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The
Architecture of Madness: Insane Asylums in the United States,
by Carla Yanni.
In the United States today, insane
asylums could be said to be revered more by urban
explorers, and those with a penchant for ruins,
than architects and architectural historians. But one look
at the massive edifices sitting on acres of land, and it
is apparent that much went into the construction of these
facilities, much that needs to be addressed. Carla Yanni's
book fills the gap in knowing why these asylums came about,
why they look the way they do, and why they disappeared
or were abandoned.
While previous books have addressed the first and last considerations,
they tended to ignore the physical aspects of the buildings,
and the author's main contention is that the architecture
cannot be separated from the treatment of the patients:
they are linked strongly, to the extent that many of these
buildings cannot be renovated to other uses as their designs
were so particular to their cause.
A professor of art history, Yanni's
very readable (i.e. non-academic) text starts in the 18th-century,
with the establishment of dedicated facilities for the treatment
of the insane, and ends in the current decade with the Clubhouse
model, though the majority of the book focuses on the 19th
century, specifically mid-century when the Kirkbride plan
dominated the shape of the Victorian asylum. Simply put,
psychiatrist Thomas Kirkbride believed
that the treatment of the insane could not be facilitated
at home, a typical hospital, or any other facility, so he
developed what is known as the linear plan, though in effect
it is a stepped series of long, single- or double-loaded
corridors (à la the red insignia on the book's cover)
that separated men and women in separate wings and isolated
the most severe cases in detached structures most removed
from the central administrative area. This inefficient,
potentially ever-growing footprint required a lot
of land, something that meshed with the belief at the time
that mental treatment is best achieved in close contact
with nature, not the city. Therefore most of these 19th-century
edifices are removed from not only urban cores but the families
of patients.
What is perhaps most fascinating
about Yanni's architectural-social study of these asylums
is how they addressed the home and family, from their role
in causing mental problems and thereafter aiding in (or
staying out of) treatment to their impact on the architecture
of the buildings, especially the interiors. For example,
Kirkbride's plan gave each patient a room, small to be sure,
but with a window and privacy, the last in many cases something
the patient might not have had at home. Within this lies
a paradox: replicating certain aspects of the home while
feeling the need to remove the individual from it for competent
and total treatment, as if the home or the family were the
primary source of the mental malady and would be a continuing
strain on the insane.
These considerations never received
full resolve in Kirkbride's and other's models, as 20th-century
science and medicine eventually made mental illness treatable
via prescription drugs and psychiatric sessions, replacing
the need for large-scale hospitals and their impressive
architecture. The uneasy relationship between the home and
the mentally-ill state of mind still lingers in the Clubhouse
model, though, an outpost that gives people somewhere to
go besides home, therefore speeding up their recovery. While
the Clubhouses are far removed architecturally from the
Victorian asylums -- the latter grandly designed in neo-stylistic
flourishes that bordered on the civic or religious and the
former low-key urban infill or renovation projects -- this
and other aspects linger, making that strong link between
the architecture and the treatment ongoing, if diminished
in scope and scale.
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