Chapter 15 Study Questions

Question 1

What is mental illness?

Answer 1

Mental illness refers to a condition characterized by behaviors, thoughts, and emotional responses that deviate from what is considered normal or socially acceptable within a particular community or cultural context.

Question 2

Identify and describe the four themes that govern the definition of mental illness

Answer 2

Harmful Behavior: The first theme highlights behaviors that deviate from societal norms and are considered harmful to oneself or others. While cultural contexts influence what is perceived as harmful, actions such as self-mutilation or suicide are generally deemed abnormal. Historical instances, like the practice of seppuku in Japan or castrating children for musical careers in Italy, indicate cultural variations in what is deemed acceptable harm.

Unrealistic Thoughts and Perceptions: The second theme involves beliefs and perceptions that significantly differ from those accepted by the community. Unrealistic thoughts (delusions) and perceptions (hallucinations) are considered signs of mental illness. These aberrant experiences often result in individuals being labeled as mentally disturbed. Cultural context plays a vital role in determining what is considered realistic or not.

Inappropriate Emotions: The third theme involves emotional responses that are considered inappropriate or extreme in a given situation. Laughing when one should cry or displaying exaggerated emotional reactions are often indicators of potential mental disturbances. Cultural norms play a significant role in defining appropriate emotional responses.

Unpredictable Behavior: The fourth theme centers on sudden shifts in beliefs or emotions, often indicating emotional instability. Rapid mood swings or changes in convictions within short periods are commonly seen as signs of psychopathology. This theme emphasizes the importance of stability and consistency in behavior and emotions for mental well-being.

Question 3

Identify and describe the three classes of early explanations of mental illness

Answer 3

Biological Explanations: These explanations suggest that mental illnesses stem from physiological dysfunctions within the body, primarily the brain. Early theories proposed that bodily abnormalities, inherited predispositions, or imbalances caused by injuries, toxins, or physiological imbalances could lead to mental illness. Influential figures like Hippocrates emphasized the role of the brain in mental disorders, pioneering a more naturalistic approach to understanding these conditions.

Psychological Explanations: Early psychological explanations of mental illness attributed abnormal behavior to psychological factors such as grief, anxiety, fear, or conflict. These factors were believed to cause mental disturbances, leading to various therapies aimed at addressing these psychological issues. The Hippocratic belief in humoral theory and the later development of psychotherapy were significant contributions in this field.

Supernatural Explanations: Supernatural explanations posited that mental illnesses were caused by supernatural forces or spiritual influences. Primitive societies often attributed mental and physical disorders to mystical entities or demonic possession. Although early Greek physicians like Hippocrates began to challenge supernatural explanations, these beliefs persisted through the Middle Ages, leading to treatments that included exorcism, magic rituals, and incantations.

Question 4

Identify and describe the general features of four early approaches to treating mental illness

Answer 4

Psychotherapy: A significant early approach involved psychotherapy, aiming to help individuals with mental disturbances. This method often involved a sufferer, a helper, and a ritualized process of assistance. Psychotherapy attempted to alleviate distressing psychological states, modify undesirable behavior patterns, and promote personal growth. Notably, the emphasis on psychotherapy as a form of treatment was a reflection of shifting perspectives on mental illness from supernatural to naturalistic explanations.

Psychological Approach: Therapy based on psychological factors aimed to address issues such as fear, anxiety, or conflict through techniques such as catharsis, relaxation, analysis, and skill-building. The focus was on resolving internal psychological conflicts and promoting effective coping strategies. This approach often emphasized the interplay between psychological and biological factors, emphasizing the importance of understanding the mind’s impact on the body and vice versa.

Supernatural Approach: Treatments based on supernatural beliefs included rituals, exorcisms, magical ceremonies, and incantations aimed at removing evil spirits or demonic influences thought to cause mental illness. These methods were based on the principle of sympathetic magic, which relied on the belief that influencing a symbolic representation of a person could affect the actual individual. This approach reflected the prevalent supernatural beliefs in ancient societies.

Biological Approach: Early biological treatments centered on the physical aspects of the body, focusing on naturalistic remedies such as herbal treatments, baths, and massages. Influential figures like Hippocrates and Galen emphasized the importance of maintaining bodily humoral balance for both physical and mental health. The shift from supernatural to biological explanations marked a significant transition in the understanding and treatment of mental illness, emphasizing the body’s role in mental well-being.

Question 5

Describe the gradual improvement in the treatment of mental illness that began in the 16th century

Answer 5

In the 16th century, a gradual shift in the understanding and treatment of mental illness began, moving away from the prevailing belief in demonic possession and witchcraft. This significant change was driven by the contributions of several influential figures, namely Philippus Paracelsus, Cornelius Agrippa, Johann Weyer, and Reginald Scot.

Question 6

Briefly describing the contributions of Philippus Paracelsus

Answer 6

Philippus Paracelsus, a notable Swiss physician and alchemist, advocated for an empirical understanding of nature and the use of chemical remedies for curing ailments. Rejecting the prevailing belief in demonology, Paracelsus emphasized a holistic approach to health, considering the influence of factors such as chemicals, magnets, and celestial alignments on an individual’s well-being. His emphasis on naturalistic explanations of mental disorders and his advocacy for the use of empirical studies laid the groundwork for a more scientific understanding of mental illness.

Question 7

Briefly describing the contributions of Cornelius Agrippa

Answer 7

Cornelius Agrippa, a 16th-century philosopher and physician, opposed the widespread witch hunts and trials, advocating for a view that the behaviors exhibited by the “bewitched” were the result of emotional or physical disorders rather than demonic possession. His efforts contributed to challenging the prevalent belief in supernatural causes of mental illness, paving the way for a more rational understanding of mental health issues.

Question 8

Briefly describing the contributions of Johann Weyer

Answer 8

Johann Weyer, a student of Agrippa, further developed the argument that individuals labeled as witches or bewitched were actually suffering from mental disturbances. He published “The Deception of Demons” in 1563, providing a well-documented rebuttal of the prevailing practices of witch hunts and trials. Weyer’s work marked a crucial step in highlighting the importance of distinguishing mental illness from supernatural explanations and advocating for a more humane treatment of those affected.

Question 9

Briefly describing the contributions of Reginald Scot

Answer 9

Reginald Scot, known for his work “The Discoverie of Witchcraft” published in 1584, also supported the view that individuals accused of witchcraft were often experiencing mental disorders. His contributions, alongside those of Weyer, helped to challenge the prevailing superstitious beliefs and promote a more rational understanding of mental health.

Question 10

Identify the most popular treatment for ailments—including mental disorders—up to the end of the 18th century

Answer 10

Despite these progressive developments, the treatment of mental illness remained largely ineffective and often brutal until the end of the 18th century. Blood-letting, a popular method employed for various ailments including mental disorders, continued to be widely practiced. Other harsh treatments, such as inducing shock in patients by spinning them rapidly in a chair or dousing them with cold water, were also utilized, albeit with limited understanding of their effectiveness. These treatments often resulted in questionable improvements in the condition of patients, highlighting the continued challenges in effectively addressing mental health issues during this period.

Question 11

Briefly describe the life and work of Philippe Pinel (1745–1826)

Answer 11

Philippe Pinel (1745–1826) was a French physician known for his significant contributions to the humane treatment of individuals with mental illnesses. He played a crucial role in changing the prevailing harsh and inhumane methods of dealing with the mentally ill by advocating for more compassionate and ethical approaches. Pinel is remembered for his pivotal role in removing restraints and chains from patients at the Bicetre Asylum and La Salpetriere, two major institutions in Paris. He emphasized the importance of segregating different types of patients, providing occupational therapy, encouraging physical treatments such as bathing and mild purgatives, and recording precise case histories of patients, thus pioneering a more humane and scientific approach to the treatment of mental illness

Question 12

Briefly describe the life and work of Benjamin Rush (1745–1813)

Answer 12

Benjamin Rush (1745–1813), an American physician and a signer of the Declaration of Independence, made significant contributions to the field of psychiatry in the United States. He advocated for the improved treatment of individuals with mental illness, advocating for fresh air, sunlight, and freedom for patients within their institutions. However, Rush also endorsed outdated practices such as bloodletting and the use of rotating and tranquilizing chairs, believing in their therapeutic benefits despite their questionable effectiveness. Despite this, his progressive views on the humane treatment of the mentally ill laid the foundation for future advancements in the field

Question 13

Briefly describe the life and work of Dorothea Lynde Dix (1802–1887)

Answer 13

Dorothea Lynde Dix (1802–1887) was an American activist and reformer who dedicated her life to advocating for the rights and improved treatment of individuals with mental illness. After witnessing the appalling conditions of the mentally ill during her time as a teacher at a Boston prison, Dix embarked on a nationwide campaign to expose the inhumane treatment of the mentally ill. Her efforts led to significant institutional reforms in numerous states, including improved conditions and treatment for those suffering from mental illnesses. During the Civil War, she served as the superintendent of female nurses for the Union and later traveled to Europe to promote better care for the mentally ill

Question 14

Briefly describe the life and work of Emil Kraepelin (1856–1926)

Answer 14

Emil Kraepelin (1856–1926) was a prominent German psychiatrist who significantly influenced the modern classification and understanding of mental disorders. He developed an extensive list of mental disorders, categorizing them based on their causes, symptoms, and treatments. Kraepelin is known for his contributions to the concept of dementia praecox, which later evolved into the modern concept of schizophrenia. His work played a pivotal role in standardizing the classification of mental illnesses, laying the groundwork for the Diagnostic and Statistical Manual of Mental Disorders (DSM), a widely used guide for mental health professionals

Question 15

Briefly describe the life and work of Lightner Witmer (1867–1956)

Answer 15

Lightner Witmer (1867–1956), an American psychologist, made significant contributions to the development of clinical psychology as a distinct discipline. He founded the first psychological clinic at the University of Pennsylvania, which focused on assessing and treating individuals with mental and developmental disorders. Witmer emphasized the application of scientific psychology to practical problems, advocating for a more systematic and research-based approach to clinical practice. His work led to the establishment of clinical psychology as a profession separate from both medicine and education, emphasizing the importance of rigorous scientific training for clinicians

Question 16

Describe the psychological and medical models of mental illness and the tension between these models

Answer 16

The medical model, rooted in the principles of natural science and positivism, seeks to explain abnormal behavior through the lens of disordered physiology or brain chemistry. It views mental illness as a result of biological factors and often emphasizes the role of genetics, biochemical imbalances, or other physiological conditions. This approach often advocates for treatments that target these underlying physiological processes, such as medication or other biological interventions

On the other hand, the psychological model focuses on the significance of mental variables, including emotional states, cognitive factors, and unconscious motivations, in understanding and treating mental illness. This model emphasizes the importance of psychological factors such as stress, conflict, and emotional disturbances in the development and manifestation of psychological disorders. It often promotes therapies that address these psychological factors, such as psychotherapy and counseling

The tension between these models arises from their differing perspectives on the causes of mental illness. While the medical model attributes mental illness primarily to physiological dysfunction, the psychological model highlights the role of psychological and emotional factors. This tension has significant implications for the diagnosis and treatment of mental illness, as it influences the approaches taken by mental health professionals in understanding and addressing psychological disorders

Question 17

Describe the views of Thomas Szasz regarding the medical model

Answer 17

Thomas Szasz, a prominent critic of the medical model, argued that many conditions labeled as mental illness are better understood as problems in living or nonconformity rather than actual diseases. He contended that the concept of mental illness is often a social, political, or moral judgment rather than a genuine medical diagnosis. Szasz suggested that psychiatry and clinical psychology should view those they assist as clients rather than patients and focus on helping individuals understand themselves, others, and life, rather than treating them for an illness. He criticized the use of psychiatric labels, arguing that they can have a self-fulfilling effect on individuals and perpetuate the perception of mental illness as a real disease.
Szasz’s views on the medical model challenged the traditional understanding of mental illness and the role of psychiatry in addressing psychological distress. His work contributed to ongoing debates regarding the conceptualization and treatment of mental health issues, emphasizing the importance of considering the broader social and cultural contexts in which mental illness is defined and addressed

Question 18

Describe the use of hypnotism as a treatment for behaviour disorders, including the work of Franz Anton Mesmer (1734–1815)

Answer 18

The use of hypnotism as a treatment for behavioral disorders has a rich history, beginning with the work of Franz Anton Mesmer, whose theory of animal magnetism laid the foundation for later developments in the field. Mesmer proposed that each person’s body contains a magnetic force field, and through the use of magnets or even just touch, this force field could be redistributed to restore health. This concept of animal magnetism formed the basis for Mesmer’s treatment practices, where he used various objects or even just his hand to influence his patients. Mesmer’s practices often induced what he referred to as a “crisis” in patients, characterized by convulsions and other intense emotional episodes

Question 19

Describe the use of hypnotism as a treatment for behaviour disorders, including the work of Marquis de Puységur (1751–1825)

Answer 19

Marquis de Puységur, a member of the Society of Harmony and a student of Mesmer, further advanced the use of hypnotism by discovering that inducing a sleeplike trance, which he termed artificial somnambulism, was effective in producing therapeutic results. He observed that individuals in this state were highly suggestible and could be made to perform various actions without any recollection upon waking. This discovery of suggestibility in a trance state laid the groundwork for later developments in the understanding of posthypnotic suggestion and amnesia.

Question 20

Describe the use of hypnotism as a treatment for behaviour disorders, including the work of John Elliotson (1791–1868), James Esdaile (1808–1859), James Braid (1795–1860)

Answer 20

The phenomenon of hypnosis was further explored and refined by various figures such as John Elliotson, James Esdaile, and James Braid. Elliotson advocated for the use of mesmerism during surgery, envisioning it as a potential surgical anesthetic. However, the medical establishment initially rejected this idea. Esdaile’s work in India, where he performed painless operations on Hindu convicts, was dismissed by many due to the skepticism surrounding his methods. Braid, a Scottish surgeon, conducted systematic examinations of hypnotic phenomena and proposed that the effects observed were a result of the subject’s suggestibility rather than any inherent power possessed by the hypnotist

Question 21

Describe the use of hypnotism as a treatment for behaviour disorders, including the work of the Nancy school

Answer 21

The Nancy school, spearheaded by figures like Auguste Ambroise Liebeault and Hippolyte Bernheim, further popularized the use of hypnotism as a therapeutic tool. They emphasized that suggestibility was a natural human trait, and some individuals were more suggestible than others. This school’s work shed light on the contagion effect, where patients witnessing the positive results of hypnotic treatment were more likely to respond to suggestion. Additionally, they highlighted the importance of posthypnotic suggestion in influencing a patient’s behavior after being aroused from the trance state

Question 22

Describe the use of hypnotism as a treatment for behaviour disorders, including the work of Jean-Martin Charcot (1825–1893)

Answer 22

Jean-Martin Charcot, known for his contributions to the understanding of hysteria, initially considered hypnotizability as an indicator of a predisposition for hysteria. However, he later acknowledged that his initial views were incorrect. Charcot’s focus on hysteria and hypnotic phenomena contributed to the understanding that traumatic experiences and dissociated ideas could lead to the manifestation of hysterical symptoms. This shift in perspective toward the psychological origins of symptoms represented a significant departure from the prevalent view of hysteria as mere malingering.