Det terapeutiska rummet. Rum och kropp i svensk sinnessjukvård 1850-1970

Sammanfattning: The aim of the thesis is to describe and analyze the Swedish public psychiatric hospitals between 1850 and 1970 as well as the treatment, care and custody that these hospitals provided. The study has as its starting point two relationships. The first is the relationship between the patient’s body and the space of the institution. One focus is on how the patient’s body has been enclosed by the institution during different time periods. The institutional space is described as an instrument for the psychiatrist and the nursing staff in their treatment, care and custody of the patients. The second relationship is formed by the intentions of the psychiatric programmes and the actual practice of institutional care. A presumption for the study is that the institutional practice is not a simple reflection of the psychiatric ideals, nor of the scientific theories, but is also tied to unspoken traditions and the practical demands of daily life in the institutions. The knowledge of the single patient produced by the psychiatrist and the staff of the institution is related to the space of the institution. The design of the mental hospitals is also related to the care and treatment they offered the patient. In the 19th century asylum the cell was the specific room to which the therapeutic expectations were directed. During the years at the turn of the century when many observation wards were introduced, the cell lost its positive meaning. Besides allowing for constant supervision the observation ward created a visually open order. From the case records, however, it is evident that many patients had power of initiative and tried to confront and manipulate the institutional order. The position of the mental hospital between the general hospital and the prison is analyzed. References to the general hospital were intensively cultivated by the representatives of psychiatry. References to the affinity with correctional treatment were not as common. The restraint, the locked doors and the long stay of the inmates are, however, examples of common denominators between the asylum and the prison. In contrast with the more glamorous story of psychiatry marked by initiative and progress, the history of the asylum revolves around the small steps, the daily interventions and the repeated activities. As a project the asylum, the mental hospital, was part of the modern society. As a practical activity this position was more uncertain and precarious.