500 B.C. – Ancient Times
- Mental illness was thought to be caused by demons or animal spirits taking over the body.
- This was also true of prehistoric man – a bronze statue formerly displayed in the Fort Worth Museum of Science and History depicted two men holding down another while using rudimentary tools to puncture his skull. The display placard read that ancient man believed that mental illness was caused by supernatural factors that may be released from the ill person’s skull (description recalled from contributor’s personal experience) (Buchanan, 2009).
- Other cultures used early forms of brain surgery to cure or alleviate any number of misunderstood maladies (O’Donnell, 2010).
- The treatment for mental illness was exorcism or torture.
- While more cautiously approached, exorcism is still used as a means of treating misdiagnosed mental illnesses today (National Catholic Reporter, 2000).
- Trepanning, which consisted of a small instrument being used to bore holes in the skull, would allow the evil spirits to leave the possessed person.
- Abuse the body badly enough, and the spirit will want to leave it.
450 B.C. – Golden Age of Greece
Hippocrates (Greek physician, father of modern medicine)
- Denied that deities/demons caused mental illness.
- Viewed abnormal behavior and illness in general as having internal causes, and thus having biological natures or etiologies.
- Has a key belief that if you took care of your body, your mind would also stay well (Hippocrates, 2010).
- Treatment was to modify the environment (tranquil life, sobriety, exercise, and abstinence from excess).
- Believed patients needed to choose health over mental illness.
- Was the basis for the Hippocratic Oath
- Physicians or healers will not deliberately harm an individual who seeks their help; they will treat anyone who comes seeking their aid; they will not give a deadly drug if the patient requests it; and they keep all information about doctor-patient professional relationships confidential (Hippocratic oath, 2010).
- Such harms still later included:
- Terrible conditions (patients shackled to walls or dark cells).
- Treatment (electric shock, bleeding, spinning, restraints) used to intimidate patients into choosing health over illness.
1800s – Reforms in Mental Health Treatment
Benjamin Rush (Leitch, 1978).
- Published the first American textbook on psychiatry, Mental Inquiries and Observations upon the Diseases of the Mind.
- Believed the cause of mental illness was exposure to severe psychological and social stressors.
- Treatment was “moral management”, which focused on the patient’s social, individual, and occupational needs (manual labor, spiritual discussion, humane treatment).
Philippe Pinel (Enersen, 2010).
- Frenchman and early reformer in the proper treatment of mentally ill individuals.
- Like Rush, also believed mental illness were caused by excessive psychological and social stresses.
- Advocated that the mentally ill be treated with sympathy, compassion, and empathy.
- One of the founders of psychiatry.
Dorothea Dix (“Dorothea Lynde Dix”, 2010).
- Helped establish 32 mental hospitals throughout the United States.
- 1845 – first public mental hospital in Pennsylvania Harrisburg State Hospital.
- 1847 – first state mental institution in Illinois established.
- 1856 – first state mental institution in North Carlina opened and named in her honor.
- Authored bills that were intended to protect, and reform treatment for, mentally ill patients.
1900s – Modern Era
- Major breakthrough: Discovery of biological cause of general paresis (syphilis of the brain) (Jasmin, 2008).
- Symptoms of syphilis are paralysis, insanity, and death.
- Treatment was to infect sufferer with malaria (high fever would kill the syphilis organism).
- Led to increased focus on diseased bodily organs as underlying cause of mental illness.
- Accompanied by tremendous advances in anatomy, physiology, neurology, chemistry.
Emil Kraepelin (Emil Kraepelin, n.d.)
- Developed a classification system of mental disorders (precursor to The DSM).
- Classified psychosis into two forms, manic depression and dementia praecox.
- Recognized that different types of disorders had different outcomes.
- Emphasized importance of underlying brain pathology.
Richard Freiherr von Krafft-Ebing(Kiff, n.d.)
- Performed extensive work and research in human sexual behavior
- Wrote Psychopathia Sexualis, the first major study of sexual perversity. This coined many terms associated with sexuality today (i.e, sadism, masochism, etc.)
- Served as authoritative influential study of human sexual behavior until Freud.
Advances in psychological understanding of mental disorders:
Sigmund Freud (Thornton, 2005)
- Developed psychoanalytic theory – the theory of psychological development in terms of stages throughout life.
- Believed unconscious processes, motives, and urges are at the core of many of our behaviors and difficulties.
- Developed the doctor-patient paradigm.
- The doctor was viewed as being in a power position, and the patient was a sick individual who would take the doctor’s words as an unquestionable fact.
B.F. Skinner (Vargas, 2005)
- Father of radical behaviorism.
- Believed that any behavior that was reinforced or rewarded would be more likely to increase or recur; any behavior that was either not reinforced or was punished would be more likely to decrease or be extinguished.
- Created experiments which demonstrated operant conditioning. Most well known for creating the Skinner Box, a devise demonstrating conditioning of rats pressing a lever to receive food. http://www.youtube.com/watch?v=PQtDTdDr8vs.
Albert Bandura (Pajares, 2004)
- Teaches at Stanford University.
- Developed Social Learning Theory(Modeling).
- Suggested that we could learn based upon what we observed in a model.
- Bobo Doll Experiment.
Albert Ellis (Ellis et al, 2005)
- Believes that we get depressed and develop other mental illnesses because of faulty thinking.
- Rational Emotive Behavior Therapy(REBT).
- REBT works well with Anxiety Disorder and Mood Disorders.
- Humanist who believed in the innate goodness of all people and in the ability of all people to grow and lead constructive lives.
- Developed the client- or person-centered therapy.
- The psychologist is seen as someone who is a skilled listener, not judgmental, and certainly not powerful nor omniscient.
- Theorized that dysfunction begins in infancy.