications dating from the early 2000s, and the subject deserved a more detailed examination. I focused on four narratives authored by women who wrote about their experiences with depression, anxiety, and suicidal ideation, and recorded the process of seeking treatment from institutions and private physicians in the mid-to-late nineteenth to early twentieth centuries. By situating these narratives within the historical context of madness and gender roles, I explored how gender defined these women’s experiences seeking treatment from prominent male physicians, and how diagnoses lessened or exacerbated their symptoms of insanity.

Initially I intended to focus on narratives of women who were involuntarily institutionalized. However, three weeks into my research, I uncovered the experiences of women who believed themselves to be mentally insane and voluntarily sought treatment. Some of these women admitted themselves to institutions, and some were privately treated. Remarkably, this subgroup was absent from the first materials I consulted. Even prominent figures like Charlotte Perkins Gilman and Catharine Beecher have little written about their experiences. My research addresses this significant gap and therefore helps us understand the history of gendered psychiatric diagnoses.

Revisiting the Record: Historiographical Perspectives and the Patients in Print

I began by revisiting two foundational works in this field: Women and Madness by Phillis Chesler and Women’s Madness: Misogyny or Mental Illness? by Jane Ussher, which helped to refresh my understanding of the prevailing argument about the patriarchal underpinnings of the history of women’s mental health. Next, I reviewed Women of the Asylum: Voices from Behind the Walls by Jeffrey Geller and Maxine Harris. This source provided excerpts from narratives alongside insights into evolving medical and gender theories. Here I discovered the four narratives that would become my focus. Despite being lumped into the category of institutionalization accounts, these were detailed descriptions by women who voluntarily sought treatment, including Catharine Beecher, Anna Agnew, Charlotte Perkins Gilman, and Ruth Pine Furniss. I then further expanded my understanding of insane asylums and institutionalization by reading select chapters from Theaters of Madness by Benjamin Reiss, focusing on exposé narratives written by infamous women such as Elizabeth Packard and Elizabeth Stone.

I supplemented my research with secondary materials found in the footnotes and bibliographies of my other sources. These included works by Michael Taussig, Carroll Smith-Rosenberg, Andrew Scull, Joseph Schneider, Peter Conrad, and a dissertation by Nancy Goldner. These provided broader insights into how physicians documented cases, the use of lesser-known treatments, and evolving notions of insanity and institutionalization during the mid-to-late nineteenth century.

Examining these sources expanded my understanding of societal perceptions of women and female insanity during this historical period, reinforcing the notion that female insanity was inextricably linked to gender norms and that the causes of insanity were viewed as purely physical—an abnormality within the body that required external treatment. However, these sources also highlighted a widespread societal fear that madness could be contagious, posing a threat to the stability of social order, a dimension I had only briefly encountered previously. ��

Moving on to primary sources, I reviewed volumes of the American Journal of Insanity from 1844 to 1863 to examine case studies of female patients and contemporary medical concepts regarding female insanity. I explored various Massachusetts Senate documents from 1841 to 1860, which contained patient demographics from Worcester State Hospital. I also examined select annual reports from institutions including McLean Asylum, Worcester State Hospital, Northampton Lunatic Asylum, New Hampshire Hospital, and Boston Hospital to understand how asylums reported female patient cases, defined diagnoses, and characterized illnesses. In addition, I read “Causes of Insanity” by Edward Jarvis, which included a lengthy list of causes of insanity in both men and women and was extremely helpful in revealing how medical men defined and categorized gendered symptoms of madness.

I conducted most of this research at UNH’s Dimond Library, opting to work with hard copies of my sources. Initially, my research process involved reading each book in its entirety while taking meticulously detailed notes. However, I quickly realized that this approach was too time-consuming and would hinder my ability to explore all my materials. To streamline my process, I organized my sources thematically (e.g., society and gender, medicine, institution history) and by type (primary and secondary). I then focused on reading only the most relevant chapters. I took notes on significant changes in cultural history, medical ideas, prominent practitioners, and wrote comments about the larger themes I saw intertwined throughout this information. After I compiled my notes, I organized them into a rough outline of my final paper, editing ideas and cutting irrelevant material as I went.

From Observation to Interpretation

This exploration of narratives from women who sought treatment for mental illness in the nineteenth and early twentieth centuries offers a unique perspective on the history of women’s psychiatry. My research revealed the complexity of gender in influencing these women’s experiences and how they interacted with medical men, seeking help for conditions they acknowledged as genuine, debilitating, and vaguely understood by their physicians.

I especially explored the agency exercised by these women in seeking treatment. Previously studied and more common female narratives of institutionalization are written by women who described their experiences as involuntary, an infringement on their liberty, and a strategy employed by their families or spouses to punish them for disobedience, most commonly for religious reasons. The accounts I explored differed greatly, in that these women recognized their need for medical intervention and sought out psychiatric institutions and physicians, suffering from conditions that modern eyes might recognize as post-partum depression, suicidal ideation, depression, and anxiety disorders. Contrary to the notion of women being victims of institutionalization as a punitive measure, these narratives demonstrated a conscious, deliberate, and vulnerable effort to find relief from their mental agony and the capability to enjoy their lives. Catharine, Anna, Charlotte, and Ruth all knew there was something wrong with them and trusted the physicians from whom they sought a cure. Seeking treatment was monumental in that it forced these women to admit they could not perform their domestic responsibilities without giving themselves over to men of science for help. The response of those physicians bears a striking and eerie resemblance to many female-patient experiences today, where it remains all too common to be gaslit, dismissed, or unsuccessfully cured by experiential treatment from male doctors.

These narratives also provide a nuanced understanding of the medical practices and treatments available to women during this time, as well as the benefits and limitations of the medical interventions they received. While some treatments, such as the rest cure (confined to lying down for weeks at a time) prescribed to Charlotte, were ultimately detrimental, others offered some measure of relief, such as the water cure (soaking in ice cold baths or being wrapped in cold wet clothes for multiple hours) prescribed to Catharine. The narratives reflect a complex interplay between the patients’ self-awareness and the medical knowledge of the time. For example, while Charlotte eventually rejected the rest cure as worsening her condition, her initial decision to seek treatment from Dr. Mitchell underscores her belief in the legitimacy of her suffering and her desperation for recovery.

Furthermore, my research sheds light on the role of gender in shaping the evolving perceptions of mental illness. The women’s narratives grapple with societal expectations of femininity and the stigma associated with mental illness. In many cases, their self-awareness and willingness to seek treatment were at odds with contemporary gender norms, which often downplayed or misunderstood women’s psychological distress. These accounts reveal the struggles these women faced not only with their illnesses but also with a medical system that was still in its infancy in understanding madness.

Paving the Road Ahead with These Mad Women

I encountered several avenues for future research that the scope of my project could not address. For instance, the peculiar history of hereditary mental illness in Harriet Beecher Stowe’s family has been addressed by only one historian. I also came across evidence suggesting that marijuana was used to treat madness as early as the 1830s, which contradicts current scholarship on the matter. While I did not delve into these subjects as they diverged from my primary focus, both could lead to groundbreaking scholarship in the field. I hope to return to these exciting areas for exploration in a future research endeavor. ��

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I would like to thank the Hamel Center for Undergraduate Research, as well as my donors, Dana Hamel, Dr. Kenneth R. Manning, and Katy Sadler, for making this research possible with their generous support. I also give tremendous thanks to my mentor, Professor Elizabeth Mellyn, for her guidance, inspiration, and unwavering confidence in me.��

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References

A comprehensive list of sources consulted during this research project; not all are cited in this research brief.

Agnew, Anna, and Francis A. Countway Library of Medicine. From under the Cloud; Or, Personal Reminiscences of Insanity. Internet Archive. Cincinnati, Printed by Robert Clarke & Co., 1886. .

Beecher, Catharine Esther, and U.S. National Library of Medicine. Letters to the People on Health and Happiness. Internet Archive. New York: Harper & Bros., 1855. .

Chesler, Phyllis. Women and Madness. Chicago: Lawrence Hill Books, 1972.

Conrad, Peter, and Joseph W. Schneider. “From Badness to Sickness: Changing Designations of Deviance and Social Control.” In Deviance and Medicalization: From Badness to Sickness, 17–37. Temple University Press, 1992. .

———. “Medical Model of Madness: The Emergence of Mental Illness.” In Deviance and Medicalization: From Badness to Sickness, 38–72. Temple University Press, 1992. .

———. “Medicine as an Institution of Social Control: Consequences for Society.” In Deviance and Medicalization: From Badness to Sickness, 241–160. Temple University Press, 1992. .

Conolly, John. "Diversities of Human Character, and Delicate Shades of Insanity - Their Relation to Offences and Crimes." The American Journal of Insanity 5, no. 4 (1848-1849): 266-275. .

Conrad, Peter, Joseph W. Schneider, and Joseph R. Gusfleld. “Deviance, Definitions, and the Medical Profession .” In Deviance and Medicalization: From Badness to Sickness, 1–16. Temple University Press, 1992.

Dean, H. “Guide to the Ruth Pine Furniss Papers YCAL MSS 431,” 2010. .

‘Documents Printed by the Order of the Senate of the Commonwealth of Massachusetts During the Session of the General Court, 1844. 11th Annual Report of the Trustees of the State Lunatic Hospital. "Diet," 75-77. .

Geller, Jeffrey L, and Maxine Harris. Women of the Asylum: Voices from behind the Walls, 1840-1945. New York: Anchor Books, 1994.

Gilman, Charlotte Perkins, and Internet Archive. The Living of Charlotte Perkins Gilman: An Autobiography. Internet Archive. Madison, Wis.: University of Wisconsin Press, 1991. .

Goldner, Nancy L. “THE MEDICALIZATION of INSANITY: A SOCIAL HISTORY of the MCLEAN ASYLUM for the INSANE,” Boston University Graduate School, 1980. .

Gray, John P. "Homicide in Insanity." The American Journal of Insanity 14, no. 2 (1857-1858): 125-140.

Grob, Gerald N. Mental Institutions in America. Free Pr, 1973.

Indiana Medical History Museum . “Indiana Medical History Museum - Voices from Central State.” , n.d. .

Jarvis, Edward, and State Library of Pennsylvania. Causes of Insanity : An Address Delivered before the Norfolk (Mass.) District Medical Society, May 14th, 1851 / by Edward Jarvis, of Dorchester. Internet Archive. [Norfolk (Mass.) District Medical Society?], 1851.

Jarvis, Edward. "On the Comparative Liability of Males and Females to Insanity, and Their Comparative Curability and Mortality When Insane." American Journal of Insanity 7-8 (1850-1851): 154. .

Kellogg, A. O., M.D. “Considerations on the Reciprocal Influence of the Physical Organization and Mental Manifestations.” American Journal of Insanity 12 (1855-1856): 309. .

Macdonald, James. "Puerperal Insanity." American Journal of Insanity 3-4 (1846-1847): 114. .

Pierce, S W, and J T Pierce. The Layman Looks at Doctors. 1929. Reprint, New York: Harcourt, Brace and Company, 1931. .

Reiss, Benjamin. Theaters of Madness : Insane Asylums and Nineteenth-Century American Culture. Chicago: University Of Chicago Press, 2008.

"Remarks Upon Monomania." The American Journal of Insanity 4, no. 2 (1847-1848): 25-37. .

Rickles, Nathan K. “The Angry Woman Syndrome.” Archives of General Psychiatry 24, no. 1 (January 1, 1971): 91. .

Scull, Andrew. Madhouse : A Tragic Tale of Megalomania and Modern Medicine. New Haven, Conn. ; London: Yale University Press, 2007.

Scull, Andrew T. “Madness and Segregative Control: The Rise of the Insane Asylum.” Social Problems 24, no. 3 (February 1977): 337–51. .

Smith-Rosenberg, Carroll. Disorderly Conduct : Visions of Gender in Victorian America. Oxford: Oxford University Press, 1986.

Taussig, Michael T. “Reification and the Consciousness of the Patient.” Social Science & Medicine. Part B: Medical Anthropology 14, no. 1 (February 1980): 3–13. .

Ussher, Jane M. Women’s Madness. The University of Massachusetts Press , 1992.

White, Barbara A. The Beecher Sisters. JSTOR. Yale University Press, 2003. .

Wikipedia Contributors. “Charlotte Perkins Gilman.” Wikipedia. Wikimedia Foundation, April 24, 2019. .

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Author and Mentor Bios

History major Claire Paley will graduate from UNH in May 2025. She received a Summer Undergraduate Research Fellowship (SURF) in 2024 to complete the study described in this research brief. In addition to her involvement with the Hamel Center for Undergraduate Research, she is a member of UNH Planned Parenthood Generation Action, an inclusive group dedicated to fighting for women’s rights, reproductive justice, and other social injustices. Claire is a member of the Hamel Honors and Scholars College as well as a member of the Phi Theta Alpha History Honors Society. She plans to pursue a doctorate in history.

Elizabeth Mellyn is an associate professor of history at UNH. She is a social and cultural historian with research and teaching interests in the global history of science, medicine, infectious disease, and mental illness from the ancient to the modern world. Primarily trained as a historian of Europe, she also teaches courses on the history of religious conflict as well as power and politics in medieval and early modern Europe. Mellyn's research has been supported by the Fulbright Commission, Harvard University's Center for Italian Renaissance Studies at the Villa I Tatti, the American Academy in Rome, and a collaborative grant between the Modern Language Initiative and the Andrew W. Mellon Foundation. In 2024, Mellyn won the Award for Excellence in Teaching in the College of Liberal Arts at UNH.��

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Copyright © 2024, Claire Paley