Historian Ute Oswald explores the role of religion in nineteenth-century asylums and questions the therapeutic benefits of engaging in similar practices today.
Can religion make us feel better? Are religious people less likely to suffer mental ill-health, or does religion exacerbate it? Research by David Rosmarin and Harold Koenig suggests that spirituality and religion are ‘strongly tied in both positive and negative ways to (…) mental health.’ They also concede that both ‘can clearly inform our understanding of the cause and etiology of mental disorders and also enhance methods of clinical treatment’ (2020, xvii). Looking back at the nineteenth-century asylum offers a historical perspective to this pertinent debate.
Nineteenth-century asylums have frequently been portrayed as places of confinement, repression and gloom. However, there is a very different side to these institutions. Amongst a new belief in the curability of insanity, the so-called ‘moral treatment’ regime emerged at the turn of the century, existing alongside, and often in competition with, medical treatment. It was ‘not so much a specific technique, as a range of non-medical treatments designed to involve the patient actively in his recovery’ (Digby 1985, 53). This range included patient occupation, recreation and religion.
My PhD research focused on the aspect of recreation in private, charitable and pauper asylums in England and Scotland, which included plays, music, art, creative writing, reading, sport and balls. Embarking on this research, I immediately noticed a strong link between recreation and religion, as the chaplain was often responsible for some of the so-called ‘rational recreations’, such as the library, educational classes, lectures, and more casual amusements such as Magic Lantern shows. The archives contained detailed chaplains’ reports and journals, and superintendents also frequently referred to religious activities; religion obviously played a significant role in the asylum set up.
I included some initial findings as a chapter in my thesis, but realised pretty swiftly that this had the potential for a bigger postdoctoral project. The topic raises many questions. How exactly did religion fit into the asylum routine? How did asylums negotiate the tension between religion as cause for disorder but also as potential cure? Which other benefits were ascribed to it? How were patients of different denominations accommodated (or not)? How can this inform mental health practices today?
Asylum Legislation and Religious Services
The Amending County Asylums Act of 1828 had stipulated that every county asylum should appoint a chaplain for Sunday services. Following further legislation in 1845, which made the erection of county asylums mandatory, religious activities became more fully incorporated into the daily and weekly asylum routine and religious denominations were increasingly entered on patients’ admission records. Asylum chapels could be situated within the main buildings or detached in the grounds, like the magnificent Memorial Church at the Crichton Royal Institution in Dumfries. Sunday services (usually at 11am and 3pm) tended to be well-attended, weekday ones less so as patients were busy at work.
Some chaplains responded by offering services in workshops and the laundry rather than the chapel. Services in asylums were shorter than in wider society, and topics and language of sermons were adjusted. In The Good Asylum Chaplain, the anonymous author recommended that ‘in his sermons [he] remembereth the peculiar class of persons whom he addresses, and escheweth all theological disputations; he is simple in his language, loathes affectation, is earnest in the manner and consolatory in the matter of his discourse’ (Anon 1893, 400). Interestingly, some asylums also accommodated the special religious needs of Roman Catholic and Jewish patients.
The laws demanding the provision of religious services in asylums were not unanimously welcomed by physicians. As ‘religious insanity’ was a frequent diagnosis, concerns were raised with regards to exposing patients with this affliction to religious activities which might exacerbate their condition. Superintendents, madhouse proprietors and clergymen debated the potential of religion as a cause for disorder, reaching different conclusions. Religious insanity caused by ‘impassioned preaching’ was labelled as ‘perversion of religion’ and offset against ‘true religion’ (Conolly 1847, 123).
Sometimes, a certain predisposition was held responsible for religious insanity; in other accounts, religious insanity was understood as a mere symptom rather than a cause. Invariably, opinions on making religious activities available to those suffering from religious insanity differed too. For some physicians, it made no sense at all exposing patients to further religious discourses. For others, it was part of their cure. Practices and approaches varied widely.
Religious Activities: Management or Cure?
Despite the apparent diversity of opinions on religion as a potential cause of mental disorder, a significant number of physicians saw great healing potential in religious activities for asylum patients. The variety of benefits proclaimed ranged from ‘remedial usefulness’ and ‘enjoyment’ to ‘comforting’ and ‘subduing’, indicating both therapeutic and managerial advantages. . Behaviour at services was used as a barometer of recovery, as here patients could demonstrate ‘decorum’ and self-control. Reverend Henry Hawkins, chaplain at Colney Hatch Asylum, saw the ‘relief to the monotony’ as another benefit. He stated that ‘the walk to and from chapel and its services are a break in the day’, which was not classed as ‘a chief advantage; still, it is not valueless’ (Hawkins 1894).
Several patient statements seemed to confirm the benefits claimed by clergymen and superintendents. At Littlemore Asylum in Oxford, a former female patient told the chaplain that ‘when she was in a most distressed and lost state of mind she found great comfort from the words of one of the Psalms’. . Other discharged patients explained how it ‘enabled them to bear their affliction, and temporary “confinement” with much greater patience’, and how it offered ‘support and comfort for the remainder of the week’. .
Religion and Mental Health Today
Why is this important? And how relevant is it in today’s reputedly ever more secular Western society? Alternative therapies such as art, drama or sport figure prominently in current mental health debates. And rightly so. For example, the Creative Health Review by the All Party Parliamentary Group on Arts, Health and Wellbeing reported clear correlations between engagement in creative activities and greater well-being. However, as Paul Summergrad suggests, ‘spirituality and religious experience are too central to human experience and culture for mental health professionals or other clinicians to ignore’ (2020). In fact, recent studies have shown that religious people report to be happiest (Stavrova et al 2013).
Using the evidence from asylum history, then, how might we harness the suggested powers of religion and spirituality and use them in our modern lives? Or, in recognition of the dangers of over-religiosity and of state religion (Lozano 2017), should we instead include more of the meditative, mindfulness-based approaches, which have long been linked to improved mental health, in our daily lives? Recent posts by Harvard Health Publishing and Time magazine seem to encourage us to do so. They suggest that we can retrain our brain and control stresses and strains, perhaps even leading to greater happiness. I, for one, will give it a try!
About the Author
Ute Oswald is an Early Career Fellow at the Institute of Advanced Study and an Associate Fellow at the Centre for the History of Medicine, both at the University of Warwick. Her research focuses on the history of asylums and non-pharmaceutical therapies. You can read more about her work here. She tweets at @uteoswald.
. Oxfordshire History Centre (OHC), OHA WP80 1846, Annual Report of the Warneford Asylum, 1846, no page numbers; OHC, OHA L1/A1/2/3, Annual Reports of Littlemore Asylum 1867-1875, Chaplain’s Report, 1871, p. 26; London Metropolitan Archives, H11/HLL/A/5/4, Annual Reports, Hanwell Asylum, 1854-1857, Chaplain’s Report 1854, p. 117; Browne, ‘What Asylums Were, Are, and Ought to Be’, in Scull (ed.), The Asylum as Utopia, p. 211.
. OHC, OHA L1/A1/2/1, Annual Reports of Littlemore Asylum 1847-1861, Annual Report 1860, p. 18.
Anon. 1893. “The Good Asylum Chaplain”. Journal of Mental Science 39, no. 166: pp. 399-401.
Browne, W.A.F. 1991. ‘What Asylums Were, Are, and Ought to Be (1837)’. In The Asylum as Utopia: W.A.F. Browne and the Mid-Nineteenth Century Consolidation of Psychiatry, edited by Andrew Scull. London/New York: Routledge.
Conolly, John. 1847. The Construction and Government of Lunatic Asylums and Hospitals for the Insane. London: John Churchill.
Digby, Anne. 1985. “Moral Treatment at the Retreat, 1796-1846”. In The Anatomy of Madness: Essays in the History of Psychiatry II: Institutions and Society, edited by W.F. Bynum, R. Porter, and M. Shepherd, 52-72. London/New York: Tavistock
Hawkins, H. 1894. “’Ut Co-operatores simus’: A Plea for Daily Services in Asylum Chapels”. Journal of Mental Science, 40, no. 170: 424-426.
Lozano, F. 2017. The rise of secularism and its economic consequences. IZA World of Labor 384 doi: 10.15185/izawol.384
Rosmarin, D.H. and H.G. Koenig. 2020. Handbook of Spirituality, Religion, and Mental Health. Cambridge, MA: Academic Press.
Stavrova O., Fetchenhauer D. and T. Schlösser. 2013. Why are religious people happy? The effect of the social norm of religiosity across countries. Soc Sci Res., 42, no. 1 (Jan):90-105. doi: 10.1016/j.ssresearch.2012.07.002
Summergrad, Paul. 2020. “Foreword”. In Handbook of Spirituality, Religion, and Mental Health, edited by D.H. Rosmarin and H.G. Koenig, xiii-xv. MA: Academic Press.