History of Mental Health Treatment

For this blog post, we decided to write a potted history of the development of mental health treatment over the ages, having found an interesting article on this topic. It is amazing to see how treatment has progressed to where we are today…

The treatment and support offered to people suffering from mental health problemsthroughout history has been both complex and bizarre. Although well intentioned, the lack of understanding and knowledge often led to inhumane and distressing events.

Looking at early beliefs, we can see a pattern emerging. The most common cause was believed to be demonic possession or some other supernatural force. For example as early as 5000 BC, early man believed that mental health problems were the result of supernatural phenomena, as can be seen by   the discovery of trepanned skulls, where holes were made in the skull to release the ‘demon’. In ancient Mesopotamia, the sufferers were treated using exorcisms, incantations, prayer, atonement, and other various mystical rituals in an effort to drive out the evil spirit.

Hebrews believed that all illness was inflicted upon humans by God as punishment for committing sin, and therefore Priests would appeal to God as the ultimate healer to cure the sickness.  Ancient Persians attributed illness to demons and believed that good health could be achieved through proper precautions to prevent diseases.

As we move forward in time, there seems to be more understanding and attempts at therapy start to include engagement of the brain and thought processes. Indeed the Ancient Egyptians recommended that those afflicted should engage in recreational activities such as concerts, dances, and painting in order to relieve symptoms and achieve some sense of normalcy.

The Greek physician Hippocrates denied that people suffered from mental health problemsdue to supernatural forces and instead proposed that it stemmed from natural occurrences in the human body, particularly pathology in the brain. Although, of course a far more enlightened belief, this resulted in treatments such as emetics and laxatives being used or patients were bled using leeches. Not so enlightened!

By the time we arrive in the sixteenth century, the shame and stigma attached to mental health problems often caused people to hide their family members suffering from mental health problems or simply abandon them, leaving them to a life of begging and vagrancy. Asylums began to be established around the world, but living conditions were often deplorable and there were very little attempts at treatment or support of the patients.

Obviously reform was needed!

Philippe Pinel in 1792, showed that patients with mental health problems would improve, if they were treated with kindness and consideration. Further advances were made with the development of psychoanalysis by Sigmund Freud. Freud believed that anxiety arose as different parts of the human mind battled each other, resulting in mental health problems. The resulting treatments created by Freud are known as psychoanalysis, or “talking cures” and began with hypnosis.

Other treatments about this time included electroconvulsive therapy and psychopharmacology, which were designed to correct a patient’s chemical imbalance. This was further developed with the first shock therapy using electricity in 1938. Anti-psychotic drug therapy became more common in the 1940s, such as thorazine, valium and prozac, although these treatments were only able to control the symptoms. This led to many people being convinced that all illnesses could be effectively managed with medication, and resulted in patients once again being left unsupported.

So having looked at this history as a whole, we find there have been much needed developments in mental health care but improvement was still needed…

In more recent times we have seen the evolution of Cognitive Behavioural Therapy. This took place in three stages.  The first stage was when behaviour therapy started to emerge independently, in both UK and America. The second stage was the growth of cognitive therapy, which took place in America during the mid-1960s. The third stage was the merging of behaviour and cognitive therapy into cognitive behaviour therapy, in the late 1980s. CBT is now widely accepted and is practised by a growing number of clinicians.  It is, probably, the most broadly and confidently endorsed form of psychotherapy.  CBT dominates clinical research and practice in many parts of the world. CBT is also advocated by the NHS as part of the treatment process. Cognitive Behavioural Hypnotherapy (CBH), the combination of Cognitive Behavioural Therapy and Hypnosis, which is of particular interest to us at the college, is proving to be extremely effective in the treatment and support of patients.

Look out for another blog post coming soon with more on the evolution of CBT.