1.2 Historical Perspectives on Mental Illness

Mental illness has been understood and treated differently throughout history. From supernatural beliefs to biological explanations, approaches have evolved dramatically. Key figures like Pinel and Freud shaped our understanding, while ethical concerns arose from past treatments.

Historical perspectives on mental illness reveal a complex journey. Supernatural, biological, and psychological explanations competed, influencing treatment methods. This evolution highlights the importance of ethical considerations and humane care in mental health treatment.

Historical Perspectives on Mental Illness

Historical approaches to mental illness

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• Supernatural explanations attributed mental illness to evil spirits, demons, or divine punishment and treated it with exorcism, prayer, and other religious rituals
• Biological explanations proposed by Hippocrates suggested mental disorders were caused by imbalances in bodily fluids (humors) and treated by restoring balance through diet, exercise, and purging
• Psychological explanations introduced by Sigmund Freud emphasized the role of the unconscious mind in mental disorders and treated them with psychoanalysis, dream interpretation, and free association
• Moral treatment movement promoted humane and compassionate care for individuals with mental disorders using occupational therapy, recreational activities, and a supportive environment (Quaker asylums)

Supernatural vs biological vs psychological explanations

• Supernatural explanations attributed mental illness to external, non-physical causes (demonic possession) and relied on religious or spiritual interventions for treatment (exorcism)
• Biological explanations focused on physical causes of mental disorders, such as brain abnormalities or chemical imbalances (neurotransmitter imbalances) and aimed to correct underlying biological issues through medical interventions (psychopharmacology)
• Psychological explanations emphasized the role of the mind, emotions, and experiences in the development of mental disorders (childhood trauma) and involved various forms of psychotherapy to address psychological issues (cognitive-behavioral therapy)
• Supernatural and biological explanations viewed mental illness as caused by factors outside the individual's control, while psychological explanations placed more emphasis on the individual's internal experiences and potential for personal growth and change

Key figures in abnormal psychology

• Philippe Pinel pioneered the moral treatment movement in the late 18th century, advocating for humane and compassionate care for individuals with mental disorders (removing chains from patients)
• Dorothea Dix lobbied for the establishment of state-funded mental hospitals in the United States during the 19th century, helping improve the living conditions and treatment of individuals with mental disorders
• Emil Kraepelin developed the first comprehensive classification system for mental disorders in the late 19th century, laying the foundation for modern diagnostic systems (DSM and ICD)
• Sigmund Freud developed psychoanalytic theory and introduced concepts such as the unconscious mind, defense mechanisms, and the importance of early childhood experiences, influencing the development of various psychotherapeutic approaches (free association)

Ethics of historical treatment methods

• Institutionalization often led to overcrowding and poor living conditions in mental hospitals, resulting in neglect and abuse, with patients sometimes subjected to inhumane treatments (physical restraints and isolation)
• Involuntary treatment raised questions about patient autonomy and the right to refuse treatment, as individuals with mental disorders were often committed to institutions against their will
• Experimental treatments, such as lobotomy and insulin shock therapy, were performed without proper scientific evidence or patient consent, violating the principles of beneficence and non-maleficence
• Stigmatization stemming from historical attitudes towards mental illness led to discrimination and social exclusion, with individuals with mental disorders sometimes viewed as morally deficient or dangerous, leading to further marginalization (societal rejection)