Normality and Mental Health Lecture Notes PDF

NORMALITY AND MENTAL HEALTH LECTURETTE BY DR. SAMEON REFERENCE: 12TH EDITION KAPLAN AND SADDOCK’S SYNOPSIS OF PSYCHIATRY, CHAPTER 34.2 MENTAL HEALTH Could be defined as the antonym of mental illness Absence of psychopathology and synonymous with normal Achieving mental health by alleviating g...

NORMALITY AND MENTAL HEALTH LECTURETTE BY DR. SAMEON REFERENCE: 12TH EDITION KAPLAN AND SADDOCK’S SYNOPSIS OF PSYCHIATRY, CHAPTER 34.2 MENTAL HEALTH Could be defined as the antonym of mental illness Absence of psychopathology and synonymous with normal Achieving mental health by alleviating gross pathologic signs and symptoms of illness DEFINING MENTAL HEALTH 1. “Average” does not mean healthy 2. What is healthy sometimes depends on geography, culture, and the historical moment 3. Make clear whether one is discussing trait or state. 4. Appreciate the twofold danger of “contamination by values” MODELS OF MENTAL HEALTH MODEL A: MENTAL HEALTH AS ABOVE NORMAL  Mental health can be conceptualized as above normal and a mental state that is objectively desirable, as in Sigmund Freud’s definition of mental health, which is the capacity to work and love.  No manifest psychopathology equals mental health  Health refers to a reasonable, rather than an optimal state of functioning. MODEL B: MENTAL HEALTH AS MATURITY  Adult mental health reflects a continuing process of maturational unfolding  Hypothesis – maturity and mental health are almost synonymous  The association of mental health to maturity is probably mediated not only by progressive brain myelination into the sixth decade but also by the evolution of emotional and social intelligence through experience. MODEL B: MENTAL HEALTH AS MATURITY In Erik Erikson’s model, the adult social radius expanded over time through the mastery of specific tasks such as “Identity versus Identity Diffusion,” “Intimacy versus Isolation,” “Generativity versus Stagnation,” and “Integrity versus Despair.”  Identity - In such a model, the social radius of each adult developmental task fits inside the next.  First, adolescents must achieve an Identity that allows them to become separate from their parents  The task of Identity requires mastering the last task of childhood: sustained separation from social, residential, economic, and ideologic dependence  Intimacy – Permits the young adult to become reciprocally, and not selfishly, involved with a partner.  Career consolidation - a task that is usually mastered together with or that follows the mastery of intimacy.  Mastery of this task permits adults to find a career as valuable as they once found play.  Persons with schizophrenia and individuals with a severe personality disorder often manifest a lifelong inability to achieve either intimacy or sustained, gratifying employment  Generativity - involves the demonstration of a clear capacity to care for and guide the next generation  Generativity reflects the capacity to give the self—finally completed through mastery of the first three tasks of adult development—away.  Its mastery is strongly correlated with successful adaptation to old age.  Integrity - Finally, in old age, it is common to feel that some life exists after death and that one is part of something greater than oneself.  The last life task in Erikson’s words is Integrity, achieving some sense of peace and unity with respect both to one’s life and to the whole world. MODEL C: MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS  This model defines mental and spiritual health as the amalgam of the positive emotions that bind us to other human beings  Love, hope, joy, forgiveness, compassion, faith, awe, and gratitude comprise the essential positive and “moral” emotions included in this model  Negative emotions originating in the hypothalamus are elaborated in the human amygdala, while positive emotions are generated in the limbic system  Positive emotion via our parasympathetic nervous system reduces basal metabolism, blood pressure, heart rate, respiratory rate, and muscle tension. EVIDENCE FOR POSITIVE EMOTIONS  Limbic structures - govern our mammalian capacity not only to remember (cognition), but also to play (joy), to cry out at separation (faith/trust), and to take care of our own (love).  Studies using fMRI demonstrated that when individuals subjectively experience existential states of fear, sadness, or pleasure, blood flow increases in limbic areas and decreases in many higher brain areas.  Pleasurable human experiences – in limbic areas, especially in the orbitofrontal region, anterior cingulate, and insula  Anterior cingulate - links valence and memory to create attachment.  Prefrontal cortex - in charge of estimating rewards and punishments and plays a critical role in adapting and regulating our emotional response to new situations.  Insula - helps to bring these visceral feelings into consciousness MODEL D: MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE  High socioemotional intelligence reflects above-average mental health in the same way that a high IQ reflects above-average intellectual aptitude.  The more you are skilled in empathy, the more others will value you, and the greater will be your social supports, self-esteem, and intimate relationships.  The following criteria can define social and emotional intelligence:  Accurate conscious perception and monitoring of one’s emotions.  Modification of emotions so that their expression is appropriate. This involves the capacity to self-soothe personal anxiety and to shake off hopelessness and gloom.  Accurate recognition of and response to emotions in others.  Skill in negotiating close relationships with others.  Capacity for focusing emotions (motivation) toward the desired goal. This involves delayed gratification and adaptively displacing and channeling impulse. MODEL E: MENTAL HEALTH AS SUBJECTIVE WELL-BEING  Subjective well-being is not just the absence of misery, but the presence of positive contentment  Subjective happiness can have maladaptive as well as adaptive facets – The search for happiness can appear selfish, narcissistic, superficial, and banal. MODEL F: MENTAL HEALTH AS RESILIENCE  There are three broad classes of coping mechanisms that humans use to overcome stressful situations:  Consciously seeking social support - individual elicits help from appropriate others  Conscious cognitive strategies - individuals intentionally use to master stress  Adaptive involuntary coping mechanisms (defense mechanisms) - distort our perception of internal and external reality to reduce subjective distress, anxiety, and depression INVOLUNTARY COPING MECHANISMS  Involuntary coping mechanisms reduce conflict and cognitive dissonance during sudden changes in internal and external reality.  Such homeostatic mental “defenses” shield us from sudden changes in the four lodestars of conflict: impulse (affect and emotion), reality, people (relationships), and social learning (conscience).  These mechanisms can restore psychological homeostasis by ignoring or deflecting sudden increases in affect and emotion  They provide a mental time-out to adjust to sudden changes in reality and self-image, which cannot be immediately integrated.  Involuntary mental mechanisms can mitigate sudden unresolvable conflict with important people, living or dead HEALTHY INVOLUNTARY MENTAL MECHANISMS  Humor - Humor permits the discharge of emotion without individual discomfort and unpleasant effects upon others  Altruism - When used to master conflict, altruism involves an individual getting pleasure from giving to others what the individual would have liked to receive  Sublimation - Sublimation is a defense mechanism that involves channeling unwanted or unacceptable urges into an admissible or productive outlet  Suppression - Suppression is a defense that modulates emotional conflict or internal/external stressors through stoicism. Suppression minimizes and postpones but does not ignore gratification  Anticipation - anticipation is the capacity to keep the affective response to an unbearable future event in mind in manageable doses. It reflects the capacity to perceive future danger affectively and cognitively and by this means to master conflict in small steps 6 MODELS OF MENTAL HEALTH 1. Mental health as Above 4. Mental health as Social- Normal Emotional Intelligence 2. Mental health as Positive 5. Mental health as Psychology Subjective Well-Being 3. Mental health as Maturity 6. Mental health as Resilience POST TEST THANK YOU FOR YOUR ATTENTION. REFERENCE: KAPLAN AND SADDOCK’S SYNOPSIS OF PSYCHIATRY, 12TH EDITION Post-Lecture Faculty Survey