The Nineteenth and Early Twentieth Centuries
Individuals have been
subject to various anomalies since time immemorial. Having recognized this over
time the various stakeholders started empathizing with the victims rather than
quarantine them. A special treatment for the disturbed people became
inevitable. It was in this background that "asylums" were established
in the 18th century. But the objective behind institutionalizing
failed, worsened the situation of mental patients. Hence, efforts were made to help
the disturbed individuals by treating them more humanely.
In the 19th
century, medical professionals or alienists had taken over looking after and
managing the “insane”, though there role was ineffective. They incorporated
traditional moral management therapy into the other rudimentary
physical-medical procedures. Consequently, mental disorders were believed to
have caused by brain damage from outward influences. Symptoms were vaguely drawn and this further
worsened the plight of the mentally disturbed.
However, institutions continued to exist. The patients experienced harsh
living conditions. They were ostracized by the public.
To sensitize the public,
Clifford Beers published a book in 1908 titled “A Mind That Found Itself” in
which he described his own mental
collapse and the kind of bad treatment he received from the institutions of the
time. The book- “roused
the nation to the plight of people with mental illnesses and set a reform
movement into motion” (Mental Health America) .
Unfortunately, by 1890 every state had built one or more publicly supported mental hospitals. By the mid-20th century, "the hospitals housed over 500,000 patients or roughly around 90%" of mentally ill of America(U.S. National Library of
Medicine, National Health Medicine) . The patients
were subjected to harsh treatment and the care was punitive and inhumane. However,
the patients treated cruelly.
In 1946 a book was published by Mary Jane Ward
titled “The Snake Pit”. The main result of this book was that it- “created
concern over the need to provide more humane mental health care in the
community instead of the overcrowded mental hospitals.” “The National Institute
of Mental Health” was established as well as the “Hill-Burton Act” was passed.
Along with this, “the Community Health Services Act of 1963 created a far-reaching set of programs to
develop outpatient psychiatric clinics, inpatient facilities in general
hospitals and community consultation and rehabilitation programs.” (Robert C
Carson, 2007)
The highlight
of this period, however, is the development of effective medications for many
disorders, for instance lithium was used in the treatment of depressive
disorders. (Robert C Carson, 2007)
The latter
part of the twentieth century was characterized by efforts to remove mental
hospitals and return the patients to the community as it will enable more
humane treatment towards them as against the isolated treatment available in
the psychiatric hospitals.
The process was called deinstitutionalization
was adopted to reduce the impact of negative adaptations that can creep into
individuals due to hospital confinement. Unfortunately, deinstitutionalization
also came with problems for the society at large remained blind to such a need.
(TANSELLA, 2002 June; 1(2))
However, due to the repercussions, “by the end of the twentieth
century inpatient treatment had replaced the community based care, day treatment
hospitals and outreach programs” (Robert C Carson, 2007) .
Contemporary Views of
Abnormal Behaviour
While on one side heated debate was going about mental hygiene
and care, the other side witnessed advances as we see in the discipline today.
The contemporary perspective of abnormal psychology is based on - a) biological
discoveries; b) system of classification that was developed; c) psychological
causes for mental disorders and; d) various “research developments in
experimental psychology” (Robert C Carson, 2007) .
Biological Discoveries:
“The biological perspective focuses on the biological
underpinnings of abnormal behavior and the use of biologically based
approaches, such as drug therapy, to treat psychological disorders (Butcher) .” Physiological and
anatomical factors causing physical and mental disorders saw advances. A major
event was the discovery of the- “organic factors causing general
paresis-syphilis of the brain.” The cure was discovered by A L J Bayle. He gave
an accurate description of the symptoms. Then, Viennese psychiatrist Richard
von Kraft-Ebbing proved the same through experimentation. The final effort of “Julius
von Wagner-Jauregg” was commendable. He introduced, “the malaria fever
treatment of syphilis associated and paresis as high fever associated with
malaria killed the bacteria” (Robert C Carson, 2007) . The most important
implication of this discovery was that it raised hopes of the medical community
by establishing the existence of organic bases for others or perhaps all mental
disorders.
Knowledge base of anatomy, physiology, neurology, chemistry and
general medicine was vastly developed. This gave an incentive to scientists as
they became aware that a pathology of an organ led to ailments. Albrecht von
Haller in his book “Elements of Physiology” highlighted the “importance of
brain in psychic functions and advocated dissection of brain during
post-mortem.” Wilhelm Griesinger in his book, “The Pathology and Therapy of
Psychic Disorders” opined “that all mental disorders can be explained in terms
of brain pathology.” However, it is important to note that these discoveries
addressed the question of “how” behind the causation and not “why”.
The Development of a Classification System
of Mental Disorders was due to the pioneer efforts of Emil
Kraepelin which can be seen as a forerunner of “DSM-IV-TR”. He noted that mental
disorders had symptoms that could “be regarded as specific types of mental
disease”. The main motive behind this system was to presumably predict a given
disorder even if unable to treat them.
Psychological Basis for Mental Disorder:
In order to understand the psychological factors in mental
disorders the pioneering step was taken by Sigmund Freud. He believed that
abnormal behavior stemmed from psychological causes based on underlying psychic
forces within the personality (Butcher) . A comprehensive
theory of psychopathology called psychoanalysis was developed by him. Freud
suggested therapies for he believed that it helped patients “discharge their
emotional tensions and helped the psychologist understand the nature of
difficulties that brought about certain symptoms” (Robert C
Carson, 2007)
.
The debate between Nancy
school (who were interested in the relationship between hypnosis and hysteria)
and Jean Charcot (suggested that degenerative brain changes led to hysteria)
led to more psychological investigation. Soon it was believed that anxiety
states, phobias and other psychopathologies had a psychological basis.
As a result, towards the end of 19th century and the
beginning of the 20th century mental disorders were believed to have
biological or psychological causes or both.
Experimental psychological research developments:
The understanding provided by the experimental psychologists did
not affect that understanding of abnormal behaviour immediately but provided a
scope for future analysis. “Wilhelm Wundt setup the first psychology laboratory
in 1879, at the University of Leipzig. He developed many experimental methods
and strategies which directly influenced the early contributors to the empirical
study of abnormal behaviour.” (Robert C Carson, 2007)
The two journals- “Journal of Abnormal Psychology, founded by
Morton Prince in 1906”, and “The Psychological Clinic founded by Lightner
Witmer” in 1907 proved to be an important landmark in the evolution of the
discipline. (Robert C Carson, 2007)
The Behavioral Perspective revolves around the idea of role of
learning in human behaviour. It emerged out to challenge the supremacy of
experimental psychology. They believed that the methods proposed by
experimental psychologists are not verifiable and only by studying directly
observable behaviour can human behavior be understood. This school propounded
by Ivan Pavlov and John B Watson argued that abnormal behaviour is “the product
of unfortunate, inadvertent earlier conditioning and could be modified through
reconditioning.” Thorndike and Skinner propounded operant conditioning according
to which external reinforcement can shape an organism’s activity. The
Behaviorist’s, though were purely laboratory in nature, their perspective does
explain maladaptive behaviour and its treatment.
The evolution of Psychology, at large, contributed to the
evolution of Abnormal Psychology. The situation in the 19th century
required a contemporary perspective to create awareness among the public and
also to effectively treat the mentally ill. These perspectives, therefore,
enlarge the scope for further research and provide a wholesome of the very need
of the subject of abnormal psychology (Butcher) .
References
The Nineteenth and Early Twentieth Centuries
Individuals have been
subject to various anomalies since time immemorial. Having recognized this over
time the various stakeholders started empathizing with the victims rather than
quarantine them. A special treatment for the disturbed people became
inevitable. It was in this background that "asylums" were established
in the 18th century. But the objective behind institutionalizing
failed, worsened the situation of mental patients. Hence, efforts were made to help
the disturbed individuals by treating them more humanely.
In the 19th
century, medical professionals or alienists had taken over looking after and
managing the “insane”, though there role was ineffective. They incorporated
traditional moral management therapy into the other rudimentary
physical-medical procedures. Consequently, mental disorders were believed to
have caused by brain damage from outward influences. Symptoms were vaguely drawn and this further
worsened the plight of the mentally disturbed.
However, institutions continued to exist. The patients experienced harsh
living conditions. They were ostracized by the public.
To sensitize the public,
Clifford Beers published a book in 1908 titled “A Mind That Found Itself” in
which he described his own mental
collapse and the kind of bad treatment he received from the institutions of the
time. The book- “roused
the nation to the plight of people with mental illnesses and set a reform
movement into motion” (Mental Health America) .
Unfortunately, by 1890 every state had built one or more publicly supported mental hospitals. By the mid-20th century, "the hospitals housed over 500,000 patients or roughly around 90%" of mentally ill of America(U.S. National Library of
Medicine, National Health Medicine) . The patients
were subjected to harsh treatment and the care was punitive and inhumane. However,
the patients treated cruelly.
Unfortunately, by 1890 every state had built one or more publicly supported mental hospitals. By the mid-20th century, "the hospitals housed over 500,000 patients or roughly around 90%" of mentally ill of America
In 1946 a book was published by Mary Jane Ward
titled “The Snake Pit”. The main result of this book was that it- “created
concern over the need to provide more humane mental health care in the
community instead of the overcrowded mental hospitals.” “The National Institute
of Mental Health” was established as well as the “Hill-Burton Act” was passed.
Along with this, “the Community Health Services Act of 1963 created a far-reaching set of programs to
develop outpatient psychiatric clinics, inpatient facilities in general
hospitals and community consultation and rehabilitation programs.” (Robert C
Carson, 2007)
The highlight
of this period, however, is the development of effective medications for many
disorders, for instance lithium was used in the treatment of depressive
disorders. (Robert C Carson, 2007)
The latter
part of the twentieth century was characterized by efforts to remove mental
hospitals and return the patients to the community as it will enable more
humane treatment towards them as against the isolated treatment available in
the psychiatric hospitals.
The process was called deinstitutionalization
was adopted to reduce the impact of negative adaptations that can creep into
individuals due to hospital confinement. Unfortunately, deinstitutionalization
also came with problems for the society at large remained blind to such a need.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489876/table/T1/-
However, due to the repercussions, “by the end of the twentieth
century inpatient treatment had replaced the community based care, day treatment
hospitals and outreach programs” (Robert C Carson, 2007) .
Contemporary Views of
Abnormal Behaviour
While on one side heated debate was going about mental hygiene
and care, the other side witnessed advances as we see in the discipline today.
The contemporary perspective of abnormal psychology is based on - a) biological
discoveries; b) system of classification that was developed; c) psychological
causes for mental disorders and; d) various “research developments in
experimental psychology” (Robert C Carson, 2007) .
Biological Discoveries:
“The biological perspective focuses on the biological
underpinnings of abnormal behavior and the use of biologically based
approaches, such as drug therapy, to treat psychological disorders (Butcher) .” Physiological and
anatomical factors causing physical and mental disorders saw advances. A major
event was the discovery of the- “organic factors causing general
paresis-syphilis of the brain.” The cure was discovered by A L J Bayle. He gave
an accurate description of the symptoms. Then, Viennese psychiatrist Richard
von Kraft-Ebbing proved the same through experimentation. The final effort of “Julius
von Wagner-Jauregg” was commendable. He introduced, “the malaria fever
treatment of syphilis associated and paresis as high fever associated with
malaria killed the bacteria” (Robert C Carson, 2007) . The most important
implication of this discovery was that it raised hopes of the medical community
by establishing the existence of organic bases for others or perhaps all mental
disorders.
Knowledge base of anatomy, physiology, neurology, chemistry and
general medicine was vastly developed. This gave an incentive to scientists as
they became aware that a pathology of an organ led to ailments. Albrecht von
Haller in his book “Elements of Physiology” highlighted the “importance of
brain in psychic functions and advocated dissection of brain during
post-mortem.” Wilhelm Griesinger in his book, “The Pathology and Therapy of
Psychic Disorders” opined “that all mental disorders can be explained in terms
of brain pathology.” However, it is important to note that these discoveries
addressed the question of “how” behind the causation and not “why”.
The Development of a Classification System
of Mental Disorders was due to the pioneer efforts of Emil
Kraepelin which can be seen as a forerunner of “DSM-IV-TR”. He noted that mental
disorders had symptoms that could “be regarded as specific types of mental
disease”. The main motive behind this system was to presumably predict a given
disorder even if unable to treat them.
Psychological Basis for Mental Disorder:
In order to understand the psychological factors in mental
disorders the pioneering step was taken by Sigmund Freud. He believed that
abnormal behavior stemmed from psychological causes based on underlying psychic
forces within the personality (Butcher) . A comprehensive
theory of psychopathology called psychoanalysis was developed by him. Freud
suggested therapies for he believed that it helped patients “discharge their
emotional tensions and helped the psychologist understand the nature of
difficulties that brought about certain symptoms” (Robert C
Carson, 2007)
.
The debate between Nancy
school (who were interested in the relationship between hypnosis and hysteria)
and Jean Charcot (suggested that degenerative brain changes led to hysteria)
led to more psychological investigation. Soon it was believed that anxiety
states, phobias and other psychopathologies had a psychological basis.
As a result, towards the end of 19th century and the
beginning of the 20th century mental disorders were believed to have
biological or psychological causes or both.
Experimental psychological research developments:
The understanding provided by the experimental psychologists did
not affect that understanding of abnormal behaviour immediately but provided a
scope for future analysis. “Wilhelm Wundt setup the first psychology laboratory
in 1879, at the University of Leipzig. He developed many experimental methods
and strategies which directly influenced the early contributors to the empirical
study of abnormal behaviour.” (Robert C Carson, 2007)
The two journals- “Journal of Abnormal Psychology, founded by
Morton Prince in 1906”, and “The Psychological Clinic founded by Lightner
Witmer” in 1907 proved to be an important landmark in the evolution of the
discipline. (Robert C Carson, 2007)
The Behavioral Perspective revolves around the idea of role of
learning in human behaviour. It emerged out to challenge the supremacy of
experimental psychology. They believed that the methods proposed by
experimental psychologists are not verifiable and only by studying directly
observable behaviour can human behavior be understood. This school propounded
by Ivan Pavlov and John B Watson argued that abnormal behaviour is “the product
of unfortunate, inadvertent earlier conditioning and could be modified through
reconditioning.” Thorndike and Skinner propounded operant conditioning according
to which external reinforcement can shape an organism’s activity. The
Behaviorist’s, though were purely laboratory in nature, their perspective does
explain maladaptive behaviour and its treatment.
The evolution of Psychology, at large, contributed to the
evolution of Abnormal Psychology. The situation in the 19th century
required a contemporary perspective to create awareness among the public and
also to effectively treat the mentally ill. These perspectives, therefore,
enlarge the scope for further research and provide a wholesome of the very need
of the subject of abnormal psychology (Butcher) .
References
1. (n.d.). Retrieved July 13, 2013, from Mental Health
America: http://www.nmha.org/centennial/history.html
1. (n.d.). Retrieved July 13, 2013, from Mental Health
America: http://www.nmha.org/centennial/history.html
2. (n.d.).
Retrieved July 14, 2013, from "U.S.
National Library of Medicine, National Health Medicine:
http://www.nlm.nih.gov/hmd/diseases/early.html"
3. Contemporary
Perspectives on Abnormal Behavior. In Abnormal Psychology (pp. 36-67).
4. Robert C
Carson, J. N. (2007). Abnormal Psychology. New Delhi: Dorling
Kindersley(India) Pvt. Ltd.,.
5. TANSELLA, G. T.
(2002 June; 1(2)). "Balancing community-basedand hospital-based mental
health care. World Psychiatry , 84–90"
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