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