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Tuesday, August 31, 2010

Brief History of Mental Health and Illness

There is a rich history of mental health and illness that spans over centuries of time. In fact, even the visualization of such a concept like mental illness has a long history of being present in historical art and medical images (Eisenhauer, 2008). From this history, many theories have been derived and while some have disappeared, others have evolved into our modern world of mental health diagnosis and treatment. In this essay I will discuss the evolution of ideas throughout time and discuss their contemporary relevance.

The first record of a concept of mental illness was witnessed through the Ancient Babylonians and the Paleolithic cave dwellers. Theses ancient people viewed mental illness as “magic” and that those who were affected by it were possessed by evil. This idea came to be known as demonology. The mentally ill often suffered at the hands of this assumption, being whipped or starved. Some even underwent trephination, chipping away at one’s skull to “release” the demons. Now it is viewed that those beliefs and practices were barbaric because the concept of mental illness was beyond the comprehension of the ancient people.

The Greco-Roman period saw a big change from the ancient Babylonians and Paleolithic cave dwellers. From this period came many different theories and concepts of mental illness. Some theorists were so sure that mental illness was biologically caused that it is documented that one individual used an eel as “shock therapy” on a mentally ill person. Though Aristotle believed that the physical heart caused mental illness, he still had the idea that mental illness had a biological cause. Alcamaeon asserted that difficulties with mental illness resulted from illness in the brain. This was very far from believing that demons caused mental illness; since the brain is the focal point of modern day neuropsychiatry. An asylum was even erected for the mentally ill in Greece where methods of diet, remedies, baths, exercise, fasting, prayers, rituals, and hypnotic/hallucinogenic drugs were used. This was one of the first examples of a mental institution where those with mental illnesses could go to get treatment. Asclepiades’s concepts are comparable to many modern theories of mental illness. He stressed the importance of environmental factors and differentiated among delusions, hallucinations, and illusions, as well as acute and chronic onsets. He also grouped illnesses according to patterns of symptoms, the first to ever accomplish such a thing. Still, however, there lingered the superstitious belief that mental illness was a supernatural disorder. Plato argued that mental illness resulted from possession of spirits. Hippocrates developed the theory of imbalance of fluids within the body as cause for mental illness, while Cicero believed “fire within the soul” and imbalances among intellect, appetites, and temper were to blame. Ancient Palestine still believed mental illness was supernatural. Even biblical reference refers to cleansing people of “unclean spirits.”

Though the Greco-Roman era saw much evolution concerning the idea of mental illness, the middle ages reverted back to the ancient belief that mental illness was caused by evil spirits. Perhaps this is why this period is often called the Dark Age. Many believed that demonic possession and demonic forces caused mental illness. Some went as far as believing that one who was mentally ill had a pact with a witch, a demon, the devil himself, or were themselves a witch. Priests and monks often “exorcised” the mentally ill; praying over them, dousing them with holy water, and making them drink potions. Pope Innocent VIII urged the clergy to start a very powerful crusade to eliminate “witches.” It is estimated that 200,000 people were executed in Germany and France alone. Though the Dark Ages witnessed some absurd views of the mentally ill, a Franciscan monk speculated that madness originated near fluid-filled cavities of the brain called lateral ventricles; this is the current thinking concerning the etiology of schizophrenia. Another individual stood out during this age. Dutchman Johann Weyer attacked demonology and helped counteract the barbaric treatment of the mentally ill with his skillful describing of disorders that are well known today. He also formulated the early version of the diathesis-stress model which is a theory used today!

The period of reform witnessed a number of changes regarding mental illness and how it was viewed. During this period, many opted for more humane treatment of mentally ill. Still, in some institutions, the mentally ill were treated humiliatingly, put on display for entertainment, and were condemned to live separate from society. Vincenzo Chiarugi of Italy fought for humane treatment by removing patients’ physical restraints, providing them with activities, and spread the word about making mental hospitals more comfortable. Philippe Pinel in France called for reform in treatment of the mentally ill, instructing his staff to treat patients kindly. Jean-Baptise Pussin started the idea of record-keeping. Many started to focus on moral treatment of patients. Dorethea Dix believed mentally ill should be public responsibility. Dix supported the building of state-supported hospitals and increased the number of people treated for mental illness. This period saw a great deal of evolution and reform in the arena of mental illness. Still, archaic ideas still crept through. Benjamin Rush still believed in outrageous ideas such as bloodletting and there was still very backward thinking present such as masturbation being the cause of numerous mental ailments.

From the 19th century to the present, the world saw a surge of many innovative ideas involving mental illness. Morel proposed that mental illness was hereditary while Griesinger and Mangnon oriented toward biological explanations of mental illness. Krafft-Ebing focused on the link between Syphilis and mental illness. Emil Kraeplin made the first organized attempt at classifying illness into syndromes and believed imbalanced chemical states and abnormal secretions of sex glands were the cause of mental illness. John P. Gray leaned toward the psychogenic view, thinking that mental illness was the result of a disturbed psychological state. Mesmer believed mental illness was caused by imbalance of magnetic fluid in the body and discovered hypnosis. Sigmund Freud recognized the link between psychological processes and mental illness and discovered the unconscious origin of psychological difficulties. He developed the school of thought known as psychoanalysis. His work is still taught in modern psychology courses. C.D. Hayden and G.A. Blumer attributed sociocultural factors as the cause of mental illness. New treatments have also evolved since the 19th century. The medical model was derived from the biological model of the Greeks and places an emphasis on symptoms, diagnosis, and treatment. Psychotropic drugs were introduced to the medical community and provided precious relief for some mentally ill patients. Manfred Sakel developed insulin shock therapy. Ladislas von Meduna used convulsant drugs as a means to treat mental illness. Ugo Cerletti and Lucio Bini developed electroconvulsive therapy. Antonio de Egas Monis developed a form of psychosurgery called a frontal lobotomy which he won a Nobel Prize for. Causal theories are a very common topic ranging from the biochemical school to the genetic school of thought. Many behaviorists such as Watson, Pavlov, and B.F. Skinner contested that mental illness was a learned, conditioned, behavior. Sociologists such as Arnold M. Rose have stressed the importance of social factors regarding mental illness igniting a field called social psychiatry. Even actual medical tests are being used to diagnose mental illnesses such as CAT scans and EEGs.

Throughout history there has been an obvious evolution of how mental illness is viewed. From the archaic views of demonology to the advanced science of neurological imaging, the world has seen a huge change in the schools of thought pertaining to mental illness. Still, much of mental illness remains a mystery and is continually being studied. Overtime, we will see the evolution of some theories and treatments with the development of new technology and new medical discoveries. Until then, one must keep an open mind about mental illness and incorporate multiple viewpoints when studying mental illness. After all, the mind is a very complicated concept.

References

Eisenhauer, J. (2008). A Visual Culture of Stigma: Critically Examining Representations of Mental Illness. Art Education, 61 (5), 13-18.

Gallagher, B.J. (2002). The Sociology of Mental Illness (4th ed.). Upper Saddle River, NJ: Prentice Hall.

3 comments:

  1. Uh, what record of the concept of mental illness exists for the Paleolithic cave dwellers?

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  2. Joanna Rose Benavidez, Psyched On Psychology AuthorSeptember 3, 2010 at 8:51 PM

    Mr. Wiss,

    You bring up a good question. Some Paleolithic cave dwellers were spiritual people and had common ideas regarding the idea of the God-Man and how this affected the mental states of those inhabiting the Earth. They incorporated their idea of the concept of mental illness with their spiritual beliefs and believed that their personality and actions were caused by the psycho-affective states of those living in their believed "dream" of this world.

    Also, this was the first instance where Trephining, or the process of boring a hole into one's skull was discovered (Millon, 2004, p.6). (Can you imagine? Psychosurgery in the stone age?)

    To get you a better resource to read more about the Paleolithic cave dwellers and other ancient cultures and their relation to the development on the concept on mental illness. Dr. Theodore Millon wrote a fascinating book called "Masters of Mind: Exploring The Story of Mental Illness From Ancient Times to the New Millenium."

    References:
    Millon, T. (2004). Masters of Mind: Exploring The Story of Mental Illness From Ancient Times to the New Millenium. Hoboken, NJ: John Wiley & Sons.

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  3. Thanks for sharing the history of the said matter. Psychology students will surely benefit from this.

    psychology college course

    ReplyDelete