A Brief Look at the Evolution of Mental Health Treatment Centers: Tracking Mental Health Institutions over 100 years

Fingersmith by Sarah Waters

Fingersmith (2002): Gender Itself as a Form of Institutionalization

Sarah Waters’s novel has the Gothic-domestic nuances of sensation fiction, with the additional element of modern criticism. Neo-Victorian criticism is possible with almost two centuries between sensation fiction and Fingersmith because of our critical distance from that particular dominant culture. It allows the story to incorporate a wider variety of scenes that Victorian sensation fiction authors simply could not write and be published due to their cultural restraints. In this way they experienced their own form of institutionalization within their writing by the denial of real-life details that became invisible due to strict Victorian morality and norms.

Waters reimagines Victorian England as a modern author who resists that restraint. The result is a narrative with unseen “sensational” details. Her treatment of wrongful institutionalization is familiar to Victorian novels but adds the missing element of abuse common to such practices. Exposing that abuse is a neo-Victorian approach to creating confrontational discourse about the normative authority that silenced such discourses in the Victorian era, especially in relation to male dominated spheres such as medical institutions. Similarly, Waters’ treatment of gender roles challenges Victorian ideals in order to confront the dominant narrative about women who were expected to depict a certain type of femininity: to marry, make tea, and to bear children. 


Fingersmith
is narrated by protagonists Susan Trinder and Maud Lilly, who are switched at birth and raised in homes that shape and form their new identities. Their “mothers,” Marianne Lilly and Mrs. Sucksby, enter a business agreement that upon turning 18 years old, the young women are to split Marianne Lilly’s inheritance. However, Mrs. Sucksby devises a plot in which she will become the only benefactor of the inheritance after she recovers Maud as her daughter and places Susan into a private asylum. In a plot that confronts the formations of personal identities in a patriarchal dominant culture, the young women prove that they are no longer defined by their prescribed narratives and they write their off-script ending together. 


The fearsome switching of the women enables a confrontational discourse about the way Victorian family structures influenced how women self-identify. When Mrs. Sucksby switches the young girls, they inherit the stories of their “new” mothers. Maud is originally the daughter of Mrs. Sucksby, a criminal baby farmer living in the slums of London, and Susan the daughter of the heiress Marianne Lilly who dies in a private asylum after being wrongfully diagnosed as mad because of her out-of-wedlock pregnancy. In this switching of matrilineal narratives, the young girls grow into women who believe the fictions about their mothers that become their self-identifications. Maud believes she is the daughter of a madwoman and this identity allows her uncle, Christopher Lilly, to take advantage of her insecurities and keep her as his personal assistant and copywriter of his published writing: pornographic texts. Susan identifies with her criminal street life as a petty thief, or fingersmith. Colloquially, this term first made reference to the vocation of a “midwife” and later to a petty-thief or pick-pocket. It negatively connotates the work of a woman’s hands at the base of society.

Waters touches upon a significant issue that contributes to the subject of the institutionalization of women because these matrilineal narratives are important factors not only in how the women view themselves, but in how others do as well. In analyzing Maud’s character and occupation, another type of fingersmith or person working with her hands, Nadine Muller enlarges the scope on Waters’ work. She writes: 
[Maud’s] association of maternal blood with ink consequently suggests that, with her belief in her inheritance of her mother’s blood, she has also inherited her uncle’s oppression, that is, she is not only heiress to a matrilineal fiction, but a fiction written by men. This connection, then, hints at an indivisible and ironic link between matrilineal inheritance and patriarchal oppression. (115)

What Muller calls “an indivisible and ironic link” is precisely why Waters returns to Victorian sensation fiction—to confront the authority of men over women. In this case she weaves together the paternal dominance within a family that directly connects the surname Lilly, property, and inheritance, with the oppression women experienced from men in writing and authorship. Maud inherits both of these fictions and women will continue to inherit these fictions if not challenged to rewrite the narrative. The link between matrilineal inheritance and patriarchal oppression was also perceptible in Lady Audley’s Secret. It became the source of power for Robert Audley to wrongly institutionalize Lady Audley, because her mother was institutionalized. It is also visible in Mrs. Sucksby’s criminal plotting, in parallel to Sir Percival Glyde and Count Fosco in The Woman in White, and how it disregards the fate of two young girls in the reach for financial security and establishment. Yet even within her female criminal agency, Mrs. Sucksby is limited to the examples established by patriarchal design.

Waters revisits Victorian fiction to confront the treatment of women in pornographic texts and how it worked to institutionalize women through the male dominated sexualized writing of their bodies, while social norms forced them into the opposite—moral and sexual oppression. This double standard further reinforced the ability for men to retain power outside of social norms while women experienced institutionalization within them. Waters confronts this irony with Maud’s role in her “uncle’s” estate. Christopher Lilly becomes a representation of how men in the Victorian era were able to eschew the strict moral codes upheld by society (if women found a way to do so, they were invisible to Victorian society or else admitted to an insane asylum). Though pornography was a hidden, sub-cultural phenomenon, it thrived in the country estate of Lilly and historically, in hidden bookstores in the alleyways of London. Christopher Lilly uses his “niece” as his assistant, yet as stated, Maud’s captivity in that role results from her submission to the narrative. Lilly could oppress her as she unfortunately oppresses herself due to the fictional matrilineal narration, and ultimately through the shame of her penmanship in transcribing narratives about men using women for sexual gratification. These illustrations in Waters’ fiction help outline the ease with which men could control women both socially and in the home—spheres dominated by men. Maud understood her social limitations as the “descendant” of a madwoman, and this allowed her to accept her role as a degraded copy-writer of pornography. No respectable role in society—and especially marriage—would be suitable for the daughter of a madwoman. While these treatments are not physical institutional buildings, they transform boundaries and expectations into walls of limitations that were culturally pervasive and shaped the identities of women for centuries.

Waters brings both the asylum and sexual control to the forefront when Susan is wrongfully placed into the private asylum. Mrs. Sucksby employs a man named Gentleman, a customer of Christopher Lilly’s, who instrumentally conducts the two-doctor test to paint Susan as a homosexual threat. Gentleman tells the doctors that Susan is his wife, Maud Lilly, who believes herself to be Susan Trinder. He then secures her fate when he tells them there is “something else” and reassures Maud with, “you did nothing to invite or encourage the gross attentions my wife, in her madness, attempted to force on you” (319). When both doctors are aghast at this detail, Gentleman bolsters the story with, “Do we need to name the unhappy passion? Must we oblige Miss Smith to rehearse the words, the artful poses—the caresses—to which my distracted wife has made her subject? Aren’t we gentlemen?” (319). Gentleman’s character operates as the voice of oppression over any tendency towards homosexuality and upholds the value of a pivotal time in which the “unhappy passion” remained unnamed and invisible, linking the act as beneath their social class when he reiterates their standing as “gentlemen.”

The doctors’ response solidifies this value when they say, “You need not fear for the safety of your mistress. Her care will soon be our concern, not yours. Then we shall keep her, and cure her of all her ills. Mr. Rivers, you understand—a case such as this—the treatment may well be a lengthy one…?” (319). Their reference to safety insinuates that a homosexual is a threat within their cultural boundaries and that a cure for such a sexual problem is a lengthy treatment due to their experience in which “treatment” is essentially ineffective. This scene highlights yet another form of patriarchal dominance with men conducting conversations and power dynamics that controlled women.

Before arriving at the asylum for the mentally insane, Susan is first institutionalized within the heteronormative social construction for women. Yet, after she arrives to the asylum, her institutional and physical “treatment” is another, worse form of abuse and control that help make connections between social ideas and their resulting physical treatments. Mariaconcetta Costantini says, “[Waters’] choice of the nineteenth century derives from her wish to explore the germinal phase of social, political and sexual discourses that are still relevant in the new millennium” (18). While homophobia does not originate from the mid-1800s, Waters highlights the evolution of its germinal phase during a period of social awareness and national identity that used the power of patriarchy and morality to control it. Her discussion of relevant sexual discourses in their germinal phase is another example of questioning the authority behind dominant cultural narratives. Questioning the Victorian treatment of homosexuality helps deconstruct the ongoing homophobia in the twenty-first century.


Susan’s treatment at the private asylum highlights abusive behavior within institutionalization and connects with the discourse Foucault opens up about the polarity of madness: “We have yet to write the history of that other form of madness, by which men, in an act of sovereign reason, confine their neighbors, and communicate and recognize each other through the merciless language of non-madness” (ix). Susan is not insane but is surrounded by people who treat her as insane, making them the other form of madness who use the “language of non-madness” as will be described. The nurses and doctors in the asylum represent the non-mad yet appear to be the ones without reason.

Waters gives us this fictional representation of a Victorian asylum to give readers a better understanding of why England saw its “lunacy panic” in the 1850s, as mentioned with regard to Collins’ novel. She creates a literary experience where the reader follows the protagonist into the institution and witnesses the actions and motives of characters who, with authority over Susan, reveal deeper social issues tied to institutionalization. Upon arrival, a nurse immediately mistreats her: “she hit me hard, with the points of her fingers, in my stomach. I think she did it in such a way, the doctors did not see. I gave a jerk, and swallowed my breath. Then she did it again. ‘Here’s fits!’ she said” (420). The dynamics between doctors and nurses are another example of a Victorian sub-culture in which gender power dynamics favor the patriarchy, even above the purpose of treating patients.

Punching Susan in the stomach gives the nurse a miniscule distribution of the power to be had within the asylum. The nurses are aware of such power and use it to their advantage because: “The doctors were like kings to them” (435). Men who control the medical establishment, who carry the voices of reason and authority, also control the nurses. The relationship between the doctors and nurses seems to create a void in proper care for insane patients as an unfortunate byproduct of confining people inside of buildings. In this setting, madness becomes diffused as if it were an element that could easily transfer to any form of matter, whether it be a person, a house or even between genders.

Madness is no longer simply reflective of intelligence, it becomes a way of understanding something that is “othered” along with the authority that names it—madness becomes indistinct and ambiguous. For example, Susan describes the asylum building as a former gentleman’s home, “but that now, it had all been made over to madwomen—that it was, in its way, like a smart and handsome person gone mad itself” (432). She then quickly thinks, “And I can’t say why, but somehow the idea was worse and put me in more of a creep than if the place had looked like a dungeon after all” (432). Madness becomes a reaction to madness and the source of reason becomes muddled, which is why Susan would prefer the less ambiguous dungeon, because it offers clearer terms.

The transformation of the gentleman’s home into an asylum for women further reinforces the idea that men easily institutionalize women within male ideals and if women resist, they must be mad. It also suggests that men are the voice of reason and women must rely on their guidance—another way of perpetuating the system, when women uphold such values. Ultimately, the asylum is a reflection of fixed norms that appear socially acceptable but hidden in plain sight are abusive and perverted roles performed by doctors and nurses—from the wrongful placement of someone like Susan, to the ineffective medical methods they administer, to the physical harm they inflict.


One particular scene in the asylum is even more haunting than Susan being punched in the stomach and forced into the building. A group of nurses threaten to sit on the patients to make them “squeak,” and Susan becomes the target of their disturbing game. They rush her and she feels like “they were like one great hot sweating beast with fifty heads, with fifty panting mouths and a hundred hands” (467). The imagery of a beast creates a juxtaposition and a dilemma when nurses—caretakers of the insane—become the ones who act mentally unstable. Nurse Bacon takes her turn sitting on Susan and “the shock and the weight of her was awful” (469). Susan’s cry for help only works against her and instigates Nurse Bacon to push herself onto Susan and she “moved her hips. Moved them in a certain way” and then said ‘Like it, do you?...No? We heard you did’” (469). This is a direct reference to Gentleman’s conversation during the two-doctor test and the main reason for Susan’s “treatment” in the asylum. Yet, the situational irony is that Susan becomes the victim of an aggressive “homosexual” assault, highlighting Waters’ criticism of an era in which sexual and political discourses defined gender roles for society while also harboring criminal behavior under the protection of male dominated spheres, such as this one in an insane asylum.

Her criticism also reveals that Susan, though she identifies as a lesbian, conducts herself with more class and dignity than the asylum staff who disdain “deviant” homosexuals. The scene grows worse for Susan after she defends herself and the doctor believes Nurse Bacon’s story that Susan was “‘in a paroxysm’” and that she was set off after “‘saying a lady’s name, and moving, as she slept!’” (470). Dr. Christie responds, “‘Right. We know our treatment for paroxysms. You men, and Nurse Spiller. Cold water plunge. Thirty minutes’” (470). It is clearly problematic to prescribe a physical punishment for sexual identity, but worse still is Susan’s punishment for Nurse Bacon’s assault. Waters creates this visual for how an institutional building, along with an institutionalized way of thinking about genders, becomes a safeguard for binary gender roles where men institutionalize women within parameters that they control. In other words, women are punished for immorality, such as homosexuality, unless they are in a submissive role to male authority and can operate within that authority.


The physical punishment of the cold-water plunge places Susan in a dire mental state where she is no longer herself, showing that “medical” treatments in asylums often contrived adverse results for the mad, further marginalizing them from society at large. For a woman like Susan—raised by the criminal Mrs. Sucksby who commits her to an asylum to secure an inheritance—respectable roles in society are a fiction that exclude her. Susan is outside the dominant text of society and therefore whether the doctors are truly unaware of the abuse she suffers or they merely turn a blind eye, it does not matter to them because she does not matter to society. A woman can be considered a project or an opportunity for financial gain because she does not fulfill a significant role if she is not wealthy, a wife, or has a father who protects her.

Ultimately, in a society dominated by men, and by women who reinforce male values, women are “commodities within transactions between men” and are as meaningless as they feel (Muller 116). In this construction of society “the acquisition of female agency thus replicates and reinforces the masculine system of commodification, exchange, and exploitation of women…proving that none of the agencies sought by Sue, Maud, [Nurse Bacon,] or Mrs. Sucksby through the adoption of a masculine role within an established patriarchal system can offer more than merely a sinister liberty” (Muller 119). A belief system that permits one gender to appear stronger and in control is a system that insults the intelligence of the other and offers only an imitation of its control, which is simply a “sinister liberty” and not a true liberty. The only hope for Susan in the asylum is to acquiesce to the asylum’s plan for her—admit to being Maud Lilly and play the role for doctors and nurses—then find an opportunity to escape and return to London.


This novel helps clarify the confinement Susan experiences due to her gender and sexuality in a male-dominated world. She is essentially institutionalized within male thinking and it is evident that the other women in the novel support this social structure and refuse to challenge it. As mentioned, Waters wants to confront these large-scale social issues and offers a small-scale alternative, at least for Susan and Maud. Once the truths about their birth mothers are revealed, Maud returns to the abandoned estate of Christopher Lilly and takes control of the female pornographic narrative by writing lesbian pornography. Susan joins her and they experience an unscripted life together. Muller states, “The narrative role she [Waters] assigns to Maud and her literary ‘sisters’ gives dignity to a female and lesbian counter-genre, which she conceives as an alternative to male-dominated literature. By revealing the real ‘yearnings of womanhood’ on the written page, her narrators join the ranks of those Victorian female writers who either wrote against the establishment or wished to do so” (35).

Dignity is a key term in consideration of the institutionalization of women. Women are stripped of dignity when men control their narratives, when they are forced into socially acceptable identities, and when they are too easily called crazy. Waters resists the heteronormative institutionalization of women for herself, her protagonists, and for female writers of both Victorian and modern fiction. Establishing new parameters for a culture that resists, or wants to resist, the institutionalization by the dominant patriarchy is a slow and lengthy process.


The genre of neo-Victorianism is imperative to the study of Victorian sensation fiction because both genres respond to institutionalization in different, yet effective ways. Victorian sensation fiction operates through shock value, by questioning English polite society with a somewhat critical approach to social problems like the wrongful institutionalization of women. It offers few details about the institutions themselves and is less politically charged about the ultimate source of power behind the punishment for those who transgress social norms, while also instigating that process for future writers. Neo-Victorian fiction offers more shock value to its highly critical and politicized writing that questions the power sources behind social issues that have existed for centuries. Muller says neo-Victorian fiction “engages with these themes because they present problems that are as fundamental to Western societies today as they were in the nineteenth century. Hence, neo-Victorian fiction functions as a literary space in which such issues can be critically explored for contemporary contexts” (130).

This study has thus far engaged with the literary spaces of sensation fiction and neo-Victorian fiction to focus on the contemporary context of how women are treated when it comes to the evolution of wrongful institutionalization. Whether it was in the attic of a home, in a private madhouse, within the confines of a matrilineal narrative or the constructed heteronormative identity, this issue remains relevant today.

 

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