History of mental illness
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Throughout history, man has had to confront behavior in its members which is now classified as mental illness, and each society has developed its own responses to this behavior. By tracking these developments, a deeper understanding of human interaction and concepts of normalcy can be gathered.
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Prehistoric times
In prehistoric times, mental illnesses were assumed to stem from magical beings that interfered with the mind. Individual tribes and groups of shamans had their own spells and rituals that they used to attempt to cure such mental illnesses. Often, such rituals took the form of exorcisms, in which the shaman would attempt to coax the evil spirit that was causing the disorder from the body. In some prehistoric societies, a primitive form of surgery was used to attempt to exercise the malignant spirits. Trepanation (also spelled trephination), the practice of drilling a hole through part of the skull without damaging the brain, was believed to allow the spirits trapped inside the skull to release. Skulls with trepanning holes dating back more than 10,000 years have been found in Neolithic Europe and South America. In fact, the presence of calluses on the surfaces of many skulls recovered showed that the operation had a surprisingly high recovery rate.
Ancient Egypt
With the first "great civilization," that of the Ancient Egyptians, came the first signs of change in the treatment of the mentally ill. Egypt, like the early stone-age societies (and indeed most societies for the next 3-and-a-half millennia), regarded mental illness as magical or religious in nature. Egyptian psychiatric theory was deeply rooted in the Egyptian conception of the self – the khat (the body), the ka (one’s guardian spirit, who guides the individual to the afterlife), and the ba (symbolized by a bird carrying the key to eternity, which leaves the body after death and resides in heaven), all playing their part in the cyclical nature of life and death. The societal obsession with death and life after death meant that the health of the mind or soul played an essential part in one’s overall health. In Ancient Egypt the first known psychiatric text (written around 20th century BC which explains the causes of "hysteria"), the first known mental hospital (a temple complex near modern Saqqara which is thought to be meant for the treatment of the mentally ill), and the known mental physician are found in history. The Egyptian focus on the well-being of the soul is embodied in the Temple of Imhotep at Memphis in the 29th century BC, a popular center for the treatment of mental illness. Methods used to attempt to cure the mentally ill included using opium to induce visions, performing rituals or delivering prayers to specific gods, and "sleep therapy," a method of interpreting dreams to discover the source of the illness. Egyptian society, with its fixation on the health of the soul, is the first major example of mental healthcare as a major priority for a society in history.
Monotheism and Mental Health
The next major developments in the history of mental health and illness came in a wave of new ideas about the self that occurred in the 6th century BC: The founding of Islam as well as the revitalization of Judaism during the Babylonian exile. Both of these world religions were to play a major role in our modern conception of mental health.
Ancient Judaism
The origins of monotheism lie in the growth and survival of Judaism in the history of ancient Israel and Judah. The concept of a single God as articulated in Judaism paved the way for a shift in views on mental health. While still almost completely religious in nature, the adoption of monotheism allowed for the idea that mental illness was not a problem like any other, caused by one of the gods, but rather caused by problems in the relationship between the individual and God, in some sense (to put it in modern terms) self-conflict or repressed guilt. Although the origin of the Israelite tribes have been dated to the late 2nd millennium BC, the major period of growth for Judaism occurred in the 6th century BC, when the Kingdom of Judah was conquered by Babylon and exiled to the Babylonian kingdom. On the waters of the Euphrates, the rabbis of the remaining tribes formulated for the first time a cohesive Jewish identity and doctrine, revitalizing monotheism in the face of ideological opposition. The new, regenerated Judaism viewed mental illness as an expression of sin (represented in archaic Judaism as possession by demons), and to the ancient rabbis an understanding of the self was critical to a relationship with God. Treatment for mental illness ranged from prayer and fasting to self-flagellation. To the Hebrews, mental health (spiritual health), was the key to righteousness and to God. By formulating this new concept of a monotheistic, and in many ways, personal deity, the ancient Hebrews moved the idea of mental health away from mysticism and into organized religion.
Ancient Islam
More than a thousand years later, Islam was beginning to spread across the Arabian Peninsula and into Asia and Africa. Like Judaism, Islam stressed the need for individual understanding of their mental situation. Those afflicted with a mental illness were thought to be possessed by jinn, supernatural spirits that can be either good or bad. The Qur'an mentions the idea of the spirit or soul constantly, preaching the idea that only though radical change of one’s conception of the universe can one move closer to God. Unlike the Jewish conception of mental illness as sin, the Islamic viewpoint interpreted mental illness as a sign of supernatural intervention that was not necessarily malignant. Changes in the psyche could be either good or bad – the Sufi movement of Islam, for instance, teaches spirituality though near-mysticism, using song, dance, and narcotics to induce an altered mental state and a closer connection of God. This new attitude towards the mind, freeing mental illness from implications of wrongdoing, paved the way for a more scientific examination of the causes and symptoms of mental illness. The first such advances were made by Islamic scholars. The Arab physician Rhazes wrote the landmark texts El-Mansuri and Al-Hawi in the 10th century, two which presented definitions, symptoms, and treatments for illness, including mental illnesses, and also ran the psychiatric ward of a Baghdad hospital. Such institutions could not exist in Europe at the time because of fear of demonic possessions. In the centuries to come, Islam would eventually serve as a critical waystation of knowledge from Classical Greece to Renaissance Europe – however, at this point in history their time had not yet come, and conquest was a higher priority to Islamic society of the period than medicine.
Topics to be covered
- Asylums, Bedlam and mental hospitals
- Sigmund Freud and psychoanalysis
- Neurology
- Development of psychiatric medications
- Care in the community
- Eugenics and the targeting of the mentally ill for extermination