Gerda Engelbracht and Andrea Hauser. Mitten in Hamburg: Die Alsterdorfer Anstalten 1945-1979. Stuttgart: Kohlhammer, 2013. 328 pp. EUR 19.90 (cloth), ISBN 978-3-17-023395-9.
Reviewed by Elsbeth Bösl (Zentralinstitut für Geschichte der Technik TU München)
Published on H-Disability (August, 2014)
Commissioned by Iain C. Hutchison (University of Glasgow)
A New Trend in German Institution Historiography
Alsterdorfer Anstalten, which roughly translates into Altsterdorfer Mental Home, in Hamburg was founded in 1850 by Lutheran pastor Heinrich Matthias Sengelmann (1821-99) and quickly turned into a large and specialized institution for the “feeble-minded,” “insane,” “retarded,” and “deranged.” Both children and adults were admitted with the focus being on fostering, pastoral and medical care, and custody. Schooling, education, life skills, and self-development were not given high priority. During the Nazi regime, the institution’s doctors and other personnel were actively involved in crimes against disabled persons. Nazi eugenics, forced sterilization, murder, deportation, and coerced human experimentations were all everyday crimes against people with disabilities in Alsterdorfer Anstalten. Postwar reconstruction was marked by significant upheaval and striking continuity in terms of infrastructure, appliances, personnel, and concepts. This is the starting point for Gerda Engelbracht and Andrea Hauser’s study.
Today, Evangelische Stiftung Alsterdorf is a social service enterprise of the Protestant churches of Germany. It offers counseling, accommodation, inpatient and outpatient care centers, education, continuing education, vocational training, housing, home care, and many other services to disabled and nondisabled persons. To mark the 150th anniversary of the institution, the governing board of Evangelische Stiftung Alsterdorf in Hamburg commissioned an independent study of the history of Alsterdorfer Anstalten from 1945 to 1979 and an exhibition on inclusion and exclusion in Hamburg. The Alsterdorf board explicitly asked for a detailed and critical study of one of the most controversial periods in the history of the institution rather than an overview of the last 150 years. The hagiographical approach that is so typical of German institution historiography was considered outdated and inappropriate. The authors were encouraged to undertake a critical study of the Nazi period as a follow-up of an earlier, highly praised study of the Nazi period and the institution’s crimes against disabled children and adults by Michael Wunder, Ingrid Genkel, Rudy Mondry, and Harald Jenner. This older book was called Auf dieser schiefen Ebene gibt es kein Halten mehr: die Alsterdorfer Anstalten im Nationalsozialismus (1988), a title that roughly translates as “‘There is nothing to hang on to anymore on this steep incline’: Alsterdorfer Anstalten during the period of National Socialism” and is currently being revised for a new edition. Engelbracht and Hauser were supported by an academic advisory council, but otherwise were given free rein.
The authors’ methodological approach is in keeping with current institutional histories. After decades of festschrifts, enthusiastic eulogies, and pretty hagiographic listings of efforts and reputed achievements, there is now a trend toward a more critical eye, often accompanied by a constructionist perspective on disability. Authors such as Engelbracht and Hauser either have a background in disability history or draw strongly on disability history’s methodologies and theoretical foundations.
As is characteristic of scholars who conduct these types of studies, Engelbracht and Hauser link their microscopic case study to the larger macroscopic picture of the history of the German welfare state from the late 1940s to 1980s, as well as to basic trends and developments in medicine, science, special education, and pastoral care. By conceptualizing Alsterdorfer Anstalten as an institutional universe and focusing on entire life situations, the authors chose to follow Ulrike Winkler and Hans-Walter Schmuhl who have developed this approach for their studies on such institutions as the Wittekindshof in Bad Oeynhausen. In terms of methodology, this means that Engelbracht and Hauser did not stop at analyzing archival material (which usually reflects the perspective of the institution and social stakeholders, such as medical authorities or the police). Instead, they also conducted structured and guideline-based interviews with (former) residents, nurses, and alternative service personnel (“Zivildienstleistende”). Their objective was both to gain access to operational knowledge and to offer those people a chance to express their views and experiences. Moreover, Hauser and Engelbracht applied a technique introduced by Petra Fuchs and colleagues in their work on Nazi eugenic crimes (“Das Vergessen der Vernichtung ist Teil der Vernichtung selbst”: Lebensgeschichten von Opfern der nationalsozialistischen “Euthanasie” ) that allows reconstruction of individual biographies from patient and resident files. As a result, the authors manage to give voice to the men and women who had lived and worked in Alsterdorf, and to speak for those who are no longer able to speak for themselves. This approach is noteworthy because it ensures that we do not regard disabled persons in history as objects, or as passive, quiescent victims of an uncaring or openly hostile society, state, science, and culture. Instead, we find ways to get to know disabled children, men, and women of the past as individual persons with their own views and opinions, as historical subjects and active persons.
To achieve this, the authors combine traditional historiographical methods with the ethnographic method of close description, following Clifford Geertz’s methodology. Moreover, Engelbracht and Hauser use their institutional history to show how images and concepts of disabilities are formed, enforced, performed, lived, and articulated. Here, the authors show that they are familiar with a sociocultural model of disability as advanced by Paul K. Longmore and Lauri Umansky in their edited collection The New Disability History: American Perspectives (2001). People with “embodied differences” may become disabled by social and economic structures and pressures, but also, and perhaps more so, by labeling, discourse, and narratives. Closed institutions, like Alsterdorfer Anstalten, condense and solidify such labels and concepts in their daily routines and regimes, interactions, and structures. It would have been nice, however, to read even more about such phenomena in this book instead of the rather detailed passages on the respective heads of the Alsterdorf institution.
In general, the authors make an effort to prove that they have got their disability history right. They do this in a way that is digestible for the more general, nonacademic readers to which this book is (also) addressed. The authors make a point of approaching terms and concepts sensitively. They reflect, for example, on what it means for the historian to deal with and write about such historical terms as “Pfleglinge,” “Patienten,” and “Pflegebefohlene” (“nurslings” and patients ). They question the concepts of “the Other” that we have been raised with and examine how we should deal with such concepts in our academic work. In a variety of ways, this book answers Schmuhl’s call for more institutional histories to adapt disability history concepts and approaches, and for German scholars of disability history to muster more interest in institutions. In exploring an institution for people who were regarded as retarded, mentally sick, or simple, it also fills a gap in institutional histories because the majority of these works still focus on institutions for blind, deaf, or physically impaired men and women.
The authors focus on the universe of the living and working conditions and everyday ways of life at Alsterdorf. However, psychological and physical violence was a major part of this universe. Violence, abuse, and neglect in German homes and institutions during the 1950s and 1960s reached the public agenda around 2009 when a huge media scandal hit residential schools. Many institutions with such histories began to clear up these issues. To conceptualize the Alsterdorf experience, Engelbracht and Hauser draw on Erving Goffman’s “total institution.” The authors take their time to explain Goffman’s concept to the general reader and clarify how residents and staff are isolated from the wider public over a significant period of time, and live together in a highly formalized, controlled, and constrained environment. In such total institutions, both residents and staff experience how their self, their essential being is corroded and their self-determination erodes. Goffman particularly focuses on forms of violence in these institutions.
The book is arranged around the periods of office of Alsterdorf’s heads of institution, in other words, 1946-54, 1955-67, and 1968-82. This makes sense because the three leaders brought in specific technical and conceptional changes when they assumed office. The authors explain these changes alongside more general social developments, including postwar reconstruction, economic growth during the West German “Wirtschaftswunder,” (economic miracle) and pluralization and liberalization during the later 1960s and 1970s, as well as the respective theological and organizational profiles of the three directors. However, although the chapters are well researched and written, there is perhaps excessive space devoted to the leaders’ respective biographies. Obviously, the book starts with chapters on postwar reconstruction and examines the changes and continuities in terms of staff, architecture, funding, and daily regimes. An interesting passage then focuses on how Nazi crimes against people with disabilities were discussed and dealt with (or not dealt with) within the institution, leading to a chapter on how the issue of “life unworthy of life” was brought up again during the Contergan scandal after 1962. The authors show that Julius Jensen, then head of Alsterdorfer Anstalten, clearly and officially took a position in favor of a right to life for every human being regardless of what his or her condition might be.
Alsterdorfer Anstalten was conceptualized as a shelter (Schutzraum) and freedom space, a world within the world (Welt in der Welt). The idea was that distancing people with disabilities from the outside world would help disabled people to live more freely and happily. It may appear paradoxical today, but the notion was that segregation actually meant integration and that disabled people were so special that they could not possibly live adequately, healthily, and contently within the “general” community. A separate and guarded living environment seemed vital. Rehabilitation appeared only to be possible within special institutions. These were not perceived as restricting, but as liberating. Life in the institution was equated to life in a close community. If residents were part of such a close, segregated, sheltered community, they could be part of the community on the whole, because they now had their very own place and function in this general community. If left “outside,” it was argued, severely disabled people would never find such a space and position and thus could never be part of the overall community. In Germany, this idea was first challenged in the 1970s by inclusive concepts flooding in from Scandinavia. These took decades, however, to be fully integrated into German disability policy and practice.
Some issues reappear in every chapter of the book. They run like a common thread through the whole narrative. Buildings were notoriously too small, out of date, and ill-equipped for anything more than custody and the most basic care—and even that was often minimal. Staff was in short supply and often hardly trained at all. Even though the institution expanded in line with the general widening of the German welfare state in the period of growing prosperity, infrastructure remained mostly archaic; employees were often much less qualified than they could have been at the time; and staff had very little time and freedom to improve living conditions or introduce amusements, recreation, and education in the way that some new-fashioned nurses would have liked to.
The years between 1955 and 1967 are mostly characterized as a threshold phase between abidance and departure. For an example, for modernization processes, the authors examine the roles of Alsterdorf nurses and changes in their work. Nurses were deaconesses subject to Protestant ideals of altruism, ministration, calling, and mission, as well as Protestant female role models. During the 1960s, however, nursing on the whole was both professionalized and further secularized in Germany. Nursing became less of a Christian mission and more of a professional occupation. This also affected the deaconesses and their subordinate personnel at Alsterdorf.
By the end of the 1960s, however, it was acutely clear that the situation at Alsterdorfer Anstalten was disastrous; protests and calls for reform and modernization became louder, both inside and especially in the wider media public. Within the staff, a new group of professionals emerged who perceived themselves as critical, modern, and resident-orientated. Many of the issues raised, such as shortage of staff and space, were well known, but there were also new concerns. The institution was now perceived as a ghetto where residents had no privacy; no real contact with the world “outside”; no individual possessions; and no choice of clothing, food, or daily activities. Instead, there was a strict and unalterable regime, humbling hygiene routines, strict gender segregation, no representation for the residents, emotional deprivation, drab and listlessly cooked meals, often no real cutlery and crockery, few attractive leisure activities, monotony, and enforced idleness. Residents were beaten, fastened, drilled, disciplined, deprived of food for punishment, and spoken to and of derisively and deprecatingly, just to name a few. Violence had many facets and only a few residents had a chance to flee the system. What had been intended as a shelter and free space was now regarded as a trap.
A group of Alsterdorf personnel began to demand outpatient assisted living, care at home, local services, early childhood support, day clinics, day care centers, transitional facilities, and a conceptual and technical reform of the closed wards. The institution became the subject of debate within and outside of Alsterdorf. Protest against closed institutions—“Heimkritik” (institution critism) and “Psychiatriekritik” (psychiatry criticism)—was an all-West German phenomenon in the 1970s. However, Alsterdorfer Anstalten was more radically criticized than other homes and schools. Everyday violence was an especially big issue. Pressure on the institution was growing and reached a hiatus in 1979 when the important political weekly Die Zeit published a damning critique of the living conditions in Alsterdorf and marked these as a human catastrophe. Both the institution and Hamburg’s inspecting authority came under the close scrutiny of the media to the point where a shutdown of all closed wards was demanded.
The study does not elaborate on reforms initiated or implemented after 1979. Instead, the authors dedicate much space to a detailed discussion of the scandals, discourse, and the solutions that were debated. They demonstrate that, from the perspective of the institution and its personnel, these debates could alternatively be understood as liberating and emancipating or as destructive and disregarding of past achievements. Interviews with former staff point to these highly diverging interpretations. They also show that, even in the 1970s with widespread debate occurring, there was a massive gulf between reform intentions and daily practice. Employees remember how a smooth and incident-free daily routine was the paramount objective. To ensure frictionless days, they resorted to physical, emotional, and psychological violence, and usually escaped reprimand.
Members of the Alsterdorf staff were expected, and themselves expected, to realize the institution’s aims and functions and to simply keep it going. Residents were cleaned, fed, cared for, and maybe spruced up a little bit if there was time, but there was no scope or little will for individual support or emotional attention. Disabled people were trained to be destitute and to be dependent on others. It was left to the individual nurse to try to introduce little changes that would make life more agreeable and interesting for the residents. Next to physical and psychological violence, there was also caring affection and the desire to help. It depended on the staff involved whether the Alsterdorf experience turned out as terrible or livable. Residents had little or no formal influence on their living conditions. Similarly, the staff, who mostly lived on the premises, had very few options for professional self-development.
Up to this point the narrative that Engelbracht and Hauser offer may appear rather traditional. Their interviews with both residents and staff, however, demonstrate that the story is more complex. Staff and residents were not diametrically opposed to each other, but part of a complicated web of shared or competing interests, functional differentiation, and permeabilities. There was, for example, the “elite” of “Hilfsmädchen” and “Hilfsjungen” (these may be translated as “help girls” and “ancillary boys”), in other words, adult women and men who were given specific tasks in housekeeping, care, and discipline. They had a little more power, a little more scope for development, but they were also instrumentalized and exploited. Given keys to locked wards and tools for restraining others, they were put in a perverse position between residents and staff. As another example, Engelbracht and Hauser note that many residents had their own ways of coping with life in the institution. Some adapted to Alsterdorf in a way that made them feel comfortable and at home, some found specific ways of emotional survival, some withdrew from the situation, and some explicitly refused to adjust and rebelled. The authors offer such insights in the biographical life-course (re)constructions. They demonstrate how residents interpreted their situation and gave meaning to their lives. They show, for example, that despite all the labeling by doctors, psychologists, and staff, some residents constructed an individual self-characterization and self-disclosure.
This book is written in German. It is a good read, well composed, and precise in its argumentation. Engelbracht and Hauser write respectfully and academically, but they also show compassion. Their book diligently follows academic standards of research and writing. It certainly has drive and can be read from cover to cover. The style is pragmatic. The book is a text that is both scientific and accessible to a broader public. To make the work accessible to a general audience, the book comes with helpful extras, including a list of all Altsterdorf premises and their functions, a map, a ten-page bibliography, and many illustrations, mostly photos and archival material. Although the photos contribute to the reading experience, it is highly debatable whether photos of former residents whose permission has not been arranged should have been used.
In short, this book is a well-produced example of an institutional history from a disability history perspective and joins a new trend in institutional historiography.
. Other such studies are Philipp Osten, Die Modellanstalt: Über den Aufbau einer “modernen Krüppelfürsorge” 1905 bis 1933 (Frankfurt am Main: Mabuse, 2004); Hans-Walter Schmuhl and Ulrike Winkler, Welt in der Welt: Heime für Menschen mit geistiger Behinderung in der Perspektive der Disability History (Stuttgart: Kohlhammer 2013); Hans-Walter Schmuhl and Ulrike Winkler, Gewalt in der Körperbehindertenhilfe: Das Johanna-Helenen-Heim in Volmarstein von 1947 bis 1967 (Bielefeld: Verlag für Regionalgeschichte, 2012); Hans-Walter Schmuhl and Ulrike Winkler, “Als wären wir zur Strafe hier”: Gewalt gegen Menschen mit geistiger Behinderung—der Wittekindshof in den 1950er und 1960er Jahren (Bielefeld: Verlag für Regionalgeschichte, 2012); Hans-Walter Schmuhl andUlrike Winkler, “Der das Schreien der jungen Raben nicht überhört”: Der Wittekindshof - Eine Einrichtung für Menschen mit geistiger Behinderung, 1887–2012 (Bielefeld: Verlag für Regionalgeschichte, 2012); and Frank Konersmann, Für ein Leben in Vielfalt: Historische Einblicke und Einsichten in 150 Jahre Stiftung Eben-Ezer (1862–2012) (Bielefeld: Verlag für Regionalgeschichte, 2012).
. See also Uta George, Kollektive Erinnerung bei Menschen mit geistiger Behinderung: Das kulturelle Gedächtnis des nationalsozialistischen Behinderten- und Krankenmordes in Hadamar: Eine erinnerungssoziologische Studie (Bad Heilbrunn: Klinkhardt, 2008).
. See also Carol Poore, Disability in Twentieth-Century German Culture (Ann Arbor: University of Michigan Press, 2007); Christian Mürner, Medien-und Kulturgeschichte behinderter Menschen: Sensationslust und Selbstbestimmung (Weinheim/Basel: Beltz, 2003); Christian Mürner, Erfundene Behinderungen: Bibliothek behinderter Figuren (Neu-Ulm: AG-Spak, 2010); and Hans-Walter Schmuhl, Exklusion und Inklusion durch Sprache: Zur Geschichte des Begriffs Behinderung (Berlin: IMEW, 2010).
. Erving Goffman, Asyle: Über die soziale Situation psychiatrischer Patienten und anderer Insassen (1961; repr. Frankfurt am Main: Suhrkamp, 1973), 13-123.
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Elsbeth Bösl. Review of Gerda Engelbracht and Andrea Hauser, Mitten in Hamburg: Die Alsterdorfer Anstalten 1945-1979.
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