Moral insanity

Moral insanity (Latin - mania sine delirio; French - folie raisonnante or folie lucide raisonnante, monomanie affective; German - Moralisches Irresein^[1]) is a medical diagnosis first described by the French humanitarian and psychiatrist Philippe Pinel in 1806.^[2] According to Pinel, moral insanity was manie sans délire (mania without delusion) and had no relation to the moral faculty.^[3] Moral insanity was a form of mental derangement in which the intellectual faculties were unaffected, but the affects or emotions were damaged, causing patients to be carried away by some kind of furious instinct (instincte fureur).^[3] Mania without delusion was a chronic disturbance of the emotions. James Cowles Prichard defined moral insanity as: "madness consisting in a morbid perversion of the natural feelings, affections, inclinations, temper, habits, moral dispositions, and natural impulses, without any remarkable disorder or defect of the interest or knowing and reasoning faculties, and particularly without any insane illusion or hallucinations."^[4][5][6]

The concept of moral insanity is indebted to the work of Philippe Pinel, which was acknowledged by Prichard, and his invention of the mental diseases of partial and affective insanity. Manie sans délire, later known as folie raissonante involved a form of partial insanity. That is, the sufferer was thought to be mad in one area only and that thus the personality of the individual might be distorted but his or her intellectual faculties were unimpaired.^[7] Both moral insanity and monomania are irrationalities of the otherwise rational mind: in both disorders the mind is fragmented into parts that are normal and parts that are dysfunctional. The distinction between moral insanity and monomania appears to be the difference between a milder systemic malfunction and a more severe but isolated one.^[8] The symptoms of moral insanity can increase, causing a degeneration into monomania.^[9] "On the surface, monomania can thus appear even more circumscribed a form of derangement than moral insanity."^[10]

Contemporary misunderstanding of the term derives from the double meaning of the word "moral" in the nineteenth century context. According to Erdmann Mueller (1899, author of a comprehensive treatise on moral insanity): "the word moral in the concept moral insanity is derived from the word affective in Esquirol's terminology and the translation of moral as virtuous or ethical is the result of a misunderstanding due to the double meaning of the word."^[11] Likewise the term moral treatment referred to a set of psychosocial techniques rather than ethical practice.^[12] Under Pinel's guidance, patients were freed from chains and shackles.^[13]

The context leading to the conceptualization of this diagnostic category was undoubtedly borne out of the frustration of alienists (the term is approximately equivalent to the modern day one of psychiatrist) by the definition of madness provided by John Locke in which delusional symptoms were required. In legal trials this definition had proved to be a great source of embarrassment to alienists because unless delusional symptoms could be clearly shown judges would not consider a plea of insanity.^[14]

Several historians have entirely discredited the notion that the diagnostic category of moral disorder was a forerunner of psychopathic disorder. As stated by the historian F.A. Whitlock: "there [is] not the remotest resemblance between their examples [Pinel's and Prichard's] and what today would be classed as psychopathic personality."^[14] Prichard's "moral insanity" was a catch-all term of behavioural disorders whose only feature in common was an absence of delusions: it is not cognate with the modern diagnostic category of antisocial personality disorder.^[15]

See also

• Insanity
• Moral treatment
• Manie sans délire

References

1. ^ Tuke, Daniel Hack (ed.) (1892). A Dictionary of Psychological Medicine. Volume 2. J. & A. Churchill. p. 813.
2. '^ Criminology by Larry J. Siegel, 10th edition.
3. ^ ^{a b} Jan Verplaetse (2009). "Chapter 7: Moral insanity as a disorder of the moral sense". Localizing the Moral Sense: Neuroscience and the Search for the Cerebral Seat of Morality, 1800-1930. Springer. pp. 193 ff. ISBN 978-1402063213. http://books.google.com/books?id=3n-G-770pIoC&pg=PA193. 
4. ^ John Macpherson (1899). Mental affections; an introduction to the study of insanity. Macmillan. p. 300. http://books.google.com/books?id=S8kUAAAAYAAJ&pg=PA300. 
5. ^ Berrios G E (1999) J C Prichard and the Concept of ‘Moral Insanity’. Classic Text Nº 37. History of Psychiatry 10: 111-126.
6. ^ Quoted in: Sass, H. and Herpertz, S. Personality Disorders: Clinical Section. In Berrios, German and Porter, Roy (Eds.), A History of Clinical Psychiatry: The Origin and History of Psychiatric Disorders. Athlone: p. 635.
7. ^ Porter, Roy (1999). The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present. Fontana: pp. 495-496.
8. ^ Patrick Brantlinger, William B. Thesing (2002). A companion to the Victorian novel. Wiley-Blackwell. p. 76. ISBN 063122064X. http://books.google.com/books?id=1ph3THM_fgYC&pg=PA76. 
9. ^ James Cowles Prichard (1837). "Case 2 & Case 3". A treatise on insanity and other disorders affecting the mind. E.L. Carey & A. Hart. p. 37. http://books.google.com/books?id=0PIRAAAAYAAJ&pg=PA37. 
10. ^ Sally Shuttleworth (1996). Charlotte Brontë and Victorian psychology. Cambridge University Press. p. 51. ISBN 0521551498. http://books.google.com/books?id=8DveVponLFQC&pg=PA51. 
11. ^ Quoted in Jan Verplaetse (2009). "Chapter 7: Moral insanity as a disorder of the moral sense". Localising The Moral Brain: Neuroscience and the Search for the Cerebral Seat of Morality, 1800-1930. Springer. p. 195. ISBN 9781402063213. http://books.google.com/books?id=3n-G-770pIoC&pg=PA195. 
12. ^ Sass, H. and Herpertz, S. Personality Disorders: Clinical Section. In Berrios, German and Porter, Roy (Eds.), A History of Clinical Psychiatry: The Origin and History of Psychiatric Disorders. Athlone: p. 635.
13. ^ Vincent Mark Durand, David H. Barlow (2005). Essentials Of Abnormal Psychology (4rth ed.). Cengage Learning. p. 16. ISBN 0495031283. http://books.google.com/books?id=yEC-aklbUkYC&pg=PA16. 
14. ^ ^{a b} Berrios, German E.(1996). The History of Mental Symptoms: Descriptive Psychopathology Since the Nineteenth Century. Cambridge: p. 426.
15. ^ Berrios, German E.(1996). The History of Mental Symptoms: Descriptive Psychopathology Since the Nineteenth Century. Cambridge: p. 427.

External links

• Moral insanity in A Law Dictionary, Adapted to the Constitution and Laws of the United States. By John Bouvier. Published 1856.
• H. F. Augstein (1996). J. C. Prichard's concept of moral insanity: A medical theory of the corruption of human nature, Med Hist. 1996 July; 40(3): 311–343.
• Charles G. Finney. Moral Insanity, Edited for the modern reader by L.G. Parkhurst, Jr. (1996)
• Lucy Ozarin, M.D., M.P.H. (2001). Moral Insanity: A Brief History, Psychiatric News, May 18, 2001, vol. 36, no. 10, p. 21