the Bethlem psychiatric hospital where the patients were fairground attractions

Between brushstroke and brushstroke, Richard Dadd (Victorian painter) conceived the disturbing idea that his father was the reincarnation of a devil. During a summer walk through the countryside in 1843 he stabbed him to death. He ran away. Shortly after, the police arrested him in France. Fed up with claiming without anyone paying the slightest attention that he, in reality, was Saint Paul, at the beginning of 1790 John Frith He tried to attack King George III of England with a stone. The last drop of energy left in the veins of Eliza Josolyne It froze in the winter of 1857. The only servant in a house with twenty rooms, Josolyne (23 years old) had to ensure that every corner was clean and tidy. When in January he was also ordered to keep alive the 20 fires that heated his weak balance, he jumped into the air. The stories of Richard, John and Eliza have different characters, settings and dates, but they share the same ending: the Bethlem Royal Hospitalone of the most famous psychiatric hospitals in the world and the one that has contributed the most to creating the myth of the nightmare asylum. Also one of the oldest. Since its foundation, in the 13th century, and until its therapies began to modernize between the 18th and 19th centuries, the London sanatorium left disastrous chapters. For years more than a hospital It was almost a “human zoo”a gallery where the rich of London flocked to (after paying a shilling per entry) enjoy the spectacle of the “crazy ones.” In 1681 rulers shamelessly referred to patients as “lunatickes”, a mixture of “lunatic” and “tickets”. Added to the public humiliation were cruel treatment and deplorable conditions. Bethlem in 1739. The black legend of Bethlem has been replicated a thousand times in literature and in 1946 inspired Mack Robson for his film Bedlam, Psychiatric Hospital. Today it is a center respected in the United Kingdom, but has not yet managed to completely shake off that disastrous past. From time to time it appears from the most unexpected corner. Five years ago, workers working on London’s Crossrail (an underground train to improve the City’s communication) came across an unpleasant surprise: bones. A pile of human bones. Upon investigation it was discovered that they belonged to the old cemetery from the psychiatric hospital. Between the mass graves with Bethlem inmates and the corpses left by the Black Death, it is estimated that there could be 4,000 skeletons. Bethelem, the remote origin of everything The origin of the psychiatric hospital dates back to 1247. Simon FitzMaryformer sheriff of London, donated land in Bishopsgate to build an asylum which was named Priory of St. Mary of Bethlehem. From that name the abbreviations Bethlem and Bedlam were derived, today synonymous of commotion and chaos. Liverpool Street station now stands at that location. Decades later, the center is already listed as a hospital and around 1400 it welcomed inpatients. In 1547 Henry VII made the decision to hand it over to the city of London to house its mentally ill patients. Over the centuries and as its activity increased, the psychiatric hospital changed locations. When the old medieval building became too small in 1676, the hospital moved to a new and opulent one located in Moorfields. Its creator, Robert Hooke, wanted it to be the Versailles of London and threw the house out the window: he planned a 165-meter-long façade, Corinthian columns, a tower with a dome, gardens… “It was a contrast: that grandiose façade and the somber interior,” explained in 2017 to the BBC Mike Jay, author of This Way Madness Lies. Great, but a total ruin. The heavy façade soon cracked and the hospital suffered serious damage. leaks. Writers like Thomas Browne doubted whether the “madmen” were the inmates or those responsible for that nonsense. The psychiatric hospital would be moved two more times. In 1815, to St. George’s Fields, in Southwark, to a building that has been occupied by the Imperial War Museum since 1936. And in 1930 Beckenhamits location even today. During his journey he passed through all kinds of hands. Towards the end of the 16th century, James I put his doctor Helkiah Crooke in charge of the hospital. It is suspected that the doctor he was so good with the scalpel as with the sack. In 1632, a decade after taking office, he was removed amid accusations of corruption and neglect of his duties. Bethlem is not remembered, however, for Hooke’s strident project or the corruption of those responsible. It is because of the chains, confinements and punishments that the patients suffered. Not always in the same way. Towards the end of the 19th century, pain therapy was “prescribed” within its walls. rotationa practice supposedly inspired by the theories of Erasmus Darwin, grandfather of the famous naturalist author of The origin of species: Sitting the patient in a chair suspended high so that he turned and turned during long sessions. William Hogarth’s “A Rake’s Progress” series of paintings ended in Bethlem. Throughout the 18th century, cold baths or shackles were not unusual either. Of Edward Wakefield (a pioneer in the colonization of New Zealand) is said to have spoken in horror of the naked, starving men chained to the walls he encountered during a visit to Bedlam in 1814. Fair attraction for the bourgeoisie For one shilling, visitors could tour the psychiatric hospital as if it were a zoo. For at least one period, inmates were exposed to the public. Nor was it unusual for them to be allowed to egg them on. “At that time (1610) there was nothing strange about encouraging such a spectacle: visiting Bethlem was seen as edifying for the same reasons as attending hangings was edifying,” explains to the BBC Jonathan Andrews, author of The History of Bethlehem. Tradition assures that up to 96,000 visitors in a single year. Different personalities also passed through the psychiatric hospital. In 1732 the painter William Hogart began a series … Read more

We have turned sadness into a psychiatric disorder. And that is a problem that is devouring us socially.

When Roland Kuhn discovered the first antidepressant in history, imipramine, the directors of Geygi hesitated to put it on the market because depression was so rare who did not believe it could become a profitable medicine (Healy, 1999). It was the 50s of the 20th century, but it seems like an alternative reality. Today, depression is omnipresent. Only in Spain, the consumption of antidepressants has grown 200% in the last fifteen years and it is nothing more than the reflection of an unstoppable international trend. How is it possible that, in just over half a century, depression has become “so common”? Are we confusing normal sadness with a psychiatric disorder, as many experts say? Are we pathologizing everyday life? I am not going to enter into terminological debates, no matter how interesting and necessary they may be. When talking about “invention of mental illness” or “pathologization of everyday life” we run the risk of minimizing problems as serious as depression and that is something that is not in question. On the contrary, the idea is understand her better to treat her better. As the neurologist Luis Querol said“if we stick to the conventional concept of diseaseanyone who has seen a melancholic depressive SUFFER (…) will recognize that it is an illness.” It is totally true: that is enough for now. Depression is a particularly insidious and destructive disorder. According to the WHOnot only is it the main global cause of disability, but it affects 350 million people and is behind 800,000 deaths each year. Synopsis of an epidemic However, this does not explain why depression has become an epidemic. Above all, because it is not a disease that we “just” discovered. Melancholy is one of those psychiatric disorders so old that they were already diagnosed by Hippocrates and classical Greek medicine. Since the 19th century, the European diagnostic tradition separated most mood disorders from deep melancholy and included this among the diseases that end up consuming the person (such as senile dementia). At the beginning of the 20th century, psychiatric practice already clearly differentiated between endogenous or melancholic depression (which affected between 1 and 2% of patients) and reactive or neurotic depression (much more common) which was a product of stress, loss or pain. (Unsplash) In 1980, in the middle of a deep reputation crisis for psychiatric practiceDSM-III changed the way we think about depression. It moves from an etiopathogenic model (which asked about the cause of the disease) to a semiological one (which, in its claim to atheoretical nature, was based on symptomatology). A careless eye might think that the change was terminological and that “endogenous” was only replaced by “major” and “reactive” by “dysthymia”; but, in reality, the DSM-III expanded the playing field. Melancholia became one of the five subtypes of major depression and, with this, the underlying depressive disorder went from having a prevalence of 2% to a prevalence of up to 17% (Kessler et al., 2005). In recent years, a good number of historians (and activists) have insisted that this change and the commercial pressure of pharmaceutical companies (Horwitz and Wakefield, 2007) have taken us to overdiagnosis current disease (Mojtabai, 2013; Parker, 2007). At its strongest, it is a difficult argument to reject. Especially because it is not that the existence of depression is denied, but rather that it is argued that the failure of epidemiologists, psychiatrists and social scientists to differentiate ‘normal sadness’ and ‘depressive disorder’ is leading to health policies that condemn many people to taking unnecessary medications and carrying the weight of stigma on their backs. Whys, doubts and conspiracy Basically, although it is not usually said clearly, we are talking about ‘iatrogenesis’; That is, suffering or damage to health caused by health professionals themselves. The current opioid crisis in the US It shows that, far from being pure conspiracy, pharmaceutical companies and their balance sheets can create a health problem of colossal dimensions. However, we must not be unfair, nor fall into banal Manichaeism. Although it may seem counterintuitive and paradoxical, many problems only appear when we have the solution them. Without antidepressants or effective behavioral therapies, depression was deep sadness, black sorrow that wells up, black shadow that amazes me. Something that was between us and there was nothing we could do to avoid it. (Jacob Sedlacek/Unsplash) Horwitz and Wakefield say that “tolerance for normal but painful emotions has fallen” in the West. And it may be true. But they forget two fundamental things: that, for the first time in the history of humanity, we can do without them and that it is not a personal problem, the modern world has tended to prioritize productive optimism and has forgotten how to live with sadness. At this point we realize that, if we want to learn to better separate “illness” from “normality”, it is not just a matter of challenging depressive overdiagnosis, but of claim sadness. The problem is that, why would we want claim sadness? And the answer, honestly, may surprise us. Sadness, said Lazarus (1991), promotes personal reflection after the loss. Focus our gaze on ourselves, promote resignation, invite acceptance (Izard, 1993). It allows us to waste time to update “our cognitive structures” (Welling, 2003); that is, to accommodate the loss. That reflective function of sadness It allows us to stop. And weigh actions, review our goals, modify our plans (Bonanno & Keltner, 1997; Oatley and Johnson-Laird, 1996). It makes us more attentive to detail, more precise. It makes us flee from heuristics and stereotypes (Bodenhausen, Gabriel and Lineberger, 2000; Schwarz, 1998) and distrust first impressions (Schwarz, 2010). Physiological arousal decreases and makes us more prone to slow thinking (Overskeid, 2000). Furthermore, it shapes us as a group. Causes sympathy, empathy and altruism in others (Keltner and Kring, 1998). The complex balance between “normality” and “disease” In 1843, Charles Darwin wrote a letter of condolence to a distant cousin in which he said that “strong affections have always seemed to me the noblest part of man’s character and the … Read more

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