What is abnormal and normal?: How History Defined “Madness”

Trigger Warning: References to mental disorders, madness and mental aslyums 

 

Nowadays, it’s rare to encounter words like “mad”, “melancholic” or “hysteria” used in medical practices to describe a patient’s symptoms.

Instead, words such as “depressed,” “anxious” or “psychosis” are more commonly used to describe conditions what we once knew as madness.

Modern scientific understanding of mental illness stems comes from a biological understanding of the mind. The brain, neurotransmitters, synaptic connections – all that neuro- jazz is at the centre of explaining how our mind and body operate.

Pathologising and medicalising the state of mind is a fairly recent concept. Ever since the emergence of DSM (Diagnostic Statistics Manual), also known as the bible of psychiatry, revolutionised how we understand mental disorders. Throughout history, our understanding of the mind, and what is abnormal has constantly changed.

So why and how did these definitions of normality and abnormality change over time?

 

History of Science is a field that explores how science and scientific knowledge has developed throughout the ages. Crossing between natural sciences and philosophy, History of Science allows us to appreciate modern day science and understand it in context of history.

So lets time travel back to Ancient Greece and unravel the story of how people thought what the normal and the abnormal mind was.

 

Ancient Greece: 500 B.C – 600 A.D

Hippocrates, the father of medicine, proposed humouralism. Image: Flickr

 

The word “melancholy” is a portmanteau of “melan” which means black and “kole” which means bile. It was thought that people who were lethargic and chronically depressed had black bile. This idea comes from “humouralism” which was a trendy school of thought in ancient medicine. Humouralism proposes that body fluids control our state of well being. It was thought that deficiency or in excess of humours would cause physical and mental problems. This was before they realised that the brain was the central dogma, the mastermind behind the body’s actions.

So in Ancient Greece, “melancholia” now we know as depression, was first hypothesised as a bodily disorder.

 

The Medieval Ages: 5th century – 15th century

As we enter in the medieval times, known as the dark ages, we start to see a spiritual understanding of the mind and the body. Religious institutions like the Catholic Church were at its political peak and was thought that demonic possession and evil spirits caused madness. Exorcism, an infamous Catholic ritual, became a popular practice among people who were considered “mad”. These were probably patients whom we now consider as schizophrenic or have bipolar disorder. 

 

The Enlightenment Era ( Age of Reason ) : 17th century – 18th century

Father of modern western philosophy,Rene Descartes. His work emphasises on “reason” which moulded modern understanding of the mind. Image: Flickr

 

The Enlightenment Era bloomed science and philosophy. This meant that the emphasis was on reason. Rationality was regarded highly and was a prerequisite to being the ideal human. As a result, people thought that lack of rational thinking caused madness. Mental asylums were firstly introduced during this age. People thought that the mentally ill or “the mad” had to be segregated from the rest of the community. 

 With the sudden increase in population followed by industrialization, mental asylums were crowded with people that were “demented” and “mad”. The conditions of these institutions were very poor, with little regards for the inmates.

 

Post- Industrialisation : 19th century – 20th century 


Freud’s chair revolutionised psychiatric practices by introducing psychoanalysis. Image: Flickr

 

We’ve all heard phrases like “Freudian slip” or “Freud’s chair”. Viennese psychiatrist Sigmund Freud popularised psychoanalysis, the archetype of modern-day psychiatric therapy. Freud revolutionised how people perceive minds and madness. He proposed that every individual had an unconscious mind, a reservoir of feelings, emotions, memories, desires outside of our conscious awareness and that we unknowingly suppress our unconscious mind. His controversial psychosexual developmental model suggests that repressed childhood traumatic events contribute the development of one’s mental illness.

Psychoanalysis was a popular method of therapy, which deviated from mental asylum approach of treating the mentally ill, conducting treatment in an intimate environment where the patient lied down on a chair and relayed their thoughts.

 

21st century

The Florey Institute of Neuroscience and Mental Health is a leading research centre for understanding the brain. Image: Flickr

 

A biological understanding of the mind and madness manifests in modern scientific literature. We now understand that certain individuals are more genetically susceptible to inducing psychotic-like symptoms (known as schizophrenia) or that they are predisposed to a condition where they have lack of neurotransmitters that control the mood. Genetics and a physiological understanding of the brain are at the heart of mental illness research.

It is clearly evident that the definition of ‘normalcy” constantly changed which suggests that there could never be a clear-cut definition of what normal and abnormal is.

 

 

Whats really important isn’t about drawing the line but is to understand and provide the best care for people who may be experiencing difficulties with their cognition and emotional processing.