Gilks Deck 1: some defenses + old guys/theories etc Flashcards
who was Eugen Bleuler
coined term “schizophrenia”
came up with the “4 As”:
blunted Affect
loosening of Associations
Ambivalence
Autism
who was Emil Kraeplin
coined term “dementia praecox”
who was Adolph Meyer
“ergasiology”
why was schizophrenia called “dementia praecox”
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.
who was Anna Freud
daughter of Sigmund
came up with defenses and ego psychology
who was Ronald Fairbairn
object relations
who was Melanie Klein
came up with OBJECT RELATIONS theory–> interested in child development
came up with the “paranoid-schizoid” stance
rival of Anna Freud
what is object relations theory
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
who was Otto Kemberg
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)
who was Heinz Kohut
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”
what is “mirror transference”
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
describe the “thick skinned” narcissist
Kemberg’s model
“oblivious, entitled, attention seeking, exploitative”–> more consistent with DSM5
describe the “thin skinned narcissist”
Kohut’s model
“hypervigilant, sensitive to slights, envious of others and needy–‘I should be great but i’m coming up short’”
who was Pierre Janet
automatisms
who was Wilfred Bion
container/contained
alpha and beta functions allow mother to digest information/emotions for baby
who was Donald Winnicott
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
who was John Bowlby
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
who was Carl Rogers
unconditional positive regard
what is unconditional positive regard
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.”
who was Mary Ainsworth
developed the Strange Situation experiment
who was B. F. Skinner
operant conditioning
who was George Engel
coined term “biopsychosocial”
who was Gregory Bateson
double bind theory of schizophrenia
what is the double bind theory of schizophrenia
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).
who was Margaret Mahler
stages of separation-individuation
how young children acquire sense of identity and separateness from mother (normal autism, normal symbiosis, differentiation, practicing, rapprochement, object constancy)
who was Malan
brief psychodynamic therapy focused on “impulse, anxiety, defense”
who was Elizabeth Kubler Ross
5 stages of grief
what are the 5 stages of grief
DABDA
Denial
Anger
Bargaining
Depression
Acceptance
who developed the idea of mirror transferrence
Heinz Kohut
who came up with object relations theory
Melanie Klein
who came up with the idea of the “good enough mother” creating a “holding environment”
winnicott
who is associated with the idea of automatisms
Pierre Janet
who focused on mother-child attachment as being central to development
John Bowlby
who is associated with defenses and ego psychology
Anna Freud
who coined the term dementia praecox
Emil Kraeplin
who coined the term schizophrenia
Eugen Bleuler
who developed transferrence focused therapy and had the concept of the thick skinned narcissist
Otto Kemberg
who developed the idea of unconditional positive regard
Carl Rogers
Who developed the strange situation experiment
Mary Ainsworth
Who coined the term biopsychosocial
George Engel
Who developed the double blind theory of schizophrenia
Gregory Bateson
who is associated with the concepts of operant conditioning
BF Skinner
who developed the 5 stages of grief
elisabeth kubler ross
who focused on stages of separation-individuation in the child
margaret mahler
how many schneiderian first rank symptoms are there
7
list the schneiderian first rank symptoms
- auditory hallucinations
- thought insertion
- thought withdrawal
- thought broadcasting
- passivity experiences (the experience that actions, bodily movements, sensations, emotions or thought processes are generated by an outside agency)
- primary delusions (beliefs arising “out of the blue”)
- delusional perception (belief that a normal perception has special significance or meaning)
list the 4 ethical principles
beneficence
nonmaleficence
autonomy
justice
describe the ethical principles of beneficence
duty to improve patients wellbeing
describe the ethical principles of nonmaleficence
duty to not harm patients
describe the ethical principles of justice
fair treatment for all
describe the ethical principles of autonomy
patients right to self determination
list the three “types” of defenses
“narcissistic-psychotic”–“less adaptive”
neurotic–“more adaptive”
mature–“most adaptive”
in what populations do you see “narcissistic-psychotic” defenses
ranging from psychotic/seen in children/seen in fantasies to adolescent-level or adult personality disorders
in what populations do you see “neurotic” defenses
common in healthy people
in neurotic disorders
in what populations do you see mature defenses
these are healthy and adaptive
what are defenses
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
what are more adaptive defenses based on
repression
what are less adaptive defenses generally based on
splitting
what determines whether someone mostly has defenses based on repression (more adaptive) or splitting (less adaptive)–> explain how this plays out
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)
in what population is splitting normal
children
when might splitting persist beyond childhood
when people need to protect their good image of an abusive or neglectful parent or caregiver
list some of the “narcissitic-psychotic”/immature / less adaptive defenses
denial
splitting
projection
projective identification
distortion
pathological idealization and devaluation
dissociation
regression
acting out
blocking
counterphobic attitude
describe the following defense, and state whether it is less, more or most adaptive:
splitting
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
describe the following defense, and state whether it is less, more or most adaptive:
projection
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
describe the following defense, and state whether it is less, more or most adaptive:
projective identification
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
give an example of projective identification playing out
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
describe the following defense, and state whether it is less, more or most adaptive:
pathological idealization and devaluation
natural results of splitting
the person idealized today can be devalued tomorrow
what are the four most “primitive” or immature defenses according to cabaniss
the ones most linked to splitting:
splitting
projection
projective identification
pathological idealization and devaluation
describe the following defense, and state whether it is less, more or most adaptive:
denial
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)
describe the following defense, and state whether it is less, more or most adaptive:
dissociation
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
describe the following defense, and state whether it is less, more or most adaptive:
distortion
grossly reshaping experience of external reality to suit inner needs–> including delusional grandiosity, hallucinations
can be seen in schizotypal PD
less adaptive
describe the following defense, and state whether it is less, more or most adaptive:
omnipotent control
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
describe the following defense, and state whether it is less, more or most adaptive:
regression
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
describe the following defense, and state whether it is less, more or most adaptive:
acting out
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)
what is selective abstraction
only events that matter are failures or deprivation; measuring self by errors; making decisions based on negative evidence and ignoring positive evidence
what is overgeneralization
something true in one case is applied to any case that is even slightly similar, making a broad rule from limited experiences
what is arbitrary inference
drawing a conclusion without sufficient evidence or without any evidence
jumping to conclusions
what is classic conditioning
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
what is negative reinforcement
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
what are “primary reinforcers”
fulfill a BIOLOGICAL NEED i.e food, drink, sex
most human reinforcers are secondary–> are learned and include things like praise, stickers, money
what is secondary reinforcement
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
where does the following attachment style rate on the areas of avoidance and anxiety:
secure/autonomous
low on both avoidance and anxiety
where does the following attachment style rate on the areas of avoidance and anxiety:
avoidant/dismissing
low on anxiety
high on avoidance
*uncomfortable with closeness and primarily values independence and freedom; not worried about partners availability
where does the following attachment style rate on the areas of avoidance and anxiety:
anxious/ambivalent/preoccupied
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
which attachment style is characterized by the following:
inconsolable when parent leaves but not reassured by parent returning
anxious/ambivalent/preoccupied
where does the following attachment style rate on the areas of avoidance and anxiety:
disorganized, unresolved
high on both avoidance and anxiety
*emotionally volatile, punitive, cannot tolerate intimacy; no strategy for having emotional needs met; dissociation can occur
list the 9 Thomas and Chess Temperament Traits
adaptability
activity level
approach/withdrawal
distractibility
intensity of reaction
quality of mood
regularity/rhythmicity
persistence/attention span
sensory threshold
what is the temperament and character inventory
test created by Cloninger–> consists of FOUR temperaments and THREE characters
what are the four temperaments from the temperament and character inventory
novelty seeking
harm avoidance
reward dependence
persistence
what are the three characters from the temperament and character inventory
self directedness
cooperativeness
self-transcendence
