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=== Precursors === [[File:Narrenturm Vienna June 2006 575.jpg|thumb|[[Vienna]]'s [[Narrenturm (hospital)|Narrenturm]]—[[german language|German]] for "fools' tower"—was one of the earliest buildings specifically designed as a "madhouse". It was built in 1784.]] The first widespread challenge to the prevailing medical approach in Western countries occurred in the late 18th century.<ref name="Dain 1994" /> Part of the progressive [[Age of Enlightenment]], a "[[moral treatment]]" movement challenged the harsh, pessimistic, [[Somatic theory|somatic]] (body-based) and restraint-based approaches that prevailed in the system of hospitals and "madhouses" for people considered mentally disturbed, who were generally seen as wild animals without reason.<ref name="Dain 1994" /> Alternatives were developed, led in different regions by ex-patient staff, physicians themselves in some cases, and religious and lay philanthropists.<ref name="Dain 1994" /> This "moral treatment" was seen as pioneering more humane psychological and social approaches, whether or not in medical settings; however, it also involved some use of physical restraints, threats of punishment, and personal and social methods of control.<ref name="Dain 1994" /> As it became the establishment approach in the 19th century, opposition to its negative aspects also grew.<ref name="Dain 1994" /> According to [[Michel Foucault]], there was a shift in the perception of madness, whereby it came to be seen as less about [[delusion]], i.e. disturbed judgment about the truth, than about a disorder of regular, normal behavior or will.<ref>Foucault (1997), pp. 39-50</ref> Foucault argued that, prior to this, doctors could often prescribe travel, rest, walking, retirement and generally engaging with nature, seen as the visible form of truth, as a means to break with artificialities of the world (and therefore delusions).<ref>Foucault (1997), p. 42</ref> Another form of treatment involved nature's opposite, the theater, where the patient's madness was acted out for him or her in such a way that the delusion would reveal itself to the patient. Thus the most prominent therapeutic technique became to confront patients with a healthy sound will and orthodox passions, ideally embodied by the physician.{{citation needed|date=February 2022}} The "cure" involved a process of opposition, of struggle and domination, of the patient's troubled will by the healthy will of the physician. It was thought the confrontation would lead not only to bring the illness into broad daylight by its resistance, but also to the victory of the sound will and the renunciation of the disturbed will. ''We must apply a perturbing method, to break the spasm by means of the spasm.... We must subjugate the whole character of some patients, subdue their transports, break their pride, while we must stimulate and encourage the others'' ([[Jean-Étienne Dominique Esquirol|Esquirol, J. E. D.]], 1816<ref name=DelaFolie>''De la Folie''. Chapter 5: ''Traitement de la folie,'' pp. 132-133: in Foucault (1997), p. 43</ref>). Foucault also argued that the increasing [[internment]] of the "mentally ill" (the development of more and bigger asylums) had become necessary not just for diagnosis and classification but because an enclosed place became a requirement for a treatment that was now understood as primarily the contest of wills, a question of submission and victory. [[File:Kewwoodcut.png|thumb|upright|left|Close up of the "Horrors of [[Kew Asylum]]" featured in Lee's Pictorial Weekly Budget Police News in 1876]] The techniques and procedures of the asylums at this time included "isolation, private or public interrogations, punishment techniques such as cold showers, moral talks (encouragements or reprimands), strict discipline, compulsory work, rewards, preferential relations between the physician and his patients, relations of vassalage, of possession, of domesticity, even of servitude between patient and physician at times".<ref name=DelaFolie /> Foucault summarized these as "designed to make the medical personage the 'master of madness'"<ref name=DelaFolie /> through the power the physician's will exerts on the patient. The effect of this shift then served to inflate the power of the physician relative to the patient, correlated with the rapid rise of internment (asylums and forced detention).<ref>''De la Folie'': in Foucault (1997), p. 44.</ref> Other analyses suggest that the rise of [[History of psychiatric institutions|asylums]] was primarily driven by [[industrialization]] and [[capitalism]], including the breakdown of traditional family structures. By the end of the 19th century, psychiatrists often had little power in the overcrowded asylum system, acting mainly as administrators who rarely attended to patients in a system where therapeutic ideals had turned into institutional routines.<ref name="Crossley2006">{{cite book|author=Crossley, Nick |chapter=Contextualizing contention |title=Contesting Psychiatry: Social movements in Mental Health |publisher=Routledge |location=New York |year=2006 |isbn=978-0-415-35417-2 |chapter-url=https://books.google.com/books?id=RuGQSN6sBA8C}}</ref> In general, critics point to negative aspects of the shift toward so-called "moral treatments", and the concurrent widespread expansion of asylums, medical power and involuntary hospitalization laws, that played an important part in the development of the anti-psychiatry movement.<ref name="Crossley1998">{{cite journal |first=Nick |last=Crossley |url=http://cat.inist.fr/?aModele=afficheN&cpsidt=2352280 |title=R. D. Laing and the British anti-psychiatry movement: a socio–historical analysis |journal=Social Science & Medicine |volume=47 |issue=7 |date=1 October 1998 |pages=877–889 |doi=10.1016/S0277-9536(98)00147-6 |pmid=9722108 |access-date=31 August 2011 |archive-date=27 January 2012 |archive-url=https://web.archive.org/web/20120127001650/http://cat.inist.fr/?aModele=afficheN&cpsidt=2352280 |url-status=live }}</ref> [[File:Badverpleging.jpg|thumb|Internee being restrained in a bathtub]] [[File:Man in restraint chair; by H. Clarke; 1869 Wellcome L0019069.jpg|thumb|upright|Internee in a restraint chair at the [[Stanley Royd Hospital|West Riding Pauper Lunatic Asylum]], 1869]] Various 19th-century critiques of the newly emerging field of psychiatry overlap thematically with 20th-century anti-psychiatry, for example in their questioning of the [[medicalisation|medicalization]] of "madness". Those critiques occurred at a time when physicians had not yet achieved [[hegemony]] through psychiatry, however, so there was no single, unified force to oppose.<ref name="Crossley1998" /> Nevertheless, there was increasing concern at the ease with which people could be confined, with frequent reports of abuse and illegal confinement. For example, [[Daniel Defoe]], the author of ''[[Robinson Crusoe]]'', had previously argued for more government oversight of "madhouses" and for due process prior to involuntary internment.<ref>Defoe, Daniel (1697). An Essay upon Projects. London: Cockerill</ref> He later argued that husbands used asylum hospitals to incarcerate their disobedient wives,<ref>Defoe, Daniel (1728). Augusta Triumphans: Or, The Way To Make London The Most Flourishing City In The Universe.</ref> and in a subsequent pamphlet that wives even did the same to their husbands.<ref>Defoe, Daniel (1740) quoted in {{Cite journal|pmc=2745864|year=2008|last1=Somasundaram|first1=O|title=Private psychiatric care in the past: With special reference to Chennai|journal=Indian Journal of Psychiatry|volume=50|issue=1|pages=67–69|doi=10.4103/0019-5545.39765|pmid=19771313 |doi-access=free }}</ref> It was also proposed that the role of asylum keeper be separated from doctor, to discourage exploitation of patients.<ref>Faulkner, B. (1789). Observation on the General and Improper Treatment of Insanity. London</ref> There was general concern that physicians were undermining personhood by medicalizing problems, by claiming they alone had the expertise to judge, and by arguing that mental disorder was physical and hereditary. The [[Alleged Lunatics' Friend Society]] arose in England in the mid-19th century to challenge the system and campaign for rights and reforms.<ref name="Hervey1986">{{cite journal|author=Hervey N |date=July 1986 |title=Advocacy or folly: the Alleged Lunatics' Friend Society, 1845–63 |journal= Medical History|volume=30 |issue=3 |pages=245–275 |pmc=1139650 |pmid=3523075 |doi=10.1017/S0025727300045701}}</ref> In the United States, [[Elizabeth Packard]] published a series of books and pamphlets describing her experiences in the Illinois insane asylum, to which she had been [[involuntary commitment|committed]] at the request of her husband. Throughout, the [[Social class|class]] nature of [[mental hospital]]s and their role as agencies of control were well recognized. The new psychiatry was partially challenged by two powerful social institutions – the church and the legal system. These trends have been thematically linked to the later 20th century anti-psychiatry movement.<ref name="Dain1989">{{cite journal|last=Dain |first=N. |year=1989 |url=http://www3.interscience.wiley.com/journal/112416171/abstract |archive-url=https://archive.today/20130105053454/http://www3.interscience.wiley.com/journal/112416171/abstract |url-status=dead |archive-date=2013-01-05 |title=Critics and dissenters: Reflections on anti-psychiatry in the United States |journal=Journal of the History of the Behavioral Sciences |volume=25 |issue=1 |pages=3–25|doi=10.1002/1520-6696(198901)25:1<3::AID-JHBS2300250102>3.0.CO;2-G|pmid=2647837}}</ref> As psychiatry became more professionally established during the nineteenth century (the term itself was coined in [[1808 in Germany]] by [[Johann Christian Reil]], as "Psychiaterie") and developed allegedly more invasive treatments, opposition increased.<ref>{{cite book|last=Kleinman |first=Arthur |title=Rethinking Psychiatry: From Cultural Category to Personal Experience |url=https://archive.org/details/rethinkingpsychi0000klei |url-access=registration |publisher=Collier Macmillan |year=1988 |isbn=978-0-02-917442-5}}{{page needed|date=January 2014}}</ref> In the Southern US, [[Slavery in the United States|black slaves]] and [[Abolitionism in the United States|abolitionists]] encountered [[drapetomania]], a pseudo-scientific diagnosis that presented the desire of slaves to run away from their masters as a symptom of pathology.<ref>{{cite web |url=https://jimcrowmuseum.ferris.edu/question/2005/november.htm |title=Question of the Month – Jim Crow Museum at Ferris State University |access-date=2024-10-05 |archive-date=2011-06-14 |archive-url=https://web.archive.org/web/20110614115746/http://www.ferris.edu/jimcrow/question/nov05.htm |url-status=live }}</ref> There was some organized challenge to psychiatry in the late 1870s from the new speciality of [[neurology]], largely centered around control of state insane asylums in New York.<ref>{{cite journal |last1=Torrey |first1=E. Fuller |title=The Year Neurology Almost Took Over Psychiatry |journal=Psychiatric Times |date=January 1, 2002 |volume=19 |issue=1 |url=https://www.psychiatrictimes.com/view/year-neurology-almost-took-over-psychiatry |access-date=26 October 2022 |archive-date=26 October 2022 |archive-url=https://web.archive.org/web/20221026235351/https://www.psychiatrictimes.com/view/year-neurology-almost-took-over-psychiatry |url-status=live }}</ref> Practitioners criticized mental hospitals for failure to conduct scientific research and adopt the modern therapeutic methods such as nonrestraint. Together with lay reformers and social workers, neurologists formed the National Association for the Protection of the Insane and the Prevention of Insanity. However, when the lay members questioned the competence of asylum physicians to even provide proper care at all, the neurologists withdrew their support and the association floundered.<ref name="Dain1989" />
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