Behav. Sci. Psychodynamics

Question 1

what is the fundamental hypotheses of psychoanalytic theory?

Answer 1

psychic determinism: every event/symptom has meaning

Question 2

what are the psychosexual stages of development?

Answer 2

libido: life force (includes sexual, aggressive)
1. oral: birth - 1.5 years: sucking, dependent
continue having oral traits as an adult (food, gum, smoke, drink)
2. anal: 1.5-3 yrs: crawling, exploring, NO!, potty training, terrible twos
as an adult: neat, on time, correct, organized, careful with money, controlled
3. phallic phase: 3-5/6 yrs: curious about sex differences, close to parent of opposite sex
4. latency phase: 6-adolescent
5. genital phase: adolescent/adult on: capacity for true intimacy

Question 3

fixation

Answer 3

extra investment of libido in one phase

Question 4

regression

Answer 4

reversion to earlier phase under stress

Question 5

ID

Answer 5

child - from birth

fun, gratification: “I want now!”

Question 6

superego

Answer 6

parent: from 5 on
conscience, rules, morals, values
develops based on input from parents, teachers, religious authorities, political authorities, social norms, legal system
"thou salt not"
DISSOLVES IN ALCOHOL

Question 7

ego

Answer 7

adult
growing, evolving “i”
purpose: deals with internal (Id and ego) and external reality

Question 8

level I defense mechanisms

Answer 8

“psychotic” mechanisms: common in a healthy individual before age 5 and common in adult dreams and fantasy

1. delusional projection
2. psychotic denial
3. distortion

Question 9

delusional projection

Answer 9

frank delusions about external reality, usually of a persecutory type

• perception of one’s feelings in another person and then acting on it
• perception of other people or their feelings literally inside oneself

Question 10

psychotic denial

Answer 10

denial of external reality (I am Jesus Christ, not John Williams)

Question 11

distortion

Answer 11

grossly reshaping external reality to suit inner needs

• unrealistic megalomaniacal beliefs
• hallucinations, wishfulfilling delusions of delusional superiority or entitlement

Question 12

level II defense mechanisms

Answer 12

immature mechanisms: common in healthy individuals 3-15 and personality disorders

• alter distress due to the threat of interpersonal intimacy or its loss - appear socially undesirable
  1. projection, 2. somatization, acting out, splitting

Question 13

projection

Answer 13

attributing one’s own unacknowledged feels to others

• severe prejudice, rejections of intimacy through unwarranted suspicion, marked hypervigilance to external danger
• paranoid personality

Question 14

somatization

Answer 14

turning an unacceptable impulse or feeling eg from bereavement, loneliness, fear or anger into complaints of pain or somatic illness
-hypochondriac, psychosomatic disorders

Question 15

acting out

Answer 15

direct expression of an unconscious wish or impulse in order to avoid being conscious of the affect that accompanies it
delinquent or impulsive act to avoid being aware of one’s feelings eg anger, sadness
-use of drugs, failure, perversion, self-inflicted injury to relieve tension
-antisocial personality disorder

Question 16

splitting

Answer 16

seeing people and events as ALL good or ALL bad

• will quickly switch between these extreme positions
• borderline personality disorder

Question 17

level III defense mechanisms

Answer 17

neurotic defenses: common in health individuals age 3-90

• alter private feelings or instinctual expression - seen as quirks or hang-ups
  1. denial 2. displacement, 3. dissociation 4. identification 5. intellectualization 6. isolation of affect 7. rationalization 8. reaction formation 9. regression 10. undoing

Question 18

denial

Answer 18

unable to accept (ignore, be unaware of, denies) intolerable facts about reality
-commonest defense in medical practice

Question 19

displacement

Answer 19

redirection of feelings toward a relatively less cared for (less cathected) object than the person or situation arousing the feelings

• kicking chairs, road rage
• most phobias, many hysterical conversion reactions

Question 20

dissociation

Answer 20

temporary but drastic modification of one’s character or of one’s sense of personal identity to avoid emotional distress

• acute reaction to trauma
• multiple personality disorder

Question 21

identification

Answer 21

unconscious patterning of one’s behavior after a powerful, influential person

• adopting habits of parent/coach
• behaviors/parenting style “runs in families”
• stockholm syndrome

Question 22

intellectualization

Answer 22

thinking about instinctual wishes in formal, affectively bland terms, and NOT acting on them - idea is in consciousness, but feeling is missing

• isolation, rationalization, ritual, undoing, restitution, magical thinking, busywork
• usually occurs in cluster (OCD)

Question 23

isolation of affect

Answer 23

intellectual knowledge and understanding of a negative event without experiencing the feelings

Question 24

rationalization

Answer 24

providing superficially reasonable accounts to explain away negative events, feelings, actions

Question 25

reaction formation

Answer 25

behavior in a fashion diametrically opposed to an unacceptable instinctual impulse

• overtly caring for someone else when one wishes to be cared for oneself
• hating someone or something one really likes (siblings0
• loving a hated rival or unpleasant duty

Question 26

regression

Answer 26

appearance of child-like behavior during period of stress

• medical crises
• when sibling is born

Question 27

undoing

Answer 27

protecting against a negative past event by acceptable “corrective” behavior eg superstitious rituals or formal atonement or confession

Question 28

level IV defense mechanisms

Answer 28

mature mechanisms: common in healthy individuals ages 12-90

• integrate reality, interpersonal relationships, and private feelings and appear as convenient virtues
  1. altruism, 2. sublimation 3. anticipation 4. suppression 5. humor

Question 29

altruism

Answer 29

vicarious but constructive and instinctually gratifying service to others
includes benign and constructive reaction formation, philanthropy, well-repaid service to others

Question 30

how does altruism differ from projection and acting out?

Answer 30

provides real, not imaginary, benefit to others from reaction formation in that it leaves the person using the defense at least partly gratified

Question 31

sublimation

Answer 31

indirect or attenuated expression of instincts without either adverse consequences or marked loss of pleasure
(sports, art, goals)

Question 32

anticipation

Answer 32

realistic anticipation of or planning for future inner discomfort

• includes goal directed but overly careful planning or worrying
• premature but realistic effective anticipation of death or surgery or separation

Question 33

suppression

Answer 33

the conscious or semiconscious decision to postpone paying attention to a conscious impulse or conflict

• looking for silver lining, minimizing acknowledged discomfort, employing a stiff upper lip
• deliberately postponing but not avoiding - “i will think about it tomorrow” and then do

Question 34

humor

Answer 34

overt expression of ideas and feelings without individual discomfort or immobilization and without unpleasant effect on others

Question 35

transference

Answer 35

patient’s unconscious “transfer” and replay of relationship with influential figures from the past (unrealistic expectations or mistrust)

Question 36

countertransference

Answer 36

MD’s transference to the patient - positive or negative