The madman: an (auto)biography : Identity and the inner world of the mentally ill based on pre-1948 admission protocols and case reports from a Prague psychiatric hospital
Abstract
This study focuses on the thematization of life and mental disorders based on admission records for the Prague Institute for the Insane from the 1830s. At that time, the Prague psychiatric hospital run alternately by e.g. W. Rilke, A. Nowak,
K. D. Schroff and G. Riedel, was considered one of the best institutions of its kind in Europe. The material for the study is based primarily on anamneses
(Krankheitsgeschichten, Krankensgeschichten) drawn up by rural and urban doctors
(but more often by simple barber-surgeons) for the purpose of hospitalization, and on case reports already drawn up by the senior consultant and house physicians at the
Institute for the Insane itself. The author focuses primarily on the following questions, which are of relevance to the issue of self-thematization, i.e. the thematization of the patient's own "self": Which behaviours were labelled "deranged" or "crazy" by those around the potential patients, and who initiated their hospitalisation and for what reasons? How did the patients themselves explain the circumstances and causes of their "insanity"? How was the disorder subsequently classified and how was it matched to the "treatment", claimed by the Prague Institute doctors to be
"individualized"?
The interviews with the medic who drew up the first medical history and then with the institute doctor compelled potential Prague psychiatric patients to engage in a kind of self-reflection over their own lives and their current condition. The potential patient was meant to deal with family relationships and childhood andadolescent traumas, as well as their attitudes to themselves and their own physicality, and to organize their own, often disorganized, illogical, confused thoughts. Even the terminology, including figurative depictions, with which the "patients" attempted to grasp a sometimes difficult-to-name condition are precious evidence for us of subjective reflections and their self-perception. After all, the statements and visions recorded by contemporary health professionals as evidence of an unhealthy mental state may raise other questions about the way in which some form of existential anxiety was experienced at the time. On a more general level, we can say that the barber-surgeons' "Krankengeschichten" are also evidence of the growing power of the "modern", post-Enlightenment state, which increasingly relied on various forms of "expert knowledge" of relevance to economics and public administration.