PSYC337 Historical Perspectives

earliest depictions of mental illness

• supernatural forces permeated descriptions of mental health problems

• ancient Mesopotamian texts

trepanation

• exit route for evil spirits

• hole in the skull

• spanned 7000 years

• no anesthetic or antibiotics given

• 70% survival rate

Johann Weyer

• one of the first physicians to start saying demons/witchcraft is not an explanation

• started using mental illness as explanation

• ridiculed by his peers

  • right idea, wrong time

witch hunts

• 1400-1800 AD

• any were likely people who suffered mental health problems

conceptualizations of mental illness in the Middle Ages

• God is punishing you

• must be bad people or else God wouldn’t have done this to them

  • allows us to punish them

Paracelsus

• rejected the notion that people were being possessed/punished by God

• suggested it had to do with the movement of the moon and stars

• origin of lunatic

• brought the idea of internal balances

Franz Anton Mesmer

• believed in magnetic forces being out of alignment

• used animal magnetism to try and correct misaligned forces, especially pain conditions

animal magnetism

• became mesmerism

• one of the first ways to control pain for surgical intervention

• essentially hypnotism

Hippocrates

• father of modern medicine

• four humours

four humours

• black bile, yellow bile, phlegm, blood

• when balanced health prevailed, out of balance disease took over

Hippocrates’ conceptualization of mental disease

• feelings of sadness and depression resulted from the excess of black bile

• an excess of yellow bile was thought to make a person angry and impulsive

• classified mental disorders in 3 ways: mania, melancholia, and phrenitis (brain fever)

Aristotle

regarded diseases as disturbances and imbalances in the bodily elements: corrupt/misplaced humours, vapours and mixtures

Aristotle’s description of mania

attributed to excessive boy heat, which disturbed the soul and its function, affecting both thought and perception simultaneously

Galen

• relied on humoral theory

• introduced bloodletting

bloodletting

carefully measured amount of blood was removed from the body by severing blood vessels or with leeches

Franz Joseph Gall

• divided the brain into categories, specific areas for psychological functions

• felt skull for bumps/ridges for abundance of characteristics

Phineas Gage

• a blast sent his tampering iron through his mouth exiting through the top of his head

• injury led to personality changes

  • impatience, irritability, increased use of profanity, inability to follow through on plans

• one of the first convincing demonstrations of the brain’s role in personality pathology

syphilis and mental disorders

• 1897: Richard von Krafft-Ebing’s experiments helped establish a relationship between syphilis and paresis (biological and mental)

• 1917: Julius von Wagner-Jauregg successfully treated syphilis and paresis with malarial fever

  • showed that brain pathology can cause a specific disorder and be treated medically

frontal lobotomy

• first performed by Walter freeman in 1936

• inserted an ice pick-like instrument through the eye socket to sever brain connections

chlorpromazine

• anti-psychotic

• developed in 1940s

• initially intended to be antihistamine, analgesic effects

• calming effect was immediate by only lasted a few hours

  • required several treatments to control patients’ agitation

imipramine

• first tricyclic anti-depressant

• initially developed as an antihistamine in 1951

• investigated as a potential antipsychotic, but antidepressant properties were discovered by Roland Kuhn

Heinz Lehman

• director of Douglas hospital

• father of modern psychopharmacology

Heinz Lehman’s role in pharmaceutical treatment

• chlorpromazine for the treatment of schizophrenia

• imipramine for depression

Jean-Martin Charcot

• neurologist

• studied patients with hysteria

• earlier in career believed hysteria had neurological origins, later believed it was more psychological

• used hypnosis to treat people instead of housing in mental institutions

Josef Breuer

• friend of Freud

• best known for treatment of Anna O.

• using hypnosis to get people to retrieve memories, led to expression of intense emotion, catharsis, led to fewer symptoms

Sigmund Freud

• took the first major steps toward understanding psychological factors in mental disorders

• put together a theory of psychopathology, gave rise to psychoanalysis

• proposed that unconscious conflicts and early childhood experiences significantly shape personality and contribute to mental disorders

the psychoanalytic couch

thought laying down and not seeing the psychoanalyst would promote better recall of dreams and regressive memories

John B. Watson

• focused on behaviour, inside the mind isn’t objective

• thought that for psychology to have credibility among sciences it had to have objective findings

• started the basis of behavioural therapy

• argues that principles of operant and classical conditioning were sufficient to explain the basis of most mental health problems

Mary Cover Jones

• mother of behaviour therapy

• conducted a groundbreaking study where she successfully reduced a young boy’s fear of rabbits and other furry objects using counterconditioning

• paired fear with pleasant stimulus

Aaron T. Beck

• developed cognitive behaviour therapy

• was initially psychoanalyst

• argues that interpretations of events, rather than events themselves, larger determine emotional responses

Aaron T. Beck cognitive theory of emotional disorders

proposes that dysfunctional thinking plays a central role in the development and maintenance of emotional disorders

Philippe Pinel

• French physician

• started humanitarian reform by removing chains from mental patients with positive results

• showed benefits of treating them as sick people, not beasts or criminals

Benjamin Rush

• encouraged more humane treatment of individuals with mental health problems

• provided patients with jobs, removed them from their shackles

• wide-ranging method of treatment focusing on patients’ social individual, and occupational needs and moral/spiritual development

• thought all illnesses were the result of overactive blood vessels, advocated for bloodletting

Dorothea Dix

• inspired by the terrible conditions she witnessed in mental hospitals, campaigned for humane treatment of mental patients

  • went to Europe, saw better conditions, brought the back to US

mental hygiene movement

• started by Dorothea Dix

• focusing on hospitalized patients’ physical well-being

Canada’ first mental institution

• Beauport asylum, main institution in QC

• 1845

• privately owned, not enough support, no physicians, care limited

Douglas hospital

• opened in 1881 by Alfred Perry

• named the protestant hospital for the insane

• intended to be the most progressive mental health institution in QC

treatments at Douglas hospital before medication

• cold water to calm patients

• cox’s chair

• restraints

• straight jacket

• physical punishment

cold water to calm patients

• strapped to chair, cold water poured on them

• goal: calm them down

cox’s chair

• put in chair, spun around

• dizziness, nausea

• goal: calm them down/alter mood

restraints

• used to reduce the probability of injuring oneself or someone else

• their use has become increasingly controversial due to potential physical and psychological harm

straight jacket

• limits degree of threat to yourself or others

• seen as more humane alternative to ropes or chains

• their use was declined with the introduction of psychiatric medications and more therapeutic approaches

• still used today if necessary

physical punishment as treatment

• pain was considered to be an effective tool to control patients

• incited fear, less likely to reproduce the problematic behaviour in question

physiognomy

Alexander Morison thought facial features could reveal your mental illnesses

reform and deinstitutionalization

• Erving Goffman’s asylums in 1961 described neglect and maltreatment of patients in mental hospitals

• beginning in 1960s, the movement was initiated to close mental hospitals

• developed community/halfway homes

unforeseen consequences of deinstitutionalization movement

minimal resources, increased homelessness, incarceration

mental illness and homelessness

33% vs 45% mental illness in homeless population vs general population

modern mental institutions

• institutionalization is considered only when behaviour is completely out of control. kept only as long as needed, emphasis on psychosocial interventions

• prioritize evidence-based treatments, aiming for recovery and reintegration into society, with focus on individualized care and patient rights