In A Refuge of Cure or Care: The Sensory Dimensions of Confinement at the Worcester State Hospital for the Insane, Madeline Kearin Ryan analyzes the therapy model of the nineteenth-century asylum. Because the five senses were believed to provide a direct conduit into a person’s mental condition, the curative force of the hospital was thought to reside in its command over sensory experience. Ryan examines how the institution was designed to target each of the five senses as a mode of therapy, and conversely, how that well-intentioned design materialized in the haphazard realm of institutional practice. In doing so, Ryan seeks to reconcile the disjuncture between the benevolent promise of the asylum model and its ultimate failure in a way that captures the complex power dynamics and heterogeneity of actors within the institution.
Madeline Kearin Ryan is project development librarian at the Worcester Historical Museum.
Chapter 1: “A State of Conscious and Permanent Visibility”: Sight as an Instrument of Cure and Control
Chapter 2: “As Syllable from Sound”: The Sonic Dimensions of Confinement
Chapter 3: The Smell of the Insane: Disciplining the Olfactory Domain
Chapter 4: Dirty Bread, Forced Feeding, and Tea Parties: The Uses and Abuses of Food
Chapter 5: “Curious Relics” and “Drafty Corridors”: The Material World of the Asylum
Ryan explores the history of asylums and mental health confinement as illustrated by the Worcester State Hospital (WSH) and its 19th-century creation as a facility to address insanity as a curable disease. Woven through Ryan's text are references to experiences of patients, administrators, and physicians as recorded in archival sources, echoing the challenges confronted by the institution while offering nuanced perspective. Insanity was perceived, in part, as a disease of civilization; WSH's goal was to create a soothing and nurturing atmosphere for therapeutic treatment. The facility was designed to encourage healing through positive encounters mediated by sensory experiences of sight, sound, touch, smell, and taste, offering the patient a stable and pleasant environment and routine. Ryan also reviews the realities WSH confronted including overcrowding; the steady increase in the population of the incurable, which eventually overwhelmed the institution; and underfunding, which made it impossible to meet envisioned goals. Descriptions of the material design of WSH, responses of patients to the "optical trickery" of the scenery created for them, and sometimes abusive control exercised over patients to sustain an artificial routine add depth to this portrait of the challenges inherent to empathetic care, contributing detail to the history of psychiatric treatment in theory and practice. Recommended. Upper-division undergraduates. Graduate students, faculty, and professionals. Students in two-year technical programs.
A Refuge of Cure orCare provides a considerable amount of new material and analysis that would contribute both to the fields of history and archaeology. It discusses an area of increasing interest in the discussion of sensory aspects of the asylum. Madeline Kearin Ryan's research also highlights previously overlooked elements of asylum history, including race, class, and beliefs about human nature and overindulgence. Ryan builds on Australian and English research in the sensory area and presents a highly detailed original analysis, offering considerable insights into many aspects of the patient experience as part of moral management.
A Refuge of Cure or Care examines the inherent contradictions between the psychiatric theory of the asylum and the reality of its application in nineteenth century institutions. Ryan outlines a unique phenomenological perspective on the materiality of the asylum, evaluating the 'sensorial assemblage' of the asylum as both lived experience and modality of treatment. Ryan contextualizes historical socio-cultural views of psychiatry with deeply personal sensory experiences, providing a roadmap of sorts for a sensorial approach that will undoubtedly have wide-ranging applications in historical archaeology.