I. Introduction To Abnormal Psychology
I. Introduction To Abnormal Psychology
I. Introduction To Abnormal Psychology
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[Introduction to Abnormal Psychology]
Defining abnormality
Robin Williams is a well-known American actor. He was famous for his comedy roles in blockbuster
movies. Despite his happy outlook onscreen, it was not known to the public that he had been suffering
from depression for many years. His mental illness was publicly revealed when he committed suicide
last 2014.
What is normality?
It is the expected behavior or way of living based on what is commonly observed in the majority of
the population.
1. SUFFERING
• Individuals who suffer or experience a similar phenomenon may have an existing abnormality.
• In Psychology, people who have depression and anxiety disorders suffer from disabling
symptoms of their disease.
• However, suffering is not an absolute indicator of abnormality.
• Suffering is a normal part of life.
• A father who is waiting for his wife to give birth normally suffers from anxiety. A child who
lost her toy is suffering from sadness.
• These kinds of suffering normally occur in healthy individuals.
2. MALADAPTIVENESS
• It is human nature to adapt to its surroundings for survival.
• However, there are adaptive behaviors that are abnormal.
• An example is a person who is depressed after losing his job, causing him to avoid social
interaction for several months.
• Another example is a person who frequently goes to the casino to relieve his stress and later
on develops an addiction to gambling.
• These maladaptive behaviors cause significant impairments in normal activities of daily
living.
• Interpersonal relationships may become strained, sleeping patterns become altered, and a
person may lose the ability to find satisfaction in what usually makes him happy.
• As in the case of Robin Williams, he committed suicide as a result of maladaptive behavior (See
Fig. 1)
3. STATISTICAL DEVIANCY
• Rare and undesirable behaviors may be indicative of an abnormality.
• These actions may be considered socially unacceptable or abnormal if it is uncommonly
observed in a group of individuals.
• An example of this would be someone with an intellectual disability, wherein objective
measures of intelligence would indicate that his performance deviates from what is normally
seen among a majority of individuals.
• However, this is not an absolute indicator of an abnormality.
• There are unusual behaviors that are still considered normal, despite their rarity.
• An example of this would be someone who displays rude behavior.
5. SOCIAL DISCOMFORT
• Aside from social norms, there are also social rules of conduct.
• When an individual goes against conventional behavior, other people will feel uncomfortable
or uneasy. For example, a lady is dining alone in a restaurant full of vacant tables.
• A stranger approaches her and asks them to share the table.
• This will make the lady uncomfortable because it is abnormal to share tables with a stranger,
especially if there are many unoccupied tables.
7. DANGEROUSNESS
• An individual who becomes a threat to him or other people around him is considered abnormal.
In fact, this dangerous behavior is considered an important indicator of hospital confinement.
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• Like all other elements that were discussed in this section, dangerousness is not an absolute
indicator of
ABNORMALITY. An example is someone who keeps exotic pets that may have venoms. In addition,
people who enjoy dangerous sports such as racecar driving, ice climbing, and base-jumping are not
considered abnormal (See Fig. 2).
It is important to know that the perception of abnormal behavior varies through time and culture. Some
social norms and traditions have changed over time. For example, during the Victorian era, it was
unacceptable for young and unmarried women to be seen in public places without an escort. Nowadays,
it is socially acceptable to see young women unaccompanied in the streets. Social tolerance to some
behaviors similarly evolved. Habits that were once considered taboo may be socially acceptable at
present. An individual's cultural background also plays a role in how he perceives normal and
abnormal behavior. For instance, in India, arranged marriages are considered normal. However,
this is unusual in Western societies.
HISTORICAL PERSPECTIVE
Early Demonology
• In ancient times, people once believed that supernatural causes could explain all unusual
occurrences.
• Unusual behavior, convulsions, and other illnesses were regarded as a form of demonic
possession or as a sign of dissatisfaction with supernatural elements.
• The belief that an evil spirit can cause possession of the human mind and body is called
Demonology. This belief is well documented in ancient Chinese, Egyptian, and Greek
literature.
• Casting out evil spirits to cure a disease is written in the bible. People believed that demonic
possession could be treated by exorcism, which is a ritual that drives out evil beings. This
elaborate ritual usually involves prayers, special rites, and at times starvation to make the
body unsuitable for demonic possession.
Fig 3. Circa 400 BC, Portrait of Hippocrates. Greek physician. Known as the 'Father of medicine,'
he developed the belief that four fluids of the body are the primary seats of disease. (Montage,
S./Getty Images, n.d.)
Early Biological Explanation
• Hippocrates is a famous Greek physician who practiced medicine in the fifth century (see Fig.
3). He is known as the father of modern medicine. He believed that diseases do not arise from
supernatural or religious forces.
• He thought that the brain is responsible for awareness, thinking, and emotional perception.
Because of this, he attributed unusual behavior and disordered thinking to an illness of the
brain.
• He deviated from the Greek belief that mental disturbances and bodily disorders were a
punishment from the gods whenever they were displeased with human behavior.
• He was the earliest to classify mental diseases into disorders of mania, melancholia, and
brain fever.
• He also believed that bodily fluids composed of blood, black bile, yellow bile, and phlegm
were critical for normal thinking and behavior.
• He postulated that any imbalance between these fluids would lead to disease.
• For example, he believed that a person who produced too much phlegm would become
sluggish, and a person who had too much blood within his body would have a bad temper.
• Since Hippocrates believed that illnesses were because by natural rather than spiritual causes,
he mastered the art of medicine through keen observation. He offered treatments that were
different from the rituals of exorcism.
• For individuals suffering from melancholia, he advised careful selection of food and drink,
avoidance of conflict, and abstinence from sexual activity.
• Hippocrates recorded all his observations and wrote a book about human disease and its
presenting symptoms. Initially, this was not well received because people preferred to
consult religious leaders for healing rituals.
• However, Hippocrates laid the conceptual foundation for contemporary medicine. In the next
centuries, the Greek and Roman Empires eventually adapted their belief that human
disease arises from natural instead of spiritual causes.
• In the period between 500-1000, the Western European civilization went through an era
called the Dark Ages.
• During this period, barbarian tribes learned that Rome did not have any rulers, causing
them to overtake this territory.
• Over time, the Greeks' and Romans' cultures became less prominent, leading to a decline in
scientific and cultural advancements. Because of this, the Church became heavily influential,
and Christian missionaries engaged in academic work. It was during this period when the
Church was separated from the state.
• As a result, Christian missionaries and religious groups gained authority over physicians when
it came to the treatment of mental illnesses.
• This practice was evident in ancient Greek writings, wherein monks performed rituals for
individuals with mental illnesses.
• During that time, descriptions of treatment varied from prayer offerings to drinking concocted
potions depending on the phase of the moon. There was a revival in the belief that spiritual
and demonic forces caused mental illnesses.
Fig 4. Front cover of Malleus Maleficarum, the book that the Church used as a guide for witch-
hunting. (Malleus Maleficarum, n.d.)
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LUNACY TRIALS
• During the thirteenth century, political jurisdiction over European cities progressed. Local
political leaders gained influence over the religious sector.
• The secular government in some regions of England built hospitals to keep mentally ill
patients away from the public.
• Historical records show that they were not released until they were perceived as normal.
• This practice was considered legal in England during the mid-fourteenth century.
• According to records, there are a lot of people who ascribed mental illness as a result of
demonic possession. During this period, the local government of England instituted lunacy
trials, wherein people who behaved strangely went to court for scrutiny.
• This was designed to identify people with mental illness and protect them from possible
harm.
Pinel’s Reforms
• At the height of the French Revolution, Philippe Pinel was assigned to oversee La
Bicetre, a popular asylum in Paris.
• Pinel was an advocate for the humane treatment of mentally ill patients. Historical
records narrate that Pinel wrongly of keeping patients chained. He believed that a more
humane form of treatment would make them better.
• To test if this was correct, he asked permission from the Revolutionary Commune to
remove the chains of mentally ill individuals. Fortunately, his request was granted, and he
freed them from chains (See Fig. 6).
• He also advocated changing the appearance of the individual rooms in the asylum. This
transformed the appearance of the asylum from a dungeon to a well-lit room.
• He was proven correct when the behavior of patients improved. After more humane
treatment, patients walked along the corridors without troubling anybody. Some patients
were cured and eventually went home to their families.
• However, some historical researchers claim that it was not Pinel who freed the patients
from their chains. Some historical documents show that it was Jean-Baptiste Pussin, a
former patient who became an orderly in the asylum.
Moral Treatment
• Mental asylums in Europe and the United States eventually adopted the
humanitarian treatment of patients that were initiated at La Bicetre. In the early 17th
century, two large asylums in the United States were established.
• These were Friends’ Asylum in Pennsylvania and the Hartford Retreat in
Connecticut.
• Humanitarian treatments eventually paved the way for the practice of moral treatment,
wherein patients have a therapeutic relationship with their attendants. Attendants
interacted and read to mentally ill patients.
• There were fewer restrictions on patients leading to a better quality of life. However,
patients' moral treatment was not sustained, and by the late 19th century, mentally ill
patients were again imprisoned or abandoned with poor access to health care.
• Dorothea Dix, a schoolteacher from Massachusetts, witnessed the plight of mentally ill
patients when she taught Sunday school at a local prison, which housed people with
abnormal behavior (See Fig. 7). She observed that facilities were scarce for mentally ill
patients because not all patients were accommodated. Her contributions improved the
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treatment of mentally ill patients. She led campaigns that resulted in the
establishment of 32 state psychiatric facilities.
• These state hospitals made healthcare more accessible to patients who cannot be
accommodated in private asylums. Unfortunately, patients outnumbered the hospital
staff, and individualized treatment was not possible.
Fig 7. Dorothea Lynde Dix (1802-1887) was an American educator, social reformer, and
humanitarian whose devotion to the welfare of the mentally ill led to widespread reforms in the
United States and abroad. (Encyclopedia Britannica/UIG, n.d.)
Nevertheless, these hospitals employed physicians who took great interest in investigating the
biological basis for mental disorders. This was generally advantageous, but less emphasis was
given to patients' psychological well-being with mental disorders.
CONTEMPORARY PERSPECTIVE
Biological Approaches
Discovering Biological Origins of General Paresis and Syphilis
• In the late 16th century, some mentally ill patients exhibited functional decline, both
mentally and physically.
• Aside from suffering from symptoms of delusions and hallucinations, some became
progressively paralyzed. These patients were diagnosed to have general paresis, and
unfortunately, almost all of these patients do not recover their physical abilities.
• In the 17th century, it was discovered that some of these patients also harbor an infection
called syphilis.
• However, the connection between paresis and syphilis was not yet established. In the late
17th century, Louis Pasteur discovered that human disease could be caused by infection
with small organisms.
• This was later on termed the germ theory of disease, and it became the foundation for
defining the biological link between general paresis and syphilis. In 1905, the bacterium
that causes syphilis was discovered. During this time, the biological connection between
infection, brain illness, and disease manifestation was established.
Biological Treatments
Insulin Shot Shock Treatment
• In the early twentieth century, attendants who supervised mental hospitals were still
outnumbered by patients. Because of this, physicians were encouraged to look for
treatments that would control the behavior of patients.
• During this time, Manfred Sakel discovered insulin shot shock treatment, wherein patients
are rendered comatose with the administration of large insulin doses (See Fig. 8). Insulin
treatment works by depriving the brain of sugar, the brain’s only food source.
• Insulin shot shock treatment improved the behavior of the majority of patients with
psychosis. However, this form of treatment was eventually discontinued when devastating
complications of irreversible coma and death were noted.
Fig 8. A nurse at the Horace Berk Memorial Hospital prepares an insulin injection for the
treatment of insanity, Philadelphia, Pennsylvania, 28 March 1938. (Underwood Archives/Getty
Images, n.d.)
Electroconvulsive treatment
• Ugo Cerletti and Lucio Bini discovered electroconvulsive treatment (See Fig. 9).
Initially, Cerletti investigated the use of electric shocks to reproduce convulsions, as seen
in epilepsy.
• He discovered that the application of electric shocks to both sides of the head could
produce convulsions. In the late 1930s, he used this treatment for a patient with
schizophrenia.
• Progressive advancements in this form of treatment were made in the following decades.
• Until today, electroconvulsive treatment is still being administered for patients with
schizophrenia and severe depression.
Fig 9. A patient received electroconvulsive therapy, better known as electric shock treatment, at
Patton State Hospital in California in 1942. (The Associated Press, n.d.)
Prefrontal lobotomy
• Egas Moniz, a brain specialist from Portugal, introduced a surgical procedure that cures
mental illness
• This is referred to as prefrontal lobotomy, wherein the frontal lobe is disconnected from
other areas of the brain.
• This was indicated for those who displayed aggressive and violent behavior. Prefrontal
lobotomy was proven successful in treating patients with mental diseases.
• However, it was observed that after surgery, patients are unable to communicate, causing
a great impairment in their way of living. In the 1950s, some brain specialists argued that
this form of treatment silenced patients because it destroyed their brains.
• Because of this, the practice of prefrontal lobotomy was eventually abandoned.
PSYCHOLOGICAL APPROACHES
Mesmerism
One of the mental illnesses that were prevalent during the 18th century was a condition called
hysteria. Hysteria is diagnosed in individuals who suffer from functional incapacities, such as
paralysis or blindness, without a known biological cause.
CATHARSIS
• Joseph Breuer is an Austrian physician who became well-known for his contributions to
psychoanalysis. During his career, he treated a patient under the pseudonym of Anna O.
• Anna O has various symptoms of hysteria, ranging from blindness, limb paralysis, and
difficulty hearing and speaking. According to historical texts, she exhibited a dreamlike
state, wherein she would sometimes mumble disturbing thoughts to herself. Breuer
documented significant improvements in her behavior after hypnosis.
• According to his observations, symptom relief lasted longer if the length of the hypnosis
session increased.
• Also, when Anna O is hypnotized, she can express her emotions and describe in detail
how her symptoms start to appear.
• Breuer discovered that recalling traumatic emotional experiences and disturbing behavior
was therapeutic. This form of therapy was referred to as the cathartic method.
Psychoanalysis
Sigmund Freud is a contemporary of Breuer (see Fig. 11). His observations with Breuer led to
his belief that unconscious conflicts are contributors to abnormal human behavior. This is the
assumption of the most popular theory in contemporary psychiatry, called psychoanalytic
theory.
1. The id was thought to be responsible for basic urges for food, water, warmth, elimination,
affection, and sexual pleasure. According to psychoanalytic theory, the id has been present
since birth, and its energy source is biological, termed the libido. This energy cannot be felt
because it is part of the unconscious.
Based on Freudian principles, the id wants immediate resolution of its urges through gratification.
This phenomenon is termed the pleasure principle. When the urge remains ungratified, tension
builds up, and the person naturally finds a way to get rid of the tension. An example of this is a
hungry baby who eliminates his tension by moving or crying. According to Freud, another way of
obtaining gratification is through fantasizing. Although this only provides short-term satisfaction.
2. Based on Freud’s assumptions, the ego develops at six months of age. Compared to the id,
which is part of the unconscious and allows fantasizing about dealing with urges, the ego is
conscious, and it allows the individual to deal with reality. According to Freud, when ego
facilitates the interaction between reality and the id’s demand for pleasure gratification. This
phenomenon is called the reality principle.
Psychoanalytic Therapy
• This form of therapy is also known as psychoanalysis, and this is still part of the
therapeutic modalities that are being used in modern psychiatry.
• The therapist performs a thorough analysis of the patient's historical background, including
childhood experiences, interpersonal relationships, and emotional attributes. Freud
developed techniques to enhance the practice of psychoanalytic therapy.
• In the free association technique, the patient can say whatever comes to mind. The patient
is usually sitting on a couch, not facing the therapist.
• The term transference is used to describe when the patients reflect on important people's
behaviors and attitudes in the patient's life. This is an occurrence that the therapist must be
able to recognize during psychoanalysis.
• For example, when the patient unnecessarily feels that the therapist is not listening to what
she is saying. This may reflect a patient’s frustration in childhood, when she is not being
listened to, rather than what is happening in reality.
• During interpretation, the psychoanalyst explains the meanings behind the patient’s
symptoms and behaviors.
ANALYTICAL PSYCHOLOGY
• Carl Gustav Jung is a Swiss psychiatrist and one of Freud's previous contemporaries (See
Fig. 12). He was instrumental in establishing Analytical Psychology. He believed that all
people have a collective unconscious, a common unconscious that consists of archetypes.
• These archetypes are basic classifications that people use to form a perception of the world
they live in. He also described gender differences in terms of personality traits. He also
theorized that people have basic id urges composed of spiritual and religious urges, which
are influenced by personality traits.
• He also described two different types of personality, namely extraversion and
introversion, depending on orientation to the environment.
Fig 12. Carl G. Jung (26 July 1875 - 6 June 1961), was a Swiss psychiatrist and
psychotherapist who was most famous for founding analytical psychology. (World History
Archive/UIG via Getty Images, n.d.)
Individual Psychology
Alfred Adler founded Individual Psychology (See Fig. 13). He believed that individual
fulfillment is derived from contributing to the growth of society. He also emphasized the
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importance of individual productivity and goal-oriented task achievement. He also theorized that
an individual’s manner of thinking greatly affects a person’s emotional and behavioral output.
Fig 13. Portrait of Alfred Adler. Photography. Around 1900. [Portrait von Alfred Adler.
Photographie. Um 1900.] (Photo by Imagno/Getty Images, n.d.)
Classical Conditioning
• This is one of the learning theories that were discovered by Ivan Pavlov. Conditioning
is a learning process wherein an individual eventually gives a different response due to
repeated stimuli. In this theory, an event that elicits an expected response is combined
with another event that does not.
• After repeated exposure to the event, the event that normally does not elicit a response
will eventually do so.
• This can be exemplified by how Ivan Pavlov discovered this behavior. Pavlov's
experiments on the digestive system showed dog meat powder to the test animal to
trigger it to salivate, which is a normal response when an animal sees food.
• As he continued his experiment, he noticed that with repeated testing, the dog salivates
earlier, and just hearing the footsteps of the feeder can trigger salivation.
Operant Conditioning
• Burrhus Frederic (B.F.) Skinner is the proponent of operant conditioning, which is a
type of learning wherein the learned behavior is an effect of a stimulus.
• This is also known as the principle of reinforcement, in which reinforcement is the
stimuli. Skinner described a positive and negative form of reinforcement, which
consequently leads to positive and negative behavioral responses.
• Positive reinforcement is the phenomenon wherein a pleasant stimulus, called a positive
reinforcer, is used to strengthen a good behavioral outcome. An example is when a child
is allowed to play longer when behaves well in class.
• Allowing the child to play longer is a positive reinforcer. As a result, this strengthens the
likelihood of the child to behave in class continually.
• On the other hand, negative reinforcement removes the presence of a pleasant
stimulus to strengthen a certain behavioral outcome. An example is when a child refuses
to eat, and the mother takes her toy. As a result, the child will eat because a pleasant
stimulus was taken away from her.
Behavior therapy
• In the 1950s, one of the therapies that emerged to cure mental illness was behavioral
therapy or behavioral modification therapy, which applies classical and operant
conditioning principles.
• The principle of operant conditioning that was described by Skinner is used to cause a
desired behavioral change. An example of behavioral therapy is systematic
desensitization therapy for the treatment of phobias. This form of treatment alters the
abnormal behavior through gradual exposure to what triggers unusual fear or anxiety.
Cognitive therapy
• Contemporary psychologists believe that thinking and perception influence behavior. For
example, a person who loses his job and thinks that he is worthless will likely fall into
depression.
• On the other hand, one who maintains a positive outlook in life is likely to look for work.
In this form of therapy, psychologists identify unpleasant thoughts that need to be
modified. Patients are made aware of their maladaptive perceptions to change how they
feel and behave.
Glossary
Abnormal psychology - is a scientific discipline that studies unusual patterns of thoughts,
emotions, and behaviors associated with mental illness.
Behaviorism - is a therapeutic principle in psychology that focuses on observed behavior.
Behavioral therapy - is a form of therapy used in psychology that applies the principles of
classical and operant conditioning to alter behavior.
Cathartic method- a form of therapy that is used to relieve emotional suffering, wherein
patients recall and re-experiences their emotional trauma.
Classical conditioning - also known as Pavlovian conditioning, wherein an event that elicits an
expected response is combined with another event that does not. After repeated exposure to the
event, the event that normally does not elicit a response will eventually do so.
Demonology- the belief that an evil spirit can cause possession of the human mind and body
Ego is a concept used in psychoanalysis; it is the conscious portion of personality that develops
from the id.
Id - a concept that is used in psychoanalysis; it is an unconscious portion of personality that has
been present since birth.
Operant conditioning - a manner of learning to obtain or remove a response through
reinforcement.
Pleasure principle - in psychoanalysis, this is the principle by which the id seeks immediate
gratification from primitive urges.
Psychoanalytic theory - described by Sigmund Freud, wherein abnormal behavior is postulated
to come from unconscious conflicts of a person.
Reality principle - in psychoanalysis, this is the principle by which the ego is able to delay
gratification and deal with the consequences in a rational manner.
Superego - in psychoanalysis, this is analogous to the mind's conscience based on perceived
societal norms and acquired personal values.
Transference - the event wherein the patient treats the psychoanalyst as a significant figure in an
individual’s past.
References