Abnormal Psychology : Bhavana 1114383 (moral therapy)

Abnormal Psychology : Bhavana 1114383 (moral therapy): Moral therapy  Moral therapy comes under humanitarian approach.The term moral really meant emotional or psychological rather than a code...

Sheetal (1114393)

Topic: Views of abnormal behavior in the later middle ages and early part of renaissance.

Abnormal psychology: It is the scientific study whose objectives are to describe,explain,predict and control behaviors that are considered strange or unusual. (Robert.Carlson, 2007)

What we understand of abnormal psychology now was not understood the same way in the middle ages. example-mania was considered as an possession.But in the 1490-1541,a Swiss physician called Paraceleus who was an critic of superstitious belief insisted that mania was not an possession but an mental illness which requires treatment.

This change of mindset among the people along with scientific questioning resulted in a movement called as "humanism"-which challenged the superstitious belief of abnormal behavior     

During the 19^th century, a physician by name Philippe Pinel was in charge of a hospital for insane men in France .He came up with a movement called moral treatment movement ,which focused on a shift from being treated like animals in a zoo to a more humane treatment ,he ordered the inmates chains to be removed,replace dungeons with sunny roams and treat patients with kindness and compassion .This treatment resulted in faster recovery and improvement of the behavior in patients.

Establishment of early asylums.

In the 16^th century ,special institutions called asylums  which was meant for the mentally ill or insane people began to grow ,these asylums  were built as a way of looking after patients who could not look after themselves .But, shockingly these patients died amidst inhumane cruelty and filth .

The first hospital was established in Europe in 1409,Spain called the “Valencia mental hospital” founded by father. Juan Pilberto Jofre ,but there is very little know about the treatment in this hospital or asylum.

During the 1547,St.Mary monastery in Bethlehem, London was converted into an asylum called “Bedlam” it is infamously known for its  inhumane activities like ,making the mentally ill people exhibited for money, making them beg and other such activities.

In the early asylums, these inmates were treated more like beast rather than humans The following case study describes the treatment of the mentally ill patients in La Bicetre, a hospital in Paris 

Treatment of inmates in early hospital 

             The patients were shacked to the walls of their dark by iron collar that held them flat to the wall and permitted little movement , there were also iron hoops around the waists  and both their hands and feet were chained ,they were more or less treated like animals with giving little food often stale and stayed in filth and dirt mentally ill people who were aggressive towards others or who were considered dangerous to themselves were chained to trees .

The philosophy of the treatment involved is based on the belief that the patients need to choose rationality over insanity ,so the treatment were aggressive which was aimed at restoring a physical balance in the body and brain

They included powerful drugs, water treatment ,bleeding and blistering, electric shocks and physical restraints  .example: a violent patient might be thrown into ice water or a restless person into hot water or might be given drugs to exhaust them and they are also made to bleed to get rid of the harmful fluids.

Humanitarian reforms

There was a great need for a humanistic approach towards the mentally ill patients who could not look after themselves to be treated with kindness and empathy.

Philippe Pinel (1745-1826) conducted an experiment to test the effect of an humanitarian approach .he ordered the chains of the inmates to be removed,unlit rooms to be replaced with sunny rooms, abuse with peace and kindness the result he got was that the inmates were happy and were healing faster.

These innovation not only improved the care of mental patients but also changed the public attitude towards the mentally ill.The success of the humanitarian experiments revolutionized the treatment of mental patients through out the western world 

During the early part of Renaissance the use of Moral Management which is a method of treatment focused on a patients social,individual and occupational needs .Moral management in asylums focused on the patients moral and physical development rather than physical or mental disorders .The treatment was done through manual labour and spiritual discussion along with humane treatment .This  treatment was effective because it was done without  the use of anti-psychotic drugs 

In-spite of the effectiveness of moral management it lost its value during the later part of 19^th century because of :

Ethnic prejudice against the rising immigrant population.

Tension between staff and patients

The decline of moral management gave rise to Mental Hygiene Movement. It focused on the physical well-being of patients

Dix and the mental hygiene movement:

 Dorothea Dix (1802-1887)- she worked as a school teacher during her young adulthood period but then she was forced to quit  due to her having tuberculosis .In 1841 she began to teach in a women`s prison, by  seeing the horrible condition of jails and the inhumane treatment of mentally ill patients ,she carried out a campaign from(1841-1881) that aroused people and legislature to do something about the inhumane treatment which was being carried out

Slowly this movement began to spread to America, millions of dollars were raised to build hygienic hospitals ,she opened  two large institution in Canada and completely reformed the asylum system in Scotland and in several other countries establishing 32 mental hospitals 

Changing attitude towards mental health in the early 20^th century:

By the end of the 19^th century ,mental patients still lived in harsh condition inspite of all the reforms made, the public viewed asylums as scary place and were   frightened of the mentally ill  their was nothing done  by the psychiatrists  to remove that fear that existed.

Clifford beers(1876-1943): he described his own bad treatment of a mental condition he underwent he was  tortured  by a straitjacket which they used as a method for  quieting the patients after he recovered in the home of a kind attendant, he started a campaign to make people realize that kindness rather than cruelty heals the sick people .he soon won the interest of the public and even many eminent psychologists

Mental hospital care in the 20^th century:

The 20^th century began with the rapid growth of mental asylums for the mentally ill with the influence Clifford beers and others, during this period patients were hospitalized for many years with harsh treatment but,1946 marked the beginning of an important period of change where humane mental treatment were provided

During the 1950`s and 1960`s  there was a great need for reforms in the psychiatric hospitals a great deal of professional was given to improve the condition in mental hospitals .The movement to change the environment of these hospitals was by adopting scientific methods  example- the use of lithium in the treatment of manic depressive disorders

During the later decades of 20^th century, vigorous efforts were made to close down mental hospitals and turn down psychiatric  disturbed people to the community rather than they being isolated .This movement is referred to as “Deinstitutionalization”  

By the end of the 20^th century, inpatient mental care was replaced by community based care The role of psychiatric care is likely to progress further in the decades to come as people realize the importance of mental care and the problems that severe mental illness can cause if ignored or left untreated. 

BIBLIOGRAPHY:

Robert.Carlson, J. (2007). abnormal psychology.

anushreejatla1114310

The development of the Psychological Basis of Mental Disorder
There was the development of the psychological factors in mental disorder. The first major step was taken by Sigmund Freud who developed a comprehensive theory of psychoanalytic. The method he used to study and treat the patients was called psychoanalysis. There developed the study of hypnosis, especially in relation to hysteria.

Mesmerism
Franz Anton started our efforts to understand psychological causation of mental disorder who further developed the idea of Paracelsus about planets on the human body. He believed that the planets affected a universal magnetic fluid in our body, the distribution of which determined health or diseases. In order to find cures for mental disorder he concluded that all people possessed magnetic forces that could be used to influence the distribution of magnetic fluid in other people, thus effecting cures.
He also treated all the patients using ‘animal magnetism’ through which he was able to remove hysterical anesthesia and paralyses. He later also demonstrated most of the phenomena connected with the use of hypnosis.

The Nancy school
Ambrose August L, a French physician who practiced in the town of Nancy, used hypnosis successfully in his practice.  A professor at Nancy named Hippolyte Bernheim became interested in the relationship between hysteria and hypnosis. Both the physicians worked together to develop the hypothesis that hypnotism and hysteria were related and both were due suggestion.
Jean Charcot was experimenting with some of the phenomena described by the mesmerists and  as a result disagreed with the findings of the Nancy School and insisted  that degenerative brain changes lead to hysteria. His finding was proved wrong but further work on this lead to awakening medical and scientific interest in hysteria.

The Beginning of Psychoanalysis
Freud who was a lecturer on nervous diseases at the University of Vienna studied under Charcot in 1885 and became interested by their use of hypnosis with hysteria patients and came away convinced that mental processes could remain hidden from consciousness.
Freud later worked in collaboration with Josef Breuer who had incorporated an interesting use of hypnosis with his patients by directing his patients to talk freely about their problems when under hypnosis. The patients experienced catharsis- emotional release when waking up from hypnosis. Thus this helped the patients in finding the relationship between their problems and their hysterical symptoms. This led to the discovery of the unconscious- hidden urges which the person is unaware which determines behavior.
Two methods helped them understand patients conscious and unconscious thought processes. First is free association- allowing the patient to talk freely thereby providing information about the feelings, desire and so forth. Second is dream analysis having patients record and describe their dreams.

The Evolution of the Psychological Research Tradition: Experimental Psychology
The origins of much of the scientific thinking in contemporary psychology lie in the efforts of Wilhelm Wundt and William James.

The early Psychology Laboratories
The first experimental psychology laboratory was established by Wilhelm Wundt in 1879 at the University of Leipzig. Wundt and his colleagues devised many experimental methods and strategies after studying factors involving the memory and sensation. He influenced the empirical study of abnormal psychology; they followed his methods and also applied his strategies to the clinical studies. J McKeen Cattell used it to assess individual mental processing. Another student Lightner Witmer established the first American psychological clinic which focuses on the problems of mentally deficient children in terms of both research and therapy. Chicago Juvenile Psychopathic Institute established in 1909 by William Healy was the first to view juvenile delinquency as a symptom of urbanization and not as result of inner psychological problems. Thus by the 20th century we had the emergence of many clinics and laboratories.
The behavioral perspective
Bahaviorists believed that the study of the techniques of free association and dream analysis din not provide acceptable scientific data as the behavior was not observable in nature. Thus observable behavior and stimuli reinforcing conditions that control it could serve as a basis for formulating scientific principles of human behavior.
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. After repeated pairing the neutral stimulus becomes a conditioned stimulus that elicits a conditioned response. This work began with the discovery of the conditioned reflex by Russian Physiologist Ivan Pavlov. This experiment was demonstrated on a dog. And a bell was rung and each time the meat was presented and the dog salivated. Thus this ringing of the bell conditioned the dog to assume that the meat would be presented and hence the dog would salivate.
American psychologist John B Watson changed the focus of psychology to the study of overt behavior rather than the study of theoretical mentalistic constructs he called behaviorism. His approach had a great emphasis on the role of the social environmental in conditioning personality development and behavior both normal and abnormal.
Operant Conditioning
E L Thorndike and B F Skinner were exploring one in which the consequences of behavior influence behavior.  Behavior that operates on the environment may be instrumental in producing certain outcomes, in turn, determine the likelihood that the behavior will be repeated on similar occasions. He studied cats and their response to the pulling of a chain if that response was followed by food. This type of learning was called instrumental conditioning and now is called classical conditioning by Sinner.

HUMANITARIAN APPROACH ESTHER 1114360

                                             HUMANITARIAN APPROACH

During the later stages of middle ages  more importance was given to human concerns and interests this movement was called ''humanism".Superstitious beliefs was an hindrance in understanding the therapeutic treatment of mental disorder began to be challenging.Parcelus was a Swiss physician .He told that dancing mania was not a form of possession but a disease .He advocated that a conflict between spiritual and instincts of humans was the cause for mental illness.He also gave a treatment for this which was called as 'hypnosis'.

ESTABLISHMENT OF EARLY ASYLUMS

In 16th century asylums came into existence .Earlier asylums were meant as a place to individuals who were troublesome in the society and who were not able to take care of themselves.It was the storage places for insane.It was unfortunate that these residents were treated in a cruel way.In the early asylums people were not treated like humans.The techniques which were used to treat were aggressive to restore the balance of both body and mind .These included  electric shocks ,powerful drugs .A violent patient would be immersed into ice water ,the patient's hand and feet were chained .There was little attention paid to whether they were fed with good food or bad food .The cells where they stayed were never swept .No one visited them except at the time of feeding .There was lack of humanity.By 18th century ,mental hospitals in Europe and America were in need of reform.

HUMANITARIAN REFORM

After french revolution Pinel conducted an experiment.He removed the chains from some inmates .His opinion was that patients should be treated with kindness .He provided them with rooms which had proper lights ,previously it was noisy and abusive which was now replaced by peace .Kindness had a positive outcome in the mentally ill patients .He employed  humane methods to treat the patients .He had issued orders to the staff to avoid beating up of patients .

TUKES WORK IN ENGLAND

William Tuke set up a pleasant house where mental patients lived and rested in a kind atmosphere which was called york retreat .They believed in treating all insane with kindness .They view that kindness would help the mentally ill people to recover.They provided mental treatment for 200 years..In 1841 Hitch introduced trained nurses .These innovations improved the care provided to the patients .It also changed attitudes  of the public towards the mentally ill people.

RUSH AND MORAL MANAGEMENT

The humanitarian experiments of Pinels and Tukes  changed the treatment of mental patients throughout the western world.Rush was the first to organize a course in psychiatry .He invented a device for treatment which was called ''the tranquilizing chair'',which was torturous .This was thought to decrease the flow of blood to the head and the muscles relaxes During the period of humanitarian reform, moral management came into existence.Moral management is defined as the treatment that focuses on the patients social ,individual needs .This approach came from the works of Pinel and Tuke .Moral management emphasizes on the patients moral and spiritual development rather than on mental disorders .The treatment  was through manual labour and humane treatment.

ESTHER 1114360 MORAL MANAGEMENT

Moral management was effective .Perhaps it was without the anti psychotic drugs which is used now.Moral management was discarded later in the 19th century.There were many reasons like increasing the hospital facilities which reflects the wrong belief that bigger hospitals would differ from smaller hospitals only in size.One more reason was the mental hygiene movement which introduced a treatment which was based on the physical well-being of mental patients .Under this condition the patient's level of comfort improved but they didn't  receive any help for their mental problems.Development in the biomedical science contributed to the discardation of moral management.The mental hygiene movement has been accounted for many humanitarian achievements.

Abnormal Psychology : Mary Annie 1114386

The Major Psychological Disorders have been existed in the earlier period in all cultures across all time periods. And the Causes and Treatment of Abnormal Behavior Varied Widely Across cultures across time periods Depending on established paradigms or world views Three Dominant Traditions Include Supernatural, Biological, and Psychological.

The past abnormal behavior and supernatural traditions

Deviant Behavior as a Battle of “superior “or good vs. “wicked “or evil Causes included demonic possession, witchcraft, sorcery, Mass hysteria  Treatments included exorcism, torture, beatings, and crude surgeries Other Worldly Causes of Deviant Behavior Movement of the moon and stars Middle Ages both “outer force” views were popular Few thought of abnormality as a physical disease .

CELIA JOHN(1114358)

TOWARDS HUMANITARIAN APPROACH:
Humanism was started in the latter part of the middle ages and early renaissance.It gives importance to human interests.earlier superstitious beliefs influenced the mental disorders, but after humanistic approach began,human interest was given importance
THE SCIENTIFIC QUESTIONING IN EUROPE:
Paracelsus,a Swiss  physician critiqued the superstitious beliefs about possession. He considered the dancing mania to be a form of disease that should be treated.He formulated the idea of psychic causes for mental illness. He also developed the concept called hypnosis.He rejected demonology and in his view abnormal behavior was based on astral influences. He believed that  the moon exerted a supernatural influence over the brain
JOHANN WEYER:
JOHANN WEYER was a German physician who made a careful study of the people imprisoned and burnt as they were accused of witchcraft. He believed that the accused were sick in mind and mental disorders.He was the founder of modern psychopathology.But despite his contributions he was mocked with names such as "Weirus Insanus" and his works were banned by the church
The establishment of early asylums: special institutions called asylums or sanctuaries were solely meant for the care of mentally ill patients grew in number during the 16th century with the motive of removing troublesome individuals fro the society.Most early asylums were often referred to as "Mad Houses" and were storage places for the insane.The inmates had to survive amidst cruel conditions and were made to beg in public and even forced to seek charity.These early asylums were modifications of penal institutions and the inmates were treated more like beasts than like human beings.
The asylums were later termed as hospitals but the treatment techniques in these  hospitals were aggressive and aimed at terrifying the patients.They included powerful drugs ,electric shocks etc., for eg. a violent patient was plunged into ice water or hot water based on the illness.
HUMANITARIAN REFORM:
 Works of Philippe Pinel. He conducted an experiment to state that people in mental asylums must be treated as humans and not beasts. To prove his experiment he removed the chains of the inmates of the mental asylums and provided them with sunny rooms and facilities to exercise on the hospital grounds and also the patients were treated in a friendly manner and the results were amazing.The previous noise,filth and abuse were replaced by peace and order. Thus his experiment showed favorable results.
RUSH AND MORAL MANAGEMENT:
Benjamin Rush ,the founder of American psychiatry encouraged more humane treatment of the mentally ill and he was the first American to organize a course in psychiatry.He invented a device called "Tranquillizing Chair". He used the theory of moral management that focused on a persons social, individual and occupational needs.Moral management also emphasized on the patients moral and spiritual development and it has achieved a high degree of effectiveness because it does not use the anti-psychotic drugs that is used today.Despite its effectiveness,moral management was abandoned by the latter part of the 19th century due to two main reasons.
One was the rise of mental hygiene movement that focused on the patient's physical well-being.although the patients comfort levels improved  under the  mental hygienists, the patients received no help for their mental problems.
Second was the advances in biomedical science that fostered the notion that all mental disorders have biological explanations and biologically based treatments that neglect the psychological and social environment of a patient.
DIX AND THE MENTAL HYGIENE MOVEMENT:
She was a tireless reformer who made a great effort in changing public attitudes towards the mentally ill and was also responsible for flourishing the mental hygiene movement in America,she has reformed the asylum system in Scotland and several other countries.

Jyotsana.L (1114364)

CONTEMPORARY VIEWS OF ABNORMAL BEHAVIOR.

As the mental hygiene movement was gaining ground in and around The US during the latter part of the 19th century, great technological discoveries also occurred. These advances were the main components which led to what we know off today as the scientific, or experimentally oriented, view of abnormal behavior and the application of scientific knowledge to the treatment of disturbed individuals. The four main themes in abnormal psychology which spanned the nineteenth and twentieth centuries and generated powerful influences on contemporary perspectives in abnormal behavior were: 

1) biological discoveries

2) the development of a classification system for mental disorders.

3) the emergence of psychological causation views and

4) experimental psychological research developments.

Establishing the link between the Brain and Mental Discoveries.
Advances in the study of biological as well as anatomical factors as underlying both physical and mental disorders developed during this time. one of the major bio-medical discoveries of the time was the discovery of the link between general paresis and syphilis. General paresis caused death with 2-5 years of occurrence and the symptoms were paralysis and mental illness. In the year 1906, August von Wasserman devised a blood test for syphilis.This development led to the possibility to check the presence of the deadly bacteria in the blood stream of an individual before the serious after effects of having the disease was seen. In 1917 Julius von Wagner-Jauregg, chief of the psychiatric clinic of the University of Vienna, introduced the malaria fever treatment for Syphilis. It was noticed that the occurrence of the malarial fever killed the possibilities of the individual to have syphilis. It acted as a vaccination and prevented the disease from coming as the fever associated with malaria killed the virus causing the disease.

Brain pathology was a major causal factor. Albrecth von Haller in his book said the importance of the brain and psychic functions and advocated postmortem dissection to study the brains of the insane. This era saw some of the answers to "how" some mental disorders are caused but the answers to "why" weren't really addressed to. The development of a classification system and also providing the diseases with proper nomenclature happened during this time.The integration of all the clinical material together can be called a Herculean task and also was one of the major contributions to the field of Psychopathology.

Anushree jatla (1114310)

1)     The development of a Classification System

Emil Kraepilin contributed to the biological view of abnormal psychology. He emphasized the importance of the brain pathology in the mental disorder thus he was the forerunner of today’s DSM-IV-TR. Underlying his classification was a Herculean task and represented a major contribution to the field of psychopathology. He also saw that each type of mental disorder as distinct from the others and thought that the course of each was a predetermined and predictable as the course of measles. Thus the outcome of a type of disorder could be predicted even if it could not be controlled.

sonia anthony 1114376

 

  HUMANITARIAN APPROACHES:

   ‘Humanism’ began has a movement that emphasized the importance of specifically human interests and concerns.

    Paracelsus, a Swiss physician, was an early critic of superstitious belief about possession and has formulated the idea of psychic causes for mental illness and advocated treatment by “bodily magnetism “, later came to be known as hypnosis.

 Though he rejected demonology, his view of abnormal behavior was that the moon exerted a supernatural influence over the brain, this idea seem to exist within few persons even today. Weyer was one of the first physician who worked in specializing mental disorders and his experience and progressive views on it, made him the founder of modern psychopathology.

 The establishment of early asylums and shrines:

     From the sixteen century on, special institutions called asylums that was meant only for the care of mentally ill grew in number and it was commonly referred as 'madhouses' were not pleasant places but storage places for the insane. The first mental hospital that was set up in Spain was the Valencia mental hospital and a little is known about the treatment of patients in this asylum.

     In 1547, the monastery of St.Mary of Bethlehem was officially made into an asylum by Henry viii.On the streets of London the inmates were forced to take charity. In early asylums, inmates were brutally treated. The inmates were chained, not much attention was paid to what they ate. The cells were not clean and all this shows that there was lack of humanity. The treatments which they used to cure the patients were very much aggressive like electrical shocks, powerful drugs. Early estimates of the cure rate of patients were only about 20 percent.

 Humanitarian reform:

      During the late eighteen century, most mental asylums in Europe and America were in great need of reform. The humanitarian treatment provided great improvement in the living conditions of patients.

 Pinel s experiment:

      In 1792, pinel received permission of the revolutionary commune to remove the chains from some of the inmates as an experiment to test his views that mental patients should be treated with kindness and consideration as sick people but fortunately it was a great success. Gradually, the whole discipline was marked with regularity and kindness that which had the most favorable effect on the insane.

 Tuke s work in England:

       Tuke set up a pleasant house where mental patients lived and rested in a kind of religious atmosphere which was called York Retreat .They believed in treating all insane with kindness and acceptance and  this would help the mentally ill  to recover. They provided mental treatment for 200 years. In 1841 Hitch introduced trained nurses .These innovations improved the care provided to the patient’s .And also changed attitudes of the public towards the mentally disturbed.

 Rush and moral management in America:

     Benjamin rush was known to be the founder of American psychiatry. He encouraged more humane treatment for the cure of mentally ill. His medical theory was associated with astrology and remedies were bloodletting and purgatives. Furthermore, he invented a device called ‘the tranquilizing chair’ which was torturous for patients. The chair was thought to lessen the force of blood on the head and the muscles seemed to relax.

    Moral management method of treatment was widely used, focused on a patient’s social, individual and occupational needs. This emphasized the moral and spiritual development and rehabilitation of a patients ‘character’. Two reasons for moral management to be abandoned: was the rise of the mental hygiene movement which advocated a treatment on the physical well being of the patients. And the other is due to the advances in bio medical science; the notion was that all mental disorders would eventually yield to biological explanations and treatments.

  Dix and the mental hygiene movement:

Dorothea Dix worked for the poor in prisons and mental institutions for decades during the nineteenth century. She has also worked as a school teacher in her young adult but later retired early due to her illness. She mentions the inhumane treatment that was practiced during that period towards the mentally ill people and also mentions how mental hygiene movement advocates better treatment to the mentally disturbed.

 The military and the mentally ill:

Mental health treatment was advanced by military medicine. The Confederate army in the war opened the first mental health facility for the mentally disturbed in warfare. The evolution of military psychiatry in Germany brought about a number of contributions of psychiatrists to the field of abnormal psychology.

REFERENCE:

 (ABNORMAL PSYCHOLOGY :Robert C Carson, James N Butcher,Susan Mineka )