De Prerogativa Regis

Whilst mental illness has been associated with the species Homo sapiens since prehistoric times, legislation associated with it is a fairly recent event.  Within the English legal system the earliest codified reference is in the 1324 statute known as De Prerogativa Regis (Andrews, Briggs, Porter, Tucker & Waddington, 1997; Baly, 1995; Fry, 1864; McGlynn, 2003; McGlynn, 2005; Tuke, 1892; Williams, 1816; Winslow, 1898; Wright & Digby, 1996). This gave jurisdiction over the persons and property of “idiots” and those who “happen to fail their wit” (that is, those who were deemed incapable of looking after their own affairs) to the monarch (Bartlett & Sandland, 2007; Letchworth, 1889; Winslow, 1898; Wright & Digby, 1996). The king was to hold the lands of the idiot without committing waste, to provide for the idiot from the lands so held, and to return the lands to the idiot’s family on the death of the idiot (McGlynn, 2005; Williams, 1816). In the case of lunatics, should they recover their senses they would have to prove to chancery that they were no longer mad in order to reclaim their property (McGlynn, 2005). The primary purpose of this law was to ensure that people with mental health difficulties were not exploited (Ramsay, Szmukler, Gerada & Mars, 2001). The officers who enforced this legislation throughout the realm were known as “escheators” (McGlynn, 2003), who held inquisitions to determine whether or not the landowners concerned were lunatics or idiots (Roberts, 1981). Roberts (1981) cites two examples of this Act in operation from the year 1464.

References:

Andrews, J., Briggs, A., Porter, R., Tucker, P., & Waddington, K. (1997). The history of Bethlem. London, England: Routledge.

Baly, M.E. (1995). Nursing and social change. (3^rd edition). London, England: Routledge.

Bartlett, P., & Sandland, R. (2007). Mental health law: Policy and practice. (3^rd edition). Oxford, England: Oxford University Press.

Fry, D.P. (1864). The Lunacy Acts. London, England: Knight & Co.

Letchworth, W.P. (1889). The insane in foreign countries. New York, NY: G.P. Putnam’s Sons.

McGlynn, M. (2003). The Royal Prerogative and the learning of the Inns of Court. Cambridge, England: Cambridge University Press.

McGlynn, M. (2005). Idiots, lunatics and the Royal Prerogative in early Tudor England. Journal of  Legal History 26: 1, 1-24.

Ramsay, R., Szmukler, G., Gerada, C. & Mars, S. (2001).  Mental illness: A handbook for caregivers. London, England: Jessica Kingsley Publishers.

Roberts, A. (1981). Mental health history timeline. Retrieved from http://www.studymore.org.uk/mhhtim.htm

Tuke, D.H. (1892). A dictionary of psychological medicine. Philadelphia, PA: P. Blakiston Son & Co.

Williams, T.W. (1816). A compendious and comprehensive law dictionary. London, England: Gale & Fenner.

Winslow, L.F. (1898). Mad humanity: its forms apparent and obscure. New York, NY: M.F. Mansfield & Co.

Wright, D.& Digby, A. (1996). From idiocy to mental deficiency: historical perspectives on people with learning disabilities. London, England: Routledge.

Code of Hammurabi

A well-preserved code of laws written in cuneiform in Mesopotamia around 1770 B.C.E. and discovered in 1901 by Gustav Jéquier in present day Iran (Cook, 2008), this is the first document where there is mention of a differentiation between illnesses of a physical nature and those of the mind, with the latter being treated by specialist priest-physicians or asu (Darton, 1999). Hammurabi was a king of Babylonia, sixth ruler of the Amorite dynasty, who reigned 1792-1750 B.C.E. (Byers, 1998; Kelly, 2009; Leick, 2002; Leick, 2003; Van de Mieroop, 2005). The Code of laws that he ordered to be distributed throughout his realm is known from several copies, the best known of which is that discovered by Jéquier. Mesopotamian culture attributed mental illnesses to demonic possession (Geller, 1997), with every specific disease state being attributed to its own demon, with over six thousand different demons being identified (Jayne, 1962; Nardo, 2007). For example, insanity was said to be caused by the demon Idta (Kent, 2003; Millon, 2004). Treatment was largely by psychotherapeutic methods or “talking therapies”, and the interpretation of dreams (Darton, 1999), preceding Freud’s ideas by nearly four millennia. The asu also used a variety of medications as treatment, most of them derived from plants or minerals (Nardo, 2007). A Babylonian tablet gives a prescription for the cure of madness: “Take a bucket, fill it with water from the mouth of the river. Impart to this the exalted magic power. Sprinkle the man with it. May insanity be dispelled!” (Kent, 2003). The royal family of Elam appear to have suffered from some form of mental illness (Nemet-Nejat,1998). Scurlock & Andersen (2005) devote a complete chapter of their book to mental health diagnoses from this period. Kaplan (2008) states that there are credible descriptions of schizophrenia in the Assyrian Codex.

Part of the Code of Hammurabi

References:

Byers, P.K. (Ed.) (1998). Encyclopedia of world biography. (2nd edition). Detroit, MI: Gale Research.'

Cook, J.W. (2008). Encyclopedia of ancient literature. New York, NY: Facts on File Inc.

Darton, K. (1999). Notes on the history of mental health care. Mind: London. Retrieved from  http://www.mind.org.uk/Information/Factsheets/History+of+mental+health/Notes+on+the+History+of+Mental+Health+Care.htm

Geller, M.J. (1997). Freud, magic and Mesopotamia: how the magic works. Folklore 108, 1, 1-7.

Jayne, W.A. (1962). The healing gods of ancient civilizations. New Hyde Park, NY: University Books Inc.

Kaplan, R.M. (2008). Being Bleuler: the second century of schizophrenia. Australasian Psychiatry 16, 5, 305-311.

Kelly, K. (2009). The history of medicine: early civilizations prehistoric times to 500 C.E. New York, NY: Facts on File Inc.

Kent, D. (2003). Snake pits, talking cures and magic bullets – a history of mental illness. Brookfield, CT: Twenty-First Century Books.

Leick, G. (2002). Who’s who in the ancient Near East. London, England: Routledge.

Leick, G. (2003). Historical dictionary of Mesopotamia. Lanham, MA: The Scarecrow Press Inc.

Millon, T. (2004). Masters of the mind: exploring the story of mental illness from ancient times to the new millennium. Hoboken, NJ: John Wiley & Sons Inc.

Nardo, D. (2007). The Greenhaven encyclopedia of ancient Mesopotamia. Farmington Mills, MI: Gale, Cengage Learning.

Nemet-Nejat, K.R. (1998). Daily life in ancient Mesopotamia. Westport, CT: Greenwood Press.

Scurlock, J., & Andersen, B.R. (2005). Diagnoses in Assyrian and Babylonian medicine: ancient sources, translations, and modern medical analyses. Champaign, IL: University of Illinois Press.

Van de Mieroop, M. (2005). King Hammurabi of Babylon – a biography. Malden, MA: Blackwell Publishing.

quotations on madness 1

Insanity: doing the same thing over and over again and expecting different results.



Albert Einstein

musical madness 1

Reflecting life itself, the music industry has a surprising number of songs that are related to mental illness. This one, written by Mick Jagger and Keith Richards in 1965, tells the story of a difficult, spoiled girl who doesn't appreciate life.

19th Nervous Breakdown

Asclepios

(also known as Aesculapius, Asclepius, Aesclepius, Asculepius, Aesculepius, Asclapius, Aesclapius, and Asculapius, and originally identified as a real person rather than a god (Elliott, 1914; Jayne, 1962; Kelly, 2009)) the Greek god of medicine. His temples, which were often built at places of outstanding beauty or near springs whose waters had healing properties (Bailey, 1926; Elliott, 1914; Jayne, 1962; Millon, 2004; Nardo, 2006), were often used as therapeutic refuges for those with mental problems (Hills, 1901; Hinshaw, 2007; Stone, 2006), with sleep therapy being one of the main thrusts of treatment (Dock, 1920; Homer, 8^th century B.C.E.). This appears to have been recommended under the belief that Asclepios would appear in the patient’s dreams, and thus heal the condition (Colp, 2000; Darton, 1999; Dock, 1920; Elliott, 1914; Moulton, 1998; Nutton, 2004). It was Asclepios, with his staff and entwined holy snake (Dock, 1920; Kelly, 2009; Moulton, 1998; Nardo, 2006), who would later become the symbol of the medical profession (Jayne, 1962). Treatments at the shrines of Asclepios often involved the use of snakes, and at one of them, at Delphi, a pit of snakes was used as a cure for insanity. The patient was suspended over the pit, and the shock of being so suspended was intended to bring the patient back to his senses (Kent, 2003).

A terracotta statuette of Asclepios, currently housed in the Louvre, Paris, France.

References:

Bailey, H. (1926). Nursing mental diseases. New York, NY: Macmillan Company.

Colp, R. (2000). History of psychiatry. In Sadock, B.J. & Sadock, V.A. (Eds.), Comprehensive textbook of psychiatry. (7th edition). Baltimore, MD: Lippincott, Williams & Wilkins.

Darton, K. (1999). Notes on the history of mental health care. Mind: London. Retrieved from http://www.mind.org.uk/Information/Factsheets/History+of+mental+health/Notes+on+the+History+of+Mental+Health+Care.htm

Dock, L.L. (1920). A short history of nursing from the earliest times to the present day. New York, NY: G.P. Putnam’s Sons.

Elliott, J.S. (1914). Outlines of Greek and Roman medicine. New York, NY: William Wood & Company.

Hills, F.L. (1901). Psychiatry - ancient, medieval and modern. The Popular Science Monthly 59, 3, 31-48.

Hinshaw, S.P.  (2007). The mark of shame: stigma of mental illness and an agenda for change. Oxford, England: Oxford University Press.

Homer (8^th century BCE). The Iliad. Retrieved from http://www.gutenberg.org/etext/2199.

Jayne, W.A. (1962). The healing gods of ancient civilizations. New Hyde Park, NY: University Books Inc.

Kelly, K. (2009). The history of medicine: early civilizations prehistoric times to 500 C.E. New York, NY: Facts on File Inc.

Kent, D. (2003). Snake pits, talking cures and magic bullets – a history of mental illness. Brookfield, CT: Twenty-First Century Books.

Millon, T. (2004). Masters of the mind: Exploring the story of mental illness from ancient times to the new millennium. Hoboken, NJ: John Wiley & Sons Inc.

Moulton, C. (Ed.) (1998). Ancient Greece and Rome: an encyclopedia for students. New York, NY:  Charles Scribner’s Sons.

Nardo, D. (2006). The Greenhaven encyclopedia of ancient Greece. Farmington Mills, MI: Gale,   Cengage Learning.

Nutton, V. (2004). Ancient medicine. New York, NY: Routledge.

Stone, M.H. (2006). History of schizophrenia and its antecedents. In Lieberman, J.A., Stroup, T.S., & Perkins, D.O. The American Psychiatric Publishing textbook of schizophrenia. Washington D.C.: American Psychiatric Publishing Inc.

psychiatric humour 1

Q. What's the difference between God and a consultant psychiatrist?

A. God knows he's not a consultant psychiatrist.

Margaret Nicholson

In 1786 George III survived a second assassination attempt, this time by Margaret Nicholson, a 36-year old needlewoman (Ingram, 1991). She tried to attract the king’s attention in St. James’s with a rolled up petition, and when he moved towards her to collect it, attempted to stab him with a blunt knife (Appignanesi, 2008; Hibbert, 1998; Jay, 2003). The king was unhurt, and her second stabbing attempt was stopped by two royal retainers. When questioned by the Privy Council over several days, her story was evinced. She was the daughter of a barber from Stockton on Tees and had had several appointments as a servant in the households of respectable families. The last of these positions had been in the employ of Lord Sebright. She had been dismissed from his employ after it was discovered that she was carrying on an affair with one of his footmen. As a result of the loss of employment, and her lover, she had attempted to petition the king on more than twenty occasions for assistance. As she had received no reply from the king, she had gone to St. James’s to remonstrate with him. The Privy Council decided that her words and actions were symptomatic of insanity, and therefore she could not be tried for treason, as she would have been if she was of sound mind. As a result she was committed to Bedlam under the Vagrancy Act of 1744 for “her natural life” (Appignanesi, 2008; Poole, 2001). The British government insisted that the first year of her confinement was spent in chains (Andrews, Briggs, Porter, Tucker & Waddington, 1997). She died in Bedlam in 1828 (James, Mullen, Pathe, Meloy, Farnham, Preston & Darnley, 2008).

The assassination attempt was portrayed in the film "The Madness of King George", viewable here:

Margaret Nicholson's assassination attempt

References:

Andrews, J., Briggs, A., Porter, R., Tucker, P., & Waddington, K. (1997). The history of Bethlem. London, England: Routledge.

Appignanesi, L. (2008). Mad, bad and sad: A history of women and the mind doctors from 1800 to the present. London, England: Virago Press.

Hibbert, C. (1998). George III - a personal history. New York, NY: Basic Books.

Ingram, A. (1991). The madhouse of language: Writing and reading madness in the eighteenth century. London, England: Routledge.

James, D.V., Mullen, P.E., Pathe, M.T., Meloy, J.R., Farnham, F.R., Preston, L., & Darnley, B. (2008). Attacks on the British Royal Family: the role of psychotic illness. Journal of the American Academy of Psychiatry and the Law 36:59–67.

Jay, M. (2003). The air loom gang – the strange and true story of James Tilly Matthews and his visionary madness. London, England: Bantam Books.

Poole, S. (2001). The politics of regicide in England, 1760-1850: Troublesome subjects. Manchester, England: Manchester University Press.

The Origins of Psychiatry

The history of psychiatry is relatively short. This is primarily because the term did not exist prior to 1808. It was coined by the German philosopher Johann Christian Reil from the Greek “ψυχή” (soul or mind) and “ιατρός" (healer or doctor) (Burch, 2009; Gask, 2004; Marneros, 2008; Richards, 1998; Shorter, 1997; Shorter, 2005).  (Reil is also famous for his description of the Katzenklavier, described in his 1803 book Rhapsodieen uber die Anwendung der psychischen Curmeth- ode auf Geisteszerriittungen (Rhapsodies on the Application of Psychological Methods of Cure to the Mentally Disturbed). This instrument had a row of cats with their tails stretched out behind them. When the keyboard was depressed, nails dropped down into the tails of the unfortunate animals, who would then produce a distinct sound. He recommended that this be used to distract the insane from their reveries (Richards, 1998)). His book also discussed the benefits of housing incurable and curable forms of madness separately (Kuehn & Klemme, 2010). Reil also founded the profession’s first journal, the Journal of Psychological Therapy, in 1805 (Burns, 2003).

The Katzenklavier or "cat piano"

References:

Burch, S. (Ed.) (2009). Encyclopedia of American disability history. New York, NY: Facts on File Inc.

Burns, W.E. (2003). Science in the enlightenment: An encyclopedia. Santa Barbara, CA: ABC-Clio Inc.

Gask, L. (2004). A short introduction to psychiatry. London, England: Sage Publications Ltd.

Kuehn, M., & Klemme, H. (Eds). (2010). The dictionary of eighteenth century German philosophers. London, England: Continuum.

Marneros, A. (2008). Psychiatry’s 200^th birthday. British Journal of Psychiatry 193, 1-3

Richards, R.J. (1998). Rhapsodies on a cat-piano, or Johann Christian Reil and the foundations of romantic psychiatry. Critical Inquiry 24, 700-736.

Shorter, E. (1997). A history of psychiatry: From the era of the asylum to the age of Prozac. New York, NY: John Wiley & Sons.

Shorter, E. (2005). A historical dictionary of psychiatry. Oxford, England: Oxford University Press.

Belgian cage

In 1880 the Belgian cage, a device that was intended to restrain the severely mad, was demonstrated at a national exhibition in Brussels (Noll, 2007). It consisted of a cage standing on short posts. A picture of the device is included in Letchworth (1889).

References:

Letchworth, W.P. (1889). The insane in foreign countries. New York, NY: G.P. Putnam’s Sons.

Noll, R. (2007). The encyclopedia of schizophrenia and other psychotic disorders. (3^rd edition). New York, NY: Facts on File Inc.

Could Schizophrenia Be Treated With Nicotine?

Ever wondered why so many patients diagnosed as having schizophrenia indulge in the smoking habit? This article proposes a reason and a possible use for nicotine as a treatment:

could-schizophrenia-be-treated-with-nicotine

Clifford Whittingham Beers

In 1900 Clifford Whittingham Beers (1876 – 1943) was confined to a private asylum in the United States, diagnosed with depression and paranoia and having attempted suicide by jumping out of a window (Burch, 2009; Noll, 2007). He had two more admissions for similar reasons, one to another private establishment, and one to a state run facility. During these admissions he experienced and witnessed serious maltreatment at the hands of asylum staff (Beers, 1908; Friedman, 2002; Noll, 2007). As a result he published an account of his experiences (Albrecht, 2006; Burch, 2009; Colp, 2000; Friedman, 2002; Noll, 2007; Oyebode, 2009; Shorter, 2005), A Mind That Found Itself (1908), and in 1909 he founded the National Committee for Mental Hygiene (Colp, 2000; Dain, 1989; Shorter, 2005), now named Mental Health America, in order to continue the reform for the treatment of the mentally ill (Albrecht, 2006).

Photographic portrait of a young Clifford Beers

References:

Albrecht, G.L. (Ed.) (2006). Encyclopedia of disability. Thousand Oaks, CA: Sage Publications Inc.

Beers, C.W. (1908). A mind that found itself. Retrieved from http://www.gutenberg.org/etext/11962

Burch, S. (Ed.) (2009). Encyclopedia of American disability history. New York, NY: Facts on File Inc.

Colp, R. (2000). History of psychiatry. In Sadock, B.J., & Sadock, V.A. (Eds), Comprehensive textbook of psychiatry. (7th edition). Baltimore, MD: Lippincott, Williams & Wilkins.

Dain, N. (1989). Critics and dissenters: Reflections on "anti-psychiatry" in the United States. Journal of the History of the Behavioral Sciences 25, 3-25.

Friedman, M.B. (2002). Clifford Beers: The origins of modern mental health policy. Retrieved from http://www.mhawestchester.org/advocates/beers802.asp

Noll, R. (2007). The encyclopedia of schizophrenia and other psychotic disorders. (3rd edition). New York, NY: Facts on File Inc.

Oyebode, F. (Ed.) (2009). Mindreadings: Literature and psychiatry. London, England: RCPsych Publications.

Shorter, E. (2005). A historical dictionary of psychiatry. Oxford, England: Oxford University Press.

Ship of Fools

In 1494 the German theologian Sabastian Brant published his Das Narrenschiff (“the ship of fools”), a satire about the current state of the church (Barclay, 1874; Cook, 2006; Kamen, 2000). Brant discusses a hundred and ten varieties of fool (Remy, 1907). Brant’s work was translated into English in 1509 by Alexander Barclay (Cook, 2006; Hager, 2005). Foucault (2006) uses this as evidence of the social exclusion of the mad in medieval times, stating that the mad were herded into ships which were then turned away from city after city in Europe (Arboleda-Florez & Sartorius, 2008), and in particular Germany. Documentary evidence from Frankfurt, for example, suggests that the practice of paying ships’ captains to remove madmen from the city was common in the late 14^th and early 15^th centuries (Kent, 2003). A man who had run naked through the streets of the city was removed in this manner in 1399. Thus the ship of fools could be considered a medieval variety of asylum. However, later scholars have stated that there were no real ships of fools, and that Foucault misinterpreted an allegorical work as truth (Dumm, 2002; Miller, 2000; Rezneck, 1991; Scull, 1989; Scull, 2007; Smith, 2006; Still & Velody, 1992).

References:

Arboleda-Florez, J., & Sartorius, N. (2008). Understanding the stigma of mental illness: Theory and interventions. Hoboken, NJ: John Wiley & Sons Inc.

Barclay, A. (1874). The ship of fools. Edinburgh, Scotland: William Paterson.

Cook, J.W. (2006). Encyclopedia of Renaissance literature. New York, NY: Facts on File Inc.

Dumm, T.L. (2002). Michel Foucault and the politics of freedom. Lanham, MD:  Rowman & Littlefield Publishers, Inc.

Foucault, M. (2006). History of madness. New York, NY: Routledge.

Hager, A. (Ed.) (2005). Encyclopedia of British writers: 16^th and 17^th centuries. New York, NY: Facts on File Inc.

Kamen, H. (2000). Who’s who in Europe 1450-1750. London, England: Routledge.

Kent, D. (2003). Snake pits, talking cures and magic bullets – a history of mental illness. Brookfield, CT: Twenty-First Century Books.

Miller, J. (2000). The passion of Michel Foucault. Cambridge, MA: Harvard University Press.

Remy, A.F.J. (1907). Sebastian Brant. In The Catholic encyclopedia. New York, NY: Robert Appleton Company. Retrieved from http://www.newadvent.org/cathen/02741a.htm

Rezneck, L. (1991). The philosophical defence of psychiatry. London, England: Routledge.

Scull, A.T. (1989). Social order/mental disorder: Anglo-American psychiatry in historical perspective. Berkeley, CA: University of California Press.

Scull, A.T. (2007). The fictions of Foucault's scholarship. Retrieved from http://tls.timesonline.co.uk/article/0,,25347-2626687,00.html

Smith, M.A. (2006). Developing a recovery ethos for psychiatric services in New Zealand. Unpublished doctoral thesis, University of Waikato, New Zealand.

Still, A., & Velody, I. (Eds.) (1992). Rewriting the history of madness. London, England: Routledge.

soul retrieval

One of the reasons for shamans indulging in psychoactive drugs may have been the psychotherapeutic process of soul retrieval (Golden, 2006; Harvey & Wallis, 2007; Lewis, 2003; Lindquist, 2004; Pratt, 2007; Saunders, 1994; Stutley, 2003; Villoldo, 2005; Walter & Fridman, 2004; Winkelman, 2004). In shamanic belief this is the notion that healing can only occur after pieces of the soul, which have previously departed the body due to trauma (either emotional or physical), are retrieved and returned to the body of the illness sufferer (Ingerman, 2007; Neff, 2006; Place, 2008). It is the role of the shaman to enter a state of altered consciousness (Harvey & Wallis, 2007; Lewis, 2003; Mora, 1985; Pratt, 2007) (often involving the use of psychoactive drugs such as hallucinogens) and find the lost pieces of soul (Stutley, 2003). This belief appears to be common to all cultures that have shamanic practices (Bever, 2008; Golden, 2006; Pratt, 2007), and it could be argued that this form of shamanic practice is the earliest form of psychotherapy (Pratt, 2007). It should also be stated that some authorities believe that shamans actually suffer from mental illness themselves (Farber, 1993; Harvey & Wallis, 2007; Pratt, 2007; Stephen & Suryani, 2000).

A Siberian shaman

References:

Bever, E. (2008). The realities of witchcraft and popular magic in early modern Europe. Basingstoke, England: Palgrave Macmillan.

Farber, S. (1993). Madness, heresy, and the rumor of angels: The revolt against the mental health system. Chicago, IL: Open Court Publishing Company.

Golden, R.M. (Ed.) (2006). Encyclopedia of witchcraft: The western tradition. Santa Barbara, CA: ABC-Clio Inc.

Harvey, G., & Wallis, R.J. (2007). Historical dictionary of shamanism. Lanham, MA: The Scarecrow Press Inc.

Ingerman, S. (2007). Soul retrieval. Retrieved from http://www.sandraingerman.com/soulretrieval.html

Lewis, I.M. (2003). Ecstatic religion: A study of shamanism and spirit possession. (3^rd edition). London, England: Routledge.

Lindquist, G. (2004). Bringing the soul back to the self: soul retrieval in neo-shamanism. Social Analysis 45, 2, 157-173.

Mora, G. (1985). History of psychiatry. In Kaplan, H.I., & Sadock, B.J. (eds.), Comprehensive text book of psychiatry. Baltimore, MD.: Williams & Wilkins.

Neff, J.  (2006). Soul retrieval: Return to wholeness. Bloomington, IN: Trafford Publishing.

Place, R.M. (2008). Mysteries, legends and unexplained phenomena: Shamanism. New York, NY: Chelsea House.

Pratt, C. (2007). An encyclopedia of shamanism. New York, NY: Rosen Publishing Group Inc.

Saunders, C. (1994). Soul retrieval: an interview with Sandra Ingerman. Body Mind Spirit Magazine, 13, 1, 36-40.

Stephen, M. & Suryani, L.K. (2000). Shamanism, psychosis and autonomous imagination. Culture, Medicine & Psychiatry 24, 1, 5-38

Stutley, M. (2003). Shamanism: An introduction. London, England: Routledge.

Villoldo, A. (2005). Mending the past and healing the future with soul retrieval. Carlsbad, CA: Hay House Inc.

Walter, M.N., & Fridman, E.J.N. (Eds.) (2004). Shamanism: An encyclopedia of world beliefs, practices and culture. Santa Barbara, CA: ABC-Clio.

Winkelman, M. (2004). Shamanism as the original neurotheology. Zygon: Journal of Religion & Science 39, 1, 193-217.

Primary mental health

Primary mental health care is a relatively new concept. It is defined by the World Health Organisation as:


1) First line interventions that are provided as an integral part of general healthcare, and
2) Mental healthcare that is provided by primary care workers who are skilled, able and supported to provide mental healthcare services.


The document Integrating Mental Health into Primary Care: A Global Perspective, produced by the WHO and Wonca in 2008, is available for free download from this link:


http://www.who.int/mental_health/policy/services/mentalhealthintoprimarycare/en/index.html


It's worth reading as it gives some important hints as to what primary mental health should look like.

The Sorcerer

It has been stated that this cave painting (in the Les Trois Frères cave system), dating from about 13,000 B.C.E.,  in Ariege, France, showing a strange being with human feet and hands and antlers, is a Stone Age psychiatrist or witch doctor (Darton, 1999), but this identification has been made with no clear rationale, especially given that shamans from different cultures tended to adopt animal dress when performing their rituals (Kelly, 2009; Pratt, 2007; Stutley, 2003; Walter & Fridman, 2004). Others (Murray, 1970) believe that the painting is merely a very early representation of the “horned god” of Wiccan belief (Guiley, 2008). In England, at Star Carr, a head-dress almost identical to that worn by the “psychiatrist”, has been found near a lake (Smart, 1998). This was found to have holes drilled in it for the placing of bindings that would keep the head-dress in place.

The Sorcerer

References:

Darton, K. (1999). Notes on the history of mental health care. Mind: London, England. Retrieved from http://www.mind.org.uk/Information/Factsheets/History+of+mental+health/Notes+on+the+History+of+Mental+Health+Care.htm

Guiley, R.E. (2008). The encyclopedia of witches, witchcraft and Wicca. (3^rd edition). New York, NY: Facts on File Inc.

Kelly, K. (2009). The history of medicine: Early civilizations prehistoric times to 500 C.E. New York, NY: Facts on File Inc.

Murray, M.A. (1970). The god of the witches. Oxford, England: Oxford University Press.

Pratt, C. (2007). An encyclopedia of shamanism. New York, NY: Rosen Publishing Group Inc.

Smart, N. (1998). The world’s religions. (2^nd edition). Cambridge, England: Cambridge University Press.

Stutley, M. (2003). Shamanism: An introduction. London, England: Routledge.

Walter, M.N., & Fridman, E.J.N. (Eds.) (2004). Shamanism: An encyclopedia of world beliefs, practices and culture. Santa Barbara, CA: ABC-Clio.

 

Patron saint of the insane

In the 11^th century a shrine to St. Dymphna, the patron saint of the insane, was established in Gheel, Belgium (Carrier & Tomlinson, 1996; Dock, 1920; Noll, 2007; Van Walsum, 2004). Dymphna was originally an Irish princess, daughter of Damon (Farmer, 1997; Jiang, 2002). He had attempted clumsy sexual advances towards her after her mother had died. Damon had lost his reason at the death of his wife. As a result Dymphna had fled to Gheel with her confessor, fellow saint Gerebemus (Kirsch, 1909; Van Walsum, 2004). However, Damon’s followers soon tracked her down, and Damon himself had gone to Gheel to try and persuade his daughter to return to Ireland. When she refused, he flew into a rage and decapitated her. He had already ordered his troops to kill Gerebemus (Van Walsum, 2004). Tradition places this at about 650 AD (Jiang, 2002). The local people buried the two bodies, and the shrine so produced soon became famous throughout Europe for miraculous cures for insanity (Van Walsum, 2004). By the 14^th century so many people were going to Gheel for cures that an infirmary had to be built (Tuke, 1892). Alongside this, mentally ill pilgrims were housed with local residents (Dock, 1920; Halliday, 1828; Hills, 1901; Letchworth, 1889; New York Times, 1875; Shorter, 1997; Walsh, 1910), possibly the world’s first example of care in the community for the mentally ill. In the 1930s it was estimated that as many as four thousand people were under this form of community care at Gheel (Hinshaw, 2007; Noll, 2007). By 1979 this number had dropped to around 1399 (Carrier & Tomlinson, 1996). Attempts to replicate this system were made (Van Walsum, 2004) in both Britain and the United States during the 19^th century, under the epithet “the cottage system”. However, as Noll (2007) points out no successful long-term program based on the Gheel model has ever been devised. St. Dymphna has a feast day on 15^th May (Farmer, 1997; Jiang, 2002), the supposed day of her death. According to Walsh (1910), shrines similar to that of St. Dymphna were set up in Ireland, Scotland, England, Germany and France, often with their own patron saints.

St. Dymphna

References:

Carrier, J., & Tomlinson, D. (Eds.) (1996). Asylum in the community. London, England: Routledge.

Dock, L.L. (1920). A short history of nursing from the earliest times to the present day. New York, NY: G.P. Putnam’s Sons.

Farmer, D.H. (1997). The Oxford dictionary of saints. Oxford, England: Oxford University Press.

Halliday, A. (1828). A general view of the present state of lunatics, and lunatic asylums, in Great Britain and Ireland and in some other kingdoms. London, England: Thomas and George Underwood.

Hills, F.L. (1901). Psychiatry – ancient, medieval and modern. The Popular Science Monthly 59, 3, 31-48.

Hinshaw, S.P.  (2007). The mark of shame: Stigma of mental illness and an agenda for change. Oxford, England: Oxford University Press.

Jiang, W. (2002). Patron saint of the mentally ill and epileptic: Saint Dymphna. Retrieved from http://www.geocities.com/kd3qc/saintdymphna.html

Kirsch, J.P. (1909). St. Dymphna. In The Catholic encyclopedia. New York, NY: Robert Appleton Company. Retrieved from New Advent http://www.newadvent.org/cathen/05221b.htm

Letchworth, W.P. (1889). The insane in foreign countries. New York, NY: G.P. Putnam’s Sons.

New York Times (1875). Lunacy abroad: A colony of madmen. Retrieved from  http://query.nytimes.com/gst/abstract.html?res=950DE4DB133BEF34BC4B52DFB667838E669FDE

Noll, R. (2007). The encyclopedia of schizophrenia and other psychotic disorders. (3^rd edition). New York, NY: Facts on File Inc.

Shorter, E. (1997). A history of psychiatry: From the era of the asylum to the age of Prozac. New York, NY: John Wiley & Sons.

Tuke, D.H. (1892). A dictionary of psychological medicine. Philadelphia, PA: P. Blakiston Son & Co.

Van Walsum, K.L. (2004). Nos malades: three examples of Christian influences in care for the insane in pre-Revolutionary France and Belgium. Journal of Psychology and Christianity 23, 3, 219-233.

Walsh, J.J. (1910). Asylums and Care for the Insane. In The Catholic encyclopedia. New York, NY: Robert  Appleton Company. Retrieved  from http://www.newadvent.org/cathen/08038b.htm

Earliest evidence for mental illness?

A trepanned skull from the Iron Age.

It is believed that the existence of trepanation (from the Greek trypanon, meaning drill (Kelly, 2009)) holes in Neolithic skulls may have been an attempt at prehistoric psychosurgery to relieve the symptoms of mental illness (Arnott, Finger & Smith 2003; Brothwell, 1963; Hinshaw, 2007; Kelly, 2009; Mariani-Costantini, Catalano, di Gennaro, di Tota & Angeletti, 2000; Mashour, Walker & Martuza, 2005; McClennon, 1997; Millon, 2004; Missios, 2007; Mo, 2007; Porter, 2002; Sabbatini, 1997; Selling, 1940; Thackery & Harris, 2003). Such skulls have been found all over the world (Blos, 2003; Kelly, 2009). The smoothness and shininess of the bone around the trepanned holes is evidence that the patients not only survived the operation, but lived on for months or years while the bone regrew, with a survival rate of around 75% (Lillie, 1998; Thackery & Harris, 2003). However, there is no evidence to suggest that there was a medical philosophy, as there was little difference between medicine, magic and religion (Darton, 1999; Millon, 2004; Rao, 1978). Trepanation as a treatment in mental illness continued up to the nineteenth century (Tuke, 1892).


References:

Arnott, R., Finger, S., &  Smith, C.U.M. (Eds.) (2003). Trepanation: History, discovery, theory. Philadelphia, PA: Psychology Press.

Blos, V. (2003). Cranial surgery in ancient Mesoamerica. Retrieved from http://www.mesoweb.com/features/tiesler/Cranial.pdf

Brothwell, D.R. (1963). Digging up bones; the excavation, treatment and study of human skeletal remains. London, England: British Museum (Natural History).

Darton, K. (1999). Notes on the history of mental health care. London, England: Mind. Retrieved from http://www.mind.org.uk/Information/Factsheets/History+of+mental+health/Notes+on+the+History+of+Mental+Health+Care.htm

Hinshaw, S.P.  (2007). The mark of shame: Stigma of mental illness and an agenda for change. Oxford, England: Oxford University Press.

Kelly, K. (2009). The history of medicine: Early civilizations prehistoric times to 500 C.E. New York, NY: Facts on File Inc.

Lillie, M.C. (1998). Cranial surgery dates back to Mesolithic. Nature 391: 854.

Mariani-Costantini, R., Catalano, P., di Gennaro, F., di Tota, G., & Angeletti,  L.R. (2000). New light on cranial surgery in ancient Rome. Lancet 355: 305-307.

Mashour, G.A., Walker, E.E., & Martuza, R.L. (2005). Psychosurgery: past, present and future. Brain Research Reviews 48, 409– 419.

McClennon, J. (1997). Shamanic healing, human evolution and the origin of religion. Journal for the Scientific Study of Religion, 36, 3, 345-355.

Millon, T. (2004). Masters of the mind: Exploring the story of mental illness from ancient times to the new millennium. Hoboken, NJ: John Wiley & Sons Inc.

Missios, S. (2007). Hippocrates, Galen, and the uses of trepanation in the ancient classical world. Neurosurgery Focus 23, 1, 1-9.

Mo (2007). An illustrated history of trepanation. Retrieved from http://neurophilosophy.wordpress.com/2007/06/12/an-illustrated-history-of-trepanation/

Porter, R. (2002). Madness: A brief history. Oxford, England: Oxford University Press.

Rao, A.V. (1978). Psychiatric thought in ancient India. Indian Journal of Psychiatry 20, 107-119.

Sabbatini, R.M.E (1997). The history of psychosurgery. Retrieved from http://www.cerebromente.org.br/n02/historia/psicocirg_i.htm

Selling, L.S. (1940). Men against madness. New York, NY: Greenberg.

Thackery, E., & Harris, M. (Eds.) (2003). The Gale encyclopedia of mental disorders. Farmington Hills, MI: Gale Group, Inc.

Tuke, D.H. (1892). A dictionary of psychological medicine. Philadelphia, PA: P. Blakiston Son & Co.

Abimelech

A Biblical character who was the son of Gideon and who ruled in Shechem for three years after the death of his father. He is the first person mentioned in the Bible who committed suicide: he ordered his armour-bearer to kill him after he had been hit on the head by a stone thrown by a woman during a siege (Comay, 1995; Evans & Farberow, 2003; Feinsod, 1997; Galpaz-Feller, 2006; Gardner, 1998; Kastenbaum, 2003). The indignity of suicide was less than that of dying at the hands of a woman.

"Then he called hastily unto the young man his armourbearer, and said unto him, Draw thy sword, and slay me, that men say not of me, A woman slew him. And his young man thrust him through, and he died."

(Judges 9: 54, King James Bible)

The Death of Abimelech by Gustave Dore

References:

Comay, J. (1995). Who’s who in the Old Testament. London, England: Routledge.

Evans, G., & Farberow, N.L. (2003). The encyclopedia of suicide. New York, NY: Facts on File Inc.

Feinsod, M. (1997). Three head injuries: the Biblical account of the deaths of Sisera, Abimelech and Goliath. Journal of the History of the Neurosciences 6, 3, 320-324.

Galpaz-Feller, P. (2006). ‘Let my soul die with the Philistines’ (Judges 16.30). Journal for the Study of the Old Testament 30, 3, 315-325.

Gardner, P. (Ed.) (1998). The complete who’s who in the Bible. Grand Rapids, MI: Zondervan Publishing House.

Kastenbaum, R. (Ed.) (2003). Macmillan encyclopedia of death and dying. New York, NY: Macmillan Reference USA.

Dancing plagues

In 1518 an enigmatic psychiatric condition broke out around Strasbourg in France (Blom, 2010; Hecker, 1837; Tuke, 1892). The dancing plague commenced with one Frau Troffea, who began a fervent dancing vigil that lasted between four and six days. Within a week 34 other citizens of the town had joined her in dancing, and by the end of the month the numbers had swelled to over 400. Medical authorities thought that the only cure would come with further dancing, but this resulted in dozens of deaths from heart attacks, strokes and sheer exhaustion. Several theories have been put forward to explain this phenomenon, ranging from the effects of ergotism (poisoning from an hallucinogenic fungus that contaminates bread; Blom, 2010; Golden, 2006; Melechi, 2003; Tuke, 1892) to mass psychogenic illness (a form of mass hysteria usually preceded by intolerable levels of psychological distress) (O’Neill, n.d.; Waller, 2009). At least seven other outbreaks of dancing mania occurred in medieval Europe, all with no rational explanation at the time (Blom, 2010; Hecker, 1837; Viegas, 2008).

An engraving of three women affected by the dancing plague, based on an original sketch by Peter Brueghel the Elder, who apparently witnessed such a scene in 1564.

References:

Blom, J.D. (2010). A dictionary of hallucinations. New York, NY: Springer.

Golden, R.M. (Ed.) (2006). Encyclopedia of witchcraft: The western tradition. Santa Barbara, CA: ABC-Clio Inc.

Hecker, I.F.C. (1837). The epidemics of the Middle Ages: The dancing mania. Philadelphia, PA: Haswell, Barrington & Haswell.

Melechi, A. (2003). Fugitive minds: On madness, sleep and other twilight afflictions. London, England: Arrow Books.

O’Neill, D. (n.d.). Etiology of the dancing plague. Retrieved from http://interculture.fsu.edu/pdfs/oneill%20dancing%20plague.pdf

Tuke, D.H. (1892). A dictionary of psychological medicine. Philadelphia, PA: P. Blakiston Son & Co.

Viegas, J. (2008). 'Dancing plague' and other odd afflictions explained. Retrieved from http://dsc.discovery.com/news/2008/08/01/dancing-death-mystery.html

Waller, J. (2009). Looking back: dancing plagues and mass hysteria. The Psychologist 22, 7: 644-647.