Delusions of Madness by Kimberly K. Taylor; Harrowing Historical Fiction About The Reality of Mental Asylums and Mistreatment of Women

Delusions of Madness by Kimberly K. Taylor; Harrowing Historical Fiction About The Reality of Mental Asylums and Mistreatment of Women

By Julie Sara Porter

Bookworm Reviews 

This review is also on Reedsy Discovery.

Spoilers: Delusions of Madness by Kimberly K. Taylor is about as skin crawling, creepy, harrowing, and anxiety inducing as any Supernatural Horror book or movie. The most disturbing part of this Historical Fiction nightmare is that it is true. It depicts the lives of patients, especially women in a 19th century mental asylum and it does not skimp on any of the details. Even if you don't have dementophobia (fear of insanity-which I do), you might still have nightmares.

Proper 19th century Ohio wife and mother, Cassie Alexander is institutionalized by her husband, Jed who reports that she has gone insane. She hasn't. She and Jed are having marital problems and he is having an affair and needs to get rid of the competition before he can move onto the Second Mrs. Alexander. He convinces a judge that she needs to be institutionalized, so she is sent to a mental asylum.

When Cassie arrives, she finds a filthy degrading place filled with suffering patients, practices that damage them even more, and a sadistic or indifferent staff that tortures and abuses those under their alleged care. It doesn't take Cassie long to figure out that mental asylums are not there to treat people or help them recover. They are places to put people to forget about them.

Mental asylums have become an important topic in the past year with President Trump insisting that immigrants “from prisons and mental asylums” are being sent to the US, probably confusing mental asylums (institutions for the treatment and care of the mentally ill) with asylum seekers (people fleeing persecution, war, or violence and applying for legal recognition as refugees to another country but whose claims are still pending). Last year he signed an executive order aimed at reducing homelessness and severe mental illness by encouraging the expansion of involuntary, long-term commitment into psychiatric care including reducing community health services and bringing back long-term mental institutions and insane asylums.

It's important to remember that the treatment at such centers wasn't always the best and to understand the history of how people were treated back in the day, to recognize the mistreatment for what it was, prevent such abuse from repeating itself, and remember that there are resources that can be contacted if such abuse does happen now.

Taylor pulls no punches in her descriptions of the horrid conditions that Cassie and the other inmates/prisoners suffer through. We are treated to drafty mildewed walls, filthy floors with rancid odors and waste that is barely cleaned, uncomfortable and filthy beds, rats and other vermin that inhabit some of the rooms, and the sounds of tortured sobbing and screaming. It is not a pleasant place to say the least, said Ms. Obvious.

Then there is the staff who make Nurse Ratched from One Flew Over the Cuckoo’s Nest look like Florence Nightingale. They beat and physically torture the patients and purposely use dehumanizing language to bring them down to their lowest basest level.

Dr. Gooding, the asylum's primary physician, sexually assaults the patients. One of the patients ends up pregnant and he arranges for her to have an illegal, painful, and potentially destructive abortion. Matron Harrow, the asylum director is adept at manipulating and mentally abusing her charges. She has a particular vendetta against Cassie because there is a personal link between her and Cassie's erstwhile husband. She saves the worst punishments for her.

The asylum patients are subjected to various torturous punishments disguised as treatment from the moment they enter. They are branded upon entry. If one steps out of line as Cassie does, they are sedated and deprived of food and water. They are subjected to torture disguised as treatment like dunking their heads in ice cold water, throwing them in solitary confinement, or strapping them to a chair and spinning it around to the point of disorienting them.

 There are also early forms of electroconvulsive therapy and lobotomies practiced by people who do not know what they are doing.All of these are means to break a patient's spirits and remove their free will. If they are constantly monitored, ridiculed, tortured, beaten, and dehumanized, they will consent to anything.

The dehumanization is revealed in various ways in the book. Some are left screaming. Others sit in fetal positions crying. Many just lie inert, no longer giving a damn. One woman whose child has died holds nothing but air in her hands under the delusion that her baby is with her. The sad part is if help and reform comes to the asylum, these women will be too far gone to appreciate it.

In some ways, the asylum is representative of the patriarchy. Women’s sanity is determined by husbands, male family members, judges, doctors, and attendants who make medical decisions for them. Women who help the system like matrons, nurses, and Conservative women can only seize power by siding with men and condemning women who don't fit the program. The results are the women are silenced, isolated, deprived of any agency, and left utterly dependent and complacent to whatever abuse they receive.

Just like other facets of the patriarchy, it takes women to challenge it and reveal what is wrong. While most of the female patients are left dependent and animalistic by the abuse, ironically it strengthens Cassie. She argues with staff when she or others are abused. She stands up for and defends those who can no longer speak or reason for themselves. She still recognizes their humanity. She covertly takes notes on her situation and tries to send hidden messages to authority figures so something legal and permanent can be done to stop it. She's not the only one.

The book is set around the same time that Nellie Bly wrote her famous Ten Days in a Mad House expose in which she faked mental illness symptoms to be institutionalized and was sent to Bellevue Hospital and later Blackwell Island. She took notes of the poor treatment and abuse and compiled them into her book which was such a sensation that reforms in mental institutions began almost immediately. Bly and her book even get a shout out in this book as Cassie and her fellow inmates now have someone speaking out for them and telling the truth. 

Cassie in the book and Bly in real life forced the public to see that the mentally ill, particularly mentally ill and institutionalized women are people with names, histories, and identities. They challenged the people in charge and on the outside to recognize their humanity and change and reform the institutions accordingly.