A look at the development of psychology as scientific field
While the field of psychology is relatively young, concepts relating to mental health and mental illness stretch back thousands of years. In the Fulcrum’s inaugural Mental Health Issue, we decided to take a historical perspective of mental health to show what things have evolved and what has stayed the same.
While our methods of treatment have become much more sophisticated, according to Dr. Susan Lamb, the University of Ottawa’s Jason A. Hannah Chair in the History of Medicine, mental illness behaviours have stayed relatively the same.
“I think one thing I’ve always found interesting is that … we can look at behaviours versus symptoms and behaviours seem to have a lot of resilience and consistency over the last 2,000 years,” she said.
Mental illness dates back to prehistoric times, where humans attempted to drive out evil spirits from the skull by trephining—a procedure where a hole was chipped into the skull using stone instruments.
In the Classical era in Greece and Rome, many physicians believed in a “humoural approach.” They believed that four main fluids in the body—blood, phlegm, yellow bile, and black bile—needed to stay in balance for a person to remain healthy.
With the advent of Christianity in the Western world, preoccupations with the devil, sin, and possession were rampant.
Another important belief at this time was the belief in witchcraft. Lamb points to the Dutch physician Johann Weyer who took a different approach in the 16th century.
“He was able to publish a book and he argues in this book that most women accused of witchcraft do not have supernatural powers, they’re not actually witches.”
Before congratulating Weyer for his medieval feminism, his explanation for witchcraft was that women have “a predisposition to gullibility and melancholy and this is what makes them especially susceptible to Satan’s influence,” said Lamb. In other words, he believed that the devil interfered with the humoural balance of women.
“It’s almost a natural explanation of supernatural activity but it’s a shift in thinking, and Weyer says any woman accused of being a witch needs to be examined by a group of physicians who can make this call. So this is new too,” said Lamb.
Scientific explanations of mental illness began to gain more ground, especially after the publication of Charles Darwin’s On the Origin of Species in 1859. One Darwinian in particular, Adolf Meyer, created and ran the first academic department of psychiatry in North America at John Hopkins University. Lamb, who wrote a book on Meyer, said “(he) wanted to bring in a notion that mental illness was biological dysfunction.”
“There was this profound belief in medical science that a physical cause would be found at autopsy in the body to explain mental disease,” said Lamb, but Meyer fought against this.
“He wanted to say that our social interactions, our experiences of life and humans, the way we feel, the way we think, those are all biological functions. You can’t cut them up, and look at them through a microscope. But that doesn’t mean they’re not biological.”
Therefore, Meyer was big player in the establishing of psychology and psychiatry as scientific fields.
However, another product of Darwinism was the rise of the eugenics movement during the late 19th and early 20th centuries.
“Its grounded in this idea that we might be able to engineer ourselves as a species if we consciously, or deliberately engineer the environment to which we adapt,” explains Lamb. “Now conflated and all mixed up in that is the notion that the human species can be divided up into different races.”
The eugenics movement quickly became a justification for the poorer treatment of ethnic minorities, women, and the poor. In Canada the eugenics movement is also intertwined with forced sterilization programs.
In 1928 the Alberta government enacted the Sexual Sterilization Act, which lead to approximately 2,800 forced sterilizations. One 17-year-old girl was diagnosed as a “moron,” which lead to her forced sterilization. In addition, Aboriginal and Metis peoples made up disproportionately larger numbers of the population who were sterilized, as well as women who were young, poor, and unmarried.
The 19th century also saw the rise of institutionalization, where thousands of mentally ill people were housed in crowded asylums that quickly became known for their abuse and neglect, despite previously good intentions.
Attitudes became more sympathetic towards the mentally ill, after the two destructive World Wars where millions of previously young, healthy people came home with post-traumatic stress disorder.
“When you have so many young, healthy, wonderful soldiers going off to WWI and so many of them having what’s called shell shock in that period,” said Lamb, “then you have a public that has to come to terms with the fact that anybody can get mental illness, that it doesn’t run in families alone.”
In the 1950s we saw the accidental discovery of the first antipsychotic medication, chlorpromazine. This medication, and the many that followed over the next five decades, allowed for more treatment of the mentally ill in their own communities and homes. This helped drive the deinstitutionalization process. Current psychiatric help is focused on communities where people live, as opposed to isolating people in asylums.
According to Lamb, the current landscape for mental health care looks more positive as “there’s a lot of attention when it comes to mental illness and mental health.”
While there is still so much we don’t understand about the many factors that influence our mental health in 2017, we’re way better off than we were even a hundred years ago.