Dynamic psychopathology Flashcards
What is the Ego governed by?
The reality principle
What is the function of the ego?
It controls motility, contact with reality, perception.
The ego through defence mechanisms can modulate the expression of drive
How does repression act?
It prevents unacceptable thoughts entering conscious awareness
Performed unconsciously it is a primary defence mechanism
How does acting out prevent conscious awareness of ideas or affect?
An individual impulsively and unconsciously expresses wishes or conflicts through action.
Includes tantrums, motiveless assaults and pleasure promiscuity
What does condensation mean in psychoanalytical terms?
The combining of various attitudes, impulses and feelings into one single image that occurs during manifest of dreams
What is primary process thinking?
Where instinctual desires cannot be delayed or modified this is how the ID functions
How does object relations theory of Winnicott, Klein and Fairburn differ to Freud’s thinking?
That individuals primary drive is to seek relationships rather than pleasure
What defence mechanisms were developed by Melanie Klein?
SIPDOG
Splitting
Introjection
Projection
Denial
Omnipotence
Grandiosity
When does the phalic stage of development begin?
Year 3 to Year 5:
- Threats and anxiety of castration
- Guilt of masturbation
- Conflict and consolidation of Oedipal involved occur
How is denial classified as a defence mechanism?
Psychotic defence mechanism - alters perception of external reality - seeing/hearing but refusal to acknowledge.
In psychotic form the actual content is replaced by fantasty
What is identification?
Changing the shape of one’s self-representation to become more like an ideal or admired person. It involves taking on the persons characteristics, feelings and behaviours as their own.
Introjection differs as the person may see themselves like the other person but not feel it.
When does the latency period occur?
From 5-6 years to 11 years
Here after the resolution of the Oedipal complex the super ego is formed. There is a relative quiescence of sexual activity.
The superego provides ongoing scrutiny of feelings, behaviour and feelings
What are the mature ego defences and how do they act?
Sublimation - channel socially unacceptable impulses into a socially acceptable one.
Altruism - by providing support and service to others receive vicarious gratification. Produced by “defeat” conflict. Importantly not altruistic surrender - which is giving up of all personal pleasures for gratification of another. Not reaction formation as the individual feels partially gratified and there is real benefit to others.
Suppression - if painful event/impulse. Conscious or semiconscious switching attention away from painful impulse. The impulse is acknowledged but not delayed. Intentionally done. Not repression which is unconscious forgetting.
Humour - produced from loss or destruction of personal belongings. Comedy and irony highlight amusing aspects of the threat signal without causing personal discomfort or making others uncomfortable. Person can tolerate and focus on other aspects
Anticipation - comes from sudden goal or threat but there is goal directed planning of behaviour and countermeasures. Note without goal-direction it is just free floating anxiety
What level are mature defence mechanisms?
Level IV:
- Amplify gratification
- Allow conscious awareness of feelings, behaviours and possible consequences
- Handle intrapsychic conflict in a best possible way
Outline Valliants levels of defence mechanisms?
Level I: psychotic defences - there is a clear disconnect between reality and
Outline Valliants (1994) levels of defence mechanisms?
Level I: psychotic defences - there is a clear disconnect between reality and what is experienced by the individual:
- Psychotic denial
- Psychotic distortion
- Delusional projection
Level II: (immature) narcissistic defences - these cause more distress to the observer than the individual
- Acting out
- Passive aggression (turning against self)
- Autistic fantasy
- Dissociation
Level III: neurotic defences - these cause more distress in the individual than the observer
- Displacement
- Intellectualisation (isolation and undoing)
- Repression
- Reaction formation
Level IV mature:
- Sublimation
- Altruism
- Suppression
- Humour
- Anticipation
Outline the neurotic defence mechanisms?
Displacement - shift interest or emotion to another less threatening object. The reaction may be very different. Process is transfer of feelings and comes from the conflict of threat
Intellectualisation - remove personal and emotional components and focus on factual components. No instinctual impulse/drive
Rationalisation - provide a wrong but socially acceptable explanation for behaviour. An excuse is provided - seen in alcohol use/teens. There may be affect felt. Motives are driven by instinctual impulse
Isolation - talk about emotional aspects but none is experienced
Undoing - symbolic actual behaviour to try and undo an unacceptable impulse. Act aimed at the consequences of behaviour to undo it. Can cause superstitions. Links to OCD and magical thinking.
Reaction formation
Repression
Dissociation (note some refer as psychotic) - temporarily and significantly alter ones identity (consciousness, behaviour, emotions) to avoid distress. Comes from conflict of promiscuous or irresponsible behaviour.
Identification with Aggressor
Which defences may be referred as narcisstic?
Projection and Denial
- Narcissistic defence mechanisms may be considered a subcategory of immature defence mechanisms
Outline the immature defence mechanisms
Acting out
Passive aggression - channel feelings of discontent through other immature means - procrastination, take sick leave
Somatisation
Somatosensory amplification/hypochondriasis
Incudes some Kleinian defence mechanisms
- Splitting
- Projection
- Projective identification
- Schzioid fantasy
Note immature defences may be normal in earlier development
What are the Kleinian defence mechanisms?
SIPDOG
Splitting
Introjection - the person internalises external objects distress and blames others of causes the distress
Denigration / denial
Omnipotence - attach great belief that internally generated thoughts can influence external world.
Grandiosity - increase self-importance
What is Freud’s topographical model of the mind?
Conscious - part of mind that is aware. Governed by the reality principle
Preconscious - can be brought into conscious awareness. The Ego mainly resides here. Interface between conscious and unconscious. Repressive barrier
Unconscious - primary process thinking and governed by pleasure principle. The supergo and the id reside here.
Topographical model cannot explain how individuals are not aware of displacement and repression. If defence mechanism operated by the Ego surely it can be brought into conscious awareness
