Читать книгу Abnormal Psychology - William J. Ray - Страница 57

One of the themes of the sciences of the 1800s was the search for organization. In understanding psychopathology, an important man associated with this search was the Paris physician Jean-Martin Charcot (1825–1893). Charcot sought to bring organization to an understanding of neurological disorders through a variety of methods such as careful observation. This observation was of both what the patient said, which we refer to today as symptoms, as well as what the clinician observed, or what we refer to as signs. The overall search was for which signs and symptoms go together to form a syndrome. An additional technique—autopsy, or examination of the body after death—further allowed for the connection of syndromes with underlying anatomy. Autopsies allowed for the determination of which tissue showed signs of pathology. Using this method, Charcot was able to show the correctness of Hughlings Jackson’s thoughts on neurological organization. Overall, Charcot showed that the human motor cortex is organized similarly to that of other animals, with the left hemisphere controlling the right side of the body and vice versa.

symptoms: features observed by the patient

signs: features observed by the clinician

syndrome: determination of which signs and symptoms go together

Charcot is best known for initially describing brain disorder relationships for a number of motor-related disorders including Parkinson’s disease and multiple sclerosis. Charcot also established Tourette’s syndrome as a separate disease when he asked his assistant Gilles de la Tourette to help him. De la Tourette wrote of cases that included a teenage boy who would show involuntary movements and scream swear words.

Charcot was also able to show that conversion reactions, in which the person shows outward signs of trouble hearing or seeing, or being unable to experience pain in the hand, were without any underlying pathology. During Charcot’s time, conversion reactions were referred to as hysteria. A young Sigmund Freud heard Charcot’s lectures on hysteria, including the observation that psychological trauma could trigger these reactions. This became the initial basis of Freud’s psychoanalytic work.

Charcot demonstrates a case of hysteria (painting by André Brouillet).

Public domain

In this manner, Charcot helped to integrate symptoms of a disorder with both psychological and brain processes. He also emphasized that, as in the case of hysteria, much of what had been seen as possession by demons could be viewed as resulting from natural causes. Thus, there was no need for faith healers or church rituals to remove evil spirits. This also encouraged society to view an individual with hysteria or another mental affliction as someone with a disorder rather than as an evil person. Much of Charcot’s work took place at the Salpêtrière Hospital for the poor in Paris.

The English word bedlam comes from the name of the first institution for the mentally ill in fourteenth-century England.

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