• Practitioner- more internal, trained as scientist
• academic- more external

writing history from modern day perspective

advantage- continuities, learn lessons from the past, help understand the present, predict the future

disadvantages- anachronism (judging the past by today's standards)

(primary qualities, element, humor, temperament)

1. hot/most - air - blood (heart) - sanguine
2. moist/cold - water - phlegm(brain) - phlegmatic
3. cold/dry - earth -black bile(spleen,bowel)-melancholic
4. dry/hot - fire - yellow bile (liver) - choleric

Personalistic- change the result of individual's actions

Naturalistic- times set the stage for progress, if one person doesn't do it another person will

-historical events are unique, science is usually repeatable

-in science causal variables can be isolated and manipulated (goal of history isn't causal)

-Science yields universal laws under all circumstances (history is not lawful in the same way, but can be lawful) 

1. both strive for truth (history: what really happened, science, truths about the world
2. knowledge is cumulative
3. evidence-based
4. conclusions are subject to refutation 
5. some sciences deal with non-repeatable events too
6. history is somewhat lawful

1. Problem of INduction

2. All experiences/evidence is interpreted

-popperain model of science- science progresses through conjecture & refutation 

-conjecture (propose) -> refutation (other ppl try to prove it wrong) 

proof is never possible but disproof is

social consturction of reality

-philosopher who felt mental illness did not exist but was constructed by society

-each society has a truth constructed by consensus of individual and institutions who have special authorities to tell the truth

AKA Postmodernism

Social construction of reality

-we have no objective knowledge of the external world (it is all uncertain) so knowledge is a social construction

Normal science and scientific revolution

The structure of scientific revolutions

Normal Science

-paradigm driven

-confirming and extending paradigm (not finding truth)

-cumulative growth of knowledge

-continuity of knowledge and concepts

-troublesome anomalies are ignored or explained away

scientific revolution

-paradigm shift

-discontinuous growth of knowledge

set of beliefs shared by a group of scientists

defines fundamental nature of thing studied (in mental illness a chemical disturbance), questions to ask, and methods

-madness: from gothic mod, meaning anger or rage

-Modness: old English, meaning folly or foolishness

-delusions (false beliefs) 

-hallucinations 

-disorganized thinking

-bizarre behavior

-severe mood swings

Mania- rage

insane-unsound mind

delirium-out of track, high fever

crazy-crushed or broken

lunacy-moonstruck

psychosis-today's term

Involes disturbances of the mind such as 

-passions

-judgment

-hallucinations

-delusions

1. organic psychoses

-general paresis of the insane (GPI) from syphilis

-alzheimer's

-alcoholism

-domain of neurology

2. functional psychoses- cause unknown

-assume a chemical imbalance but don't always know what the imbalance is

-domain of psychiatry

1. Infections disease
2. toxins (alcohol, mercury, drugs)
3. neurological diseases (TBI, alzheimers, epilepsy)
4. metabolic disorders (pellagra, hyperthyroidism)
5. functional or cause unknown

• Antiquity-enlightenment: madness, mania
• enlightenment-20th century: insanity lunacy
• 20th century-present: psychosis

Madness

melancholia

sanguine - cheerful, hopeful, confident

phlegmatic - not easily excited, sluggish, apathetic

melancholic

choleric (billious)- angery

• Hippocratic corpus- compilation of medical records (observation, openness to explanations, natural causes)
• Father of medicine
• Emphasized naturalism and observation (empiricism)
• Introduced humors
• First to say illnesses weren't God's punishment but of natural causes)

Hippocrates

-written about epilepsy and attributing it to the 4 humors instead of a religious meaning

-patients are phlegmatic but it does nto attack the bilious

-brain is really important and controls everything

Started by William Tuke (lay person)

-put into effects ideals proposed earlier (nice hospital, small, wel staffed) 

-ideals of moral practices

-founder of experimental physiology

Contributions: 

-arteries contain blood

-7 cranial nerves

-sensory & motor nerves

-nerves relay impulses from brain and spine

-believed in hippocratic doctrin of humors

dualsim - separate things (descarte)

monism- idealism, all mind no matter (berkeley)

Materialism, physicalism, naturalism

-Logical behaviorsm

-neurophysiological identity theory: mind is identical to brain cell activity

Idealism

-all mind, not matter, all reality is mental

-Berkeley- to perceive is to be perceived (god always there)

-future is fixed by the past, no free will 

-every effect has a natural cause, since the start of time is a complex chain

-complex of a phenomenon can be udnerstood by its parts

Hierarcy of sciences from complex to simple (sociology, psychology, biology, chemistry, physics) 

Idea may be fundamentally wrong

-emergence (whole more than sum of parts) 

-Mary problem w/ colors

If right in priciple we can't reduce mental to biological yet

Information Processing theory of mind

-brain is a computer (wetware) and mind is software emerged from information processing

-mental events are causal 

-mind can exist on non-biological substrates

-problems with information processing in one of 2 areas (wetware or software) 

2 causes of this damage (genetic, experiential)

e.g. genetic damage to software- lacking theory of mind or ascribing mental process to others

-peak in mid 1950s at 500,000 in mental hospitals

-today about 50,000

-came into contact w/ mentally ill in prison bible studies and wanted to improve conditions

-early advocate for mentally ill

-pressed for construction of state hospitals & for government involvement

-went to farms, homes and found locked up mentally ill people to present to legislators

-first psychiatrists (french insane, latin estrange)

-medical specialty with idea of a therapeutic asylum

-"psychiatry" termed by Reil

-concerned with mental alienation

-phsycial isolation of hospital

-superintendents isolated for mainstream medicine

-earliest systematic writings on mental illness (phrenitis- hippocrates brain swelling)

-condition of pores between atoms determines health

-solidism and atomism

Mania- impariment of reason, sudden emotional change, delusions

-eclectic

-saw ppl exhibiting manic and depressive states w/ normal inbetween (bi-polar) 

-stressed the course and outcome of disease (diagnosing)

-drilling a whole in the skull to the dura-mater

-used for migraines, epilepsy, and mental illness

-epiricism dies

-demonology restored

-mentally ill as witches

-priests acting as psychiatrists

-hippocratic medicine survived in european monasteries, eastern roman empire, middle east

-academic med was naturalistic and empirical

-preists were often trained physicians

-inquisitions aimed at heretics not mentally ill

-torture of mentally ill was rare

-religious institutions source of social compassion for ill

obsession w/ demonology and persecution of m. illwas uring renaissance and after

-Prevalence: ration of ppl in category to number of ppl in population (extent of disease in general pop)

-Incidence- number of new cases occuring in a period of time (risk for developing disease) 

1. broaden concept of mental illness (counting neurosis) 
2. improved identification of cases
3. increasing length of disease (decrease in death or recovery rate) 
4. increase in the # of people getting sick

-national committee for mental hygeine- focus on prevention

-big on de-institutionalization

-A mind that found itself (he was m. ill but was in remission long enough to write this book about the conditions)

-

-last ones were written when psychoanalysis appeared saintly and they actually don't work

-needs to depict that disorders do have a biological cause

-insidious early onset, chronic course (no recovery), progressive deterioration in personality emotion & cognition

-not seen before 1800 then drastically increase

-increased cognitive stress

-rise in infectious disease (viruses) due to more ppl in one place

-schizophrenia correlated with flu pandemics

-season of brith effect (3rd trimester in winter are more likely to have kids with schizophrenia)

1st alienist

-1st to suggest asylums could be therapeutic

-removed from stress, calm and clean, routine, self control, doctor/patient relationship

Moral Therapy (psychotherapy-instilling hope) - specified how to run an asylum w/ humain treatment

Battie thought all nerves, chiarugie thought it had a psychological sense

-usually credited with moral therapy 

-"unchained ppl" but replaced w/ straight jackets

-advocated principles of moral therapy

Originators of "romantic psychiatry"- m illness had social cause and emphasized environmental influence (passion leads to m. illness and is influenced by circumstances) 

-implemented idea of "therapeutic community"

-pinel's pupil

-Father of American Psychiatry

-wrote text books, learned moral therapy but didn't use it

-bled patients, tranquilizer w/ box over head

-syphilis (GPI)

-alcoholism

-schizophrenia (recency hypothesis)

1. redistribution

2.population growth

3. increased prevalence

4. increased incidence

-cause is childhood experience (mother cold and unloving)

-solution- dr. Kick (freudian) gave her insight into her mother

-strongly favored psychotherapy 

-showed med treatments (electroconvulsive, narcoanalysis-psychoanalysis w/ a sedative, and hydrotherapy -dunking in cold water or baths)

-many of the prominent figures came from private clinics that were not coming from the politis or the public

-m. ill people weren't treated well in history

-started as bethlem with 6 insane men in England

-lots of gruesom pics of it

-bedlam now synonym for chaotic madness

-in 1815 they had 122 patients