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Prehistoric times In
prehistoric times, mental illnesses
were assumed to stem from magical beings that interfered with the mind.
Individual tribes and groups of shamans
had their own spells and rituals that they used to attempt to
cure such mental illnesses. Often, such rituals took the form of
exorcisms, in which the shaman would attempt to coax the evil spirit that
was causing the disorder from the body. In some prehistoric societies, a
primitive form of surgery was used
to attempt to exercise the malignant spirits.
Trepanation (also spelled
trephination), the practice of drilling a hole through part of the
skull without damaging the
brain, was believed to allow the
spirits trapped inside the skull to release. Skulls with trepanning holes
dating back more than 10,000 years have been found in Neolithic
Europe and
South America. In fact, the presence
of calluses on the surfaces of many skulls recovered showed that the
operation had a surprisingly high recovery rate.
Ancient Egypt
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With the first "great civilization," that of the Ancient
Egyptians, came the first signs of change in the treatment of the mentally
ill. Egypt, like the early
stone-age societies (and indeed most
societies for the next 3-and-a-half millennia), regarded mental illness as
magical or religious in nature. Egyptian psychiatric theory was deeply
rooted in the Egyptian conception of the self - the khat (the
body), the ka (one’s guardian spirit, who guides the individual to
the afterlife), and the ba (symbolized by a
bird carrying the key to
eternity, which leaves the body after
death and resides in heaven), all playing their part in the cyclical
nature of life and death. The societal obsession with death and life after
death meant that the health of the mind or soul played an essential part
in one’s overall health. In Ancient Egypt the first known psychiatric text
(written around 20th century BC
which explains the causes of "hysteria
"), the first known mental hospital
(a temple complex near modern
Saqqara which is thought to be meant for the treatment of the
mentally ill), and the known mental physician are found in history. The
Egyptian focus on the well-being of the soul is embodied in the Temple of
Imhotep at
Memphis in the
29th century BC, a popular center for
the treatment of mental illness. Methods used to attempt to cure the
mentally ill included using opium
to induce visions, performing rituals or delivering prayers to specific
gods, and "sleep therapy," a method of interpreting
dreams to discover the source of the
illness. Egyptian society, with its fixation on the health of the soul, is
the first major example of mental healthcare as a major priority for a
society in history.
Monotheism
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and Mental Health
The next major
developments in the history of mental health and illness came in a wave of
new ideas about the self that occurred in the
6th century BC: The founding of
Islam as well as the revitalization
of Judaism during the
Babylonian exile
Both of these world
religions were to play a major role in our modern conception of mental
health.
Ancient Judaism The origins of
monotheism lie in the growth and survival of Judaism in the
history of ancient Israel and Judah.
The concept of a single God as
articulated in Judaism paved the way for a shift in views on mental
health. While still almost completely religious in nature, the adoption of
monotheism allowed for the idea that mental illness was not a problem like
any other, caused by one of the gods, but rather caused by problems in the
relationship between the individual and God, in some sense (to put it in
modern terms) self-conflict or repressed guilt. Although the origin of the
Israelite tribes have been dated to the late
2nd millennium BC, the major period of growth for Judaism
occurred in the 6th century BC,
when the Kingdom of Judah was conquered by
Babylon and exiled to the Babylonian kingdom. On the waters of
the Euphrates >, the
rabbis of the remaining tribes
formulated for the first time a cohesive Jewish identity and doctrine,
revitalizing monotheism in the face of ideological opposition. The new,
regenerated Judaism viewed mental illness as an expression of sin
(represented in archaic Judaism as possession by demons), and to the
ancient rabbis an understanding of the self was critical to a relationship
with God. Treatment for mental illness ranged from prayer and fasting to
self-flagellation. To the Hebrews, mental health (spiritual health), was
the key to righteousness and to God. By formulating this new concept of a
monotheistic, and in many ways, personal deity, the ancient Hebrews moved
the idea of mental health away from mysticism and into organized
religion.
Ancient Islam Around the same
time as Judaism was taking root as a cohesive religion, Islam was
beginning to spread across the Arabian
Peninsula and into Asia
and Africa. Like Judaism,
Islam stressed the need for individual understanding of their mental
situation. Those afflicted with a mental illness were thought to be
possessed by jinn, supernatural spirits that can be either good or
bad. The Koran mentions the idea
of the spirit or soul constantly, preaching the idea that only though
radical change of one’s conception of the universe can one move closer to
God. Unlike the Jewish conception of mental illness as sin, the Islamic
viewpoint interpreted mental illness as a sign of supernatural
intervention that was not necessarily malignant. Changes in the psyche
could be either good or bad - the Sufi
movement of Islam, for instance, teaches spirituality though
near-mysticism, using song, dance, and narcotics to induce an altered
mental state and a closer connection of God. This new attitude towards the
mind, freeing mental illness from implications of wrongdoing, paved the
way for a more scientific examination of the causes and symptoms of mental
illness. The first such advances were made by Islamic scholars. The Arab
physician Rhazes wrote the
landmark texts El-Mansuri and Al-Hawi in the
10th century, two which presented definitions, symptoms, and
treatments for illness, including mental illnesses, and also ran the
psychiatric ward of a Baghdad
hospital. Such institutions could not exist in Europe at the time because
of fear of demonic possessions. In the centuries to come, Islam would
eventually serve as a critical waystation of knowledge from
Classical Greece to
Renaissance Europe - however, at this
point in history their time had not yet come, and conquest was a higher
priority to Islamic society of the period than medicine. Extermination
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