Essay on the Classification of the Insane

by M. Allen

I delicately, but candidly tell them, that they are considered to be insane, that the disease has produced some change in their usual mode of feeling and thinking, that the object of the proposed visit is their good, and that if they will only go willingly along with me, I pledge myself they shall be treated as visitors, unless their own conduct should oblige me to act otherwise towards them. If after all the pains I take, (and no pains can be too great to accomplish my object in this faithful way,) they still refuse, I then tell them, that their going is a matter quite settled, and cannot possibly be altered; that they may as well make a merit of necessity, and like rational beings, go at once with cheerfulness, and good-will, in order that they may still receive the good which I have promised them.

If after such explanations they do consent to go willingly, or even without much force, a grand point is accomplished; for in this case, suppose after their arrival they grossly commit themselves, and justly forfeit their claim to the treatment I have promised them, and I am obliged to abridge them of the liberty they had really given them, they then feel and often acknowledge the justice of any change in their treatment, which is the result of their gross misconduct, and they exert themselves with the hope of regaining the liberal privileges they have forfeited, and thus from their desire to be considered and treated as visitors, they put forth into operation what is of the greatest importance, the valuable principle of self-control.

In most cases, while nothing is more consoling to their afflicted spirits than friendship, and the society of those they love, nothing is more grievous to them than its loss. To form such a feeling, is very difficult; but by beginning and proceeding on these principles, showing them that truth and justice and kindness are the basis of our actions, we establish a wonderful moral influence over them.

It will often happen, however, in stating to them that their minds are not considered in a right state, they will stoutly deny it. I then assure them, I shall be very glad to find they are right, and hope they will not force upon me by their conduct, a different conviction. Stating to them very gravely, what I understand has led to this conclusion, saying, if we judge by the acknowledged rules of the world, they must confess there is something very unusual and strange in their words and actions; but at the same time, I trust they will not in future commit or lose themselves, as it appears they must have done. In which case I promise them I will myself befriend them, and endeavour to replace them as soon as possible, in the confidence of their friends, but which I can only do when their conduct will enable me to transfer to their friends the confidence it has given me. Many, of course, assert, that what others call insanity, they know to be correct and proper; then I say, we must have time to examine it at leisure, that it is too weighty a matter to determine in haste. Where the person cannot be made to comprehend all this reasoning, of course other methods must be adopted, according to the nature, exigencies, and the state of each patient. In fact, it is impossible to state all that is, or ought to be done on these occasions; we can only hint at the spirit of the procedure, for every separate case requires its own appropriate plan of procedure.

To show the propriety and advantages in this method of proceeding, I shall state the important fact, that some few have at once been cured, without removal from home, by the powerful influence of its candour and honesty.—And in all cases, when, after all this labour and delicacy, they are removed, and are, subsequently, on the same principles, and in the same spirit, treated with every possible indulgence, and the greatest degree of forbearance, even overlooking many lesser faults, and waiting, until, as we say, “they break out and commit themselves,” in some very decided manner, so as to furnish us (even in their own estimation) with a very palpable plea to abridge them of their indulgencies, they have then forced upon them the conviction of their error, and are obliged to acknowledge the justice of any change that is made.

It is singular, that many have on this plan been speedily cured by the self-restraint this system conspired with other things to give them; and many others have recovered without ever feeling or considering themselves as having been treated as insane patients; and most of them do not consider themselves as under any confinement whatever. Not more than about 3 p. cent. suffer any personal restraint, and not one for years under any constant personal coercion, and we have, at times, been for months together with not more than one patient whom we were afraid of trusting in the grounds alone.

I must more particularly advert to this most powerful argument in favour of this plan, which is, that it conduces to form the habit of self-control, which is the habit above all others which ought ever be our aim to form. It ought to be the primary object in every moral plan of cure. But I shall have some further observations to make on this principle, and the various means which tend to form and increase it, in another place. I only hint at these things at this time, for the purpose of showing that all these delicate, modified, conditional, and encouraging plans of superintendance are assisted by the arrangements I have described.

In fact, so important have I considered this plan of Classification, that when I first came to Leopard’s Hill Lodge, I contrived the best way I could, with my means, to have a family and front part of the house, independent of the galleries; and should I be called upon to extend my plan to meet my increasing success, and should my life be spared, and time and health permit me to follow out my views and to build an Asylum upon a larger scale, I should keep these principles of Classification, as well as many others, in view, in the plan I should adopt, for I am more and more confirmed that they are extremely important; and I may mention as proofs, that at all the houses we have had parties in the front part, who would, in their conduct and pursuits, and social enjoyments, put to shame many families who are reckoned perfectly sane. We have visiting parties from house to house, with the usual amusements of cards, chess, billiards, cricket, &c. For some months we published a weekly newspaper of considerable interest. Nor is it unworthy of notice, that some articles of a very superior kind in our critical Journals have been written in this place; all which gives it more an air of social enjoyment and comfort, than the coldness and repulsiveness usually attendant on the loss of liberty, and forms within ourselves a little world of interest, better suited, I believe, to the state of the inhabitants than the real world could be to them. It is, in fact, a System of Classification, originating, if not in the most enlightened, at any rate in the most humane considerations of the various states and maladies of mental aberration, and which enables us to exercise a powerful influence over those under our care. It is in agreement with our conviction of the importance of that which may be laid down as a maxim, that, if the mind be maintained in a state of tranquillity, the affections are more likely to be brought into a right state, the effects of functional disorder, or even disease, to subside; the mists of delusion to clear away; and the light of the understanding to resume its province.

The last and most important consideration is, that this plan has induced several (especially before the letter and spirit of the law were opposed thereto) to return voluntarily on their perceiving symptoms of their returning malady.

I could give, were it not that motives of delicacy forbid me, some very striking and interesting cases, illustrative of these facts and these principles, and the beneficial results which arise out of them.