A look at the history of mental illness from the Stone Age to the 20th century.
VonDr. Ingrid G. Farreras
psychology teacher
Hood University
References to mental illness are found throughout history. However, the development of mental illness was not linear or progressive, but rather cyclical. Whether a behavior is considered normal or abnormal depends on the surrounding context and therefore changes according to the given moment and culture. In the past, behaviors that were unusual or deviated from the sociocultural norms and expectations of a particular culture and era were used to silence or control particular individuals or groups. As a result, a less culture-relativistic view of abnormal behavior has focused on whether the behavior poses a threat to self or others, or causes enough pain and suffering that it interferes with work duties or relationships with family and friends.
Throughout history there have been three general theories of the etiology of mental illness: supernatural, somatogenic, and psychogenic. Supernatural theories attribute insanity to possession by evil or demonic spirits, the displeasure of the gods, solar eclipses, planetary gravity, curses, and sin. Somatogenic theories identify changes in bodily function as a result of disease, genetic inheritance, or brain damage or imbalance. Psychogenic theories focus on traumatic or distressing experiences, maladaptive associations and cognitions or distorted perceptions. Etiological theories of mental illness determine the care and treatment of the mentally ill. As we shall see below, a person believed to be possessed by the devil is viewed and treated differently than a person believed to be suffering from excessive yellow bile. Their treatments will also be different, from exorcism to bloodletting. However, the theories remain the same. They coexist and are also recycled over time.
Trepanation is an example of the first supernatural explanation of insanity. Examination of prehistoric skulls and rock carvings from 6500 B.C. C. has identified the surgical drilling of holes in skulls to treat head injuries and epilepsy, as well as to allow the release of evil spirits trapped in the skull (Restak, 2000). Around 2700 BC C., the Chinese medicine concept of complementary positive and negative physical forces ("yin and yang"), attributed mental (and physical) illnesses to an imbalance between these forces. Therefore, a harmonious life that allowed the right balance of yin and yang and the movement of vital air was essential (Tseng, 1973).
Mesopotamian and Egyptian papyri from 1900 BC C. describes women suffering from mental illness as a result of a wandering uterus (later called hysteria by the Greeks): the uterus can become detached and adhere to parts of the body such as the liver or chest cavity, preventing or altering its proper functioning and sometimes making it painful symptoms. The Egyptians and later the Greeks therefore also used somatogenic treatment with strong smelling substances to bring the uterus back to its right place (attracting pleasant smells and expelling unpleasant smells).
Throughout classical antiquity we see a return to supernatural theories of demonic possession or divine displeasure to explain abnormal behavior that was beyond a person's control. Temple visits with religious healing ceremonies and incantations to the gods were used to aid in the healing process. The Hebrews saw insanity as a punishment from God, so the treatment was confession of sins and repentance. It was also believed that doctors could comfort and cure insanity.
Greek doctors rejected supernatural explanations for mental disorders. It was around 400 BC. C. when Hippocrates (460-370 BC) attempted to separate superstition and religion from medicine by systematizing the belief that a deficiency, or particularly an excess, of one of the four essential bodily fluids (i.e. the humors) - blood , bile - black bile and phlegm - was responsible for physical and mental ailments. For example, someone who was very temperamental was suffering from a lot of blood and therefore bloodletting would be the necessary treatment. Hippocrates placed mental illness in one of four categories: epilepsy, mania, melancholy, and brain fever, and like other prominent physicians and philosophers of his day, he did not believe that mental illness was shameful or that people with mental illness should be held accountable. for your behavior problems. Relatives cared for the mentally ill at home, and the state did not share responsibility for their care. Humor remained a recurring somatogenic theory well into the 19th century.
Although the Greek physician Galen (AD 130-201) rejected the idea of a womb with an animistic soul, he did agree with the idea that an imbalance in the four bodily fluids could cause mental illness. However, it also opened the door to psychogenic explanations for mental illness by allowing the experience of mental stress as a potential cause of abnormalities. Galen's psychogenic theories were ignored for centuries, because for nearly a millennium physicians attributed mental illness to physical causes.
In the late Middle Ages, economic and political unrest threatened the power of the Roman Catholic Church. Between the 11th and 15th centuries, supernatural theories of mental disorders again dominated Europe, fueled by natural disasters such as plagues and famines, interpreted by laypeople as caused by the devil. Superstition, astrology, and alchemy took over, and common treatments included rites of prayer, touching of relics, confessions, and atonement. From the 13th century, the mentally ill, especially women, were persecuted as possessed witches. At the height of the witch hunts in the 15th-17th centuries, when the Protestant Reformation plunged Europe into religious conflict, two Dominican friars wrote thisdetonator(1486) as the definitive manual for conducting witch hunts. Johann Weyer and Reginald Scot tried to convince people in the mid-16th century that accused witches were in fact insane women and that insanity was not due to demonic possession but to metabolic disorders and disease, but the Church Inquisition forbade both. his writings. Witch-hunting only subsided in the 17th and 18th centuries, after more than 100,000 suspected witches were burned at the stake (Schoeneman, 1977; Zilboorg and Henry, 1941).
The modern treatment of mental illness is most closely associated with the establishment of hospitals and asylums since the 16th century. The purpose of these institutions was to house and imprison the mentally ill, the poor, the homeless, the unemployed and criminals. The war and economic depression produced large numbers of undesirables who were separated from society and sent to these institutions. Two of the most famous institutions, St. and the 17th century. How lockdown laws focused on protecting the publicvonthe insane, governments became responsible for housing and feeding the undesirables in exchange for their personal liberty. Interned against their will, most inmates lived in the dirt and chained to walls, and were usually put on public display for a fee. However, mental illnesses were considered somatogenic, so treatments were similar to physical illnesses: laxatives, bleeding, and emetics.
Although inhuman by today's standards, the view of insanity of the time compared the insane to animals (i.e., animalism) who lacked the capacity to reason, who could not control themselves, were capable of violence without provocation, who lacked the same physical sensitivity to pain or temperature, and he could live in miserable conditions without discomfort. Therefore, it was believed that instilling fear was the best way to bring sanity back to a disturbed mind.
Protests against the living conditions of the mentally ill broke out in the 18th century, and a more humane view of mental illness developed in the 18th and 19th centuries. In 1785, the Italian physician Vincenzo Chiarughi (1759–1820) freed patients at his St. Bonifacio in Florence, Italy, promoting good hygiene and recreational and professional training. What is better known is that the French doctor Philippe Pinel (1745–1826) and the former patient Jean-Baptise Pussin introduced a “moral treatment” in La Bicêtre and Salpêtrière in 1793 and 1795, which also included the liberation of patients by moving them to well-ventilated places included. ventilated. . bright spaces and promoting conscious activity and freedom of movement on the floor (Micale, 1985).
In England humanitarian reforms arose out of religious concerns. William Tuke (1732–1822) urged the Yorkshire Society of (Quaker) Friends to found the York Retreat in 1796, where patients were guests and not prisoners, and where the standard of treatment depended on dignity and courtesy, and therapy and morals. value of manual labor (Bell, 1980).
Although the United States had institutions for the insane, such as the Hospital of Pennsylvania in Philadelphia and the Hospital of Williamsburg, founded in 1756 and 1773, the somatogenic theory of insanity of the time, particularly promoted by the father of American psychiatry, Benjamin Rush ( 1745 –1813) – have spawned treatments such as bloodletting, spinning and tranquilizer chairs. However, as Tuke's York Retreat became the model for half of the new private nursing homes established in the United States, psychogenic treatments such as compassionate care and physical labor became the hallmark of new American nursing homes such as the Friends Asylum in Frankford, Pennsylvania and the Bloomingdale Asylum in New York City, founded in 1817 and 1821 (Grob, 1994).
In the United States, however, the moral treatment had to be abandoned in the second half of the 19th century, when these nursing homes became overcrowded and private in nature, and could no longer provide the space or care needed. When retired teacher Dorothea Dix discovered the resulting neglect, she lobbied for the creation of state hospitals. Between 1840 and 1880 he helped establish more than 30 mental institutions in the United States and Canada (Viney & Zorich, 1982). In the late 19th century, moral treatment gave way to the psychiatric movement, which former patient Clifford Beers started with the publication of his memoirs in 1908.A spirit that has found itself. Building on Pasteur's discovery of the germ theory in the 1860s and 1870s, and particularly the discoveries of vaccines against cholera, syphilis, and typhoid in the early 20th century, the psychiatric movement returned to a somatogenic theory of mental illness.
However, European psychiatry in the late 18th century and throughout the 19th century struggled between somatogenic and psychogenic explanations for mental illness, particularly hysteria, which caused physical symptoms such as blindness or paralysis with no apparent physiological explanation. Franz Anton Mesmer (1734-1815), influenced by contemporary discoveries of electricity, attributed hysterical symptoms to imbalances in a universal magnetic fluid found in individuals rather than to a wandering womb (Forrest, 1999). James Braid (1795-1860) traded this belief in mesmerism for hypnosis, proposing a psychogenic treatment to eliminate symptoms. At this time the famous neurologist of the Salpetriere hospital, Jean-Martin Charcot (1825–1893), as well as Ambroise Auguste Liébault (1823–1904) and Hyppolyte Bernheim (1840–1919) of the Nancy school in France, were engaged in a bitter etiological struggle around hysteria, with Charcot arguing that the hypnotic suggestibility underlying hysteria was a neurological condition, while Liébault and Bernheim believed it was a general trait that varied across populations. Josef Breuer (1842-1925) and Sigmund Freud (1856-1939) settled this dispute in favor of a psychogenic explanation of insanity, treating hysteria through hypnosis, which eventually led to the cathartic method, which became the forerunner of psychoanalysis. first half of the 20th century.
Psychoanalysis was the dominant psychogenic treatment for mental illness in the first half of the 20th century and formed the basis for the more than 400 different schools of psychotherapy that exist today (Magnavita, 2006). Most of these schools focus on broader behavioral, cognitive, cognitive-behavioural, psychodynamic, and client-centered approaches to applied psychotherapy in individual, marital, family, or group formats. However, negligible differences were found between all of these approaches; its effectiveness in treating mental illness is due to factors common to all approaches (not elements specific to each approach): the therapist-patient alliance, the therapist's loyalty to the therapy, the therapist's competence, and the placebo effects ( Luborsky et al al., 2002). ; Messer and Wampold, 2002).
Instead, the most important somatogenic treatment for mental illness can be found in the establishment of the first psychoactive drugs in the mid-20th century. Fixations, ECT, and lobotomies continued to be used in US state institutions well into the 1970s, but they quickly gave way to a burgeoning pharmaceutical industry that viewed and treated mental illness as a chemical imbalance in the brain.
Both etiological theories coexist today in what the psychological discipline regards as a biopsychosocial model for explaining human behavior. Although people can be born with a genetic predisposition to a particular mental disorder, certain psychological stressors must be present for them to develop the disorder. Socio-cultural factors such as socio-political or economic unrest, poor living conditions or problematic interpersonal relationships are also considered contributing factors. As much as we would like to believe that we are above the treatments outlined above, or that the present is always the most enlightened time, let's not forget that our current thinking continues to reflect the same underlying somatogenic and psychogenic theories of mental illness. in this book. superficial history of 9,000 years.
references
- Bell, LV (1980).Treatment of the mentally ill: from colonial times to the present. New York: Embers.
- Wald, D. (1999).Hypnosis: A History. New York: Pinguin.
- Grob, GN (1994).The Crazy Among Us: A History of Mental Health Care in America. New York: Free Press.
- Luborsky L, Rosenthal R, Diguer L, Andrusyna TP, Berman JS, Levitt JT, . . . Krause, E.D. (2002). The dodo bird verdict is, for the most part, alive and well.Clinical Psychology: Science and Practice, 9th, 2–12.
- Messer, S.B. and Wampold, B.E. (2002). Let's face it: Common factors are more effective in therapy than specific ingredients.Clinical Psychology: Science and Practice, 9th(1), 21–25.
- Micale, MS. (1985). La Salpêtrière in the age of Charcot: an institutional perspective on the history of medicine at the end of the 19th century.Journal of Contemporary History, 20, 703–731.
- Restak, R. (2000).mysteries of the mind. Washington, DC: National Geographical Society.
- Schoeneman, T.J. (1977). The role of insanity in the European witch-hunts of the sixteenth and seventeenth centuries: an appraisal.Journal of the History of the Behavioral Sciences, 13(4), 337–351.
- Tseng, W. (1973). The development of psychiatric concepts in traditional Chinese medicine.Archives for General Psychiatry, 29, 569–575.
- Viney, W & Zorich, S (1982). Contributions to the history of psychology: XXIX. Dorothea Dix and the History of Psychology.Psychological reports, 50th, 211–218.
- Zilboorg, G. and Henry, G.W. (1941).A history of medical psychology.. . . . New York: W. W. Norton.
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