Gilks Deck 1: some defenses + old guys/theories etc Flashcards

1
Q

who was Eugen Bleuler

A

coined term “schizophrenia”

came up with the “4 As”:
blunted Affect
loosening of Associations
Ambivalence
Autism

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2
Q

who was Emil Kraeplin

A

coined term “dementia praecox”

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3
Q

who was Adolph Meyer

A

“ergasiology”

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4
Q

why was schizophrenia called “dementia praecox”

A

the disorder we know today as schizophrenia was originally called dementia praecox, or early dementia, by Kraepelin (1883), who believed that the brains of individuals who developed schizophrenia had begun to deteriorate prematurely.

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5
Q

who was Anna Freud

A

daughter of Sigmund

came up with defenses and ego psychology

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6
Q

who was Ronald Fairbairn

A

object relations

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7
Q

who was Melanie Klein

A

came up with OBJECT RELATIONS theory–> interested in child development

came up with the “paranoid-schizoid” stance

rival of Anna Freud

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8
Q

what is object relations theory

A

theory of psychoanalysis

based on assumption that all individuals have within them an INTERNALIZED and primarily UNCONSCIOUS realm of RELATIONSHIPS

these relationships refer not only to the world around the individual but more specifically to the other individuals surrounding the subject

focuses primarily on the INTERACTION people have with others and how those interactions are internalized and how these now internalized object relations affect ones psychological framework

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9
Q

who was Otto Kemberg

A

contributed to object relations theory

developed “TRANSFERENCE FOCUSED psychotherapy” specifically for BORDERLINE patients

had a feud with Cohut about narcisism and borderline personalities –> Kemberg’s narcisisst is more consistent with DSM5 description (“thick skinned” narcissist)

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10
Q

who was Heinz Kohut

A

founder of SELF-PSYCHOLOGY

wrote about empathy and courage

special interest in narcissism–> his version was the “thin skinned” narcissist

developed concepts of “MIRROR TRANSFERENCE”

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11
Q

what is “mirror transference”

A

the remobilization of the grandiose self

its expression in “I am perfect and I need you in order to confirm it”

can result in feelings of boredom, tension and impatience in the analyst, whose otherness is not recognized

–> counter transference is thus a sign of it

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12
Q

describe the “thick skinned” narcissist

A

Kemberg’s model

“oblivious, entitled, attention seeking, exploitative”–> more consistent with DSM5

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13
Q

describe the “thin skinned narcissist”

A

Kohut’s model

“hypervigilant, sensitive to slights, envious of others and needy–‘I should be great but i’m coming up short’”

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14
Q

who was Pierre Janet

A

automatisms

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15
Q

who was Wilfred Bion

A

container/contained

alpha and beta functions allow mother to digest information/emotions for baby

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16
Q

who was Donald Winnicott

A

the “GOOD ENOUGH” MOTHER creates a “holding environment” where child can feel omnipotent, allowing him to be curious and playful

emphasis on PLAY

true self and false self–> what you present to the world

TRANSITIONAL OBJECTS

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17
Q

who was John Bowlby

A

influenced by Winnicott

also primarily interested in development

had idea that “children are responding to real life events and not unconscious fantasies”

focused on MOTHER-CHILD ATTACHMENT as being essential medium for human interaction–> implications for later relationships and personality functioning

ATTACHMENT BEHAVIOURS promote proximity to desired person–> human infants are monotropic and tend to attach to one person

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18
Q

who was Carl Rogers

A

unconditional positive regard

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19
Q

what is unconditional positive regard

A

the basic acceptance and support of a person regardless of what the person says or does, especially in the context of client-centred therapy

“Rogers believed that unconditional positive regard is essential for healthy development and tried to establish it as a therapeutic component. Through providing unconditional positive regard, humanistic therapists seek to help their clients accept and take responsibility for themselves. Humanistic psychologists believe that by showing the client unconditional positive regard and acceptance, the therapist is providing the best possible conditions for personal growth to the client.”

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20
Q

who was Mary Ainsworth

A

developed the Strange Situation experiment

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21
Q

who was B. F. Skinner

A

operant conditioning

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22
Q

who was George Engel

A

coined term “biopsychosocial”

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23
Q

who was Gregory Bateson

A

double bind theory of schizophrenia

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24
Q

what is the double bind theory of schizophrenia

A

Bateson et al. (1956) proposed that schizophrenic symptoms are an expression of social interactions in which the individual is repeatedly exposed to conflicting injunctions, without having the opportunity to adequately respond to those injunctions, or to ignore them (i.e., to escape the field). For example, if a mother tells her son that she loves him, while at the same time turning her head away in disgust, the child receives two conflicting messages about their relationship on different communicative levels, one of affection on the verbal level, and one of animosity on the nonverbal level. It is argued that the child’s ability to respond to the mother is incapacitated by such contradictions across communicative levels, because one message invalidates the other. Because of the child’s vital dependence on the mother, Bateson et al. argue that the child is also not able to comment on the fact that a contradiction has occurred, i.e., the child is unable to metacommunicate (Bateson et al., 1956).

The symptomatology of schizophrenia, it is argued, reflects the accommodation of the individual to a prolonged exposure to such interactions. Once ‘victims’ have learned to perceive their universe in terms of contradictory environmental input, the inability to respond effectively to stimuli from the environment is no longer contingent on the extent to which stimuli from the environment are contradictory in specific interactive sequences. Instead, the individual will generally experience any input from the environment as conflicting information without being able to discriminate between different communicative levels. In the long run, this inability manifests itself as typically schizophrenic symptoms such as flattened affect, delusions and hallucinations, and incoherent thinking and speaking (Bateson et al., 1956).

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25
Q

who was Margaret Mahler

A

stages of separation-individuation

how young children acquire sense of identity and separateness from mother (normal autism, normal symbiosis, differentiation, practicing, rapprochement, object constancy)

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26
Q

who was Malan

A

brief psychodynamic therapy focused on “impulse, anxiety, defense”

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27
Q

who was Elizabeth Kubler Ross

A

5 stages of grief

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28
Q

what are the 5 stages of grief

A

DABDA

Denial
Anger
Bargaining
Depression
Acceptance

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29
Q

who developed the idea of mirror transferrence

A

Heinz Kohut

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30
Q

who came up with object relations theory

A

Melanie Klein

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31
Q

who came up with the idea of the “good enough mother” creating a “holding environment”

A

winnicott

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32
Q

who is associated with the idea of automatisms

A

Pierre Janet

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33
Q

who focused on mother-child attachment as being central to development

A

John Bowlby

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34
Q

who is associated with defenses and ego psychology

A

Anna Freud

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35
Q

who coined the term dementia praecox

A

Emil Kraeplin

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36
Q

who coined the term schizophrenia

A

Eugen Bleuler

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37
Q

who developed transferrence focused therapy and had the concept of the thick skinned narcissist

A

Otto Kemberg

38
Q

who developed the idea of unconditional positive regard

A

Carl Rogers

39
Q

Who developed the strange situation experiment

A

Mary Ainsworth

40
Q

Who coined the term biopsychosocial

A

George Engel

41
Q

Who developed the double blind theory of schizophrenia

A

Gregory Bateson

42
Q

who is associated with the concepts of operant conditioning

A

BF Skinner

43
Q

who developed the 5 stages of grief

A

elisabeth kubler ross

44
Q

who focused on stages of separation-individuation in the child

A

margaret mahler

45
Q

how many schneiderian first rank symptoms are there

A

7

46
Q

list the schneiderian first rank symptoms

A
  1. auditory hallucinations
  2. thought insertion
  3. thought withdrawal
  4. thought broadcasting
  5. passivity experiences (the experience that actions, bodily movements, sensations, emotions or thought processes are generated by an outside agency)
  6. primary delusions (beliefs arising “out of the blue”)
  7. delusional perception (belief that a normal perception has special significance or meaning)
47
Q

list the 4 ethical principles

A

beneficence

nonmaleficence

autonomy

justice

48
Q

describe the ethical principles of beneficence

A

duty to improve patients wellbeing

49
Q

describe the ethical principles of nonmaleficence

A

duty to not harm patients

50
Q

describe the ethical principles of justice

A

fair treatment for all

51
Q

describe the ethical principles of autonomy

A

patients right to self determination

52
Q

list the three “types” of defenses

A

“narcissistic-psychotic”–“less adaptive”

neurotic–“more adaptive”

mature–“most adaptive”

53
Q

in what populations do you see “narcissistic-psychotic” defenses

A

ranging from psychotic/seen in children/seen in fantasies to adolescent-level or adult personality disorders

54
Q

in what populations do you see “neurotic” defenses

A

common in healthy people

in neurotic disorders

55
Q

in what populations do you see mature defenses

A

these are healthy and adaptive

56
Q

what are defenses

A

the UNCONSCIOUS and AUTOMATIC ways in which the mind response to internal and external STRESS and emotional conflict

they are coping mechanisms that LIMIT a persons awareness of painful affects like anxiety, depression or envy and resolve internal conflicts

57
Q

what are more adaptive defenses based on

A

repression

58
Q

what are less adaptive defenses generally based on

A

splitting

59
Q

what determines whether someone mostly has defenses based on repression (more adaptive) or splitting (less adaptive)–> explain how this plays out

A

whether they have achieved object constancy –> knowing that bad and good can exist in the same person

*if someone can tolerate the idea that bad and good feelings can coexist in themselves or others, they can deal with painful or anxiety provoking thoughts and affects by keeping them within themselves but making them unconscious (repression)–> if they cannot deal with that coexistence of bad and good, they need to separate the bad from the good and thus they have to experience some of their feelings as if they are coming from outside themself (splitting)

60
Q

in what population is splitting normal

A

children

61
Q

when might splitting persist beyond childhood

A

when people need to protect their good image of an abusive or neglectful parent or caregiver

62
Q

list some of the “narcissitic-psychotic”/immature / less adaptive defenses

A

denial

splitting

projection

projective identification

distortion

pathological idealization and devaluation

dissociation

regression

acting out

blocking

counterphobic attitude

63
Q

describe the following defense, and state whether it is less, more or most adaptive:

splitting

A

preserves good feelings and avoids bad feelings by SEPARATING them into DIFFERENT PEOPLE

ie mom is always good and dad is always bad

less adaptive

64
Q

describe the following defense, and state whether it is less, more or most adaptive:

projection

A

protects by perceiving unacceptable thoughts, feelings and fantasies as originating outside the self

attributing one’s own unacknowledged feelings to others

“the defense mechanism of projection enables a person conflicted over expressing anger to change ‘I hate him’ to ‘he hates me’”

often used to justify prejudice or evade responsibility –> if severe, may develop into paranoid delusions

less adaptive

65
Q

describe the following defense, and state whether it is less, more or most adaptive:

projective identification

A

occurs when one person projects a thought or feeling into another person and then behaves in a way to make the second person experience the projected feeling –> in this way, the first person maintains an “identification” with the feeling

inducing ones own unacknowleged feelings into another

can be seen in antisocial and narcissistic PDs

less adaptive

66
Q

give an example of projective identification playing out

A

Mr C was passed over for a promotion by his boss–> says hes fine with it, but unconscious rage is so overwhelming that he starts coming into work two hours late and his boss gets so angry he fires Mr. C

67
Q

describe the following defense, and state whether it is less, more or most adaptive:

pathological idealization and devaluation

A

natural results of splitting

the person idealized today can be devalued tomorrow

68
Q

what are the four most “primitive” or immature defenses according to cabaniss

A

the ones most linked to splitting:

splitting
projection
projective identification
pathological idealization and devaluation

69
Q

describe the following defense, and state whether it is less, more or most adaptive:

denial

A

protects people from unacceptable feelings by DISAVOWING THEIR EXISTENCE

can be more or less adaptive depending on how much reality is disavowed

(i.e Mr. E presented to derm c/o acne and was found to have giant tumour in neck)

70
Q

describe the following defense, and state whether it is less, more or most adaptive:

dissociation

A

avoids unacceptable thoughts and affects by disconnecting the self from aspects of current reality

can involve losing ones consistent sense of identity, memory, and ability to perceive sensations or current sense of reality

quintessential “HIGH COST” defense –> major cognitive functions are sacrificed to avoid the experience or memory of a massive trauma

less adaptive

71
Q

describe the following defense, and state whether it is less, more or most adaptive:

distortion

A

grossly reshaping experience of external reality to suit inner needs–> including delusional grandiosity, hallucinations

can be seen in schizotypal PD

less adaptive

72
Q

describe the following defense, and state whether it is less, more or most adaptive:

omnipotent control

A

fantasy that the source of everything that happens is oneself

it is based on the non-recognition of the separate existence of others with a will different from ones own

exerting power over others can be the goal i.e in NPD, ASPD

73
Q

describe the following defense, and state whether it is less, more or most adaptive:

regression

A

occurs when people go back to earlier ways of functioning to avoid anxiety provoking feelings

people who usually function at a very high level may use this defense during periods of stress

in most extreme, can look like dependent PD but can also be used i.e med student who goes home during exams so mom makes her meals

74
Q

describe the following defense, and state whether it is less, more or most adaptive:

acting out

A

avoids painful or uncomfortable feelings by enacting the feeling without becoming consciously aware of it

direct expression of unconscious wish/impulse to avoid being conscious of accompanying affect and avoid tension from postponement

classically, refers to enacting feelings generated within therapy (ie someone books yoga during regular session times when finds out therapist going on mat leave)

75
Q

what is selective abstraction

A

only events that matter are failures or deprivation; measuring self by errors; making decisions based on negative evidence and ignoring positive evidence

76
Q

what is overgeneralization

A

something true in one case is applied to any case that is even slightly similar, making a broad rule from limited experiences

77
Q

what is arbitrary inference

A

drawing a conclusion without sufficient evidence or without any evidence

jumping to conclusions

78
Q

what is classic conditioning

A

Pavlovian, an unconditioned stimulus (food) spontaneously, reflexively, produces an unconditioned response (salivation). Learning can occur where a conditioned stimulus (bell) provokes the unconditioned response (drooling) through ‘paired association’ between the UCS and the CS

79
Q

what is negative reinforcement

A

removal of an aversive stimulus that leads to increased frequency of behaviour, for example: a child pouts and refuses to eat her vegetables. Her parents take away the offending veggies. Since the behavior (pouting) led to the removal of the aversive stimulus (the veggies), she will pout more often

80
Q

what are “primary reinforcers”

A

fulfill a BIOLOGICAL NEED i.e food, drink, sex

most human reinforcers are secondary–> are learned and include things like praise, stickers, money

81
Q

what is secondary reinforcement

A

more powerful than primary reinforcement because it is not tied to biological needs

i.e if a dog is not hungry, he is less likely to listen to your commands if food is the reward

token economy (i.e contingency management) is an example of secondary reinforcement

82
Q

where does the following attachment style rate on the areas of avoidance and anxiety:

secure/autonomous

A

low on both avoidance and anxiety

83
Q

where does the following attachment style rate on the areas of avoidance and anxiety:

avoidant/dismissing

A

low on anxiety

high on avoidance

*uncomfortable with closeness and primarily values independence and freedom; not worried about partners availability

84
Q

where does the following attachment style rate on the areas of avoidance and anxiety:

anxious/ambivalent/preoccupied

A

low on avoidance

high on anxiety

*craves closeness and intimacy, very insecure about the relationship; fears abandonment; can be inconsolable when parent leaves but not reassured by parent returning

85
Q

which attachment style is characterized by the following:

inconsolable when parent leaves but not reassured by parent returning

A

anxious/ambivalent/preoccupied

86
Q

where does the following attachment style rate on the areas of avoidance and anxiety:

disorganized, unresolved

A

high on both avoidance and anxiety

*emotionally volatile, punitive, cannot tolerate intimacy; no strategy for having emotional needs met; dissociation can occur

87
Q

list the 9 Thomas and Chess Temperament Traits

A

adaptability

activity level

approach/withdrawal

distractibility

intensity of reaction

quality of mood

regularity/rhythmicity

persistence/attention span

sensory threshold

88
Q

what is the temperament and character inventory

A

test created by Cloninger–> consists of FOUR temperaments and THREE characters

89
Q

what are the four temperaments from the temperament and character inventory

A

novelty seeking

harm avoidance

reward dependence

persistence

90
Q

what are the three characters from the temperament and character inventory

A

self directedness

cooperativeness

self-transcendence