A Glimpse into the History of Psychiatry
Purpose: A review of the earliest practices in the treatment of mental illness.
1. Identify the earliest treatments and protocols as documented through history.
2. Understand the historical stigmas and terminology in regards to mental illness.
3. Awareness of the progression in treating the mentally ill.
The Earliest Known History of Psychiatry.
Unearthed skulls dating back to 6500 BCE have been discovered by archeologists to have large holes drilled into the sides of them. (1) The purpose of the drilling was to release the demon spirits that ruled inside these unfortunate beings. (2) The thought at the time was that strange, disruptive, or unexplainable behaviors demonstrated by individuals was a direct consequence of demons controlling the persons soul. These behaviors were seen not as a medical condition of any kind, but primarily relating to bad morals. There are Biblical references that Jesus cast out devils in those demonstrating irrational or crazed behaviors. Of course there are also Biblical reference that describe maniacal behavior that Jesus also healed and those individual were thought to simply be ill.
The term used to describe this surgical procedure is trepanning or trephination. It has also been referred to burr holing. Trepanning is hought to be the oldest surgical procedure performed that can be validated by archaeologists. (1) It is also thought to be the first attempt to reign in unruly or deviant behaviors. Mental illness was an unknown in this era. The prevailing thought of the time was that these individuals were ruled by evil spirits. Hippocrates endorsed trepanning, writing explicit instructions in how to perform the surgery.
This drilling into the brain occurred in an era where there was no anesthesia. The individuals who received this surgery lay for 30-60 minutes while their skulls were drilled into. There are estimates that state about 40% of those who received this surgical procedure died soon after or suffered such severe brain damage that they lived in a vegetative state following. (3) Archeologists have found skulls that show healing following the procedure and conclude many did survive the trepanning (2)
If we reach that far back in psychiatric history it would appear as though mainstream psychiatry has actually come a long way. To gain insight in to all disciplines of study it’s critical to venture back in time to get a glimpse of its history. It’s necessary to study the roots in an effort to accurately extrapolate where things have been, where things are, and where the vision is directed for the future. Advancements in health care have unfolded through trial and error. These progressive improvements in patient care are profoundly swayed by public attitudes and medical theories. Since we have had such difficulty in finding our way out of the stigma mental illness maintains on today’s society, it is not surprising that psychiatry...