Evolution of Abnormal Behavior

Rudradeep Guha
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A few thousand years ago, the origin of mental illnesses were a mystery. They were thought to be caused due to possession by evil spirits and thus exorcism, prayers and ‘magic’ were used to attempt to cure them. It was Hippocrates who put forward the idea of brain pathology being the reason for mental disorders. He recognized heredity, predisposition and environmental factors along with physical trauma as possible causes of mental disorders and reinforced his beliefs with detailed records of his patients obtained through clinical observation. He also valued dreams as a way of understanding his patients’ personalities, a practice later extended by the likes of Freud to develop the concept of psychoanalysis. However, despite his progressiveness, Hippocrates was ultimately limited by the poor knowledge of anatomy and physiology in those times. Plato and Aristotle also recognized mental illness as something that could not be controlled and made provisions for the care of those suffering from it. Hippocrates’ work was built upon by Galen, who classified causes of mental disorders into two categories – physical (like shock, alcoholism) and mental (emotional causes, economic misfortunes). 

Until the 16^th century, mentally ill people were treated like animals; imprisoned, tortured and hunted for practicing witchcraft. Johann Weyer, concerned by the inhumane treatment of people he considered to be innocent and sick, wrote a book refuting the practices. Due to this, his works were condemned and banned by the Church, though they were praised by the scientific community. Asylums were created to remove mentally disturbed individuals from the public, but within these ‘sanctuaries’, patients were subjected to aggressive treatment methods, perennial restraints, and were often put on show for outsiders’ entertainment. In desperate need of reform, Philippe Pinel convinced authorities at La Bicetre in Paris to remove the shackles from the patients and treat them with kindness and consideration. The results were extremely convincing as many patients showed significant improvement. William Tuke did similar work in England where he set up the York Retreat, where mental patients received proper treatment and were well cared for. News of success of the Humanitarian reform spread and hospitals started taking measures such as the appointment of trained nurses, elimination of restraints, and inspection of asylums to ensure that guidelines were being followed. As treatment, the Humanitarian movement focused on moral and spiritual development of patients by caring for their social, individual and occupational needs. Eventually, moral management was abandoned because of rising immigrant population in the hospitals causing tensions between staff and patients, undertrained staff and overcrowding of hospitals. Moral management was replaced by the mental hygiene movement, which focused only on a patient’s physical comfort while ignoring the mental disorder completely. This was exacerbated by the rise of biomedicine, which promised biology-based treatments. This led hospitals to stop active treatment of the mental illness and focus instead on making the patients as comfortable as possible until the arrival of a treatment. 

In the early 19^th century, several important events occurred, such as the discovery of the potential of electric shocks in treating depression and research into mental disorders in war casualties. These led to important advancements in the treatment of mental disorders. Eventually, especially around 1946, the harsh treatment of patients in mental hospitals decreased with greater awareness about mental health care. New institutions and legislations were established, promoting research and training in clinical psychology through psychiatric residencies and creating psychiatric clinics and rehabilitation centers. During the late 20^th century, in an effort to reduce isolation of people with mental disorders, dispel the unpopular view of people towards mental hospitals, and to be cost efficient, hospitals and asylums started closing down and returning patients to the public. Though this was perceived to be a humane act, this process, called deinstitutionalization, left many mentally disturbed people helpless and left them to a harsh and cruel existence. With great advances in anatomical and biological knowledge, the French physicist A.L.J. Bayle recognized general paresis as a specific type of mental disorder, which resulted in the establishment of a definitive link between the brain and mental disorders and organic pathology as one of the primary causes of mental disorders. Wilhelm Griesinger was a significant contributor to this viewpoint and believed that all mental disorders could be explained by brain pathology. After the general paresis treatment discovery, other breakthroughs were also made, as Alois Alzheimer did for cerebral arteriosclerosis and senile mental disorders. Although brain pathology explained how mental disorders occurred, it did not explain why. Despite this, due to the work of Emil Kraepelin, the ability to predict the course of mental disorders was attained which in turn helped him develop a classification system that was a pre-cursor to the DSM-IV that we use today. 

One of the most popular psychological perspectives is Sigmund Freud’s psychoanalysis. Its development however came about from hypnotism and mesmerism, which were popular, but later discredited by other scientists. Freud was interested in hypnotism and used it initially in practice to make his patients talk about themselves freely, a method called free association which let people feel catharsis, a significant emotional release. Freud also popularized dream analysis, the recording of dreams which allowed psychiatrists to better understand the patient’s emotional problems. The work of Wilhelm Wundt and William James was instrumental in setting up clinical practices. Wundt established the first experimental psychology laboratory in University of Leipzig where they devised many basic experimental strategies and methods. He influenced many others like Cattell and Witmer who set up many laboratories across the US. Witmer was responsible for opening a clinic for mentally deficient children and is considered the father of clinical psychology. Another clinic called Chicago Juvenile Psychopathic Institute, established by William Healy, helped him recognize a new area of causation in environmental factors. Over time, apart from psychoanalysis, other approaches also came up. Behaviorism was one of most important, and focuses on how humans learn. Behaviorism came about from work on classical conditioning, especially by Ivan Pavlov, who demonstrated that dogs begin to salivate in response to a stimulus like a bell after the stimulus is regularly accompanied by food. Watson also subscribed to behaviorism and believed that psychology should focus on studying overt behavior rather than theoretical mental constructs. Watson and behaviorism had a huge impact on American psychology. Like Watson, B.F. Skinner also worked on a type of conditioning, called operant conditioning. For example, if a certain action is followed by food, then probability of that action in the future increases and similarly, decreases for actions followed by a negative stimulus. 

Thus, knowledge of abnormal psychology has evolved over the years, and the knowledge we have now is influenced and dependent on much of the work of psychologists, philosophers, and scientists in the past.