Abnormal lecture 1

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historical views cont 2

The lunacy trials • From 13th century on, as the cities of Europe grow bigger, the power shift from the church to municipal authorities (Schull, 2015) •à establishment of the first asylums • The fist lunacy trials were established in England to determine a person’s madness • The defendant’s orientation, memory, habits and daily routines were discussed during the trials •Bethlem and other early asylums • St Mary of Bethlem was found on 1243 • Patients were treated in a very inhumane manner • & they became of the main touristic attractions in London •Renaissance (1500) • Less power to the church and a more progressive approach to mental disorders • St Vincent de Paul (1576- 1660):

• Mental diseases are not different than bodily diseases and Christianity demands of the human and powerful to protect people who suffer, and the skilful to relieve them (Castiglioni, 1924) 

•1600: The establishment of early asylums • Asylums: individuals with MDs often lived in inhumane conditions • Aim: to ‘protect’ society from madness • These treatments continued until the 18th centaury •

Institutions were created because the public feared the insane – it was more for the benefit of the cities and towns than the people who were suffering with mental health issues

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Reform

•Humanitarian reform • France: Pinel (1758-1826):

received permission from the revolutionary committee to remove the chains from MH patients in institutions

• UK: William Tuke (1736-1822): The York retreat: individuals with MDs worked, rested in a religious atmosphere •à The Quakers contend for 200 years • 20th Centaury ‘beginning of de-institutelization’ •Current Mental Health Reforms : From institutional to community care • In Europe the Green Paper on Mental Health (2005) • WHO (2008) • UK: No health without mental health (2011) • Deinstitutionalization • Community Based Mental Health Services – Multidisciplinary approach – Users’ centred – Users must play an active role in designing and shaping their treatment program – They should be involved in designing their policy Is the policy in place?!  

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historical views

Hippocrates 460-377 BC

Disagreed that mental health disorders (MHDs) are due to demons…

• à as other diseases, they have natural causes à they can be treated

• à Mental Disorders (MDs) are due to brain pathologies, may due to hereditary predisposing or injuries causing sensory or motor disorders

• Clinical observation is essential in order to understand the individual’s problems - Revolutionary breakthrough on how to treat people with MHDs 

Egyptian culture (300 B.C.)

• Sanatoria: a cool surroundings has a great therapeutic value ----- Activities such as: – dancing – parting – walks – rowing along the Nile – concerts – hydrotherapy – massages  At first there was a positive approach to mental disorders and curing them with laugther but as the church got more powerful people started seeing them as negatives and therefore treating them with punishments rather than cures 

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historical views cont

Galen (AD 130- 200; Rome)

• Supported Hippocrates’ view on Mental Disorders (MDs) – MDs could have physical (e.g. injuries) or emotional causes (e.g. disappointments in love)

• Also alcohol misuse, economical problems, adoloscential changes can all be related to MDs…

• Anatomy of the nervous system (through animals)

Abnormality during the Middle Ages (500 to 1500AD)

• Superstitions

 • No attempt to understand the causes of MDs

• Madness was dealt by the church through exorcism &/or other rituals

 • Cristian missionaries used exorcisms and the healing of the possessed as a proof of the power of the word of Christ over the enemies (Schull, 2015)

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Summary of lecture

• It is very difficult to have a universal definition of normal/abnormal behaviour; this varies depending on the contexts

 In clinical psychology abnormal behaviour is related to suffering, ‘maladaptiveness’, violation of standards & irrationality

• The history of madness can help us to understand the current view on abnormal behaviour

• Only in the last few decades MH policy across Europe outlined the need for community based multidisciplinary mental health services where users play an active role

• Still, the policy hasn’t been fully implemented… 

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Historical view on madness

Demonology, Gods and Magic

Chinese, Egyptians, Hebrews and Greeks considered ‘mad people’ as possessed by demons à they behaved in ‘abnormal way’ against their religion and believes

• E.g. Hebrews: mental disorders (MDs) àGod’s punishment à God abandoned the individual à Individuals had not control/ saying over her/his own situation

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Elements of abnormality - criteria of normality

Suffering: even if in some cases this is denied (e.g. manic behaviour) Maladaptiveness: behaviours that interfere with the individual’s ability to function (bi-polar) Unpredictable loss of control: (i.e., without ‘rational’ reasons) Violation of standards  Irrationality: e.g. delusions Criteria of normality Efficient self-perception - a realistic awareness of our own capabilities, motivations, emotions & feelings Appropriate perception of the reality- not misperceiving what others say or do Realistic self-esteem and acceptance Self-direction & productivity  Sensitivity and ability to recognize the feeling of others as necessary prerequisite to sustain a balanced relationship

People with mental disorders will not be able to fulfil some of these tasks – therefore are not seen as normal but instead are known as abnormal 

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Definitions of abnormality

If it doesn’t fit in the average – statistical abnormal

All generations have different ideas about what is normal – chronological

Different cultures have different norms and social conventions – social 

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Western perspective

It is important to know about the history of madness because norms and social conventions change regularly – and also in order to challenge something it is good to know the background

If normal against the minority /this is difficult when it comes to assessing normal health as different cultures have different conventionsthe majority do it then it is 

Stigmas

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How is a stigma constructed?

1 - a distinggushable label is applied to a group

2 - The label has negative attributes

3 - People with this label are seen as different

4 - people with the label are discriminated against by others

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