History of Clinical Psychology Page 1 of 8
HISTORICAL AGES IN EUROPE & EXAM TIMELINE
Exam takeaway — the key pattern:
Confinement → Medicalisation → Classification → Biological treatment →
Historical ages timeline Psychological science → Evidence-based psychological practice
Dates Exam timeline summary:
Period Label
(approx.)
1750s Enlightenment: madness understood through reason,
Western Roman ~500 Classical period productivity and social order rather than spiritual/moral
Empire explanations
Early Middle Ages 500–1000 Dark Ages Late 1700s–1800s Great confinement — poor, mad, deviant, or
Late Middle Ages 1000–1500 economically unproductive people moved into
institutions (Foucault, 1961)
Early Modern 1500–1750 Renaissance
1808 County Asylums Act — counties required to provide care for
Modernity 1750+ Enlightenment / Age of Reason /
"pauper lunatics"
Industrial Age
1845 Lunacy Act — shift from "inmates" to "patients"; madness
increasingly medicalised
1850s+ Classification into neuroses and psychoses
1889 Kraepelin — classification from symptoms to syndromes
CHANGING ATTITUDES TO MADNESS & THE GREAT CONFINEMENT
Before Enlightenment: madness had an ambivalent status — stigma but Asylums — County Asylums Act (1808):
also positive/spiritual lens (e.g. reflected in Shakespeare)
First mental health legislation in the UK
Enlightenment (mid-1700s): attitudes changed — emphasis on
Required county authorities to provide care for 'pauper lunatics' —
rationality, order, productivity
removed from workhouses and prisons
Economic reasons drove change — need to get people into work, gather
No treatment for mental health — just moral kindness, dignity and routine
taxes
People moved in as they weren't contributing economically
Began the "great confinement" throughout Europe (Foucault, 1961) —
Workhouses slowly morphed into county asylums
those who didn't fit categories of work confined to workhouses; no longer
Marks "the birth of psychiatry"
allowed to roam free
Those confined became the subject of (medical) study Foucault's exam angle: Confinement was not purely humanitarian — it also
reflected social control and economic productivity. Asylums represented
both care and control.
, History of Clinical Psychology Page 2 of 8
LUNACY ACT (1845), CLASSIFICATION OF MENTAL ILLNESS & KRAEPELIN
Lunacy Act (1845): Émile Kraepelin (1856–1926):
Changed status of mentally ill from 'inmates' to 'patients' German psychiatrist; studied with
A growing assumption that madness was a treatable disease Wilhelm Wundt
Increasing attention paid to the types of madness Revolutionised taxonomy of
30-year progression: prisoner/inmate → patient — growing 'Madness'
interest/optimism that madness was treatable Emphasised syndrome (symptom
patterns) rather than single
Classifying mental illness — by the 1850s: symptoms
Neuroses: disorder affecting mood and self-esteem — associated with Produced an enduring taxonomy;
fear, anxiety and panic influenced all subsequent
Kraepelin
Psychoses: disorders affecting reason and grasp of reality — associated psychiatric nosologies
with delusions and hallucinations
Classification still apparent today. Signifies a transition from compassion Kraepelinian Dichotomy (1889):
(moral treatment) to being a patient (medicalising). Since there was no Refined the separation of neurotic and psychotic conditions
treatment at the time, category didn't matter; organic medicine still Further divided psychoses into dementia praecox and manic-
developing (blood-letting the only option). depressive illness
Subsequently reformulated as schizophrenia and bipolar disorder
Neuroses included: OCD, impulse control, anxiety disorders, phobias,
hysteria and "conversion" hysteria
Kraepelin's significance: Shifted classification from isolated symptoms to
syndromes (patterns). Shaped later nosologies like DSM, even though
validity of these categories remains debated.
DSM-III (1980) — DIAGNOSTIC AND STATISTICAL MANUAL, 3RD EDITION
Radical revision of DSM-II by the APA ✓ Strength: Made diagnosis more criteria-based and standardised;
Lists conditions regarded as mental disorders; lists criteria required to improved reliability
diagnose them ✗ Limitation: Standardisation ≠ validity. Categories can be consistently
Adopts Kraepelinian schema (division of psychoses and neuroses) applied without necessarily mapping neatly onto underlying causes.
Happened due to the US reimbursement system — needed a code for
insurance Good exam wording: DSM-III improved diagnostic reliability by giving
No scientific evidence to justify this criterion initially — but shifted attention clinicians clearer criteria, but this did not automatically solve questions of
to the condition itself validity, because categories can be consistently applied without necessarily
mapping onto natural disease entities.
HISTORICAL AGES IN EUROPE & EXAM TIMELINE
Exam takeaway — the key pattern:
Confinement → Medicalisation → Classification → Biological treatment →
Historical ages timeline Psychological science → Evidence-based psychological practice
Dates Exam timeline summary:
Period Label
(approx.)
1750s Enlightenment: madness understood through reason,
Western Roman ~500 Classical period productivity and social order rather than spiritual/moral
Empire explanations
Early Middle Ages 500–1000 Dark Ages Late 1700s–1800s Great confinement — poor, mad, deviant, or
Late Middle Ages 1000–1500 economically unproductive people moved into
institutions (Foucault, 1961)
Early Modern 1500–1750 Renaissance
1808 County Asylums Act — counties required to provide care for
Modernity 1750+ Enlightenment / Age of Reason /
"pauper lunatics"
Industrial Age
1845 Lunacy Act — shift from "inmates" to "patients"; madness
increasingly medicalised
1850s+ Classification into neuroses and psychoses
1889 Kraepelin — classification from symptoms to syndromes
CHANGING ATTITUDES TO MADNESS & THE GREAT CONFINEMENT
Before Enlightenment: madness had an ambivalent status — stigma but Asylums — County Asylums Act (1808):
also positive/spiritual lens (e.g. reflected in Shakespeare)
First mental health legislation in the UK
Enlightenment (mid-1700s): attitudes changed — emphasis on
Required county authorities to provide care for 'pauper lunatics' —
rationality, order, productivity
removed from workhouses and prisons
Economic reasons drove change — need to get people into work, gather
No treatment for mental health — just moral kindness, dignity and routine
taxes
People moved in as they weren't contributing economically
Began the "great confinement" throughout Europe (Foucault, 1961) —
Workhouses slowly morphed into county asylums
those who didn't fit categories of work confined to workhouses; no longer
Marks "the birth of psychiatry"
allowed to roam free
Those confined became the subject of (medical) study Foucault's exam angle: Confinement was not purely humanitarian — it also
reflected social control and economic productivity. Asylums represented
both care and control.
, History of Clinical Psychology Page 2 of 8
LUNACY ACT (1845), CLASSIFICATION OF MENTAL ILLNESS & KRAEPELIN
Lunacy Act (1845): Émile Kraepelin (1856–1926):
Changed status of mentally ill from 'inmates' to 'patients' German psychiatrist; studied with
A growing assumption that madness was a treatable disease Wilhelm Wundt
Increasing attention paid to the types of madness Revolutionised taxonomy of
30-year progression: prisoner/inmate → patient — growing 'Madness'
interest/optimism that madness was treatable Emphasised syndrome (symptom
patterns) rather than single
Classifying mental illness — by the 1850s: symptoms
Neuroses: disorder affecting mood and self-esteem — associated with Produced an enduring taxonomy;
fear, anxiety and panic influenced all subsequent
Kraepelin
Psychoses: disorders affecting reason and grasp of reality — associated psychiatric nosologies
with delusions and hallucinations
Classification still apparent today. Signifies a transition from compassion Kraepelinian Dichotomy (1889):
(moral treatment) to being a patient (medicalising). Since there was no Refined the separation of neurotic and psychotic conditions
treatment at the time, category didn't matter; organic medicine still Further divided psychoses into dementia praecox and manic-
developing (blood-letting the only option). depressive illness
Subsequently reformulated as schizophrenia and bipolar disorder
Neuroses included: OCD, impulse control, anxiety disorders, phobias,
hysteria and "conversion" hysteria
Kraepelin's significance: Shifted classification from isolated symptoms to
syndromes (patterns). Shaped later nosologies like DSM, even though
validity of these categories remains debated.
DSM-III (1980) — DIAGNOSTIC AND STATISTICAL MANUAL, 3RD EDITION
Radical revision of DSM-II by the APA ✓ Strength: Made diagnosis more criteria-based and standardised;
Lists conditions regarded as mental disorders; lists criteria required to improved reliability
diagnose them ✗ Limitation: Standardisation ≠ validity. Categories can be consistently
Adopts Kraepelinian schema (division of psychoses and neuroses) applied without necessarily mapping neatly onto underlying causes.
Happened due to the US reimbursement system — needed a code for
insurance Good exam wording: DSM-III improved diagnostic reliability by giving
No scientific evidence to justify this criterion initially — but shifted attention clinicians clearer criteria, but this did not automatically solve questions of
to the condition itself validity, because categories can be consistently applied without necessarily
mapping onto natural disease entities.
