10 Facts Behind American Horror Story: Asylum

***Massive Spoilers Ahead*** 

Seriously. If you haven’t seen the final episode of AHS and you don’t want it spoiled for you don’t read ahead. Even though this is a little bit of a lesson on the history of psychology it ties into the show and will definitely contain all kinds of juicy tidbits on the show. Did you ever wonder, “what the hell are those baths?” or “why is she even in here? That’s not really a mental illness is it?” We are going to take a very geeky journey back through time to the middle of the 1960s. It was a very dark time in terms of mental health treatment. Though up until very recent times all mental health “treatment” fell under the label of The Dark Ages. In The Sixties we hadn’t moved much beyond Bedlam in terms of how we were treating people with mental illness. And as we saw in American Horror Story: Asylum, some people were still convinced mental illness was caused by sin. People had no concept of brain chemistry. They tended to pathologize socially unacceptable behaviors. Mental health professionals often did the best they could, but many times they were understaffed and working without basic necessities. 

Mental institutions became horror stories. Overcrowding led to rampant disease, death was common. And that’s exactly why American Horror Story made the archetypal Asylum the setting of choice for their second season. It truly is an American horror story. This article will examine some of the more fact-based parts of the show. So don’t expect us to explain why Kit is important to the aliens.

10. What is hydrotherapy?

You may have wondered what was up with the baths they were always zipping people into. This practice is called hydrotherapy and it has been used since ancient times for many medical ailments. For most of its history hydrotherapy was used to help blood flow and regulate body temperature. But what about in mental institutions? As much as it looked like torture, the baths were really used to help a patient relax. They were zipped up so that the person could rest with their legs stretched out. A little like a bath pillow. It would also be used for patients who needed to be restrained often in order to prevent bedsores. So when Sister Jude was sending everyone to the baths, she was really just sending them to “time out.” It was a non-invasive sedation method. Onto to something just a tad more invasive…

9. What is lobotomy?

Before we go into this, remember the time period we are discussing here. People were absolutely desperate to find cures for mental illnesses. And the idea that people could be cured of mental illness was a huge leap forward from an age when people assumed you were possessed by demons. So they did their best. They had no understanding of how the brain works (or that its best to keep most of it intact).

The lobotomy they performed on Anne Frank is called a transorbital lobotomy. It was the quickest and most efficient way to perform this surgery which was, at one point, very much in vogue. Sure it only helped about 1/3^rd of the people it was performed on (1/3^rd didn’t change and 1/3^rd got worse) but that was better than anything else they had. We are going to describe what happened. Just go ahead and look back at the puppy if you get too grossed out. Basically they take what looks like an ice pick and a hammer and hammer the ice pick behind your eye and make a nice scrambling motion in your brain. This was a widespread practice until better options came along. Like…

8. What is shock treatment?

Today we call “shock treatment” electroconvulsive therapy or ECT (because the first euphemism still sounds painful). And both Lana and Jude get the privilege of being shocked. In both of these cases it was used as a form of torture. Which is unfortunately very close to reality. Though it was meant to treat mania, depression and other mood disorders, it was also a reliable threat and punishment if patients got out of line. During ECT an electric shock is sent through the system, causing convulsions. They imagined it would help restart the brain in a way that would alleviate the symptoms of mood disorders. Sometimes shock treatment would result in the dislocation of bones. Often it resulted in short term amnesia, sometimes even long term amnesia. It is still used (although with many precautions and care for the patient) to treat severe depression and it has been found to help a great deal. (Carrie Fisher has spoken openly about her shock treatment and potential memory loss.) 

7. Did Nazis really get into the United States after World War II?

Yes they did. And it would have been very easy for Dr. Arden to sneak into the United States. He is a scientist and the government would have found a way to let him in. However, they probably wouldn’t have wasted all that effort to have him making half-human creatures in an institution. Nazis escaped to all over the world.  And while the Israeli government managed to hunt many of them down, they didn’t get them all…

6. Why did Jude fall apart in the Asylum if she was sane?

It’s a process called institutionalization. Between sedative medications that can cause hallucinations, shock treatment, isolation and lobotomies a lot of people ended up more mentally ill than they went in. And that’s exactly what happens to Jude. Left without stimulation, care or interaction people will lose it. And that’s exactly what happens to Jude after she is left to rot in Briarcliff.

5. Why was Shelley kept in there?

Being an overtly sexual woman used to be considered a mental illness. And that’s exactly that they labeled Shelley with. Nymphomania. Some doctors thought it was a physical illness connected to the reproductive tract. These issues would then affect the brain. Later on it was linked to bipolar disorder. A sexual appetite of any kind was frowned upon. Even having sexual dreams or masturbating could be considered evidence for nymphomania. Shelley represents a nightmare to these physicians, out of control female sexuality on the loose.

4. Why was Lana kept in there?

Speaking of the scariness of sexuality, why exactly was Lana locked away? Sure, being Gay was unacceptable and illegal in many parts of the country. But was it a mental illness? Of course it was! And it was in the DSM (Diagnostic and Statistical Manual of Mental Disorders) until 1974. Think that Dr. Threadson’s therapy methods are a little harsh? They’re pretty close to the truth. Aversion therapy was very common, as doctors tried to convert “inappropriate” homosexual feelings into “appropriate” heterosexual feelings. They would also do their best to teach young women how to be feminine and how to “be” women. And it wouldn’t have been unusual for Lana to be trapped in the institution. Men and women would be reported by their families and then picked up in the middle of the night and taken to an institution.

3. What’s up with Pepper?

Pepper is one of the best characters in American Horror Story: Asylum, especially after she is finally able to speak her truth after the aliens abduct her. She is framed for a murder she didn’t commit simply because she has microcephaly. It is a birth defect resulting in a smaller head and brain. It can severely limit brain function. People born with this condition had very little prospects in life. They were limited to wasting away in institutions or traveling with sideshows. Pepper’s hair is very stereotypical of “pinhead” freak show attractions.

2. Things couldn’t have been that bad right?

Things were horrendous in institutional settings at about the time that Lana does her expose on Briarcliff. In fact, Geraldo Rivera launched his media career the exact same way. He exposed the horrors of the real life Briarcliff, Willowbrook. Willowbrook was an institution for children with developmental disorders. When Geraldo exposed it, staff were found to be experimenting on the children, sexually and physically abusing the children and neglecting even the most basic care. It was described as a snake pit. And it, along with many other state run institutions, were shut down in the 1970s due to public outcry.

1. Ok. So things were pretty bad. How did it change?

By the work of people very much like Kit and Lana. The real survivors of these institutions told their stories. They protested what had happened to them. And as word got out it became clear that these horrors had to end. And media exposés of places like Willowbrook led to laws that reformed how we are allowed to treat the most vulnerable among us. However, these abuses continue to go on in many places throughout the world.

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