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"Asylum" through Time

Ananya Iyer

Remedial for missed quiz 1


Remedial entry for quiz1. What on the outside is just a tall, brick structure in modern times is used as a  shield by society against the “lunacy” that lies within. The concept of an institution that houses and treats mentally ill individuals, or a mental asylum,  has come a long way from its initial, primal conception. Jonathan Miller’s documentary “Out of Sight” tries to explain this evolution by analyzing not only the actual institution, but also the social, political, economic scenarios of the time. He also introduces figures who introduced radical changes in the field of psychoanalysis and therapy, and explains the impact that each had on the treatment of mental health and the development of psychological perspectives to their current form.
The earliest predecessor to the mental asylum was built Greece, sanctuaries called Epidauros. Miller starts from the Middle to early Modern Ages, wherein the first instances of legitimate literature on this subject can be found. During the Middle Ages, victims of mental disorders were either sometimes seen as proponents of innocence, or mediums of divine communication. So in some cases, there was a sense of reverence attached to them. This perception started to change the Modern Ages, clues of which are seen in Shakespeare’s King Lear and more works of the time. Even though the opening of Bethlem Hospital, a clinic for the mentally unstable, ushered in a new age in patient care, in society overall, severely destabilized individuals were whipped, beaten, chained, made to bleed and vomit to purge the illness, kept in terrible custodial conditions, whereas the less harmful were given no attention, left to roam and rot.
Changes in this setting began to be seen only in the 18th century. One of the first revolutionaries in the world of mental health, Phillippe Pinel, changed therapeutic attitude, in that he drew emphasis in treatment towards the mind instead of the body. Here is the first instance of a shift from a biological to cognitive perspective. Another major contributor to treatment was William Tuke, the Principal of the York Retreat. The York Retreat was an asylum which replicated a Quaker house, which was considered a place  of peace culturally. The thought behind this was that “a replica of the décor they (patients) had lived in would usher in the decorum they had lapsed from.” In these institutes, peace and non-violence reigned while bad actions led to a loss in privileges, we glimpse the trace of a token economy. A small group of asylums following this same model opened in the 19th century, housing a total of 500 patients.
 Now, in the age of colonialism, this same principle was furthered in that, it was believed that manic passion could be reconciled with rational self-interest. Hence attempts were made to reinstate rational thinking and to show patients that there was everything to lose with divergent behavior. The quarters and services were made to project reason and order. A behaviourist perspective developed, in that, retraining was given importance. There was a yearly meeting up of the staff, patients and ordinary members of society in a ball of sorts to test and reinforce rational, social behavior. In the middle of the 20th century, this model was coupled with physical forms of treatment, in what we now know as the biological perspective. The connections between physical and mental disorders were discovered and attempts were made to solve both using medicine.
However, these new discoveries also took an exaggerated form in some countries where, in places like Hadamar, Germany, people with serious disorders started to be seen as genetic defects to the purity of the country, which needed to be eliminated. They started to be identified as a “lower species of humanity” and with this kind of negativity in place, were thus tortured, with many succumbing to the trauma. In an investigation conducted by Albert Doytch, he found that many of these facilities had death tolls of as much as 10 patients per day. They recorded a thinning population over the years which could be during to fiscal needs or simply neglect. He reported them as having a conspicuous lack of policy and the experience being like euthanasia by neglect. Only in the 20th century after the arrival of Allied power were the inmates at many such institutions freed. In the USA, during the Kennedy administration, civic rights legislation and the importance of freedom caught speed, and the patients were given the rights to accept treatment from the least restrictive facilitator, since parallels were drawn between patients and other social groups with restricted freedom.  This was probably the advent of modern therapy and treatment as we know it today.
India also went through a similar kind of evolution over the years. However, in India, a medical, scientific approach towards psychological treatment was adopted only in the latter half of the 20th century. Until then psychotherapy and understanding was clouded by superstitions and religious colouring, wherein sanity was characterized by unity of the body and soul. So, the said evolution was much quicker, concentrated and is an ongoing process, a large part of the Indian population is still in the dark about the progress and importance of mental health and treatment.
The number of mental treatment facilities has greatly reduced over the years, which can be seen as a success of new methods of non-restrictive treatment and an abolition of violent institutions. However it can also be seen as a failure to procure the required public funds or lack of public trust. Either way, as demonstrated by Jonathan Miller, it is crucial to over social morale and health, and asylums have come a long way in everything they symbolize and stand for. Mental health as a collective has now reached a state of public importance and starting to gather the attention it deserves. Hence, it is important to understand that, while the word “asylum” due to its dark history tends to have numerous negative connotations, to many, it was, and is, a place of refuge and sanctuary in a society that tends not to accept them.

-Ananya Iyer



Works Referenced

 Miller, Jonathan, presenter. Madness 2: Out of Sight. PBS, 1991. https://youtu.be/bSPpQ2JFbg8

Nizamie, S. Haque, and Nishant Goyal. "History of Psychiatry in India". Indian Journal of Psychiatry. 52.(suppl 1)(2010):S7-S12. Web. 

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