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This 48 page Class Notes was uploaded by Lauren Gray on Wednesday April 27, 2016. The Class Notes belongs to 370 at University of Alabama - Tuscaloosa taught by Wyley B Shreves in Winter 2016. Since its upload, it has received 21 views. For similar materials see History and Systems in Psychlogy at University of Alabama - Tuscaloosa.
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Date Created: 04/27/16
Chapter 6 Mental Health and the Start of Clinical Psychology Outline • Historical Look on Mental Health • What changed? • Four types of Knowledge • Different causes to abnormal psychology • Types of treatment • Psychiatry vs. Psychology History of Mental Health • Up until this point we have focused on our understanding of Psychology changed over time – Focusing on the typical Pre-1800s • Prior to the 19 century very little was written or discussed about people with mental health problems • Even more materialistic thinkers drew a line at the abnormal – Curses, possession, witchcraft – It was a YOU problem Relatively rare Outline • Historical Look on Mental Health • What changed? • Four types of Knowledge • Different causes to abnormal psychology • Types of treatment • Psychiatry vs. Psychology What changed? • Why do we see a continuous spike in attention to mental health in the 1800s? • One word: cities • Urbanization from industrialization created a threefold problem – Sex, drugs, and alienation What did they do before then? • In an agrarian society family took care of members with mental health problems – “Out of sight…” • Alternatively left to fend for themselves – Not be able to survive – Would inevitable commit some form of crime • Purely legal problem Sex! • As populations grew more dense the rate of STDs rose as well • Top issue was syphilis – Neurosyphilis • Infection eats the spinal cord and even the brain Drugs! • Chemicals we consider illicit narcotics today were readily available – Prescription & over the counter • Heroin, Cocaine, and Opium were thought to help dozens of different maladies or just to “relax” • Withdrawal, Abuse, Tolerance – Physical symptoms Stress Alienation… • The rise of cities brought about a never before seen problem: • Alienation: Devastating pressure of city – Lack of identity, endless “rat race” • Reaction in the literature – Karl Marx to Mark Twain Outline • Historical Look on Mental Health • What changed? • Four types of Knowledge • Different causes to abnormal psychology • Types of treatment • Psychiatry vs. Psychology Folk • Mental problems have had a long history of being negatively portrayed • Rare folk remedies – Plants or herbs • Mental deficiencies and crime were often seen as one in the same Folk • Often mental health problems were considered a moral problem • Overtime mental problems were de-mystified – The “forbidden” seen as normal • Sex • Slowly, even now, people began to see mental health in terms of a medical condition Idealogical • Religious doctrine often placed very negative prescription on the mentally unsound • If you deviated from the norm – Good, righteous and moral • This highly reinforced folk beliefs that did not want any part in helping the “afflicted” Legal • As industrialized nations influenced citizens social lives more and more we see governments ever increasingly involved with mental health – Education • Separating and improving education Legal • What you see if a very slow reactionary path – Governments did not know what to do • Heck, no one knew what to do! • Punishment – Interact after a crime has been committed • Isolation – Asylums and Sterilization • Treatment – Medications and therapy • Integration and Prevention – Social programs and early intervention Scientific • Researchers developed categorical sets detailing the symptoms of mental health disorders – History of empirical data – No one could agree on a standard! Empirical data? • As we learned more about the brain we had an extensive past to look into – Madness (insanity, lunacy) • Withdrawn – “low” – Lack of movement or speech • Overactive – “hyper” – Hallucinations, delusions of grandeur • Very valuable later in how we look at schizophrenia – Not very helpful if you are blacksmith in the 1700s Nothing is Standardized • Each physician who studied mental health problems devised their own classifications based on who they saw and how they interpreted it Neurosis vs. Hysteria • Neurosis: overwhelming anxiety and avoidant behavior • Hysteria: Psychological and physical complaints without a clear cause • How do you classify someone who has panic attacks in public? Awareness does not equal progress • Many well known disorders today can trace their identification back hundreds if not thousands of years • Mood disorders – MDD • Eating disorders – Anorexia nervosa and bulimia • Substance abuse – Physical results of long term alcohol abuse • Having a name did not improve treatment Why is it so difficult? • Physical ailments are, comparatively, infinitely easier to identify and distinguish • How do you fix a broken bone? • Treat infections? Outline • Historical Look on Mental Health • What changed? • Four types of Knowledge • Different causes to abnormal psychology • Types of treatment • Psychiatry vs. Psychology Different Causes • Over time different researchers have focused on different elements to explain mental disorders – Brain – Nervous System – Heredity – Society Brain • By the 19 century it is commonly accepted that the brain is the root of all mental functioning – If there is a problem go to the source! • Clinical-pathological modal – Any mental deficiency should have a physical counterpart Localization of Function • Phineas Gauge – Brain & Personality • Broca – “Third frontal convolution of the frontal cortex” • Wernicke – Strokes could lead to certain aphasia What’s the issue? • The brain does not rely on independently functioning parts • We need everything working – Consciousness • Reductionists: Took a complex system and tried to explain in with a simplified system Nervous System • Other researchers determined it must be the brains inability to properly communicate with the body • “Check the lines!” • Relaxation therapies became the rage – Let the nerves get back in their proper state Relaxation Therapy • The “spa” becomes fashionable – Conjunction with the beginnings of “vacations” • You do sometimes see positive results – Alienation = stress – Subjective well-being is an important piece in mental health • Taking a severe bi-polar individual to a hot spring? Hereditary • In trying to look at more preventable methods, others turned to looking into family history • Degeneration: Generational reduction in physical and mental attributes – Strong evidence to support these theories Social-Hygiene • Just like you would amputate a gangrenous limb, we must remove the mentally incapable from procreating – Eugenics without the positives Social Causes • As social progressivism became bigger, a greater focus on societal problems was undertaken • People only suffer from mental health problems when placed in extraordinary circumstances Who was right? • All of these approaches held some form of truth that we use today • “Antithesis Stress modal” – Genetic predisposition + a stressful life event • We can see the results – Neurotransmitters Outline • Historical Look on Mental Health • What changed? • Four types of Knowledge • Different causes to abnormal psychology • Types of treatment • Psychiatry vs. Psychology Types of Treatment • Various historical approaches have tried to “fix” people with mental health problems – Early treatments • Experimental • Moral • Mental “Experimental” • I mean this is a negative term and not in an empirical sense • Medical doctors were allowed to try whatever they thought would work • “Cleanliness” – Cold baths • Purging – Laxatives or bloodletting • Indiscriminate drugs – Heroin to “calm you down” Moral • The main proponents of Moral treatments were in reaction to the neglect found in most asylums – Calls for human treatments • Dorothea Dix – Separation of the severely handicapped • Vincenzo Chiarugi Moral Therapy • Others came from a theoretical position: Mental illness as the result of a serious misfortune – Believed society played the biggest role in mental health disorders • By experiencing compassion and trust and learning basic life skills patients could overcome their problems Mental Therapies • Perhaps the most used and most influential is “talk therapy” • The relationship between patient and therapist was paramount – Find was the root cause was and work with the patient to overcome that cause • Introspective Mental Therapies • Often, the therapies were much more fanciful • Mesmer thought that hypnotism would remove “blocks” to positive mental energies • “Hypnology” thought that by placing the patient in a state of rest where – More open to suggestion – Transfer energy from the therapist Who has had the longest impact? • Empirical – We no know that certain drugs greatly help with certain disorders • Lithium and the manic symptoms of bi-polar disorder • Moral – “Unconditional positive regard” in a therapy environment • Mental – Talk therapy is a cornerstone of modern clinical treatments Outline • Historical Look on Mental Health • What changed? • Four types of Knowledge • Different causes to abnormal psychology • Types of treatment • Psychiatry vs. Psychology Psychiatry vs. Psychology • As we have seen, Psychology had a long, hard road in finding its place in the scientific community and differentiating itself as its own discipline – Experimental Psychology • Clinical Psychology had an even tougher road Why did clinicians have it so hard? • Physicians (medical community) thought it was their sole place to diagnose and treat mental health problems – Psychiatrists • Legal climate supported this argument – Licensing Boards – Created to protect society – Served as an excluding barrier Lightner Whitmer • Responsible for creating the field of Clinical Psychology • Studied under Wundt • Personified a growing argument from Psychologists – Psychologists were now the ones chiding another field Lightner Whitmer • Worked with children – Speech delay – Learning problems – Hyperactive – Motor problems • Used the scientific method to test and see if treatments were working – Experimental methods Whitner’s 3 rules • 1: Be free of idle speculation – Only use observable behaviors • 2: Cause not harm with our methods – Emotional, Psychological, or Physical • 3: Work closely with other professionals – Medical, Teachers, Parents, & Community Other accomplishments • Whitner was the first to describe – Autistic behaviors – Dyslexia • He created a new way for Psychologists to work by tying looking at mental health issues with the University system
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