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The History of Mental Health

While in therapy confronting my traumatic experiences and struggling to answer as my therapist asks “tell me more,” I wonder if perhaps a good old fashioned exorcism would just be easier…


There has been a cyclic evolution of the believed cause of mental illness: interweaving through history are beliefs that it originates from supernatural intervention, physiological roots, or psychogenic causes. As we navigate questions about mental health, we want to reflect on historical perspectives that may impact our current beliefs and health-care systems.


The Dark Ages of Mental Health

In ancient cultures, mental disorders were usually attributed to spiritual or supernatural causes. If you suffered a mental illness, it was believed that you either seriously pissed off the wrong vengeful God, or perhaps you were unlucky enough to catch a nasty spirit. Extreme measures were taken to purge people of these unwelcome guests. Prehistoric skulls from 6500BC have been found with holes drilled in them, likely as a method of releasing the evil spirits. Alternatively, religious ceremonies and repentment were used to absolve people from the displeasure of the Gods or to expel spirits. Less jarringly, Ancient Chinese cultures (2700BC) believed that a harmonious life required the proper balances of positive and negative forces (Yin and Yang) and mental illness manifested from an imbalance of these forces.



Cutting the Stone (circa 1494) by Hieronymus Bosch


Veering away from these spiritual explanations to more a body-centered perspective, Hippocrates (400BC) first proposed there was instead a physiological cause of mental disturbances – an imbalance in ‘four essential humours’ of the body. Based on these, there were four classifications of mental illness: epilepsy, mania, melancholia, or brain fever. Though arguably an improvement from previous methods, things like bloodletting (the removal of blood and impure fluids to cure conditions) were still cruel and unusual.


Justification of plagues and wars in the 15-17th century saw a return to supernatural beliefs, and views on the mentally ill regressed disturbingly. Many mentally ill women, believed to be possessed, were hunted and burned at the stake in the infamous and tragic witch hunts. In the 16th century, hospitals and asylums for the mentally ill were established. While this may sound like a step in the right direction, the reality of these patients’ lives were bleak. These institutions sought to isolate patients from the public, often into destitute and cruel living conditions. People were either left to wither away, akin to prisoners, or subject to ‘treatments’ more closely resembling torture. These included practices like electroconvulsive therapy, drug induced shock therapy to cause convulsions, lobotomies, and chemical constraint using opium, morphine and tranquilizers.


Anxious Thoughts by Dayo Nimotalah Atekoja. Source: Anxious Thoughts | Mental Health Art (theperspectiveproject.co.uk)


Building Towards Compassionate, Community-Based Care

Improved standard of care began in the 18th century, with a proposed model of compassionate care and humane approaches to patients. Piloting this switch was a memoir “A Mind that Found Itself” by Clifford Beers detailing his horrific treatment in a mental hospital. This account evolved into the Mental Hygiene Movement, which later morphed into the Mental Health Movement. Shortly after began a shift away from asylum-based care into community-oriented care. Patients were treated with greater respect and dignity, and granted access to recreational and occupational therapy.


 
“That the very delusion which drove me to a death-loving desperation should so suddenly vanish would seem to indicate that many a suicide might be averted if the person contemplating it could find the proper assistance when such a crisis impends.”

- Clifford Whittingham Beers, A Mind that Found Itself

 

Building on our scientific understanding of mental health, the concept of psychology as an experimental field began in the 20th century. Theories on the workings of the mind arose, such as from the famous clinician Sigmund Freud with his ideas on the unconscious mind and psychoanalysis. Yet still, the mentally ill were largely misperceived by the general public as violent or deranged. The mental health movement was advocating to reduce stigma and misconceptions about mental disorders, but remained a fairly small grassroots movement.





Overcoming the Mental Health Stigma

Suffering from a mental illness has never been easy. Throughout history, the mentally ill have been considered as wrong-doers enduring the ‘justified’ wrath of gods, as those with vile imbalances in their bodies that need to be forcefully removed at any cost, or as dangerous burdens on society that need to be locked away. While we have made great strides in understanding the complex, multidimensional causes of mental illness, we aren’t there yet. Still many people do not seek treatment due to disparities in delivery of mental health treatment, a lack of integration of mental health services into primary care, prejudice and shame stemming from misunderstanding about mental health. To move beyond this, we must recognize that mental health is a universal experience across an ever-shifting spectrum. And just to reassure you, after researching for this post, I will gladly take modern-day therapy over an exorcism, anytime.

To learn more about what mental health is, check out our post: What is mental health? and send us your own questions about mental health!


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