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The History of Abnormal Psychology
Transcript of The History of Abnormal Psychology
It is difficult to draw the line between normal and abnormal dysfunction so these problems are considered part of a continuum instead of in separate present or absent categories. This criterion for a psychological disorder requires that the patient upset with the presented symptoms they are suffering. This alone cannot define an abnormal behavior though.
Impairment is another criterion that cannot define abnormal behavior alone but does, in some circumstances, become something of personal distress. For example, being shy would not fill this criterion, but being so shy you make every attempt to avoid all social interaction would fill the criterion. This criterion refers to behaviors considered to be abnormal within each patient's culture. This criterion is very reliant on social norms to determine whether one's behavior is abnormal.
Robert Sapolsky (2002) was a neuroscientist who worked closely the Masai tribe of East Africa. Sapolsky's informant within the tribe was quoted saying, "But she hears voices at the wrong time," in reference to a woman of the tribe who the people believed had gone crazy. The power of the church's influence in the end of the 14th century led to popular superstitions among people who began to believe that psychological disorders were afflictions by the devil, witches, or even possessions.
These people were often blamed for misfortunes within the town. To rid them of this they were exorcised, had the cross pattern shaved into their hair, or tied to a wall hear the front of a church to hear mass.
These beliefs continued through the next few centuries and are seen in cases like the Salem witch trials. During the same time there was also an enlightened view that insanity was a natural phenomenon caused by mental or emotional stress and was curable.
Depression and anxiety were considered illnesses though the church viewed their symptoms as exhibiting the sin of sloth.
Treatment was done through rest, sleep, a healthy environment, baths, ointments, and various potions.
These people were often moved from house to house in the village, cared for by all in turn. Possession was, by many, considered to be a punishment for past evil deeds, paying for sinful or immoral behavior. Others viewed possession as involuntary and considered the individual to be blameless of their actions.
The treatments for possession began with exorcism. If that failed they would try to make the body uninhabitable to spirits by confinement, beatings, and other forms of torture.
One "therapist" thought it wise to hang his patients over a pit of poisonous snakes and scare the evil spirits out of the body. Shockingly enough, this would sometimes work, if only temporarily. Mass hysteria is characterized by large-scale outbreaks of bizarre behavior.
In the Middle ages these incidences were thought to be caused by possession and one reasonable guess that the people were reacting to bug bites.
Today incidences of Mass Hysteria are considered to be a phenomenon called emotion contagion or mob psychology. Hippocrates
considered to be the father of modern Western medicine.
suggested that all psychological disorders could be treated like any other disease.
believed that psychological disorders could be caused by brain pathology, head trauma, and genetics.
recognized the importance of interpersonal contributions to psychopathology.
Coined the term Hysteria to describe a condition he had learned from the Egyptians.
Biological tradition, having been established in Classical Greece and further developed in Rome, suffered a lack of practice in the centuries that followed it.
The biological tradition was reinvigorated in the 19th century because of two reasons: discovering the nature and cause of syphilis, and John P. Grey.
Syphilis is a sexually transmitted disease caused by a bacterial microorganism entering the brain.
Syphilis causes delusions both of persecution and grandeur, as well as other bizarre behaviors.
Patients with Syphilis present in much the same way those with Psychosis do but unlike psychosis patients with Syphilis showed a steady deterioration for about five years that ultimately ended in death. Patients with Psychosis remained fairly stable. This is what prompted a separate disease designation.
Louis Pasteur's Germ theory facilitated the identification of the microorganism that caused Syphilis.
Malaria was found to kill the microorganism through intense fever and thus became a "cure" for a brief time.
Finally it was found that penicillin could cure Syphilis without the need to infect a patient with Malaria. Grey's influence on the biological treatment of psychological disorders lead to an increased understanding of biological contributions to psychopathology and development of new treatments.
Electric shock, brain surgery, and insulin shock therapy were commonly used treatments in the 1930's.
insulin shock therapy was soon deemed too dangerous but electric shock therapy, originally used by Benjamin Franklin, was continued and is used today in electroconvulsive therapy though greatly modified.
Opium, reserpine, neuroleptics were used as sedatives for patients with hallucinations and delusions.
Later Benzodiazepines (minor tranquilizers) were used to reduce anxiety and became the most widely prescribed medication in the world under brand names like Valium and Librium. These are not prescribed often in the present.
These medicinal treatments were followed by Baromides and Neuroleptics which have met the same fate as Benxodiazepines.
Despite the back and forth, the effects these drugs had on symptoms like hallucinations and delusions motivated the search for more biological causes of psychological disorders. A psychological disorder is defined as a psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or sulturally expected. Abnormal behavior has been considered a battle between good and evil. The Moon and the Stars The Swiss physician, Paracelsus, rejected the idea of evil spirits and instead theorized that the movements of the moon and stars directly influenced our psychological functioning.
He claimed that the moon's gravitational effects on body fluids caused mental disorders. This is where the term 'lunatic' comes from. Galen
Further developed Hippocrates' theories into the humoral theory which stated that all normal brain functioning was dependent on four major brain fluids: blood, black bile, yellow bile, and phlegm.
An imbalance in the humors was considered to be the cause of different psychological disorders.
Since each of the four humors was related to a state of dryness, heat, moisture, and cold, these states were used to bring their respective humor back into balance.
A common practice to balance the humors was bloodletting or inducing vomiting. John P. Grey Considered the most influential American Psychiatrist of the time.
Was editor of the 'American Journal of Insanity' which later became the 'American Journal of Psychiatry' and was the flagship publication of the APA.
Believed that the causes of insanity were always physical.
Reintroduced the emphasis on treatment through bed rest, diet, and proper room temperature and ventilation. Grey is credited with inventing the rotary fan to ventilate his hospital.
Under Grey the conditions in hospitals became much more humane and livable but also very large and impersonal. Consequences of the Biological bbbbbbbbbTradition In the late 19th century Grey and his colleagues lost focus on treating patients with psychological disorders, believing them to be brain pathologies and therefore incurable. So focus shifted from treatment to diagnosis, legal questions of a patient's responsibility for their actions, and the study of brain pathology.
Emil Kraepelin was one of the first in this time to distinguish that many disorders likely had different causes. He established this through records of different ages of onset and slightly different presenting symptoms.
The Psychological Tradition Moral Therapy Asylum Reform & decline ...... of Moral Therapy. Psychoanalytic Theory The Structure of the Mind Defense Mechanisms Psychosexual Stages of Development Later Developments in Psychoanalytic Thought Psychoanalytic Psychotherapy The Behavioral Model The Psychological tradition focused not only on the biological aspects of psychopathology, but also the social and cultural aspects.
Moral Therapy was known for trying to treat institutionalized patients as normally as possible and doing so in a setting that reinforced normal social interaction.
Relationships in these institutions were carefully nurtured.
Positive reactions to appropriate behavior was key and restraint and seclusion were eliminated.
Moral Therapy began in Greek temples during the 6th century B.C.E. but Moral Therapy as a system began with Philippe Pinel and Jean-Babtiste Pussin at a hospital in Paris. Moral Therapy was known to work best when the patients in each institution numbered 200 or fewer, but post civil war immigration increased patient loads to one or two thousand per hospital.
Even when the hospitals were sufficiently staffed, immigrants were not given moral treatment simply because they were not "native" Americans.
Dorthea Dix began a reform movement in the late 19th century to improve the deplorable conditions in mental hospitals called the mental hygiene movement.
Her movement included making sure everyone who needed care received it, even the homeless. This led to an influx of patients and the rapid transition from moral therapy to custodial care due to a lack of staff. In the late 18th century Anton Mesmer suggested that many psychological problems were caused by an undetectable fluid in all living organisms called "animal magnetism" being blocked.
Mesmer's method of curing patients was opposed by the medical establishment and Benjamin Franklin himself conducted an experiment in which he found that 'mesmerism' was nothing more than strong suggestion.
Despite this, Mesmer is still widely regarded as the father of hypnosis.
The physician Jean-Martin Charcot demonstrated that some techniques of mesmerism were very effective on several psychological disorders and did much to legitimize the practice.
The most famous student under Charcot was Sigmund Freud who, with Josef Breuer, "discovered" the unconscious mind.
These two also found that it was therapeutic to relive emotional trauma and release associated tension.This was called catharsis.
Freud took these findings and developed them into the psychoanalytic model. The first of three facets to psychoanalytic theory.
The mind contains three major parts: the id, ego, and superego.
The id is the source of strong sexual and aggressive feelings (libido) and death instinct (thanatos) which are always in opposition.
The id operates on the pleasure principle.
The ego acts on reason and logic, keeping the id in check and operates according to the reality principle.
The superego operates according to the moral principles having been instilled in us by our parents and culture.
The id and superego are always at odds with each other and it is the role of the ego to mediate. These conflicts are called intrapsychic conflicts.
Freud stated that we are only fully aware of the secondary processes of the ego. Defense mechanisms were seen as a tool used by the ego to keep primitive emotions associated with conflicts in check.
Different Psychological disorders seem to be associated with different defense mechanisms.
Healthy defense mechanisms like humor and sublimation were seen to correlate with psychological health. Freud theorized that in infancy and early childhood we pass through psychosexual stages of development. This made Freud the first to take a developmental perspective on abnormal behavior.
The stages, oral, anal, phallic, latency, and genital, represent distinctive patterns of gratifying our basic needs and satisfying our drive for physical pleasure.
If we did not receive appropriate gratification in a specific stage, or if something in that stage made a lasting impression (fixation), Freud theorized that an adult's personality would reflect this stage.
Freud believed that all nonpsychotic psychological disorders came from unconscious conflicts, the anxiety they cause, and the defense mechanism implemented by the ego. He called these disorders neuroses. Anna Freud furthered her father's work by developing ego psychology which focuses on the way in which defensive reactions determine our behavior.
Heinz Kohut used psychoanalytic thought to focus a theory on how one's self-concept allow and individual to progress towards health or develop neuroses. This approach was called self psychology.
A related idea called object relations focuses on how the important people around you may influence your internal conflicts.
Carl Jung and Alfred Adler rejected much of Freud's theories and formed other schools of thought. Jung introduced the theory of collective unconscious which is a wisdom accumulated by society and culture that is stored deep in individual memories and passed down trom generation to generation. Both Jung and Adler, unlike Freud, believed that human beings were innately good. Techniques of psychotherapy are designed to reveal the nature of unconscious mental processes through catharsis and insight.
Freud's two primary techniques were free association and dream analysis.
Free association is used to reveal emotionally charged material that may be repressed because it is too painful or frightening.
Dream analysis is done by analyzing the content of dreams and using them to reflect the primary process thinking of the id and relate them to unconscious conflicts.
In the phenomenon of transference a patient will begin to relate to the therapist as they did to an important figure in their childhood, most often a parent.
Classical psychoanalysis requires therapy four to five times a week for 2 to 5 years. It's goals are to analyze unconscious conflicts, resolve them, and restructure the personality to put the ego back in charge.
Today psychoanalysis is still practiced but many psychotherapists use a loosely related approach called psychodynamic psychotherapy. This differentiates most significantly from psychoanalysis in that it is much more brief and does not emphasize personality reconstruction. Also called the cognitive-behavioral model or social learning model, the behavioral model brought the systematic development of a more scientific approach to psychological aspects of psychopathology. Classical Conditioning Classical conditioning was "discovered" by Ivan Pavlov.
It is defined as a type of learning in which a neutral stimulus is paired with a response until it elicits that response.
The method for classical conditioning would be to present an unconditioned stimulus with the desired conditioned stimulus. After repeated pairings the subject would elicit the previously unconditioned response in the presence of the conditioned stimulus alone, making the response a conditioned response.
If the conditioned stimulus is presented alone too many times the subject will no longer elicit the conditioned response. This is a process called extinction. Behaviorism Behavior Therapy Operant Conditioning Behaviorism was established by John B. Watson.
Watson believed that, like any other science, psychology was an objective experimental branch of natural science and that psychoanalysis had no place in its methods.
Watson is most well known for his "Little Albert" experiment.
A student of Watson's, Mary Carver Jones, later found that not only can fear be learned but it can also be unlearned. Joseph Wolpe is credited for pioneering behavioral therapy through his technique of systematic desensitization.
Systematic desensitization was a process in which an individual was gradually introduced to the objects or situations they feared so that their fear could extinguish.
Wolpe also had patients do something that was incompatible with fear while they in the presence of the object or stimulation. Most often this was a trance-like relaxation. B.F. Skinner developed operant conditioning.
Operant conditioning is a type of learning in which behavior changes as a function of what follows the behavior.
Skinner saw behavior as something that operates on the environment and changes it in some way.
Using positive and negative reinforcement, Skinner was able to teach animals, mainly dogs and pigeons, to do tricks including dancing, playing ping-pong, and playing a toy piano.
To do this he used a process called shaping where the animal was given positive or negative reinforcement as they got closer and closer to doing a behavior. The Scientific Method and an Integrative Approach Two developments in the 1990's came together to shed light on the nature of psychopathology. These were the increasing sophistication of scientific tools and methodology, and the realization that no one influence- biological, behavioral, cognitive, emotional, or social- ever occurs in isolation.
Now we are seeing an explosion of knowledge from the fields of cognitive science and neuroscience.
Today the valid model of psychopathology is multidimensional and integrative, coming from neuroscience, cognitive science, behavior science, and developmental science.