History of Psychopathology
Transcript of History of Psychopathology
History of Psychopathology
PSY 5310: Advanced Abnormal Psychology
Historical Perspective
Historical Perspective on Abnormality
• Historically there is a movement from supernatural to
natural explanations
• As we will see, many present-day misconceptions are
rooted in historical perceptions - many of which are myths
Historical Perspective on Abnormality
• For example: Cartesian Dualism is making a comeback,
together with neo-reductionism
Trephination
• Evidence from prehistoric times;
first clear-cut evidence from 8500
years ago
• Believed to be attempts to treat
psychopathology (‘insanity’)
• Q: Up until when was this practice
used?
• A: Early 20th century!
Ancient Greece
• Hippocrates (460-377 BC)
• The Father of Modern Medicine
• Mental illnesses are illnesses of the body
• Observed many patients (was interested in their dreams)
• Four Humors: Blood, phlegm, yellow bile, and black bile
• Four categories of abnormal behavior: Epilepsy, Mania, Melancholia, and Brain fever.
Ancient Greece
• Plato (423-347 BC)
• Mental illness is caused by weakness of the rational mind over impulses and desires.
• Treatment: Rational discussion – to strengthen the rational mind
• ‘Insane’ individuals are not responsible for crimes and should not be punished
Later Greek and Roman Thought
• Galen (130-200 AD)
• An influential Greek physician active in Rome
• Two types of psychological disorders
– Physical: Head injuries, excess alcohol consumption,
or changes in menstrual cycle
– Psychological: Shock, fear, financial problems, and ‘broken
heart’…
Later Greek and Roman thought
• Promising times…
• Medicine developed rapidly
• Temples were built to be used as humanitarian places to heal
• Pleasant environment was emphasized
• Treatment: diet, massage, exercise, education; but also, bleeding, and purging agents…
• But the next 1000 years put an end to this progressive humanitarian approach…
The Middle Ages (400-1400 AD)
Middle Ages (400-1400 AD)
• In Europe – Superstitions, exorcism, very cruel
‘treatments’
• Exorcism – Emphasis on the pride of the devil and the
need to insult, curse, and offend the ‘devil inside’
Middle Ages (400-1400 AD)
• Mass madness/psychosis –
– Tarantism : A dancing mania
believed to be caused
by a spider bite
Witch Hunting
• 15th and 16th centuries AD
• Mainly females accused of
deviating from Christianity and of dealing
with the devil that granted them superpowers
• Video evidence
The Renaissance Period (14-16th Century)
• The rebirth of scientific thinking
• (Saint) Teresa from Avila – A Spanish nun was one of
the first critics of the idea of possessions.
• Hysterical nuns are not possessed they are “ill-like”
• The first asylums – subhuman conditions
• Cruel treatment to convince patients to choose the path of
reason
Phillippe Pinel (1745-1826)
• Recognized as the person who made the first step towards the taking over of asylums by physicians
• Proponent of “moral treatment”
• Pinel’s experiment - 1792
Dorothea Dix (1802-1887)
• Started a small revolution out of Boston
• Was very active in establishing dozens of humane asylums
• Initially a success…that later failed miserably...
• Such an environment in itself does not significantly improve major
psychopathologies – These require treatment
The Modern Perspective
The Modern Perspective
• Psychoanalytic perspective
• Behavioral Perspective
• Cognitive Perspective
• Present day – Third wave approaches
The Modern Perspective
• By the end of 19th century – focus on the brain as the
cause of mental illness
• Emil Kraepelin (1856-1926) – Considered to be the father
of Biological Psychiatry
• New system for classification of mental disorders
• Based on scientific investigations,
psychopharmacology and genetic studies
The Roots of the
Psychoanalytic Perspective
• Franz Mesmer (1734-1815)
• A magnetic fluid in the body impacts health
• The technique: ‘Mesmerism’ to treat Animal Magnetism
• Had a weird way of putting people in a trans
• Was determined a charlatan
• But his ideas laid the ground for hypnosis as a treatment of hysteria
Roots of the
Psychoanalytic Perspective
• Jean Charcot (1825-1893) – A French neurologist
• The first to establish the connection between
hysteria and hypnosis
• Mentored Sigmund Freud in his clinic
The Psychoanalytic Perspective
• Sigmund Freud (1856-1939)
• Topographic model
(id, ego, superego)
• Sexual drive
• Unconscious
• Importance of catharsis
The Psychoanalytic Perspective
• Psychosexual Stages
– Oral : first 18 months
– Anal : 18 months – 3
– Phallic : 3 – 6 years
– Latency : 6 – 12 years
– Genital : 6 onwards
Defense Mechanisms
RegressionRetreating to a behavior of an earlier developmental period to prevent anxiety and satisfy current needs
Denial Refusing to perceive or accept reality
DisplacementDischarging unacceptable feelings against someone or something other than the true target of these feelings
Rationalization Inventing an acceptable motive to explain unacceptably motivated behavior
IntellectualizationAdopting a cold, distanced perspective on a matter that actually creates strong, troubled unpleasant feelings
Projection Attributing one’s own unacceptable motives or desires to someone else
Reaction formation
Adopting a set of attitudes and behaviors that are the opposite of one’s true dispositions
IdentificationAdopting the ideas, values, and tendencies of someone in a superior position in order to elevate self-worth
Sublimation Translating wishes and needs into socially acceptable behavior
The Behavioral Perspective
• Ivan Pavlov (1849-1936)
• Classic conditioning
The Behavioral Perspective
• John Watson (1878-1959)
• Rejected both the biological and
psychoanalytic paradigms
• Blank Slate
• Later B.F. Skinner (1904-1990) and
E. L. Thorndike (1874-1949) advanced
the idea of Operant Conditioning
The Behavioral Perspective
The Cognitive Perspective
• Albert Ellis (1913-2007): Rational vs irrational beliefs, emotional factors, reconstructions of beliefs as means therapy (REBT)
• Albert Bandura (1925-): Beliefs, social learning
• Aaron Beck (1921-): Automatic thoughts are distorted by affect; The father of Cognitive Behavioral Therapy
Third-Wave Approaches
• Focus on people’s ability to understand and regulate their emotions
• Incorporates techniques from behavioral, cognitive therapy with Zen Buddhism
• Dialectical Behavior Therapy (DBT)- Difficulties in managing
negative emotions and in controlling impulsive behaviors
• Acceptance and Commitment Therapy (ACT) - Avoidance is the heart of all problems
Humanistic Approaches
• Humanistic theories: Based on the assumption that humans have an innate capacity for goodness and for living a full life
• Carl Rogers - Individuals naturally move toward personal growth, self-acceptance, and self-actualization– Self-actualization: Fulfillment of ones potential for love,
creativity, and meaning
– Client-centered therapy: Therapist communicates a genuineness in his or her role as helper
Family Systems Theory Salvador Minuchin
• Views the family as a complex interpersonal system, with its own
hierarchy and rules that govern family members’ behavior
• Removing the Identified patient
• Views a family member’s psychological disorder as an indication
of a dysfunctional family system
• Family systems therapy: Believes that an individual’s problems
are always rooted in interpersonal systems, particularly family
systems
Past, Future, Present…
• From Daemons to Freud, from Mesmerism to CBT
• Where are we standing currently?
• How do we perceive mental illness today?
• Do we know what mental illness is?
• How do we treat mental illness today?
• Do we know what to do with severely ‘ill’ patients?