Dorothea Dix Biography Essay Outlines
Dorothea Dix played an instrumental role in the founding or expansion of more than 30 hospitals for the treatment of the mentally ill. She was a leading figure in those national and international movements that challenged the idea that people with mental disturbances could not be cured or helped. She also was a staunch critic of cruel and neglectful practices toward the mentally ill, such as caging, incarceration without clothing, and painful physical restraint. Dix may have had personal experience of mental instability that drove her to focus on the issue of asylum reform, and certainly her singular focus on the issue led to some important victories.
Dorothea Lynde Dix was born in Hampden, Maine, in 1802. Evidence suggests she may have been neglected by her parents, and she appears to have been unhappy at home. She moved to Boston in 1814 to live with her wealthy grandmother. Dix had only attended school sporadically while living with her parents, but in early adulthood, with limited options for women in the professions, Dix became a schoolteacher. She established an elementary school in her grandmother’s home in 1821, and 3 years later, published a small book of facts for schoolteachers that proved extremely popular. By the time of the Civil War, Conversations on Common Things; or, Guide to Knowledge: With Questions had been reprinted 60 times. Written in the style of a conversation between a mother and a daughter, and directed at the young women who dominated the teaching profession, the book reflected Dix’s belief that women should be educated to the same level as men.
She went on to publish several other works, including books of religious poetry and fictional texts featuring moral lessons. Dix’s record of publications and the social circles accessible to her through her grandmother’s significant wealth allowed her to mix with some of the brightest and most influential thinkers of her time. She associated with Ralph Waldo Emerson and worked as a governess for William Ellery Channing, the so-called “Father of Unitarianism.”1
In 1831, Dix opened a secondary school in her own home. She frequently suffered from bouts of illness, especially during the winter, developing a cough and general fatigue. By 1836, her intense commitment to teaching and demanding workload seemed to have taken its toll. She began to dwell on the idea of death, and felt overwhelmed by her physical illnesses. Biographer David Gollaher, the first scholar to have access to all of her papers, has suggested that she suffered from depression at several times during her life, and that she experienced a type of mental breakdown during this period.2
Perhaps her own struggles helped make her a more compassionate advocate for people who had been diagnosed as mentally unstable or insane. Certainly her ill health ended her teaching career and brought her into a new circle of contacts. Emerson, Channing, and Dix’s physician encouraged her to take a restorative trip to Europe, and made the necessary introductions on her behalf. She convalesced in England for more than a year at the home of politician and reformer William Rathbone. During her stay, she met prison reformer Elizabeth Fry, and Samuel Tuke, founder of the York Retreat for the mentally ill. She returned to Boston in 1837, just after the death of her grandmother. The inheritance she received enabled her to support herself fully and devote her time to reform and charitable work.
In 1841, Dix volunteered to teach Sunday school classes to female convicts in East Cambridge Jail. During her visits she saw people with mental illnesses who had been treated inhumanely and neglectfully, and she became determined to improve conditions. She began to investigate the treatment of the mentally ill in Massachusetts, and in 1843 submitted her first “memorial” to the state legislature, an excerpt of which is republished here. These pamphlets were the only means by which a woman could participate in political life in America. Women were barred from voting, could not hold office, and did not present such testimonials themselves before the legislature—a male representative had to read the text aloud. Although she had significant political influence and promoted the education of women, Dix never joined the wider feminist movement or lent her public support to their cause. She has also been criticized for her views on slavery and her resistance to abolitionism.
This memorial reveals how Dix worked within the conventions of her time to carve a role for herself in public life and draw attention to the horrendous treatment of the mentally ill in prisons, almshouses for the poor, and asylums. Ideals of femininity characterized women as having a special responsibility to the most vulnerable members of society, and a moral authority superior to men’s. At the same time, women were supposed to be protected from images and experiences of suffering and degradation. Dix was able to use her vivid and upsetting descriptions to powerful effect, damning the existence of these abuses and shaming political leaders into taking action on her behalf, and on behalf of the “inmates” of these institutions.3
The model of care that Dix supported, “moral treatment,” was developed from the work of French psychiatrist Philippe Pinel and from new practices used at hospitals such as England’s York Retreat. Her tireless work and dramatic testimonials highlighted the appalling conditions in existing institutions and promoted the inherent value of compassionate care.
1. Wood AG. Dorothea Lynde Dix. In: Garraty JA, Carnes MC, eds. American National Biography. New York, NY: Oxford University Press; 1999:635–637.
2. Gollaher D. Voice for the Mad. New York, NY; London, England: The Free Press; 1995:93.
3. Michel S. Dorothea Dix; or, the voice of the maniac. Discourse. 1994; 17:48–66.
Dix, Dorothea Lynde (04 April 1802–17 July 1887), social reformer, was born in Hampden, Maine (on the Penobscot River), the daughter of Joseph Dix, a minister, and Mary Bigelow. During her early years Dorothea shared a small cottage with her parents and two younger brothers. Because her family was quite poor, she often traveled to Boston to live with her grandparents. In 1816 she began a career as a teacher. Five years later Dix opened her own school for young women in Boston. During this early period of her life, Dix worked diligently, teaching during the day while reading and writing late into the evening. Included among her students were the daughters of influential Bostonian William Ellery Channing, who became one of her early supporters.
In 1827 Dix became severely ill with tuberculosis. In an effort to regain her health, she spent the spring and summer that year at Channing’s country retreat in Portsmouth, Rhode Island. Following this, Dix dedicated herself to writing while also working to regain her health. Having already published a science textbook for young students titled Conversations on Common Things (1824), Dix subsequently produced other books, including Ten Short Stories for Children (1827), Meditations for Private Hours (1828), The Garland of Flora (1829), and The Pearl or Affection’s Gift: A Christmas and New Year’s Present (1829).
With her health still not fully restored, Dix again joined the Channing family for a vacation in the fall of 1830. This time they traveled to St. Croix. After an extended retreat, Dix returned to teaching in Boston in 1831. For the next five years she followed an exhaustive schedule, which now included caring for her aging grandmother. During this time she complained to her friend Anne Heath in Brookline, Massachusetts, “There is so much to do, I am broken on a wheel.” In the spring of 1836 she collapsed. Suffering frequent pain and hemorrhaging, she soon lost the use of a lung. In an effort to recover her strength once again, Dix sailed to Liverpool, England, where she stayed in the home of William Rathbone, a wealthy merchant and friend of Channing. Often bedridden and extremely weak, Dix stayed in Liverpool for a total of eighteen months.
In England Dix learned of the work of Philippe Pinel, a French doctor who had campaigned for prison reform during the late eighteenth century. She also became familiar with the efforts of William Tuke, Rathbone’s grandfather, who founded a sanctuary for the mentally ill in England called the Retreat at York. The careers of these two men soon would inspire her to investigate the plight of the insane in the United States.
After hearing of the death of her grandmother, Dix returned to Boston in 1837. Shortly thereafter, she received an inheritance that freed her from the need to work as a teacher. During the next few years Dix remained preoccupied with her health. Advised to avoid the New England winter, she spent time in Washington, D.C., and in Oakland, Virginia.
By 1841 Dix had regained her strength. That winter she visited a jail in East Cambridge, Massachusetts, after being invited to teach a Sunday school class. Having heard rumors of the horrible conditions that existed in the jail, she took the opportunity to inspect the facility herself. After listening to the concerns of a group of women prisoners, she asked to see where the “insane” were kept. Taken to a dark, underground cavern, Dix discovered a number of mentally ill women in cold, filthy cells.
Shocked by this experience, Dix consulted with her friend Channing. He advised her to talk with influential men in the community in order to arouse public opinion regarding the plight of the mentally ill. She visited with educator Horace Mann, abolitionist Charles Sumner, and the head of the Perkins Institute for the Blind, Samuel Gridley Howe. Gaining the support of these men, known at the time as “the three horsemen of reform” in Massachusetts, Dix began an eighteen-month tour of poorhouses and prisons in the state. During this time, she visited approximately 500 towns in search of the mentally ill. In many cases she found individuals kept in cages, chained to walls, or otherwise mistreated.
In support of Dix’s efforts, Howe published an article in the Boston Daily Advisor on 8 September 1841 that criticized the treatment of the mentally ill throughout Massachusetts. Along with other letters published around the same time, Howe’s description sparked significant public response. Encouraged, Dix decided to take up the cause of the mentally ill full-time. Two years later she composed the first of what would become several “memorials” to state legislatures throughout the country. In A Memorial to the Massachusetts Legislature (1843) she described what she had seen during her tour and called for immediate reforms. “Men of Massachusetts,” she wrote, “I implore. I demand pity and protection for these of my suffering, outraged sex.” With the support of Howe, Mann, and others, Dix’s petition was approved and a bill was passed that soon provided needed funds for the mentally ill at the Worcester State Hospital. After this first victory, she expanded her campaign to the states of New York, New Jersey, Pennsylvania, Maryland, Ohio, Kentucky, and Tennessee.
On 10 April 1844 the Providence Journal printed an article by Dix describing the living conditions of Abram Simmons, an insane man held in a jail near Providence, Rhode Island. Titled “Astonishing Tenacity of Life,” Dorothea wrote describing Simmons’s cell:
Six to eight feet square, built entirely of stone and entered through two iron doors, excluding both light and fresh air, and entirely without accommodation of any description for warming and ventilating. The internal surface of the walls was covered with a thick frost … the only bed was a small sacking stuffed with straw. The bed itself was wet, and the outside covering was completely saturated with drippings from the walls and stiffly frozen.
She then offered a portrait of Simmons himself. “In utter darkness, encased on every side by walls of frost, his garments [were] constantly more or less wet, with only wet straw to lie upon, and a sheet of ice for his covering, has this most dreadfully abused man existed through the past inclement winter.” She suggested that “his teeth must have been worn out by constant and violent chattering for such of length of time, night and day.” With this vivid account, Dix created new opportunities for mental health reform.
While in Providence, Dix visited the home of wealthy businessman Cyrus Butler to ask for money to help improve treatment of the mentally ill. To her surprise, Butler agreed to donate $40,000 to her cause. This allowed several hundred of the city’s “mentally incompetent” to be transferred to a new hospital. Following this success, Dix turned her attention to New Jersey, where she presented a memorial to the state legislature. The New Jersey lawmakers approved her proposal to establish a new state hospital in February 1845. A similar decree also gained the necessary votes in the Pennsylvania legislature the same year.
By the end of 1845, Dix had traveled approximately 10,000 miles, visiting eighteen state penitentiaries, 300 county jails, and more than 500 poorhouses in much of the U.S. Midwest and South, as well as in portions of eastern Canada. At this point, she had helped to establish six new hospitals for the mentally ill and had influenced the improvement of numerous other facilities. During the following three years she continued to lobby state legislatures on behalf of the mentally ill.
Beginning in 1848 Dix increasingly devoted her energy to reforms at the federal level. She began a new project that proposed that revenue collected from the sale of public land be used to establish a federal fund for the mentally ill, blind, deaf, and mute across the nation. Despite significant support for the measure, Congress turned down her request. Quickly, she appealed again. This time Dix more than doubled the amount of public domain requested. In her memorial to Congress, she described the conditions she had observed in jails, poorhouses, and other facilities, where inmates were “bound with galling chains, … lacerated with ropes, scourged with rods, and terrified beneath storms of profane execrations and cruel blows; now subject to gibes and scorn and torturing tricks, now abandoned to the most loathsome necessities, or subject to the vilest and most outrageous violations.” Recognizing her determination, Congress designated a special alcove in the Capitol library for Dix. Despite her persistence, however, approval of her proposal continued to be frustrated by political delays in Washington. With the opening of the 1850 Congress, Dix again increased the amount of land requested and worked to gain additional support. Further action was unsuccessful, however, until early 1854. At that time the Senate voted to approve Dix’s bill by a two-thirds majority. In August the House also passed the measure. When the bill reached the desk of President Franklin Pierce, he vetoed it. Asked why he disapproved of the legislation, Pierce said that he feared it would make the federal government responsible not only for the “indigent insane” but also “all the poor of the United States.” Although Pierce’s veto had killed Dix’s bill, it did not end her determination to champion the cause of the mentally ill.
Dix left for Liverpool in September 1854. In February of the following year she traveled to Scotland, where she resumed her reform campaign. Working constantly, Dix conferred with notable London doctors and visited several institutions in both Scotland and England. By April she had generated sufficient interest to persuade Queen Victoria to appoint a Royal Commission to investigate the condition of the mentally ill. Two years later, Parliament approved a law that allocated funds for the improvement of asylums in Scotland.
After her success in the United Kingdom, Dix then set her sights on the European continent. Beginning in June 1855, she traveled for approximately one year, visiting institutions in France, Switzerland, Italy, Greece, Turkey, Russia, Sweden, Norway, Denmark, Holland, and Germany. In Rome she appealed to Pope Pius IX, who later facilitated the creation of a new asylum. Cyrus Hamlin, a Turkish doctor who had hosted Dix in Constantinople, later conveyed his impression of her to biographer Francis Tiffany: “She had two objects in view, the hospitals and prisons. To these she seemed wholly devoted, although her conversation and her interest, embraced a vast variety of subjects … Miss Dix made the impression [of being] a person of culture, judgement, self-possession, absolute fearlessness in the path of duty, and yet a woman of refinement and true Christian philanthropy.” As with her experiences in Italy and Turkey, Dix’s talent as well as her tireless dedication brought about important changes in the treatment of the mentally ill in many of the countries she visited.
In the fall of 1856 Dix returned to New York. For the next five years she continued to work for mental health reform in the United States and Canada. In 1860 her earlier efforts in Washington finally bore fruit. Her bill, allocating funds for the New Jersey State Hospital in Trenton, passed both the House and Senate and was signed by President James Buchanan. That same year Dix’s lobbying prompted the Tennessee legislature as well as private donors in the state of Pennsylvania to provide significant sums dedicated to the treatment of the mentally ill.
In 1861 the outbreak of the Civil War temporarily suspended Dix’s advocacy for the mentally ill. On 10 June 1861 she was appointed superintendent of U.S. Army nurses. For the next few years Dix trained approximately 180 young women, including Louisa May Alcott, for medical duty during the war. One doctor testified to Dix’s dedication during this period by writing that she “was a very retiring, sensitive woman, yet brave and bold as a lion to do battle for the right and for justice. … She was very unpopular in the war with surgeons, nurses, and any others, who failed to do their whole duty.” As with her deep commitment to the cause of mental health reform, Dix’s service during the war won the respect of many. She received special recognition for her service during the war in December 1866 when Secretary of War Edwin M. Stanton awarded her two national flags for “the Care, Succor, and Relief of the Sick and wounded Soldiers of the United States on the Battle-Field, in Camps and Hospitals during the recent War.”
Following the war, Dix resumed her career as an advocate for the mentally ill. Traveling the country as before, she continued to visit institutions and lobby state legislators. In Washington, Dix persuaded the visiting Japanese chargé d’affairs to help establish facilities for the mentally ill in his country. In late 1875 she was pleased to learn that an asylum had been built in Kyoto.
At the age of seventy-nine, Dix, who never married, took her final tour to parts of New England and New York. After this, she retired in Trenton, New Jersey, where, after a convalescence of five years, she died.
In her lifetime, Dorothea Dix brought about significant changes in the care of the mentally ill in North America and Europe. Her work influenced conceptions about those held in prisons and asylums by identifying mental illness as a medical rather than moral issue. Her efforts helped pave the way for improved treatment of the mentally ill as well as the creation of more than 120 new mental health facilities. As biographers Charles Schlaifer and Lucy Freeman wrote, “It was Dorothea Lynde Dix who lifted the status [of the insane] from that of wounded beasts who were brutalized, chained, thrown food as though they were vicious dogs, and left to freeze in the cold, to that of troubled mortals who could be helped to regain their senses as they received understanding care that helped them reach the roots of their inner disturbances” (p. 161). Dix’s compassionate work and dedicated effort for over forty years helped open the eyes of many to the plight of the mentally ill. Her distinguished career as an advocate for reform has earned her an important place in history as well as the respect of people around the world.
Dorothea Lynde Dix.
Oil on canvas, 1868, by Samuel Bell Waugh.
National Portrait Gallery, Smithsonian Institution.