Stigma,shame and family secrets as consequences of mental illness in previous generations: A micro-history approach

Abstract

In this article we evaluate micro-history as a method for investigating the meaning of stigma, shame and family secrets through generations. We present micro-histories of two Australian soldiers who developed mental illness years after serving in World War 1 and were committed to a psychiatric hospital where they died. Data were drawn from publicly available records and interviews with family members. The contrasting stories held by the families of each man illustrate the transmission of stigma and secrets through families. We explore possible reasons for the differences between the families related to the wider literature on stigma and mental health and show why the family stories people present should be considered social constructions rather than facts. We also address ethical issues that arose during the research, and which have relevance for researchers investigating sensitive or potentially stigmatising topics.

Keywords

Australia Beechworth family secrets mental illness micro-histories stigma

Introduction

Wow. What a story and I thank you so much. I was always led to believe that my uncle [Johnny¹] died overseas in the War. It appears to me that his sisters whom I saw regularly until their deaths didn’t want me to know about him being in a mental hospital.

(Email from participant Steve)

In this article, we evaluate the usefulness of micro-history for exploring deeply felt family issues by examining the stories of two families who experienced the stigma of mental illness in previous generations. We draw on the literature of family secrets and shame before presenting micro-histories of two Australian soldiers who fought in World War 1 and later died in the former Mayday Hills Psychiatric Hospital, Beechworth, Victoria, a small rural town 275 km north-east of Melbourne, Australia. The findings are drawn from a wider study of the hospital, its staff and patients. Ethics approval for the study was given by Charles Sturt University Human Research Ethics Committee, No. H2014042. While it is not possible to claim a causal link between war service and subsequent illness, the use of micro-history to reveal the families’ stories add to our understanding of the often-forgotten consequences of war, and the ways secrets are managed within families.

The decision to disclose an illness to family members is not taken lightly, yet it is an integral part of deciding how to manage the illness experience. The choice between disclosure and secrecy is especially difficult if the illness could be considered shameful or stigmatising. There may be concerns for the ongoing functioning or safety of the family, along with fear of being rejected or stigmatised if the illness is associated with deviant behaviours (Persson et al., 2022; Smith et al., 2021). While the costs of disclosure may be high, the burden and potential outcomes of maintaining secrecy are also considerable and may have ramifications many years later. In making the decision whether, when and to whom to disclose, the person is exercising agency and maintaining control over their own situation. The picture is different if family members decide who, within and beyond the family, should know of the illness or whether it should become a family secret. This places power in the hands of those who know the secret and disempowers other family members.

Mental illness remains a condition that is stigmatised and may be concealed. While there is greater disclosure than in the past, the knowledge that a family member has or had mental illness may be considered shameful and hence becomes a family secret. Such secrets may persist for many years, and it is important to understand their on-going effects on family members. With its small-scale, individual approach, micro-history may provide insights into the management of family secrets while expanding conceptual understanding of stigma and family shame.

Micro-history

Micro-history is a theory and method of historical research in which a small-scale, individual approach is used as a lens through which to view wider events of history (Paul, 2018). It evolved in the 1980s as a reaction to the quantitative approaches current in historiography at the time that emphasised objectivity and reductionism. Micro-historians argued that statistics and averages were misleading when considering the situations and stories of individuals and small groups (Rodda, 2010). In contrast, micro-history is small in scale, inductive and holistic. There are clear parallels here with the growing popularity of qualitative methods in sociology in the same era and for similar reasons. By rejecting the need for individuals’ stories to be representative of a wider whole, micro-historians remind us that every life has consequences for others and all stories contribute to greater understanding of past events (Gamsa, 2017). After comparing several approaches to the study of history, Rodda (2010: 4) claimed that micro-history was the most promising route to understanding the lives of individuals and families, because it put flesh on the bones of the lists of dates and places generated by classic historical research.

Although being focussed on the small scale of individuals and families, micro-histories go beyond simple case studies to provide insight into larger issues affecting society (Evans, 2021) and as such, can be considered analogous to Mills’ sociological imagination by revealing links between private troubles and public issues (Mills, 1959). Like oral history, micro-history has been used to ‘hear the stories’ of marginalised and under-represented groups sometimes overlooked by traditional historians (Carroll, 1990; Paul, 2018).

In terms of its place in social research, micro-history falls within the genre of narrative approaches. Denscombe (2014) claimed that while narrative refers to a story, for use in research the story should have a specific purpose, a plot linking the past to the present and involve people. While it is common in narrative research for the story to be told by key participants, in micro-history the researcher can use other sources such as documents and genealogical techniques to construct the story, with the aim of developing a ‘thick’ description of the people and events involved (Rodda, 2010).

Stigma

Stigma is the means by which individuals or groups are identified and judged as unworthy and shunned, demonised or blamed by their peers, who consider them unfit to participate in normal society (Scambler, 2009). Goffman’s (1963) seminal work Stigma: Notes on the Management of Spoiled Identity led to a profusion of theoretical and empirical work examining the nature and operation of stigma. People may be stigmatised because of their appearance, behaviour, beliefs, state of health or ethnicity, for example, and the impact may be temporary or permanent. Goffman emphasised the individual and relational aspects of stigma, identifying how it disrupted normal social interactions (Scambler, 2009).

More recently, emphasis has shifted to the role of power and the operation of stigma at a structural or societal level. Goldberg (2017) claimed that stigma invariably mirrors social inequalities because it is linked to power structures in society. For stigma to be applied, an in-group must mark an out-group as different based on a characteristic, and there must be a negative judgement, deviance, associated with that characteristic. For Goldberg, ‘stigma is irreducibly a function of power and inequality’ (Goldberg, 2017: 476).

Secrets and shame

Individual stigma can affect not only persons identified as deviant or different, but also those associated with them. Goffman (1963) acknowledged this ‘courtesy’ stigma as applying to those who are related through the social structure to the stigmatised individual, to the extent that wider society considers all such persons equally stigmatised (Angermeyer et al., 2003). Individuals can be stigmatised within families, and families may strive to keep behaviours or events secret as a way of protecting the family from courtesy stigma. Information management is used to control stories passed around the family or handed down to younger generations. Smart (2011) examined the role played by secrets within families and highlighted that the stories people tell about and within families are often social constructions rather than immutable facts. They serve to sustain relationships in which past and present are blended and give meaning to each other. In this way, families are as much a collection of memories as a group of people. Secrets can act to protect an individual from others within the family, and on a larger scale to protect the family from outside sanctions, and these both indicate the use of power in relation to stigmatised persons or behaviours.

Barnwell (2019a) claimed that secrecy may be used within families to manage stigma, which she termed ‘sticky’ because it can taint families within and across generations. She used the concept of slow violence to describe a two-step process whereby the fear of sanctions arising from a stigmatised characteristic or act pressures families into silencing or excluding members deemed responsible for such stigma, which in turn leaves successive generations to cope with this legacy of secrets about forgotten or hidden family members. Secrets − things wilfully hidden − act as markers of stigma within families and indicators of the norms and values that existed at the time the secret originated and the desire of families to escape social sanction.

Shame is an emotion closely associated with the management of stigma. Bericat (2012) believed emotions reflect power and status in society as experienced through social interaction, and consequently shame has a fundamental role in social structure and social dynamics, especially status. Shame is linked to a sense of identity as an individual or family member, to one’s sense of self and status in the world. Shaming or ‘outing’ of someone is used by a powerful person or group to show that they consider certain behaviours unacceptable and that the target person ought to feel ashamed (Crozier-De Rosa, 2014; Probyn et al., 2019). Barnwell (2109a) has suggested that the management of family secrets by older generations is a means of controlling the passage of shameful emotions through the family and hence the transmission of stigma.

The control of family secrets by older generations raises questions about how long secrecy can be maintained. Does secret knowledge remain hidden until it is lost through the passage of time, or is there some point at which it can or should be revealed? And who should decide that it should be revealed? There are also differences in the strength of emotions within families, between and within generations and over time and distance, and these would influence the extent of shame and stigma. People have referred to proximity of time and relationship when discussing family emotions in relation to secrets (Barnwell, 2019b) and we would argue that geographic distance is also important, both for keeping secrets and for feeling released from obligation to maintain secrecy. Norms of behaviour change over time, too, and behaviours or events once considered shameful may now be more acceptable or less deserving of shame. Barnwell (2019a) has called for more research to elucidate how successive generations of families manage secrets that reflect discrimination arising from legal and moral proscriptions of earlier times.

One way in which family secrets may be revealed is through research into family history. The interest in genealogy as a hobby has grown in recent years, thanks to television programmes like Who Do You Think You Are and the availability of online records through companies such as Ancestry^®. Inevitably, such research uncovers secrets that families had kept hidden for generations. In a 2016 survey of Australian amateur family historians, Barnwell (2019a, 2019b) investigated whether they had discovered secrets hidden by previous generations. She found that secrets were concealed through generations because behaviours that transgressed norms of the time were considered shameful and families feared social sanctions. Smart (2011) identified similar concerns in the United Kingdom, arguing that the discovery of family secrets can shatter myths of respectability in families and be seen by younger generations as hypocrisy. Conversely, revelations of secrets such as homosexuality can lead to sorrow and concern for the relatives involved. Mental illness and institutionalisation were often identified among events that families sought to conceal (Barnwell, 2019b).

Stigma and mental illness

There has been extensive research into stigma associated with mental illness, particularly in the United States (Scambler, 2009). As early as 1950, Star, a senior researcher at the influential National Opinion Research Center at the University of Chicago, conducted a study into people’s ideas about mental illness. Among its findings was that people wanted to distance themselves from mental illness, two-thirds of participants believed recovery from psychosis was not possible while 37% thought recovered patients would always show signs of their illness, and, by implication, be a threat to one’s safety or wellbeing (Star, 1955).

Star’s work was conducted before antipsychotic drugs revolutionised treatment for mental illness. The study was updated and replicated in 1996 to see if attitudes had changed and participants again expressed a strong desire for social distance from people with mental illness (Link et al., 1999; Phelan et al., 2000). Supporting this, in a 2019 study of 1300 Australian paramedics, over 40% of participants expressed a desire for social distance from men with mental illness, while stigmatising attitudes were strongest towards people experiencing mental health issues when these co-occurred with drug and/or alcohol problems. Authors commented that this finding may reflect particularly negative attitudes in wider society about people who experience problems with alcohol or other drugs (Turning Point, 2019). In Australia today, stigma remains a barrier to receiving quality healthcare for people using alcohol and other drugs (Farrugia et al., 2021).

There is strong evidence for the existence of courtesy stigma associated with mental illness. In 2011, researchers in Melbourne, Australia, interviewed 20 caregivers of young people experiencing first-episode psychosis. While some were open about their situation, others were secretive and minimised contact with friends and family because of fear or previous experience of stigma. This was especially apparent in participants whose first language was not English and who may already have been experiencing stigma and disempowerment (McCann et al., 2011). Olasoji et al. (2016) in Australia and Angermeyer et al. (2003) in Germany found similar results.

Historically, World War 1 brought mental illness to public attention like no event before it, when previously healthy men developed the condition known as ‘shell shock’ after being in combat. First identified in 1915, the term soon became a label for all somatisation of traumatic experience (Jones and Wessely, 2014). The expectation that soldiers would control their emotions in the most extreme circumstances of horror in the trenches, termed ‘compulsory resilience’ by Baár (2015), added to the strain they were experiencing in combat. With no obvious organic lesions or physical causes for shell shock, sufferers were deemed to have weak personalities, genetic vulnerability or a lack of moral fibre, to the extent that shell shock was considered a form of malingering and was stigmatised as a mental illness (Jones and Wessely, 2014). At the time, mental illness was poorly understood and there were few, if any, effective treatments. It was not until 1980 that the emergence of mental illness following battlefield exposure was officially recognised, when Post-Traumatic Stress Disorder (PTSD) was included in the Diagnostic and Statistical Manual of Mental Disorders (Jones and Wessely, 2006).

In Australia, soldiers repatriated with shell shock were defined as military patients. Rather than being committed to public psychiatric institutions, men who would otherwise have been vilified on return to civilian life were sent to specially established military convalescent hospitals. This was portrayed as a means of protecting returned soldiers from stigma, but their segregation also kept them out of public view and ensured that the community was not exposed to soldiers with mental illness (Larsson, 2009a; Muir, 2002).

Difficult though this was for men and their families, the situation was worse for men diagnosed with mental illness years after the War. Veterans whose illnesses or injuries resulted from war service were eligible for pensions if causation could be established, and official headstones acknowledging their service could be placed on their graves. The burden of proof was much harder for veterans with mental illnesses, and to minimise costs the Repatriation Department² often used the pre-existing illness argument, claiming that men with mental illness must have had personality weakness or vulnerability, thus adding to the stigma and distress for men and their families (Larsson, 2009b; Muir, 2002). The stigma of their illness was considerable, especially if deviant behaviours such as alcoholism or venereal disease³ were possible causes. Sufferers’ deteriorating physical and mental health meant they were committed to public psychiatric hospitals often located far from home. On death, they were buried in unmarked graves, their war service forgotten unless relatives claimed the body (Larsson, 2009c).

As part of centenary commemorations of World War 1 in Australia, the national government widened the criteria under which official headstones could be placed on graves of war veterans. The Beechworth Cemetery Trust sought assistance from the authors to prepare applications for five veterans who had died in Mayday Hills Psychiatric Hospital and were buried in unmarked graves. A biography of each man was needed as part of the application, and any surviving family members were to be informed, if possible. The authors decided to use micro-history to compile the information, taking the opportunity to evaluate the use of micro-history as a research technique.

Procedure

There are various ways to conduct micro-history research, including traditional historical techniques, genealogical skills and interviews (Evans, 2021; Gamsa, 2017; Paul, 2018) and the choice of methods will depend on researchers’ academic disciplines and the research aims. To research the men’s biographies and identify possible living relatives, the first author (a genealogist) used records from the National Archives of Australia, Public Record Office Victoria, electoral rolls, newspapers, subscription genealogy sites Ancestry^® and Find My Past^®, telephone directories and Facebook^®. These sources are in the public domain, but in Australia access to records of people who may still be alive is restricted under privacy legislation, with birth records withheld for 100 years and marriage records for 60 years. Hence, it was only possible to identify one probable relative each for two of the five veterans, Bill Fletcher and Johnny Kett (pseudonyms), whose stories are used as exemplars.

The Cemetery Trust asked the first author to write to both families on their behalf. This raised ethical concerns for the authors, given the stigma surrounding mental illness, and they decided that the letters should not mention the circumstances of the men’s illness and death, even though at this point, we believed there was sufficient evidence to confirm that both relatives knew about their veteran’s mental illness, as shown below. Letters were sent, informing the relative about the headstone and asking for confirmation of their relationship to the veteran.

The two families were markedly different. Bill Fletcher had a large extended family and one member had visited the Beechworth Cemetery previously to place a notice on Fletcher’s grave, naming his six children. One daughter had married a man with a distinctive name, and this enabled us to trace a probable grandchild of Fletcher. He gave our letter to a cousin, Lorraine, who contacted us. In contrast, Johnny Kett had no children but in his Army records there was a letter from his two sisters about his illness, showing their married names and an address. One sister had had a son, Steve, who confirmed he was Kett’s only great-nephew.

Ethical issues need mention here. It could be argued that Lorraine and Steve became ‘participants’ in our research as soon as they received the first letters from us, and hence should have been asked to consent to participation. We disagree, because we believe we were still acting as intermediaries for the Cemetery Trust at that point. It was not until they replied, telling us about the veterans, that we saw the value of their stories, and decided that, at an appropriate time, we would invite Lorraine and Steve to be interviewed as part of our wider Beechworth project. Our actions were consistent with Kvale’s (1996) ‘virtue ethics’ model, which places a contextual or situational ethics position alongside the abstract principles of the deontological model, which he argues can be carried to extreme ‘moral absolutism’ (Kvale, 1996: 121). The model emphasises researchers’ moral values and ethical skills in reflexively managing ethical dilemmas (Edwards and Maunther, 2002). At all times, our actions were guided by the need for beneficence towards the families involved. We did consider withdrawing from the project but believed that, once letters had been sent, we owed it to the families to continue our involvement.

Both participants gave written informed consent to be interviewed. Because of the distances involved and COVID-19 travel restrictions, the interviews were conducted by telephone by the first and second authors, recorded digitally and transcribed, and a content analysis was performed. In the interviews, we used unstructured interactive interviewing, termed ‘conversational intimacy’ by Corbin and Morse (2003: 338), enabling participants to feel comfortable when telling their stories. Lorraine and Steve decided the content and sequence of their stories in response to our request to hear about their veteran. Lorraine was interviewed in November 2019, 7 months after the initial letter to her cousin. The interview lasted 30 minutes and she spoke about Fletcher’s illness and his wife’s efforts to keep the family together. Steve’s circumstances were different, and we maintained contact with him by email for 3 years before his interview in October 2021. His interview lasted 40 minutes and ranged more widely than Lorraine’s. After telling us how he knew about Kett, he spoke about his family’s relationships and mental illness more broadly. Since the interviews, we have maintained contact with Lorraine and Steve. Both have read a draft of this article and provided written informed consent to publish their family’s story. Pseudonyms are used throughout to protect confidentiality and no citations are given that may identify individuals.

Findings

The two men were typical of their generation. They were living in working-class suburbs of Melbourne, Victoria, before enlistment. While there are similarities in the men’s stories, their relatives’ responses were very different and show the challenges families faced when knowing a member had died in a psychiatric hospital.

Bill Fletcher

Bill Fletcher was a labourer aged 28 when he enlisted in February 1915, but his Army career got off to a difficult start. He was dismissed in August 1915 before embarkation because he had venereal disease. In 1916, he re-enlisted and married just before sailing for France. He received gunshot wounds in 1918 and was medically evacuated to England, where he was diagnosed with gonorrhoea and syphilis again. On return to Melbourne, he married again in 1919, possibly bigamously, and fathered six children, the youngest of whom died in infancy. He was diagnosed with schizophrenia in 1927 and was committed to psychiatric hospitals, first in Melbourne and later in Beechworth until his death in 1965.

Lorraine spoke about her grandfather:

Well, when I was growing up all that was ever mentioned whenever we enquired about grandfather, was that, oh he’s in a hospital in Beechworth because he was gassed in the War and he’s not well. (. . .) I set about in the last few years trying to discover what that story was. A friend of mine here helped me to track him down through his War Service records.

After Fletcher’s death, Lorraine applied to the Repatriation Department for an official headstone on his grave, but this was denied because his death was not deemed directly attributable to War service:

I had contacted the War Graves Dept. to see if we could get a headstone erected, but they informed me that his death had to be directly related to his war injuries. As he died in 1965 of a heart attack I didn't think it would qualify, although he was in the May Day Hills hospital (. . .). So I am thrilled to learn that there is now a headstone on his grave.

(Lorraine, email, 20 October 2019)

Fletcher’s wife carefully managed the information about her husband’s illness. When grandchildren enquired about their grandfather, they were given an explanation that was suitable for their age, but which, more importantly, presented an acceptable picture of an injured War veteran. In this way, she minimised the risk that the truth about his diagnosis would be revealed to ensure the family was not exposed to courtesy stigma. As the grandchildren reached adulthood, they developed further understanding of his condition. Lorraine explained:

I thought, well how did he get there? It just never occurred to me that, oh that’s a shocking thing, or how terrible for the family, or anything like that. It never gave me any . . . you know, there wasn’t any stigmatisation or anything. I just thought it was interesting.

The Fletcher family exemplified the way in which the family secret sustained their kinship by defending them from criticism or sanctions from outside the family, as argued by Smart (2011).

Johnny Kett

Johnny Kett was also aged 28 when he enlisted in 1915. Immediately before enlistment, he married a woman with whom he had been cohabiting and who had two young daughters, father(s) not named. He embarked for France in February 1916, received gunshot wounds to the buttocks in August 1916 and never resumed active service. Between the end of the War and being certified as insane in 1939, Kett committed acts of domestic violence and was estranged from his wife and stepdaughters. On admission to Beechworth, he was diagnosed with Korsakov (sic) syndrome caused by excessive alcohol use. After his death in 1974, post-mortem examination also revealed permanent damage to his hip bone.

In his Army papers there was a letter written by his two sisters in 1967. They stated that their brother had ‘lost his memory’. When Steve received our letter, he confirmed that he knew about Kett:

I have heard many a story of not only about Johnny but about the family through my young years from my nan (grandmother), [name] who died in 1971.

I would be very interested in anything relating to Johnny’s story.

Once again thank you taking the time to find and contact me.

(Steve, email, 26 January 2018)

On receiving this email, the authors wrongly assumed that Steve had been told about Kett’s mental illness and hospitalisation. The first author replied to Steve, stating this assumption, and giving more details about Kett and the headstone project. Steve replied immediately:

Wow. What a story and I thank you so much. I was always led to believe that my uncle died overseas in the War. It appears to me that his sisters whom I saw regularly until their deaths didn’t want me to know about him being in a mental hospital. (. . .) Also I was told he never married maybe they were embarrassed about that.

Thank you for all the information you have given me.

(Steve, email, 8 February 2018)

Steve’s revelation about Kett surprised and concerned the authors. We maintained contact with Steve and invited him to be interviewed in October 2021 when we were writing this article. We asked how he knew about Kett:

We actually had a family bible that goes back to 1828 and there was those war colours and they told me they were Johnny’s and (. . .) he was an uncle and I asked about him and told he was killed in World War One in France.

Kett’s sister had concealed the truth that he had been in a psychiatric hospital for many years and instead portrayed him as a war hero. She also never mentioned Kett’s estranged wife or stepdaughters.

When asked about his reaction to our email about Kett’s illness and death, Steve replied:

Ah, very surprised actually, but I thought more about how, the family, sort of were embarrassed about it. I’d always been told he’d died in World War One in France, and I knew nothing different, then you told me he was buried in Beechworth and, ah, I thought, hang on. . ..

Int: Now you’ve had time to think about it, have your feelings changed towards your grandmother or the family generally?

No, not really, I was surprised in the way, um, he obviously had a problem, or he wouldn’t have ended up where he was. To me it appears . . . and in those days, you didn’t want to really associate with someone or your relatives who had that problem. (. . .) So basically, probably it had to be a secret, it was obviously mental health or whatever and had it been today, you read about it every second day in the papers. That sort of stuff, it reflected the old days, they really didn’t want to know about it.

Steve believes that family shame about Kett meant they did not want to be associated with him; in other words, they felt the stigma of his illness and possibly the behaviours associated with it, as described by Barnwell (2019a, 2019b).

We asked Steve what he thought about families keeping secrets:

I find it disappointing, that’s all, because they owe them. Uncle Johnny was, until I got your letter three years ago, a war hero but unfortunately, he was mentally disturbed and died in a mental hospital, so a bit different.

Kett’s sister made a deliberate decision to withhold information about him. In doing so, she created the acceptable and common story that Kett had died in the War to deflect further questions about him. This may have been to protect the young man from the stigma of knowing there was insanity in the family, and to protect the family from courtesy stigma if Kett’s diagnosis became known more widely. She may also have been ashamed of the antecedents to Kett’s hospitalisation, including alcohol abuse and domestic violence. Even his war injuries − gunshot wounds to the buttocks − could be interpreted as a sign that he was running away from the enemy, a shameful act considered a sign of cowardice.⁴

The lives of Fletcher and Kett deteriorated after the War until they required psychiatric care. Neither seemed to fit the classic pattern of shell shock, but it is easy to imagine that their experiences coupled with the lingering effects of their injuries took their toll.

Discussion

The use of micro-history in this study enabled us to uncover stories of two families in a similar situation that they managed very differently. The extensive use of documentary sources coupled with subsequent unstructured interviews allowed us to build a picture over time to see how the families had been affected by the stigma of mental illness, the steps they had taken to minimise shame and embarrassment, and the effects of these actions on the current generation. The micro-histories provided a glimpse into the lives of two ordinary men and their families. These were not lauded War heroes but foot soldiers who answered the call to enlist. However, from their experiences we can gain insight into the effects of war on countless similar families. There are no statistics on the numbers of men who developed mental illness after the War, but numbers alone could not convey the burdens families experienced. Hence, the importance of small-scale, individual approaches like micro-history. Apart from the often devasting social and economic effects that families, principally wives and mothers, had to deal with there was also the fear of being ostracised because of the high level of stigma surrounding mental illness in the community (Larsson, 2009b).

The micro-histories add to our understanding of stigma and secrets in a number of ways. Barnwell (2019a) claimed that while every family may have unique secrets, there are other secrets held by numerous families and these are embedded in a web of historical and political processes which together with social practices and mores compel silence for fear of social retribution if the secret becomes known. The secret held by the Fletcher and Kett families was not unique to them. Many soldiers developed mental illness during or after World War 1, but the extent of illness was concealed from the wider public by government policies and actions. If the Repatriation Department did not accept their illness as resulting from war service, patients were placed in civilian asylums and labelled as lunatics rather than War veterans at a time when mental illness was a matter of great shame within families (Larsson, 2009b). Every affected family would have had to work out how to handle the stigma and shame.

The Fletcher and Kett families managed the secret of mental illness in different ways. Barnwell (2019b) found that people spoke about emotional closeness and time or recency when decided how to manage secrets within families. She also noted that we needed to learn more about how and why families deal with stigma and secrets (Barnwell, 2019a) and the micro-histories provide clues to why the families acted differently. While it is not possible to judge the degree of emotional closeness within each family, there were two ways in which the families differed considerably, and these were geographic proximity and cultural heritage. We believe consideration of these extends Barnwell’s work on how families manage secrets. Fletcher’s wife, children and grandchildren continued to live in the family home in Melbourne after his hospitalisation and inevitably, friends and neighbours would have enquired about his illness. By not specifying its nature but attributing it to war injuries, the family had an explanation that was socially acceptable, and which helped to minimise courtesy stigma. The secret helped to protect the family, but it became less important after Fletcher and his wife died and as the grandchildren grew into adulthood and moved elsewhere. They sought to expand their partial knowledge to gain deeper understanding of their grandparents and what they had been through. In contrast, Kett’s sisters had married and moved away from Melbourne before he became ill. By keeping Kett’s hospitalisation a secret, they ensured that their new acquaintances would have no reason to ostracise the family. This suggests that geographic distance may make it easier for family members to manage information and keep secrets because the risk of them being accidently revealed is reduced. While geographic distance does not necessarily reduce emotional closeness between family members of one generation such as siblings, it may be harder for successive generations to feel emotionally close to a geographically distant relative they have never met.

The second and probably stronger reason for the differences between the families was cultural heritage. Kett came from a family with Chinese heritage and he and his siblings might have experienced stigma and discrimination from a young age. In Australia in 1914, Chinese people were a stigmatised group. Men who wished to serve in the Australian Imperial Force had their eligibility determined by local recruiting officers who had the power to reject applicants who looked or sounded ‘too Chinese’. Kett was one of only 200 Australians of Chinese descent accepted to serve (Kennedy, 2013). Their Chinese heritage might have sensitised his sister to protect her child and grandchild at all costs from courtesy stigma arising from Kett’s behaviour and illness. She concealed his domestic violence, alcoholism and mental illness, all of which remain stigmatising events today, but also his marriage and stepdaughters, suggesting this had not been acceptable to the family. Ryder et al. (2000) highlighted the influence of long-standing cultural beliefs on family attitudes to mental illness. In a study comparing Canadians of Chinese and European descent, they found Chinese had more negative attitudes to mental illness, were more affected by stigma and more likely to keep a diagnosis secret. The authors attributed their findings to the central tenet of collective family responsibility in Chinese culture, leading to the belief that all family members are in some part responsible when a member develops mental illness. It is impossible to discern the extent of acculturation of Kett’s family, but this belief could partially explain their reaction to his illness.

In both families, grandmothers were instrumental in constructing and transmitting images of the family that they wanted preserved by selecting what information to keep secret and what to pass on. This shows the importance of older generations in creating or maintaining secrets, and the role of women in creating and sharing family stories (Evans, 2021). Fletcher’s grandchildren accepted the information their grandmother had given them, adding to it as they developed further understanding and enhancing the construction of the family image presented by their grandmother. For the Kett family, however, the grandmother constructed an acceptable secret, death in the War, to conceal the painful truth of his mental illness. In so doing, she may have wished to protect her grandchild from the shame and stigma she had lived with through knowing about her brother’s illness. This echoes Barnwell’s (2019b) claims that family secrets used to control shameful emotions and the passage of stigma through the family have a protective function for younger generations, but concealment can leave families vulnerable to shock, anger or disbelief if they discover the truth later in life. Kett’s great-nephew was surprised to learn the truth of his illness and death and disappointed to know that his grandmother had lied to him. Kett’s story can be read as an example of slow violence of stigma on two levels. The grandmother effectively disowned her brother, removing him from the family story, and in doing so she hid the truth from her grandson. He now has to decide what to do with the secret he possesses (Barnwell, 2019a).

Family secrets do not remain hidden for all time. Some die out as successive generations lose temporal, geographic or emotional proximity to the source of the secret, but there is always the possibility that the secret may be exposed. The activities of amateur family historians have led to the uncovering of family secrets, generating various emotions among family members (Barnwell, 2019a, 2019b; Smart, 2011). Secrets may also become known if they are revealed by a third party, either deliberately or by accident, as happened in this research. In the 4 years since first writing to the Fletcher and Kett families, the authors have reflected on their actions and the outcome of them. We agree with Speziale and Carpenter (2003) that the open, emergent nature of qualitative research means that researchers cannot foresee exactly what will arise during the research. We could be accused of being naïve or even heartless in telling the families about their veteran’s mental illness, but we acted in the belief that the families had some knowledge of this, judging by the notice on Fletcher’s grave and the letter from Kett’s sisters in his Army file. We also believed that we were conveying good news to them, that the veterans’ war service was to be acknowledged with headstones. We were horrified and felt guilty when we learned we had unwittingly revealed a long-held secret to Steve, yet we believe he is accepting of this and grateful for the information about Johnny we have provided. Nevertheless, the experience reminds us that researchers are always in a position of power over those they research, and that any project can have unexpected or unintended consequences.

Conclusion

In this article, we used the stories of two soldiers who developed mental illness years after serving in World War 1 to evaluate micro-history as a research technique, particularly to see its relevance for explicating the management of stigma within families. Mental illness is a complaint with many causes and diverse symptoms and there were few effective treatments before the discovery of psychoactive drugs. One enduring feature of mental illness is stigma, affecting not only patients but their families, and the burden of stigma is multiplied if a person’s mental illness is attributable in part or whole to behaviours considered deviant or immoral, such as alcohol abuse or promiscuity. The men in this case study conformed to society’s expectations when they enlisted to serve and it is reasonable to assume that War service contributed, in part or whole, to each man’s mental illness and ultimate death, but this was not recognised at the time they were diagnosed. The micro-histories showed that the two families used different strategies to keep secret the truth about the men’s illnesses. Both families had found that constructing a family narrative that emphasised the men’s War service, with its connotations of duty, valour and courage, was more socially acceptable than the truth about their illness and the stigma and shame this would have brought. The fact that family histories can be social constructions rather than absolute facts always needs to be remembered by social researchers and clinicians, especially when investigating possible antecedents of illness. This is nothing new, but our research shows that some secrets can persist for many years and through several generations.

We conclude that micro-history is a useful tool for studies like ours that deal with sensitive issues across generations, although in some cases, its use may be limited by the lack of relevant documents or their unavailability because of privacy legislation. Generalisation is not possible when using micro-history, but the different actions of the two families shed light on the development and persistence of family secrets. We have no direct evidence from the grandmothers themselves or from the intermediate generation, the parents of the informants, who may have been able to elucidate why and how the secrets were developed. Despite these limitations, we believe the article is a useful addition to the literature on family secrets related to mental illness especially in war veterans, and a good example of a research technique that is not widely known.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Eileen Clark

Notes

Author biographies

Eileen Clark is an Adjunct Research Fellow at Charles Sturt University, Albury, NSW, Australia. She holds degrees in sociology and genealogy and her research interests include mental health and qualitative methodologies.

Jennifer Munday is an Associate Professor in the Faculty of Arts & Education at Charles Sturt University. An arts-based researcher, she collaborates with her co-authors on social history projects connected to Mayday Hills, the former Beechworth mental hospital.

Alison Watts is an Adjunct Lecturer at Southern Cross University, Lismore, New South Wales. Her PhD doctorate titled ‘Maternal Insanity in Victoria, Australia: 1920–1973’ is based on her grandmother’s time as a patient at Mayday Hills mental hospital, Beechworth.

References

Angermeyer

Schulze

Dietrich

(2003) Courtesy stigma–a focus group study of relatives of schizophrenia patients. Social Psychiatry and Psychiatric Epidemiology 38: 593–602.

Baár

(2015) Prosthesis for the body and for the soul: The origins of guide dog provision for blind veterans in interwar Germany. First World War Studies 6(1): 81–98.

Barnwell

(2019a) Family secrets and the slow violence of social stigma. Sociology 53(6): 1111–1126.

Barnwell

(2019b) “Given it is all so remote from us”: Family secrets, ancestral shames and the proximities of emotion. Emotions and Society 1(1): 83–98.

Bericat

(2012) Emotions. Sociopedia.isa, 1–13. Available at: https://sociopedia.isaportal.org/resources/resource/emotions/ (accessed 13 December 2021).

Carroll

(1990) Keeping Time: Memory, Nostalgia, and the Art of History. Athens, GA: University of Georgia Press.

Corbin

Morse

(2003) The unstructured interactive interview: Issues of reciprocity and risks when dealing with sensitive topics. Qualitative Inquiry 9(3): 335–354.

Crozier-De Rosa

(2014) Shame and the anti-suffragist in Britain and Ireland: Drawing women back into the fold? Australian Journal of Politics & History 60(3): 346–359.

Denscombe

(2014) The Good Research Guide, 5th edn. Maidenhead: Open University Press.

10.

Edwards

Maunther

(2002) Ethics and feminist research: Theory and practice. In: Maunther

, (ed.) Ethics in Qualitative Research. London: SAGE, pp.14–31.

11.

Evans

(2021) How do family historians work with memory? Journal of Family History 46(1): 92–106.

12.

Farrugia

Pienaar

Fraser

, et al. (2021) Basic care as exceptional care: Addiction stigma and consumer accounts of quality healthcare in Australia. Health Sociology Review 30(2): 95–110.

13.

Gamsa

(2017) Biography and (global) microhistory. New Global Studies 11(3): 231–241.

14.

Goffman

(1963) Stigma: Notes on the Management of Spoiled Identity. Harmondsworth: Penguin.

15.

Goldberg

(2017) Introduction: On stigma & health. The Journal of Law Medicine & Ethics 45: 475–483.

16.

Jones

Wessely

(2006) Psychological trauma: A historical perspective. Psychiatry 5(7): 217–220.

17.

Jones

Wessely

(2014) Battle for the mind: World war 1 and the birth of military psychiatry. Lancet 384: 1708–1714.

18.

Kennedy

(2013) Chinese Anzacs. Australians of Chinese Descent in the Defence Forces 1885–1919, 2nd edn. O’Connor: A. Kennedy.

19.

Kvale

(1996) InterViews: An Introduction to Qualitative Research Interviewing. London: SAGE.

20.

Larsson

(2009a) Families and institutions for shell-shocked soldiers in Australia after the First World war. Social History of Medicine 22(1): 97–114.

21.

Larsson

(2009b) Shattered Anzacs. Living With the Scars of War. Kensington, NSW: UNSW Press.

22.

Larsson

(2009c) A disenfranchised grief: Post-war death and memorialisation in Australia after the First World war. Australian Historical Studies 40(1): 79–95.

23.

Link

Phelan

Bresnahan

, et al. (1999) Public conceptions of mental illness: Labels, causes, dangerousness, and social distance. American Journal of Public Health 89(9): 1328–1333.

24.

McCann

Lubman

Clark

(2011) Responding to stigma: First-time caregivers of young people with first-episode psychosis. Psychiatric Services 62(5): 548–550.

25.

Mills

(1959) The Sociological Imagination. Harmondsworth: Penguin.

26.

Muir

(2002) “Idiots, imbeciles and moral defectives”: Military and government treatment of mentally ill service personnel and veterans. Journal of Australian Studies 26(73): 41–47. 225–227.

27.

Olasoji

Maude

McCauley

(2016) A journey of discovery: Experiences of carers of people with mental illness seeking diagnosis and treatment for their relative. Issues in Mental Health Nursing 37(4): 219–228.

28.

Paul

(2018) What is microhistory? Social Evolution and History 17(2): 64–82.

29.

Persson

Smith

Wallace

, et al. (2022) Understanding ‘risk’ in families living with mixed blood-borne viral infection status: The doing and undoing of ‘difference’. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 26(3): 284–301.

30.

Phelan

Link

Stueve

, et al. (2000) Public conceptions of mental illness in 1950 and 1996: What is mental illness and is it to be feared? Journal of Health and Social Behavior 41(2): 188–207.

31.

Probyn

Bozalek

Shefer

, et al. (2019) Productive faces of shame: An interview with Elspeth Probyn. Feminism & Psychology 29(2): 322–334.

32.

Rodda

(2010) Trespassers in time: Genealogists and microhistorians. DLitt Dissertation, Drew University, Madison, NJ.

33.

Ryder

Bean

Dion

(2000) Caregiver responses to symptoms of first-onset psychosis: A comparative study of Chinese and Euro-Canadian families. Transcultural Psychiatry 37(2): 255–266.

34.

Scambler

(2009) Health-related stigma. Sociology of Health & Illness 31(3): 441–455.

35.

Smart

(2011) Families, secrets and memories. Sociology 45(4): 539–553.

36.

Smith

AKJ

Persson

Drysdale

, et al. (2021) Family imaginaries in the disclosure of a blood-borne virus. Sociology of Health & Illness 43: 1422–1436.

37.

Speziale

HJS

Carpenter

(2003) Qualitative Research in Nursing, 3rd edn. Philadelphia, PA: Lippincott Williams & Wilkins.

38.

Star

(1955) The public’s ideas about mental illness. In: Annual meeting of national association for mental health, Indianapolis, IN, United States, 5 November. Chicago, IL: National Opinion Research Center. Available at: https://www.norc.org/PDFs/publications/StarS_Publics_Ideas_1955.pdf (accessed 13 December 2021).

39.

Turning Point (2019) Beyond the emergency: A national study of ambulance responses to men’s mental health. Turning Point, Richmond, VIC, Australia. Available at: https://www.beyondblue.org.au/docs/default-source/about-beyond-blue/beyond-the-emergency-report.pdf?sfvrsn=5b6db0ea_4 (accessed 24 July 2022).