What were the two major arguments of asylums?
Moral treatment and social control..
What is the argument of social control?
Asylums are to remove “problematic people” from society, form of social control, psychiatric are agents of control not care, framed mental illness as abnormal/antisocial, asylums not a solution but a PRECURSOR, critiqued as places of confinement, not curing, hidden agenda that was succeeding.
What is the argument of moral treatment?
Asylums are treatment of mental illness, rather than restraint and punishment and attempt to restore mental health. Goal - end dehumanizing treatment, have a calm environment, new skills, work, recreational activities. Few lived to this standard.
What is the approach of whig history?
-misrepresentative
-oversimplification
assumes human progress is inevitable and positive, evolving but always improving
-focusing on key figures and events (life doesn’t necessarily get better and women and marginalized groups are often underrepresented)
What is a social history approach?
considers key achievements and notable figures and the daily lives of ordinary people and how they have experienced it
What was “madness”?
An elastic concept that helped explain range of unusual, bizarre, or irrational human behaviours
What were the ways madness was explained?
- demonic possession
- misfortune in love
- health injuries
What were the ways madness was treated?
- Trepanning
- religious ceremonies
- beatings
- counter spells
What is medicalization?
Process where condition becomes understood as something that should be treated by physicians
What were some factors that contributed to the medicalization of mental illness?
- challenged to the authority and power of the church
- the scientific revolution - idea that science could solve problems and explain the natural world
- the enlightenment - skepticism about religion, focus on rationality
- increased urbanization - increased visibility of people who appeared mad and perceived as dangerous —> public attention, incarceration, institutional care
- increase in not blaming victims
When were asylums developed
19th century - large state run institutions or mental hospitals
What is the eugenics movement and what did it cause in regards to mental illness?
- Wiping out “inferior” genes
- forced sterilization and lifelong institution
What were some ways people in the 19th century thought mental illness was physical?
- genes
- lesions
What was Sigmund Freud’s treatment techniques?
Help patients access and understand their unconscious thoughts and urges (ex: dream analysis, free association, psychoanalysis)
In what ways was Freud’s work influential?
- Extended definition of mental distress (included more ‘mild” forms of anxiety and obsessions)
- moved treatment from hospitals to private offices
- childhood experiences influence our mental health in adulthood (interpersonal relationships)
- modern treatments for mental illness (psychotherapy)
What was the psychoanalysis informed attachment theory?
Good mothering = foundation for emotional health and healthy relationships
What were some critiques of psychoanalytic theory in early 20th century?
- lack of research/scientific rigour in development of theory
- heavy emphasis on childhood sexuality
- promoting sexist stereotypes
What was the patients’ rights movement?
- advocating for patient rights
- working to destigmatize mental illness
- improve access to treatment
- part of larger rights movements (civil rights, human rights..)
What is deinstitutionalization?
- process where many large state run hospitals were closed in favour of individuals accessing treatment in the community
What led to deinstitutionalization?
- consumer groups advocating for greater patient autonomy and self determination (drew attention to poor conditions)
- physicians seeing hospitalization potentially or inherently harmful
- intro to psychopharmaceuticals in 1950’s
How did the intro to psychopharmaceuticals lead to deinstitutionalization?
- optimistic that patients could be treated in community
- decreased use of shock therapies and psychosurgery
What were some limits of deinstitutionalization?
- lack of community based services developed to meet the needs of patients leaving institutions
