The History of Psychopathology PDF

Reasons for Believing SW-3453-75317133  How do we know the things we know? How do we know that stars are huge balls of fire? Like the sun, but very far away? – They look like pinpricks in the sky How do we know that the Earth is a smaller ball whirling arou...

Reasons for Believing SW-3453-75317133  How do we know the things we know? How do we know that stars are huge balls of fire? Like the sun, but very far away? – They look like pinpricks in the sky How do we know that the Earth is a smaller ball whirling around one of those stars? What if I told you I could fly?  Good and Bad Reasons for Believing There are many Betrand Russell more bad reasons – “It is not what the than good reasons man of science – Observation* believes that – distinguishes him, Tradition but how and why he – Authority believes it.” – Intuition Observation Observation Observation  Tradition The trouble with tradition – No matter how long ago a story was made up, it is still exactly as true or untrue as the original story was Tradition Tradition  Intuition/Common Sense Many of the most important scientific discoveries have been counter- intuitive Common sense differs from theoretical sense  Intuition/Common Sense “A bat and a ball cost $1.10 in total. The bat costs $1.00 more than the ball. How much does the ball cost?”  Intuition/Common Sense “A bat and a ball cost $1.10 in total. The bat costs $1.00 more than the ball. How much does the ball cost?” – Many people respond by saying that the ball must cost 10 cents. Is this the answer that you came up with? Although this response intuitively springs to mind, it is incorrect. If the ball cost 10 cents and the bat costs $1.00 more than the ball, then the bat would cost $1.10 for a grand total of $1.20. The correct answer to this problem is that the ball costs 5 cents and the bat costs — at a dollar more — $1.05 for a grand total of $1.10. Intuition/Common Sense Theoretical Sense Theory  Authority Believing in something because you are told to believe it by somebody important Authority figures disagree Truth and Knowledge  Truth and Knowledge ‘Nullius in verba’ (‘Take no one’s word for it’) – Prior to the Enlightenment Was believed that everything important that was knowable – Had already been discovered – Was enshrined in authoritative sources such as ancient writings and traditional assumptions – A tradition of criticism was imperative for the sustained, rapid growth of knowledge  Truth and Knowledge “Here’s another thing I believe: We are far better equipped to take on the challenges we face than ever before. I know that might sound at odds with what we see and hear these days in the cacophony of cable news and social media. But the next time you’re bombarded with over-the-top claims about how our country is doomed or the world is coming apart at the seams, brush off the cynics and fearmongers. Because the truth is, if you had to choose any time in the course of human history to be alive, you’d choose this one. Right here in America, right now.” - Obama  How do we know the things we know? Dogmatism Empiricism Dogmatism Empiricism – The tendency for – The belief that accurate people to cling to their knowledge can be acquired through assumptions observation* Dogma – An essential element of – A principle or set of the scientific method principles laid down by Empirical an authority as – Based on, concerned with, incontrovertibly true or verifiable by observation or experience rather than theory or pure logic  The Scientific Method The scientific method - A procedure for finding truth using empirical evidence – Simply a way of knowing something It’s not a perfect way of knowing something, but it’s the best that we’ve got When better ways come along, science incorporates them  The Scientific Method A few more thoughts: Any scientific theory that cannot be disproven is worse than useless* In science, we don’t attempt to prove, we attempt to disprove The scientific theories that we adhere to are those that have withstood many attempts to be disproven Not perfect, but the best method we have Science is a way of knowing [period] Silent regarding what we do with what we know  Science Theory Peer review Hypothesis Replication Data collection Methods Examination of Reliability evidence Presentation of Refinement of data theory  The History of Psychopathology Well, how did we get here?  The History of Psychopathology Efforts to understand and resolve problems of psychopathology – Traced throughout many centuries and cultures Times and places where mysticism and charlatanism flourished – Have unfolded without the care and watchful eye of scientific methods Based largely off of “bad” reasons for believing Many current techniques and theories are connected to these past efforts  The History of Psychopathology Historical periods – Each Is dominated by certain beliefs that ultimately won out over previously existing conceptions Retains elements of the previous periods Historical Review – Helps us understand how current conceptualizations have roots in Chance events Cultural ideologies Accidental discoveries Brilliant and creative innovations  Ancient History The Sacred Approach – Psychopathology was the expression of transcendent magical action brought about by external forces – Animistic Phase Connection between primitive beings and the forces of nature World is populated by animated entities and forces that act on the mind and soul – Mythological Phase Every symptom of a disorder was thought to be caused by a deity who, if appropriately implored, could benevolently cure  Ancient History The sacred Approach cont. – Demonological Phase Two competing forces struggled for superiority – Creative and positive » Represented by a good parent or God – Destructive and negative » Represented by the willful negation of good in the form of demonic forces  Early Hindus Susruta – He followed the traditional beliefs of demonic possession – Suggested that passions and strong emotions of the mentally disordered brought about physical ailments These were best served by psychological help  Hindu Medicine Proposed the existence of three emotional inclinations – Wise and enlightened goodness Seated in the brain – Impetuous passions The source of the pleasure and pain qualities Seated in the chest – Blind crudity of ignorance The basis for animalistic instincts Seated in the abdomen  Indian Cultures Charaka Samhita (600 B.C.) – Defines Ayu (life) as a state consisting of Shareera ( body) Indriya (senses) Satva (psyche) Atma (soul) – Cannot be destructed and is reincarnated – The mind Responsible for cognition Directs the senses, controls the self, reasons, and deliberates – The equilibrium between the self/life and mind is paramount to good health  Indian Cultures Charaka Samhita (600 B.C.) cont. – Doshas – bodily fluids Vata, Pitta, and Kapha Spoiler alert! – Similar to the Greek humoral theory – Food influences The mind Personality characteristics Interactions between the three Doshas  Indian Cultures Charaka Samhita (600 B.C.) cont. – Personality types leading to mental illness are the result of: Unwholesome diet Moral transgressions – Mental disorders are seen as largely metaphysical Different appearances of mental disorders result from – Heredity, imbalanced doshas, temperament, inappropriate diet, and metapsychological factors  Babylonian Empire The Babylonians assigned a demon to each disease – For example, insanity was caused by the demon Idta – Each demon was to be exorcised through special medicines (primarily herbs and plants), confessions, and other methods These helped to restore a balance between conflicting supernatural forces  Chinese Medicine Neijing (The Canon of Internal Medicine) – Compiled between 300 B.C. and 100 B.C. – Stated that the primary causes of psychiatric illness were vicious air, abnormal weather, and emotional stress Tends to explain pathology change via philosophical principles – This framework has undergone little change  Chinese Medicine Basic principles – Complementary: Yin and Yang – Five elements: gold, wood, water, fire, and earth – Principle of Tao (i.e. the way) Considered the ultimate regulator of the universe The most desirable state of well-being and longevity Achieved by integrating the individual self into the realm of nature – Personality types were portrayed on the basis of a combination of the five elements Fiery type, earthy type, golden type, and watery type  Greek Civilization Pythagoras (circa 580-circa 500 B.C.) – First philosopher to claim that the brain was The organ of the human intellect The source of mental disturbances – Thought the mathematical principles of balance and ratio accounted for characterological differences e.g., degrees of moisture or dryness, proportion of cold or hot Balances and imbalances would account for health or disease  Greek Civilization Pythagoras (circa 580-circa 500 B.C.) – Thought the soul was composed of three parts: Reason – reflected truth Intelligence – synthesized sensory perceptions Impulse – derived from bodily energies – Brain Center of the rational parts of the soul – Heart Center of the irrational parts of the soul  Greek Civilization Hippocrates (circa 460 – circa 377 B.C.) – His work highlighted a naturalistic view – Thought the source of all disorders, mental and physical, was within the patient, not within spiritual phenomena “It is not god which injures the body, but disease (Hippocrates, 400 B.C.)”  Greek Civilization Hippocrates (circa 460 – circa 377 B.C.) – Identified four basic temperaments Choleric – excess in yellow bile – Associated with a tendency towards irascibility Melancholic – excess in black bile – Characterized by an inclination towards sadness Sanguine – excess in blood – Individuals are prompted towards optimism Phlegmatic – excess in phlegm – Conceived of as an apathetic disposition – These terms are still used today… e.g. “sanguine,” “humorous,” or “good- humored”  Greek Civilization Hippocrates (circa 460 – circa 377 B.C.) – Conceptualization of humors supplanted practices of exorcism and punishment – Recommendations included Exercise, tranquility, massage, music, diet, marriage, and bloodletting  Greek Civilization Plato (circa 428 – circa 347 B.C.) 1. Powerful emotional forces come to the foreground and overwhelm the everyday behavior that typifies a person’s life 2. Conflicts exist among different components of the psyche 1. Discord between the rational side and emotions  Greek Civilization Plato (circa 428 – circa 347 B.C.) 3. Mental disorders do not result from simple ignorance, but from irrational superstitions and erroneous beliefs  Greek Civilization Aristotle (384 – 322 B.C.) – Gave special attention to The need for experimental verification The use of sensory-based, observable data – The first major philosopher to take an inductive and empirical approach – Thought data should be grounded in empirical observables This would minimize the risk of subjective misinterpretations  Emergence of Modern Psychiatry Emil Kraepelin (1856-1926) – Wrote Compendium of Psychiatry (1893) A 300-page volume classifying psychiatric diagnoses He actively worked on the 9th edition at the time of his death in 1926 – At this time had expanded to a four volumes and 3,000 pages – Presented a logic for organizing syndromes by clinical symptomatology, course, and outcome  Emergence of Modern Psychiatry Emil Kraepelin (1856-1926) – Established definitive patterns of two major disorders Manic-depressive psychosis (now known as bipolar disorder) Dementia praecox (now known as schizophrenic disorders) – Termed the autistic temperament “These children exhibited a quiet, shy, retiring disposition, made not friendships, and lived only for themselves.”  Emergence of Modern Psychiatry Eugen Bleuler (1857-1939) – Recognized for his description of Schizophrenia He coined this term to replace dementia praecox – The term, schizophrenia, is unfortunate Suggests a “splitting between segments of the mind” – These patients do not suffer any form of splitting – Characterized by disordered thinking leading to hallucinations and delusions  Emergence of Modern Psychiatry Adolf Meyer (1866-1950) – Distanced himself from Kraepelin’s view of illness as strictly deterministic – Saw psychiatric disorders as a consequences of environmental factors and life events – Psychobiological approach to schizophrenia Detailed his interactive and progressive view of the nature of pathogenesis  Sigmund Freud (1856-1939) Arguably the most influential psychologist of the early 20th century – Emphasized early childhood experiences Adult disorders are a direct product of the continued operation of past events Adult behaviors arise from clear-cut antecedent causes – These causes persist out of awareness (i.e. unconscious) – Psychic conflict Behavior arises from competing desires and their prohibitions – Enumerated stages of “psychosexual” development Aaron Timothy Beck (1921 - 2021) Cognitive Therapy – He found that most depressed patients had broad, negative views of themselves, others, and the future – Thought these negative “distortions” should be able to be corrected or restructured based on evidence – More than 1/3 of all therapists today speak of themselves as cognitive in orientation