You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The contributions made by Sheppard and Enoch Pratt Hospital to American psychiatry and psychoanalysis can be divided into three eras: (1) the era of humane psychiatry, before psychoanalysis began to be accepted in the United States (1891-1920); (2) the era in which psychoanalysis and individual psychotherapy became increasingly accepted (1921-1960); and (3) the era in which both psychiatry and psychoanalysis have entered actively into the life of the community (1961-present). Sheppard influenced and was influenced by all three eras.
Following nineteenth-century advocates of humaneness in the treatment of the mentally ill, Sheppard Asylum began “to carry forward and improve the ameliorated treatment of the insane,” to quote from Sheppard's bequest. Its first superintendent, Edward N. Brush, considered mental illness curable and preventable. Under him Sheppard specialized in patients considered amenable to recovery, a category which excluded, for example, alcoholics and opium addicts. Brush discouraged the practice of bringing patients to the hospital by deception. Patients' needs for confidentiality, privacy, courteous treatment, and comfort were respected. Buildings were constructed to resemble pleasant private residences. Patients had opportunities for recreation, occupational therapy, and employment. He prohibited violence in treating patients; if force was needed, it was applied by two or three persons to prevent injury. In 1901 he instituted hydrotherapy as a tranquilizing treatment. He preached the necessity for prompt attention to mental illness and early admission to a hospital, as he believed that home treatment was inadequate. Sheppard was one of the pioneers in stressing the study of the whole individual, rather than only of his mental disorder. Some patients worked during the day, returning to the hospital at night, this program anticipating by fifty years the concept of the night hospital. By the early