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John Conolly and the historical interpretation of moral management

University of British Columbia

A number of explanations have been offered to account for the development and decline of the movement to reform the care and treatment of the insane, which began in Britain in the late eighteenth century, and was to find its most complete expression in the system known as moral management. The traditional or internalist school argues firstly, that humanitarianism was the motivating force behind the changes in the treatment of insanity, and secondly, that conditions for the mad improved because of a growth of medical and scientific knowledge. These views of the reform of the treatment of insanity were challenged by Michel Foucault, and other revisionist historians who were affected by his insights. Andrew Scull has been a most influential member of this group. He viewed insanity reform as having grown out of a socio-political need to manage deviancy, which led physicians to appropriate a non-medical form of asylum management, known as moral treatment, and recast it as a medical therapeutic requiring medical expertise for its administration. This helped justify their attempt to make themselves indispensable in the care and treatment of insanity. Recently, Scull used this approach in analyzing the career of John Conolly, a well-known asylum doctor of mid-nineteenth-century Britain, who instituted, in a large public asylum, a form of moral management known as the non-restraint system. Scull described Conolly as an unsuccessful general practitioner who achieved renown and economic security because of his position as an asylum administrator, despite his earlier criticisms of asylum care. In this thesis, I have examined Conolly's writings on the theories and practices of moral management, as well as writings on those subjects by other important figures of late eighteenth- and nineteenth-century psychiatry. I have drawn on the work of Robert Castel, Roger Smith and Karl Figlio in order to demonstrate that the practices of moral managers like John Conolly are better understood in terms of a group of concepts— the schema of stimulated motion, predisposition, and hierarchy—which developed out of a combination of medical, social and philosophical influences which were themselves generated in an epistemological framework constituted around the general principle of organization. In addition, these concepts provided a rationale for regarding the theoretical and practical aspects of asylum medicine as integrated. This conceptual analysis helps explain Conolly's adoption of the practice of moral management. Thus, his role as advocate cannot be understood exclusively in Scull's terms, as an example of careerism, but is better understood as a practical corollary of existing psychiatric theory and practice.

Text

2010-07-18

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http://hdl.handle.net/2429/26633

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