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Annmarie Adams on Freedom and the Cage

17 December, 2020

This annotation is an extract from: Annmarie Adams (2018) review ‘Freedom and the Cage: Modern Architecture and Psychiatry in Central Europe, 1890–1914’, Journal of the Society of Architectural Historians, March 2018, 97-98

Leslie Topp’s Freedom and the Cage explores seven public psychiatric institutions built between 1898 and 1914 in the late Habsburg Empire, the Austro-Hungarian territories whose major cities included Prague, Vienna, and Kraków. The central idea of the book is that each of these hospitals offered a degree of freedom within a highly controlled environment. Such freedom of movement made the psychiatric hospital seem more ‘normal’. This paradoxical notion – that one could move about in a seemingly normal way even though confined – comes from Michel Foucault’s influential work on the asylum in History of Madness. Topp warns that for architectural historians who work on institutions, ‘there is no escaping Foucault’, and thus her six-chapter, generously illustrated book also serves as an example of how to use the French philosopher’s work as a historical source rather than as a theory to be wholly accepted or rejected… .

By far my favourite two chapters of Topp’s book are those titled ‘Spaces’ and ‘Boundaries’, chapters five and six, respectively. While the first four chapters take on thematic issues illustrated by one or two of the seven case studies, the tone and rhythm of the book changes in this superb double act that analyzes them all at once. In ‘Spaces’, Topp examines the spatial codes of the Habsburg asylums by looking closely at the plans. She takes readers on a tour through corridors and cells, arguing convincingly that the image of confinement in the corridor-system hospitals was as dependent on the arrangement of these elements as it was on walls, locks, and bars. The climax of chapter five is Topp’s revelation that the plan for Otto Wagner’s Lower Austrian Provincial Institution for the Care and Cure of Mental and Nervous Disorders, or ‘am Steinhof’, in Vienna, which opened in 1907, is the most conservative in the group, featuring the problematic corridor from days gone by and a grid-like site plan that meant pavilions were seen as undifferentiated. Among the case studies Topp presents, the Steinhof psychiatric hospital is likely the one best known to readers, given its famous architect and the predominance of its domed church.

Freedom and the Cage contributes enormously to the literature on hospital architecture produced in the past twenty-five years, complementing excellent work by scholars such as Thomas Markus, Christine Stevenson, Jeremy Taylor, and Carla Yanni, with whom Topp explicitly engages in her book. Most obviously, Topp covers a geographical area and a range of primary sources not previously covered by English speaking scholars. Like Markus’s Buildings and Power (1993), Topp’s book tackles the relationship between power and the plan. Like Stevenson’s Medicine and Magnificence (2000), it shows that hospital design was often counterintuitive: If fresh air was key to healing, as miasmatists believed, why did it make sense to contain the sick in an inward-turning building? As Taylor does in his work on the pavilion-plan hospital typology, The Architect and the Pavilion Hospital (1997), Topp posits hospitals ‘in conversation’, viewing each of the seven institutions she discusses as a different position on the challenge of designing a cage that appears to support free movement. ‘I have seen these plans not as mute technical diagrams to be deciphered by the architectural historian but rather as positions in a debate’, she says. Carla Yanni’s 2007 book The Architecture of Madness, on American asylums, shares with Freedom and the Cage a deep understanding of how psychiatry and architecture were entwined in this period. Unmentioned by Topp but significant in this literature is Jeanne Kisacky’s Rise of the Modern Hospital, also published in 2017, making this a banner year for the architectural history of hospitals.

Annmarie Adams on Freedom and the Cage

This annotation is an extract from: Annmarie Adams (2018) review ‘Freedom and the Cage: Modern Architecture and Psychiatry in Central Europe, 1890–1914’, Journal of the Society of Architectural Historians, March 2018, 97-98