304 Abnormal Psychology
another. One example is self-flagellation, in which an indi-
vidual flogs himself with whips until blood flows from his
body. Some cultures regard this as a worthy religious prac-
tice; in the downtown section of a modern American city, it
would most likely be judged pathological.
We must also note that in many cases, the accidental dis-
covery of an effective treatment has spurred the scientific
research necessary to understand why the treatment worked.
The treatment led to the theory, not vice-versa. In other cases,
a treatment derived by logical inference from a theory may
survive many years of unimpressive results. Treatment is also
constrained by the resources that the patient or the society can
command. The poor are treated differently from the rich, a sit-
uation not unknown in any branch of medicine and not a form
of discrimination directed uniquely at the mentally ill.
The reports of physicians who became famous enough to
achieve recognition are not always reliable sources of infor-
mation. Fame and fortune, then as now, awaited the clinician
who could claim cures where none had achieved them before.
Clinician self-interest in such cases was a sure obstacle to
reliable information about the actual successes and failures of
novel treatments. We shall see this phenomenon recur time
and time again, from Paracelsus to Mesmer and from psy-
choanalysis to prefrontal lobotomy. Such a history makes for
interesting reading, but it makes difficulties for the historian.
Finally, one of the greatest problems facing the historian is
the fact that only exceptional events tend to be recorded
while the mass of ordinary events does not, thereby leaving a
misleading record of what actually happened most of the time
to most of the people. From such a process has arisen a pop-
ular history of psychopathology, leaving the serious historian
to clarify what did not happen as well as to recount what did.
Popular Myths of Psychopathology
The popular theme in psychopathology is that over the cen-
turies we have become increasingly knowledgeable and hu-
mane in our treatment of mental illness. Past beliefs about the
origins of psychopathology are seen as mostly unintelligent,
and earlier treatment methods as inhumane and ineffective.
An amalgam of these histories runs somewhat thus: From
the beginning of mankind, people believed that abnormal
behavior was caused by spirit or demon possession. Until
approximately the eighteenth century, mental illness elicited
superstitious reactions, hostility, maltreatment, and even per-
secution by the community at large. One exception allowed
in this grim scenario is said to have occurred in Greece in the
fifth century B.C., when, thanks to one notable physician,
Hippocrates, a rational and scientific approach to abnormal
psychology abruptly appeared and briefly flourished.
Some texts extend this period to the time of Galen
(ca.A.D. 130–200), a Greek physician at the court of the
Roman Emperor Marcus Aurelius. They tend to claim that
after the collapse of the Roman Empire the fledgling naturalis-
tic, scientific approach to understanding psychopathology was
eclipsed by a resurgence of rampant superstition, usually
attributed to the retrograde influence of the Christian church.
Early in the fifteenth century, so the myth goes, it was a com-
mon practice to segregate the mentally ill by putting them on
“ships of fools.” Before this time Europe had virtually no
mental hospitals although thousands of asylums were built to
confine lepers, and once leprosy disappeared, the mentally ill
were confined in them. Finally, during the eighteenth century,
Philippe Pinel (1745–1826) liberated the insane from their
chains in the Salpêtrière in Paris and enlightened individuals
began moral treatment of the insane in small establishments.
Unfortunately, so the story goes, during the nineteenth century
these relatively benign institutions grew into giant warehouses
where, again, the mentally ill were maltreated. Finally, as a
result of the efforts of psychiatrists and psychologists, knowl-
edge of the causes of incrementally improved, culminating in
humane scientific understanding and treatment, and the mal-
treatment of the mentally ill ended.
In fact, improvements in the care of the mentally ill have
arisen in part as a result of advances in scientific knowledge,
in part by improvement in socioeconomic conditions which,
in turn, stem in large part from technological innovations.
How people with mental illness were treated in the past de-
pended then, as now, on their social position and their finan-
cial resources. It appears that many individuals who posed no
danger to themselves or others often had the support and care
of their families, were extended shelter by the religious com-
munity, or permitted to support themselves by begging.
Treatments accorded in the past must be compared not to
conditions today, but to the general conditions of those times.
Although past housing conditions for mentally ill people
were deplorable by modern standards, so were housing con-
ditions during the same time period for sane poor people.
Insane people were sometimes cruelly treated and sane per-
sons accused of heresy, witchcraft, treason, even petty thiev-
ery, were also subjected to great cruelties. Demons and other
supernatural causes were invoked when naturalistic explana-
tions were inadequate and rational treatments of no avail. We
tentatively suggest that before the invention of the micro-
scope, which enabled scientists to see germs, the belief that
demons inhabiting the body were responsible for serious
bodily and mental ills was not irrational.
Many of these mythical histories have a professional
or political agenda. The thesis that the times prior to the
eighteenth century were characterized by demonological