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Chapter 2

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PSYC 3390
Margaret Lumley

Chapter 2: Historical and Contemporary Views ofAbnormal Behaviour Pages 29-59 Historical Views of Abnormal Behaviour • Earliest treatment of mental disorders practiced thousands of years ago o Certain forms (those with headaches, convulsive attacks etc.) medicine man treated by “trephining” i.e. chipping away one area of the skull with stone instruments until a hole was cut through the skull; this was thought to allow evil spirits to escape when in fact may have just relieved some pressure Demonology, Gods, and Magic • Early writings show Chinese, Egyptians, Hebrews, and Greeks often attributed abnormal behaviour to a demon or god that had take possession of the person • Main treatment for demonic possession was exorcism Hippocrates’Early Medical Concepts • Hippocrates, referred to as the father of modern medicine, denies deities and demons intervened in the development of mental illnesses • Insisted mental disorders had natural causes and appropriate treatments • Believed that mental disorders were due to brain pathology • Emphasized the importance of heredity and predisposition • Pointed out that injuries to the head could cause sensory and motor disorders • Doctrine of the four humours: o The four elements of the material world (earth, are, fire, water) combined to form the four essential fluids of the body: blood (sanguis), phlegm, bile (choler), and black bile (melancholer) o These fluids combined in different proportions within individuals and a person’s temperament was determined by which of the humours was dominant o Earliest & longest-lasting typologies of human behaviour: the sanguine, the phlegmatic, the choleric, and the melancholic  Each of these “types” had it’s own personality attributes • Hippocrates considered dreams to be important and developed a basic concept of modern psychodynamic psychotherapy • While he emphasized the natural causes of diseases, clinical observation, and brain pathology as the root of mental disorder, he had little knowledge of physiology Early Philosophical Conceptions • The Greek philosopher Plato studied mentally disturbed individuals that committed criminal acts and ways to deal with them  he believed these people should not receive punishment in the same way as normal persons o Plato also made provisions for mental cases to be cared for in the community o Plato viewed psychological phenomena as responses of the whole organism, he emphasized the importance of individual differences in intellectual and other abilities, and took into account sociocultural influences in shaping thinking and behaviour o Plato’s idea of treatment included “hospital” care for individuals who developed beliefs different than the broader social order where they would be engage in conversations comparable to psychotherapy • Aristotle, a student of Plato, developed descriptions of consciousness o Held the view that “thinking” as directed would eliminate pain and help to attain pleasure o Aristotle discussed and rejected the possibility of psychological factors such as frustration and conflict causing mental disorders o He subscribed to the Hippocratic theory of disturbances in the bile Later Greek and Roman Though • Medical practices had developed to a higher level • Pleasant surrounding were considered great therapeutic value for mental patients • Physicians used a wide range of therapeutic measures including diet, massage, hydrotherapy, gymnastics, and education, as well as some less desirable practices, such as bloodletting, purging, and mechanical restraints • One of the most influential Greek physicians was Galen o Made a number of original contributions concerning the anatomy of the nervous system o Findings were based on the dissection of animals as human autopsies were not allowed o Galen took a scientific approach to the field dividing the causes of psychological disorders into physical and mental categories o Among causes he named were injuries to the head, excessive use of alcohol, shock fear, menstrual changes, economic reversals, and disappointment in love • Roman physicians… o Wanted to make their patients comfortable and used pleasant physical therapies such as warm baths and massage o They followed the principle contrariis contrarius (opposite by opposite) – for example, having their patients drink chilled wine while they were in a warm tub Abnormality during the MiddleAges • During the MiddleAges, the more scientific aspects of Greek medicine survived in the Islamic countries of the Middle East • The first mental hospital was established in Baghdad in 792 C.E. • In these hospitals mentally disturbed individuals received humane treatment • The outstanding figure in Islamic medicine was Avicenna fromArabia, called the “prince of physicians”, and the author of “The Canon of Medicine”, perhaps the most widely studied medical work ever written • Avicenna frequently referred to hysteria, epilepsy, manic reactions, and melancholia • In Europe during the MiddleAges, scientific inquiry into abnormal behaviour was limited, and the treatment of psychologically disturbed individuals was characterized more often by ritual or superstition than by attempts to understand an individual’s condition • Two events of the times was madness and exorcism Mass Madness • During the last half of the MiddleAges in Europe a peculiar trend emerged in efforts to understand abnormal behaviour • It involved mass madness: the widespread occurrence of group behaviour disorders that were apparently cases of hysteria • Whole groups of people were affected simultaneously • Dancing manias (epidemics of raving, jumping, dancing, and convulsions) were reported as early as the tenth century • One episode that occurred in Italy was known as tarantism – a disorder that included an uncontrollable impulse to dance that was often attributed to the bite of the southern European tarantula or wolf spider. This later spread to Germany and the rest of Europe where it was known as Saint Vitus dance o Similar to the ancient orgiastic rites through which people had worshiped the Greek god Dionysus, these rites had been banned with the advent of Christianity o They were deeply embedded in the culture, and were kept alive in secret gatherings o With time, the meanings of the dances changed, the old rites appeared but were attributed to symptoms of the tarantula’s bite o The participants were no longer “sinners” but the unwilling victims of the tarantulas spirit o The dancing became the “cure” and is the source of the dance we know today as the tarantella • Isolated rural areas were afflicted with outbreaks of lycanthropy – a condition in which people believed themselves to be possessed by wolves and imitated their behaviour • Mass madness reached its peak during the fourteenth and fifteenth century – a period noted for social oppression, famine, and epidemic diseases • Today, “mass hysteria” is known as mass psychogenic illness o It typically involves sufferers mistakenly attributing bodily changes or sensations to serious disease o Symptoms typically have rapid onset, quickly spreading to others, and have a rapid remission o Outbreaks generally occur after an environmental event or trigger o The “index person”, the first person to report symptoms, may be suffering from a genuine medical condition but misinterprets the significance of symptoms, people nearby learn of this concern, become anxious, and possibly find the symptoms in themselves even though they ay just be normal bodily reactions Exorcism and Witchcraft • In the MiddleAges in Europe, management of the mentally disturbed was left largely to the clergy • During the early parts of the MiddleAges they were treated for the most part kindly. • “Treatment” consisted of prayer, holy water, sanctified ointments, the breath or spittle of priests, etc. • In some monasteries and shrines exorcisms were performed by the gentle “laying on of hands” often joined with vaguely understood medical treatments • Recently there has been a resurgence of superstition with over 350 exorcist priests in Italy. In the U.S. many bishoprics also maintain exorcists on staff • It used to be thought that in the MiddleAges mentally disturbed people were accused of being witches, however with more research it seems that it may have been more typical for accused to be an impoverished woman with a loud mouth Toward Humanitarian Approaches • During the end of the MiddleAges and the early Renaissance, scientific questioning reemerged The Resurgence of Scientific Questioning in Europe • Paracelsus, a Swiss physician, was an early critic of superstitious beliefs about possession o Insisted the dancing mania was not a possession but a form of disease o His beliefs were coloured by his astral beliefs; he believed that the moon exerted a supernatural influence over the brain • Johann Weyer was a German physician and writer that wrote under the name “Joannus Wierus” o He published a book, The Deception of Demons, that argued a considerable number of those condemned as witches were really sick in mind or body and were essentially innocent o He was one of the first physicians to specialize in mental disorders and he is the founder of modern psychopothy o He was too ahead of his time and was scorned by his peers and the church where his works were banned Establishment of EarlyAsylums and Shrines • From the sixteenth century on, special institutions called asylums – sanctuaries or places of refuge meant solely for the care of the mentally ill – grew in number • The early asylums in Europe and North America were primarily residences or storage places for the insane, with horrible conditions and the patients were treated like animals • The philosophy of treatment involved the belief that patients needed to choose rationality over insanity • The treatment techniques were aggressive and d
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