Narrative survival: personal and institutional accounts of asylum confinement

Lit Med. 2012 Spring;30(1):12-41. doi: 10.1353/lm.2012.0006.


This essay has been conceptually eclectic in that we have integrated concepts from genre theory and discourse analysis. In our interpretation of Merivale and Marshall's narratives, we have also drawn upon Frye's Anatomy of criticism, a canonical text in literary genre theory. Such an eclectic approach seems warranted by both the contextual and textual features of Merivale's and Marshall's narratives, and in particular by Merivale's use of Mennipean satire with its encyclopedic detail. In our discussion of Merivale and Marshall's Admissions Records we have drawn on speech act theory to suggest that the Order (to admit a patient), the two medical certificates that follow, and finally, the notice to admit a patient constitute a constellation of texts, a genre suite, with a powerful illocutionary force. These texts are the prelude to and the means of confinement; they are both act and process. At the heart of our comparison of the asylum records of Merivale and Marshall with their "survivor narratives" is our analytic conclusion that the Ticehurst case histories can be said to constitute a linear "chronicle" of what Hayes Newington, the writer of the two case histories observed and inferred about his two patients. As chronicles, the Ticehurst Asylum case histories are linear representations or realistic accounts. As such, these archival documents provide a genuine insight into the "ways that that reality offers itself to perception". The institutional accounts exist in--and mark a--"flat time," equalized by each dated entry depicting the writer's mechanical act of observing/noting in brief, stereotypical sentences, e.g., "Patient is better [or, conversely, no] better today." We dubbed this metronomic time: beating regularly and evenly, flattening out the individual trajectories of each patient's illness. Metronomic time is normative. Each beat is calculated precisely to be the same as next. The dispassionate nature of clinical observations and the metronymic rhythms of the asylum fit with this flat, regular, uniform view of time. Once metronomic, institutional time is set in motion by the precipitating event of the certificates of insanity, entries are logged with regularity and observations are made in a formulaic, abbreviated, and predictable manner. By contrast, the passage of time recorded in both Merivale's memoir and Marshall's oral account is irregular, unpredictable, marked by acute catastrophes and long anxious periods of waiting for a resolution, by peaks of conflict and turmoil alternating with valleys of dazed stupor or inaction. Time in their accounts is also recursive; events are re-lived, sometimes more than once, as the patients recount their feelings about their confinement. Time for Merivale and Marshall (and presumably other patients as well) acquires a symphonic pattern: recursive, with dramatic highs and lows, unfolding multiple variations of a central theme-in both of these cases, denial of insanity. Both metronome and symphonic time have similar rhythmic "deep structures," but while one is simply a repetitive drumbeat of the quotidian, the other takes off into richer, more elaborate arrangements invested with personal meaning.

Publication types

  • Historical Article

MeSH terms

  • England
  • History, 19th Century
  • Hospitals, Psychiatric / history*
  • Humans
  • Inpatients / history
  • Inpatients / psychology*
  • Medicine in Literature
  • Narration*