The history of abnormal psychology began with the research of the famous ancient Greek philosopher Plato in the fourth century B.C. During his time, most believed that the strange behaviors and actions that psychologists study today were caused by evil spirits. Plato believed this to be false and spoke his ideas of these behaviors being caused by a "natural madness, usually caused by a disease". Unfortunately his words had no affect on the common people of his age. During the Dark Ages, the idea of the behaviors being caused by evil spirits escalated to the idea that people were being possessed by demons. Many people were exorcised by the churches or burned at the stake for possessing these "demons". Over approximately one hundred thousand innocent people were killed for the same reasons by the Inquisition. It wasn't until early 19th century that the idea of evil spirits and demons was tossed aside, and the idea of these behaviors being caused by illnesses in the mind was finally embraced.
Somatogenic - abnormality is seen as a result of biological disorders in the brain (Kraeplin, 1883). However, this approach has led to the development of radical biological treatments e.g. lobotomy. Psychogenic - abnormality is caused by psychological problems. This has led to slightly bizarre treatments. Mesmer used to put his patients in a darkened room with music playing, then entered wearing a flamboyant outfit and pressed the 'infected' body areas with a stick. It has also led to the development of hypnosis, psychoanalysis (Freud) and carthasis as psychological treatments, as well as humanism (Carl Rogers, Abraham Maslow).
The standard abnormal psychology and psychiatry reference book in North America is the Diagnostic and Statistical Manual of the American Psychiatric Association. The current version of the book is known as DSM IV-TR. It lists a set of disorders and provides detailed descriptions on what constitutes a disorder such as Major Depressive Disorder or anxiety disorder. It also gives general descriptions of how frequent the disorder occurs in the general population, whether it is more common in males or females and other such facts. The diagnostic process uses five dimensions called 'axes' to ascertain symptoms and overall functioning of the individual. These axes are as follows
Genetics
Biological factors
Psychological factors
Socio-cultural factors
Genetics
An important area of expertise for many clinical psychologists is psychological assessment, and there are indications that as many as 91% of psychologists engage in this core clinical practice. Such evaluation is usually done in service to gaining insight into and forming hypotheses about psychological or behavioral problems. As such, the results of such assessments are usually used to create generalized impressions (rather than diagnoses) in service to informing treatment planning. Methods include formal testing measures, interviews, reviewing past records, clinical observation, and physical examination.
There exist literally hundreds of various assessment tools, although only a few have been shown to have both high validity (i.e., test actually measures what it claims to measure) and reliability (i.e., consistency). These measures generally fall within one of several categories, including the following:
Psychodynamic
The Psychodynamic perspective developed out of the psychoanalysis of Sigmund Freud. The core object of psychoanalysis is to make the unconscious conscious—to make the client aware of his or her own primal drives (namely those relating to sex and aggression) and the various defenses used to keep them in check. The essential tools of the psychoanalytic process are the use of free association and an examination of the client's transference towards the therapist, defined as the tendency to take unconscious thoughts or emotions about a significant person (e.g. a parent) and "transfer" them onto another person. Major variations on Freudian psychoanalysis practiced today include Self Psychology, Ego Psychology, and Object Relations Theory. These general orientations now fall under the umbrella term psychodynamic psychology, with common themes including examination of transference and defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state.
Humanistic
Humanistic psychology was developed in the 1950s in reaction to both behaviorism and psychoanalysis, largely due to the person-centered therapy of Carl Rogers (often referred to as Rogerian Therapy) and existential psychology developed by Victor Frankl and Rollo May. Rogers believed that a client needed only three things from a clinician to experience therapeutic improvement—congruence, unconditional positive regard, and empathetic understanding. By using phenomenology, intersubjectivity and first-person categories, the humanistic approach seeks to get a glimpse of the whole person and not just the fragmented parts of the personality. This aspect of holism links up with another common aim of humanistic practice in clinical psychology, which is to seek an integration of the whole person, also called self-actualization. According to humanistic thinking, each individual person already has inbuilt potentials and resources that might help them to build a stronger personality and self-concept. The mission of the humanistic psychologist is to help the individual employ these resources via the therapeutic relationship.
Cognitive behavioral
Cognitive Behavioral Therapy (CBT) developed from the combination of Cognitive psychology and Behaviorism, and from more specific earlier therapies known as cognitive therapy and rational emotive behavior therapy. CBT is based on the theory that how we think (cognition), how we feel (emotion), and how we act (behavior) all interact together. In this perspective, certain thoughts or ways of interpreting the world (often called schemas) can cause emotional distress or result in behavioral problems. Certain behaviors, such as avoidance of feared situations, can also maintain distress. The object of CBT is to discover the biased or irrational thinking that leads to emotional problems and to help the client take control over his or her thinking processes and behaviors in such a way that will lead to increased well-being. There are many techniques used, such as systematic desensitization, socratic questioning, and keeping a cognition observation log. Modified approaches that fall into the category of CBT have also developed, including Dialectic Behavior Therapy and Mindfulness-based Cognitive Therapy.
Systems or Family Therapy
Systems or Family therapy works with couples and families, and emphasizes family relationships as an important factor in psychological health. The central focus tends to be on interpersonal dynamics, especially in terms of how change in one person will affect the entire system. Therapy is therefore conducted with as many significant members of the "system" as possible. Goals can include improving communication, establishing healthy roles, creating alternative narratives, and addressing problematic behaviors. Important contributors include John Gottman, Jay Haley, Susan Johnson, and Virginia Satir.
Other perspectives
Multiculturalism.
Although the theoretical foundations of psychology are rooted in European culture, there is a growing recognition that there exist profound differences between various ethnic and social groups and that systems of psychotherapy need to take those differences into greater consideration.[ Further, the generations following immigrant migration will have some combination of two or more cultures—with aspects coming from the parents and from the surrounding society—and this process of acculturation can play a strong role in therapy (and might itself be the presenting problem). Culture influences ideas about change, help-seeking, locus of control, authority, and the importance of the individual versus the group, all of which can potentially clash with certain givens in psychotherapeutic theory and practice. As such, more psychologists and training programs are integrating knowledge of various cultural groups in order to inform therapeutic practice in a more culturally sensitive and effective way.
Feminism.
Feminist therapy is an orientation arising from the disparity between the origin of most psychological theories (which have male authors) and the majority of people seeking counseling being female. It focuses on societal, cultural, and political causes and solutions to issues faced in the counseling process. It openly encourages the client to participate in the world in a more social and political way.
Positive Psychology.
Positive psychology is the scientific study of human happiness and well-being, which started to gain momentum in 1998 due to the call of Martin Seligman, then president of the APA. The history of psychology shows that the field has been primarily dedicated to addressing mental illness rather than mental wellness. Applied positive psychology's main focus, therefore, is to increase one's positive experience of life and ability to flourish by promoting such things as optimism about the future, a sense of flow in the present, and personal traits like courage, perseverance, and altruism. There is now preliminary empirical evidence to show that by promoting Seligman's three components of happiness—positive emotion (the pleasant life), engagement (the engaged life), and meaning (the meaningful life)—positive therapy can decrease clinical depression.