Before the reform movement of the mid 1800s, insane asylums were seen as little more than dumping grounds for those who were considered to have no place in society. Likewise, the people who found themselves confined in ‘madhouses’ were often regarded with fear and ridicule. There were many different theories about what caused mental illness, and just as many theories about how to diagnose and cure it. As new technologies such as photography began to emerge, forward thinking practitioners began to explore the potential therapeutic and diagnostic benefits it might bring.
A Difficult Diagnosis
Before psychiatrists had a clear idea about what caused mental illness, they only had external symptoms on which they could base their diagnoses. As well as observing abnormal behaviours, many early psychiatrists believed that the key to diagnosing mental illness lay in facial expressions, an idea known as physiognomy. Many practitioners believed that a person must be able to present an outward appearance of normality in order to be considered ‘cured’. Conversely, any abnormal appearance would be classified as a symptom of mental disorder or even criminality. The idea was closely linked to phrenology; the theory that a person’s personality and predispositions could be determined by the shape and contours of their head.
Photography as Therapy
The advent of new photographic techniques meant that photography became a useful tool by which doctors could diagnose and classify their patients. The first person to begin photographing patients in an asylum setting was Hugh Welch Diamond, who was the superintendent of Surrey County Asylum during the 1850s. He was an avid proponent of photography and firmly believed that photography could be used therapeutically to help cure his patients. He argued that by showing his patients photographs of themselves they would be forced to recognise and confront their illness, which would ultimately aid their recovery.
Many other influential psychiatrists agreed with this notion, including John Conolly, who was the director of Hanwell Asylum and the first practitioner to follow complete non-restraint in the asylum. Connolly was a strong advocate of humane treatment of psychiatric patients, and used photographs to demonstrate the positive impact of his regimen. He published a number of articles illustrated with photographs that showed his patients ‘before and after’, demonstrating their recovery and return to respectability.
A Clearer Picture
Photographs were considered to be more scientific than drawings by some medical practitioners, because photographs were seen as completely objective. Unlike drawings, they would be free from any preconceptions or biases that may have been consciously or unconsciously added by the artist. However, this was not entirely the case. As any other portrait artist would, photographers often posed their subjects in very specific ways, and asylum practitioners often staged their photographs in a way that sought to highlight the physiognomic features they believed they saw in their patients. For example, photographs of patients were often taken after a diagnosis had already been made, and the photograph was therefore intended to try and display the elements that the psychiatrist believed typified the disorder they saw.
The invention of the calotype in 1840 meant that photographs could be produced much more quickly than before, and most importantly could be easily duplicated, as the images were produced on paper rather than copper plates. This meant that photographs could be reproduced and distributed via publications that were available both to other professionals and the general public. This meant that asylum patients could be presented in a more humanised way, rather than in the fanciful or romanticised manner that artists often used to portray madness.
A Lasting Impact
Even though physiognomy was little more than a pseudoscience, the images of asylum patients still produced some positive outcomes. By publishing photographs of recovered patients, Conolly and Diamond helped to humanise those suffering from mental disorders. Far from being ‘hopeless cases’, these images demonstrated that with the right care people could recover. Rather than fear or derision, the public came to view these people with sympathy, and the way that patients in asylums were treated gradually improved as a result.
Sources and Further Reading
https://fr.wikipedia.org/wiki/Hugh_Welch_Diamond
https://www.britannica.com/technology/photography/Photographys-early-evolution-c-1840-c-1900
https://repository.upenn.edu/cgi/viewcontent.cgi?article=1510&context=asc_papers