Progress and Power: Exploring the Disciplinary Connections between Moral Treatment and Psychiatric Rehabilitation

For much of the 20th century, scholars of American and European applied psychology and psychiatry have concerned themselves with the concepts of progress and power. In an effort to revisit the character of 19th-century psychiatry and to use the results as a means of evaluating 21st-century practice, this paper explores the relationship between power and progress in two popular but chronologically distinct approaches to caring for the mad: 19th-century moral treatment and late 20th-century psychiatric rehabilitation. Using the theoretical framework of Foucault (1979), moral treatment (as developed by Thomas Story Kirkbride, for example, [1854] 1973) and psychiatric rehabilitation (as developed by William A. Anthony and colleagues, for example, Anthony, Cohen, and Farkas 1990) are compared for the degree to which each is structured by disciplinary interests and technologies. Based on this textual analysis, important differences emerge. Not only do these differences cast moral treatment in a new, and perhaps more positive light, but they also shed light on how disciplinary structures might affect a psychiatric approach's ability to carry out expressly humanitarian goals. To the extent that both propositions are accurate, the traditional view equating psychology and psychiatry's progress with a diminished reliance on power is brought into question.