Background+Info


 * NINETEENTH CENTURY: REFORM & MORAL TREATMENT**
 * 1) MORAL TREATMENT MOVEMENT (1800s)**
 * a) Phillip Pinel** -implements a series of reforms in the Parisian hospital system in 1793 (French Revolution) treat with support and kindness, unchained &;prevented physical abuse, improved living conditions, offered support and advice, successful with many patients
 * b) William Tuke** - Quaker -England, York Retreat
 * c) Benjamin Rush** - in USA reforms Pennsylvania Hospital
 * d) Dorothea Dix** -responsible for new laws that mandated humane care &;public mental hospitals
 * 2) Decline of the Moral Treatment Movement** -due to social changes (immigration, lack of government and public support), insufficient $ appropriations for hiring staff ---> overcrowding --> ineffective---> custodial care.
 * II. SOMATOGENIC/BIOLOGICAL PERSPECTIVE** -roots in Greek &;Roman times, but not widely accepted until the late 1800s when General Paresis (delusions of grandeur,cognitive decline, paralysis) was proven to be caused by syphilis infection
 * a) Emil Kraeplin** -textbook with classification of syndromes
 * b) General paresis** linked to an organic disease, syphilis
 * III. PSYCHOGENIC PERSPECTIVE** -begins to gain acceptance during late 1800's
 * A. Anton Mesmer-** mesmerism, animal magnetism, hypnosis, suggestion, treatment for hysterical disorders
 * B. Charcot** - began to study hypnosis, legitimized field
 * C. Freud &;Breuer** - hypnosis, catharsis, counter suggestion,
 * IV. THE PSYCHODYNAMIC MODEL:**
 * A. Hypnosis** suggests role of unconscious intrapsychic conflict in hysteria, but problems with symptom substitution and not all can be hypnotized.
 * B. Free association** to consciously access/emotionally process repressed conflicts
 * C. Freud's Theory**
 * 1) Three Processes of Personality**: ID (instinctual, pleasure principle, primary process thinking) EGO (reality principle, secondary process thinking), SUPEREGO (morals, ego ideal). Intrapsychic conflict.
 * 2) Different levels of consciousness**-perceptual consciousness, pre-conscious, unconscious
 * 3) Anxiety** -realistic, neurotic, and moral anxiety
 * 4) Defenses &;Consciousness** - Repression, Projection -disowning projections,Reaction formation - feeling substitution, Displacement, Identification -identification with the aggressor, Denial, Intellectualization, Rationalization, Sublimation
 * 5) Maturational Hierarchy** - ranging from extreme distortion to more mature redirection of energy -Vailliant's longitudinal research methods, maturity of defenses during undergrad predicted overall psychological, social, and medical adjustment
 * 6) Stages of psychosexual development:** oral, anal, phallic (Oedipal and Electra Complex), latency, genital, Erogenous zones, libido, fixation (overindulgence or trauma/frustration)
 * D. NEO-FREUDIANS:** Jung, Adler, Horney, Sullivan, Erikson, differed with Freud on several grounds, did not maintain his biological/drive focus, but emphasized role of early socialization
 * E. MODERN PSYCHODYNAMIC THEORIES** -Klein, Kernberg, Kohut, Mahler, Stern, focus on the development of self and other representations and relationship schemas acquired during early development and how these schemas alter one's subsequent intrapsychic and interpersonal functioning.

In the 1800s, one could have his or her head examined, literally, using [|phrenology], the study of the shape of the skull developed by respected anatomist [|Franz Joseph Gall]. Other popular treatments included [|physiognomy] —the study of the shape of the face—and [|mesmerism], developed by [|Franz Anton Mesmer] —designed to relieve psychological distress by the use of [|magnets]. [|Spiritualism] and [|Phineas Quimby] 's "mental healing" technique that was very like modern concept of "positive visualization" were also popular. While the scientific community eventually came to reject all of these methods, academic psychologists also were not concerned with serious forms of mental illness. That area was already being addressed by the developing fields of [|psychiatry] and [|neurology] within the [|asylum] movement and the use of [|moral therapy] .[|[1]] It wasn't until the end of the 19th century, around the time when [|Sigmund Freud] was first developing his "[|talking cure] " in [|Vienna], that the first scientifically clinical application of psychology began—at the <span style="color: rgb(0, 43, 184); text-decoration: none">[|University of Pennsylvania] , to help children with <span style="color: rgb(0, 43, 184); text-decoration: none">[|learning disabilities].

<span style="color: rgb(0, 43, 184); text-decoration: none">  <span style="border: 1pt none windowtext; padding: 0in; color: rgb(0, 43, 184); text-decoration: none"> The private <span style="color: rgb(0, 43, 184); text-decoration: none">[|Brattleboro Retreat], shown here ten years after its 1834 founding, was the United States' model for dignified "moral treatment". The Retreat Farm, a crucial part of therapy, operates to this day. Progress in treatment was also occurring in the United States, often ahead of similar advances in Europe. Due to its relative youth, the United States is the only major nation where psychiatric hospitals were first established for treatment, rather than punishment. This was especially true in tolerant New England and particularly one institution in <span style="color: rgb(0, 43, 184); text-decoration: none">[|Brattleboro, Vermont]. In 1834, Anna Marsh established the prestigious <span style="color: rgb(0, 43, 184); text-decoration: none">[|Brattleboro Retreat] to offer "merciful, ethical, and scientific care" to the mentally ill. Originally named the Vermont Asylum for the Insane, the hospital pioneered the application of "moral treatment" based on clean living, patient empowerment, and therapeutic farm work. The hospital grew into a large research facility complete with these world firsts: a patient-produced newspaper, hospital swimming pool, bowling alley, gymnasium, theater, chapel, patient choir, patient sports leagues, outing club, dairy farm, and patient-run companies. Marsh endowed the Brattleboro Retreat in memory of her late physician husband. The vision she expressed in her will would come to impact around the world. Today it stands as a member of the Ivy League Hospitals. The original hospital building was the Marsh home, which still stands among the large riverside campus. The Hartford Retreat (now the <span style="color: rgb(0, 43, 184); text-decoration: none">[|Institute of Living] at <span style="color: rgb(0, 43, 184); text-decoration: none">[|Hartford Hospital] ) and <span style="color: rgb(0, 43, 184); text-decoration: none">[|McLean Hospital] also set the tone for the United States' history of relatively humane private psychiatric facilities. The Quakers of the mid-Atlantic states, particularly Pennsylvania, also offered dignified treatment that was among the most progressive in the world. The transition to state hospitals and "state schools", however, brought with them many abuses that shocked operators of private American psychiatric hospitals. Reformers, such as American <span style="color: rgb(0, 43, 184); text-decoration: none">[|Dorothea Dix] began to advocate a more humane and progressive attitude towards the mentally ill. Some were motivated by a so-called Christian Duty to mentally ill citizens. In the United States, for example, numerous states established state mental health systems paid for by taxpayer money (and often money from the relatives of those institutionalized inside them). These centralized institutions were often linked with loose governmental bodies, though oversight and quality consequently varied. They were generally geographically isolated as well, located away from urban areas because the land was cheap and there was less political opposition. Many state hospitals in the United States were built in the 1850s and 1860s on the <span style="color: rgb(0, 43, 184); text-decoration: none">[|Kirkbride Plan], an architectural style meant to have curative effect. States made large outlays on architecture that often resembled the palaces of Europe, although operating funding for ongoing programs was more scarce. Many patients objected to transfers from private hospitals to state facilities. Some Brattleboro Retreat patients tried to hide when state officials arrived to transfer them to the new Waterbury State Hospital. This decline in patient census led to the collapse of many private institutions, which still accepted indigent patients even when state reimbursement for private hospitals dropped in the face of rising state hospital costs.
 * United States **