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EVOLVEMENT OF CONCEPT OF MENTAL ILLNESS.
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Historical overview. Impact of scientific discoveries. Different schools of thought. Integration of biological & psychological models of mental illness.... More...
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Paper Abstract:
Historical overview. Impact of scientific discoveries. Different schools of thought. Integration of biological & psychological models of mental illness.
Paper Introduction:
The Concept of Mental Illness
Introduction
Throughout the history of humankind, the concept of mental illness has varied in accordance with the prevalent beliefs of the people in the society. Although mental illness is generally manifested in an individual’s behavior that deviates radically away from social expectations, the assessment and treatment of mental illness has evolved from prehistoric times till today. In prehistoric times, people believed that mental illness was caused by supernatural forces. However, with the emergence of scientific studies, biological and psychological explanations began to shape the concept of mental illness. By tracing the historical development of the concept of mental illness, this study offers an important background for understanding the complexity that su
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In A Preservation Institute Policy Study [Online], 1-28. Albert the Great and Thomas Aquinas dismissed thenotion that mental illness was an external manifestation of the sickness ofthe soul. New York: John Wiley & Sons, Inc.Drummond, E. 21). Before furtherinformation was found, it was believed that three neurotransmitter systemswere the source of mental illness. Available: www.peele.net/lib/reduct.html [2 , November 9].Persaud, R. The unwillingness of the patients to participate actively in thisapproach has contributed to its ineffectiveness, further undermining thevalidity of the psychodynamic concept of mental illness (Peele, 1981, p.8 9). Contrary to the images painted by the anti-psychiatrymovement, people who are confined in psychiatric hospitals suffer from agenuine illness that inflict tremendous pain in their lives and the livesof their family (Luhrmann, 2 , p. 2 41). New York: John Wiley & Sons, Inc.Early psychoanalysts. Therefore, he supported the notion that mental illness resultedfrom the interaction between the mind and the body. Nonetheless, Kraeplin's classificationsystem was still important for researchers and psychologists to understandthe importance of both psychological and biological approaches.Furthermore, Kraeplin's classification system formed the foundation for thedevelopment of detailed descriptions of specific mental illnesses (Shorter,1997).The Contemporary Concept of Mental Illness The pendulum swing between the biological and psychologicalperspectives of mental concept throughout history has formed the foundationfor contemporary psychology. (1997). [Online], 1-14. In addition, emotional control may or may not be a positive force.Although people can benefit from exhibiting self-control in certaininstances, they may be suppressing their spontaneous expression at othermoments. Mentally ill people were chained in dampdungeons, deprived of light and air. (1961). As described in this study, the biological and psychological models in themselves are insufficient in addressing the complexity of mental illness. Furthermore, he contributed to the concept ofmental illness in his categorization of mental illness into the followinggroups: melancholia, mania, dementia and idiocy. Therefore, Cicerostated that mental health could only be achieved by a harmoniousrelationship between the "rational, irrational and lustful parts of thesoul" (Mora, 1985, p. Chemicals or choices: The dilemma of mental health care. 77, inSteven, 2 b, p. At the same time, theorists were also exploring the psychologicaldimension of mental illness. With the use of brain imaging techniques and discoveries inneuroscience, Dr. E. However, with the scientific discoveries in the Enlightenment era, believers in the supernatural forces were replaced by theorists who sought to understand the mental ill from a biological and psychological viewpoint. In 1756, the first public hospital to accept the mentally ill wasbuilt in Pennsylvania. The Concept of Mental IllnessIntroduction Throughout the history of humankind, the concept of mental illnesshas varied in accordance with the prevalent beliefs of the people in thesociety. Because they cannotascertain the validity of the diagnosis, psychiatrists can only rely on thesymptoms to make their decisions (Luhrmann, 2 , p. Without the scientific perspective, people in the ancient days believed that mental illness had supernatural causes. Media Spotlight, 6-7. 2 4 ). The psychoanalytic process was successful in unleashing the turbulentpassions suppressed within mentally ill individuals.Even today, psychoanalysis remains the central model used by contemporarypsychiatrists who adhere to the psychological model. He also subscribed to Gockel's point ofview about mental illness. Without the validity of objective tests, psychiatriststake great license in diagnosing mental illnesses such as schizophreniaregardless of the inherent contradictory nature of the diagnostic criteria(Stevens, 2 b, p. The Moslems based their humane treatment of the mentally ill ontheir relationship with God; therefore, this explanation retained thesupernatural aspect that dominated this period. Morethan just Rogers' advocacy of self-acceptance, Maslow (1962) states thatthe mentally healthy person needs to modify his current being until hediscovers his true nature. 1 ). 2 42).Mental Illness at the Start of the 2 th Century In his textbook, Emil Kraepelin (1855-1926) distinguished betweenmanic-depressive psychosis and dementia praecox. (1995). For the first time in thedevelopment of psychology, scientists were willing to integrate the twoapproaches in their treatment of mentally ill patients, instead ofrestricting themselves to either approach. However, the theorists of the Greek era did not synthesize theirapproaches. According to Plato (428-348 B.C.), mental illness was a result of theindividual's failure to acknowledge his psyche, thus leading to thesuppression of truths. 53-54).Essentially, the biomedical model has sought to reduce the complexity ofmental illness into classifiable categories that establish physicalrelationships between behavior and the nervous system (Peele, 1981, p.8 7). in Mora,1985, p. For many psychiatrists, the fact that they can prescribe drugsthat influence the biochemical activity of the brain demonstrates thatmental illnesses are organic in nature (Stevens, 2 a, p. However, it fails to recognize the fact thatanxiety is not always a negative emotion. It was an impressive achievement for Greeksto have recognized the roles of both the body and the mind in mentalillness. Shamans used natural substances to exorcise the evil spirits fromthe mentally ill. (2 ). Underthe oppressive atmosphere, theorists suppressed their thoughts about mentalillness in order to protect their lives and the lives of their families.Although many people did not agree with the persecution of witches forwitchcraft ritual, they did not dare challenge the prevalent notion ofwitchcraft and mental illness (Romm & Friedman, 1994, pp. E., & Weinberg, L. Psychopharmacology forms the backbone of the biomedical model ofpsychiatry. 11). Nonetheless, there were also philosophers and doctors who proposedtheories that challenged the supernatural conception of mental illness.According to the German philosopher, Gockel (1547-1628), an individual'smental health depended on the organs that connected the passions and bodyhumors. Although both the two theorists uphold the importance of theindividual over the social, they also contradict one another. The de-institutionalization of mentally ill patients has led to the deaths of manyhomeless mentally ill individuals who are unable to lead independent lives.Many who suffer from physical diseases have died on the streets becausethey are not competent enough to seek help for their illnesses (Siegel,1999, p. Szasz is well-known for his conception of mental illness as a mythconstructed by psychiatric professionals using their scientific authority.For Szasz, psychiatrists have transformed "problems in living" into"psychiatric symptoms" that are taken as seriously as those of physicalillnesses (in Bobgan & Bobgan, p. (1994). Mental illness was attributed to taboo violations,failure to perform rituals and demonic possession. The humanistic perspective ofthe Moslems should be differentiated from the contemporary humanisticpsychology. Neither should you believethat your problems are due solely to a "chemical balance"" (pp. By these descriptions, schizophrenia appears to be abroad umbrella term that can encapsulate a wide variety of contradictorycharacteristics. Towards a psychology of being. London: Van Nostrand Company, Inc.Mora, G. Available: www.preservenet.com/studies/MentalHealth.html [2 , November 9].Stevens, L. in Gramwell & Tomes,1995, p. 2,5). However, the emphasis on somatic causes of mentalillness also gained greater recognition (Mora, 1995, pp. Abnormal Psychology (7th ed.). According to VincenzoChiarugi (1759-182 ), the caregivers had a "supreme moral duty and medicalobligation to respect the insane individual as a person" (qtd. A history of psychiatry: From the era of the asylum to the age of Prozac. Measuring mental health rather than illness. In Antipsychiatry.org [Online], 1-12. American Psychologist, 36, 8 7-818. They believed that mental illness had somatic causes. According to these writers, theconcept of mental illness was created by the dominant social order tosuppress the unique and creative expression of people who deviate from theprevalent norms of the society. Therefore, it does notacknowledge the rights of the individual to assert their uniqueness(Persaud, pp. The historical journey that has led to the current concept of mental illness has established the validity of both approaches in the treatment of the mentally ill. Available: www.antipsychiatry.org/exist.htm [2 , November 9].Stevens, L. The staffcultivated the individual needs of the patients through bodily exercise,walks, reading and arts and crafts. The advocates of this movement called forthe humane treatment of mentally ill patients. So don't accept the myththat we can make an "accurate diagnosis."... Available: www.enabling.org/ia/szasz/vatz2.htm [2 , November 9]. In England, William Tuke (1732-1819) created a warm and nurturingenvironment that was unlike a medical facility for his patients. In contemporary psychology, the integration of the biological and psychological models of mental illness has been effective for many mentally ill patients. Felix Platter (1536-1614), a Swiss physician, included the classification of mental disease inhis medical textbook on psychiatry. 2 34-5).Greek concept of mental illness In Greek society, supernatural notions of mental illness continued tobe embraced by the majority of the people. Porter (Eds.), Discovering the history of psychiatry. However, more recent research has indicated that other undiscoveredneurotransmitter systems also contribute to the mental disorders (Luhrmann,2 , pp. [Online], 1-28. Furthermore, the difficulty of offering a consistent definition of acomplex mental condition such as schizophrenia has also triggeredwidespread criticisms of the biomedical model of mental illness. Available: www.antipsychiatry.org/schizoph.htm [2 , November 9].Vatz, R. However, towards the end of 18th century, developments in Europeantransformed the perspective of people towards the mentally ill. 8 7). According topsychoanalysts, mental illness is associated with "psychological conflict,anxiety and guilt"-a clear legacy of Freud's work (Persaud, p. According to Szasz (1972), the biomedical model of mental illnessprovides a scientific justification to impose violence against mentally illpatients in the name of psychiatric treatment even when there are no provenphysical causes for treatment (in Roberts, 1996, p. This discovery led manyto speculate about the possibility that mental illnesses could originatefrom viral diseases (Davison & Neale, 1997). 9).The Anti-Psychiatry Movement of the 196 s and 197 s The very concept of mental illness was challenged by the anti-psychiatry movement in the 196 s and 197 s headed by prominent writers suchas Michel Foucault and Thomas Szasz. Although mental illness is generally manifested in an individual'sbehavior that deviates radically away from social expectations, theassessment and treatment of mental illness has evolved from prehistorictimes till today. According to Bandura(1969), individuals learn to interact appropriately with one anotherthrough the "interactional and modeling processes" of their childhood stagewhen they are socialized (in Persaud, p. (1994). In Szasz's opinion, a cleardistinction should be erected between brain diseases with organic causesand mental illnesses that relate to society's construction of appropriatebehavior. For example, it was believed thatschizophrenia was caused by excessive amounts of dopamine and depressionwas caused by too little norepinephrine. 238-4 ).Mental Illness in the 17th Century The 17th century was still influenced by the popular belief inwitchcraft. 2 37). 3-4). The lack of scientific knowledge to enable psychiatrists toidentify and separate patients with brain disease from others makes itimpractical to use Szasz's criterion of assessment. Kaplan & B. However, it was Benjamin Rush, considered the father of Americanpsychiatry, who focused attention on the biological approach of mentalillness. Therefore, it is important to incorporate the socioculturalcontext in considering the appropriateness of various emotions (Persaud,pp. Fuller Torrey states that schizophrenia and manic-depressive disorders "are diseases of the brain, just as multiplesclerosis, Parkinson's disease, and Alzheimer's disease" (in Siegel, 1999,p. Of 2 minds: The growing disorder in American psychiatry. They were supervised by guards whotreated them as though they were animals. What is even more disturbing in terms ofpsychopharmacology is the presence of many former mentally ill patients whohave overcome their sickness without the use of medication (Menninger,1989, p. Other research also established arelationship between serotonin and depression (Luhrmann, 2 , pp. This approach is extremely useful ineliminating fears such as fear of flying or heights. His classification systemlaid the foundation for the classification system used in the AmericanDiagnostic and Statistical Manual of Mental Disorders. Furthermore, situational and socioculturalcontexts are taken into account as significant factors that influence thethoughts, emotions and behavior of mentally patients (Peele, 1981, p. At thetime, it was evident to the physicians and theorists that psychologicaltheories best explained the mental condition of neurosis while thebiological theories accounted for psychosis. S. 13). [Online], 1-4. The complete guide to psychiatric drugs. Infact, by the end of the 17th century, people no longer believed in thephilosophical and supernatural causes of mental illness (Mora, 1985, pp.238-9).Mental Illness in the 18th Century With the total rejection of supernatural causes of mental illness,the clinical explanation of mental illness began to emerge. [Online], 1- 12. 11).Conclusion From this discussion, it is evident that the concept of mental illness has evolved in tandem with the changes in overall society. New York: Oxford University Press [Online], 1-29. History of psychiatry: The psychiatric clinics of North America. Foucault conceived of the people confinedin 18th century asylums to be philosophers and poets who defied the middle-class way of life (Luhrmann, 2 , p. Philadelphia: W. (1998). 2 37).Mental Illness in the Middle Ages During this period, the Hippocratic theory captured the attention ofthe people. Essentially, some depressed individuals mayneed to change the personal and social aspects of their existence. Does mental illness exist? While there were somephysicians who strived to find effective treatments for their patients,there were many others who did not believe that mental illness could becured (Gramwell & Tomes, 1995, p. Although thisconception of mental illness was simplistic and incorrect, it shifted theattention away from the supernatural towards the natural realm. Instead, the theorists were divided in their pursuits: whileone group studied the body, the other group focused solely on the mind(Mora, 1985, pp. Many were called witches. 5). Eugen Bleuler (1898-1927), who coined the term "schizophrenia" in19 8, pursued the biological approach towards psychosis. 47-8). The scientificdevelopments made in other fields during the Enlightenment era were alsoused in the assessment and treatment of mental illness. 2 36-7).The Renaissance Concept of Mental Illness The irrational beliefs of the witch-mania from the end of 14th to17th century held back the development of psychology during the era. Dr. Edward Drummond (2 ), AssociateMedical Director at Seacoast Mental Health Center, states: "... 816). TheMoslems worshipped the mentally ill because they regarded them as saintswho were chosen by God to speak the truth. While the biomedical modelseemingly offers a quick and straightforward solution to mental illness,the psychodynamic model requires tremendous introspection and a willingnessto on the part of the patients to take responsibility for their ownactions. 6). However, in the context of this discussion, it is evident that thisdistinction between brain diseases and the environment does not reflect theactual reality. 7). (2 a). In France, Phillippe Pinel revolutionized the living conditions ofthe mentally ill in the asylums. Madness in America: Cultural and medical perspectives of mental illness before 1914. Although these fourcategories focused on the psychological aspects of mental illness, Pinelalso sought to relate them to the biological components of the body. Therefore, at this stage, the belief in supernatural causes of mentalillness persisted. Available: www.mdx.ac.uk/www/study/mhhlib.htm [2 , November 9].Rogers, C. Many psychiatrists who believe in the biological concept of mentalillness tend to administer drugs to all patients. According to him, the blood vessels of the brain were the key tounderstanding mental illness (Mora, 1985, pp. The biomedical concept of mental illness is also further underminedby the fact that research studies have failed to establish biologicalcorrelations between mental illness and the nervous system. Evidently, Rogers' conception of mentalillness contradicts the prevalent definition of mental illness as theindividual's ability to exhibit conformist behavior (Persaud, p. Therefore, he believed that mental illness was a brain disease thatresulted from the interaction between internal and external elements. During the latter half the 2 th century,mental illness continues to be defined by the conflicting models of thebiological and psychological approaches. 77 in Stevens, 2 b, p.4). Available: www.bipolarworld.net/psychoan.html [2 , November 2 ].Gamwell, L., & Tomes, N. Hippocrates (46 -355B.C.) established the theory that mental illness was caused by thedysfunctional interaction of the "four bodily humors" (Mora, 1985, p.2 35). New York: John Wiley.Siegel, C. The hospital staffregarded the mentally ill patients as animals. The moralmovement treatment played a significant role in altering the attitudetowards mentally ill patients. Schizophrenia: A nonexistent disease. This concept of mentalillness takes into account the powerful influence of childhood upbringingand the immediate environment on the individual. 2 41-2). 2 36-7).Mental Illness in 13th Century This period was characterized by the continuous emphasis of somaticcauses of mental illness. Baltimore: Williams & Williams.Peele, S. Available: www.rapidnet.com/~jbeard/bdm/Letter/v1n2-1.htm [2 , November 9].Carducci, B. Skinner, the most prominent advocate,states that mental illness or other forms of undesirable behavior can becontrolled by conditioning. In prehistoric times, people believed that mental illnesswas caused by supernatural forces. 7-8).Other psychological models of mental illness Beyond the fundamental opposing approaches of the biological and thepsychological models, there are also a vast number of different types ofpsychotherapy such as cognitive behavioral psychology and humanisticpsychology (Luhrmann, 2 , p. Richard Burton (1517-164 ) studied the psychological and social causes of mental illness such asjealousy, fear and loneliness. Therefore, they did not attempt to seek evidence toprove that mental illness was caused by materialistic factors (Mora, 1985,pp. Nonetheless, there were other learned men in Greek society whoproposed natural explanations about mental illness. Catatonic schizophrenics exhibit the characteristics of "posturing,rigidity, stupor, and often mutism" in direct contrast to the suspiciousand jumpy behavior of paranoid schizophrenics (Torrey, 1988, p. 2 41). In the early writings of Cotton Mather (1663-1728), a Puritanminister in colonial Massachusetts, he stated that mental illness was theresult of "an inexpressible interest in Satan" (qtd. According to the Greeks'perspective, the devil had gained control over the mind and body of thevictim. From the following discussion, it will beevident that the two approaches are necessary in order to compensate forthe deficiencies of the other. In direct contrast to the above psychological perspectives thatemphasize a predetermined set of social values, Rogers and Maslow'shumanistic psychology places the focus on the individual. [Online], 1-8. In M. In an increasingly superficial and materialistic social climate,the probing aspect of the psychodynamic model does not appeal to manypatients. 23). The patients were also reinforced byreceiving certain privileges when they made progress in their condition.This treatment is similar to the behavioral modification approach (Mora,1995, p. (1985). This issue raises the fundamental argument raised bythe anti-psychiatry movement. 9). In Dr.Torrey's (1988) book, Surviving Schizophrenia, the diagnostic categories ofschizophrenia with various personality types often contradict one another.While paranoid schizophrenics supposedly suffer from "delusions and/orhallucinations," hebephrenic schizophrenics are identified by the fact that"well-developed delusions are usually absent" (p. The diverse responsesof individual bodies towards medications and the interaction betweendifferent medications make the psychiatrists' task hard to determinewhether the patient's progress or regression can be attributed to anyparticular medication. In fact, prominent psychiatrists have conceded the factthat decades of research on the biological causes of psychiatric disordershave yielded no conclusive results. ReferencesBobgan, M., & Bobgan, D. (1996, Autumn). The psychology of personality. Because there was no scientific knowledge available during thisperiod, people attributed inexplicable phenomena or strange behavior tosupernatural forces. It is evident that the evolution of the concept of mental illnessfrom the supernatural to the natural realm can be attributed to thescientific growth of the Enlightenment era. 2 34-2 54). Ithaca: Cornell University Press.Luhrmann, T. The coexistence of differentmodels is significant during this period is important because it formed thefoundation for the diversity of approaches that define contemporarypsychology (Mora, 1985, p. By introducing medical care into theasylums, Pinel facilitated the recovery of some of the patients ("EarlyPsychoanalysts," p. Social learning psychologists have a more sophisticated concept ofmental illness as inappropriate social behavior. From theirperspective, mentally ill individuals are unable to embrace theirindividuality and therefore unable to function properly in their life(Persaud, p. Unlike other doctors, psychiatrists do not prescribe medicationbased on their diagnoses. The diagnostic criteria formental illnesses are often so vague that patients who perceive theirsadness as a mental illness can convince psychiatrists of their "clinicaldepression" (in Siegel, 1999, pp. Sadock (Eds.), Comprehensive textbook of psychiatry (pp. 3). In psychoanalysis, anxiety is regarded as asymptom of mental illness. History of psychiatry. 5-6). However, in the latter part of the 2 th century, the excitingscientific discoveries of the biomedical model have taken precedence overthe psychodynamic model for several reasons. Psychology: Science or religion? 4). Wilhelm Griesinger found a potentialrelationship between psychic disturbances and changes in the physiologicalstates. 3). 351 in Vatz & Weinberg, 1994, p. 27 -1). (1981). The breakdown of thesocialization process can cause mental illness. While the biomedical model of mental illness transforms the patientinto a helpless individual at the mercy of the doctor and the illness, thepsychoanalytical model of mental illness restores individual responsibilityand freedom to the patient. However, the psychiatrists' ability to assess the effectiveness ofthe medication prescribed is compromised by the fact that the patient istaking other medications (Luhrmann, 2 , pp. Critics have also found inherent problems with the psychoanalyticperspective of mental illness. (1997). 2). The rhetorical paradigm in psychiatric history. Instead,they develop a dependence on their psychiatrists to numb their feelingswith drugs (Peele, 1981, p. 7). 18). In the Arabic parts of the world, the humanistic perspectives beganto emerge with the establishment of asylums for the mentally ill. When he became superintendent ofthe Bicetre in France, Pinel (1745-1826) followed the moral movement byfreeing the mentally ill from chains. However, this definitionis limited by the fact that the social rules are arbitrarily defined byconsensual agreement of the social population. Their mental condition is interwoven with theiremotions, dreams and repressed memories, not a separate entity. However, the biological causes of mental illness did not explain thetypes of mental illness that could be classified under neurosis. To many mentally ill patients who cope with theirillness on a daily basis, the biomedical model of mental illnessdehumanizes them by taking away their identity and their responsibility.Unlike patients suffering from physical illnesses that invade their bodiesfrom the outside, their mental condition is an integral part of their being(Luhrmann, 2 , pp. Reductionism in the psychology of the eighties: Can biochemistry eliminate addiction, mental illness, and pain? nobiological etiology has been proven for any psychiatric disorder (exceptAlzheimer's disease, which a genetic component... At the time, there were two madhouses inParis: Bicetre and Salpetriere. According to Torrey, the comparison of brains of patients andindividuals without the disorders show a structural and functionaldifference (Siegel, 1999, p. This version of mental illness was known as demonology (Davison &Neale, 1997). B. Constantinus Africanus (ca 1 2 -1 87), who founded the firstmedical school of the world in Salerno, believed that the imbalance withinthe body led to the excessive production of bile and creates melancholia.It is important to note that the discovery that the brain had differentfunctions during this period increased the people's acceptance ofHippocrates' biological explanation of mental illness. Therefore, hesucceeded in delineating the difference between neurosis and psychosis. H. Thomas Sydenham (1624-1689) began todistinguish between neurotic and hysterical symptoms. 15). However, the lack of a cleardistinction between psychosis and neurosis in the categorization of mentalillness led to the domination of the biological model over thepsychological model. In fact, an objective instrument of assessing mentalillness in patients in the psychodynamic model is directly antithetical toits concept. People in thesesocieties believed that the evil mind was at work within the mentally illpeople. LouisPasteur's germ theory established the fact that human beings can contract adisease when they are infected by tiny organisms. 2 35-6).Roman Concept of Mental Illness Expanding on Plato's psychological concept of mental illness, Cicero(1 6-43 B.C.) asserted that mental illness sprang from excessive anxiety.He believed that an individual with an anxiety-prone personality sufferedfrom mental illness when he had committed a mistake. Therefore, Plato presented a psychologicalperspective of mental illness. 53-4). However, in the latter half of the 19th century, the biologicalapproach towards mental illness captured the attention of the public asmore scientific discoveries were made. He believed that mental illness could be cured with proper diet,drink and sexual abstinence (Davison & Neale, 1997). However, the treatment of the mentally ill duringthis period was marred by abuse and controversy. 4). Instead, they decide which medication toprescribe to the patients based on the symptoms. The use ofmedication to treat schizophrenia today can be attributed to Bleuler'sefforts in studying psychosis from the biological approach. Even Hippocrates'biological explanation of mental illness lacked scientific validity (Mora,1985, pp. In H. Pacific Grove: Brooks/Cole.Davison, G. In fact,according to Albert the Great and Aquinas, all negative character traitssuch as arrogance and resentment could be explained by biological causes.Nonetheless, the two theorists still believed that the development of themental illness was a result of supernatural forces and evil powers actingon the bodies of the mentally ill. However, thebehavioral concept of mental illness places inordinate power in the handsof behavioral psychologists who will not only condition, but also determinewhat actions constitute appropriate behavior. In behavioral psychology, B.F. While mental hospitals that dealwith severe cases of mental illness place a great emphasis on thebiological concept of mental illness, psychological approaches are alsoused to treat different types of mental illness or used in tandem with apatient who has been medicated. No theorists had succeeded in formulating aclassification system or guidelines to differentiate between the mentalillnesses in order to lend validity to the effectiveness of the twoapproaches (Mora, 1995, p. The concept of mental illness within the domainof individual responsibility has moral repercussions in which patients haveto take responsibility for the consequences of their deranged actions(Luhrmann, 2 , p. S. Instead of addressing the real problemsunderlying the mental illness, patients are medicated (Siegel, 1999, p. When mentally ill patients commit theirbizarre acts of self-inflicted violence, they have made the choice to hurtthemselves intentionally. London: Constable and Company Ltd.Romm, S., & Freidman, R.S. M. As mentionedbefore, Rogers believe that individuals should embrace their individuality.However, Maslow asserts that mental health cannot be achieved without theconsistent effort of growth and development in order to reach one's truenature (Persaud, p. Mental health and civil liberties. 47). 83). By tracing the historical developmentof the concept of mental illness, this study offers an important backgroundfor understanding the complexity that surrounds the concept of mentalillness in contemporary psychology.Prehistoric and Ancient Concept of Mental Illness During this period, the concept of mental illness was primarilydefined by the magical-religious system that was characterized bysupernatural forces. Furthermore, the highly subjective nature of the psychodynamic modelwithout the establishment of any criteria for assessing the mental statusof patients also undermines this model's conception of mental illness(Persaud, p. I. According to Rogers (1961), mentally ill people exhibit the followingcharacteristics: 1) They are defensive and unwilling to expose themselvesto new experiences; 2) They have preconceived conceptions of their life andrelate every aspect of their actual experiences with their preconceivedstructure; and 3) They rely on conventional knowledge, instead of theirindividual judgment and intuition. 8). However, with the emergence ofscientific studies, biological and psychological explanations began toshape the concept of mental illness. Psychiatrists and psychologists whooveremphasize the effectiveness of one approach without acknowledging theother are likely to undermine the well-being of the patient.The biological model The fundamental difficulty of the biomedical conception of mentalillness lies in the fact that unlike physical illnesses, no objectivediagnostic tests have been formulated to determine the presence of mentalillnesses in patients (Luhrmann, 2 , p. (2 ). 15). Over the centuries, with increasing scientific discoveries, adherents from the different schools of thought began to formulate ideas from both perspectives. The early psychoanalytic movement reasserted the significance of thepsychological concept of mental illness through the treatment of neurosis.Through his theories about the libido, the oral, anal and phallic stagesand the unconscious, Sigmund Freud (1856-1939) believed that neurosis wascaused by unconscious conflict that was unresolved (Carducci, 1998).Although Freud attempted to use hypnosis to tap into the unconscious of thepatients, he found that it was ineffective. Likethe witches, the mentally ill were also persecuted because they wereaccused of being possessed by the devil. Psychiatrists remove theincentive for patients to deal with their feelings of depression and growfrom their past experiences. On becoming a person. Micale & R. 25 ). Maslow (1962) believes that a mentally healthy person strives forself-actualization-the process of discovering one's true identity. In Antipsychiatry.org [Online], 1-12. Although the Romans were aware of Hippocrates' somatic explanation ofmental illness, they were interested primarily in supernatural orpsychological causes (Mora, 1985, p. (1962). C., & Neale, J. (1999). However, Platter still clung onto the beliefthat supernatural causes might explain the condition of some of hispossessed female patients. Therefore, the human freedomand dignity will be destroyed in the name of eliminating mental illness inthe behavioral psychologists' utopian world (Siegel, 1999, p. New York: Alfred Knopf.Maslow, A. In fact, during this period, researchers found that the integrationof both biological and psychological approaches were both essential in thetreatment of mentally ill patients. 5). These examples represent only a tiny sampleof the work that was accomplished by many theorists and physicians.Certainly, the work in these areas reflected the change in the public'sperception about witches and the supernatural causes of mental illness. (2 b). M. 5). Through the discoveries aboutthe human body, scientific thoughts and techniques were incorporated intothe study of mental illness.Mental Illness in the 19th Century During the first half of the 19th century, German psychiatry wascharacterized by the two approaches towards mental illness: thepsychological versus the biological models. Available: www.psychologypsychiatry.com/Measuring%2 Mental%2 Health.htm [2 , November 9].Roberts, A. Saunders Company.Shorter, E. 6). J. Thus, the accusation raised by the anti-psychiatry movement against psychiatrists is valid in these instances when"problems in living" are transformed within the medical setting into mentalillness that requires medication. At certain times, anxiety can bea positive emotion that galvanizes people to develop and change. 15-16).The psychological concept of mental illness In contrast to the objective nature of the biomedical approach thatseeks to identify characteristics of a mental illness, the psychoanalyticalapproach focuses the attention on the subjective aspects of the patient.Here, the psychiatrist attempts to relate to their patients as individualsand understand the way they think and feel on a conscious and unconsciouslevel (Luhrmann, 2 , p. However, thebiomedical concept of mental illness still differs from that of physicalillnesses. Therefore, he discovered thetechnique of free association in which the patients would reveal theirthoughts during their sessions in a bid to establish connections betweentheir feelings and their illness ("Early Psychoanalysts," p.
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