Blast from the past - Dr Ellen Holtzman

For the most part, private asylums offered the treatments that were popular at that time. In the late 19th and early 20th centuries, most physicians held a somatic view of mental illness and assumed that a defect in the nervous system lay behind mental health problems. To correct the flawed nervous system, asylum doctors applied various treatments to patients’ bodies, most often hydrotherapy, electrical stimulation and rest.

From 1890 to 1918, however, when the private hospitals were at the height of their popularity, medical thinking about the etiology of mental illness also began to change. A small number of physicians abandoned the somatic view of mental illness and adopted a more psychological understanding of the disease. Among them was Boris Sidis (1867–1923) (see left). Before obtain- ing his medical degree, Sidis had earned a PhD from Harvard University under the tute- lage of William James (1842–1910).

Sidis’s psychological training distinguished him from other asylum doctors. He argued that consciousness itself, rather than the nervous system, was the “data” of psychology. Sidis also believed in the subconscious. In his treatment, Sidis hypnotized patients to gain access to memories buried in their subconscious. After he roused patients from the hypnotic trance, Sidis described their memories to them. Patients’ awareness of their hidden memories, according to Sidis, eliminated all of their symptoms.

In 1910, Sidis opened a private asylum, the Sidis Psychotherapeutic Institute, on the Portsmouth, N.H., estate of a wealthy New Englander. Hoping for referrals from psychologically minded colleagues, he announced the opening of his hospital in thePsychological Bulletin and advertised it in the Journal of Abnormal Psychology, which he had founded. The ad noted that he would treat patients by “applying his

special psychopathological and clinical methods of examination, observation and treatment.”

Sidis touted the luxury of the asylum’s accommodations and setting, even more than the availability of psychotherapy. “Beautiful grounds, private parks, rare trees, greenhouses, sun parlors, palatial rooms, luxuriously furnished private baths, private farm products,” wrote Sidis in his brochure describing the institute. Moreo- ver, he offered his patients the somatic treatments of hydrotherapy and electrical stimulation, as did his less psychologically minded colleagues. The emphasis on luxury combined with the availability of the popu- lar somatic treatments, even in an institu- tion created by an “advanced” thinker like Sidis, suggests that wealthy patients expected a traditional, medical approach to treatment.