I come as the advocate of helpless, forgotten, insane, and idiotic men and women…of beings wretched in our prisons, and more wretched in our almshouses.
Page 1 of Dorothea Dix’s Memorial to Massachusetts Legislature, 1843
Dorothea Lynde Dix is well known for her work advocating for prison reform, as well as reform for institutions that house the mentally ill. Her work has often been cited as coming from a moral or even a Christian perspective, but could there be more to the story?
Read more about the life of Dorothea Dix, as well as the historical movements that surrounded her life and her work. How have other reform movements, like in education or women’s suffrage, or even the dawn of psychiatric medicine influenced her own ideas as she fought for disability justice?
Table of Contents
The Past is a Foreign Country
Continue reading to explore what kind of world Dorothea Dix grew up in. How would these prevailing movements have influenced Dix’s life and her ideas as she fought for disability justice?
An Ever-Evolving Language
In the times of Dix, psychology and psychiatric medicine were only just starting to be recognized as a legitimate medical field. As a result, many professionals were utilizing language that, when looked at from a modern lens, can be seen as incredibly misguided. If not misguided, then extremely backward.
However, it is important to understand the historical context in which many of these sources are written. Usage of these words in our modern society would (and perhaps should be) definitely be taken with great offense. But in the 19th century, a time when Germ Theory was barely beginning to be accepted in the professional medical realm, similar beginnings were happening in the realm of psychology and psychiatric medicine.
Oftentimes, this created situations where professionals could not fully explain the origins of the mental illnesses they were treating. As a result, external or physical causes were used to explain how these illnesses developed.
For example, the word lunatic continued to be used, and came from the notion that the moon affected a person’s mental state and could cause someone to become seriously mentally ill.
Similarly, words such as insane and mad were used as a sort of catch-all term, describing anyone staying in an almshouse or an insane asylum. This could include individuals who, by modern standards, would be understood as having both psychiatric and non-psychiatric conditions like Down Syndrome, certain learning disabilities, and even old age.
From this, it can be said that Dix also fought for the humane treatment of the developmentally disabled, in conjunction with the mentally ill and prisoners.
The Great Awakening
Throughout the 19th century, a series of religious revival movements referred to as “The Great Awakening” first got its bearings in England, and quickly spread to the United States. With the first wave occurring over 50 years prior in the 1700’s, in the 1800’s people experienced the Second Great Awakening, with some even arguing that a Third Great Awakening occurred in the later half of the century.
Overall, these periods of religious revival consisted of a revival of the Christian religion in both Britain and the United States. People felt a renewed sense of their faith, especially women. In particular with the Second Great Awakening, a number of colleges, seminaries and mission societies were established.
Nationwide Social Reforms
Besides in the religious sector, reform movements were developing in all matters of society. Below are some of Dix’s contemporaries that were each active in their own respective areas of reform, along with a brief description of their work.
Ida B. Wells-Barnett was a journalist who, with her many other abolitionist contemporaries, used her talents to showcase the suffering Black Americans faced under the institution of slavery. Born into slavery herself but freed shortly after the end of the Civil War, Wells-Barnett was an activist her whole life. She not only wrote articles shedding light on lynchings to an international audience, but she was also a fierce advocate for the suffragette movement. Wells-Barnett eventually became the founder of the National Association of Colored Women’s Club and was also heavily involved with the NAACP.
Horace Mann was the one who spearheaded educational reform. Like Dix, Mann was also born in Massachusetts. He eventually became a lawyer and in 1837 was elected as the Secretary of the state’s newly created Board of Education. From there, Mann was able to begin implementing his ideas across the state, and other states soon followed suit. He was a strong supporter of publicly funded education and argued that a strong education system will foster an equally strong political climate, as well as an overall happier society. His most influential work includes getting teachers to be trained in teaching before they can start entering the classroom.
Elizabeth Cady Stanton was a suffragette who is most well known for initiating the historic Seneca Falls Convention and can be considered as one of the first giants in women’s rights and the overall suffragette movement that extends into the 20th century. She is also known for being the co-author of The Declarations of Sentiments, a document that famously parodies the language found in The Declaration of Independence. She lived to be a prolific writer and advocate for not only women’s suffrage but also for the end of slavery.
Dorothea Dix’s work coincided with a lot of change happening in other parts of society. Being a women and a schoolteacher herself, it is hard to imagine that any of these prevailing movements of the time did not have some kind of influence on her ideas and philosophies.
Becoming a National Advocate
Read about aspects of Dorothea Dix’s personal life, and how her experiences have shaped her to become the advocate she is known as today.
Advocating for Her Own Needs?
Many have speculated whether or not Dix has suffered bouts of mental illness throughout her life. Born in 1802 in Hampden, Maine, it is postulated that Dix suffered childhood abuse and/neglect in her early childhood until she moved in with her affluent grandmother in 1814.
She began to dwell on the idea of death, and felt overwhelmed by her physical illnesses.
Dr. Manon S. Parry of the National Institutes of Health, 2006
In adulthood, Dix dedicated herself to teaching and became a school teacher. She published many books. Some of her works included religious poetry, but arguably her most well known work is Conversations on Common Things, a book that inadvertently expressed her opinion that regarding equal access to education for both men and women.
Still, her work had placed a toll on her health. David Gollaher, a biographer who was the first to analyze all of Dix’s papers, concluded that she may have suffered from depression at many times in her life. Dr. Manon S. Parry of the National Institute of Health adds to this, “By 1836, her intense commitment to teaching and demanding workload seemed to have taken its toll. She began to dwell on the idea of death, and felt overwhelmed by her physical illness.” Today, it is now understood that her physical illness was tuberculosis.
Perhaps Dix’s own personal experience with mental illness allowed her to empathize more for the individuals she saw being mistreated. This would allow her to be more motivated in what would eventually be her lifelong work in advocating for those situated in insane asylums and prisons.
Moral Treatment – A Revolutionary Cure for the Mentally Ill
Due to her personal connection with her wealthy grandmother, Dix was able to insert herself into the social circles of many influential individuals of the time, both in the United States and in Britain. After experiencing several bouts of ill health in the 1830’s, she traveled to Europe and met reformers such as William Rathbone, Elizabeth Fry and Samuel Tuke, all of which influenced Dix’s personal ideas concerning insane asylum and prison reform. But Dix was arguably most influenced by the French physician Philippe Pinel, who first popularized the concept of moral treatment.
According to Louis C. Charland, whose writing eventually became published in The Encyclopedia of Clinical Psychology, the methods involved with moral treatment were never meant to have the ethical/religious connotation that most people today understand it to have. He explains that the name “Moral Treatment” can be quite misleading because the use of the word “moral” at the time was only meant to mean what we now call “mental” or “psychological”.
While methods pertaining to the moral treatment can be perceived as more ethically sound than previously used treatments of the time, the treatment plan as a whole was meant to be understood as a careful record-keeping treatment plant rooted in psychology. This method was diametrically opposed to previous treatment plans which focused on the physical means of treatment such as “bloodletting and purging, as well as beatings and prolonged periods of immobilization and isolation in most unhygienic settings”.
Charland continues to explain that while each institution varied widely in their specific practices pertaining to Moral Treatment, some common threads can be identified. In most cases, treatment takes a holistic approach, with a goal to treat patients with proper rest, adequate nutrition, and exercise. Patients are scheduled in a variety of social activities throughout the day, such as outdoor walks in the park, knitting and other crafts. There is also a careful record-keeping aspect of moral treatment, requiring that patients be monitored carefully and treatment be adjusted accordingly if results aren’t favorable. After a period of time remaining in the asylum, patients were expected to return to their homes in a much better state than when they left.
Nonetheless, methods pertaining to moral treatment were still utilized under the context of Christian values. For example, Samuel Tuke and his family owned York Retreat for the Mentally Ill was well known for using moral treatment in their treatment plans. Being a family of Quakers, their specific method of the Moral Treatment was heavily infused with their religious and spiritual views. As a result, historians are still struggling to understand which aspects of their treatment methods were more religiously driven, and which were more medically driven. With the rise in religious fervor due to the Second Great Awakening at the time, it is very possible that other institutions could’ve implemented elements of Christianity into their methods as well.
Being a Christian herself, the methods pertaining to moral treatment would’ve greatly appealed to Dix. Especially when compared the more callous physical approach to treatment which was more prevalent of the time, moral treatment would’ve easily been adopted into the humanitarian values that Christianity holds. Therefore, when it came time for Dix to take up a job teaching Sunday School in a prison, one can only imagine the horror Dix felt when she saw the conditions of her new workplace.
These humanitarian values will once again be brought up almost a century later in the New York City Willowbrook Scandal.
Take me there now! – Chapter 2: Deinstitutionalization
From Sunday School Teacher to Advocate
What Dorothea Dix saw at the prison she was working at shocked her. The prisoners were living in such inhumane conditions, with little to no light, heat, clothing or sanitary facilities. Furthermore, the prisoners who were mentally ill were not separated from the rest.
Appalled by what she saw, Dix set out on a 2-year journey visiting the prisons and asylums all over the state of Massachusetts. She compiled her notes on everything she saw in a lengthy memorial to the state legislature in 1843. However, due to the lack of political rights women had at the time, she could not personally deliver her memorial. It ended up being read out loud by a male representative.
Dix begins her memorial with a passionate and assertive tone and, determined to speak for those who cannot speak she writes, “I come as the advocate of helpless, forgotten, insane, and idiotic men and women…of beings wretched in our prisons, and more wretched in our almshouses.” She then goes on to describe the notes she has taken at each location she has visited.
Below are a few excerpts taken from Dix’s memorial that highlight some of the horrendous conditions she found in many of these institutions. Any words italicized are referring to the towns in which these particular institutions were located in.
Lincoln. A woman in a cage. Medford. One idiotic subject chained, and one in a close stall for seventeen years. Pepperell. One often doubly chained, hand and foot
Page 2
The use of cages all but universal. Hardly a town but can refer to some not distant period of using them; chains are less common
Page 2
Even though Dix makes it clear that she does not want to incriminate the caretakers of these patients, she does take time to illustrate the dire conditions many of these places are in. Oftentimes, wards and other caretakers do not have the means and resources to properly care for such patients. For example:
To my exclamation of horror, the mistress replied: “Oh, we can’t help it. Half the skin is off sometimes. We can do nothing for her; and it makes no difference what she eats, for she consumes her own fifth as readily as the food which is brought her.”
Page 2. This was the explanation one of the caretakers gave to explain why a patient was being housed in such poor conditions. The comment about the patient’s skin is referring to her skin peeling as a result of the unhygienic conditions she was living in, causing intense skin irritation.
A testament to the life she was raised in, there are many references to God, often found in the form of prayers being quoted such as:
“Why am I consigned to hell? dark — dark — I used to pray, I used to read the Bible — I have done no crime in my heart. I had friends. Why have all forsaken me! — my God, my God, why hast thou forsaken me!”
Page 3
Or used as a persuasive method to instill conviction in the state senators and call them to act:
When the good Lord shall require an account of our stewardship, what shall all and each answer?
Page 3
Dix ends the memorial by urging the state legislature to commit to “this sacred cause” and to also “exercise that ‘wisdom is the breath of the power of God'”. In a way, Dix provides a compelling argument for what should eventually be the implementation of moral treatment in these facilities. She presents it in a visceral, emotional manner that not only comes from a moral and humanitarian angle to it, but also a religious and spiritual one as well. This method can be seen as incredibly effective given once again, the rise in religious fervor the nation was experiencing as a result of the Second Great Awakening.
The Legacy of Dorothea Dix
Dorothea Dix did not stop at the local state legislature. In 1848, she sent a bill to Congress asking the federal government to set aside 5 million acres to be used to serve the mentally ill. It eventually came through with the help of an executive order signed by then President Millard Fillmore in 1852. Construction of a hospital for army and navy veterans soon went underway.
Dix continued her work even after serving in the Civil War as a volunteer nurse. In the end, she influenced a total of fourteen states who passed legislature to better serve the developmentally disabled, and thirty-two hospitals were built as a result of her work. She passed away in 1887.
Further Readings
- More about Dorothea Dix
- Link to view the entire memorial Dorothea Dix wrote to Massachusetts State in 1843
- Dorothea Dix and the English Origins of the American Asylum Movement by David L. Gollaher et. al. Published in Project Muse under the Canadian Review of American Studies
- More about Christianity in 19th century America
- Piety and Poverty: Working Class Religion in Berlin, London, and New York, 1870 -1914, 1996 by Hugh McLeod
- Encyclopedia of the American Religious Experience, Vol. 3, 1988 by Charles H. Lippy and Peter W. Williams
- More about Psychiatric Treatment in 19th century America
- A Home Away From Home by Dr. Ellen Holtzman. Published in 2012 with the American Psychological Association
- More about present day religion-driven advocacy for disability justice
- JCCA, formerly known as the Jewish Child Care Association, founded in 1822 An article published on The Examiner News congratulating a graduating class of JCCA students who have developmental disabilities
- Hope for New York, a Christian based non-profit organization that funds many service programs, including those that serve the developmentally disabled, founded in 1992
- More about present day research surrounding spirituality and treating developmental disabilities
- Multiculturalism, Religion, and Disability: Implications for Special Education Practitioners by A. Brooke Blanks and J. David Smith. Published in 2009 under Education and Training in Developmental Disabilities (JSTOR)
- Role of Spirituality and Religion in Family Quality of Life for Families of Children with Disabilities by Denise J. Poston and Ann P. Turnbull. Published in 2004 under Education and Training in Developmental Disabilities (JSTOR)
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About The Contributor
Madeline Liu was the main contributor for the research done on Dorothea Dix, but she also helped design this website and made sure it was easy to navigate (or so she hopes)! Read more
