1: History of mental Health perspectives and Treatment approaches Flashcards
What is the biopsychosocial approach?
- Mental illness caused by several interrelating factors
- Bio = genetic predisposition, brain abnormality
- Psy = disturbed childhood, dysfunctional thinking pattern
- Social = environmental stressors, relationship difficulties
○ Now adopted by most mainstream practitioners for treatment/ care - Attempt to provide more holistic approach with understanding mental disorders + address ads/dis of considering from just one approach
What is the social constructionist approach to mental illness?
- Idea of what constitutes mental illness are tied in to the social, cultural, religious and individual factors
Prehistorically, what was the typical explanation for mental illness and what evidence is there showing how they were treated?
- Demonic possession
- Treated using Trepanning –> hole in skulls
- Currently practiced by some communities today
What is trepanning?
- A form of surgery involving a hole being made in the skull of living individuals
- A form of treatment for mental illness (demonic roots)
What was Paul Broca’s explanation for trepanning?
- Holes = allows demonic energy/ evil spirits to escape
- Often when dead = skull broken up and used as amulets
How does the Bible portray mental illness/ madness compared to prehistoric ideas of demonic possession?
- An affliction bestowed on individuals by God as a punishment for sin
What is lycanthropy?
- Condition where an individual believes they are an animal
- King Nebuchadnezzar
- Psychiatry literature = associated with other conditions (sz, depression)
Psychodynamic = transformation represents the manifestation of primitive id instincts - escape guilt feelings
Who is Prophet Ezekiel?
- Jewish priest = Hearing voices + catatonic movements
Contemporary authors suggest sz
Why does Cook (2012) cautions against the examination of biblical figures using modern diagnostic criteria?
Because contemporary authors will not have a full appreciation of the cultural context within which these individuals, and stories about them, derive
What changes occurred during the Greek and Roman era?
- Shift towards a more rational and systematic approach to madness
- Plato = madness a result of disconnection between the rational mind and the irrational chest
- Parallel to conflict with id and ego
What were the distinction within madness made by Plato - fist of its kind?
- Melancholia (sadness/ depression)
- Mania (mental excitement)
- Dementia (declining mental faculties)
What are Humours?
- Fluids which were thought to be present in the body in differing quantities: Black Bile, Yellow Bile, Blood and Phlegm
- An imbalance = madness
What did Hippocrates promote in-terms of the origin of madness?
- imbalance of fluids (humours) = different types of madness
- Ex black bile = melancholia
- Ex Yellow bile = anxiety + impulsiveness
- Ex Blood = mania
- Ex Phlegm = Emotional indifference
What was Hippocrates the first physician to describe?
- Puerperal Psychosis - psychosis that sometimes occurs after childbirth
- Thought madness was caused by the womb travelling to the brain LOL
What treatment did the ancient Greeks use to treat madness?
- Both psychological + physiological treatments
- Psychological - reward-base approach, persuasion
- Physiological - relaxation, whipping, forced cold baths
Believed it to be a private family matter and really let loose as long as they were not being a nuisance
What was the understanding of madness/ mental illness during the middle ages?
- Shift back to theoretical/ superstitious understanding
- Emphasis on faith –> punishment from God for sinning
- Test of faith, witch curse, active agents for the devil
According to their understanding of mental illness, how were they treated?
No treatment = just executed by burning, drowning, hanging
What may have exacerbated the theoretical/ superstitious belief of madness?
Highly influential book (Malleus Maleficarum) stated that if you did not believe in the reality of witchcraft + existence of the devil = heretic thereby at risk of trial and execution themselves
What role did the Dutch Physician Johann Weyer have in shifting the understanding of mental illness to rediscover the rational understanding (Humoral Theory + systematic approach) ?
- Published book ‘The Deception of Demons’ discussing that actually some of the ‘witches’ may just have been mentally ill and proposed explanations for some of their behaviour
- Resulting in the mad less likely to be accused of witchcraft
Following the shift in the understanding of madness stemming from Johann Weyer, how were those mentally ill treated?
- Often just looked after within community but those who are considered troublesome put into asylums = asylum era
Who were sent to asylums when they first popped up?
- Anyone of nuisance to society = prisoners, prostitutes, poor, mentally ill
How did institution diversification come about from asylums?
- Since everyone was there they could not tell who were okay to work and who were not
= madhouses, prisons, almshouse
What were the treatments used in asylums?
- Physiological remedies - blood clotting, forced vomiting
- More experimental methods - spinning chair
- Early form of shock therapy?
What is the social approach to madness ?
- A prominent explanation in America during the 19th C
- Considered madness caused from a range of social factors eg poor parenting, social deprivation
- Treatment focused on promoting order, structure and responsibility
Why was there an increase in the number of asylums in America?
- A social approach taken
- Reported higher figures of people being cured
Social cures = belief that it is working
- Reported higher figures of people being cured
What are some problems with the asylums in America during this time?
- Reports of patients not reliable since only reported thos who were cured + same person cured and readmitted 48 times
Asylums = overpopulation often with immigrants to impose their ‘rules’/ normal behaviour
What was the consequence of asylums becoming over-populated?
Purpose of institution = one of containment, restraint + general subjugation
What is Grandiose Delusion?
- When an individual believes that they have a special purpose in life eg save the world/ be famous
What role did the Grandiose Delusion have in the development of understanding mental illness/ madness?
- This mental illness was related to the syphilis bacteria
- Giving indication that some mental health problems were of biological origin rather than spiritual/ social
Placing understanding + treatment of mental health in the medical domain
- Giving indication that some mental health problems were of biological origin rather than spiritual/ social
What is hysteria?
- Coined by Jean-Martin Charcot
- Term used to describe individuals whose emotional trauma appeared to result in physical symptoms
What is at the centre of Freud’s theory?
- Idea that human mind contains competing drives which are shaped by childhood experiences
What did Freud believe was the cause of hysteria?
Consequence of the unconscious interplay between the different facets of the personality
What is the case of Anna O showing the cause and treatment for hysteria?
- Drank lots of fluids via high in water content fruits
- During hypnosis, where unconscious thoughts/ desires uncovered = saw dog drink out of cup = disgusted
- Therapy = recognition of their unconscious thoughts + feelings = problem dissipate
- Recognition leads to recovery
