In ancient times, understanding and treating mental disorders were shaped by a blend of

medical and supernatural beliefs. Egyptian papyri from the 16th century B.C. showed
recognition of the brain's role in mental functions, yet magic and incantations were often relied
upon to treat behavioral disorders.

Various early civilizations, including the Chinese, Egyptians, Hebrews, and Greeks, attributed
abnormal behavior to demons or gods. Possession could be seen as benevolent or malevolent,
depending on the symptoms, leading to treatments like exorcism and trepanation.

Hippocrates’ Early Medical Concepts

 Around 400 B.C.E., the ancient Greeks, led by the physician Hippocrates, shifted the
understanding of mental disorders from supernatural causes to natural explanations
rooted in the human body, a perspective still held today.
 Hippocrates, often regarded as the father of modern medicine, rejected the idea that
deities and demons were responsible for mental illnesses.
 Instead, he asserted that mental disorders, like other diseases, had natural origins and
could be treated accordingly.
 He believed that:
o the brain was the central organ for intellectual activity and
o that mental disorders were linked to brain pathology.
 Hippocrates categorized mental disorders into three groups and providing detailed
clinical descriptions based on patient observations.
o mania, melancholia, and phrenitis (brain fever).
 Hippocrates also contributed to the doctrine of the four humors, which
o associated personality or temperament with the dominance of certain bodily
fluids (blood, phlegm, bile, and black bile).
 He recognized the significance of dreams in understanding a patient's personality,
foreshadowing modern psychodynamic concepts.
 Hippocrates' treatment approaches were more advanced than prevailing exorcistic
practices of his time.
o For example, he recommended a balanced lifestyle, sobriety, a vegetable-based
diet, celibacy, moderate exercise, and bleeding when necessary to treat
melancholia.
 o He also acknowledged the role of the environment and sometimes relocated
patients from their families.
 Despite his revolutionary ideas, Hippocrates had gaps in his understanding due to
limited knowledge of physiology.
o Notably, he inaccurately attributed hysteria (unexplained physical symptoms
without organic pathology) to women and suggested marriage as a remedy,
believing it was caused by the uterus moving within the body.

Hippocrates' ideas laid the foundation for modern approaches to mental disorder understanding
and treatment, emphasizing natural causes and evidence-based practices.

Greek philosophers like Plato, Aristotle, and Galen contributed to the early understanding
of mental disorders. They explored factors such as

 consciousness,
 bodily fluids, and
 psychological stress,
 emphasizing individual differences and
 sociocultural influences.

Middle Ages

 Middle East: The Islamic countries established humane psychiatric hospitals,

influenced by Greek medicine.
 Avicenna's work contributed significantly to mental illness understanding and
treatment.
 During the Middle Ages (approximately A.D. 500 to A.D. 1500), the scientific aspects
of Greek medicine found continuity and development in the Islamic countries of the
Middle East.
 Notably, the first mental hospital was established in Baghdad in A.D. 792, with
 similar institutions emerging in Damascus and Aleppo.
o These early psychiatric hospitals provided humane treatment for individuals
with mental disorders.
 One prominent figure in ancient medicine during this era was Avicenna from Persia
(c. 980–1037), often referred to as the "prince of physicians."
 o Avicenna authored "The Canon of Medicine," which is regarded as one of the
most widely studied medical works in history.
o In his writings, Avicenna frequently discussed various mental disorders,
including hysteria, epilepsy, manic reactions, and melancholia.
o Avicenna's unique approach to the treatment of mental disorders is exemplified
in a case study involving a young prince suffering from a mental disorder.
o His work during this time contributed significantly to the understanding and
treatment of mental illnesses and left a lasting impact on the field of medicine.

Case study involving a young prince - In an early treatment case, a prince suffering from
melancholia believed he was a cow, mooing and expressing a desire to be killed for stew.
Avicenna, a renowned physician, was called to treat him. Avicenna initially played along,
telling the patient that a butcher was coming to slaughter him, which brought relief to the
patient. Later, Avicenna entered the room with a knife, and the patient indicated his location by
mooing. Avicenna then had the patient bound and assessed his condition, concluding that he
needed to be fattened. With appropriate food, the patient regained strength, his delusion
disappeared, and he was ultimately cured.

In contrast, Europe during the Middle Ages lacked scientific thinking and humane treatment
for mental illness. The clergy managed mentally disturbed individuals with prayer, holy water,
and exorcism. Witchcraft accusations were not as closely tied to mental illness as once
believed.

Understanding historical beliefs and practices regarding mental disorders highlights the
evolving and complex nature of this field across different civilizations and eras.

In the 1500s and 1600s, a

 shift towards scientific thinking and

 humanism challenged superstitious beliefs about mental disorders, leading to the
 emergence of early asylums for better treatment and care.

Key figures during this period included:

 Paracelsus, a Swiss physician, rejected demonology and introduced the idea that mania
was a form of disease influenced by psychic causes.
  Johann Weyer, a German physician, argued against the persecution of those accused
of witchcraft, asserting that they were actually mentally ill. He is considered a pioneer
in the study of mental disorders.

 St. Vincent de Paul, a clergyman, emphasized that mental illness should be treated like
physical illness, challenging superstitions and advocating for compassion and care.

These advocates paved the way for a resurgence of reason and observation in the understanding
of mental disorders, moving away from superstition and demonology.

Early asylums were established in the 16th century, initially as refuges for the mentally ill.
However, most of these asylums, often called "madhouses," provided deplorable conditions
and cruelty rather than therapeutic care. Examples included St. Mary of Bethlem in London
(known as "Bedlam"), asylums in Mexico and France.

Treatment in these early asylums focused on restoring "physical balance" in the body and brain,
using aggressive methods like water treatments, bleeding, electric shocks, and physical
restraints. These institutions represented a grim period in the history of mental health care,
where patients were often mistreated and subjected to inhumane conditions.

In the late 18th century and 19th century, significant reforms in mental health care aimed at
providing more humane treatment emerged, marking a turning point after centuries of
inhumane practices in asylums.

In Europe:

 Philippe Pinel, a French physician, removed chains from patients at La Bicêtre hospital
in Paris, focusing on kindness and consideration, which replaced harsh conditions with
order and peace.

 William Tuke, an English Quaker, founded the York Retreat, offering compassionate
care driven by Quaker beliefs in kindness and acceptance.

 Samuel Hitch introduced trained nurses at the Gloucester Asylum in England in 1841,
improving care, and the 1842 Lunacy Inquiry Act mandated regular inspections and
restraint elimination.

 The 1845 Country Asylums Act expanded humane treatment requirements in England
and extended reforms to British colonies following a scandal in Kingston, Jamaica.
In the 19th and 20th centuries, changing social attitudes and evolving medical practices
significantly influenced the treatment of mental disorders:

Nineteenth Century Views of Mental Disorders:

 Early 19th-century mental hospitals were managed by laypersons, and treatment relied
on moral management practices.

 Medical professionals, known as "alienists," had limited involvement in mental health

care, and effective treatments were scarce.

 In the latter part of the 19th century, alienists gained control of asylums and
incorporated moral management therapy into their medical procedures.

 Psychiatrists of the era believed emotional problems were linked to depletion of bodily
energies, leading to "neurasthenia."

In the late 19th and early 20th centuries, significant advancements shaped modern
perspectives in abnormal psychology:

1. Biological Discoveries: Unveiling the biological basis of mental disorders,

emphasizing brain pathology and genetics.

2. Classification System: Creation of standardized systems like the DSM for diagnosing
and categorizing disorders, aiding research.

3. Scientific Views on Causes: Replacing supernatural explanations with scientifically

informed perspectives that consider biological, psychological, and sociocultural
factors.

4. Experimental Psychology: Introduction of rigorous scientific methods, exemplified

by Wilhelm Wundt's lab, to study mental processes and behavior systematically.

The emergence of modern views on abnormal behavior in the late 19th and early 20th
centuries was marked by significant developments that shaped contemporary perspectives in
abnormal psychology. Here is a summary of these key developments, along with the names of
notable contributors, particularly those from Europe:

Biological Discoveries: Key developments in establishing the link between syphilis and
general paresis, a severe mental illness associated with syphilis of the brain, involved:
  Contributors: A. L. J. Bayle (1825), Richard von Krafft-Ebing (1897), August von
Wassermann (1906), Julius von Wagner-Jauregg (1917).

 Contribution: The discovery of the biological basis of mental disorders, especially the
link between syphilis and general paresis. This involved the identification of syphilis-
causing bacteria, the development of a blood test for syphilis, and the use of malarial
fever treatment for syphilis, which represented a significant milestone in the treatment
of mental disorders.

BRAIN PATHOLOGY AS A CAUSAL FACTOR: During the period from the 1700s to the
early 1900s:
1. Increased Scientific Exploration: Scientists like Albrecht von Haller and Wilhelm
Griesinger emphasized the role of brain pathology in mental disorders.

2. Identification of Brain Pathologies: Alois Alzheimer and others in the 20th century
established brain pathologies in conditions like cerebral arteriosclerosis and senile
mental disorders.

Developments in Research: The Search for Medications to Cure Mental Disorders

 Roman physician Galen and Paracelsus used medications for mental disorders in
ancient times.

 French psychiatrists Jean Delay and Pierre Deniker discovered the effectiveness of
chlorpromazine in the 1950s, leading to a decline in psychiatric inpatients.

 Chlorpromazine, though effective, had serious side effects.

 Newer drugs like clozapine, developed in the 1970s, were more effective with fewer
side effects.

 No major discoveries in treating psychotic disorders have occurred since the

development of chlorpromazine.

 Ongoing research aims to find new and more effective treatments beyond dopamine
activity for these complex conditions.

2. Classification System:

 Contributor: Emil Kraepelin

  Contribution: Kraepelin developed a standardized classification system for mental
disorders, treating each type as unique and distinct. His meticulous descriptions laid the
foundation for contemporary psychiatric classifications and research in
psychopathology.

3. Scientific Views on Causes: Development of the Psychological Basis of Mental Disorder

 Contributor: Sigmund Freud

 Contribution: Freud's work in psychoanalysis and the understanding of the

unconscious mind's role in human behavior marked a significant milestone in the
development of psychologically based explanations for mental disorders. His
techniques, including free association and dream analysis, influenced the field of
abnormal psychology.

Early Explorations of Psychological Factors:

 Contributor: Franz Anton Mesmer

 Contribution: Mesmer's development of "mesmerism" contributed to early

explorations of psychological factors in mental disorders, even though his methods
faced skepticism. His work sparked a renewed interest in hypnosis and the study of
psychological influences on mental health.

4. Evolution of Experimental Psychology:

 Contributors: Wilhelm Wundt, William James, J. McKeen Cattell

 Contribution: Wilhelm Wundt's establishment of the first experimental psychology

laboratory in 1879 at the University of Leipzig laid the foundation for contemporary
psychology.

These advances marked a significant triumph over a mental disorder, offering hope for
discovering organic bases for other mental illnesses.

Experimental psychology persists today with advancements in research methods like genetic
testing and brain imaging, contributing to a deeper understanding of abnormal behaviors.