We discussed the shift that took place form a religious to a scientific explanation of madness, and the subsequent redefinition of madness as mental illness. This shift was precipitated by all of the following, except…
A) The scientific revolution
B) The “Enlightenment”
C) Urbanization
D) Deinstitutionalization
D!
According to the eugenics movement, mental illness was a hereditary disorder that could be efficiently addressed through ________.
A) Institutionalization and sterilization
B) Abortion and birth control
C) Abortion and deinstitutionalization
D) Birth control and sterilization
A!
What is the eugenic movement
- reduce prevalence of mental illness by forced sterilization and life-long institutionalization
What did the people who did not believe in hereditary transfer believe in?
- believed that organic lesions caused mental illness nad were acquired during one’s life
What did proponents believe in?
- believed that these could be identified through autopsies and surgical techniques
- a biologic/organic view of mental illness
What did Emil Kraeplin (psychiatrist) say about mental illness?
- that mental illness was a broad term including series of discrete diseases (each had its own cause, symptoms, and natural course - similar to the view in the DSM)
Who was Sigmund Freud?
important theorist trained as a neurologist
What did Freud argue
- argued that mental illness was psychological in nature emphasizing the importance of personal experiences and the unconscious mind (psychoanalysis)
What did Freud’s treatment techniques focus on? give examples of some treatments
focused on helping patients access and understand their unconscious thoughts and urges
- dream analysis, free association, hypnosis
Review (can’t think of questions so read carefully and memorize)
- Freud’s work included more “mild” forms of anxiety and obsessions (e.g., anxieties and obsessions among people who would not typically be admitted to asylums)
- His treatment techniques began to move treatment for mental illness from the hospital to private offices (the psychiatrist’s “couch”)
- Freud popularized the notion that our childhood experiences influence our mental health in adulthood, especially interpersonal relationships
- Although psychoanalysis as practiced by Freud is less common now, his ideas have been foundational in modern treatments for mental illness (modern talking therapies or psychotherapy)
What is WHR Rivers
- a medical doctor and anthropologist at Craiglockhart Hospital in Scotland
- treated many wounded and former WWI soldiers
What were some of the symptoms of trauma
- memory disturbances, temporary blindness, and paralysis without evident physical cause
What were the treatments for trauma?
- based on Freud’s idea
- included psychotherapies designed to draw the traumatic experiences out of the unconscious so that the soldiers could process the memories
What are the 2 things that psychoanalysis informed
- understanding and treatment of Trauma
- attachment theory
Explain the attachment theory
- focus on child development, the mother-child relationship, and how these may impact adult mental health
- “good mothering” was seen as the foundation for emotional health and healthy relationships
What are 3 critiques of psychoanalytic theory in early 20th century
- lack of research/scientific rigour in the development of theory
- heavy emphasis on childhood sexuality was problematic for some
- Freud’s normative ideas about fender were critiqued by some
The Cognitive Behavioural Therapy draws on the behavioural theories of who?
- Skinner and Pavlov
- recondition responses to stimulie
- also draws on cognitive therapy techniques of Beck and Ellis
- supports patients in rationally examining their “automatic thoughts” and how they relate to their emotions and behaviours
Why is CBT widely use in healthcare settings?
- time limited (can be short term)
- cost effective
- amenable to evaluation of outcomes
- aligned with goals of evidence-based treatment
Why were physical treatments like shock therapies and psychosurgery made?
- clinicians thought it might be possible to cure mental illness with direct physical interventions actin on the biology of the brain
Give other physical treatment examples
- Electroconvulsive Therapy (ECT)
- insulin shock
- medically induced convulsions or comas
- prefrontal lobotomies (severing prefrontal cortex)
What did prefrontal lobotomies often result into?
- used for some mental and behavioural disorders but these often resulted in personality changes, lost capacity and harms (brain damage, death in some cases)
explain the recognition of the rights and perspectives of patients
- because of the recognition of errors in the past, attitudes about rights have changed dramatically
- voices of patients have been largely absent from accounts of treatment of mental illness (due to focus on practitioners, lack of sources)
- movements work to destigmatise mental illness and improving access to treatment
What does deinstitutionalization mean?
- the process whereby many large, state-run hospitals, were closed in favour of individuals accessing treatment in the community
What led to deinstitutionalization?
- very poor conditions of asylums
- many physicians also saw forced hospitalization as being potentially or inherently harmful
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