Unit 8: Chapter 15: Early Diagnosis, Explanation, and Treatment of Mental Illness

animal magnetism

A force that Mesmer and others believed is evenly distributed throughout the bodies of healthy people and unevenly distributed in the bodies of unhealthy people.

Nancy school

A group of physicians who believed that because all humans are suggestible, all humans can be hypnotized.

posthypnotic suggestion

A suggestion that a person receives while under hypnosis and acts on when he or she is again in the waking state.

Philippe Pinel

Among the first, in modern times, to view people with mental illness as sick people rather than criminals, beasts, or possessed individuals. In the asylums of which he was in charge, Pinel ordered that patients be unchained and treated with kindness in a peaceful atmosphere. Pinel was also responsible for many innovations in the treatment and understanding of mental illness.

Hippocrates

Argued that all mental and physical disorders had natural causes and that treatment of such disorders should consists of such things as rest, proper diet, and exercise.

Dorothea Lynde Dix

Caused several states (and foreign countries) to reform their facilities for treating mental illness by making them more available to those needing them and more humane in their treatment.

Describe the gradual improvement in the treatment of mental illness that began in the sixteenth century, including the work of Philippus Paracelsus, Cornelius Agrippa, Johann Weyer, and Reginald Scot. Identify the most popular treatment for ailments - including mental disorders - up to the end of the eighteenth century. (pp. 495-496)

Even during the 16th century, when witch hunts and trials were very popular, a few courageous people argued that witches were not possessed by demons, spirits, or the devil. They argued that the type of behavior which is displayed was caused by emotional or physical disorders. One such individual was the ill-tempered flamboyant Swiss physician Phillippus Paracelsus. Paracelsus argued that an understanding of nature should come from experience and not from the blind allegiance to ancient philosophy as was often and exemplified by the scholastic's. He noted that herbal remedies employed by common people were often effective in curing disorders. being an alchemist, he speculated that it was the chemical composition of such remedies that explained their effectiveness, and he performed empirical studies to determine which chemicals could cure specific ailments. incidentally, in one of his many chemical experiments Paracelsus mixed sulfuric acid and alcohol, thus creating an early harmless anesthetic. Although Paracelsus rejected demonology, he did believe in a 'universal spirit' that permeated nature. When people were in harmony with the spirit, they were healthy; when they were not, they were unhealthy. Paracelsus believed that things such as chemicals, magnets, and the ailments of heavenly bodies could influence one's harmony with nature and their for one's health. As bizarre as the suggestions were, they tended toward naturalistic explanations of mental disorders and away from Supernatural explanations. One of Paracelsus's maxims was, "keep sorcery out of medicine." Paracelsus denounced the cruel treatment of women brought before the Inquisition as witches, saying, "there are more superstitions in the Roman Church than in all of these women". If the term spiritual is replaced by psychological, the following statement by Paracelsus has a modern ring to it: "there are two kinds of diseases in all men: one of them material and one is spiritual... against material diseases material remedies should be applied. against spiritual diseases spiritual remedies." According to Alexander and Selesnick, PA was the second physician to argue against labeling individuals as witches; Agrippa had been the first. not only did Cornelius Agrippa argue against witch-hunts, but also saved many individuals from the ordeal of a witch trial. In 1563 agrippa's student Johann w Weyer published 'The Deception of Demons', in which he claims that those labeled as witches or as Bewitched were actually mentally Disturbed people. Weyer's deception was a carefully written, well-documented, step-by-step rebuttal of the malleus maleficarum. He refer to the witch burning as godlessness and condemned theologians, judges, and Physicians for tolerating it. What year became known to his contemporaries as a crusader against winch hunting, and this was enough for him to be considered weird, insane, or even a witch. The view that witches were actually people with mental illness also found support from Reginald Scott, who wrote 'Discovery of Witchcraft', and from a Swiss psychiatrist Felix Plater. In his book 'Practice of Medicine', Plater outlined several different types of mental disorders, including consternation, foolishness, mania, delirium, hallucinations, convulsions, drunkenness, hypochondria, disturbance of sleep, and unusual dreams. The arguments of such people were eventually effective. In 1682, Louie XIV of France abolished the death penalty for witches. Although mental illness increasingly came to be viewed as having natural rather than Supernatural causes, it was still poorly understood, and people with mental illness were treated very poorly—if they were treated at all. bloodletting was still the most popular way of treating all ailments, including mental disorders, and methods were devised for introducing shock in patients. One such method was to spend patients very rapidly in a chair; another was to throw several buckets of cold water on chained patients. Physicians would often report dramatic Improvement in the condition of the patient following such treatments. These dismal conditions for people with mental illness lasted until the end of the eighteenth century.

Marquis de Puységur

Found that placing patients in a sleep like trance was as effective in alleviating ailments as was Mesmer's approach, which necessitated a crisis. He also discovered a number of basic hypnotic phenomena.

Describe the use of hypnotism as a treatment for behavior disorders, including the work of Franz Anton Mesmer (1734-1815), Marquis de Puységur (1751-1825), John Elliotson (1791-1868), James Esdaile (1808-1859), James Braid (1795-1860), the Nancy school, and Jean-Martin Charcot (1825-1893). Define animal magnetism, the contagion effect, artificial somnambulism, posthypnotic amnesia, and posthypnotic suggestion. (pp. 504-510)

Franz Anton Mesmer: In his dissertation, which was titled "On the Influence of the Planets", she maintained that the planets influence humans through a forest called animal gravitation. With the success of his magnetic treatment, Mesmer had the information he needed to challenge one of the most famous actresses of the late 18th century, and Austrian priest named Johann Gassner, who claimed great success and curing patients by driving out demons. Mesmer claimed that Gassner's cures resulted from the rearrangement of animal gravitation, not the removal of demons. In the heated debate that ensued, Mesmer won, and exorcism as a form of psychotherapy suffered a major setback. As mentioned, this was generally regarded as an improvement in the treatment of mental illness because Mesmer's cure was natural (although fallacious) and Gassner's was Supernatural. At first, messmer assumed that each person's body contains a magnetic force field. And the healthy individual, this forcefield is distributed evenly throughout the body, but in the unhealthy individual it is unevenly distributed, causing physical symptoms. I using magnets, it was possible to redistribute the forcefield and restore the patient's health. When magnetic therapy became popular, Father Hell claimed to be the first to have used it. A great dispute followed, which was covered by the newspapers. During this controversy, which Mesmer (probably unjustly) won, the term animal magnetism was first used. In 1777 Mesmer agreed to treat Maria Teresa Paradies, a17 your old pianist who had been blind since the age of three. messmer claimed that his treatment returned her site but that she could have see only well alone in his presence. The medical community accused Mesmer of being a charlatan, and he was forced to leave Vienna. He fled to Paris where, almost immediately, he attracted and enthusiastic following. He was so popular that he decided to treat patients in groups rather than individually, and still he was effective. Because of what was later called the contagion effect, many patients who would not respond to suggestion when alone with the physician would do so readily after seeing others respond. As was undoubtedly the case with exorcism and with faith healing, many of Mesmer's patients reported being cured of their ailments. In all of these cases, the symptoms removed were probably hysterical—that is, of psychological origin. In 1784 The Society of Harmony (a group dedicated to the promotion of animal magnetism) persuaded the king of France to establish a commission to objectively study the effects of animal magnetism. This truly high-level commission consisted of Benjamin Franklin (the commission's presiding officer); Antoine Lavoisier, the famous chemist; and Joseph Guillotine, the creator of a way to put condemned people to death in a 'humane' manner. The commission conducted several experiments to test mesmer's claims. In one experiment, a woman was told that she was mesmerised by a mesmerist behind a door, and she went into a crisis although there was actually no one behind the door. In another experiment, a patient was offered five cups of water, one of which was mesmerised. She chose and drink a cup with plain water but experienced a crisis anyway. Much to Mesmer's this may, in its report of August 1784, the commission concluded that there was no such thing as animal magnetism and not any positive results from treatment supposedly employing it were due to the imagination. The commission branded mezmur a Mystic and a fanatic. Although many people, some of them prominent, urged Mesmer to continue his work and his writing, the commission's findings had essentially destroyed him, and he sank into the obscurity. Marquis de Puységur: Although the commission's report silent to Mesmer himself, other members of the Society of Harmony continue to use and modify Mesmer's techniques. One such member, the Marquis de Puységur, discovered that magnetizing did not need to involve the violent crisis that mesmer's approach necessitated. Simply by placing a person in a peaceful, sleep like tramps, Puységur could demonstrate a number of phenomena. Although the person appeared to be asleep, he or she would still respond to Puységur's voice and follow his commands. When Puységur instructed the magnetized patient to talk about a certain topic, perform various motor activities, or even dance to imagined music, he or she would do so and have no recollection of the events upon waking. Because a sleep like transfer placed the crisis, Puységur renamed the condition artificial somnambulism. he found that the therapeutic results of using this artificial sleep were as good as they had been with Mesmer's crisis approach. With his new approach, he made many discoveries. In fact, he discovered most of the hypnotic phenomena known today. He learned that well in the somnambulistic state, individuals are highly suggestible. If they were told something was true, they acted as if it were true. Paralysis and various sensations, such as pain, could be moved around the body solely by suggestion. When individuals were told that a part of their body was anesthetized, they could tolerate normally painful stimuli such as Burns and pinpricks without any sign of distress. Also, a wide variety of emotional expressions, such as laughing and crying, could be produced on command. It was observed that individuals could not remember what had occurred while in a trance, a phenomenon later called post-hypnotic amnesia. What is now called post-hypnotic suggestion was also observed. That is, while in a trance, an individual is told to perform some act such as scratching his or her nose when they hear their name. After being aroused from the trance, the individual will typically perform the act as instructed without any apparent knowledge of why he or she is doing this. John Elliotson, James Esdaile, James Braid: Because magnetizing a patient could, by suggestion, make him or her oblivious to pain, a few Physicians began to look up magnetism as a possible surgical anesthetic. John elliotson suggested that mesmerism could be used during surgery, but the medical establishment for baited even when other anesthetics were not available. In 1842 W. S. Ward performed a leg amputation in which the patient was magnetized, but some physicians accused the patient of being an imposter. Other Physicians said that patients should suffer pain during an operation because it helps them recover better. In India, James Esdaile, a surgeon with the British Army in Calcutta, performed more than 250 painless operations on Hindu conference, but his results were dismissed because his operations had been performed on natives and therefore had no relevance to England. about this time, anesthetic gases were discovered, and interest in magnetism as an anesthetic faded almost completely. The use of gases was much more compatible with the training of the Physicians of the day then where the mysterious forces involved in magnetism or somnambulism. James Braid, a prominent Scottish surgeon, was skeptical of magnetism, but after carefully examining a magnetized subject, he was convinced that many of the effects were real. Braid proceeded to examine the phenomenon systemically, and in 1843 he wrote 'The Rationale of Nervous Sleep'. Braid explain magnetism in terms of prolonged concentration and the physical exhaustion that followed, stressing that the results are explained by the subject's suggestibility rather than by any power that the magnetizer possessed. He renamed the study of the phenomenon neurohypnology, which was then shortened to hypnosis (hypos is the Greek word for sleep). Braid did as much as anyone to make the phenomenon previously known as magnetism, mesmerism, or somnambulism respectable within the medical community. the Nancy school: Convinced of the value of hypnosis, Augustus Ambrose Liébeault wanted to use it in his practice but could find no patient willing to be subjected to it. Eventually, he agreed to provide free treatment any patient willing to undergo hypnotism. A few patients agreed, and he was so successful that his practice was quickly threatened by any excess of non-paying patients. Soon he was treating all his patients with hypnotism and accepting whatever fee they could afford. A school grew up around his work, and because he practiced in a French village just outside of the city of Nancy it was called the Nancy School. The School attracted a number of Physicians; among them Hippolyte Bernheim, who became the major spokesperson of the Nancy school. bernheim contended that all humans are suggestible that some are more suggestible than others, and highly suggestible people are easier to hypnotize than those less adjustable. Furthermore, Bernheim found that whatever a highly suggestible patient believed would improve his or her symptoms usually did so. Jean-Martin Charcot: When Jean-Martine Charcot became the director of La Salpêtrière (the institution where Pinel had released the patients from their chains) in 1862, he immediately converted it into a research center. Though flamboyant, Charcot was considered one of the most brilliant physicians in all of Europe. Space does not permit presenting a complete list of Charcot's impressive accomplishments as a neurologist, but a sample includes the following: He carefully observed his patients' symptoms, and upon their death he correlated those symptoms with specific abnormalities in the brain and spinal cord. He and his colleagues identified features of the spinal cord associated with poliomyelitis and multiple sclerosis. He described a disease of the motor neurons still referred to as Charcot's disease. He helped identify brain structures associated with a number of behavioral and physiological functions. And he instituted temperature taking as a daily Hospital routine. Because of these and other accomplishments, Charcot's La Salpêtrière became a place of pilgrimage for Physicians from throughout the world; it became 'the mecca of neurologists.' Among those attending Charcot's lectures and demonstrations were Alfred Binet, William James, and Sigmund Freud, we studied with Charcot from October 13th 1885 to February 28th 1886. Pierre Janet was Charcot's student, and he agreed with his mentor that for some individuals, aspect of the personality could become dissociated, or split off, and these dissociated aspects of the personality could manifest themselves in hysterics symptoms or in hypnotic phenomena. Janet, like Charcot, speculated that both might result from the subconscious influence of dissociated aspects of Personality. He noticed that the dissociated aspects of a patient's personality quite often consists of traumatic or unpleasant memories, and it was there for the therapist's task to discover these memories and make the patient aware of them. Hypnosis was used to discover these dissociated memories, and when they were brought to the attention of a patient, his or her hysterical symptoms often abated. As was the case with Charcot, we see much in Janet's work that anticipated Freud's. Even the names used to describe their methods were similar; Janet called his method psychological analysis, and Freud called his psychoanalysis. The ideas of Janet and Freud were so similar that there was a dispute between the two over priority.

Pierre Janet

Like Charcot, theorized that components of the personality, such as traumatic memories, could become dissociated from the rest of the personality and that these dissociated components are responsible for the symptoms of hysteria and for hypnotic phenomena.

Benjamin Rush

Often called the first U.S. psychiatrist. Rush advocated the human treatment of mental illness but still clung to some earlier treatments, such as bloodletting and the use of rotating chairs.

Briefly describe the life and work of Philippe Pinel (1745-1826), Benjamin Rush (1745-1813), Dorothea Lynde Dix (1802-1887), Emil Kraepelin (1856-1926), and Lightner Witmer (1867-1956). (pp. 496-502)

Philippe Pinel: Philippe Pinel came from a family of Physicians and received his medical degree in 1773 from the University of Toulouse. He moved to Paris, where he concentrated on training the that city's poor people. Pinel became interested in mental illness when a close friend became afflicted with mental disorder and female could not treat him. The work of Joseph Daquin believed that mental illness was a natural phenomenon that should be studied and treated by means of the methods of natural Science. Pinel and duck on became close friends, and to Daquin dedicated the second edition of his book 'Philosophy of Madness' to Pinel. In 1793 he was appointed director of the Bicêtre asylum, which had been an institution for the insane since 1660. On touring the facility, Pinel found that most inmates were chained in guards patrol the walls to prevent escape. Pinel ask for permission to release the prisoners from their chains. The first inmate to be unchained was an English soldier who had once crushed a guard's skull with his chains and was considered to be a violent person. Once released from his chains, the man proved to be nonviolent, and he helped Pinel care for the other inmates. Two years later, the soldier was released and pinnell gradually removed more inmates from the constraints, improved rations, stopped bloodletting, and forbade all harsh treatment. He segregated different types of patients, encouraged occupational therapy, favored bathing and mild purgatives as physical treatments, and argued effectively against the use of any form of punishment or exorcism. In addition, Pinel was the first major sites case histories and statistics on his patients, including a careful record of cure rates. In Britton, William Tuke, a Quaker and a prosperous retired tea and coffee merchants with no medical training, visited a lunatic asylum and was horrified by what he saw. He dedicated the remaining 30 years of his life to improving the plight of those with mental illness, and in 1792 he founded the York retreat. At The retreat, designed more like a farm than a prison, inmates were given good food, Freedom, respect, medical treatment, recreation, and religious instruction. In 1788 Italian physician Vincenzo Chiarugi was appointed superintendent of ospedale di Bonifazio, a newly-opened hospital for mental illness in Florence. Even before pee now, Chiarugi had argued that those with mental illness should be spared physical restraint and harsh treatment. He also provided work and recreational activities for his patients and recorded detailed case histories. Chiarugi's advice for dealing with mental illness has a particularly modern ring to it. Pinel's work was guided primarily by the psychological model of mental illness, and Chiarugi's work was guided primarily by the medical model. Benjamin Rush: Benjamin Rush had among his friends Thomas Jefferson and John Adams, and he served as surgeon General of the army under George Washington. As a member of the Continental Congress, he was one of the original signers of the declaration of Independence. Rush had many strong convictions: he argued for the abolition of slavery; he opposed capital punishment, public punishment, and the inhumane treatment of prisoners; he advocated the education of women; and he argued for a greater emphasis on practical information in school curricula. He was the first US psychiatrist. he believed that bloodletting relieved vascular congestion, that rotating relieved the patient's congested brain, and that strapping a patient's arms and legs in a so-called tranquilizing chair come to the patient. Dorothea Lynde Dix: Also in the United States, Dorothea Lynde Dix in 1841 began a campaign to improve the conditions of the mentally ill. In 1841, when Dix have begun her campaigning, Mental hospitals housed only about 15% of those needing care; by 1890, that figure had risen to about 70%. To a large extent, the Improvement was due to her efforts. Alexander and Selesnick speculate that there were three reasons for the patients for treatment, even after it was no longer believed that they were possessed by demons. The reasons were ignorant of the nature of mental illness, fear of those with mental illness, and the widespread belief that mental illness was incurable. The work of such individuals as Kraepelin, Witmer, and the early hypnotists dramatically improved the understanding and treatment of mental illness. Emil Kraepelin: Emil Kraepelin, a German psychiatrist who did postdoctoral research with Wundt, attempted to do for mental disorders what Wundt and his colleagues attempted to do for Sensations—classify them. In 1883 grapeland published a list of mental disorders that was so through it was adopted the world over and has lasted until recent times. He based his classification of mental diseases on what caused them, how much they involved the brain and nervous system, their symptoms, and their treatment. Some of the mental illness Kraepelin listed for dementia praecox, paranoia, manic depression, and neurosis. Kirkland's friend, neurologist Alois Alzheimer, observed that a general loss of memory, reasoning ability, and comprehension sometimes accompanies old age. It was Kraepelin who dubbed this condition Alzheimer's disease. Kraepelin believe that most major mental illnesses, such as dementia praecox, are incurable because they are caused by constitutional factors. When the Swiss psychiatrist Eugen Bleuler found that dementia praecox could be successfully treated, he changed the name of the disease to schizophrenia, which literally means "a splitting of the personality." The DSM, is a direct descendant of Kraepelin's earlier work. Kraepelin and Psychopharmacology. Kraepelin was among the first, if not the first, to systematically study the effects of drugs on various cognitive and behavioral functions. In the early 1880s, while studying in Wundt's laboratory, he studied the effects of poisons, such as alcohol, on various mental functions. Upon leaving Leipzig to take his academic post at Dorpat, he and his assistants continue to study what, in 1892, Kirkland called pharmacopsychology. Lightner Witmer: Lightner Witmer earned his Doctorate under Wundt. After taking a class from James McKeen Cattell, Witmer resigned his position at rugby and entered graduate school. Cattell put Witmer to work studying individual differences in reaction times. He intended to earn his Doctorate under Cattell, but when Cattell moved to Columbia, Witmer went to Leipzig for his advanced degree. Witmer's training at Leipzig coincided with Titchener's. In 1894 the university created special courses for public school teachers, and Witmer became involved in those courses. One teacher's description of the problem the student was having learning to spell strengthened witmer's developing belief that psychology should provide practical information. The student was a fourteen-year-old boy who had what would probably be diagnosed today as dyslexia. Witmer decided to work with the students, and this marked the beginning of his career as a clinical psychologist. In 1896 Witmer founded the world's first Psychological clinic at the University of Pennsylvania, only 17 years after the establishment of Wundt's experimental laboratory. In 1907 Witmer found at the 'Psychological Clinic Journal', which was instrumental in promoting and defining the profession of clinical Psychology. The journal continued publication until 1935. To Witmer and others, a new profession was clearly emerging, and it needed to have a name. In the opening article of the first issue of his journal, Witmer named the profession Clinical Psychology. In 1908 Witmer established a residential school for the care and treatment of retarded and troubled children. This was the first of several such schools that he established. In the same year, Witmer began publishing articles that were highly critical of what he viewed as unscientific, or even fraudulent, ways of treating mental illness. He was especially critical of William James because of James's interest in supernatural phenomena. McReynolds argues that Witmer should be considered the founder of clinical Psychology, but he recognizes That others may argue that Freud, Binet, or Rogers should be getting that honor. In Witmer's case the designation of founder is based primarily on the following six pioneering achievements: 1) He was the first to enunciate the idea that the emerging scientific psychology could be the basis of a new helping profession. 2) He established and developed the first facility to implement his idea—a Psychological clinic, headed by a psychologist and primarily staffed by psychologists. 3) He proposed the term clinical Psychology for the new profession and outlined its original agenda. 4) He conceptualized, organized, and carried out the first program to train clinical psychologist in the sense he defined. 5) Through his founding and longtime editor ship of the journal, the Psychological clinic, specifically intended to be the organ of the new profession, he further to find the area, publicized it, and attracted Young persons to it. 6) Through his own activities in performing the kinds of professional activities that he envisaged for clinical psychologists, he served as a role model for early members. As far as clinical Psychology is concerned, however, Witmer made 3 lasting Impressions: (a) the idea that scientific psychology, and its rigorous experimental sense, can, if appropriately utilized, be useful in helping people; (b) the conception that this help can best be provided through the instrument of a special profession (clinical Psychology) that is independent of both medicine and education; and (c) a commitment to the view that clinical Psychology should itself be highly research-oriented and should be closely allied with basic psychology. As far as Witmer was concerned, clinicians should be scientists—scientists who apply their knowledge to helping troubled individuals.

Identify and describe the general features of early approaches to treating mental illness, as well as the three classes of early treatment. Specify which of these approaches returned later in history and describe the nature of this return. (pp. 489-495)

Psychotherapy is any attempt to help person with a mental disturbance. No matter what its form, cost or setting, all that is meant by psychotherapy is the service that one human being, a helper, renders another, sufferer, toward the end of promoting the ladders well-being. The common elements in both ancient and modern forms of psychotherapy are a sufferer, a helper, and a systemized ritual through which help is proffered. Although the specific purposes in Consulting a psychotherapist are as numerous and unique as the individuals who seek such help, the basic reasons have always been to obtain assistance in (1) removing, modifying or controlling anxiety, depression, alienation, and other distressing psychological States, (2) changing undesirable patterns of behavior such as timidity, over aggressiveness, alcoholism, Disturbed sexual relationships, and the like, or (3) promoting more positive personal growth and the development of greater meaning in one's life through effective personal functioning, or through the pursuit of new educational, occupational, recreational, or other goals which will better allow expression of the individuals potential. The Psychological Approach: when psychological factors such as fear, anxiety, frustration, guilt, or conflict were viewed as the process of mental illness, treatment was aimed at those factors. Methods used throughout history to address psychological factors thought to be responsible for mental illness include having the individual observe (such as by watching a drama) or personally reenact the traumatic experience in order to create a catharsis (purging the mind of disturbing emotions); having the person listen to relaxing music; offering support, reassurance, and love from authority figures or relevant others; analyzing dreams, thoughts, and motives; and attempting to teach the sufferer new and more effective skills to enable better coping with personal or interpersonal problems. Today the last method would exemplify behavior therapy. Generally, natural law is the belief that you get what you deserve in life. The implications for psychotherapy are clear. To alleviate suffering, the patient must change his or her ways, and it is his therapist's job to help him or her do so. The Supernatural Approach: If it was believed that evil forces entering the body caused illness, bernecker would involve removing those forces. In attempting to coax the invading forces from an infected person's body, the primitive medicine with use appeal, bribery, reverence, and intimidation—and sometimes exorcism, magic rituals, and incantations. In his famous book 'The Golden Bough', Sir James Frazer discussed sympathetic magic, which, for primitive humans, was extremely important in the explanation and treatment of ailments. Fraser distinguished between two types of sympathetic magic: homeopathic and contagious. homeopathic magic was based on the principle of similarity. An example of homeopathic magic is the belief that what one did to a model or image of a person would affect that person. contagious magic, which was based on the principle of contiguity, involved the belief that what was once close to or part of someone would continue to exert an influence on that person. Bleeding a patient or removing a section of his or her skull were apparently also widely used to allow evil spirits to escape from the body. thousands of prehistoric human skulls have been found throughout the world with man-made openings in them. These skulls display and opening made by chipping away at it with a sharp Stone, a procedure known as trepanation. The Biological Approach: As early as 3000 BC, the Egyptians showed great proficiency in treating superficial wounds and setting fractures. Hippocrates was among the first to liberate medicine and psychiatry from their magico religious background. The Greeks, starting with Thales, had a tendency to replace mystical explanations with naturalistic explanations. epocrates applied the naturalistic outlook to the workings of the human body. In addition to believing that physical health was associated with a balance among the four humors of the body, the Hippocratics implicated the brain as a source of mental health or illness. Hippocratic identified several mental illnesses. Asteria is a term used to describe a wide variety of disturbances such as paralysis, loss of sensation, and disturbances of sight & hearing. The Hippocratic accepted the earlier Greek and Egyptian convention that hysteria is a uniquely female affliction. Hystera is the Greek word for uterus, and it was believed that the symptoms of Hysteria are caused by the uterus wondering to various parts of the body. Although later proven false, this view of Hysteria represents the biological approach to explaining mental illness. The Return of the Supernatural Approach: When the Romans came to power, they adopted much of the Greek emphasis on knowledge and reason even though they were more concerned with law, technology, and the military then were the Greeks. With the collapse of the Roman empire came and almost complete regression to the non rational thinking that had characterized the time before the Greek naturalists. Although w. B. Maher & B. A. Maher refer to be therapeutic practices that occurred during the middle Ages as eclectic, the emphasis was on exorcising demons. Even with the preoccupation with demons and exorcism, however, witch hunts were not typical during the middle Ages. Witch-hunts occurred primarily during the Renaissance and the Reformation. Witch Hunts. Magic, sorcery, and witchcraft have been practiced since the dawn of human history. In Christian Europe, prior to about the middle of the 14th century, such activities were typically viewed as remnants of paganism and were discouraged with relatively mild sanctions and punishments. During this period, the existence of witches (those in consort with the devil) and witchcraft (the evil work performed by witches) were taken for granted by almost everyone in Europe, especially Eastern Europe. Eventually, the church became so concerned with witches and their evil deeds that a wholesale, institutionalized persecution of them was begun. The result was a rain of terror that group to Europe for about three centuries. According to Zusne and Jones, the European persecution of witches occurred mostly between 1450 and 1750, with its peak around 1600. On December 9th, 1484, Pope Innocent VI I I issued a Papal bull (an official document) that authorized the systematic persecution of witches. In his bowl, the pope authorized Heinrich Kramer and James Springer, both Dominican priest and professors of theology, to act as inquisitors in northern Germany. To guide their work, Kramer and sprenger wrote 'Malleus Maleficarum' (The witches hammer). Please refer to page 493.

Emil Kraepelin

Published a list of categories of mental illness in 1883. Until recent times, many clinicians used this list to diagnose mental illness. Today the Diagnostic and Statistical Manual of Mental Disorders.

supernatural model of mental illness

The assumption that mental illness is caused by malicious, spiritual entities entering the body or by the will of God.

medical model of mental illness

The assumption that mental illness results from such biological causes as brain damage, impaired neural transmissions, or biochemical abnormalities.

psychological model of mental illness

The assumption that mental illness results from such psychological causes as conflict, anxiety, faulty beliefs, frustration, or traumatic experience.

natural law

The belief prevalent in the 18th century that undesirable or sinful behaviour has negative consequences such as a mental or physical disease or poverty, and virtuous behavior has positive consequences such as good health or prosperity.

sympathetic magic

The belief that by influencing things that are similar to a person or that were once close to that person, one can influence the person.

Identify and describe the three classes of early explanations of mental illness. (pp. 487-488)

The proposed explanations of mental illness that have been offered throughout history fall into three General categories: biological, psychological, and supernatural. Biological: Generally, biological explanations of abnormal behavior constitute the medical model of mental illness. This model assumes that all disease is caused by the malfunctioning of some aspect of the body, mainly the brain. The bodily abnormalities causing mental illness can be inherited directly, as was supposed to be the case with natural fools. Many events interfere with the normal functioning of the body. Such events include injuries; tumors and obstructions; ingestion of toxins; polluted air, water, or food; disease; excessive physical stress; and physiological imbalances such as those caused by improper diet. Psychological: A psychological model of mental illness proposes that psychological events are the causes of abnormal behavior. Here, psychological experiences such as grief, anxiety, fear, disappointment, frustration, guilt, or conflict are emphasized. How much psychological explanations were stressed buried with time and place. Supernatural: In primitive times, people attributed most elements not caused by obvious things—such as falling down, being attacked by an animal or an enemy, or overeating or drunkeness—2 mysterious forces entering the body. People did not distinguish between mental and physical disorders but believed both to be inflicted on a person buy some moral or immoral being. This constitutes the supernatural model of mental illness.

artificial somnambulism

The sleeplike trance that Puysegur created in his patients. It was later called a hypnotic trance.

trephination

The technique of chipping or drilling holes in a person's skull, presumably used by primitive humans to allow evil spirits to escape.

posthypnotic amnesia

The tendency for a person to forget what happens to him or her while under hypnosis.

contagion effect

The tendency for people to be more susceptible to suggestion when in a group than when alone.

homeopathic magic

The type of sympathetic magic involving the belief that doing something to a likeness of a person will influence that person.

Describe the psychological and medical models of mental illness and the tension between these models. Describe the views of Thomas Szasz regarding the medical model. (pp. 502-504)

This return to naturalism was both good and bad for psychology. It was good because it discourage mysticism and Superstition. No longer did people use evil demons, spirits, or forces to explain mental illness. On the negative side, it discouraged a search for the psychological factors underlying mental illness, for it suggested that a search for such factors was a return to demonology. By the mid-nineteenth century, the dominant belief was that the cause of all illness, including mental illness, was disordered physiology or brain chemistry. This belief retarded psychology's search for psychological causes of mental illness, such as conflict, frustration, emotional disturbance, or other cognitive factors. Under the organic, or medical, model of mental illness, psychological explanations of mental illness or suspect. Because it was generally believed that all disorders had an organic origin, classifying mental diseases just as organic diseases had been classified made sense, and this is what Kraepelin attempted to do. The debate still exists between those who seek to explain all human behavior in terms of physiology or chemistry (those following a medical model) and those who stress the importance of mental variables such as conflict, frustration, anxiety, fear, and unconscious motivation (those following a psychological model). This debate is illustrated in the explanations currently offered for alcoholism. those individuals accepting the medical model claim that alcoholism is a disease that either is inherited (perhaps only as a predisposition) or results from a biochemical imbalance, a metabolic abnormality, or some other biological condition. those individuals accepting the psychological model are more likely to emphasize the alcoholic's life circumstances in their explanation—circumstances that caused the stress, frustration, conflict, or anxiety from which the alcoholic is presumably attempting to escape. Some believe that unless an illness has a neurophysiological basis, it is not an illness at all. That is, it is possible for a brain to be diseased and caused various behavior disorders, but in such a case there is no mental illness, only an actual physical disease or dysfunction. For example in his influential book "The Myth of Mental Illness", Thomas Szasz, himself a psychiatrist, contends that what has been and is labeled a mental illness reflects problems in living or nonconformity but not true illness. therefore according to him, the diagnosis of mental illness reflects a social, political, or moral judgment, not a medical one. Of course, problems and living are very real and can be devastating enough to require professional help. According to him, psychiatry and clinical Psychology are worthy professions if they view those whom they help as clients rather than patients and have as their goal helping people to learn about themselves, others, and life. They are invalid, or pseudo-sciences, if they view their goal as helping patients recover from mental illness. Szasz argues that the belief that mental illness is a real illness has hurt many more people than it has helped. For one thing, he says, to legal problems in living as an illness or as a disease implies that a person is not responsible for solving those problems, that they are circumstances beyond his or her control. Furthermore, Szasz, and others, observe that diagnosing a person as having a particular mental illness May encourage him or her to think and act in ways dictated by the diagnosis.

What is mental illness? Identify and describe the four themes that govern the definition of mental illness. (pp. 486-487) Comment: As Hergenhahn notes in this chapter, there has always been a tension between the medical model perspective and psychological model perspective on behavioral disorders. The label "mental illness" assumes that behavioral disorders are illnesses that should be treated within the framework of the medical model. The medical model and the psychological model often lead to very different treatments. For example, for much of the nineteenth and twentieth centuries, the medical model dictated that people with behavioral disorders be housed in mental hospitals, where they were encouraged to remain calm and spend a good deal of time in bed, much like people recovering from a physical disease. However, the psychological approach dictated just the opposite: People with behavioral disorders should be encouraged to remain in their natural environment and to function independently as much as possible.

Today, besides the term mental illness, we use such terms as psychopathology and abnormal behaviour. At earlier times, terms such as mad, lunatic, maniac, and insane have been used. Harmful Behavior: Normal individuals possess a powerful motive to survive, and therefore Behavior contrary to that motive, such as self-mutilation or suicide, is considered abnormal. Unrealistic Thoughts And Perceptions: If a person's beliefs or perceptions differ markedly from those considered normal at a certain time and place in history, those beliefs and perceptions are taking as signs of mental illness. using today's terminology, we say that people are having delusions if their beliefs are not shared by other members of the community. Similarly, people are considered abnormal if their perceptions do not correspond to those of other members of the community. Both false beliefs (delusions) and false perceptions (hallucinations) have traditionally been taken as representing unrealistic contact with reality and therefore as abnormal. Inappropriate Emotions: Inappropriate or exaggerated emotional responses have been and are still standard criteria used in labeling a person as mentally ill. Unpredictable Behavior: Sudden shift in one's beliefs or emotions have also traditionally been taken as signs of psychopathology. What these criteria of mental illness all have in common is that they Define abnormality in terms of the behavior and thought processes of the average person in a community. Of course, characteristics of this average person will vary according to the mores of his or her culture. This means that two categories of people are susceptible to being labeled mentally ill: those who for one reason or another cannot abide by cultural norms and those who choose not to.

Jean-Martin Charcot

Unlike most of the physicians of his day, concluded that hysteria was a real disorder. He theorized the inherited predisposition toward hysteria could become actualized when traumatic experience or hypnotic suggestion causes an idea or a complex of ideas to become dissociated from consciousness. Isolated from rational control, such dissociated ideas become powerful enough to cause the symptoms associated with hysteria, for example, paralysis.

Franz Anton Mesmer

Used what he thought were his strong magnetic powers to redistribute the magnetic fields of his patients, thus curing them of their ailments.

Lightner Witmer

founder of clinical psychology