The perception of mental illness and psychological differences has taken several turns and evolved to reach the scientific peak it is at today. The various misconceptions of the past have played a role in bringing therapy to its present state. From the concept of spirits possessing people who suffer from psychological disorders, psychology has brought treatment of mental illness far. From the negative outlook these disorders were viewed in, today a comparatively positive light is thrown on such issues. The following sequence of posts attempt to put forward the chronological development of the same.
In ancient Mesopotamia, it was believed that all forms of sickness came from powerful spirits entering a person’s body and attaching to a person. Assyrian tablets make reference to the use of incantations and prayers to the gods, as well as direct challenges to demons, which were believed to inflict every type of disease, both physical and psychological. Ancient Babylonian priests performed rituals by destroying a clay or wax image of a demon.
Accounts from ancient Persia, dating back to around 600 BC, offer evidence of exorcism using prayer, ritual, and holy water by the religious leader Zoroaster, who was considered the first magician, and who founded the religion Zoroastrianism.
In Christianity, there are many references to Jesus performing exorcisms, and the ability to cast our evil spirits was a sign of a true disciple. In one well known story, Jesus encountered a madman and commanded that the foul spirits leave him; the spirits then entered into a herd of pigs, which ran over a cliff and drowned in the waters below.
The middle Ages (500-1500AD) saw a revival of ancient superstition and demonology and mental illness was seen to be the result of evil possession. The barbaric treatment of mental illnesses was primarily left to the clergy who exorcised patients through a variety of techniques which caused physical pain, such as scourging.
Over the centuries, the rites of exorcism have included the use of prayers, commands, fumigations, holy water, hellebore, rue, salt, and roses. However, it has also attracted its fair share of skepticism. Many scientists believe that so-called demonic possession is simply a form of mental illness, such as hysteria, mania, psychosis, and Tourette’s syndrome, schizophrenia or personality disorder. Skeptics claim that the illusion that exorcism works on people experiencing symptoms of possession is attributed to the power of suggestion, or the placebo effect, which has also been used to explain phenomena such as faith healing.
Beliefs in spirit possession have remained virtually unchanged since the beginning of civilization and still exist to this day. But whether possession by demonic forces is real or simply the result of a medical or psychological imbalance is still hotly debated.(April Holloway)
Exorcism: A psychiatric viewpoint W H Trethowan Department of Psychiatry, The University of Birmingham
Couched in psychiatric terms exorcism bears a close resemblance to that particular treatment procedure known as abreaction which, while it can be brought about wholly by psychological means, is often enhanced by the intravenous administration of certain drugs or by getting the patient to inhale ether or carbon dioxide. These and other measures tend to produce a state of growing excitement, together in the end, with clouding of consciousness and greatly heightened suggestibility. For psychiatry the technique has limited applications, but has been found to be of considerable use in the treatment of soldiers suffering from acute states of battle neurosis. Induced by this means to relive their experiences, but, on this occasion under controlled circumstances, the subjects may usually be fairly readily relieved of their symptoms.
Psychodynamic aspects of demoniacal possession
This leads us back to a consideration of the psychodynamic aspects of the matter. It is clear that man’s idea of the existence of the devil almost certainly springs from his need to repudiate his deep-seated instinctual drives such as are concerned with lust, hate, envy, and aggression and which, by their very nature, are so likely to arouse in him, feelings of guilt. Following Freud, it would seem also that the most common way in which man divorces himself from his own sense of vileness is via the psychological mechanism of projection. Strength is lent to this defense mechanism by a fantasy of evil as something personified. Thus is the devil brought to life while at the same time man is at least partly relieved of the responsibility for some of his more bestial actions.
Journal of medical ethics, 1976, 2s 127-137
The audio tape of Emily rose exorcism with pictures:
Trepanation (also known a trepanning, trephination, trephining or burr hole) is a form of surgery in which a hole is drilled or scraped into the skull, thus exposing the dura mater in order to treat health problems related to intracranial diseases, though in the modern era it is used only to treat epidural and subdural hematomas, and for surgical access for certain other neurosurgical procedures. Circular or rectangular holes would be cut by drills. The procedure was performed on men, women, and children, but predominantly on males.
Trepanation was carried out for both medical reasons and mystical practices for a long time: Evidence of trepanation has been found in prehistoric human remains from Neolithic times onwards, per cave paintings indicating that people believed the practice would cure epileptic seizures, migraines, and mental disorders. Furthermore, Hippocrates gave specific directions on the procedure from its evolution through the Greek age.
There is a great deal of speculation about why ancient civilization used trepanation, as it was – and still is – carried out in the absence of head trauma. However, it is almost certain that all those who used it did so because they somehow linked the brain with behavior. Some anthropologists suggest that trepanation was performed as part of tribal or superstitious rituals. Other researchers believe that the procedure was used as a treatment for conditions such as headaches, epilepsy, hydrocephalus and mental disorders. These were presumably attributed to possession by evil demons, such that a hole in the skull would have provided the spirits a passage for escape. Although the reasons for trepanning and the instruments used for the procedure differ with time and from culture to culture, the result is always the same: a hole in the head, usually made when the individual was full conscious and, often, anaesthetized.
In ancient cultures, a well-known belief was that mental illness were caused due to supernatural phenomenon such as evil eye, demonic possessions and sorcery.
In Persia mental illness were connected to loss of reason, and writings covered links between the brain and disorders, and spiritual/mystical meaning of disorders. wrote about fear and anxiety, anger and aggression, sadness and depression, and obsessions. Many believed that the reason for the mental illness are caused by possession of djinh or genie and many over the top attempts such as beatings and cleansing were done as cures to exorcise it.
The Persians practised precautionary measures to prevent such mental illness’s such as personal hygiene and purity of mind and body.
Evil eye or buri nazar can be described as ill feelings, jealousy for another person. The evil eye is said to have negative consequences on the target. Esphand seeds were used to remove the ill effects of the evil eye. While the esphand is burning there is a short poem Zoroastrian prayer accompanied by it the espand plant is a rich natural source of five alkaloids, harmane, harmine, harmaline, harmalol and tetrahydroharmine (from the Indian name for the plant, harmal), the MAOI-A (monoamine oxidase inhibitor A), substances that have been used in modern medicine to treat clinical depression.
HIPPOCRATES’ AND HUMORS
Temperament theory has its roots in the ancient four humors theory. It may have origins in ancient Egypt or Mesopotamia, by the Greek physician Hippocrates (460-370 BC) who systemized and developed it into a medical theory. He believed certain human moods, emotions and behaviours were caused by body fluids called “humors”: blood, yellow bile, black bile, and phlegm.
Next, Galen (AD 131-200) developed the first typology of temperament in his work, De temperamentis, and searched for physiological reasons for different behaviours in humans. He mapped them to a matrix of hot/cold and dry/wet taken from the Four Elements. There could also be “balance” between the qualities, yielding a total of nine temperaments. The word “temperament” itself comes from Latin “temperare”, “to mix”. In the ideal personality, the complementary characteristics or warm-cool and dry-moist were exquisitely balanced. In four less ideal types, one of the four qualities was dominant over all the others. In the remaining four types, one pair of qualities dominated the complimentary pair; for example; warm and moist dominated cool and dry. These latter four were the temperamental categories Galen named “sanguine”, “melancholic”, “choleric” and “phlegmatic” after the bodily humors. Each was the result of an excess of one of the humors that produced, in turn, the imbalance in paired qualities.
In humoral medicine, disease and insanity was believed to be caused by an humoral imbalance of these four humors. The theory behind the treatments was that removing one of the humors would restore the imbalance. Strangely, blood was seen as a poison to be removed and this is the origin of bloodletting. Vomiting was induced by spinning machines and drugs in order to remove phlegm. Blistering and cupping were done to remove the clear liquid of the blood (blood plasma) which they believed was making people sick. To blister, you would apply sulphuric acid to the skin. Cupping is where you apply a vacuum to a cup which is placed on the skin, which in turn creates a blister under the skin of plasma.
Here is a video to tell you more about such inhuman ways of treating mental illness.
Leeching therapy. Another form of blood letting was also practiced and very surprisingly, is still used to cure many diseases. Don’t believe it? Check this link, but at your own risk.
TALISMANS AND AMULETS AGAINST SPIRITS
Amulets and talismans are the most diverse forms of an addition to the body when it comes to warding off spirits. Amulets are objects of natural origin, endowed with magical power either initially, or because of “charging”. Talismans are things created by man and charged with magical energy. Examples of amulets can be called a stone with a natural hole or a rabbit’s paw. Examples of mascots are a piece of parchment or a coin, which bears certain characters or the magic words. How amulets and charms can be made for different purposes. What are the most fundamental: the protection from the evil eye, health, wealth, love, strength and power.
In the medieval era, because of the staunch belief that mental illnesses was because of the residing evil spirits inside the body of the patient and thus amulets or talismans were of great use to keep such spirits away from those who are supposedly normal and also for those who were not completely mad.
Call it a belief or just a tradition down the line, even today, these tricks are used to keep people sane and happy.
Here is a link to show you its contemporary uses and beliefs.
China the most populous country in the world and supposedly a county to be the next superpower wasn’t always advanced like it is now. Back then, in china the mentally ill were shunned by their families in a dingy, dark room and neglected. They were isolated, some felt it could spread so mostly they didn’t have any contact with people of that sort Some even gave up on them and they were mocked and made fun off, sometimes the officials arrested them for their odd behaviour too. They had miserable life because the Chinese missionaries believed mental illness didn’t harm them only the US.
An American medical missionary man finally came to aid to the situation, he disagreed and he worked long and hard to change the treatment of the mentally ill. When he opened his Refuge for the Insane, Kerr declared some new principles: first, insane patients were ill and should not be blamed for their actions; second, they were in a hospital, not a prison; and third, they must be treated as human beings, not as animals. He pledged to conduct a course of treatment based on persuasion rather than force, on freedom rather than restraint, and on a healthy outdoor life with a maximum of rest, warm baths, and kindness. The first psychiatric hospital was established by John Kerr the American missionary
Though the first evidence of the management of the ill in China was in Tang dynasty though they didn’t consider them mentally ill. homeless widows, orphans and the mentally ill were cared for in the Bei Tian Fang, a type of charity facility administrated by monks
MADHOUSES TO MENTAL CARE HOMES
The early 15th century saw the establishment of several mental institutions, which were popularly known as madhouses, workhouses or asylums. The families of mentally ill patients found taking care of such people troublesome and hence the need for such madhouses grew. The conditions in such asylums were extremely unhygienic and brutal. Often the patients were abused and even abandoned. The treatment of the inmates was no different than the treatment given to animals. Patients were chained to the walls and the ones who were better off were forced to beg. Purging, bloodletting, blistering, dousing patients in either boiling or ice-cold water to “shock” them, sedatives, and using physical restraints such as straitjackets were common forms of “treatment” used by the caretakers. Many patients suffered and died in these circumstances. This continued till the late 1800s, when reformers such as Phillipe Pinel and William Tuke raised their voice against such filthy and cruel environments. This marked the beginning of the ‘Humanitarian movement’ which brought light to the curability of mental diseases and improved the living conditions of the patients substantially. They believed kindness and consideration would improve the mental health of the patients. The famous La Bicetre and Bedlam are some examples of such institutes
The following story serves to portray the harsh and displeasing lifestyle of the madhouse inmates and to show the change brought about in the late 19th century.
The story is self composed and largely fictional, although based on some real facts.
As I heard the bell ring, I quickly packed my things and ran out to go home. As I walked back home, I remembered that it was a Friday. Friday was the day we visited my elder brother in the asylum. It was about a year or two back when mother and father told me that brother will no longer be living with us. Brother was a little different from the rest of us but he was still loving and kind most of the time. However, sometimes he would become very violent. I was told that he was sick and would be taken to a place where he would feel better. I did not want brother to leave, but I was told that I would see him every Friday. But now all my excitement for Friday had turned into terror. I dreaded every Friday. I could not bear to even enter La Bicetre to see brother. This building was the most dingy and dirty one I had ever come across. It was filled with people shackled to walls with no room to even move. The rooms were filled with faeces and looked like they had never been cleaned. I did not like to see brother in such a place. He had lost that smile but looked at me with hope to get him out of there. I saw brother getting worse and not better. Nevertheless, we had to visit him. As we approached the buildings, I noticed some men and women from La Bicetre begging outside. As we came nearer, I could hear the screams and cries of the patients inside. I entered the building and walked straight to my brother’s room, trying not to look at the other pitiable sights. Despite all my efforts, I couldn’t help seeing this man being doused with boiling hot water. He shrieked in pain and struggled to break free. But the more he retaliated, the more he was thrashed. I quickly walked ahead as I knew I could not help him. In my previous visits, I had seen a man intentionally hurt a patient, making him bleed. I had tried to shout and tell him to stop and tried to tell my parents as well but my mother just pulled me along and told me to be quiet. It scared me that my brother may have been treated in the same ways. When I entered the room, I saw my brother in the corner looking terrified. He acknowledged my presence by becoming slightly calm. He then wailed and pleaded my parents to take him home. He pointed outside and fell to the ground with hope to be taken outside. My parents tried to pacify him but ignored all his pleas. I knew that my mother wanted to take him home but could not. Brother also asked for food and indicated that he was hungry. But parents were not prepared to help him. All I could do was plead along with brother. As we left I cried and begged mother. But all my efforts went in vain. All I could do was pray fervently. This went on for 2 more years. I saw brother being tortured and abused. As I grew, I understood why but was convinced that brother was better off when treated with love. I tried to avoid going to the spectre of La Bicetre but I knew brother felt better when I visited him.
One fine day, everything I knew about La Bicetre changed. The patients were left free and were not kept chained anymore. The rooms were cleaned and also had windows allowing sunlight into them. I could hear music with a peaceful rhythm in every room. The shrieks that characterized the entrance of La Bicetre had almost disappeared. I could see brother getting better. He was a lot calmer and so were the other inmates. I was now even allowed to take him out for walks. I was told that I had Phillipe Pinel to thank. He had taken over La Bicetre and had made several changes in the running of the institution. Fridays were again marked with an excitement to see brother. My desperate prayers had been answered.
Also read the following article about the heroic revelation brought about by a young journalist to bring about change in the asylum maintenance.
HYPNOSIS IN THERAPY
How many times have you been “mesmerized” by something feeling captured by it taking you into a trance? The word “mesmerize” has been named after Franz Anton Mesmer. Anton Mesmer is widely attributed as the modern father of hypnosis. He believed that mental health depended on aligned magnetic forces within the human body which he called ‘animal magnetism’. The treatment he propagated involved high doses of iron which was followed by movement of magnets over the bodies of the patients. He would usually stand his subjects very still while he swept his arms across their body, sometimes for many hours on end. The patients were seen to go into a trance and then emerge to feel better. This treatment came to be popularly known as Hypnosis. Mesmer treated up to 30 patients at a time. Today hypnosis is used as a therapy technique to retrieve lost memories and as a research tool. Although hypnosis can be quite a controversial technique, today most psychologists agree that hypnosis can be a powerful and resourceful technique in treating mood, pain and anxiety disorders. It is also used to change habits of addiction such as quitting smoking. The following video explains the science and facts behind the technique of hypnosis.
Freud is known to be the finding father of psychoanalysis and psychodynamics which are theories which help in understanding the human behaviour and also treat mental illnesses to some extent. Talking cure is another name for psychoanalysis in this he would just ask his patients to talk about they felt and what was there on their mind. He developed a particular technique for talking that was part of psychoanalysis named free association. Freud used interpretations of what the patient were saying to help him recover forgotten memories. The main point in this is that talking helps if both the therapist and subject are involved and Freud was actively involved his patients completely. In modern assessments, it is proved that involved, interactive and empathic therapists accelerate the persons process of recovery. Today, psychotherapy often involves the use of cognitive-behavioural therapy to treat depression, anxiety and many other disorders. These practices are based on different theoretical pillars than those constructed by Freud. Nevertheless, many practitioners today use a combination of psychodynamic and cognitive-behavioural techniques to help patients achieve their goals.
Unbeknownst to many people is the fact that Freud, medical doctor/neurologist that he was, predicted that medications would one day be discovered that would cure mental suffering.
He also helped in recognising how events that take place in childhood impact their later lives. It was the first time it was being noticed and talked about and all because of Freud. He did background researches and collected data and came to the conclusion that severe trauma such as sexual molestation experiences as a child and inability to cope with the feelings of shame and guilty resulted in anxiety and depression and further affected their later life. In many ways, this was the beginning of the field of child psychology.
BEHAVIOURISM IN MENTAL HEALTH
Behaviourism is a theory of cognition that focuses on behaviour instead of thoughts, feelings, or motivations. Originally developed in the early 20th century, behaviourism continues to influence contemporary psychology, with behaviourist principles coming into and out of fashion every few years
Behaviourist principles can be helpful in a clinical setting, since observing behaviour is easier than analysing emotions. Many mental health professionals use approaches based upon behaviourist ideas. For instance, cognitive behavioural therapy, attempts to change behaviour by addressing unhealthy or inaccurate thoughts. Rather than discussing the past or endlessly analysing emotions, clients relying on CBT identify unhealthy thought patterns, gain an understanding of the connections between thoughts and behaviour, and then perform assignments designed to change their thoughts and, therefore, their behaviour.
What is cognitive psychology?
Cognitive psychology is the scientific study of mind and mental function, including learning, memory, attention, perception, reasoning, language, conceptual development, and decision making. The modern study of cognition rests on the premise that the brain can be understood as a complex computing system.
What is mental illness?
A mental disorder is a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.”
Many theories of mental health agree on the important role played by cognition. They differ however in how and by what process cognition influences mental health. Research in cognitive neuroscience directs our attention to 4 major points as relevant to theories of mental health: (1) monism as a framework, (2) issue of neural plasticity, (3) connection between mental operation and action system (i.e., the control of cognitive and motor activity is shared by the same neural connection.), (4) the issue of the unconscious. On the other hand, research in cross-cultural psychology indicates that cognitive process is strongly influenced by cultural values and norms. Thus, a valid mental health theory should account for all these components.
Over the past two decades, many studies have been published examining the relationship between cognitive ability and a variety of health outcomes, including both physical and mental health. Most of these types of studies have shown that having lower cognitive ability measured is a strong predictor of multiple psychiatric disorders, including depression, or one of its manifestations (e.g., suicide completion., suicidal thoughts).
This relationship between cognitive ability and depression appears to manifest itself throughout the life cycle, including childhood, adulthood, or in the elderly. More than just a predictor, though, many studies have shown that cognitive ability measured at one-time point is related to depression at a later time point indicating that cognitive ability might play a causative role in depression. As depression is problem that many individuals encounter in their life, including adults and children across the age spectrum, and one with serious potential sequelae, finding potential risk or causal factors, especially in children and adolescents, could be of much benefit in helping individuals obtain the treatment they need.
After controlling for initial levels of depression, cognitive ability, and other covariates, depressive symptoms in adolescence are related to cognitive ability in early adulthood, but adolescent cognitive ability is not related to adult depression levels. Moreover, after controlling for adolescent levels of depression and cognitive ability, the cognitive ability-depression relationship disappears in adulthood.
The cognitive ability-depression relationship appears early in life, and it is likely that the presence of depressive symptoms leads to lower cognitive ability. Thus, intervening at early signs of depression not only can help alleviate depression, but will likely have an effect of cognitive ability as well.
This results from this study show the importance of addressing depressive symptoms during childhood/adolescence. Depressive symptoms are occurring in childhood and adolescence more frequently now than before , and the results from this study indicate that this time in development is likely when depressive symptoms become associated with cognitive ability. Thus, while early intervention is important to treating depression , such intervention could likely have a positive influence on later cognitive ability, as well.
INSTITUTIONAL RESEARCH IN THE PRESENT TIMES
Modern psychiatric hospitals evolved from, and eventually replaced the older lunatic asylums. The treatment of inmates in early lunatic asylums was sometimes brutal and focused on containment and restraint. With successive waves of reform, and the introduction of effective evidence-based treatments, modern psychiatric hospitals provide a primary emphasis on treatment, and attempt where possible to help patients control their own lives in the outside world, with the use of a combination of psychiatric drugs and psychotherapy.
Outpatients or daytime health facilities
The vast majority of mental health facilities fall into this category and are privately owned. These types of mental health facilities offer day programs where a person may visit the facility for treatment. Treatment at these facilities often includes medication management, group therapy, individual therapy and classes that teach skills to be used in dealing with a mental illness. Day treatment facilities, as the name implies, do not have patients stay overnight and so are suitable for people who have already stabilized their mental health condition. A day treatment program may be what a person enters into after leaving an inpatient psychiatric facility.
Separate Inpatient Units of a General Hospital
The second most common type of mental health facility is a separate inpatient unit of a general hospital. Many regions aren’t big enough for separate mental health facilities and so combine them with their general healthcare facility. These inpatient units are where mental health emergencies are handled – such as a person who is floridly psychotic. Stays are typically short-term and are used to stabilize a mental health condition.
Residential Mental Health Treatment Facility for Children or Adults
About 8.4% of mental health facilities in the United States are residential facilities for adults and about 7.5% are residential facilities for children’s mental illness treatment needs. Residential treatment centres tend to be private mental health facilities. Treatments here vary widely from equine treatment to exercise to therapy to psychotropic medication. These are typically long-term mental health facilities.
Only about 6.2% of mental health facilities are full psychiatric hospitals and more than half of these are privately owned. These hospitals are just like general healthcare hospitals in that they are staffed by doctors, nurses and other qualified healthcare professionals. Stays at psychiatric hospitals may be short or medium length often depending on a person’s ability to pay for mental health services at this type of facility. These types of facilities can handle emergency mental health situations and non-emergent cases as well.
United States Department of Veteran’s Affairs
The smallest percentage of mental health facilities belongs to the United States Department of Veteran’s Affairs (VA). These public institutions are set up to specifically serve the military population. Common conditions treated here include posttraumatic stress disorder (due to combat, military sexual trauma, etc.), suicidal ideation and substance use disorders.
- theory of Freud
- proponent of four humor theory
- 15th century french asylum
- first humanitarian movement reformer
- Technique used to change habits of addiction
- place where recreational activities were used as treatment
- La Bicetre
Even though we have come a long way to bring about the scientific awareness of psychological disorders, it is important to remember that we still have many improvements to make, Especially in India, although the negative light in which we view mental disorders has considerably decreased, it has not disappeared. It is essential that we continue to make efforts in this direction.