Historical Perspectives on Abnormal Behavior

    Ancient societies attributed abnormal behavior to divine or supernatural forces.  Prehistoric peoples may have practiced trephining as a form of treatment, although recent evidence suggests that this practice may represent an ancient form of surgery.  In ancient Greece, people who behaved abnormally were sometimes sent to special temples where divine intervention was sought to effect a cure.  In medieval times, belief in possession held sway, and exorcists were used to rid people who behaved abnormally of the evil spirits that were believed to possess them.  There were some authorities in ancient times, like the Greek physician Hippocrates, who believed that abnormal behavior reflected natural causes, specifically imbalances in bodily fluids or humors.  Different concentrations of these humors resulted in different types of abnormal behavior.  Galen, a Greek physician who attended the Roman emperor Marcus Aurelius, adopted Hippocrates' teachings and is credited with discovering that arteries carried blood, not air,, as was formerly believed.  Johann Weyer, a Belgian physician during the period of the Renaissance, took up the cause of Hippocrates and Galen by arguing that abnormal behavior and thought patterns were caused by physical problems.

    The 19th century German physician Wilhelm Griesinger argued that abnormal behavior was caused by diseases of the brain.  He along with another German physician who followed him, Emil Kraepelin, were influential in the development of the modern medical model.  Which likens abnormal behavior patterns to physical illnesses.  Kraepelin's categorization of mental disorders set the stage for the development of modem systems of classification.

    Asylums, or "madhouses," began to crop up throughout Europe in the late 15th and early 16th centuries, often on the site of former leprosariums.  Conditions in these asylums were dreadful and in some, such as the Bethlehem Hospital in England, a circus atmosphere prevailed.  With the rise of moral therapy in the 19th century, largely spearheaded by the Frenchmen Jean-Baptiste Pussin and Phillipe Pinel, conditions in mental hospitals improved.  Proponents of moral therapy believed that mental patients could be restored to functioning if they were treated with dignity and understanding.  The cause of humane treatment was advanced in the United States by such figures as Dr. Benjamin Rush, the "father of American psychiatry," and the schoolteacher Dorothea Dix.  But Rush also used certain harsh treatments that are now discredited, such as purging and ice-cold baths.  Dix, who traveled widely throughout the United States advocating more humane treatment for people with mental disorders, was credited with the establishment of some 32 mental hospitals across the country.  The decline of moral therapy in the latter part of the 19th century led to a period of apathy and to the belief that the "insane" could not be successfully treated.  Conditions in mental hospitals deteriorated, and they offered little more than custodial care.

    Not until the middle of the 20th century did public outrage and concern about the plight of mental patients mobilize legislative efforts toward the development of community mental health centers as alternatives to long-term hospitalization.  This movement toward deinstitutionalization was spurred by the introduction of psychoactive drugs called phenothiazines, which curbed the more flagrant features of schizophrenia.

    Abnormal behavior may be viewed from various contemporary perspectives.  The medical model conceptualizes abnormal behavior patterns like physical diseases, in terms of clusters of symptoms, called syndromes, which have distinctive causes that are presumed to be biological in nature.  Biological perspectives incorporate the medical model but refer more broadly to approaches that relate abnormal behavior to biological processes and apply biologically based treatments.  Psychodynamic perspectives reflect the views of Freud and his followers, who believed that abnormal behavior stemmed from psychological causes involving underlying psychic forces.  After abandoning hypnosis as a form of treatment, Freud developed psychoanalysis as a means of uncovering the unconscious conflicts dating back to childhood that he believed were at the root of mental disorders such as hysteria.  Also arising in the early 20th century were learning perspectives that flowered from the work of physiologist Ivan Pavlov and the work of behaviorists like John Watson and B. F. Skinner.  Learning theorists posit that the principles of learning can be used to explain both abnormal and normal behavior.  Behavior therapy is an outgrowth of the learning model.  Humanistic-existential perspectives reject the determinism of psychodynamic theory and behaviorism.  Humanistic and existential theorists believe that it is important to understand the obstacles that people encounter as they strive toward self-actualization and authenticity.  Cognitive theorists focus on the role of distorted and self-defeating thinking in explaining abnormal behavior.  Some adopt an information-processing model to explain abnormal behavior.  Sociocultural theorists believe that abnormal behavior is rooted in social ills, such as poverty, not in the individual.  Eclectic models attempt to integrate the contributions of various models.