Limit setting in mental health: historical factors and suggestions as to its rationale.
The task of enforcing behavioural limits in mental health settings is widely regarded as necessary but also potentially counter-therapeutic. There has been little discussion of the ideological basis for limit setting in psychiatry, and this paper attempts to locate the progress of this ideology from the moral treatment movement to contemporary medicalized psychiatry. It is suggested that limit setting has its foundations in the Enlightenment tradition of the autonomous individual and the power of reason, and in the dual functions of psychiatry as a therapeutic and social control system. The account draws on the work of critical psychiatry, as well as on recent research concerning the discourses and practices of mental health nurses, and concludes that these dual functions are inherent to the psychiatric project.
Vatne
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S
Institute of Health Science, Molde University College, Molde, Norway. solfrid.vatne@himolde.no
Holmes
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C
D032763:Behavior Control / Q000266:history*; D005060:Europe; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006778:Hospitals, Psychiatric / Q000266:history; D006808:Humanism / Q000266:history; D006801:Humans; D009656:North America; D010344:Patient Advocacy / Q000266:history; D026684:Personal Autonomy; D010686:Philosophy, Medical / Q000266:history; D011209:Power, Psychological; D011570:Psychiatry / Q000266:history*; D012926:Social Control, Formal; D012945:Social Values; D013240:Stereotyping; D019366:Western World / Q000266:history