CHAPTER 13 - THERAPY
Therapy Through the Ages
● The History of Therapy
○ Ancestors used to believe that a person’s bizarre behavior was often the
work of a demon that had possessed or taken command of the person’s
body - techniques such as exorcism or trephining (chipping a hole in the
skull to let the demon out) were used to rid the body of demons
○ Hippocrates proposed that physical and psychological disorders have
natural causes
■ Disorders result from imbalances among four humors (liquids) in
the body: black bile, blood, phlegm, and yellow bile
■ Black bile in excess leads to melancholia - severe depression
■ Baths, exercise, and massage were used to treat
○ Asylums and Hospitals
■ People in the 16th and 17th centuries who suffered from
psychological disorders were accused of being witches
● Brutally torchered and frequently killed
● Some were housed in institutions where patients were often
kept in chains and slept on straw beds
○ Hospitals were known for their disorganization,
unsanitary conditions, and inhumane treatment of
patients - bedlam
○ Moral therapy
■ In the 18th century mentally ill people were chained to walls in
Paris
● Very harsh treatment and punishment
● Philippe Pinel argued that these patients needed humane
care and treatment
○ Inspired by her patient Jean-Baptiste Pussin who was
a patient, then released and ran the hospital
differently
■ The belief that providing a humane and relaxed environment could
produce positive changes in a person’s behavior
■ Benjamin Rush introduced moral therapy in the united states
● Still restrained manic patients in his tranquilizer chair
○ State Mental Hospitals
■ Dorothea Dix became concerned about the plight of homeless and
disturbed people
● Insisted that the states had an obligation to provide care for
the mentally ill - convinced states to establish or enlarge
mental hospitals
, ● Clifford W Beers wrote a book “A Mind that Found Itself”
about his experiences in an early institution for the mentally
ill
○ New Forms of Treatment
■ Franz Anton Mesmer and his notion of animal magnetism offered a
very different view of psychological disorders and their treatment
● Started with hypnosis/magnetism as treatment
■ Freud used hypnosis too, but it was less effective at treating the
unconscious as he hoped
● He continued exploring the unconscious for clues to the
causes and treatment of psychological disorders
■ Some others were exploring the biological roots of disorders
● Some disorders develop from other biological causes
● The development of biomedical treatments such as
psychosurgery and electroconvulsive shock therapy are in
the works
○ Deinstitutionalization
■ Drugs were used to help control many serious symptoms
■ There was a growing belief that community care was more effective
than hospitalization
■ People could only be committed if they were a danger to themselves
or others
■ Deinstitutionalization: discharging large numbers of patients from
mental hospitals and then closing part or all of those hospitals
● About 90% of the people who would have been
institutionalized were now living outside of institutions
○ The Community Mental Health Movement
■ Community Mental Health Centers Act - provided funds for the
establishment of community mental health centers in which
patients would be treated on an outpatient bias
■ Mental health professionals placed more emphasis on preventing as
well as treating psychological disorders
■ Primary prevention - prevent disorders from occuring (stress
reduction or community recreation programs)
■ Secondary prevention - detect existing disorders and provide
treatment at early stages
■ Tertiary prevention - reduce the damage caused by disorders for
both the patients and society
■ Still need to focus on mental health occurrences in college students
and children
Therapy Through the Ages
● The History of Therapy
○ Ancestors used to believe that a person’s bizarre behavior was often the
work of a demon that had possessed or taken command of the person’s
body - techniques such as exorcism or trephining (chipping a hole in the
skull to let the demon out) were used to rid the body of demons
○ Hippocrates proposed that physical and psychological disorders have
natural causes
■ Disorders result from imbalances among four humors (liquids) in
the body: black bile, blood, phlegm, and yellow bile
■ Black bile in excess leads to melancholia - severe depression
■ Baths, exercise, and massage were used to treat
○ Asylums and Hospitals
■ People in the 16th and 17th centuries who suffered from
psychological disorders were accused of being witches
● Brutally torchered and frequently killed
● Some were housed in institutions where patients were often
kept in chains and slept on straw beds
○ Hospitals were known for their disorganization,
unsanitary conditions, and inhumane treatment of
patients - bedlam
○ Moral therapy
■ In the 18th century mentally ill people were chained to walls in
Paris
● Very harsh treatment and punishment
● Philippe Pinel argued that these patients needed humane
care and treatment
○ Inspired by her patient Jean-Baptiste Pussin who was
a patient, then released and ran the hospital
differently
■ The belief that providing a humane and relaxed environment could
produce positive changes in a person’s behavior
■ Benjamin Rush introduced moral therapy in the united states
● Still restrained manic patients in his tranquilizer chair
○ State Mental Hospitals
■ Dorothea Dix became concerned about the plight of homeless and
disturbed people
● Insisted that the states had an obligation to provide care for
the mentally ill - convinced states to establish or enlarge
mental hospitals
, ● Clifford W Beers wrote a book “A Mind that Found Itself”
about his experiences in an early institution for the mentally
ill
○ New Forms of Treatment
■ Franz Anton Mesmer and his notion of animal magnetism offered a
very different view of psychological disorders and their treatment
● Started with hypnosis/magnetism as treatment
■ Freud used hypnosis too, but it was less effective at treating the
unconscious as he hoped
● He continued exploring the unconscious for clues to the
causes and treatment of psychological disorders
■ Some others were exploring the biological roots of disorders
● Some disorders develop from other biological causes
● The development of biomedical treatments such as
psychosurgery and electroconvulsive shock therapy are in
the works
○ Deinstitutionalization
■ Drugs were used to help control many serious symptoms
■ There was a growing belief that community care was more effective
than hospitalization
■ People could only be committed if they were a danger to themselves
or others
■ Deinstitutionalization: discharging large numbers of patients from
mental hospitals and then closing part or all of those hospitals
● About 90% of the people who would have been
institutionalized were now living outside of institutions
○ The Community Mental Health Movement
■ Community Mental Health Centers Act - provided funds for the
establishment of community mental health centers in which
patients would be treated on an outpatient bias
■ Mental health professionals placed more emphasis on preventing as
well as treating psychological disorders
■ Primary prevention - prevent disorders from occuring (stress
reduction or community recreation programs)
■ Secondary prevention - detect existing disorders and provide
treatment at early stages
■ Tertiary prevention - reduce the damage caused by disorders for
both the patients and society
■ Still need to focus on mental health occurrences in college students
and children
