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! " # $ %& ' ' ( )*&')+,-++ " &( &. )- / 0 - ' & ! ), ' ' ' -/ )1 - / ' & - / '$ '2 ' ' -/ '$ ' & & -3 4& 5 "2 $ 6 0 & - # 7 ' & ' -( 8 8 & '- "2 9 & 2 & 9 & 0 - / ' ' & 7 & ' ' -/ $ & ' ' -: ' & ' & ' $ -/ 9 $ & ' & ' & - $ )+ ;<<-$'- < &=>;'; ; ;&1)66 #3*11) #3*11 $ %& +1 $ EROTIC INSANITY Imelda Helena Ek Erotic Insanity Sex and psychiatry at Vadstena asylum, Sweden 1849–1878 Imelda Helena Ek ©Imelda Helena Ek, Stockholm University 2017 ISBN print 978-91-7649-868-2 ISBN PDF 978-91-7649-869-9 Copyright for cover image Mathias Liebing. Printed in Sweden by Universitetsservice US-AB, Stockholm 2017 Distributor: Department of Culture and Aesthetics To Isobel, light of my life. Contents Acknowledgements 3 Introduction 5 Aim and research questions 6 Methodology and sources 6 Theoretical concepts: Power, discipline and medicalisation 10 Previous scholarship 16 Outline 21 Prologue: Swedish lunacy reform and the European context 23 1. The Physician-Traveller 32 Doctors abroad 35 Public and private institutions 39 Hjertstedt, John Conolly and the non-restraint movement 42 Beauty, order and comfort 48 Conclusion 52 2. The Aetiology of Erotic Insanity 54 Erotic and sexual causes 54 Disappointed love 60 Anger, pride and lust 62 Social causes 65 Heredity 66 Harmful stimuli 68 Conclusion 71 3. Nymphomania 73 Labelling the Erotic: Describing Nymphomania and Satyriasis 74 The Origin and Seat of Nymphomania 82 The boundaries of decency 86 Cases of nymphomania 90 Hildegard C, admitted in first class, August 28th, 1859 90 Anna J, admitted in third class, 18th February, 1870 93 Conclusion 103 4. Masturbation 106 “Suspected onanist”: Descriptions of masturbating patients 109 Diagnosis and prognosis 111 Masturbation as moral and medical issue 117 Female masturbation 122 Cases of Masturbation 127 Carl P, a farmer, admitted in 3rd class, August 3rd 1868 127 Karl W, admitted in 3rd class, 26th of June, 1888 129 Conclusion 131 5. Erotomania 134 Love as source of joy and cause of disease 135 Erotic symptoms 141 Silences and omissions 145 “Fancies” – erotic and religious symptoms 146 Irregular sexuality 150 1 Case of Love Madness 153 Fredrika S, admitted in 1st class, 29th of January, 1892 153 Conclusion 156 6. Treatment and management 158 Psychological treatment: Building the curative asylum 159 Work as treatment 164 Mechanical restraint 168 Somatic treatment 174 The role of the physician 180 Patients on treatment 183 Conclusion 185 Table A. Medicinal treatments used at Vadstena asylum in the period 1826-1890 188 Results and concluding analysis 191 Coda 202 Summary in Swedish 203 Works Cited 210 Index 230 2 Acknowledgements On my first day at Northumbria University back in 2003, I decided that I was going to try and stay at university for as long as possible. There was something about the environment, about the sense of possibility, about realising just how much there was to learn that made me dizzy with excitement. Fourteen years later, I still feel that way. My time as a PhD candidate has been spent in the Department of Culture and Aesthetics at Stockholm University. It has been a privilege to work, learn and grow in such a stimulating environment, and with so many inspiring scholars around. First of all, my heartfelt thanks go to both my supervisors. As my main supervisor, Professor Elisabeth Mansén has applied her wide-ranging knowledge and experience and her keen eye to countless chapter drafts with admirable patience. Her genuine enthusiasm for the subject matter of my thesis has opened up new avenues of inquiry, and encouraged me to trust my instincts and skills. My second supervisor Karin Dirke has an uncanny ability to identify the weakness in any argument, and the fluff in any text. Her constructive and perceptive readings have helped me to structure, formulate and present my ideas, while providing much-needed encouragement and support. I would also like to thank all past and present participants at the research seminar in The History of Ideas at Stockholm University, for providing their insight to my texts at various stages throughout the process. Working on a doctorate can be a lonely and somewhat bewildering experience, and it would have been even more so without my fellow PhD candidates in the department. Thank you to Emma Hagström Molin, Matts Lindström, Johan Fredrikzon, Isabelle Ståhl, Lydia Wistisen and Hilda Jakobsson for taking the time to read drafts of my work and provide insightful feedback, as well as sharing advice and encouragement along the way. Some colleagues become more than just associates, and some of the best, most interesting, challenging and hilarious conversations and exchanges during the last five years have been had at the lunch table, in the hallways and over pints at the pub. Linn Holmberg, Annika Berg, Staffan Bergwik and Daniel Strand are the coolest friends anyone could wish for. Thank you to the administrative staff at Humanistvillan, and especially to Polly Hsu, Mia Åkestam and Magdalena Hernow who have always been on hand to help out with the administrative and practical side of work. You have saved my sanity on many occasions. Furthermore, I would like to thank Cecilia Riving for her insightful and meticulous reading of the first full draft of my thesis. Recieving detailed advice from another historian of psychiatry at that crucial point in time was absolutely essential. Staff at the Regional Archives in Vadstena, the Swedish National Archives at Marieberg and the Stockholm City archives have taken an interest in my research and been enormously 3 generous with their expertise in acquiring and deciphering a wealth of writing by nineteenth-century doctors. Thanks to Mathias Liebing, who gave me permission to use his beautiful and evocative photograph for the front cover, and to Andy Redfern for your meticulous proofreading of my final manuscript. A special thanks also to Jim Löfgren at Östergötlands museum who provided images for this book at the eleventh hour, and to Sverker Högberg, for telling me the story of his grandfather, attendant at the Vadstena asylum around the turn of the last century, and for providing me with additional sources. Finally, the thesis support team at the Stockholm University Library have contributed their technical expertise to the layout and formatting of this book, and I couldn’t have done it without them. Curiously, my life seems dotted with men whose names start with J, and three of them deserve a special mention for their part in making this book happen. Thank you Jesper, for convincing me to apply for a PhD position when I was convinced I didn’t have a chance of getting it. You believed in me when I could not, and that made all the difference. Thank you John, my constant office-companion for the past five years, for your constructive feedback on my work, our chats about life, parenting and politics, and most of all for your unfailing kindness. And thank you Jens, shekh ma shieraki anni, for all your help and (tech-) support. Your love has strengthened me in ways you don’t even know. A final thanks goes to my friends, who lit the way on stormy seas, and provided tea, laughter and musical entertainment when my morale was failing. You know who you are. Look Isobel, mummy’s book is finished! Maybe some day when you’re older you will care that I dedicated it to you. I love you more than ice cream and rainbows. Imelda Helena Ek Stockholm in July 2017 4 Introduction Erotic Insanity is a project concerned with the earliest beginnings of psychiatry in Sweden, highlighting the central and problematic position of sexuality in nineteenth- century society. It is a study of doctors, their interpretation of irregular behaviour and the growth of a medical specialty. It is also, however, a study of words, stories and language. Finally, it is concerned with men and women who became patients; indi- viduals whose conduct was perceived as being “erotic” as well as “mad”. When the first seeds of Swedish psychiatry were sown in the form of a government act in 1823, physical institutions were the first to materialise. At the time, Sweden had no legis- lation regulating the admission of insane persons into care and treatment, no official classification system of the various types of mental illness, no instruction in the contemporary doctrines of psychiatry within medical education in universities, and as a result no doctors specialised in the field. However, in 1826, the Vadstena county asylum for the insane was established as the first institution devoted exclusively to the care of the unsound of mind. The position was advertised three times and received no applicants before the physician to the venereal hospital at Vadstena, Georg Engström, was personally approached by the Board of Directors. Engström agreed – somewhat reluctantly – to become superintendent. Thus, the first Swedish asylum came into being. Psychiatry, in the sense of an established medical discipline devoted to the study, diagnosis, treatment and prevention of mental disorders, was yet to develop. Ludvig Magnus Hjertstedt, whose period of service coincided with the establishment of practical
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