How Have We Depicted Madness Through History

Andrew Scull has published a provocative tour of how Europeans have treated "madness" over the last two millenniums in an online blog post at THE PARIS REVIEW under the title, "Madness and Meaning." He illustrates his essay with a variety of fascinating figures, paintings, photographs, etc. Scull, who teaches at UC San Diego, has recently published his magnum opus, Madness in Civilization: A Cultural History of Insanity (Princeton University Press) and this essay reflects the general themes of his treatise.

Scarred Memory: A World War II Nurse's Lobotomy

Scarred Memory: A World War II Nurse's VA Lobotomy Takes Toll on Family She Raised (Wall Street Journal)
by Michael M. Phillips

Dorothy is one of the last survivors among roughly 2,000 psychiatrically ill veterans the Veterans Administration lobotomized in the 1940s and 1950s. The Wall Street Journal in 2013 first detailed the VA lobotomy program and profiled the troubled life of World War II pilot Roman Tritz, 91, the only living lobotomized veteran the newspaper could locate at the time.

Lawmakers then asked the VA to find other surviving lobotomized veterans. VA headquarters, which says its files on such old cases are archived and difficult to access, hadn’t found any other survivors when Dorothy’s family contacted the Journal."

Lives in the Asylum

Committed: Stories About Stays in Psychiatric Facilities.

A collection of four stories gathered on the Longreads blog site.

1. "Something More Wrong" (Katherine B. Olson, The Big Roundtable, July 2013)

2. "Mentally Unfit" (Zachary McDermott, Gawker, April 2014)

3. "My Lovely Wife in the Psych Ward." (Mark Luckach, Pacific Standard, January 2015)

4. "Mr Bad Weekend" (Alan Hanson, Matter, January 2015)

Félix Vicq D'Azyr (1786) Brain Images

Under the heading "Brains" (20120902) the blog, BibliOdysssey, has posted an amazing set of 15 neuroanatomical atlas illustration plates from the 1786 'Traité d'Anatomie et de Physiologie' by Félix Vicq D'Azyr (1748-1794, Wikipedia entry). The blog's author (peacay) cites the Hagströmer Medico-Historical Library Virtual Book Museum's (Stockholm, Sweden) description of the book's creator: "Vicq d-Azur, permanent secretary to the Paris Academy of Medicine and personal physician to Marie Antoinette, found that his dissections of the brain were facilitated by first hardening the brain in alcohol. He identified accurately for the first time many of the cerebral convolutions, along with various internal structures of the brain. He rediscovered the white line in calarine cortex and described the mammillothalmic tract which still bears his name, as well as the central sulcus with the pre- and postcentral convolutions and insula twenty years before Reil and Rolando."

BTW, while he died during The Terror period of the French Revolution (1794), his passing was due to pneumonia rather than the guillotine.

I was struck both by how beautiful the engravings are as well as their accuracy/informative quality. A
link is provided to the set on Flickr® with varying sizes available of each plate for download and use.

At the bottom of the entry, there is a very helpful list of online sources regarding Vicq D'Azyr and this volume.

The Split Brain

Split Brain
A news feature at Nature, "The Split Brain: A Tale of Two Halves" should intrigue psychologists and others interested in the development of our understanding of hemispheric dominance in the brain. Written by David Wolman, it describes the role of patients in the 1960s enlisted after their "split brain" operations (cerebral commissurotomies) as Roger Sperry, Michael Gazzaniga, and others learned about the brain's functioning from their responses to testing.

What Happened to the Girls in Le Roy?

Story in the New York Times Sunday Magazine (registration required) about the eruption of tics, writhing, and other manifestations of what might be conversion hysteria in a modern context. The article by Susan Domus begins:

"Before the media vans took over Main Street, before the environmental testers came to dig at the soil, before the doctor came to take blood, before strangers started knocking on doors and asking question after question, Katie Krautwurst, a high-school cheerleader from Le Roy, N.Y., woke up from a nap. Instantly, she knew something was wrong. Her chin was jutting forward uncontrollably and her face was contracting into spasms.

She was still twitching a few weeks later when her best friend, Thera Sanchez, captain of one of the school's cheerleading squads, awoke from a nap stuttering and then later started twitching, her arms flailing and head jerking. Two weeks after that, Lydia Parker, also a senior, erupted in tics and arm swings and hums. Then word got around that Chelsey Dumars, another cheerleader, who recently moved to town, was making the same strange noises, the same strange movements, leaving school early on the days she could make it to class at all. The numbers grew--12, then 16, then 18, in a school of 600--and as they swelled, the ranks of the sufferers came to include a wider swath of the Le Roy high-school hierarchy: girls who weren't cheerleaders, girls who kept to themselves and had studs in their lips. There was even one boy and an older woman, age 36…"
A fascinating story well worth a look….

Wellcome Collection: Brains

The Wellcome Collection in London, UK will host a new exhibition, Brains: The Mind as Matter, March 29 through June 17, 2012. The exhibit is described as:

"Our major new free exhibition seeks to explore what humans have done to brains in the name of medical intervention, scientific enquiry, cultural meaning and technological change. Featuring over 150 artefacts including real brains, artworks, manuscripts, artefacts, videos  and photography, 'Brains' follows the long quest to manipulate and decipher the most unique and mysterious of human organs, whose secrets continue to confound and inspire. 'Brains' asks not what brains do to us, but what we have done to brains, focusing on the bodily presence of the organ rather than investigating the neuroscience of the mind."

A series of
images galleries displays figures which illustrate
  • Measuring-Classifying
  • Modelling-Mapping
  • Cutting-Treating
  • Giving-Taking
There is also a 360º brain to examine.

Hudson River State Hospital

[Hudson River State Hospital Old Building Drawin]
When I was first went into the Jesuits over 40 years ago, I lived at the novitiate in Poughkeepsie, NY. Part of our routine as novices was teaching "catechism" to elementary school-aged children in different venues every week. One of the two places I was assigned to teach at was the Hillcrest School for Children at the Hudson River State Hospital, located only about a half-mile down the road from the Jesuit facility. Actually, the Hillcrest School was set in the very back of the property, well away from the main entrance on Route 9 and we had to take a car back and forth for our weekly visits on Saturday afternoons. I suspect that the main reason for our going there, from the point of view of the hospital, was to give the young kids (they were aged about 6 to 14 years old) someone to talk to. My catechism students, as I recall, included two young brothers who had thrown their youngest baby brother out the window and an 8- or 9-year-old boy who heard voices all the time. My most vivid memory of Hillcrest itself was the temperature inside the building. It always seemed to be somewhere between 80 and 85 degrees in all seasons of the year. I was told that the reason for this was to keep the young patients perpetually fatigued and lethargic. Whether that was true, most of the other novices and me attempted as much as possible to go outside with our young charges onto the grounds of the hospital, both to run around the somewhat hilly area nearby, play a few games like catch, and escape the oppressive heat of their institutional home. I further recall a concerted attempt by at least some of the kids in season to search out and pick rhubarb that grew along the grassy knolls near Hillcrest.

Driving onto the property of the Hudson River State Hospital took visitors into a very different world than the one outside the hospital's stone walls. In the mid-1960s, the patient population living on the grounds of the facility could be numbered in the thousands (at its height, the hospital lodged about 9,000 patients in a mostly self-sustained and enclosed "total institution" as Erving Goffman would have termed it). As our car wound its way past the older buildings on the campus (the picture to the upper left is a drawing of the original "Kirkbride" building at HRSH), we would see many groups of patients being led from one place to another by staff members while, in other spots, patients were sitting in chairs or on benches simply staring out at whatever could be found nearby. It was, I recall, a very quiet environment and few of the mostly older and dilapidated-looking residents seem to speak at all to anyone nearby. Nonetheless, the grounds went on and on and occupied many tree-filled acres.

Psychologist Michael Britt, Ph.D. offers a glimpse into the Hudson River State Hospital (HRSH, later renamed the Mid-Hudson Psychiatric Center), in a recently-posted podcast interview on his website, The Psych Files. Dr. Roger Christenfeld, Research Director at a drastically-smaller current facility, discusses the history and therapeutic work of the HRSH in his interview with Britt. During 33 minutes, Christenfeld provides a glimpse of why the hospital was built and opened in 1869, what life was like for many patients in the late 19th and early 20th centuries, and how the notion of a state psychiatric facility changed profoundly after about 1955.

Target Link: Episode 27: From Insane Asylum to Psychiatric Center: A Brief History (33 minutes, the interview is in mp3 format and can be downloaded to your computer)

Associated Resources
  • Historic 51: A website devoted to the history of the Hudson River State Hospital. Includes many images and other information (e.g., a timeline) telling the story of the HRSH
  • Kirkbride Buildings: This website has photos of the "Kirkbride" style building at HRSH, a standard form for psychiatric asylum buildings in the 19th century. As the introduction to this site explains: "Once state-of-the-art mental healthcare facilities, Kirkbride buildings have long been relics of an obsolete therapeutic method known as Moral Treatment. These massive structures were conceived as ideal sanctuaries for the mentally ill in the latter half of the nineteenth century. Careful attention was given to every detail of their design in order to promote a healthy environment and to convey a sense of respectable decorum. Placed in secluded areas within expansive grounds, many seemed almost palace-like from the outside. But growing populations and insufficient funding led to unfortunate conditions that spoiled their idealistic promise."

Searching for the "Engram" and Finding It at UC-Irvine

In his volume on memory, the German evolutionary biologist, Richard Semon (1859-1918), postulated that the result of encoding an experience in memory would result in a specific physical trace of that experience in the brain's cells, or what he termed an "engram" (Semon, 1904, 1921 [in English]; see Cherkin, 1966, note 1 for a brief explanation of Semon's argument). The famed American neuropsychologist, Karl S. Lashley (1890-1958), searched in vain for evidence of such engrams or memory traces in his Harvard laboratory and went on to propose a countertheory of memory as function of non-localized "mass action" across the brain.

Following upon the work of Ramon y Cajal and Sherrington, the Canadian neuropsychologist, Donald O. Hebb (1904-1985), disagreed with Lashley and argued for a mechanism by which memories could be localized, i.e., his proposal for the "Hebbian synapse" on the neuron and collections of such synapses across associated neurons in the form of "cell assemblies" (see Brown & Milner, 2003, for a longer appreciation of Hebb's contributions). For the past four decades, the focus for identifying Hebbian synapses has been undertaken under the overarching research concern for long-term potentiation (LPT), that is, the assumption that "information is storied in the brain as changes in synaptic efficiency..." and that "the location of storage, the engram of learning and memory, must therefore be found among those synapses which support activity-dependent changes in synaptic efficiency" (Bliss & Collingridge, 1993, p. 31).

In a report published in the Journal of Neuroscience, a group of researchers at the University of California at Irvine have reported the first direct visual and physical evidence for a memory trace. As the press release from the UCI describes their breakthrough work

the study shows that synaptic connections in a region of rats' brains critical to learning change shape when the rodents learn to navigate a new, complex environment. In turn, when drugs are administered that block these changes, the rats don’t learn, confirming the essential role the shape change plays in the production of stable memory...Working with advanced microscopic techniques called restorative deconvolution microscopy, the UC Irvine team found that the LTP-related markers appear during learning and are associated with expanded synapses in the hippocampus. Because the size of a synapse relates to its effectiveness in transmitting messages between neurons, the new results indicate that learning improves communication between particular groups of brain cells.  (UC Irvine scientists, 2007, July 25).

So, more than a century after Semon proposed a role for a physical trace in the brain's cell in the establishment of a memory, laboratory research has appeared to confirm this finding.

Target article: Fedulov, V., Rex, C. S., Simmons, D. A., Palmer, L., Gall, C. M., & Lynch, G. (2007). Evidence that long-term potentiation occurs within individual hippocampal synapses during learning. Journal of Neuroscience, 27(30), 8031-8039. [Link to abstract]

Press release: UC Irvine scientists unveil the 'face' of a new memory [Press release]. (2007, July 24). Today@UCI. Retrieved July 31, 2007 from the UCI website:


Bliss, T. V. P., & Collingridge, G. L. (1993, Jan 7). A synaptic model of memory: Long-term potentiation in the hippocampus. Nature, 361(6407), 31-39.

Brown, R. E., & Milner, P. M. (2003). The legacy of Donald O. Hebb: More than the Hebb synapse. Nature Reviews Neuroscience, 4, 1013-1019. Retrieved July 31, 2007 from

Cherkin, A. (1966, Jan 15). Toward a quantitative view of the engram. Proceedings of the National Academy of Sciences of the United States of America, 55(1), 89-91.

Hebb, D. O. (1949). The organization of behavior: A neuropsychological theory. New York: Wiley. (Reprinted by Lawrence Erlbaum Associates, 2002.)

Semon, R. (1904). Die Mneme als erhaltendes Prinzip im Wechsel des organischen Geschehens. Leipzig, Germany: Wilhelm Engelmann.

Semon, R. (1921). The mneme. London: Allen and Unwin.

Wellcome Trust Opens Image Collection Online

The Wellcome Trust has made available both its historical and contemporary image library for biomedical topics. Read More...

Albert Ellis Dies at 93

The New York Times reports that the founder of "rational-emotive behavior therapy," Albert Ellis, has died at age 93. Ellis was both an incredibly influential figure in
his challenge to the orthodoxy of Freudian theory in the 1950s and 1960s, but also one of the great characters in psychology. His belief that people are prone to think like they were crazy (and thereby makes themselves nuts) and that people believe all sorts of nonsense prompted him to rail and challenge both patients and critics alike. I only saw Ellis once or twice at the annual meeting of the American Psychological Association, but to hear him preach the "Gospel of St. Albert" as the New York Times obit writer put it was a bracing experience. In class, lectures and discussions about Ellis' approach to therapy in my experience often bring out passionate statements in support and opposition. But, they are always fun.

Target article: Kaufman, M. T. (2007, July 25). Albert Ellis, influential psychotherapist, dies at 93. New York Times. Retrieved July 24, 2007 from the New York Times website.

Resources: Albert Ellis Institute | Albert Ellis (@ Wikipedia)