From Alienism to Psychiatry

Abstract

Freebody demonstrates how the divergent pathways to professionalisation taken by French and English psychiatry generated different views regarding the causation and treatment of mental disorders, and the therapeutic value attributed to work and other occupations. French psychiatry’s close links to neurology led to an adherence to a physiological interpretation of mental disorder, and to the persistence of a custodial model of care, or “alienism”, in the provinces, and to a preference for biological methods of treatment in the capital. After their experiences of treating “shell shock” during World War I, English psychiatrists (and a small group of Parisian psychiatrists) began to see the causes of mental disorder holistically, the result of psychological, social or environmental factors, or a combination of these and physiological factors. For these psychiatrists, occupation and psychotherapy became useful tools in the active treatment of curable patients, not simply the preserve of calm, chronic, incurable and convalescent patients.