The Science of Treating the Mentally Deranged: From Demonology to Psychotherapy and Beyond

Five-hundred thousand years ago the ancient cave-dwelling shaman used a crude technique known to us moderns as “trephining” to treat certain mental disorders. By using crude stone instruments the shaman would chip away at the skull of the afflicted to form a circle. The circular opening was called a “trephine” and these primitive; early-people believed that the evil-spirit dwelling within the head of the sufferer could now more easily escape. The practice of Demonology by our ancient forefathers was likely successful in alleviating some pressure on the brain and fossil evidence shows many patients survived these rudimentary operations and lived years afterward (Butcher, 2007).

Specific abnormalities unique to the individual exhibiting the unwanted behavior are detailed in the writings of early Chinese, Egyptians, Hebrews and Greeks. Bizarrely patterned speech and peculiarities accompanying gesticulation helped these early practitioners of abnormal psychology decipher if the occupying spirit was good or evil. The ancients might have treated the afflicted with trepidation, awe and respect because they believed they were in the presence of the supernatural, thus dealing with a religious or mystical realm (Butcher, 2007).

Plato felt that the criminally “mad” should only be liable for monetary damage while remaining out of reach from other, more severe, punishment applications. It was Plato who first wrote about hospitalizing those who held mental belief systems that stood juxtaposed to the societal norms and values of popular culture. Those whose mental fabric did not share the same culturally-manufactured, broad, social-order were to be provisionally cared for by the very community to which they could not cohere. Those who society deemed as humanly frail and suffering would be engaged in the early equivalent of psychotherapy (Butcher, 2007).

 "The Lord will strike you with madness, blindness and panic" (Dt. 28:28). Saul, as punishment for his disobedience to God, goes into a deep depression, stops eating and eventually commits suicide by falling on his sword (1 Sam. 31).” (O’Connell, R., 2001)

                     European Middle Ages

The Clergy found their duties to include managing the mentally ill. Treatment at the time included considerable kindness for the most part and consisted of a regimen of prayer, holy water, “laying of hands” by priests, and mild forms of exorcism.

It is not uncommon in these modern times to read about people who are devoutly religious and/or superstitious engaging in exorcism rituals to dispel evil and supernatural forces they believe to be the underlying cause of psychological problems (Butcher, 2007). Tragically, it is all too common for a poor result that culminates in the death of the “cursed” or “demonically possessed.”

“Jesus cures the possessed along with lepers, the blind, the deaf and the lame. In Matthew, a man comes to Jesus beseeching him: "Lord, have pity on my son, for he is a lunatic. And Jesus rebuked him, and the demon came out of him, and from that hour the boy was cured" (Mt. 17:14-17)” (O’Connell, R., 2001)

              Humanitarian Reform Spreads through Europe and America

Gone were the Dark Ages whose mentally ill were confined in unlighted, foul smelling cells, devoid of creature comforts, with shackles both of steel and mental despair. In their place were modified penal institutions that became known as Asylums. Although occasionally the mentally ill were paraded about for a small fee paid to their “keepers” by the curious in society; the asylums were an improvement.

Treatment techniques were being actualized in the hopes of “restoring physical balance in the body and brain” (Butcher, 2007, pg.17). Indisputably aggressive and aimed at intimidating the patients, their care included the following: powerful drugs, water treatments intended to shock the system, bleeding and blistering, electric shocks, lobotomy and physical restraints (Butcher, 2007).

Shortly after the first phase of the French Revolution a man named Pinel experimented with using fewer restraints and allowing the inmates more kindness and consideration. Pinel realized that although people were “sick” they were not vicious beasts or criminals.

Straitjackets replaced shackles and beatings, once regularly performed, were forbidden by the keepers of the inmates. An English Quaker named William Tuke established the famed York Retreat in England. He fought a devoted and courageous battle against “brutality, ignorance, and indifference” (Butcher, 2007, pg. 18). Medical practitioners saw patients improve and public policies were changed regarding caring for the mentally ill (Butcher, 2007).

 “Insulin shock therapy (IST) was introduced in the 1930s as a treatment for schizophrenia and psychosis. A massive quantity of insulin would be injected into a patient to reduce blood sugar and bring on a coma. After about an hour, the patient would be revived with injections of glucose…

  The Victorians were right to build asylums to provide refuge for people who would otherwise be on the street." (Korotona, 2006).

                                Current Theoretical Viewpoints and Interpretations

There are components with significant value that must be included to ascertain a clinical picture of a mental disorder. This emergent clinical picture describing the disorder should include causal factors and treatments.

Although clinicians and diagnosticians will come from differing research backgrounds and enlist differing treatment strategies for those suffering from psychopathological disorders a thoughtful and respectful examination of the patient is tantamount to proper care.

We need to have an inclusionary approach to diagnosis and treatment that considers the broader social environment, or sociocultural aspect, as well as sub cultural influences, undercurrents or triggers (Butcher, 2007).

Progressive and cumulative scientific research and findings that examine biological and physiological elements are values rooted in contemporary fieldwork. We need to refrain from post modern views depicting the mentally ill with pessimistic views and strategies. We must always incorporate human dignity, scientific integrity, and our current optimistic state for growth potential.

Presently, the working definition of “abnormal” psychology remains elusive. While we cannot fully and adequately explain the term to everyone’s satisfaction, it is important to consider the following: “suffering, maladaptiveness, deviancy, violations of society’s standards, causing discomfort in others, irrationality, and unpredictability” are effects and consequences that should grab our attention (Butcher, 2007, pg 39).