HISTORY

OF ABNORMAL PSYCHOLO
GY

History of Psychology
Eric Snitchler
Kevin Harris

Abnormal Psychology Time Machine

An aspect of abnormal psychology that has been and continues to be debated is the cause of mental
illness.Throughout history, people have developed a variety of theories to explain psychological
disturbances.Generally, these theories have fallen on one of three general
themes: mystical/supernatural, scientific/medical, or humanitarian.
Mystical explanations regard abnormal behavior as the result of possession by spirits.The
scientific/medical approach considers natural causes, such as biological imbalances, faulty learning
processes, or emotional stressors.Finally, the humanitarian approach tends to view abnormal behavior
as the result of cruelty or poor living conditions.The differing etiological theories as well as advancing
knowledge have had large impact on the treatment of those with psychological disorders and have
influenced current theories in clinical psychology.

10000 B.C. 3,000 B.C. --- Prehistoric Times

As far as historians can ascertain, Paleolithic people saw no distinction between
medicine, magic, and religion.Archeologists have uncovered skulls with holes
drilled in them dating back as far as 8,000 B.C.Researchers have determined
that, for some, bone healed near these holes indicating that the procedure may
have been surgical and that the person survived.

Many theories have been developed as a means to explain the purpose behind
this surgery, called trephining.Some anthropologists theorize that the holes may
have been drilled into the skull as a means of releasing evil spirits that were
trapped inside the head causing abnormal behavior.Other anthropologists
believe that trephining was used to treat medical problems (e.g., removal of a
tumor).However, the true purpose for trephining during the Stone Age remains
unknown.Trephining continues to be practiced today among certain African
tribes for the relief of head wounds.

For an idea of how you might have been treated if you had a mental illness in
the Stone Age click here.

1800 B.C. 1700 B.C. -- CODE OF HAMMURABI

In Mesopotamia, between 1795-1750 B.C., Hammurabi, King of Babylon, issued a structured code of
laws, known as the Code of Hammurabi. The Code of Hammurabi was preserved on Cuneiform, a
system of writing developed by the Sumerians, which consisted of writing onto wet clay with a wedge
and then drying those clay tablets.This code is the first-known example an orderly body of laws created
by a ruler. The code of laws includes legal procedures for physicians in the treatment of a variety of
physical ailments such as payment for successful services rendered as well as punishment for a failed
service to his patient (e.g., loss of the physicians hands).
Mesopotamian diseases were viewed from a primarily mystical perspective and were blamed on spirits:
gods, ghosts, etc.Each spirit was believed to cause a disease in any one part of the body.Some diseases
were referred to as Hand of signifying a divine cause whereas others were simply identified by
names (e.g., bennu).
For an idea of how you might have been treated in Mesopotamia during the
1700's B.C. click here.

Hammurabi

800 B.C. --- 1000 A.D. GREEK AND ROMAN CIVILIZATION

During Greek and Roman civilizations, we see a much more scientific view of mental illness being
developed with many concordant humanitarian treatments.However, theories regarding mystical
explanations remained powerful and eventually toppled the scientific approach.
According to Homer (800 B.C.) mental illness was caused by Gods taking a mind away.In terms of
treatment during the time that Homer is reputed to have existed, Asclepius, an eminent physician,
developed several forms of treatment.Later Asclepius was revered as a God of healing and numerous
temples were created in his name. For an idea of how you may have been treated during the 800's
B.C. click here
The foundation of a systemic approach to psychological and physical
disorders is considered to have begun with the early Greek
philosophers.Hippocrates (460 377 B.C.) wrote numerous papers
describing psychological disorders such as psychosis, mania, phobias, and
paranoia.Hippocrates theorized that four humours or bodily fluids were
responsible for both physical and mental health.The four important bodily
fluids were: black bile, yellow bile, phlegm, and blood.
Hippocrates

Having too many of any of these fluids could account for changes in an individuals personality and
behavior.Hippocrates theorized that an excess of black bile would make a person "melancholic"
(depressed), and an excess of yellow bile would cause a person to be "choleric" (anxious or irritable).Too
much phlegm would result in a person being "phlegmatic" (indifferent).An excess of blood would cause a
person to be "sanguine" (experience unstable mood shifts).It is important to note that Hippocrates saw no
distinction between physical and psychological disorders.Hippocrates views dominated thinking regarding
psychological disorders for the next 500 years.In addition however, Hippocrates views were challenged by
supernatural theories and the concomitant cruel treatment of psychologically disturbed people.
To see what sort of "therapy" you might have received in Greek and Rome during 400 B.C. if you were
mentally ill click here.

The next significant in advance in the scientific approach was made in the first century B.C. by a Greek
physician living in Rome who introduced new and more humane ideas about psychological
disorders.Asclepiades (129-40 B.C.) disagreed with Hippocrates that an imbalance of bodily substances
caused psychological disorders.He believed that psychological disturbances could be the result of
emotional problems and spoke out strongly against the incarceration of the mentally ill and bleeding (a
treatment that continued for another 1500 years).Other important advances made by Aesclepiades were a
distinction between acute and chronic psychological disorders and between hallucinations and
delusions.Asclepiades also developed several original treatments including a swinging bed to relax the
emotionally disturbed patient and music therapy.
Later, Aretaeus (50-130AD), a medical philosopher in Rome determined that
manic and depressive episodes could occur in the same person with intervals
of lucidity between.Aretaeus also rejected Hippocrates ideas regarding the
four humours and believed in more humanitarian care for his patients.He also
said that not all patients with mental illness were intellectually
deficient.Therefore, we have evidence that there were some humanitarian
treatments and viewpoints during the period of the Greek and Roman
philosophers.

Unfortunately, in the years before Christ, the attitudes towards the

psychologically disturbed began to shift towards more spiritual views and
the advances of the Greek and Roman philosophers and physicians began to
decline.Aulus Cornelius Celsus (25BC-50AD), who lived in Ancient Rome
during the time of Jesus Christ believed that a sort of force should be
applied to the insane to cause a sudden fear into the spirit forcing it to flee the
body.His beliefs helped to reinforce the belief that some psychological
disorders were caused by angry gods or spirits.Celsus beliefs and writings
were later used as evidence to justify the burning of witches.His version of
treatment also corresponded to exorcism as a form of treatment, which was
often performed by a shaman, priest, or medicine man.

Many years later Claudius Galen (131-200 A.D) developed a new system of medical knowledge based on
the study of anatomy rather than on philosophical speculation.He was the first researcher to conduct
experiments on animals in order to study the workings of the internal organs.He invented the use of the

pulse for diagnosis and his books on anatomy were used until the 19th century.Galen was appointed to be
physician of the gladiators in 157 A.D. and went to Rome in 162 A.D. to become a doctor to the emperor
Marcus Aurelius.Unfortunately, Galen maintained Hippocrates beliefs in the four humours as the cause of
mental disturbance.However, Galen also suggested that a failure to control ones passions (i.e., anger)
might cause a kind of madness.

Galen's Dissection of a Pig

300 A.D. -- 1500 A.D. THE MIDDLE (DARK) AGES

Following Galen and during the Middle Ages, almost no new
scientific advances in the understanding of mental illness were
made.The Middle Ages are marked by a resurgence of beliefs
regarding spiritual causes for abnormal behavior.Individuals
with psychological disorders were blamed for their illness
because of moral weakness or for participating in forbidden
practices with the devil, sorcerers, or other demons.These
views resulted in a large stigma for having a mental
illness.There were some beliefs in physical causes among
some groups, primarily a continuation of Hippocrates theory of
the four humours and a belief in mental illness as arising from
the malfunction of the brain or its ventricles.
Very few physicians spoke out against the treatment of the
mentally ill suggesting that they be treated as sick people
deserving of humane treatment.Those few who did speak out
against the church faced professional and personal
danger.More accurate views of mental illness appear to have
been held by poets and writers who provide suggestions that
highly stressful events may result in emotional disorders that
could be treated with a psychological approach.
Ever wonder how you might have been treated during the
beginning of the Middle Ages. To get an idea click here.
Although religious thinking resulted
in a strong belief in spiritual
possession and brutal treatments for
the mentally ill, Christian views also
called for charity.Monasteries or
poorhouses, which had been built to
house people who could not pay
their expenses, were built all over
Europe and allowed the mentally ill
shelter.Early in the conception of the
monasteries, patients were treated

with concern and were even issued

arm badges so that they could be
returned if their symptoms
worsened.These poorhouses later
became known as asylums with the
most famous being
the Hospital of St. Mary of Bethlehem in London.The hospital
was originally created in 1247 for poor people, and by 1403
began to house people called lunatics.In the next few
centuries, the inhumane and chaotic housing of the
psychologically disturbed came to be known as bedlam, a
derivative of the hospitals name.The hospital quickly became
overcrowded and the residents more uncontrollable and the
hospital employed chains and punishment to control
patients.Similar conditions were found at other asylums as they
became overcrowded.

A Female Ward in 1860

Click here to read a description of

your treatment at the "bedlam"
Witchhunts began at the beginning
of the Renaissance and were at their
height in the 14thand 15 centuries in
Europe.They became more
widespread in America later, as
evidenced by the Salem witch trials
in 1692.Some historians believe that
many psychologically ill were called
witches.Witchhunts were justified by
the publication of the Malleus
Malifacarum (The Witchs Hammer),
an indictment of witches written by
two Dominican monks in Germany in
1486.The book denounced witches
as heretics and devils who must be
destroyed in the interest of
preserving Christianity.It consisted of
three main sections: 1) arguments in

support of the existence of witches

and witchcraft and that by doubting
their existence was to be a heretic;
2) a description of how witches could
be identified; and 3) treatment for
witches which was deportation,
torture, and burning at the
stake.Women, particularly poor, old
women, as well as midwives, were
the main targets of persecution and
many historians argue that the
mentally ill were not particularly
targeted. Click here if you want to
know what kind of "treatment" you
may receive during the 14th and
15th century if you were mentally ill.
During the 16th century, while
mystical beliefs predominated causal
explanations for mental illness, there
were some voices of reason starting
to be heard.Jahann Weyer (15151588) wrote a book in 1563
called De Praestigiis
Daemonum(The Deception of
Demons) which attempted to
discredit beliefs in demon
possession causing abnormal
behavior.He did not disagree entirely
with the concept of demonic
possession, but argued that natural
causes may result in abnormal
behavior.He also considered druginduced symptoms of psychosis
(e.g., hallucinations) and ultimately
formed the basis for later
humanitarian approaches for the
treatment of individuals who were
mentally ill.Weyer was also severely
ridiculed for his beliefs by religious
and political leaders and was
accused of being a sorcerer.

17TH, 18TH, AND 19TH CENTURY

During the 17th, 18th and early 19th centuries, people with mental
illness continued to suffer from poor treatment. Most were left to
wander in the wilderness while some were committed to
institutions. Either way, it was not a good situation as conditions
in asylums remained terrible.

In 1766, Franz Anton Mesmer (17341815) received a doctorate in

medicine from the University of
Vienna. He hardly practiced
medicine, and instead focused on
the fascinating invisible forces
(gravity, magnetism) proposed by Sir
Isaac Newton. Mesmer believed that
hysterical states (anesthesia,
paralyses, blindness, deafness)
were caused by an imbalance of a
universal magnetic fluid in the body.
He treated patients using various
types of magnetic objects. Also, he
felt his body was, like a magnet,
capable of communicating with the
magnetic fluid, which would bring
Mesmer using his soabout changes in the behavior of the called
subject. While his contemporaries
magnetic influence on
thought of Mesmer as a quack, he a
did help many people overcome
subject.
their hysteria. Though he believed
the illnesses to be purely physical,
he is generally considered one of the
early practitioners of hypnotism. If
you are curious about what it
might have been like to be a patient
of Mesmers,click here.
As the general publics awareness of the awful conditions in
asylums such as Bedlam grew, improvements began to appear.
In 1789 Vincenzo Chiarugi (1759-1820) introduced regulations
at his mental hospital in Florence, Italy that increased standards
for hygiene, recreation, and work opportunities. At nearly the
same time, Jean-Baptiste Pussin, superintendent of "incurable"
mental patients at La Bicetre hospital in Paris, France forbade
staff to beat patients and released them from shackles. Philippe
Pinel(1745-1826) continued these reforms upon becoming chief
physician at La Bicetres ward for the mentally ill in 1793. Pinel
is considered historically to be a primary figure in the movement
for humanitarianism. However, he is credited for much of the
work that Pussin did before he arrived at La Bicerte.
Nonetheless, he emphasized keeping case histories of patients
and developed the concept of "moral treatment", which involved
treating patients with kindness and sensitivity. Pinel removed
the chains of the people imprisoned at La Bicetre (symbolically
celebrated in the painting) and he argued that they must be
treated as sick human beings rather than evil beasts. Many
patients who had been incarcerated for years were restored to
health and eventually discharged from the hospital.

Pinel symbolically frees the ill from their shackles.

Following the lead and success of Pinel, a Quaker William Tuke (1732-1822) established the York Retreat
House in rural England. The retreat enabled people with mental illness to rest peacefully, talk about their
problems, and work.
Meanwhile in the United States in 1769, Benjamin
Rush (1745-1813) was appointed professor of chemistry
and medicine at the college of Philadelphia. Rush is
considered the father of American psychiatry as he
instituted a more scientific approach, and made many
changes that improved the conditions for the mentally ill.
The fact that he was a founding father, politician, and
signed the Declaration of Independence gave him the
power to institute reform. He put into action plans for
better ventilation, separation from violent and nonviolent patients, and arranged recreation and exercise
programs for the sick. However, his methods of
treatment were still inhumane and ineffective. He
believed bloodletting, purging, and terrifying were
beneficial. For more information on what it might be like
Benjamin Rush
to be treated by Rush, click here. Benjamin
Rushs Medical Inquiries and Observations upon
Diseases of the Mind (1812) was the first work on
psychiatry published in the United States.
Between 1817 and 1828, following the examples of Pinel and Tuke, many institutions opened that
devoted themselves exclusively to the treatment of the mentally ill. The first private mental hospital
opened in the United States was the Asylum for the Relief of Persons Deprived of the Use of Their
Reason in 1817 in what is now Philadelphia.
Even though there was great emphasis on moral treatment in the 19 th century, drugs were also used quite
often. While claiming to be moral, the chains were exchanged for powerful sedatives to control the
aggressive patient. The most common drugs used were alcohol, cannabis, opium, and chloral hydrate.
These treatments were not very successful as less than a third of the patients improved.

Moral treatment had nearly been abandoned and

circumstances for most of the mentally ill in the
United Sates, especially the poor, remained
dreadful. In 1841, Dorthea Dix (1802-1877), a
Boston schoolteacher, began a campaign to make
the public aware of the plight of the mentally ill
people. By 1880, she was successful in seeing that
32 psychiatric hospitals for the poor had opened
Dorthea Dix
However, the staff of these public hospitals were taking in so many patients that couldnt get into the
private institutions, they were unable to provide the individual attention that was such a big part of moral
treatment. More and more, these asylums were taken over by physicians who were more interested in
experimenting with biological aspects of mental illness, rather than psychological well being and patient
care.
Jean Martin Charcot (1825-1893) was an established neurologist who brought respectability to the study
of hypnosis. Born in Paris, where he spent most of his life, he studied at a hospital that Pinel had
converted from a prison. Charcot saw a connection between hypnosis and hysteria and argued that only
patients with hysteria could be hypnotized. He went on to become a great clinician and a renowned
teacher. Writers, philosophers, and even famous actors attended lectures. Sigmund Freud attended
lectures on a grant for four months in 1885-1886. Charcot believed in brain localization as he related
clinical symptoms to brain autopsies and developed the clinical anatomical method.

Jean Marin Charcot

Charcot lectures on hypnotic states.

Emil Kraepelin (1856-1926) brought much needed

order to the classification of mental disorders
focusing on the biological aspects of mental illness.
This approach resulted in closer alignment of
psychiatry with medicine because many categories
of mental illness were treated in disease terms. Two
major groups Kraepelin focused on was dementia
praecox (schizophrenia) and manic-depressive
psychosis. He believed a chemical imbalance
caused schizophrenia and a metabolism irregularity
caused manic-depression. Kraepelins classification
ideas laid the groundwork for todays classification
system

Emil Kraepelin

In the united Kingdom in 1882, the Statistical Committee of the Royal Medico-psychological Association

came up with a classification scheme that was revised many times but never adopted by its members. In
Paris in 1889, the Congress of Mental Science adopted a classification system, but it was never actually
used. Finally in the United States, the Association of Medical Superintendents of American Institutions for
the Insane, which later became known as the American Psychiatric Association, adopted an idea similar
to the British system. This system incorporated many of Emil Kraepelins ideas.
Sigmund Freud (1856-1939) began using
psychoanalysis as a treatment for mental illness and
developed a theory of mind that emphasized
unconscious motivation. His concepts of
development, personality, and structure of the mind
were not new, but he assembled them and
reassembled them in new and innovative ways. For
more detailed information about Sigmund Freud's
Sigmund Freud
life and theories click here. For information on being
a patient of Freudsclick here
Clifford Whittingham Beers (1876-1943), a Yale
graduate, suffered a mental breakdown and was
confined to an asylum from 1900-1903. After his
recovery, he aroused new concern for mentally ill
individuals when he published a study of his
experience titled A Mind That Found Itself (1908).
Beers was responsible for founding the National
Committee for Mental Hygiene, which worked to
prevent mental illness and ensure humane
treatment.

C.W. Beers

Historical Perspectives on Abnormal Behavior

Ancient societies attributed abnormal behavior to divine or supernatural
forces. Prehistoric peoples may have practiced trephining as a form of
treatment, although recent evidence suggests that this practice may represent
an ancient form of surgery. In ancient Greece, people who behaved
abnormally were sometimes sent to special temples where divine intervention
was sought to effect a cure. In medieval times, belief in possession held
sway, and exorcists were used to rid people who behaved abnormally of the
evil spirits that were believed to possess them. There were some authorities
in ancient times, like the Greek physician Hippocrates, who believed that
abnormal behavior reflected natural causes, specifically imbalances in bodily
fluids or humors. Different concentrations of these humors resulted in
different types of abnormal behavior. Galen, a Greek physician who attended
the Roman emperor Marcus Aurelius, adopted Hippocrates' teachings and is
credited with discovering that arteries carried blood, not air,, as was formerly
believed. Johann Weyer, a Belgian physician during the period of the
Renaissance, took up the cause of Hippocrates and Galen by arguing that
abnormal behavior and thought patterns were caused by physical problems.
The 19th century German physician Wilhelm Griesinger argued that
abnormal behavior was caused by diseases of the brain. He along with

another German physician who followed him, Emil Kraepelin, were influential
in the development of the modern medical model. Which likens abnormal
behavior patterns to physical illnesses. Kraepelin's categorization of mental
disorders set the stage for the development of modem systems of
classification.
Asylums, or "madhouses," began to crop up throughout Europe in the late
15th and early 16th centuries, often on the site of former leprosariums.
Conditions in these asylums were dreadful and in some, such as the
Bethlehem Hospital in England, a circus atmosphere prevailed. With the rise
of moral therapy in the 19th century, largely spearheaded by the Frenchmen
Jean-Baptiste Pussin and Phillipe Pinel, conditions in mental hospitals
improved. Proponents of moral therapy believed that mental patients could be
restored to functioning if they were treated with dignity and understanding.
The cause of humane treatment was advanced in the United States by such
figures as Dr. Benjamin Rush, the "father of American psychiatry," and the
schoolteacher Dorothea Dix. But Rush also used certain harsh treatments
that are now discredited, such as purging and ice-cold baths. Dix, who
traveled widely throughout the United States advocating more humane
treatment for people with mental disorders, was credited with the
establishment of some 32 mental hospitals across the country. The decline of
moral therapy in the latter part of the 19th century led to a period of apathy
and to the belief that the "insane" could not be successfully treated.
Conditions in mental hospitals deteriorated, and they offered little more than
custodial care.
Not until the middle of the 20th century did public outrage and concern
about the plight of mental patients mobilize legislative efforts toward the
development of community mental health centers as alternatives to long-term
hospitalization. This movement toward deinstitutionalization was spurred by
the introduction of psychoactive drugs called phenothiazines, which curbed
the more flagrant features of schizophrenia.
Abnormal behavior may be viewed from various contemporary
perspectives. The medical model conceptualizes abnormal behavior patterns
like physical diseases, in terms of clusters of symptoms, called syndromes,
which have distinctive causes that are presumed to be biological in nature.
Biological perspectives incorporate the medical model but refer more broadly
to approaches that relate abnormal behavior to biological processes and apply
biologically based treatments. Psychodynamic perspectives reflect the views
of Freud and his followers, who believed that abnormal behavior stemmed

from psychological causes involving underlying psychic forces. After

abandoning hypnosis as a form of treatment, Freud developed psychoanalysis
as a means of uncovering the unconscious conflicts dating back to childhood
that he believed were at the root of mental disorders such as hysteria. Also
arising in the early 20th century were learning perspectives that flowered from
the work of physiologist Ivan Pavlov and the work of behaviorists like John
Watson and B. F. Skinner. Learning theorists posit that the principles of
learning can be used to explain both abnormal and normal behavior. Behavior
therapy is an outgrowth of the learning model. Humanistic-existential
perspectives reject the determinism of psychodynamic theory and
behaviorism. Humanistic and existential theorists believe that it is important to
understand the obstacles that people encounter as they strive toward selfactualization and authenticity. Cognitive theorists focus on the role of
distorted and self-defeating thinking in explaining abnormal behavior. Some
adopt an information-processing model to explain abnormal behavior.
Sociocultural theorists believe that abnormal behavior is rooted in social ills,
such as poverty, not in the individual. Eclectic models attempt to integrate the
contributions of various models.