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3 Feb 08 – Mental Illness: A Social Construction?

3 February 2008

On this day in 1845, Dorothea Dix presented a document to the Pennsylvania state legislature describing her 2-year survey of the state’s treatment of people with mental illness.  She found people with mental illnesses in jails, alms-houses, and cellars of public buildings.  As a result of her presentation, the Pennsylvania State Lunatic Hospital was created.

This story brings up the question of what is mental illness.  How did Dix determine that the mentally ill were to be found in these different locations?  How do we define mental illness? 

We can read a lot about the typical definitions, to be found in our diagnostic manual, The Diagnostic and Statistical Manual of Mental Disorders (DSM) now in its 4th edition (with a text revision).  Essentially, disorders are defined based on expert consensus and research conduct on these professionally accepted constructs. 

An alternative view, however, was presented by Thomas Szasz in his book entitled, Myth of Mental Illness (which was originally published as an article in the American Psychologist).  Szasz traced the history back to the Middle Ages and a pair of monks named Sprenger and Kramer, which always makes me think of a bad daytime talk show.   

[SIDE NOTE: In fact, Sprenger and Kramer did have a bit of a scam going on where they claimed to be clairvoyant.  They would set up a tent.  One of the two would gather information from the people outside the tent.  The people would be ushered in and the one who gathered information would go around the back of the tent and feed information to the one in the tent doing the “clairvoyancy,” thus making the people believe that they knew things they couldn’t know.]

Though the history of people being conceived of as mentally odd probably goes back further than Sprenger and Kramer, these two codified a specific category of mental deviance in a book entitled Malleus Maleficarum (which means “Hammer of Witches”).  In this book, Sprenger and Kramer developed means of determining who witches were.  They defined them based on certain features, which are relatively unimportant to the present discussion.  What is important is that this book was used to determine who were witches.  Then, individuals used it to go out and find witches.  Unfortunately, those finding the witches were paid on a sort of commission, wherein they received the lands of those found guilty of witchery.  So, it is probably not surprising that a number of single women were found to be witches.

 

At any rate, in the 1960s, Zilboorg discovered the Malleus Maleficarum and made the following statement, “the Malleus Maleficarum might with a little editing serve as an excellent modern textbook of descriptive clinical psychiatry of the fifteenth century, if the word witch were substituted by the word patient, and the devil eliminated.” Essentially, Zilboorg felt that Sprenger and Kramer, who happened to be a couple of con artists, had created a document, which happened to be used selectively to fabricate witchery and claim riches, was an excellent frame of reference for defining mental illness – if only we were to change the word witch to patient and take the devil out of it.

Szasz came along and interpreted both the Malleus Maleficarum and our current diagnostic system as social fabrications.  The point of both were to control people that did not fit neatly into the current social system.  In essence, Szasz said that “mental illness” was a social construction.  Szasz also felt like the “treatment” of this social construction was borderline abusive.  For example, he described the treatment of the “father of modern psychiatry” whose face appears on the DSM, Benjamin Rush.  Benjamin Rush was a signer of the Declaration of Independence, the personal physician of George Washington (and probably bled him – a common treatment at the time – to death), and a psychiatrist.  Rush’s treatments sometimes involved spinning people excessively until they said they no longer were experiencing the aberrant thoughts/behaviors.  He also devised specific treatments for specific individuals.  One person thought he had snakes in his intestines and Rush gathered some snakes from his garden, put them in a bucket, and had the person defacate in the bucket – now the snakes were out!  Another thought he was a plant and Rush urinated on him to kill the plant (or some such).  This, for Szasz, was evidence enough of the origin of poor treatment of those deemed “mentally ill.”

I guess, given this, it is not a far stretch that Dix would find the mentally ill in such destitute locations.  Still, we might benefit from some better understandings of what mental illness truly is.  Instead of accepting particular framings, we might benefit more from understanding the humanity and inhumanity that is involved in such designations and the treatment that stems from it.  What, for example, does it mean for those individuals, without words such as “crazy,” “depressed,” “anxious,” etc., to feel what they feel?  What does it mean for them to be told they are depressed, anxious, crazy, etc.?  What does it mean for them to be treated the way they are?  What are their relationships like?  How do they feel they fit into the world?  How do they conceive of the world?  What do the hallucinations and delusions of schizophrenics mean to them?  If there are some meanings to them, should we dismiss them as the result of a biochemical imbalance and treat them, as a result, with some psychotropic medication and ignore the meaning that these individuals do have?

Fuel for thought, I guess… head to my website GivingPsychologyAway.net for more fuel for thought regarding psychology.

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February 3, 2008 Posted by | In Psychology | , , , , , , , , , , , , | 5 Comments

25 Jan 08 – E. G. Boring – Myth Making in Psychological History?

25 January 2008

On this day in 1933, Edwin G. Boring’s book entitled, Physical Dimensions of Consciousness was published. As the title of this book implies, Boring was inclined to conceive of psychological phenomena in biological terms. Given this, it is no small wonder that Boring’s history of psychology (entitled, A History of Experimental Psychology) was revisionistic – putting a revised slant on the history, which made biological theorizing central to the foundation of psychology. There are three examples, which stand out among others, of how Boring went about revising history: the selection of 1879 as the official date of psychology’s beginning, the selection of the “father of experimental psychology,” and the characterization of this “father” as a physiological reductionist.

1879?

Boring solidified 1879 as the beginning of experimental psychology. His selection of this date has had such a profound impact that it is now rare to sit through a history of psychology course, especially in undergraduate psychology, and not be required to select this date on an examination. In fact, I think this showed up on my licensing exam (I know it was in the study materials).

How did Boring arrive at this date? Honestly, I am not quite sure. Based on other research (e.g., Robert Watson’s historical research) it is clear that even the suggested location of “the very first formal psychological laboratory in the world” was not actually formally “founded” until about 1894. I think we can be sure that Boring had some justification for choosing this year. Unfortunately, this is lost to “history.”

Father of Experimental Psychology?

What we do know is that Boring had a clear preference for whom he associated with this date and this formal psychological laboratory: Wilhelm Wundt. Based on what we learn in the history of psychology, this is the patently obvious selection as the father of experimental psychology. Wundt, unfortunately, was not the obvious choice. Two other psychologists, at minimum, preceded Wundt in their experimental efforts in psychology: William James and Gustav Fechner.

William James, for example, began teaching at Harvard University in 1875, four years before the chosen date of 1879. There, he brought together threads of psychological experimentation, physiological medicine, and forms of explanation derived from the theory of evolution. He was involved in active psychological experimentation and his seminal work on the topic of psychology, presenting elements of all his early interests, entitled, The Principles of Psychology was published in 1890, 4 years before the formal founding of Wundt’s laboratory.

Alternatively, Gustav Fechner was conducting research even earlier. With a background in physics (and during his career holding the chair of the physics department at Leipzig), Fechner was probably the first “psychologist” to develop experimental methods for the study of psychological phenomena. His work was a conjunction of experimental methods for the study of perception and philosophical debate regarding the fundamental nature of psychological phenomena. Fechner’s views on both, in the are called “psychophysics,” were summed up in his book entitled, Elements of Psychophysics (English translation of the German), published in 1860 – a full 19 years prior to the chosen date for the beginning of experimental psychology!

Why Wundt, then?

Given the foregoing, we are certainly left with the question of why Wundt was chosen to hold the exalted title of “Father of experimental psychology.” Well, there are somewhat apparent responses to this question, both founded in Boring’s perspective on psychology and in his writing on the history of psychology.

Boring (born in 1886), as a professor at Harvard University (where he developed and chaired the Department of Psychology in 1934), would certainly have been familiar with James (not to mention he would have been familiar with him by notoriety alone). Yet, by the time that Boring interacted with Jamesian thought, James had moved from experimentation to investigation of philosophical concerns. James’ perspective on philosophical concerns and the role of religion in psychological (presented in his text entitled, Varieties of Religious Experience: A Study in Human Nature published in 1902) had a decidedly dualistic tone. That is, he conceived of humans as having both a corporeal body and a metaphysical/spiritual mind (his framing of which sometimes made it difficult to determine whether he believed humans were determined or had agency – “free will”). Boring, alternatively, as the title of his book (which started this blog) suggests, was more inclined to view humans as the product of their biology alone.

Similarly, Fechner, while steeped in the physics of his time, also conceived of humans in a different manner than did Boring. In fact, Fechner saw body and mind as two ways of conceiving of the same thing. Fechner’s perspective, then, was a holistic conception, not unlike the Copenhagen Interpretation of Quantum Physics, which conceived of physical objects as having a complementary composition that is both “corporeal” and, for lack of a better word, “inferred.” From both perspectives, it was essential to understand both sides of the whole in order to understand the phenomena under analysis. Boring was quite aware of this aspect of Fechner’s position and chose to see it as prompted by the fact that Fechner suffered through a period of physical and mental illness: for Boring, instead of considering this perspective as possibly legitimate (based on his own biases), he instead considered it the ramblings of a troubled man. It didn’t hurt that it clearly did not fit with Boring’s own conceptions.

However, there was one person he knew he could at least make conform with his own perspectives, through a tricky kind of slight of hand: Wundt. This slight of hand was the fact that Wundt was portrayed by his student Titchener as a physical reductionist (e.g., someone who saw humans as essentially the product of their physical composition).

Physiological Reductionism?

Unfortunately, Wundt’s own writing does not even conform to this physiological reductionism perspective. Wundt, not unlike James, was a dualist. He perceived that conceiving of humans as only the products of their physiology as something that would take away all meaning from the human condition. Still, in his experimentation, he focused on those “objective” elements of the dualism (e.g., the physical), which Titchener took with him to the United States (and to Boring). Wundt, however, continued to present his philosophical analyses outside of the laboratory, where he clearly indicated this dualistic mindset.

In then end, then, Boring revised the history of psychology in a way that fit with his own perspectives. He chose Wundt (and a date that “sufficed”) because, via Titchener, Wundt could be painted to fit Boring’s conception of what psychology (and, specifically, experimental psychology) was all about.

Fuel for thought, I guess… head to my website GivingPsychologyAway.net for more fuel for thought regarding psychology.

January 25, 2008 Posted by | In Psychology | , , , , , , | Leave a comment