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Chapter 2

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Richard B Day

Psych 2AP3: Abnormal Psychology – Major Disorders Chapter 2: Historical and Contemporary Views of Abnormal Behaviour Historical Views of Abnormal Behaviour - trephining: operation in which a hole was cut through the skull, 6500 B.C.E - Edwin Smith papyrus: brain recognized as the site of mental functions - Ebers papyrus: relies on incantations and magic for explaining or curing diseases that had unknown causes - Demonlogy, Gods and Magic:  Chinese, Egyptians, Hebrews, and Greeks often attributed such behaviour to a demon or god who had taken possession of a person depending on the symptoms  Exorcism: magic, prayer, incantation, noisemaking and use of concoctions - Hippocrate’s early medical concepts:  Greeks considered the human body sacred, little could be learned of human anatomy or physiology  Denied that deities and demons intervened in development of illness  Mental disorders had natural causes and appropriate treatments  Brain is central organ of intellectual activity and mental disorders were due to brain pathology  Heredity and predisposition, injuries to the head cause sensory and motor disorders  Mania, melancholia and phrenitis (brain fever)  Four humours: essential fluids of the body – blood, phlegm, bile and black bile combined in different proportions within different individuals, person’s temperament determined by dominant humour  Importance of dreams in understanding a patient’s personality - Early philosophical conceptions:  Plato:  Studied mentally disturbed individuals who committed crimes and argued that they weren’t responsible for their acts and shouldn’t receive the same punishment as normal people  Viewed psychological phenomena as responses of the whole organism, reflecting internal state and natural appetites  Importance of individual differences in intellectual and other abilities  Sociocultural influences in shaping thinking and behaviour  Mental disorders were in part divinely caused  Aristotle:  Thinking as directed would eliminate pain and help to attain pleasure  Rejected the question of whether mental disorders could be caused by psychological factors  Subscribed to Hippocratic theory of disturbances in the bile - Later Greek and Roman thought:  Pleasant surroundings were considered of great therapeutic value  Therapeutic measures: diet, massage, hydrotherapy, gymnastics, education, bloodletting, purging, and mechanical restraints  Galen:  Contributions to the anatomy of the nervous system  Hippocratic tradition  Causes of psychological disorders: physical and mental  Roman medicine: pleasant physical therapies and the principle of contrariis contrarius - Abnormality during the Middle Ages:  First mental hospitals in Middle East  Avicenna: individuals received humane treatment  Europe: scientific inquiry into abnormal behaviour was limited and the treatment of psychologically disturbed individuals was characterized more often by rituals or superstition  Mass madness:  Tarantism: disorder that included uncontrollable impulse to dance that was often attributed to the bite of the southern tarantula or wolf spider. Believed to be the result of sins but then became unwilling victims of tarantula’s spirit and the dance became the cure  Lycanthropy: condition to which people believed themselves to be possessed by wolves and imitated their behaviour  Black death: depression, fear, and wild mysticism engendered by the terrible events of this period  Index person: first person to report the symptoms  Exorcism and witchcraft:  Prayers, holy water, sanctified ointments, breath or spittle of a priests, touching of relics, visits to holy places, mild forms of exorcism  Exorcisms: drive out the devil from a person believed to be possessed performed by the gentle laying of hands  Many mentally disturbed people were accused of being witches and thus were punished and killed.  Two types of demonically possessed people: physically and spiritually 2.1 Developments in Thinking: Hysteria and Melancholia through the Ages - Hysteria:  Conversion disorder  Attributed to the uterus and wandering of the uterus - Melancholia:  Depression  Medical conditions, religious states or human frailties  Demonic possession or ancient Greek humours  Biological determinants for disorders  Manic depression 2.2 Developments in Thinking: Early Views of Mental Disorders in China - Based on belief in natural rather than supernatural causes - Ying and Yang - Chung Ching: based his views of physical and mental disorders on clinical observations and implicated organ pathologies as primary causes. Stressful psychological conditions could cause organ pathologies, treatments utilized both drugs and regaining emotional balance through activities. - Regressed to a belief in supernatural forces as causal agents Toward Humanitarian Approaches - The resurgence of scientific questioning in Europe:  Paracelsus:  Dancing mania was not a possession but a form of disease  Conflict between instinctual and spiritual natures of human beings, psychic causes for mental illness and hypnosis.  Belief in astral influences  Weyer:  Those imprisoned, tortured and burned for witchcraft were really sick in mind or body  Clergy:  Began to abandon the idea of demonology - The establishment of early asylums and shrines:  Asylums: sanctuaries or places of refuge meant for the care of the mentally ill  Valencia mental hospital  Asylums in Quebec were run by the Catholic church  Early asylums in North American and Europe were primarily modifications of penal institutions  Hospitals devoted exclusively to psychiatric problems required their own kind of supervision in their own institution  Initially, the philosophy of treatment involved the belief that the patients needed to choose rationality over insanity: powerful drugs, bleeding and blistering, electric shock and restraints. - Humanitarian reform:  Pinel’s experiment: received permission to remove the chains from some inmates as an experiment to test his views that mental patients should be treated with kindness and consideration  Tuke’s work in England: york retreat, a pleasant house where mental patients lived, worked, and rested in a kindly, religious atmosphere  Moral management in North America: Benjamin Rush encouraged more humane treatment of the mentally ill  Moral management: wide-ranging method of treatment that focused on patient’s social, individual, and occupational needs  Emphasized patients’ moral and spiritual development and the rehabilitation of their “character”  Done without antipsychotic drugs  Ethnic prejudice against the rising immigrant population, failure of the movement’s leaders to train their own replacements, and overextension of hospital facilities  Mental hygiene movement: method of treatment focusing on the physical well-being of mental patients  All mental disorders would eventually yield to biological explanations and biological treatments  Dix and the mental hygiene movement: campaign that aroused people and legislatures to do something about the inhuman treatment accorded to the mentally ill.  The military and the mentally ill:  Mental health problems that could interfere while on duty  Treating mentally disordered war casualties  Alcohol consumption and ability to fire weapons - Nineteenth-Century Views of the Causes and Treatment of Mental Disorders:  Effective treatments for disorders were unavailable  Alienists gained control of the asylums and incorporated the traditional moral management therapy into their medical procedures  Acquired more status and influence in society and became influential
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