Histories of dynamic psychotherapy in the late 19thcentury have focused on practitioners in continental Europe, and interest in psychological therapies within British asylum psychiatry has been largely overlooked. Yet Daniel Hack Tuke is acknowledged as one of the earliest authors to use the term ‘psycho-therapeutics’, including a chapter on the topic in his 1872 volume, Illustrations of the Influence of the Mind upon the Body in Health and Disease. But what did Tuke mean by this concept, and what impact did (...) his ideas have on the practice of asylum psychiatry? At present, there is little consensus on this topic. Through in-depth examination of what psycho-therapeutics meant to Tuke, this article argues that late-19th-century asylum psychiatry cannot be easily separated into somatic and psychological strands. Tuke’s understanding of psycho-therapeutics was extremely broad, encompassing the entire field of medical practice. The universal force that he adopted to explain psychological therapies, ‘the Imagination’, was purported to show the power of the mind over the body, implying that techniques like hypnotism and suggestion might have an effect on any kind of symptom or illness. Acknowledging this aspect of Tuke’s work, I conclude, can help us better understand late-19th-century psychiatry – and medicine more generally – by acknowledging the lack of distinction between psychological and somatic in ‘psychological’ therapies. (shrink)

This paper suggests that late nineteenth-century definitions of self-mutilation, a new category of psychiatric symptomatology, were heavily influenced by the use of self-injury as a rhetorical device in the novel, for the literary text held a high status in Victorian psychology. In exploring Dimmesdale’s “self-mutilation” in The Scarlet Letter in conjunction with psychiatric case histories, the paper indicates a number of common techniques and themes in literary and psychiatric texts. As well as illuminating key elements of nineteenth-century conceptions of the (...) self, and the relation of mind and body through ideas of madness, this exploration also serves to highlight the social commentary implicit in many Victorian medical texts. Late nineteenth-century England, like mid-century New England, required the individual to help himself and, simultaneously, others; personal charity and individual philanthropy were encouraged, while state intervention was often presented as dubious. In both novel and psychiatric text, self-mutilation is thus presented as the ultimate act of selfish preoccupation, particularly in cases on the “borderlands” of insanity. (shrink)