Battie's tailored management

Domain XVI · Historical, discredited & harmful · William Battie · 1751 · London

What it is

What it is. This is a historical practice, not a therapy to deliver. William Battie (1703 or 1704 to 1776; sources differ on the birth year) was a London physician, a governor of Bethlem Hospital from 1742, and the first physician of St Luke's Hospital for Lunaticks, which opened at Moorfields in…

Format

• 1751: St Luke's opens at Windmill Hill, Moorfields, in a converted foundry, for 26 patients, with Battie as first physician. Its rules barred public viewing of patients; patients were sorted into "curable" and "incurable" groups (in 1761, 50 curable and 20 incurable). Battie was allowed to teach…
• Session number and length follow the client's needs and the setting; the phases below are, to be fitted into the client's existing therapy.

Evidence status, as the guide reports it

• 1763 to 1764: Battie gives evidence to a House of Commons inquiry into private madhouses (1763) and resigns from St Luke's (April 1764). He also ran private madhouses, and fee-paying confinement was part of his practice.

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?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• 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

• using history to score points against colleagues; it is working when a concrete practice change follows.
• presenting history as a story of steady progress; it is working when trainees can name both gains and costs.
• pressure to stay silent; it is working when the concern is formally logged and the person at risk is protected.
• family conflict over disclosure; it is working when the client's decision reflects their values and the family's.
• advocacy becoming a substitute for grieving, or burnout; it is working when the activity brings meaning and connection.

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.