The Family as a Locus of Illness: Secrecy, Suffering, and Institutional Practices

Abstract

The family has long played a key role in the perception, interpretation, and treatment of mental illness across Europe and North America. Yet, historical studies of psychiatry tend to neglect the complex relationship between psychiatric institutions, patients, and their families. Using a Danish nerve sanatorium as a case, this article traces the shifting meanings attached to the family and the home as a potential cause and cure of mental illnesses from the mid-1950s to the late 1980s. While the family figured prominently in conceptions of mental illness throughout these decades, the specific interpretations and treatment practices, as well as the degrees of secrecy, altered significantly. From offering discretion and seclusion and focusing on outer, objectively verifiable circumstances regarding family relationships, doctors increasingly emphasized internal psychodynamics between family members and encouraged openness as a path to healing. The findings call for greater scholarly attention to the complicated intertwinements of psychiatric practices, family history, and changing knowledge practices in the shifting historical configurations of experiences of mental illness.