Notes on Historical Models of Abnormal Behavior

Supernatural Model

• Early framework: behavior influenced by factors outside the body and environment (outside forces).
• Key ideas historically: spirits, the moon, stars, demons; belief persists in some people today via astrology.
• Archaeological/anthropological evidence cited: human skeletons with egg-sized cavities in the skull, interpreted as attempts to treat evil spirits believed to inhabit the body via trepanation (drilling of the skull).
• Psychological/social response: fear of skull drilling led people to comply with tribal norms.
• Cultural beliefs by era and region:
  • Babylonians: belief that movement of stars/planets influenced behavior, thoughts, and actions.
  • Greeks: gods could cloud minds or “play” with disrespectful people; those labeled mad were treated in temples and healed through dreams perceived as divine intervention; incurable cases could be expelled or punished.
• Hippocrates (Golden Age of Greece): illnesses of body and mind have natural causes, not possession; key for the shift toward medical explanations.
• Transition to the medical model began to take shape but was constrained by religious authority (Church).
• Humoral theory (medical model precursor): health depended on balance among the 4 vital fluids in the body — $ext{phlegm}, ext{black bile}, ext{blood}, ext{yellow bile}$.
  • Imbalance blamed for abnormal behavior.
• Medieval treatment context:
  • Church reinforced belief in possession; exorcism used as treatment.
  • If exorcism failed, some bodies were tortured as a continuation of ritualistic punishment.
• Renaissance and witchcraft:
  • Witchcraft reached its peak; witches believed to form pacts with the devil, perform satanic rituals, harm others.
  • Torture used to elicit confessions (e.g., claims of flying, sexual relations with the devil).
• English hospitals and asylum history:
  • Unusual behavior sometimes kept in hospitals in hope of restoration; public demonstrations occurred to raise hospital income.
• Jean-Baptiste Pussin (Pazan) and Philippe Pinel (France):
  • Advocated humane treatment for the insane; unchaining patients and removing harsh practices.
  • Launched the move toward “moral therapy”: humane treatment in relaxed, humane environments.
• Moral therapy and its limits in the US:
  • Mental hospitals grew in size but often deteriorated in care quality (straight jackets, restraints, crowded wards, poor sanitation).
  • By the $1950s$ (mid-20th century), shift occurred from state hospitals to community-based treatment due to abuse and neglect.
• Summary of impact:
  • This era marks a transition from demonology and magical explanations toward reason and science, setting the stage for the medical model.

Biological Perspective (Medical Model)

• Key idea: abnormal behavior results from biological factors; disease arises from natural causes.
• Early biological view linked to diseases such as syphilis: believed that the bacterium causing syphilis invaded the brain and led to a mental state called general paresis.
• Outcome: reinforced the medical perspective that some mental illnesses have identifiable biological causes.

Psychological Perspective

• The claim: biology alone cannot explain the complexity of abnormal behavior; psychological factors contribute critically.
• Jean-Martin Charcot (neurologist) and hypnosis: studied hysteria and suggested psychological processes could produce symptoms.
• Sigmund Freud and the psychodynamic model:
  • Observed hysteria symptoms could be made to disappear or appear through hypnosis, suggesting a psychological rather than sole biological origin.
  • Concluded that factors giving rise to hysteria lie outside conscious awareness; helped establish the first major psychological perspective.
• Breuer and Anna O. (breathing case):
  • Anna O. reported hysterical complaints with no medical basis; hypnosis allowed relief, at least temporarily.
  • The treatment was called the “talking cure”; the idea that blocked or forgotten emotions could become physical symptoms.
  • Catharsis: emotional discharge of feelings; therapeutic effect from expressing previously repressed emotions.
• Influential figures and ideas in psychodynamic/psychological theory:
  • Carl Jung: a healthy personality integrates conscious and unconscious images; overemphasis on the unconscious without reconciliation leads to imbalance.
  • Alfred Adler: inferiority complex arises from physical deficits; compensation occurs; when exaggerated, it can become unhealthy and socially distancing.
  • Karen Horney: basic anxiety results from harsh, uncaring parenting; repressing needs leads to basic hostility and dependence on parents; needs become a lifelong mechanism for coping, normal unless pursued desperately.
  • Carl Rogers: conditions of worth shape self-concept; authentic self alignment reduces disorganization; moving away from authenticity contributes to disordered behavior.
• Core takeaway: psychological factors (unconscious processes, emotional conflicts, early experiences) can significantly shape abnormal behavior.

Sociocultural Perspective

• Causes of abnormal behavior can lie within social and cultural contexts rather than solely in the individual.
• Key factors include:
  • Unemployment and poverty
  • Family separation and social isolation
  • Stigma surrounding mental illness
• The perspective emphasizes how societal structures and norms influence prevalence, expression, and treatment of mental disorders.

Biopsychosocial Perspective

• Integrative framework: abnormal behavior arises from dynamic interactions among biological, psychological, and sociocultural factors.
• Practical approach: evaluate multiple domains to understand presenting problems.
• Example from lecture:
  • A client reports depressive symptoms potentially linked to low grades; can explore:
  • Biological: any medical issues or genetic predispositions; blood tests to rule out biological causes.
  • Psychological: cognitive patterns, coping strategies, interpretation of information, past traumas, and emotional processing.
  • Social/Cultural: family safety, toxicity of the home, social supports, cultural expectations, and stigma.
• Interplay conceptually tied to real-world assessment and treatment planning.
• Emphasis on continuity with foundational principles from GenPsych and related coursework (e.g., integrating prior models with current practice).

The Diathesis–Stress Model (Key Mechanism in Biopsychosocial Perspective)

• Core idea: individuals have varying levels of vulnerability (diathesis) that interact with environmental stress to produce disorders.
• Conceptual variables:
  • Diathesis (D): genetic, biological, or early-life vulnerabilities.
  • Stress (S): life events or environmental pressures and challenges.
  • Result (R): probability or likelihood of developing a disorder.
• Simple mathematical representation (interaction model):
  • $R = D imes S$
• Threshold concept:
  • Disorder manifests when the interaction exceeds a threshold $T$:$$R \,\ge\, T\;\Rightarrow\;\text{disorder}
• Example from lecture:
  • Person A has greater diathesis (higher vulnerability) and experiences similar stressors, increasing R relative to Person B who has lower vulnerability.
• Practical implication:
  • Both vulnerability and stressors matter; treatment may target reducing stressors, enhancing coping, or addressing biological risk factors.

Connections, Examples, and Practical Implications

• From supernatural to science: historical progression shows a shift from supernatural explanations to rational, evidence-based approaches.
• Ethical implications:
  • Humane treatment (moral therapy) vs. cruel confinement and coercive measures.
  • Ongoing concerns about stigma, civil rights, and the quality of care in mental health settings.
• Real-world relevance:
  • Modern practice often adopts a biopsychosocial lens, recognizing that culture, environment, biology, and psychology collectively influence mental health.
• Examples highlighted in lecture:
  • Use of exorcism and torture historically; later reforms toward humane care.
  • Role of public hospitals and entertainment-driven income in the past; shift toward patient dignity and community-based care.
  • Psychological therapies emphasizing talk therapies, hypnosis, and cathartic release as pathways to symptom relief.

Summary of Major Perspectives and Their Significance

• Supernatural model: behavior influenced by external or non-material forces; historical relevance but largely superseded by scientific explanations.
• Biological perspective: emphasizes physiological causes (e.g., disease, brain pathology, infections) and laid groundwork for medical treatments.
• Psychological perspective: focuses on internal mental processes, emotions, and experiences; foundational to psychotherapy and concepts like unconscious conflicts.
• Sociocultural perspective: highlights the role of social structures, culture, and stigma in shaping mental health and access to care.
• Biopsychosocial perspective: integrative approach synthesizing all three domains to understand and treat disorders.
• Diathesis–Stress model: formalizes how vulnerability and stressors interact to trigger disorders, guiding prevention and intervention strategies.

Key Concepts and Terminology (Glossary)

• General paresis: a neuropsychiatric syndrome associated with late-stage syphilis, illustrating the biological basis for some mental disorders.
• Moral therapy: humane, compassionate treatment approach aiming to create less oppressive environments for patients.
• Catharsis: emotional discharge believed to have therapeutic effect by bringing repressed emotions to conscious awareness.
• Diathesis: inherent vulnerability or predisposition to a disorder (genetic, biological, or developmental).
• Stress: environmental pressures or life events that can trigger a disorder when coupled with diathesis.
• Threshold (T): the point at which the combined vulnerability and stress lead to the appearance of symptoms.
• Psychodynamic model: framework emphasizing unconscious processes, early life experiences, and internal conflicts as drivers of behavior.
• Humanistic aspects (related to moral therapy): emphasis on authentic self, self-worth, and the pursuit of growth within therapeutic contexts.