Fin de Siècle Europe Psychiatric Institution/Asylum Queries

Stringer Greenbrier

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Good afternoon. Right now I am in the middle of a historical fiction writing project of mine, and having extensively researched the topic at hand, I think I need to consult some experts on early twentieth century psychiatric institutions or asylums in Europe, particularly Austria and Vienna.

Firstly, my understanding of the late nineteenth century and early twentieth century around central Europe, from Paris to Zurich to Vienna to Rome, is that it was gradually marked by a feeling of progress, moving away from Schopenhauer-like world philosophy and embracing idealism, optimism, the idea that anything positive might just be possible. My question for you is if this was mirrored in psychoanalysis, with many psychologists or doctors denouncing the somatic or nervous system origin theory of mental illness around the beginning of the twentieth century, opting instead to believe it was all in the mind. As such could the phrase Fin de Siècle be extended to the domain of central European psychiatric institutionalisation, as conceptions of patients were becoming more and more positive, and the idea of treatments or cures for the mentally ill becoming more and more tangible? Have the two ever been brought together before?

Secondly, on a less abstract note, how would the staff or administration panel of a psychiatric institution in, say, Vienna, be setup? Would the doctors be referred to as doctors, nurses, analysists, therapists, etc.? I'm just wondering what a patient would refer to his carers as, how many he would have, how many patients there would be... this is all not very clear online. What would these staff members do? I know it wasn't common to prescribe medication in this era, so were they just minding them twenty-four hours a day? Apparently artwork, physical activities, games were encouraged as forms of therapy. For a patient admitted there, what would an average day in a psychiatric asylum consist of?

How prevalent was psychoanalysis becoming in treatments from 1897 to 1908?

How expensive would it be to have a family member committed to a psychiatric institution during this time period? Presumably less expensive than a hundred years before when only the very rich were able to do so. Did the government subsidise a portion of the costs following the nineteenth century push to have the mentally ill considered as patients on a compassionate basis?

Could patients be sedated in 1899, or put to sleep? Was there some sort of sleeping pill they could use back then?

Lastly, what type of clothes would people working in a psychiatric institution wear back then? Like a nurse uniform (long gown, apron, big hat) or a doctor before the white coats took precedence (normal clothes and shoes, maybe with an apron on in case of surgery)?

Thanks for your time. I understand I just asked a lot of questions. Most of my research was able to cover everything else but for the above I could find no information or conflicting sources. I'd really appreciate any help you could give me. As this is a period piece I'd like to be as faithfully accurate to the time as possible.
 

King Neptune

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By then, there were government institutions in addition to private hospitals. That was the era when the large mental hospitals in the U.S. were built, and the same was true in Europe.
I believe that chloral hydrate and alcohol were used as sedatives, and physical restraints were still in common use.
 

Tsu Dho Nimh

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What does your plot need to have happen? Instead of a generic "tell me all you know", figure out whether certain plot points are possible.

Have you read "Shattered Minds" about women and psychiatry, and "The Yellow Wallpaper"?

Various sedatives were used, including some dangerous ones from various herbs, and some innocuous ones.
 

M Louise

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Your questions are so broad, I'm struggling to know where to begin. Could you be more specific?

Fin de Siècle was a term that referred to ennui, a disillusioned, exhausted feeling that came with the end of a century of wars in Europe and especially France. At the same time there was great excitement about modernity, speed, progress -- the railroad, telegraph systems, modern inventions and the science of the mind. The older mental asylums ('bedlams') were modernised and began to offer more humane treatments, although this was not true of colonial psychiatry in Africa, Asia or the Caribbean.

You might want to look at articles on the studies of performative hysteria conducted by the neurologist Jean-Martin Charcot at Hôpital Salpêtrière in Paris. Women believed to be suffering from hysteria were hypnotised by Charcot and would exhibit states of paralysis or have convulsions before an audience of male medical students and researchers. Freud and Breuer used Charcot's insights into 'the speaking symptom' to develop theories of the Unconscious and what would become 'the talking cure'. The women confined to institutions (similar to sanatoriums) in Europe were mostly middle-class, from affluent families. In addition to case studies in Freud, I'd look at DM Thomas's novel The White Hotel, as well as what Virginia Woolf went through while being treated for depression and mania in about 1910 (the biography by Hermione Lee has a sympathetic account).

For more context on the pathologising of women and emotional illness in institutions, I'd also look at Mad, Bad and Sad: A History of Women and the Mind Doctors from 1800 to the Present by Lisa Appignanesi. And of course The Yellow Wallpaper by Charlotte Perkins Gilman, as recommended.

What changes much of this (and I'm generalising wildly in an effort to be helpful) will be the collective experiences of war 'shell shock' (then seen as male hysteria) analysed and treated during and after WWI. You'd find some fictionalised details in Pat Barker's novels on the Great War.
 
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