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Chapter 2


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Ayesha Khan

PSY240 CHAPTER 2 – HISTORICAL AND CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOUR HISTORICAL VIEWS OF ABNORMAL BEHAVIOUR - Trephining – chipping away one area of the skull with crude stone instruments until a hole was cut through the skull, opening called a “trephine”, allowed evil spirit to escape (may have relieved a certain amount of pressure on the brain) – some cases showed healing around opening so patient survived the operation - Two Egyptian papyri (16 century B.C.E.) – provide some clues to earliest treatments of diseases and behaviour disorders o Edwin Smith papyrus  Detailed descriptions of treatment of wounds and other surgical operations  Brain is described (possibly first time that brain was linked to mental disorders) o Ebers papyrus  Covers internal medicine and circulatory system  But relies more on incantations and magic for explaining and curing diseases Demonology, Gods, and Magic - Chinese, Egyptians, Hebrews, and Greeks attributed abnormal behaviour to a demon or god who had taken possession of a person - Primary treatment for demonic possession – exorcism: various techniques for casting an evil spirit out of an afflicted person, involved using magic, prayer, incantation, noisemaking, and concoctions made from sheep’s dung and wine Hippocrates’ Early Medical Concepts - “father of medicine” - Insisted that mental disorders had natural causes and appropriate treatments - Believed that brain was central organ of intellectual activity and mental disorders were due to brain pathology - Also emphasized importance of heredity and predisposition and injuries to head could cause sensory or motor disorders - Classified mental disorders into three categories: o Mania o Melancholia o Phrenitis - Four elements of the world: earth, air, fire, and water had attributes of dryness, cold, heat, and moistness – combined to form four essential fluids of the body – blood (sanguis), phlegm, bile (choler), and black bile (melancholer) - Fluids combined in different proportions within different individuals and person’s temperament was determined by which was dominant - From this view: the sanguine, the phlegmatic, choleric, and melancholic – each type brought its own personality attributes - Big on the concept of modern psychodynamic psychotherapy PSY240 CHAPTER 2 – HISTORICAL AND CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOUR Early Philosophical Conceptions Plato - Studied mentally disturbed individuals who had committed criminal acts - Mental cases be cared for in the community - Viewed psychological phenomena as responses of whole organism, reflecting its internal state and natural appetites - Took into account sociocultural influences in shaping thinking and behaviour - Idea included a provision for “hospital” care for individuals who developed beliefs that ran counter to those of society – would be able to engage in conversations comparable to psychotherapy to promote health of their souls Aristotle - Wrote about mental disorders - Descriptions of consciousness o Thinking as directed would eliminate pain and help to attain pleasure - Followed Hippocrates theory of disturbances in the bile Later Greek and Roman Thought - Sanatoria’s – temples dedicated to Saturn o pleasant surroundings considered to be of great therapeutic value for mental patients, provided with constant activities - Romans followed concept of contrariis contrarius – opposite by opposite (example – having patients drink chilled wine while in a warm tub) Galen - made contributions concerning the anatomy of the nervous system - findings based on dissection of animals - divided causes of psychological diseases into physical and mental categories 2.1 – Hysteria and Melancholia through the Ages  Hysteria o referred to as conversion disorder in DSM-IV-TR o physicians held view that hysteria was caused by “wandering of the uterus” until seventeenth century when Willis theorized that this disorder resulted from a disorder of the brain  Melancholia o Commonly known as depression o Disorders might have been viewed variously as medical conditions or religious states or human frailties o Von Bingen noted that melancholia took different forms in men and women PSY240 CHAPTER 2 – HISTORICAL AND CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOUR o Premodern view of melancholia as a disorder introduced by Philippe Pinel o Griesinger – biological basis for disorders, need to seek biological determinants for disorders o Kraepelin – preparing the modern view of psychiatry, also identified manic depression as major category of depression Abnormality during the Middle Ages - First mental hospital established in Baghdad in 792 C.E. o Mentally disturbed individuals received humane treatment - Avicenna referred to as “prince of physicians”, and author of ”The Cannon of Medicine” o In writings referred to hysteria, epilepsy, manic reactions, and melancholia - Mass madness – occurrence of group behaviour disorders (apparently cases of hysteria), whole groups of people affected at the same time – dancing manias (epidemics of raving, jumping, dancing, and convulsions) o Reached its peak during the Black Death which killed approximately 50 percent of the population of Europe - Tarantism – disorder that included an uncontrollable impulse to dance (often attributed to bite of the southern European tarantula or wolf spider), occurred in Italy early in the thirteenth century o later spread to Germany and rest of Europe, known as Saint Vitus dance o with time, the meanings of the dances changed, and were often banned but kept alive in secret gatherings o participants no longer sinners but the unwilling victims of the tarantula’s spirit, dancing was the cure - Iycanthropy – condition where people believed themselves to be possessed by wolves and imitated their behaviour, occurred in isolated rural areas - mass hysteria, known as mass psychogenic illness – involves sufferers mistakenly attributing bodily changes or sensations to serious disease, outbreaks typically occur after an environmental event or trigger, interpreted as sign of danger - index person – first person to report the symptoms but misinterprets the significance of the symptoms o people nearby learn of this concern become anxious, and scan their bodies for indications of the dreaded affliction – symptoms include normal bodily reactions or anxiety-related bodily sensations - Exorcism and Witchcraft o Monasteries served as refuges and places of confinement o Medieval period  mentally disturbed treated with kindness o “treatment” consisted of prayer, holy water, sanctified ointments, breath or spittle of priests, touching of relics, visits to holy places and mild forms of exorcism o Exorcism – symbolic acts performed to drive out the devil from persons believed to be possessed PSY240 CHAPTER 2 – HISTORICAL AND CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOUR o During the middle ages, many mentally disturbed people accused of being witches and were punished, often killed but many of the people considered to be witches were typically woman with a sharp tongue and bad temper o Two types of demonically possessed people:  Physically possessed considered to be mad  Spiritually possessed likely to be considered witches 2.2 – Early Views of Mental Disorders in China Chinese medicine was based on a belief in natural rather than supernatural causes for illnesses, but treatments were focused on restoring balance TOWARD HUMANITARIAN APPROACHES  Movement emphasizing the importance of specifically human interests and concerns The Resurgence of Scientific Questioning in Europe Paracelsus - Against the idea of superstitious beliefs about possession - Postulated conflict between instinctual and spiritual natures of human beings - Formulated idea of psychic causes for mental illness, and advocated treatment by “bodily magnetism”  hypnosis - Convinced that moon exerted a supernatural influence over the brain Johann Weyer - Witches were sick in mind or body and as a consequence, great wrong were being committed against innocent people - One of the first physicians to specialize in mental disorders - Founder of modern psychopathology The Establishment of Early Asylums and Shrines - Asylums – sanctuaries or places of refuge meant solely for the care of the mentally ill (grew in number from the sixteenth century), usually not pleasant places, moreover seen as a place that removed troublesome individuals who could not care for themselves from society - First asylum established in Europe in Spain in 1409 – the Valencia mental hospital founded by Father Juan Pilberto Jofre - In the early days, philosophy was that patients needed to choose rationality over insanity, and the treatment techniques were aggressive included powerful drugs, water treatments, bleeding and blistering, electric shocks, and physical restraints PSY240 CHAPTER 2 – HISTORICAL AND CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOUR Humanitarian Reform [late eighteenth century] Pinel’s Experiment - View that mental patients should be treated with kindness and consideration - Chains were removed, well-ventilated sunny rooms, patients permitted to exercise on hospital grounds, kindness extended to them, and his experiment was a success - Document raises question about the date of humanitarian reform; head of hospital removed chains from patients and put on straitjackets, and forbade staff from beating patients Moral Management in North America - Benjamin Rush – founder of North American psychiatry – encouraged more humane treatment of the mentally ill – first North American to organize a course in psychiatry – medical theory involved astrology, and his remedies were bloodletting and purgatives – invented the “tranquilizing chair” thought to lessen force of blood on head while muscles were relaxed - Moral management – wide-spreading treatment in asylums emphasized patients’ moral and spiritual development and rehabilitation of their “character” rather than their physical or mental disorders – treatment usually done through manual labour and spiritual treatment with humane treatment – very effective - Moral management abandoned in late nineteenth century due to ethic prejudice against rising immigrant population leading to tension between staff and patients; the failure of the movement’s leaders to train their own replacements; and overextension of hospital facilities - (first reason for the abandonment of moral management) – moral hygiene movement – advocated method of treatment that focused on physical well-being of hospitalized mental patients - (second reason for the abandonment of moral management) – advances in biomedical science Dix and the Mental Hygiene Movement - Dorothea Dix – fought for the poor and “forgotten” people in prisons and mental institutions (nineteenth century) - 1841 – began to teach in a women’s prison - Carried a campaign that aroused people and legislatures to do something about the inhumane treatment for the mentally ill - Established 32 mental hospitals The Military and the Mentally Ill - Mental health treatment advanced by military medicine - First mental health facility for treating mentally disordered war casualties opened by Confederate Army in American Civil War - Kraepelin – viewed alcohol as cause of psychological problems among soldiers PSY240 CHAPTER 2 – HISTORICAL AND CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOUR Nineteenth-Century Views of the Causes and Treatment of Mental Disorders - Mental hospitals controlled by laypersons (early nineteenth century) - Psychiatrist (called “alienists” at the time) played little role in caring for the mentally ill and management of the asylums - Effective treatments for mental disorders were unav
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