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Song and Sanity: Music as Treatment in 19th-Century Asylums

Music was once used as a form of "moral therapy."

Key points

  • Music has long been known to have an impact on mental health, both positive and sometimes negative.
  • In the 19th century, "moral therapy" was partly based on the belief that patients could be helped by being treated with compassion and dignity.
  • Music was used as a form of moral therapy in 19th-century asylums.

I woke up this morning with a song in my head. It was Booker T and the MGs' "Time is Tight," a really catchy track that put me in the right frame of mind to start my day. Here in the UK, Booker T and the MGs' song "Soul Limbo" is the soundtrack for the cricket season during the summer. I've been listening to the current test match between England and New Zealand, so that's probably why a song by Booker T and the MGs popped into my head as I woke up. The song had an additional meaning as I and everyone else in the house had slept in. Time was tight. But even though the morning proved to be a blur of getting lunches made, shoelaces tied, and dogs walked, I kept humming that tune. And it helped, not only during the morning, but all day.

Normally, I probably wouldn't have thought too much about getting a song stuck in my head. It happens quite regularly after all (and usually it's not a song I want there). But Rosemary Golding's book Music and Moral Management in the Nineteenth-Century English Lunatic Asylum made me think again. Golding's book describes the extent to which music was used in English asylums during the 1800s.

Music as "moral therapy"

Palgrave Macmillan, used with permission
Music and Moral Management in the Nineteenth-Century English Lunatic Asylum, by Rosemary Golding
Source: Palgrave Macmillan, used with permission

The 19th century was a time of expansion when it came to asylum provision. Although we tend to think of asylums in negative terms these days, they were often built with good intentions.

Many English asylums were also established with "moral therapy" as their guiding framework (Golding uses the term "moral management." Moral therapy was based on the belief that patients could be helped by being treated with compassion, kindness, and dignity in a clean, comfortable environment that provided freedom of movement, opportunities for occupational and social activity, and reassuring talks. In many asylums, social activity included both music and dance.

It's important to note that it wasn't just wealthy patients that were able to partake in musical entertainment. Patients at pauper asylums, which catered for the poor, also had access to music at times. In fact, it was an advertisement for an organist to work at a pauper lunatic asylum that spurred Golding to research further into the use of music in asylums.

So, how was music employed? While patients often listened to music and took part in dances, they also played it themselves on occasion. Asylum bands and choirs were established and often boasted extensive repertoires. The Brookwood Asylum Band in Surrey, for instance, played selections from Verdi, Strauss, Rossini, and Donizetti, as well as more popular tunes. Their program for the 1874-75 season listed two concerts per months, along with two extra concerts in December for Christmas and New Year's.

Music was intended to help patients therapeutically, socially, and even physically via dance. Patients looked forward to concerts and dances, which could be used as incentives for good behavior. Asylum staff also looked forward to such occasions, as they provided a break from what could be a monotonous and demanding routine. Finally, and crucial to moral therapy, music provided a means through which asylums could prepare patients for returning to the outside world.

Music was sometimes viewed as a threat to health

Although music was viewed positively in many English asylums, it has also been seen as a threat to health. As James Kennaway's entertaining book, Bad Vibrations: The History of the Idea of Music as a Cause of Disease demonstrates, music has also been seen as potentially detrimental. These theories gained some authority during the Enlightenment when music, along with other stimulants, such as coffee, tea, and tobacco, were thought to overexcite the nerves. Women were thought to be especially vulnerable to such effects.

The benefits are worth remembering today

For me, there is something intrinsically enjoyable in music (well, good music, at least) that is beneficial to mental health. Part of it may be the way that music can naturally make us mindful, in the way that exposure to nature can; it coaxes us into living in the moment and setting anxieties aside. But it can also remind us of times past and help us to put things in perspective. Many asylum superintendents understood just that during the 19th century. It is worth remembering today, too.


Golding, R. (2021). Music and Moral Management in the Nineteenth-Century English Lunatic Asylum. Basingstoke: Palgrave

Kennaway. J.(2012). Bad Vibrations: The History of the Idea of Music as a Cause of Disease. Burlington, VT: Ashgate.