Ch 11 - Jeff Standen

of these were little better than zoos or prisons. St Mary's of
Bethlehem in London (better known as Bedlam) was
converted into a hospital for the 'insane' in 1547, and put its
collection of chained up 'lunatics' on show to the paying
public.
The 18th century
'
The first modern psychological model emerged in Paris in
the 1790s. Philippe Pinel (1745-1826) suggested that
psychological disorder was the result of stressful events in
life, and that the abnormal needed sympathy and time to
recuperate, not torture or chaining up. Under his guidance,
Parisian hospitals like the Salpetriere became refuges (or
asylums) for the psychologically disordered, designed to
help the inmates recover - not to imprison them or put them
on show. Pinel's humane treatment of his patients, involving
such modern practices as occupational therapy and talking
through problems, became known as 'moral treatment'.
Similar developments took place in England (where Quakers
opened the York Retreat in 1 796) and later in America.
Bedlam was finally closed and possession by the Devil,
exorcism, and witchcraft were increasingly rejected as
superstitious nonsense.
The biological model of abnormality developed slowly
during this period. Physicians continued to use bleeding (a
leftover from Galen) for all manner of physical and mental
disorders, and there was a flurry of interest in the healing
powers of magnets, inspired by the claims of the notorious
con-man Franz Anton Mesmer (1734-1815). In the
meantime, governments were incarcerating every kind of
'deviant' (the sick, the 'mad', beggars, orphans, prostitutes,
unmarried mothers and so on) in institutions - just in case
crime, immorality or psychological disorder were as
contagious as plague (Foucault, 1977).
The 19th
Pinel freeing patients from chains and shackles in Paris
In the 19th century, biology and medicine developed much
more rapidly. Charles Darwin's theory of evolution (1859)
drew attention to the importance of biological inheritance,
and Louis Pasteur's discovery of germs in the 1860s at last
explained how contagious diseases spread. Soon after, the
idea that psychological disorders could have biological
causes was strengthened by the discovery that 'general
pariesis' (a form of insanity) was caused by syphilis - a
sexually transmitted disease. From the 1840s, professional
associations of 'mad-doctors' or 'alienists' (later called
psychiatrists) were established in Europe and America, and
by the 1860s, the German scientist Wilhelm Griesinger
could confidently assert that all 'mental diseases are brain
diseases'. Some of these diseases he thought were inherited,
some due to infection.
Between 1883 and 1913, Griesinger's pupil Emil