Mental Health History

Depiction of the Mentally Ill

My aim in this post is to explore the depiction of mental disorders and disabilities in the medium of photography and my personal experience in wrestling with this.

According to the Merriam Webster dictionary, a disorder is an abnormal physical or mental condition and a disability is a disqualification, restriction or disadvantage. Mental disorders and disabilities are often lumped into the category of mental illness. Since illnesses are the province of the medical community, how do they address them? There are two major compendia of mental disorder and disability classifications on which the medical community relies” The Diagnostic and Statistical Manual of Mental Disorders (DSM), a publication of the American Psychiatric Association (APA) and the International Classification of Diseases (ICD-10, Chapter V), generated by the World Health Organization (WHO). The classification of mental illnesses is a very complex and controversial topic that I hope to address in a separate discussion. In this post, I discuss the pictorial portrayal of metal states.

Mental Illness depicted in the Arts

Art forms which depict the mentally ill include: Literature – from Greek Tragedy to Sybil; Film – from Dr. Jeckyl and Mr. Hyde to One flew Over the Cuckoo’s Nest; Drawing and Painting, from Durer’s Melancholia to Munch’s The Scream; Photography, from Dian Arbus’ Untitled (1972) to Mary Ellen Mark’s Ward 81 and in Music – epitomized by Bernard Hermann’s score to Psycho. Music and mental illness represents a fascinating area of discussion.

Mental states depicted in the Sciences

In The Face of Madness Hugh W. Diamond and the Origin of Psychiatric Photography edited by Sander L. Gilman, Eric T. Carlson, M.D. describes some of the early efforts to use images of sick people for medical education purposes. He describes a letter from Benjamin Rush, physician, writer, humanitarian and signer of the Declaration of Independence, to the painter Gilbert Stuart in 1802: “Thirty years ago I communicated to Mr. [Charles Willson] Peal, [late 18th, early 19th century painter] a wish to see a gallery of portraits of sick people laboring under such diseases as show themselves in features and countenance…” He included “madness” and “melancholy” in his list of maladies and diseases. Rush continued, “By means of a gallery of portraits such as I have hinted at, the study of medicine might be much aided, and benevolent sympathies be excited in persons who from education, situation, or too much sensibility are precluded from seeing the originals in sick rooms or hospitals.” (L.H. Butterfield, ed. Letters of Benjamin Rush (Philadelphia: American Philosophical Society, 1951.) p. 852, quoted from Sander L. Gilman The face of Madness, New York: Brunner/Mazel, 1976). In other words, sensitive portrayal of the mentally ill could engender sympathetic treatment.

The practice of phrenology in the late 18th century by Gall and Spurzheim made a connection between the shape of a person’s head and intellect as well as many other personal characteristics.

Mental Illness in the popular Press

In addition to artistic expression of this aspect of the human condition, of course mental illness has been the subject of numerous legends, rumors and news coverage in the popular press. This might be the most important aspect of depiction of mental illness as it relates to public policy and is worthy of, and indeed has been the object of much study. Mental illness is also discussed on social media. I am sure that its effectiveness will be the subject of future sociological studies.


Portraits, prior to photography, have been painted for many centuries. Patrons in search of immortality secured the services of skilled artisans to create images to be seen by future generations. With patronage comes control. The artist had little choice but to paint, draw or sculpt a respectful (if not truthful) image of his ‘boss’. With the advent and maturation of photography, portraiture became more about the relationship between the photographer and the subject. A certain kind of truth – a truth of the moment – can be crafted (or manipulated).

Some people say photographs don’t lie. I have found that not to be the case. Photographers have been using images to tell whatever truth they wish to portray. Why are so many photographs taken of politicians during speeches” we hear o the whirr of the cameras and see the blizzard of flashes with every gesture. Surely one picture would serve the purpose of documenting a speech. Yes, but which picture> is it the one where a tear is wiped away; where the politician is looking up? down? smirking? So many pictures are taken so the photo editor can choose an appropriate image. Appropriate to what? Appropriate to his or her point of view: how he or she wishes the subject to appear.

There are rules to respect privacy. One cannot go to the hospital, for instance, and take photographs of patients without permission. Celebrities are always on guard against the paparazzi, and with good reason. Embarrassing and revealing photographs sell.

It is easy to exploit with images. Unusual images are worth money. People will gawk at almost anything. Take the circus for example: freak shows attract hordes of people. So how can one respectfully depict the obviously physically handicapped and mentally ill?

My Brother

Respectful portrayal of the handicapped is a question near and dear to my heart, since my older brother is profoundly retarded and autistic. Michael has never spoken and it was never obvious to me if he know who I was. One of his eyes focuses in one direction and one in another, like an out of control Marty Feldman.

Mike lived at home until I was ten years old. I remember home life as very chaotic. Michael would yell and hit himself and wander around. I always wanted to make contact with him, but it was impossible. I used to write my thoughts down, partly to help me think. My mother made arrangements to bring him to Willowbrook, a mental institution on Staten Island, NY when he was 14. She told me that he had his bar mitzvah there, but I don’ remember. My family and I used to visit him there. Michael lived there until it was closed (in the 1970s) after wide scale abuse was uncovered.

As a child, I always had an attraction to photography, and a good eye for taking photographs. There is a picture of me at about 8 years of age, with a brownie camera around my neck. I must have taken a lot of pictures then. Today I can only identify a few of the old family snaps as mine. Sometimes when I show the family pictures to people who never met Michael, they say, “He looks so normal. When did your parents know he was ill?” This is how I know photographs lie. He was never normal.

I studied photography seriously later in my life and began taking Michael’s photograph – with permission – at his 40th birthday party. I was taking a photography class at the time and thought I would use the opportunity to document a family occasion. It was the beginning of my long term project documenting Michael’s life.

The photographs I took at the start of the project have both the qualities of being detached and personal. Where was Michael? Who or what was he? Was I like him? Was he like me? How close could I get? If I got close enough with my camera, would I be able to discover something from that picture that I couldn’t see in real life? I included the rest of my family in the mix. How did having Michael as a family member shape us” I was searching for an inkling of closeness or recognition. I photographed Michael at his home, at day programs, at parties with friends and at the grocery store. I attended the periodic reviews held by his caregivers to discuss his medical, socialization status and progress toward personal goals.

Did I portray Michael respectfully? I had love for him as a family member and as a human being. But I also felt every emotion at times during the project. Beyond the most prevalent emotion of frustration, there was joy, surprise and even anger. My purpose in photographing him was to understand him and, in particular, my relationship with him. I believe that my images of him were respectful and that this is evident to the viewer

Future posts will include some of my photos.

5 thoughts on “Mental Health History

  1. Michael is lucky that you are his brother. You have not lost sight of him as a person, no matter how difficult it is (or he is?) I wish you were closer to us here. It is very difficult for me to get to see him, and very frustrating when I do see him. Bless you darling. Love, Mom

  2. Pingback: Mental Health History | Brotherly Love - WISDOM

  3. I found this post very touching and the statement about the camera not revealing the truth is thought-provoking. Your brother is blessed to have you as a sibling.

Leave a Reply