PSYC 4039 week 2
PSYC 4039 week 2 PSYC 4039
Popular in MADNESS AND MEDICINE
Popular in Psychology (PSYC)
This 9 page Class Notes was uploaded by Lindsey Notetaker on Thursday September 1, 2016. The Class Notes belongs to PSYC 4039 at Louisiana State University taught by A. Baumeister in Fall 2016. Since its upload, it has received 77 views. For similar materials see MADNESS AND MEDICINE in Psychology (PSYC) at Louisiana State University.
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Date Created: 09/01/16
CONSTRUCTION OF REALITY Foucault’s Social Construction of reality o Truth I relative to culture and time o There is no absolute truth—something that is true to one culture, may not be for another o All knowledge is uncertain o Both truth and morality are culturally defined and relative o We have no objective knowledge of the external world The new historicism/ postmodernism o Implications No distinction between fact and fiction Foucault believed mentally illness was not real. He believed all of the mentally ill were put on a ship and sailed around, got off at ports and then got back on the boat. No distinction between history and literature o Such views are most prevalent in: Literary criticism History Cultural studies Linguistics Social science Thomas Kuhn- the structure of scientific revolutions o Normal science Paradigm driven (set of beliefs that all scientists working on a given problem accept as true) Defines fundamental nature of the thing studied Example: mental illness is caused by the disturbance of brain chemistry Defines questions that are legitimate to ask Example: asking about levels of neurotransmitters in the brain Defines methods Aimed at confirming and extending paradigm Contrary to the belief that scientists are looking to disprove the paradigm Cumulative growth of knowledge Continuity of knowledge and concepts Saying you are depressed because you had a bad mother is not consistent. Saying you are depressed because there isn’t enough serotonin in your brain is consistent Troublesome anomalies and ignored or explained away Scientists discover things that don’t fit with the paradigm (anomalies). Scientists either ignore the finding- assuming it is wrong, or they develop a theory around the finding working backwards when it comes to explaining anomalies. This isn’t how it is supposed to work o The belief system of scientists shapes how they do their research o Scientific revolution Paradigm shift Discontinuous growth of knowledge HISTORY OF PSCYHIATRIC NOSOLOGY (CLASSIFICATION) First solid evidence of mental illness o The ancients: Melancholia Depression Phrenitis Brain fever- probably refers to delirium which is associated with a very high fever Hysteria Plays a big role in the development of Freudian psychology A person has physical symptoms and a lot of emotionality, but the psychical symptoms have no biological bases Example: going blind after experiencing something horrible Mania (madness, etc.) Different than how we define it today—a person has racing thoughts, they’re agitated, psychotic, today it has a specific clinical meaning It used to be a general term for severe mental illness Melancholia and mania have been the 2 main bases of mental illness for years o We call severe mental illness, EXCLUDING mania, psychosis Von Feuchtersleben coined the term psychosis in 1845 Disturbance of mind involving Passions: uncontrollable emotions Judgement can be very poor Hallucinations: sensory experience in the absence of sensory output o Main one is auditory Delusions: fixed false belief o Most common form of delusion is the delusion of persecution- the belief that people are out to get you th Term comes into general use in early 20 century Organic vs functional psychoses Organic: o Demonstrable neuropathology (“organicity”) Definitive biologic cause for psychosis Example: syphilis- GPI (general paresis of the insane) Other psychotic disorders didn’t have paralysis as a symptom Toxins Example: alcohol, mercury, lead, drugs Neurological diseases Example: epilepsy, Alzheimer’s, tumors, head injury Metabolic disorders Examples: Pellagra (mental disorder caused by vitamin deficiency), hyperthyroidism, PKU th In the 20 century organic psychoses become the domain of neurology Functional: o There is something wrong with the way the brain functions No demonstrable underlying pathology o Oragnicity presumed, but not demonstrable o Schizophrenia (classic form of psychoses), manic-depressive (bipolar) disorder main functional psychoses Still don’t know to this day what causes these o Historically functional psychoses were the “bread and buther” of psychiatry o In the 19 century many non-psychotic functional disorders were “discovered”, greatly expanding the domain of psychiatry and psychology o Current classification Everywhere except the US relies on the International Classification of Disease (ICD) US psychiatry’s formal classification book is called the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) Approximately 200 categories of mental disorders Diagnosis is based on occurrence of a subset of symptoms Diagnosis is “syndrome” based. A syndrome is a collection of symptoms. DSM has improved diagnostic reliability (main reason for developing the DSM) There was no standardization of the symptoms that characterized the different disorders before the DSM Validity of diagnostic categories is questionable Distinction between organic and functional disorders still widely used PHILOSOPHY OF MADNESS Mental disorders are disorders of the mind Ontology: branch of philosophy that deals with being as such. What is the nature of being? Most problems that patients present to psychologists and psychiatrists are first person sunjective experiences o Disurbances of though o Disturbances of perception o Disturbances of emotion Mind- body problem o Body Material Has mass and form Has location in time and space Is about nothing o Mind Not material Has no mass or form Has no location in space, may or may not be temporarily limited Mental activity (consciousness) is about something 2 bed-rock theories of mind o Dualism Mind and body are fundamentally different substances; they are both real, but irreducibly distinct Popularized by Rene Descartes Proposed two-way interactionism Mind influences body Body influences mind Strict dualism excludes the mental from science o Monism Mind and matter are not fundamentally different; they can be unified; one can be reduced to the other Idealism, it’s all mind, no matter George Berkely- “to be is to be perceived” o If everyone leaves the classroom except for you, you do not exist because no one perceives you. o Everyone and everything is held into existence by the existence of God Materialism, it’s all matter, no mind; all mental activity is strictly dependent on physical activity of the brain Materialistic monism Most widely accepted theory of mind by scientists Identity theory o Mental events= physical events in the brain o Relation between mind and brain is like water = H2O; water is nothing but H2O, water and H2O are synonyms Logical behavioral o Mental states are behavioral dispositions o All that need to be said about a mental state is a description of behavior that allows observers to infer mental state in another Example: thirst is nothing more than the tendency to drink when given water Materialism implies reductionism and determinism o Reductionism A philosophical position that hold that a complex phenomenon is nothing more than the sum of its part Higher phenomena (like consciousness) are wholly explained by (can be reduced to) the properties of lower order phenomena (brain cell activity) o Determinism Every event (even mental) has a physical cause The present is the effect of the past and he cause of the future If you had “God-like” knowledge (of everything), according to determinism, you could predict the future with absolute certainty Antithesis of reductionism and determinism o Emergence When simple things combine to create a more complex phenomenon new laws and concepts “emerge” that are necessary for understanding the more complex phenomenon The whole is more than the sum of its parts The whole cannot be explained by reductions o Freedom or free-will The future is indeterminate and probalistic Humans can choose what they think and doo Humans have “free-will” Information as a unifying concept o Information is the basis of life ad according to some theorists the universe is information o The brain is an information processing device; that is, it is a biological computer; it is a biologic substrate for information processing o Consciousness thought to be an epiphenomenon of brain cell activity Epiphenomenon: o The epiphenomenon may or may not be reducible, it may or may not be causal Information processing and the etiology (cause) of madness o Mental disorders are disorders of information processing o 2 possible loci of defects in information processing Hardware (brain) Software o 2 possible causes of hardware and software problems Genetic (inborn, the “nature” in nature vs nurture) Defective genes can cause brain pathology that leads to mental illness Can defective genes cause a defect of software that leads to mental illness? Probably; blank slate is a myth. We are born with certain computational processes that are necessary to make sense of the external world. Language acquisition- for a child, it is almost effortless to absorb a language- it is as though a genetically engineered program kicks into place that allows language to develop. After a certain age it becomes very difficult to learn a language. “The theory of mind”- the idea that we believe that other people have minds. Whenever we interact with other people, we are trying to figure out what is going on in their mind; to do this, we first have to believe that everyone has a mind. o “As Nature Made Him”- book about how a boy was raised as a girl. They gave him hormone treatments, sent him to dance class, psychologists worked with him to help him identify himself as a girl. From the beginning it was very clear that it wasn’t working. Didn’t like playing with dolls, preferred to play with trucks. When it came to use the bathroom, the boy who was raised as a girl, refused to sit down to pee, he/she wanted to stand. They did an operation on him along with hormones to make the genitals as female as possible. He is extremely unhappy and ends up killing himself. Bottom line: your brain and genes make up who you are. Experiential (environment or nurture) o Experience can alter physical aspects of brain that leads to mental illness (ex: isolation rearing) o Experience also definitely affects the processing and content of information in the brain leading to mental illness (ex: PTSD) Nature vs nurture is a false dichotomy- both can mess up the software or hardware of a person Heuristic value of information processing: approach to treatment of mental illness o There are 2 fundamental types of causes of mental illness: defective software and defective hardware o There are 2 fundamental approaches to treating mental illness: Correct the defect in the software of the brain: Psychotherapy Counseling Education Behavior modification Correct the defect in the hardware: Drugs Psychosurgery Coma and convulsive therapies MADNESS FROM PREHISTORY TO THE ENLIGHTENMENT Historical periods o Prehistory: from evolution of modern humans to the invention of writing o Antiquity: 8thcentury BC to 5 thAD century. Writing an history begins in this thme pethod o Middle ages- 5 to 15 centuries o Renaissance- 15 to 17 centuries o Enlightenment- 17 to 18 centuries o Modern era- 18 to 20 centuries Mental illness in prehistory o We don’t know much since nothing was written down. o Fairly safe assumption to believe that mental illness existed in this time period o The only hard evidence we have of mental illness is many instances when skulls have neatly cut-out parts of the skull- believed to be an early attempt to cure mental illness. The most common explanation for this: people would open up the skull of a mentally ill person to release the demon Early antiquity o Babylonians Idta, demon of insanity?? Might be made up Code of Hammurabi contained record of beginning of “systematized” medicine. Described many diseases (epilepsy), introduced study of life history, emphasized hygiene and medical ethics. Medicine was magical, religious, animistic, and astrological o Egyptians Imhotep, god of medicine Brain seat of mental function Hysteria- though to be due to a misplaced uterus, fumigation of vagina. Primarily religious and magical but had drawn modern aspects (ex: dance, concerts, drawing). Describes the brain as seat of mental function o Hebrews One God is the source of health and disease Mental illness is a punishment by God Influenced by Babylonians and Egyptians. No medical text, relied on the Talmud (Jewish Law). Psychologically sophisticated. Thought the heart was the seat of intellect and emotion Insanity caused by demon possession o Greeks Adopted supernatural perspective Homer- Odysseus plows field and sows with salt to feign insanity God of medicine: Asclepius If you had a mental illness, you would go to a temple. Priests were appealing to a god to cure your mental illness o Central theme: supernaturalism The advent of “modern” medicine in the Hellenistic period, roughly (323 BC-30 BC) o Hippocrates- the father of medicine Emphasized naturalism and observation (empiricism) Naturalism- focuses on the natural world being the cause as opposed to the supernatural world Move away from supernaturalism to explain disease Hippocratic Corpus 26 treatises More than 50 subjects- everything from infectious diseases to the treatment of hemorrhoids Written by various physicians None of these early writing dealt with mental illness but in the course of describing these other diseases there are descriptions that sound like mental disorders Hippocratic theory- often referred to as the humoral theory Thought mental disorders were due to disturbance in body fluid o Blood, phlegm, black bile, and yellow bile Examples of causes of illness: o Eat wrong portion of hot or dry food o Wrong exposure to elements (ex: too much hot or dry wind) o Loss of fluid (ex: the menstruation or masturbation) Treatment- reestablish balance through bleeding, enemas, etc. “proto-psychology” theory of personality (or temperament) o Phlegmatic: relaxed, peaceful, lethargic o Choleric: short-tempered, irritable o Sanguine: optimistic, social cheerful o Melancholic: analytical, quiet, sad “on the sacred disease” o The sacred disease is believed to be epilepsy. o People with severe epilepsy found themselves in mental hospital people used to think it was a mental disorder “it appears to me to be nowise more divine nor more sacred than other diseases” “from nothing else but the brain come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentation…And by this same organ we become mad” This is the first explicit biologic explanation for why we become mad Ancient treatments for mental illness Opium Purges the gastrointestinal tract- gives the person diarrhea and makes them throw up Bleeding Cupping Poultice “first, do no harm” – “the golden rule of medicine” o Relaxation o Diet o Entertainment
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