Lecture L3 History of Clinical Psychology 1: Background and Roots

參考文獻/圖片來源：Pomerantz, A. (2013). Clinical psychology: science, practice, and culture?(3rd ed.). Thousand Oaks, CA: SAGE Publications.

[A Note on Language]

Terms used by clinical psychologists today did not exist hundreds of years ago

- Scientific diScoveries

- Social and political changes

Terms used in the past are not used today: Insanity, Madness, Lunacy

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3.1 Background on the History of Psychology

Important to distinguish between broader ideas/practice and the organized field

- Roots trace back thousands of years

- Clinical psychology emerged as a formal area of practice in the late 1800’s

Treatment of mental health problems occurred in other settings (e.g., medical, religious) before clinical psychology

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3.2 Clinical Psychology in Ancient Cultures

- Hippocrates (father of the modern medicine)

- Trained/practiced as a physician in Greece

- Hippocratic Oath 希波克拉底誓言

Connections to clinical psychology:

- Argued that all illness could be traced to a physical cause (e.g., rather than a religious origin, punishment from gods)

- Identified imbalance of humors as the cause of illness/mental illness

Examples: melancholia, mania

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- Siddhartha Gautama

- Indian spiritual teacher and philosopher 釋迦牟尼 悉達多·喬達摩

Connections to clinical psychology:

- Mindfulness as a component of the path to enlightenment

- Connected to mindfulness-based and acceptance-based treatments today

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3.3 Asylums & the Moral Treatment Movement

- Emergence of Asylums

Renaissance through the 19th?Century

- Increased popularity in 1700’s (with urbanization)

- Many people previously cared for by families at home

Typically conditions were poor and inhumane - Prisoners, not patients

- Example: Bethlehelm Hospital (“Bedlam”) in London (people in chains)

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- Asylums in the U.S.

First public asylum in Williamsburg VA

- Opened in 1773, before Revolutionary War

- Based on European model

“Treatments”?differ from what we consider treatments: “Shock”?water treatments; Restraints; Bleeding and blistering

By 1840, fewer than 10 asylums had been built in the U.S.

Most people not “treated”?in asylums through the late 1800s:

- Homes:

Often confined and strained if disruptive

Given physical freedom if not disruptive

- Prisons:

Psychiatric explanations not considered

Large number of individual with mental illness in prisons

- Almshouses

Developed from the English poor house system

Communities responsible for caring for residents

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- Moral Treatment Movement

Started in the late 1700’s - Increased in popularity in the mid-19th?century

Increased recognition of the inhumane treatment of individuals with mental health problems

Poor conditions predominated, but change was emerging

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- The Kirkbride Design

Need for more asylums evident in the mid-1800’s

- Private institutions for small numbers of people

- Few public asylums existed

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Thomas Story Kirkbride (1809-1863)

- Physician, advocate of moral treatment

- Believed architecture could be an important part of treatment

- Develop a specific design that was widely used in the late 1800’s

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Key Features of the Design:

Built in a rural environment on high ground (outdoor activity)

Central structure for offices and visiting spaces

Wings on either side of the main structure, one for men and one for women (maximize windows)

All rooms with windows for light, fresh air, and views of the countryside

Common rooms for recreation and activities

Wide hallways for walking/activity when the weather was poor

3.4 Pioneers in Change

Dorothea Dix

Completed similar tours and advocacy work in 30 other cities throughout the US

- Including tours in New York, New Jersey, Pennsylvania, Maryland, Ohio, Kentucky, Tennessee

Worked to create federal funding for public asylums

- Bill approved by Congress in 1854; but Franklin Pierce (president) vetoed

Traveled throughout Europe advocating for change

- Scotland, England, France, Switzerland, Italy, Greece, Turkey, Russia, Sweden, Norway, Denmark, Holland, Germany

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Raising Public Awareness

- Nellie Bly

Young journalist assigned an undercover piece by New York World

- Women’s Asylum on Blackwell’s Island

Pretended to experience mental health problems

- Examined and briefly held at Bellevue Hospital

- Ultimately sent to Blackwell’s Island

After 10 days, the New York World was able to secure her release

- Bly’s Ten Days in a Mad-House

- Wrote a series of articles?-?A book

- Described:

- Process of being “evaluated”

- Inhumane treatment by staff

- Observations of other women there

- Led to increased funding from NYC and a grand jury investigation

- Much of the language is considered offensive and inappropriate now

- Bly’s description of the conditions in the hospital and the treatment of patients may be disturbing.