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
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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