PSYC 372 Unit 2

Which of the following was NOT one of Hippocrates’ suggested treatment strategies for melancholia?

Juxtaposition of “opposite by opposite” (e.g., cold wine in a hot bath)

The fact that episodes of the “dancing manias” (i.e., tarantism mass madness) peaked at the time of the Black Death (i.e., bubonic plague in 1300’s/1400’s) illustrates that:

major issues impacting society can often affect individuals’ mental health.

Which of the following is NOT one of the three components of the deinstitutionalization process, according to Lamb and Bachrach?

a. Removing patients from institutions and decreasing the number of institutions.
b. Decreasing rates of institutionalization, instead diverting patients elsewhere.
c. Developing alternate local community services for shorter-stay/outpatient care.
d. Decreasing the rates/dosages of psychoactive substances used in treatment.

Which of the following is the best definition of “bullshit” according to Frankfurt?

When one creates something for the sake of profit by filling in where there is a
desire but a lack of knowledge/resources to do so legitimately.

Which of the following statements regarding asylums is FALSE?

a. Earliest asylums (circa 1600) treated the mentally ill terribly, essentially removing
them from society and quarantining them for taunting and entertainment.
b. Asylums in the 1700’s were primarily run by pastoral/religious counselors,
praying over patients to remove the “evil spirits” in their minds.
c. Dix and Beers led a humanitarian effort to improve the care provided at in-patient
mental health facilities through the 1800’s and 1900’s, which was largely effective.
d. Deinstitutionalization in the mid to late-1900’s had numerous effects upon society,
including an increase in the “revolving-door effect” and incarceration rates.

According to Dr. Miller’s summary of Ellenberger’s anthropological review of responses to abnormality throughout history, which of the following is NOT one of the three identified themes?

a. glorification
b. punishment
c. treatment
d. validation

Dr. Miller presented a summary of Kleinman’s (1988) analysis of the few ways of
understanding suffering. Given the following description, which form of understanding suffering is taking place? “A client reports having thoughts about how he is worthless, has no future, lives in a hateful world, and sees no hope for improvement, and his clinician says ‘Oh your description of symptoms perfectly fits the negative cognitive triad of depression which I was trained on in graduate school—so that means you are suffering from Major Depressive Disorder.’”

a. Illness
b. Disease
c. Sickness
d. Pain

Dr. Miller’s text makes several arguments about power and social control in the history of abnormal psychology. Which of the following is NOT one of the ways in which Miller illustrates that powerful entities exert control over others?

a. Labeling: By convincing half the population that they are disordered, this keeps them spending money on mental health services.
b. Localizing: By quarantining those deemed “unfit” for society into one place (i.e., an
asylum) they were easier to contain and control.
c. Linking: By showing family linkages through genetic testing, those at higher risk for mental problems are forced out of leadership opportunities.
d. Licensing: By limiting the number of professionals eligible to provide certain services, the income for those services is centralized to a small powerful group

How would you describe the phenomenon of mass madness?

a longstanding occurrence which is uncommon but does continue to happen

Examining the history of abnormal psychology shows us:

a. As a species, we’ve struggled for thousands of years to understand ourselves.
b. Many past explanations of abnormality were unscientific (e.g., spirits, humors).
c. There is reason to believe our current understanding may still be flawed, imperfect, and absolutely still a work-in-progress.

Dr. Miller summarizes Ellenberger’s 1974 anthropological evaluation of responses
to abnormal psychology as including these three historical themes:

1. Punishment

2. Glorification

3. Healing

What are some examples of the Punishment response to abnormality?

• Our earliest records show exorcisms and trephining (drilling holes in one’s skull)
were occurring prior to 2000B.C. and likely to those with psychotic problems.
• Witch hunts in the 15’ and 1600’s sometimes used symptomatic presentations as
evidence of witchcraft and punished women with burning at the stake.
• Early asylums (pre-1800’s) were overcrowded and housed people in terrible
conditions, sometimes including public mimicry of the inpatients.
• Arguably, today’s psychotic/suicidal patients are “punished” by loss of freedom.

What are some examples of the glorification response to abnormality?

• Those claiming to “see the future” may be delusional, but are paid for their
clairvoyant predictions by certain groups of followers.
• In popular media culture, those suffering with mental health problems are
sometimes praised and treated as more insightful or “deep” than everyday people.
e.g., dark music lyrics about depression or substance abuse; paintings and other visual art which portrays human pain or obsessiveness; self-effacing and self-deprecating comedians
• Arguably, those “speaking in tongues” or having direct communion with a deity
are hallucinating, but in some religious circles are treated as special and powerful.

What are some examples of the healing response to abnormality?

• Some of the earliest evidence comes from ~2500B.C. ancient Chinese healers using
surgeries and forms of prayer treatment for their mentally ill.
• Ancient Greeks and Romans made some attempts (~300-500B.C.)
- Plato’s framing of psychological issues as being natural, body-related, and encouragement of hospitals
- Aristotle’s approach of using “thinking” to cure mental ailments—essentially an early cognitive psych model
- Hippocrates’ categorizations of problems and his treatment protocols
• Arguably, today’s mental health professionals all attempt to engage in healing.

What was Hippocrate’s Treatment Protocal for Melancholia? (Depression)

• Utilize dreams to understand patients’ personalities
• Be aware of the context (e.g., remove from family if in conflict)
• Seek regularity and tranquility in activities
• Be sober and avoid excess of any sort
• Eat healthy
• No sex
• Exercise (but don’t over-fatigue oneself)
• Bleeding, if needed, to reset the four humors

What are some examples of mass madness?

• “meowing nuns” of 1400’s in France
• “dancing plague” of 1518 in France
• “Halifax slasher” of 1938 in England
• “laughter epidemic” of 1962 in Tanzania
• “genital thieves” of 1990 in Nigeria
• “suicide village” of 2016 in India

• Many mass madnesses of “tarantism” (i.e., uncontrollable dancing) occurred during the Middle Ages in Europe, at the height of the Black Plague.
• The Koro mass madness (i.e., fear that others have stolen one’s genitals) in Nigeria took place during a period of feminism and increasing women’s power.
• The “suicide village” (i.e., enormous percentage of deaths by suicide) in the village of Badi in Madhya Pradesh, India, was spurred by extreme economic downturn

What are some lessons we can learn from mass madness?

• Societal/cultural events of major importance can lead to changes in mental health trends
• Most mass madnesses appeared to inflict those particularly stressed by odd/novel circumstances
• The mind and body have an extremely strong connection—illness in the mind can manifest bodily
• While mental health problems aren’t contagious, per se, there are instances of a problem spreading socially
• These may seem like weird historical anecdotes, but they continue!

Deinstitutionalization timeline?

1400-1600’s: asylums spread, poor care
1850’s: Dorothea Dix campaigns for humanitarian care
1908: Clifford Beers publishes “A Mind That Found Itself”
1946: National Institute of Mental Health established
1963: Community Health Services Act
1970-1990’s: Deinstitutionalization takes place

What is the definition of deinstitutionalization?

1) Removing individuals from inpatient mental health settings and shrinking the number of institutions.
2) Decreasing the frequency of individuals being institutionalized, diverting them to other care options.
3) Developing alternative local community services, meant to be out-patient or shorter-stay care

What are the pros and cons of deinstitutionalization?

• Pro Side: Some argue that this political movement was aimed at providing more humane treatment, increasing the freedom of patients, saving money, and decreasing long-term dependency on social institutions.
• Con Side: Others argue that this has increased homelessness among the severely mentally ill, bolstered the “revolving door” phenomenon, and displaced inpatients to jails/prisons/streets.

What are the ways to understand suffering?

Illness

Disease

Sickness

What disorder’s in Greenberg’s book of woe did he mention were “discoveries” of the 1850’s?

• Drapetomania
- the disease causing slaves to run away
• Dyaesthesia Aethiopica
- malady causing slaves to do poor quality work or avoid work

Other examples:

• the forced sterilization of low-IQ and mentally ill Americans until the early/mid-1900’s
- yes, that means eugenics... like the Nazis
• pathologizing non-heterosexual orientations and using that to justify limiting their rights
- homosexuality was listed as a disorder in the DSM until the mid-1970’s

If, as Dr. Miller (through Kleinman) suggests, DSM labeling is indeed a form of
social control, then who all are being “controlled?”

• about half the population over their lifetimes
• about one quarter the population in a given year

According to the NIMH’s Epidemiological Catchment Area (ECA) study (a major
epidemiological effort in the 1980’s):

• lifetime prevalence of at least one (any) mental disorder was approx. 48% or half
• one-year prevalence of at least one (any) mental disorder was approx. 26% or one-quarter
• of those with at least one disorder, 60% had two or more
- this is called comorbidity (i.e., having more than one disorder simultaneously)

If, as Dr. Miller (through Kleinman) suggests, DSM labeling is indeed a form of
social control, then who all are gaining “control?”

Short answer: those with legal privilege to charge money for treatment