CLINICAL PSYCHOLOGY AND PSYCHOPATHOLOGY - OVERVIEW
The earliest explanation of what we now refer to as psychopathology involved the possession by evil
spirits and demons. Many believed, even as late as the sixteenth and seventeenth centuries, that the
bizarre behavior associated with mental illness could only be an act of the devil himself. Thus many
individuals suffering from mental illness were tortured in an attempt to drive out the demon. Most
people know of the witch trials where many women were brutally murdered due to a false belief of
possession. When the torturous methods failed to return the person to sanity, they were usually
considered to be eternally possessed and were executed.
In the eighteenth century (often called The Age of Enlightenment or The Age of Rationalism) people
began to look at mental illness differently. It was during this period that "madness" began to be seen
as an illness beyond the control of the person rather than the act of a demon. Because of this,
thousands of people confined to dungeons of daily torture were released to asylums where medical
forms of treatment began to be investigated.
Today, medical practice continues to be a driving force in the diagnosing and treatment of
psychopathology, although research has shown the powerful effects that psychology has on a person's
behavior, emotion, and cognitions.
Mental illness is classified according to the Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition (DSM IV), published by the American Psychiatric Association. The DSM uses a
multiaxial or multidimensional approach to diagnosing because there is a number of factors in a
person's life that can impact their mental health. It assesses five dimensions as described below:
Axis I: Clinical Syndromes
 This is what we typically think of as the diagnosis (e.g., depression, schizophrenia, social
phobia)
Axis II: Developmental Disorders and Personality Disorders
 Developmental disorders include autism and mental retardation, disorders which are typically
first evident in childhood
 Personality disorders are clinical syndromes which have a more long lasting symptoms and
encompass the individual's way of interacting with the world. They include Paranoid,
Antisocial, and Borderline Personality Disorders.
Axis III: Physical Conditions which play a role in the development, continuance, or exacerbation of
Axis I and II Disorders
 Physical conditions such as brain injury or HIV/AIDS that can result in symptoms of mental
illness are included here.
Axis IV: Severity of Psychosocial Stressors
 Events in a persons life, such as death of a loved one, starting a new job, college,
unemployment, and even marriage can impact the disorders listed in Axis I and II. These
events are both listed and rated for this axis.
Axis V: Highest Level of Functioning
 On the final axis, the clinician (a psychologist or a psychiatrist) rates the person's level of
functioning both at the present time and the highest level within the previous year. This helps
the clinician understand how the above four axes are affecting the person and what type of
changes could be expected
Mental illness can have a devastating effect on an individual, their family and friends, and on the
community in many ways. On the individual level, a reduced ability to care for oneself, strong
negative emotions, distorted thoughts, inappropriate behavior, and reduced ability to maintain a
relationship are only a few possible outcomes. Friends and family have a major responsibility to care
for someone suffering from a mental illness, since the emotional and behavioral components of some
illnesses can be very difficult at times to understand and to deal with. Mental illness also effects the
community due to the high incidence of homelessness and unemployment in some serious disorders
such as schizophrenia.
These are the obvious effects of mental illness, but there are less obvious effects due to the
misperception of the mentally ill. Not too long ago when people heard the term mentally ill, many
thought of severe cases and associated these individuals with bizarre behavior, violence, and a lack of
caring about themselves and the world. In this sense, people with mental illness were almost
dehumanized. They were avoided and feared.
This is changing now as people understand that mental illness affects many people in many different
ways. We as a society are starting to see that depression does not mean weakness, that anxiety does
not mean fear, and that schizophrenia does not mean violence. We are beginning to understand that
needing help for mental or emotional reasons does not represent a character flaw.
However, many people continue to stereotype the mentally ill population. The effects of this are
twofold. First, being labeled as weak, fearful, violent, or flawed destroys the self-esteem of mental
patients. They may begin saying to themselves "Everyone can't be wrong, I must be a terrible person
to let this happen." The results are a deeper depression, increased anxiety, lower self-esteem, and
isolation, to name only a few.Second, due to the stigma associated with mental illness, many people
do not seek out help. This is especially true for mood and anxiety disorders which, ironically, have
very well researched and successful treatments available. These two factors cause the cycle of many
mental illnesses to continue and to strengthen.
These negative effects with continue to diminish as more politicians become aware of the truths about
mental illness, as more advocacy groups get the word out, and as more of those suffering or who have
friends and family with a mental illness break the stereotypes and speak out.Society still has a long
way to go, but compared to the time when mental illness was seen as demonic possession, it has
already come a great distance.
Adapted from: www.allpsych.com/clinicalpsychologyandpsychopathology
READING COMPREHENSION:
I Read the definitions and try to supply synonyms of the following words:
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asylum - a hospital for mentally incompetent or unbalanced person
exacerbation - action that makes a problem or a disease (or its symptoms) worse
stigma - a symbol of disgrace or infamy
Now, think of synonyms for these words from the text:
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Dungeon
Devastating
Flaw
II Answer the following questions:
1.
2.
3.
4.
5.
6.
7.
Compare the ideas about mental illness now and in the 16th and 17th centuries?
What changes did the 18th century bring?
What is the driving force in treating mental illness today?
How is mental illness classified today?
What are the negative effects that mental illness can have?
How do people stereotype the mentally ill population?
How can this situation be improved?