2. • Whether a behavior is considered normal or abnormal depends on
the context surrounding the behavior and thus changes as a
function of a particular time and culture. In the past, uncommon
behavior or behavior that deviated from the sociocultural norms
and expectations of a specific culture and period has been used as
a way to silence or control certain individuals or groups.
• As a result, a less cultural relativist view of abnormal behavior has
focused instead on whether behavior poses a threat to oneself or
others or causes so much pain and suffering that it interferes with
one’s work responsibilities or with one’s relationships with family
and friends.
3. • Throughout history there have been three general theories of the
etiology of mental illness: supernatural, somatogenic, and
psychogenic
• Supernatural theories attribute mental illness to possession by evil
or demonic spirits, displeasure of gods, eclipses, planetary
gravitation, curses, and sin. Somatogenic theories identify
disturbances in physical functioning resulting from either illness,
genetic inheritance, or brain damage or imbalance.
4. • Psychogenic theories focus on traumatic or stressful experiences,
maladaptive learned associations and cognitions, or distorted
perceptions. Etiological theories of mental illness determine the
care and treatment mentally ill individuals receive. As we will see
below, an individual believed to be possessed by the devil will be
viewed and treated differently from an individual believed to be
suffering from an excess of yellow bile. Their treatments will also
differ, from exorcism to blood-letting.
5. • Trephination is an example of the earliest supernatural
explanation for mental illness. Examination of prehistoric skulls
and cave art from as early as 6500 BC has identified surgical
drilling of holes in skulls to treat head injuries and epilepsy as
well as to allow evil spirits trapped within the skull to be released
(Restak, 2000). Around 2700 BC, Chinese medicine’s concept of
complementary positive and negative bodily forces (“yin and
yang”) attributed mental (and physical) illness to an imbalance
between these forces. As such, a harmonious life that allowed for
the proper balance of yin and yang and movement of vital air was
essential (Tseng, 1973).
6. • Greek physicians rejected supernatural explanations of mental
disorders. It was around 400 BC that Hippocrates (460–370 BC)
attempted to separate superstition and religion from medicine by
systematizing the belief that a deficiency in or especially an
excess of one of the four essential bodily fluids (i.e., humors)—
blood, yellow bile, black bile, and phlegm—was responsible for
physical and mental illness.
7. • Modern treatments of mental illness are most associated with the
establishment of hospitals and asylums beginning in the 16th century.
Such institutions’ mission was to house and confine the mentally ill, the
poor, the homeless, the unemployed, and the criminal.
• Psychoanalysis was the dominant psychogenic treatment for mental
illness during the first half of the 20th century, providing the launching
pad for the more than 400 different schools of psychotherapy found
today (Magnavita, 2006). Most of these schools cluster around broader
behavioral, cognitive, cognitive-behavioral, psychodynamic, and client-
centered approaches to psychotherapy applied in individual, marital,
family, or group formats.
8. • Diagnostic and Statistical Manual of Mental Disorders
• The DSM has undergone various revisions (in 1968, 1980, 1987,
1994, 2000, 2013).
• Created in 1952.
9. Stigma
• a mark of shame or discredit.
• a mark of disgrace associated with a particular circumstance,
quality, or person.
• -Merriam Webster Dictionary
• Stigma causes people to feel ashamed for something that is out of
their control. Worst of all, stigma prevents people from seeking
the help they need. For a group of people who already carry such
a heavy burden, stigma is an unacceptable addition to their pain.
(NAMI)
10. Ways to work with and through Stigma
• Talk Openly About Mental Health
• Educate Yourself and Others
• Be Conscious of Language
• Encourage Equality Between Physical and Mental Illness
• Show Compassion for Those with Mental Illness
• Don’t Harbor Self-Stigma
11. • There are strengths and limitations to a psychiatric diagnosis and
the diagnostic process generally.
• Unlike many physical disorders there is a much higher degree of
uncertainty attached to a psychiatric diagnosis. The systems of
classification that have been developed aim to reduce this
uncertainty but personal interpretations still figure large. If and
when a diagnosis is reached we immediately stumble into the
problem of labeling.
12. • First, the labels (the diagnosis) applied to people whether a
phobia, a form of depression, or a type of personality suggests
they are different. A human yes, but to those unfamiliar with the
condition they may be viewed as not quite normal, perhaps
unstable and unreliable, making them feel wary or uneasy? The
label itself becomes self-fulfilling and can bias the way clinicians
and the public see the person.
13. • A diagnosis can give a false impression of certainty, yet the
Diagnostic and Statistical Manual (DSM) that guides diagnosis is far
from a scientific document, despite its many supporters. With a
few notable exceptions no physical cause has been found for
psychological disorders and no biological tests are available to
support a diagnosis. In real terms a diagnosis is little more than a
reflection of the therapist’s opinion of what you have told them.
Go to a different psychiatrist and you may well get a different
diagnosis.
