History of Abnormal Psychology
Historians of psychology trace the roots of abnormal psychology all the way back to prehistoric practices such as trephining, which is the puncturing of the skull with a sharp object presumably to release something—whether it be blood, pressure, swelling, or possibly even evil spirits believed to possess the mentally ill (Bootzin & Acocella, 1996). Imagine what it must have been like to be the first person ever to observe someone else actively hallucinating, or experiencing symptoms of depression or anxiety so severe that the person is literally immobilized, or in the throes of a violent epileptic seizure, or suffering from delirium, and so on. You would probably have had a very difficult time making sense of his or her behavior, and even more difficulty trying to relay what was happening to someone else. In order to better understand, describe, and if necessary treat or alter these conditions, you would need a system to classify and explain human behaviors and experiences, particularly when they reached extremes.
The ancient Greek physician Hippocrates, whom you may recognize as the principal author of the Hippocratic Oath (the pledge made by medical doctors to do no harm to their patients, among other things), was among the first to develop and record such a classification system. Hippocrates believed that our bodily fluids or humors (blood, yellow bile, black bile, and phlegm) were directly related to the four seasons (spring, summer, autumn, and winter, respectively) as well as the four universal elements (air, fire, earth, and water, respectively), and were also linked to our thoughts and behaviors. He also believed that, when people exhibited strange behaviors and symptoms of sickness, an imbalance in their humors had occurred. For example, he believed an excess of black bile (from the Greek melas + khole) caused people to feel sad or dysphoric, a state that people still sometimes describe as “melancholy” (Comer, 2001; Monte & Sollod, 2003). Treatments were developed based on the notion that in order to correct the imbalance, one must make use of things that possessed the opposite characteristics of the humor causing the illness. An excess of black bile, associated with the element earth and the season autumn, both viewed as primarily cold and dry, causing melancholia, would presumably be reversed via something with hot and wet properties—perhaps a warm bath, a nice bowl of hot soup, or maybe vigorous exercise. Treatments usually revolved around changing a person’s diet or having him or her engage in physical activity, and resorted to more invasive and potentially deadly methods (e.g., using poison to cause vomiting and/or diarrhea) only when more standard methods failed. Some of what Hippocrates believed and wrote may seem silly, based on what is known today, but at the very least he should be given due credit for being very curious and observant, and for keeping the patient’s health and well-being at the forefront of medical practice. In addition, there are some interesting parallels between his original characterization of human temperament based on humors and more modern models of the structure of personality (e.g., the Big 5 factor analytic model of personality; Monte & Sollod, 2003). To be sure, his model of personality and abnormal behavior was inadequate and grossly oversimplified, but he was a keen observer who paid special attention to patterns and similarities occurring among his patients. He could easily describe what he saw, but had difficulty explaining things without relying on concepts like seasons, elements, the Gods, and so on. He lacked the methods and values of science that people simply take for granted today.
Relying on explanations and methods that were not scientific was a problem that carried forward through the Middle Ages. Although some theories put forth economic or political explanations, there is some speculation that the witch hunts in Europe (roughly 1400-1500)—and later (the 1600s) in the United States in places like Salem, Massachusetts—were essentially cases of mass hysteria caused by an inability to understand or explain things that were new or different. As a result, there was a tendency to rely solely on preexisting belief systems (e.g., religion) to make sense of strange behaviors and decide how best to handle them. Some people accused of being witches were believed to be “possessed” by evil spirits, and were subjected to everything from harassment to execution as a result. It is plausible that at least some of these “witches” may simply have been people who were showing signs and symptoms of what psychologists would now call mental illness or disorder, but popular beliefs during those times made little room for such a notion, let alone providing a way of supporting and treating these people in a humane manner.
Not until the Renaissance were more regular records and descriptions of the hospitalization of the mentally ill seen. A perfect example is the St. Mary of Bethlehem hospital in London, which was converted from medical to psychiatric facilities to house the mentally ill. Although the conditions were less than ideal (the term “bedlam,” meaning chaos or mayhem, is derived from the name of this hospital; Bootzin & Acocella, 1996), it was still an improvement over cracking a person’s skull open or burning him or her at the stake. The good news was that society finally had places (other than prisons or the gallows) where people exhibiting abnormal behavior could go to receive some measure of protection from harm, either to themselves or others, and possibly some kind of treatment. The bad news was that these were also places where people were warehoused like animals, ostracized from their families and communities, and treated with unproven methods. At best, the methods were comical (e.g., spinning them around in a mechanical chair at dizzying speeds). At their worst, the techniques were degrading, inhumane, or even deadly (e.g., keeping people chained up indefinitely or confined to very small cells or boxes).
Reforms in the 18th century by influential figures such as Jean-Baptiste Pussin and Philippe Pinel (in Paris) and William Tuke (in England) helped solidify the notion that those who exhibited strange behaviors and experienced disturbing symptoms should be treated in a humane fashion and given the respect and support that individuals would want for themselves or their loved ones. They pioneered a new approach that was known as “moral therapy,” which essentially provided patients with peaceful and supportive environments designed to improve their morale. This was dramatically different from previous approaches and was highly effective, as some records indicate that up to 70 percent of patients showed improvement or recovery (Bootzin & Acocella, 1996).
Benjamin Rush and Dorothea Dix carried on the tradition of moral therapy in 19th-century America, which continued important reforms and led to the rapid construction and expansion of psychiatric hospital facilities directly supported at the state level. Unfortunately, the growth of the facilities outpaced the training of new professionals in the methods of moral therapy, and there were not enough qualified people to staff these new hospitals (Comer, 2003). At about the same time, with the rise in power of the medical profession, the focus in Europe and America began to shift toward biological research and interventions. Thus, moral therapy fell out of favor, and the therapeutic gains and impressive rates of improvement and recovery were also lost.
However, there were some positives to come out of this period of rapid growth in the number of hospitals and the emphasis on studying and classifying abnormal behavior. For example, Wilhelm Wundt, considered by many as the father of experimental psychology, established the first experimental psychology lab in 1879 in Leipzig, Germany. Emil Kraepelin, one of Wundt’s students, devoted his career to applying Wundt’s methods and techniques to the study of abnormal behavior (Bootzin & Acocella, 1996). If Wundt is the father of experimental psychology, then his student Kraepelin can be considered the father of experimental abnormal psychology. Kraeplin published his Textbook of Psychiatry in 1883 and gave professionals one of the first comprehensive classification systems of psy-chopathology. In the early 1900s, several hospitals developed their own research labs, capitalizing on the powerful combination of science and medicine, which would lead to exciting discoveries and advances, particularly in the rapid development and trials of new medications. The 1950s in particular saw dramatic advances with the discovery of new medications, most notably antipsychotics (also known as neuroleptics or major tranquilizers) such as Thorazine.
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