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LESSON 3
PSYCHOPATHOLOGY IN HISTORICAL CONTEXT I
Throughout history, many societies have held quite different views of the problems that we consider to be mental disorders. The search for explanations of the causes of abnormal behavior dates to ancient times, as do conflicting opinions about the etiology of mental disorders. Ancient records attribute abnormal behavior to the disfavor of the gods or the mischief of demons.
Models for Studying Psychopathology
- Supernatural Model
- Biological Model
- The Psychological Model
What purpose do these Models serve? These Models try to explain the cause of individual Abnormal Behavior. Each model represents its own individual interpretation of psychopathology and recommends its individual treatment procedures. So all the models try to answer the question that
Following are the Models of Studying Psychopathology
1. The Supernatural Model This Model attributes Abnormal Behavioral to magic, evil spirits, demons, moon and the stars. This model includes
a- Witchcraft and Demonology b -Moon and Stars c- Mass Hysteria
a- Witchcraft and Demonology The individuals suffering from mental disorders are possessed and controlled by magic, evil spirits and demons etc. The Treatments included punishments like chaining them or keeping them in cages or horrible ritual of boring a hole in the skull. These victims after going through an unfair trial were condemned as witches or demons were burned alive or hanged. Witchcraft trials reached their peak in the sixteenth and seventeenth century. In 1692, in a small town of Salem, Massachusetts a group of 19 women and men were hanged as witches.
b- Moon and stars The Latin word for moon is Luna, this inspired people to use the word lunatic for abnormal people, but now this word , is not used any more. According to this notion the movements of the full moon and the stars have an effect on behavior of people. This view is reflected by followers of astrology who think that their behavior as well as major events in their lives can be predicted by the position of the planets.
c- Mass Hysteria It is a phenomenon in which the experience of an emotion seems to spread to those in the surroundings around. If an individual is frightened and sad this feeling and experience spreads to near by people and soon this feeling further escalates, develops into a panic and the whole community is affected. For example the 8th^ October 2005 Earthquake experience affected the whole Pakistani nation and the whole nation was traumatized. The Supernatural model is still popular and used in undeveloped cultures where poverty is high and literacy rate is low and mental health professionals are not permitted to play their role. People still look towards
magic and rituals performed by peers and fakirs for the solutions of mental disorders. docsity.com
2-Biological model This model attributes mental disorders to disease and biochemical imbalances in the body.
Greek Contribution
- Hippocrates (450-377 B.C.)
- Galen (129-198A.D.) Nineteenth Century
- J.P. Grey -
- E. Kraeplin - Twentieth Century
- Insulin shock therapy
- Electroconvulsive therapy
The Greek contribution The Greek physician Hippocrates ridiculed demonological accounts of illness and insanity. Instead, Hippocrates hypothesized that abnormal behavior, like other forms of disease, had natural causes. Health depended on maintaining a natural balance within the body, specifically a balance of four body fluids (which were also known as the four humors): blood, phlegm, black bile, and yellow bile. Hippocrates argued that various types of disorder or psychopathology, resulted from either an excess or a deficiency of one of these four fluids. The Hippocratic perspective dominated medical thought in Western countries until the middle of the nineteenth century. People trained in the Hippocratic tradition viewed “disease” as a unitary concept. In other words, physicians did not distinguish between mental disorders and other types of illness. All problems were considered to be the result of an imbalance of body fluids, and treatment procedures were designed in an attempt to restore the ideal balance.
Four fluid theory Galen a Roman physician adopted Hippocratic theory and advocated that the four fluids relate to the Greek environmental concepts such as heat (blood) ,dryness (black bile), moisture ( yellow bile) and cold ( phlegm). Each fluid was related to one quality. Excess of one or more fluids were treated by regulating the environment to increase or decrease heat, dryness, moisture and cold depending on the deficiency of the fluid. Example King Charles the sixth, when he got sick he was treated according to the following concept of Galen. He was moved to less stressful countryside environment to restore the balance of his body fluids .Rest, good diet and exercise were recommended.
Techniques of Treatment 1- Bloodletting , a technique where a measured amount of blood was removed by leeches to minimize aggressive tendencies. Induced vomiting was used to reduce Depression .The diagnosed person was forced to eat tobacco and half boiled cabbage for vomiting. 2- Syphilis A sexually transmitted disease caused by a bacterial micro-organism entering the brain. The person having syphilis developed behavior patterns and cognitions of a psychotic disorder i.e. Schizophrenia and paralysis. The symptoms of Schizophrenia include Hallucination (apperception), delusion (false belief) of grandeur, persecution and reference and bizarre behaviors as well.
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Early asylums were little more than human warehouses, but as the nineteenth century began, the moral treatment movement led to improved conditions in at least some mental hospitals. Founded on a basic respect for human dignity and the belief that humanistic care would help to relieve mental illness, moral treatment reform efforts were instituted by leading mental health professionals of the day.
Contribution by Dorthea Dix In the middle of the 1800s, Dorthea Dix argued that treating the mentally ill in hospitals was to be more humane and more economical than caring for them haphazardly in their communities. She urged that special facilities be provided to house mental patients. The creation of large institutions for the treatment of mental patients led to the development of a new profession— Psychiatry.
By the middle of the 1800s, superintendents of asylums for the insane were almost always physicians who were experienced in taking care of people with severe mental disorders. The Association of Medical Superintendents of American Institutions for the Insane (AMSAII), which later became the American Psychiatric Association (APA), in 1844.
Worcester Lunatic Hospital: A Model Institution In 1833, the state of Massachusetts opened a publicly supported asylum for lunatics, a term used at that time to describe people with mental disorders, in Worcester. Samuel Woodward, the asylum’s first superintendent, also became the first president of the AMSAII. Woodward claimed that mental disorders could be cured just like other types of diseases. Treatment at the Worcester Lunatic Hospital included a blend of physical and moral procedures.
3. Psychological Model consists of following a. Psychoanalysis b. Humanistic c. Behavioristic
Psychoanalysis Psychoanalysis was pioneered by Sigmund Freud (1856-1939). He learned the art of Hypnosis from France. He experimented with somewhat different procedures of Hypnosis. He used Hypnosis in a innovative way. He encouraged his patients to talk freely about their problems, conflicts and fears .He discovered the unconscious mind and its influence in psychopathology by using the techniques of Free Association, Dream Analysis and Freudian Slips.
Structure of the mind: According to Freud the mind consists of
Id Mind--------------ego Superego
Id – which operates on pleasure principle, it is childish and immature. Libido provides energy to Id, Ego and Superego. Ego operates on Reality Principle and it is the master control .It works on logic and reason The Superego it operates on the moral principle and it is the conscience of the Psyche. The Ego mediates and resolves conflict between Id and Superego.
Defense Mechanism or Coping Styles The Ego battles with Id and Superego to resolve conflicts, at times the resulting anxiety is so overwhelming that the Ego has to adopt unconscious protective processes called Ego Defense Mechanisms or Coping Styles. They have following characteristics in common
- Operate at unconscious level.
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- Distort reality.
- Protect the Ego.
- All normal and abnormal individuals both use it in their daily life.
Some important ego defense mechanisms are following
1-Denial, 2- Displacement, 3- Projection, 4- Reaction formation,5- Repression, 6-Rationalization, 7- Sublimation
Psychosexual Theory of Development Freud proposed a theory of development. This is known as the psychosexual theory of development. The main emphasis in this theory is on the physical and psychological development.
1- Oral stage -birth to 18 months 2- Anal stage-18 months to 3 years Psychosexual theory of ------------ 3- Phallic stage -3 to 6 years development 4- Latency stage 5-Genital stage-6 to 12 years
The stages of development represent patterns of gratifying our basic the needs, those needs which are not gratified appear as fixations or psychopathologies at later adulthood. Oral stage fixations include nail biting, chewing pencils. Freud is the first personality theorist to discuss the developmental perspective in the study of abnormal behavior.
Psychoanalytic Therapy It focuses on unconscious processes, conflicts and past experiences.
The techniques include
- Free Association
- Dream Analysis
- Freudian Slips
- Transference
- Analysis of humor
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