La médicalisation de l'intuition charitable : de saint Jean de Dieu à Philippe Pinel

Abstract

To shed some light on the medicalization movement that has pervaded psychiatry for more than a decade, the authors focus on the origin of our discipline in France from a historical point of view. They compare the work of Philippe Pinel, founder of French psychiatry and the work of the brothers of Saint John of God in the 18th century. These brothers began admitting the mentally ill in five of their French hospitals (Cadillac, Charenton, Château-Thierry, Pontorson and Senlis). They provided sympathetic and compassionate care derived from their Christian humanism and inspired by their founder saint John of God (1495–1550). They materialized the charitable intuition that he had had towards the insane. They gave primacy to compassion in their approach to caring. During the French revolution, as the order of Saint John of God was dissolved and dispersed Philippe Pinel was appointed “Doctor in charge of the infirmaries” at the Bicêtre hospital in Paris in 1793. Pinel, who had studied theology, subscribed to the charitable instinct but he transformed it by introducing scientific and empirical philosophic dimensions. He suggested a medical approach based on observation and analysis of large numbers of the mentally ill. As an example of this medicalization process, the authors propose a comment on one of Pinel's articles entitled “Medical Thoughts on the Monastic Life”. This view of the history of psychiatry allows a renewed understanding of our scientific and medical approach in psychiatry. On the other hand, it seems to raise some questions about the place given to subjectivist dimensions, such as empathy, in our daily caring practice.