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Lec1: History of Abnormality (How abnormality was treated in the past…
Lec1: History of Abnormality
What is abnormal psych
what is abnormal
many definitions but none are universally accepted
definitions share these features
the 4 Ds
Distress
Bhvr that cause distress to the individual or others
cause emotional pain & suffering to the individual
Problems
bipolar-manic disorder or antisocial personality disorder doesn't fulfill this criteria
Dysfunction (disability)
interferes with ability to function in daily life
eg. take care of oneself, social interaction, social roles & productivity
culture has an influence on this (eg. we need to be productive & carry out daily activities in an effective fashion)
Harmful dysfunctional
Deviance
Bhvrs that are diff, extreme, unusual & infrequent
What is considered deviant/normal is influenced by cultural norms
Danger
eg. aggressive, suicidal, homicidal
Bhvr is dangerous to oneself or others
have been changes of terminology over time
Elusive nature
elusive & subjective
Society determines the definition & how to apply the criteria to particular cases
based on consensus & is a work in progress
Def
in order to describe, predict, explain, & change abnormal patterns of functioning
the
scientific study
of abnormal bhvr
Other Views (Thomas Szasz)
Rejected concept of mental illness cos of cultural influences
so-called "abnormalities" are only "problems of living"
The Myth of Mental Illness (1960)
Societies use "mental illness" to control those who threaten social order
With Church of Scientology, Szasz co-founded CCHR
Citizens Commission on Human Rights
to fight "human rights crimes" committed by psychiatrists
How abnormality was treated in the past
Europe in the Middle Ages (Demonology returns)
Treatment
Return of exorcism
nearing end of Middle Ages, demonology lost favour again
Rise of clergy
downplay of science
Satan-> Deviant behaviour
Outbreaks & mass madness
Tarantism
uncontrollable urge to dance->groups of ppl jump & dance into convulsions
Lycanthropy
believe oneself is possessed by wolves & animals
abnormality seen as a conflict bet good & evil
AD 500 - 1350
Witch hunt
dunking test
The Renaissance (Rise of Asylums)
Asylums
BUT led to overcrowding
"hospitals" for lepers-> asylums to take care of mentally ill
AD 1400 - 1700
Bethlehem Hospital
Henry VIII handed the hospital to City of London to confine the mentally ill cos no space-> later became a tourist attraction
Greek & Roman Views
Hippocrates
4 humours
disorders due to imbalance
Yellow bile->irritation, anxiety, anger (imagine angry pikachu)
Black bile->melancholic (imagine gus fring)
Phlegm->sluggish (Imagine Eeyore coughing)
Blood->changeable temperament (imagine deadman wonderland)
Treatment
"rebalance" humours through warm baths, massage, blood letting
due to natural causes & physical problems
500 B.C - 500 A.D
19th Century (Reform & Moral Treatment)
by 1850s
Reversal of moral treatment mvt
Declining recovery rates
Lack of treatment
money & staff shortages
Long-term hospitalisation became the rule once again
William Tuke
reform in England
the York Retreat
Philippe Pinel
unchained the mentally ill
Advocated moral treatment in asylums
emphasised moral guidance, humane & respectful treatment
"Lunatic Ball"
Dance in a Mad House
In 1800, asylums were reformed
in US
Benjamin Rush
Father of American Psychiatry - Humane Approach
Intelligent, sensitive attendants; reading, talking to patients
small gifts from doctors would be therapeutic
Dorothea Dix
Fought for reforms - new laws & greater gov funding
State mental hospitals
Made humane care a public & political concern
Ancient views
Treatment
force demons out from the body
eg. trephination & exorcism
Evil Spirits
abnormal bhvrs were work of spirits
Beliefs begun as far back as Stone Age
20th Century Dual Perspectives
Somatogenic Perspective
factors responsible for re-emergence
Biological Discoveries
Germs cause diseases
Syphilis (germs) cause
general paresis
(paralysed & have psychiatric symptoms like hallucinations)
Biological "Treatments"
tooth extraction, tonsilectomy, hydrotherapy, lobotomy, insulin therapy (to induce coma), ECT
Quite disappointing until 1950s
Genetics
some illnesses run in the family
Eugenics movement
State laws to prohibit marriage, force sterilisation
Laws upheld by Supreme Court (US) in 1927
Emil Kraepelin's textbook
Pioneered classification of mental illness into distinct groups
Each has specific biological causes, course, outcomes
1st psychiatry textbook in 1883
2 major syndromes
Dementia praecox (Schizophrenia)
Manic-depressive psychosis (Bipolar disorder)
Described mental illness as "syndrome"
Abnormal functioning is induced by
physical
causes
Mainly for "In-patients"
Psychogenic Perspective
Mesmer & Charcot
hypnosis to treat hysteria which is caused by distribution of magnetic fluid in body called "animal magnetism"
Hysterical disorders
ppl lost functioning or feeling in some part of the body for no apparent physiological reason
Breuer
Use hypnosis to treat hysteria, let patient talk during hypnosis
Reliving an earlier emotional trauma to decrease emotional tension
Cathartic Method
Hypnotism rise in popularity
primarily for "outpatients" (these ppl don't live in the hospital)
abnormal functioning induced by
psychological
causes
How are people with severe mental illness treated
Led to "de-institutionalisation"
Rise in outpatient care cos these drugs allow them to cope with daily life
BUT this causes problems
outpatient care
short-term hospitalisation, long-term management
However
too few community programs available
only 40% of those with severe disturbances receive treatment
now the primary mode of treatment
1950s Psychotropic medications
Antidepressants
Anxiolytics (for anxiety)
Antipsychotics