OCR Psychology A Level Book 2 sample

According to Allison Foerschner the ‘ introduction of psychopharmacology is arguably one of the most significant and successful contributions to mental illness treatment ’ (2010). We will discuss the use of medication to treat schizophrenia later in this chapter. Anti-psychiatry movement In the 1960s a strong movement started that was against the medical model and the biological treatment of mental illness. Psychiatry is the treatment of mental illness as practised by medically trained doctors—so ‘anti-psychiatry’ is against the medical model. Two of the key research articles in this chapter supported the anti-psychiatry movement. David Rosenhan (page 16) questioned whether it is possible to diagnose mental illness—he asked the question ‘ if sanity and insanity exist, how shall we know them? ’. He believed that although we may think we can tell the normal from the abnormal, the evidence for this ability is not quite as compelling. Thomas Szasz (page 44) argued that the concept of mental illness was simply a way to exclude nonconformists from society. He argued that mental illnesses did not have a physical basis and therefore should not be thought of in the same way as physical illnesses. Unusual behaviours should be seen as what they are— they are ‘problems in living’. In his view our understanding of ‘mental illness’ had not progressed much further than demonology. Psychogenic approach Aetiology During the late 19th century focus shifted towards a psychogenic perspective. This means that mental illness was attributed to psychological factors, rather than physical or spiritual factors as had historically been the case. One of the best-known advocates of the psychogenic approach was Sigmund Freud who suggested that mental illness was due to unconscious processes in the brain. Unconscious processes are thoughts and emotions that we are unaware of but which can have a profound influence on our behaviour. Treatment The first psychogenic (psychological) treatments were largely dominated by Freudian psychoanalysis . Freud’s aim was to gain an insight into what has happened in the past, and into thoughts that lie in the unconscious mind. Such thoughts cannot be easily accessed so he developed the method of free association where a patient expresses thoughts exactly as they occur, even though they may seem unimportant or irrelevant. He also used dream analysis because dreams are not censored and therefore unconscious thoughts and feelings are expressed in dreams. Psychoanalysis became the dominant psychogenic treatment during the early 1900s. This led to many types of talking therapy including those we are familiar with today such as cognitive behaviour therapy . The somatogenic approach Aetiology During the 20th century, there was a renewed focus on somatogenic (physical) explanations of mental illness—people in the distant past, such as the Greeks, had explained mental illness in terms of biological dysfunction and it became popular again with improved methods of studying the brain. Mental illness was explained in terms of abnormal brain structure and abnormal levels of neurotransmitters . It was also explained in terms of inherited genes. This has been referred to as the medical model because psychological problems were firmly linked to physical causes in the same way that physical illness is explained in terms of physical causes such as viruses and bodily systems. This became the dominant view of mental illness in the 20th century. Treatment With the emphasis on physical explanations for mental illness, came the assumption that physical treatments would be a solution to all mental illnesses. Treatments included electroconvulsive therapy (where powerful electric currents are passed through the patient’s brain), psychosurgery (where parts of the brain are removed, such as lobotomy), and psychopharmacology (drug treatments). Drug treatments are now the dominant somatogenic treatment, based on the assumption that mental illness is largely caused by some form of neurochemical dysfunction. By controlling the symptoms of disorders through the administration of drugs, this made care in the community possible—patients could live in their own homes, or in a communal facility, whilst receiving treatment that kept their disorder under control. 1796 1800s 1900s Mid–late 1900s 1960s Current viewpoint First humane care in Britain opened by Mr Tuke at the York Retreat. Acceptance that mental illness is due to the mind. Introduction of talking therapies. Emphasis on psychoactive drugs and ‘decarceration’ (care in the community). Anti-psychiatry movement gained momentum. Biopsychosocial treatments. check your understanding 1. Briefly describe how mental illness was explained in prehistoric times. 2. Outline what Hippocrates proposed about the fluids in people’s bodies. 3. Describe briefly the psychogenic approach to mental illness. 4. Explain the somatogenic approach to mental illness. 5. Outline the anti-psychiatry movement. 11 Background: Historical views of mental illness