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       NINETEENTH -CENTURY VIEWS OF THE CAUSES AND  TREATMENT OF MENTAL DISORDERS

   

     During the nineteen century mental hospitals were controlled by few people named 'Layperson'. Because of their prominence of moral management in the treatment of 'lunatics'. The medical psychiatrist and professionals were treating the people who were mentally retarded. This abnormal people were known as Alienated or insane.

       More over there was no effective treatments available during this century. The only procedures were available were drugging, bleeding and purging which produced few objective results.

 The alienists acquired more status and influence in society and became influential as purveyors of morality.Mental disorders were understood and conditions such as depression were considered to be the result of nervous exhaustion problems were caused by depletion of bodily energies.

When a person puts too much pressure his nerves get shattered this was known as neurasthenia a condition involved pervasive feelings of low mood, lack of energy and physical symptoms related to lifestyle.

   

                Contemporary views of Abnormal behaviour 

Great technological discoveries occurred  both at home and abroad in the nineteenth century.During the nineteenth and twentieth centuries 4 major themes in abnormal psychology were spanned and generated powerful influences on the contemporary perspectives in abnormal psychology.

• Biological discoveries
• The development of a classification system of mental disorders
• Emergence of psychological causationS 
• Experimental psychological research development 

 

Biological Discoveries :{Establishing link between the Brain and Mental disorders}.

During this period the study of biological and anatonical factors as underlying both physical and mental disorders were developed.

 

 

                            General paresis and Syphilis  

The discovery of a cure for general paresis began in 1825. When the french physician A.L.J.Bayle differentiated general paresis as a specific type of mental disorder.According to the psychiatrists the patients did not develop a secondary symptoms of syphilis.

 

 

                                Brain Pathology as a casual factor 

 

With the emergence of modern experimental science in the early part of the eighteenth century, knowledge of anatomy physiology, neurology, chemistry, and general medicine increased rapidly. disease body organs were one of the cause of physical ailments.It was the one of the net logical step for the research to assume that mental disorder was an illness based on the pathology of an organ . German psychiatrist Wilhelm Griesinger in his text book The Pathology and Therapy of Psychic disorder, published in 1845 insisted that all mental disorders could be explained in the terms of brain pathology.

 

                    The development of a Classification System

 

Emil kraepelin played a dominant role in the early development of the biological view point. This text Lehrubucher Psychiatrie not only emphasised the importance of these contributions was his system of classification of mental disorder.The most important of these contributions  was his system of classification of mental disorders , which became the forerunners of today's DSM-IV-TR.Thus the outcome of the disorder could be predicted, even if it could not yet be controlled. 

      Causations Views:Establishing the Psychological Basis Mental Disorder 

 

The first major steps taken by Sigmund Freud , most frequently cited psychological theorist of the twentieth century. During five decades observation, treatment and writing. Freud developed a comprehensive theory of psychopathology that emphasised the inner dynamics of unconscious motives. the methods he used for the study and treat patients came to be called as Paychoanyalysis.

 

Mesmerism : 

Franz Anton Mesmer an Austrian physician developed the idea of paracelsus  about the influences of planets on the human body.Mesmer believed that the planets affected a universal magnetic fluid on the body , the distribution of which determined health or disease. In attempting to find cure foe mental disorders , Mesmer concluded that all people possessed magnetic forces that could be used to influence the distribution of the magnetic fluid in other people.

 

 

                The Evolution of the Psychological Research Tradition

 

This was demonstrated by Wilhelm Wundt and William James.The origins  of much of the scientific thinking of contemporary psychology lie in early rigorous efforts to study psychological processes objectively.Although the work of these experimental psychologists did not bear directly on clinical practise or on our understanding of abnormal behaviour, this was clearly influenced a few decades later in moulding the thinking  of psychologists who brought these rigorous attitudes into the clinic.

 

                               The Behavioural Perspective 

 

In the early twentieth century another school behaviourism emerged out of experimental psychology.Behavioural psychologists believed that the study if subjective experience through the techniques of free association and dream analyses did not provide acceptable scientific data. According to them only the observable behaviour and the stimuli and reinforcing conditions that control it could serve as a basis for formulating scientific principles of human behaviour. 

 The behavioural perspective is organised around a cenral theme : the role of human behaviour.The learning plays an important role in human behaviour.

 

                                 Classical conditioning 

 

The origins of the behavioural view of abnormal behaviour and its treatment are tied to experimental work on the type of learning  known as classical conditioning. Classical conditioning means a form of neutral stimulus is paired repeatedly with unconditioned behaviour. After repeated pairings the neural stimulus becomes a conditioned stimulus that elicits a conditioned response. This work began with the discovery of the conditioned reflex by Russian Psychologist Ivan Pavlov. 

 

American Psychologist John.B. Watson who was searching for an objective ways to study human behaviour,was excited by the discoveries of Pavlov. Watson reasoned that if psychology was to become a true science it would have to abandon the subjectivity of inner sensations and other mental event. Watson thus changed the focus of psychology to the study of overt behaviour rather than theoretical mentalistic constructs , an approach he called behaviourism.He also challenged the psychoanalysts and the more biologically oriented psychologists by suggesting that abnormal behaviour was the product of unfortunate inadvertent earlier conditioning and could be modifies through reconditioning.Thus Watson's approach placed heavy emphasis on the role of social environment in conditioning personality development and behaviour both , normal and abnormal. 

 

                               Operant conditioning   

Operant conditioning, first investigated by Thorndike and then by Skinner, concerns what happens when a behaviour (the instrumental response or operant) is immediately followed by an unconditioned stimulus. It is also called ad instrumental conditioning .In Skinners view behaviour is shaped when something reinforces a particular activity of an organism. 

 

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Mental hospital care in the twentieth century:

The twentieth century began with a continued period of growth in asylums for the mentally ill; however the fate of mental patients during that century was neither uniform nor entirely positive. At the beginning of the twentieth century, with the influence of enlightened people such as Clifford beers, mental hospitals grew substantially in number, predominantly to house persons with severe mental disorders such as schizophrenia, depression, organic mental disorders, tertiary syphilis, paresis and severe alcoholism. During this period, hospital stays were typically quite lengthy, and many mentally ill individuals were destined to be hospitalized for many years. The mentally ill in early American communities were generally cared for by family members, however, in severe cases they sometimes ended up in almshouses or jails. Because mental illness was generally thought to be caused by a moral or spiritual failing, punishment and shame were often handed down to the mentally ill and sometimes their families as well. As the population grew and certain areas became more densely settled, mental illness became one of a number of social issues for which community institutions were created in order to handle the needs of such individuals collectively. During the later decades of the twentieth century, our society had seemingly come full circle with respect to the means of providing humane care for the mentally ill in the hospital environment. Vigorous efforts were made to close down mental hospitals and return psychiatrically disturbed people to the community, ostensibly as a means of providing more integrated and humane treatment than was available in the isolated environment of the psychiatric hospital. Large numbers of psychiatric hospitals were closed, and there was a significant reduction in state and county mental hospital populations, from over half a million in 1950.

Nineteenth century views of the causes and treatment of mental disorders

In the early part of the nineteenth century, mental hospitals were controlled essentially by laypersons because of the prominence of moral management in the treatment of lunatics. Medical professionals or alienists, as psychiatrists were called at this time in reference to their treating the alienated or insane had a relatively inconsequential role in the care of the insane and the management of the asylums of the day. Moreover effective treatments for mental disorders were unavailable, the only measures being such procedures as drugging, bleeding and purging, which produced few objective results. However, during the latter part of the century, alienists gained control of the insane asylums and incorporated the traditional moral management therapy into their other rudimentary physical medical procedures.

The military and the mentally ill:

Mental health treatment was also advanced by military medicine. the first mental health facility for treating mentally disordered war causalities was opened by the confederate army in the American civil war. An even more extensive and influential program of military psychiatry evolved in Germany during the late 1800s. One early research program illustrates the interplay between medicine and military administration. 

Contemporary views of abnormal behavior:

The four major themes in abnormal psychology that spanned the nineteenth and twentieth centuries and generated powerful influences on our contemporary perspectives in abnormal behavior

·         Biological discoveries

·         The development of a classical system for mental disorders

·         The emergence of psychological causation views and

·         Experimental psychological research developments

The beginnings of psychoanalysis:

The first systematic attempt was made by Sigmund Freud. Freud was a brilliant Viennese neurologist who received an attempt as lecturer on nervous diseases at the University of Vienna. Freud worked in collaboration with another physician, Josef Breuer, who had incorporated an interesting innovation into the use of hypnosis with his patients. The patients usually displayed considerable emotion and, on awakening from their hypnotic states, felt a significant emotional release, which was called a catharsis. It was this approach that thus led to the discovery of the unconscious the portion of the mind that contains experiences of which a person is unaware and with it the belief that processes outside of a person’s awareness can play an important role in determining behavior.

Two related methods enabled him to understand patients conscious and unconscious thought process. One method is free association, involved having patients talk freely about themselves, providing information about their feelings, motives and so forth. A second method, dream analysis, involved having patients record and describe their dreams. These techniques helped analysts and patients gain insights and achieve a better understanding of the patient’s emotional problems.

The early psychological laboratories:

In 1879 Wilhelm Wundt established the first experimental psychology laboratory at the University of Leipzig. He studied the psychological factors that are involved in memory and sensation. He also influenced early contributors to the empirical study of abnormal behavior, they followed this this methodology and applied some of his research strategies to study clinical problems.

The Nancy school:

Ambrose august liebeault, a French physician practiced in the town of Nancy, used hypnosis successfully in his practice. Their hypothesis was based on two lines of evidence:

1.      The phenomena observed in hysteria such as paralysis of an arm, inability to hear, and anesthetic areas.

2.      The same symptoms also could be removed by means of hypnosis. The physicians who accepted this view ultimately Came to be known as the Nancy school.

The behavioral perspective:

The behavioral perspective is organized a central theme, the role of learning in human behavior. This perspective was developed through research in the laboratory rather than through clinical practice with disturbed individuals, its implications for explaining and treating maladaptive behavior became evident.

Classical conditioning:

Classical conditioning is a form of learning in which a neutral stimulus is paired repeatedly with an unconditioned stimulus that naturally elicits an unconditioned behavior. This work began with the discovery of the conditioned reflex by Russian psychologist Ivan Pavlov around twentieth century. Pavlov demonstrated that dogs would gradually begin to salivate in response to a nonfood stimulus such as a bell after the stimulus had been regularly accompanied by food.

Operant conditioning:

B.F skinner formulated the concept of operant conditioning, in which reinforces could be used to make a response more or less probable and frequent. Thorndike studied how cats could learn a particular response, such as pulling a chain, if that response was followed by food reinforcement. This type of learning came to be called “instrumental conditioning” and was later renamed as operant conditioning by skinner.

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Mass madness

Mass madness is group hysteria where a large group has an uncontrollable outburst of emotions or fear, usually irrationally. During the last half of the middle Ages in Europe, A peculiar trend emerged in efforts to understand abnormal behavior. It involved mass madness—the widespread occurrence of group behavior disorders that were apparently cases of hysteria. Whole groups of people affected simultaneously. Dancing manias (epidemics of raving, jumping, dancing, and convulsions) were reported as early as the tenth century.

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 Arshiya kauser
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Definition:

       Abnormal psychology is the branch of psychology that studies unusual patterns of behaviour , emotion and thought, which may not be understood as precipitating a mental disorder.

HISTORICAL VIEWS OF ABNORMAL BEHAVIOUR.

         Stone Age cave dwellers were the first people to start the earliest treatment of mental disorder which was practised by them some half a million years ago.Some of the people who started searching treatments for mental disorder were Shaman, he is known as medicine man. He treated the disorder by means of operation now called as " Trephining". This operation was performed with crude stone instruments . And this consisted of chipping away one area of the skull in the form of a circle until the skull was cut through. This was called 'trephine'. This was thought that evil spirits that was thought to be causing all the trouble to escape and incidentally have relieved a certain amount of pressure on the brain.  In some of the cases it was found that trephined skulls of primitive people show healing around the opening and lived for many years.

Human life existed 3millions years ago or more but the written records were from some around thousand years ago. Due to this our knowledge about ancestors is very limited.  As there was no treatments for disorders but there were two Egyptian papyri during 16th century B.C provides us some clue to the earliest treatments of disease and behaviour disorders. A person who provided first detailed descriptions of the treatment of wounds and other surgical operations was The Edwin Smith papyrus. During his time the brain was first described in history and it clearly showed that brain was recognised as the site of mental functions.

Further papyrus offered another perspective on treatment . It covers the internal medicine and the circulatory system but it more relies on incantations and magic for explaining and curing disease that had unknown causes. Here surgical techniques ere used but still they coupled it with their prayers and like that it reflected the prevailing view of the origin of behaviour disorder.


DEMONOLOGY, GODS AND MAGIC.

        Abnormal behaviour in early writing's showed that the Chinese, Egyptian, Hebrews, and Greeks often attributed this kind of behaviour to demon or god who had taken possession of a person. Whether it was a good spirit or bad one but it had affected the individual.  Individual who spoke about or appeared to have a religious or mysterious significant had usually possessed god. Those people were often treated with respect thinking that they had supernatural power. Most of the people who got possession were considered that it was the work of an angry god or evil etc. This was the false notion about people. The primary treatment for the demonic possession was to take away the evil spirit from the effected person. The techniques varied to the type of possession they had. Some of them were praying, incarnation, chatting prayers,giving sheep's dung and wine.


HIPPO CRATES EARLY MEDICAL CONCEPTS.

       Greek Hippo crates was known as the Father of Medicine and he made a substantial contributions to the field of sciences. He said that there are no demons and deities who intervened in the illness and mental disorder of the person but instead it was also a kind of disease. He classified the mental disorders in three types they are Mania, Melancholia and phrenitis.

During this period there was a considerable understanding about the treatments to be given to the people who had mental disorder. Were people thought the earth was made of air,heat,water and fire which attributed to heat.cold,moistness and dryness. This all elements were then later combined to the human bodies that was blood, phlegm,bile and black bile. These fluids were combined with different people with different positions and the person temperament was determined by his or her humour with that of the dominant.

During this time Hippo crates thought that through dreams we can understand a patient's personality. The treatments were exorcist practices than a prevalent one. He also told about the environment which effects ones individual so he made those people to get out from their families. He focused on the natural causes of the disease on clinical observation and on brain pathology.

Early Physiological Conceptions of Consciousness and Mental Discovery.

 
The one of the famous Greek philosopher was Plato who did a study on the mentally disturbed people who committed criminal acts and studied how to deal with those people. He said that these people shouldn't get punishments which normal individual gets rather they can get punishment by paying for the damage one. Because some may commit act because of their anger or they might have some kind of mental disease. He also told that the mental cases shouldn't be ignored by the society rather it should be cared. He told that not only the intellectual thinking but also the socio-cultural perspective is responsible to the way individual thinks and its behaviour.

According to Plato the treatments can include hospital care been provided to the individual and also for engaging them in periodical conversation with the psychotherapy.

 LATER GREEK AND ROMAN THOUGHT.

      The works of Hippo crates were later taken by the Greek and Roman physicians. The physicians at this time used many treatments for the mental disorder such as gymnastic,education, dieting, massaging ,hydrotherapy etc.
Where as the Roman physicians wanted to make their patience calm so they used techniques like hot bath , massaging and they also made their patience drink chilled wine when they are in hot water tub.

 Abnormality During The Middles Ages.

        During the middle age period there was only Greek medicine which survived in the Islamic countries. And the first hospital for the mentally disturbed people was established at Baghdad  in 729 A.D. There was a very good figure if Islamic medicine was Avicenna from Arabia and hence this was called as the prince of physicians. During the middle age in Europe the scientific treatments were very limited for the disturbed people so mostly the treatments which were given to the individuals were often characterised by the ritual or superstitions than to understand the individuals condition. At this time the medical institutions,social structure and beliefs started changing drastically. The power of super natural and superstitions  started gaining popularity. They believed that SIN was not only a casual factor which caused the illness but there are the other factors too.

To look better at the history they looked into the two events of that time that occurred in middle age. They are  Mass Madness and Exorcism this two events will let us know how they are related to abnormal behaviour.

1. MASS MADNESS

During the last half of the middle age in Europe this trend was emerged to understand the abnormal behaviour among the individual. This refers to a widespread occurrence of a group behaviour disorders that were apparently the cases of hysteria. This group of people were affected simultaneously. Like for example dancing mania . Once upon a time there was a period were one such episode occurred in Italy early in thirteen century was known as "Tarantism". This referred to a disorder that included uncontrollable impulse to dance which was often attributed to the bite of the Southern European Tarantula.

Like that even Isolated rural areas were affected by the outbreaks of lycanthropy - this a condition in which people believed themselves to be possessed by wolves and imitated their behaviour. And the person who is been affected by this disorder had to be amputated which led to the death of that person.

Mass madness was started during the 17th century but it was been peaked during the 14th and 15th century. And this was a period of social oppression, famine and epidemic disease. At this time Europe was ravaged by the plague knows as Black Death which took away billions of life of people and also disrupted severely the social organisations. Many of the peculiar cases of mass  madness were related to fear,depression and wild mysticism of the events that occurred during that period of time.

2.EXORCISM AND WITCHCRAFT

Exorcism are referred to as symbolic acts that are performed to drive out the devils from the person believed to be possessed.

During the middle age the management of mentally disturbed people was largely left to the clergy. They took all the care of those people. And also monasteries served as refuges and places for confinement. During this age the mentally disturbed people were treated with more kindness. The treatments that were given are the holy water, prayers, sanctified ointments,breath of the priests,visits of the holy places and mild forms of exorcism.


And when the person possessed the evil spirit in his body then it was been removed by sprinkling of holy water by the priest so that the evil spirits leaves the individual and goes.

It had been longed middle age thought that people who are mentally disturbed were know as Witches and people used to accuse them as witches and thus these people were punished and were killed. There was one man by name  Robert Burton he s enlightened scholar who considered that demonic possession is potential cause of a disorder and therefore classified as those were two types of demoniacally possessed people they are :  Those who were physically possessed were considered as mad and the other was those who were spiritually possessed were the witches. These two categories were blurred in the eyes of the historians which resulted that witches and illness were connected more frequently in the medieval minds than in cases. The changing relation between witches and mental illness points out to the broader level of the issue which leads to the difficulties in interpreting the historical events accurately.

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The Evolution of the Psychological Research Tradition: Experimental Psychology

The origins of much of the scientific thinking in contemporary psychology lie in early rigorous efforts to study psychological processes objectively, as demonstrated by Wilhelm Wundt (1832-1920) and William James (1842-1910).

The Early Psychology Laboratories: 

                Wilhelm Wundt opens first experimental laboratory in psychology at the University of Leipzig, Germany. In 1896, one of  Wudnt's students, Lightner Witmer combined research with application and established the first American psychological clinic at the University of Pennsylvania. By the first decade of 20th century a number of psychological laboratories and clinics were set up, and a great deal of research was being generated. this period saw the origin of many scientific journals for the propagation of research and theoretical discoveries. By the start of the twentieth century it was seen that there were a lot psychological laboratories and clinics were emerging in all over which meant that Psychology as a study was getting more appreciation. 

There emerged many perspectives in this era. First of the slot was The Behavioral Approach. which consisted of Classical conditioning and Operant conditioning.

Classical conditioning:
Origins of the behavioral view of abnormal behavior and its treatment are tied up with experimental work This involves the stimulus being paired with an unconditioned stimulus that is neutrally elicits an unconditioned behavior. This neutral stimulus then becomes conditioned that elicits a certain type of conditioned response. This was experiment was done by Russian physiologist Ivan Pavlov and John B Watson.
  
Operant Conditioning:
E.L.Thorndike and B.F.Skinner was the man behind Operant conditioning.They were on the turn to find out whether a particular behavior will be repeated if a similar setting is given again. This type of learning was called "instrumental conditioning" and was later given the name Operant Conditioning. According to Skinner, "behavior is shaped when something reinforces a particular activity of an organism-which makes it ossible to shape an animal's behavior almost as a sculptor shapes a lump of clay.

  

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The Establishment of Early Asylums and Shrines

From the sixteenth century on, special institutions called asylums, sanctuaries or places of refuge meant solely for the care of mentally ill, grew in number. The story of the rise of the lunatic asylum and its gradual transformation into, and eventual replacement by, The modern psychiatric hospital, is also the story of the rise of organized, institutional psychiatry. The first hospital established in Europe was probably in Spain in 1409-- the Valencia mental hospital founded by Father Juan Pilberto Jofre (Villasante, 2003)- although this point has been the subject of considerable discussion (Polo, 1997; Trope, 1997). Other institutions for the insane were established after the Christian Reconquista, including hospitals in Valencia (1407), Zaragoza (1425), Seville (1436), Barcelona (1481), and Toledo (1483).  The Priory of Saint Mary of Bethlehem, which later became known more notoriously as Bedlam, was founded in 1247. At the start of the fifteenth century it housed just six insane men. The former lunatic asylum Het Dolhuys from the 16th century in Haarlem, the Netherlands is now a museum of psychiatry with an overview of treatments from the origins of the building up to the 1990s. These asylums were primarily modifications of penal institutions, and the inmates are treated more like beasts than like human beings. The Public Hospital in Williamsburg, Virginia, constructed in 1773, was the first hospital in the United States devoted exclusively to mental patients. Zwelling's 1985 review of the  Public Hospital's treatment methods shows that the philosophy of treatment involved the belief that the patients needed to choose rationality over insanity, thus the treatment techniques were aggressive , aimed at restoring a "physical balance in the body and brain". 

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An EXORCISM can be defined as “the expulsion of Demons or other evil spirits reputed to have taken possession of a person, place or object.” An exorcism usually involves putting holy water on the demon while directing orders and threats at the demon. However in some cases an exorcism can take much longer because of the arguments between the exorcist and the demon. Cases like these can also involve the thrashing of the victim’s body with sticks. Although many priests are doubtful in regards to exorcisms, requests are still made for priests to carry out the ritual. With authorization from their bishops some priests, mostly Catholic, still perform exorcisms. WITCHES can also perform exorcisms.

The exorcists rid the demons from the victim by calling on the assistance of God, Christ, the twelve apostles and other friendly spirits. When someone or something was believed to be possessed by a demon or demons, getting an exorcist would be the first response. If an exorcism failed the first time, the exorcist may have to keep repeating the exorcism. This meant that cases could usually be very difficult and required much patience. An exorcism would usually be done at midnight.Prayer and Holy water was also used. The exorcist would also attempt to identify the demon by name, find out how many demons were involved and find out if they would leave on their own accord or whether he or she had to use force to make them depart from the body that they inhibited. Many believe that the ritual of exorcism had a beneficial psychosomatic effect, but there have been cases when it has had the opposite effect.

Mass madness is a condition in which a big group of people exhibit a similar kind of emotional or physical symptoms, such as anxiety or too much of happiness also called epidemic hysteria. Mass hysteria as collective symptoms of disease is at times knows as mass psychogenic illness. Mass hysteria usually begins when an individual becomes ill or hysterical during a period of stress. The symptoms that are usually seen are nausea, muscle weakness or headache.

Lycanthropy according to myth is the supernatural condition where an individual shape shifts into a wolf. In the western world, these beasts were commonly known as “werewolves”. All the cultures around the world have recorded such man beasts and gave them different names. In Central America for instance, these beasts were called “werejaguars", the umbrella term used for metamorphosis and its variants is “Therianthropy”.

Clinical lycanthropy is a psychiatric syndrome that involves a belief that the affected person can transform into, has transformed into, or is a non-human animal.

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Contemporary views on Abnormal psychology

During the 19^th century there existed the hygiene movement in the United States along with that saw the occurrence of the great technologies. These advances help know what is the scientific or experimentally oriented; vie of abnormal behavior and the application of scientific knowledge to the treatment of the disturbed individuals.

Therefore there are four themes which have had great influences on the contemporary perspectives.

1)      Biological Discoveries: Establishing the Link between the Brain and Mental Disorder

This period saw the development of study of the biological anatomical factors and thus led to a major biomedical breakthrough. This led to discovery of the organic factors underlying general paresis- syphilis of the brain, it produced paralysis and insanity and typically cause death within 2-5 years as a result of brain deterioration.

General Paresis and Syphilis

The cure of this disorder was discovered by French physician A.L.J Bayle in the year 1825.He gave a complete and accurate description of the symptoms and the reasons of the disorder. Later in 1897, an experiment conducted by Richard von Krafft-Ebbing established the relationship between general paresis and syphilis. They conducted it involving the inoculation of paretic patients with matter from syphilis score. None of the patients show any secondary symptoms of syphilis and was assumed that that they were previously infected.

In 1906, august von Wassermann devised a blood test for the syphilis patients it made it easy to detect the bacteria in the individual’s blood stream. Finally in 1917, Julius von Wagner-Jauregg introduced the malarial fever treatment for the treatment of syphilis and paresis as he knew that high fever associated with malaria killed off the bacteria. He tested this on 9 patients and among them saw improvement in three and recovery in the other three patients.

Today we have the penicillin as an effective and simpler treatment for the syphilis.

Brain Pathology as a casual factor

This period saw the emergence of the modern experimental science in the 18^th century. Scientists began to focus on the diseased body organ as the cause of the physical aliment. The next was to assume that mental disorder was an illness based on pathology of an organ-the brain.

In 1757 albrecht von Haller in his book emphasized the importance of the brain in psychic functions and advocate for the postmortem dissection to the study of the brain.  However the first systematic representation of the brain was made by Wilhelm Griesinger and stated in his book that all mental disorders could be explained in terms of brain pathology. Alois Alzheimer and other investigators established the brain pathology in cerebral arteriosclerosis and in the senile mental disorder. Certain types of mental retardation and other mental illnesses were discovered.

The organic bases of mental disorder addressed the ‘how’ behind causation but not the ‘why’. For example although we know what causes certain ‘persenile’ mental disorder- brain pathology, we don’t know why some individuals are afflicted and others are not.

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                       ABNORMAL BEHAVIOR FROM CONTEMPORARY PERSPECTIVE 

The term "Abnormal  Behavior"(or dysfunctional behavior) arising from the word "Abnormality" which implies deviating from normal or deviating from the typical, takes us back to the late 19th and early 20th centuries, when the Mental Hygiene Movement began to took its place or ground in United States as an attempt by Progressive-era reformers to control venereal disease, drug abuse, acceptable sexual behavior in addition to an array of pamphlets, posters, textbooks and films, spreading awareness and also disseminate sexual education through the use of scientific research methods with great technological advancements. These advances helped usher in what we know today as scientific, rational or experimentally oriented view of abnormal behavior and the application of scientific knowledge to the treatment of the disturbed individuals.

          

The four major themes or perspectives took its ground during the nineteenth and twentieth centuries, after which it had its powerful influence on the concurrent views in the abnormal psychology field :

• biological discoveries
• development of classification system
• emergence of a psychological causation views
• experimental psychological research  developments

Biological  Discoveries

 The combined efforts of the scientists and the researchers brought about advances in the study of biological  and anatomical factors resulted biomedical breakthrough to occur. The organic factors came to the picture as the underlying reasons for the physical and mental disorder for example the syphilis of the brain caused paralysis and insanity which leads to death.

General Paresis

Physician A.L.J  Bayle (1852) differentiated or categorized general paresis as the specific type of mental disorder. Dr A.L.J  Bayle actually described the symptoms of this disorder with strong reasons to believe. Later, Viennese psychiatrist Richard Von Krafft- Ebbing conducted experiments which involves inoculating pare tic patients with matter from syphilitic sores. But August Von Wassermann devised a blood test for syphilis. This development made it possible for the patients to detect those deadly viruses or the bacterias flowing in the bloodstream.

Finally, In 1917, Julius Von wager Jauregg, chief of the psychiatric clinic of the university of Vienna introduced malarial fever treatment for syphilis and paresis because he understood that high fever associated with bacteria would killed off the bacteria. After experimenting on nine patients, 3 of the improved drastically and the other 6 were apparently improving. The same with the case of  Bahr and Brutsch in Indiana in 1928, they also found out that out of the 100 people , 37% of the people actually recovered , but this treatment became short lived due to the introduction of the medicines. With the development of the modern experimental science,  knowledge at anatomy, psychiatry, chemistry, neurology, physiology quite increased. Now, scientists, began to put emphasis on the brain pathology. Researchers came to assume that most  or all the mental disorders were based on the pathology of brain. Albrecht Von Haller, in his book “Elements of Physiology” put emphasis on the importance of brain in the psychic functions and advocated the postmortem dissection methods to study the brains of the insane. Griesinger in his textbook “ the pathology and the therapy of the psychic disorders explained disorders in terms of brain pathology. It is important to note that although the discoveries of all the causation factors which are there underlying the mental  disorders.

THE CLASSIFICATION SYSTEM

Emil Kraeplin played a dominant role in the early development of the classification system. He contributed his viewpoints and gave importance to brain pathology in mental disorders . The most important classification of his contributions is DSM-IV-TR. He noted that there are regular symptom patterns occurred together to be addressed as the mental disorders.

CAUSATION VIEWS: ESTABLISHING THE PSYCHOLOGICAL BASIS OF THE MENTAL DISORDER

Despite of understanding the biological factors, there are psychological factors too. These

Psychological factors are responsible for the mental disorders. The first major step taken by psychologist in twentieth century is Sigmund Freud. He introduced the psychoanalytic school where he emphasized the unconscious and the inner motives of a person or an individual. This implies that behavior or mental disorders explained through the unconscious and the inner motives of the person. The methods he used to study and treat patients came to be known as psychoanalysis.

MESMERISM

  

Mesmerism is a technique came to be known as influence of planets on human bodies.

The researcher Mesmer believed that the planets affected a universal magnetic fluid in the body, the distribution of which affected the mind and health of an individual. But eventually his theory of mesmerism could not take its place in the history of psychology. Heated arguments increased among the medical colleagues and the other practitioners which made him leave Paris and quickly fade away in the world of darkness.

THE NANCY SCHOOL

Ambrose August Liebeault (1823-1904) introduces hypnosis in his practice. Nancy at the time of his practice became interested in the relationship between hysteria and hypnosis. The Nancy school of thought basically adopted two main hypothesis, first, the phenomenon observed in hysteria  for instance paralysis of the arms, legs inability to hear, and anesthetic areas in which an individual could get stuck with a pin without feeling any pain. Second, the same symptoms could be removed by hypnosis. This is how Nancy school of thought came to known as. But later on heated discussions and debates followed between Charcot and the Nancy school as Charcot insisted that degenerative brain disorders led to hysteria.

PSYCHOANALYTIC SCHOOL OF THOUGHT

Sigmund Freud took an attempt to the inner meaning or the underlying reasons of these mental disorders. He proposed that mental processes could remain hidden from unconscious. After working with the physician Josef Breuer, Freud directed patients to talk freely about their problems under hypnosis. This method is known as catharsis. The second method to unconscious was free association which signifies letting patients talk about their problems freely which provided information about their motives , feelings, emotions. The third but not the least was the dream analysis talks about analyzing one’s dream and coming out with their inner conflicts troubling their mind, body and health. These are the important school of thoughts which led their inventions and discoveries to understand critically the hidden causal factors of the mental disorders.

REFERENCES

Carson,R.C., Butcher,J.N and Mine,S.(2004). Abnormal psychology. 13th Edition. New Delhi:     Pearson Education.

Barlow,D.H. and Durand,M.V. (2000). Abnormal Psychology. 2nd Edition. New Delhi:     Thomson Publication.

Jumana M K 1114363

CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOR--PSYCHOANALYSIS


The first major steps in understanding the psychological factors in mental disorders were taken by Sigmund Freud. He developed a comprehensive theory of psychopathology that emphasized the inner dynamics of unconscious motives, that are at the heart of the psychoanalytical approach.

The ancestral roots of hypnosis are traced back to the study of hypnosis, especially hysteria.
Hypnosis is an induced state of relaxation in which a person is highly open to suggestion.

Haritha 1114385

Abnormal psychology: the study of abnormal behavior, including theories and research about causes, assessment, and treatment.

Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion and thought, which may or may not be understood as precipitating a mental disorder

Psychopathology: an abnormal pattern of behavior that is unusual, distressing, dysfunctional, and that may cause the sufferer to be dangerous to self or others

1. Nineteenth century  views of the causes and treatment of mental disorders :

In the early nineteenth century,effective treatment were not available for mental disorders because the mental hospitals were controlled by laypersons. And there was prominence of moral management.

Unavailability of effective treatment was a major problem for the mentally retarded/ mental disorders.

Few procedures used by those laypersons were bleeding, drugging and purging, which dint bring out enough objective results on the mental disorders.

 Medical professionals were called as 'alienists' or medical professionals in the 19th century. And these alienists incorporated the traditional moral management into their physical and mental procedures.

In those days, there was no proper understanding of mental disorders as such, and especially disorders like depression were considered to be a result of nervous exhaustion

Early twentieth century is the time when there was attitude change in the mindset of people towards the mental patients.

In the nineteenth century end, the appearance of mental hospitals were actually considered scary because  it had a big fortress kind of appearance and a place where the mental patients lived under harsh surrounding. The general public who visited the mental hospitals, they found it to be an eerie place,and its patients to be a strange and frightening lot. Since the earliest psychiatrists had very little information to impart, they were unable to educate and people and to reduce their fear, and to change their mindset about these mental hospitals and its patients.

As a means to quieten the excited patients, the psychiatrists used bad treatments such as chains and other torture devices.

Mental hospital care in the 19th century:

mental hospitals housed people who were having severe mental problems like paresis, severe alcoholism, schizophrenia, tertiary syphilis, organic mental disorder and depression.

by 1940, the mental hospital housed 4lakh patients. At that point of time, the patients had to stay for a very long period of time, even years. First half of the 20th century, there was very little effective treatment and the care was often harsh, punitive and inhumane. 1946 was marked as an year of change since the release of a very influential book published by Mary Jane Ward brought about attention to the problems of the mental patients and helped them in the change of treatment to more humane kind.

In 1946 itself, The National Institutes of Mental Health was organized, and it provided research and training and even clinical psychology training programs. In this period, Hill-Burton Act funded mental hospitals, it also helped in creating outpatient psychiatric clinics, inpatient facilities, community consultation, and rehabilitation programs.

During 1950's and 1960's there was necessity for reform in psychiatric hospitals was a major concern for many professionals and laypersons. In the later decades of 20th century, our society had gained respect to the means of providing humane care for the mentally ill in the hospital environment. 

Contemporary views:
Great technological advances occurred during the later years of 19th century, which led to the application of scientific knowledge to the treatment of disturbed individuals. There were great Biological discoveries made by establishing the link between the brain and the mental disorder.
Next came the discovery of brain pathology as a reason for mental disorder, following that came the disorders caused by toxic substances such as lead, and certain types of mental retardation and other mental illnesses were discovered.
In the early part of 18th century, knowledge of anatomy, neurology, physiology, chemistry, general medicines came into greater circle. These kind of discoveries  led to biological/organic pathology which had physical ailments.

Psychiatric classification system which was developed by Kraepelin played a very important role in the development of biological viewpoint.

Sigmund Freud was the first person to take major steps in understanding psychological factors in mental disorders. Only in the latter 19th century scientific investigation into psychological factors and human behavior began.

Emergence of behaviorism as the most important model in abnormal psychology which consisted of a central theme -"Learning plays and important role in behavior" This concept has given the most important implication for explaining and treating maladaptive behavior.

Reference: 

• Abnormal Psychology 13th edition by Carson, Butcher, Mineka, and Hooley

Varsha.C 1114332 (Abnormal Psychology: Insight)

Name : Varsha Chandrashekar

Roll Number:1114332

Class: PSEco

Abnormal Psychology

What is abnormality?

Abnormal Psychology isn’t that uncommon as we think it is. Though it is generally thought that it only existing with in a certain section of the society, it actually also exists much closer in one’s home. Issues such as eating disorders like bulimia, anorexia or substance abuse fall under the criteria of abnormal psychology. Now before we dwell into the detailed area of this topic, it is necessary to first understand what is abnormality? To put it in simple terms, abnormality is anything that deviates from normal norms of the society or environment in which it is ratified. One example out the million case studies can be given for a clearer understanding.

Case Study/Example:

Monica is a young, intelligent girl in her teens who is a star student in her school. Her personal life is just as good with her family and peers. If you were to meet her, you would think she had minimal amount of problems in her life. But Monica has been having an eating disorder since 13 years of age. She has been following a ‘diet’ since the beginning of her teenage life due to fear of losing her ‘perfect shape’. She ate very little food during the day and at night she would stuff herself with unhealthy foodstuffs in order to fill her stomach only to vomit it out the next hour. She frequently misses morning classes due to weakness and lack of energy in the body. However, she denies any sort of problem related to food and her body and calls herself as ‘thin’ compared to the rest of the girls. The previous week she decided to stop with the ‘diet’ and eat regular full meals. However she found it next to impossible to stop and is now treading on a dangerous path of getting rapidly thin which could prove fatal.

Now as you read this you may have innumerable question in your mid. That is if people in Monica’s family have an eating disorder too. Or since she is in her teens, is she really having an eating disorder with a completely psychological explanation or is she just trying to fit in her popular friends circle. Moreover to let in a few more details, Monica’s family members such as her paternal aunt and maternal grandmother had such a disorder too.  This is what we term as family aggression. Although there is a change of name in this cases study for protection of her identity, this is a real case and a real problem.

Given below is a graph depicting children with abnormal disorders/behaviors among different age groups:

(SOURCE: GOOGLE IMAGES)

Role of a Psychologist and Clinician:

If one were to understand mental disorders then it becomes obvious to learn to solicit questions regarding such kind of behaviors in order to help patients and families suffering from mental disorders. Without a doubt, posing questions is an imperative part of a psychologist’s job. They are taught to ask questions and conduct research. Psychologists not only have to raise questions but also rely on scientific skills to gather information and present it in a logical and lucid way. Arguably, treatment that was found a decade or even 5 years ago would not be the best of ways to cure patients; hence psychologists have to make use of the latest research to opt for the most effective treatment.

Meaning of Abnormal Behavior and Elements:-

It would be next to impossible to arrive at a perfect definition of abnormality or a disorder. However there are certain elements of abnormality which make it clearer to understand the field of study. We cannot say that one element is enough to define abnormality as every element is dependent on the other and also if there are greater similarities between the element and the person’s behavior; the easier it is to diagnose the abnormality of the person. Given below are a set of elements that assess the degree and criteria for abnormality:-

1. Suffering: Psychological suffering is indicative of abnormality. People in                 depression suffer psychologically as well as people with anxiety disorders. But there are people who are just frenzied or become agitated over thing like the net days exams. Although that is suffering it is hardly labeled abnormal. Experts in this field state that although suffering is considered as an element for abnormality, it is not a sufficient or even highly necessary condition for abnormality.

2. Maladaptiveness: This is a more serious indicator of abnormality. This is because it interferes with our relationships and enjoyment with family and peers and invades our well being too. For example, Monica in the above case study would withdraw from eating to the point where she is so frail that she needs to be hospitalized. However not all disorders have the element of maladaptiveness. For example, a contract killer would kill a person in return for a sum of money which according to him is his wage. According to him, this behavior is not abnormal because it is the way he makes his living. But on the other hand we consider it abnormal because it goes against the norms set by the society and hence is maladaptive for the society.

3. Deviancy: Deviancy would lead us to the meaning to being ‘away for normal’. But just statistically considering unique or rather rare behavior to be abnormal would not help in defining abnormality. People often make value judgments when defining abnormality. When something is rare but desirable we consider it to be normal such as being a computer genius. But if something is rare and undesirable such as being dyslexic then it is likely to be considered as abnormal. Also if something is common but undesirable it is less likely considered to be abnormal such as being arrogant or selfish.

Thomas Edison who is the inventor of the light bulb is a genius to reckon but this is not considered as abnormal..

4. Violation of Standards of Society: Almost all cultures around the world have a set of rules and regulation. These are further framed as laws. Some societies set standards and norms which are to be followed by all individuals in the society. Any individual who breaks or refuses to follow the rules and norms are said to be abnormal. This also depends on the degree to which the laws are broken and also the commonalty of such violations. For example murder is considered as abnormal by any society but illegal parking is less likely to be considered abnormal in comparison.

5. Social Discomfort: Violation of any social rule would lead to people around feel a sense of discomfort and uneasiness. For example when a stranger invades your personal space or sits next to you even though there are free seats everywhere else, you would feel uneasy and a sense of discomfort would start to build. It can be said that unless you are a therapist working under such conditions, it would seem greatly abnormal to you.

6. Irrationality and Unpredictability: we as normal people expect others to behave I a certain code of conduct which is just as normal. However, even though being unconventional is a part and parcel of some individuals, it is inevitable that we would judge them after a certain point of time. For example a person who recites Martin Luther King’s speech during a ceremony, it would be considered as normal but if a person would say it out loud in the middle of the street lying flatly on the ground, it would be considered as abnormal. Also it is important to note that what is important is how we as people evaluate if others can control his or her behavior. Schizophrenic patients often have disordered speech which is considered to be irrational.

These are the main criteria for considered a person to abnormal and deviate from what we call normal behavior in the society.

Need for Classification of Mental Disorders:-

There is a dire need to classify information in almost all areas of study. This is due to the fact that classifying information provides us with nomenclature which is a naming system and it helps us to structure that information in a more organized and helpful manner. It not only helps us to structure information but also helps us learn more about the disorder regarding its causes and most importantly how it would best be treated. For example in the above case study, Monica’s eating disorder would help us study what type of disorder it is and what would be the best treatment. This is vital as it would distinguish the type of treatment that can be used on the respective patients.

Finally classifying information would help us ascertain the degree of problems the medical health profession can tackle. It would also help in finding out which problem needs reimbursement and the amount of imbursement.

Disadvantages of Classification:-

There are a few disadvantages as well when we classify information. When we classify or simplify information we acquire a loss of information as it is in a short hand format. Any information which is in a short hand format will lead a loss of information. For example, learning about the person’s disorder would give us more information rather than just being told that he or she has ‘anorexia’. Hence we are losing out personal details of the actual person who is suffering from mental disorders by further simplifying the information.

When a person is diagnosed with a certain type of mental disorder, there is a sense of stigma or fear that is automatically attached to him or her. For example, people who are vocal about diseases like diabetes are likely to be more secretive about a mental disorder as they have fear unwanted social and occupational consequences. In the above case study Monica would prefer to be secretive eating disorder and would rather change the topic to something else.

Along with sigma, there is a sense of stereotyping that occurs among people. Stereotypes are notions people have on others on the observation or knowledge of one thing about them. For example stereotyping that people from Delhi are rude and people from South India are very orthodox in nature. Hence, because we know about a certain type of behavior that complements a certain type of mental disorder; we tend to automatically presume that these are behaviors that attached any person with a psychiatric diagnosis.

Along with stigma and stereotyping there occurs a predicament of labeling. A person who is diagnosed with a particular mental disorder and is grouped under a number of symptoms, this diagnostic label is almost permanent in their minds even though they have completely recovered. Also more importantly, person’s self-concept is damaged when they are diagnosed with mental disorders such as autism, bulimia etc. Language is essential when dealing with patients suffering from mental disorders. It is crucial to know that diagnostic classification doesn’t classify people but it classifies the disorders people have. It is now widely recommended that doctors specify the disorder the patient is suffering from rather than labeling them. For example it is preferred to say the “a person with autism” rather than autistic giving a feeling that the person is more than the diagnosis and not just the diagnosis.

The DSM 4 Definition of Mental Disorder:-

The American Psychiatric association’s Diagnostic and Statistical Manual of Mental Disorder or popularly known as ‘DSM’, is considered as the gold standard for measuring numerous mental disorders. The DSM is presently in its 5^th edition and was first published in 1994 and was faintly improved in 2000. The 4^th edition of DSM defines mental disorders as the following:

·         “A clinically significant behavioral or psychological syndrome or pattern.”

·         “Associated with distress or disability which means impairment in one or more important areas of functioning.”

·         “Not simply a predictable and culturally sanctioned response to a particular event such as death of a loved one.”

·         “Considered to reflect behavioral, psychological or biological dysfunction in the individual.”

However, there are a few debatable flaws in this definition proposed by DSM4. For instance, the cause of mental disorders is not mention by the DSM. One can say that DSM has endeavored to be ‘a theoretical’. Behaviors which are linked to culturally authorized responses such as depression or sadness due to loss of a loved one is ruled out by DSM. DSM also emphasizes that mental disorders are the product of dysfunction which is inherent in individuals and not in groups. It has been argued upon that knotty or difficult behavior by itself cannot be the dysfunction because by saying so, it would be like saying that mental disorders are caused due to mental disorders which is incorrect.