Class 6 - Clinical psychology - History of Psychopathology Flashcards
(146 cards)
1
Q
Ancient Psychopathology
– from here on–
A
before 1500s
2
Q
How did ancient SOCIETIES (social factor) interpret/attribute mental illness to?
and
What did its treatments include?
A
Many ancient societies attributed mental illness to supernatural causes, such as:
- Demonic possession
- Spiritual imbalance.
Treatments included trephination (drilling holes in the skull), exorcisms, and appeasement of spirits.
3
Q
What happed in Ancient psychopathology era?
A
- Trephination
- Animism
- Religious cultures began to incorporate a specific “demon” into the practice. E.g., Siddhartha Gautama
- Ramayana
- Ayurveda Indian medicine - hollistic approach
- Traditional chinese medicine - hollistic approach, Hippocrates
- Pre-islamic
-
Islamic Medicine
- Abbasid leaders
- Bimaristan
- Islamic psychology
- Al-Rhazi
- Ibn-Sina
- Al-Balkhi
4
Q
Memoroze this word:
Trephination
A
Trephination
5
Q
Which process dated back over 8000 years?
A
Trephination
6
Q
What is Trephination?
A
A hole was drilled – in the skull, – to release demons – that caused malady (disease or disorder of mind and body).
7
Q
What else did people think/hypothesize that Trephination helped with?
A
- Migraine
- Pressure in the head
8
Q
What did one burtal site in Ancient
France found?
A
That 40 – out of 120 skulls –
had a hole in them.
9
Q
In which countries is the evidence of trephination found?
A
- America
- Africa
- Asia
- Europe
10
Q
What is Animism?
A
A belief – that everything – has a soul or spirit.
11
Q
How did people see Animism as?
A
It’s interwoven– with an appreciation of nature.
12
Q
Which cultures practised Animism?
A
- Indigenous culture
- African culture
- Shinto culture
13
Q
What role did animism play in early mental health beliefs?
A
Animism, – the belief that all things possess a spirit, – shaped early interpretations of mental illness. – When someone showed signs of mental illness People believed spirits had taken over their body, causing changes in behavior or health. people later believed that the spirits taook over people’s body to cause harm and bad luck.
14
Q
Read this:
A
People believed everything had spirits. If someone showed signs of mental illness, they thought a spirit had taken over their body. Later, people believed spirits controlled actions to cause harm or bad luck, leading to exorcisms. Over time, mental illness was seen more like depression or anxiety, but many still thought possession happened because of wrongdoing. Even then, mental illness was recognized (but not as it exists today).
15
Q
Unlike Animism, what did religious cultures began to incorporate?
A
A specific “demon” into the practice.
16
Q
In religious belief, what does “spirit” typically has?
A
- Agency
- Name
- Hierarchy
- Carries out a specific purpose
17
Q
Give an example of: In religious belief, this
“spirit” typically has agency, a name, hierarchy, and carries out a specific purpose.
A
“Mara”, the “spirit”, is a buddhist demon-like creature – that represents Temptation and Delusion, – trying to prevent – Siddhartha Gautama from achieving enlightenment.
18
Q
Did the concept of mental health existed as it does today during the Ancient psychopathology era?
A
No
19
Q
What did people believe that caused any sudden changes in behaviour or physical ailment/illness in ancient psychopathological era?
A
Demonic possession
20
Q
What was sometimes this demon given?
A
A specific name
21
Q
How the Treatment was given in ancient psychopathology era?
A
In the form of:
- Exorcism
- Appeasing the spirits
- Medicinal remedies
- Physical interventions
22
Q
Give an example of: Sometimes demons were incorporated within stories.
A
- Ramayana, – which tells the story of Rama, – who aims to save his wife, Sita, – from the demon Ravana.
- Written Roughly in 700-500 BCE.
- The period of – DEPRESSION and ANGUISH – Sita faces after her abduction.
- The story speaks – of her RELIEF and RESILIENCE – as she is eventually reunited with friends and family.
- Shows Mental illness is NOT a new phenomenon – and
was clearly documented – many thousands of years ago.
23
Q
When was The Ramayana, written?
A
Roughly in
700-500 BCE.
24
Q
What does Ramayana discusses?
A
- The period of – DEPRESSION and ANGUISH – Sita faces after her abduction.
- The story speaks – of her RELIEF and RESILIENCE – as she is eventually reunited with friends and family.
25
Is Mental illness depicted through **Ramayana** a new phenomenon
and
when was **Ramayana** documented.?
* **Mental illness** is **NOT** a **new** **phenomenon**.
* Was **clearly** **documented** -- many **1000s** of **years ago**.
26
Give 2 examples of when the Ancient psychopathology reflects stories of demons?
1. **Siddhartha** **Gautama**
2. **Ramayana**
27
Which of the 2 stories showcases that mental illness was documented many 1000s years ago:
**Siddhartha** **Gautama** or
**Ramayana**
**Ramayana**
28
Which approach did India follow to treat mind and the body?
A **hollostic** **approach** -- **Ayurveda**
29
What does **Ayurveda** address?
1. **Mental clarity**
1. **Emotional stability**
1. **Yoga**
1. **Strength**
1. **Dietary complements** to **improve lifestyle**.
30
What is **Ayurvedas** aim?
To **find balance** to **treat illness.**
31
What concept did Ayurveda use to explain imbalances?
Concept of **doshas** (**vāta**, **pitta**, **kapha**)
32
Give example -- Ayurveda used the concept of doshas (vāta, pitta, kapha) to explain imbalances.
**Imbalances** in **Pitta** -- may lead to **Jealousy** and **Irritability**, -- and **eating non-spicy foods** may **help** to **balance**.
33
How is the holistic approach rooted in human nature?
Holistic approaches emphasize **BALANCE** and **IMBALANCE** in both **Physical** and **Mental Health**, as seen in the **Three Doshas** (***Ayurveda***), -- the **Five Elements** (***Traditional Chinese Medicine***), and the **Four Humors** (***Hippocrates idea***).
34
The concept of **humors** was a system of what and in which countries was it prevalent?
* The concept of **humors** was a system of **medicine**
* **Prevalent** in ancient **Greece** and **Rome**
35
How does Traditional Chinese Medicine (TCM) relate to holistic health?
* TCM is based on the **Five Elements** (WMW-FE = ***Wood***, ***Metal***, ***Water***, ***Fire***, ***Earth***) and the idea that **imbalances** in these **elements** can lead to **illness**.
* Like **Ayurveda**, it **emphasizes** **restoring balance** through **diet**, **lifestyle**, and **herbal remedies**.
36
How were imbalances in the Humors treated?
**Lifestyle** and **dietary changes**
37
What is the key similarity between Ayurveda, TCM, and Hurmour Theory?
All **emphasize**:
* The **interconnectedness** of **mind** and **body**
* **Personal responsibility**
* **Proactive changes** in **lifestyle** to **maintain health**.
38
How did Pre-Islamic Arabic Medicine explain illness?
* **Illness** was often **attributed** to Djinn (**genies**), -- which could be **good** or **bad**.
* **Shamans** performed **healing rituals**, believing they had a **connection** -- between the **human** and **spiritual world**.
39
How did the rise of Islam shift medical perspectives?
* The **rise of Islam** -- and it’s quest for **KNOWLEDGE** and **TRANSLATION** **movement**, -- **shifted** the **ethos of Arabic culture** -- to practice **OBJECTIVE** **science**. -- This gave **rise** to the **House of Wisdom** and the **BIMARISTAN**.
* The **Abbasid leaders** heavily **promoted** -- **SCIENTIFIC** **advancement**. -- They were **open** of other **cultures** and **regularly incorporated** their **works** into their **own knowledge**. -- They placed **focus** on **mental health as part of medicine**.
40
What were Bimaristans, and how did they approach mental health?
Bimaristans were -- **hospitals** that **treated** -- both **physical** and **mental illnesses** -- using a **HOLISTIC** **approach**, -- **recognizing** the **interconnectedness** of **mind** and **body**.
41
How did Bimaristans approach mental health **treatment**?
or
Through what **treatments** did Bimaristans approach mental health?
Bimaristans used **multifaceted** treatments, including:
1. **Music therapy 🎵**
1. **Occupational therapy** (***gardening***, ***crafts***, ***cognitive activities***) 🌱🎨
1. Early forms of **counseling** to address **negative thoughts** and **promote well-being** 🧠
42
How did Islamic medicine differ from pre-Islamic healing practices?
It **shifted** -- from **supernatural explanations** -- to **scientific methods,** -- focusing on ***observation***, ***classification of mental disorders***, and ***structured treatments.***
43
How do early Islamic mental health approaches resemble today's/contemporary era's practices?
* They emphasized **personalized** **treatment**, -- **acknowledging** that **some patients** -- **respond** better to **external interventions** (e.g., ***therapy***, ***lifestyle changes***) -- rather than **medication** alone.
* Bimaristans often had -- **separate wards** for **mental health patients**, -- a clear **indication** that their **conditions** were **recognized** as **seperate**
from **physical illness**.
44
What concept/study did Islamic Psychology explore?
The **concept**/**study** of **self** (**psyche**).
45
What did Islamic Psychology-- The **concept**/**study** of **self** (**psyche**) focus on
and
What did it influence?
It **focused** on:
* **Emotions**
* **Thoughts**
* **Behaviors**.
This understanding of the psyche likely infleunced **early counseling practices.**
46
Who was Rhazes (Al-Razi)’s and What was Rhazes (Al-Razi)’s contribution to mental health?
A **physician**.
* He who **wrote** about **mental disorders** and **their treatment**.
* Also **emphasized** the **importance of Observation** and **experience in medicine**.
47
How did Ibn Sina contribute to psychology?
Ibn Sina **discussed** **mental health disorders**
in his book, **The Canon of Medicine**.
48
Why is Al-Balkhi considered a pioneer in psychology?
He is often cited as a **pioneer** in **CBT** -- with his **work** **Sustenance** of the **Body** and **Soul**, --
**recognizing** that **thoughts**, **emotions**, and **well-being influence each other**.
49
Modern Psychopathalogy
--from here on--
--from here on--
50
What happened in Modern Psychopathalogy?
1. Feudalism and Society in Europe
2. Mental illness in Feudal Europe
3. Bethlem hospital: From priory of mental institutions
4. Brthlem Hospotal Treatment: Harsh condition & Superstition
5. Bethlem & the reformation
6. Dehumanizing & Torture at Bethlem
7. Intellectual movemnets POst Black Death & their impact on Mnetal Health
8. Phillipe Pinel
9. Moral Treatment: Phillipe Pinel
10. Evolution of Moral Treatment in Mental Health Care: Key Figures & their Impact
51
Read this:
now euprope version of treating mental illness. we looked at **demon model** > then moved into **hollistic approach** that we are one with nature and to greater degree the world is going to interact back with us >**medical info age** >islamic looked int knowledge = adopting ideas into previous knowledge available > **How barbarians affected/caused feudalism?**
***now we have this period where there it was difficult to live as there was a lot of interanl and external strick going on***. problems like **food shortages, death due to war existed.** they looked someone to blame for this. peole blamed **minority groups**. same things happened here as society was fractured globally and locally. This **led to a rise in middle class**. — when people had levels of **mental illness they were seen as destabilizing the society** at first (possessed by demons).— what did **govt** do in response to this = they were **scapegoated** as they **considered mentally ill people** the cause of destabilizing the society.
52
See the meaning of:
Feudalism
Feudalism was a system in which people were given land and protection by people of higher rank, and worked and fought for them in return.
53
What key factors contributed to the **growth of feudalism in Europe**?
1. The **rise** of **warring towns** and **city-states**.
2. The **emergence** of the **middle class**.
3. A **rapid** **increase** in **population**.
| Warring meaning = conflict with each other.
54
What Zeitgeist did the following lead to:
Meanwhile in Europe, the growth of feudalism - which came with the rise of warring towns and city states, the rise of the middle class, rapid increase in population.
* A **society** of **fear**.
* A **constant** **need** for -- **order** and **control**.
55
Who held significant power and influence over people's lives, over townspeople during feudal times?
The **clergy**
56
How were **societal events** explained/seen/interpreted in feudal Europe?
Since **religion** was **law**, -- **events** were **seen** through -- a **religious lens**.
57
How did feudalism’s strict social hierarchy affect those at the bottom?
They were often **blamed** for -- **society’s tragedies**.
58
Read what **Famine** means:
Famine: a **severe and widespread scarcity of food**, -- often **leading** to **starvation** and **death**.
59
Why were unproductive individuals shunned in feudal society?
Because of **famine** and **resource shortages**, -- those **who** **could not** -- **contribute** -- were **seen** as a **burden**.
60
How were individuals with mental health problems treated in feudal Europe?
They were **scapegoated** -- as the **cause** of many **societal problems** and **often shunned.**
| scapegoat = person who is blamed for something that someone else did
61
Feudalism & Society in Europe
🔹 **Rise of Feudalism**: Warring towns, a growing middle class, and population surges created fear and a need for control.
🔹 **Religious Influence**: The clergy held power, and societal events were interpreted through a religious lens.
🔹 **Social Hierarchy**: The strict structure left little sympathy for the poor, who were often blamed for societal issues.
🔹 **Scapegoating**: During famines, unproductive individuals were shunned, and those with mental health problems were blamed for destabilizing society.
62
Why was mental illness misunderstood in feudal Europe?
Because of the **lack** of the **Scientific understanding** -- leading to **superstitious beliefs**.
63
How were visible mental health problems perceived?
They were **associated** with **demonic possession**, -- **increasing** **fear** and **chaos** in **towns**.
64
Why were mentally ill individuals seen as a threat?
**Townspeople** believed -- they **destabilized** -- the **fragile social order**.
65
Mental Illness in Feudal Europe
🔹 **Lack** of **scientific knowledge** -- led to **superstition**.
🔹 **Mental illness** -- was seen as -- **demonic possession**.
🔹 **Townspeople feared** the **mentally** **ill**, -- **believing** they **threatened** the **fragile social order.**
66
When was Bethlem founded, and what was its original purpose?
* **Founded** -- as a **priory** in **1247**.
* It **initially** **functioned** -- as a **charitable hospital** -- for the **poor** and **sick**.
67
Why did Bethlem start accepting patients with mental health conditions?
* Due to the **stigma** around **mental illness**, -- which was **attributed** -- to **supernatural** **causes**.
* **Lack** of **dedicated** **institutions** -- for the **mentally ill.**
68
Instead of sending mentally ill individuals to jail, **where** were they placed and **why**?
In **Bethlem** -- because their **existence** -- was **seen** as an **inconvenience**.
69
**What** led to an increase in mental health patients in Bethlem?
The **Growth** of **London** and **other cities** -- in the **13th** and **14th** **centuries** -- resulted in **more cases** of **mental** **illness**.
70
When did Bethlem officially become known as a hospital for the "**insane**"?
**By** the **14th century**, -- **Bethlem primarily** housed **mentally ill patients** -- and **became** **known** as **Bethlem Hospital.**
71
**In which year** did the City of London take over Bethlem’s management?
In **1403**
72
Bethlem Hospital: From Priory to Mental Institution
or
Why did Bethlem Hospital start accepting mentally ill patients?
Bethlem Hospital: From Priory to Mental Institution
🔹 **Founded in 1247** as a priory and charitable hospital for the poor and sick.
🔹 Began accepting mentally ill patients due to **stigma** and lack of alternatives.
🔹 **Growth** of cities in the **13th-14th centuries** **led** to more mental health cases.
🔹 Became known as Bethlem Hospital, primarily housing the "**insane**."
🔹 City of London took over in **1403**, ensuring its continued operation.
73
see attached picture.
74
What **societal conditions** influenced the harsh treatment of mentally ill patients at Bethlem?
1. **Food insecurity**
1. **Fear** for **safety**
1. A **belief** in **religious** and **superstitious explanations** for **mental illness**
75
Why was Bethlem often referred to as "Bedlam"?
* Due to the **harsh conditions**
* **Overcrowding**
* **Chaotic environment** within the **hospital**.
76
What were the **living conditions** like for patients at Bethlem?
1. **Patients faced limited food**
1. **No contact** with the **outside world**
1. **Overcrowding**
1. **Dirty conditions**
1. **No** **respect** given
77
How did the Bethlem Hospital treat mentall ill patients?
or
or What was the **treatment** in Bethlem Hospital for mentall ill?
1. **Long periods of restraint**
2. **Physical** **punishment** (***designed to “beat” the “craziness” out of prisoners***)
3. **Purgatives** and **emetics** (***inducing*** ***vomiting*** and ***diarrhea*** to ***balance*** the ***humors***)
4. **Non-existent medical care** (since treatments were ***based*** in ***superstition*** and ***incorrect theories*)**
5. **Exorcisms**
78
Bethlem Hospital Treatment: Harsh Conditions and Superstition
🔹 **Zeitgeist**: Food insecurity, fear for safety, and religious perspectives shaped harsh treatments.
🔹 Patients **lived** in overcrowded, dirty conditions with no outside contact or respect.
🔹 **Treatments** included restraint, physical punishment, purgatives, exorcisms, and non-existent medical care.
🔹 Bethlem was nicknamed "**Bedlam**" due to the chaotic environment and brutal treatment.
79
How did the **zeitgeist** influence **societal** & **religious** **attitudes** towards mental illness during the time of Bethlem Hospital?
**Religious** and **societal** perspectives, -- including **food insecurity** -- and **fear for safety**, -- **contributed** to **harsh** **treatment** -- and the **belief** that **mental illness** was caused by **supernatural forces**.
80
see picture
81
What happened to conditions at Bethlem after it came under the City of London's control?
* **1547**: **King Henry VIII -- granted** **control** of **Bethlem** --to the **City of London**.
* Despite the **change in control**, -- **conditions at Bethlem worsened, -- and the treatment** of **patients** -- continued to **deteriorate**.
82
How did the separation of Church and State impact mental health care?
| - SA Ques 100%
The **separation** led to the **government** -- **taking** **more** **responsibility** -- for **mental health care** as a **state-wide issue**, --- **rather** than the **church** **providing it** out of **kindness**.
83
What shift occurred in the perspective on mental illness after the Reformation?
**Religious** and **superstitious** **beliefs** -- regarding **mental illness** -- **began** to **fade**.
84
Bethlem & The Reformation
🔹 1547: King Henry VIII granted control of Bethlem to the City of London, part of the Reformation.
🔹 Bethlem became one of the five Royal Hospitals under the City's administration.
🔹 Despite the change, conditions worsened at the hospital.
🔹 Separation of Church and State shifted mental health care responsibility to the government.
****
🔹 Mental health care became a secular concern, and superstition about mental illness began to wane.
85
What **rationale** did Bethlem hospital use for treating mental illness?
The rationale was that -- **inducing physical sickness** in the **body**, -- such as ***through malarial therapy***, -- could **heal mental illness**.
86
How did the Bethlem hospital dehumanize patients in the 1670s?
* The hospital **charged** the public to **view patients**.
* **Encouraged** **them** to **provoke anger in patients**.
* Made **patients to perform for the crowd**.
* **Throw tomatoes at patients**.
87
How did the hospital justify its dehumanizing treatment of mental health patients?
The hospital **justified** -- the **treatment** -- by **claiming** that **mentally ill patients** -- **DO NOT** **feel** any **emotions** or **pain**, -- **no matter what** was **done** to **them**.
88
What new “treatments” were introduced in the 1770s at Bethlem?
1. **Rotational therapy**
1. **Cold water therapy**
1. **Whipping**
1. **Blistering**
All of which were **similar** to **torture techniques.**
89
Dehumanization and Torture at Bethlem
or
How did Bethlem Hospital dehumanize and mistreat mentally ill patients, and what rationale was used for these practices?
🔹 **Rationale**: Physical illness (e.g., malarial therapy) was believed to heal mental illness.
🔹 **1670s**: The hospital started charging the public to view patients, provoking them, and forcing them to “put on shows” and endure tomato throwing.
🔹 Patients were **dehumanized**, with the belief that they didn’t feel emotions or pain.
🔹 **New treatments** included rotational therapy, cold water therapy, whipping, and blistering, similar to torture used on war criminals.
90
What **intellectual** movements emerged after the Black Death and how did they influence views on mental health?
* The **Renaissance**
* **Humanism** (1576-1600s)
* The **Scientific Revolution** (16th-18th CE)
* The **Enlightenment** (18th CE)
These movements influenced views on mental health, **though little progress was made** during this period **in terms of treatment**.
91
What was the focus of the **Renaissance** and **Humanism** in relation to **mental health**?
* The **Renaissance** and **Humanism** -- emphasized: **Reason**, **Observation**, and **Empirical Thought**,
* But it **did NOT** lead to **significant progress** in the **treatment** or **understanding** of **mental health**.
92
What did the **Scientific Revolution** emphasize, and how did it affect **mental health**?
* The Scientific Revolution focused on: -- **Empirical Observation**, -- **Experimentation**, -- and **Technological Advances**
* But **did** **NOT** **focus** on **mental illnes**s or its **treatment**.
93
What did the **Enlightenment** emphasize, and how did it influence views on **individual rights** and **mental** **health**?
* The Enlightenment emphasized: -- **Individual Rights**, -- **Knowledge**, -- and **Challenged** **Traditional Authority**, -- laying the **groundwork** for **future shifts in perspectives**
* But it **did NOT** **directly address mental health**.
94
Intellectual Movements Post-Black Death and Their Impact on Mental Health
OR
How did intellectual movements after the Black Death, such as the Renaissance, Humanism, the Scientific Revolution, and the Enlightenment, influence the understanding and treatment of mental health?
🔹 After the Black Death, the Renaissance, Humanism, the Scientific Revolution, and the Enlightenment emerged, emphasizing reason, observation, and individual rights.
🔹 Despite these movements, little progress was made in understanding or treating mental health during this period.
95
What did Philippe Pinel suggest?
**Patients** -- would **recover** -- **if someone** -- just **cared** **about** **them**.
96
Read this:
* The **Enlightenment** shifted the **treatment** of **mental illness** by **emphasizing** **humane care** and **scientific solutions**.
* **Philosophical ideas** about **individual** **liberty** and **human emotions** challenged **supernatural views**.
* This period also saw the **rise of science** , **focusing** on **empathy** and **empirical understanding** rather than divine intervention.
97
What was the **new** **zeitgeist** that emerged for treating mental illness during the **Enlightenment**?
The new zeitgeist -- **emphasized** the **idea** -- that **if** we could **Identify** and **Understand** a **Problem**, -- **we could fix it**.
This **led** to **changes** in the **treatment of mental illness**, focusing on: H U E P C B
* **humane care**
* **empathy**
* **scientific solutions**
98
What role did Phillipe Pinel play in the development of mental health treatment during the Enlightenment?
* Phillipe Pinel **rejecting the view that mentall ill were irrational beasts**.
* He **believed** that **humane treatment would aid their recovery**.
* He **introduced** the **concept** of **Moral Treatment**.
99
What key principles did the "Moral Treatment" approach emphasize?
**H** - **U** - **E** - **P** - **B**
1. **Humane care**
1. **Understanding**
1. **Empathy**
1. **Positive environments**
1. **Belief** that **mentally ill patients** are **still human beings deserving of respect**.
100
What did Moral Treatment provide for patients?
* **Positive atmosphere**
* **Structured routines**
* **Activities** to help form **identity** and **purpose**
* **Individualized care** suited to each **patient's needs.** (islamic golden age, today = we do same things).
101
What were the classifications of mental illness in the book written by Phillipe Pinel?
**M M D I**
* **Mania**
* **Melancholia**
* **Dementia**
* **Idiocy**
102
How did the shift in mental health treatment during the Enlightenment influence the care of mentally ill patients?
The shift in treatment led to the moral treatment approach, emphasizing humane care, empathy, and positive environments. Pinel's influence encouraged seeing mentally ill patients as human beings deserving of respect and individualized care. This shift led to a focus on recovery through structured routines, engaging activities, and a positive, supportive atmosphere.
103
What was the York Retreat and how did it embody moral treatment for mental illness?
* The York Retreat was **designed** like **a family home**, located in the **countryside**.
* **Patients** could **engage** in **peaceful** **activities** like ***music***, ***writing***, ***gardening***, and ***reading***.
* The **goal** was to **create** a **calm**, **supportive environment** where patients could **build positive relationships** with **staff** and **fellow patients**.
* It implemented **moral treatment** **principles**, focusing on ***kindness***, ***respect***, and ***empathy***.
104
Who was the founder of the York Retreat and what was his background?
* The York Retreat was **founded** by a **religious Quaker** and **prominent tea merchant.**
* He was **dedicated** to **creating** an **asylum** based on **moral treatment principles**.
105
How did Dorothea Dix contribute to mental health reform in the USA?
* Dorothea Dix **visited** **American** and **European asylums** and **prisons**, **documenting** the **poor conditions**.
* She **worked** to **expose** the **abuses** in these **institutions** through **formal reports** to **state legislatures**.
* She also **spread awareness** of these issues **publicly**.
106
How did the Zeitgeist change during the era of moral treatment?
* The **Zeitgeist** **shifted** towards a more **humane** and **scientific understanding** of **mental illness**.
* The **focus** moved from **seeing patients as irrational** or **possessed** to **recognizing** them as **suffering humans** deserving of **care** and **empathy**.
* **Key figures** like **Pinel**, Tuke, and **Dix** **influenced** these changes by **promoting** the **idea** that **mental illness should be treated** with ***kindness***, ***respect***, and ***individualized care***.
107
How did the development of moral treatment in mental health care lead to significant changes in how patients were treated and the role of key figures like Pinel, Tuke, and Dix?
* **Pinel** introduced the idea that mentally ill patients were not irrational or half-human but suffering individuals. He emphasized humane treatment and moral care for recovery.
* The **York Retreat**, founded by a religious Quaker and tea merchant, embodied these ideas by creating a peaceful, family-like environment where patients could engage in constructive activities like music, writing, and gardening.
* **Dorothea Dix**, influenced by Pinel and Tuke, became a key figure in the USA. She documented the poor conditions of asylums and prisons in both America and Europe, advocating for reform through formal reports and public awareness.
* The **Zeitgeist shifted** towards ***recognizing*** mental illness as something that*** needed empathy and care, not punishment,*** and led to the widespread ***adoption of moral treatment principles across asylums***.
108
What was the **Great Confinement** (~1880–1950)?
A **period** where -- **mental illness** was **increasingly** **medicalized**, -- leading to **overcrowded** **asylums** -- and -- the **shift from moral treatment** -- to **custodial care**.
109
What **problem** arose as a result of increased mental health awareness and asylum construction?
## Footnote
* **Custodial care** is non-medical assistance with daily living activities for individuals who need help with tasks like bathing, dressing, and eating, often provided by non-medical professional
Asylums became **Overcrowded** , -- which **led** to -- a **decline** in **quality of care** --- and -- a **return to custodial care** instead of **moral treatment**.
110
How did scientific advancements influence mental health treatment during this time?
The **rise** of -- **neuroscience** -- and **behaviorism** -- led to **experimental** **treatments**, -- like **phrenology**, **malarial therapy**.
111
What role did Gottlieb Buckhardt played in **phrenology**?
He **piloted** the idea of **drilling** **holes** -- into **patients' skulls** -- to **examine** the **brain** and **attempt** -- to "**cure**" **mental** **illness**.
112
What was the unintended consequence of moral treatment reforms?
The **increased** -- **visibility** and **acceptance** of **mental illness** -- led to **more people being institutionalized**, -- **worsening** **overcrowding** and **care conditions**.
113
What was malarial therapy, and why was it used?
* A **treatment** -- where **patients** were **intentionally infected** -- with **malaria** to **induce high fevers**, -- **believed** to **cure mental illness**.
* It reflected that people were **desperate for any cure**.
114
What were the key features of the Great Confinement (1880–1950) in mental health history?
* The period saw increased **medicalization of mental illness**, -- leading to **overcrowded** **asylums** -- and a **shift** from **moral treatment** to **custodial care**.
* **Desperate** for **cures**, treatments like **malarial therapy **and early psychosurgery (like **phrenology**) emerged.
* Advances in **neuroscience** and **psychology**, influenced by **Darwin’s work,** **shaped new approaches**, but **institutions** remained **overwhelmed**, often **prioritizing** **custodial** care.
115
What was the **Goal** of **removing** the **Prefrontal Cortex** (**PFC**) in early psychiatric procedures (**phrenology**)?
| * Does anyone remember **Trephination**?
It was **intended** -- to **control** -- **mental illness symptoms**, -- though it **resulted** in severe **Cognitive** and **Emotional impairments**.
116
How did Antonio Moniz "refine" the lobotomy procedure in the 1930s?
He **drilled** **holes** -- **in the **skull** and -- used a "**Leukotome**" (like an **ice pick**) to **scramble** the **PFC**, -- winning a **Nobel Prize** for this **technique**.
117
What was Walter Freeman’s contribution to lobotomy procedures?
He invented the **Transorbital** **Lobotomy**, -- a **faster** **method** using an **ice pick** -- through the **eye socket** -- to **access** the **brain**.
118
Approximately how many lobotomies were performed in the USA?
**Around 100,000**
119
Why was the lobotomy seen as a "solution" despite its severe effects?
It **calmed** **patients**, -- **reducing** **caregiver burnout**, -- and was **considered** a more "**scientific**" way of **controlling patients** -- rather than **physical restraints**.
120
What was the impact of lobotomy procedures on mental health treatment?
* **Lobotomies** were **refined** and **aimed** to reduce **PFC** excitation but caused **severe cognitive and emotional impairments.**
* With around **100,000 performed in the USA**, the procedure **won a Nobel Prize** and was **legitimized** as a **scientific solution**.
* Because It **calmed** **patients**, -- **reducing** **caregiver burnout**, -- and was **considered** a more "**scientific**" way of **controlling patients** -- rather than **physical restraints**.
121
What was the rationale behind inducing seizures as a treatment for schizophrenia?
A few geniuses **observed** -- that **people with epilepsy** -- **did NOT develop schizophrenia**, -- **leading** them to **believe** that **inducing seizures** could **prevent** or **treat** the **disorder**.
122
What was Cardiazol therapy, and how did it work?
Cardiazol was -- a **strong GABA agonist** that -- **caused** **neurons** to **fire** **rapidly**, -- **mimicking** a **seizure** to **treat schizophrenia**.
123
How did Electroconvulsive Therapy (ECT) originate?
Inspired by **seizures** caused by **cattle prods** in **animals**, -- doctors used **electricity** to **induce** **controlled seizures** -- as a **cheaper alternative** to **Cardiazol therapy**.
124
How has ECT changed over time?
Today, ECT is **performed** **under anesthesia** -- with **low-dose electrical currents**, --- making it **much** **safer** and -- **reducing recovery time**.
125
Why were treatments like Cardiazol therapy and ECT widely used in hospitals?
**Overcrowded** **institutions** -- were **desperate** for **ways** to **Calm** **patients**, --- leading to **widespread** **use** of **seizure-inducing treatments**.
126
How did induced seizures become a treatment for schizophrenia, and how has the approach evolved?
* A few geniuses **observed** -- that **people with epilepsy** -- **did NOT develop schizophrenia**, -- **leading** them to **believe** that **inducing seizures** could **prevent** or **treat** the **disorder**.
* Cardiazol was -- a **strong GABA agonist** that -- **caused** **neurons** to **fire** **rapidly**, -- **mimicking** a **seizure** to **treat schizophrenia**.
* Inspired by **seizures** caused by **cattle prods** in **animals**, -- doctors used **electricity** to **induce** **controlled seizures** -- as a **cheaper alternative** to **Cardiazol therapy**.
* Today, ECT is **performed** **under anesthesia** -- with **low-dose electrical currents**, --- making it **much** **safer** and -- **reducing recovery time**.
* **Overcrowded** **institutions** -- were **desperate** for **ways** to **Calm** **patients**, --- leading to **widespread** **use** of **seizure-inducing treatments**.
127
Contemporary Psychopathalogy..
..from here on..
**~1950s** to **now**
128
As these “treatments” were reaching their peak, something happened that changed psychology forever....
| **Exam** Question!
**Invention** of **drugs** (***chloropromozipe: anti-psychotic drug***) happened.— **take** the **drug** and **go home**.
129
What major event changed psychology forever during the peak of early psychiatric treatments?
| **Exam** Question!
The **invention** of **chlorpromazine** (***an antipsychotic drug***) in 1954, which **allowed** **patients** to **manage mental symptoms** and be **discharged** from **institutions**.
130
What was the impact of chlorpromazine on mental health care/what did this drug lead to?
| **Exam** Question!
It led to **rapid deinstitutionalization**, -- as **patients** -- **could** **take** **medication** and **go home**, -- significantly **reducing** **asylum populations**.
131
What was the Community Mental Health Act of 1963?
A **law** that **aimed** to **replace asylums** with:
* **Community-based care**, offering **psychotherapy**, **medication** **management**
* **24-hour emergency services**
* **Mental health education**.
132
How did the Community Mental Health Act compare to earlier mental health reforms?
It was **similar** to the **York Retreat,** -- promoting **humane treatment** -- and **community support**, --- but **faced challenges** in **execution**.
133
How did the invention of **antipsychotic drugs** change mental health care?
Explain picture.
| **100% on exam**!
* The discovery of **chlorpromazine** in 1954 **revolutionized** mental health **treatment** by allowing **patients** to **manage symptoms with medication**, leading to **rapid deinstitutionalization**.
* This shift was **reinforced** by the **Community Mental Health Act of 1963**, which **aimed** to **replace** **asylums** with **community-based care**, offering psychotherapy, medication management, and **emergency services**.
* While it **resembled** earlier humane reforms like the **York Retreat**, its **implementation** faced **significant challenges** as there was no plan to implenent it neither there were resources..
134
What were the unintended consequences of deinstitutionalization?
Explain picture.
* While **deinstitutionalization** **promised** **community-based care**, -- there **was** -- **no real plan** or **budget** **beyond reallocating funds**.
* As hospitals **closed**, **ex-patients were** often **left without support**, -- **leading** many to **end** **up** in **Jail**, **Homeless shelters**, or **worse conditions**. --- The **assumption** that **long-term patients** could easily **transition** back into **society proved false,** --- and **60 years later**, we are still waiting on the promised **system of care**.
135
How is the opioid crisis in Vancouver’s Downtown Eastside (DTES) connected to deinstitutionalization?
Explain picture.
* After **deinstitutionalization**, -- many people with **mental health issues** -- were **left without support** -- and **migrated** to **low-income areas** like ***DTES***, -- which had **affordable housing** and some **welfare infrastructure**.
* Over time, **lack of proper mental health care** -- and **social support** -- **contributed** to **HOMELESSNESS** and **SUBSTANCE USE**, **indirectly fueling** the **OPOID** **crisis**.
136
Why did many ex-patients from River View Hospital end up in Vancouver’s Downtown Eastside (DTES)?
* When **River View Hospital closed**, -- the **BC government did not allocate funds** for promised **community-based programs**, -- leaving **many ex-patients WITHOUT** **INCOME** or **SUPPORT**.
137
What was the government’s approach to mental health care after deinstitutionalization in BC?
**Instead** of **building community-based services** as promised, the **government** saved **money by defunding River View** and **assumed facilities** could be **repurposed** without **proper planning.**
138
How did deinstitutionalization contribute to rising crime in DTES?
The **lack of mental health support led to POVERTY**, **HOMELESSNESS**, and **ADDICTION**. -- With many **struggling to survive**, **crime** **followed**.
139
Why was DTES considered an “out of sight, out of mind” solution?
Since **DTES** is located **outside Vancouver’s downtown** core, -- **ex-patients and low-income individuals** were **pushed** into the **area** (same as they were oushed into Bethlem, only difference the stigma towards mental illness was less now) -- **without** **addressing their needs**, making them **less** **visible** to the **general public** and **policymakers**.
140
How did the closure of River View Hospital contribute to the struggles in Vancouver’s Downtown Eastside (DTES)?
Explain Picture.
* When **River View Hospital closed**, -- the **BC government did not allocate funds** for promised **community-based programs**, -- leaving **many ex-patients without** **income** or **support**.
* Many **migrated** to **DTES**, where some **welfare services existed**, but **WITHOUT real planning**, **POVERTY**, **HOMELESSNESS**, and **CRIME** increased.
* The **area became** an "**out of sight, out of mind**" solution **rather** than a **true support system.**
141
How did deinstitutionalization contribute to the current state of the Downtown Eastside (DTES)?
Explain picture.
**Deinstitutionalization** -- **left many individuals**/**ex-patients** -- with **untreated** **mental illness** and **no support systems**, --- leading to **POVERTY**, **ADDICTION**, and one of the **worst OPOID EPIDEMICS** **worldwide**, --- showcasing **DTES** as a **center** of **social inequality** in **Vancouver**.
142
What significant investment was made in 2021 for mental health care in British Columbia?
Riverview Hospital received **$101 million** for -- **a multi-phase project** -- to **reintroduce** -- **community mental health programs**.
143
What was the first step in Riverview Hospital’s redevelopment plan?
The **establishment** of -- the **Red Fish Healing Centre**-- for **Mental Health** + **Addiction**.
144
What additional plans were proposed for the Riverview Hospital site?
* **Affordable housing**.
* **Community-based mental health programs**.
145
What remains uncertain about the new mental health initiatives at Riverview?
While there are **initiatives** for **community-based mental health programs**, -- **NO** concrete plans **have been finalized yet**.
146
What recent efforts have been made to improve mental health care in British Columbia?
Explain the image.
* In **2021**, **Riverview Hospital** received **$101 million** for a **multi-phase project**, starting with the **Red Fish Healing Centre** for **MENTAL HEALTH** and **ADDICTION**.
* There are also **plans for affordable housing** and **community-based mental health programs,** -- though **NO** **concrete plans** have been **finalized**.
