Amy Milne-Smith
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Personal shame
Failures of morality and the will
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This chapter puts the patient at the forefront of analysis and is deeply influenced by recent trends in the history of emotions to interrogate shame and stigma. The value-laden diagnostic system of Victorian lunacy meant that patients were often held responsible for their own breakdowns. Without a thorough understanding of the causes of mental illness, ‘intemperance’ was often used as a cover for any disease doctors believed was self-inflicted. Both patients and their families were well aware that men could be blamed for their mental breakdown, leading to shame and secrecy.

This chapter outlines the intellectual framework of this culture of shame, and how patients struggled within this context. The ideal late Victorian man was above all things in control of himself and his place in the world. A man who lost control of his mind and his emotions struggled to retain his sense of manhood. When men felt culpable for that loss, their shame added an extra layer of humiliation. In particular, when a man’s madness was associated with alcohol or sex, internal and external pressures of shame intensified. Often patients were hardest on themselves, and doctors feared that guilt over sexual indiscretions could be more damaging than the sexual habit itself. Chapter sources include memoirs and case notes to find the voices of the patients, along with medical texts and fiction to get a sense of the broader popular and medical contexts of the issues.

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Out of his mind

Masculinity and mental illness in Victorian Britain


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