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ELIZABETH PACKARD
A Noble Fight
By Linda V. Carlisle
UNIVERSITY OF ILLINOIS PRESS
Copyright © 2010 Board of Trustees of the University of Illinois
All right reserved.
ISBN: 978-0-252-03572-2
Introduction
IN THE SPRING OF 1875, a distraught Mary Todd Lincoln, wife of the slain president, was involuntarily committed to a private mental hospital in Batavia, Illinois, by a court order requested by her son, Robert Lincoln. Fifteen years earlier, an unknown Illinois woman named Elizabeth Packard was also involuntarily committed to a state mental hospital in Jacksonville. There are remarkable connections between the two cases. Both women contested their confinement, both were examined and declared insane by Dr. Andrew McFarland, both had explored Spiritualism, and both were befriended by Chicago attorneys and activists James and Myra Bradwell.
For three decades following her release, Elizabeth Packard traveled the United States lobbying for laws to protect the civil rights of married women and the mentally ill. Historians have noted that the Illinois laws that governed Mary Lincoln's institutionalization in 1875 were among the most stringent in the nation because of Packard's reforms. Among these laws was Packard's law requiring a jury trial at which individuals might defend their sanity prior to commitment. The law was intended to prevent false commitment of individuals by relatives with perfidious motives; however, opponents decried it as a public humiliation of the insane and their families. In practice, Robert Lincoln's lawyers subverted the law by notifying Mrs. Lincoln of her impending trial only a few hours beforehand and by then appointing a lawyer for her who supported her commitment. It was, however, Packard's law protecting the rights of mental patients to send and receive mail that enabled Mrs. Lincoln to correspond with attorneys James and Myra Bradwell, who then pressed successfully for her release.
Elizabeth Packard's resistance of her own commitment and the laws she was later instrumental in passing changed the jurisprudence of insanity in the United States. As one historian has noted, "modern-day civil commitment codes have their genesis" in Packard's campaign. After Packard, involuntary commitment and management of mental institutions in the United States would be shrouded in legislation protecting the civil liberties of those deemed insane.
Who then was Elizabeth Packard and what propelled her into the role of reformer? Packard was the wife of Reverend Theophilus Packard, Jr. who, alarmed at her heretical religious ideas, exasperated by her assertiveness, and appalled at her suggested affair with another man, declared her insane. Confined for three years in the Illinois Hospital for the Insane under the care of Dr. Andrew McFarland, Packard emerged from the asylum in 1863 determined to campaign for laws to protect the personal liberty of those alleged to be insane. Unable under existing laws to recover her children or personal property from her husband, she also became an advocate for equal rights for married women.
Packard called her story "The Great Drama," and indeed it was. With tales of a heartless husband, a conspiring doctor, a mother torn from her children, and unrequited love, Hollywood could write no better plot. Indeed to some, her story seems like a clichéd romance employing stale themes of a wronged, but strong, woman beset by male tyrants and villains. However, historians of women will recognize themes of oppression and struggle for identity and voice that have been repeated in generation after generation of women from ancient times to the present. Still, to know Elizabeth Packard, the historian must look beyond both the melodrama of her books and her representations of herself as victim and heroine.
Despite the drama in her writing, Packard did not thrive on public attention or spectacle. She did not, for example, join the lyceum circuit or appear in popular public forums, as did other public women of her day. Instead, she approached her public work methodically, one might even say "professionally," following the example of her antithesis, Dorothea Dix. She sought out powerful reformers (Gerrit Smith and Wendell Phillips) and politicians (President Ulysses S. Grant, state governors, and legislators) to advance her cause and worked to influence them personally as well through pen and press. As she worked for asylum reform, she became increasingly knowledgeable about new practices in asylum management and the legalities surrounding commitment laws. In studying the whole of her life, it becomes evident that her appeals for reform were based on much more than the emotion and melodrama of her personal story.
A public figure from the 1860s to the 1890s, Packard gained national notoriety as she lobbied legislatures, literally, from coast to coast. However, unlike Dorothea Dix, Packard won few friends in America's fledgling psychiatric profession. While Dix worked with asylum doctors to build institutions for care of the insane, Packard sought to change the asylum system and limit the authority of the doctors. This earned Packard the disdain and animus of early psychiatrists.
Despite opposition from the Association of Medical Superintendents of Institutions for the Insane (AMSAII), forerunner of the American Psychiatric Association, Packard achieved extraordinary success as states from Maine to Washington Territory passed, with variations, many of her laws. Furthermore, her persistent critique joined a chorus of other voices that, together, compelled America's emerging psychiatric profession to develop more exacting criteria for defining, diagnosing, and treating mental illnesses.
Packard fueled her campaign with sensational books and pamphlets about her personal experience, and supported herself with income from her "publishing business." But, beneath the veil of a female scribbler peddling a combined asylum narrative and Gothic romance, Packard addressed some of the most compelling social questions of nineteenth-century America: What civil rights are due married women? What rights and liberties are due those individuals deemed to be insane? What boundaries may a society reasonably impose on an individual's beliefs and behaviors?
Thus, Elizabeth Packard's life story is important on many levels. It is an intellectual history in which we see the interaction of Revolutionary ideology, Calvinist thought, and popular religion in shaping an individual's worldview. Packard's meld of religious ideas that mixed traditional and novel beliefs along with her insistence on "personal liberty" reflects the tumultuous intellectual environment of her time. It was an era in which traditional religion, based in shared creeds and theology, was yielding under pressure of the Second Great Awakening to a religious expression based on individual experience and private belief systems. This phenomenon, which historian Nathan Hatch called the "democratization of American Christianity," gave birth to self-defined popular religious expression that called into question both past traditions and "expert knowledge."
The shift from the communal, hierarchical society of colonial times to a more democratic and individualistic society created an intellectual conundrum that is reflected in Packard's demands for freedom of conscience and speech: To what extent—at whose expense—should one demand individual rights? What is a reasonable balance between striving for personal liberty and sacrificing for the common good? Which of us, for example, would sacrifice our children's welfare for a perceived greater good? Indeed, Elizabeth Packard would struggle at intervals throughout her life to balance what she viewed as dual, yet conflicting duties to her family, to self, and to the God, who, she believed, called her to reform work.
Packard's story is also social history, demonstrating how changing societal views of mental illness resulted in the development of new institutions. While Enlightenment philosophy inspired new views of mental illness, the cultural shift from communally oriented to individual-oriented society led to changing views of who was responsible for care of the mentally ill. Gradually, over the eighteenth and nineteenth centuries, responsibility for care of the insane moved from the family and immediate community to charitable institutions and the state. Medieval views of the mentally ill as animal-like creatures in need of restraint or exorcism gave way to hopes for treatment and even cure, allowing for the introduction of "moral treatment."
Developed by French physician Philippe Pinel, moral treatment called for humane care that stressed minimal use of physical restraint in favor of a psychologically oriented therapy. Moral treatment prescribed confinement of the individual in a pleasant, orderly environment that fostered a return to sane behavior. York Retreat, built in England in 1792 by Quaker philanthropist William Tuke, was among the earliest institutions established for moral treatment of insanity. In the United States, moral treatment was instituted as early as 1834 at the Vermont Asylum for the Insane in Brattleboro.
Both moral treatment and public acceptance of societal responsibility for care of the insane expanded in the 1840s through the work of Dr. Thomas Kirkbride and Dorothea Dix. Dix lobbied for funding for state-sponsored asylums, while Kirkbride, superintendent of the Pennsylvania Hospital for the Insane, developed national models both for moral treatment and for the design of institutions that would foster that treatment.
Influenced by Tuke's York Retreat, the Kirkbride plan called for a central, multistory building, with a series of symmetrical wings on each side. The wings were arranged so windows on both sides provided both natural light and views of an attractive pastoral landscape. Reformer Dorothea Dix worked with asylum superintendents to persuade state legislatures to establish state-funded institutions for the insane modeled on the Kirkbride plan for both buildings and moral treatment.
Unfortunately, by the time Elizabeth Packard was confined in the Hospital for the Insane in Jacksonville, Illinois, it was apparent that many of these institutions were falling short of the hopes and ideals of their founders. While moral treatment was clearly an enormous advance over earlier treatment, and certainly beneficial for some, it was not useful in all cases. Even when desirable, it was increasingly difficult to practice moral treatment in the large, public asylums of the mid-nineteenth century.
The demographic transformation wrought by urbanization and immigration added further impetus to changing perceptions of proper care and treatment of the insane. Increased immigration and concentration of population in cities both coincided with the growth of mental institutions and created additional stress on those institutions. Overcrowding, false expectations for cure, and the necessity of long-term care for incurables along with the difficulty of managing a large, expensive institution and its staff were but a few of the difficulties confronting asylum superintendents. By the mid-nineteenth century, public faith in these institutions had been shaken by the complex realities involved in institutional care and treatment of the insane.
As early psychiatrists confronted these administrative challenges, they were also grappling with definitions, typology, and treatment modalities. Proceedings of nineteenth-century AMSAII conferences reveal the impassioned debates of a profession still seeking consensus on basic definitions and causes of insanity. What denoted the line between insanity and merely eccentric ideas or odd behavior? Were "minor mental maladies" a form of insanity? The answers often reflected religious ideas and contemporary culture more than scientific theory or proven evidence. The doctor who sought to rely on methodical evidence or theory still had to contend with powerful religious and cultural undercurrents expressed in the beliefs of patients' families and the general public, not to mention the state officials who controlled funding for public mental hospitals.
Surrounding all of these issues was the jurisprudence of insanity, which raised questions not only of individual rights and liberty, but also professional turf. Who had final say in the laws that governed commitment and care of the mentally ill individual: the family, the local doctor, the asylum doctor, the judge, the jury, the attorney? What civil rights did the mentally ill retain? The answer could mean the difference between liberty and involuntary commitment to a mental institution. In the case of the criminally insane, it could be the difference between treatment, prison, or execution.
Thus changing beliefs regarding care and treatment of the mentally ill have, historically, involved broader cultural shifts that affected institutions, organizations, and laws. Elizabeth Packard's challenge to the institutions, organizations, and laws of her time reflected yet another shift in the history of care and treatment of the mentally ill. It marked the end of large public mental hospitals and a trend toward varied treatments for differing types and degrees of mental illness.
Packard's story also reveals how the fact of her sex shaped her beliefs, defined her role in society, and made her vulnerable to commitment to an insane asylum. Packard was a transitional woman who lived in the blurred margin between traditional and progressive views of women's proper place in society. She deeply valued her roles as wife and mother, and accepted the home as woman's natural sphere. However, influenced by the writing of domestic feminists such as Catharine Beecher, she expected to be granted a degree of authority and certain basic rights within that sphere. A daughter of the Early Republic, she held liberty as her highest value. It was unthinkable to her that anyone—male or female, slave or free—could be denied freedom of expression, liberty of conscience in religious matters, or protection of basic human rights. These progressive views would create difficulties for Packard in her marriage and community.
The intellectual, social, and cultural fluidity of nineteenth-century America both expanded societal boundaries and made it more difficult to discern the limits of acceptable beliefs and behaviors. How far beyond the norm an individual could venture depended not only on the nature of one's ideas and actions but also on geography, class, association, and sex. This was particularly true for women. For example, nineteenth-century woman's rights advocates found much support in New England, where, in notable instances, husbands and wives teamed in the dual crusades for abolitionism and woman's rights. Couples like the Theodore Welds, the Gerrit Smiths, and the James Motts found support among likeminded associates. The boundaries for these individuals were expanded by class position, the support of spouses and associates, and their location in a geographical region where reform movements were essentially the norm. But Elizabeth Packard, as the wife of a Calvinist minister in a rural Midwestern community, would not enjoy such advantages.
Nevertheless, buoyed by the optimism of new ideas, Packard confidently expressed her opinions and demanded her rights with apparent disregard for the boundaries the wife of an orthodox minister was expected to respect. Driven by intellectual curiosity and a sense of religious calling, she contested the gender-specific norms that defined her place in law and society. Radically for a woman in her position she demanded the right to think for herself declaring, "I though a woman, have just as good a right to my opinion, as my husband has to his, although he is a professed minister of Christ."
Thus, ultimately Elizabeth Packard's story is about boundaries. In pursuit of personal liberty, Packard pushed the intellectual, cultural, and social limits of her day, naively at first, but later deliberately. In so doing, she breached reinforcing boundaries of gender and religion, and became ensnared in the indeterminate definitions of insanity espoused by the emerging profession of psychiatry.
Packard was controversial in her own time and remains so today. Some question whether her reforms truly benefited the insane. Certainly her laws requiring greater external oversight of asylums and postal rights for patients succeeded in decreasing the likelihood of false commitments and patient abuse. Many, however, believe that her law requiring a jury trial for both women and men prior to involuntary commitment was a too extreme response to what she considered a radical violation of her civil rights.
(Continues...)
Excerpted from ELIZABETH PACKARD by Linda V. Carlisle Copyright © 2010 by Board of Trustees of the University of Illinois. Excerpted by permission of UNIVERSITY OF ILLINOIS PRESS. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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