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 There is no universal agreement about what we mean by abnormality or disorder. No one element of abnormality is sufficient in and of itself to define or determine abnormality, but the greater the similarity between the given persons behavior and the elements of abnormality described in The World Around Us 1.2 the more likely it is that the person is abnormal or mentally disordered in some way.

Historical Views Of Abnormal Behavior

The Stone Age cave dwellers about half a million years ago found the earliest makeshift treatment of mental disorders. "Trephining" is the form of treatment the early shaman or medicine man gave the mentally ill which probably consisted of individuals complaining about severe headache and convulsive attacks. Through history though there have been milestones in the views of abnormal behavior.
1. Demonology, Gods and Magic.
2. Hippocrates and his pre-historic medical concepts
3. Early Philosophical Conceptions of consciousness and Mental discovery
4. Later Greek and Roman thought
5. Abnormality during the Middle Ages.

Towards Humanitarian Approaches

During the latter part of the middle emphasizing the importance of specifically human interest and concerns began- a movement that can be loosely referred to as “humanism “. Consequently, the superstitious beliefs that had hindered the understanding and therapeutic treatment of mental disorders began to be challenged.

The various milestones in this approach are:

1.       The Resurgence of Scientific Questioning in Europe

2.       The Establishment of Early Asylum and Shrines

3.       Humanitarian Reform

CONTEMPORARY VIEWS OF ABNORMAL BEAVIOUR

Great technological discoveries occurred both home and abroad in the latter years of the nineteenth century. There are four dimensions in abnormal psychology that spanned the nineteenth and twentieth century’s and generated powerful influences on our contemporary perspectives in abnormal behaviour:

                                i.            Biological discoveries.

                              ii.            Development of a classification system for mental disorders.

                            iii.            The emergence of psychological causation views and,

                            iv.            Experimental psychological research developments.

BIOLOGICAL DISCOVERIES:  Establishing the Link between the Brain and Mental Disorder

The development of physical and mental diseases took place in this period.  An important biomedical breakthrough which came with the discovery of organic factors fundamental “general paresis-syphilis of the brain” a severe “mental illness” (Robert C.Carson, 2011) of those days general paresis generated paralysis and insanity and normally caused death within a span of 2-5 years. This scientific discovery is a combined effort of various scientists and has been researched for about a century.

GENERAL PARESIS AND SYPHILIS:

In 1825 a cure for general paresis was discovered. , when the French physician A. L. J. Bayle talked about general paresis being a specific type of mental illness. He proved his points with various accurate descriptions of the symptom pattern and convinced that general paresis was a distinct mental disorder. Only after some years in 1897 “the Viennese psychiatrist Richard von Krafft-Ebbing conducted experiments with inoculation of paretic patients with matter of syphilitic sore.” (Robert C.Carson, 2011) As none of the patients who underwent this experiment developed secondary symptoms thus came up to the conclusion that they were previously infected. Eventually leading to the relationship between general paresis and syphilis.

Ultimately in 1917, “Julius von Wagner-Jauregg, chief of the psychiatric clinic of the University of Vienna,” (Robert C.Carson, 2011) familiarised the treatment for malaria. As malaria is associated with high fever and thus would kill all the bacteria’s involved. He conducted this experiment by infecting nine paretic symptoms in three patients and apparent recovery in the other three. Now, of course there are penicillin’s for the treatment of malaria syphilis, but the first method ever used for its treatment was by medical science thinking it to be a mental disorder. Abnormal Psychology has come a long way through- from superstition to scientific proof giving hopes in the medical community that organic bases could be found for all the diseases.

Brain pathology as a casual factor:

Scientists in this era began to focus on the “diseased body organs as the cause of physical ailments” (Robert C.Carson, 2011) and they believed that this diseased organ to be brain. Various scientists such as Albert von Haller focused on the importance of brain in mental functions and also studied the brains of the mentally ill people. Whereas, “Alois Alzheimer and other investigators established the brain pathology in cerebral arteriosclerosis and in the senile mental disorders” (Robert C.Carson, 2011) ultimately in the twentieth century the “organic pathology” underlying the diseases caused by the presence of toxic substances e.g. led various types of mental retardation and mental illness were discovered.

The development of a classification system:

A scientist named Emil Kraepelin had a major role to play in the biological viewpoint.  “His book does not only deal with the importance of brain pathology in mental disorder disorders but also made several related contributions that helped establish this viewpoint” (Robert C.Carson, 2011) the main contribution being the system of classification of mental disorder. Which became the predecessor of today’s DSM-IV-TR. In which he noted that certain symptom pattern occurs together so that they can be grouped in one group of mental disorder.

Kraepelin viewed every type of mental disorder to be different from each other and thought that the course of each was “predictable” and “predetermined” which can be seen in the case of measles.

Caution Views: Establishing the psychological Basis of Mental Disorder.

Regardless of laying significance on the biological research, the psychological factors were progressing as well. The first step was taken by the well known psychologist Sigmund Freud who during the five decades observed, treated and wrote a “comprehensive theory of psychopathology that emphasized the inner dynamic of unconscious motive.” (Robert C.Carson, 2011)  The means to study and treat patients came to be known as psychoanalysis. This can be related to hypnosis. “Hypnosis is an “induced state of relaxation” in which a person is highly open to suggestions” (Robert C.Carson, 2011).

Mesmerism:

“Franz Anton Mesmer an Austrian physician added to the development of “Paracelsus” about the influence of planets on humans. He believed that the planets had an affected our magnetic body fluids, the distribution of which determined health or disease.” (Robert C.Carson, 2011).

He concluded saying that “all people possessed magnetic force that could be used to persuade the distribution of the fluid in other people which effects cure” (Robert C.Carson, 2011). He practiced his views in Vienna and several other cities. He opened a clinic in Paris where he treated all kinds of ailments using animal magnetism. Where he placed them in a dark room around a tub containing a mixture of various chemicals and iron rods jotting out and these were applied to the affected areas, following this method he treated diseases such as hysteria, paralysis. He also demonstrated many phenomena’s that were later linked with the use of hypnosis. Mesmer was however forced to leave Paris and his methods were a subject of debate for a long period of time where two distinct groups were formed.

THE EVOLUTION OF THE PSYCHOLOGICAL RESEARCH TRADITION: Experimental Psychology.

The first experimental psychology laboratory was set up at the University of Leipzig by William Wundt.

“The Behavioural Perspective- this perspective runs around a central theme of “the role of learning in human behaviour.” (Robert C.Carson, 2011). At first this was developed through research in a laboratory and not in a clinical practice with distributed individuals, its implication for explaining and treating maladaptive behaviour soon became evident”. (Robert C.Carson, 2011)

Classical Conditioning:

Classical Conditioning was discovered by Ivan Pavlov, when he conducted his experiment with his dog. Classical Conditioning is “a form of learning in which neutral stimulus is paired repeatedly with an unconditioned stimulus that naturally elicits an unconditioned behaviour” (Robert C.Carson, 2011) his experiment was conducted to see if a response would occur with the presence of an unconditioned stimulus. The dog initially salivated at the time when the food was presented along with a bell ringing, later the dog salivated when the bell was heard but no food presented. Thus we can say that the dog has been conditioned. 

Operant Conditioning:

 E.L. Thorndike, B.F Skinner were exploring another kind of behaviour, where, “The consequence of behaviour influences Behaviour” (Robert C.Carson, 2011) “Behaviour that operates on the environment may be instrumental in producing certain outcomes, and those outcome, in turn determine the likelihood that the behaviour will be repeated on similar occasions.” (Robert C.Carson, 2011) Here, he talks about reinforcement and punishment. Where, the good behaviours are rewarded and the awful one punished. This was initially known as instrumental learning. (Robert C.Carson, 2011)

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HISTORICAL VIEWS OF ABNORMAL BEHAVIOR

Our historical efforts to understand abnormal psychology include both humour and tragedy. In this section, we will highlight some views of psychopathology, and some of the treatments administered, from ancient times to the twenty-first century. In a broad sense, we will see a progression of beliefs from what we now consider superstition to those based on scientific awareness—from a focus on supernatural explanations to knowledge of natural causes. The course of this evolution has at times been marked by periods of advancement or unique, individual contributions, followed by long years of inactivity or unproductive, backward steps.

Demonology, Gods, and Magic

References to abnormal behaviour in early writings show that the Chinese, Egyptians, Hebrews, and Greeks often attributed such behaviour to a demon or god who had taken possession of a person. Whether the “possession “was assumed to involve good spirits or evil spirits usually depended on the affected individual’s symptoms. If person’s speech or behaviour appeared to have a religious or mystical significance; it was usually thought that he or she was possessed by a good spirit or god. Such people were often treated with considerable awe and respect, for people believed they had supernatural powers.

MASS MADNESS

Mass madness is when people get in an uproar about something because others are influencing them and then everyone begins to panic.

Dancing mania was a social phenomenon which involved groups of people dancing continuously .Men, women and children were affected by dancing mania who danced until they collapsed from exhaustion. One of the first outbreaks was in Aachen, Germany, in 1374, and it spread throughout Europe; one notable outbreak occurred in Strasbourg in 1518.

It affecting thousands of people across several centuries and dancing mania was not an isolated event and remedies were based on guesswork. Generally, musicians accompanied dancers, to help ward off the mania.

The several theories proposed range from religious cults being behind the processions to people dancing to relieve themselves of stress and put the poverty of the period out of their minds. It is, however, thought to be as a mass psychogenic illness in which the occurrence of similar physical symptoms, with no known physical cause, affects a large group of people as a form of social influence.

Characteristics of Dancing Mania

It occurred in times of hardship. Thousands of people would appear to dance for hours, days, weeks, and even for months. Most of the people did not reside where the dancing took place, they used to travel from place to place and this lead to exchange of culture and traditions which was strange to the local people.

The dancers were   in a state of unconsciousness, and unable to control themselves. Some dancers decorated their hair with garlands and all the dancing outbreaks were not calm. Some was violent were the dancers acted like animals, and jumped, hopped and leaped about. The dancers never stopped and some danced until they broke their ribs and subsequently died. Throughout, dancers screamed, laughed, or cried, and some sang songs.

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Historical Views Of Abnormal Behavior 

The Establishment of Early Asylums: “From the sixteenth century on, special institutions called asylums sanctuaries or places of refuge meant solely for the care of the mentally ill—grew in number. The early asylums were begun as a way of removing from society troublesome individuals who could not care for themselves. Although scientific inquiry into abnormal behavior was on the increase, most early asylums, often referred to as “madhouses,” were not pleasant places or “hospitals” but primarily residences or storage places for the insane. The unfortunate residents lived and died amid conditions of incredible filth and cruelty. The first asylum established in Europe was probably in Spain in 1409—the Valencia mental hospital founded by Father Juan Pilberto Joffre (Villasante, 2003)—although this point has been the subject of considerable discussion (Polo, 1997; Trope, 1997). Little is known about the treatment of patients in this asylum. In 1547 the monastery of St. Mary of Bethlehem in London (initially founded as a monastery in 1247; see O’Donoghue, 1914) was officially made into an asylum by Henry VIII. Its name soon was contracted to “Bedlam,” and it became widely known for its deplorable conditions and practices. The more violent patients were exhibited to the public for one penny a look, and the more harmless inmates were forced to seek charity on the streets of London. These early asylums were primarily modifications of penal institutions, and the inmates were treated more like beasts than like human beings. This treatment continued through most of the eighteenth century” (Robert, Butcher, Hooley, & Mineka, 2007)

Humanitarian Reform: “By late eighteenth century, most mental hospitals in Europe and American were in great need of reform. The humanitarian treatment of patients received great impetus from the work of Philippe Pinel (1745–1826) in France. In 1792, shortly after the first phase of the French Revolution, Pinel was in charge in Paris. In this capacity, he received the grudging 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, not as vicious. The monastery of St. Mary of Bethlehem in London became an asylum for the mentally ill in the reign of King Henry the VIII during the sixteenth century. The hospital, known as “Bedlam,” became infamous for its deplorable conditions and practices “(Robert, Butcher, Hooley, & Mineka, 2007).

 TUKE’S WORK IN ENGLAND : “At about the same time that Pinel was reforming, an English Quaker named William Tuke (1732–1822) established the York Retreat, a pleasant country house where mental patients lived, worked, and rested in a kindly, religious atmosphere (Narby, 1982). This retreat represented the culmination of a noble battle against the brutality, ignorance, and indifference of Tuke’s time. The Quaker retreat at York has continued to provide humane mental health treatment for over 200 years (Borthwick, Holman, et al., 2001), even though the mental hospital movement spawned by its example evolved into large mental hospitals that became crowded and often offered less-than-humane treatment in the late nineteenth and early twentieth century’s” (Robert, Butcher, Hooley, & Mineka, 2007).

RUSH AND MORAL MANAGEMENT IN AMERICA: “The success of Pinel’s and Tuke’s humanitarian experiments revolutionized the treatment of mental patients throughout the Western world. In the United States, this revolution was reflected in the work of Benjamin Rush (1745–1813), the founder of American psychiatry and also one of the signers of the Declaration of Independence. While he was associated with the Pennsylvania Hospital in 1783, Rush encouraged more humane treatment of the mentally ill; wrote the first systematic treatise on psychiatry in America, Medical Inquiries and Observations upon Diseases of the Mind (1812); and was the first American to organize a course in psychiatry. But even he did not escape entirely from the established beliefs of his time. His medical theory was tainted with astrology, and his principal remedies were bloodletting and purgatives. In addition, he invented and used a device called “the tranquilizing chair,” which was probably more torturous than tranquil for patients. The chair was thought to lessen the force of the blood on the head while the muscles were relaxed. Despite these limitations, we can consider Rush an important transitional figure between the old era and the new” (Robert, Butcher, Hooley, & Mineka, 2007).

During the early period of humanitarian reform, the use of moral management, a wide ranging method of treatment that focused on a patient’s social, individual, and occupational needs which became relatively widespread. This approach came out largely from the work of Pinel and Tuke. (Robert, Butcher, Hooley, & Mineka, 2007)

“Moral management in asylums emphasized the patients’ moral and spiritual development and the rehabilitation of their “character” rather than their physical oriental disorders, in part because very little effective treatment was available for these conditions at the time. The treatment or rehabilitation of the physical or mental disorders was usually through manual labor and spiritual discussion, along with humane treatment. Moral management achieved a high degree of effectiveness—which is all the more amazing because it was done without the benefit of the antipsychotic drugs used today and because many of the patients were probably suffering from syphilis, a then-incurable disease of the central nervous system. In the 20-year period between 1833 and 1853, Worcester State Hospital’s discharge rate for patients who had been ill less than a year before admission was 71 percent. Even for patients with a longer preadmission disorder, the discharge rate was 59 percent (Bockhoven, 1972). In London, Walford (1878) reported that during a 100-year period ending in 1876, the “cure” rate was 45.7 percent for the famed Bedlam Hospital. Despite its reported effectiveness in many cases, moral management was nearly abandoned by the latter part of the nineteenth century. The reasons were many and varied. Among the more obvious ones were ethnic prejudice against the rising immigrant population in hospitals, leading to tension between staff and patients; the failure of the movement’s leaders to train their own replacements; and the overextension of hospital facilities, which reflected the misguided belief that bigger hospitals would differ from smaller ones only in size” (Robert, Butcher, Hooley, & Mineka, 2007).

“Two other reasons for the demise of moral management are, in retrospect, truly ironic. One was the rise of the mental hygiene movement, which advocated a method of treatment that focused almost exclusively on the physical well-being of hospitalized mental patients. Although the patients’ comfort levels improved under the mental hygienists, the patients received no help for their mental problems and thus were subtly condemned to helplessness and dependency” (Robert, Butcher, Hooley, & Mineka, 2007).

 Reference: 

 Robert, Butcher, Hooley, & Mineka. (2007). Abnormal Psychology (13th edition ed.). Pearson Education and Dorling Kindersley Publishing.

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HUMANITARIAN APPROACH

The humanistic model

Sometimes referred to as ‘the third force in psychology’, the humanistic movement was a reaction against the determinism of the psychodynamic and behaviourist paradigms. It attempted to focus more on the individual as a whole person. According to Carl Rogers and other leading figures in this movement, people are rational beings, able to make their own choices, and are motivated toward a state of fulfilment. Psychological problems occur when people experience incongruence between their real self and their ideal self. This generates a feeling of low self-worth. The humanistic model does not believe in labelling people by diagnosing them as having specific mental disorders. Every individual’s problems are seen as unique and the therapy lies in providing nurturing therapeutic conditions which enable the person to find his/her own way forward in dealing with problems.

From the sixteenth century on, special institutions called asylums—sanctuaries or places of refuge meant solely for the care of the mentally ill—grew in number. The early asylums were begun as a way of removing from society troublesome individuals who could not care for themselves. Although scientific inquiry into abnormal behaviour was on the increase, most early asylums, often referred toas “madhouses,” were not pleasant places or “hospitals “but primarily residences or storage places for the insane. The unfortunate residents lived and died amid conditions of incredible filth and cruelty. (Abnormal Psychology)

Example

An individual with feelings of despair and a lack of motivation to live would be understood in terms of a low sense of self-worth, perhaps to do with the lack of a nurturing environment. This has led to them losing touch with their true self. They are valuing themselves in overly negative ways, and feel that they are unacceptable and unlovable as a person. In order to get in touch with their true self, it is necessary to experience conditions that offer empathy, acceptance and genuine understanding.

 Strengths of the humanistic model:

  There is a large body of research, particularly case histories, to back up the claims of the humanistic model. The model offers an optimistic view of personality. It is regarded as an ethical model because it focuses on the person rather than the diagnosis. The model facilitates the human capacity for self-cure

Weaknesses of the humanistic model:

 The focus on the individual carries the assumption that people should be able to help themselves, and may neglect important environmental and social factors (e.g., poverty and discrimination). Some disorders requiring medical treatment may go untreated due to the reluctance to diagnose.The model tends to espouse western ideals of individuality and freedom, which may not take into account more collectively based cultures. (Bruch)

Institutions and Reforms

The first asylum for the mentally ill was probably in the Islamic world in the first century, but they became more common in Europe during the middle Ages. However, these institutions were not great places. The facilities were unsanitary, and treatments involved sometimes horrifying experiments. One of the most notorious asylums was Bedlam, which was in London. Descriptions of Bedlam from the 18th century show a place of inhumane treatment. During the day, the patients were left to wander in the yard, where tourists and schoolboys watched them and poked fun. At night, they were chained up.Across the English Channel in Paris, Dr. Philippe Pinel worked as a physician in a mental institution. Horrified by the treatment of patients, Pinel and his predecessor Jean-Baptiste Pussin began a humanitarian movement in the treatment of the mentally ill. They removed the chains from patients who were considered dangerous.

To the surprise of many people, the men became gentler when treated with kindness and released from chains. The success of Pinel and Pussin led others to join the humanitarian movement, including William Tuke in England and Dorothea Dix in the United States. Slowly, the conditions in institutions became better. (Reforms in Abnormal Psychology: Demonology through Humanitarian Reforms)

Moral therapy

Moral therapy comes under humanitarian approach. The term moral really meant emotional or psychological rather than a code of conduct. Its basic tenets included treating institutionalized patients as normally as possible in a setting that encouraged and reinforced normal social interaction, thus providing them with many opportunities for appropriate social and interpersonal contact. Relationships were carefully nurtured individual attention clearly emphasized positive consequences for appropriate interactions and behaviour.

Asylum reform and Decline of Moral Therapy

After a period of time there was a decline in moral therapy .Dorothea Dix began the mental hygiene movement campaigned endlessly for reform in the treatment of the insane. Her work was known as the mental hygiene movement. In addition to improving the standards of care she worked hard to make sure that everyone who needed care received. Through her efforts humane treatment became more widely available in American institutions.Dix's heroic efforts was a substantial increase in the number of mental patients. This led to a rapid transition from moral therapy to custodial care.

A final blow to the practice of moral therapy was the decision, in the middle of the 19th century, that mental illness was caused by brain pathology and, therefore, was incurable. Later this led to the beginning of different approaches. (DURNAND)

Emil Kraepelin (1856-1926) brought much needed order to the classification of mental disorders focusing on the biological aspects of mental illness. This approach resulted in closer alignment of psychiatry with medicine because many categories of mental illness were treated in disease terms. Two major groups Kraepelin focused on was dementia praecox (schizophrenia) and manic-depressive psychosis. He believed a chemical imbalance caused schizophrenia and a metabolism irregularity caused manic-depression. Kraepelin’s classification ideas laid the groundwork for today’s classification system. In the United Kingdom in 1882, the Statistical Committee of the Royal Medico-psychological Association came up with a classification scheme that was revised many times but never adopted by its members. In Paris in 1889, the Congress of Mental Science adopted a classification system, but it was never actually used. Finally in the United States, the Association of Medical Superintendents of American Institutions for the Insane, which later became known as the American Psychiatric Association, adopted an idea similar to the British system. This system incorporated many of Emil Kraepelin’s ideas.

Works Cited

Abnormal Psychology. (n.d.).

Bruch, H. (. (n.d.). ABNORMALITY MODELS . Retrieved from AS PSYCHOLOGY: http://as-psychology.pbworks.com/w/page/9174232/AbnormalityModels

DURNAND, B. A. (n.d.). ESSENTIALS OF ABNORMAL PSYCHOLOGY. CENGAGE BRAIN USER.

Reforms in Abnormal Psychology: Demonology Through Humanitarian Reforms. (n.d.). Retrieved from EDUCATION PORTAL: http://education-portal.com/academy/lesson/reforms-in-abnormal-psychology-demonology-through-humanitarian-reforms.html

Bibliography

Abnormal Psychology. (n.d.).

Bruch, H. (. (n.d.). ABNORMALITY MODELS . Retrieved from AS PSYCHOLOGY: http://as-psychology.pbworks.com/w/page/9174232/AbnormalityModels

DURNAND, B. A. (n.d.). ESSENTIALS OF ABNORMAL PSYCHOLOGY. CENGAGE BRAIN USER.

Reforms in Abnormal Psychology: Demonology Through Humanitarian Reforms. (n.d.). Retrieved from EDUCATION PORTAL: http://education-portal.com/academy/lesson/reforms-in-abnormal-psychology-demonology-through-humanitarian-reforms.html