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      Another big idea that emerged in the 1800s was that all of nature is in constant flow and that things, including organisms, change. This idea focused on the evolution of species and is most often associated with the work of Charles Darwin (1809–1882). Variation was to become one of the major components of Darwin’s thinking concerning evolution. In fact, he began his thinking with the assumption that heritable variations can and do occur in nature. Darwin then presented the important realization that not all plants or animals that come into existence survive. Many organisms such as sea stars, for example, produce millions of eggs of which only a limited number survive. Depending on climate conditions, food supply, predator population, and a host of other factors including disease, only a limited number of births survive to maturity.

      hierarchical integration: through inhibitory control, the various levels of the brain, such as the brain stem, the limbic system, and the neocortex, are able to interact with each other, and higher levels restrict or inhibit the lower levels

      variation: the assumption that heritable variations can and do occur in nature

      natural selection: Darwin’s idea that if an organism has even slight variations that help it to compete successfully for survival, then over time the species will be made up more of members with these characteristics and less of individuals lacking these features

      sexual selection: the manner in which males and females choose a mate

      Consequently, Darwin (1859) suggested, “There is a frequently recurring struggle for existence.” Who is to survive in this struggle? Darwin suggested that if an individual has even a slight variation that helps it to compete successfully for survival, then over time the species will be made up more and more of members with these characteristics and less and less of individuals lacking these features. This process is referred to as natural selection. Darwin described this process in his 1859 book, On the Origin of Species by Means of Natural Selection.

      Darwin later extended the theory of natural selection to include sexual selection, or the manner in which males and females choose a mate. This work is described in his 1871 book, The Descent of Man. Darwin noted that males and females differ not only in terms of organs of sexual reproduction but also in secondary sexual characteristics such as mammary glands for the nourishment of infants in females or facial hair in males. According to Darwin, sexual selection depends on the success of certain individuals over others of the same sex. Darwin also saw that besides same-sex competition, there is also competition to attract members of the opposite sex. As you can imagine, there has been continuous debate and research concerning what attraction means for males and females.

      Darwin began the Origin work with the question of natural selection especially as it related to animals. In The Descent of Man, he expanded these ideas to humans and also examined the question of sexual selection. In other works, such as his notebooks, he extended his research to cognitive and emotional processes. The broad question is that of how psychological functions have evolved. One answer he gives is that living in social groups produces an increase in cognitive ability. Darwin also presents notes on memory and habit, imagination, language, aesthetic feelings, emotion, motivation, animal intelligence, psychopathology, and dreaming (Gruber, 1974). One important question is the manner in which self-preservation, sexual selection, and social processes are reflected in psychopathology.

      A Search for Organization

      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.

      © Burstein Collection/CORBIS

      Care for Those With Mental Disorders

      In 1330, a convent of the order of St. Mary of Bethlehem became the first institution for the mentally ill in England. The institution eventually received a royal charter and, over the years, the word Bethlehem became Bedlam, and the institution was referred to as “Old Bedlam.” The English word bedlam comes from this institution. Various reports suggested that the inmates were often chained, treated cruelly, and not given proper food or clothing. As depicted in novels of the day, people in the 1700s would go to Bedlam to see the inmates as an outing in much the same way today we might go to a zoo. In 1814, some 96,000 people visited the asylum.

      In the 1800s, there was a campaign in England to change the conditions for the patients, which led to the establishment of the Committee on Madhouses in 1815. This ushered in a period of concern for the patients rather than seeing them as objects of curiosity as in the previous century. Treatment for patients during the 1800s brought new practices including the therapeutic value of work.

      During this period, there was a spirit throughout the world to adopt a “moral treatment of the insane.” Three important individuals in this movement were Benjamin Rush (1745–1813) in the United States, Phillipe Pinel (1745–1826) in France, and Vincenzo Chiarugi (1759–1820)

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