‘Women on the Edge: Motherhood & the Family in Turmoil in the Twentieth Century’: Workshop Summary

On the 7 – 8 September 2023, Dr Kelly-Ann Couzens and Professor Hilary Marland and hosted a two-day workshop at the Centre for the History of Medicine, University of Warwick, entitled ‘Women on the Edge: Motherhood & the Family in Turmoil in the Twentieth Century’. The event was generously funded by the Wellcome Trust as part of the ‘Last Taboo of Motherhood? Postnatal Mental Disorders in the Twentieth Century’ (2021 – 2024) project and arranged with the help of our Research Centre Coordinator, Keri Husband. The objective of the workshop was to bring together scholars working in history, criminology and law, whose research explores the relationship between motherhood, mental or emotional states, and criminality within the family, in the long twentieth century. More specifically, we were keen to focus on the role psychiatric, legal, “expert”, and popular thinking has had in understanding “deviant” female behaviour in the past. We were also interested in reflecting upon sources and critical approaches for recovering these complex histories as well as discussing the challenges researchers have encountered in tackling these themes on both a personal and methodological level.

DAY ONE

The workshop commenced on Thursday afternoon with some brief opening remarks, welcoming speakers to the University and detailing how the themes of the event linked with the ‘Last Taboo of Motherhood’ project. Our first session, entitled ‘Perspectives, Sources & Ethical Considerations’ commenced with a paper by Associate Professor Lydia Plath (University of Warwick). Plath’s paper, titled: ‘What To Do With a Plank of Wood? Some Reflections on Writing About Sexual Violence and Its Aftermath in Victorian England’ explored the discovery and response to a piece of wood in Plath’s childhood home that detailed an alleged rape in 1886. Disturbingly, the source suggested that the survivor may have been ‘in the family way’ (become pregnant) because of the attack perpetrated upon her. Plath discussed how this source could be used as a springboard to interrogate broader issues of sexual violence within working-class communities in rural Worcestershire in the 1880s and to explore the liminal and precarious position of women who worked in the local glove trade. Her paper also explored the materiality of the plank of wood as a historical source and the ethics this unique record posed for the development of Plath’s research on this topic.

‘The Last Taboo of Motherhood’ team at the ‘Women on the Edge’ Workshop (2023) (L-R) Dr Kelly-Ann Couzens, Dr Fabiola Creed & Professor Hilary Marland

Following a short break, we began our second session with three papers on the theme of ‘Medicine, Diagnosis & Treatment in the Past’. The first paper was by Dr Alison Pedley (University of Roehampton) and titled: ‘We are still far from possessing an adequate comprehension of the psychology of pregnancy: Criminal Lunacy and Puerperal Mania in Broadmoor Criminal Lunatic Asylum, 1895-1960.’ Pedley’s paper traced change and continuity within the medical regimes of Broadmoor’s chief medical superintendents from the late-nineteenth century to first half of the twentieth century. In particular, she explored the published research produced by doctors David Nicholson (superintendent from (s/f.)1886-1896), Richard Brayn (s/f. 1896-1910), John Baker (s/f. 1910-1920) and Stanley Hopwood (s/f.1938-1952) on women diagnosed as suffering from mental disorders associated with pregnancy, childbirth or lactation. Pedley was also interested in tracing the links these clinicians made between these mental illnesses and suicidal or homicidal behaviours. Although these doctors oversaw and treated a diverse group of patients in their role as asylum superintendents, Pedley highlighted that female ‘criminal lunatics’ who harmed themselves and/or their children while insane, proved a subject of repeated and sustained interest for Broadmoor’s leading medical officials. Her paper also raised important questions around the extent to which psychiatric experts linked maternal mental illnesses to subsequent bouts of mental instability, such as during the menopause (climacteric insanity). Pedley also raised the issue of the role asylums occupied at times as places of both care, and obstetric quarantine, for women suffering from mental illness.

Dr Morag Allan Campbell’s (Independent Scholar) paper: ‘She will be watched carefully: The Conditional Release of Women Prisoner’s From Perth Prison’s Criminal Lunatic Department’ was an excellent follow up to Pedley’s discussion of Broadmoor. Campbell offered a contrasting perspective on responses to maternal child killers within Britain, by exploring the Scottish context as a case study. Using newspaper reports and the institutional records of four women from the north-east of Scotland who had been former inmates of Perth Criminal Lunatic Department in the early decades of the twentieth century, Campbell traced the encounters these women had with the criminal justice system and the regimes of surveillance that followed their conditional release from the Department. Her research emphasized the power authorities exerted over women and their families, as well as the extent to which personal freedoms were curtailed for fear that the Department’s former inmates might relapse mentally or potentially re-offend once exposed to the stresses of poverty, childbearing and family life, once more.

The final paper of the day was given by Professor Hilary Marland (University of Warwick) and titled: “A sophisticated blackmailer: Mothers, Maternal Mental Illness and Bonding in Post-War Britain’. Marland’s paper focused on the development of Mother and Baby Units (MBUs) in Britain after the 1950s, and the extent to which treatment for mentally ill mothers was informed by new ideas within psychiatry around attachment theory and infant bonding. Marland’s research demonstrated that the early pioneers of MBUs, like Gwen Douglas, Thomas Main and Desmond Barton, instigated a radical shift in the treatment of maternal mental illness by admitting mothers, alongside their babies, for treatment in specialized mental health units. This change in treatment practice was informed by the work of John Bowlby and others, who argued that a mother’s failure to bond with her new infant could have a harmful impact on the developing child. MBUs were considered a partial solution to this issue because they facilitated attachment and bonding by keeping mother and baby together at an important stage in the child’s development.

The first day subsequently closed with a small drinks reception in the Faculty of Arts Building, followed by a dinner for the workshop speakers at Scarman Conference Centre.

DAY TWO

The first session on Friday morning was composed of two papers on the theme ‘Framing the Offence of Infanticide in England and Wales’. It began with a joint-paper given by Dr Rachel Dixon (University of Hull) and Professor Tony Ward (University of Northumbria) entitled: ‘On the Edge of Infanticide: Mothers Killing Infants Aged 1 – 18 Months, 1870 – 1938’. Dixon and Ward’s paper explored how mental responsibility was defined and negotiated in cases of maternal child killing and the law from the late-Victorian era to the inter-war years in England and Wales. This period saw significant agitation for reform of the law on infanticide, culminating in the implementation of the current Infanticide Act 1938. Dixon and Ward were particularly interested in how the language adopted in infanticide legislation to describe a woman’s mental state at the time of the killing (namely that the ‘balance of her mind was disturbed’) paralleled the practice adopted in coronial inquests of suicide cases. Dixon and Ward also underscored the close links between maternal mental illness, suicide and child murder within their research, a theme that echoed Pedley’s findings within the context of Broadmoor Asylum. The speakers also discussed how marital status and respectability shaped the responses of courts to mothers who killed, with harsher responses likely to be meted upon single women, rather than their married counterparts.

Professor Tony Ward & Dr Rachel Dixon at the ‘Women on the Edge’ Workshop (2023) Tony and Rachel presented a joint-paper entitled: ‘On the Edge of Infanticide: Mothers Killing Infants Aged 1 – 18 Months, 1870 – 1938’.

The development of infanticide law in the inter-war years was also the subject of Dr Kelly-Ann Couzens’ (University of Warwick) paper: ‘[O]ne ‘of those little wayside domestic tragedies of life: The Infanticide Act 1938 and the Inter-War British Family’. Couzens’ paper explored the role of Viscount Bertrand Dawson of Penn, a royal physician and peer in the House of Lords, who was instrumental in drafting and promoting an infanticide bill that would be legislated (with minor amendments) as the Infanticide Act 1938. Dawson was an important figure in the British medical profession throughout the first half of the twentieth century and was deeply interested in eugenics, birth control and national “fitness”. Couzens argued that Dawson’s involvement in infanticide law reform should be seen as a function of his professional status and identity, unique personal politics and deeply held concerns over population decline worsening in the mid-1930s. As with Dixon & Ward’s paper, Couzens’ research also revealed that marital respectability played an important role in justifying compassionate legal and political responses to women that killed their children, with Dawson keen to frame his Bill as protecting respectable married women from the harshness of the prevailing laws. As a whole, this session highlighted promising new directions of research within the historiography of the Infanticide Acts, as well as exposing challenges in researching histories at the junction between mental illness, law and policy.

Dr Kelly-Ann Couzens presenting her paper entitled: '[O]ne ‘of those little wayside domestic tragedies of life: The Infanticide Act 1938 and the Inter-War British Family’.

The second pannel of the day focused on ‘Motherhood and the Criminal Justice System’ and included two papers focusing on the Irish and English and Welsh contexts, respectively. The session began with Lynsey Black’s (Maynooth University) paper: ‘Murder and Motherhood in Ireland, 1922 to 1964’. Black analysed the profile and criminal justice response toward women prosecuted for murder in Ireland from independence to the mid-1960s. Importantly, most female defendants surveyed in Black’s research were charged with the killing of their own children, making it important for Irish courts to account for violence that challenged acceptable notions of femininity, respectability and morality. Nevertheless, compassion and flexibility could be exercised within Irish courtrooms to such women, especially by jurors who could return verdicts at odds with the weight of prosecution evidence or find in opposition to the sympathies of the sitting judge. Black’s paper emphasized prominently that pathologizing women as sinful, “mentally defective” or (to a much lesser extent) insane, offered discursive mechanisms by which female offending could be explained away. However, these explanations obscured the significant role structural factors (such as poverty, the burden of single motherhood, community opprobrium and the rural/city divide) had in shaping, and making sense of, female offending.

The final paper of the workshop was given by Professor Lizzie Seal (University of Sussex) and titled: ‘Themes of Motherhood in Cases of Racialised Women Accused of Murder and Attempted Murder in Britain, 1950 – 1970’. Seal’s paper explored how ideas of “motherhood”, femininity and emotion emerged within media reporting surrounding the prosecution of four racialized women charged with murder, manslaughter or attempted murder in post-war England and Wales. Seal’s analysis revealed that ideas of motherhood were central to evoking sympathetic responses to violent women, even in instances where the alleged victim was not a child themselves, but the defendant’s partner or spouse. In the case of ‘Willie May P’, charged with the manslaughter of her adulterous husband in 1960, the British press framed the defendant positively as a wife and mother who had suffered as a victim of her husband’s cruelty. Seal also highlighted how racial discourses and paternalistic attitudes shaped the treatment of female offenders at trial too. In the case of ‘Dorette L’, who while heavily pregnant fatally struck down her partner with a water jug, the judge was keen to emphasise that Dorette L was a ‘simple creature’ whom psychiatric evidence had shown to be of ‘low intelligence’. Cumulatively then, this session underscored how ideas of motherhood and femininity were central to framing lay, legal, and media responses to criminal women, regardless of place, identity or victimology. The findings of Black and Seal’s research contribute our understandings of the interaction between motherhood, identity and criminal justice in the British Isles during the twentieth century.

Professor Lizzie Seal gave the final paper of the workshop, with a presentation titled: ‘Themes of Motherhood in Cases of Racialised Women Accused of Murder and Attempted Murder in Britain, 1950 – 1970’

ROUNDTABLE

The final session of the workshop was a summary and roundtable discussion. This provided an opportunity to close the workshop by reviewing some of the key questions, themes and ideas that had emerged in the research presented across the two-day event. The roundtable opened with a discussion of motherhood as a central, recurring and nebulous theme that united all papers. Questions were raised as to what it meant to be a “mother” in the past, who decides if someone is a “mother” or not, and to what extent this role or identity may be tied to time or place. This topic remains central to lay, legal, expert and media reactions to child murder cases, as historically a woman who kills her own children, has been seen to commit an “unnatural” or “deviant” act that transgresses the expectations, and instincts, of her sex. Conversation then focused on policing the boundaries of “good womanhood” and the role surveillance and institutional settings have had in monitoring and shaping women’s mental states in the past. It was noted that marital status and respectability emerged as a surprisingly strong theme across the workshop papers. Indeed, it was striking how dominant married or unmarried motherhood was to diagnoses of mental illness, regimes of treatment for mentally ill women, and to representations of female offenders in the past.

Debate also centred on the extent to which it was possible for scholars to recover the voice and perspective of women as defendants, patients and historical actors, more generally. Asylum records and criminal case files are sensitive records, often subject to restrictions on public access that can last decades. This was remarked on as a particular challenge for scholars using medical and legal records for their research on twentieth-century developments. The workshop closed with a brief discussion of future directions within this field and of historical cases that had stayed with researchers personally. Of note was the extent to which family history research by members of the public had intersected, in sometimes highly fruitful ways, with the formal historical and legal research of some workshop participants. Following the closing roundtable discussion, that lasted approximately one hour, the ‘Women on the Edge’ workshop concluded with a late lunch on Friday afternoon before the company parted ways.

Dr Lynsey Black, Keri Husband, Dr Lydia Plath, Dr Alison Pedley, Professor Hilary Marland & Dr Morag Allan Campbell

‘Born in the Asylum: Insanity of Pregnancy and Unwed Mothers around 1900’

In a previous blog of January 2022, I described the admission and treatment of women suffering from puerperal insanity in two large London asylums, Colney Hatch and Claybury, around the turn of the twentieth century. As well as confining women who became mentally ill shortly after giving birth, a significant number were admitted during their pregnancies, with a diagnosis of ‘insanity of pregnancy’. They were retained in asylums partly for their own safety, as women suffering insanity of pregnancy were seen as particularly vulnerable to suicide. Many subsequently delivered their babies in the asylum. While most of the women diagnosed with insanity of pregnancy were married, single women were also frequently admitted, and asylum doctors noted that these women were particularly liable to mental breakdown.[1] At Claybury Asylum, 56 cases of insanity of pregnancy were admitted between 1894 and 1902; 14 of whom were single women.[2]

A destitute girl throws herself from a bridge. Etching by G. Cruikshank, 1848. Wellcome Images

During the nineteenth century, single mothers, particularly those who gave birth to more than one illegitimate child, often found themselves condemned for their immorality. However, they were also likely to be considered as objects of pity, their mental breakdown said to be prompted by heightened feelings of shame, grief, fear and anxiety about their futures. Dr John Conolly, physician to London’s Hanwell Asylum between 1839 and 1852, described how ‘anxiety, the fear of abandonment, and the pressure of poverty’ were conspicuous causes of puerperal insanity and that ‘some of these causes operate more strongly when the mother is not married’.[3] Even in extreme cases, when such mothers were accused of infanticide or attempting to destroy their newborn child, doctors and courts connected such actions to their desperate circumstances. Such women were described as being victims of betrayal by the men who had abandoned them, alone, in a situation of want, obliged to work, yet in terror of their pregnancies being discovered, all circumstances which exacerbated their mental distress.[4]

Maternity hospitals, in contrast to asylums, recorded relatively few cases of puerperal insanity, as women were generally discharged within a week or so of their deliveries, before their mental disorder manifested itself. Those that did occur were more likely to be women giving birth out of wedlock. Edinburgh based obstetrician, Dr James Simpson commented that unmarried mothers were ‘far more under the influence of depressing moral emotions’ and liable to develop puerperal mania. Their ‘terrible predicament’ then exacerbated the condition.[5] Writing in 1882, Dr Ernest Mackintosh of the Glasgow Maternity Hospital noted the general distress unmarried mothers faced in their daily lives and talked of the ‘overwhelming shame’ of local mill workers and seamstresses who were subject ‘to cold, calculating desertion’ by the fathers of their unborn children. Following delivery these women gave way ‘to paroxysms of weeping’, which threw their nervous systems into disorder.[6]

Not all responses, however, were sympathetic, and by the late nineteenth century childbirth out of wedlock was increasingly linked to hereditary influences. Joseph Wiglesworth, Assistant Medical Officer at Rainhill Asylum in Liverpool, referred to ‘old offenders’ in a language more associated with criminality than mental illness. Women who had attacks of mania after their first confinements out of wedlock, he argued, were likely to become insane again after each subsequent delivery of an illegitimate child. He dismissed the notion that shame and grief prompted their condition, attributing their mania to the same ‘defective inhibitory power’ that caused single women to become pregnant in the first place.[7] Robert Jones of Claybury Asylum was more sympathetic, claiming that, especially in first pregnancies, single women faced ‘the moral shock of disappointment and shame in addition to… nervous exhaustion’. Yet, he also described the role of hereditary predisposition, ‘the baneful influence of an evil heredity’, in nearly 50 per cent of the cases of insanity associated with reproduction at Claybury Asylum, and an enormous 82 per cent in cases of insanity of pregnancy.[8]

Claybury Asylum plan, 1891, Hospitals and asylums of the world. Vols. 1-2, by Henry C. Burdett. Wellcome Images.

While it is likely that birth in the asylum was a relatively common occurrence (Jones claimed 49 cases of insanity of pregnancy were delivered in Claybury between 1894 and 1902), we know very little about the circumstances of the deliveries or how the women were cared for.[9] Asylum case books tended to simply note the date of delivery, to report if the birth was straightforward or protracted, and briefly described the woman’s recovery. Similarly, little information is given about the fate of the baby, though most appear to have been removed to the care of relatives or to a local workhouse. Unusually, a ‘birth book’ has survived in the archives of Claybury Asylum, which recorded deliveries in the asylum between 1893 and 1955. It also recorded baptisms taking place at the asylum, vaccinations, and the removal of the newborn to the workhouse or by the husband or other relatives. Occasionally, the baby remained with the mother and they were discharged together. Sadly, amongst the most striking features of the birth book were the large number of stillborn babies and the deaths of babies shortly after delivery. Of the six babies delivered between October and December 1893, two were stillborn and two died shortly after birth. The mother was single in all but one of the cases where the infant died.[10]

Asylum cases involving single mothers were typified by a blend of despair at the desperate circumstances these women found themselves in, alone, stigmatised and facing extreme poverty, and concerns about their loose morals and poor hereditary status, particularly if they were admitted on more than one occasion to the asylum. In the case of Maud E., admitted to Colney Hatch in May 1900, the hereditary connection was stark, as Maud herself was illegitimate. The initial diagnosis was vague, and it was Maud’s mother – perhaps reminded of her own plight two decades previously – who explained to the asylum doctors that Maud’s melancholia resulted from ‘worry resulting from her pregnant condition’. Aged 21 and a former housekeeper, Maud was noted in the casebook to be depressed and delusional. She refused food claiming it was poisoned, and her melancholia took a religious form, her ‘arms stretched out and praying’. An uncle who also visited, described Maud as previously bright and capable but she became worried ‘over the trouble she had got into’. Maud was delivered of a baby boy in August; forceps had to be used and she was also given chloroform. For a few days Maud denied that she had delivered the baby. However, shortly after the case book noted that ‘she was now satisfied that it was hers’. Maud went on to make a good recovery and was discharged together with her baby in November 1900 after six months in the asylum. The photograph below depicts a happy outcome with the mother and baby leaving Colney Hatch in good health. However, as a young single mother, Maud and her baby were likely discharged to a difficult and uncertain future.[11]

London Metropolitan Archive, H12/CH/B/11/47, Case book for female patients, Dec. 1899-Aug. 1900.

[1] For responses to cases of puerperal insanity taking place out of wedlock during the nineteenth century, see Hilary Marland, Dangerous Motherhood: Insanity and Childbirth in Victorian Britain (Houndmills: Palgrave Macmillan, 2004), ch. 6 and especially pp.154-8. [2] Robert Jones, ‘Puerperal Insanity’, British Medical Journal, 8 and 15 March 1902, 579-86, 646-51, pp.579, 580. [3] John Conolly, ‘Description and Treatment of Puerperal Mania’, Lancet, 28 March 1846, 349-54, p.350. [4] See Marland, Dangerous Motherhood, ch. 6 and Cath Quinn, ‘Images and Impulses: Representations of Puerperal Insanity and Infanticide in Late Victorian England’, in Mark Jackson (ed.), Infanticide: Historical Perspectives on Child Murder and Concealment, 1500-2000 (Aldershot: Ashgate, 2002), 193-215 for the relationship between insanity and infanticide in Victorian Britain. See Kelly-Ann Couzen’s blog of October 2022 on the 1922 Infanticide Act and use of the insanity plea. [5] James Y. Simpson, Clinical Lectures on the Diseases of Women (Edinburgh: Adam and Charles Black, 1872), p.567. [6] Ernest Aeneas Mackintosh, ‘Mental Excitement in the Lying-in: Its Importance with Regard to Maternity Hospitals’, Edinburgh Medical Journal, XXVII (July 1881-June 1882), April 1882, 899-904, pp.900, 904. [7] Joseph Wiglesworth, ‘Puerperal Insanity: An Analysis of Seventy-Three Cases of the Insanities of Pregnancy, Parturition and Lactation’, Transactions of the Liverpool Medical Institution, 6 (1885-86), 349-62, pp.358-9. [8] Jones, ‘Puerperal Insanity’, p.585. [9] Ibid., p.579. [10] Redbridge Central Library, Claybury Asylum, Birth Book 1893-1955. [11] London Metropolitan Archives, Colney Hatch Asylum/Friern Hospital, H12/CH/B/11/47, Casebook for Female Patients Admitted Dec. 1899-Aug. 1900.

‘Women and Mental Illness in Post-War Britain’ Workshop Summary

University of Warwick, 13-14 April 2023.

On 13-14 April 2023, I organised a two-day workshop at the University of Warwick on ‘Women and Mental Illness in Post-War Britain’, with Professor Hilary Marland and the support of our Centre for the History of Medicine Coordinator, Keri Husband. The workshop was kindly supported by the Wellcome Trust, Warwick’s Centre for the History of Medicine and the University of Warwick’s Global Research Priority, Health. The aims of our workshop were to bring together scholars from different career stages, universities, projects and disciplines to exchange ongoing research on women's mental illness in post-war Britain and explore new subject matter, approaches, issues and ethical considerations in the field of women’s mental health history. The workshop focused largely on motherhood and mental illness in connection with our Wellcome-funded project ‘The Last Taboo of Motherhood? Postnatal Mental Disorders in Twentieth Century Britain’. Other interconnected and novel histories were also shared, including research on asylums (Dr Louise Hide) and orthorexia and clean eating in the twenty-first century (Dr Louise Morgan). The papers also addressed the issues of using new kinds of sources and the ethics of working with sensitive materials.

Day One

Panel One: Gender and Mental Health On the first day, after a brief introduction where everyone explained their synergies with the workshop, our first panel explored ‘Gender and Mental Health’. Dr Fred Cooper (University of Exeter) examined women’s mental health through his paper ‘Formidable Discontents: Loneliness, Gender, and Feminism in Post-war Britain’, which focused on the 1950s. Building on the work of Penny Tinkler, Martin Moore and Eleanor Wilkinson, Cooper shared his ongoing research, including experiences of urban and suburban living for housewives. Cooper used an impressive range of visual sources to illustrate the changing tensions and issues regarding privacy, class, companionship and attempts to rectify the decline in neighbourly communities and support networks to resolve loneliness.

Next, Professor Tracey Loughran (University of Essex) spoke about ‘“Ordinary” Unhappiness and Alienation in Women’s Life Stories, c. 1960-1990’. Loughran is the PI of the Wellcome-funded ‘Body, Self and Family: Women's Psychological, Emotional and Bodily Health in Britain, c. 1960-1990' project, which created an intersectional history of gender, body and the self from the bottom-up rather than the top-down. She highlighted the critical issue of normalising unhappiness and how “ordinary” narratives go unnoticed and remain under-researched as they do not stand out during interviews or in the archive. Loughran suggested that we revisit our sources and subjects, and reflectively put ourselves in the interviewees’ shoes (i.e., how do we use humour and distractions to minimise our own unhappiness in everyday discussions?) to become more conscious and better researchers.

Credit: A woman raising her hands to her face in despair. Watercolour by M. Bishop, 1970. Wellcome Collection.

Panel Two: Student Mental Health in the 1960s.

The second panel explored ‘Student Mental Health in the 1960s’. Dr Sarah Crook (Swansea University) presented a remarkable paper, ‘Contested Spaces: Women Undergraduates and Mental Illness in Post-war Britain’. She illustrated how the medical experts working within some British universities were quick to attribute mental health issues that arose among female undergraduates to their family lives, relationships, and personal issues rather than consider the tertiary environment – or ‘Contested Spaces’ – that they were newly experiencing. Crook, positively concluded, however, that women were highly influential in both shaping and improving universities’ mental health provision from the 1960s onwards. I (University of Warwick) then illustrated in my paper on ‘Mental Health, Marriage, Motherhood and Education, c.1960-1975’ how women had to “drop in and out” of their marriages, childrearing duties, education and work – and in turn prioritised or ignored their mental health issues – to survive a significant culture change in expectations by the early 1960s. Feminist literature, like The Myth of Superwoman (1975), has exposed the challenges of needing to be a ‘perfect’ housewife and ‘the new career woman who could have it all’ by the early 1970s. I argued that these pressures also existed in the previous decades.

Credit: A woman threatened by red clouds and winds. Watercolour by M. Bishop, 1969. Wellcome Collection.

Panel Three: Chronic Illness and Mental Health

The third and final panel of the day focused on ‘Chronic Illness and Mental Health’. Dr Andrew Burchell (University of Warwick) shared his fascinating research undertaken with Professor Mathew Thomson in ‘Narrating Chronicity: Biographical Voices, Gender and Illness from the Mass Observation Project Archive’, focusing on mental health narratives from the Mass Observation Project. This constituted part of the Wellcome-funded Cultural History of the NHS Project. Burchell explained how we could access the narratives in the archive for our own research. He also revealed how they can speak back to their readers, both challenging and disrupting our attempts to find historical patterns in everyday life and health matters. Dr Hannah Elizabeth (London School of Hygiene and Tropical Medicine and the University of Edinburgh) then shared an extraordinarily moving and vital paper, ‘Recovering Experiences of HIV-affected Pregnancy in Edinburgh’. The paper is part of Elizabeth’s broader Wellcome-funded project, ‘What’s love got to do with it? Building and maintaining HIV-affected families through love, care, and activism in Edinburgh 1981-2016’. In their paper, Elizabeth used memoirs, oral histories, counselling manuals, training material and print press coverage to expose problematic cases and the discrimination associated with HIV diagnosis throughout pregnancy and at birth. They also suggested ways to sensitively re-tell these narratives without stripping people's agency.

Credit: A woman falling headlong into a red abyss. Watercolour by M. Bishop, 1959. Wellcome Collection.

Day Two

Panel Four: Mental Health and Institutions of Help and Harm The opening panel for the second day explored the theme of ‘Mental Health and Institutions of Help and Harm’. Dr Louise Hide's (Birkbeck, University of London) project, ‘Hiding in Plain Sight: Cultures of Harm in Residential Institutions for Long-term Adult Care, Britain 1945-1980s’ is also Wellcome-funded. Hide’s reflective paper considered how asylum patients of the 1960s and 1970s were unethically shown in television documentaries when the medium became popular. In her words, historical research on these sources then ‘objectifying[ly]’ turns the ‘medical gaze to the historian’s gaze without their [the patients] consent’. She explained how this can also be done through the internet and through social media in a world of endless channels of dissemination. Hide then suggested ways to become more responsible researchers and think carefully about how people could unethically use and circulate our own research outputs and ways to avoid it. Panel Five: Confinement, Motherhood and Mental Health

Our fifth panel, ‘Confinement, Motherhood and Mental Health’, started with our project PI Professor Hilary Marland’s (University of Warwick) paper on ‘Motherhood, Guilt and Mental Illness in Post-war Britain’. Marland focused on the setting up of Mother and Baby Units (MBUs) after the 1950s and the involvement of the National Childbirth Trust (NCT) in promoting the extension of support and treatment to mothers experiencing postnatal mental illness, highlighting the tensions between the care of the mother and concerns about how the mother’s mental illness might hinder bonding and the infant’s development. Marland's paper also showed how the narratives of NCT mothers reflected upon similar tensions. For her paper on ‘Confined Motherhood in Pandemic-Era Postpartum Psychosis Narratives’, Georgia Poplett (University of Durham) then gave an energised paper on a gothic horror novel The Upstairs House (2021) and film The Babadook (2014). The film is based on a single mother who battles with her son's fear of a monster in the house, but soon discovers the sinister presence around herself. As an interdisciplinary researcher (Creative Writing and Medical Humanities), Poplett addressed the ethics and considerations of using testimonies to write fictional representations of postpartum psychosis. I particularly liked the metaphor of the Babadook confined to the basement, symbolising people’s dormant but ever-present mental health issues.

Credit: An image from the book in "The Babadook," illustrated by Alex Juhasz.

Panel Six: Mental Health in the Twenty-first Century Our final panel ‘Mental Health in the Twenty-first Century’ brought us to present day issues in mental health research. Dr Louise Morgan's (University of Warwick) novel paper, ‘Orthorexia and Clean Eating in Twenty-First Century Britain’, grounded in the broader history of eating disorders, discussed orthorexia's origins and ‘genderless[-ness]’ in relation to clean eating. The term 'orthorexia' was coined in 1998 and refers to an obsession with 'healthy' eating. When considering women’s prevailing obsession with body size and dieting particularly since the post-war period, orthorexia is a topic of monumental significance. Morgan illustrated how social media influencers can reach broader audiences and might hold more authority than medical professionals in ‘clean eating’ debates. And finally, Charli Colegate (University of Sheffield) presented her research on ‘Positionality and Ethical Questions in a Qualitative Study of the Reproductive-related Experiences of Women with a History of Severe Mental Illness’. As a sociologist, Colegate valuably showed us historians how to conduct more fruitful interviews by explaining to interviewees the reason behind our interest in mental health research. By disclosing this information, the relationship between interviewer and interviewee is more equal. Like Loughran and Hide, she offered another method of deploying our personal experiences and positionality as researchers in our writing to improve our practice. She also reflected on the motives behind people agreeing to be interviewed. Finally, she addressed the differences in communication based on the different modes of interview, from phone and video calls to in-person interviews.

Credit: A woman dressed in ochre lies prostrate on a purple ground burying her face in her hands. Watercolour by M. Bishop, 1965. Wellcome Collection.

Concluding Roundtable Discussion

The workshop concluded with a roundtable discussion, which returned to the questions of sources, ethics and care in the context of our historical subjects, interviewees and our own positionality as researchers. Building on Dr Ute Oswald’s (University of Warwick) question on the first day, we discussed the pros (e.g., safety) and cons (e.g., agency-stripping) behind anonymising narratives and returned to the issue of how the expanding opportunities for dissemination, including public engagement, might risk the integrity of our research and the contributions of our historical subjects and interviewees. Dr Jade French (University of Loughborough) noted the abundance of sources we can work with – including more novel social media sources, as Morgan had illustrated in her paper – and the difficult decision-making behind choosing which work best for mental health research. We also spoke about ethical approval procedures at universities, the timing of applications as our projects unfold and develop, and how university processes might focus largely on legal issues. We discussed how to offer better protection for the subjects we are historicising through anonymity, as well as safeguarding our own wellbeing when working on challenging subjects. Hide and another attendee, Dr Jessica Hamett (University of Bristol) also spoke about the Challenging Research Network, and the regular online seminars which provide support and reflective conversations for researchers working in challenging areas. Although the workshop roundtable may have raised more questions than answers, we now have a stronger network of researchers to consider and better resolve issues surrounding mental health research.