The History of Abnormal Psychology

Psychology is the study of human thoughts, feelings and behaviors. Abnormal psychology is the study of abnormal thoughts, feelings and behaviors. Abnormal thoughts, feelings and behaviors may or may not be part of a larger mental illness, or psychopathology. But, psychologists who study abnormal psychology usually work to treat people who have some type of mental illness, even if it’s just a temporary case of the blues.

Abnormal behavior is behavior that deviates from what is expected and normal. The study of abnormal behavior is called abnormal psychology.

Culture and Abnormality

Abnormal behavior is sometimes hard to define, for several reasons. First of all, people have to agree on what’s normal. This can vary widely both within and outside cultures. For example, when British settlers first moved to America, they were used to fencing land and raising livestock on it. They had a good idea of the difference between public and private land.

However, the American Indians viewed land as a public thing and didn’t understand the concept of fencing parts off. Further, they used the land to raise crops, not livestock. To the Indians, the white man’s way of fencing land and keeping animals in pens seemed very abnormal!

Culture isn’t just about what happened in early America. A woman walking down a street in America without a top on would be considered to be acting abnormally. However, in a culture where bare-breasted women are normal, a woman with a top on might be seen as abnormal.

Historical Perspectives of Abnormal Psychology

How do we define abnormal behavior?

• Psychological disorder – Abnormal behavior pattern that involves a disturbance of psychological functioning or behavior.
• Abnormal psychology – The branch of psychology that deals with the description, causes, and treatment of abnormal behavior patterns.
• Medical model – A biological perspective in which abnormal behavior is viewed as symptomatic of underlying illness.

Criteria for Determining Abnormality

1. Unusualness
2. Social deviance
3. Faulty perceptions or interpretations of reality
4. Significant personal distress
5. Maladaptive or self-defeating behavior
6. Dangerousness

Cultural Bases of Abnormal Behavior

Behavior that is normal in one culture may be deemed abnormal in another.

The standards we use in making judgments of abnormal behavior must take into account cultural norms.

Traditional Native American cultures distinguish between illnesses that are believed to arise from influences outside the culture, called “White man’s sicknesses,” such as alcoholism and drug addiction, from those that emanate from a lack of harmony with traditional tribal life and thought, which are called “Indian sicknesses” (Trimble, 1991).

The Demonological Model

• Trephination – A harsh, prehistoric practice of cutting a hole in a person’s skull, possibly in an attempt to release demons.
• The notion of supernatural causes of abnormal behavior, or demonology, was prominent in Western society until the Age of Enlightenment.
• In ancient Greece, people who behaved abnormally were sent to temples dedicated to Aesculapius, the god of healing.
• Incurables were driven from the temple by stoning.

Origins of the Medical Model: In “Ill Humor”

• Humors – According to the ancient Hippocratic belief system, the vital bodily fluids (phlegm, black bile, blood, yellow bile).
• An imbalance of humors, he thought, accounted for abnormal behavior.
• A lethargic or sluggish person was believed to have an excess of phlegm, from which we derive the word phlegmatic.
• An overabundance of black bile was believed to cause depression, or melancholia.
• An excess of blood created a sanguine disposition: cheerful, confident, and optimistic. An excess of yellow bile made people “bilious” and choleric—quick-tempered, that is.

Medieval Times

• Belief in supernatural causes led to beliefs that abnormal behaviors were a sign of possession by evil spirits or the devil.
• This belief was part of the teachings of the Roman Catholic Church, the central institution in Western Europe after the decline of the Roman Empire.
• The Church’s treatment of choice for possession was exorcism.

Witchcraft

• The late 15th – 17th centuries were times of massive persecutions, particularly for women accused of witchcraft.
• Church officials believed the witched made pacts with the devil.
• Diagnostic tests such as the water-float test were used to detect witchcraft.

Asylums

• By the late 15th and early 16th centuries, asylums, or madhouses, began to crop up throughout Europe.
• Asylums often gave refuge to beggars as well as the mentally disturbed, and conditions were appalling.
• At St. Mary’s of Bethlehem Hospital—from which the word bedlam is derived—the public could buy tickets to observe the antics of the inmates, much as we would pay to see a circus sideshow or animals at the zoo.

The Reform Movement and Moral Therapy

• Jean-Baptiste Pussin and Philippe Pinel in the late 18th and early 19th centuries argued that people who behave abnormally suffer from diseases and should be treated humanely.
• Pinel (1745–1826) became medical director for the incurables’ ward at La Bicêtre in 1793 and continued the humane treatment Pussin had begun.
• Dorothea Dix (1802–1887), a Boston schoolteacher, traveled about the country decrying the deplorable conditions in the jails and almshouses where mentally disturbed people were placed.
• As a result of her efforts, 32 mental hospitals devoted to treating people with psychological disorders were established throughout the United States.

  A Step Backward

• In the latter half of the 19th century, the belief that abnormal behaviors could be successfully treated or cured by moral therapy fell into disfavor.
• Deplorable hospital conditions remained commonplace through the middle of the 20th century.
• By the mid-1950s, the population in mental hospitals had risen to half a million patients.
• Deinstitutionalization – A late 1950s policy of shifting the burden of care from state hospitals to community-based treatment setting in order to reform mental health system.

The Community Mental Health Movement: The Exodus from State Hospitals

• Congress in 1963 established a nationwide system of community mental health centers (CMHCs, USDHHS, 1999a).
• CMHCs were charged with providing continuing support and care to former hospital residents who were released from state mental hospitals under a policy of deinstitutionalization.
• Phenothiazines reduced the need for indefinite hospital stays and permitted many people with schizophrenia to be discharged to halfway houses, group homes, and independent living.
• The mental hospital population across the United States plummeted from 559,000 in 1955 to fewer than 100,000 by the 1990s (Grob, 2001).

Contemporary Perspectives on Abnormal Behavior

The Psychological Perspective

• Jean-Martin Charcot (1825–1893) experimented with the use of hypnosis in treating hysteria, a condition characterized by paralysis or numbness that cannot be explained by any underlying physical cause.
• Among those who attended Charcot’s demonstrations was a young Austrian physician named Sigmund Freud (1856–1939).
• Psychodynamic model – The theoretical model of Freud and his followers, in which abnormal behavior is viewed as the product of clashing forces within the personality.

The Biological Perspective

• Wilhelm Griesinger (1817–1868) argued that abnormal behavior was rooted in diseases of the brain.
• Emil Kraepelin (1856–1926) likened mental disorders to physical diseases.
• Griesinger and Kraepelin paved the way for the modern medical model, which attempts to explain abnormal behavior on the basis of underlying biological defects or abnormalities, not evil spirits.
• Dementia praecox – The term given by Kraepelin to the disorder now called schizophrenia.
• The medical model gained support in the late 19th century with the discovery that an advanced stage of syphilis—in which the bacterium that causes the disease directly invades the brain itself—led to a form of disturbed behavior called general paresis (from the Greek parienai, meaning “to relax”).

• The later discovery of Alzheimer’s disease, a brain disease that is the major cause of dementia, lent further support to the medical model.
• The medical model is a major advance over demonology.

The Sociocultural Perspective

• Sociocultural theorists believe the causes of abnormal behavior may be found in the failures of society rather than in the person.
• Accordingly, psychological problems may be rooted in the ills of society, such as unemployment, poverty, family breakdown, injustice, ignorance, and the lack of opportunity.
• Sociocultural factors also focus on relationships between mental health and social factors such as gender, social class, ethnicity, and lifestyle.

The Biopsychosocial Perspective

• Many mental health professionals endorse the view that abnormal behavior is best understood by taking into account multiple causes representing the biological, psychological, and sociocultural domains.
• Biopsychosocial model – An integrative model for explaining abnormal in terms of the interactions of biological, psychological, and sociocultural factors.
• Perspectives on psychological disorders provide a framework not only for explanation but also for treatment.

References:
Bernstein, D.A. & Nash, P.W. (2008). Essentials of psychology (4th ed.) Boston: Houghton Mifflin Company.
Comer, R.J. (2013). Abnormal Psychology (8th ed).  Worth Publishers
Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) American Psychiatric Publishing, 2013
Feldman, R. (2013). Essentials of understanding psychology (11th ed.). New York, NY: McGraw-Hill.
Friedman, H.S. & Schustack, M.W. (2012), Personality: classic theories and modern research (5th ed). Boston: Pearson Allyn & Bacon.
McGraw-Hill.McGraw Hill Higher Education (2013), The McGraw Hill Companies, Inc.
Ryckman, R. M. (2013). Theories of personality (10th ed.). Mason, OH: Cengage Learning.
Sue,Sue, and Sue (2014).  Understanding Abnormal Behavior (10th Ed), Cengage Learning