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Mental nurses and their patients, 1935–74
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Anecdotal evidence of the testimonies of patients who received treatments for sexual deviations and medical attitudes towards them are scattered in the recorded accounts of gay, lesbian, bisexual, transgendered, intersex and queer/questioning (GLBTIQ) people. This book examines the plight of men who were institutionalised in British mental hospitals to receive 'treatment' for homosexuality and transvestism, and the perceptions and actions of the men and women who nursed them. It explores why the majority of the nurses followed orders in administering the treatment - in spite of the zero success-rate in 'straightening out' queer men - but also why a small number surreptitiously defied their superiors by engaging in fascinating subversive behaviours. The book is specifically about the treatments developed for sexual deviations in the UK. Transvestism was also treated fairly widely; however, not to the same extent as homosexuality. After an examination of the oppression and suppression of the sexual deviant, the introduction of aversion therapies for sexual deviance is considered. During the 1930s-1950s, mental health care witnessed a spirit of 'therapeutic optimism' as new somatic treatments and therapies were introduced in mental hospitals. The book also examines the impact these had on the role of mental nurses and explores how such treatments may have essentially normalised nurses to implement painful and distressing 'therapeutic' interventions . The book interprets the testimonies of these 'subversive nurses'. Finally, it explores the inception of 'nurse therapists' and discusses their role in administering aversion therapy.

Tommy Dickinson

Treatment Act 1930, which was geared towards a model of treatment, where patients would have greater autonomy; and the Mental Health Act 1959 that put a new emphasis on community care. In the period between these two Acts, nurses witnessed what has been described as ‘therapeutic optimism’; as new therapeutic options particularly somatic (physical) therapies for treating psychiatric patients were introduced.2 The introduction of these new approaches raised expectations of curative treatment, in keeping with the nomenclature of the new 1930 Act. This chapter explores these

in ‘Curing queers’
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Tommy Dickinson

because they reduced the degree of voluntariness on the part of the patient. These mixed public discourses of sexual deviation also created uncertainty for the nurses in this study. The nurses were also exposed to a number of contextual factors in their clinical practice, which may have influenced their decision to administer aversion therapy to cure sexual deviations. The introduction of the Mental Treatment Act 1930 brought a wave of therapeutic optimism around the possibility of curative treatment for mental patients. This led to the introduction of new somatic

in ‘Curing queers’
Murray K. Simpson

system and preceded developmental approaches. Pinel and Esquirol notionally held onto idiocy, but held little therapeutic optimism, and it was left marginalized in the framework of moral treatment. Degenerationist and neurological approaches in the latter half of the nineteenth century linked idiocy and insanity organically. The methods and aims of the medico-pedagogues and later physicians of idiocy were, again, quite different. It was advantageous to attain autonomy and to redefine and reposition idiocy outside of psychiatry. Psychoanalysis, Garrabé suggests

in Intellectual disability
Nursing shell-shocked patients in Cardiff during the First World War
Anne Borsay
and
Sara Knight

doctors tried to establish which treatments worked best with which symptoms, informed by competing approaches to understanding and managing mental illness. The therapeutic optimism originally associated with moral management techniques had dissipated as late nineteenth-century public asylums struggled with unresponsive chronic cases and the routines of institutional life were gradually reworked to deliver mass rather than personalised care.32 At the same time, the influence of Sigmund Freud’s psychoanalysis was penetrating British medicine. One of the most renowned

in Mental health nursing
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Vicky Long

‘humanitarianism 1 science 1 government inspections 5 “the great nineteenth-­century movement for a more humane and intelligent treatment of the insane”’.34 Viewing the asylum as an instrument of social control which psychiatrists exploited as a mechanism for professional aggrandisement, revisionists pointed to the ways in which psychiatry perpetuated notions of social, gender and racial inequality. Such studies traced how therapeutic optimism gave way to pessimism as theories of degeneration reinforced policies of custodialism by the 1870s, transforming asylums into custodial

in Destigmatising mental illness?
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Is it time to change our approach to anti-stigma campaigns?
Vicky Long

again, efforts to destigmatise mental illness focused on ‘promising’ patients, at the expense of ‘chronic’ patients. Thus, the new therapeutic optimism embodied by physical treatment methods, for example, was achieved in part by segregating those whose illnesses were more long standing and less amenable to somatic treatment methods, while the appeal of admissions wards was enhanced by removing chronic patients to segregated wards. My concern is that current anti-­stigma campaigns also focus upon acute, minor and transient experiences of mental disorder, and similarly

in Destigmatising mental illness?
Ben Harris

instructions and act purposefully. As Virginia came to realise in The Snake Pit, by the middle of the twentieth century most of the work performed by psychiatric patients had little if any claim to the status of therapy. A hundred years earlier, however, work by patients was often part of a therapeutic regimen. While this did not survive the death of therapeutic optimism in the late nineteenth century, the start of the twentieth century saw a revival in the use of and faith in work therapy. It centred in New England, where clergy, psychologists and physicians briefly

in Work, psychiatry and society, c. 1750–2015
Ricardo Campos

heredity and degeneration. Sanz thought that the negative regression of the human race was not unavoidable, as was argued by Morel and other psychiatrists, because there were regenerative elements present in the environment that cushioned and corrected the ‘pathological energies’ contracted through heredity. 45 Thus he distanced himself from the nihilistic idea that the implacable laws of heredity would lead to the total degradation of the human species. This therapeutic optimism was reflected in the articles he

in Alcohol, psychiatry and society
Stephen Snelders

economic and social rather than a racial problem.49 The Surinamese racial framing of leprosy was influential, but ultimately only of relevance in the colonies. Treatments The therapeutic optimism that Schilling expressed in 1769 had completely disappeared in Suriname half a century later. There was no cure for leprosy. Van Hasselaar described all failed methods of treatment, including sulphur baths and purgatives, decoctions of juniper or wild 54 54 Leprosy and colonialism rosemary, and the administration of sarsaparilla or mercury.50 These were typical remedies

in Leprosy and colonialism