In her Encyclopedia of Asylum Therapeutics, sociologist Mary de Young has written an engaging volume that unearths practices and theories directed toward mental disorders and connects strands of treatment within psychiatric institutions across centuries. The volume really is an encyclopaedia, with entries arranged in alphabetical order from ‘Awakenings’ to ‘Total Push’. Within each entry, de Young explains the term, offers alternative names or ways in which the concept might have been noted, and traces its history. De Young uses sources that explain medical ideas and practices, but also employs others to illustrate how recipients of the treatments experienced them and how they were received by the public. The volume offers a view of the eclectic methods that asylum physicians have employed over the centuries, from some that have been well described (‘Psychosurgery’) to others that have faded from modern memory (‘Rotation, Oscillation and Vibration’).
The encyclopaedia entries are well referenced and there are bibliographies for each one that include both primary and secondary sources. Some entries are more extensive than others – ‘Shock Therapy’ is appropriately long at twenty-four pages, while ‘Metallotherapy’ gets three pages. De Young includes practices that are rooted in specific times and places (‘Hypothermia’) as well as others that span centuries and continents (‘Expressive Therapy’ includes art, music and dance). Many entries discuss interventions done on patients’ bodies, although de Young does include psychological factors such as ‘Moral Treatment’. Some of the entries help to clarify concepts frequently encountered by scholars and teachers of the history of psychiatric institutions, such as ‘Hydrotherapy’, ‘Forced Feeding’ and ‘Mechanical Restraints’. The scope is international, but Western in its orientation.
Although de Young’s emphasis throughout is on therapeutic approaches by asylum physicians, she is careful not to let the encyclopaedia become either heroic in celebrating physicians’ achievements or overly polemic in its criticisms of past practice. While it would be easy to read the entries as evidence of the ridiculous (or harmful) ways in which asylum physicians have done things to patients (a reading that is supported by the cover picture of an attendant spraying a powerful hose of water on a naked patient), de Young generally makes an effort to outline the ideas behind therapeutics and to put them in context. She observes, throughout, that physicians articulated their desire to help incurable patients, which helps to explain some of the more desperate interventions she describes (although, occasionally, she reveals outrage about past practices, such as physical management in ‘Salutary Fear’).
The choice to focus on the time period between the 1750s and the 1950s is an interesting one that cuts across standard narratives of somatic therapies. By showing continuities from the eighteenth to the twentieth centuries, de Young calls into question historians’ typical story of asylums in their transition from moral treatment in the nineteenth century to somatic treatments in the twentieth century. And, by ending her encyclopaedia before the era of medications, de Young resists the use of history as a foil to celebrate modern achievements. She explicitly emphasises that the history of therapeutics is not a progressive narrative but continues in circles – the encyclopaedia format reinforces this argument. De Young also makes the choice to take an exceedingly broad view of the ‘asylum’ – she includes within that term any kind of institution that housed individuals perceived to have problems with mood, thinking or behaviour. This allows her to illustrate the ways in which local context, with shared social and cultural assumptions, helped to shape theories and practices directed at patients and also how those were viewed and experienced by patients and those around them.
There are a few aspects of the encyclopaedia format that are hard on the reader. For the longer entries, the references are included after a brief introduction of the topic before subheadings of the topic. This makes it necessary to go back and forth within the volume to identify sources for that topic. In addition, occasionally, de Young wanders into descriptions of the second half of the twentieth century or current practices, sometimes without the careful attention to evidence she uses for the earlier time periods. Within each entry, it is sometimes hard to locate a practice or idea in space and time – it would have been helpful to note more explicitly when and where the individual or theory she describes is situated.
Encyclopedia of Asylum Therapeutics achieves its intended object: to provide a good reference to interventions done within psychiatric institutions. It is less satisfying to read cover-to-cover, but the entries are well organised and the writing is lively. The volume will be a great teaching tool for students wishing to learn about treatments and to spur investigation, and its availability as a cheaper e-book will aid in its use in classrooms. It is broad enough in its approach that students in the social sciences as well as those in the health professions will find something to stimulate their critical thinking. The book will also be valuable for those curious about continuities over time and the longer view of psychiatric therapeutics.
