Psychiatry 1-2 Flashcards
Two branches of mental illness
Neurosis and psychosis
Define neurosis
A relatively mild mental illness that is not caused by organic disease.
There is no radical loss of touch with reality.
Define psychosis
A severe mental disorder in which thought and emotions are so impaired that contact is lost with extreme reality.
Why are rates of mental illness going up in the USA?
DSM5 uses very loose definitions
Psychiatrists want to make money
People love drugs
Disability in USA
Unemployment benefits paid by the states. Disability insurance paid by the federal government, so states save money to “make” the unemployed disabled.
The decline in number of families on welfare and the increase of people considered disabled.
4 Mental Illness Models
Redemption model, explanation model, identity model and compensation
What is the redemption model?
“I’m not lazy, I have the laziness syndrome”
Lance Armstrong did this wrong, Matthew Newton did it right.
What is the Affluenza defence?
A social theory claiming that individuals with very privileged and wealthy backgrounds sometimes struggle to determine the difference between right and wrong due to the nature of their upbringing.
Diminished responsibility because of mental illness, but non-existing diagnosis and not in the DSM5
What is the explanation model?
Blaming can stop, because you finally understand.
It is my brain, not me
What is the identity model?
Identity disorder. Asperger’s syndrome no longer exists because more than 90% of individuals with Asperger’s in the USA are self-diagnosed. Asperger internet forums.
What is compensation?
You have to prove that you have the mental illness through damage (e.g. PTSD) and negligence.
When did anti-psychiatry start?
Started in the 1960s and 1970s
What did Thomas S. Szasz think of psychiatry?
He was anti-psychiatry, and claimed there was no such thing as mental illness. He thought it was all hysteria: patient complains, doctor cannot find anything.
Mental illness is a form of manipulation or it is a form of repression by society. PSYCHIATRY IS A FORM OF SOCIAL CONTROL.
Who did Thomas S. Szasz believe were psychiatrists?
Psychiatrists are priests, police officers, teachers because they are instilling conforming behaviours.
They deal with behaviour that breaks social conventions.
What did Ronald Laing believe about schizophrenic people?
He said that schizophrenia is an authentic experience of the self, therefore we should given them the resources to let them explore their journey.
What did Irving Goffman think of mental asylums?
Asylums are total institutions (just like army, prisons, concentration camps); there is nothing that distinguishes you from anyone else.
They rob individuals of their identity as you lose all ability to make decisions for yourself.
What are total institutions? (Irving Goffman)
Institutions that when you enter you have to give up all of your clothing and personal possessions, your hair is cut short and your whole life is regulated; there is nothing that distinguishes you from anyone else.
View of insane asylums before 1970
They were the hallmark of psychiatry
What happened to asylums in the 1970s?
Deinstitutionalisation
Why were asylums deinstitutionalised?
They were closed because they were becoming overcrowded and they believed that you just ended up with a mental problem just by being in there.
Did closing asylums solve the problem?
NO
Mental illness is linked to homelessness and more than medication is needed to fix them.
What did Rosenhan prove about being labelled insane?
Proved that once you get that label of being insane, it is very hard to get rid of.
His experiment seriously undermined the credibility of psychiatry.
The Mental Hospital is not a good place to be: it maintains an arbitrary diagnosis, rather than helping underlying distress.
What is the relation between depression and smartphones?
Since the release of the iPhone in 2007 the amount of times per week teenagers go out with friends decreased.
Communication has increased but more people feel lonely.
Who originally decided who was admitted to insane asylums?
Decided by a judge; doctors did not decide who was admitted.
Michel Foucault and Thomas Szasz thought there were 2 types of people that were put into insane asylums.
Foucault - the poor; during the Enlightenment, vagrants and the idle poor were locked up
Szasz - the wealthy; wealthy individuals wanted to get rid of troublesome family members: the trade in lunacy
What were the 3 configurations in the mental hospital?
Heroic treatment (before 1800) Moral treatment (1800-1850) Therapeutic pessimism (after 1860)
What was heroic treatment?
If you lack reason, you may as well be an animal. Lack sensitivity; resist disease; violent, chaos, terror.
Insanity caused by chains of false impressions, false ideas and associations.
What was the treatment during the heroic period?
Establishing absolute authority and control; depletion (blood-letting, emetics, purgatives, cupping). They wanted to eradicate their false impressions and ideas.
Innovative treatment methods included: tranquilizing chair, gyrating chair, Chinese temple, immersion in cold water and near-drowning (‘water boarding’)
What was moral treatment?
The insane are confused children in search of guidance, gentle care and discipline. Mental hospitals should be pleasant and restful.
Had a religious origin; non-restraint; re-education; appeal to self-control, self-discipline; highly structure in a pleasant environment.
Used occupational therapy
What settings did moral treatment actually work in?
In small settings, with highly motivated staff and a high attendant-patient ratio. Also only worked with less severe forms of mental illness.
What is therapeutic pessimism?
Large state mental asylums opened.
There was consensus: mental illness ought to be treated in mental hospitals; care should be available regardless of income and mixture of custodial care and treatment.
