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Hearing Voices. Brendan Kelly
Читать онлайн.Название Hearing Voices
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isbn 9781911024446
Автор произведения Brendan Kelly
Издательство Ingram
Attention is also devoted in Chapter 6 to the emergence of military psychiatry in Ireland, the ill-fated Health (Mental Services) Act 1981, the opening of new acute psychiatric units in general hospitals, issues relating to mental health nursing, the 1984 policy, Planning for the Future, and the outstanding contribution of Professor Anthony Clare to psychiatry in Ireland and beyond. Chapter 6 incorporates considerations of the emergent emphasis on human rights in mental health in Ireland and the role of international human rights movements in creating a context for changes in policy, law and social perceptions of mental illness and psychiatry.
Chapter 7 explores the recent history of psychiatry in Ireland in the early twenty-first century, looking at the Mental Health Act 2001; the 2006 policy, A Vision for Change; the development of child and adolescent psychiatry; the Irish Journal of Psychiatry (1982), the Irish Journal of Psychological Medicine (1982) and other professional journals in Irish psychiatry; the emergence of the College of Psychiatrists of Ireland (2009); and the 2015 review of the Mental Health Act 2001. Important service developments are explored, including the ongoing move to community care, the evolution of the National Forensic Mental Health Service and mental health services for the deaf.
The final chapter, Chapter 8, focuses on the future of psychiatry in Ireland in light of the historical analyses presented in earlier chapters, as well as recent data. This concluding section focuses particularly on interactions between psychiatry and society; societal ‘structural violence’ and social exclusion of the mentally ill; postpsychiatry and other reformist movements; suicide; ongoing issues relating to human rights; and likely future developments in clinical, academic and historical psychiatry. The book concludes with a consideration of the overall future of psychiatry in Ireland, based on events and trends over past centuries and informed by the state of psychiatry in early twenty-first century Ireland.
Throughout the book, extensive details of primary and secondary sources are provided for readers who seek further information on any topic. I have devoted particular attention to citing and quoting primary material and cross referencing to the secondary literature, with an especially strong emphasis on publications relating directly to psychiatry in Ireland. It is hoped that this extensive quotation, citation and referencing will assist future researchers.
For the most part, practicing psychiatrists are not discussed in depth, although some are mentioned. For recently retired or recently deceased psychiatrists who are discussed (especially in Chapter 6), it is too soon to present a historically informed, critical appraisal of their contributions. As a result, my accounts of recent figures should not be read as critical, historical analyses of their lives and work, which would be premature at this short remove, but as summaries of their careers and achievements (with some brief comments). Future historians will be better placed to comment critically on the enduring effects of their work, and hopefully the brief accounts presented here will assist in informing such assessments.
Finally, throughout this book, original language and terminology from the past and from various archives and reports have been maintained, except where explicitly indicated otherwise. This represents an attempt to optimise fidelity to historical sources and does not represent an endorsement of the broader use of such terminology in contemporary settings.
1
THE BIRTH OF PSYCHIATRY IN IRELAND
It is not considered desirable in certain circumstances to have a flat-footed man dealt with as lame, but in other circumstances it is considered desirable and it is done. In like manner, in certain circumstances, it is not considered desirable to have a particular kind or degree of mental unsoundness dealt with as lunacy, but in different circumstances this is considered desirable, and it is done.
It is thus plain that the number of registered lunatics in a country is not a fixed figure, which cannot be increased or diminished. On the contrary, it is a figure which can be made to change greatly through the operation of many and varying causes; and it is obvious that this should not be forgotten by those who are deciding what ought to be the relations and duties of the State to the insane.
Committee on Lunacy Administration (Ireland),
Second Report of the Committee Appointed by the
Lord Lieutenant of Ireland on Lunacy
Administration (Ireland) (1891)1
The history of psychiatry is interesting, important and complicated to unravel.2 In Ireland, this history commences with the prehistory of psychiatry in the Middle Ages and early modern era, and continues with explorations of Gleann na nGealt (Glenn of the Lunatics) and Mad Sweeney (in the twelfth century), and Brehon Law (up to the seventeenth century). The emergence of new forms of institutional care is explored, as are the lives and works of Sir William Fownes and Jonathan Swift, both of whom were connected with the establishment of St Patrick’s Hospital, Dublin, in 1746. Burnham’s ‘drama’ of the healer3 features strongly in the form of Dr William Saunders Hallaran and the succession of enthusiasms for new treatments that emerged in Ireland (and elsewhere) in the late 1700s and early 1800s. This is how it all began.
The Middle Ages and Early Modern Era
Early understandings of mental illness in Ireland, as in other countries, focused on supernatural and religious explanations for the unusual beliefs and behaviour displayed by persons who would later be regarded as mentally ill.4 In pre-Christian Ireland, it was believed that druidic priests, acting for pagan deities, could induce madness by throwing a ‘madman’s wisp’ (a ball of grass or straw) in a person’s face.5 Fullon, a druid of Leinster around 600 BC, was reputedly the first to cast such a spell, initially making incantations on the wisp of straw and then throwing it at his victim.6 A similar fate befell Comgan, son of Maelochtair, King of the Decies in Munster in the seventh century, when a young woman he spurned persuaded a druid to throw a magic wisp on him, leading to skin ulceration, baldness and madness, interspersed with periods of lucidity during which the unfortunate but still articulate Comgan robustly declaimed poetry and prophecies.7
The moon was commonly linked with madness in early Ireland and there was a belief that a seaside rock in Dunany, County Louth, known as Cathaoir Ana (Madman’s Chair), attracted the mentally ill, who could be cured by sitting on it three times.8 Conversely, those who were not mentally ill and sat on it might become mad. According to another account, if a mad person sat on the rock during a period of lucidity, that lucidity would be maintained because the mental state of the person at the time he or she sat on the rock would be so fixed for life. Early Irish literature and folklore are full of other references to madness and various unusual psychological states. Stories such as the Cattle Raid of Cooley (Táin Bó Cúalnge), the central epic of the Ulster cycle, as well as many other strands of Irish folklore, present vivid descriptions of altered states of mind and diverse kinds of madness.9
The arrival of Christianity saw the emergence of beliefs that insanity was attributable to possession by the devil or punishment by God, and the phrase duine le Dia (person of God) came into common use for persons with intellectual disability. One story claims that St Mochuda cured a man of madness (owing to demonic possession) by interceding with God.10 Another tells how a Norman archer became mad after entering the sacred area surrounding a perpetually burning fire lit by St Brigid in Kildare.11 This man blew on the fire and became insane, blowing into people’s mouths and running from house to house blowing on every fire he could find. He was seized by his comrades and, at his request, brought to water where, thirsty from all the blowing, he drank so much that he burst and died on the spot. Another man tried to enter the circle around St Brigid’s