Moral Treatment In the Sense of Psychological Treatment

   The phrase "moral treatment" came into vogue late in the eighteenth century and was used by Vincenzo Chiarugi and by Philippe Pinel in their respective textbooks. In his 1801 work, Pinel explained, "the general precepts to follow in psychological treatment" (le traitement moral). "In the well-founded hope of returning to society individuals who seemed lost," Pinel recommended gaining the confidence of patients by talking to them and treating them fairly, organizing fixed daily schedules of asylum life, involving patients in work of various kinds, giving them timely and appetizing meals, and other steps directed toward a well-run and orderly mental hospital. Given that many of the patients suffered from "a lesion of their psychological faculties" (lésion des facultés morales; p. 211), a psychological approach rather than sheer physical confinement seemed the best way of imposing "energetic and long-lasting impressions on all of their external senses" (1809, 2nd ed., pp. 251, 258). In the words of Pinel’s biographer, Dora Weiner, "The reserved but well-meaning attitude of [Pinel] encouraged the patients to confide in him their worries and to recall their vicissitudes. The daily presence of this inhabitant of the Salpêtrière reassured them. Thus took wing the popular image of ‘the good Monsieur Pinel’ " (Pinel, p. 244).

   * The son of Édouard Séguin; see Mental Retardation.

   The private mental hospital "York Retreat," founded in 1791 by York merchant William Tuke (1732–1822), practiced "moral treatment" in addition to "medical treatment." As Quaker philanthropist and merchant Samuel Tuke (1784–1857), William’s grandson, explained in his 1813 book, Description of the Retreat, an Institution near York, for Insane Persons, "If we adopt the opinion, that the disease originates in the mind, applications made immediately to it are obviously the most natural." Learning from the experience of the Retreat, "much may be done towards the cure and alleviation of insanity, by judicious modes of management, and moral treatment." "Take, for example, the unhappy manic . . . frequently unconscious of his own disease. . . . He is unable to account for the change in the conduct of his wife, his children, and his surrounding friends. They appear to him cruel, disobedient, and ingrateful." "In such cases, the judicious kindness of others appears generally to excite the gratitude and affection of the patient" (pp. 131–136). Thus, by moral treatment the Tukes seem to have understood a general kind of extension of Quaker principles.