Chapter 15

Question 1

What 4 types of behavior are generally considered to be indicative of mental illness?

Answer 1

1. Harmful behavior: Behavior which is self-mutilating or suicidal is generally considered abnormal.
2. Unrealistic thoughts and perceptions: A person’s beliefs or perceptions which differ markedly from those considered normal at a certain time and place in history are considered abnormal and signs of mental illness.
   * Delusions are abnormal beliefs, hallucinations are abnormal perceptions.
3. Inappropriate emotional displays: Emotional displays are inappropriate based on the community in which one lives
   The person is often said to be mental ill.
4. Unpredictable behavior
   * Beliefs and emotions experience
   sudden shifts
   * This may be a sign of mental illness.

Question 2

What issues are there with these views?

Question 3

What are the 3 models that have been used historically to approach the concept of mental illness?

Answer 3

Biological, psychological and supernatural

Question 4

What is the biological model?

Answer 4

• Aka the medical model of mental illness
• Assumes that all disease is caused by a malfunction of some aspect of the body, mainly the brain.
• These malfunctions may be inherited either directly or indirectly, such as a predisposition toward mental illness.
• Other events which may affect biological functioning, may also result in problems, such as injuries, tumors, toxins, pollution, disease, excessive stress, physiological imbalances, among other things.

Question 5

What is the psychological model?

Answer 5

• Psychological events are the causes of abnormal behavior
• Events such as grief, anxiety, fear, disappointment, frustration, guilt, or conflict are emphasized.
• Biological and psychological explanations of mental illness most often exist simultaneously.

Question 6

What is the supernatural model?

Answer 6

• Disorders, both mental and physical, are inflicted on people by some mortal or immortal beings.
• This model was popular during the Middle Ages.

Question 7

Describe psychotherapy

Answer 7

• Defined as any attempt to help a person with a mental disturbance.
• The common elements in the psychotherapy situation has always been a sufferer, a helper, and a systematic ritual or practice through which help is proffered.
• The basic reasons for seeking help have been
  1) Removing, modifying, or controlling
  distressing psychological states
  2) Changing undesirable behavior patterns
  3) Promoting more positive personal growth and the development of greater meaning in one’s life.

Question 8

Describe the psych approach in detail

Answer 8

• Therapist’s job to help the person change
  behavior
• This may take and has taken many different forms.
• These forms range from observing (by watching a drama) or personally reenacting a traumatic experience in order to create a catharsis, listening to relaxing music, offering support, reassurance, and love, and analyzing dreams, to teaching better coping skills.
• Natural law
• Belief that you get what you deserve in life.

Question 9

Describe the supernatural approach in detail

Answer 9

To dispel supernatural forces from the person, the primitive doctor/priest/“therapist” would attempt to coax the invading forces out by various means

• Ranged from appeals and bribery to exorcism, magical rituals, trepanation and incantations.

Physical actions were also used to rid the person of the “spirits” causing the problems

• Examples:
• Bleeding a patient
• Removing a portion of the skull (called trepanation)
• Sympathetic Magic: Two types
• Homeopathic magic
• Based on the principle of similarity; belief that what one did to a
  model of a person would affect the person.
• Contagious magic
• Based on the principle of contiguity; belief that what was once close to someone would continue to exert influence on that person.

Question 10

Describe bio approach in detail

Answer 10

• Hippocrates and later Galen proposed that many ailments were a function of bodily, natural causes
• Thus natural remedies were prescribed.
• Things such as baths, fresh air, special diets, and rest were prescribed.
• It was the condition of the brain then, that determined whether a person was mentally normal or abnormal.

Question 11

Describe the return of the supernatural approach

Answer 11

• Took place during the Middle Ages and had a religious bent.
• People with abnormal behavior were seen as possessed by demons or witches or in some other way in alliance with the devil.
• The ages of the witch hunts and the inquisition began in this time but carried through into the Renaissance and Reformation.
• The Malleus Maleficarum was the official manual for the Inquisition
• In the Renaissance, many people with mental illness were locked up in “lunatic asylums.”
• One such famous asylum was St. Mary of Bethlehem Hospital. It came to be known as Bedlam, this institution was typical of such places at the time, inmates were chained, beaten, fed only enough to stay alive, subjected to bloodletting, and put on public display for visitors.

Question 12

What improvements in treatments occurred during the Middle Ages?

Answer 12

Despite the witch hunts and trials and persecutions, several people argued against the notion of possession by evil spirits and believed that natural causes and natural remedies could be beneficial for those behaving abnormally.

• Around the 1600s mental illness began to be viewed as having natural rather than supernatural causes, but it was still poorly understood.
• Treatment included the popular procedure of bloodletting
• Other methods were devised in hope of “shocking the patients
  back to their senses.”
• For example, Spinning people at high speeds in chairs; throwing cold water on them.
• These conditions continued well into the 18th century.
• Paracelsus differentiated between material and spiritual
  (psychological) diseases
• The Deception of Demons was written as a rebuttal to the Malleus Maleficarum.

Question 13

Describe Pinel’s contributions

Answer 13

• In the late 18th century, he proceeded slowly to improve the treatment of the mentally ill.
• First, he unchained them and segregated them based on their behavior.
• He encouraged occupational therapy, favored baths and mild purgatives as physical treatments, and argued forcefully against the use of any type of punishment or exorcism.
• Others, like William Tuke and Vincenzo Chiarugi, followed his lead and treatment improved.

Question 14

Describe the contribution’s of Benjamin Rush

Answer 14

• Wrote a book in which he encouraged more humane treatment
• However, he still advocated bloodletting and use of rotating and tranquilizing chairs.

Question 15

Describe the major contributions of Dorothea Dix

Answer 15

• Herworkbroughtaboutinstitutional reforms in many states and across Europe.

Question 16

Describe the work of Emil Kraeplin

Answer 16

• In 1883, Kraepelin published a list of mental disorders that was so thorough it was adopted by the world over and has lasted until recent times.
• He based his classification of mental diseases on what caused them, how much they involved the brain and nervous system, their symptoms, and their treatment.

Question 17

Describe Witmer’s contributions

Answer 17

• Founded the first psychological clinic
• Founded the journal Psychological Clinic
• Coined the term clinical psychology.
• He made three lasting impressions on clinical psychology:

1) Experimental psychology can be useful in helping people

2) This help can best be provided through a special profession (clinical psychology) that is independent of both medicine and education
3) A commitment that clinical psychology should be highly research oriented and be closely allied with basic psychology.

Question 18

Describe the tension between the psych and medical models

Answer 18

• Psychological Model
• Proposes that the roots of mental illness are in psychological causes such as conflict, frustration, emotional disturbance, or cognitive factors.

Medical Model

• Supports the view that mental illness has organic origins just as any other illness.
• Debate Between Psychological and Medical Models
• Still contested today and has many supporters on both sides of the issue.

Question 19

Describe Szasz

Answer 19

• Wrote an influential book, The Myth of Mental Illness
• The book argues that unless an illness has a neurophysiological basis, it is not an illness at all.
• In the case of what has been labeled mental illness:
• It reflects problem in living or nonconformity, but not a true
  illness.
• Thus, the diagnosis of mental illness reflects a social, political, or moral judgment, not a medical one.
• Labeling someone with mental illness or disease implies that they are not responsible for solving the “problems in living” which they have.
• Labeling a person with a mental illness or disease can, and in many cases does, encourage the person to act in ways dictated by the diagnosis.

Question 20

Describe Mesmer’s work

Answer 20

• Developed a “magnetic” cure in which magnetic forces were employed to heal (later called animal magnetism).
• Became very well known for this cure’s abilities
• As his fame grew, his critics became more relentless.
• Eventually, a commission of inquiry discounted
• Mesmer’s claims and animal magnetism died out.
• Contagion effect
• Patients would not respond to suggestion when alone with a physician, but would do so readily after seeing others respond.

Question 21

Describe Puyesgur’s work

Answer 21

• Developed what he called artificial somnambulism, which was a trance- like state under which the person would respond to his commands.
• Observed many of the phenomena, which we know of today with hypnosis, including posthypnotic amnesia and posthypnotic suggestions.

Question 22

Describe the contributions of Elliotson, Esdaile and Braid

Answer 22

• Examined this process as a means to produce an anesthetic response for use during surgery.
• Despite the banning of its use by the medical establishment, this method was used successfully on many occasions.

Question 23

Describe the Nancy School

Answer 23

• The “school” grew out of the work of Ambroise Auguste Liébeault with hypnosis with his patients, which was located just outside of the city of Nancy, France.
• Hippolyte Bernheim became the major spokesperson for this school.
• Bernheim contended that all humans are suggestible, but some are more so than others; the more suggestible a person is, the easier it is to hypnotize him/her

Question 24

How did Charcot describe hysteria and hypnosis?

Answer 24

• Charcot developed the use of hypnosis for treatment of hysteria, and concluded that hypnotizabillity indicated the presence of hysteria.
• Through hypnosis the doctor could relieve the effects of traumatic events, which would dispel the hysteria symptoms.
• Charcot was also a very accomplished neurologist.
• Freud studied with Charcot for a time and was greatly influenced by him.
• Pierre Janet, a student of Charcot’s, used hypnosis to discover dissociated memories, and when they were brought to the attention of a patient, his/her hysterical symptoms often abated.

Question 25

Describe how Erickson approached treatment

Answer 25

• Erickson used to cure people by talking in a very roundabout way about patient’s symptoms, subtly suggesting ways to view their symptoms in non-symptomatic ways.
• Indirect Hypnosis