My purpose in doing this is to learn more about the history of psychiatry and neuroscience, focusing on Meyer's role in trailblazing a sudden change in the rituals of psychiatric care in a more humanized way. I hope that in deep-diving into original copies of Meyer's diaries, notes, publications, and personal correspondence that I will better understand his visions, claims, and practices, as well as distinguish how the Phipps set itself up to be a humane alternative from abusive insane asylums and the extent to which professionals there saw how much more effective their treatment was for a person to move back to a state of health. I think it is extremely interesting to study the history of psychiatry because in a way, it is studying the history of people and their surrounding societal culture at the time; it is intriguing to study how various individuals have seen themselves in comparison to other "normal" citizens in society, and why this perspective changes as a result of historical and social forces. As a strong advocate for mental health issues, I find that in understanding this field's history, that I can better understand the perspectives of my elders, whether that is my parents or grandparents, on mental health and its stigmatization. I believe that in order to find solutions and have meaningful conversations with someone who may disagree with you, that you must aim to understand their perspective as much as possible - I strongly believe mental health issues would not face nearly as much stigmatization if more people studied its history.
Pictures of the Phipps Psychiatric Clinic
Adolf Meyer is such a significant figure in the history of psychiatry because he arrived at a time when he had to reconfigure the public's negative perspectives of psychiatric institutions since the abuses of insane asylums had begun to be realized, but people were still grappling to resolve how to best help their mentally diseased loved ones. Therefore, Meyer had to challenge common beliefs of hereditary stigma, the incurability of insanity, and the horrific conditions of all psychiatric institutions throughout his process of creating the Phipps Psychiatric Clinic. Not only did Meyer establish psychiatry as a science-based medicine, but he established a relation between the hospital and the home with prevention and aftercare and expanded public and medical perspectives of which conditions or symptoms warranted the use of psychiatric care, placing a huge emphasis on a person's willingness to accept mental help as an indicative phase in which mental abnormalities could be modified. For all of these reasons and more, I chose to study Adolf Meyer along his revolutionary journey in the history of psychiatry.
Picture of Meyer from archives
Before my journey began, I had to do some pre-work with some of the archivists at the Alan Chesney collection so that I could have access to some of its exclusive material. After connecting with my Reference Archivist, Andy Harrison, I soon learned that the collection had a whopping 766 boxes of documents and artifacts that span Adolf Meyer's life from 1866-1950 which was WAY too much for me to read in a couple days! Therefore, I decided to focus on the time between 1908-1915 during which Meyer was in the process of planning the creation of the Phipps Psychiatric Clinic, as well as finally opening and beginning its operation with patients in 1913. Even so, there were thousands of documents within this time period, so after telling Andy about my research goals, he found a couple hundred artifacts for me to analyze when I came to the archive for two days.
I arrived at the archive at 10AM on Wednesday morning, meeting the JHU staff and getting acquainted with the area. It was great to finally meet Andy to put a face to the guy I was emailing!
Andy is on the far right of the top picture. The other picture is the sign into the medical archive room and on the right are the hundreds of documents I went through!
For the next two days, from 10AM to 5PM I read countless amounts of documents spanning Adolf Meyer's career at the Phipps. Below, you will see the first sketches of the Phipps clinic, with the last picture showing a final blueprint of plans. It was really interesting to see sketches from the preplanning stage to opening days.
Mr. Phipps had announced his intention to make the gift of the clinic in the summer of 1908 but ground was not actually broken until July, 1910. I later learned in documents that this was because Mr. Grosvenor Atterbury, the architect of the clinic, went to Europe with Meyer to study psychiatric clinics there and as a result revised his architectural plans before their final acceptance on July 15, 1910. However, more problems arose towards expenses of the clinic, since Meyer and Atterbury's new plans were far more expensive than the original $58,300 Phipps had agreed to donate. Reasonably so, Phipps refused to pay more than his previous agreement so Meyer was forced to revise his budget and plans again, abandoning two of three laboratories which he planned to establish as integral parts of the clinic (for neuropathology and psychology). Needless to say, Meyer was deeply disappointed that the new venture had to start on a restricted basis but he was determined to get this first psychiatric clinic opened in America.
I read much of Meyer's correspondence with Atterbury, as they discussed meticulous plans for the clinic. From electrical units to hydraulics, each man put much thought in every detail of the clinic. For example, they wanted to put elevators in the clinic for patient ease, and were wary about having too many or too few light fixtures since it could disrupt the behavior of the patients. In one letter, Atterbury talked about the wall colors for the patients, seeing in Europe that more anxious people should have blue walls while more depressed people should have red walls. I found this interesting because it had striking similarities to morale architecture in the asylums. Atterbury even ended up writing "Hospitals and Esthetics" to show his reasonings behind his design of the clinic.
One of Meyer's letters to Atterbury, explaining that he should keep in mind first and foremost how to provide an environment in which the patients want to stay in the clinic for treatment, not leave.
I also went through a large amount of Meyer's journals in which I found many interesting quotes that highlight his unique view of psychiatric patients which I will include below:
1. "Nor should we expect that any one-sided method will get at the facts or that any single scheme of therapy will be effective to the exclusion of all others." - The Scope of Psychopathology
2. "One thing is certain. We have to get away from the idea of 'one person, one disease.'" - The Aims and Meanings of Psychiatric Diagnosis
3. "Freedom is not chaos; it is choice, and choice implies rejection as well as espousal." - The Contributions of Psychiatry to the Understanding of Life Problems
4. "What is wanted is more willingness to study the facts and to create perspective and less authoritativeness." - The Contributions of Psychiatry to the Understanding of Life Problems
5. "...it is the so-called mental aspect, including the understanding of the person; of that aspect of the person which is likely to guide or misguide public opinion - that which constitutes the moods and morale of the patients and the willingness and capacity to accept and use assistance and to develop a real conscience about health." - Inter-Relations of the Domain of Neuropsychiatry
6. "The insane are not a definite class destined for good or bad." - The Problem of the State in the Care of the Insane
7. "The progress in the study of mental disorders according to their nature and not merely in bulk has brought many worthy consequences." - The Problem of the State in the Care of the Insane
8. "It (mental hygiene movements) is a direct service to the positive needs and opportunities of the community in behalf of what I reemphasize as health, happiness, efficiency, and social adaptation." - Individualism and the Organization of Neuropsychiatric Work in a Community
Meyer's "Points to be Considered During Construction"
The Phipps Clinic opened at an extremely significant time in the history of general medicine, as the hospital was transformed to a site of medical expertise, research, and training. Meyer attempted to offer psychiatry a hospital model of patient care, and aimed to bring the field to emphasize the "patient as a person." While others saw psychiatry in a custodial state, Meyer spoke hopefully about the possibility of curing mental diseases at the Phipps. In opening up the Phipps, Meyer created countless opportunities for new discoveries to be made in the field.
General information about the Phipps given to patients upon arrival
Luckily, I was able to purchase scans of any document that I may want to look at for later research so I should be getting about sixty scans in the next couple weeks to hopefully use for research on my junior tutorial paper! I am excited to continue researching Meyer this year - I hope to find out more about the hidden voices of some patients at the Phipps who might not have had a good experience or could have been unrightfully turned away. On the path to progress, it is hard to be perfect as Meyer constantly strived to be when turning away and taking in patients of varying mental statuses. In discovering more about patient care, I think I will see some of the difficulties and downfalls of the progress he was attempting to make in psychiatry.
Thank you so much to everyone on the Rosenkrantz Committee for making this research dream a reality! I learned so much on this journey and can't wait to expand upon my research this year and beyond.
Me on my last day in the archive!
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