The history of psychic and physical suffering is a history of humanity. From primitive society’s magical priest, medicine man, healer, or sorcerer, to the contemporary psychologist and psychiatrist, the life of the human-being is one that includes a history of trying to reduce the suffering of those who have been, and are, tormented. Today we can understand these as interactions of processes that are social and biological, neurological, psychic, emotional, and genetic.
This paper will survey the history of health-care in the areas of mental illness. This traces through magic to mysticism; from theological self-reflection, to philosophical empiricism; and from early scientific experimentation, to the development of artifacts such as the Diagnostic and Statistical Manual of Mental Diseases, Fourth Edition, more commonly known as the DSM-IV (Young 1998, p. 7)
We have progressed and regressed several times in this history, but as human beings, perhaps it is our “nature” to move recursively.
In The History of Psychiatry, Alexander & Seleznick (1967) review several studies of ancient and primitive medicinal traditions to explain the social importance of a tribe or clan’s medicine man (p. 17-18). Typically, the position was inherited and the herbal formulas, dances and chants, and other rituals were handed down from parent to child. What was also significant, however, was the experience of an illness – or a trance – with symptoms resembling psychosis. He then had to be treated by another medicine man, and cured of his mental illness in order to be eligible for an apprenticeship (Alexander & Seleznick, 1967, p. 18).
It is likely that these psychotic episodes were induced with kinds of toxins found in mushrooms, tree barks, or roots, and worked to produce hallucinations, however the experience itself was critical to the belief that enduring and surviving the psychosis was the key to curing it in others.
Babylonians and Egyptians practiced both magical and religious arts as healing arts, as well as relying on astronomical beliefs and appointing divine significance to celestial events. There is also evidence of this practice in the Hebrew Talmud, which relied upon “stories” for passing knowledge on to future generations of health practitioners (Young 1999, p. 8).
Similar interpretations of mental health emerged in Hindu medicine, where beliefs of demons and possession were connected to religious rites and mysticism. Significantly, during these primitive developments there is one character of healing that is shared by these beliefs and practices: empathy. It was in the experience of suffering that the healer became qualified to heal others; in the experience of depressions, and introspection, that documentation was cultivated in the interests of healing such afflictions in others (Alexander & Seleznick 1967, p. 26).
During what is typically known as the Classical period, The Greek philosophers played an important role in developing perspectives towards helping to alleviate the suffering of others. Hippocrates (460-377 B.C.) developed his doctrine of medicine, stating from the onset that “it is nature that heals the patient,” and thus introduced the self-reflexive and introspective capacities of humans as curative properties (Young 1998, p. 12). Hippocrates recognized the importance of a patient’s life history in determining how to alleviate illness, and also identified the brain as the most important organ, and the “interpreter of consciousness…” (Alexander & Seleznick, p. 31-32).
Philosophers such as Plato and Aristotle can be understand as writing the traditions of rational thought, and of introducing the initial ideas of logic and rationality into human interactions. Whereas Plato continued to advocate larger “forms” of intervention, however, Aristotle introduced the materialist sciences, the study and analysis of phenomena through standardized methods, and the necessity of categories for classification of everything, including the body, and mind of the person (Young 1998, Rapaport 1974, p. 43)
Aristotle described the content of consciousness, and distinguished between emotions, sensations, and conation “striving” (Rapaport, p.45). Following Aristotle in this kind of clarity, the Roman philosopher Cicero (106-43. B.C.) produced the notion of psychosomatic illnesses, that physical ailments could easily be a product of emotional factors (Rapaport, p. 47). While the language for these observations was still confined to the limitations of Classical thought, the foundations of psychology were emerging in these observations.
There is a saying, “Two steps forward, three steps back,” that refers to recursive learning. This is certainly the case of the Medieval period, in relation to its contributions to barbarism and a return to primitivism in the healing arts (Alexander & Seleznick 1967, p. 53). With the increase in religious authority, an increase in beliefs of demonic possession returned, and all rational thoughts concerning the relations of mind and body were replaced with spiritual dominance. During the 12th, 13th, and 14th centuries, there were compassionate understandings being generated in the French arts (Wright, 1937/1985) but their influence had no effect on the irrational persuasions of religious mythologies.
There are indications of a slight shift in these attitudes towards the end of the 14th century (Alexander & Seleznick, p. 53) where “…the physical care of the insane was better in the Middle Ages than it was during the 17th and 18th centuries.” (p. 53); however, this was not an accepted cultural practice, but more restricted to specific hospitals who incorporated spiritually-based diagnoses with rational care (Wright, p.123).
The most significant contribution of the Middle Ages came from Aurelius Augustus, known as St. Augustine. Born in North Africa (A.D. 354), he was most profoundly influenced by the writings of Cicero (Alexander & Seleznick, p. 54). In an effort to deal with his own confusion between his passions and his spiritual aspirations, St. Augustine composed the Confessions, the first introspective analysis, that is, selfanalysis that methodically examined his earliest memories and their relations to his ongoing struggles to find peace.
Apart from this text, medieval understandings of mental health and mental illness were pervasively oppressive, where physical ailments were segregated towards physicians’ care, and mental problems were treated as spiritual ailments, requiring exorcism and religious rituals to save the soul. During this time, a belief in witchcraft gained currency, and especially women who worked as midwives and herbal healers were targeted as demonic and evil (Young 1998, p. 12).
What changed most dramatically during these “dark” centuries was an increase in trade with countries of the Mediterranean, and with increased trade, came the influence of different cultures, arts, languages, and texts (Alexander & Seleznick, p. 71-72). Now that there was greater access to the classical Greek texts of Aristotle, a revival in Greek rationalism returned; and simultaneously, an influx of artistic interpretations that challenged the dominant beliefs of the evils of flesh. As the Europeans moved into the Renaissance period, the arts shifted towards naturalism, realism, and beautifying the real, challenging the religious mysticism that pervaded the cultural arts with a completely different perspective of the human body (Alexander & Seleznick, p. 75). Accompanied with interests in rationalism, the mind and the body became philosophically unified.
There are many ways to characterize the Renaissance period; however, in the realms of psychology and mental health, one of the most influential writers was the philosopher Spinoza (1632-1677). Recognized as a pre-Freudian psychologist (Young 1998, Alexander & Seleznick 1967), Spinoza unified the physiological and the psychological as symptoms of a living organism. Unfortunately, while philosophical ideals progressed, the care of the mentally ill regressed to kinds of torture chambers and bizarre practices of surgery and water submersion (Alexander & Seleznick, p. 98).
Spinoza produced a detailed analysis of the consciousness, and initiated psychodynamic models of mental processes (Young 1998, p. 14). Relegating these processes to the living organism re-introduced the importance of psychological phenomena as material manifestations, where the body and the mind were a unified interaction (Young, p. 14).
Overall, the Renaissance represents a realistic approach towards understanding mental illness. The philosophy of Spinoza, furthermore, succeeded in critiquing Descartes’ doctrine of mind-body dualism, and established a holistic concept of the organism (Young 1998, Alexander & Seleznick 1967, Rapaport 1974).
One of the most important understandings that took place during the 17th and 18th centuries involved the care of the mentally ill. The importance of observation and classifications of symptoms had become increasingly significant to the developments of science and medicine. One of the most dynamic influences in the work of classifying symptoms and diagnosing different disorders was William Cullen (1712-1802). It is the detail of his work that made a difference, and his identification of nervous disorders, mania, depression, and general neuroses (Alexander & Seleznick, p. 109). Cullen was the first to use the word “neurosis” to describe diseases that were not accompanied by fevers or physiological pathologies (p. 109).
Treatments continued to depend upon archaic practices such as nosology (operating on the nose), blood-letting, ice-water submersion, and a “spinning chair” devised by Hermanne Boerhaave (1668-1738), which was believed to relieve brain congestion through rotary movements (Alexander & Seleznick, p. 112).
Another influence of the Enlightenment came from the works and influences of Phillipe Pinel (1745-1826), who separated psychotic illnesses on the basis of Cullen’s diagnoses. Pinel identified patients with melancholia, manias with, and with deliriums, dementia, and radical mood swings (p. 112). Pinel also believed in moral treatments, which re-introduced ideas of “care” into the studies of mental illness, and a change in social perspectives of mental illness as a health condition that required medical treatment. Furthermore, Pinel was one of the first physicians to point out that chaining and torturing people made it impossible to determine whether mental symptoms resulted from illness, or from the effects of imprisonment and torture (Alexander & Seleznick, p. 117). In spite of the name, however, the “age of enlightenment” was not especially enlightened towards the care of the mentally ill. Treatment remained committed, generally, to the confines of dungeons, and, as in the Middle Ages, while there were specific hospitals that were humanitarian in their approaches to treatment, European treatment of insane did not change until the late 18th and early 19th century (Wright 1937/1985, p. 172).
Much of the progress that advanced the treatments of mental illness were a result of technological innovations. Increased access to microscopic studies of pathologies, and a greater understanding of neurochemistry came about as a direct result of technological improvements (Young 1998, Rapaport 1974). As neurology emerged into a field of its own, mental diseases became more specifically studied and sympathetically treated (Alexander & Seleznick, p.151). Research in cerebral localization, and cellular architectures of the brain led to increased understandings of the interconnectedness of the central nervous system and the brain.
In 1906, Mary Whiton Calkins spoke at a conference for the British Association for the Advancement of Science, and challenged Darwinian methodologies of functional science as being distinct from structural science, and argued for a unified approach to the study of abnormal psychological phenomena:
In contemporary psychology, the two procedures, structural and functional, are too often opposed to the point of mutual exclusion. The structural psychologist is often wont to ignore functional relations and the functional psychologist to condemn structural psychology as an artificial, abstract, and inadequate account of consciousness.(p.62)
The importance of this argument points towards contemporary psychology and the renewed interests in Darwinian theories for understanding abnormalities (Young 1998, p. 17).
As Young (1998) argues, distinguishing structural and functional processes is not productive, but protective. Dependence upon classifications, specifically from the DSMIV, alleviates the psychologists’ concerns, but does not contribute to the care and understanding required for treatment in mental illness:
Classification frees us from the anxieties of contingency, idiosyncrasy, and individuality. A diagnosis takes us to a therapy without passing trough a real relationship with the individual. Second, classification, in the sense of a structured model of typing people according to syndromes, gives us the comfort, ersatz though it is, that we are dealing with natural kinds, in the way the classifier, called a taxonomist in biology, finds specimens and reduces them to the known or the newly typed and classified. (p. 22).
In his history of the DSM, Young (1998) points out the dominance of the objectivist approach to diagnosis, and emphasizes that without a value system, without a morality in treatment and care, the DSM de-values the human being by subjecting them to purely functional systems of evaluation.
The evaluative dimension is inescapable in the human sciences, no matter what we discover about the brain, hormones, neurotransmitters and the evolution of our characteristic ways of acting and expressing our emotions. Values, as embedded in approaches to nature and human nature, also set the parameters of our philosophies of science, of physical and living nature and of ourselves (p. 25).
This recalls not only Pinel’s 18th century concerns about moral treatment, but as well those expressed by Jerome Bruner in 1947. Then, Bruner argued that personality and social values needed to be integrated into studies of perception, thus challenging the objectivist to account for individuation in experience as a significant factor in psychological studies (p. 34).
While technology can now systemically catalogue neural activity in assessing abnormal psychological phenomenon, the importance of social and moral values continues to be separated from psychological research and treatment (Young 1998, p. 24). The dependence upon psychotropic drugs remains highly political, as diagnosis and treatments are increasingly designed to remove the symptoms, and admit there is “no cure” for certain abnormalities (Young 1998).
The return of biological determinism and the leaps made in genetic research also indicate a diminishing interest in treatment. There is an increased interest in returning to the work of researching the functions of abnormal psychology, and not accounting for the structures of the psyche, the social and cultural influences in human development, and the necessity of interpersonal contact for healing (Young 1998, p. 25).
As such, the recursive cycles of human progress are in a regressive phase, as in the history of psychology and interests in mental illness. Perhaps the 21st century will provide a different age of enlightenment, where diagnosis and classification become less important than treatment, and the alleviation of suffering.
The science of abnormal psychology is sophisticated and methodical, the technologies and techniques are advanced and quite progressive in terms of detail and physiological significance.
The humanitarian aspects of research and treatment in abnormal psychology appear to be lacking, however, and if history is the indicator of what lies ahead, perhaps there will be futuristic renaissance in the care and treatment of mental illness. Also we provide high-quality academic writing help. Our Ph.D. writers are qualified specialist and they can create any type of content
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