By Gemma Angel, on 17 December 2012
Recently, I was lucky enough to be able to borrow a replica strait-jacket, which visitors to the Grant Museum were only too eager to try on, offering an interesting point of departure for conversations on freedom and constraint within a mental health context. The backdrop of the Grant Museum itself offered a striking way of representing a comparison often made in histories of psychiatry: as Andrew Scull puts it, “the madman in confinement was treated no better than a beast; for that was precisely what, according to the prevailing paradigm of insanity, he was.” Scull was talking about the 17th and 18th centuries in particular – for him, the introduction of moral treatment (an approach focused on providing a restful environment and work and occupational opportunities for asylum inmates) around 1800 encouraged a shift in understandings of the mentally afflicted. From being viewed as animals, requiring control and confinement, they were re-classified as children, who might be educated.
This idea of a clear shift is overly simplistic, failing to take into account, for example, changing ideas of education, child-rearing or cruelty to animals. Indeed, Patricia Allderidge has criticised the use of cases of restraint to support this argument. The dehumanising nature of restraint is often supported by reference to cases like that of James Norris, an American marine who was admitted to Bethlem in 1800. From 1804, Norris lived in an iron harness which had been specially made for him, and is pictured below. The effects of a severe head injury made Norris violent and dangerous, and all other methods of controlling his behaviour had apparently failed, resulting in serious injuries to staff and other patients. This type of restraint was thus extremely unusual, and cannot be used to make general points about contemporary ideas of insanity. What’s more, there are other suggestions that Norris was not necessarily confined because he was considered to be “a beast”: as Allderidge notes, the least-quoted aspect of Norris’ life at Bethlem is that “he occupied himself … by reading the books and newspapers which were given to him, and amusing himself with his pet cat”.
In popular lore, the history of asylums is frequently presented as closely associated with mechanical restraint. Few people, for example, are aware of the “non-restraint” movement in England and Wales, which saw all restraining garments, straps or chains disappear from the vast majority of asylums for a half-century, from 1840. This rather complicates the widespread assumption that social or medical change must necessarily be progressive: if one encounters a strait-jacket in a museum collection, for example, it is much more likely to be a twentieth century garment than a Victorian one. This idea can be disturbing for those who like to imagine a humane present contrasted with a brutal past. The arguments used during the non-restraint debates indicate that this topic was also much more complex than ideas of progress allow for. Those who were wary of adopting a blanket policy of non-restraint argued that other measures of coercion were simply being substituted, including physical handling by staff, the use of locked rooms and padded cells, and “chemical restraint” by drugs (all issues, along with legal constraints, which remain concerns in psychiatry today).
Indeed, one of the most disturbing cases that I came across in my asylum research was well within the non-restraint period. In 1865, Henry Wright, a middle-aged clerk, was admitted to Bethlem after severely wounding himself by cutting his own throat. While in hospital, Henry made repeated efforts to tear open his wound, so that, a month after admission, it was noted that “[i]t is not safe to leave hold of his hands for an instant. He is looking ill and sedatives have very little effect on him.” For much of his time at Bethlem, Henry was accompanied everywhere by two attendants, who ceaselessly kept hold of his hands, severely limiting his movements. This was not considered to be restraint: nor did it help Henry, who made his last recorded suicide attempt a year after admission, following which he was discharged uncured.
Sad cases like Henry’s remind us that the assumption that restraints are necessarily dehumanising can actually perpetuate the associations between madman and beast suggested by Andrew Scull. While strait-jackets are often assumed to be cruel, they also tend to be judged as evidence of the wearer’s problematic nature. When restraints appear in film or TV, they tend to be used to signify potential danger to others: as Henry’s case indicates, most people who wore such clothing were considered dangerous only to themselves. Even those who were thought to be a danger to others, like James Norris, do not necessarily fit the stereotype of the “raving lunatic”, and were able to carry out intellectual pursuits while confined. An excellent exhibition at Guy’s Hospital by artist Jane Fradgley (Held, on until 8 March 2013), offers a much more nuanced perspective on so-called “strong clothing”, suggesting that it can in some cases be protective, as well as restrictive. For people like Henry and James, restraint of some kind was inevitable: whether this was in the extreme form suffered by the latter, or the sedatives and physical holding used to try and prevent the former from severely injuring himself.
 Andrew Scull, Museums of Madness (London: Allen Lane, 1979), pp. 64-6
 Patricia Allderidge, ‘Bedlam: fact or fantasy?’ in William Bynum, Roy Porter and Michael Shepherd eds. The Anatomy of Madness: Essays in the History of Psychiatry (London; New York: Tavistock Publications, 1985), Vol. 2: 17-33, pp. 25-6