Dr. Philippe Pinel

Early treatment of insanity generally embraced a view that insane persons had lost their reason, and though not responsible for their actions, could only be housed until they either somehow got better or died. Such treatments as existed were typically physical: bleeding, whipping, spinning, chaining, isolating from others, etc.

In the early 1800s, reformers such as Dr.  Philippe Pinel began to view the insane as people who had lost their reason because of exposure to severe stress or shocks. Victorians had terms like brain fever and shattered nerves to describe this kind of condition. Patients were seen as needing protection from society for a time so they could recover, and many alienists began using fewer restraints and stressful physical treatments. They believed that patients could be helped by moral treatments. These included friendly discussions of the patients’ problems, chores or occupations to discipline their time, and guidance for their interactions with others.

Glore Patients Out For a Stroll, 1902, courtesy Glore Psychiatric Museum

Though popular for several decades, the movement lost favor as medicine became incorporated into treatments, asylums became overcrowded, and money to pay for moral treatment (which required more attendants because patients received more than custodial care) became issues.

________________________________________________________