Specialists who have studied bones, artwork and remnants of ancient societies have noticed that the societies probably regarded abnormal behavior as the work of evil spirits. Most ancient societies believed that all events around and within them were from the actions of magical, possibly sinister, beings who controlled the entire world. In particular, they viewed the human body and mind as battlegrounds for good and evil to fight over. Abnormal behavior was seen as a victory for evil spirits, where the cure was to force the demons from a victim's body.
This view might have existed in the stone age as skulls from that period, which were found in Europe and South America, show evidence of an operation known as trephination. In this operation, a stone instrument was used to cut away a circular section of the skull. Trephination was used for individuals with hallucinations, seeing or hearing things that are not there, or melancholia, extreme sadness, and immobility. The reason for removing pieces of the skull was to release the evil spirits that were supposedly causing the problem. However, trephination may have been used to remove bone splinters or blood clots caused by stone weapons during tribal warfare. Even so, it is certain that societies believed abnormal behavior was related to demonic possessions.
The treatment for abnormality in religious societies was more related to exorcisms. The idea was to coax evil spirits to leave the person or to make the person's body uncomfortable for the spirit to force them to leave. A priest would recite prayers, plead with the evil spirits, insult the spirits, make loud noises, or have the person drink bitter poisons. If these exorcisms failed, the priest would preform a more extreme form of exorcism involving making that person uncomfortable including whipping or starvation.
Greek and Roman Views
For 1,000 years, philosophers and physicians gave different explanations for abnormal behaviors. Hippocrates taught that illnesses had natural causes. His perception of abnormal behavior was as a disease from internal physical problems. He believed a form of brain pathology was the reason and resulted from an imbalance of the four humors, fluids that flowed through the body. The four humors were as follows: yellow bile, black bile, blood, and phlegm. Too much yellow bile caused mania, a state of frenzied activity. An excess of black bile caused melancholia, unshakable sadness. To treat the dysfunctioning humors, Hippocrates attempted to correct the levels of bile. He believed the black bile could be reduced by a quiet life, a diet of vegetables, temperence, exercise, celibacy, and bleeding. Other philosophers who believed in this theory include Plato and Aristotle.
The Views of the Middle Ages
When Rome fell, the church became more powerful and controlling. Behavior was viewed as a conflict between good and evil. Who would be triumphant? God or the Devil? Society blamed the devil for troubles such as war, urban uprisings and plagues. Abnormal behavior increased greatly and outbreaks of mass madness, where large numbers of people shared delusions and hallucinations. Another disorder, tarantism, became known where groups of people would suddenly start to jump, dance, and go into convulsions. These people believed they had been bitten by a spider, the tarantula, and danced to cure their disorder.
Yet again, exorcisms were brought back to the light. Priests would plead, chant or pray to make the evil spirits flee. If the exorcism did not work, torture was performed. When the Middle Ages came to a close, demonology and its methods were lost from view. Medical theories of abnormality took religion's place to help the mentally ill. Lunacy trials were held in England to determine the sanity of individuals. Sometimes a hit of the head or fear of one's father were held responsible for an individual's unusual behavior. During these years, many individuals with psychological disturbances received treatment in medical hospitals in England.
The Renaissance and the Birth of Asylums
In the early Renaissance, cultural and scientific activity bloomed. Individuals with mental disorders improved at home while their families were aided financially by the local parish. Religious shrines were devoted to the humane and loving treatment of people with mental disorders that were visited by people from miles away to gain psychic healing. Community mental health programs began at this time to give loving care and respectful treatment. Sadly, these improvements in care began to fade by the mid-sixteenth century. Government officials discovered that private homes and community residences could house only a small percentage of those with severe mental disorders and that medical hospitals were too few and too small. The hospitals and churches were turned into asylums. At first, they gave good care to the patients. However, when the asylums began to become crowded with mentally ill, they turned into prisons where patients were held in filthy conditions and with cruel treatments.
In 1547 at Bethlehem Hospital in London, patients were bound in chains who constantly cried out. During the full moon, they might be chained and whipped to prevent violence, an ironic action. The hospital became a popular tourist attraction. Society would pay to look at the horrifying actions and noises of the inmates. At the Lunatics' Tower in Vienna, patients were herded into narrow hallways by the outer walls so that tourists outside could look up and see them.
The Nineteenth Century
Treatments improved during the nineteenth century. Philippe Pinel, the chief physician at La Bicetre, argued that the patients were sick people whose illnesses should be treated with sympathy and kindness. For the first time, patients were allowed to move freely about the hospital grounds, had sunny and well-ventilated rooms along with support and advice. Pinel's approach proved very successful. Many patients who had been shut away for decades improved over a short time and were released.
Moral treatment emphasized moral guidance and respectful techniques. Patients with psychological problems were largely viewed as productive humans whose mental functioning broke under stress. Mental ill patients were thought of as deserving of individual care, including talking about their problems, given useful activities, work to perform, companionship, and quiet.
By the end of the century, treatment of mental health patients declined once again. When mental hospitals showed up left and right, money and staffing seemed to dissipate. Prejudice against people with mental disorders began at this time. As more patients disappeared into distant mental hospitals, society viewed them as strange and dangerous. Public mental hospitals were providing only custodial care and ineffective medical treatments and were more crowded every year.
Early 20th Century
When moral movement declined, two different perspectives fought for the attention: somatogenic and psychogenic.
- Somatogenic - Abnormal behavior was classified into syndromes. The discovery of general paresis caused realization of an irreversible disorder with both physical and mental symptoms, including paralysis and delusions of grandeur. The new understanding of general paresis caused doubts that physical factors were responsible for many mental disorders. Yet biological approaches yielded disappointing results. Although many medical treatments were developed for patients in mental hospitals during that time, most techniques failed. Physicians tried tooth extraction, tonsillectomy, hydrotherapy, and lobotomy. Even worse, biological views and claims let some groups try eugenic sterilization.
- Psychogenic - This is the view that the chief causes of abnormal functioning are often psychological. Greek and Roman physicians believed many mental disorders are caused by fear, disappointment in love, and other psychological events. Even so, the psychogenic perspective did not gain much attention until hypnotism showed potential. Under hypnotism, patients would talk more openly about their problems and mental state. Some patients with hysterical disorders, mysterious body ailments with no apparent physical basis, received hypnosis and stated what was bothering them. The psychoanalytic approach had little effect on the treatment of severely disturbed patients in mental hospitals. This type of therapy requires levels of clarity beyond the capabilities of some patients because of their condition.
At this point, we do not live in a time of great enlightenment about dependable treatments of mental disorders. However, the past 50 years have brought major changes in methods of treating abnormal functioning. There are new psychotropic medications to help those that are depressed or psychotic. There are health care communities to provide programs to help those with mental illness or trauma. Another popular use consists of short-term hospitalization to provide psychotherapy care to then put patients into the health care communities. Private psychotherapy is also used, such as counseling to help talk about problems and difficulties the patient is facing.
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