TW for extensive discussions of mental illness and suicide

A few notes to start. I originally presented this at the July 2018 SHEAR conference in Cleveland, which means that while it is deeply-considered and deeply-sourced, it is also something that had to be read in 20 minutes or less. It was also written to both make an argument and provoke conversation about that argument, not simply to be provocative, but because those kinds of conversations help us, as scholars, make our work better. This is all to say that there’s much more to this story, and to the argument I was making, and there are dozens of threads to be pulled in here. I have no idea if I’ll ever have the chance to weave them into something bigger than this, but I’m glad I got to tell this story. 

Three other things: I created a (hopefully) helpful family tree of the Sedgwicks and Minots discussed in the paper which you can find here. The Massachusetts Historical Society has this pretty complete listing of Theodore Sedgwick and three generations of his descendants (click on “Appendix” in the table of contents), and you can see how most of them have all been laid out in the famous Sedgwick Pie, the family burial plot in Stockbridge, MA. Also, I am not attempting to retroactively diagnose the people I’m analyzing in this paper; when I use terms like “depression,”  “mania,” and “insanity,” I am using the words and understandings that the physicians and family members used in their writing at the time. And finally, thanks to Greg Wiker for putting together our panel, to him and Leah Richier for speaking on it with me, to Dea Boster for chairing, to Becky Noel and Jeff Mullins for their comments, and to Mike Mortimer for live tweeting the panel, which you can read here.

In the spring of 1841, Charles Sedgwick awaited word of his son Charlie’s safe arrival in Liverpool. He hoped that the activity of the voyage would provide Charlie some relief from the severe depression he had experienced over the past eighteen months. Word arrived on April 21st. Charlie had died by his own hand.

In the days and weeks that followed, Charles expressed resigned gratitude that his son was at peace, but also argued that the manner of Charlie’s death was as much a merciful act of Providence as his death itself. How could a man like this – a New England elite and liberal (if unaffiliated) Protestant – express these beliefs about mental illness and suicide at a moment of such faith in human progress, when many physicians believed they could treat and even cure mental illness?

I argue that he drew on contemporary ideas about a benevolent God and the meaning of human suffering to come to terms with a tragedy that, in his eyes, demonstrated the continued failure of mankind to treat and cure the kind of mental illness his family had endured for three generations.

Born in 1791, Charles was fifty years old when his son died. Over those same fifty years, historians chart a distinct change in the way physicians treated mental illness in Europe and the United States. Condemning their predecessors’ methods as cruel, European physicians like William Tuke argued for “moral treatment.” Under the proper supervision of a doctor, in a healing environment, with their passions and appetites diverted and regulated, those with mental illness could be treated and even cured.[1]

An increasingly-professionalized community of physicians in the United States asserted similar claims, and many politicians and social reformers believed them. In the late 18th century, Benjamin Rush and others urged the creation of separate wards for the treatment of those with mental illness, though they continued using older treatments like bloodletting.[2] McLean Hospital, opened in Charlestown, Massachusetts in 1818, was the first of several private asylums which put moral treatment into full practice, expanding into state asylums in the 1840s.[3]

But by the time of his son’s illness, Charles Sedgwick had reason to doubt these heroic claims. Both his mother and brother had been treated by physicians using moral treatment which had not only failed to cure them but seemed to have made their mental illness worse before their premature deaths. Charles did not reject the principles of moral treatment, but he was willing to reject the expertise of its professional advocates.

In the fall of 1839, Charles received a letter from William Minot, the brother of his sister-in-law Jane. 17-year-old Charlie, just beginning his junior year at Harvard, was “ill at his house of a nervous fever.” Despite William’s reassurance, Charles departed for Boston that day, and arrived to find that Charlie had been steadily improving.[4]

Despite positive contemporaneous accounts of Charlie’s recovery, a lifetime of experience meant the family was immediately on guard for evidence of mental illness.

Charles’ mother Pamela had experienced her first episode of mental illness on the eve of his birth in 1791. For years, her husband Theodore asserted that his wife’s “episodes” were caused by overwork and could be treated by hiring more domestic staff.[5] Her half-brother, a doctor, believed it was a “disorder of the blood,” not the brain.”[6]

When Charles’ brother Harry began exhibiting similar symptoms in 1826, his family members initially wrote it off as his extravagant personality made more irritable by periodic blindness.[7] It took two years for the family to fully accept this was something more and seek treatment.

In the wake of Harry’s illness, some of the Sedgwicks acknowledged this might be hereditary. But many things were hereditary, and the Sedgwicks believed this particular tendency could be counteracted by what amounted to proactive moral treatment, described by  Theodore Sedgwick II in a letter to his son as: “conduct regulated by wisdom & far removed from all extravagant hopes, fears, phantasies” and the maintenance of a “sound mind in a sound body,” since “bodily illness brings on insanity.”[8]

Charlie may have been “fast getting into as quiet a state as the Sedgwicks ever are,” but that wasn’t saying much. Charles was concerned that his son’s illness might catalyze something worse in his Sedgwick mind.[9]

His subsequent decisions demonstrate that he still believed in the principles of moral treatment but was no longer willing to place his faith – and his son’s life – in the hands of its professional practitioners.

His mother’s treatments at the turn of the century reflected early attempts at moral treatment in the United States. Theodore Sedgwick placed his wife under the care of doctors who practiced bloodletting and kept her separated her from her family – as far as 150 miles away – to calm her mania. Each period of treatment sent Pamela home “much improved,” though the improvement never lasted. When Charles was 12, these treatments stopped, and his mother died four years later in 1807.[10]

Twenty years later, when confronted with their brother Harry’s periods of mania and depression, the siblings considered placing him under the care of doctors, who now advocated moral treatment in dedicated asylums, but their mother’s experience made them skittish.

In December 1828, Catharine stated that doctors might be able to help her brother, but knew his wife opposed it. Harry himself had “most solemnly warned her against ever putting him into the hands of a ‘mad Doctor’ & in his sane moments he expressed great horror of sending patients to the hospital.” He made the source of his fear abundantly clear to his wife: “they served my mother & if you do it Jane you will repent it forever & forever!”[11]

Yet less than a month later, Jane and Charles brought Harry to McLean where he was placed under the care of Rufus Wyman. Wyman’s moral treatment again included keeping Harry completely separated from his family for nearly a year, save two visits from his oldest brother, to settle his alternately “exalted” and “depressed” passions.[12]

Instead, Harry became a “most violent maniac,” and by December 1829, the family deeply regretted what they had done.[13] Catharine wrote that “the thought of his confinement has become an intolerable burden to me – it seems like imprisonment – an infliction in which we have part.”[14]

Jane removed her husband to Eli Todd’s Hartford Retreat, founded in 1824, where he experienced a “moral treatment” more to his liking, including chess with Todd and visits from his family.[15] He was released home five weeks later in a calmer state.[16] Over the next year and a half, however, his illness gradually returned. He slipped into a coma in the fall of 1831 and died two days before Christmas.[17]

This background helps us understand both Charles’ familiarity with the principles of moral treatment and his deep skepticism of its practitioners’ methods and optimism.

He consulted Samuel Woodward, the head of the Worcester Asylum, James Jackson, the first physician of Massachusetts General and founder of McLean, and Walter Channing, Jackson’s assistant and a close family friend. All agreed that there was no cause for alarm over Charlie’s illness, and only Woodward suggested keeping him out of school, though not for the whole term.[18]

These doctors were not only “experts,” they were fellow elites and friends, but though they assured Charles this was as an isolated incident, he could not accept their conclusions.

Charlie did not return to Cambridge that term, or ever. Charles put his choice down to being a “fidgety and anxious person” himself, but he was not alone; “the nerves of the whole family [were] on the outside” about Charlie.[19] His reason may have returned easily this time, but his father was unwilling to take chances.

Charles accepted physician’s beliefs on the causes of mental illness and the basic tenets of moral treatment, but he never placed his son in their care. Instead, Charlie remained at home, engaging in regular physical exercise and a sedate course of study, reading Greek and history.[20]

It’s not difficult to imagine that an elite family believed they could provide a healing environment for one of their own, but equally important is their experience with family separation as a part of moral treatment.

Pamela Sedgwick attributed her distress to her husband’s absence and was then subjected to treatment that mandated further separation from her family. Harry begged his family not to place him in a hospital, but they did anyway. When his wife finally came to see him at Hartford, he screamed at her for leaving him isolated in such places for so long.[21]

In the wake of Harry’s death, Charles wrote to his brother Robert: “It was a sad error to permit him to go into that solitude unattended by some friend.”[22] Moral treatment may have been fine on principle, but the practice of family separation had only brought pain to the Sedgwicks, and they rejected it for Charlie.

By May 1840, Charles was cautiously optimistic about his son’s recovery, and Charlie went to New York to work in the law offices of a cousin, but like his uncle and grandmother, Charlie slipped into depression again and returned home to Lenox.[23] He spent the fall with his extended family in New York, and his younger sister Bessie reported to her father in December that he was “out of sorts but not so weak or fearful as at Lenox,” and the older women of the family agreed: “Aunt Lizzy considered him perfectly recovered and Aunt Susan confirms her in that opinion.” Even the homeopathist favored by some of the city Sedgwicks found Charlie’s sluggish circulations “to be now in perfection.”[24]

And yet again, Charles Sedgwick did not trust the doctor’s assurances, nor those of his sisters-in-law and daughter. Within a month of these letters, Charlie was preparing to set off on the packet to Liverpool, with this father’s full support.[25]

The family was hopeful that occupation would help Charlie, but they were worried too. Catharine seemed concerned that this wouldn’t cure her nephew, but Charles reassured her that if it didn’t, they could always try again.[26] Charlie’s mother seemed deeply concerned for his safety on the voyage, but his older sister Kate was worried for what came after.

In a letter to her father marking Charlie’s birthday on April 5th, she said she was “more anxious for him after he leaves the ship, loses the sphere of necessary exertion, & has time again to brood over himself, to extend the cloud of the past over the future.”[27] They had taken a chance in treating him themselves, and in sending Charlie away alone, they took an even greater chance. Charles regretted sending his brother into solitude, but had he made the same mistake with his son?

Kate’s fear was ultimately borne out. As Catharine later reported: “Captain Delano wrote that [Charlie] was cheerful during the greater part of the voyage, active and useful to him. The day before their arrival he took to his bed and said he had a bad fit of dyspepsia. It was with difficulty that Capt. D. persuaded him to leave the ship and go with him to his hotel — he was in the deepest dejection. The next day he was found dead in his bed with an empty phial of laudanum beside him.”[28] He had not lived to see the birthday his sister had commemorated in his absence.

The morning after receiving the news that his oldest son had died, Charles wrote to Catharine: “He is at rest, poor boy, and I am not unthankful…I assure you, after much reflection, that the loss is not aggravated by the manner of his death. I think there is as much reason to believe that that was a merciful dispensation of Providence, as there is to think that God ever interferes in the affairs of men by any special interposition whatever…

Charlie has been taken from the evil to come — mercifully taken from sufferings which human skill could not remove, which the watchful affection of earthly friends could not alleviate.”[29]

He elaborated on this point in a letter to Susan: “I am glad that my dear boy is at rest. I fear that some of my friends have fancied that there were some ingredients mixed in this bitter cup that have increased its bitterness — but I have not tasted them. If he had no choice, God has in mercy taken him from the evil to come.”[30]

We see this theme further elaborated in the regret Charles did express: “I was impatient of Charlie’s weakness, intolerant when his disease was upon him. The experience of seventeen and a half years…ought to have satisfied me that disease had wrought the change in him, and that he had no greater power of will than the dead.”[31]

The doctor who performed a post-mortem declared of Charlie’s brain: “Neither time, nor care, nor art could have restored the organ.” In light of this, Charles spoke even more emphatically about his son’s suicide: “I am so satisfied with Charley’s change in his mode of being that I cannot murmur or repine — so fully convinced that suffering awaited him here, that I am thankful.”[32]

In these reflections, we see how his family’s decades-long experience with doctor-supervised moral treatment formed the basis of three “truths” from which Charles Sedgwick formulated suicide as a blessing: that human skill could not cure Charlie’s suffering, that the love of his family could not alleviate it, and that Charlie himself had no control over it. These three truths then combined with one more, a truth that Charles would not abandon, even in his sorrow: that his God was a benevolent and merciful God.

Elizabeth Clark outlines emerging ideas of pain and suffering in the antebellum period that proceeded from new understandings of God as benevolent, rather than punitive. Liberal Protestants distinguished “unavoidable” pain brought on by illness from “avoidable” pain which stemmed from the violence in hierarchical relationships.[33]

Even as this perspective downplayed the importance of suffering in personal moral growth, the idea of gazing upon and entering into the suffering of others led white abolitionists to use the image of the suffering slave – the victim of punitive, avoidable pain in an immoral hierarchical relationship – to “call forth deep sympathy,” in William Ellery Channing’s words.[34]

Pain caused by typhoid fever was unavoidable, pain suffered in enslavement was avoidable, but how was the suffering caused by mental illness categorize in an age when doctors vowed they could treat and even cure it? In his letters after Charlie’s death, Charles repeatedly used the phrase “the evil to come.” He spoke from experience, believing that his child’s suffering would continue and increase with no natural foreseeable end. He believed his son’s pain was not only unavoidable but also unendurable.

Given what he had seen his mother and brother endure, he was confident that neither doctors nor family members nor Charlie himself could cure or alleviate his suffering. We also must consider that Charlie’s own lack of control is what made his suffering particularly unendurable in his father’s eyes.

While the suffering endured by an enslaved black woman who could not consent might be greedily lapped up by northern white audiences seeking to use it as fuel for their moral growth, could a young white man be expected endure such suffering and objectification in which “he had no choice?”[35]

Charles Sedgwick believed his benevolent God would move Charlie’s hand to end his own life before demanding he live it in suffering he could not avoid and should not have to endure.

A little over a year before his initial illness, Charles wrote to his son: “my dear boy, do not commit the unpardonable sin of denying that God has created us for happiness.”

In an age of boundless faith in the ability of humans to make the world better, Charles watched three generations of his family endure mental illness that could not be cured and suffering that could not be alleviated.

He did not lose faith in human skill, but until it had advanced to the point that it could bring his son back to happiness – for a young white man like Charlie, something inseparable from reason and agency – he was willing to leave it to the mysterious workings of Providence. Whatever Charles Sedgwick’s benevolent God decided was, in his words, “the best that could happen.”

[1] Mary-Margaret Mahoney, “Books as Medicine: A History of the Use of Reading to Treat the Self and Its Diseases in the Anglophone World, 1800-1940” (Ph.D. dissertation, University of Connecticut, 2018), Ch 1.

[2] Richard Bell, We Shall Be No More: Suicide and Self-Government in the Newly United States (Cambridge, Harvard University Press, 2012), 251.

[3] Bell, 104-5.

[4] Letters from Charles Sedgwick to His Family and Friends, ed. Catharine Maria Sedgwick (Boston: Privately Printed, 1870), 141-2.

[5] Life and Letters of Catharine M. Sedgwick, ed. Mary E. Dewey (New York: Harper & Brothers, 1872), 27-8.

[6] John Sedgwick, In My Blood: Six Generations of Madness & Desire in an American Family (HarperCollins: New York, 2007), 108.

[7] Letter, Catharine Maria Sedgwick to Frances Sedgwick Watson, January 21, 1828, box 80, folder 2, Sedgwick Family Papers, Massachusetts Historical Society; Letter, CMS to FSW, February 8, 1828, box 80, folder 2, SFP, MHS.

[8] Sedgwick, In My Blood, 195-6, also LLCS, 27-8

[9] LCS, 142.

[10] Richard E. Welch, “Theodore Sedgwick (1746-1813): Federalist” (Ph.D. dissertation, Harvard University, 1952), 616-9; Timothy Kenslea, The Sedgwicks in Love: Courtship, Engagement, and Marriage in the Early Republic (Boston: Northeastern University Press, 2006), 21-8.

[11] Letter, CMS to FSW, December 27 1828, box 80, folder 2, SFP, MHS.

[12] Sedgwick, In My Blood, 191; Rufus Wyman, A discourse on mental philosophy as connected with mental disease: delivered before the Massachusetts Medical Society, June 2, 1830 (Boston: From the Office of the Daily Advertiser, 1830), 18.

[13] Sedgwick, In My Blood, 191.

[14] Letter, CMS to Louisa Davis Minot, December 13, 1829, box 80, folder 3, SFP, MHS

[15] Sedgwick, In My Blood, 192-3.

[16] William Minot to Jane Minot Sedgwick I, May 27, 1830, box 27, folder 4, SFP, MHS

[17] Sedgwick, In My Blood 193-5.

[18] LCS, 141-2.

[19] LCS, 142.

[20] LCS, 136-7.

[21] Sedgwick, In my Blood, 193-4

[22] LCS, 66.

[23] Proceedings at the Fiftieth Anniversary of the Graduation of the Class of 1841 at Harvard University (Boston: Alfred Mudge & Son, 1892), 75.

[24] Elizabeth Dwight Sedgwick to Charles Sedgwick, December 20, 1840, box 7, folder 7, Charles Sedgwick Papers, MHS.

[25] LCS, 142-3.

[26] LCS, 145.

[27] Katharine Maria Sedgwick to CS, April 5, 1841, box 4, folder 22, CSP, MHS.

[28] LCS, 145-6.

[29] LCS, 146-7

[30] LCS, 148.

[31] LCS, 147.

[32] LCS, 149.

[33] Elizabeth B. Clark, “”The Sacred Rights of the Weak”: Pain, Sympathy, and the Culture of Individual Rights in Antebellum America” Journal of American History 82, no. 2 (September 1995): 471-3.

[34] Clark, 476-8.

[35] See Saidiya V. Hartman’s Scenes of Subjection: Terror, Slavery, and Self-Making in Nineteenth-Century America (New York: Oxford University Press, 1997).