Insanity

Insanity in the Early Republic

Insanity became an important public concern at the time of the nation's founding. After the American colonies declared their independence by separating from England, a new nation was established based on Enlightenment concepts of science and reason and republican ideals grounded in a patriarchal government and a citizenship of rational, independent white males. But mental illness seemed to pose a challenge to a society founded upon these principles. Political leaders feared that male insanity weakened the new nation by reducing male citizens to the mental level of their supposed intellectual inferiors; namely women, children, and slaves.

The association that early American leaders drew between manhood, rationality, and republicanism resulted in the construction of numerous mental asylums in the early republic. The Pennsylvania Hospital, directed by the physician Benjamin Rush from 1783 to 1813, treated patients as dependent children (the opposite of independent manhood), with physicians and attendants acting as parents. The paternalistic environment that pervaded asylums in the early nineteenth century encouraged physicians to focus on the behavior of the patient, on observable symptoms, rather than on the disease itself. Rather than attempting to find the cause of emotional outbursts or childlike behavior, physicians attempted to retrain men to act within the confines of an accepted masculine ethos. Once male patients consistently avoided their so-called errant behavior, physicians released them into society with their abilities to reason and rights as citizens fully restored. In this context, Rush's method of treatment fully embraced republican concepts of manhood, supporting the paternal hierarchy and male intellectual supremacy.

The Nineteenth Century: Masturbatory Insanity and Neurasthenia

The American belief that insanity was inconsistent with manhood and republican citizenship remained consistent throughout the nineteenth century. However, the onset of the market revolution and rapid urbanization prompted physicians to identify “new” mental illnesses that, while affecting both genders, were particularly troubling in men, since men were primarily responsible for economic production and other public endeavors.

One newly identified form of insanity was masturbatory insanity, which began to appear in record numbers beginning in the 1830s. Concerned that masturbation threatened the emerging masculine imperatives of the market society (i.e., the self-control, economic productivity, and reproduction necessary to national strength), physicians increasingly linked it to insanity. Physicians generally agreed that masturbatory insanity was caused by excessive stimulation, but they disagreed over what kinds of stimulation were most dangerous. Some believed that the proliferating leisure activities available in growing urban centers, such as going to saloons, attending theaters, and reading newspapers, corrupted men's minds with sexual images that encouraged masturbation, which led to insanity. Others argued that the pressures of market competition drove men to masturbate in an effort to relieve their tension. Both of these theories linked insanity to men's failure to conform to cultural expectations of masculinity; that is, to operate effectively in a market society and to exercise self-control.

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