Novel Reading as a Mental Illness: circa 1864-89, Time and Treatment Modalities

In my research for “Surviving Sister”, a novel that tells the stories of two sisters in the 1950s afflicted with mental disorder, I ran across a very interesting article with photographs. Which you can see here:

I am finding many obscure medical references to treatment modalities. Very little is explained, even in medical journals, about what these modalities actually involved. For example; “immersion therapy”, sounds like deep thought, but what they actually did was immersing hysterical patients into a bath of ice cold water. It was believed to cool the core body temperature down, calming the nervous system.



Another interesting photo on this web site lists the reasons that patients were admitted to the asylum. I would have most likely never found my way out if ever I found my way in. Read down the list and see if you fit anywhere. When you get to “Novel Reading” stop and think about that. I’m terribly afflicted.


Sheesh! No wonder so many folk ended up in these places without any medical justification. Families often sent “undesirables” for simply being “lazy” when they showed signs of depression. Many were locked away for the remainder of their lives, even buried on hospital properties.

Treatment modalities were given long, complex terms like, “Lateral cerebral diathermia treatment,” a method using a galvanized current to jolt psychosis sufferers.


Different facilities around the nation employed various “treatments” and there was no uniform guide for consistency by diagnosis. Controlling symptomatic behaviors was the expectation of facility staff. No one was ever cured, they were reformed or recovered.

Very hard to get a handle on exactly what was going on inside of these places except through tales told by survivors. Documentation is limited. Scary, huh? And we think facilities are bad now. Certainly not ideal, but a vast improvement over what I am seeing from yesteryear.

I believe the biopsychsocial model used during the 1980s was the closest we have come to ideal. The State hospitals cleaned up their act. Facilities were equipped with swimming pools and gyms, walking trails and jogging tracks, offered art and music therapies and took patients out into the community to introduce these “clients” to vast community resources. We went to art shows, bowling, support group meetings, theaters. There was much more individual and group “talk” therapy.

The typical stay during that decade was thirty days to six months. People took advantage of the system, malingering for months into years and insurance companies caught on quickly reducing lifetime maximums and days allowed per episode. Now they are strictly medical model, shoving a few pills at patients and sending them to community outpatient services in a matter of a few short days…before the meds (which usually take two weeks to thirty days to reach effective therapeutic level) even have a chance to kick in. Only the sickest and most psychotic are allowed more than a two week stay.

In many ways it is good to have patients treated in their own communities rather than as inpatient, but most communities simply don’t provide the necessary resources and that’s sad.

What do you think about mental health resources available in your community?

20 thoughts on “Novel Reading as a Mental Illness: circa 1864-89, Time and Treatment Modalities

  1. This is terribly sad. I have seen worse. I rotated at an old state mental hospital a number of years ago and they had these huge tubs in a room. I did not understand at the time how they had been used. I learned that a few years later….


    1. When I worked Psychiatry in the eighties, people actually did very well and often got symptoms under control and had enough time to see if meds needed adjustment without repeated hospitalizations. I believe in much of the medical model and what it offers, but it is not ideal, and nobody wants to pay for ideal.


  2. How absolutely archaic. I can hardly get my head around this list for starters.
    I have no idea about mental health treatments in my area except to say a huge psychiatric hospital has been newly built and it take up what looks like a city block. I hear all the latest and greatest is available there.


  3. Oh my! They would have committed me and thrown away the key back then! I seem to recall H’s mom telling us one time about being sent to some sort of place like this when she was a child living in NYC for about a month. For what reason I don’t remember. There was a bit about wrapping her tightly in warm blankets I think.She was the sanest person I knew. I wish I had been paying more attention. There is no family left that could enlighten us on what really happened. 😦


  4. I don’t know anything about mental illness facilities in my area at the present time. In the late eighteenth-century, ideas about mental illness began to change. Pennsylvania Hospital included a facility for mental patients–at the time quite progressive. Doctors believed women were more susceptible to mental illness–and sexual transgressions could cause them to go insane. And in the nineteenth-century, there were water cures, and other treatments. Do you know of Sarah Ruhl’s play, “In the Next Room or the Vibrator Play–based on doctors using vibrators on women to cure “hysteria?”


    1. I haven’t heard of that, no. I am finding too very hard to find actual treatment modalities described. Everything is so obscure, or they talk all around it. I saw many sexual tools used to treat women during the Victorian era for hysteria. I’m looking primarily at 1950s.


      1. I know you’re not really interested in 18th and 19th centuries–I just commented because that’s the stuff I know about–and it kind of went with the novel reading as a cause of madness. 🙂


  5. If I had made it past novel reader they would have snagged me on “over action of the mind”! Pretty barbaric. And EXCESSIVE sexual abuse? Is there any sexual abuse that’s NOT excessive? I don’t even want to KNOW what “women trouble” means – it was probably another that would have qualified me!


  6. For many years, we had a large mental hospital (Northern State Hospital) in my home town of Sedro-Woolley, WA. The people who worked there thought it was quite successful. The State closed it in the early ’80s. The stated reason was to give the patients more freedom and to use more modern community-based treatments. It’s believed now that it was mainly for budgetary reasons.

    The number of mentally ill people who are homeless or in jail are symptomatic of a system that doesn’t work.


    1. Absolutely. The one I worked in did not close, but most patients were sent out to community based services for the same reason, but the community wasn’t ready to receive them. So sad what has become of the system.


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