Abnormal Psychology

The History of Abnormal Psychology 15

Moral treatment

The treatment of the mentally ill that provided

an environment in which people with mental

illness were treated with kindness and

respect and functioned as part of a community.

alleviate pain and other medical symptoms. A scientifi c commission, headed by Ben-

jamin Franklin, investigated mesmerism and discredited the theory of electromagne-

tism and the treatment based on that theory (Chaves, 2000). Nonetheless, Mesmer’s

treatment was more humane than many that had come before it.

The humane treatment of people with psychological disorders found a great

supporter in French physician Phillipe Pinel (1745–1826). He and others trans-

formed the lives of asylum patients at the Salpêtrière and Bicêtre Hospitals (for

women and men, respectively) in Paris: In 1793, Pinel removed their chains and

stopped “treatments” that involved bleeding, starvation, and physical punishment

(Porter, 2002). Pinel and his colleagues believed that “madness” is a disease; they

carefully observed patients and distinguished between different types of “madness.”

Pinel also identifi ed partial insanity, where the individual was irrational with regard

to one topic but was otherwise rational. He believed that such a person could be

treated through psychological means, such as reasoning with him or her, which was

one of the fi rst mental treatments for mental disorders.

During the same period in England, King George III (1738–1820) displayed psy-

chotic symptoms during his reign. In 1788, Francis Willis, who ran a private asylum,

treated King George by creating blisters on his skin to draw out the “evil humors.”

When the king exhibited “mad” behaviors, Willis punished him, for example, by re-

straining him in a type of straightjacket, in an effort to bring him to his senses (Fraser,

2000). Willis used restraint when he felt it was necessary but also tried to talk people

out of their delusions, which is another mental treatment for mental disorders. More

recently, scientists have proposed that King George probably suffered from porphy-

ria, a rare genetic disorder of metabolism that can cause delusions and confusion; in

the king’s case, it was likely triggered by exposure to arsenic (Cox et al., 2005). When

the king recovered from his bout of porphyria, the methods that Willis had used to

treat his “madness” were, for a short time, hailed as cures for insanity.

Moral Treatment

During King George III’s reign, a group of Quakers in York, England, developed

a treatment that was based on their personal and religious belief systems. Mental

illness was seen as a temporary state during which the individual was deprived of

his or her reason. Moral treatment consisted of providing an environment in which

people with mental illness were treated with kindness and respect. The “mad” resi-

dents lived out in the country, worked, prayed, rested, and functioned as a com-

munity. Over 90% of the residents treated this way for a year recovered (Whitaker,

2002), at least temporarily.

Moral treatment also began to be used in the United States. Around the time

that Pinel was unchaining the mentally ill in France, Doctor Benjamin Rush (1745–

1813), a physician at the Pennsylvania Hospital in Philadelphia, moved the men-

tally ill from fi lthy basement cells to rooms above ground level, provided them with

mattresses and meals, and treated them with respect.

In Massachusetts and other states, however, the mentally ill were still frequently in-

carcerated with felons under deplorable conditions. This began to change in the 1840s

after Dorothea Dix (1802–1887), a schoolteacher, witnessed the terrible conditions that

mental patients were forced to endure in asylums. She was inspired to engage in lifelong

humanitarian efforts to ensure that the mentally ill were housed separately from crimi-

nals and treated humanely, in both public and private asylums (Viney, 2000). Dix also

helped to raise millions of dollars for building new mental health facilities throughout

the United States. Her work is all the more remarkable because she undertook it at a

time when women did not typically participate in such political endeavors.

Moral treatment proved popular, and its success had an unintended conse-

quence: Unlike private asylums, public asylums couldn’t turn away patients, and

thus their population increased tenfold as the mentally ill were joined by people

with epilepsy and others with neurological disorders, as well as many who might

otherwise have gone to jail. As a result, public institutions housing the mentally ill

King George III of England exhibited signs of

psychosis—hallucinations and delusions. Among

the treatments the king received were various

forms of punishment, which the man in charge

of his care, Francis Willis, believed would induce

the king to “come to his senses.” The king’s mad-

ness was probably a result of a medical condition,

porphyria, unidentifi ed at that time, and Willis’s

treatment probably delayed his recovery.

Dagli Orti/The Art Archive

Humanitarian Dorothea Dix worked

tirelessly for humane treatment of

the mentally ill in the United States

(Viney, 2000).

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