Final Review Notes

Final Review Notes - Madness & Medicine: FINAL REVIEW...

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Tony Robert Fleury: 1887 painting entitled “Pinel freeing the insane” - Medicine entering and removing chains from the mad men, giving birth to the first chapter of psychiatric efforts to engage the mentally ill - Pinel’s “Act of Liberation” is not just history- it is a myth, that has been shaped and elaborated so as to become a moral story; to provide psychiatry with an intellectual and moral compass Zilboorg : Pinel introduced psychiatric case studies as the cornerstone of psychiatric research and mental hospitals- hospital reform and reorganization opened a new tradition of practical and research psychiatry. Pinel: “The mentally ill… are sick people whose miserable state deserves all the consideration that is due to suffering humanity. One should try with the most simple methods to restore their reason.” Pinel: French physician who operated Bicetre and Salpertriere; changed policies so that chains were removed from patients and treated those individuals with dignity Tuke : Moral treatment as the most effective and logical option for treating mental illness; this new technique appealed to the humanity of the patient and care provider, insisting that physical manifestations of illness were just a result of disease. New treatment used in asylums - Fear and coercion should only be employed when necessary - Patients respond to kindness; compassion can temper eccentricities and the general attitude of dealing with mentally ill should be analogous to dealing with children- appeal to rational sensibilities The Asylum for Persons Deprived of the Use of their Reason : Pennsylvania, 1813: First asylum to use moral treatment in the United States. Mission was to “provide for the suitable accommodation of persons who are or may be deprived of the use of their reason, and the maintenance of an asylum for their reception, which is intended to furnish, besides requisite medical aid, such tender, sympathetic attention as may soothe their agitated minds, and under the Divine Blessing, facilitate their memory” Abuses at Bethlem: 1813 scandal surrounding York Madhouse - Dorothea Dix, “I come as the advocate of the helpless, forgotten, insane men and women held in cages, closets, cellars, stalls, pens! Chained, naked, beaten with rods, and lashed into obedience!” o Dix persuaded state governments to build state hospitals for the mentally ill Deviance as an explanation for the new asylums following Bedlam Advent of social control Scheff : Mental illness is a label that certain people impose on those who don’t seem to be able to cope socially and thus gives us expert license to do something like put individuals in mental hospitals. Label turns these people into individuals we feel we no longer have to interact with.
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NEW GENERATION OF HISTORIANS : Is there another way to think about the original impulses that created the new asylum? Given the way the roles of the mentally ill are socialized into disempowerment, authenticity and obedience, is it certain that moral treatment is nothing
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Final Review Notes - Madness & Medicine: FINAL REVIEW...

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