Madness, Insanity or Psychopathology? An Historical Overview

Madness, the non-legal word for insanity, has been recognized throughout history in every known society. Primitive cultures turned to witch doctors or shamans to apply magic, herbal mixtures, or folk medicine to rid deranged persons of evil spirits or bizarre behavior, for example.

In ancient Israel it was held that disturbances of the mind or emotions were caused by "supernatural forces" or an angry God, as a punishment for sin or failure to follow the commandments. The Old Testament is replete with references to kings and commoners that go insane, and the Jewish prophets were thought to be psychologically abnormal because they acted in strange ways, departed markedly from the norm in appearance, and foretold of future events that few understood.

The Greeks replaced concepts of the supernatural with a secular view, believing that afflictions of the mind did not differ from diseases of the body. They saw mental and physical illness as a result of natural causes and an imbalance in bodily humors. Hippocrates frequently wrote that an excess of black bile resulted in irrational thinking and behavior.Greeks

RomansRomans made further contributions to psychiatry, in particular the precursor to contemporary practice. They put forth the idea that strong emotions could lead to bodily ailments, the basis of today’s theory of psychosomatic illness. The Romans also supported humane treatment of the mentally ill, and to support such codified into law the principle of insanity as a mitigation of responsibility for criminal acts.psychosomatic

The Middle Ages, however, witnessed the end of the progressive ideas of the Greeks and Romans.

During the 18th century, the French and the British introduced humane treatment of the clinically insane, though the criteria for diagnosis and placement in an asylum were considerably looser than today, often including such conditions as speech disorder, speech impediments, epilepsy and depression.

Europe's oldest asylum is the Bethlem Royal Hospital of London, also known as Bedlam, which began admitting the mentally ill in 1403.asylumBethlem Royal HospitalLondon

The first American asylum was built in Williamsburg, Virginia, circa 1773.

Before the 19th century these hospitals were used to isolate the mentally ill or the socially ostracized from society rather than cure them or maintain their health. Pictures from this era portrayed patients bound with rope or chains, often to beds or walls, or restrained in straitjackets.

A patient (Totok) in a mental institution in Indonesia in the 1990’s.

Sigmund Freud developed psychoanalysis around the turn of the century, and made profound contributions to the field with his descriptions of the unconscious, infantile sexuality, the use of dreams, and his model of the human mind.

Freud’s famous couch.

"Show me a sane man, and I will cure him for you." - Carl Jung

The interpersonal therapy developed by Carl Rogers during the 1940s focused on the transmission of warmth, genuineness and acceptance from the therapist to the individual. By the late 1960s there were over 60 different types of psychotherapies, ranging from psychodrama (using drama techniques) to guided imagery (using mental pictures and stories).

With the advent of more robust research findings regarding psychotherapy, there is growing evidence that most of the major therapies are about of equal effectiveness, with the key common element being a strong therapeutic alliance. Because of this, more training programs and psychologists are now adopting an eclectic orientation. This integrative movement attempts to combine the most effective aspects of all the schools of practice.

The ancient practice of yoga has become one of the many “new” therapies employed by mental health practitioners with a holistic approach.