A lot of the tools used to “cure” mental illness have been barbaric and painful and shameful and, of course, absolutely useless.
Seldom, though, do you find the treatment that’s just straight up comedic. At least, on its face.
Dr. Joseph Mason Cox, born in 1763, came to the treatment of mental illness honestly, which is to say that his grandfather owned an asylum called Fishponds and Cox inherited it after his grandfather died. A tale as old as time! Who among us hasn’t been the beneficiary of this kind of nepotism?
Having spent his whole life around the patients at the asylum, Cox had lots of time to theorize about the possible cures for the various ailments he’d seen. As a young boy, he probably dressed his tin soldiers in makeshift straightjackets (I assume? I just made this up, but I can’t imagine what else a child might have done whilst hanging about the ol’ workhouse). Cox watched his grandfather and, later, his mother run the place and formulated some theories.
To be very clear, Cox was definitely not a quack (and even if he was, there’s still some pretty important context to consider when we, modern folks who know about germ theory and stuff, can learn about his approach). He was, though, a product of his time.
Like his grandfather, he was pretty firm in his belief in compassion, rather than brute force, and he preferred very individualized health plans. This was rare among prior generations (and later generations), but at the time that Dr. Cox began running Fishponds, the broadly accepted idea about mental illness was that, in all of its forms, it represented a complete loss of agency.
The “moral treatment” method, which was way more humane than previous styles of treatment, didn’t require patients to be chained or beaten — but it did take away functionally all of their rights.
Oh, and bloodletting was still pretty popular at the time, but haunted blood was a common diagnoses for at least another 100 years or more, so…you work with what you’ve got, I guess.
Anyway, it was against this backdrop that Dr. Cox got his medical degree and began to conduct a decent amount of study into the causes and treatments of mental illness. Unfortunately, he had two strikes against him — the first that he began running Fishponds at the age of 25 and the second that the 1780s weren’t exactly the height of scientific neurological and psychological research.
Here are some examples of treatments that Cox espoused: Playing classical music for patients, hydrating them (it was paradoxically common practice to deny patients with low appetite any water), providing them with regular exercise, and access to time spent with a religious figure, which was basically just talk therapy.
So, you know, a lot of stuff that sounds pretty familiar! But that wasn’t enough.
Time to Get Spun
Cox’s big idea was, ah, novel. Often, the root veggies and brandy diet didn’t cure his patients. Instead of trying to hit the crazy out of people or drug them into oblivion or mentally corrode them until they were unable to think, he believed that it might be possible to soothe the symptoms of mania by physically manipulating the brain particles themselves.
In Practical Observations on Insanity, he presented this idea to the world: A chair that spun people around until they were healed.
If you’ve ever wondered where the term “spin doctor” comes from, now you know. Actual “spin doctors” were practitioners who quite literally spun people around until…something occurred.
“Cox’s Chair” was, he explained, “easily constructed by suspending a common Windsor chair to a hook in the ceiling, by two parallel ropes attached to the hind legs, and by two others passing round the front ones joined by a sliding knot, that may regulate the elevation of the patient when seated, who, besides being secured in a strait waistcoat, should be pre- vented from falling out of the chair by a broad leather strap, passed round the waist and buckled behind the spars, while another strap to each leg may fasten it to the front ones of the chair.”
Once a person was properly strapped to a chair suspended from the ceiling like a kind of eerie, hands-free hora (though not really because they were only suspended a few inches off the floor), Dr. Cox would then ask an attendant to begin “turning him round according to the degree of velocity required.”
Which may leave you wondering, “ok, so…it’s a swing? Clearly that can’t work. If swinging cured depression we wouldn’t have our current epidemic number of sullen three-year olds."
And you’d be right, for the most part. According to Dr. Cox, the quick rotation worked to calm patients and, ultimately, help them sleep (kind of like when we put babies in oscillating chairs). From the good doctor:
“One of its most valuable properties is proving a mechanical anodyne. After a few circumvolutions, I have witnessed the soothing lulling effects, when the mind has become tranquillized, and the body quiescent; a degree of vertigo has often followed, and this been succeeded by the most refreshing slumbers.”
This was not a perfect cure, though, and Dr. Cox was quick to acknowledge that yes, patients often soiled themselves in one way or another. Again, from his own writing:
One of the most constant effects of swinging is a greater or less degree of vertigo, attended by pallor, nausea, and vomiting; and frequently by the evacuation of the contents of the bladder.
Whelp! You know what they say about omelettes and eggs and whatever. And anyway, it’s not like my psychotropic regimen has never made me vomit on myself before.
Because the chair didn’t actively harm the patient — no cutting! No bloodshed! Just mild barfing! How kind! — it fit right into the day’s “moral treatment'“ push. Plus, it was kind of hard to prove whether or not it was working, since there were no scans or exams which would definitively prove one way or another whether the brain cells had been jumbling into a more pleasing order.
Cox himself even called it “a moral and a medical mean in the treatment of maniacs.”
But like…was it treating people? Actually treating them? The answer, according to modern medicine, is a resounding “who knows!”
A modern spin!
A handful of contemporary research teams have revisited Cox’s spinning chair idea to test its ability to mend the mind. In a 2013 article called Cox’s Chair Revisited: Can Spinning Alter Mood States? performed one of the most highly controlled. The paper, which was published in the journal Front Psychiatry, touts the use of “a unique 3-D-turntable at the University of Zurich,” which allowed for more specific calculations.
They found:
Subjects indicated feeling less "good," "relaxed," "comfortable," and "calm" and reported an increased alertness after vestibular stimulation. However, there were no objective adverse effects of the stimulation.
…Which basically means that the people didn’t barf or fall over and spontaneously erupt in sobs, but it also means they didn’t feel better, either.
Not that there was much to feel better about; the research only use 11 “healthy” subjects, which I’m pretty sure means they weren’t actually testing on people with bipolar. And 11 isn’t exactly a substantial sample size. And the big fancy Spin-O-Meter didn’t provide the same kind of, shall we say, terror factor as an elevated chair.
Plus, this study didn’t, near as I can tell, follow up on the biggest claim that Dr. Cox made, which was taking a spin helped them sleep — something anyone with mania knows is a fuuuuucking challenge.
[Aside: If anyone wants to pay me to sit in a spinning chair when I’m manic and see what happens, I would 100% be down. Slide into my DMs, doc!]
Anyway, the point is that none of the recent science has necessarily worked to create similar conditions to Cox’s original invention. It’s pretty apparent to those of us who have even seen a cartoon drawing of a brain at some point in our lives that centrifugal force doesn’t change the way our neurons fire.
That said, humans do (for the most part) kind of love spinning around! I’ve watched my 5-year-old niece park herself on a merry-go-round for so long that she can barely walk afterward. As adults, we do it on the Graviton at the fair, when we dance, and when we’re being drunken assholes during karaoke when someone sings The Chicks and everyone joins in on “wild open spaaaaaaaces.”
I’m not a scientist, but I do think there could be something to be said about the way that getting properly dizzy refocuses your mind. I remember when I took adult ballet classes because I’m a masochist and I would get so twisted up during chaine turns that I would have to collect myself for a solid 20 seconds. It was like a kind of forced meditation when all other thought went immediately out the window and I had to focus on just keeping myself upright.
Then again, I’m also a chronically clumsy person who often gets vertigo for precisely no clear reason, so I may not be the best source on this.
But it does make me wonder if all the time I spent fidgeting at my work desk — any annoying my office mate by spinning back and force in my chair — was somehow my brain seeking out what it needed.
Honestly, I have heard of way weirder ways to treat mental illness. I mean, I take lithium every day and no one knows how that works. So maybe I’ll go for a spin later and report back?