Book Review: Asylum - a Mid-Century Madhouse, by Enoch Callaway

Although one may hesitate to even imagine what took place in the early history of the sprawling Worcester Insane Asylum, as it was originally dubbed when established in 1833, Dr. Enoch Callaway, a semi-retired Emeritus Professor of Psychiatry at USC San Fransico, shares an absorbing snapshot of Worcester in its mid-twentieth century heyday.

The author's personal reminiscences reveal Worcester State Hospital as a site of research and hope, a warehouse of the mentally ill, and an unlikely home for young doctors who were truly in residence.

In Asylum, Callaway paints a very clear picture of the history of psychiatry that few others can provide. He not only relays stories of the happenings at this colossal institution of broken minds, Callaway places these day-to-day madhouse events against the backdrop of the times and the evolving face of clinical psychology.

Madhouse Resident

Enoch Callaway knew what it meant to truly be a medical resident; eating, breathing and sleeping psychological practice and theory. During his time at Worcester, the state mental hospital was the home address of the author, his wife, his colleagues, their spouses and thousands of mental patients.

Psychiatric Treatment Transformed

While Callaway was in residence, the psychiatric climate of the times meant that, "those of us who were true believers knew that a sufficiently deep analysis would cure any mental illness."

The crucial time period made these vignettes all the more absorbing. Dr. Callaway worked at Worcester during an age when psychiatry had an overabundance of faith in Freud's psychoanalytic process and little knowledge of psychopharmacology. Shortly after Callaway's stint in the madhouse, newly discovered medications began to profoundly transform the treatment of mental illness.

The Struggle to Help Psychiatric Patients

Asylum shows the many frustrations and few triumphs of mental health practitioners trying to treat the mentally ill armed mainly with psychoanalytic theory and desire to make a difference in patients' lives. The author provides many personal examples of the period's treatment techniques including not only psychotherapy, but electric shock for depression and insulin treatments that put schizophrenics into controlled comas. Callaway candidly shares the successes and failures.

Mental Illness and Society

The author also very skillfully weaves in comparisons with fictional mentally ill characters from literature (I Never Promised You a Rose Garden, Out of the Shadows, and Madness in the Streets) and cinema (The Snake Pit, One Flew Over the Cuckoo's Nest and A Beautiful Mind) to help readers better understand the world of the mentally ill and the institutions that have historically housed psychiatric patients.

In his concluding chapters, Callaway opines on how scientific advances and changes in policy have dramatically changed how society perceives, treats and even criminalizes mental illness.

Lesson from History

The author believes that this very personal glimpse into the rise and fall of an historically important insane asylum may provide important lessons that speak to, and inform, our treatment of today's mentally ill. For those interested in psychology, history and mental illness, this book is certainly worth a read.

More Information

• Title: Asylum - A Mid-Century Madhouse and Its Lessons about Our Mentally Ill Today
• Author: Enock Calloway, MD
• Publisher: Praeger Publishers
• ISBN-13: 978-0-275-99704-5
• ISBN-10: 0-275-99704-9
• List Price: $44.95

Additional Psychology Information and Book Reviews

See the psychology information website Psychology Prof Online for information on mental disorders or other Suite101 book reviews, including another excellent psychology read, Understanding Personality Disorders: An Introduction, by Dr. Duane Dobbert.