Monitor on Psychology - March 2012 - (Page 24)

Capsule tIme A home away from home Luxurious accommodations were the staples of America’s Gilded Age asylums, which offered stateof-the-science treatment — for the rich only. By DR. ELLEN HoLTzMAN u ntil the 19th century, people with mental illness were cared for by family members, who quietly attended to their needs in rural areas. But with the dawn of the Industrial Age, and its accompanying growth of crowded cities, many people feared people with mental illness were a threat to public safety. That perceived threat provided the impetus for the creation of asylums to confine psychiatric patients. Consequently, by the second half of the century, many states had opened public psychiatric asylums. These sanctuaries ultimately became the hospitals for the poor, since the better-off patients could take refuge in the private philanthropic asylums, such as McLean Hospital in Massachusetts, which required patients to pay their own way. The closing decades of the 19th century saw another shift in the care of mentally ill people: In response to the deteriorating conditions of the public hospitals, a number of physicians opened small, private asylums in their own homes for psychiatric patients. For the wealthy patient, hospitalization in a doctor’s residence — a “home away from home” — was undoubtedly a welcome alternative to public care. To some extent, the small private asylums resembled the early 19thcentury hospitals promoted by two European reformers, Phillipe Pinel (1745–1826) and William Tuke (1732– 1822). Critical of the harsh treatment of the mentally ill in Europe at the time, Pinel and Tuke advocated using a regular routine and a pleasant environment — or moral therapy as it was called — as tools for treating mental illness. The large public hospitals, facing financial constraints and a growing patient population, simply could not offer this type of attention to patients. Psychotherapy emerges For the most part, private asylums offered the treatments that were popular at that time. In the late 19th and early 20th centuries, most physicians held a somatic view of mental illness and assumed that a defect in the nervous system lay behind mental health problems. To correct the flawed nervous system, asylum doctors applied various treatments to patients’ bodies, most often hydrotherapy, electrical stimulation and rest. From 1890 to 1918, however, when the private hospitals were at the height of their popularity, medical thinking about the etiology of mental illness also began to change. A small number of physicians abandoned the somatic view of mental illness and adopted a more psychological understanding of the disease. Among them was Boris Sidis (1867–1923). Before obtaining his medical degree, Sidis had earned a PhD from Harvard University under the tutelage of William James (1842–1910). Sidis’s psychological training distinguished him from other asylum doctors. He argued that consciousness itself, rather than the nervous system, was the “data” of psychology. Sidis also believed in the subconscious. In his treatment, Sidis hypnotized patients to gain access to memories buried in their subconscious. After he roused patients from the hypnotic trance, Sidis described their memories to them. Patients’ awareness of their hidden memories, according to Sidis, eliminated all of their symptoms. In 1910, Sidis opened a private asylum, the Sidis Psychotherapeutic Institute, on the Portsmouth, N.H., estate of a wealthy New Englander. Hoping for referrals from psychologically minded colleagues, he announced the opening of his hospital in the Psychological Bulletin and advertised it in the Journal of Abnormal Psychology, which he had founded. The ad noted that he would treat patients by “applying his special psychopathological and clinical methods of examination, observation and treatment.” Sidis touted the luxury of the asylum’s accommodations and setting, even more than the availability of psychotherapy. “Beautiful grounds, private parks, rare trees, greenhouses, sun parlors, palatial rooms, luxuriously furnished private baths, private farm products,” wrote Sidis in his brochure describing the institute. Moreover, he offered his patients the somatic treatments of hydrotherapy and electrical stimulation, as did his less 24 M o n i to r o n p s yc h o l o g y • M a rc h 2 0 1 2

Table of Contents for the Digital Edition of Monitor on Psychology - March 2012

Monitor on Psychology - March 2012
President’s column
From the CEO
Supreme Court rejects eyewitness protections
New member benefit: prevention screenings
A psychodynamic treatment for PTSD shows promise for soldiers
Was ‘Little Albert’ ill during the famed conditioning study?
New research identifies ways to improve eyewitness identifications
In Brief
‘Our health at risk’
Perspective on Practice
APA endorses higher education guidelines
Random Sample
Judicial Notebook
Help for struggling veterans
Driving out cancer disparities
In the Public Interest
Practice, virtually
The legal and ethical issues of virtual therapy
Psychologist PROFILE
Bringing life into focus
Pay attention to me
Division Spotlight

Monitor on Psychology - March 2012