Lesson 10 - Mental Illness

Question 1

What were the 3 initial categories for explaining mental illness?

Answer 1

Supernatural
Biological (AKA somatogenic) - eventually became the medical model
Psychological

Question 2

How did people get rid of non-normative behaviour in primitive cultures?

Answer 2

Since it was believed that evil spirits were causing the behaviours, they were trying to force demons out of the body through trephination (holes in skull) and exorcism

Question 3

Define sympathetic, homeopathic and contagious magic for getting rid of illnesses (as mentionned by Frasier in 1189)

Answer 3

Symathetic: symbolically imitating the desired outcome, can be homeopathic or contagious

Homeopathic: based on law of similarity (like produces like)
Contagious: based on law of contaigon, suggesting that what was once connected to a person continues to exert an influence on them (voodoo)

Question 4

What influence did the shift from mythos to logos have on the vision of mental illnesses?

Answer 4

We saw the start of naturalized medicine (Croton, Hippocrates and Galen)

This biological perspective was well accepted in the stoic roman society, but vanished with the Fall of Rome

Question 5

What influence did the reversion back to the supernatural (after the Fall of Rome) had on the vision of mental illness?

Answer 5

The church rejected all forms of scientific knowledge and investigation

Any behaviour that was not typical was seen as a conflict between good and evil, and evil behaviour was considered as heretic (non-typical behaviour increased at this time because almost anything could be considered as heretic)

Question 6

What is the Malleus Maleficarum?

Answer 6

A book meant to explain the existence of devils and witches, how pacts with the devil are made, and how witches were to be interrogated and treated upon confession

Question 7

What was the influence of the Malleus on sexuality?

Answer 7

It was believed that sexual lust invited the devil and that women were + vulnerable because they had stronger desire (pathologizing female sexuality - link with Lilith)

Question 8

What happened at the Salem witch trials?

Answer 8

More than 20 girls were accused of heresy and killed, while it was discovered that a fungus in rye bread was responsible for their odd behaviour

Question 9

What was the overall influence of the supernatural approach?

Answer 9

It pathologized sexuality (more female but also male)
Stigmatized mental illness
Gave us an example of how the zeitgeist influences the way mental illnesses are conceptualized and treated
Proved the necessity of the biological and psychological perspective

Question 10

What is one possible explanation for crazy delusional confessions?

Answer 10

The effect of torture can make people admit to anything

Question 11

What was the philosophy/functioning of the Priory of the New Order of St.Mary of Bethlem?

Answer 11

Small almshouse - 12 rooms
Monks would care for those in need with harsh treatment, basic diet and isolation from society

Eventually became the Bethlem Royal Hospital

Question 12

What were the living conditons at Bethlem Royal Hospital6

Answer 12

Atrocious and poor. People could walk in and watch the inmates as zoo animals for a fee.

The 2 statues of melancholy and raving madness at the doorstep well illustrate the spirit of the place

Question 13

What were some of the treatments for mental illnesses in hospitals in the 18th century?

Answer 13

Bloodletting
Dunking in cold water
Shocking
Spinning chair
Crib (restraint)

Question 14

Name some reasons why women could be brought to asylums for in the 18th century

Answer 14

Post partum depression
Alcoholism
Social transgressions such as infidelity
Their family had become fed up with them

Question 15

What were the contributions of the Duke of Tuscany Peter Leopold in terms of treating the mentally ill?

Answer 15

He created the “legge sui pazzi”, or “Law on the insane”, which advocated for better treatment of the mentally ill, and then opened the Bonifacio Hospital in 1788, and appointe Vincenzo Chiarugi as head of the hospital

Question 16

How did Vincenzo Chiarugi run his hospital?

Answer 16

A detailed history was required for each patient, they had high hygienic standards, men were separated from women, the rooms and furnitues offered protection to the patients (strait jackets), force could NOT be used on the patients

Question 17

What was the influence of Philippe Pinel on the treatment of the ill? - in Paris

Answer 17

He believed that illness was the result of excessive exposure to social and psychological stresses

Removed the chains of inmates, and segregated them

Kept histories, stats on the patients and the rates of cure

Fed them, bathed them, and stoppe harsh treatments (replaced with occupational therapy)

Question 18

What was the influence of William Tuke on the treatment of the ill? - in England

Answer 18

Founded The Retreat, a religious sanctuary for mentally ill people

Focused on humane treatment (taught them self-discipline, gave them support, food, and exercise)

Would have tea with patients

Question 19

Who was responsible for making the conditions of patients better in the USA?

Answer 19

Benjamin Rush

Unchained patients, brought them out of the basement, let them walk outdoors

However his treatments still included bleeding, purging, hot/cold baths, mercury and tranquilizer chair

Question 20

What was the influence of Dorothea Dix on USA’s mental hospitals?

Answer 20

After seeing the conditions of mental inmates, she advocated for better treatment, and realized that there was a discrepancy between public and private institutions

The first state hospital was built on a farmland, and physical labour became part of the treatment.

These state hospitals were very large

Question 21

Explain Nellie Bly’s “Ten Days in a Madhouse”

Answer 21

She proved herself insane and got admitted at the Women’s Lunatic Asylum on Blackwell island in NYC

The treatments were horrendous and the staff was cruel to the patients - she wrote a news article about it which raised over 1M$ to improve the patient’s conditions

Question 22

What were the issues with big hospitals such as Blackwell Island’s?

Answer 22

Money limitations
Staff limitations
Quality of care was declining

Question 23

What was the main belief of Franz Anton Mesmer?

Answer 23

That there must be tides, or magnetized fluids in the human body

Imbalance in those fluids resulted in bad health

These forces were called “animal magnetism”

Question 24

How did Mesmer treat patients at first (inspired by his mentor priest Maximilian Hell)?

Answer 24

He asked his patients to drink water infused with iron shavings and then used large magnets over their body to make the shards move (thus balancing the fluids/energy)

Question 25

After a while, how did Mesmer’s treatments change?

Answer 25

He stopped using magnets and resolved to using his own hands only, since he considered he had strong “animal magnetism”

Question 26

Who did Mesmer treat that made people question his methods?

Answer 26

Fraulein Paradies, a blind pianist who claimed she was cured - she could only see in the presence of Mesmer

Question 27

What was Mesmer’s banquet?

Answer 27

He treated several patients at once by asking them to touch an iron bar coming out of a tub of water, and turned them into a transient state with his voice and relying on the contagion effect.

Question 28

What did the Marquis de Puysegur cure with Mesmer’s method? (now that Mesmer had been discredited by 2 investigations revealing that animal magnetism did not exist)

Answer 28

He cured a young man from depression by attaching him to a tree and taking him into a transe-like state by talking to him. Upon waking up he claimed that he was cured

Question 29

How did the Marquis describe the experience he had with his patients?

Answer 29

He compared the state of his patients with sleep-walking, which he called “magnetic sleep” - his patients were sedate

He said that the practitionner had to build an intimate rapport wiht the patient (the magnetized) and that in this way, posthypnotic suggestions could be introduced and recalled later

However, right upon waking up the patients had posthypnotic amnesia (they did not remember the session)

Question 30

Did Victor (the man treated by the Marquis) remember anything from his sessions?

Answer 30

He seemed to have another self only awake during the sessions, which could remember the content of the previous sessions. Once awakened, he did not remember the previous sessions.

Question 31

What did the Marquis inspired?

Answer 31

Some claimed that he did the first psychotherapy session ever, and his work will inspire Freud and Jung’s analytical theories

Question 32

What were the contributions of John Elliotson in the field of hypnotism?

Answer 32

He mesmerized 2 teen girls, the Okey Sisters, and proved that they were indifferent to pain. However it was determined that they were frauds and that he only did this for money

Question 33

What were the contributions of James Esdaile in the field of hypnotism?

Answer 33

He was a scottish surgeon and used the mermerizing for pain management during medical procedures

His results were dismissed because his work was done on “Natives” and the anesthetic gases were discovered not long after

Question 34

What were the contributions of James Braid in the field of hypnotism?

Answer 34

He stressed the importance of suggestibility rather than the patient-doctor connection.

Renamed animal magnetism/mesmerisim “neurypnology”m which was later shortened to hypnosis

Question 35

What is the Nancy School?

Answer 35

A French hypnosis-centered school of psychotherapy

Emile Gallé and Auguste Ambroise Liébeault founded it, and offered the services for free in order to find people willing to try it.

After claims of curing people, it became extremely popular. It was important for later conceptualizations of hypnosis and the role of suggestion

Question 36

What are the symptoms of hysteria? Who first talked about it?

Answer 36

Partial paralysis, hallucinations, nervousness, anxiety, irritability, agitation, shortness of breath, fainting, insomnia and sexual forwardness

Question 37

What was the origin of hysteria?

Answer 37

It was believed to be a problem with the womb or uterus moving around in the body.

Aretaeus of Cappadocia believed that the uterus had agency and was seeking moisture in the body.

It was also believed to be caused by sexual deprivation

Question 38

What were the treatments of hysteria?

Answer 38

Holding something foul smelling to the nose and sweet smelling to the groin and sneezing, or drinking bitter potions or vaginal fumigations, or pelvic massage to induce a “hysterical paroxysm” (later brought vibrators to life)

Question 39

What were Charcot’s beliefs about hysteria?

Answer 39

That it had a biological cause - however his students showed him that women under hypnosis could be made to recreate the symptoms

He realized that most of his patients had suffered abuse (like Louise Augustine Gleizes)

This is the FIRST time someone will suggest a psychological cause for a disease

Question 40

What were the 3 stages of Charcot’s treatment of hysteria?

Answer 40

1. Lethargy: tired feeling as one drifts into transe
2. Catalepsy: Limbs would become very rigid, and ego is no longer present (can ask questions)
3. Somnambulism: act out their symptoms - time to install post-hypnotic suggestions

Question 41

What was the influence of Pierre Janet on hysteria?

Answer 41

He was one of Charcot’s students and also believed that it was entirely psychological

He showed that dissociation is the most direct psychological defense against traumatic experiences

Question 42

What is hysteria today?

Answer 42

It could be classified into many categories such as somatoform disorder, conversion disorder or histrionic personality