The place and times also contribute to how we define mental disorders. Thousands of years ago, mysterious behaviors were often attributed to supernatural powers and madness was a sign that spirits had possessed a per- son. As late as the 18th century, the emotionally dis- turbed person was thought to be a witch or to be possessed by the devil. Exorcisms, ranging from the mild to the hair raising, were performed, and many people endured horrifying tortures. Some people were even burned at the stake.
By the late Middle Ages, there was a move away from viewing the mentally ill as witches and possessed by demons, and they were increasingly confined to public and private asylums. Even though these institu- tions were founded with good intentions, most were little more than prisons. In the worst cases, inmates were chained down and deprived of food, light, or air in order to “cure” them.
Little was done to ensure humane standards in mental institutions until 1793, when Philippe Pinel (1745–1826) became director of the Bicêtre Hospital in Paris. Under his direction, patients were released from their chains and allowed to move about the hospital grounds, rooms were made more comfortable and sanitary, and questionable and violent medical treatments were abandoned (James Harris, 2003). Pinel’s reforms were soon fol- lowed by similar efforts in England and, somewhat later, in the United States where Dorothea Dix (1802–1887), a schoolteacher from Boston, led a nationwide campaign for the humane treatment of mentally ill people. Under her influence, the few existing asylums in the United States were gradually turned into hospitals.
The basic reason for the failed—and sometimes abusive—treatment of mentally dis- turbed people throughout history has been the lack of understanding of the nature and causes of psychological disorders. Although our knowledge is still inadequate, important advances in understanding abnormal behavior can be traced to the late 19th and 20th cen- turies, when three influential but conflicting models of abnormal behavior emerged: the biological model, the psychoanalytic model, and the cognitive–behavioral model.
The Biological Model How can biology influence the development of psychological disorders?
The biological model holds that psychological disorders are caused by physiological mal- functions often stemming from hereditary factors. As we shall see, support for the biologi- cal model has been growing rapidly as scientists make advances in the new interdisciplinary field of neuroscience, which directly links biology and behavior (see Chapter 2,“The Biolog- ical Basis of Behavior”).
For instance, new neuroimaging techniques have enabled researchers to pinpoint regions of the brain involved in such disorders as schizophrenia (Kumra, 2008; Ragland, 2007) and antisocial personality (Birbaumer et al., 2005; Narayan et al., 2007). By unravel- ing the complex chemical interactions that take place at the synapse, neurochemists have spawned advances in neuropharmacology leading to the development of promising new psychoactive drugs (see Chapter 13,“Therapies”). Many of these advances are also linked to the field of behavior genetics, which is continually increasing our understanding of the role
In the 17th century, French physicians tried various devices to cure their patients of “fantasy and folly.”
biological model View that psychological disorders have a biochemical or physiological basis.