TOPIC 1: THE HISTORICAL CONTEXT OF MENTAL HEALTH
Views before the 1800s
Mental health seen from a primarily supernatural point of view
Common binding principle that mental illness caused by some sort of imbalance in the
universe
Most of these views attribute mental illness to possession by evil/demonic spirits or
displeasure of gods through sin
Some attribute other factors like planetary gravitation/ eclipses
Physical thing in body that needs to be removed recovery
- Determinism
Examples
Madness punishment from god/ possession
Treatment
- Trepanation – holes drilled into skull to let demons out
- Exorcism techniques – beatings, restrains, starvation
Humourism
Mental illness caused by imbalance of 4 humours which make up fluids in our body
Blood, black bile, yellow bile, phlegm
Humour: temperament
- Bb: depression, yb: impulsivity, p: calm, b: optimism
Treatment
- Bloodletting: leeches over organ thought to cause imbalance to remove blood
- Diets, laxatives
Witchcraft
Particularly for women who had been ‘possessed’ for which dunked (those possessed
survived and those not drowned)
Estimates suggest 100,000 women met this fate
Lunatic asylums
Whilst inhumane by todays standards run on idea mental illness people had no capacity for
reason and capable of violence without provocation e.g.. in an animal like state
For this reason, exposed to extreme temperatures etc. as instilling fear seen as best way to
restore order to the disordered mind
Changes to views 1900s onwards
More somatogenic explanations of mental health
- Ie. To suggest mental health problems indication of disturbances in brain structure/
function/ genetic inheritance
- Resulted in move towards medical treatment
At same time psychogenic explanations were beginning to develop with psychoanalysis and
cognitive explanations in the early 20th century
These two views have since been applied across the field with varying levels of effectiveness
Psychogenic explanations
Mental illness attributed to psychological factors and experiences
Influenced by Freudian theory and thinking in the late 19th century
Treatment by psychological theory e.g., psychoanalysis
Somatogenic approach
More relevant focus back on physiological reasons for mental illness enhanced by diathesis
stress models and biochemical models
, Here illness purely physiological cause and treatment
Modern day thinking applies both approaches
Definitions of abnormalities
Defining a person/behaviour as ‘abnormal’ implies something undesirable and requiring
change so caution must be used when applying it
For reasons, psychologists ned reliable and valid methods for distinguishing ‘normal’ from
‘abnormal’
Therefore, a definition of abnormality needed that
- Objective – not dependent on opinion + produces same results regardless of who applies
it
- Is not over or under inclusive
- Doesn’t incorrectly label abnormal traits as normal (type 2 error) or incorrectly label
normal traits as abnormal (type 1)
4 definitions of abnormality
1) Statistical infrequency
2) Deviation from social norms
3) Failure to function adequately
4) Deviation from ideal mental health
Statistical infrequency
Suggests that a trait, way of thinking/ behaviour should be classified as abnormal if it is rare
- E.g.. depression as majority of people don’t have it
Evaluation
- Quick identification, easy to do
- Lots of stats tests available which means that statistical frequency introduces objectivity
and allows more scientific way of measuring abnormality reducing subjectivity and
therefore leading got more accurate way of defining abnormality
- Suggests that anyone who differs from the average is abnormal so it doesn’t take into
account desirability of behaviours (e.g. highly intelligent people are statistically rare) so a
weakness as js because somebody falls outside statistical common area of distribution
curve doesn’t mean that they are abnormal so definition not always accurate
- Can be ethnocentric – cultures differ on what they consider as normal behaviour so
definition cannot be generalised ot every culture and therefore this definition may lead
to individuals being inaccurately defined as being abnormal
Deviation from social norms
We decide what is normal/ ideal and anything that deviates is abnormal
Their behaviour may be: incomprehensible to others, make others uncomfortable/
threatened
Necessary to consider:
- Degree to which norm violated, importance of that norm and value attached by social
groups to different violations
- For example is the violation rude, eccentric, abnormal or criminal
Evaluation:
- Temporal validity issues: social norms change over time and those acts abnormal in
1950s may not be now. E.g. being an unmarried mother
- Culturally relativist: social norms differ between cultures so definition doesn’t
consistently produce accurate definition of abnormal behaviour
, - Suggests all behaviour that breaks social norms abnormal- doesn’t distinguish between
socially deviant behaviour and mental abnormality many behaviours socially deviant but
not psychological abnormalities (e.g. drunk driving)
- What classed as breaking norm open to subjectivity
- Can take into account desirability of behaviours
- Theory implies we should stick to norm but breaking it can be positive
Deviation from ideal mental health
We decide what is ideal and anything that deviates from this is regarded as abnormal
Most popular explanation of this is by Jahoda who suggested 6 criteria people should meet
to be classed as not abnormal
1) Positive view of the self
2) Capability for growth and development
3) Autonomy and independence
4) Accurate perception of reality
5) Positive relationships and friendships
6) Environmental mastery
Evaluation
- Culturally relativist: seems to be based on one culture (e.g. autonomy and independence
values more commonly attributed to individualistic cultures)
- Collectivist cultures strive for the greater good of the entire community and may have
different ideal cultural norms therefore cant be used universally
- Means many people abnormal
- Focuses on suitable characteristics which can be used to set goal for treatment (practical
application cognitive behavioural therapy)
- Many criteria difficult to measure E.g. , self-actualisation
Failure to function adequately
A person is considered abnormal if unable to cope with demands of everyday life, they may
be unable to perform the behaviours necessary for day to day living
- E.g. self care, hold a job, interact meaning with others
Rosenhan and Seligman 1989 suggest the following characteristic:
- Suffering
- Maladaptiveness -danger to self
- Vividness and unconventionality – stands out
- Unpredictability and loss of control
- Irrationality/ incomprehensibility
- Causes observer discomfort
- Violates moral/ social standards
Evaluation
- can easily be identified by others and easy to assess
- Some are subjective observer discomfort etc
- Difficult to determine when personal distress becomes dysfunctional as personal distress
sometimes functional and necessary
- Presence of an abnormality doesn’t always result in failure to function – e.g. an
individual with depression may still be bale to hold a job and run a family successfully so
not necessarily displaying failure to fiction so this is a limitation as it shows definition is
inadequate in truly identifying behaver that may be considered abnormal as there are
some circumstances in which losing control is not dysfunctional
Views before the 1800s
Mental health seen from a primarily supernatural point of view
Common binding principle that mental illness caused by some sort of imbalance in the
universe
Most of these views attribute mental illness to possession by evil/demonic spirits or
displeasure of gods through sin
Some attribute other factors like planetary gravitation/ eclipses
Physical thing in body that needs to be removed recovery
- Determinism
Examples
Madness punishment from god/ possession
Treatment
- Trepanation – holes drilled into skull to let demons out
- Exorcism techniques – beatings, restrains, starvation
Humourism
Mental illness caused by imbalance of 4 humours which make up fluids in our body
Blood, black bile, yellow bile, phlegm
Humour: temperament
- Bb: depression, yb: impulsivity, p: calm, b: optimism
Treatment
- Bloodletting: leeches over organ thought to cause imbalance to remove blood
- Diets, laxatives
Witchcraft
Particularly for women who had been ‘possessed’ for which dunked (those possessed
survived and those not drowned)
Estimates suggest 100,000 women met this fate
Lunatic asylums
Whilst inhumane by todays standards run on idea mental illness people had no capacity for
reason and capable of violence without provocation e.g.. in an animal like state
For this reason, exposed to extreme temperatures etc. as instilling fear seen as best way to
restore order to the disordered mind
Changes to views 1900s onwards
More somatogenic explanations of mental health
- Ie. To suggest mental health problems indication of disturbances in brain structure/
function/ genetic inheritance
- Resulted in move towards medical treatment
At same time psychogenic explanations were beginning to develop with psychoanalysis and
cognitive explanations in the early 20th century
These two views have since been applied across the field with varying levels of effectiveness
Psychogenic explanations
Mental illness attributed to psychological factors and experiences
Influenced by Freudian theory and thinking in the late 19th century
Treatment by psychological theory e.g., psychoanalysis
Somatogenic approach
More relevant focus back on physiological reasons for mental illness enhanced by diathesis
stress models and biochemical models
, Here illness purely physiological cause and treatment
Modern day thinking applies both approaches
Definitions of abnormalities
Defining a person/behaviour as ‘abnormal’ implies something undesirable and requiring
change so caution must be used when applying it
For reasons, psychologists ned reliable and valid methods for distinguishing ‘normal’ from
‘abnormal’
Therefore, a definition of abnormality needed that
- Objective – not dependent on opinion + produces same results regardless of who applies
it
- Is not over or under inclusive
- Doesn’t incorrectly label abnormal traits as normal (type 2 error) or incorrectly label
normal traits as abnormal (type 1)
4 definitions of abnormality
1) Statistical infrequency
2) Deviation from social norms
3) Failure to function adequately
4) Deviation from ideal mental health
Statistical infrequency
Suggests that a trait, way of thinking/ behaviour should be classified as abnormal if it is rare
- E.g.. depression as majority of people don’t have it
Evaluation
- Quick identification, easy to do
- Lots of stats tests available which means that statistical frequency introduces objectivity
and allows more scientific way of measuring abnormality reducing subjectivity and
therefore leading got more accurate way of defining abnormality
- Suggests that anyone who differs from the average is abnormal so it doesn’t take into
account desirability of behaviours (e.g. highly intelligent people are statistically rare) so a
weakness as js because somebody falls outside statistical common area of distribution
curve doesn’t mean that they are abnormal so definition not always accurate
- Can be ethnocentric – cultures differ on what they consider as normal behaviour so
definition cannot be generalised ot every culture and therefore this definition may lead
to individuals being inaccurately defined as being abnormal
Deviation from social norms
We decide what is normal/ ideal and anything that deviates is abnormal
Their behaviour may be: incomprehensible to others, make others uncomfortable/
threatened
Necessary to consider:
- Degree to which norm violated, importance of that norm and value attached by social
groups to different violations
- For example is the violation rude, eccentric, abnormal or criminal
Evaluation:
- Temporal validity issues: social norms change over time and those acts abnormal in
1950s may not be now. E.g. being an unmarried mother
- Culturally relativist: social norms differ between cultures so definition doesn’t
consistently produce accurate definition of abnormal behaviour
, - Suggests all behaviour that breaks social norms abnormal- doesn’t distinguish between
socially deviant behaviour and mental abnormality many behaviours socially deviant but
not psychological abnormalities (e.g. drunk driving)
- What classed as breaking norm open to subjectivity
- Can take into account desirability of behaviours
- Theory implies we should stick to norm but breaking it can be positive
Deviation from ideal mental health
We decide what is ideal and anything that deviates from this is regarded as abnormal
Most popular explanation of this is by Jahoda who suggested 6 criteria people should meet
to be classed as not abnormal
1) Positive view of the self
2) Capability for growth and development
3) Autonomy and independence
4) Accurate perception of reality
5) Positive relationships and friendships
6) Environmental mastery
Evaluation
- Culturally relativist: seems to be based on one culture (e.g. autonomy and independence
values more commonly attributed to individualistic cultures)
- Collectivist cultures strive for the greater good of the entire community and may have
different ideal cultural norms therefore cant be used universally
- Means many people abnormal
- Focuses on suitable characteristics which can be used to set goal for treatment (practical
application cognitive behavioural therapy)
- Many criteria difficult to measure E.g. , self-actualisation
Failure to function adequately
A person is considered abnormal if unable to cope with demands of everyday life, they may
be unable to perform the behaviours necessary for day to day living
- E.g. self care, hold a job, interact meaning with others
Rosenhan and Seligman 1989 suggest the following characteristic:
- Suffering
- Maladaptiveness -danger to self
- Vividness and unconventionality – stands out
- Unpredictability and loss of control
- Irrationality/ incomprehensibility
- Causes observer discomfort
- Violates moral/ social standards
Evaluation
- can easily be identified by others and easy to assess
- Some are subjective observer discomfort etc
- Difficult to determine when personal distress becomes dysfunctional as personal distress
sometimes functional and necessary
- Presence of an abnormality doesn’t always result in failure to function – e.g. an
individual with depression may still be bale to hold a job and run a family successfully so
not necessarily displaying failure to fiction so this is a limitation as it shows definition is
inadequate in truly identifying behaver that may be considered abnormal as there are
some circumstances in which losing control is not dysfunctional
