Psych 215 Chapter 1
What lead to the decline of moral therapy
Asylum Reform
John P Grey
Became the editor of the American Journal of Insanity the precursor of the current American Psychiatric Association. His position was that the causes of insanity were always physical.
Mental depression and anxiety were recognized as illnesses.
Common treatments were rest, sleep, and a healthy and happy environment. Other treatments included baths, ointments, and various potions. In the 14th and 15th centuries, people with insanity were moved from house to house in medieval villages as neighbors took turns caring for them. This was seen as beneficial.
The counterpart (too the Greek tragedy Opedius Rex) in girls is called the
Electra complex. Girls desire to be more like her father and brothers.
Consequences of the biological tradition
Grey and his colleagues thought mental disorders were the result of some as yet undiscovered brain pathology and were therefore incurable.
Hippocrates and Galen
Hippocrates and Galen
Historical conceptions
Historical conceptions
Saint Vitus's Dance and tarantism
In the middle ages whole groups of people would simultaneously be compelled to run out in the streets, dance, shout, rave, and jump around in patterns as if they were at a particularly wild party late at night.
Mental health professionals take a scientific approach to their clinical work and therefore are called scientist- practitioners.
In this they Keep up with the latest scientific developments in their field and therefore use the most current diagnostic and treatment procedures Second scientist- practitioners evaluate their own assessments or treatment procedures to see whether they work. (They are not accountable not only to their patients but also to the government agencies and insurance companies that pay for the treatments, so they must demonstrate clearly whether their treatments are effective or not.) Third, scientist- practitioners might conduct research, often in clinics or hospitals, that produce new information about disorders or their treatment, thus becoming immune to the fads that plague our field, often at the expense of patients and their families.
Moon and the Stars
Moon and the Stars
what inspired the word lunatic
Paracelsus, a swiss physician
the discovery of a cure for general paresis
Physicians observed a surprising recovery in patients with general paresis who had contracted malaria, so they deliberately injected other patients with blood from a soldier who was ill with malaria. Many survived this treatment because the high fever burned out the syphilis bacteria.
The id has its own way of processing information.
Referred to as the primary process, this type of thinking is emotional, irrational, illogical, filled with fantasies, and preoccupied with sex, agression, selfishness, and envy. In the first months of life we realize we must meet our basic needs without offending everyone around us.
Stress and Melancholy
Reflected the enlightened view that insanity was a natural phenomenon, caused by mental or emotional stress that was curable.
Humanistic Theory, what was the watchword for this movement?
Self actualizing,
sublimation.
Some people may redirect their energy towards something productive
introspection
Subjects reported on their inner thoughts and feelings after experiencing certain stimuli. The results of armchair psychology were inconsistent and discouraging to many experimental psychologist
The 19th Century
The 19th Century
Demons and witches
The Catholic Church was able to spread the idea that individuals who expressed abnormalities were possessed by evil spirits. Treatments in this case were exorcism, in which many religions performed rituals in efforts to get rid of the victim of evil spirits. Other approaches included shaving the pattern of a cross in the hair of the victims head and securing sufferers to a wall near the front of a church so that they might benefit from hearing mass.
psychosexual Stages of development
The stages are oral, anal, phallic, latency, and genital- represent distinctive patterns of gratifying our basic needs and satisfying our drive for physical pleasure.
The structure of the mind
The structure of the mind
We focus on 3 major facets in psychoanalytic theory
The structure of the mind and the distinct functions of personality that comstimes clash with one another The defense mechanisms with which the mind defends itself from these clashes or conflicts The stages of early psychosexual development that provides grist for the mil of our inner conflicts
critical to the humanistic approach
Unconditional positive regard, the complete and almost unqualified acceptance of most of the client's feelings and actions
Pavlov's classical conditioning. A type of learning in which a____ stimulus
a neutral stimulus is paired with a response until it elicates that response.
Psychological disorder
a psychological dysfunction within an individual associated with distress or impairment in functioning and a response that is not typical or culturally expected.
Abnormal behavior
a psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is not typical or culturally expected.
Statisticians often use the term Ganger causality to describe when
a series of events temporally predicts another series of events. But even if events are related, it is often difficult if not impossible to pinpoint a single cause of something.
Unfortunately, Dorothea Dix caused
a substantial increase in the number of mental patients.
Anxiety is a signal that
alerts the ego to marshal defense mechanisms, unconscious protective processes that keep primitive emotions associated with conflicts in check so that the ego can continue its coordinating function. Anna Freud later develops these ideas more fully
By the 1970's drugs known as benzodiazepines were used to reduce
anxiety. These names were Valium and Librium were among the most widely prescribed drugs in the world.
Syphilis, Behavioral and cognitive symptoms of what we now know as advance syphilis, a sexually transimitted disease caused by a
bacterial microoganism entering the brain, including the belief that everyone is plotting against you (delusion of persecution). Or that you are God (delusion of grandeur)
Unfortunately, in the mid 19th century, human treatment declined (moral therapy)
because of a convergence of factors. After the civil war, enormous waves of immigrants arrived in the United States, yielding their own populations of mentally ill.
Hans Jurgen Eysenck and Stanley Rachman called this approach
behavioral therapy.
Watson was considered to be the founder of
behaviorism, strongly influenced work of pavlov.
Hippocrates assumed that normal brain functioning was related to four bodily fluids or humors
blood, black bile, yellow bile, and phlegm. Blood came from the heart, blackbile from the spleen, phlegm from the brain and choler or yellow bile from the liver. For example, too much black bile was said to be depression(melancholia).
They believed that psychological disorders might be caused by
brain pathology or head trauma and could be influenced by heredity (genetics).
Psychosocial treatment approaches to the causation of psychopathology, which focus not only on psychological factors
but also on social and cultural ones.
This can date back to plato as with the biological tradition. Patients would all be
cared for, massaged, and provided with soothing music.
release of emotional material became known as
catharsis.
Carl Rogers Originated
client centered therapy, later known as person centered therapy. Therapist takes a passive role making as few interpretations as possible
If the ego is unsuccessful and the id or superego becomes too strong.
conflict will overtake us, and psychological disorders will develop. Because these conflicts are all within the mind, they are referred to as intrapsychic conflicts. THink of the case of Anna O.
The purpose of the superego is to
counteract the potentially dangerous agressive and sexual drives of the id the basis for conflict is readily apparent.
The application of person centered therapy to more severe psychological disorders has
decreased substantially over the decades, although certain variations have arisen periodically in some areas of psychopathology.
Insidious onset
develop gradually over an extended period of time
Supernatural tradition
deviant behavior has been considered a reflection of the battle between good and evil. In the Persian empire from 900 to 600 B.C, all physical and mental disorders were considered the work of the devil.
AIDs was a virus that was believed to be a
divine punishment for what they considered as immoral behavior.
Anna Freuds first proponent of the modern field of
ego psychology.
Mass hysteria demonstrates the phenomenon of
emotion contagion, which the experience of an emotion seems to spread to those around us.
Moral therapy became influential. It referred more to
emotional or psychological factors rather than to a code of conduct. It included treating institutionalized patients by encouraging social interaction. With many opportunities to interact.
Behaviorism
focuses on how learning and adaptation affect the development of psychopathology.
Rauwolfia serpentine, later renamed reserpine and another class of drugs called neuroleptics (major tranquilizers)
for the first time hallucinatory and delusional thought processes could be diminished in some patients, these drugs also controlled agitation and aggressiveness.
Classical psychoanalysis requires therapy how many times and for how long?
four to five times a week for 2-5 years.
Psychoanalytic Psychotherapy, Freud developed techniques of
free association, in which patients are instructed to say whatever comes to mind without the usual socially required sensoring.
What became a symbol of psychotherapy?
free association, in which patients are instructed to say whatever comes to mind without the usual socially required sensoring. Other techniques included dream analysis.
Etiology, or the study of origins
has to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions. Correlation does not imply causality.
Paracelsus, a swiss physician who lived from 1493 to 1541
he rejected the notions of possession by the devil, suggesting instead that the movements of the moon and starts had profound effects on peoples psychological functioning. Echoing similar thinking in ancient Greece. Talked about the gravitational effects of the moon on bodily fluids might be the possible cause of mental disorders.
If the ego mediates correctly we can go on to
higher intellectual and creative pursuits of life
Object relations
how children incorporate the images, the memories, and sometimes the values of a person who was important to them. Object in this sense refers to important people.
Jung also suggested that spiritual and religious drives are much a part of
human nature as are sexual drives, this emphasis and the idea of the collecitive unconscious continue to draw the attention of mystics.
Carl Rogers, (1902-1987) Most influential
humanist
Galen developed the
humoral theory of disorders
The role of the ego is to mediate conflict between the
id and the superego.
Jung also emphasized the
importance of personality traits.
Clinical description
in hospitals and clinics patients "present" scientist- practitioners with a specific problem or set of problems or we discuss the presenting problem.
Breuer and Freud belief of the conscious mind was?
incorrect.
In 1927 a viennese physician Manfred Sakel, begin using
increasingly higher dosages until patients convulsed and became temporarily comatose. Some recovered . This was called insulin shock therapy.
As Maslow noted, the humanistic model found its greatest application among what types of individuals?
individuals without psychological disorders
Adler focused on feelings of
inferiority and the striving for superiority, he created the term inferiority complex.
Dorothea Dix, campaigned endlessly for reform in the treatment of
insanity. (1802-1887) Her work became best known as the mental hygiene movement.
Cognitive Behavioral Model combines?
insights from the behavioral model, the cognitive model, and the social learning model.
Edward Titcheners (1867-1927) Emphasized the study of
introspection
Psychopathology
is the scientific study of psychological disorders. This field contains specifically trained professionals including clinical and counseling psychologists, psychiatrist, psychiatric social workers, and psychiatric nurses.
Empathy
is the sympathetic understanding of the individual's particular view of the world.
One important function of clinical descriptions
is to specify what makes the disorder different from normal behavior or from other disorders. Statistical data may also be relevant. For example How many people in the population as a whole have the disorder? This figure is called the prevalence of the disorder. Statistics on how many new cases occur during a given period, such as a year, represent the incidence of the disorder. Other stats may contain the sex ration, precentage of men and women with it.
The fuller understanding of the relationship between current emotions and earlier events is referred to as
isight.
Mass Hysteria
large scale outbreaks of bizarre behavior.
The study of abnormal behavior across the entire age span is referred to as
life-span development psychopathology. This field is relatively new but expanding rapidly.
Watson presented
little albert with Peter.
The cognitive operations or thinking staples of the ego are characterized by
logic and reason and are referred to as the secondary process as opposed to the illogical and irrational primary process of the id.
Acute onset
meaning that they begin suddenly.
"The prognosis is guarded"
means that the probable outcome doesn't look good.
Sanguine, meaning red like blood,
meant that blood was flowing through one's body, it meant they were cheerful and optimistic.
The Greek physician Hippocrates is considered to be the father of
modern western medicine. Wrote the Hippocratic Corpus between 450 and 350 B.C
the psychoanalytic model is the
most comprehensive theory yet constructed on the development and structure of our personalities. He also speculated on where this development could go wrong and produce psychological disorders.
Data flow from research (3 things)
must attempt three basic things, to describe psychological disorders, to determine their causes, and to treat them.
Sucking in the stages of development is
necessary for feeding, the lips, tongue, and mouth become the focus of libidinal drives and, therefore, the principal source of pleasure. If we did not receive the proper gratification during a specific stage or if a specific stage left a particularly strong impression it can stick through our life. This is called a fixation. Biting nails, chewing pencils and so on.
Jung rejected many aspects of Frueds sexual aspects and introduced the concept
of the collective unconscious, which is a wisdom accumulated by society and culture that is stored deep in individual mamories past down from generation to generation.
Abraham Maslow (1908-1970), most systematic in describing the structure of
personality. The postulated a hierarchy of needs, beginning with the most basic physical needs for food and sex and ranging upward to our needs for self actualization, love, and self esteem. Social needs which are friendships.
One of the most controversial and frequently mentioned psychosexual conflicts occurs during the
phallic stage from ages 3 to 5-6. It is characterized by early fenital self stimulation. This is the subject of Greek tragedy Oedipus Rex, which Oedipus is fated to kill his father and unknowingly marry his mother. Freud asserted that all young boys relive this fantasy when genital self stimulation is accompanied by images of sexual interactions with their mothers.
The Id functions according to the
pleasure principle, with the goal of maximizing pleasure and eliminating any associated tensions or conflicts. The goal of pleasure which is particularly prominent in childhood, often conflicts with social rules and regulations.
They (Adler, Jung, and Freud) all believe that human nature is
positive and that there is a strong drive toward self- actualization. And also that by removing barriers to both internal and external growth the individuals would improve and flourish.
Neuroleptics have what type of effect on psychotic symptoms
positive effects on psychotic symptoms of hallucinations, delusions, and agitation
"The prognosis is good", means that the individual will
probably recover
The anticipated course of a disorder is called the
prognosis.
First approach was _____(from the schools of thought)
psychoanalysis, based on Sigmund Freuds (1856-1939) elaborate structure of the mind and the role of unconscious processes in determining behavior.
The relationship between the therapist is called
psychoanalyst.
Freud took these basic observations and expanded them into the
psychoanalytic model
Ego, it is what is
realistic
Psychological dysfunction
refers to the breakdown in cognitive, emotional, or behavioral functioning. For example if you go on a date and the whole time while on it you want to go home, your emotions are not functioning properly.
Carl Jung and Alfred Adler were students of Freud who came to_____ his ideas
reject
To determine a clinical description,
scientist- practitioners must represent a unique combination of behaviors, thoughts, and feelings that make up a specific disorder. (The word clinical refers both to the types of problems or disorders that you would find in a clinic or hospital and to the activities connected with assessment and treatment.)
During the 1950's the first effective drugs for
severe psychotic disorders were developed in a systematic way. Before that time, a number of medicinal substances, including opum had been used as sedatives along with countless herbs and folk remedies.
The Id is the source of our
strong sexual and agressive feelings or energies. The animal within people. It could make someone a rapist or killer. The energy or drive within the id is the libido.
Hippocrates Recognized the importance of psychological and interpersonal contributions to psychopathology
such as the sometimes-negative effects of family stress. On some occasions he removed patients from their families.
The third important structure is the
superego
Joseph Wolpe, best known for
systematic desensitization. Similar to the treatment with little peter.
Biological tradition waxed and waned during the centuries after Hippocratesand Galen but was reinvigorated in the 19th century because of two factors,
the discovery of the nature and cause of syphilis and strong support from the well respected American psychiatrist John P. Grey
Defense Mechanism
the ego fights a continual battle to stay on top of the warring id and superego.
Freud states there are three major parts of functions
the id, the ego, and the superego.
Edward Thornsike, best known for
the law of effect.
Development of Biological Treatments in the 1930's
the physical interventions of electric shock and brain surgery were often used. For example insulin was occasionally given to stimulate appetite in psychotic patients who were not eating but it also seemed to calm them down
Ego operates on
the reality principle instead of the pleasure principle.
There are three models to the historical conceptions
the supernatural, the biological, and the psychological
As (psychoanalyst) the relationship between one and a therapist evolves
the therapist may discover the nature of the patient's intrapsychic conflict. This phenomenon is called transference.
Countertransference,
the therapist projects some of their own personal issues and feelings, usually positive, onto the patient.
Erikson's greatest contribution was his
theory of development across the lifespan, in which he described in some detail the crises and conflicts that accompany eight specific stages. The mature age, beginning at about age 65.
The next discovery by Breuer and Freud was that it is
therapeutic to recall and relieve emotional trauma that has been made unconscious and to release the accompanying tension.
Cognitive Behavioral Models revolutionized the field because...
they brought the systematic development of a more scientific approach to psychological aspects of psychopathology.
In the middle of the 19th century, mental illness was caused by brain pathology, and therefore, was incurable until the reemerging in different schools of
thought in the 20th century.
Breuer and Freud believed that they had discovered the
unconscious mind and its apparent influence on the production of psychological disorders.
Second approach was _____(from the schools of thought)
was behaviorism, associated with John B. Watson, Ivan Pavlov, and B.F Skinner, which focuses on how learning and adaptation affect the development of psychopathology.
Skinner strongly influenced
watson
Later development in psychoanalytic thought Anna Freud (1895-1982) she concentrated on the
ways in which the defensive reactions of the ego determine our behavior.
For example the oral stage extending till 2 years from birth signifies that
we have a central focus on the need for food.
superego
what we might call the conscience, the moral principles instilled in us by our parents and culture. It is the voice that nags at us when we know were doing something wrong
collective unconscious
which is a wisdom accumulated by society and culture that is stored deep in individual mamories past down from generation to generation.
Displacement
you do poorly on a test and then argue with the store clerk. Here the ego adaptively decides that expressing primitive anger at your professor may not be in your best interest. But since the store clerk has no authority your anger is displaced to them.