Lecture 5 Flashcards
Mesmer and magnatism (the birth of therapy)
Background on Mesmer
Mesmer & Magnetism
The birth of Therapy. Begins with Franz Anton Mesmer, He discovered hypnosis. He seemed to be influenced by exorcisms that catholic priests performed. These were only banned by the church in the 1940s. This was often done to try and cure mental disorders.
He was a physician from Vienna. He seemed at a young age to be kind of sketchy. Received his these on the influence of the gravitational force of planets on biological organisms. This made sense at the time due to the popularity of Newton and the relative novelty of gravity. He plagiarised his thesis. From someone in the UK. Not that into working – married a rich widow to become a socialite.
How did mesmer start using magnetism
(his wifes relative)
What is animal magnetism?
Was a good musician, organised many parties etc. Eventually, one of his wife’s relatives comes to see him for a medical condition. Has convulsions. Tried some medical things which do not work. He recalls gravitational forces and so used magnetism (also being discovered at the time and relatively unknown). Many treatments involving magnets – it seems to work! The patient is cured. Mesmer decides to continue treating patients like that. Eventually realises he does not need the magnets. Just his hands is enough. He must have some special “animal magnetism” in us.
Is it the hypnotist or hypnotisee that determines who can be hypnotized?
What is suggestability?
Actually, the idea that all of the skills in hypnotism comes from the hypnotist. Not true. Almost anyone can be trained to hypnotise people BUT not everyone can be hypnotised. Suggestibility is the aptitude to transform the idea into an act.
Prof. Roy’s experience with suggestability is what?
Prof. Roy did his PhD with Pierre Rainsville who conducted an image study ion the effects of hypnotism on pain. At UdeM the ethics board required a witness for each hypnosis session. Often Prof Roy so has seen a lot. There is a huge variability in how much people can be hypnotised. For some people it works really well. Very hard to achieve post hypnotic suggestions – stuff that will have effects even out of hypnosis.
Why is hypnosis research so baguette-centric?
The field of hypnosis research is very small. Heavily French. This is in part because eventually Mesmer ran into problems with what he was doing in Vienna (he claimed to cure a girls blindness and clearly did not – he blamed the parents, and they did not take kindly to it). Authorities investigated him and he fled to Paris. Rapidly becomes a sensation there. Partly its his skills at hypnosis but a lot because of his socialite skills. SO popular that he has too many patients.
Social contagion affect and mesmer’s croissant parties.
Came up with the idea that he would magnetise liquid with his animal magnetism and put it in a bucket. With metal bars attached. People would just sit around the bucket and hold the bars. Would become magnetised by this force. It worked even more because of the social contagion effect. If one person says they are feeling something, others will too. People are fainting – has a special room for them. People are good for him for some time.
How did Benjamin Franklin put an end to all this French foolishness?
Other doctors demand an investigation into mesmer’s magnetism sessions. Led by Benjamin Franklin who is then the US ambassador to France. Unsurprisingly, there is no real effect. There is no proof of animal magnetism. In other words, it is a scam. For a long time, people do not notice what is interesting there – the suggestibility of the people that was causing the effect! Comes back later.
Where did Mesmer go aftar Benny Franklin made him look a dick?
He fled to Switzerland, and we do not hear from him again. He retired.
Why did surgeons become interested in hypnosis?
When did this stop?
Eventually the anesthetists will become interested in hypnosis. Surgery was done without this at the time. James Braid made it into something a bit more medical and called it hypnotism. Used it for pain relief in surgery. Is used widely until anesthesia drugs are discovered in the 1840s and is readily abandoned as hypnotism does not work well on everyone (and drugs do).
When did hypnosis dissapear and then reappear?
For as while, hypnotism is not being used seriously. Comes back for mental health work in the 19th Century.
How were mental health issues managed before the 16th century?
Before the 16th century it was essentially informal and mostly given by the families. Social support in effect. Sometimes this would go well. There are reports of people with mental disorders being chained up etc. Very variable.
What happened in the 16th century that changed this?
Was it about helping the patients?
In the 16th century, asylums are used. Kind of like prisons. The reasons for the change are larger cities and populations.
People with mental disorders roam the streets, homeless and cause social problems. The authorities decide they need to be put in an asylum for social control. Not really about treatment.
For Foucalt, what were the asylums about?
For Foucault the treatment of people with mental disorders is all about exclusion. During this period, this is all people were given.
In the 16th century, was mental health considered a medical issues and if not, what was it called?
It is not considered a medical issue and just called madness.
What did William Battie write and how did it change the perception of mental health issues?
In 1759 a British physician William Battie, wrote Treatise on Madness and this was when people began to realise that maybe mental disorders are related to dysfunction in brain or body. Perhaps madness is related to a medical condition.
Who was Phillipe Pinel and what did he do?
In 1794, Phillipe Pinel, the father of psychiatry is nominated as the head of a hospital in Paris. The first thing he does is unchain the patients
It is not clear from the lectures whether this unchaining is physical or metaphorical. IMO it is both
How did the French Revolution and the Enlightenment influence Pinel?
This was 5 years after the French revolution which embodied the ideals of the enlightenment. Pinel is all about using science for society, believes that mental health issues are medical issues. In his Memoir on Madness, he says mental health issues can maybe be cured and so abandoning them is not humane. Physicians start trying to help people.
What was Pinel’s Nosographe?
What 4 parts did it contain?
Also came up with the first classification for mental health disorders. “Nosographie (classification system) philosophique de l’analyse applique à la médicine” He had 4 main catégories :
- Melancholia – dépression now.
- Mania – insanity. Now schizophrenia, manic bipolar
- Dementia – Alzheimer’s
- Idiotism – mental retardation or now intellectual deficiencies
What were the historical two types of treatment for mental health issues?
Historically, 2 main types:
(1) medical/physical types – like cold showers, fast spinning in the short-term calms people (vestibular stimulation), leeches – drain blood as this contained bad stuff that was causing the issue.
(2) Moral treatments – persuading the patient to behave normally – this really means talking with the patients.
In the first half of the 19th century, after Pinel, which of the two types of mental health treatment dominates?
During the first half of the 19th century (after Pinel) moral dominated. Administered by psychiatrists. Typically, the patients are either in an asylum or could be (severe) and hence psychiatrists have a low status. They were dealing with the previously excluded people.
In the second half of the 19th centruty, how did syphillus change what tyoe of treatment was dominant for mental health issues?
In the second half the biological treatments come back. Maybe we could find a medical treatment. A determining factor of this was the discovery of the microbe that causes syphilis. Once you contract this and it is cured, you are at higher risk of dementia later on. And so doctors knew that. If the microbe causes syphilis and the associated dementia, maybe other conditions can be traced to a pathogen too.
Neurologists vs. Psychiatrists
There was also a new group pf physicians called neurologists. They were interested in milder forms of mental disturbances “nervous disorders”. They treat them privately, but the serious ones are still in asylums. Psychiatrists treat the more serious forms, neurologists the less ones. Very interested in Hysteria.
What was hysteria?
Is it a definable condition?
Why was it thought to originate in the womb?
Hysteria is characterised by anxiety shortness of breath, fainting, insomnia, irritability, nervousness as well as sexually forward behaviour. Resemble the first patient of Mesmer. These can also mimic those of more definable disease e.g., limb paralysis. Which is why they get referred to neurologists.
But in reality, this is an umbrella term. 2 Patients can have relatively similar symptoms or very different ones. A loose condition.
Originally thought to be only women so maybe it is related to the uterus. This only makes sense in the context of the day and when considering the new idea idea that mental health could be traced to organic cause i.e., if something seems to be mainly affecting women, and there is an organic cause, perhaps it is something that only women have? So, then the uterus. Some docs think they are faking it for attention.
Jean-Martin Charcot
Very famous neurologist at the time
Did important work on Epilepsy and ALS
In France, ALS still called “Charcot’s disease”.
Why did Charcot think that hypnosis was a disease?
Why did he think that epilepsy, hypnosis and hysteria were similar and had an underlying cause?
In 1880 Charcot started working on hysteria. His thesis is that there is similarity between hysteria and the effects of hypnosis as hysteric symptoms can be induced under hypnosis.
3 medical conditions that he knew well follow similar pathways (according to Charcot) - In particular, according to him, they had 3 phases
- Epilepsy – aura > tonic phase > tonic phase
- Hysteric attack – aura > large movement stage > hallucinatory stage > delirium
- Hypnosis – lethargy > cataplexy; loose muscle tone > somnambulism – can be suggested to
What was the proposed organic cause for hypnosis, epilepsy and hysteria?
Could be organic pathology
the same thing (hereditary degeneration) that causes hysteria an epilepsy might also cause susceptibility to hypnosis. The same three conditions might be caused by the same thing. Could be organic pathology
he called it hereditary degeneration)
– he called it hereditary degeneration
Charcot, Claire Whitman and the phydicians from the town of Nancy (Liebeault & Bernheim)
Every Tuesday, Charcot would teach with patients. He has his favourite patient, Claire Whitman, probably had histrionic personality disorder. She performed essentially, every Tuesday and Charcot would explain his ideas. Very famous neurologists went to these classes. Eventually Freud comes to visit.
Eventually, people question him. Physicians from the town of Nancy did not agree. Liebeault and Bernheim do research and conclude that hypnosis is not a disorder or disease; there is nothing wrong with people that can be hypnotised. It is present in everyone to one degree or another as susceptibility. They do not see the 3 stages in their experiments.
And so, Charcot is being criticized and he is also doing more fantastic things lie using magnets and reverse patient symptoms by changing the polarity of the magnets e.g., patient cries and he reverses it and they laughs.
An example of the criticism against Charcot by Delboeuf.
For example, Delboeuf visits him and notices that the only way that his magnet worked is if he said but did and the patient understood his expectations. Charcot would tell the patient what he expected of them. He concludes that the patient is just responding to his instruction. This was the time period where Binet decided he would rather leave Charcot and find another lab!
Freud biographical basics (early life)
Freud was a neurologist who eventually visited Charcot.
Freud
As a teen, he considered different options. Finally decides that medicine is a safe bet. Enters medical school at 17 in Vienna and meets two people that influenced his theory.
How did Franz Brentano inlfuence Freud?
What is “aboutness” and how does it relate to psychological states according to Brentano?
Did Brentano think Psychology should follow a physical sciences model?
Did Freud?
One was Franz Brentano who alongside Wundt is considered a pillar of psychology. At the tame time Wundt wrote his book, he writes Psychology form an empirical standpoint. Wundt wants to ground psychology within physiology.
Brentano thinks that psychology is totally different from physiology and different from the physical sciences. They study physical objects, but psychological states are not objects, they are acts that always refer to objects e.g., I think of an atom, I believe in an atom.
The state is an act of thinking or believing and the main property if psych phenomena is this “intentionality” or “aboutness” (about an object). So physical sciences study objects but psychological states are not objects, they are acts that refer to objects and therefore outside the realm of physical sciences. Very different to Wundt.
Eventually Freud will agree and stop trying to relate his psychoanalytic theories to physiological processes concluding that our knowledge of these is insufficient in his time to explain what he talks about.
What is a state?
Why must psychological theories be “dynamic” accoriding to Brentano?
The state is an act of thinking or believing and the main property if psych phenomena is this “intentionality” or “aboutness” (about an object).
According to Brentano, adequate psychological theories must be “dynamic” i.e., capable of accounting for the influence of ever-changing motivational factors on thought.
Psychological states are acts and so psych should understand the motivation behind those acts.
Freud and Ernst Bruke
Freud’s true love was neurology. Ernst Bruke was his professor. He was a mechanistic physiologist who rejected vitalism. Freud did many experiments with him but wanted to be a medical doctor so left him and began practical training at Vienna’s General Hospital with Theodor Meynert,
Freud and Theodore Meynert
What was Freud’s first book about?
Why did he visit Charcot?
Theodor Meynert was a neurologist who had previously taught Wernicke. Freud’s first book was on Aphasia, so he was very mainstream at the time. In 1885 he sponsored Freud to visit Charcot in Paris not because of hysteria related stuff just because this was good for his training.
Why did Freud turn to the treatment of Hysteria?
He established a practise but struggled to make money. Maybe because he was Jewish and at the time it was hard to be accepted and respected as a Jew and also maybe because it is hard to start a practise anyway.
He found it hard to get a place in hospital.
And so he takes more and more hysteria patients that others do not want to take and he used what he learned with Charcot. But at this time the controversy with Charcot is serious and so he wants to sort of distance himself from it.
Who was Anna O. (Bertha Pappenheim)?
How did she influence Freud?
What mentor treated her?
He remembers the treatment of a patient (Bertha Pappenheim aka Anna O) treated by his mentor Josef Breuer. She was a relative of the family of Breuer which is why he treated her even though he usually did not do hysteria patients.
What method did Breuer use to treat Anna O.?
He developed what he called the cathartic method. Starts with hypnosis like Charcot but then try to remember the first time the symptom occurred. She had a blinking thing and she remembered that the first time she squinted like that was to hide tears from her dying dad. As soon as she realised that, her symptoms disappeared.
