Chapter 2- Earliest Views of Abnormal Behavior
Avicenna from Persia (BC 980-1037)
"prince of physicians" and author of The Canon of Medicine
The Anatomy of Melancholia was written in
1621
The National Institutes of Metal Health was organized in
1946
The need for reform in psychiatric hospitals was a prominent concern of many professionals and laypersons alike during the
1950s and 1960s
Dorthea Dix is credited with establishing
32 mental hospitals
The first mental hospital was established in
Baghdad in AD 792
St. Mary of Bethlem became called
Bedlam
The brain is described probably for the first time in history in the
Edwin Smith Papyrus
Our efforts to understand psychological causation of mental disorder starts with
Franz Anton Mesmer
Erik Kraepelin (1856-1926)
German psychiatrist who played an enormous role in the development of methods for classifying different types of abnormal behavior
Wilhelm Griesinger (1817-1868)
German psychiatrist who wrote the textbook The Pathology and Therapy of Psychic Disorders
In 1547 the monastery of St. Mary of Bethlem in London was officially made into an asylum by
Henry VIII
Chung Ching
Hippocrates of China; wrote two well-known medical works around AD 200
In 1784, the French physician Philippe Pinel (1745-1826) was placed in charge of
La Bicetre
On the Deceits of the Demons contained a step by step rebuttal of the
Malleus Maleficarum
The systematic treatise on psychiatry in America that came out in 1812 and was written by Benjamin Rush is the
Medical Inquires and Observations upon Diseases of the Mind
In 1583 Johann Weyer published
On the Deceits of the Demons
Freud and Breuer's joint paper
On the Psychical Mechanisms of Hysterical Phenomena
Aristotle was the pupil of
Plato
The Anatomy of Melancholia was written by
Robert Burton
In 1879 Wilhelm Wundt established the first experimental psychological laboratory at the
University of Leipzip
Johann Weyer (1515-1588)
a German physician and writer who wrote under the Latin name of Johannes Wierus and was ahead of his time
Paracelsus (1490-1541)
a Swiss physician and early critic of superstitious beliefs about possession
Richard von Krafft-Ebing
a Viennese psychiatrist that conducted experiments showing that exposing patients with paresis to matter from syphilitic sores did not lead to the development of syphilis, which suggested that they must already have been infected
Clifford Beers (1876-1943)
a Yale graduate who described his own struggle with mental illness and the mistreatment he received in three different institutions and wrote the nook A Mind That Found Itself in 1908
References to abnormal behavior in early writings show that the Chinese, Egyptians, Hebrews, and Greeks often attributed such behavior to
a demon or god who had taken possession of person
The Hill-Burton Act of 1946 and the Community Mental Health Act of 1963 helped to create
a far-reaching set of programs to develop outpatient psychiatric clinics, inpatient facilities in general hospitals, and community consultation and rehabilitation programs
Philippe Pinel's work at La Bicetre Asylum was
a great success
La Bicetre Asylum
a hospital in Paris
After approximately 200 years of inhumane treatment in asylums, several leading physicians in Europe began to make reforms that proposed
a much more humanitarian treatment of patients
Hippocrates considered dreams to be important in understanding
a patient's personality
York Retreat
a pleasant country house where patients with mental illness lived, worked, and rested in a kindly, religious atmosphere
Hill-Burton Act of 1946
a program that funded community mental health hospitals
Henry Cotton
a psychiatrist at a New Jersey hospital who developed a theory that mental health problems such as schizophrenia could be cured by removing the infections that he believed caused the condition
Lobotomies
a surgical procedure that disconnects the prefrontal area from the rest of the brain
Mesmer believed that the planets affected
a universal magnetic fluid in the body, the distribution of which determined health or disease
The National Institutes of Metal Health provided
active support for research and training through psychiatric residencies and (later) clinical psychology training programs
Sanguine
active, optimistic
The treatment techniques for patients with mental illness in the United States were
aggressive
Choleric
agitated, irritable
The Pathology and Therapy of Psychic Disorders insisted that
all mental disorders could be explained in terms of brain pathology
In attempting to find cures for mental disorders, Mesmer concluded that
all people possessed magnetic forces that could be used to influence the distribution of the magnetic fluid in other people, thus effecting cures
Franz Anton Mesmer (1734-1815)
an Austrian physician who further developed the ideas of Paracelsus about the influence of the planets on the human body
William Tuke (1732-1822)
an English Quaker who established the York Retreat
Most possessions were considered to be the work of
an angry god or an evil spirit
Dorthea Dix (1802-1887)
an energetic New Englander who became a champion of poor and "forgotten" people who had been consigned to prisons and mental institutions for decades during the nineteenth century
Robert Burton (1576-1640)
an enlightened scholar who wrote The Anatomy of Melancholia
he typically accused witch during the Middle Ages was
an impoverished woman with a sharp tongue and a abd temper
Hypnosis
an induced state of relaxation in which a person is highly open to suggestion, first came into widespread use in late-eighteenth and early-nineteenth- century France
Trepanation
ancient practice of drilling holes in skull to release evil spirits
Mesmer gained a broad following in Paris in 1778 when he opened a clinic in which he treated all kinds of diseases by using
animal magnetism
Beginning in the sixteenth century, societies began to put people determined to be suffering from mental illness into
asylums
Four major advances in the nineteenth and twentieth centuries that changed the way that abnormal behavior was viewed and treated are
biological discoveries, the development of an agreed-upon classification system for mental disorders, the emergence of scientifically informed views about the causes of abnormal behavior, and the emergence of experimental psychology
The four elements of the material world combined to form the four essential fluids of the body which are
blood (sanguis), phlegm, bile (choler), and black bile (melancholic)
Chung Ching's treatments utilized
both drugs and the regaining of emotional balance through appropriate activities
Hippocrates believed that mental disorders were due to
brain pathology
The Snake Pit
called attention to the plight of patients with mental illness and helped to create concern over the need to provide more humane mental health care in the community in place of the overcrowded mental hospitals
Phlegmatic
calm, relaxed
Hippocrates believed that the brain was the
central organ of intellectual activity
Erik Kraepelin noted that
certain symptoms occurred together regularly enough to be regarded as specific types of mental disease
During the latter part of the Middle Ages and the early Renaissance the superstitious beliefs that had hindered the understanding and therapeutic treatment of mental disorders began to be
challenged
Management of people who were mentally disturbed in the Middle Ages were left to the
clergy
Chung Ching based his views of physical and mental disorders on
clinical observations
Hippocrates relied heavily on
clinical observations
Residents of early asylums lived and died amid
conditions of incredible filth and cruelty
When people were thought to be possessed by a good spirit or god they were often treated with
considerable awe and respect
In The Anatomy of Melancholia those physically possessed were
considered mad
Lightner Witmer (1867-1956)
considered to be the founder of clinical psychology
Emil Kraepelin (1856-1926)
credited with paving the way for the modern view of psychiatry; his classification schema is still cited today; and he identified manic depression as a major category of depression
Mesmerism was
debunked
St. Mary of Bethlem became widely known for its
deplorable conditions and practices
A.L.J. gave a complete and accurate
description of the symptom pattern of paresis and convincingly presented his reasons for believing paresis to be a distinct disorder
One of Aristotle's most lasting contributions to psychology are his
descriptions of consciousness
Sigmund Freud (1856-1939)
developed a comprehensive theory of psychopathology that emphasized the inner dynamics of unconscious motives (often referred to as psycho dynamics) that are at the heart of the psychoanalytic perspective
Sigmund Freud and Josef Breuer
directed patients to talk freely about their problems while under hypnosis
Catharsis
discharge of emotional tension associated with something, such as by talking about past traumas
Erik Kraepelin saw each type of mental disorder as
distinct from the others and thought that the course of each was as predetermined and predictable as the course of measles; so the outcome of a given type of disorder could presumably be predicted even if it could not yet be controlled
Plato shared the belief that mental disorders were in part
divinely caused
Although the development of antipsychotic medications is rightly seen as an enormous development in research and clinical practice, they
do not work for all patients and still come with some serious side effects
Alienists
early term for psychiatrists
Public perceptions of mental health began to change in the
early twentieth century
The four elements of the material world were thought to be
earth, air, water, and fire
Moral management achieved a surprisingly high degree of
effectiveness
Aristotle believed that "thinking" as directed would
eliminate pain and help to attain pleasure
Elementa Physoologiae Corporis Humani
emphasized the importance of the brain in psychic functions and advocated postmodern dissection to study the brains of the insane
At St. Mary of Bethlem the more violent patients were
exhibited to the public for one penny a look
Benjamin Rush (1745-1813)
father of American psychiatry and one of the signers of the Declaration of Independence and was the first American to organize a course in psychiatry
Hippocrates
father of modern medicine
Paracelsus insisted that mania should be treated as a
form of a disease
Asylums by Erving Goffman
further exposed the inhumane treatment of patients with mental illness and provided a detailed account of neglect and maltreatment in mental hospitals
Novel Targets
going after something other than dopamine activity
If a person's speech or behavior appeared to have a religious or mystical significance, it was usually thought that he or she was possessed by a
good spirit or god
The four elements of the material world had attributes of
heat, cold, moistness, and dryness
Hippocrates emphasized the importance of
heredity and predisposition
Asylums
historically, these were institutions mean solely for the care of the mentally ill
In the first mental hospitals individuals with mental disturbances received
humane treatment
The movement that began during the latter part of the Middle Ages and the early Renaissance, a movement began emphasizing the importance of specifically human interests and concerns is called
humanism
Avicenna frequently referred to
hysteria, epilepsy, manic reactions, and melancholia
With animal magnetism, it turns out that those who believed that they were exposed to magnetized objects
improved regardless of whether the objects actually were magnetized or not
Samuel Hitch's innovations
improved the care of patients and changed public attitudes toward people with mental disturbances
Animal Magnetism (Mesmerism)
in a dark room, patients were seated around a tub containing various chemicals, and iron rods protruding from the tub were applied to the affected areas of the patients' bodies. Accompanied by music, like a stage magician he appeared in a lilac robe, passing from one patient to another and touching each one with his hands or his wand. By doing this he was purportedly able to remove hysterical anesthesias and paralyses
Unconscious
in psychoanalytic theory, a major portion of the mind, which consists of a hidden mass of instincts, impulses, and memories and is not easily available to conscious awareness, yet plays a important role in behavior
After deinstitutionalization rates of hospitalization decreased as rates of this increased
incarceration
The Ebers Papyrus relies more on
incarnations and magic for explaining and curing diseases with unknown causes
The Lunacy Inquiry Act of 1842
included a requirement that asylums and houses be effectively inspected every 4 months to ensure proper diet and the elimination of the use of restraints
With the emergence of experimental science in the early 1700s, knowledge of anatomy, physiology, neurology, chemistry, and general medicine
increased rapidly
In The Republic, Plato emphasized the importance of
individual differences in intellectual and other abilities
Over time alienists became
influential as purveyors of morality, touting the benefits of Victorian morality as important to good mental health
Dorthea Dix carried a zealous campaign between 1841 and 1881 that aroused people and legislatures to do something about the
inhumane treatment accorded to people with mental illness
The Ebers Papyrus covers
internal medicine and the circulatory system
The treatment techniques for patients with mental illness in the United States were designed to
intimidate patients
Julius von Wagner-Jauregg
introduced the malarial fever treatment of syphilis and paresis after realizing that the high fever associated with malaria seemed to kill off the syphilis bacteria in 1917
Philippe Pinel
introduced the pre-modern view of melancholia as a disorder without the taint of demonic possession or ancient Greek humor and advanced our scholarly understanding of mental disorders by improving a classification scheme and examining the causes of the disorder
Samuel Hitch
introduced trained nurses into the wards at the Gloucester Asylum in 1841 and put trained supervisors at the head of the nursing staffs
Tranquilizing Chair
invented by Benjamin Rush and was used to temporarily restrain and treat violent patients by strapping down their limbs an restricting the movement of their head
In The Anatomy of Melancholia those spiritually possessed were
likely to be considered witches
The three general categories Hippocrates classified all mental disorders into are
mania, melancholia, and phrenitis (brain fever)
China was one of the earliest developed civilizations in which
medicine and attention to mental disorders were introduced
Aristotle (384-322 B.C.) wrote extensively on
mental disorders
Johann Weyer was one of the first physicians to specialize in the study and attempted treatment of
mental disorders
The Anatomy of Melancholia considered demonic possession a potential cause of
mental disorders
Johann Weyer argued that those accused of witchcraft were really
mentally ill and not deserving of persecution
Free Association
method for probing the unconscious by having patients talk freely about themselves, their feelings, and their motives
Dream Analysis
method involving the recording, description, and interpretation of a patient's dreams
Psychoanalysis
methods Freud used to study and treat patients
In the cae of witchcraft and mental illness, the confusion may be due, in part, to
misunderstandings about demonic possession
Johann Weyer's wide experience and progressive views justify his reputation as the founder of
modern psychopathology
Deinstitutionalization policy was considered
more humane and cost effective to treat those with severe mental illness in their own community
Benjamin Rush encouraged
more humane treatment of patients with mental illness
In early asylums inmates were treated
more like beasts than human beings
Over time alienists acquired
more status and influence in society
Mental Hygiene Movement
movement that advocated a method of treatment focused almost exclusively on the physical well-being of hospitalized mental patients
Deinstitutionalization
movement to close mental hospitals and treat people with severe mental disorders in the community
Edwin Smith Papyrus
named after its nineteenth-century discoverer; contains detailed descriptions of the treatment of wounds and other surgical operations
Hippocrates denied that deities and demons intervened in the development of illnesses and instead insisted that mental disorders had
natural causes and appropriate treatments
Chinese medicine was based on a belief in
natural rahter than supernatural causes for illnesses
Neurasthenia
nervous exhaustion
Since the development of chlorpromazine
no medications with novel targets have been developed for the treatment of psychotic disorders
Paracelsus insisted that mania was
not a possession but a form of disease
Dorthea Dix organized the nursing forces of the
nursing forces of the Union Army during the Civil War
The origins of much of the scientific thinking in contemporary psychology lie in early rigorous efforts to study psychological processes
objectively
Galen (AD 130-200)
one of the most influential Greek physicians who practiced in Rome
Chung Ching believed that stressful psychological conditions could cause
organ pathologies
By 1940 the public mental hospitals housed
over 400,000 patients, roughly 90% of whom resided in large state-funded hospitals; the remainder resided in private hospitals
The Country Asylums Act
passed in England in 1845 and required every county to provide asylum to "paupers and lunatics"
The Public Hospital in Williamsburg was the first in the United States devoted exclusively to
patients with mental illness
Early asylums were primarily modifications of
penal institutions
Melancholic
pensive, thoughtful
The Ebers Papyrus offers a
perspective on treatment
Galen took a scientific approach to the field, dividing the causes of psychological disorders into
physical and mental categories
During the early medieval period, "treatment" for people with mental disturbances consisted of
prayer, holy water, sanctified ointments, the breath or spittle of the priests, the touching of relics, visits to holy places, and mild forms of exorcism
Around 400 B.C.E. the ancient Greeks shifted the understanding of mental disorders from the work of supernatural forces to
problems in the human body
Mary Jane Ward
published The Snake Pit in 1946
Jean Delay and Pierre Deniker are two French psychiatrists who, in the 1950's, found that chlorpromazine, a drug originally developed for completely different purposes, was very effective at
rapidly reducing psychotic and manic symptoms
In the Middle Ages monasteries served as
refuges and places of comfort
Exorcism
religiously inspired treatment procedure designed to drive out evil spirits or forces from a "possessed" person
Asylums were initially created to
remove from the community troublesome individuals who could not care fore themselves
Plato viewed psychological phenomena as
responses of the whole organism reflecting its internal state and natural appetites
The treatment techniques for patients with mental illness in the United States aimed at
restoring a physical balance in the body and brain
Hippocrates believed that hysteria was
restricted to women and caused by the uterus wandering to various parts of the body pining for children and believed marriage was the best remedy
Hippocrates' emphasis on the natural causes of diseases, on clinical observation, and on brain pathology as the root of mental disorders was
revolutionary
The movement to change the mental hospital environment was enhanced significantly by
scientific advances in the last half of the twentieth century, particularity the development of effective medications for many disorders
During the latter part of the Middle Ages and the early Renaissance, this reemerged
scientific questioning
The Middle Ages in Europe were largely devoid of
scientific thinking and humane treatment for those with mental illness
Chinese medicine reached a relatively sophisticated level during the
second century
At St. Mary of Bethlem the more harmless inmates were forced to
seek charity on the streets of London
Hippocrates pointed out that injuries to the head could cause
sensory and motor disorders
During the latter decades of the twentieth century vigorous efforts were made to
shut down mental hospitals an return psychiatric patients to the community in order to provide more integrated and humane treatment
In The Republic, Plato took into account
sociocultural influences in shaping thinking and behavior
Erving Goffman
sociologist who wrote in Asylums in 1961
The Pennsylvania Hospital in Philadelphia provided patients with mental illness with
some cells or wards
Plato (427-347 BC)
studied individuals with mental disturbances who had committed criminal acts and how to deal with them
The effects of animal magnetism were due to the power of
suggestion (hypnosis) rather than to animal magnetism
Chinese views of mental disorders regressed to a belief in
supernatural forces as casual agents
When people were thought to be possessed by a good spirit or god they believed they had
supernatural powers
In the 1920s through the 1940s, American psychiatrist Walter Freeman followed the strategies developed by Portugese psychiatrist Egas Moniz to treat severe mental disorders using
surgical procedures called lobotomies
Today we have penicillin as an effective, simpler treatment of
syphilis
Richard von Krafft-Ebing established the relationship between
syphilis (a biological connection) and general paresis (a mental disorder)
Benjamin Rush wrote the first
systematic treatise on psychiatry in America
According to the early writings of the Chinese, Egyptians, Hebrews, and Greeks whether the "possession" was assumed to involve good spirits or evil spirits typically depended on
the affected individuals symptoms
Galen made a number of original contributions concerning
the anatomy of the nervous system based on dissections of animals
The discovery of a cure for general paresis began in 1825 when the French physician A. L. J. Bayle suggested that
the collection of symptoms seen in those with general paresis are one specific type of mental disorder
Britain's policy of providing more humane treatment to people with mental illness was substantially expanded to
the colonies
One of the earliest known writings on the use of drugs to treat mental disorders is the work of the Roman physician Galen who describes
the concoction of various medications and the clinical use of drug therapy with patients experiencing mental disorders
The changing view of the relationship between witchcraft and mental illness points to the issue of
the difficulties of interpreting historical events accurately
Maher and Maher pointed out that the best known of the earlier paradigms for explaining personality or temperament is
the doctrine of the four humors, associated with Hippocrates and later with the Roman physician Galen
Psychiatrists in the nineteenth century thought that emotional problems were caused by
the expenditure of energy or by the depletion of bodily energies as a result of excess in living
In some monasteries and shrines in the Middle Ages exorcisms were performed by
the gentle "laying of hands"
During the latter part of the Middle Ages and the early Renaissance, a movement began emphasizing
the importance of specifically human interests and concerns
Johann Weyer was deeply disturbed by
the imprisonment, torture, and burning of people whose strange behavior led them to be accused of witchcraft
A major biomedical breakthrough came with the discovery of
the organic factors underlying general paresis-syphilis of the brain
Moral management in asylums emphasized
the patients' moral and spiritual development and the rehabilitation of their "character" rather than their physical or mental disorders
In the early part of the nineteenth century, mental hospitals were controlled essentially by laypersons because of
the prominence of moral managment in the treatment of "lunatics"
At La Bicetre Asylum Philippe Pinel instituted
the removal of chains from some of the patients as an experiment to test his vies that people with mental illness should be treated with kindness and consideration, as sick people
The earliest and long lasting views of personality "types"
the sanguine, the phlegmatic, the choleric, and the melancholic
In the Edwin Smith Papyrus the brain was recognized as
the site of mental functioning
Mesmerism
theory of "animal magnetism" (hypnosis) formulated by Anton Mesmer
Psychoanalytic Perspective
theory of psychopathology, initially developed by Freud, that emphasizes the inner dynamics of unconscious motives
In The Anatomy of Melancholia there were these two types of demonically possessed people
those physically possessed and those spritiually possessed
Hippocrates classified all mental disorders into
three general categories
Clues to the earliest treatments of diseases and behavior disorders are from
two Egyptian papyri from the sixteenth century B.C.; the Edwin Smith papyrus and the Ebers papyrus
Erik Kraepelin described and clarified
types of mental disorder, working out a scheme of classification that is the basis of the system that we still use today
Paracelsus experimented with
various chemicals as medications to treat human disorders
Moral Management
wide-ranging method of treatment that focuses on a patients social, individual, and occupational needs
The Malleus Maleficarum is a
witch-hunting book published in 1486
Albrecht von Haller (1708-1777)
wrote Elementa Physoologiae Corporis Humani in 1757
