Every society, past and present, has faced the problem of psychological abnormality. The way people viewed and treated it has changed a lot over time.

In the Stone Age:

In prehistoric times, half a million years ago, people believed abnormal behavior was caused by evil spirits. They thought the human body and mind were a battleground between good and evil forces. Abnormal behavior was seen as a victory of evil spirits. One treatment in that time was trephination, where a stone tool was used to cut a hole in the skull to release these spirits. A stone instrument or trephine was used. This was done for people who had hallucinations or melancholia (extreme sadness and immobility). In recent times, some believe that trephination might used to treat head injuries caused by tribal warfare.

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Another common treatment was exorcism, performed by shamans or priests. They tried to drive out or remove spirits by praying, using magic, making loud noises, giving bitter drinks, or, in extreme cases, whipping or starving the person.

During the Greek and Roman Period (500 B.C. – 500 A.D.):

In this time period, ideas became more scientific. Hippocrates, known as the father of modern medicine, believed that illness had a natural cause and abnormal behavior as a disease arising from internal physical problems. He thought that it was caused by an imbalance of four body fluids or humors. These were yellow bile, black bile, blood, and phlegm. Too much yellow bile caused mania, while too much black bile caused melancholia (deep sadness). Treatments included a healthy diet, exercise, rest, and sometimes bleeding.

In the Middle Ages (500 – 1350 A.D.):

In the Middle Ages, the church had great power and rejected scientific investigations. Again, abnormal behavior was seen as a sign of Satan’s influence. During this time, mass madness spread out, like tarantism (also known as Saint Vitus’ Dance), where a group of people suddenly start to jump, dance, and convulsions, thinking a tarantula spider bite caused it.

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Lycanthropy (thinking they were bitten and possessed by a wolf). Treatments were mainly exorcism by clergy, sometimes involving torture. By the end of this period, demonology declined, and medical hospitals, like Trinity Hospital in England, were established and became more common.

During the Renaissance (14th–16th Century) and the rise of asylums:

In this time, German physician Johann Weyer, the first physician to specialize in mental illness, believed that the mind could be sick like the body. He is now considered the founder of the modern study of psychopathology. At first, the care was improved, patients were treated kindly, and Gheel in Belgium was established for this purpose.

By the mid 1500s, governments turned hospitals and monasteries into asylums (institutions whose primary purpose was to care for people with mental illness). But soon overcrowding made them feel like a prison. In 1547, Henry VIII gave Bethlem Hospital in London to hold the mentally ill. But those patients were chained and treated poorly, and became a tourist attraction. The hospital was called “Bedlam” which means a chaotic uproar.

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In the 19th Century:

By that time, the treatment began to improve. In 1793, during the French Revolution, Philippe Pinel, a physician in Paris brought a revolutionary change. At La Bicêtre, an asylum in Paris for males, he freed them from chains, gave them sunny rooms, with care.

Similar reform was done in La Salpêtrière, a female mental hospital for females. In England, William Tuke followed similar ideas and founded the York Retreat (in 1796). In the US, Benjamin Rush, the father of modern American psychiatry, developed humane approaches. Dorothea Dix pushed for humane care, which led to the creation of state mental hospitals. However, moral treatment declined due lack of staffs, prejudice against people with mental disorder.

Early 20th Century

At the beginning of the 20th century, two opposing perspectives emerged, they are, these were: somatogenic perspective and psychogenic perspective.

Somatogenic perspective: It views that abnormal psychological functioning has physical causes. This idea was came from Hippocrates and became strong in this time. Emil Kraepelin published first modern textbook on psychiatry where he described mental disorder and syndromes. Besides a biological discovery also supported this. Untreated syphilis could cause general paresis, which leads both physical (paralysis) and psychological (delusion) symptoms, which indicates physical illness causes psychological issues.

Psychogenic perspective: According to this, the main cause of abnormal functioning is psychological. This view gained popularity by the discoveries of hypnotism. Friedrich Anton Mesmer used a method called mesmerism (early hypnotism) to treat patients with hysterical disorders (physical problems with no clear cause). Later it was found that hypnosis could create and remove these symptoms. Josef Breuer found that, under hypnosis, talking with patients about past painful events relieved symptoms. Building on these ideas, Sigmund Freud developed psychoanalysis, the first major psychological therapy based on unconscious processes. He believed that unconscious conflicts, childhood experiences, and hidden emotions shaped abnormal behavior. He also introduced outpatient therapy.

From spirits and exorcisms to scientific theories and therapy, views and treatments about abnormality have changed greatly over time. These laid the foundation of our modern understanding of mental health.