Origins of Therapy-Bored Out of Your Skull

Origins of Therapy-Bored Out of Your Skull

Origins of Therapy-Bored Out of Your Skull

Gateway Question 15.1: How did psychotherapy originate? Fortunately, the odds are that you will not experience problems as serious as those of Joe, the student we just met. But if you did, what help is available? In most cases, it would be some form of psycho- therapy, a psychological technique that can bring about positive changes in personality, behavior, or personal adjustment. It might, as with Joe, also include a medical therapy. Let’s begin with a brief history of mental health care, including a discussion of psychoanalysis, the first fully developed psychotherapy.

Early treatments for mental problems give good reasons to appreciate modern therapies (Sharf, 2012). Archaeological findings dating to the Stone Age suggest that most primitive approaches were marked by fear and superstitious belief in demons, witchcraft, and magic. If Joe were unlucky enough to have been born several thousand years ago, his “treatment” might have left him feeling “bored.” You see, one of the more dramatic “cures” practiced by primitive “therapists” was a process called trepanning (treh-PAN- ing), also sometimes spelled trephining (Terry, 2006). In modern usage, trepanning is any surgical procedure in which a hole is bored in the skull. In the hands of primitive therapists, it meant boring, chipping, or bashing holes in a patient’s head. Presumably, this was done to relieve pressure or release evil spirits (• Figure 15.1).

Origins of Therapy-Bored Out of Your Skull

Joe would not have been much better off during the Middle Ages. Then, treatments for mental illness in Europe focused on demonology, the study of demons and persons plagued by spirits. Medieval “therapists” commonly blamed abnormal behavior on supernatural forces, such as possession by the devil, or on curses from witches and wizards. As a cure, they used exorcism to “cast out evil spirits.” For the fortunate, exorcism was a religious ritual. More often, physical torture was used to make the body an inhospitable place for the devil to reside.

One reason for the rise of demonology may lie in ergot- ism (AIR-got-ism), a psychotic-like condition caused by ergot poisoning. In the Middle Ages, rye (grain) fields were often infested with ergot fungus. Ergot, we now know, is a natural source of LSD and other mind-altering chemicals. Eating tainted bread could have caused symptoms that were easily mistaken for bewitchment or madness. Pinching sensations, muscle twitches, facial spasms, delirium, and hallucinations are all signs of ergot poisoning (Matossian, 1982). Modern analyses of “demonic possession” suggest that many victims may have been suffering from epilepsy, schizophrenia (Mirsky & Duncan, 2005), dissociative disorders (van der Hart, Lierens, & Goodwin, 1996), and depression (Thase, 2006). Thus, many people “treated” by demonologists may have been doubly victimized.

Then, in 1793, a French doctor named Philippe Pinel changed the Bicêtre Asylum in Paris from a squalid “mad- house” into a mental hospital by unchaining the inmates (Harris, 2003). Finally, the emotionally disturbed were regarded as “mentally ill” and given compassionate treatment. Although it has been more than 200 years since Pinel began more humane treatment, the process of improving care continues today.

Origins of Therapy-Bored Out of Your Skull

When was psychotherapy developed? The first true psychotherapy was created by Sigmund Freud little more than 100 years ago ( Jacobs, 2003). As a physician in Vienna, Freud was intrigued by cases of hysteria. People suffering from hysteria have physical symptoms (such as paralysis or numbness) for which no physical causes can be found.

Such problems are now called somatoform disorders, as discussed in Chapter 14, pages 499–501.

BRIDGES

• Figure 15.1 Primitive “treatment” for mental disorders sometimes took the form of boring a hole in the skull. This example shows signs of healing, which means the “patient” actually survived the treatment. Many didn’t.