Category Archives: Psychology

Psychology (1-1000 CE): Comparative Analysis

Reference: SC: Psychology

Divergent Paths and Shared Insights

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Epistemological Frameworks

The first millennium of the Christian Era witnessed fundamentally different trajectories in Eastern and Western approaches to mental illness, yet certain themes emerged across cultures that suggest universal aspects of human psychological understanding.

Western approaches oscillated between naturalistic and supernatural explanations. The Greco-Roman medical tradition established by Hippocrates, systematized by Celsus, and elaborated by Galen provided a coherent naturalistic framework based on humoral imbalance and brain pathology. However, the rise of Christianity introduced competing supernatural explanations centered on sin, demonic possession, and divine punishment. Byzantine medicine preserved the Greco-Roman naturalistic tradition while existing within a Christian cultural matrix, creating a complex synthesis. The Desert Fathers developed a third approach—neither purely naturalistic nor crudely supernatural—that understood mental afflictions as spiritual-psychological states requiring disciplined cognitive and contemplative interventions.

Eastern approaches generally maintained more consistent naturalistic frameworks while integrating spiritual dimensions without contradiction. Indian Ayurvedic medicine understood mental illness through the lens of dosha imbalance while accommodating supernatural etiologies (the agantuja category of unmada) without allowing them to dominate the medical framework. Buddhist psychology grounded mental suffering in the universal mechanisms of attachment, aversion, and ignorance, locating the problem and the solution entirely within the structure of consciousness itself. Chinese medicine integrated emotional and physiological dimensions seamlessly, viewing mental disorders as disruptions in the flow of qi and imbalances among organ systems. Islamic medicine synthesized Greek, Persian, and Indian knowledge while firmly rejecting supernatural explanations, insisting that mental illness was a medical condition requiring rational treatment.

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Therapeutic Modalities

Despite diverse theoretical frameworks, practical therapeutic interventions showed remarkable convergence across cultures. Pharmacological treatments were universal: Western physicians prescribed various herbal compounds, purgatives, and dietary modifications; Ayurvedic medicine employed extensive materia medica tailored to dosha imbalances; Chinese medicine developed complex herbal formulas; Islamic physicians like Alexander of Tralles and Al-Razi utilized hundreds of pharmaceutical preparations.

Psychotherapeutic interventions emerged independently across traditions. Roman physicians like Asclepiades advocated humane treatment including “light, music, and hydrotherapy”. Galen emphasized “counsel and education”. Ayurvedic texts prescribed treatments through “knowledge, specific knowledge, restraint, memory, and concentration”, using “exposure of the patient to mutually contradictory psychic factors” for emotional disturbances. Buddhist psychology developed systematic cognitive techniques for removing intrusive thoughts that closely parallel modern CBT. The Desert Fathers created contemplative practices for “guarding the heart” and managing the “demon of acedia”. Islamic physicians like Al-Razi pioneered psychotherapy, emphasizing positive therapeutic relationships and using sudden emotional reactions to catalyze healing.

Environmental and occupational therapies appeared across cultures. Greek and Roman physicians recommended travel, exercise, and pleasant environments. Byzantine hospitals provided comprehensive care. Islamic bimaristans employed “occupational therapy, aromatherapy, baths, and music therapy”. Chinese medicine emphasized appropriate environmental conditions for emotional balance. The convergence suggests these approaches addressed genuine therapeutic needs recognized across diverse cultural contexts.

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The Role of Spirituality and Religion

The relationship between religious/spiritual frameworks and mental health treatment varied significantly. In the Christian West, increasing religious dominance often displaced medical frameworks, though this was neither universal nor uncontested. Byzantine physicians maintained professional medical approaches while practicing Christianity. Monastic psychology, rather than rejecting naturalistic understanding, developed sophisticated introspective techniques grounded in systematic observation of mental states.

In the East, spiritual and medical frameworks achieved greater integration. Ayurvedic medicine embedded treatment within a comprehensive philosophical worldview without the spiritual dimension overwhelming medical observation. Buddhism developed psychological systems that were simultaneously therapeutic practices and paths to enlightenment—the distinction between treating mental illness and achieving awakening was one of degree rather than kind. Chinese medicine integrated spiritual concepts like Shen with physiological observation seamlessly. Islamic medicine, while deeply embedded in Islamic civilization, insisted on the medical nature of mental illness and rational treatment, achieving a synthesis where faith informed ethics without dictating medical theory.

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Institutional Developments

The development of specialized institutions for mental health care emerged most dramatically in the Islamic world with Al-Razi’s psychiatric ward and the bimaristan system. While Byzantine hospitals included medical care and Western monasteries provided refuge for the mentally distressed, these institutions did not develop the specialized, systematic approach to psychiatric treatment seen in Islamic medicine. The bimaristans represented “centers of healing, where monks utilized a combination of herbal remedies, dietary regulations, and spiritual rituals to address physical and mental health issues”, but with explicit medical organization and trained physician staff.

Chinese and Indian contexts developed different institutional patterns. While hospitals existed in ancient India and China, the available evidence from this period does not document specialized psychiatric facilities comparable to the Islamic bimaristans. However, monastic communities in both Buddhist and Hindu contexts provided structured environments for mental cultivation and healing, functioning as therapeutic communities even if not formally organized as medical institutions.

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Psychology (1-1000 CE): The Islamic Revolution

Reference: SC: Psychology


The Birth of Psychiatric Medicine (9th-11th Centuries CE)

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The Founding of Psychiatric Institutions

The Islamic Golden Age (roughly 8th-13th centuries CE) witnessed the most revolutionary advances in the treatment of mental illness during the first millennium. Islamic physicians synthesized Greek, Persian, and Indian medical knowledge while making groundbreaking innovations that would not be matched in the West until the modern era.

Abu Bakr Muhammad Ibn Zakariya Al-Razi (Rhazes, 865-925 CE) achieved a milestone in psychiatric history by establishing the first dedicated psychiatric ward in Baghdad. This represented a paradigmatic shift in how mental illness was conceptualized and treated. Al-Razi “viewed mental illnesses as conditions that required medical intervention, challenging the prevalent notions that attributed such ailments to supernatural causes or moral failings”. His approach was “revolutionary for his time”—he insisted that “mental disorders should be recognized and treated as medical conditions”.

In these psychiatric wards, Al-Razi “conducted thorough clinical observations of patients with psychiatric conditions and implemented treatment strategies involving diet, medication, occupational therapy, aromatherapy, baths, and music therapy”. The comprehensiveness of treatment reflected a holistic understanding that mental illness affected the whole person. Al-Razi “gave priority to the doctor-patient relationship” and “advised physicians on how to keep the respect and confidence of their patients”, recognizing that the therapeutic relationship itself was curative.

Al-Razi developed innovative psychotherapeutic approaches that anticipated modern psychotherapy by a millennium. He “advocated for psychotherapy,” emphasizing that “positive remarks from doctors could uplift patients, enhance their well-being, and facilitate a faster recovery”. He believed that “a sudden, intense emotional reaction could rapidly improve psychological, psychosomatic, and organic disorders”, employing what he called “a simple but dynamic approach” to psychotherapy. In one famous case, Al-Razi treated Prince Mansur of Ray for severe joint pain through an elaborate psychological intervention—staging an emotionally shocking confrontation in a bathhouse that successfully mobilized the prince to move when conventional treatments had failed.

Al-Razi made crucial diagnostic distinctions. He clarified that “a Majnun (insane) is not epileptic, as an epileptic person is otherwise healthy except during seizures”. He distinguished different types of melancholia, noting that “the reason is merely misdirected” rather than destroyed. Remarkably, he “asserted that religious compulsions could be overcome by reason to achieve better mental health,” accomplishing “a primary form of cognitive therapy for obsessive behavior”. He also advocated that “mental health and self-esteem are crucial factors influencing a person’s overall health”, anticipating modern biopsychosocial models.

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Comprehensive Biopsychosocial Systems

Abu Zayd al-Balkhi (9th century CE) was “the first to discuss the interconnectivity between physical and mental well-being by linking illness with the nafs (self/soul) to the development of physical ailments”. In his treatise Masalih al-Abdan wa al-Anfus (“Sustenance of the Body and Soul”), he “developed approaches that we would now view as cognitive and talking therapy”. Al-Balkhi’s interventions included instructing individuals “to keep helpful cognitions at hand during times of distress,” employing “persuasive talking, preaching, and advising,” differentiating “between normal and extreme emotional responses to situations,” and studying “the development of coping mechanisms for anger, fear, sadness, and obsessions”. This framework, connecting cognitions and pathological behaviors, bears striking resemblance to modern cognitive behavioral therapy.

Al-Balkhi was also notable for “distinguishing between neuroses and psychosis, classifying neuroses into four categories: fear and anxiety (al-khawf wa al-faza’), anger and aggression (al-ghadab wa al-haraq), sadness and depression (al-huzn wa al-inhizam), and obsessions (al-waswas)”. This categorical system demonstrated sophisticated clinical observation and represented an early psychiatric nosology.

Al-Akhawayni Bukhari (?-983 CE) gained such renown for his treatment of mentally ill patients that he became known as “Bejeshk-e Divanehgan” (The Doctor of the Insane). His work Hidayat contained detailed chapters on various mental conditions: “Mania,” “Malikhulia” (Melancholia), “Kabus” (Nightmare), “Ghotrab” (Dementia), and “Khonagh-o-Rahem” (Conversion Disorder). Al-Akhawayni made the crucial observation that melancholia “results from the impact of black bile on the brain”, explicitly localizing mental illness in neurological substrates.

He classified patients with melancholia into distinct subtypes based on clinical presentation. The first group exhibited “fear with no definite etiology, self-laughing, self-crying, and speaking meaninglessly”—symptoms we would now associate with major depressive disorder with psychotic features. A second group claimed to possess stunning abilities, “introduced themselves as a prophet or king,” or believed they had “turned into other beings, like hens and roosters, and mimicked their behaviors”—presentations consistent with grandiose delusions seen in bipolar disorder with psychotic features or schizophrenia. Al-Akhawayni emphasized nutritional interventions, believing that “some foods, such as wholemeal bread, beef, and salted fish, can be beneficial to the melancholics’ condition”.

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The Synthesis of Avicenna

Ibn Sina (Avicenna, 980-1037 CE) produced The Canon of Medicine, which “was the basis for studying medicine in the East and the West for multiple centuries”. The Canon “discusses, among other things, the structure of psychological apparatus of human being and the connection of psychological functions with the brain as well as the role of psyche in etiology of somatic diseases”. Avicenna’s work represented the pinnacle of medieval understanding of mental illness, integrating philosophical psychology with clinical observation.

Avicenna provided detailed phenomenological descriptions of mental disorders. He distinguished between early and chronic phases of melancholia: the early phase involved “suspicions of evil, fear without cause, quick anger, involuntary muscle movements, dizziness, and tinnitus,” while the chronic phase showed “moaning, deep suspicion, profound sadness, restlessness, and delusions” including fears “that the sky may fall on one’s head” or of “being swallowed by the earth”. Avicenna was “among the first physicians to document that anger often serves as a transitional state between melancholic depression and mania—what psychiatry now calls the ‘switch’ phenomenon”.

Remarkably, Avicenna recognized what “wouldn’t be formally recognized by modern psychiatry for nearly a millennium: what we now call ‘mixed states,’ where features of depression and mania occur together”. He noted that some melancholic patients would show “increased libido, involuntary laughter, and even grandiose thoughts like imagining ‘that one is king’”.

Avicenna explored the psychology of death anxiety, identifying it as “a universal fear” with three cognitive causes: “(a) ignorance as to what death is, (b) uncertainty of what is to follow after death and (c) supposing that after death, the soul may cease to exist”. This analysis demonstrated sophisticated understanding of how cognitive interpretations generate emotional states.

Avicenna’s understanding of psychosomatic medicine was centuries ahead of his time. “He recognized the influence of emotional and mental states on physical health, suggesting that pain perception could be shaped by factors such as stress, anxiety, and sadness,” while “positive emotions and mental tranquility could reduce it”. This dual focus on psychological and physical conditions made it “critical for physicians to address both” aspects of patient care.

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Institutional Care and Cultural Context

The Islamic world developed sophisticated institutional care for mental illness through bimaristans (hospitals). These institutions had “separate wards for different illnesses, patients suffering from anxiety or showing signs of psychological distress were treated” with comprehensive modalities. The Mansuri Hospital in Cairo provided “medical treatment for Muslim patients, male and female, rich and poor, from Cairo and the countryside”, emphasizing accessibility regardless of social status. These hospitals included “lecture rooms, a library, as well as a chapel and a mosque”, integrating medical education with treatment.

The cultural context was crucial: “During the Islamic Golden Age, mental disorders were seen as phenomena that existed, requiring clinical assessment and treatment, and categorized and assessed systematically by employing rational judgements and observation rather than cultural beliefs based on supernatural causes”. While “the use of religious and medical forms of healing co-occurred—for instance, the use of prayer and ritual healing in addition to using treatments according to the medical model of the time”—the medical framework remained primary. This stood in stark contrast to medieval Christian Europe, where “discourse of mental illness as result of demons, spirits, spiritual distress, and sin dominated”.

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Notes:

  1. Nafs (نَفْس) is an Arabic word meaning the self, soul, psyche, or ego, central to Islamic thought, representing the inner self with desires, emotions, and free will, having both negative (commanding evil) and positive (tranquil) states, requiring spiritual struggle to tame its lower instincts (like lust, anger) towards a higher, peaceful state, often described in stages (like the commanding self, reproaching self, tranquil self). It’s the aspect of the spirit interacting with the physical body, driving actions and choices, distinct from the pure spirit (ruh) but linked to it. 

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Psychology (1-1000 CE): The Eastern Trajectory

Reference: SC: Psychology

Holistic Systems and Cognitive Therapies

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Indian Medical Psychology (1st Century Onward):
The Ayurvedic Framework

Ancient Indian medicine developed sophisticated understandings of mental illness centuries before the Common Era, but the classical texts were composed and systematized during the early centuries CE. The Charaka Samhita and Sushruta Samhita (composed in their current forms during the 1st-2nd centuries CE, though based on much earlier oral traditions) contain detailed expositions of mental disorders.

The primary Ayurvedic category for major mental disorders was unmada, literally meaning “frenzy, madness, or mental derangement”. The Charaka Samhita defined unmada as “the excessive wandering of the intellect, mind, and memory,” a condition that encompassed what modern psychiatry would classify across multiple diagnostic categories including various forms of psychosis, severe mood disorders, and organic mental syndromes. The text specified that unmada was “brought on by the consumption of impure food, blasphemy, and mental shock”, reflecting a biopsychosocial understanding that integrated dietary, spiritual, and traumatic etiologies.

Ayurvedic medicine classified unmada into five subtypes based on which of the three fundamental physiological principles (doshas) were vitiated. Vataja unmada resulted from vitiation of the vata humor (associated with movement and the nervous system), pittaja unmada from vitiation of pitta (associated with metabolism and transformation), kaphaja unmada from vitiation of kapha (associated with structure and lubrication), sannipataja unmada from simultaneous vitiation of all three doshas, and agantuja unmada from exogenous causes including possession by supernatural entities. This classification system demonstrated remarkable sophistication, recognizing that similar behavioral presentations could arise from fundamentally different pathophysiological processes.

The Ayurvedic understanding of mental illness was deeply integrated with its model of personality and consciousness. Mental health was understood to depend upon the balance of the trigunas—three fundamental qualities of mind: sattva (harmony, goodness, clarity), rajas (passion, activity, restlessness), and tamas (inertia, darkness, ignorance). “Improving Sattva and achieving a balance between Rajas and Tamas are necessary for mental well-being”. The hrdaya (emotional heart and seat of intellect) was identified as the origin point where aggravated doshas would travel into the mental channels, “subsequently causing an imbalance within the mind”.

Treatment approaches combined pharmacological, psychological, and spiritual interventions. The Charaka Samhita prescribed that “the mind should be treated with knowledge, specific knowledge, restraint, memory, and concentration”. Therapeutic methods included herbal medicines, dietary modifications, massage (abhyanga), fumigation (dhuma), music therapy, and psychotherapeutic interventions. For unmada caused by loss of something the patient loved, “he is made to regain a similar object. Simultaneously, he is consoled with pleasing assurances of friends as a result of which he becomes free from the ailment”. For unmada caused by emotions—“passion, grief, fear, anger, exhilaration, jealousy and greed”—physicians employed “exposure of the patient to mutually contradictory psychic factors” to restore equilibrium.

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Buddhist Psychology (1st-5th Centuries):
Cognitive Approaches to Mental Suffering

Buddhism developed a comprehensive psychological system that distinguished between general human suffering (dukkha) and specific mental illnesses. The Buddha himself “distinguished between two kinds of illness (rogo): physical illness (kāyiko rogo) and mental illness (cetasiko rogo)”. The Buddha attributed mental illness to “the arising of mental defilements (Kleshas) which are ultimately based on the unwholesome roots (three poisons) of greed, hatred, and confusion”.

From the Buddhist perspective, “everyone who is not an awakened being is in some sense mentally ill”—as the Buddha stated in the Pali canon, “those beings are hard to find in the world who can admit freedom from mental disease even for one moment, save only those in whom the asavas mental fermentations are destroyed”. This radical claim did not pathologize normal human experience but rather established enlightenment as the standard of perfect mental health. The Buddhist approach to mental suffering was fundamentally therapeutic and pragmatic—rather than metaphysical speculation, Buddhism offered “a method of cleansing the stream of consciousness from ‘contaminations’ and ‘defilements’”.

Buddhist texts identified five major hindrances (nivarana) that prevent mental cultivation and contribute to psychological distress: sense desire, hostility, sloth-torpor, restlessness-worry, and doubt. The therapeutic methodology for removing negative or intrusive thoughts, detailed in the Vitakkasanthana Sutta (MN 20, “The Removal of Distracting Thoughts”), prescribed five cognitive techniques that strikingly anticipate modern cognitive-behavioral therapy:

  1. Focus on an opposite or incompatible thought or object
  2. Ponder the perils and disadvantages of the thought and its harmful consequences
  3. Ignore the thought and distract oneself through another activity
  4. Reflect on the removal or stopping of the causes of the target thought
  5. Make a forceful mental effort to suppress the thought

Nagarjuna (c. 150-250 CE), founder of the Madhyamaka school of Mahayana Buddhism, revolutionized Buddhist philosophy and psychology through his concept of sunyata (emptiness). Nagarjuna’s philosophy functioned as “linguistic therapy: it uses language to reveal how language deceives us”. He argued that mental and emotional turmoil arises from clinging to conceptual elaborations (prapancha)—fixed ideas about the nature of reality, self, and phenomena. These conceptualizations “do not accurately reflect how the world actually is” and generate suffering because we mistake linguistic constructs for reality.

Nagarjuna demonstrated through rigorous dialectical analysis that all phenomena, including mental states and the self, lack intrinsic existence (svabhava). This “cognitive default” of projecting substantial existence onto things reflects “our tendency to become attached to things, reflecting a need for solidity and permanence, forever frustrated by the certainty of death”. The therapeutic goal was not to replace deluded thinking with a correct philosophical view but rather to let go of all fixed conceptual positions. “Our emotional and mental turmoil is replaced by a beatitude or serenity (shiva) that cannot be grasped but can be lived”.

Vasubandhu (fl. 4th-5th century CE), philosopher and co-founder of the Yogacara school, developed a sophisticated psychological system centered on consciousness and its transformations. Vasubandhu elaborated the theory of eight types of consciousness: the five sense consciousnesses, empirical consciousness (mano-vijnana), a self-aggrandizing mentality (manas), and the alaya-vijnana (storehouse consciousness). The storehouse consciousness explained psychological continuity and the mechanisms of karmic conditioning—the “seed” (bija) of each experience is “stored subliminally and released into a new experience,” providing “a quasi-causal explanation for the functioning of karmic retribution”.

Vasubandhu’s analysis revealed that what we take to be an external objective world is actually constructed within consciousness itself. “We are fooled by consciousness into believing that those things which we perceive and appropriate within consciousness are actually outside our cognitive sphere”. This insight—that “cognition takes place only in consciousness and nowhere else”—anticipated by over a millennium Western philosophical idealism and phenomenology. The therapeutic implications were profound: suffering could be addressed by transforming the very basis of consciousness. “Buddhism is a method of cleansing the stream of consciousness from ‘contaminations’ and ‘defilements’”, achieved through ashraya-paravritti (overturning the basis) whereby consciousness (vijnana) is gradually transformed into unmediated cognition (jnana).

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Chinese Medical Psychology (1st-10th Centuries):
The Integration of Emotion and Physiology

Traditional Chinese Medicine developed during the Han Dynasty (206 BCE-220 CE) and flourished through the Tang Dynasty (618-907 CE), creating a comprehensive system for understanding the relationship between emotional states and physiological processes. The foundational text, the Huang Di Nei Jing (Yellow Emperor’s Inner Classic), described the Shen (spirit or consciousness) as residing in the Heart and governing consciousness. The Shen concept evolved from a mystical force into “a clinical entity in Traditional Chinese Medicine (TCM), influencing diagnostics and treatments for emotional and mental imbalances”.

Zhang Zhongjing’s Shang Han Lun (Treatise on Cold Damage, c. 200 CE) built upon this foundation, addressing “how external pathogens can disrupt the Shen, leading to symptoms like delirium or restlessness”. The text emphasized that “the Heart is the sovereign of all organs and represents the consciousness of one’s being. It is responsible for intelligence, wisdom, and spiritual transformation”.

Chinese medicine conceptualized mental disorders as arising from disruptions in the flow of qi (vital energy) and imbalances among the internal organ systems. “According to Chinese medicine theory, MDD major depressive disorder is mostly characterized by emotional disorders and stagnation of qi, which leads to a loss of regulation of the liver, a loss of function of the spleen, and a loss of nourishment of the heart”. The system recognized both external emotional factors (worry, fear, anger) and internal factors (the qi of the organs being easily disturbed) as contributing to mental illness.

Treatment modalities integrated herbal pharmacology with emotional and spiritual interventions. Classical formulas like Xiao Yao San (Free and Easy Wanderer Powder), first recorded during the Song Dynasty (960-1127 CE) but based on earlier traditions, have been “used in the treatment of psychiatric disorders for thousands of years”. The formula’s eight herbs were designed to address liver qi stagnation, a fundamental pattern underlying many emotional disorders. Chinese physicians documented successful treatments of hysteria, insomnia, and depression using these formulas, with detailed case records surviving from the medieval period.

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Notes:

  1. Asava (or Āsava), a Pali/Sanskrit term in Buddhism, refers to mental effluents, defilements, or cankers like sensual desire, craving for existence, wrong views, and ignorance that “flow” from the mind, perpetuating the cycle of rebirth (samsara) and suffering.
  2. Alaya-vijnana (or ālaya-vijñāna) refers to the “storehouse consciousness,” a foundational concept in Mahayana Buddhism (especially the Yogācāra school) representing the deep, subconscious repository where all karmic seeds and impressions from past experiences are stored, influencing present perceptions. It’s the basis for identity and rebirth, a deep level of mind holding everything.

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Psychology (1-1000 CE): The Western Trajectory

Reference: SC: Psychology

From Greco-Roman Naturalism to Christian Supernaturalism

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Early Imperial Rome (1st-2nd Centuries):
Medical Systematization

The opening centuries of the Christian Era marked the culmination of Greco-Roman medical thought regarding mental disorders. 

Aulus Cornelius Celsus (c. 25 BCE-50 CE) produced the first systematic taxonomy of mental illnesses in his encyclopedic work De Medicina. His classification system represented a sophisticated attempt to categorize the diverse manifestations of psychological distress into distinct disease entities: phrenitis (delirium accompanied by fever), melancholia (depression), a disorder characterized by false images and disordered judgment (resembling modern schizophrenia), delirium arising from fear, lethargus (coma), and morbus comitialis (epilepsy). Celsus introduced the term insania (insanity) into medical vocabulary and advocated for a range of treatments that combined harsh interventions—bleeding, frightening the patient, emetics, total darkness—with more humane approaches such as music therapy, travel, sport, reading aloud, and massage.

Aretaeus of Cappadocia (active in the second half of the 2nd century CE) advanced clinical psychiatry through meticulous observation and detailed case documentation. His most significant contribution was recognizing the cyclical nature of certain mental conditions, observing that some patients alternated between periods of profound melancholia and states of mania—an early description of what contemporary psychiatry recognizes as bipolar disorder. Aretaeus differentiated nervous diseases from mental disorders and provided classic accounts of various forms of insanity, including hysteria, headaches, mania, and melancholia, describing patients as experiencing “aversion to food, despondency, sleeplessness, irritability, and restlessness”.

Galen of Pergamum (129-216 CE) synthesized and expanded upon Hippocratic humoral theory, asserting that mental disturbances resulted primarily from humoral imbalances in the brain that damaged its functioning. His therapeutic approach aimed at re-establishing the balance of bodily humors through evacuations, drugs, and dietary modifications. Galen’s most innovative contribution was his recognition of psychosomatic relationships—he famously documented a case in which a female patient’s pulse became irregular when the name of a specific male dancer was mentioned, leading him to conclude that the patient was “in love” and demonstrating that “thinking can lead to physiological consequences”. This observation represented “the first clear description of a psychosomatic (mind-body) relationship”. Galen emphasized the importance of counsel and education in treating psychological problems, recommending that therapy involve “a mature, unbiased older person” who would confront patients whose passions—anger, jealousy—were responsible for their psychological difficulties.

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The Christian Transformation (3rd-5th Centuries):
The Return of Supernatural Explanations

The rise of Christianity as the dominant religious and intellectual force in the Roman Empire precipitated a profound shift in explanations of mental illness. As Christianity spread, “ideas about sin dominated, and the ‘psychotherapists’ of the era were priests rather than physicians”. The Church became “the primary authority on health and illness, and religious interpretations replaced medical ones”. Mental disorders were increasingly viewed through the lens of demonology—the belief that demons or evil spirits could possess humans and cause abnormal behaviors. Church authorities often interpreted unusual behaviors, emotional disturbances, or psychological symptoms as evidence of demonic influence or punishment for sin. This represented a regression from the naturalistic explanations that had characterized Greco-Roman medicine.

Yet the picture was more complex than simple rejection of medical knowledge. 

Tertullian (c. 160-c. 220 CE), despite his theological rigor, “showed greater respect for physicians than many of his pagan contemporaries” and demonstrated extensive knowledge of contemporary medical thought. His anthropology emphasized “the indivisible unity of flesh and soul,” which paradoxically led him to maintain an “elevated view of the body” and appreciation for medical treatment. Early Christians generally “accepted Greco-Roman ideas that disease results from an imbalance of the humors and disconnect between mind and body”, attempting to remove excess humors through purgative medicines, bloodletting, and cauterization. Church fathers like Tertullian, Clement of Alexandria, and others “saw medicine as God’s gift”.

Origen (c. 184-c. 253 CE) developed a sophisticated theological psychology grounded in Platonic philosophy. His doctrine of the preexistence of souls posited that God originally created incorporeal “spiritual intelligences” (psychaí) devoted to contemplating their Creator. As the “fervor of the divine fire cooled,” these intelligences grew “bored of contemplating God” and their love “cooled off” (psýchesthai), transforming them into souls (psychē) encased in material bodies. For Origen, mental and spiritual conditions reflected the degree to which a soul had fallen from its original state of contemplation. He theorized that “a single lifetime is not enough for a soul to achieve salvation, for certain souls require more education or ‘healing’ than others”, prefiguring later concepts of spiritual development and therapeutic education. Origen’s framework integrated body and soul: “the purity and subtleness of the body with which a soul is enveloped depends upon the moral development and perfection of the soul to which it is joined”.

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Monastic Psychology (4th-5th Centuries):
The Desert Fathers and Acedia

The emergence of Christian monasticism in the deserts of Egypt, Syria, Palestine, and Mesopotamia between the 3rd and 7th centuries created a unique laboratory for psychological observation and spiritual therapy. The Desert Fathers, who sought lives of solitude, manual labor, contemplation, and silence, developed sophisticated understandings of mental and spiritual afflictions. These monks, who “we could also say were the first therapists,” created recommendations to heal the “sicknesses of the soul”.

Evagrius of Pontus (346-399 CE) produced Antirrhetikos, “the first and most complete early Christian book on demonology”. He systematized eight “wicked thoughts” (logismoi) that afflict Christians: gluttony (gastrimargia), sexual infidelity (porneia), greed (phylargia), pride (hyperephania), despair (lype), anger (orge), boasting (kenodoxia), and acedia (akedia). Acedia, “the most troublesome of all” the evil thoughts, was characterized by spiritual listlessness, torpor, restlessness, boredom, and indifference to religious practice. Evagrius associated acedia with “the plague that stalks at noonday” (Psalm 91:6), calling it “the noonday demon” that struck when monks were at their weakest—when the midday sun beat down, their energy waned, and their fasting stomachs growled. The afflicted monk experienced “an inert state without pain or care,” becoming “resistant to prayer and devotional reading,” unmoved by “rebuke or exhortation,” “spiritually numb and completely inert”.

John Cassian (360-435 CE), Evagrius’s student, transmitted these insights to Western monasticism through his Institutes and Conferences. Cassian’s vivid description of acedia’s manifestation in a monk’s cell captures its psychological reality: “He fancies that he is making no progress… he complains that he is unfruitful… he looks anxiously this way and that, and sighs that none of the brethren come to see him”. Cassian’s works profoundly influenced Western Christian spirituality—Benedict prescribed reading the Conferences in his monastic rule, and later Western thinkers including Gregory the Great, Alcuin, and Thomas Aquinas drew upon Cassian’s psychological insights. The monastic response to acedia involved “guarding the heart,” sobriety, hospitality, and meditation—practices that anticipated modern mindfulness-based therapies by nearly two millennia.

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Byzantine Medical Continuity (4th-7th Centuries):
Preserving and Advancing Greco-Roman Knowledge

While Western Europe increasingly interpreted mental illness through supernatural frameworks, the Byzantine Empire maintained and developed the Greco-Roman medical tradition. Byzantine physicians followed Hippocratic theory, diagnosing illnesses through examination of the four humors (blood, phlegm, yellow bile, black bile) connected to particular seasons and qualities (hot, cold, dry, moist). Treatment involved dietary changes, pharmaceuticals, bloodletting, and surgery to expunge problematic humors.

Oribasius (c. 320-400/403 CE), physician to Emperor Julian the Apostate, created Collectiones medicae (Medical Collections), “a kind of encyclopedia comprising all the anatomical and physiological medical knowledge of the time”. Though only about 25 of the original 70+ volumes survive, Oribasius’s work “paved the way for Galenism, as he was the first to consider Galen’s works as fundamental for the progress of medicine”. His systematic compilation preserved extensive material from Galen and earlier physicians that would otherwise have been lost, creating “a precious source on the history of ancient and early Byzantine medicine”.

Aetius of Amida (late 5th/early 6th century CE), physician to Emperor Justinian I, produced the Tetrabiblion (16 books), a comprehensive medical textbook that “gives significant information about surgical approaches” and detailed descriptions of various conditions. Aetius was reportedly “the first Greek physician who embraced Christianity”, representing the gradual integration of Christian identity with medical practice. His work “influenced Islamic and European medicine” and drew upon the knowledge of earlier physicians including Rufus of Ephesus, Leonidas, Soranus, and Philumenos.

Alexander of Tralles (c. 525-c. 605 CE) was “one of the most eminent physicians in the Byzantine Empire” who gained “great reputation, not only at Rome, but wherever he traveled in Spain, Gaul, and Italy”. His Therapeutics, written from extensive practical experience in extreme old age, demonstrated sophisticated understanding of mental disorders. Alexander classified melancholia into subtypes based on humoral imbalances: black bile melancholia characterized by depressed mood, anxiety, and delusions; yellow bile melancholia characterized by anger. He recognized that “anger resulted when one transitioned from melancholia to mania,” anticipating by over a millennium modern psychiatry’s recognition of “switch phenomena” in mood disorders. Alexander’s work described over 600 pharmaceutical preparations, including his Twelve Books which “exemplify the use of medicine to treat all types of diseases, including what he described as ‘melancholy’ which modern doctors would describe as depression”.

Paul of Aegina (c. 625-c. 690 CE), educated at Alexandria’s medical school, was acclaimed as the “Father of Early Medical Writing”. His Medical Compendium in Seven Books represented the culmination of Byzantine medical knowledge—“for many years in the Byzantine Empire, his work contained the sum of all available medical knowledge and was unrivaled in its accuracy and completeness”. Paul distinguished 62 types of pulse associated with various diseases and dealt extensively with apoplexy and epilepsy. His surgical expertise was legendary: he performed tonsillectomy, trephination, paracentesis, lithotomy, and breast amputation. Paul’s work achieved extraordinary influence in the Islamic world—his reputation “seems to have been very great, and it is said that he was especially consulted by midwives, whence he received the name of Al-kawabeli or ‘the Accoucheur’”. The Arabic translation by Hunayn ibn Ishaq in the 9th century transmitted Byzantine medical knowledge to Islamic civilization, where it would be transformed and expanded.

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Psychology Timeline (Modern Period)

Reference: SC: Psychology

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West

1800s

  • c. 1800 – Franz Joseph Gall developed cranioscopy, the measurement of the skull to determine psychological characteristics, which was later renamed phrenology; it is now discredited.
  • 1807 – Georg Wilhelm Friedrich Hegel published Phenomenology of Spirit (Mind), which describes his thesis-antithesis-synthesis dialectical method, according to which knowledge pushes forwards to greater certainty, and ultimately towards knowledge of the noumenal world.
  • 1808 – Johann Christian Reil coined the term “psychiatry”.

1810s

1820s

1840s

1850s

1860s

1870s

1880s

1890s

1900s

1910s

1920s

1930s

1940s

1950s

1960s

1970s

1980s

1990s

21st century

2000s

2010s

2020s

2020

2021

  • July – A study reports that adolescent loneliness in contemporary schools and depression increased substantially and consistently worldwide after 2012.
  • September – Psychologist and behavior geneticist Kathryn Paige Harden publishes The Genetic Lottery: Why DNA Matters for Social Equality, an argument for using genetics to create a just society – including in terms of psychology-related predispositions, similar to a bioethical argument made by Papaioannou in 2013.
  • October – The American Psychological Association releases guidelines for the optimal use of social media in professional psychological practice.
  • December – In applied behavioural science, “megastudies” as meta-analyses are proposed and demonstrated for investigating the efficacy of many different interventions designed in an interdisciplinary manner by separate teams, e.g. to inform policy.

2022

2023

  • February – A study hypothesizes mental health awareness efforts (in current forms) or increasingly glamorised and romanticised mental disorders on social media (e.g. quotes about depression on aesthetically appealing backgrounds shared more widely on certain social media – especially TikTok) may contribute to the recent substantial rise in reported mental health problems by intensifying and over-diagnosing of such. Around 2023, the rapid rise of TikTok prompts extensive research into potential harmful effects of such apps such as higher levels of mental problems correlating with higher levels of usage or addictive elements of this and similar apps.
  • March – Bioengineers show bodily system changes can induce anxiety, in specific altered heart rate by itself in risky contexts, after earlier studies also implicated immune system elements.
  • April – The first review of interventions against false conspiracy beliefs is published, indicating interventions “that fostered an analytical mindset or taught critical thinking skills” are most effective and that preventive action is important.
  • June – A time-use study provides the first comprehensive bird’s-eye view, with a “global human day” framework, of what humans currently spend their time on.

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East

  • 1872–1950 – Sri Aurobindo’s Integral Psychology
    Sri Aurobindo formulates an “integral” psychology that treats consciousness as fundamental, introduces the “psychic being” as evolving soul, and outlines a multi‑tiered model of mind (from physical mind up to supramental) with practices for their transformation.
  • 1905 – First psychology lab in India
    Sir Brojendra Nath Seal establishes what is widely regarded as India’s first psychology laboratory at Calcutta University, initiating institutional Western‑style psychological research in India.
  • 1916 – First Department of Psychology in India
    N. N. Sengupta founds the first Department of Experimental Psychology at the University of Calcutta, explicitly connecting laboratory methods with India’s long introspective traditions.
  • Mid‑20th century – Indian and Buddhist thought enter global psychology
    As humanistic and transpersonal psychologies emerge (c. 1960s), Indian concepts of self‑realization, samādhi, nirvāṇa, and Buddhist meditation are integrated into Western theories of self‑actualization and peak experiences.
  • 1926–2022 – Thich Nhat Hanh and engaged mindfulness
    Thich Nhat Hanh develops a modern, socially engaged Buddhist psychology, articulating the Five and Fourteen Mindfulness Trainings and presenting mindfulness as a whole‑life practice beyond symptom relief.

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