The History and Evolution of Abnormal Psychology

Human behaviour is a complex puzzle. And understanding its functions has been as complex as well. Today, we know that our behaviour is influenced by our environment, personal choices, people around us, and even our genes. But that was not the understanding in ancient times. Back then, people believed in all sorts of things, from being possessed by spirits to imbalances in the bodily fluids. But as the field of medicine evolved and grew, so did that of psychiatry and psychology. Enabling us to understand psychopathology in a much better way.  

What is Abnormal Psychology?

Abnormal psychology is the study of maladaptive and abnormal behaviour. This branch of psychology assesses, diagnoses, and treats unusual patterns of behaviours, thoughts, or emotions. Any “abnormal” behaviour deviates from the current societal norms. Thus, a behaviour which may be considered abnormal today may not be given the same status twenty or thirty years down the road.

But the history of abnormal psychology is vast, and it has seen many changes throughout the years. Its journey through various cultural, religious, philosophical, and scientific shifts has shaped our current understanding of mental illness and abnormal behaviour. For a large part of human history, those who had any abnormal thoughts or displayed any abnormal behaviour were seen as cursed or possessed. They were ostracised. Our understanding behind the reasons for such behaviour then moved to a purely scientific one, with imbalances of bodily fluids or as a symptom of underlying illnesses.

Today, we explain and treat abnormality as a result of psychological, interpersonal, social, and cultural factors. Abnormal psychology in the modern world focuses on psychological disorders; studying the condition, understanding its symptoms and underlying causes, diagnosing and treating it, as well as preventing it from occurring. Mental health professionals now have a structured way to identify, diagnose, and treat the disorders.  

The Supernatural Explanations: When Spirits and Demons Took the Blame

In ancient civilisations, abnormal behaviour was seen through a supernatural or religious lens. People back then attributed anything out of the ordinary to being demonic or possessing some supernatural entity. Anyone behaving abnormally was said to have been punished by the divine.

1. Trephination: Drilling Out the Evil

One of the earliest examples of supernatural explanations for mental illness is trephination. The drilling of holes in skulls was supposed to allow evil spirits trapped in a person to leave the body. Archaeological findings of the Stone Age era in Europe and South America provide evidence for the same (Weiner & Freedheim, 2003).  

2. Hippocrates’ Naturalistic Shift

The first breakthrough in the field occurred in Greece when Hippocrates, often regarded as the father of medicine, suggested that mental disorders could be caused by imbalances in the bodily fluids of “humours”. Hippocrates believed that the mind and body were closely linked,  and thus any disturbances in the body’s natural balance could cause mental illnesses. This was one of the first perspectives to bring about a shift from supernatural explanations to a more naturalistic understanding of abnormal behaviour (Zilboorg & Henry, 1942).  

3. The Middle Ages: Witch Hunts and Possessions

By the late Middle Ages, supernatural theories of abnormal behaviour gained popularity once again. This belief became popular again because of natural disasters like plague and famine,  as the larger body of people believed that these were brought about by the devil. And thus any mental illness was seen as the consequence of some sort of evil influence.

Many of these individuals were believed to be possessed by demons or witches. Because of this, they were subjected to exorcisms, torture, or execution. At the height of this era were the witch hunts of the sixteenth and seventeenth centuries, when people (mostly women) accused of witchcraft were deemed mentally ill, and as a result were tortured and killed. The stigma around mental illness during this period was because of the widely accepted belief in the supernatural  (Schoeneman, 1977). 

The Biological Model: From Humours to Brain Chemistry

1. Hippocrates and Galen’s Theory of Humours

The biological understanding of abnormal behaviour essentially started with Hippocrates’ theory about the imbalance of bodily fluids or humours. He suggested that health depended on maintaining a balance between the four humours: blood, phlegm, black bile, and yellow bile.  Arguing that the type of abnormal behaviour or psychopathology depended on an excess or a deficiency in one or more of these fluids.

Galen, a Roman physician, adopted Hippocrates’  theory and developed it further. He said that each of these fluids relates to one of the four qualities: heat (blood), cold (phlegm), dryness (black bile), and moisture ( yellow bile). Thus, the imbalance in one or more of these fluids could be treated by regulating the environment  (Barlow & Durand, 2002). 

2. The 19th Century Renewal of Biological Explanations

The biological underpinnings of mental disorders were then renewed in the 19th century. J.P.  Grey suggested that mental disorders were always a result of physical causes. And thus a mentally ill patient should be treated as if they were physically ill; i.e., they should be put on rest, follow a specific diet, and have proper room temperature and ventilation.

3. Kraepelin and the Foundations of Modern Diagnosis

Researchers began to link mental illness to brain structure and chemical imbalances, laying the foundation for modern psychiatry and the use of medication in treatment. This time also marked the use of new treatment techniques. Electric shock, electroconvulsive therapy, and brain surgeries were used as treatment methods. Further, Emil Kraepelin contributed to the area of diagnosis and classification. He distinguished between various psychological disorders, stating that each had a different age of onset, different symptoms, different time course, and different causes. His work laid the foundation of the modern classification system followed by health care professionals (Barlow & Durand, 2002; Whitbourne, 2016). 

The Psychological Approaches: Shaping the Mind’s Understanding

1. Early Thinkers: Plato and Aristotle

The psychological approaches to abnormal behaviour didn’t arise suddenly. There were many precedents that led to the formal formation of a psychological outlook on mental illnesses.  One of which is credited to Plato, he believed that negative social and cultural influences in one’s life, as well as the adverse things that people learn from their environment, could lead to maladaptive behaviour. Another example is that of Aristotle, who also implied the influence of early learnings and social influences on later psychopathology.  

2. The Rise of Moral Therapy and Asylums

“Asylums” began to exist from the 16th century, but it wasn’t until the spread of moral therapy that the asylums became more habitable and therapeutic, and less like prisons. The moral therapy focused on treating the patients in normal social environments rather than treating them as prisoners. In the mid-1800s, Dorothea Dix campaigned to bring about a reform in the treatment of those with abnormal behaviours.

She argued that it would be more economical and humane to treat mentally ill patients in hospitals than to care for them in their own communities. She advised that the formation of facilities to house mental patients would be a good, if not the best, solution. Apart from the proposals, she ensured that the standards of care were improved and that anyone who needed care received it. Her work came to be known as the mental hygiene movement. Her work led to the creation of a large number of institutions for the treatment of mental patients. This led to the development of a new profession of psychiatry (Weckowicz & Liebel-Weckowicz, 1990).  

3. The 20th Century Schools of Thought

This was followed by an inactive period in the psychological approach. But post this emerged several different schools of thought in the 20th century. The first major school of thought was psychoanalysis, based on Sigmund Freud’s theory of mind and the levels of unconscious processes in determining behaviour. He proposed that conflicts in the mind  (often unconscious) were central to mental illness. These conflicts were either a result of childhood trauma or unresolved desires. He also explained parts of the mind in terms of desires or social rules.

The second school was that of behaviourism. This emphasised the importance and significance of observable behaviour. Behaviourism believes that all behaviour, including abnormal behaviour, is learned through interaction with the environment. Ivan Pavlov, B.F. Skinner and John Watson were the key figures in this school of thought. They demonstrated how behaviour could be learned or strengthened. They illustrated how behaviour could be “conditioned” or how any behaviour could either be strengthened through reinforcement or be weakened through punishment.

Following this were many other schools of thought, including structuralism, functionalism, humanistic, and cognitive. While all these approaches do differ in the theories and techniques, they collectively have shaped how clinicians understand and treat abnormal behaviour (Barlow &  Durand, 2002; Butcher et al., 2018; Weiner & Freedheim, 2003).

The Modern Era: Towards a Biopsychosocial Understanding

In the modern era, the field of abnormal psychology is an integration of different approaches and models. Rather than a reliance on a single theory or approach, today’s mental health clinicians adopt elements of biological, psychological, and social perspectives to understand human mental disorders more comprehensively. This type of integration is sometimes referred to as the biopsychosocial model, which recognises that genetics, brain chemistry,  personality traits, cognitive processes, relationships with others, and unique cultures all play a part in one’s overall mental health. 

1. Diagnostic Systems: DSM and ICD

Diagnostic instruments have become increasingly refined. The Diagnostic and  Statistical Manual of Mental Disorders (DSM), prepared by the American Psychiatric  Association, provides standardised criteria for the diagnosis of mental illness. It has been revised a number of times to keep up with changing scientific knowledge, cultural factors,  and practitioner experience. Likewise, the International Classification of Diseases (ICD), used globally, provides diagnostic guidelines accepted by the World Health Organisation.

2. Treatment Advances: From Medications to Therapies

Treatment methods are also diverse and evolving. Psychopharmacology has advanced significantly over the years, resulting in the development of medications that can manage symptoms of mental disorders like depression, anxiety, and schizophrenia etc. Furthermore,  psychotherapies such as cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT), among others, have emerged and are widely used.

3. Technology and Research: Peering Inside the Brain

Technological advancements are also helping reshape the field. Techniques like brain imaging (fMRIs and  PET scans) are now being used by researchers to study brain structures and functions.  

Overall, the modern era has increased awareness about mental health and has reduced the stigma surrounding mental illnesses. While there still are many challenges today, the field continues to grow and thrive, providing a better, comprehensive understanding of the disorders, symptoms, and treatments. And all this happened with greater compassion and acceptance than ever before. 

Conclusion 

While our understanding of abnormal behaviour started with the view of supernatural forces and then moved to more reasonable biological causes and psychological perspectives, none of this happened in a sort of timeline, i.e., happening one after the other. But rather, it was an interplay of a lot of people working on different things and having different conclusions at the same time.

So, to understand the history easily, we can divide them into sub-streams, but in reality, a lot of it occurred simultaneously, with many researchers saying the same or similar things over time. Now, in the modern world, we have a better understanding of what abnormal behaviours or mental illnesses are, and how they can be treated. Today, we understand, analyse, and treat abnormality as a result of psychological, interpersonal, social,  and cultural factors. Mental health professionals now also follow a structured categorisation system to categorise and explain disorders in a more comprehensive, universal, and standardised manner.

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