History of Abnormal History of Abnormal PsychologyPsychology

Learning ObjectivesLearning Objectives

Historical conceptions of defining, Historical conceptions of defining, understanding, and treating understanding, and treating psychopathologypsychopathology

Fluid nature of psychopathologyFluid nature of psychopathology Specific details regarding Specific details regarding

conceptualizations conceptualizations Philosophical underpinnings of Philosophical underpinnings of

current diagnostic streamscurrent diagnostic streams

HippocratesHippocrates

1. Black Bile ---- Depression1. Black Bile ---- Depression 2. Yellow Bile ---- Tension/Anxiety2. Yellow Bile ---- Tension/Anxiety 3. Phlegm ---- Dull, Sluggishness3. Phlegm ---- Dull, Sluggishness 4. Blood ---- Mania/Mood Swings4. Blood ---- Mania/Mood Swings

ParacelcusParacelcus

Man is a microcosm, or a little world, because he is an extract from all the stars and planets of the whole firmament, from the earth and the elements; and so he is their quintessence.Paracelsus

ParacelcusParacelcus One category of loss of senses: One category of loss of senses:

– lunatics who through their own lunatics who through their own devices had fallen under the influence devices had fallen under the influence of the moon (lunacy), those who were of the moon (lunacy), those who were insane from birth, due to careless and insane from birth, due to careless and passionate sexual intercourse by the passionate sexual intercourse by the parents; witchcraft; and melancholy. parents; witchcraft; and melancholy. Paracelsus also made it quite clear Paracelsus also made it quite clear that spirits did not cause mental that spirits did not cause mental illness (Green, 2009). illness (Green, 2009).

ParacelcusParacelcus Therapies that he recommended Therapies that he recommended

included bleeding (which he considered included bleeding (which he considered to be the main thrust of treatment for to be the main thrust of treatment for mania), essences of gold, silver, iron, mania), essences of gold, silver, iron, mercury, lead, pearls, coral, antimony, mercury, lead, pearls, coral, antimony, sapphire and sulphur (all alchemical sapphire and sulphur (all alchemical remedies), opium, mandrake, remedies), opium, mandrake, astrological shielding to prevent lunacy, astrological shielding to prevent lunacy, and the use of charms to treat those and the use of charms to treat those afflicted by witchcraftafflicted by witchcraft

Dr. CameronDr. Cameron

Discussed in textDiscussed in text McUltra McUltra

Pathways to Pathways to ConceptualizationsConceptualizationsKraeplinKraeplin

Biological, disease Biological, disease processes, causes like processes, causes like virusesviruses

DSM 1-5 and beyondDSM 1-5 and beyond Current focus on Current focus on

symptom as entitysymptom as entity Lots of concern with Lots of concern with

reliabilityreliability

FreudFreud

Psychological, Psychological, underlying dynamics underlying dynamics of person, personality, of person, personality, and environmentand environment

Psychoanalytic Psychoanalytic conceptsconcepts

Psychodynamic Psychodynamic Diagnostic ManualDiagnostic Manual

AlbertaAlberta Insane Asylum, PonokaInsane Asylum, Ponoka 19119111

British British ColumbiaColumbia

Public Hospital for the Insane, New Public Hospital for the Insane, New WestminsterWestminster

18718788

British Columbia Mental Hospital, British Columbia Mental Hospital, CoquitlamCoquitlam

19119133

ManitobaManitoba Selkirk Asylum, SelkirkSelkirk Asylum, Selkirk 18818866

Home for Incurables, Portage-la-PrairieHome for Incurables, Portage-la-Prairie 18918900

Brandon Asylum, BrandonBrandon Asylum, Brandon 18918911

New BrunswickNew Brunswick Provincial Hospital, Saint JohnProvincial Hospital, Saint John 18318355

Provincial Lunatic AsylumProvincial Lunatic Asylum 18418488

Nova ScotiaNova Scotia Nova Scotia Hospital for Insane, HalifaxNova Scotia Hospital for Insane, Halifax 18518577

OntarioOntario Provincial Lunatic Asylum, TorontoProvincial Lunatic Asylum, Toronto 18518500

Kingston Asylum (Rockwood), KingstonKingston Asylum (Rockwood), Kingston 18518566

London Asylum, LondonLondon Asylum, London 18518599

Orillia Asylum for Idiots, OrilliaOrillia Asylum for Idiots, Orillia 18618611

Hamilton Asylum, HamiltonHamilton Asylum, Hamilton 18718766

Mimico Branch Asylum, MimicoMimico Branch Asylum, Mimico 18918900

Hospital for Insane, BrockvilleHospital for Insane, Brockville 18918944

Cobourg AsylumCobourg Asylum 19019022

Penetanguishene Asylum, PenetanguishenePenetanguishene Asylum, Penetanguishene 19019044

Whitby Hospital, WhitbyWhitby Hospital, Whitby 19119144

Prince Edward Prince Edward IslandIsland

The Prince Edward Island Hospital for the InsaneThe Prince Edward Island Hospital for the Insane 18718777

QuebecQuebec Quebec Lunatic Asylum, BeauportQuebec Lunatic Asylum, Beauport 18418455

Provincial Lunatic Asylum, St. John’sProvincial Lunatic Asylum, St. John’s 18618611

L’Hospice St. Jean de Dieu, Longue PointL’Hospice St. Jean de Dieu, Longue Point 18518566

L’Hospice St. Julien, St. Ferdinand d’HalifaxL’Hospice St. Julien, St. Ferdinand d’Halifax 18718733

L’Hospice Ste. Anne, Baie-St. PaulL’Hospice Ste. Anne, Baie-St. Paul 18918900

Protestant Hospital for the Insane, VerdunProtestant Hospital for the Insane, Verdun 18918900

St. Benedict Joseph Asylum, near city of St. Benedict Joseph Asylum, near city of MontrealMontreal

18818855

SaskatchewaSaskatchewann

The Saskatchewan Provincial Hospital, The Saskatchewan Provincial Hospital, BattlefordBattleford

19119144

NewfoundlanNewfoundlandd

Asylum for the Insane, St. John’sAsylum for the Insane, St. John’s 18518555

Northwest Northwest TerritoryTerritory

Taken to asylums of Alberta and Taken to asylums of Alberta and SaskatchewanSaskatchewan

19119144

YukonYukon Taken to New Westminster by Royal Taken to New Westminster by Royal Northwest Mounted PoliceNorthwest Mounted Police

18718777

Biomedical TherapiesBiomedical Therapies

ECT (started with Meduna)ECT (started with Meduna) Psychosurgery (started with Psychosurgery (started with

Munoz; now called NMD: Munoz; now called NMD: Neurosurgery for Mental Disorder)Neurosurgery for Mental Disorder)– Pre-frontal lobotomyPre-frontal lobotomy– Transorbital leucotomyTransorbital leucotomy– CingulotomyCingulotomy

Neurosurgery for Mental Neurosurgery for Mental Disorders (NMD)Disorders (NMD) Refractory for other treatmentRefractory for other treatment Informed consentInformed consent Not commonNot common Only a few centres do NMDOnly a few centres do NMD Radiofrequency Radiofrequency

ThermocoagulationThermocoagulation Gamma KnifeGamma Knife

Symptom as Focus (Kraeplin)Symptom as Focus (Kraeplin) Underlying Cause as Focus (Freud)Underlying Cause as Focus (Freud)