Alternative Psychiatric Narratives is a conference taking place at Birkbeck on 16-17 May 2014. One of its convenors, PhD candidate Janet Weston, considers some of its themes in relation to her own research.
When I began my PhD research in the history of medicine just over a year ago, I hadn’t given much thought to patients. As far as I could see, my investigations into early twentieth-century medical engagements with sexual “deviance” meant looking at doctors and their doings, and my horizons were restricted to their professional journals, their theories and research, and their attempts to categorise and cure.
As time went on, I became increasingly curious about the nameless and faceless individuals who found themselves being written about, researched and, as far as their doctors were concerned, sometimes cured of their sexual irregularities. Many of these patients were also prisoners and criminals: stigmatised sexual offenders whose lives and experiences were shameful or distasteful to themselves and to others. Their interactions with medicine were often peripheral to the main business of crime and punishment, and for many their medical treatment was a short-lived episode, undertaken under duress and permanently linked to an ignominious criminal conviction. Even those who volunteered for medical assistance without finding themselves in any trouble with the law were often motivated by fear of arrest or public disgrace. Secrecy and shame meant that accounts from these patients’ perspective are few and far between. Although the changing tide of medical and public opinion has lead to some of those who received medical treatment to eliminate same-sex desires describing their experiences in memoir and documentary form, many other patients from the past have all but disappeared in silence.
This has encouraged me to turn to alternative sources, from novels and plays, to campaigning literature and interviews, and has prompted a return to medical notes and records to reconsider traces of patient voices there as well. The possibilities that might lie within such diverse sources is one theme that we hope to explore in the Alternative Psychiatric Narratives conference next May: what might we learn by looking at different expressions of psychiatry’s history, from maps to monuments, fiction to film, or by revisiting familiar records from a new angle? Accounts of medicine are not restricted to formal reports, and experiences are not limited to the hospital or consulting room. In fact, histories of medicine can go far beyond both doctors and patients. My research so far has brought home the extent to which psychiatry that dealt with sexuality left the asylum and intervened in prisons, courts, GPs’ consulting rooms, and domestic spaces, to shape and be shaped by nurses and wardens, families and friends, probation officers, magistrates and activists, as well as psychiatrists and their patients.
For me, though, patients still loom large as a group that should not be forgotten, but finding ways to access their experiences was only the first problem. As patient narratives began to surface in their myriad forms, I’ve realised that knowing how to read and use these presents just as many challenges. Words spoken and then transcribed after hours of interviews, or carefully composed, rewritten and edited for publication, were all are loaded with meanings that I couldn’t confidently interpret, shaped by unspoken goals and unshared assumptions, sometimes eloquent, sometimes poetic, sometimes inarticulate and confusing.
Nat Burke (a pseudonym), regularly convicted from the 1940s onwards of indecent assault, larceny and soliciting as a male prostitute, was prescribed drugs to suppress his libido, imprisoned seven times, and given psychotherapy on release. In interview in the late 1960s, he reflected on some of the complexities of his own narrative. ‘All I’ve got for you is words’, he said, explaining that for some people like him, words were ‘for speaking when they’re covering-up what they don’t want to say’. He thought of the years he had ‘talked and talked, and said nothing to anyone’. Nat recognised that his storytelling could conceal as much as it revealed, and that it was indelibly shaped by his audience and the solutions he wanted to find.
Struggling to give an account of himself through tears and anger, he tried to explain that his criminal convictions only laid out the ‘story of a lifetime, but not of a life’. The version of himself that was expressed on his criminal record was only one aspect of his life, not the whole, and he hoped that this new version, a narrative given in answer to his interviewer’s questions, might offer something else. ‘If I tell you the whole story’, he wondered, ‘maybe even while I’m telling it I might learn a bit more about myself; I might somehow come to believe in that thing I’ve been short of up to now. An unknown feeling, which goes by the name of hope’. Still looking for answers, this version of Nat’s narrative was shaped by a new confidence, perhaps born out of years of psychotherapy, that insight into his past would help his future.[1]
Nat recognised that this iteration of his story was far from a straightforward point of access to his experiences. His interviewer, Tony Parker, also recognised in his introductory note that Nat’s story was unique and not ‘representative of a type, only of himself’. Appreciating what influenced this particular version of Nat’s narrative, its points of reference, and its relevance to broader histories are just a few of the problems presented to those, like me, who want to use it as a window onto history. By focusing on “alternative psychiatric narratives” next May, we hope not only to explore non-traditional texts, voices, and spaces relating to psychiatry in different times and places, but also to address some of the difficulties of knowing how, and if, to use these resources. Although some of the patients in my research are, like Nat, no longer entirely unknown to me, I’m still not sure that I understand their experiences or what their stories might mean.
Proposals are now welcome for papers on the theme of Alternative Psychiatric Narratives: please visit our website for more information or email us.