Rush's tranquillizing chair

Domain XVI · Historical, discredited & harmful · Benjamin Rush · 1810 · Philadelphia

What it is

This guide is listed for history and safety. The chair was a restraint device of the early asylum; it is not a treatment and is not recommended. It is described here as the National Library of Medicine's image and historians show it. The guide covers the psychotherapist's own work: historical…

Format

• Phases of the psychotherapist's work:

Who practises it, and how they are trained or regulated

• Transatlantic context. Early-asylum medicine used rotating and swinging machines, sudden drenching, and restraining chairs. A restraining chair was made for George III, and a chair like Rush's was considered for the King in 1811 but not adopted.
• Repair, advocacy and follow-up. Advance statements, complaints and records, service-level advocacy, re-engagement with needed care. The work ends or continues by the client's choice.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Polite compliance hiding anger; dropout. It is working when the client can disagree openly and keeps coming.
• Present-day superiority ("we'd never do that"). It is working when learners link the history to their own practice.
• Rushing to reassure; collusion with unsafe practice. It is working when guilt becomes something the client can think about and act on.
• Fatalistic beliefs about heredity; over-identification. It is working when the relative becomes a person with a story, not only a patient record.
• Token consultation; blaming individual staff. It is working when incidents of restriction fall and patients report being asked about their preferences.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.