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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.