Psychiatry 1-2

Question 1

Two branches of mental illness

Answer 1

Neurosis and psychosis

Question 2

Define neurosis

Answer 2

A relatively mild mental illness that is not caused by organic disease.

There is no radical loss of touch with reality.

Question 3

Define psychosis

Answer 3

A severe mental disorder in which thought and emotions are so impaired that contact is lost with extreme reality.

Question 4

Why are rates of mental illness going up in the USA?

Answer 4

DSM5 uses very loose definitions

Psychiatrists want to make money

People love drugs

Question 5

Disability in USA

Answer 5

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.

Question 6

4 Mental Illness Models

Answer 6

Redemption model, explanation model, identity model and compensation

Question 7

What is the redemption model?

Answer 7

“I’m not lazy, I have the laziness syndrome”

Lance Armstrong did this wrong, Matthew Newton did it right.

Question 8

What is the Affluenza defence?

Answer 8

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

Question 9

What is the explanation model?

Answer 9

Blaming can stop, because you finally understand.

It is my brain, not me

Question 10

What is the identity model?

Answer 10

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.

Question 11

What is compensation?

Answer 11

You have to prove that you have the mental illness through damage (e.g. PTSD) and negligence.

Question 12

When did anti-psychiatry start?

Answer 12

Started in the 1960s and 1970s

Question 13

What did Thomas S. Szasz think of psychiatry?

Answer 13

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.

Question 14

Who did Thomas S. Szasz believe were psychiatrists?

Answer 14

Psychiatrists are priests, police officers, teachers because they are instilling conforming behaviours.

They deal with behaviour that breaks social conventions.

Question 15

What did Ronald Laing believe about schizophrenic people?

Answer 15

He said that schizophrenia is an authentic experience of the self, therefore we should given them the resources to let them explore their journey.

Question 16

What did Irving Goffman think of mental asylums?

Answer 16

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.

Question 17

What are total institutions? (Irving Goffman)

Answer 17

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.

Question 18

View of insane asylums before 1970

Answer 18

They were the hallmark of psychiatry

Question 19

What happened to asylums in the 1970s?

Answer 19

Deinstitutionalisation

Question 20

Why were asylums deinstitutionalised?

Answer 20

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.

Question 21

Did closing asylums solve the problem?

Answer 21

NO

Mental illness is linked to homelessness and more than medication is needed to fix them.

Question 22

What did Rosenhan prove about being labelled insane?

Answer 22

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.

Question 23

What is the relation between depression and smartphones?

Answer 23

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.

Question 24

Who originally decided who was admitted to insane asylums?

Answer 24

Decided by a judge; doctors did not decide who was admitted.

Question 25

Michel Foucault and Thomas Szasz thought there were 2 types of people that were put into insane asylums.

Answer 25

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

Question 26

What were the 3 configurations in the mental hospital?

Answer 26

Heroic treatment (before 1800)
Moral treatment (1800-1850)
Therapeutic pessimism (after 1860)

Question 27

What was heroic treatment?

Answer 27

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.

Question 28

What was the treatment during the heroic period?

Answer 28

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’)

Question 29

What was moral treatment?

Answer 29

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

Question 30

What settings did moral treatment actually work in?

Answer 30

In small settings, with highly motivated staff and a high attendant-patient ratio. Also only worked with less severe forms of mental illness.

Question 31

What is therapeutic pessimism?

Answer 31

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.