History of Madness

William Hogart: Scene in Bedlam

Although 2500 years ago Hippocrates suggested that mental problems had a natural cause and that cause laid in the brain and imbalance of body fluids, giving treatment and therapy for mentally ill patients is relatively new practise.

After the era of Hippocrates and his amazingly accurate assumptions, interpretations about the cause of mental disorders took a huge step backwards when Christianity was spreading- and with it the similar beliefs related to mental illnesses which were prevailing before Hippocrates-: That mentally unstable people were demonised. These kind of beliefs were in power for hundreds of years, and even though some priests were trying to cure mentally ill by religious rituals, in most cases they were locked up in prisons or killed. These beliefs about demons were culminating in Witch-hunt on Early Modern period, where abnormal behaviour was the evidence of witchcraft. Mentally ill were tortured and burned to death.

Witch-hunt also brought the realisation, that mental problems could not be removed by killing the people who had them, as these problems were emerging also among the new population.
Words 1st mental hospital St. Mary of Bethlehem (“Bedlam”) in London, was opened in 1247. Bedlam was used for mentally ill patients from the late 14th century. Patients were mainly kept in chains or solitude, and they got very little or no treatment at all. The actual treatments were more like torturing methods: Commonly used treatments were cold baths, vomiting and bleeding. Some patients received additional treatments, e.g swing chair therapy in which chair spun at 100 times per minute. Patients were also beaten by the staff, and they lived in filth and chaos.

Swing chair was commonly used treatment method in Bedlam.

Patients in Bedlam were kept in chains, but the place was open for public and anyone could have a visit. On the 17th century Bedlam became a big tourist attraction and started to sell tickets to their premises for people who wanted to see “mad folk”. Day trips combined picnic on the countryside and visit to the mental hospital got very popular especially among rich people and artists.

On the late 18th century a French physician Philippe Pinel developed a more human approach. Mentally ill were released from chains and received individual attention and care. Despite these improvements, the conditions in Asylums were still poor and prison alike. Also, the risk of getting diagnosed mentally ill was increasing especially among women, who on the 18th  and 19th centuries were often diagnosed “hysteric” and sent to the mental hospitals. In Finland, the oldest mental hospital (Seili, opened 1619), also had mainly women patients who were sent there for the rest of their lives. Often the reason was PMS symptoms or sexually immoral behaviour.

Seili Hospital was opened in 1691 on the Archipelago of Turku

The treatment of mental disorders took a new shape when leucotomy and lobotomy were discovered on 1930’s. Lobotomy – which means that the connections in the brain’s prefrontal cortex are cut- was seen as a solution for many mental disorders, but it left the patient emotionally blunted and changed his/her personality permanently. Lobotomy was widely used especially in Nordic countries, and it was not before the late 70’s, when this cruel operation was banned.

Few decades after S. Freud had published the psychoanalyses in the early 1900’s, psychotherapy methods were started to take into consideration when treating mental disorders. Before the broader knowledge of psychoanalyses, it was strongly recommended that patients should not be talked to or listened, as this might somehow stimulate them in a negative way.

As it probably is with many other vulnerable groups, treatment of mental problems are the reflection of the culture and its historic era. In the western world, with broaden welfare, treatment of mental disorders is getting better along attitudes are also turning to more tolerant and understanding. While in some part of the world mental problems are still strongly stigmatising and patients are kept in captivity. Despite the dehumanizing treatment of mentally ill in history, I would like to believe that thereäs always been people with wider understanding and compassion to see the humanity beyond the madness. It is a different story, whether these views have had a chance to change things.



Lecture by PhD Juhani Ihanus, Kliininen Psykologia 2019

Lobotomia oli oman aikansa tuote, https://yle.fi/uutiset/3-5312795





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