Psychopathology

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Psychopathology

• A historical perspective

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Histories of psychopathology

• The traditional view
• A reconstructed view
• Biblical considerations

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Supernatural causation

• Traditional views
• Displeasure of the gods
• Demonic possession Trephining
• Reconstructed view
• Ethnocentricity uncovered
• Biblical accounts
• King Saul
• Nebuchadnezzar

Lucas van Leyden, d. 1533
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Somatogenesis

• Hippocrates naturalistic approach
• Proposed physical remedies
• Maintained careful clinical records
• Proposed theory of the humors
• Offered the first nosology
• Mania
• Melancholia
• Phrenitis
• Developed further by Aesclepiades, Aretaeus, and
  Galen

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More on somatogenesis

• Aesclepiades (100 B.C.)
• Distinguished between delusions and
  hallucinations
• Espoused music therapy
• Opposed bleeding and imprisonment as treatments
• Aretaeus of Cappadocia(50-130 A.D.)
• Distinguished between chronic and acute
  conditions
• Claimed that emotional problems could cause
  abnormal behavior
• Observed that mania and melancholy could be poles
  of the same illness

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Galen (130-200 A.D.)

• Studied the neuroanatomy of apes and pigs
• Extended Hippocrates doctrine of the humors to
  personality and predisposition to mental disorder
• Separated emotional causes from medical causes
• During the Dark Ages, Galens influence
  declined in the West, but continued in Islamic
  countries, eg. Al-Razi (865-925), who established
  a mental treatment unit in Baghdad.

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Ecclesiastical traditions

• The fall of Rome and the loss of Greek medicine
• The rise of the monasteries
• Reconstruction of the textbook account
• Cultural decay and the rise of witchcraft
  accusations
• The Inquisition 1140 vs 1252
• Pope Innocent VIII, 1484
• Sprenger and Institoris
• Malleus maleficarum, 1486

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The effects of the Inquisition

• Rarely charged the mentally ill
• Clearly distinguished insanity in England
• Alonso Solazar y Frias, 1610

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The Islamic view of mental illness

• The Koran urges that the insane be fed and
  clothed, and spoken to with splendid words.
• Al-Razi (865-925)
• Ibn Sina (Avicenna, 980-1037) asked that the
  insane be treated humanely.
• He also employed free association.

• Sultan Mehmed the Conqueror of Istanbul (1453)
• established an asylum that used singers and
  players
• for the enjoyment of patients

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The involvement of the state

• Lunacy trials in England, 13th century
• Institutionalized care
• Holy Trinity Hospital, Salisbury (c. 1350)
• Mixing beggars and the mentally ill Asylums
• The Priory of St. Mary of Bethlehem Old Bedlam
  est. 1243 (Hogarth and Stravinsky)
• Medicalization Benjamin Rush (1745?-1813)
• Father of American psychiatry

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Moral treatment

• Philippe Pinel (1745-1826) and William Tuke
  (1732-1822) Early enthusiasm
• La Bicetre, York Retreat, and Friends Asylum
• Re-analysis Drug treatment and 30 success rates
• Dorothea Dix (1802-1877) Good acts with bad
  consequences
• The state hospital system
• The Kirkbride plan A balance of the senses

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Somatogenesis renewed

• Vesalius (1514-1564), Willis (1621 1675),
  Wren (1632 1723) the normal brain
• Thomas Sydenham (1624-1689) and empirical
  classification
• William Griesinger
• Emil Kraepelin (1856-1926) syndromes
• A Textbook of Psychiatry (1883)
• Dementia praecox chemical imbalance
• Manic-depressive psychosis irregular metabolism
• Richard von Krafft-Ebing and general paresis
  (1905) dementia and paralytic attacks

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Psychogenesis

• Mesmer (1734-1815) and Charcot (1825-1893)
• Breuer and catharsis Anna O.

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Sociogenesis

• Social conditions cause disorders
• Social conditions permit disorders
• Mass hysteria The tarantella
• DID, SRA
• Disorders cause social conditions?
• Disorders permit social conditions?

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The classic asylum State Lunatic Hospital,
Danvers, MA (1878)
http//abandonedasylum.com/
Danvers photographs