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Psychology (1,899)
PSY240H5 (135)
Chapter 2

PSY240 - Chapter 2 Notes

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Ayesha Khan

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CHAPTER 2: HISTORICAL AND CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOUR HISTORICAL VIEWS OF ABNORMAL BEHAVIOUR • trephining  fact that many survived the operation may have contributed to the persistence of this practice; may have incidentally relieved P on the brain Demonology, Gods, and Magic Hippocrates’ Early Medical Concepts • believed that the brain was central organ of intellectual activity and mental disorders were due to brain pathology • pointed out that head injuries could cause sensory and motor disorders • doctrine of the 4 humours o 4 elements of the material world thought to be earth, air, fire and water, which had attributes of dryness, cold, heat and moistness o these elements combined to form 4 essential fluids of the body – blood (sanguis), phlegm, bile (choler) and black bile (melancholia) o the fluids combined in diff proportions w/in diff ppl and a person’s temperament was determined by which of the humours was dominant o from this view behaviour seen as: the sanguine, phlegmatic, choleric and melancholic; each of these had their own associated characteristics • recognized imp. of env. and often removed patients from their families • believed hysteria restricted to women and caused by the uterus wandering to various parts of the body, pining for children  remedy = marriage Early Philosophical Conceptions • Plato – shared the belief that mental disorders were in part divinely caused • Aristotle – generally believed Hippocrate’s theory of disturbances in bile Later Greek and Roman Thought • Galen – contributed to anatomy of NS; divided causes of psychological disorders into physical and mental categories; some of the causes included: head injuries, excessive use of alcohol, shock, etc. • Roman physicians wanted to make their patients comfortable and thus provided pleasant therapies such as warm baths and massage o they also followed principle of contrariis contrarius (opposite by opposite) – ex. drinking chilled wine in warm tub Box 2.1 - Developments in Thinking – Hysteria and Melancholia through the Ages Hysteria • referred to as “conversion disorder” in DSM • has a long history • believed that it was caused by wandering of the uterus until 17 century when Willis theorized it resulted from a disorder of the brain Melancholia • premodern view of it as a disorder introduced by Philippe Pinel o improved classification schema and examined causes of the disorder • Griesinger o focus on biological determinants for disorders • Kraepelin o credited for modern view of psychiatry o identified manic depression as a major category of depression Abnormality during the Middle Ages • first mental hospital established in Baghdad (792 CE) Avicenna from Arabia – frequently referred to hysteria, epilepsy, manic reactions and melancholia Case Study – An Early Treatment Case • A prince had melancholia and suffered from the delusion that he was a cow • said he should be slaughtered • Avicenna went in w/ a knife and said that the cow was too lean and should be fattened • the prince was given food until he gained strength, got rid of his delusion and was cured • Middle Ages – largely devoid of scientific thinking and humane treatment for mentally disturbed Box 2.2 – Early Views of Mental Disorders in China - Early Chinese medicine based on a belief in natural rather than supernatural causes for illness o ex. Yin and Yang = positive and negative forces that complement each other (balance is physical and mental health); if not, illness results; treatments focused on restoring balance – withheld food b/c pos. force and thought this needed to be reduced - Golden Box Summary (ancient Chinese doc summarizing medical theory and treatment) presented zang-zao, illness that resembled symptom pattern of hysteria - Chung Ching – like Hippocrates o believed organ pathologies were primary cause of mental disorders o believed stressful psychological conditions could cause organ pathologies and his treatments involved drugs and regaining emotional balance - reverted back to supernatural forces as causal agents - “Dark Ages” not so long as in the West, nor as severe (in terms of treatment of mental patients) Mass Madness • Mass madness: widespread occurrence of group behaviour disorders that were apparently cases of hysteria o reached peak in 14 and 15 century b/c of social oppression, famine and epidemic diseases; Black death (plague) o “mass hysteria” – today known as mass psychogenic illness; in contemporary cultures, typically involves people mistakenly attributing bodily changes or sensations to serious disease; symptoms typically have rapid onset and quickly spread to others and have a rapid remission • typically occur after an environmental event or trigger (ex. heavy smog) which is misinterpreted as sign of danger o ‘index person’ – first person to report symptoms ( may be suffering genuine medical condition, but misinterprets significance of the symptoms); people nearby learn about this and look for indications of the disease in them – symptoms are probably bodily reactions or anxiety related o ex. mass hysteria in Nigeria – men feared that their genitals had vanished; this fear accompanied by a fear of death was referred to as “Koro” • Tarantism: included uncontrollable impulse to dance that was often attributed to bite of tarantula o later spread to Europe where it was known as Saint Vitus Dance • rites had been banned with the arrival of Christianity • so rites kept alive in secret gatherings • with time, meaning of the dances changed – people no longer sinners but bitten by the tarantula, dancing = cure • Iycanthropy: condition in which ppl believed to be possessed by wolves and imitated their behaviour Exorcism and Witchcraft - during early part of medieval period, the mentally disturbed were treated for the most part with considerable kindness o treatement consisted of prayer, holy water, sanctified ointments, mild forms of exorcism, etc. - recent resurgence of superstition o exorcism still practiced in many countries - long thought that during Middle Ages, many mentally disturbed ppl were accused of being witches and thus punished and often killed o may not be true to that extent – one person noted that witches may have been impoverished women with a sharp tongue o physically possessed ppl were considered mad and spiritually possessed were likely considered witches TOWARD HUMANITARIAN APPROACHES • Paracelsus – believed moon influenced the brain; advocated treatment by bodily magnetism st • Johann Weyer – one of 1 physicians to specialize in mental disorders; founder of modern psychopathology The Establishment of Early Asylums and Shrines • Monastery of St.Bethleham became known as Bedlam because of its practices o violent patients shown to public for money o harmless ppl forced to seek charity on the streets • some early asylums housed people with a variety of probs such as psychiatric disorders, physical disabilities, etc. Case study – Treatment in Early Hospitals • patients were shackled, in dark cells, had iron collars that held them against wall • little attention to if they were fed adequately • unclean • philosophy of treatment involved belief that patients needed to choose rationality over insanity o treatments were aggressive – ex. powerful drugs, plunging patients into ice/hot water Humanitarian Reform Tuke’s Work in England Quaker retreat • place where patients lived, worked, and rested in a religious atmosphere • Quakers believed in treating all ppl with kindness and acceptance Moral Management in North America Benjamin Rush • founder of North American psychiatry • his medical theory was tainted with astrology • remedies included blood letting and purgatives • invented “tranquilizing chair” – thought to lessen the force of the blood on the head while muscles relaxed Moral Management • wide-ranging method that focused on a patient’s social, individual and occupational needs • in asylums moral management – emphasis on moral and spiritual development of patients • was very effective at the time • this method was abandoned later because o ethnic prejudice against rising immigrant pop. o failure of movement’s leaders to train ppl to replace them o rise of mental hygiene movement o advances in biomedical science  thought due to biological explanation so psychological and social env. became basically irrelevant; waited for biological cure, which never arrived Mental hygiene movement • method that focused on physical well-being of hospitalized mental patients • improved patients’ comfort levels, but did not receive help for mental problems Dix and the Mental Hygiene Movement Dorothea Dix • established 32 mental hospitals • through her efforts, mental hygiene movement grew in Canada and the U.S The Military and the Mentally Ill • mental health treatment also advanced by military medicine • in Western world, first mental health facility for treating mentally disordered war casualties was opened by the Confederate Army in the Civil War • program of military psychiatry • Kraepelin conducted a research project t
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