While its lessons are some two centuries old, moral treatment remains the greatest advance in the history of inpatient treatment of mental illness. Recent books and reviews have generally shaped our understanding of moral treatment into an early 19th century enclave in humanitarian psychological care for those suffering from insanity that was preceded by violence and banishment and followed by custodialism and therapeutic nihilism. This paper uses literature both from the era in question and previous to our generation to present a new picture of its contributions and limitations. A multi-fold definition is proposed for moral treatment. Its components are asylum sequestration, authoritarianism, compassion, early psychology, occupational treatment, self-control, and therapeutic optimism. A number of previously under-described features stand out when examined through this lens. Rather than uniquely charitable, it was best suited to wealthy patients. Impractical for average or severe patients, moral treatment was most applicable to those who were convalescent and suitably intimidated. Early psychological treatments were only a minor armament in its therapeutic arsenal. The heralded restraint-free conditions were an exaggeration. The anticipation that high rates of patient cures was limited to the moral treatment era (cult of curability) is likewise mistaken. Pessimistic cure rates in the era of custodialism failed to merit the title nihilistic. These limitations are frequently unknown or ignored by scholars and lend some context to the praise of moral treatment, which is no less praiseworthy, just a bit more seasoned and nuanced.
...MoreSimilar Citations
Article
Edward M Brown;
(2018)
François Leuret: the last moral therapist
(/isis/citation/CBB819171641/)
Article
Boyce, Niall;
(2012)
A Secret History
(/isis/citation/CBB001200870/)
Article
Carlos Francisco Almeida de Oliveira;
Carlos Evandro Martins Eulálio;
Viriato Campelo;
Paulo Dalgalarrondo;
Tom Dening;
(2016)
A historiographic study of psychiatric treatments in Brazil: mentalism and organicism from 1830 to 1859
(/isis/citation/CBB284956374/)
Article
Sharlene D Walbaum;
(2019)
The invisible woman: Susan Carnegie and Montrose Lunatic Asylum
(/isis/citation/CBB650430833/)
Article
Sheila Dickson;
(2018)
Rotation therapy for maniacs, melancholics and idiots: theory, practice and perception in European medical and literary case histories
(/isis/citation/CBB641233436/)
Article
Coleborne, Catharine;
(2009)
Families, Insanity, and the Psychiatric Institution in Australia and New Zealand, 1860--1914
(/isis/citation/CBB001232097/)
Article
Finnane, Mark;
(2009)
Australian Asylums and Their Histories: Introduction
(/isis/citation/CBB001232093/)
Article
Monk, Lee-Ann;
(2009)
Working in the Asylum: Attendants to the Insane
(/isis/citation/CBB001232098/)
Article
Weaver, John;
Wright, David;
(2009)
Suicide, Mental Illness, and Psychiatry in Queensland, 1890--1950
(/isis/citation/CBB001232099/)
Article
Maria Luisa Valacchi;
Davide Orsini;
Francesca Vannozzi;
(2019)
Solo "roba da matti"? Le sostanze di origine minerale della Farmacia del Manicomio di Siena
(/isis/citation/CBB203353902/)
Book
David Scrimgeour;
(2015)
Proper People: Early Asylum Life in the Words of Those Who Were There
(/isis/citation/CBB325630550/)
Article
Baur, Nicole;
(2013)
Family Influence and Psychiatric Care: Physical Treatments in Devon Mental Hospitals, c. 1920 to the 1970s
(/isis/citation/CBB001213644/)
Thesis
Alex Crawley;
(2018)
Method in His Madness Enacting Male Normativity in Holloway Sanatorium for the Insane, 1880-1910
(/isis/citation/CBB459377349/)
Article
Viviana Faschi;
(2018)
Nietzsche's Illness Diagnosis Issues: A Review of His Clinical Records and Some Recent Hypotheses
(/isis/citation/CBB271866077/)
Book
Mary de Young;
(2015)
Encyclopedia of Asylum Therapeutics, 1750–1950s
(/isis/citation/CBB954758413/)
Article
Hutchison, Iain;
(2011)
Institutionalization of Mentally-Impaired Children in Scotland, c.1855--1914
(/isis/citation/CBB001232201/)
Book
Ernst, Waltraud;
Mueller, Thomas;
(2010)
Transnational Psychiatries: Social and Cultural Histories of Psychiatry in Comparative Perspective, c. 1800--2000
(/isis/citation/CBB001232181/)
Article
Wallis, Jennifer;
(2013)
The Bones of the Insane
(/isis/citation/CBB001320330/)
Article
Sammet, Kai;
(2004)
Gute Arbeit: “pflichtmäßige Führung” und “höhere Anforderungen”: Beurteilungsmuster des Wärterverhaltens und die Einführung des Non Restraint in der Charité in den 1860er Jahren
(/isis/citation/CBB000501342/)
Article
Slijkhuis, Jessica;
Oosterhuis, Harry;
(2014)
Cadaver Brains and Excesses in Baccho and Venere: Dementia Paralytica in Dutch Psychiatry (1870--1920)
(/isis/citation/CBB001420765/)
Be the first to comment!