Bethlem Royal Hospital

Statue adorning the entrance to Bethlem at it's Southwark location

I really enjoyed our class excursion to Bethlem Royal Hospital. The lecture given by the archivist illustrated in a tangible way many of the points made in both the Showalter and Duffin readings. He spoke about the changing class structure of asylums in England during the Victorian era—he noted that after Bethlem’s move to Southwark in 1815, and particularly by the mid-19th century, Bethlem began to admit only a “better class of patient.” With the advent of the network of county asylums, to which the pauper-lunatics were shuttled off, Bethlem was able to begin to escape its reputation as “Bedlam.” As Showalter describes in his “Domesticating Insanity,” the term “madhouse” was phased out and replaced with kinder, gentler terms, such as “retreat,” or “asylum.”

Additionally, the archivist mentioned the concept of “moral management” that became the standard method of treatment in Bethlem during the time. In a shift away from restraint-based treatment methods, asylums began to use “moral” treatments that attempted to address the emotional and mental side of illness. Both Duffin and Showalter discuss moral management, with Showalter describing it as a system that enforced good habits and taught self-control, rather than merely controlling the physical symptoms of insanity. Our archivist also noted that the architecture of the hospital at its current location is set up in home-style villas. This could be considered a type of “moral architecture” of a more modern kind than what was practiced in the Victorian era. Moral architecture, as an extension of moral management, attempts to expose patients to benevolent influences, according to Showalter.

One thing I found fascinating about the Showalter reading was the description of the Lunatics Ball. Showalter writes, “Seen at such a close range and in holiday settings, madness was no longer a gross and unmistakable inversion of appropriate conduct, but a collection of slightly disquieting gestures and postures.” This sentiment is similar to what our archivist (I’m terribly sorry I can’t recall his name) said to us after we read the cases in the archives—that the mental illnesses of these patients were usually not the defining factor of in their lives, and that often times they went on to lead perfectly normal lives after their stay in Bethlem.

A case book from Bedlam in 1889