PS251 Personality Exam 1 (Shim 2016)

5 levels of the false self

1) extremely maladaptive (mask) - psychopath 2) moderately maladaptive (caretaker) - "double life" 3) minimally adaptive (defender) - high suicide risk 4) moderately adaptive (imitator) - "as if" personality 5) adaptive (facilitator) - develops "social self"

3 types of children (Masterson & Offer)

1) normal children - communicate fairly well with their parents, might have some anxiety or depression because they are nonentities lacking agency 2) vulnerable children - "flounder" in areas of their life such as school, and might exhibit delinquent behavior. Their behavior can be reversed with the proper guidance/help from parents. 3) character disordered children - extremely moody and may always think/talk about death. If immediate intervention by parents is not received these children could commit suicide or face other personality disorders later on in life.

2 goals of id

1) seek pleasure 2) avoid pain

3 stages of recovery, Herman's "Father-Daughter incest"

1) task of first stage is establishment of safety 2) task of second stage is remembrance and mourning 3) focus of third stage is reconnection with ordinary life Shim: may be missing preliminary stage, "triage"

4 traumogenic ("trauma-causing") factors

1) traumatic sexualization 2) betrayal 3) powerlessness 4) stigma

8 psychosocial stages (Erickson)

8 psychosocial stages Compare to Freud's psychosexual stages: Same age ranges for first five 1) Trust vs. Mistrust (birth - 1.5) - "Can I trust the people around me?" (feeding) 2) Autonomy vs. Shame & Doubt (18 mo. - 3 years) - "Can I do things myself?" (toilet training) 3) Initiative vs. Guilt (3-5 years) - "Am I good or bad?" (exploration, play) 4) Industry vs. Inferiority (6 - 11 years) - "How can I be good?" (school) 5) Identity vs. Role Confusion/Diffusion (moratorium) (12+) - "Who am I?" (social relationships) 6) Intimacy vs. Isolation (early adult) - "Will I be loved or alone?" (romantic relationships) 7) Generativity vs. Stagnation/Self-absorption (middle adult) - "How can I contribute to the world?" (parenthood/work) 8) Integrity vs. Despair (late stage adult) - "Did I live a meaningful life?" (reflection)

8 problems in the literature (Prior)

Explain each: 1. borderline children are not borderline adults 2. limitations of etiological theories (Mahler) 3. BPD supplanted by PTSD but not clear about implications 4. childhood trauma and childhood psychopathology 5. resistance to looking at the experience of the traumatized child 6. do we recognize PTSD in children? or is it misdiagnosed as AD/HD? 7. why does sexual trauma cause a particular pattern to occur? 8. treatment difficulties

erotic transference

Freud first to note when transference includes sexual feelings directed to therapist patient convinced that only when therapist satisfies these cravings can real happiness be achieved repetitive and compulsive nature to demands **goal to resolve transference in so patient can find appropriate partners in outside world

____ took the idiographic approach

Galileo

4 pivotal factors that result from trauma

Prior 1) repetition of abusive relational pattern 2) identification with the aggressor 3) self-blame 4) seeking object contact through sexual/violent means

Introjection

Traumatized child's integration of basic representations of self and other

trauma is to repression as therapy is to _____

adaptation

if child does not learn trust in parents, may develop this

antisocial tendency, or a prominent "false self"

according to Freud, what results from unacceptable impulses, and how do we deal with this?

anxiety, and defense mechanisms

trauma

anything above and beyond normal events

nomothetic

aspects of a theory applied to the general public ~Aristotle~ nomo = custom, law... applies to all ex: fortune cookies, Chinese zodiac

idiographic

aspects of a theory applied to the individual ~Galileo~ idio = personal, distinct, private, "one's own"

someone who was sexually abused at a younger age who later tries to seduce an authority figure is attempting _____ as a result of ______

attempting mastery as a result of repetition formation mastery - attempting to deal with abuse repetition formation - repeating behaviors that were traumatic earlier in life

object relations units

comprised of subject (me, positive/negative), object (other, positive/negative), and emotional tone (positive/negative) if positive units are integrated into the psyche, it is easier for the psyche to push out negative units

"working model of relationship"

concept designed to capture a person's largely unconscious beliefs, assumptions, feelings, and expectations about human relationships

when things morph during dreams

condensation

creative illusionism

basing theory off own personal experiences and observation ex: you notice a strange rash and ask other people about it, if many people have the same rash you feel better about it (similarly, theorists base personality theories off self-observation)

preconscious

"limbo" where conscious is protected from unconscious through defense mechanisms

parapraxis

"slip of the tongue" (Freudian slip)

Zeanah & Zeanah model (trauma bonding)

"working model of relationship" provides internal rules for the direction and organization of memories and attention, govern how incoming interpersonal info is attended to and perceived, determine which affects are experienced, select the memories that are evoked and mediate behavior with others "working model" seems to compel individuals to recreate experiences congruent with their relationship history

examples of the " false self"

- "Polly-Ann child" (false smile) - "curse of the nice people" (can't say no)

the "endopsychic situation"

- Fairbairn - in object relations, when we're healthy we internalize positive units and reject negative ones - here, people expel positive units and internalize negative ones, resulting in beliefs that they cause all their own problems

"internal saboteur"

- Fairbairn - people (in an endopsychic situation) who self-sabotage - "you're okay but I'm not okay" - hopeful and optimistic about the world, but not about themselves

"necessary but intolerable"

- Fairbairn - those in an endopsychic situation pick up things that are bad for them, like relationships

"confusion of tongues"

- Ferenczi - whatever children are given is what they label as "love," thus comes to "speak" the language of passion the perpetrator demands in order to get the "love" the child needs - child reacts to sudden unpleasure (sexual abuse) not by defense (due to weak, undeveloped personality) but by identification and introjection of the aggressor - to maintain order where love = abuse, innocent = guilty, trust = pain, child's psyche fragments and each fragment behaves as a separate personality unaware of the others (etiology of DID) - child is given sexual hate, not sexual love, they assume that the abuse is a consequence of their own behavior (self-blame)

4 traumogenic (trauma-causing) factors

- Finkelhor & Browne 1) traumatic sexualization 2) betrayal 3) powerlessness 4) stigmatization

censorship

- Freud - force in mind that excludes all tendencies that displease the conscience - these tendencies are described as "repressed," they remain unconscious and if one attempts to bring them into the patient's consciousness one provokes "resistance"

psychic determinism

- Freud - our minds are active and each of the subsystems in our minds wants to express itself - all mental processes are determined by unconscious or preexisting mental complexes

moratorium

- Identity vs. Role Confusion stage of Erickson's theory of psychosocial development - the problem of adolescence is one of role confusion—a reluctance to commit which may haunt a person into his mature years - when a person can freely experiment and explore (is given a "moratorium"), what may emerge is a firm sense of identity

"the illusion of safety"

- Janoff Bulman - in reality, trauma can happen to anyone, anytime

self-blame child

- Prior believes he/she can evoke rejection and aggression from adults, therefore he/she provokes the inevitable abandonment rather than wait for it to come

"ordinary devoted mother"

- Winnicott - provides specific adaptive context for newborn to flourish and mature - when the kid reaches the "realization" stage, they have a sense of feeling loved and can avoid annihilation anxiety

"meaning of symptoms"

- Winnicott - "why these symptoms?" - symptoms can serve a self-protective purpose

"Life is normally difficult"

- Winnicott - depathologizing symptoms - importance of external reality (unlike Freud) - in medicine, symptoms are the sign of a healthy body fighting illness, it's the same for psychology (healthy mind fighting awful things)

modification of Kohut's "self/other continuum"

- Winnicott - infant is born without capacity to feel concern for others - maturity is indicated by the capacity to understand another's perspective (empathy) * narcissism in adults means they're fixated, maybe something happened in childhood

"world of ordinary life"

- Winnicott - we must balance the external and the internal to cope with life's difficulties - how do we not fall back on symptoms? - if we treat the bad stuff as "ordinary life," we can't function

"good enough" mothering

- Winnicott claims that you really don't need to be a perfect parent, you just have to be "good enough" - must offer closeness and love to provide the baby with comfort and reassurance, so that it can learn that "someone not me is reacting TO me"

personality integration

- Winnicott, stage 1 - initially, we're "unintegrated," we're a "potential human" with only instincts and reflexes - parent must respond consistently to child's needs - kid starts to feel safe, no more confusion about hunger, etc. - when parent consistently response, child begins to understand that there is himself and also his parents * cuddling/love then leads to the next stage (personalization)

personalization

- Winnicott, stage 2 - process of taking ownership of one's body - when parents physically take care of child (snuggling, etc.), child learns that it has its own body - self/other distinction - traumatized people starve, injure, have delusions about their own bodies, never become comfortable

realization

- Winnicott, stage 3 - occurs when external reality starts to impinge on parent/child relationship - parent can't always be there - ideally, kid says, "I'll be okay until mom gets back" - "right to die"

"realization"

- Winnicott, stage 3 - the stage where a child passes from the "world of magic" in which it cries and there's a breast, etc., to understanding that it can't exist on it's own - must rely on internal experiences to cope with this realization (if experiences with parents are unreliable, can't cope...)

Freud's "injury-cure" model

- all human experiences are comprised of at least two elements (affect and ideation - thoughts and feelings) - the "injury" model results in affect and ideas being disconnected from each other and repressed based on similarities - the "cure" model involves recovering the repressed elements and re-integrating the affect with their component ideas and vice versa

object relations treatment

- classical (blank screen) - contemporary (attending to interaction --> counter-transference, to create "corrective emotional experiences") * both perspectives believe that the patient's insight will help them modify their behaviors, but Shim says insight follows behavior change

criticisms of object relations

- difficult to test scientifically - self-reported data may not be accurate (here it is helpful to get others for a fuller picture) - too much emphasis on sexual underpinnings - unconscious given too much credit - image of human nature too negative * BUT, Freud/Breuer gave us talk therapy! and... - a method of study (self-report) - first to look at childhood issues/trauma - first to recognize child sexual abuse

"simple trauma"

- person has good life, bad things happen, symptoms arise - most commonly studied trauma in research - example: PTSD

primary process (memory)

- produces a memory image of an object needed for gratification in order to reduce the frustration of not having been gratified yet - develops as the id encounters frustrations of its desires, and it works because for the id, an image is the same as an object ("an identity of perception") - preverbal and dreamlike, not rational as with the ego. It's called "primary" because it comes first in human development: for Freud if not for later theorists, the baby is "all id."

"complex trauma"

- repeated abuse - a syndrome frequently seen in clinical settings - can't apply the treatment of simple trauma - examples of symptoms: BPD, DID, depression, PTSD, substance abuse

aspects of true self (Winnicott)

- sense of aliveness in one's body - learns to deal with life's difficulties (what doesn't kill you...) - false self is sublimation of true self rather than a defender

differences between mourning & melancholia

- suicidal thoughts - homicidal thoughts

transitional objects

- the first "not me" objects that kids use in Winnicott's realization phase - important because child assumes rights over the object - pictures are most common (not limited to babies)

wish fulfillment

- the satisfaction of a desire through an involuntary thought process - can occur in dreams or daydreams, in symptoms of neurosis, or in hallucinations

censor system

being "mind blind" - protection from your own pain through defense mechanisms

abreaction

decathexis in a therapeutic setting

problem with true self (Winnicott)

difficulties may arise if the gap between true and false self is too great, and if the false self is too successful (can fall into the cycle of the moderately adaptive false self, or "imitator," the "as if" personality)

shifting the target of one's fears or desires

displacement

for which disorder is hypnosis a viable treatment option?

dissociative identity disorder

repetition formation

endlessly repeating behaviors that were traumatic earlier in life

life is to death as

eros is to thanatos

Prior's definition of trauma (1996)

event damages capacity to relate to others AND evokes annihilation anxiety

Freud's definition of trauma (1920)

event results in object loss and overwhelmed psyche

choice child faces (Prior)

identification with the abuser or annihilation anxiety

theory of mind

kids with this are able to interpret how others are likely to react in certain situations 1. establish that your own belief is false 2. put yourself in another's mind

dreamwork

latent content distorted, displaced, symbolized, condensed, incorporated

Freud's topographical theory

mind composed of - conscious (deals w/ real world) - preconscious (defense mechanisms) - unconscious (deals w/ things not immediately knowable)

_____: subjective experience :: ______: social acceptance

private self : subjective experience public self : social acceptance

paranoia about significant other cheating on you while you're cheating on them is an example of ____

projection

this is necessary if the child is to feel truly heard and joined by the therapist

reenactment of abuse

personality theories

serve as "models" (paradigms, guides, maps) of the human psyche

transference

taking old issues and projecting them onto new situations e.g., in the story about "Dan," he projected his unresolved feelings of powerlessness about his father leaving onto his fiancé, when she told him she was leaving and he did nothing to stop her

annihilation anxiety

the imagined fear of psychic destruction that will occur as a result of some catastrophe or loss - "the vanishing breast" - child starts to remember that the breast/food disappears, that the child is not creating it - fear - if child has been given enough "good enough" mothering, he/she has protection against this fear

Bion "attacks on linking" (treatment difficulty, severe sexual trauma)

the psyche's primitive defense attempt to protect against pain by destroying all meaning and interconnectedness of thought, feeling, and action fragmentation and fears of rejection lead child to resist interpretation of relational fears/dilemmas in play or relationship with therapist -- can be strong enough to prevent effective work on these concerns

resistance (clinical term)

the reluctance of people to accept and see the cause of their underlying problems, especially if that knowledge makes one feel awful about him/herself (e.g. jealousy, insecurity)

personality

the set of psychological traits and mechanisms within the individual that are organized and relatively enduring and that influence his or her interactions with, and adaptations to, the intra-psychic, physical and social environments

morality principle (Freud)

the superego operates on this and motivates us to behave in a socially responsible and acceptable manner

how is child's object hunger transformed by the confusion of tongues?

the wish for contact is experienced as the wish for a violent or sexual relationship that would be retraumatizing

Seduction theory and why it was refuted

theory - sexual abuse gets repressed, but it can only stay repressed if psychic energy ("libido") is expended, leaving psychiatric/somatic symptoms instead --> first recognition of PTSD why it was refuted - Freud told colleagues that they abused his patients, bad reputation, exile ca. 1897, salvaged his career by discrediting his patients

counter-transference

therapist's feelings for patient

for the seriously abused child, human relationships present only these two possibilities

to be an abuser or to be abused

the reason for the "compulsion to repeat" unpleasant experiences is...

to eventually master them

mastery

traumatized person attempts to relive events in an attempt to master and fully deal with situation

denial

unintentional lying

possession

victim fears being abused again but also fears becoming abuser

pleasure principle (Freud)

what drives the id and seeks instant gratification of all needs, wants, and desires

manifest content (Freud)

what you experience in your dream

latent content (Freud)

what your dream symbolizes, or the "true meaning"

emotional neglect

when adults don't express love to children

"going on being"

when children can internalize parents' love and self-soothe with "good-enough mothering," child will trust mother and realize that it can survive during periods where it expects her but she doesn't come; "she will come back, I will go on being until then"

complicated grief

when unresolved mourning turns into depression

secondary elaboration

when you try and tell someone about your dream and it just doesn't have the same effect because you don't have the words to convey the feelings from the dream