Heather Murray, Asylum Ways of Seeing: Psychiatric Patients, American Thought and Culture

In Asylum Ways of Seeing, Heather Murray promises a ‘book about people with mental illnesses and distress and those in their orbits who cared for and observed them’ (p. 1). In so doing, Murray charts an exuberantly wide terrain for what she has dubbed ‘patient cultures’, using an impressive range of sources: patient case files (from public and private hospitals), patient and family letters, medical literature to memoirs, novels and Hollywood films, and a broad range of anti-psychiatry literature. Focusing on North America, Murray weaves together her disparate sources to create four broad chronological eras that begin with the early 1920s and end with the present. She writes of the post–World War I era that ‘a sense of inevitability was more likely to define ideas about mental illness within the confines of institutional psychiatry particularly during the interwar era, and this posture toward one’s lot in life had its parallel in a larger sensibility and mode of engagement with life: a sense that one was powerless to change the way things are, that what can’t be cured must be endured’ (p.4). She characterises the mid-century patient as transformed by the therapeutic optimism of ‘biological cures’, in which the patient sheds resignation for an ‘ideal of activity and transformation’. She writes, ‘As scientific modernity came to be seen as something that the individual could engage with and possibly manipulate, autonomy and self-possession deepened as ideals in the institutional setting’ (pp. 5–6). By the late 1960s and 1970s, with an increasing crescendo of critiques of state hospitals and psychiatry as repressive, and against the background of the growing civil rights movement, she describes a new emerging patient culture, one that reflected a growing distrust of institutions and their potential for repression and a newfound neoliberal ideology that valorised individual independence and disdained dependence, especially on the welfare state.