Given this broad blanket, which quickly wrapped many within its folds, moral insanity proved controversial, even within psychiatry. As a general concept, it had been questioned in France since 1810, in Germany since 1822. After all, as one doctor pointed out, its symptoms were such that they could “arise in the bosom of anyone, sane or insane… We might not call that insanity. We might say truly, his temper has got the better of him.”7 In time, its critics would declare it a “misfortune for science”8 that the idea was ever pursued at all.
But when Elizabeth was sent to the asylum, its advocates were still passionately defending it, even amid increasing doubt. Psychiatrists arrogantly insisted that just because a person appeared sane in all other ways, they knew better. They were the experts; it was for them to say who had crossed that thinly veiled line between sane and insane.
And more often than not, they opted for the latter. The diagnosis had become so prevalent that McFarland lamented its sufferers multiplied “faster than institutions can possibly be built for their accommodation.”9 Hence the overcrowding Elizabeth had witnessed. Soon, however, McFarland anticipated that would be in the past; he’d recently secured funding for an entire new wing, just for women, to meet demand. The new wards, with space to commit another 150 female patients, would open the following year.
A similar planned extension for men would languish without support from the legislature. It would not be completed for another six years.
Though Elizabeth was not familiar with the term moral insanity, she nevertheless appreciated the true, social reasons behind her committal. It was “to keep me humble, and in my proper place.”10 Her husband had sent her to the asylum “fully determined I should have a thorough dressing down, or breaking in, before he should take me out again.”11
And she understood exactly who was supposed to be doing the breaking in: friendly Dr. McFarland. Indeed, as Dr. Tenny put it to another patient, “I will be your father, mother, sister, and brother, friend, and Doctor.”12 The physicians became ciphers for the absent family members, there to encourage the women to behave.
Their actions lay under the umbrella of what was known as moral treatment, summarized as “the law of love.”13 Intimate relationships between patients and doctors were encouraged, so that kindness and sympathy might draw a patient out, the psychiatrist exerting a positive influence upon her. Already Elizabeth thought of McFarland as “my counselor and guide.”14 The doctor was “a most noble, kind protector.”15 Moral treatment encompassed the environment too, with the building itself and patients’ daily activities engineered toward peaceful recovery. Amid these delightful settings, the insane were to be taught “proper values, morality and healthy habits that would enable them to return to the world as responsible citizens.”16 It was not so much “therapeutic intervention as that of ethical supervision.”17 And doctors’ records show that “cured” women were those who became “quiet, decorous in manners and language, attentive to their dress, [and] disposed to useful activity.”18
Or, as Elizabeth put it, women who’d been broken in.
When McFarland dangled the olive branch before her, Elizabeth considered it. She could have taken it, could have decided that returning to her children was more important than her own sense of selfhood. But, she said, “Self-defense forbids it.”19 She could not shake her conviction: “I have done no wrong.”20 In her letters home to her husband, she begged him to repent. She knew if she went home now, nothing would be different. So she would not submit.
“Old Packard will find his Elizabeth has got the grit in her,” she wrote fiercely. “I don’t think the discovery will afford him much satisfaction. But it does me.”21 She concluded archly, “I think it will be a long time before this cure will be effected.”22
But just because she wouldn’t obey, that didn’t mean she didn’t want to go home.
She simply needed another strategy.
As she gazed at Dr. McFarland in her room—so intelligent, so reasonable, so very sympathetic—she lit upon it. She would stay at the asylum, but of her own volition. She would stay weeks, even months if that was what it took. But she was going to give the doctor the chance to see the truth. She’d been placed here on a false charge of insanity. She didn’t need to be cured. She didn’t need to submit.
She was just as sane as he was.
She just needed to give McFarland a little more time to see it for himself.