Hearing women as mad in the asylum: past perceptions haunting the present

Dolly MacKinnon explores auditory constructions of female madness in the start of our series on the history of women and mental health.

From the claim a woman sounds ‘hysterical’ to having their opinions met with the colloquialism ‘mad cow’, women are frequently heard as mad. Men are heard as mad too, but they are not called ‘mad bulls’ or ‘hysterical men’. All too readily, and seemingly uncritically, women are linked with madness in everyday culture.

Hysterical comes from the word hysteria, meaning ‘of the womb’, deriving first from classical Greek and then Latin. The nineteenth and early twentieth centuries were the heyday of hysteria: one in which this old-fashioned medicalised term for madness could be coupled with a new, cutting-edge surgical cure in the form of a hysterectomy that removed a woman’s uterus. The historical belief that a woman’s physical body—her womb—could cause madness was still prevalent. Hysteria only ceased to be part of the medical lexicon in the 1950s.

Yet historical medical and cultural beliefs, some spanning thousands of years, still underpin the conscious and unconscious cultural uses of these terms today. Women are still being heard as transgressing institutional power structures, and being labelled as mad as a result. Why are women so readily heard as mad today, and in the past? In the asylum, how and why did medical men interpret what they thought they heard as mad? Historical analysis of the practices of hearing women’s madness in the asylum reveals much about why these antiquated perceptions linger into our present.

The physical presence of the asylum is long gone from the twenty-first-century landscape, with former buildings surviving only as repurposed exclusive, gated residential communities, or university campuses. Yet the horrors the word evokes still haunts the present. The word asylum originally meant a retreat from the world, and yet by the early nineteenth century that word was also equated with the horrors of incarceration, and the social stigma carried by women, men and children kept there.

To be inside an asylum was to be outside of cultural norms. In Britain, America, Canada, Europe, South Africa, India and Australasia, those experiencing mental illness were incarcerated in purpose-built asylums, later called hospitals. They comprised symmetrical architectural structures with wards for women on one side, and for men on the other. The sexes only mixed officially under strict medical supervision. Permanent gender segregation finally ceased in the 1960s.

Bedlam Hospital at Moorfields in London, 1730. Image is author’s copy.

The daily asylum regime was divided into regulated gendered activities for those able to participate: work (domestic for women, or gardening, agricultural or industrial for men); segregated religious services; and sports, concerts or dancing, that might be mixed. Margaret Isabel Wilson, institutionalised in America during the 1930s, in her published memoir described these regulated sounds: ‘[t]here were bells, bells, bells; [and] orders, orders, orders’ governing every aspect of life. These institutions were intended to re-instil morality, gender roles, and order, where possible.

At all times, patients’ behaviours were listened to, heard and interpreted by the medical staff, as well as any official visitors to these institutions. At the Ipswich Asylum, Queensland, Australia, in 1930, when several patients petitioned both the Queensland Times’ journalist and members of the official party visiting the institution, about their ‘fancied grievances’, the Home Secretary ‘listened attentively to what some men had to say about the conditions at the hospital’. But ‘invariably, however an odd word here and there, or the general trend of the complaint served to show … that the grumblings were all born of deranged minds.’ To authorities they sounded mad. Many patients knew the power of the way their words were heard by medical staff. American Lydia A. Smith, in her 1898 memoir concluded: ‘Yes, all you could say and all you could do would only be some symptom of the fatal disease’.

The Hospital of Bethlem [Bedlam], St. George’s Fields, Lambeth: The Female Workroom. Wood engraving probably by F. Vizetelly after F. Palmer, 1860. Image via Wellcome Collection.
This ‘medicalised hearing’ was also replete with conscious and unconscious biases centred on masculine assumptions of gender, class, religion and race. Women were considered biologically susceptible to madness because of medical beliefs about their physical inferiority to men, and the influence their wombs were thought to have on their mental state.

These perceptions worked in tandem with gendered Christian creation beliefs: Eve was formed from Adam’s rib; Eve listened to the snake in the Garden of Eden and ate the apple; Eve then tempted Adam to eat the apple from the Tree of Knowledge, which he did; and as a result God threw Adam and Eve out of Paradise. Eve suffered the consequences of her sin, as she was to suffer the pain of childbirth for eternity. These medical perceptions bound up with biblical understanding of women, as either whores or virgins, governed women’s medicalised experiences within the asylum, and the ways they were heard.

Madness was considered audible to medical experts, and governed by the law. By listening closely to the speech quantity and quality it was thought possible to determine whether someone’s conversation complied with or violated particular patriarchal norms. The medical account of Olga L., in the Adelaide Receiving House in 1952, demonstrates this practice. Olga’s medical certificate at admission provided a censored and sanitised version of the slander the doctor said she heard: ‘She complains that voices over the air call her filthy names and accuse her of shop-lifting clothes from Myers’. The reference to shoplifting also implied a breach of the law.

‘The serpent entwines itself around the body of Eve.’ Walter Crane, 1899. Image via Wikimedia Commons.

But detailed doctor’s notes also survive revealing another account of what Olga sounded like: ‘[J]ust look at that fat bitch, the fucking bastard! She set fire to her house. She stole clothes’. Olga’s language is heard as bad, and recorded in two different ways. As historian Greg Denning, in another context concluded, it was not so much the violence of the delivery of bad language that set it apart, but rather those hearing it being unable to position it within the discourse of certain power relationships. Asylum records, like that for Leila K. in 1917, demonstrate this transgressive dichotomy between compliance and deviance: she wrote letters that were ‘coherent + fairly sensible’, yet her ‘language [was] very foul at times’.

Asylum women spoke, but their voices were heard as mad by gendered medical ears, that acted to normalise masculine understandings of power, gender roles, and the distinctions between reason and madness. The provision of hyper-gendered asylums whispered and shouted patriarchal perceptions of order and submission into the ears of mad women. But as Adeline T P Lunt, in her published memoir (1871) candidly observed: ‘the very same opinions that might be expressed [by patients] in any polite society[,] I the world, measured by narrow judgement, — and in fact they [asylum staff] are always alert to catch a ray of disease, — are again (in the asylum) openly denounced as “crazy talk”’.

Charting these flawed perceptions, over time, enables us to hear the genesis of deep-seated and deeply held understandings of madness as gendered. Given this history, we need to actively call out and debunk out-dated historical thinking when we hear it coming from the voices of men and women in the institutions of the parliament, the academy, the law, the medical fraternity, and the press today.


Dolly MacKinnon is an Associate Professor at The University of Queensland. Her research background engages with history and music. Her cultural history research spans the early modern to the modern and concentrates on hearing the histories of the marginalized and institutionalized by analysing the mental, physical (including material culture) and auditory landscapes of past cultures.

For her groundbreaking work on hearing madness and sounding cures, first published in 2003 and republished in 2017, see Hearing madness and sounding cures: recovering historical soundscapes of the asylum’, Politiques de communication 2017/3: 77-106.

Copyright remains with individual authors who grant VIDA holding a perpetual, world-wide, royalty free and non-exclusive license to use, distribute, reproduce and promote content. For permission to re-publish any VIDA blog post, in whole or in part, please contact the managing editors at auswhn@gmail.com.au



This entry was posted in Mental Health. Bookmark the permalink.