Pinel, Pussin, and the historical roots of peer support
This is Tony Robert-Fleury’s famous painting entitled Freeing the Insane. Some consider this painting to depict the birth of modern psychiatry. In fact, a young Sigmund Freud had expressed his appreciation for this painting when he attended lectures by Jean-Martin Charcot in 1885. It depicts French physician Phillipe Pinel ordering the unchaining of female patients at Paris’ Salpetriere Asylum Hospital in 1800.
Pinel was at the forefront of a widespread asylum reform movement, known as the era of “moral treatment,” which had spread across Europe and the United States at the time. Psychiatrists (then called “medical alienists”) and the lay superintendents of the asylums contributed to humanizing the treatment of people with serious mental illness by making confinement less brutal and treatment more gentle and interactive. Dr. Pinel in particular was known to spend a great deal of time with his patients, listening attentively as he recovered their life histories.
Now, less known of this painting is about the gentleman actually unchaining the patients. His name is Jean-Baptiste Pussin. He was serving as the superintendent of the Bicetre Hospital in Paris when Pinel had been assigned as the chief physician there. Pussin had once been a patient at the Bicetre with scrofula, or cervical tuberculous, which at the time was believed to be not only physical in nature but also spiritual or psychological. When Pinel arrived, he relied on Pussin to learn how the hospital functioned. Pussin’s key management strategy was to hire as many staff for the hospital as possible from among recovered patients because they were, in his words, "more gentle, honest, and humane” and “averse from active cruelty” (which sadly was not uncommon of the time). Much of what gets credited to Dr. Pinel, he learned from a former patient, Pussin.
References:
- Fee, E., & Brown, T. M. (2006). Freeing the insane. American journal of public health, 96(10), 1743. https://doi.org/10.2105/AJPH.2006.095448
- https://www.commongroundprogram.com/blog/historical-roots-of-peer-practitioners