OCR Psychology A Level Book 2 sample

Background The specification requires that you know the background to the topic area. For topic 1 this is divided into three parts: historical views of mental illness, defining abnormality and categorising mental disorders. On this spread we look at four historical views of mental illness. This spread covers the essential information you will need on background for the exam but you also need to link the background to issues and debates and to the key research. We will look at these links on page 18. The historical context of mental health Topic 1 Trephining (or trepanning) was used as a treatment, as long ago as 6500 BC. It involved holes being drilled into the skull using sharp stones to release the demons that were causing the ‘madness’. Careful studying of trephined skulls revealed that some people actually survived this treatment! Bear in mind this was before anaesthetics. Greek culture – Humoral theory Aetiology Around 400 BC, Hippocrates, who was a Greek physician, argued that mental illness was not caused by supernatural punishment, but by physiology. More specifically he said that four types of fluid in the body combine to make each person’s personality. These are referred to as the four bodily humours—black bile, yellow bile, blood and phlegm. Each of these types of bodily fluid was thought to relate to a different personality dimension. Black bile was linked to traits of being quiet, introverted and serious; yellow bile to being impulsive, ambitious and restless; blood was associated with being courageous, hopeful and playful; and phlegm was linked with being calm, patient and peaceful. A healthy personality is one in which there is a balance of the four humours. Disorders were attributed to an imbalance, or more likely an excess in one of the four humours. The symptoms related to the particular fluid that was in excess. For example, excess yellow bile led to mania, whilst excess black bile caused melancholia (sadness). This theory remained prominent until the 1800s. The term ‘hippocratic oath’ that doctors still have to take nowadays stems from Hippocrates, in relation to never harming a patient. Treatment To redress the balance between the four bodily humours, clinicians would ‘purge’ the patient, by using emetics or laxatives but in extreme cases bloodletting (phlebotomy) or the use of leeches to drain blood. Symptoms were also treated with changes to lifestyle, e.g. diet and exercise. At this stage in the history of mental illness it was recognised that people with mental illnesses should be looked after and not stigmatised or blamed. This theory also led to the understanding that abnormal behaviour can be treated with physiological remedies. Historical views of mental illness Whether behaviour is classed as mental illness depends on many factors, such as culture, context and also the historical time period. On this spread we will discuss four of the key historical views of mental illness throughout history. Each historical view offers its own aetiology (explanation) of mental illness and each of these leads to its own treatments for mental illness. As the viewpoints have changed, so has the terminology. For example, terms such as ‘madness’ and ‘lunacy’ were accepted medical usage even into the early 1900s. Nowadays the appropriate term to use is ‘people with mental health problems’. The term ‘insanity’ is still used, but not as a medical term—it is a legal term. Prehistory – Supernatural explanation Aetiology One of the earliest explanations for mental illness was supernatural phenomena. Abnormal behaviour was attributed to witchcraft, religion and demonic possession. People also believed that mental illness was a punishment for wrongdoing, a view shared by Hebrews, Ancient Egyptians and Early Chinese. Treatment Treatments for the supernatural explanations involved saying prayers and immersing the individual in holy water. Ancient Persians believed that mental illness could be cured by undertaking good deeds and having positive thoughts. Exorcisms were also a treatment to rid the individual of their demonic possession. This involved trephining (see caption above), stretching, starving, immersing in boiling or freezing water or whipping so that the evil spirit in the body would be so uncomfortable it would leave. Timeline of key events in the history of the treatment of mental illness 6500 BC 800–700 BC 792 BC 1247 1500s Exorcism, e.g. trephining— also known as trepanning. Humoral theory, bloodletting. First mental hospital opened— in Baghdad. Bethlem Royal Hospital (Bedlam) opened in London—Britain’s first hospital for the mentally ill. Asylums built to protect the public from the mentally ill and protect the family from the ‘embarrassment’ of their ill family member. Historical views of mental illness Chapter 1: Issues in mental health 10