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Veronica Joyce
Dr. Lyn J. Freymiller
CAS 137H
7 October 2014
From Bedlam to Bedtime Stories
We have all been taught about the horror-wrought past of mental illnesses. What our high
school textbooks seem to neglect is the progress that has been made in that area. Mental illness is
the term used when someone cannot function within society due to a physical or psychological
disability. It can mean anything from depression to schizophrenia. The diagnosing process for
mental disorders has improved but become more complicated through the years. Treatments after
diagnosis have also changed drastically since the Middle Ages (Wingfield). The torturous ways
of the past have become nothing more than spooky bedtime stories for todays children. I will be
analyzing the paradigm shift in the various views, treatments, facilities, and diagnoses that
characterize each of the following time periods: Middle Ages-1600s, 1700s, 1800s, 1900s and
2000s. The information I have gathered is based on American and Western European histories of
mental illnesses.
Middle Ages through 1600s
Madness was the word given to the behavioral patterns of the mentally ill in medieval
times. It generally referred to those who were thought to be possessed by evil spirits. Religion
was a key factor in the way mental illnesses were perceived (Craig). When Christianity became
the official religion of the Eastern Roman Empire, they integrated folk superstitions with

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religious tradition. Music and art (folk) was used to heal satanic possessions (religion). Next
to plagues, mental illness was the biggest societal concern of this time period. Some towns
viewed the mentally ill as being spiritually blessed. They believed that they were communicating
with a higher power. Other towns burned witches at the stake without anything other than an
accusation of witchcraft. The church blamed those who were possessed for the bubonic plague.
This led to the witch hunts from the 1400s to the 1700s (Kelly).
Around the same time that Europeans were moving to America, the mad were being
quarantined in torturous facilities. What constituted treatment was extreme: bleeding, cathartics,
emetics, hot and cold showers, whipping, and chaining (Windfield). Those thought to be
mentally ill may be thrown in a freezing river in the hopes of shocking them into good mental
health. In cases of witchcraft or possession, priests would perform exorcisms. Merely an
accusation of demon possession was enough to exile or kill a possibly sane person (Kelly).
If they were permitted to live outside of those torturous establishments, the town made
sure that it did not have to support the mentally ill. Laws were made to ensure that they did not
come to depend on the town they traveled to. They may have been asked to leave and therefore,
forced to drift from town to town (Wingfield). Sometimes, they could go to monasteries for
shelter. Other times, they were chained in madmen towers. Medieval hospitals had special
wards for the mentally ill. Eventually, specialized hospitals opened for the insane. Bedlam is
one of the most well-known. The conditions within the hospital were deplorable. There, the
patients were chained and only just barely kept alive. Bedlam was like a living hell (Kelly).
Treatment of the mentally ill regressed towards the end of the seventeenth century. It was
easier to throw patients in institutions like Bedlam than to treat them with less severe measures.
Witch hunts, exorcisms, and chains were the defining characteristics of mental health treatment

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during this time period (Kelly). Even though it was such a long span of time, there was very little
progress in terms of mental health treatments from the Middle Ages through the 1600s.
1700s
Poor treatment of the mentally ill continued into the eighteenth century. In America,
hospitals were still accepting the mentally ill along with the physically ill. Those patients were
treated with the old, painful physical remedies. It wasnt until the late 1700s that the harsh
method of curing the mentally ill changed (Wingfield). Dr. Benjamin Rush, the father of
American psychiatry brought about monumental changes in the way patients were handled. He
urged physicians to see them as people, to humanize their patients. However, his actual
therapeutic techniques did little to help the mentally ill. He used bloodletting and drugging to
no avail. His real contribution was in the understanding of the symptoms that were associated
with various disorders. In colonial America, most insane people were being kept in crawl
spaces, poorhouses, or they were wandering in the streets. Doctors were beginning to understand
what mental disorders were but they still had no facts about their causes (Dain).
In the 1750s, advancements were being made in the field of medicine. This affected the
world of mental illnesses because new treatments were being developed for all diseases. More
was being understood about how the body functioned and what caused disorders both mental and
physical. Illnesses were still thought to be caused by celestial bodies rather than abnormalities in
the physical world. There was no real delineation between mental diseases so it was hard to
develop treatments for specific disorders. General treatments were used instead. Diets, herbs, and
very strong drugs were the main mode of psychological treatments. Bleeding and lobotomies
existed through this century (Dain).

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From about 1754-1790, many new methods of treatment were developed. Gentler
approaches were taken to heal the mentally ill. Mental diseases were being viewed as natural
occurrences rather than divine or satanic possessions (Dain). Around the 1790s in York, England
and Paris, France patients were finally being unchained and treated as humans. Moral
therapy became the norm for treating mental illness. Patients were admitted to hospitals
designed specifically for them. There they were taught that the way they were acting was
unacceptable. Doctors tried to teach them how to behave in society (Wingfield).
During this time period, compassion and understanding were beginning to spread through
the America and Western Europe. As more advances were made in the medical field, so were
advances in the psychological world made. This century brought about better treatment of
patients and more options for treating them. The idea of treating the patients morally was born in
the late 1700s and became a turning point for mental health treatment in the nineteenth century
(Dain).
1800s
In the early 1800s, Quakers made Friends Asylums for the mentally ill. In these
establishments, patients were treated kindly and many were able to return to their lives. High
rates of discharge gave psychotherapy validity. Mental hospitals were being built in towns during
this time. The people of those towns were exposed to the patients and many of the myths
surrounding mental illness fell away. Having less fear of the people in the hospitals made people
inclined to treat them humanely rather than to chain them up (Dain).
Medicine was making even bigger improvements during the nineteenth century. Mental
illnesses were being linked to abnormalities in the brain discovered during autopsies. Physicians
began to look at mental illness through a scientific lens rather than a religious one (Dain). Many

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treatments were reformed in the 1800s. Distinctions were made between problems that were
caused by psychiatric disorders and those that were caused by organic disorders. Disorders that
were thought to be mental disorders were discovered to be caused by things like vitamin
deficiency rather than psychosis. Many asylums were built during this time. Dorthea Dix began
her policy-changing campaign in 1841. After witnessing the appalling state of a mental facility,
she set out to change the way the inmates were treated. The state governments started regulating
the asylums (Wingfield).
Sigmund Freud (1856-1939) is the man accredited with the existence of psychoanalysis
as a treatment for mental disorders. At the time, patients who exhibited mental illnesses were
considered hysterics. Josef Breuer, a well-known medical practitioner in the late 1800s found
that his hysterics felt relieved when they were able to tell him all of their problems. It was
originally called the talking cure and later became known as catharsis. It was one of the first
types of modern therapy (Szasz 103-105). Freuds methods were the beginning of the movement
towards using psychology to heal patients. He developed approaches to the psyche that allowed
him to access the subconscious of a person. His work opened to door to many psychologists of
the 1900s (Wingfield).
The use of antiquated treatments waned and institutions were immensely improved
during this time. Advances in medicine allowed for greater advances in mental health care. As
the government became more involved, treatment facilities were better funded and their
conditions improved greatly.
1900s
Different methods of therapy were employed in the 1900s. While shock therapy and
physical tortures still existed as questionable treatments for mental illness, there were many new

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methods to use as treatments. Tranquilizers were being used rather than insulin which puts the
patient in a coma in the hopes of remedying their illness by shocking them out of it (Wingfield).
One of these newer approaches uses movement to examine a persons psyche. The patients are
observed doing specific movements. The way in which they execute those movements is
analyzed. These results show the psychologist what the persons problems are and how to go
about curing them (Pesso). These new treatments allowed some patients to return home. They
could live somewhat normal lives.
Freud had the greatest influence on psychology in terms of treating the mentally ill. One
of his followers, Carl G. Jung administered Freuds techniques to more severe cases of mental
illness. He was one of the first people to be able to remedy the causes of acute psychological
disorders rather than just treat the symptoms of them. More of Freuds followers like Adolf
Meyer and William Alanson White worked in organizations to better the treatment and facilities
for the mentally ill. They worked in organizations like National Committee for Mental Hygiene.
The goals of the National Committee were to prevent mental illness and to improve institutional
conditions for the mentally ill. Meyer and White are accredited with being huge forces behind
the revolution in psychiatry. Their progress led to the development of the American
Psychological Association (APA) (Wingfield). The APA made the first ever manual of mental
disorders in 1952, known as the Diagnostic and Statistical Manual of Mental Disorders (DSM).
This development allowed doctors to diagnose over four hundred maladies of the mind (Boots).
With the development of better treatment facilities and methods of diagnosing mental
diseases, there were more patients in said facilities than ever. There were not enough trained
psychiatrists to handle the amount of people admitted to mental hospitals. Though mental
illnesses affected more people than cancer, the research for cures for them was far less funded.

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Electroshock therapy was still being used on patients (Mental Illness). In 1959, the Chicago
Daily Tribune published an article about new laws for the treatment of mental illnesses. These
laws better regulate the amount of people in treatment facilities. There would be ways for the
patients to leave the institutions. They could pass various checkups to prove that they can
function in society. They would also need to be referred to the hospital by more than one source.
These laws reduce the number of patients in the mental hospitals.
A wave of deinstitutionalization swept America in the 1960s. Patients were being
released from hospitals and being brought into community homes. Many people began to fear
them mentally ill again. Having them in communities bread concern about public safety.
Although about half of all Americans will have a DSM disorder in their lifetimes, the vast
majority of these diagnoses are not associated with aggressive behaviors. Studies done during
this time concluded that there was no real correlation between group homes and violence. Still,
people protested the addition the mentally ill to their towns (Boots).
This century was characterized by change. Views of the mentally ill changed; facilities to
house the mentally ill changed; the ease with which disorders were diagnosed changed. It was a
time of development in the field of psychotherapy. Not all of it was positive change, the public
view of mental illness backslid somewhat in the 1900s. That perception carried into the 2000s.
2000s
Freuds influence is still felt in the twenty-first century. The APA has led to even more
reforms in the world of mental illness.
In the decades that followed to the close of the twentieth century, there were three
important developments: continuing developments in medicine that directly affected the
treatment of mental illness; expanding government participation in funding and oversight

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of patient care; and a proliferation of psychotherapeutic "schools," most a response to the
growing popularity of psychoanalysis (Wingfield).
Gathering background information on the patients has become a key part of mental health
treatment in the current decades. Understanding past behaviors and family history allows doctors
to better diagnose the possible mental illnesses their patients have. There is a fine line that
doctors have to walk between over diagnosing and under diagnosing mental disorders. If they are
too free with their diagnoses of psychological problems, everyone will be considered mentally
ill. However, if they fail to diagnose what might seem like a harmless tendency towards the
irrational, they may be missing a potential mass murderer. Cases like those in Aura, CO. and
Newtown, CT. prove this point. Neither gunman was diagnosed with a mental disability (Miller).
Today, the mentally ill are no longer in chains. They have more freedom and much
cleaner places to be housed. The public perception of mental illness has yet to reach acceptance
but it is much closer than it has ever been. Now those stories of torture are just that; stories.
Conclusion
There has been a large amount of change in the treatment of the mentally ill as well as the
understanding of their diseases. Every time period was characterized by different views of the
mentally ill. These views generally affected the treatments and facilities for the psychotic. As
science and medicine progressed, so did the perception of mental illnesses. Mental illnesses are
complex and ever-changing so the treatments for them must follow suit. As psychiatrists are able
to learn more about the disabilities they treat, their ability to treat those disorders evolve as well.
Society has stopped excluding mental patients from civilization and has begun working to help
them live normal lives. In the Middle Ages, very little was understood therefore, very little
compassion was given. Currently, there are many options for those diagnosed with mental

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disorders as well as much more acceptance of those affected. There is still room for improvement
in todays society but it has come a long way since witch burning.

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Works Cited
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Renzetti and Jeffrey L. Edleson. Vol. 1. Thousand Oaks, CA: SAGE Publications, 2008.
450-451. Gale Virtual Reference Library. Web. 3 Nov. 2014.
Craig, L. A. (2014), The History of Madness and Mental Illness in the Middle Ages: Directions
and Questions. History Compass, 12: 729744. doi: 10.1111/hic3.12187
Dain, Norman. "Mental Illness." Encyclopedia of the New American Nation. Ed. Paul Finkelman.
Vol. 2. Detroit: Charles Scribner's Sons, 2006. 355-360. Gale Virtual Reference Library.
Web. 5 Nov. 2014.
Kelly, Evelyn B. "Mental Illness During the Middle Ages." Science and Its Times. Ed. Neil
Schlager and Josh Lauer. Vol. 2: 700 to 1449. Detroit: Gale, 2001. 144-146. Gale Virtual
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"Mental Illness." American Decades. Ed. Judith S. Baughman, et al. Vol. 6: 1950-1959. Detroit:
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"MENTAL ILLNESS." Chicago Daily Tribune (1923-1963): 24. Jan 12 1959. ProQuest. Web. 4
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Miller, Elaine Tilka, PhD, RN, CRRN,F.A.H.A., F.A.A.N., and Wilson, Cornelia R, EdD,
LPCC,P.M.H.C.N.S.-B.C., F.A.A.N. "Mental Illness - Hidden no More." Rehabilitation
Nursing 38.2 (2013): 61-2. ProQuest. Web. 4 Nov. 2014.
Pesso, Albert. Movement in Psychotherapy: Psychomotor Techniques and Training. New York:
New York University Press, 1969. Print.
Szasz, Thomas. The Myth of Psychotherapy: Mental Healing as Religion, Rhetoric, and
Repression. Garden City, New York: Anchor Press/ Doubleday, 1978. Print.

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Wingfield, William E. "Mental Illness." Dictionary of American History. Ed. Stanley I. Kutler.
3rd ed. Vol. 5. New York: Charles Scribner's Sons, 2003. 312-315. Gale Virtual
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