The Origins of Psychopathology

Introduction
Psychopathology has been viewed differently throughout history and throughout various cultures. The ancient Chinese, Greeks and Romans viewed it psychopathology as a spiritual issue, and they all had their own ways of treating it—from dietary interventions to music interventions to getting more fresh air out of doors and in a natural setting, and so on (Kyziridis, 2005). The Egyptians viewed it as a physical disorder. The Hindus viewed it as an issue of finding the right balance between the physical and the spiritual. In the Middle Ages, it could be viewed as anything from demonic possession to a sign of holiness (Smith, 2007). Indeed, nothing really has changed because as Wedge (2011) points out, “there is no consensus in the medical community about what behaviors constitute a particular ‘disorder’.” Bleuler helped to popularize the idea of the “split mind” in modern times, which has been used to characterize schizophrenia—but even schizophrenia is poorly understood and researchers cannot agree on precisely what it is or what causes it, though they have been able to identify means of controlling it to some extent. Freud sought to explain psychopathology by looking at the family dynamic and the underlying early childhood issues that could be hidden in the unconscious trying to work their way out (Kyziridis, 2005). Some researchers believe it is hereditary, others environmental, and still others a combination of factors, including a spiritual dimension. McGuire et al. (1995) argued, for instance, that a “predisposition to verbal hallucinations is associated with a failure to activate areas concerned with the monitoring of inner speech” (p. 596). And for children the issue is even more complex because children can be misdiagnosed as having a psychopathological disorder if they are judged by adult standards of behavior. It has to be remembered that children behave differently from adults and they could just be exceptionally creative or energetic or hyperactive or virtually anything else under the sun.
Various Perspectives on Etiology
Freud, Jung and Adler all had unique perspectives on the etiology of psychopathology. Freud and Jung were of the psychoanalytical school. Adler formed the humanist school. Freud began the work on the psychoanalysis, by exploring the levels of consciousness and linking these levels with a motivating force for human behavior, and troubled psychopathology was in his view the result of repressed desire in the unconscious trying to work its way out—usually some fixation from childhood. Jung developed this idea by incorporating elements of moral philosophy into the framework and adopting a more spiritual approach to the problem of psychopathology, seeing it as rooted in both repression but also in morality. Adler moved away from their concepts by theorizing that man was much more actively in control of his own destiny than what Freud or Jung speculated. Adler viewed psychopathology as being the result of not being able to achieve one’s goals or being given the opportunity to do so. He viewed people as self-determining and conscious of their desires.
Freud, Jung and Adler all focused on the question of the human personality—but their tenets were distinct: For instance, Adler did not hold that innate instincts were what motivated behavior as Freud and Jung held; instead, he viewed that identified goals and the preferences of the individual were what motivate them. Jung’s view of personality structure differed from Freud’s in that he believed it possible for the unconscious and the conscious to merge. Jung described the personality in terms of archetypes; Adler in terms of survival; Freud in terms of topographical psychic repression. Other researchers have speculated that it is biological: Nimgaonkar (2006), for instance, states that “literally hundreds of causes have been proposed” but that the best theory of etiology for psychopathology is that it is hereditary, meaning that the root cause is going to be biological.
The 19th century novelists—from Dostoevsky to Hawthorne to Melville to Gogol—they all had an intense focus on the inner workings of the mind and soul and their works shed a great deal of light on what could be called the first descriptive approach to psychopathology. Dostoevsky is best known for getting inside the minds of criminal and misfits. Crime and Punishment told the story of a young man who deliberately murders a woman who owns a pawn shop and then is haunted by the guilt of what he has done. In Demons, the author examined a society breaking down under a barrage of liberal impulses. In The Idiot who looked at various cases of individuals suffering from symptoms of psychopathology. The insights that these authors revealed helped others to begin exploring the realm of the mind and trying to make sense of the ways in which people express themselves and the inner conflict going on inside of themselves.
Throughout history the etiology has ranged from witchcraft to genetic disorder. It has been viewed as having a physical to a spiritual dimension to an emotional disturbance to a problem regulating one’s ability to pursue goals. The truth is likely somewhere in the middle.
Directions Psychopathology May Be Taking
Because of the influence of PC (politically correct) culture it is very likely that more and more traditional ideas and concepts become viewed as signs of psychopathology. After all, here is the reality: as can be seen throughout all history and from culture to culture, the maladies of the mind and soul are always viewed differently and those in positions of power will promote the view that they themselves hold. They will have a sense of what is normal and normative and if one deviates from that, those in power will label them as having a mental disorder. So if the ruling class in the West consists of PC culture leaders, those individuals who are frustrated by PC culture and vent their frustrations by getting angry or losing patience and reacting with emotion may be viewed as having some form of psychopathology.
In the past, people who have shown themselves to be different have generally be removed from society. Mental patients were put into mental hospitals or given electro shock therapy—as happens in One Flew Over the Cuckoo’s Nest. Orwell described a world in which everyone was expected to conform to the standards dictated by Big Brother and non-conformists were viewed as having a psychopathology and were thus admitted to Room 101 for re-education. This type of phenomenon could be in store for our future, as the direction that psychopathology takes is really just a reflection of the direction that society in general is heading. Science typically reflects the culture and the times in which it is implemented.
Thus, in the Middle Ages, culture took a more spiritual view and some were held to be saints and others possessed by an evil spirit. In later centuries, there was not much empathy or sympathy for the plight of those with a troubled mind. Today, empathy and sympathy have grown by leaps and bounds, but cultures are never static and today’s culture appears to be shifting once more and a more rigid mentality has taken root among the leaders of the culture industry today. If that rigid mentality continues it could lead to individuals being labeled as dangerous for society because they have a psychopathology that is not good for the community.
Whatever direction the study of psychopathology takes in the future, it will likely need to come up with some way to explain the culture and cultural issues that are impactful today. The study of psychopathology should not be divorced or separated from the study of sociology. Psycho-sociological approaches should be studied and used to apply to those with mental issues, and Carl Whitaker’s approach to experiential family therapy could be viewed as a helpful way to discuss pathopsychology (Watson, 2011). The spiritual side of life should also receive some focus, for psychologists today are also discovering that a spiritual approach to therapy can have a positive impact for clients and patients.
The goal should be nonetheless to understand people as individuals and to look at each case individually. There is not going to be a one-size-fits-all definition or approach to psychopathology that can be applied to everybody at all times. Each person presents with issues that are unique and each person has to be understood holistically, and sometimes that means going beyond the person and bringing in others—such as members of the person’s family. The more that we can begin to understand the whole person, the more likely we are to be able to assess the issues and bring the person to a better place with a higher quality of life. We may not always understand everything perfectly, but the main ideas—the common sense logic of a Carl Whitaker—should still have a place in our approaches.
References
Kyziridis, T. (2005). Notes on the history of schizophrenia. German Journal of Psychiatry 8, 42-8.
McGuire, P.K. et al. (1995). Abnormal monitoring of inner speech: a physiological basis for auditory hallucinations. The Lancet 346, p. 596-600.
Nimgaonkar,V. (2006). Causes of schizophrenia. PA: University of Pitt.
Smith, D. (2007). Muses, Madmen, and Prophets: Hearing Voices and the Borders of Sanity. NY: Penguin Books.
Watson, J. C. (2011). Treatment failure in humanistic and experiential psychotherapy. Journal of Clinical Psychology, 67(11), 1117-1128. doi:10.1002/jclp.20849
Wedge, M. (2011). Six problems with psychiatric diagnosis for children. Retrieved from https://www.psychologytoday.com/us/blog/suffer-the-children/201105/six-problems-psychiatric-diagnosis-children