Americas,  Italy,  Paula,  United States

Learning, Learning Difficulties and Mental Illness

Édouard Séguin (1812–1880)
Édouard Séguin (1812–1880)

Today’s effort is a bit of a mish mash. I don’t have the skill to tell a story as ER does, and I don’t have that element of controversy that AG has in his work, and I certainly cannot weave a factually detailed narrative in the way Phoebe does it. All of our brains work in different ways; some of us are academically gifted, others good at solving problems or creating amazing works of art. Some people are just good at making or fixing stuff. But each one of us is good at something. And that is the point of

my offering today. That mental health is no bar to intelligence, and the two are not mutually exclusive.

I’m not going to give you a run down on each of the people I touch on in this article, not a full one anyway; that’s a job I will leave to the writers. Instead I’m going to lead you on a short journey, and tell the story of how each of these people contributed to that journey. I found the inspiration for this article whilst playing around with a little mystery offered in the form of an inscription in an old book, delivered to the lovely Elizabeth Chadwick the other day, so thanks Elizabeth, this one is for you (and I still firmly believe that the dedication you have in that book, is something to do with the Seguins).

In the early part of the 18th century, Edouard Seguin studied medicine under Jean Marc Itard, who famously took on and worked with the “Wild boy of Aveyron”. Itard achieved limited success in his venture, which led professionals in the field of human development to conclude that there is a natural process to the learning of social skills, and that these skills – the ability to communicate efficiently and function in human society – were learned at specific times during development with appropriate stimulus from others. If those lessons were not forthcoming, the optimum period for absorbing the knowledge would be lost and the lesson unlearned.

Seguin used his time with Itard to develop his own theories regarding the development of the infant brain, particularly those of children who had congenital brain damage or birth related brain injuries. Working from the new angle of physiology rather than traditional theory, that the brain development in these children were neither diseased nor abnormal, rather suffered “arrested development” at some point before, during or shortly after birth, Seguin set up the first private school in his hometown of Paris, treating these children by firstly strengthening their physical carriage, believing this would help them intellectually and then by stimulating the intellectual abilities with specially developed lessons to enable them to learn everyday skills. Seguin published many books and articles, including studies on Aphasia, Lunacy, Idiocy and physiology of brain injured patients. He was credited with the naming of an involuntary muscle contraction presenting before epileptic seizures, known as Seguin’s Sign.

In around 1850 he took his family and his techniques and moved to America, to assist in several educational institutions that had been set up based on his own model, eventually reaching New York in 1860 where he went to work in Randall’s Island asylum in the children’s facility to improve their living conditions. Randall’s island, like nearby Ward’s and Blackwell’s Islands, have since their purchase been associated with various institutions turned over to the housing and treatment of the most unfortunate members of New York society, including those with mental illness, those deemed “idiots”, sick emigrants, vagrants, juvenile delinquents and others. Wards was also later used as a mass cemetery for those who died whilst in these facilities, as well as those pre-deceased from other cemetery clearances.

Maria Montessori
Maria Montessori

Due to the successes of Seguin’s methods, a young Italian Physician, graduating in the fields of both Psychiatry and Pediatrics, followed the teachings of both Seguin and Itard closely and later developed and built on the theories she had learned. Maria Montessori was the first female Physician in Italy, graduating from the medical school of the University of Rome with the highest honours in 1896. After a period working in the free clinics, taking care of the most poverty stricken children of the area, she was given the ominous task of running the new Orthrophenic school, previously the municipal asylum for “deficient and insane” children. Her first action was to dismiss the majority of the “care-taking” staff who were quickly seen to treat their charges with disdain and contempt. Using methods she had developed for breaking down simple social and personal skills into easy lessons, including non-verbal skills, which she had implemented successfully with particularly her blind patients, Maria improvised her methods and was quite quickly able to teach her more capable new patients, to look after firstly themselves and then the other, younger or less able children. Basic self-care regimes, dressing and washing etc were quickly mastered.

As she was able to recruit further staff members who were interested in learning her methods, Maria was able to increase the skills, through new lessons using purpose made materials she had developed. Montessori was desperate to prove the methods could work on other children, but was denied access to school age children. Instead she was placed at the head of a new institute, basically a day-care for pre-school children of the poorest working classes, at Casa dei Bambina. Despite their initial aggressiveness, unlike the mentally disturbed children she had worked with previously who had to be coaxed to use the materials, she was surprised to find these young children responded positively and with genuine interest to the methods she had developed. One day she arrived to find that the children had broken into the school through an unsecured window, and had helped themselves to materials from the cupboard which someone had neglected to lock. They were all sitting quietly working away. From that point, the materials were no longer locked away. Her methods and designs for not just teaching materials, but the aides for young children, small toilets and low hand basins and so on, are implemented in schools worldwide, particularly in the facilities developed as Montessori Schools.

But our journey is not over quite yet. Following in his father’s footsteps, Edward Constant Seguin graduated in New York as a Physician in 1864, after serving during the civil war as a medic. Specialising in Neurological disorders, Seguin was an early mover in the new field of medical thermometry. After a period spent back in his birthplace of Paris, studying diseases of the nervous system under Charcot and Brown-Sequard, he returned to New York in 1870 and was employed by William Draper, in his practice. In 1871 he was given the Chair of Diseases of the Nervous System at the College, which he held for five years before his resignation, founding the Neurological clinic during his employment.

Seguin jr, like his father, published several papers and studies on various aspects of neurosis. His most prominent later work centred on the theory that those suffering mild to moderate mental illness could be successfully treated for their condition, in the comfort and stability of their own homes, with adequate family support and the attentions of a trained physician. His research was thought to be pioneering and changed the viewpoint that sufferers of mental health issues automatically needed to be removed from their comfort zone and kept in isolation, without undue stimulation, in order to prevent further stress.
Sadly, his career suffered a dramatic pause in 1882. Seguin’s wife, Margaret, whom he had been treating at home himself for bouts of “melancholy” perhaps as part of his ongoing research, vanished one afternoon. As a result of her fits of depression, her brother Dr Amidon, who lived a few doors away, had taken to meeting with her daily in an effort to keep up her spirits. Seguin, with his brother in law’s assistance, felt it was better to allow Margaret to remain in the relative comfort of their home, rather than be admitted to either a facility from where she may never return, or one of the private rest-homes which had sprung up, whose mantra was calm and quiet isolation from all previous contacts to minimize distress. Seguin perhaps felt these alternatives unsuitable for his delicate wife and their circumstances.

Despite already having seen his sister once that day, at lunchtime, Dr Amidon visited his sister later in the afternoon, to be informed she was not at home. Upon returning a few hours later, there was still no sign of her, and a feeling of alarm was raised when the hall-boy mentioned that the spare room door was locked, a most unusual occurrence. From being concerned that his sister had thrown herself into Central Park Lake – thereby confirming existing concerns of suicidal tendencies – whilst out with the children, Dr Amidon went to break down the door of the locked room. Upon gaining entry, he found the bodies of his sister and all three of her children aged 4, 5 and 7. Margaret had shot them all to death, after binding their hands and blind-folding them, apparently in a game of Hide and Seek, placing two inside a walk in closet where their bodies still lay, before executing them all with shots to the head. She then turned one of the three loaded guns on herself.

Although Seguin removed himself somewhat from his practices, he continued to publish, and to maintain that his theory was workable. He continued to deny the need for incarceration into institutions for all but the most severely afflicted. His previous statement “It is fair to say that, in the present state of psychiatry in America, to be pronounced insane by physicians, by a judge, or by a jury, means imprisonment for months, years, or for life.” remained his verdict on such establishments. It is sad to note that despite being a pioneer in the more moderate treatment of mental illnesses, Seguin was unable to see the extremity of signs displayed by his wife, in order to prevent such a tragedy. The hall-boy, who had worked for the family for three years later confirmed that Mrs Seguin’s habits were somewhat peculiar, and that she often seemed sad. It was said that the happier the children seemed, the more marked her melancholy, as it troubled her that her children had been ‘doomed to a life of misery and her one object was to save them from the fate which she imagined was in store for them.’

Following the tragedy, Seguin moved away from his home back to Europe, returning to New York in 1885. Despite the horror of the tragedy in his own life, Edward Seguin’s methods of home-treatment of mental illness continued to be trusted and developed by his peers. After working in his own practice, and re-marrying twice, Edward eventually retired in 1896. In 1898, Edward Seguin passed away from cirrhosis of the liver. He left request to be buried with his father who had passed away some 18 years before, and his beloved children in the Seguin family plot at Woodlawn Cemetery, Bronx. He left all his professional materials to the college, and his belongings to his third wife. No mention was made of the guns Margaret had used to end the lives of his family, which he owned. It also remained unstated that Margaret had been buried within the vault alongside her children, and Seguin’s final resting place reunited them all.