Chapter One: Past and Present

What is Psychological Abnormality?

  • Clinical Scientists: gather info systematically in order to describe, predict, and explain the phenomena they study
  • Clinical Practitioners: detect, assess, and treat abnormal patterns of functioning
  • There’s no definition of abnormal behavior that’s accepted by everyone
  • Psychological abnormalities are defined by general criteria in society
Deviance, Distress, Dysfunction, and Danger
  • Common feature across definitions: the four d’s
  • Deviance - going against social norms
  • Distress - causes the sufferer distress (subjective) or could cause distress for the people around you
  • Dysfunction - interferes with the person’s ability to conduct daily activities in a constructive way
  • Dangerous (however, vast majority of ppl with disorder aren’t dangerous)
  • Influences:
      * Social norms
      * Culture
      * Biological, economical, societal context
The Elusive Nature of Abnormality

  • Szasz: mental illness is created by culture to control people
      * ex: women and hysteria
      * Everything is on a continuum, ‘disorders’ are just variations of genetics
      * Called mental illness invalid and a myth

  • Eccentrics: display abnormalities but don’t follow the four d’s
      * Weeks: fifteen dif characteristics in eccentrics

  • As time passes, the social idea of deviance changes
      * ex: tattoos are no longer deviant

What is Treatment?

  • Treatment: procedure designed to change abnormal behavior into more normal behavior
  • Essential features of all therapy forms:
      * Sufferer / Patient
      * Trained healer / Therapist
      * Therapeutic contacts

How Was Abnormality Viewed and Treated in the Past?

Ancient Views and Treatments
  • Prehistoric societies believed that all events around and within them resulted from the actions of spirits - abnormal behavior was caused by evil spirits
      * Would drill holes in skulls to exorcize demons: trephination
      * Treatment for severe abnormal behavior (hallucinations, melancholia)
      * Exorcism: priest would recite prayers and whip / starve the person
Greek and Roman Views and Treatments

  • Hippocrates thought mental illness meant something was physically wrong

  • 500 BC-500 AD

  • Abnormal behavior was a disease arising from internal physical problems

  • Brain pathology resulted from an imbalance of four humors
      * Too much yellow vile caused mania
      * Too much black vile caused depression
      * Blood
      * Phlegm

  • Treatment: quiet life, bleeding, exercise, celibacy, diet

Europe in the Middle Ages: Demonology Returns

  • 500-1350

  • Related to the catholic church rejecting science and controlling education

  • Terrible time to live (plagues, wars, etc.), causing abnormal behavior to increase
      * Mass madness

  • Treatment: exorcism, death, hospitalization, torture

The Renaissance and the Rise of Asylums

  • 1400-1700

  • Johann Weyer: mind is as susceptible to sickness as the body
      * First physician to specialize in mental illness
      * Founder of modern study of psychopathology

  • Asylums: institutions whose primary purpose was to care for people with mental illness

  • Once asylums began to overflow, they virtually became prisons for patients

The Nineteenth Century: Reform and Moral Treatment

  • Benjamin Rush: father of psychology in America, believed in moral treatment

  • Treated patients like humans instead of possessed entities

  • Downfall of moral treatment: ran out of money, overcrowding, and low recovery rates

The Early Twentieth Century: The Somatogenic and Psychogenic Perspectives

  • Dual perspectives

  • Somatogenic Perspective: Abnormal behaviors are rooted in biology (physical causes)
      * Emil Kraepelin: Physical things can happen to you to cause mental dysfunction
        * ex: fatigue ➝ mental dysfunction
        * Developed the first modern system for classifying abnormal behavior
      * Biological discoveries that linked the physical and the mental
        * Untreated syphilis causes mental disorders
        * Some biological claims led to proposals for eugenic sterilization

  • Psychogenic Perspective: Abnormal behaviors are rooted in psychology
      * Freud: psychoanalysis and outpatient/talking therapy
      * Hypnotism: changing mental states
      * Psychoanalysis: A form of discussion where clinicians help patients gain insight into their unconscious psychological processes
      * First signs of outpatient therapy

  • Today, people are still not very enlightened about mental disorders

Recent Decades and Current Trends

  • New psychotropic medications discovered in 1950s, led to deinstitutionalization
      * Antipsychotic drugs: correct distorted thinking
      * Antidepressant drugs
      * Anti-anxiety drugs
      * Outpatient care

  • Today: primarily use outpatient care, things are less expensive, insurance covers more, more programs dedicated to specific disorders.

A Growing Emphasis on Preventing Disorders and Promoting Mental Health
  • Looking at social factors
  • Promoting mental health
  • Looking at kids early
  • Positive Psychology: Study and enhancement of positive feelings, traits, abilities, and group-directed virtues
Technology and Mental Health

  • New triggers and vehicles: people can find become more easily radicalized with groups online

  • Digital distractions: causes issues with our attention spans

  • Tele-mental health services and mental health apps

  • Web-based misinformation

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