Like psychiatry, Gothic fiction has often been read in relation to religious practice or in light of the history of medicine. By bringing these approaches together, I offer an alternative history of both the early Gothic novel and modern psychiatry—one that reveals their intimate interconnection at a formative moment in the lives of both. Freudian readings have previously dominated Gothic criticism relevant to psychiatry, despite the remarkable overlap of therapeutic technique between the eighteenth-century proto-psychiatrist and the Gothic novelist. In contrast to the emerging discipline of proto-psychiatry, the early Gothic wears its historical and religious investments on the surface, generating aesthetically pre-modern Catholic environments in which the loss of medieval holism and sacramental healing can register, even terrify. In mourning what proto-psychiatric practice conceals, the Gothic novel therefore establishes a displaced healing site that absorbs—and, crucially, abstracts—the sacramental healing potentials that medical management of the mind rhetorically disguises. In rediscovering the healing imagination in eighteenth-century medicine and the early Gothic novel (1764-1820), I consider three therapeutic mediums—environments, idols, and the spirit—in three respective texts: The Mysteries of Udolpho (1794), The Monk (1796), and Frankenstein (1818). In demonstrating the entanglements between proto-psychiatry and the Gothic novel, I illustrate not only how proto-psychiatric practices emerge from literary forms, but also the ways in which medical “progress” becomes recursive, haunted by backward movement, paradox, and loss.