Pinel's Mental Alienation

This article begins by discussing the history of mental illness, going as far back as the 1700s. It goes over professionals in the field, the incidence rate, and treatments, all of this from the different time periods throughout the United States. The author also makes a point to acknowledge the different perceptions there were in the past of mental

“Timeline: Treatments for Mental Illness” notes the history of mental illness; before the 1840s, being mentally ill was considered to be a form of religious punishment and demonic punishment by many cultures. In 1407 the first European establishment for mentally ill was established in Valencia, Spain. As time progressed it was shown that Europeans began to increasingly isolate the mentally ill; treated inhumanly, often kept chained to walls in dungeons. In the late 1700s some changes were made as concerns for the mentally ill people’s well being grew. After the French revolution Phillippe Pinel, a French physician, took over the Bicêtre insane asylum, forbidding the use of chains and shackles. He provided the mentally ill with better living conditions, sunny rooms and the ability to roam around the grounds. Though some things have improved, mistreatment in other asylums persisted. In

Hippocrates was the first to recognize that mental illness was due to ‘disturbed physiology’ as opposed to ‘displeasure of the gods or evidence of demonic possession’. It was not until about one thousand years later that the first place designated for the mentally ill came to be in 15th century Spain. Before the 15th century, it was largely up to individual’s families to care for them. By the 17th century, society was ‘often housing them with handicapped people, vagrants, and delinquents. Those considered insane are increasingly treated inhumanely, often chained to walls and kept in dungeons’. There are great strides for the medical treatments for the mentally

In Bly’s time, mental illnesses were not taken seriously. Bly described the asylum she was admitted to as overcrowded, cold, and dirty (ch. 7). It defeated the purpose of trying to give extra attention to those in need. It was easy to get admitted into an institution, but nearly impossible to make it out because the treatment was not treatment.

She moved to England and had encounters with several social reformers including, Dr. Samuel Tuke, who was son of the founder of a progressive institution for the mentally ill. While in England, she was given a book of the writings of Dr. Philippe Pinel of Paris, who was the first doctor to free the insane from their chains. This sparked her curiosity and she began her studies into the treatment of the mentally ill along with the concept of “moral treatment”, which means to treat with encouragement and kindness rather than brutality. Proper moral treatment called for individual attention and thus required a setting that encouraged familiarity. It was not just her compassion over their sufferings but the question, “What class of positive forces, philanthropic, medical, legislative, judiciary, can be summoned into the field to cope with this awful problem?” In 1841, Dorothea Dix was teaching Sunday school classes to female convicts in East Cambridge Jail. During her encounters at the jail, she saw the mentally ill being treated inhumanely and neglectfully, and she became determined to improve conditions. This led her to traveling more than 10,000 miles to explore and investigate the living conditions of the mentally ill as well as the injustices they faced in jails across the United States. She wanted to take a personal survey of every encounter she had

Because there are so few general histories on this subject, larger libraries should invest and purchase this work. Grob has published scholarly works on the treatment of mentally ill in the past but this account is highly readable and meant to target everyday readers. The book tracks the changing approaches in the treatment of the mentally ill in the U.S. psychiatry has basically transformed from dealing with asylums to now being a private-office practice. In the early history of this field, ``lunatics'' were primarily seen as a family or community responsibility, and those who had no one to take care of them were seen not as a medical issue but an economic or social one. Widows, orphans, and people who generally needed public assistance were housed in public almshouses.

For centuries societies have been superstitious and afraid towards mental illness; mainly due to a lack of knowledge. While there were “cures and treatments” for individuals that were deemed insane many were sent to either prisons or asylums. The conditions of these facilities were unsanitary, the physical and sexual abuse was frequent, and the staff was not properly trained to care for patients. Patients were also chained, caged, or restrained to beds in rooms that were often unheated.

Wright, D. (1997). Getting out of the asylum: understanding the confinement of the insane in the nineteenth century. Social History of Medicine, 10, 13

The evolution of mental health care put forth in the book has been one plagued with torture and inhuman practices. During the eighteenth century, mentally ill patients were confined to what can only be described as dungeons. “The lunatics” were housed in “unheated, dingy cells in the basement, where they had often slept on straw,” and placed in chains (3). Under such condition patients mad little to no progress, and were simply tucked away from the rest of society. However, in the early nineteenth century, physician Benjamin Rush of the Pennsylvania Hospital, created a “mad ward,” where patients were moved to humane living condition and received medical treatment (3). Rush recognized the early work of the Quakers, who rationalized the mental

Sanity and insanity are two deeply intertwined concepts. Any observation made upon the nature of either conversely reshapes our understanding of the other. In Ken Kesey’s One Flew Over the Cuckoo’s Nest, there is a power struggle in a psychiatric ward between two conflicting definitions of sanity and insanity and what behaviour can be categorized as such. Miss Ratched’s sanity is achieved through a rigid hierarchal network of rules that enforces uniformity and order while the patients’ revolutionary sanity achieved solely through rebelling from the rules that limit the individual’s freedom and sense of self. In detailing the tension between two opposite views on sanity, Kesey scrutinizes the way society forms its perceptions towards sanity and exposes the flaws in its narrow definition of sanity. The process of defining sanity is formed by rules that act as the model of sanity which is inherently unjust to non-conforming

Pinel’s approach to treating mental illness in 1973, was called “Moral Treatment and Occupation”. He firmly believed that moral treatment meant treating one’s emotions. Occupation then began to be defined

The originality of the term ‘prisoner or patient’ can date back to the early 19th century, when specialist institutional provision was introduced to care for people with a mental deficiency. Many people, who required treatment for such deficiencies, were primarily cared for by their families and the parish authorities; known as ‘Care in the Community’ (Bartlett and Wright, 1999:183-185). Anyone displaying behaviour deemed abnormal were declared ‘insane’, and if violent behaviour was exhibited they were confined to ‘Madhouses’ or placed in ‘Workhouses’. The introduction of the Lunacy Act in 1845 and 1890 was regarded, as a ground-breaking outcome in the treatment of the mentally ill (Eldergill, 1998:61). The Act helped reform the status

A variety of treatment techniques were present in the mental facility. We will examine those of McMurphy, Nurse Ratchett, and the head doctor. Nurse Ratchett and the head

Philippe Pineal, the founder of the moral treatment, was born in Toulouse, France on April 20, 1745. His father was a surgeon so he had some pretty big shoes to fill. He initially began studying for literature and theology, but practiced medicine receiving his M.D. at the University of Toulouse. At first, he was unable to practice medicine because his degree was from the provinces, but still worked as an unlicensed doctor anyways in a private asylum.

Philipe Pinel was a French physician as well as psychiatrist. He was born the son of a barber surgeon in St.-Paul-Cap-de-Joux. Philipes mother had come from a family with many surgeons, and doctors as well (Enersen). Originally wanting to study religion, this “born-again” doctor decided to focus on the mental health of others when his friend who was mentally ill ran into the countryside and was eating by wolves (Enersen). Shortly after that, he became chief physician at Bicetre, which was an asylum for criminally insane men in Paris. Philipe discovered that the patients were living in horrific conditions. For example, many patients had been chained to walls for years and were put on display like a freak show (X) Philipe had the chains removed from the patients at Bicetre.