history of abnormal behaviour Flashcards
psychological disorder:
what are the three main criterias?
1) psychological dysfunction
2) distress/impairment
3) deviance from norm
psychological dysfunction
1) psychological dysfunction:
- disturbance in cognitive, emotional, and/or behavioural functioning
dysfunction refers to a breakdown whether it’s in cognition so a breakdown in how some thinking or breakdown in emotion and or behavior so psychological dysfunction refers to a breakdown in either cognition emotion and or behavior
so for instance an individual experiencing the delusion that they are some omnipotent deity they would be having a breakdown in cognition because their thought processes are not consistent with reality an individual who is unable to experience joy is having a breakdown in emotion an individual who is unable to leave her home and attend work due to fear of having a panic attack she would be exhibiting a breakdown in behavior OK so some form of disturbance in cognitive emotional and or behavioral functioning that would fall under psychological dysfunction so many people may experience subtle versions of a reaction like this pain however they don’t usually meet criteria for a disorder so it can be difficult to know where to draw the line between normal and abnormal dysfunction and because of this we often understand these problems to occur on a continuum rather than black and white categories such as present or absence OK so to an extent we all experience you know some level of dysfunction in in our thinking or in how experience emotions or in our behavior but whether or not that is classified as an app normal level of dysfunction there’s a lot that we take into consideration and that’s why we see things as occuring on a continuum or or a spectrum for example rather than as a category of black and white categories such as present perhaps it
distress/ impairment
2) distress/ impairment:
- individual experiences personal distress associated with the disorder
- ’ extreme expressions’ of emotions, behaviours, and cognitions that impair functioning
now in terms of distress or impairment distress can take the form of psychological or physical pain or both at the same time distress Simply put it refers to suffering alone distress is not sufficient enough to describe behavior as it normal so think about it the loss of a loved one if any of you have experience in a significant grief the loss of a loved one can cause even the most cold quote normally functioning individual pain and suffering an athlete who experiences a career ending injury would display distress as well suffering is a part of life and it cannot be avoided um and so experiencing distress alone is not sufficient to diagnose someone with a disorder because we all experience distress to an extent
impairment this is this refers to when the person experiences A disabling condition a disabling condition that limits their ability to engage in activities of daily living OK so maybe they can no longer maintain the minimum standards of hygiene or maybe they’re unable to pay bills or participate in social events you like going to parties or just attending social events maybe they struggle with going to work or school so impairment it can interfere with an individual’s ability to perform important life roles so you know you have a row less student some people it’s a caregiver or parent OK so when people have these you know the psychological dysfunction word there’s a disturbance in their cognition their emotions or the behaviors these extreme expressions of emotions or behaviors and cognitions impair that individuals ability to function in ways that society would expect that they should pay so we see
deviance from norm
consider these behaviours:
- a man driving a nail through his hand
- a woman refusing to eat for several days
- a man barking like a dog and crawling around on hands and knees
deviance from norm
- a response that is rare/atypical, or is not culturally expected
And the third component is deviance from the norm OK so first I want you to consider some of these behaviors a man driving a nail through his hand think about it a woman refusing to eat for several days a man barking like a dog and crawling around on hands and knees K so psychological disorder requires some deviance from the norm so if we look at these individual things some of these would seem a little bit abnormal they don’t necessarily seem normal to us however several of these behaviors are accepted in certain circumstances so in many religious traditions for example refusing to eat for a period of time or fasting is a common ritual of cleansing impenitence you might think the other behaviors abnormal in any context yet even these behaviors are accepted in certain circumstances in Mexico for example some Christians have themselves nailed to crosses on Good Friday to commemorate the crucifixion of Jesus among the Yoruba of Africa traditional healers act like dogs during healing rituals pay cultural norms play a large role in defining abnormal behavior OK so deviance from the norm is a response that is rare or atypical or is not culturally expected so even though some and you know some of these things that I’ve listed they seem atypical in some cases they may actually be culturally expected and therefore they wouldn’t meet that requirement of deviating from the norm OK so basically looking at that word abnormal it shows that it indicates a move away from what is normal what is typical or average so deviance refers to behavior that violates social norms or cultural expectations because culture determines what is normal so when a person is said to be deviant when he or she fails to follow the stated and unstated rules of society called social norms then this would be a deviance from the norm so there’s a lot of cultural variation in acceptable behavior for example in Newfoundland in Newfoundland I don’t I don’t know if anyone in my class are from Newfoundland as well you may know this it is socially acceptable to refer to a stranger as my lover it’s a term of endearment but it’s not socially acceptable everywhere so I don’t go around referring to strangers here as my lover if I were a Newfoundland then I would and so deviance from the norm the psychological disorder the behaviors must be rare at any given time and outside of the norms OK so you must keep the individuals context in mind
approaches to understanding abnormal behaviour:
1) supernatural tradition
2) biological tradition
3) psychological tradition
supernatural tradition
what are the explanations of deviant behavior?
- Good vs. Evil
historically deviant behavior has been understood in terms of good versus evil so the supernatural theories have typically viewed abnormal behavior as a result of divine intervention curses demonic possession and personal sin
- Unexplainable behaviour/suffering –> Evil
any unexplainable behavior or suffering essentially this would mean that there was some evil present
- Demons, Witches, and Possession
demons witches exorcisms you would often see believe in these types of things and you would see exorcisms happening obviously to deal with things like possession
these are often byproducts of religious traditions
- The Moon and Stars
in terms of the moon and stars you’ll see individuals believing that the moon the stars astrology astrology could influence behavior and this gave rise to the term lunatics if anybody is interested
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Take a look at the supernatural tradition so in terms of psychological disorder if we look back across history we will see that they have always existed if you look at pass works there have always been examples of bipolar disorders, dementia, phobias for example
supernatural tradition
what are the treatment approaches?
- Exorcisms
- Snake pits, confinement, beatings, torture
- Hydrotherapy
- Trephination
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in terms of treatment approaches based on the supernatural tradition there were many Catholic priests would often perform exorcisms, peers and ministers would employ ritual prayer and fasting astrologers and folk healers might use herbs terms an astrological talismans engraved metal disks that patience wore on ribbons around their necks some patients might be left in darkness and solitary confinement in London’s first men’s mental institution is called Saint Mary of Bethlehem it was known as bedlam patients would be whipped chained subjected to a very meager diet they may sleep on beds of straw and basically they would be exhibited like circus animals for curious onlookers medical treatments tended to be quite extreme very painful and brutal they would subject the mentally ill to anything from bleeding snake pits beatings torture I’m not sure if any of y’all have heard of hydrotherapy but for centuries water has been used to treat people with mental health problems but not always in the same way so when mental illness was seen in primarily supernatural terms water was seen as a spiritual purifier so this makes sense when you think of the baptism and holy water of Christianity and the cleansing rituals of other religions during the Middle Ages manic people were often ducked into holy wells to the point of exhaustion in many ways hydrotherapy has been replaced by other types of shock therapies insulin shock treatment for example electroshock therapy lobotomy’s but before you dismiss hydrotherapy altogether I want you to think about the last nice hot bath that you took did it make you feel better what about the last swim that you took in a clear pristine lake or in the ocean water continues to be a healer and perhaps one that we should consider more carefully obviously not in the same approach that individuals would have taken during the supernatural tradition but I don’t think we can write off water altogether ASMR as a form of therapy in terms of trephination during the Middle Ages one treatment called trephination would involve drilling holes into the skulls of a person who is exhibiting abnormal behavior and the purpose of this was to allow spirits to depart or spirits to leave so that was called trephination another English position his name was Thomas Willis he practiced trephination drilling a hole into a patient skull to release the foul vapors and excessive humors so you can see a picture there of skull that was recovered and that hole in the skull would have been the result of trephination so it’s you know thank goodness for modernization of therapy I suppose so that’s all I want to say about the supernatural tradition we can talk more about it in class if anything into interested you in particular in terms of the moon and the stars and astrology I’m not here to hate on any of the individuals that are into astrology you know you do you Boo
biological tradition
who is Hippocrates
Hippocrates (460-377 BCE)
- Hippocratic Corpus
so Hippocrates for example Hippocrates was known as the father of medicine he was a Greek physician who along with his associates wrote a piece of work called the hypocritic corpus so in this work they proposed that psychological disorders could be treated like any other disease and they were caused by brain pathology head trauma genetics and family stressors
- Abnormal behaviour as a physical disease
- Theorized on brain pathology, genetics, family influences
- Hysteria (somatic symptom disorders) caused by a “wandering uterus”
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so in terms of the biological tradition now we’re moving a little bit further ahead in time the biological tradition logical tradition it’s a historical approach to understanding psychological disorders that emphasized the physical causes of mental disorders
so essentially Hippocrates was a little off the mark when it came to specific details but it is remarkable how accurate he was in identifying broad categories of factors that do influence the development of psychopathology but the biological tradition as part of this approach there was this belief that insanity is a natural phenomenon an curable so treatments might include bathing potions caring for the individual and here’s the last point I have hysteria so hysteria now known as somatic symptom disorders hysteria individuals with hysteria may have very symptoms individuals have you know they may present with to the physician with arms that are completely numb that can’t be used and very random sort of symptoms women would normally present with these and so many pathologies and women essentially were blamed or labeled as hysteria and the belief here was that these symptoms were caused by a wandering uterus cases a displaced uterus caused all of these medical pathologies and women so to cure this interesting Lee people working from the biological tradition would propose that women could heal their wandering uterus uterus through marriage or fuma gating the vagina and fuma gating the vagina if anybody’s interested that means steaming it so apparently that would cure your hysteria if it was caused by a wandering uterus so take notes yall
biological tradition
who is Galen?
Galen (ca.129-198 CE)
- Humoral Theory
(Blood, Black bile, Yellow bile, Phlegm)
- Disease caused by imbalance of humors
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Galen was a Roman physician and he built upon the ideas of Hippocrates so his school of thought held that diseases including psychological disorders were due to an imbalance among four bodily fluids and he called these fluids humors and so this is called the humoral theory ascension ascentia Lee
so the humours were blood black bile yellow bile and phlegm so for example too much black bile in in an individual this would be called melon collar and this was believed to cause depression galen’s beliefs have been discredited but many of the terms he used have lived on so for instance there is a specific subtype of depression and it’s named after gallons melon collar and an it’s called major depression with melancholic features which is kind of interesting so Galen he was this Roman physician he extended the ideas of Hippocrates and basically different concentrations of humors will lead to different disorders
so if there was excess blood in a system then this would cause insomnia and delirium
if there was excess black bile this would cause melancholy
if there was excess yellow bile this would mean an individual was hot tempered
an if there was excess phlegm then this would cause someone to experience sluggishness s
so humoral theory it’s not unlike the chemical imbalance here that many people believe in today
so essentially diseases according to Galen were caused by an imbalance of these four humors
biological tradition
what were the historical treatment approaches?
- Regulate environment
- Rest
- Good nutrition
- Exercise
- Bleeding or Bloodletting
- Induced vomiting
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an in terms of treatment treatments for imbalances in humours often involved regulating the environment depending on which humour was out of balance so this could involve either increasing or decreasing aspects of the environment such as heat dryness moisture or cold so other treatments might involve bleeding or blood letting an induced vomiting good nutrition rest exercise were also a part of the biological tradition but essentially this approach involved very much regulating the environment to sort of mitigate the imbalances within the humours of the individual
biological tradition in the 19th century
what is syphilis/ general paresis?
Syphilis/General Paresis
- Advanced symptoms resembled psychosis
- Subgroup of psychotic individuals steadily deteriorated
Injected patients with blood from soldier with malaria – many recovered - Discovery of cure for general paresis reinforced belief that ”madness” resulted from curable infection
- Belief in biological reductionism strengthened
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discovery happened and you know it’s quite interesting how things turn out but the discovery of the nature and cause of syphilis in the 1919 century actually renewed support for the biological tradition it had the this sort of all biological tradition had been losing its credence since Hippocrates and galen’s work not a lot of people were really subscribing to this view however individuals with this disease with syphilis demonstrated some behavioral and cognitive symptoms that resembled psychosis so there are delusions of persecution in grand juror when syphilis was left untreated however interesting Lee these individuals deteriorated steadily developed paralysis and died within five years of on set so this is now we call the at the time it was called general paresis and how we know it to be syphilis but what happened there is this interesting interesting discovery many individuals who contracted malaria recovered suddenly from this illness so physicians actually began injecting other patients with blood from a soldier who had contracted malaria and many people recovered So what we now know is that the high fever that is caused by malaria actually burned up the syphilis bacteria penicillin penicillin was later found to cure syphilis but at the time this malaria cure actually convinced people that the madness and the psychotic symptoms could be traced back to a curable infection and this is what reinforces belief in a biological basis for mental disorders so it is termed general paresis and essentially individuals develop these you know this whole these symptoms that continue to deteriorate they they would experience paralysis of death within three to five years it was quite sudden and when they discovered this syphilis bacteria it reinforces the idea that all diseases are caused by a bacteria or germs and essentially it heightened biological reductionism K so this belief in biological reduction reductionism with strengthened and biological reductionism this is the belief that all mental health issues all diseases are caused by something biologically whether that’s bacteria or germs etc so just a really cool sort of random experience that these doctors found but we can see now that selfless was yes it was a bacteria was calling causing the psychotic features but not all psychosis can obviously be traced back necessarily to a biological basis so something to keep in mind for sure
biological treatment approaches in the 1930s
Electric shock (electroconvulsive therapy)
Brain surgery (lobotomy)
Insulin shock therapy for psychotic patients
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in terms of biological treatment approaches in the 1930s there was the introduction of electric shock or electroconvulsive therapy we will talk about electroconvulsive therapy more in chapter 3 it’s much safer today largely thanks to anesthesia at the time and not super safe but it was a biological treatment used brain surgery was often used as well so lobotomy’s you know these are surgeries where parts of the brain are essentially cut out of the individual insulin shock therapy was also used for psychotic patients so insulin was given usually to stimulate appetite in psychotic patients and this also seemed to calm them down so some physicians began administering too much too often and this led to convulsions and essentially comatose patients
biological treatment approaches in the 1950s
introduction of modern medication
- First wave of antipsychotics (neuroleptics)
> Major tranquilizers - Benzodiazepines for anxiety (minor tranquilizers)
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in the 1950s this is when we see the introduction of modern medication so the first wave of antipsychotics came along also called neuroleptics so the first wave of antipsychotics these are major tranquilizers at the time and then benzodiazepine’s were developed for anxiety and these were called minor tranquilizers
psychoanalytic theory
who is sigmund freud?
- accessed the unconscious mind
- iinsight: A fuller understanding of the relationship between current emotions and earlier events is called insight
- catharsis: recalling and reliving emotional trauma that has been made unconscious and releasing the accompanying tension is therapeutic
(structure of mind)
- id, ego, superego
- intrapsychic conflict
(defence mechanisms)
- coping styles
- psychosexual stages of development
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psychoanalytic theory even though a lot of it does not necessarily apply today it’s still sometimes important to know you know just the foundation where things began that were then improved upon significantly
so Freud was the individual who pioneered the idea that unconscious forces influence over behavior and personality so he believed that childhood events and unconscious conflict often pertaining to sexual urges and aggression would shape a person’s experiences in adulthood
so Freud’s theory of psychoanalysis created the framework for psychoanalytic therapy so it’s a deep individualized form of talk therapy it encompasses an open conversation the aims to uncover ideas and memories long buried in the unconscious mind paint
so insight catharsis these are important concepts and also three key facets
the id,eg and superego are obviously quite important in psychoanalytic theory so as of mind earth that did these the end holds primitive desires and urges OK so it’s this unconscious in instinctual dark component of a psyche that seeks pleasure it’s not rational or iaccessible and primarily possessed his sexual and aggressive urges
The Super ego this embodies a persons higher moral code this moral compass is responsible for self-control for decision making and sacrifice these abilities that allow an individual to live well with others and society the superego is thought to arise from parental authority according to Freud’s view it has absolute an inflexible standards which leads inevitably to conflicts with the impulsive end
now the ego this represents the self and the ego balances and resolves conflicts between the two competing forces the permanent impulses of the idd and the morals and values of the Super ego so the ego then represents ones reality ones identity in decision making consciousness
so in Latin the word ego means I there’s been many many revisions over the years and so we’re just going to cover a general overview of cycle psychoanalytic theory here OK so obviously that one important concept in psychoanalysis is catharsis so this is recalling and releasing unconscious emotional trauma
in terms of that term intrapsychic conflict this comes from the ego managing the desires of the id and superego an from the horrible childhood traumatic memories or horrible urges that an individual may have so sometimes the ego becomes very overwhelmed by the anxiety that results from the conflict between the id and superego it’s exhausting so in this case there are unconscious protective processes that are used to keep these emotions in check the anxiety can be overwhelming so the ego uses defence mechanisms to reign it all in eager text describes many defence mechanisms I’m just going to cover a couple here so we have denial this is one of the most common defence mechanisms it occurs when you refuse to accept reality or facts people in denial may block external events or circumstances from the mind so that they don’t have to deal with the emotional impact in other words they just simply avoid painful feelings or events in terms of projection this is when we mis attribute our own unacceptable thoughts or feelings to another individual so for example you may dislike your new coworker but instead of accepting that you choose to tell yourself that they actually dislike you so now you start to interpret their words and actions towards you in the worst way possible even though they may not actually dislike you we also have displacement so this is when you direct your feelings about a person or situation towards a less threatening person or object so a good example of this defence mechanism is getting angry at your partner because you had a bad day at work your partner isn’t the target of your strong emotions but your subconscious may believe that reacting to them is likely less problematic than reacting to your boss
in terms of the psychosexual stages of development according to Freud children go through a series of these psychosexual stages that leads to the development of the adult personality and during these five psychosexual stages which are the oral analphallic latent and general stages the erogenous zone associated with each stage serves as a source of pleasure each stage of development is marked by conflicts that can help build growth or stifle development depending on how they are resolved so if these psychosexual stages are completed successfully a healthy personality is the result however if certain issues are not resolved at the appropriate stage fixations can occur and a fixation is a persistent focus on an earlier psychosexual stage and until this conflict is resolved the individual will remain stuck in this stage so a person who is fixated at the oral stage for example may be overdependent on others and may seek oral stimulation through smoking drinking or eating
psychoanalysis techniques
free association: Psychoanalytic therapy technique intended to explore threatening material repressed into the unconscious. The patient is instructed to say whatever comes to mind without censoring. /so this can also be called spontaneous word association this is when an individual the therapist says a word and the client has to respond with whatever word comes closest or comes first to mind and then these words will then be interpreted
Dream analysis: Psychoanalytic therapy method in which dream contents are examined as symbolic of id impulses and intrapsychic conflicts./ dream analysis is obviously very important for it believes that dreams were vehicles for people to act out their unconscious wishes and desires and that interpreting these symbols in dreams could elicit some awareness and insight so scientists today very much disagree with Freud’s conclusions or entirely contest the idea that dreams possess deeper meaning it dreams can still be helpful in a therapeutic context if they initiate discussion and insight
Interpretation
Transference (and counter-transference):
Psychoanalytic concept suggesting that clients may seek to relate to the therapist as they do to important authority figures, particularly their parents.
transference this is a phenomenon where a patient unconsciously directs feelings or desires toward an important figure in his life such as a parent on to the therapist for example a patient may respond angrily when the therapist unconsciously reminds the patient of his domineering father now counter transfers this encompasses the feelings that the patient evokes in the therapist therapists can sometimes observe their countertransference and leverage it into insight that can help the patient for example a therapist who feels irritated by a patient for no clear reason may eventually uncover subtle unconscious provocations that annoying repel others thereby keeping the patient unwittingly isolated so those behaviors can then be addressed in therapy
Resistance: resistance in a psychoanalytic context is anything that works against the progress of therapy and prevents the patient from accessing unconscious material so it’s any idea attitude feeling or action that gets in the way of potential change so paying attention to moments of resistance basically fried food for assistance as an unconscious process that people use to protect themselves against intolerable anxiety anxiety and pain that might result if they became aware of these repressed feelings
