Moral Therapy
"The removal of the insane from home and former associations, with respectful and kind treatment under all circumstances, and in most cases manual labor, attendance on religious worship on Sunday, the establishment of regular habits and of self-control, diversion of the mind from morbid trains of thought, are now generally considered as essential in the Moral Treatment of the Insane."
-American Journal of Insanity, 1847
"The removal of the insane from home and former associations, with respectful and kind treatment under all circumstances, and in most cases manual labor, attendance on religious worship on Sunday, the establishment of regular habits and of self-control, diversion of the mind from morbid trains of thought, are now generally considered as essential in the Moral Treatment of the Insane."
-American Journal of Insanity, 1847
Broadly defined, moral treatment was a practical method of curing mental illness through the construction of a humane environment. By removing the chains of the insane and replacing them with a structured asylum environment and mental amusements such as gardening, it was argued that habits of self-control could be induced in patients that would ultimately lead to sanity. Structure, in the form of architecture and landscape, was intended to be a less obtrusive method of confinement on the patient. The grounds of the asylum provided a safe, albeit limited, space for patients to move around in and enjoy nature while the asylum allowed for the classification of patients according to their disorder which in turn allowed for improved individualized care. Medicine coexisted with environmental determinism in the moral asylum to aid physicians where amusements failed.
Doctor Rufus Wyman, Superintendent of the McClean Asylum for the Insane in Massachusetts, stated that moral management:
should afford agreeable occupation. It should engage the mind, and exercise the body; as in riding, walking, sewing, embroidery, bowling, gardening, mechanic arts; to which may be added reading, writing, conversation, &c., the whole to be performed with order and regularity. Even the taking of food, retiring to bed, rising in the morning and at stated times, and conforming to stated rules in almost everything, is a most salutary discipline.
should afford agreeable occupation. It should engage the mind, and exercise the body; as in riding, walking, sewing, embroidery, bowling, gardening, mechanic arts; to which may be added reading, writing, conversation, &c., the whole to be performed with order and regularity. Even the taking of food, retiring to bed, rising in the morning and at stated times, and conforming to stated rules in almost everything, is a most salutary discipline.
Schools and museums could even be included in the asylum design as an intellectual additive to educate the diseased brain. In diary extracts published in the American Journal of Insanity a patient under Superintendent Amariah Brigham at the New York State Lunatic Asylum describes a cabinet of curiosities kept on the asylum grounds:
We visited the Asylum Museum this afternoon. Dr. B., showed much kindness in explaining the relative merits of the various curiosities...The Museum contains many good pictures, minerals, especially ores of metals, and collections in natural history. A glass case of beautiful butterflies attracted much attention. There are, also, many Indian relics, curiosities from foreign countries, and a large assortment of ancient and modern coins. I examined the head of an Egyptian mummy, three or four thousand years old...I observed many excellent Daguerreotype likenesses of patients; they are life like, and none who have seen the originals can fail to recognize them. |
The world written about and developed by physicians for the insane was ideal. In the moral asylum everything was in its proper place, correctly classified and treated. The abnormal became the normal and the unnatural was so immersed in the established social customs of nineteenth century society that insanity was no longer something to be feared. What the physicians sought so desperately to create was a utopia for the mind. A place where the most refined, educated aspects of mainstream culture could reside to heal all that did not fit, all that was anomalous. The reality of insanity railed against the utopian moral asylum to create a world where the necessity of restraint and medicine were masked, at least for a short while, by planned gardens and grandiose architecture. No matter how hard moral physicians tried, though, they were never able to fully realize their theoretical plans for moral therapy.