1.5 PUTTING IT...together
A Work in Progress
Since ancient times, people have tried to explain, treat, and study abnormal behavior. By examining the responses of past societies to such behaviors, we can better understand the roots of our present views and treatments. In addition, a look backward helps us appreciate just how far we have come—
At the same time, we must recognize the many problems in abnormal psychology today. The field has yet to agree on one definition of abnormality. It is currently made up of conflicting schools of thought and treatment whose members are often unimpressed by the claims and accomplishments of the others. And clinical practice is carried out by a variety of professionals trained in different ways.
As you travel through the topics in this book, keep in mind the field’s current strengths and weaknesses, the progress that has been made, and the journey that lies ahead. Perhaps the most important lesson to be learned from our look at the history of this field is that our current understanding of abnormal behavior represents a work in progress. The clinical field stands at a crossroads, with some of the most important insights, investigations, and changes yet to come.
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BETWEEN THE LINES
Famous Psych Lines from the Movies: Take 2
“The hallmark of a sociopath is a lack of empathy.” (Gone Girl, 2014)
“Do you have any idea how crazy you are?” (No Country for Old Men, 2007)
“Are you talkin’ to me?” (Taxi Driver, 1976)
“Mother’s not herself today.” (Psycho, 1960)
“Dave, my mind is going. I can feel it.” (2001: A Space Odyssey, 1968)
“I’m not going to be ignored!” (Fatal Attraction, 1987)
“I begged you to get some therapy.” (Tootsie, 1982)
How, then, should you proceed in your study of abnormal psychology? To begin with, you need to learn about the basic tools and perspectives that today’s scientists and practitioners find most useful. This is the task we turn to in the next several chapters. Chapter 2 describes the research strategies that are currently informing our knowledge of abnormal functioning. Chapter 3 then examines the range of views that influence today’s clinical theorists and practitioners. Finally, Chapter 4 examines how abnormal behaviors are being assessed, diagnosed, and treated. Later chapters present the major categories of psychological abnormality as well as the leading explanations and treatments for each of them. In the final chapter, you will see how the science of abnormal psychology and its professionals address current social issues and interact with legal, social, and other institutions in our world.
BETWEEN THE LINES
Early Asylums
Most of the patients in Middle Age asylums, from all classes and circumstances, were women.
The first asylum in colonial America was established in Williamsburg, Virginia, in 1773.
(faqs.org, 2014; Barton, 2004)
BETWEEN THE LINES
Psychiatrists Nix Insurance Payments
Only 55 percent of psychiatrists are willing to accept insurance payments.
Almost 90 percent of all other kinds of physicians accept insurance payments.
Only 43 percent of psychiatrists accept Medicaid, insurance for low-
income people. Almost 75 percent of all other kinds of physicians accept Medicaid.
(Pear, 2013)
SUMMING UP
WHAT IS PSYCHOLOGICAL ABNORMALITY? Abnormal functioning is generally considered to be deviant, distressful, dysfunctional, and dangerous. Behavior must also be considered in the context in which it occurs, however, and the concept of abnormality depends on the norms and values of the society in question. pp. 2–
3 WHAT IS TREATMENT? Therapy is a systematic process for helping people overcome their psychological difficulties. It typically requires a patient, a therapist, and a series of therapeutic contacts. pp. 6–
7 HOW WAS ABNORMALITY VIEWED AND TREATED IN THE PAST? The history of psychological disorders stretches back to ancient times. Prehistoric societies apparently viewed abnormal behavior as the work of evil spirits. There is evidence that Stone Age cultures used trephination, a primitive form of brain surgery, to treat abnormal behavior. People of early societies also sought to drive out evil spirits by exorcism. pp. 8–
9 GREEKS AND ROMANS Physicians of the Greek and Roman empires offered more enlightened explanations of mental disorders. Hippocrates believed that abnormal behavior was caused by an imbalance of the four bodily fluids, or humors: black bile, yellow bile, blood, and phlegm. Treatment consisted of correcting the underlying physical pathology through diet and lifestyle. p. 10
THE MIDDLE AGES In the Middle Ages, Europeans returned to demonological explanations of abnormal behavior. The clergy was very influential and held that mental disorders were the work of the devil. As the Middle Ages drew to a close, such explanations and treatments began to decline, and people with mental disorders were increasingly treated in hospitals instead of by the clergy. pp. 10–
11 THE RENAISSANCE Care of people with mental disorders continued to improve during the early part of the Renaissance. Certain religious shrines became dedicated to the humane treatment of such individuals. By the middle of the sixteenth century, however, persons with mental disorders were being warehoused in asylums. pp. 11–
12 THE NINETEENTH CENTURY Care of those with mental disorders started to improve again in the nineteenth century. In Paris, Philippe Pinel started the movement toward moral treatment. Similar reforms were brought to England by William Tuke. In the United States, Dorothea Dix spearheaded a movement to ensure legal rights and protection for people with mental disorders and to establish state hospitals for their care. Unfortunately, the moral treatment movement disintegrated by the late nineteenth century, and mental hospitals again became warehouses where inmates received minimal care. pp. 12–
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THE EARLY TWENTIETH CENTURY The turn of the twentieth century saw the return of the somatogenic perspective, the view that abnormal psychological functioning is caused primarily by physical factors. Key to this development were the work of Emil Kraepelin in the late 1800s and the finding that general paresis was caused by the organic disease syphilis. The same period saw the rise of the psychogenic perspective, the view that the chief causes of abnormal functioning are psychological. An important factor in its rise was the use of hypnotism to treat patients with hysterical disorders. Sigmund Freud’s psychogenic approach, psychoanalysis, eventually gained wide acceptance and influenced future generations of clinicians. pp. 16–
17 CURRENT TRENDS There have been major changes over the past 50 years in the understanding and treatment of abnormal functioning. In the 1950s, researchers discovered a number of new psychotropic medications, drugs that mainly affect the brain and reduce many symptoms of mental dysfunctioning. Their success contributed to a policy of deinstitutionalization, under which hundreds of thousands of patients were released from public mental hospitals. In addition, outpatient treatment has become the primary approach for most people with mental disorders, both mild and severe; prevention programs are growing in number and influence; the field of multicultural psychology has begun to influence how clinicians view and treat abnormality; and insurance coverage is having a significant impact on the way treatment is conducted.
It is also the case that a variety of perspectives and professionals have come to operate in the field of abnormal psychology, and many well-
trained clinical researchers now investigate the field’s theories and treatments. And finally, the remarkable technological advances of recent times have affected the mental health field. In particular, they have contributed to various kinds of cybertherapy and to new triggers and vehicles for psychopathology. pp. 18– 25
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