PSY9-Chapter 1 Abnormal Behavior and its Nature PDF
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Ms. Cyrem F. Decena, RPsy, RPm
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This chapter defines abnormal psychology and distinguishes it from normal behavior. It explores different theoretical models and perspectives, like the supernatural, biological, and psychological traditions.
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CHAPTER 1 Abnormal Behavior and its Nature Ms. Cyrem F. Decena, RPsy, RPm Instructor III CHAPTER 1 TOPIC OUTLINE Defining Abnormal Psychology Normal Behavior and Abnormal Behavior Three Theories or Models Supernatural Tradition Biological Tradition...
CHAPTER 1 Abnormal Behavior and its Nature Ms. Cyrem F. Decena, RPsy, RPm Instructor III CHAPTER 1 TOPIC OUTLINE Defining Abnormal Psychology Normal Behavior and Abnormal Behavior Three Theories or Models Supernatural Tradition Biological Tradition Psychological Tradition Present Perspectives Professionals Within Psychopathology Determinants of Psychopathology Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III ABNORMAL PSYCHOLOGY It is the application of science in the study of mental disorders. It is the study of individuals with mental, emotional, and physical pain. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III ABNORMAL PSYCHOLOGY It is also referred to as psychopathology-- - psycho which means mind and pathos meaning illness or disease. A branch of psychology that studies abnormal behavior and ways of helping people who are affected by psychological disorders. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III DEFINING NORMALITY Normal behavior – behavior that is socially acceptable to the standards of the society. Criteria for Normality: Normality is average: what is accepted by the majority Normality is social conformity: anyone who conforms to social norms is normal Normality is personal comfort: if a person feels comfort or pleasure, then it is normal Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III WHAT IS ABNORMAL BEHAVIOR? Abnormal literary means “away from the normal.” Abnormal behavior is a behavior that deviates from what is expected and normal. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL (MENTAL) DISORDER It is a psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III CRITERIA OF ABNORMAL BEHAVIOR Unusualness: behaviors that are deviant or unusual are considered abnormal Social deviance: behaviors deemed normal in one culture may be viewed aas abnormal in another. Faulty perceptions or interpretations of reality: hallucinations and delusions are generally taken as signs of an underlying mental disorder Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III CRITERIA OF ABNORMAL BEHAVIOR Significant personal distress: states of personal distress caused by troublesome emotions. Maladaptive or self-defeating behavior: behaviors that leads to unhappiness rather than self-fulfillment. Dangerousness: behavior that is dangerous to oneself or other people may be considered abnormal. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III SOME 1. A label is applied to a group of people that MISCONCEPTIONS distinguishes them from others (e.g., “crazy). ABOUT ABNORMAL 2. The label is linked to deviant or undesirable BEHAVIOR attributes by society (e.g., crazy people are STIGMA dangerous) destructive beliefs and 3. People with the label are discriminated against attitudes held by a unfairly (e.g., clinic for crazy people can’t be society that are built in our neighborhood). ascribed to groups considered different in 4. People with the label ae seen as essentially some manner, such as different from those without the label, people with mental contributing to an “us” versus “them” mentality illness. (e.g., we are not like those crazy people). Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III FOUR D’S OF ABNORMAL BEHAVIOR Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III FOUR D’S OF ABNORMAL BEHAVIOR Psychological DYSFUNCTION Dysfunction refers to something that has gone wrong and is not working as it should. Breakdown in cognitive, emotional, or behavioral functioning. Internal mechanism is unable to perform its usual function. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III FOUR D’S OF ABNORMAL BEHAVIOR Personal DISTRESS The behavior must be associated with great distress to the individual or to others around him or her. A person’s behavior may be classified as disordered if it causes him or her great distress. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III FOUR D’S OF ABNORMAL BEHAVIOR DISABILITY Impairment in some important area of life (e.g., work or personal relationships) can also characterize mental disability Impairment is set in the context of a person’s background. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III FOUR D’S OF ABNORMAL BEHAVIOR DEVIANCE (Violation of social norms) Reaction is outside cultural norms Something is considered abnormal because it occurs infrequently; It deviates from the average. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III The Diagnostic and Statistical Manual (DSM) Widely Accepted System Used to classify psychological problem and disorders DSM Contains Diagnostic Criteria for Behaviors that; Fit a pattern Cause dysfunction or subjective distress Are present for specified duration And for behaviors that are not otherwise explainable Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III HISTORICAL PERSPECTIVES of Abnormal Behavior Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III ETIOLOGY Etiology, or the study of origins, has to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions TREATMENT Treatment, also, is often important to the study of psychological disorders. If a new drug or psychosocial treatment is successful in treating a disorder, it may give us some hints about the nature of the disorder and its causes. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III THREE (3) THEORIES OR MODELS SUPERNATURAL TRADITION. Result of divine intervention (curses, demonic posession, sin). To rid the person of such, they turn to reliegios rituals such as exorcism, confession, and atonement, BIOLOGICAL TRADITION. Similar to physical disease, which is caused by the breakdown of the systems of the body. The cure for abnormal behavior was to restore bodily health. PSYCHOLOGICAL TRADITION. Results of traumas (bereavement, chronic stress). Rest, relaxation, and a change of environment can be helpful. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Demons and Witches During the last quarter of the 14th century, religious and lay authorities supported these popular superstitions and society as a whole began to believe more strongly in the existence and power of demons and witches. The conviction that sorcery and witches are causes of madness and other evils continued into the 15th century, and evil contin- ued to be blamed for unexplainable behavior, even after the found- ing of the United States, as evidenced by the Salem, Massachusetts, witch trials in the late 17th century. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Early Demonology Many early philosophers, theologians, and physicians who studied the troubled mind believed that disturbed behavior reflected the displeasure of the gods or possession by demons. The doctrine that an evil being or spirit can dwell within a person and control his or her mind and body is called demonology. The belief that odd behavior was caused by possession led to treating it by exorcism, the ritualistic casting out of evil spirits. Exorcism typically took the form of elaborate rites of prayer, noisemaking, forcing the afflicted to drink terrible- tasting brews, and on occasion more extreme measures, such as flogging and starvation, to render the body uninhabitable to devils. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Stone Age One treatment for abnormality in the Stone Age and well into the Middle Ages may have been to drill holes in the skull of a person displaying abnormal behavior to allow the spirits to depart (Feldman & Goodrich, 2001). Certain forms of mental disorders (headache, convulsiv attacks) were treated through trephining or trepanning--- an operation performed with crude instruments and consisted of chipping away one area of the skull. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Trephination Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Modern times In the modern times in the Philippines, this can be equated to: gayuma, barang at kulam engkanto at diwata pinaglaruan ng duwende, nuno sa punso undin, siokoy Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Stress and Melancholy Insanity was a natural phenomenon, caused by mental and emotional stress, and is curable. Common treatments: rest, sleep, and a healthy and happy environment Other treatments: baths, ointments, and various potions Communal treatment for the insane: people with insanity, along with those with physical deformities or disabilities, were often moved from house to house in medieval villages as neighbors took turns for caring them. Slides: Ms. Cyrem F. Decena, RPsy, RP Instructor III Treatments for Possession AIDS: divine punishment for homosexuality. The acquired immune deficiency syndrome (AIDS) epidemic was associated with a similar belief among some people, particularly in the late 1980s and early 1990s. Exorcism: reliable, if not, other methods are used such as beating, confinement and other forms of torture Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Treatments for Possession Other approaches: hanging people over a pit full of poisonous snakes or dipping on icy water Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Mass Hysteria Large-scale outbreak of bizarre behavior during the Middle Ages wherein people go out running in the streets, dancing, shout, rave, and jump. Also called St. Vitus’ Dance or Tarantism. Believed to be a reaction to insect bites. Mass hysteria may simply demonstrate the phenomenon of emotion contagion, in which the experience of an emotion seems to spread to those around us. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Mass Hysteria If someone nearby becomes frightened or sad, chances are that for the moment you also will feel fear or sad- ness. When this kind of experience escalates into full-blown panic, whole communities are affected (Barlow, 2002). People are also sug- gestible when they are in states of high emo- tion. Therefore, if one person identifies a “cause” of the problem, others will probably assume that their own reactions have the same source. In popular language, this shared response is sometimes referred to as mob psychology. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III The Moon and the Stars Paracelsus, a Swiss physician who lived from 1493 to 1541, rejected notions of possession by the devil, suggesting instead that the movements of the moon and stars had profound effects on people’s psychological functioning. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III The Moon and the Stars Lunacy may be the oldest and most crease in excitement at the new and full pervasive of all concepts purporting to moons. Suicides were found to peak at account for behavioural abnormality, dating from the Hippocratic period, about 400 B.C. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III The Moon and the Stars This lunar explanation, even if unsubstantiated, was a welcome alternative to explanations involving demons or witches. Even today, many people believe that a full moon is linked to odd behavior; however, there is no scientific evidence to support this belief. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION In the fifth century B.C., Hippocrates, often called the father of modern Western medicine, separated medicine from religion, magic, and superstition. He and his associates left a body of work called the Hippocratic Corpus, written between 450 and 350 B.C., in which they suggested that psychological disorders could be treated like any other disease. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION Hippocrates regarded the brain as the organ of consciousness, intellectual life, and emotion; thus, he thought that disordered thinking and behavior were indications of some kind of brain pathology. Hippocrates is often considered one of the earliest proponents of the notion that something wrong with the brain disturbs thought and action. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION Hippocrates classified mental disorders into three categories: mania, melancholia, and phrenitis, or brain fever. He also described four main fluids or humors that directed normal functioning and personality; blood which arose in the heart, black bile arising in the spleen, yellow bile or choler from the liver, and phlegm from the brain. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION GALEN. A physician who continued on the work of Hippocrates. Hippocratic-Galenic Approach The humoral theory was, perhaps, the first example of associating psychological disorders with a “chemical imbalance” SANGUINE (literal meaning “red, like blood”) describes someone who is ruddy in complexion, presumably from copious blood flowing through the body, and cheerful and optimistic, although insomnia and delirium were thought to be caused by excessive blood in the brain. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION MELANCHOLIC means depressive (depression was thought to be caused by black bile flooding the brain). PHLEGMATIC personality (from the humor phlegm) indicates apathy and sluggishness but can also mean being calm under stress. CHOLERIC person (from yellow bile or choler) is hot tempered. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION 1. Bleeding or Bloodletting. Measured amount of blood was removed from the body, often with leeches. 2. Induce vomiting. well-known treatise on depression published in 1621, Anatomy of Melancholy, Robert Burton recommended eating tobacco and a half-boiled cabbage to induce vomiting. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION In ancient China and throughout Asia, the Chinese focused on the movement of air or “wind” throughout the body. Unexplained mental disorders were caused by blockages of wind or the presence of cold, dark wind (yin) as opposed to warm, life-sustaining wind (yang). Treatment involved restoring proper flow of wind through various methods, including acupuncture. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION Hippocrates also coined the word hysteria to describe a concept he learned about from the Egyptians, who had identified what we now call the somatic symptom disorders. Advanced syphilis. A sexually transmitted disease caused by a bacterial microorganism entering the brain, include believing that everyone is plotting against you (delusion of persecution) or that you are God (delusion of grandeur), as well as other bizarre behaviors. Louis Pasteur’s germ theory of disease, developed in about 1870, facilitated the identification of the specific bacterial microorganism that caused syphilis. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION John Perdue Grey (1825 – 1886) Champion of the biological tradition in the United States Often served as forensic psychiatrist Strong believer that mental illness was due to physical causes that could be found in the brain Mentally ill patients are to be treated as though they are physically ill The emphasis was again on rest, diet, and proper room temperature and ventilation Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION Under Grey’s leadership, the condition in hospitals greatly improved and they became more humane, livable institutions. But in subsequent years they also became so large and impersonal that individual attention was not possible. It was almost 100 years before the community mental health movement was successful in reducing the population of mental hospitals with the controversial policy of deinstitutionalization, in which patients were released into their communities. Unfortunately, this practice has as many negative consequences as positive ones. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION In the 1930s, the physical interventions of electric shock and brain surgery were often used. Benjamin Franklin discovered accidentally, and then confirmed experimentally in the 1750s, that a mild and modest electric shock to the head produced a brief convulsion and memory loss (amnesia) but otherwise did little harm. 1950s – the first effective drugs for severe psychotic disorders were developed in a systematic way Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION LOBOTOMY. A surgical procedure in which the nerve pathways in a lobe or lobes of the brain are severed from those in other areas. It is also called prefrontal leukotomy. It has always been controversial, but widely performed for more than two decades as treatment for schizophrenia, manic depression and bipolar disorder, among other mental illnesses. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION DR. WALTER JACKSON FREEMAN II An American physician who specialized in Lobotomy. 1936 – he performed the first US prefrontal lobotomy on a Kansas housewife. 1967 – he performed his last lobotomy before being banned from operating. He performed about 3,500 lobotomies in 23 states. He died from cancer on May 31, 1972 at the age of 76. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION After 2,500 operations, Freeman performed his final ice-pick lobotomy on a housewife named Helen Mortenson in February 1967. She died of a brain hemorrhage, and Freeman's career was finally over. Freeman sold his home and spent the rest of his days traveling the country in a camper, visiting old patients, trying desperately to prove that his procedure had transformed thousands of lives for the better. Freeman died of cancer in 1972. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION Howard Dully During Helen Mortenson’s operation Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION Consequences of the Biological Tradition Late 19th century – John P. Grey and his colleagues ironically reduced or eliminated interest in treating mental patients, because they thought that mental disorders were the result of some as-yet- undiscovered brain pathology and were therefore incurable Hospitalization of patients was the only available course of action In place of treatment, interest centered on diagnosis, legal questions concerning the responsibility of patients for their actions during periods of insanity, and the study of brain pathology itself Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III BIOLOGICAL TRADITION EMIL KRAEPELIN A German psychiatrist, one of the most influential of his time He developed classification system of mental illness that influenced subsequent classifications He made distinctions between Schizophrenia and Manic-depressive psychosis One of the founding fathers of psychiatry Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION PLATO He suggested that causes of maladaptive behavior were the social and cultural influences and the learning that took place in that environment Best treatment: reeducate the individual through rational discussion Precursor to modern psychosocial treatment Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION ARISTOTLE He also emphasized the influence of social environment and early learning on later psychopathology Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION MORAL THERAPY During the first half of the 19th century, a strong psychosocial approach to mental disorders. The term moral actually referred more to emotional or psychological factors rather than to a code of conduct. It is a system originated with the well-known French psychiatrist Philippe Pinel and his close associate Jean- Baptiste Pussin. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION MORAL THERAPY 19th century psychosocial approach to mental disorders. Moral = emotional or mental Treating patients as normally as possible in a setting that encouraged and reinforced normal social interaction Its advocates believed that an asylum patient had a better chance of recovery if treated as a child rather than an animal 16th century asylums --- hospital where people who are mentally ill are cared for especially for long period of time Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION PHILIPPE PINEL (1745-1826) French physician, founder of moral treatment. Worked as a medical journalist and then as unlicensed doctor in a private asylum 1970s – he became Physician-in-Chief at the men’s and women’s public asylums in Paris He believed that people under his care should be treated like patients rather than like animals or criminals Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION WILLIAM TUKE After William Tuke followed Pinel’s lead in England, Benjamin Rush, often considered the founder of U.S. psychiatry, introduced moral therapy in his early work at Pennsylvania Hospital. An English businessman, philanthropist, and Quaker He appealed to the Society of Friends (Quakers) to revolutionize the treatment of the insane He collected sufficient funds to open the York Retreat for the care of the insane in 1796 He pioneered new, more humane methods of treatment for the mentally ill Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION BENJAMIN RUSH (1745-1813) “Father of American psychiatry,” was the first to believe that mental illness is a disease of the mind and not a “possession of demons” He believed that mental illness was caused by inflammation of the brain He invented the tranquilizing chair to control blood flow to the brain Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION The tranquilizing chair was supposed to control the flow of the blood toward the brain and, by lessening muscular action or reducing motor activity, reduced the force and frequency of the pulse. It did neither harm nor good. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION The photo above shows Pinel removing the chains from patients at the Paris Asylum for insane women Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION DEVELOPMENT OF ASYLUMS Twelfth century, England and Scotland had 220 leprosy hospitals serving a total population of a million and a half. Leprosariums were converted to asylums, refuges for the confinement and care of people with mental illness. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Bethlehem and Other Early Asylums The Priory of St. Mary of Bethlehem was founded in 1243. Records indicate that in 1403 it housed six men with mental illness. In 1547, Henry VIII handed it over to the city of London, thereafter to be a hospital devoted solely to the confinement of people with mental illness. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Bethlehem and Other Early Asylums The conditions in Bethlehem were deplorable. Bethlehem eventually became one of London’s great tourist attractions by 18th century. Even as late as the 19th century, viewing the patients was considered entertainment, and people bought tickets to see them. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Moral Treatment In the United States, the Friends’ Asylum, founded in 1817 in Pennsylvania, and the Hartford Retreat, established in 1824 in Connecticut, were established to provide humane treatment. Patients had close contact with attendants, who talked and read to them and encouraged them to engage in purposeful activity; residents led lives as close to normal as possible and in general took responsibility for themselves within the constraints of their disorders. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Moral Treatment Dorothea Dix, a crusader for improved conditions for people with mental illness who fought to have hospitals created for their care, helped effect this change. She campaigned vigorously to improve the lives of people with mental illness and personally helped see that 32 state hospitals were built. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Moral Treatment A schoolteacher who had worked in various institutions, she had firsthand knowledge of the deplorable conditions imposed on patients with insanity, and she made it her life’s work to inform the American public and their leaders of these abuses. Her work became known as the mental hygiene movement. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Franz Mesmer suggested to his patients that their problem was caused by an undetectable fluid found in all living organisms called “animal magnetism”, which could become blocked. Mesmer is widely regarded as the father of hypnosis, a state in which extremely suggestible subjects sometimes appear to be in a trance. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Franz Anton Mesmer, an Austrian physician practicing in Vienna and Paris in the late eighteenth century, believed that hysteria was caused by a particular distribution of a universal magnetic fluid in the body. Hypnosis (the word mesmerism is a synonym for hypnotism; the phenomenon itself was known to the ancients of many cultures, where it was part of the sorcery and magic of conjurers and faith healers). Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Jean-Martin Charcot. The great Parisian neurologist Jean Martin Charcot also studied hysterical states. Demonstrated that some techniques of mesmerism were effective with a number of psychological disorders, and he did much to legitimize the fledgling practice of hypnosis. He believed that hysteria was a problem with the nervous system and had a biological cause, he was also persuaded by psychological explanations Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Josef Breuer A Viennese physician who treated a young woman, whose identity was disguised under the pseudonym Anna O., with a number of hysterical symptoms, including partial paralysis, impairment of sight and hearing, and, often, difficulty speaking. Breuer hypnotized her, and while hypnotized, she began talking more freely and, ultimately, with considerable emotion about upsetting events from her past. Breuer’s method became known as the cathartic method. Reliving an earlier emotional trauma and releasing emotional tension by expressing previously forgotten thoughts. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Bertha Pappenheim (Anna O.) Bright, attractive young woman who was perfectly healthy until she reached 21 years of age Her father developed a serious chronic illness and she cared for him 5 months after her father became ill, she noticed that during the day her vision blurred and that from time to time she had difficulty moving her right arm and both legs She also began to experience some difficulty speaking, and her behavior became unpredictable Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Bertha Pappenheim (Anna O.) Shortly thereafter, Anna O. consulted Breuer Series of treatment sessions using hypnosis and subsequent “talking through” One at a time her “hysterical” ailments disappeared, but only after treatment was administered for each respective behavior Freud took these basic observations and expanded them into the psychoanalytic model, the most comprehensive theory yet constructed on the development and structure of our personalities Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION SIGMUND FREUD (1856-1939) Austrian neurologist best known for developing psychoanalysis --- set of psychological theories and therapeutic techniques used to treat some psychological disorders. He studied under Charcot, but later rejected Charcot’s idea that hysteria was rooted in weak nerves. His friend and mentor Joseph Breuer introduced him to the case study of a patient known as Anna O. (Bertha Pappenheim) Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION The basic principles of mental functioning that Freud originally proposed remained constant through his writings and are still applied by psychoanalysts today Although most of it remains unproven, psychoanalytic theory has had a strong influence Three major facets: 1. structure of the mind 2. defense mechanisms 3. stages of early psychosexual development Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE STRUCTURE OF THE MIND Id – operates according to pleasure principle; source of strong sexual and aggressive feelings or energies; the animal within us Ego – operates according to reality principle; part of our mind that ensures that we act realistically Superego – conscience; represents the moral principles instilled in us by our parents and our culture Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Defense Mechanisms It is a strategy used by the ego to protect itself from anxiety. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Oral (birth to 1 year) – sex instinct centers on the mouth because infants derive pleasure from such oral activities such as sucking, chewing, and biting Anal (1 to 3 years) – voluntary urination and defecation become the primary methods of gratifying the sex instinct Phallic (3 to 6 years) – pleasure is now derived from genital stimulation; children develop an incestuous desire for the opposite-sex parent (called the Oedipus complex for boys and Electra complex for girls) Latency (6 to 11 years) – traumas of the phallic stage cause social conflicts to be repressed and sexual urges to be rechanneled into schoolwork and vigorous play Genital (age 12 onward) – puberty triggers a reawakening of sexual urges; adolescents must now learn how to express these urges in socially acceptable ways Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Psychoanalytic Therapy In psychoanalytic and newer psychodynamic treatments, the goal of the therapist is to understand the person’s early- childhood experiences, the nature of key relationships, and the patterns in current relationships. With free association, a patient reclines on a couch, facing away from the analyst, and is encouraged to give free rein to his or her thoughts, verbalizing whatever comes to mind, without censoring anything. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION Psychoanalytic Therapy Transference refers to the patient’s responses to his or her analyst that seem to reflect attitudes and ways of behaving toward important people in the patient’s past, rather than reflecting actual aspects of the analyst–patient relationship. In the technique of interpretation, the analyst points out to the patient the meanings of certain of the patient’s behaviors. Defense mechanisms are a principal focus of interpretation. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION NEO-FREUDIAN PSYCHODYNAMIC PERSPECTIVES Jung and Analytical Psychology Carl Gustav Jung, a Swiss psychiatrist originally considered Freud’s heir apparent, broke with Freud in 1914 on many issues, after a 7-year period of intense correspondence about their disagreements. Jung proposed ideas radically different from Freud’s, ultimately establishing analytical psychology. Jung hypothesized that in addition to the personal unconscious postulated by Freud, there is a collective unconscious, the part of the unconscious that is common to all human beings and that consists primarily of what Jung called archetypes, or basic categories that all human beings use in conceptualizing about the world. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION NEO-FREUDIAN PSYCHODYNAMIC PERSPECTIVES Adler and Individual Psychology Adler’s theory, which came to be known as individual psychology, regarded people as inextricably tied to their society because he believed that fulfillment was found in doing things for the social good. Like Jung, he stressed the importance of working toward goals. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION NEO-FREUDIAN PSYCHODYNAMIC PERSPECTIVES Continuing Influences of Freud and His Followers 1. Childhood experiences help shape adult personality. 2. There are unconscious influences on behavior. 3. The causes and purposes of human behavior are not always obvious. Freud’s Ideas on Depression He theorized that the potential for depression is created early in childhood, during the oral period. According to the theory, the mourner’s anger toward the lost one becomes directed inward, developing into ongoing self-blame and depression. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM John Watson looked to the experimental procedures of the psychologists who were investigating learning in animals, and because of his efforts, the dominant focus of psychology switched from thinking to learning. Behaviorism focuses on observable behavior rather than on consciousness or mental functioning. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM Ivan Pavlov, Russian physiologist and Nobel laureate, discovered classical conditioning, quite by accident. Experiment conducted on Little Albert cited a possible relationship between classical conditioning and the development of certain disorders, in this instance a phobia. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM Edward Lee Thorndike, formulated what was to become an extremely important principle, the law of effect: Behavior that is followed by consequences satisfying to the organism will be repeated, and behavior that is followed by noxious or unpleasant consequences will be discouraged. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM B.F. SKINNER, introduced the concept of operant conditioning, so called because it applies to behavior that operates on the environment. Renaming Thorndike’s “law of effect” the “principle of reinforcement”, Skinner distinguished two types of reinforcement. Positive reinforcement refers to the strengthening of a tendency to respond by virtue of the presentation of a pleasant event, called a positive reinforcer. Negative reinforcement also strengthens a response, but it does so via the removal of an aversive event Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM Operant conditioning principles may contribute to the persistence of aggressive behavior, a key feature of conduct disorder. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM Learning often goes on even in the absence of reinforcers. We all learn by watching and imitating others, a process called modeling. ALBERT BANDURA, an influential social cognitive psychologist who was perhaps best known for his social learning theory, the concept of self-efficacy, and his famous Bobo doll experiments. Until his death on July 26, 2021, he was a Professor Emeritus at Stanford University and was widely regarded as one of the most influential psychologists in history. In the 1960s, experimental work demonstrated that witnessing someone perform certain activities can increase or decrease diverse kinds of behavior, such as sharing, aggression, and fear. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE RISE OF BEHAVIORISM Behavior Therapy Behavior therapy emerged in the 1950s. In its initial form, this therapy applied procedures based on classical and operant conditioning to alter clinical problems. One important behavior therapy technique that is still used to treat phobias and anxiety today is called systematic desensitization. Developed by Joseph Wolpe in 1958, it includes two components: (1) deep muscle relaxation and (2) gradual exposure to a list of feared situations, starting with those that arouse minimal anxiety and progressing to those that are the most frightening. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE IMPORTANCE OF COGNITION Cognitive Therapy In cognitive therapy, the therapist typically begins by helping clients become more aware of their maladaptive thoughts. By changing cognition, therapists hope that people can change their feelings, behaviors, and symptoms. The roots of cognitive therapy included Aaron Beck’s cognitive therapy and Albert Ellis’s rational-emotive behavior therapy (REBT). Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE IMPORTANCE OF COGNITION Dr. Aaron T. Beck is globally recognized as the father of Cognitive Behavior Therapy (CBT) and one of the world’s leading researchers in psychopathology. His contributions to the field of mental health and the tangible impact he had on the lives of so many people are astonishing. He was an Emeritus Professor of Psychiatry at the University of Pennsylvania, where he worked on developing and testing his theories for almost 70 years. He also served as President Emeritus of the Beck Institute, where he inspired a generation of CBT practitioners and trainees with his wisdom, humor, and grace. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PSYCHOLOGICAL TRADITION THE IMPORTANCE OF COGNITION Albert Ellis’s rational-emotive behavior therapy (REBT). Ellis’s principal thesis was that sustained emotional reactions are caused by internal sentences that people repeat to themselves; these self-statements reflect sometimes unspoken assumptions––irrational beliefs–– about what is necessary to lead a meaningful life. In Ellis’s REBT, the aim is to eliminate self- defeating beliefs Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PRESENT PERSPECTIVES Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Present Perspectives Pharmacotherapy – use of drugs in therapy Psychotherapy – treating mental health problems by talking with a psychiatrist, psychologist or other health provider Problem: Deinstitutionalization – policy of moving severely mentally ill people out of large state institutions and then closing part or all of those institutions Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III PROFESSIONALS WITHIN PSYCHOPATHOLOGY Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Professionals within Psychopathology Clinical Psychologists. has a Masters or Doctoral degree in clinical psychology and, most importantly, a PRC license in Psychology. Psychiatrists. hold an M.D. degree and have had postgraduate training, called a residency, in which they have received supervision in the practice of diagnosis and pharmacotherapy (administering medications). Medical doctors specializing in diagnosing and treating mental, emotional, and behavioral disorders. They undergo extensive training in medical school, followed by a residency program focused on mental health. Professionals within Psychopathology Psychiatric Nurse receives training at the bachelor’s or master’s level. Nurses can also receive more specialized training as a nurse practitioner that will allow them to prescribe psychoactive medications. Counseling psychologists originally dealt mostly with vocational issues; their focus today may be quite similar to that in clinical psychology, though still with less of an emphasis on mental disorders and more of an emphasis on prevention, education, and general life problems. Counseling psychologists work in a variety of settings, including schools, mental health agencies, industry, and community health centers Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III Professionals within Psychopathology Social workers have an M.S.W. (master of social work) degree and a PRC license in Social Work. The focus of training is on psychotherapy. Those in social work graduate programs do not receive training in psychological assessment. Marriage and family therapists treat families or couples, focusing on the ways in which these relationships impact a variety of mental health issues. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III DETERMINANTS OF PSYCHOPATHOLOGY Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III The 4P Factor Model Predisposing factors: Why me? Make someone prone or susceptible to a certain pathology; remote effect (does not come out at an early stage, only when triggered) This can include medical and psychiatric history, family history, temperament genetics and chronic social stressors. Slides: Ms. Cyrem F. Decena, RPsy, RPm Instructor III The 4P Factor Model Precipitating factors: Perpetuating factors: Protective factors: Why now? Why does it continue? What can I rely on? It trigger the onset of a These are the current The protective factors can certain disorder; things that are making the reduce and prevent the immediate effect. What patient’s condition endure occurrence and has made them take the as symptoms may reoccurrence of a mental decision to come? progressively become health disorder. worst. Reasons could be from The protective factors can current symptoms, These could be the be the patient’s strength, concurrent illness, onset severity of their condition, resilience and support in or exacerbation of illness, compliance issues, their lives or the amount behavioural response, the unresolved predisposing of support they have with role of inciting event and and perpetuating factors. their family and social so on. groups. Slides: Ms. Cyrem F. Decena, RPsy, RPm Slides: Ms. Instructor Cyrem F. Decena, III RPsy, RPm End of