The History Of Therapeutic Procedures: Part 1 of 3

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In every age the dominant influence in the choice of therapy has been the particular model of abnormality in use by the therapist. The first known attempt at treatment of what we would now call emotional disorder took place roughly half a million years ago, during the Stone Age (Coleman, Butcher, & Carson, 1980). There is archeological evidence from the period of a practice known as trephining, which involved chipping a round hole in the skull with a stone tool presumably to allow an evil spirit, or demon, to escape. Some of these unearthed skulls show evidence of healing around the hole so at least some “patients” survived this drastic remedy and lived for several years afterward.

Early recorded history shows a similar belief among the Chinese, Hebrews, Egyptians, and Greeks that mental abnormalities were the result of possession by demons. The accepted mode of treatment was exorcism (expulsion of demons) involving rites of prayer and assorted attempts to make the body a most undesirable place for evil spirits. These included drinking vile liquids that were then regurgitated presumably along with the offending demon. Other approaches perhaps reserved for more stubborn cases, included flogging and starvation, Some centuries later, Hippocrates (c, 450-c. 377 B.C.), the Greek physician, rejected the prevailing idea of possession and formulated an early medical model, He divided mental illness into three categories: mania, melancholia, and phrenitis, or brain fever. All three, he thought, arose from natural disturbances of the body. Treatment was therefore aimed at the body and depending on the category, included vegetarianism, exercise, sexual abstinence, and bleeding. By the Middle Ages, however, the belief in demons had revived. Priests took over the treatment of abnormal behavior first with prayers and sprinklings of holy water, and later with more violent forms of exorcism. Starting in the fifteenth century, abnormal behavior was thought to be due to witchcraft. Treatment consisted of torturing “witches” until they confessed, and then burning them to death.

Witchcraft was still an offense punishable by both church and state in the early sixteenth century. Persecution of witches was not, however, without strong opposition. One of the leading attackers, Johann Weyer, published a book based on a humanitarian model arguing that witches were mentally ill rather than “possessed.” He advocated treatment based on understanding and help rather than on torture and burning at the stake. Although Weyer is regarded as the founder of modern psychopathology, his ideas were met at the time with scathing criticism.

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