The History of Associationism and British Medical Psychology

AT the beginning of the eighteenth century the time-honoured identification of mental disease with derangements of the humoral factors still prevailed.Another closely related, but less well known tradition localized diseases of the mind to specific mental faculties.Diseases of the imagination were thus distinct from diseases of thejudgment, memory, or will.These ideas were based upon an implicit vitalism; i.e. the faculties were envisioned as free and active aspects of the mind in some way independent of the laws governing the material and biological world.Faculty psychology and its assumed vitalism are of particular importance to the present study since it was this school ofthought that the eighteenth century psychology of associations attempted to discredit.The complex history of this new approach is described in Warren's History of Associationism.Several distinct themes are present, the first and most fundamental element being John Locke's assertion that knowledge was based upon sensation.David Hume further developed this simple statement in his observation that the sensation of related objects became associated in the mind so that the subsequent sensation of only one of the related objects would bring about the recollection of the whole series.Finally Hartley explained associating sensation in terms of the Newtonian concepts of vibration and gravitation.In so doing he emphasized the materialistic flavour of the psychology, making it acceptable to the new science of physics, although still finding it possible to evade the charge of materialism.Despite this pious and ambivalent concession to the past, Hartley's thought represented a radical departure from the psychology of active faculties, which gradually became discredited by eighteenth-century physicians.In its place a different concept of mental disease was fashioned around the new psychology of associations.This mechanistic psychology dominated the scene for only a limited period, for in the nineteenth century interest revived in the active functions of the mind among a group of little-known Scottish physicians and psychologists.The renewed interest in faculty psychology led to a reinterpretation of associationism which was to leave a lasting imprint on modern medical psychology. ASSOCIATIONISM AND INSANITYJohn Locke first described disorders of the mind in terms of the sensing and associating mechanisms.His basic formulation was very simple-madmen associate ideas incorrectly, whereas idiots were incapable of associating ideas.In fine, The defect in Naturals, seems to proceed from want of quickness, activity, and motion, in the intellectual Faculties, whereby they are deprived of Reason: whereas mad Men, on the other side, seem to suffer by the other Extream.For they do not appear to me to have lost the Faculty of Reasoning: but having joined together some ideas very wrongly they mistake them for Truths ... as though incoherent Ideas have been cemented together so powerfully as to 46