To think that some hundred or so years ago, the reality of those suffering with severe mental illnesses was a terrifying future of asylums, lobotomies and criminal insanity, is deeply disturbing when considering the advancements of psychiatry over the past couple of centuries. During the 18th century, the first age of philosophical enlightenment occurred, and after that, the Industrial Revolution. These movements transformed the long-accepted ideas of man, and classified them as beings capable of the almost divine capabilities of reason and rationality. In addition, they also sought more egalitarian relationships in society. By looking at man as a complex being, this translated into a more human-based moral therapy when it came to treating those suffering with mental disorders. Prior to Freudian times, this era of therapeutic measures was rooted in validating the patient’s experiences and restoring them to their prior rational self. 

Although treatment was not entirely humane, especially as we know therapy today, this idea of reinstating oneself with their rational selves was definitely a progressive notion. This treatment, according to McLean Hospital director in 1841 was rooted in “separation, direction, classification and occupation.” Essentially, they would uproot the patient from their prior toxic environment, redirect them into a new more stimulating environment, in which there was a heavy emphasis on healthier thoughts and behavior, and then ‘distract’ them through usefulness by working. This treatment, introduced in the 1800s, is similar to many inpatient treatment programs which force the individuals to assimilate to their new environments, all while focusing on healthier thought processes to allow reentering into society. In addition, the transformation of moral therapy in ‘asylums’ during this era included the introduction of an asylum superintendent in the 1800s, according to Thomas Kirkbride in the Pennsylvania Hospital of the Insane. Essentially, this was a licensed individual that worked one-on-one with the struggling patients of the asylum and overlooked daily functions. Having an asylum superintendent transformed the role of physicians into those capable of social and psychological change. Later, around the late 1850’s and 1860’s a large influx of immigrants seeking psychological help caused some change in the established moral therapy, but nonetheless, even in contemporary times, we see the influence of this moral therapy on present-day treatment. 

Even now, in 2020, we still face innumerable challenges when it comes to administering helpful, validating psychological treatment. Due to an alarming increase in rates of mental illness of the current population, despite the highest supply of practicing psychologists and psychiatrists to date, the real issue is rooted in giving everyone a fair chance at seeking treatment. This is rooted in economic issues of insurance companies unfairly or outwardly refusing to sponsor psychological treatment, and socially-imposing harmful stigmas about mental health. Perhaps revisiting the fundamental ideology of moral-based therapy from the 1800s is important in challenging these economic and social issues related to getting help. In order for a happier and healthier population, we need to validate one’s experiences and treat mental health services as a human right. 

References:

Harris, Ben. “Therapeutic Work and Mental Illness in America, c. 1830–1970.” Work, Psychiatry And Society, c. 1750–2015, edited by WALTRAUD ERNST, Manchester University Press, 2016, pp. 55–76. JSTOR, www.jstor.org/stable/j.ctt1b3h9bj.8. Accessed 2 Oct. 2020.