A motley crowd: The emergence of personality disorder as a diagnostic category in early twentieth-century South African psychiatry

History of Psychiatry

Volumn 12, Issue 2-46, 2001, Pages 157-176

  Swartz, Sally ^a   Ismail, Faldiela ^b  

^a UNIVERSITY OF CAPE TOWN   (South Africa)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DIAGNOSIS; HISTORY; MENTAL DISEASE; PATHOLOGY; SOUTH AFRICA;

DIAGNOSIS; HISTORY, 20TH CENTURY; MENTAL DISORDERS; SOUTH AFRICA;

EID: 0345778089     PISSN: 0957154X     EISSN: None     Source Type: Journal    
DOI: 10.1177/0957154x0101204602     Document Type: Article

References (67)

1. J. C. Bucknill, The Care of the Insane and Their Legal Control (London: Macmillan, 1880), 3.
2. S. Swartz, '"Work of mercy and necessity": British rule and psychiatric practice in the Cape, 1891-1910', International Journal of Mental Health, xxviii (1999), 72-90.
3. Valkenberg Asylum was first opened for white patients in 1891, and for black patients in 1916. From the outset it was intended to be a model of progressive modern treatment, and its doctors prided themselves on being up-to-date with trends in European (particularly British) diagnostic practice. For a brief history of the institution, see S. Swartz, 'Changing diagnoses in Valkenberg Asylum, Cape Colony, 1891-1920: a longitudinal view', History of Psychiatry, vi (1995), 431-51.
4. A. J. Rosanoff, Manual of Psychiatry (New York: John Wiley & Sons, 1927), 333-54. All case records referred to in this paper are from Valkenberg Mental Hospital. They are housed at the University of Cape Town library. In terms of an agreement with the Hospital Board, patients may not be named, for reasons of confidentiality. For research purposes cases referred to will be identified by folder number and date of admission, for those who might wish to peruse them.
5. Rosanoff, Manual of Psychiatry, 186.
6. G. E. Berrios, The History of Mental Symptoms: Descriptive Psychopathology since the Nineteenth Century (Cambridge: Cambridge University Press, 1996); 424-8.
7. H. Sass and S. Herpertz, 'Personality disorders: clinical section', in G. E. Berrios and R. Porter (eds), A History of Clinical Psychiatry: The Origin and History of Psychiatric Disorders (London: The Athlone Press, 1995), 633-44, 635.
8. J. C. Prichard, 'Moral insanity', excerpt from A Treatise on Insanity, reprinted in V. Skultans, Madness and Morals: Ideas on Insanity in the Nineteenth Century (London: Routledge & Kegan Paul, 1975), 182.
9. H. Maudsley, 'A traitor in one's nature', excerpt from The Pathology of Mind, reprinted in V. Skultans, Madness and Morals, 197.
10. H. Maudsley, 'A traitor in one's nature', excerpt from The Pathology of Mind, reprinted in V. Skultans, Madness and Morals, 197.
11. For a detailed discussion of this issue, see J. Saunders, 'Quarantining the weak-minded: psychiatric definitions of degeneracy and the late-Victorian asylum', in W. F. Bynum, R. Porter and M. Shepherd (eds), The Anatomy of Madness: Essays in the History of Psychiatry, Vol III, The Asylum and Psychiatry (London and New York: Routledge, 1988), 273-96.
12. Details of the Act, and implications for practioners are given in M. Craig, Psychological Medicine: A Manual on Mental Diseases for Practioners and Students (London: J. & A. Churchill, 1917), 368-72.
13. Craig, Psychological Medicine, 367.
14. W. Norwood East, An Introduction to Forensic Psychiatry in the Criminal Courts (London: J. & A. Churchill, 1927), 126-31.
15. Quoted in G. E. Berrios, The History of Mental Symptoms, 431.
16. D. K. Henderson, Psychopathic States (New York: Norton, 1939). D. K. Henderson and R. D. Gillespie, A Text-Book of Psychiatry for Students and Practitioners (London: Oxford University Press, 1936).
17. D. K. Henderson, Psychopathic States (New York: Norton, 1939). D. K. Henderson and R. D. Gillespie, A Text-Book of Psychiatry for Students and Practitioners (London: Oxford University Press, 1936).
18. S. Swartz, 'Colonising the insane: causes of insanity in the Cape, 1891-1920', History of the Human Sciences, viii (1995), 431-51.
19. S. Swartz, '"Work of mercy and neccessity"', 76-81.
20. Cape Archives (hereafter CA), Government Publications (hereafter U.G.), Report of Commissioner for Mental Hygiene for the Union of South Africa, 1922-23, 36-24, p.1.
21. D. Foster, 'Historical and legal traces, 1800-1900', in S. Lea and D. Foster (eds), Perspectives on Mental Handicap in South Africa (Durban: Butterworths, 1990), 21-70.
22. T. D. Greenlees, 'Insanity among the natives of South Africa', The Journal of Mental Science, xli (1895), 71-8, 72; N. Marsh, Towards Racial Health (London: Routledge, 1918), 209; A. Stoler, 'Making Empire respectable: the politics of race and sexual morality in twentieth century colonial cultures', American Ethologist, clxvii (1989), 634-60, 634.
23. T. D. Greenlees, 'Insanity among the natives of South Africa', The Journal of Mental Science, xli (1895), 71-8, 72; N. Marsh, Towards Racial Health (London: Routledge, 1918), 209; A. Stoler, 'Making Empire respectable: the politics of race and sexual morality in twentieth century colonial cultures', American Ethologist, clxvii (1989), 634-60, 634.
24. T. D. Greenlees, 'Insanity among the natives of South Africa', The Journal of Mental Science, xli (1895), 71-8, 72; N. Marsh, Towards Racial Health (London: Routledge, 1918), 209; A. Stoler, 'Making Empire respectable: the politics of race and sexual morality in twentieth century colonial cultures', American Ethologist, clxvii (1989), 634-60, 634.
25. D. Foster, 'Historical and legal traces', 29.
26. T. Duncan Greenlees, 'Insanity amongst the natives of South Africa', Journal of Mental Science (1895), 75.
27. J. Dunston, 'The problem of the feebleminded in South Africa', The Journal of Mental Science, lxvii (1921), 449-58, 456.
28. In the 1920s and 1930s, many Coloured and African children in Cape Town were deprived of schooling altogether, because they had access to mission schools only. CA, School Board Correspondence [hereafter SBC], 1/1/1/4, 2 August 1922.
29. There was concern about white women being raped by black men in domestic or urban settings, and steps were taken to counter this. That white men had sex with black women, in coercive and non-coercive contexts, does not seem to have been an official concern at all, probably because offspring would not have needed to be accommodated, or even acknowledged as existing, in the white communities. Report of the Commission Appointed to Enquire into Assaults on Women, CA, U.G. 39-'13, 1913.
30. J. Dunston, 'The problem of the feebleminded', 457.
31. The term 'Coloured' was used during this period to refer to those regarded as having 'mixed' racial parentage, as a result of relationships between 'Europeans', slaves and KhoiKhoi people. In the Cape, the term often included Malay people as well. The term 'native' referred to indigenous African peoples. For a discussion of anxieties about miscegenation in the Cape context, see S. Dubow, Racial Segregation and the Origins of Apartheid in South Africa, 1919-36 (London: The Macmillan Press, 1989).
32. CA, SBC, 1/1/1/9, 1 December 1937.
33. T. D. Greenlees, 'Insanity among the natives', 71.
34. V. Bickford-Smith, Ethnic Pride and Racial Prejudice in Victorian Cape Town (Johannesburg: Witwatersrand University Press, 1995), 67.
35. For example, Gertie R., F.C. 871, 1930 was said to have intelligence 'average for her race and class'. Cathrina R., F.C. 853, 1930 was said to be 'moderately intelligent for a coloured person'.
36. S. Swartz, 'Colonizing the insane', 51.
37. V. Bickford-Smith, Ethnic Pride and Racial Prejudice, 104-16.
38. M3045, 1928; F2233, 1927;M3054, 1928; M3358, 1930.
39. S. Dubow, Scientific Racism in Modern South Africa (Cambridge: Cambridge University Press, 1995).
40. Johannes de S, MC 935, 1928; Taliep S, MC 1107, 1930.
41. John H., M3122, 1929.
42. Henry van R., M3329, 1930.
43. H. Calloway, Gender, Culture and Empire: European Women in Colonial Nigeria (Chicago: University of Illinois Press, 1987); C. Knapman, White Women in Fiji, 1835-1930: The Ruin of Empire (Boston: Allen & Unwin, 1986); C. Swaisland, Servants and Gentlewomen to the Golden Land: The Emigration of Single Women from Britain to Southern Africa, 1820-1939 (Pietermaritzburg: University of Natal Press, 1993).
44. H. Calloway, Gender, Culture and Empire: European Women in Colonial Nigeria (Chicago: University of Illinois Press, 1987); C. Knapman, White Women in Fiji, 1835-1930: The Ruin of Empire (Boston: Allen & Unwin, 1986); C. Swaisland, Servants and Gentlewomen to the Golden Land: The Emigration of Single Women from Britain to Southern Africa, 1820-1939 (Pietermaritzburg: University of Natal Press, 1993).
45. H. Calloway, Gender, Culture and Empire: European Women in Colonial Nigeria (Chicago: University of Illinois Press, 1987); C. Knapman, White Women in Fiji, 1835-1930: The Ruin of Empire (Boston: Allen & Unwin, 1986); C. Swaisland, Servants and Gentlewomen to the Golden Land: The Emigration of Single Women from Britain to Southern Africa, 1820-1939 (Pietermaritzburg: University of Natal Press, 1993).
46. C. Swaisland, Servants and Gentlewomen, 41.
47. For a discussion of prostitution in Cape Town, see R. Hallett, 'Policemen, pimps and prostitutes: public morality and police corruption in Cape Town, 1902-4', in C. Saunders (ed.), Studies in the History of Cape Town, Vol. I (Cape Town: History Department and Centre for African Studies, 1979), 1-41.
48. Irene W, FE2323, 1928; Jessie C, F2570, 1930.
49. Fatija M, FC769, 1929.
50. Gertie R, FC871, 1930; Annie J, FC 864, 1930.
51. C. Swaisland, Servants and Gentlewomen, 41.
52. Report of the Commission Appointed to Enquire into Assaults on Women, CA, U.G. 39-'13, 1913.
53. Commission into Assaults, 37.
54. Ibid., 7-9.
55. Leslie A., M3100, 1928.
56. Commission into Assaults.
57. In the same year, her mental age was assessed as 9 years. In 1930, she was diagnosed as 'psychopathic personality plus ?feeblemindedness'. These revisions demonstrate the extent to which, at this time, intelligence testing was a haphazard affair. Mary E., FE 2257, 1920.
58. Annie J., F 2233, 1927.
59. Colin M., M 2901, 1927; Peter G., M 2888, 1927, Colin S., VB 348, 1926.
60. Annie v. R., FE 2071, 1926.
61. Lucy W., VB 230, 1920.
62. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th edn (Washington DC: American Psychiatric Association, 1994), 629.
63. For example, a study of admissions to Western Cape state hospitals for the year 1994 revealed that 20% of a sample of 2,110 patients were given a diagnosis which included personality disorder on admission. N. Msomi, 'Description of the racial distribution of psychiatric diagnoses in three state hospitals in the Western Cape', unpublished Masters dissertation, (University of the Western Cape, 1997), 53.
64. An excellent example can be found in Harriet Lerner's analysis of the use of the 'hysterical personality' diagnosis to characterize behaviour in women, which male psychiatrists found to be in conflict with preconceived views of appropriate femininity. Lerner, H. E., 'The hysterical personality, a "woman's disease"'. Comprehensive Psychiatry, xv (1953), 656-75.
65. B. Luske, Mirrors of Madness: Patrolling the Psychic Border (New York: Aldine de Gruyter, 1990).
66. S. Swartz, 'Using psychodynamic formulations in South African clinical settings', South African Journal of Psychology, xxix (1999), 42-8.
67. N. Msomi, 'Racial distribution of psychiatric diagnoses', 53.