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Thesis title: ‘What did they do all day?’ Patient work, psychiatry and society in France and England, 1900–1940
Start year: 2015
Although belief in the therapeutic properties of work and pastimes for mentally ill people has a long history - Galen proclaimed as early as c. ACE170 that work was “nature’s physician” - patient work is rarely the subject of systematic historical analysis. This can largely be accounted for by the enduring emphasis in the history of psychiatry on medical ideas and treatments, rather than interventions that do not appear to require medical expertise. Research that focuses on patients’ activities is limited to the work of Jennifer Laws (2011) and Vicky Long (2006) and a recently published edited volume by Waltraud Ernst (2016). However, there remains a dearth of material on patient work in France and Britain during the early twentieth century.
My research project contests the view that the early twentieth century was a "dead period" in the history of psychiatry. The turbulence of the period – World War I followed by economic depression and political instability - contributed to a dynamic environment in which attitudes towards work, non-work and care of the mentally ill were fundamentally challenged. Aude Fauvel (2013) highlights the advent of shock treatments, rest cures and psychoanalysis, as well as the establishment of outpatient clinics, as evidence of therapeutic innovation. However, patient work and related activities also formed a crucial aspect of this therapeutic mix, though this has yet to receive the attention it deserves. This project will rectify this significant historiographical omission.
The project is relevant to contemporary debates regarding employment and mental health, notably those concerning the number of workdays lost due to mental ill-health (11.3m in England in 2013, according to the UK Labour Force Survey). In England, in particular, reductions in disability allowances are forcing the mentally ill to be financially independent, despite unemployment standing at nearly 6% (Guardian, 18/2/2015). Equipping those suffering from mental ill-health with workplace skills remains just as pressing today as in the 1920s and 1930s.
My thesis will address how attitudinal changes (which were far-reaching during the early twentieth century) were incorporated into asylum practice, thus highlighting the way in which society and psychiatry are intrinsically linked and how work and activity in mental institutions have evolved over time in response to wider social, institutional and medical contexts. Crucially, the comparative approach will offer a valuable means of identifying different trajectories of development, as well as alerting the historian to the potential uniqueness or commonality of events. France and England have been chosen because of their shared history in regard to moral therapy and their long-standing exchange of ideas on medical theory and practice. The project investigates the continuities and ruptures that characterised the situation a century after the heyday of moral therapy, examining the impact of different social and political circumstances, legal frameworks and new theories about labour efficiency on the configuration of patient work and leisure activities as part of, or apart from, medical regimes.
My research is funded by the Wellcome Trust, following the award of a PhD studentship.
Patient Work, Moral Therapy, Occupational Therapy, Psychiatrists, Asylums, Mental Hospitals, Mental Health Legislation, Transnational Psychiatry, Coercion, Empowerment, Patient Experience
In addition to conducting a survey of the secondary literature pertaining to my PhD topic, I have been preparing articles based on research conducted for my MA Dissertation which focused on the Dorset House School of Occupational Therapy.
I will be assisting Professor Ernst with organising a conference, “Alcohol Flows Across Cultures”, taking place at St Anne’s College, Oxford in June 2016.