introduction + 1.1 a brief history of psychopathology

psychopathology

The in-depth study of mental health problems.

clinical psychology

The branch of psychology responsible for understanding and treating psychopathology.

All-important aspects of psychopathology in the examples of Joan, Peter, Erica, and Jo:

• Important aspects of their life (such as their moods or cravings) are out of their control and they cannot cope.

• Conditions have resulted in them failing to function properly in certain spheres of their life (e.g., as a mother or as a student).

• Life appears to be controlled by interpretations of the world that are extreme and are probably not real.

Why can we not attempt to define psychopathology on the basis that some ‘normal’ functioning (psychological, neurogical, or biological) has gone wrong?

• We are stull some way from understanding the various processes that contribute to mental health problems.

• Many forms of behaviour that require treatment by clinical psychologists are merely extreme forms of what we would call ‘normal’ or ‘adaptive’ behaviour.

demonic possession

Historical explanations of psychopathology such as ‘demonic possession’ often alluded to the fact that the individual had been ‘possessed’ in some way.

medical model

An explanation of psychopathology in terms of underlying biological or medical causes.

asylums

In previous centuries asylums were hospices converted for the confinement of individuals with mental health problems.

community care

Care that is provided outside a hospital setting.

Explanations of psychopathology in terms of ‘possession’ have taken many forms over the course of history:

Many who have been suffering debilitating and distressing psychological problems have been persecuted and physically abused rather than offered the support and treatment they need.

René Descartes

Body-mind dualism.

Because minds could not be diseased, mental health problems must be located in the body, and more specifically in the brain.

It’s at this point that psychopathology moved from being a concern of theology or demonology to being in the realm of medicine.

psychiatry

A scientific method of treatment that is based on medicine, the primary approach of which is to idetify the biological causes of psychopathology and treat them with mediciation or surgery.

The primary approach of the medical model of psychopathology:

To identify he biological causes of psychopathology and treat them with medication or surgery.

In contrast to the medical model, in many cases it is not the individual or any part of their biology that is dysfunctional, it is the ..?.. they have had that are dysfunctional and has led to them thinking and acting in the way they do.

experiences

biological reductionism

This happens when the medical model adopts what is basically a reductionist approach by attempting to reduce the complex psychological and emotional features of psychopathology to simple biology.

It cannot easily encapsulate the distress felt by sufferers, nor can it easily explain the dysfunctional beliefs and forms of thinking that are characteristic of many psychopathologies.

recovery model

Broad-ranging treatment approach which acknowledges the influence and importance of socio-economic status, employment and education and social inclusion in helping to achieve recovery from mental health problems.

This ‘something is broken and needs to be fixed’ view of psychopathology is problematic for a number of reasons:

1. Rather than reflecting a dysfunction, psychopathology might just represent a more extreme form of normal behaviour; Common psychopathology symptoms such as anxiety and depression are on a dimension from normal to distressing, rather than being qualitively distinct;

2. It can be stigmatising to be labelled as someone who is biological or psychologically imperfect, and people with mental health problems are oftem viewed as second-class citizens - even when their symptoms are really only more prominent and persistent versions of characteristics that we all possess.

Bethlem Hospital

One of the first psychiatric hospitals originally established in Moorfields, London.

moral treatment

Approach to the treatment of asylum inmates, developed by the Quaker movement in the UK, which abandoned contemporary medical approaches in favour of understanding, hope, moral responsibility, and occupational therapy.

Philippe Pinel (1745 - 1826)

Often considered to be the first to introduce more humane treatments during his time as the superintendent of the Bicêtre Hospital in Paris.

• removing chains

• treat inmates as sick human beings rather than animals

social breakdown syndrome

A pattern of psychological and social deterioration, including apathy and withdrawal, that can result from long-term institutionalization in asylums. It's now understood as a secondary effect of the institution rather than a symptom of the underlying mental illness itself, caused by factors like lack of stimulation, social isolation, and the adoption of a "sick role" within the institution.

milieu therapies

The first attempts to structure the hospital environment for patients, which attempted to create a therapeutic community on the ward in order to develop productivity, independence, responsibility, and feelings of self-respect.

token economy

A reward system which involves participants receiving tokens for engaging in certain behaviours, which at a later time can be exchanged for a variety of reinforcing or desired items.

Why did token economy use decline since the 1980s?

• The legal and ethical difficulties of witholding desired materials and events so they can be used as reinforcers.

• A lack of consesus (general agreement) on whether behaviours nurtured in token economy schemes were maintained after the scheme ended and whether they generalised to other environments and settings.

Community Mental Health Team (CMHT)

A multidisciplinary team of professionals, such as psychiatrists, nurses, and social workers, who provide support and treatment to individuals with mental health conditions in their local communities.

Assertive Outreach Teams

Specialised, multi-professional mental health teams that provide intensive, community-based support to individuals with severe and persistent mental illness who struggle to engage with traditional services.