psychology
General Psychology Course
Third Year
1. Introduction:
Psychology is the science of mind and behavior. It is a now science and not as
advanced as physics, chemistry, or medicine. This new field has had a profound
influence on philosophy, theology, literature, and historical research. Psychology enables one to go inside people
and understand why they act the way they do. One can also predict the way they
will act. I can also understand myself better and grow and mature and develop
the abilities and powers God has given me. Nowadays people in the helping
professions such as social workers, nurses, school administrators, teachers and
ministers cannot function well without a working knowledge of Psychology. This study will also help those who want to
improve their English because psychological terms are now common in English.
New vocabulary to be learned will be listed on each page.
The
Biophysical Approach: The method is
scientific. They want to deal with the physical, what can be seen, measured
verified. They consider the structure and chemistry of the brain, nervous and
endocrine system. Heredity is important. They look for tumors, or lesions
caused by poisons, injury, or infections.
In
treatment they use drugs, exercise, neurosurgery, radiotherapy and ECT. For diagnosis they use x-rays, biopsies, EEC,
scan, PET scan, echo image (ultra sound), MRI
Hippocrates, (400-367 B.C.)
the father of medicine, gave us the theory of the four temperaments. This early psychology insight was believed
and used for over 2000 years, almost up to present times. From the four elements of Empedocles, 490-430
B.C. He inferred four humors of the body, and the four temperaments which he
observed in human disposition. He theorized that the temperaments were caused
by excess of the humors, i.e. too much black bile creates a sad person.
Elements
|
Humors (body fluid)
|
Temperaments
|
|
Earth
|
Yellow Bile (Liver)
|
choleric (angry)
|
|
Water
|
Black Bile (spleen, kidney)
|
melancholy (sad)
|
|
Fire
|
Blood (heart)
|
sanguine (hopeful)
|
|
Air
|
Phlegm (Lungs)
|
apathetic (calm)
|
|
Spear
|
Urine (Bladder)
|
Phlegmatic (Timorous/Nervous)
|
Vocabulary to and use: Biophysical, Intrapsychic, Phenomenological, Theory,
Cope, Strategy, Modify, Apathetic, Phlegmatic, Humor, Spleen, Bile, Tumor,
Choleric, Melancholy, Sanguine, Phlegm, Element, Temperament, Interpersonal,
Style, Assertive, Heredity, Endocrine, Lesion, Biopsy, Scan, Radiotherapy.
Aristotle,
philosopher
and also physician, followed Hippocrates’ teaching on the biological causes of
physical and mental illnesses, but mistakenly believed that the heart and not
the brain is the source of higher activities for humans. His predecessor, Empedocles, strangely enough
taught that humans think with their blood.
In fact, conscious processes cannot occur without the brain. The total sum of neural activity equals one’s
conscious world.
The basic unit of the nervous system is the neuron or
nerve cell. It is composed of the nerve
cell, dendrite and axon. The dendrites
look like tiny fine roots coming out from the cell. The axon is a filament (wire) coming out from
each neuron. Some are very short; some
are over three feet long. The dendrites
receive messages; the axons send messages.
There are some 20 billion nerve cells in the brain. Another 5 billion make up the spinal cord and
the rest of the system, which extends to all parts of the body. The system runs on electricity and
chemicals. The axons and dendrites do
not touch. There is a small gap called a
synapse. The electric charge jumps
across this synapse to bring the message.
Various chemicals, called neural transmitters, quicken or slow down the
activity of the system. These chemicals
act at the synapse gap. Even in sleep
the brain and nervous system’s electrical activity is going on. Only at death does it stop. Messages travel 395 feet per second along the
axons.
The electroencephalogram, EEG, measures
electrical activity in various parts of the brain. Wires are taped to the skin on various parts
of the skull. These can pick up currents
in the brain even these are only a few micro volts in strength. A micro volt is one millionth of a volt. The EEG picks up the tiny currents and
records them as brain waves on a strip of paper. A person who is awake produces about ten
waves per second. Waves are measured in
hertz. One hertz is one wave per
second. In sleep the brain produces
about two hertz. When the person is
active or excited, the brain produces 18-20 hertz. If the brain has a lesion, hemorrhage, tumor
or infection, that area of the brain produces slower and irregular waves. During sleep the hertz are about ten, the
same as when the person is awake. Brain
waves are like fingerprints; each person’s are unique.
Nerve cells or neurons do not reproduce like other cells
of the body, so damage done by injury, hemorrhage; blockage of blood, lack of
oxygen, tumor, or infection is irreparable.
Poisons and malnutrition are also causes of brain damage. In order to remain alive, nerve cells
constantly need oxygen and glucose which are supplied by the blood.
In the brain there is gray
mater and white matter. The gray matter
is composed of neurons. The white is
composed of glia cells. The glia cells cushion
and protect the neurons. It seems they
also supply some nutrition and remove waste products. There are five or ten times as many glia
cells as neurons, perhaps, 200 billion.
The white matter also contains fibrous material which gives body to the
brain.
The brain can be divided into three parts: fore, mid, and
hind. In the hind-brain is the medulla
oblongata. It contains the control
centers for heartbeat, breathing, blood pressure, and peristalsis. If the medulla is destroyed, life ceases
immediately. In the mid-brain one finds
a small but important area called the hypothalamus. It seems to be the seat of primitive
emotions: fear, anger and joy. It also
regulates the pituitary, the master gland of the endocrine system. The fore-brain, (the entire brain weighs
about 3 pounds and is about 82 square inches in size). By the age of seven the
brain is almost full size.
Vocabulary: Neuron, Dendrite, Axon, Filament, synapse, Neural transmitter,
Electroencephalogram, Micro volt, egg, brain wave, hertz, hemorrhage, oxygen,
glucose, malnutrition, gray matter, write, glia cells, fibrous, unique, medulla
oblongata Peristalsis, hypothalamus, Primitive, Pituitary, Gland, Endocrine
system, Cerebrum, Lobe, Hemorrhage, Irreparable, Billion.
2. On the walls of the Temple of Delphi, built high on the jagged cliffs of Mount
Parnassus, was inscribed the most famous of all Creek precepts: “Know
thyself”. Contemporary psychology has
become a partially successful response to this admonition.
Each of the four approaches
to psychology is based on a different hypothesis or theory. A theory is a plausible and scientifically
acceptable principle offered to explain empirical data and events. For example, many ordinary people still
believe the theory that mental illness is demonic possession. Plato, a contemporary of Hippocrates,
believed that many mental disorders were “divine” illnesses. In the course of time some theories are
proven or disproven; Ptolemy (2nd cent. A. D.) held that the earth
was the center of the universe. Later
the hypothesis of Copernicus (1473-1543) that the earth and other planets
revolve around the sum, was proven by Calileo (1563-1642). Up until the time of Columbus
No one of the four
approaches to psychology has all the answers or a handle on the whole
truth. Each has a great deal to
offer. The fact that each school offers
great true and insight underlines the complexity and depth of human beings.
Just as astronomy has
deepened our appreciation of the greatness of the universe, so psychology
brings into the depth and wonder of the human person. In 1934 astronomers had counted about 34,000
stars in he heavens. Now it is known
that there 100 billion stars in the milky-way galaxy alone. The next closest galaxy is 150,000 light
years away. And it is estimated that
about 100 billion other galaxies are out there, some much larger than our milky
way. The universe is about 20 billion
years old. A cosmic year in 225,000,000
(225 million) years, the time it takes our solar system to revolve once around
the galaxy. The homo sapiens (human
being) about one cosmic year ago began to inhabit the earth. The human brain and nervous system is
composed of about 25 billion neurons, all interconnected. The nervous system unifies, regulates, and
protects the whole organism. We are only
beginning to understand how it works.
The biophysical theory holds
that mental health and sickness can be understood in terms of genes (heredity),
temperament, physical constitution, the structure and chemistry of the brain,
and the endocrine system. The
intra-psychic people understand health and pathology in terms of the
unconscious processes.
The phenomenological view
sees growth and immaturity, psychological health and illness as the result of
separation from or acceptance of self.
The behaviorists see the control of a person’s environment as the key to
living happily and well. So each system
has its own theory or mind set.
In men (those who are right handed) usually the left side
of the brain is quite dominant. In women
usually the left side is not so strongly dominant, and more of the activity is
shared with the right side. This
explains why women recover more quickly from a paralyzing stroke. Girls also can sing tunes at an early age,
and they exceed boys in language abilities.
They also are more dexterous with their hands. Boys show early visual superiority, and excel
in activities calling for total body coordination. Boys are more curious in exploring their
environment, and in solving mechanical problems mentally. If the wires of an electroencephalogram (EEG)
are attached to a person’s skull, when a boy is solving a mechanical problem
mentally, the right side will show electrical activity. In the girl both side will light up. For left-handed people the brain is organized
somewhat differently.
Key words for the four
theories are body, unconscious, self, and environment. The first approach sees the person as a
machine (Honda); the second sees the person as mystery to be solved, unlocked
or opened; the third see the person as a fellow human being, the fourth sees
the person as a computer programmed with habits through the environment.
Vocabulary: Galaxy—systems of stars like
the Milk Way
Demonic—related to an evil
spirit
Dexterous—skillful
Cosmos—from the Greek word
Kosmos meaning universe
Computer—an electronic
devise that can store, retrieve, and process information.
The
hind, mid, and
forebrain can be called the reptilian, mammalian, and primate brain. The top parts of the cerebrum are called the
cerebral cortex. The gray matter in the
cortex is the source of the powers that distinguish humans from animals, such
as the ability for abstract thinking speech, and artistic creation. The cerebral cortex also contains the centers
for touch, vision, and hearing, and the motor center for movement of eyes, arms,
legs, fingers, shoulders, as well as facial muscles. The axons coming down from the brain cross
over, so the left side of the brain controls the right side of the body and
vice versa. On the left side of the
cortex is the rational verbal power. On the
right are centers for non-verbal ideas, emotions, music processing and artistic
work.
Because of their nervous system, animals and insects are
born with various skills, i.e. spiders spinning webs, mosquitoes seeking food
at night, fish and birds migrating long distances, birds building their
nests. However, they always do their
work the same way. Because of their
highly developed cerebrum, human do their tasks in infinitely different ways,
as is seen in the thousands of different cultures in our world. These vary in language, beliefs, customs,
laws, tools, dress, art, ritual, etc.
The human nervous
system: The central nervous system, CNS,
is made up of the brain and spinal cord.
The peripheral nervous system is composed of cranial and spinal nerves which
reach out to every part of the body, PNS.
The voluntary nervous system VNS, is connected to all the muscles of the
body that can be moved at will. These
muscles are striated, that is, banded or striped in appearance.
The autonomic nervous system, ANS, works without
conscious control, and controls the vital functions of the body, such as heart
beat, blood pressure, blood chemistry, breathing, digestion, body temperature,
etc. It is connected to all the organs:
eyes, stomach, heart, lungs, bladder, glands, kidneys, blood vessels, nose,
ears, etc. It controls the smooth or
non-striated muscles which work involuntarily.
The ANS is controlled by a center deep inside the brain called the
diencephalon. The VKS is controlled by
outer crust of the cerebrum, called the cortex.
The autonomic nervous system
is divided into the sympathetic, SNS, and parasympathetic nervous system,
PSNS. The SNS stimulates or excites the
body for action or work. It stimulates
heartbeat, breathing, blood pressure, consumption of glucose, etc. The PSNS calms and balances the body. It controls maintenance, rebuilding,
elimination, temperature digestion, sleep, thirst, and appetite.
The endocrine system: The
endocrine or ductless glands are the thyroid, parathyroid, thymus, adrenal
glands, pancreas, ovaries, testicles, and pituitary. These glands excrete hormones (chemical
messengers) into the blood. Over 50
different hormones have been discovered in this system. The pituitary is called the master gland, for
it controls the other glands. It is
located at the base of the brain, near the hypothalamus. The hypothalamus is part of the diencephalon
mentioned above. The hypothalamus
controls the pituitary. The pituitary is
1.5 cm. in diameter. It produces some
eight different hormones. One of these
is the growth hormone, which cause growth in the young person.
The thyroid gland is located
in the lower larynx or voice box in the throat.
When it receives a hormone from the pituitary it is stimulated to
produce its own hormone called thyroxin, Thyroxin controls the body’s rate of
metabolism by regulating oxygen consumption.
Metabolism means the rate at which the body produces energy by burning
digested food.
Vocabulary: Reptile, mammal, primate,
Cerebral, Cortex, Abstract, cns, pns peripheral, Nervous, system, Voluntary
nervous system, vns, striated Muscles, Autonomic, nervous system, ans, bladder,
non-striated Muscles, Kidney, Luncs, Dicestion, Blood Vessels, smooth Muscles,
involuntary, diencephalon, sns, sympathetic nervious, system, psrs,
parasympathetic, nervous system, excrete, consumption, Elimination, Ductless,
Thyroid, Parathyroid, Thymus, Adrenal Clands, Pancreas, Ovaries, Testicles,
Hormone, Larynx, Thyroxin, Metabolism, Banded, Stripes.
3. The three stages of neuropsychological
development (brain development):
In the first stage, birth to 18 months, the
infant lives in the world of feeling (attachment). In his primitive existence he is conscious of
needs and feelings. The objects he
senses are unconnected and random, without cause or effect.
In the second stage, 1-6 years old, the child
becomes conscious of self (autonomy) and objects out side oneself
(reality). Through movement
(locomotion), and getting some self-control, the child gets a sense of self, as
a separate being.
In the third stage, 4-18 years old, the cortex
of the brain (cerebrum) forms and gets inter-connected, and the person begins
to think in terms of concepts and symbols.
At first all four-legged animals are called “doggie”, but as the cortex
develops, new names, concepts and symbols are learned.
The brain is helped to develop by stimulation. The most rapid brain growth occurs during the
first three years. At that time if
proper development does not occur because of mismanagement in the home or because
of malnutrition, it is hard to make up later.
The later stages are not as crucial as the first three years.
Impoverishment
of stimulation:
Infants neglected in orphanages may lack social awareness as adults, be slow in
reaction, poor in problem solving, unable to stand stress, be unable to resist
disease. Animal (monkeys) raised in
isolation, lack emotion, curiosity, social behavior, learning ability.
Enrichment of stimulation: In animal experiments
(monkeys, rats), changes in brain weight and chemistry occur according to when
and how stimulation is given. With
proper stimulation, animal prove to be better at problem solving and can stand
more stress. With infants it is believed
that too much stimulation develops certain parts of the brain; later as adults
these persons will over-react to social stimulation.
Sensory - attachment stage, birth to 18 months: First month mostly taste, touch, and
smell. Then in the 2nd month
hearing and sight, and the child begins to sense more distant objects. The task is social attachment and the crisis
is trust vs. mistrust. In this stage
quantity is more important than the quality of stimulation. In the final two stages quality is more important.
Sensory-more-autonomy, 1-6 years: The tasks are locomotion, speech, and
self-control. The crisis is an
independent sense of self vs. shame and doubt.
Intracortical-initiative, 4-18 years. The task is learning skills, team play, sex
role (what it means to be a boy, man, girl, women), peer-groups. The crisis in initiative which is the ability
to reflect, plan, and act in novel ways independent of parents’ supervision,
and in that way to achieve a sense of identity. vs. guilt about one’s feelings
and confusion about ones’ identity.
1-2 months
Turns head in direction that cheek is touched
Able to suck and/or swallow easily
Startles easily in response to loud noise
Gaining in length and weight
Pays attention to someone’s face in direct line of
sight
3-4 months
Makes sounds other than crying
Holds a rattle and smiles
Rolls from stomach to back
Turns head toward bright light and color
Shows gains in height and weight
4-6 months
Reaches for and grasps objects
Moves toys from
hand to hand
Smiles in response to others
Rolls from stomach to back and back to stomach
Balances while sitting for a few seconds
6-9 months
Creeps or crawls forward on tummy by moving arms and
legs
Babbles and laughs out loud, plays pat-a-cake and
peek-a-boo
Sits independently
Turns head to locate sounds
Shows gains in height and weight
9-12 month
Pulls to a stand
Picks up small objects
Crawls on hands and knees, walks with both hands
held
Imitates simple sounds, waves “bye-bye”
Able to sit on own
12-15 month
Says words besides “mama” and “dada”
Walks without help
Drinks from a cup or glass
Takes turn rolling a ball
15-18 month
Looks at picture books turns pages
Feeds self with a spoon
Likes to push, pull and dump things
Walks without support
Tries to talk and repeat words
Indicates needs by pointing and/or grunting
18-24 month
uses 2-3 word sentence has a vocabulary of 20
words/signs
Carries objects when walking, can kick a large ball
Shows affection, offers hugs and kisses
Says “no” often
Chews small bites of food
Understands simple directions such as “give me the
ball”
Can point to nose, eyes, mouth, ears, etc
24-30 month
Can eat without assistance
Runs well, throws a ball forward
Gives first name when asked
Enjoys playing with other children
Can hold crayon, likes to scribble
Turns door knobs and can unscrew lids
Enjoys being read to
4. What a Development
Delay?
The
first three years of your child’s life are so important. Human learning and development are most rapid
in the time from birth to age 3. That’s
why it’s important to give a child the best start possible. The earlier a child with a disability or a
developmental delay is diagnosed and gets help, the better that child’s
ultimate quality of life.
The following checklist offers some examples of typical
child development. Of course, every
child develops at his or her own pace, but if your child shows a delay, he or
she may benefit from a comprehensive developmental assessment.
The thyroid
needs iodine to produce thyroxin, and in areas such as Jamalpur (the goiter
belt of Bangladesh
The parathyroid glands are
four small seed like bodies attached to the back of the thyroid, two on each
side. Their function is to secrete a
hormone which regulates the balance of calcium and phosphorus in the body, two
minerals which are essential for strong bones and teeth. If too little hormone is produced, tetany
occurs. This is muscular spasm in wrists
and ankles. If too much is produced, the
bones and teeth become soft and fragile.
The pancreas, the large digestive gland, yellow in
color. Six inches long, has a head, tail
and body, and is located behind the stomach and left lower ribs. The hormone of this gland is insulin. Insulin helps to convert sugar into glucose
so it can enter the muscles and be burned for energy. When insulin is deficient, sugar builds up in
the blood and is passed out in the urine.
When insulin is excessive, the glucose in the blood gets too low, and
not enough glucose will get to the brain.
The person will begin to get nervous and tremble. At that time the person must eat sugar or
convulsions, coma, and death my follow.
The first condition is called diabetes mellitus (sugar diabetes). The second is called hypoglycemia. There is relationship between the pituitary
and the secretion of insulin.
The adrenal glands, small
and triangular in shape, lie in front and on top of each kidney. The center part of the gland produces the
hormone adrenaline. This is the fight or flight hormone. The
central part of the gland or medulla is linked with the sympathetic nervous
system which signals in times of danger, anger or stress. The eye pupils dilate for better sight, blood
pressure rises, the heart beats faster, breathing is speeded up. Adrenaline also causes the liver to use its
stores of sugar (glycogen) which brings extra fuel to the muscles. The outer part of the adrenal gland is
controlled by a hormone from the pituitary called ACTH which causes the outer
part to secrete over 30 different hormones.
These 30 or more chemicals carry out a wide variety of assignments in
maintaining body functions. They control
the body’s balance of vital minerals, especially, sodium chloride (salt) and
potassium. Salt is necessary to maintain
water balance and blood pressure. They
also cause the body to break down fats and proteins in increased quantities in
times of tress or illness.
The thymus gland is just behind the breast bone. It is
a temporary organ. It is largest at
the age of nine month and shrinks to almost nothing after the age of two,
although it functions up to the age of puberty.
This gland is essential in developing the body’s defense or immune
system.
The sex glands,
ovaries and testicles, are regulated by hormones secreted by the pituitary. At about the age of 12, one of these hormones
is secreted into the blood. This causes
the ovaries to secrete another hormone called estrogen. This causes the girl’s body to develop into
women. In the same way hormones from the
pituitary regulate the women’s 28-day menstrual cycle until she reaches
menopause at about the age of 45.
Likewise for with boys, at about the age of 14, the pituitary signals
the testicle to give off testosterone.
Testosterone stimulates the male characteristics to develop, such as
beard, deep voice, broad shoulders, muscles.
It also induces aggressiveness and sexual interest.
Vocabulary: Iodine, Goiter, Cretinism,
Calcium, Phosphorus, Tetany, Spasm, Insulin, Convulsion, Coma, Diabetes,
Hypoglycemia, Secrete, Urine, Adrenalin, Pupil of, The eye, Dilate, Glycogen,
Acth, Sodium Chloride, Potassium, Protein, Immune System, Mineral, Puberty,
Estrogen, Menstrual, Menopause, Testosterone, Aggressive, Fragile, Retardation.
There is a long standing tug of war in psychology about what is more important in the
making of the human personality:
heredity or environment. The
same dispute is found in philosophy in Plato’s innate ideas vs. Aristotle’s
tabula rasa. Is behavior basically
inherited or learned? Is psychology
basically biogenic or pyschgenic? Are we creatures of nature or nurture? The
biophysical people are impressed with genetics, as are intrapsychic people but
to a lesser extent. Freud made the
famous dictum, “biology is destiny”.
Those in behavioral psychology tend to believe firmly in the primary
role of environment. To a lesser extent
so do those in humanistic (phenomenological) psychology. The question is: are we more socially
determined, or more innately (inborn) determined? Human environment begins at the time the
sperm fertilizes the ovum and ends at the time of death. It is optimistic and hopeful to believe that
my destiny depends on environment and personal effort, and that my
possibilities are unlimited.
However, through
heredity a person is born male or female; skin, eyes, hair, stature, nervous
and endocrine system stamp one as a very unique person, different from anyone
else who has ever lived or will live.
All living things inherit instinct.
An instinct is an biological drive, or urge or disposition which is
common to all members or the species.
Birds build their nests; spiders spin their webs, all in the same
way. Human have two basic instincts, the
drive for self preservation and the urge for reproduction, the drive for food
and the urge for mating. Of the two the
need for food is the stronger. Humans
can live happily without sex, but they can not live very long at all without
food. It is evident that insects and
animals are genetically determined., to a great extent. Temperaments are also inherited. A temperament is a biophysical disposition to
react emotionally in a certain way.
Biophysical clinicians speak of five temperaments they observe in
people; the four described by Hippocrates, and the fifth one, timorous, refers
to people who have an inborn fear of injury or stress.
5. Some physical dysfunctions are inherited, such as some diseases of the blood, sickle cell anemia and
thalassemia, albinism, hemophilia (of which Queen Victoria was a carrier),
phenylketonuria (PKU), glaucoma, Huntington’s chorea, and muscular
dystrophy. In PKU, the newborn child is not able to digest proteins properly. Unless diagnosed very early, the lack of
protein will cause brain damage and mental retardation.
In human tissue
cells there are 23 pairs or 46 chromosomes.
Twenty-three are donated by the sperm cell and 23 by the ovum. Within each chromosome is the DNA
molecule. On this long spiraling
molecule the genes are assembled. The
particular formation of the genes in each chromosome constitutes the genetic
code that transmits hereditary traits from generation to generation. In the female each ovum contains 23 X
chromosomes; in the male, each sperm either 23 X, or 22 X plus one Y
chromosome. If the sperm with the X
chromosome unites with the ovum it is female XX; if the sperm with the Y unites
the child will be a male XY. So it is
the father who determines the sex of the child.
O course, it is pure chance which sperm will find the ovum. In each sperm ejaculation there are some 3
million sperm cells. Woman is born with some 700,000 undeveloped ovas. Each sperm and each ovum has a different and
unique gene formation or genetic code, so the possibilities are almost
infinite. This is called the gene pool. This pool contains all the possible traits I
can inherit from my ancestors. If one
goes back only ten generation, there are 1024 grandparents contributing to the
gene pool. Schizophrenia is often
hereditary, although the disease may span several generations. Likewise, it seems that depression is more
likely to run in families.
Left-handedness also is thought to have a genetic basic.
Vocabulary: Cross, Environment, Innate, Tabula
rasa, Biocemic, Psychogenic, Nuture, Genes, Genetics, Dictum, Humanistic,
Behavioral Psychology, Learning theory, Tehavior modification Inborn Sperh,
Fertilize, Primary, Ovum, Stature, Instinct, Disposition, Reproduction,
self-preservation, Mating, Drive, Urge, Clinician, Timorous, Stress,
Dysfunction, Sickle cell Anemia, Thalassemia, Albinism, Hemophilia, Carrier
Phenylketonuria, Pku, Glaucoma, Chorea, Muscular Dystrophy, Tissue, Chromosome,
DNA, Molecule, Spiral, Genetic Code, X andY Chromosomes, Ejaculation, Gene
Pool, Schizophenia, Depression, generation, Ancestor, XX, xy, trait,
Diagnose.
Down’s
syndrome is not hereditary, but is a
congenital disorder involving physical malformations. In 1959 it was discovered that the cause is
an extra chromosome. The fertilized ovum
contains 47 instead of 46 chromosomes.
The extra chromosome that causes this birth defect is always found next
to chromosome no. 21. The baby will have
a broad face with slanted eyes, a large tongue, and thin skin. The back of the head is flat and the child
will speak with a deep croaky voice.
Usually there is a crease extending across each palm. Depending on the type of brain defect,
retardation will take various forms.
These children tend to be affectionate and easy to deal with. With satisfactory and early training these
victims can live comparatively productive lives. This disorder is also called mongolism or
mongoloidism. It occurs about once in
every 500 births, or about 50,000 in Bangladesh
Retardation is defective or insufficient development of the brain
causing the inability to learn at the usual rate. In all countries of the world, about 3% of the
children are retarded; in Bangladesh
Intelligence is determined partly by heredity and partly by cultural environment. By enriching a person’s experiences,
intelligence can be increased. The
measurement of a person’s intelligence requires the evaluation of a person’s
performance on many different tasks.
Intelligence is the total capacity of an individual to think rationally,
to act with a definite purpose, and to be able to deal effectively with one’s
personal life situation. In other words
it is the ability to adapt to and control ones environment.
Hydrocephalus is an abnormal enlargement of an infant’s
head after birth, caused by blockage of the brain’s two large cavities
(ventricles). The channels, which drain
away this fluid into the spinal canal are closed off due usually to some
inflammation. Since the skull bones are
not yet fused, the head expands in size.
The swelling is usually not noted until two or three months after birth
when the forehead stands out and large veins appear on the skull. The surgeon can put in a tube to shunt off
the liquid that constantly forms is the ventricles. The pressure inside the cranium will cause
serious brain damage unless the pressure is soon released. Otherwise the child will be severely
retarded. The blockage can also occur in
young children and adults in which case the skull will not enlarge.
6. Encephalitis is an inflammation of the brain usually
caused by an invading virus. It is
thought to be spread sometimes from animals to humans by mosquitoes, ticks,
lice and flies. It is also caused by the
same viruses that cause chickenpox, mumps, influenza, colds sores and
shingles. Rabies and sleeping sickness
are two types of encephalitis. The
hermes virus and other can invade the brain as complication 6f these other
common infections. The symptoms are
acute and sudden headache, fever restlessness, nausea; later convulsions and
drowsiness may occur.
Vocabulary: Down’s syndrome, Mongolism, Moncoloidism, Concentital, Croaky, Fertilize, Birth Defect, I.Q. Intelligence Quotient, Adapt, Hydrocephalus, Blockage, Cavity, Ventricle, Spinal Canal, Skull, Fuse, Shunt, Cranium, Virus, Tick, Lice Mumps, Measles, Cold, Sore, Rabies, Sleeping Sickness, Encephalitis, Herpes, Acute nausea, Convulsion, Drowsiness, Syphilis, Canal, Crease.
In
severe cases neck
muscles got stiff, and in extreme cases the patient may go into a coma. If enough neural tissue is destroyed by the
virus children, after recovery become hyperactive, agitated, and difficult to
handle. When they grow up they may he
erratic, moody people. With adults who
suffer encephalitis, if there is sufficient neural damage, it may affect muscle
control i.e., hands trembling, walking unsteady, face without (masklike)
bacterial infections also cause encephalitis.
Epilepsy is a disturbance of the central nervous system. From ancient times, people have feared and
misunderstood this affliction. In Bangladesh
There
are three kinds of epilepsy: Grand mal (great sickness). In this type the
seizure is usually preceded by an aura, which warns the victim and sometimes
the onlooker that a convulsion is on the verge of coming. During the aura the person may see black
spots, smell a bad odor, feel a rush of anxiety, feel dizzy, hear sounds in
cars, have stomach cramps, or some muscles may began to twitch. The seizure soon begins and the person falls
to the ground. The episode lasts only
two minutes. During the first minute the
body is rigid, the arms are bent, the fists are clenched. Breathing stops. During the second minute air is forced out to
the lungs with a cry or scream. Then the
spasms and jerking of the limbs begin.
The jaws will open and close.
There may be loss of bladder and bowel control, foaming at the mouth,
and unless something is placed in the mouth, the tongue and inside of cheek may
be bitten. The person makes up with a
headache, exhausted and confused. Then
they often sleep deeply for several hours.
If he patient is not on drug therapy, seizures may occur even several
times a day or only once every few years.
Petitmal (little
sickness): The seizure consists of a
brief blackout or lapse. The person
stops what he or she is doing, and stares blankly as if daydreaming. After 10-15 seconds the person begins to work
again. In cpilenary the person is
conscious or remembers what has happened.
In the petitmal there may be minor muscle jerking and the head may
drop. Petitmals only happen to younger
people and the symptoms stop by the age of 30.
Psychomotor epilepsy. The person
may be talking to a friend; suddenly he steps talking, walks away and does some
meaningless task, or he may stay there and babble incomprehensibly. After a few minutes he “comes back to his
senses”, unaware of what he has done.
Most cases of epilepsy are controlled by medicines called
anticonvulsant. In the future, surgeons
may be able to remove the brain cells causing the discharge, or a brain
pacemaker could act as a circuit breaker in preventing the electrical
discharge.
Apoplexy, also known as a stroke, is a condition in which
either a blood clot or a hemorrhage in the brain causes paralysis and often the
loss of speech. Elderly people who
suffer stroke often have arteriosclerosis or hardening of the arteries. This
condition causes the clotting or hemorrhage.
Strokes come on suddenly usually without warning, commonly paralyzing
only one side of the body. If the person
survives, often there is a good possibility of regaining all or part of the
lost abilities, including speech and the use of limbs. A person may suffer a series of little
strokes rather than a massive one. These
little strokes may cause a limb or the side of the face to feel numb. Often these slight attaches are followed by a
major stroke. Strokes usually hit people
over 40, but they may afflict the younger, even a child or infant.
Alcoholism is a chronic
condition caused by compulsive drinking of alcoholic beverages. The victim will finally sacrifice most goals
and values for the sake of drinking.
Chronic heavy drinking causes damage to the central nervous system, and
eat lead to permanent alcoholic. Alcoholics may have episodes of what is called
DT’s (delirium tremens). These episodes
usually last from three to six days. In
the DT’s, the victim will see and feel terrifying spiders and insects. The body temperature rises, perspiration
becomes profuse, there is rapid heart rate, nausea, and the hands, tongue and
lips coarsely tremble. When the episode
is over, the victim goes into a deep sleep.
He later will hazily recall the terrifying hallucinations. This may deter him from drinking for a short period.
7. Some disorders such as cerebral arteriosclerosis, Alzheimer’s disease, and
Parkinson’s disease are associated with aging.
Alzheimer’s hits mostly middle-aged women. With the hardening of the blood vessels in
the brain the victim suffers memory loss and emotional instability, often also
difficulties in speech. The cause is
unknown. The condition tends to run in
families. Parkinson’s hits people
between 50 and 70. In Bangladesh
SIDS: Sudden Infant Death
Syndrome, or crib death, death of an apparently healthy infant. The death usually occurs during sleep and at
night. It is estimated that in Bangladesh
Electric shock treatment,
also called electric convulsive therapy, ECT, is a treatment sometimes used for
severe depressive disorder, especially agitated depression (a psychotic
disorder) and menopause syndrome. The
patient is put to sleep. Then electrodes
are attached to the person’s head. A
current of about 100 volts is passed through the frontal area of the brain for
less than one half a second. It is the
convulsions and not the electricity that affects the cure. Why it works, has not been explained. It was first used in 1935. With the advent of newly discovered drugs,
ECT is used less often. ECT is time
consuming and complicated. It probably
causes some minor brain damage. Some
patients complain of loss of memory power.
Vocabulary: Neural, Hyperactive, Erratic, Moody, Mask,
Bacteria, Epilepsy, Etiology, Trauma, Genius, Toxic, distinctive, Grand Mal,
Seizure, Aura, Verce, Cramps, Onlooker, Twitch, Clench, Spasm, Episode, Bowel,
Symptom, Petit Mal, Blackout, Lapse, Babble, Incomprehensible, Anticonvulsant,
Pacemaker, Circuit, Apoplexy, Stroke, Blood clot, Paralysis, Elderly,
Arteriolosclerosis, Artery, Massive, Alcoholism, Compulsive, chronic, Dt’s,
Delirium Tremens, Profuse, Perspiration, Hazily, Hallucination, Alzheimer’s
Syndrome, Parkinson’s Disease, Instability, Slurred, Degenerate, Dopamine,
Tremors, Sudden Infant, Death syndrone, Sids, Crib death, Electric Shock,
treatment, Electric Convulsive Therapy, Ect, Acitated Depression, Electrode,
Thalamus, Respiration.
Definitions: Diagnosis—description, identification, and
labeling of a pathological conditions.
Prognosis—prediction of the course and outcome of a
pathological condition.
Acte disorder—a disorder having sudden onset, sharp
rise, and short course.
Chronic disorder—longstanding impairments that are
likely to be permanent.
Dysfunction—impaired or disturbed functioning.
Etiology—study of the causes of pathological
conditions.
Trait—a more or less enduring characteristic of a
person.
Therapy—the treatment of pathological condition.
Idiopathic—of unknown cause, presumed to come from
the person’s constitutional makeup.
Trauma—severe physical or psychological injury.
There
was a
revolution in psychiatry and clinical psychology in the 1950’s, because of the
discovery of two new drugs. In the late
1940’s chlorpromazine was discovery in France Australia Europe
and North America were filled with permanent
patients who had to spend their whole life locked in. Now when the drugs take effect they are sent
to their local community where they will continue medication and
treatment. Often they will relapse and
they return for a time to the institution, and are released when they
improve. This is called the swinging
door policy. Chlorpromazine is called a
tranquilizer; Lithium carbonate is an antidepressant. The “hows” and “whys” these drugs produce
their effect on the brain is still a matter of speculation.
The
Constitutional theory of psychology has been developed by the research of
William Sheldon. He tries to find a
relationship between body physique, temperament and psychopathology. He, of course, is stressing heredity, because
one’s physical constitution is genetically determined. In people one can observe three types of
morphology (shape or form); the endomorph, mesomorph and ectomorph. The endomorph is soft and round, with weak
arms and legs, and small hands and feet.
His temperament is comfort-loving and sociable. When mentally ill, they suffer
depression. The mesomorph is muscular
and solid, with a quarish body, and big hands and feet. His tends to be socially insensitive. His mental weakness would lend to a paranoid
condition, that is, violence, delusions of persecution, hallucinations, and
delusions of grandeur. The ectomorph is
thin and fragile and has highly developed nervous system. His temperament is introverted and
restrained. He likes solitude. When mentally deteriorated, they would be
schizophrenic, escaping reality into a dream world, lacking concern for serious
situations sometimes speaking in a silly, garbled, unintellible manner. Although this theory has some valuable
insights, it no longer considered valid or practical. Sheldon did his research in the 1940’s. Each research had also been done before
Sheldon even before the turn of the century.
Finally at the end of this
biophysical approach matter, the Psychosomatic (also called Psychophysical)
disorders can be considered. For the
symptoms of these illnesses, no virus, bacteria, dietary reason fungus, protozoa
(ameba), special allergy, toxin, or tumor can be found responsible. Yet it is fairly obvious that the cause of
these sicknesses is simple and straightforward, not due to an illusive,
unconscious, intrapsychic problem. The
person is merely prevented from discharging tension because of repeated
tension-producing situations. The
bottled up energy, caused by constant electrical stimulation in the brain,
eventually brings about an imbalance, and harms some part of the body. Independent personalities do not suffer these
disorders because they almost always find ways to discharge their anxieties,
and they aren’t too worried about other people’s feeling, or what they may
think. On the other hand, persons who
are perfectionistic and ambitious, are the ones who may suffer migraine
headaches, while those who are harboring anger and resentment may suffer
hypertension (high blood pressure).
Certain illnesses seem to favor certain personality types. Just why this happen is still a matter of
investigation. The six most common
psychosomatic ailments are; peptic
Vocabulary: Chlorpromazine, Lithium, Tranquilizer, Antidepressant, Physique,
Speculation, Constitutional, Morphology, Endomorph, Mesomorph, Ectomorph,
Introverted, Restrained, Solitude, Deteriorate, Psychophysical, dietarY, Fungus,
Protozoa, Ameba, Allergy Toxin, Merely, Tension, Anxiety, Perfectionist,
Migraine, Hypertension, Harbor, Peptic Ulcer illusive, Obvious, Delusion,
Grander, Medication, Psychopathology.
Definitions: Synapse—junction where impulses from one
neuron pass to another.
Hallucination—a perception that
has no basis in external reality. “I
hear voices”. I saw a wild water buffalo
in the library reading a book.
Toxic—poisonous.
Delusion—Afalse belief maintained despite objective
evidence to the contrary.
8. Ulcer, colitis,
hypertension, migraine headaches, bronchial asthma and neurodermatitis
Peptic ulcer: an ulcer of the stomach or duodenum. The
duodenum is involved ten times more often than the stomach. The duodenum is the first ten inches of the
small intestine. Very common; One person
in ten will has a peptic ulcer some time during life. It is four times as frequent in men as in
women. It common between the age of 20 and
40, but most common between 45-55. The
stomach juices contain hydrochloric acid.
In this case the overactive nervous system causes an excess secretion
which “Eats up” the digestive tract. The
most important part of treatment is R (Rest) and R (Relaxation) Rest and Relaxation, including tranquilizers and sedatives.
Mucous Colitis: Intestinal colic (cramps),
especially after meals, or after excitement, and passage of large amounts of
mucous in the stools. It is relieved by
relaxation. The colon is the large intestine,
about five feet long. Idiopathic
hypertension: high blood pressure. It affects
one fifth of the adult population. Too
much emotional stress is to be avoided, Familial.
Migraine: a severe headache, sometimes called a sick
headache usually affecting only one side of he head, preceded by an aura. The aura is flickering or flashes of light in
one or both eyes, or merely feelings of apprehension, and sweating. Migraines are likely to begin at puberty and
to disappear after 50. It may run in families,
affecting women more than men. The
headaches may occur every day, or with women once a month preceding menstruation, or as rarely as once a
year. The headache comes because
arteries in the brain and in the scalp fill up with blood and enlarge, producing
throbbing and pain. Many sufferers have
been relieved through psychotherapy and personality modification. Recently, techniques of meditation and
biofeedback (biofeedback is the technique of using monitoring devices to
furnish information regarding an autonomic bodily function, such as heart rate
or blood pressure, in an attempt to gain some voluntary control over that
function. It may be used clinically to
treat certain conditions, such as hypertension and migraine headache.), have
been used to prevent the symptoms and sometimes to get rid of the headaches
altogether.
Branchill asthms:
coughing and wheezing with mucous congesting the air passages,
associated with allergy. If severe, may
lead to coma. Emotional upset can bring
it on. When emotional stress is
involved, psychotherapy may be recommended.
Neurodermatitis: A chronic skin disorder
characterized by itching. It is
associated with allergy and presumed to be psychological in origin. As with the other psychosomatic disorders,
this illness can be relieved, it the patient will learn to manage environmental
stress, and modify harmful attitudes and habits. Tranquilizers and other drugs may also help.
Psychiatrists and other allopathic doctors in Bangladesh
usually are trained in the biophysical approach. However, people especially in the villages
have many choices when they are sick.
They can go to homeopathic, bio-chemic, or ayurvedic doctors, or to the kabiraj,
fokir, manda, or herb (gachanto),
as well as to palmists or astrologers.
In fact many patients are helped by these treatments. This is because they trust or believe in
these doctors. Research shows that if a
patient receives a placebo (fake medicine made of chalk or sugar) from a doctor
he trusts, 20-40% of the time he will be helped. The reason is that taking medicine from a
trusted doctor causes the brain to secrete a hormone called endorphin, a
compound similar to morphine which helps in times of stress. The same thing happens in the brain nitrous
oxide (a pain killer used by dentists) or acupuncture is used. People who are suggestible and submit are
most easily helped by placebos. There
are four ways a person can react in trying to help people use the methods of
modern medicine, for example: in dealing with people using fokirs, when they
are mentally ill. You can fight the fokirs.
In which case, you will end up frustrated and discouraged. You go along with them. That wouldn’t be honest. You can ignore in which case you are avoiding
your responsibility. The fourth way
requires the most maturity and wisdom: you can play the game lightly. By wit and humor, in this case, you can show
the folly of wasting money and time on fokirs.
Vocabulary: Competitive, Psychotherapy, Paranoid, Psychiatry, Clinical
Paychology, Insanity, Mucous Colitis, Bronchial Asthma, Neurodermatitis,
Digest, Duodenum, Hydrochloric Acid, Digestive Tract, Intestine, R & R,
Tranquilize, sedative, Colic, Cramp, Stool, Familial, apprehension, Sweat,
Menstruation, Scalp, Throbe, Biofeedback, Astrologer, Palmist, allopathic,
Homeopathic, Biochemic, Ayurvedic, Wheeze, Placebo, Endorphin, Morphine,
Nitrous, Oxide (Laughing Gas), Acupuncture, Suggestible, folly, Wit, Humor,
Herb, Flicker, Colon.
9. II. The Intrapaychic Approach: It is less scientific than the biophysical
approach. It is based on theory and
speculation. They respect all that the
biophysical scientists have discovered.
However, they believe that the human person is far deeper, complex, and
mysterious, than would seem on the surface.
They do their work in clinical settings rather than in experimental
laboratories. They are referred to as
depth psychologists. As was mentioned
above, they emphasize heredity above environment, but not so much as the
biophysical people. (Freud is the
founder of this approach. Three points
stand out in intrapyschic psychologies: 1) Emphasis on early childhood,
especially from birth though five years; “the child is father to the man”. Adult disorders are direct products of early
events.
2) These unpleasant and unacceptable memories are
repressed and unconscious. Nevertheless,
they are very much alive and can produce much anxiety, the cause of which is
not perceived.
3) When these memories
threaten to emerge, they are warded off or controlled the intrapsychic defense
mechanisms.
To cure the patient the
therapist must search out these underground memories, and discover the
unhealthy defense mechanisms that are being used. When they are properly brought to light they
lose their power.
There are four methods the
depth psychologist use to get to the unconscious
1) Free association: the
patient is asked to relax his usual controls and to verbalize every passing
thought and emotion.
2) Dream analysis: Dreams have
been called the “guardians of sleep”.
Freud in his most famous book, The Interpretation of Dreams (1900)
called dreams, “the royal road to the unconscious”. Dreams are not about future events, rather
they tell the person about himself. At
night repressed fears and desires filter through the patient’s defenses in various
symbolic disguises. Dreams have been
called the forgotten language. He therapist
translates and deciphers the symbolic language of the dreams.
3) Projective tests: the three most well known tests are the
Rorschach (1922) in this test the testee is shown ten cards containing
ink-blots in various designs and asked to imagine what they are. Also called the in-blot test.
b) The TAT, Thematic
Apperception Test (1935—in this test the subject is shown picture card of
social and human situation and asked to tell an exciting story about each
picture. c) Word Association (1905)—the person is asked to speak a string of
words, any words that come into the mind, “tree, bird, sky, earth, sea man,
women, child, dog, etc” on and on for some time. These open—ended tests reveal the unconscious
processes, and yield information about the personality of he client.
4) Transference: Freud
discovered that in the patient/therapist relationship, transference is bound to
take place. This means that feelings and
attitudes which the patient had in childhood toward parents, now are unconsciously
directed on the therapist: love, devotion, respect, hatred, fear, anger. Transference brings these feelings of the
past into the light so that they can be examined. The therapist has done nothing that should
evoke these emotional reactions. Rather
he is supposed to take a passive role in the relationship, neither approving
nor disapproving the person’s attitude or statements. He serves as a blank screen for the patient’s
opinions. If the therapist makes the
mistake of taking seriously the feelings being directed on him, he will
endanger the healing process of the relationship. This is called counter-transference and must
be guarded against and avoided.
Other psychologists have proposed variations of Freud’s
theory. Some of these are Jung, Adler,
Rank, Horney, Reich, Fromm, Erickson, Sullivan and Klein. Although they differ on some of Freud’s
interpretations, they adhere to the intrapsychic approach.
Vocabulary: Complex,
Defense Mechanism, Anxiety, Free Association, Verbalize, Analysis,
Interpretation, filter, Disguise, symbolic, therapist, Decipher, Filter,
Projective Test, Rorschach Test, Ink-blot, Tat, Thematic Apperception Test,
Word Association Test, Transference, Screen, Counter-Transference, Adhere,
Process, Client.
Definitions:
Stress—any condition, biological or psychological, that taxes the coping
capacities of a person.
Syndrome—a group of symptoms, interrelated, and
forming a particular disorder.
Psychotherapy—treatment by psychological methods.
Menopause—period in middle life when menstruation
stops.
10. Sigmund Freud
(1856-1939) is one of the most
controversial and influential figures of modern times. Jewish, he lived in Vienna , Austria
Freud proposed that the
structure of the human psyche has three components; the id, ego, and
superego. The id composed of two
instincts, the life instinct, called the libido, and the death instinct
(mortido), of which the libido plays the more important role. The libido is sexual energy. These two instincts are akin to the instincts
mentioned on page 5, reproduction and self-preservation. They are similar to sex and aggression, and
to love and war. Freud said that for a
person to be happy in life, two things are necessary: love and work. By this he meant the proper channeling and
use of the instincts. The first two
stories of the Bible, Adam and Eve and Cain and Able dramatize these two
instincts.
The id is completely
unconscious to us. It is a primitive
chaos, similar to Aquinas’s prime matter, or to Buddha’s “everything is
burning”. It is like the pure energy produced in a nuclear explosion, where
matter is changed into energy.
Libido is a Latin word,
meaning wish or desire, and in fact the id can only wish. The id operates completely on the pleasure
Principle. The new infant is pure id. No ego or superego has yet been formed. The infant feels that it’s being immortal,
its charms irresisable, and its thoughts and feelings omnipotent.
The ego forms out of the id
because the child learns that in the
real world it can’t have everything.
The pleasure principle
doesn’t work. I see than my immortal
being can be threatened with death.
Looking in the mirror I see I am flawed and not irresistible. The world and people soon show me that I am
not omnipotent. The ego forms in order
to negotiate with the real world, the ego, and superego and draw up a
compromise solution. The ego (which is
really the self) becomes the manager.
The world of the ego is natural, like a jungle, out of control. There is no cause and effect; things just
happen, and anything can happen. The
world of reality, which the ego sees is necessary, is more orderly and
artificial. The ego sees that instead of
a jungle, an orchard or garden is needed in order to live a happier and better
life. The let loose would deal in sex
and murder. With the help of the ego and
also superego, these id energies can be transformed into love and labor. The ego can arrange and learn. The id cannot; it can only wish.
The superego is formed from
the ego, not from the id. It acts as
judge or censor over the activities and thoughts of the ego. It has three functions: conscience,
self-observation, and formation of ideals.
It is the task of the ego to
bring about compromises between reality and the impulses of the id, and between
the impulses of the id and the inhibition of the superego. Failure to do this brings tension and
emotional disorder. The ego tries to
bring about this balance through the defense mechanisms. The id is like a wild horse. The ego is the rider. The defense mechanisms are like the bridle,
blinders, saddle and whip. The id may
also be compared to a blind king whose power and authority are total and
compelling, but who must rely on others to properly distribute and use his power.
The processes of the defense
mechanisms, like the id, are unconscious, that is outside our awareness. Likewise, certain portions of the ego and
superego remain unconscious. Freud
compared the human psyche to a huge iceberg floating in the sea. We only see a small part of it sticking above
the water. Most of it is hidden from our
eyes. Again, he compared the psyche to a
huge river and a dam. The swirling
waters will somehow get through. The
challenge is to control them and direct them so they will produce electricity
to light up cities, and irrigation to produce abundant crops. Hopefully, this can accomplished through the
ego, superego and defense mechanisms.
Vocabulary: Controversial, Psychoanalysis, Hypnosis, Delve, race, Psyche, Id,
Ego, Superego, Libido, Akin, Unconscious, Chaos, Nuclear, Pleasure Principle,
Reality Principle, Irresistable, Charm, Flawed, Portion, Iceberg, Swirl,
Negotiate.
Definitions:
Psyche—soul, self, mind.
Id—the part of the
personality associated with primitive instinctual impulses. Superego—the part of the personality
associated with social prohibition and morality.
11. The defense
mechanisms
are the ways the ego protects itself from internal or external threat or
tension. They manage the drives and
needs of the instincts, and the internal conflicts caused by the
instincts. These mechanisms arrange so
that the needs of the instincts be expressed only indirectly. They are usually unhealthy, because they tie
up and use psyhic energy, which could be used for constructive purposes.
1) Repression: Painful memories and
unacceptable impulses are blocked out, and kept from consciousness. The memories otherwise would be unbearable.
2) Denial: denies the existence of
intolerable thoughts, feeling, or events,
3) Regression: Retreats to an earlier and
less mature style of functioning. The
person is not able to face the anxieties and conflicts of adult life.
4) Fixation: refuses to grow up in
order to avoid the conflicts and challenges of life. Fear responsibility and the loss of security.
5) Projection: ascribing to other people
the unacceptable traits and impulses I refuse to see in myself.
6) Reaction formation: behaving in a way that is
opposite of the unacceptable feeling or desire.
7) Undoing: guilt for the past is
atoned for through symbolic acts.
8) Sublimation: Unacceptable impulses are
channel into socially approved activities.
This mechanism is called the successful defense, and is healthy. It makes civilization, art, and progress
possible.
9) Humor: permit one to focus on
things that are uncomfortable or disturbing.
Humor is the highest of the defense mechanism.
10) Suppression: to postpone dealing with
unpleasant feelings or (healthy) events.
11) Anticipation: planning or preparing
oneself for the future. Healthy.
12) Compensation: undesirable traits are
concealed and overcome by strengthening a more desirable trait, Can be healthy.
13) Identification: Joining oneself with
another person, group, or movement in order to increase feelings of self
worth. Not always unhealthy.
14) Fantasy: Fanciful imagination in
which unconscious conflicts are resolved and unconscious desires are gratified.
15) Rationalization: logical reasons given for
unacceptable feelings, thoughts, or actions.
Used to appease the superego.
16) Displacement: transfers negative
emotions from one object to a more neutral or safe object.
17) Isolation: thought and emotion are
separated to avoid anxiety. It is a form
of intellectualization.
As a rule, defense
mechanisms are an expensive way to operate because of the energy they consume
controlling anxiety and conflicts. As
ego strength and maturity increases, the person can replace these with what is
called interpersonal coping strategies.
These will be described later.
Vocabulary: Intolerable, Atone, Neutral,
Intellectualization, Distort.
Definitions: Defense mechanism—An itrapsychic (unconscious) process employed to
deny or distort discomforting thoughts or emotions.
Illusion—A misinterpretation or false perception of
a real sensory experience. “That was
only thunder, not guns”.
Ego—the division of personality structure which
mediates and resolves conflicts between the instinctual drives of the id, the
prohibitions and ideals of the superego, and reality of the world.
Ego strength—the capacity of a person to cope with
the stresses of life.
Cope—to deal with and overcome problems and
difficulties.
Gene—a submicroscopic unit of inheritance arranged
within the chromosomes.
Frustration—experiencing the thwarting of a desire
or need.
Heredity—genetic transmission of traits from parent
to child.
Hormone—chemical substance secreted by endocrine
glands to stimul at and regulate physiological processes.
Lesion—neural tissue damage due to injury or
disease.
Melancholy—a tendency to experience sadness.
Choleric—inclined to irritability and hostility.
Sanguine—cheerful and optimistic in disposition.
Placebo—an inactive substance given as medicane,
sometimes has beneficial results.
Psychiatry—field of medicane concerned with the
diagnosis of treatment of mental illness.
Apathetic (phlegmatic showing little emotion, calm,
indifferent,
The
Intrapsychic
position on mental illness can be summarized in this fashion: If the id is not sufficiently satisfied in
childhood, that is, if it is frustrated, it remains a driving force (imbalance)
of unsatisfied tension hanging over from early years. There is too much unfinished business. All
pathology, then, is a frustration of the biological instincts. The Id
is strong, while the ego is weak. The
superego also may be too strong for the ego to manage properly. The result is anxiety. Anxiety is apprehension and tension, the source
of which is unknown or unrecognized. It
is free-floating, that is floating around with no object to focus on. This unconscious tension and conflict erupts
in neuroses, such as, hypochondria, scrupulosity, phobias, sleepwalking,
conversion (hysteria), or dejection.
Schizophrenia is said to be a paralyzing of the id. The person has no feeling for a job, people
or life, and finds relief only in daydreaming.
12. Psychosexual Stages of Development
Freud described the stages
of childhood development and how the instincts must be dealt with in each
stage. He called these the psychosexual
stages of development. The stages center
in the sphincter muscles: mouth, anus, bladder.
The first stage from birth to 1.5 years is the oral stage. The libido (sexual energy) finds relief and
pleasure with the lips and tongue by nursing and eating.
The second stage begins in the second year, lasts for one year. Is called the anal stage. Here the parents give the child toilet
training. The child finds satisfaction and
pleasure in learning to control the sphincter muscles of the anus and
bladder. He also finds out this is the
way to please or frustrate his parents.
With this new found power often a battle of wits arises. The third stage takes place in the fourth and
fifth year. It is called the phallic
stage. Here the libido energies center
on the genitals. There is some touching
and curiosity about the sexual organ, and children become aware of the
differences between boys and girls. At
the same time he boy, for instance, will want to possess, his mother, and
becomes the rival of the he father for his affection. For girls the problem is similar; she wishes
to possess her father and sees her mother as the major rival. Freud called this the Oedipal complex. In the Greek tragedy by Sophocles, Oedipus,
the king, kills his father, not realizing his true identity, and later marries
his mother. When he becomes aware of
what he has done, he tears out both his eyes in atonement. Freud considered this third period crucial in
the development of psychopathology.
The next stage is the called the latency period. It begins after the phallic stage, from age 6
to about 12. In this period the child’s
sexual interests become dormant or at least some what inactive. During these years the superego is more
firmly established and organized. The
restrictions and prohibition that his parent have been teaching him are learned
and internalized. So the conflicts now
are not just between his instinctual parents, rather the conflict is between
his instinctual drive and his ideals.
The child’s superego will be modeled after his parents’ superego; in
fact, they will be filled with the same contents. The superego is the vehicle that carries
tradition, values, and ideals of a society from generation to generation.
The final stage is the genital stage. This
begins about 12 and extends through the rest of life. The sexual life awakens again, and the young
person becomes attracted and interested in individual usually of much the same
age.
Freud believed that it is
very difficult to come through childhood unscathed. It is a very difficult and crucial
period. First of all, parents are not
able and in most cases do not know how to deal with the crises of
childhood. Secondly, the time span to
work through the stages is quite short.
When the stage is not worked through properly, the anxieties and
conflicts of that stage will persist into adulthood. This is called fixation or being caught in a
stage of development. In the first stage
trust or mistrust is learned and embedded in the psyche. A person fixated in this stage would always
fear losing support, be cautious, and over cooperative, and unable to face
Vocabulary: Pathology, Apprehension,
Neurosis, Hypochondria, Conversion Neurosis, Hysteria, Dejection, Psychosexual
stages, Sphincter, Anus, Oral, Latency, Oedipal Complex, Phallus, Crucial,
dormant, Unscathed, Genital, Fixation, Embed.
Definition: Genital—Pertaining to the sexual organs.
Innate—inborn.
Neology—systematic classification of pathological
conditions.
Pathology—physical or mental illness.
The
challenges and independence of adult life: In the
second stage the child must learn autonomy.
If this is not accomplished shame or doubt result. According Erickson this period turns out the
adult will and have a feeling of competence or incompetence. Freud believed that a fixation at this stage
results in a person who is too orderly, stingy, and stubborn.
In the third period the child learns initiative or
guilt. According to how he works through
this third crisis, he or she in later life will have an attitude of
self-esteem, or a feeling of guilt about one’s self and about one’s
wishes. Fixation here can result in a
personality who is a bully and an obstructionist. This is, at the same time, the explosive
personality who is vacillating and unpredictable. On the other hand, if the oedipal conflict is
resolved adequately, the child will learn to transform sexual desires into
expressions of affection. The boy will
identify with his father’s masculinity, and the girl with her mother, and they
will channel their struggle into acceptable activities, such as athletics and
social competition. This means, in other
words, that they are handling their sexual and aggressive impulses in a mature
manner.
As mentioned above, beyond
the defense mechanisms, there is a more efficient and healthier way of dealing
with the instinctual drives and the conflicts they generate. This higher order of operation is called
interpersonal coping strategy or the personalities patterns. There are eight of these strategies or
patterns. When, and how, where these
eight patterns are used can be called a person’s life style. A brief description of each of these eight is
given on page 21. Horney (1885-1952) was
born in Germany
13. Later, Theodore Millon developed Horney’s observation into
the eight personality patterns. He
points out that there are four generic types of personalities determined by
where people seek support in order to cope with life. The detached person goes neither to self not
to others for support. The dependent
person goes to others for support. The
independent goes to self for support.
And ambivalent person has inner conflict about whether to go to others
or to self for support. The ambivalent
can’t firmly decide which way to choose, others or self. These four strategies in going toward,
against or away from people for support are either active or passive in their
method. This makes eight specific
interpersonal strategies or personality patterns in all. On he next page is a brief picture of each of
these life styles.
If a person is adaptive, any
one of these strategies can be used according the circumstances in which one
finds oneself. Usually a person will
have one pattern of interpersonal relating which for him feels most comfortable
and advantageous. This is the strategy
the uses he most. Then there will be a
couple of other styles that he uses frequently, and one or two that he only
uses infrequently. For example
disciplined person is serious minded and efficient about his work, but when he
goes to a party he may become like the social personality, talkative and
care-free. If his rights are violated,
he might become tough minded and blunt like the assertive person. Or in prayer he may become quiet and calm
like the apathetic or phlegmatic person.
These eight patterns may be
healthy or unhealthy (pathological). To
indicate what shift takes place, when these patterns become unhealthy, we will
change the name of each pattern: the apathetic-asocial; sensitive-avoidant;
cooperative-submissive; social-gregarious (hysterical);
self-assured-narcissistic; assertive-aggressive; disciplined-conforming
(compulsive); unpredictable (vacillating)-negativistic.
Vocabulary: Autonomy, Competence,
Initiative, Bully, Obstructionist, Vacillate, Adequate, Masculinity, Life
style, Strategy, Personality pattern, Submissive, Arrogance, detached, Generic,
all the names given in last paragraph above.
Definition: Life style—almost the same as personality pattern.
Mood—one’s emotional state.
Brief Scale Descriptions
Scale 1 – Apathetic
Personality: High scorers tend to keep
to themselves, appearing rather quiet and unemotional. They are even-handed, fair-minded and not
easily excited. They tend not to get
emotionally involved with others and do not often feel strongly about
things. They do not avoid other people,
but simply feel indifferent about having others around.
Scale 2 – Sensitive Personality: High scorers tend to be quite shy or socially
ill-at ease with others. These persons
would like to be close to people but have learned that it is better to maintain
one’s distance and not to trust the friendship of others. Although they often feel lonely, they avoid
close interpersonal contact, often fearing rejection and tending to keep their
sometimes very strong feelings to themselves.
Scale
3 –
Cooperative Personality: High scorers tend to be softhearted, sentimental and
kindly in relationships with others.
They are extremely reluctant to assert themselves, however, and avoid
taking initiative or assuming a leadership role. They are inclined to be quite dependent on
others, preferring to let them take the lead and give direction. It is typical of them to “play-down” their own
achievements and to underestimate their abilities.
Scale 4 – Sociable
Personality: High scorers are talkative,
socially charming and frequently dramatic or emotionally expressive. They tend to have strong, but usually brief
relationship with others. These persons
always look for new excitements and interesting experiences. They often find themselves becoming bored
with routine and longstanding relationships.
Scale 5 – self-assured
Personality: High scorers tend to be
quite confidant in their abilities and are often seen by others to
self-centered and egocentric. They
rarely doubt their own self-worth and set in a self-assured manner. These persons tend to take others for granted
and often do not share or concern themselves with the needs of those to who hey
relate.
Scale 6 – Assertive personality:
High scorers are strong-willed and tough minded, tending to lead and dominate
others. They frequently question the
abilities of others and prefer to take over responsibility and direction in
most situations. They are often blunt
and unkind, tending to be impatient with the problems or weaknesses of others.
Scale 7 – Disciplined Personality:
High scorers are very serious-minded, efficient, and rule-conscious persons who
try to do the “right” and “proper” things.
They tend to keep their emotions under check and dislike “showy”
people. They prefer to live their lives
in a very orderly and well-planned fashion, avoiding unpredictable and
unexpected situation.
Scale 8 – Unpredictable Personality: High scorers tend to be discontent and
pessimistic. They often find themselves
behaving unpredictably; sometimes being out-going and enthusiastic, then
changing quickly to the opposite. These
people often feel guilt about their moodiness, apologize to the people involved
but soon are just as moody as ever.
14. There are three signs by which a personality pattern can
be judged unhealthy. The first one is
that the person is inflexible or rigid in using it. The person may be using just one strategy for
most circumstances. For instance a
sensitive (#2) may be so shy, fearful, and quiet that he is not able to enter
into social life at school or even with family and relatives. He is so ill at case with people that he
rarely asserts himself even when he needs something or his rights are
violated. Or a social personality (#4)
is married but bored with the routine of family life. She wastes money on numerous loud saris. She is flirtatious and her husband doubts
whether their child is his son. She
talks about devotions and church, but never prays alone, because she is uneasy
by herself. She seems to have many
friends, but apparently no close relationships develop.
The second feature of an
unhealthy pattern is that it fosters vicious circles. For instance, An arrogant, dogmatic attitude
in the assertive person (#6) will turn his co-workers against him. He in turn will become more scornful and
angry, and say that it only proves you can’t trust anyone. Thus his problems are intensified and
perpetuated.
The third distinguishing
feature of the pathological strategy is lack of stability. The person is fragile. He has weak “ego strength”. So he reverts to the energy-consuming defense
mechanisms.
Here three indications or
signs used to evaluate mental health: a) Reality awareness. The defense mechanisms, such as repression or
rationalization can cause the person to deny or distort reality. The man above declares that no one can be
trusted. b) emotional control. A
cooperative person (#3) will go into a serious depression, for instance, if the
mechanisms of fixation or regression fail to win support. This person will become clinging and helpless
like a child, playing down his talents in order to avoid responsibility. If not supported, they may collapse into deep
dejection. c) cognitive control. Painful though and emotions sometimes are so
strongly repressed and blocked, especially in the sensitive person that his
thoughts and thinking process will be fragmented and disconnected. The person will appear confused and will
ramble in his speech.
If
the tenuous stability of such individuals further deteriorates, the pathology
will go from wild severity to moderate severity. That is, the defense mechanisms will start to
lose control of the instincts and inner conflicts. The pressure of internal and external forces
is becoming too much. Symptoms will
appear. These symptoms will be anxiety,
neurosis, or psychosomatic illness or a mixture of these.
The person suffering anxiety
will always seem on edge, unable to relax, tense, worrisome, irritable,
preoccupied with fears and calamities, and prone to nightmares and
insomnia. He or she will have a poor
appetite, and probably suffer undue fatigue.
Sometimes trivial events will be viewed as devastating and
crushing. This is because unconscious
fears and impulses are breaking through his crumbling controls. Feelings of unreasonable hostility and guilt
are also likely to be part of the picture.
For brief periods of an hour or two the patient’s heart may race, the
breathing quickens, he feels faint, nauseous, chilly and weak, and will
perspire profusely.
In many individuals, when
the coping control and equilibrium are disrupted, neurotic symptoms may
appear. A neurosis is a personality
disorder of mild or moderate severity.
However, the symptoms are dramatic, such as in phobias and conversion
(hysteria). Despite these discomforts
they maintain their internal balance and are able to function in society. Their symptoms enable them to discharge
unconscious anxiety and hostilities, and at the same time solicit attention,
supports and sympathy from others.
Vocabulary: Inflexible, Dejection,
Intensify, Perpetuate, Flirtatious, Scornful, Vicious Circle, Stability,
Fragile, Cling, Collapse, Tenuous, Deteriorate, Sererity, Calamity, Prone,
Insomnia Fatigue, Equilibrium, disrupt, Ramble, Undue.
Definition: Vicious circle—a situation in which attempts to solve problems tends
to perpetuate the same problems and create new ones.
Unconscious—out of awareness; the portion of the
psyche containing repressed memories and emotions that cannot be brought to
awareness except through special techniques such as hynosis and free
association.
Type—classification of persons according to a single
dominant characteristic, for example, sanguine, or extrovert. Each type is made up of many traits: the
traits of a sanguine person are playful, hopeful, easy-going, contented,
etc. The traits of an extrovert would be
lively, active, sociable, impulsive, excitable, etc.
Symptom—a significant sign of an underlying illness,
such as fever, anxiety, weakness, high blood pressure, pain, etc.
Sibling—offspring of the same parents, i.e.,
brothers and sisters
15. As was the
case in psychosomatic disorders, independent personalities
do not suffer neurosis, however, they will suffer anxiety attaches well as
paranoid and sociopathic symptoms if their controls should disintegrate. Likewise, apathetic (#1) personalities do not
suffer psychosomatic illness not neuroses, but they are subject to attaches of
acute anxiety, although not often: and can suffer schizoid symptoms if their
reality awareness or affect weakens.
There six common neurosis:
1) Phobia—strange and irrational fears that the person knows are
absurd, but which must be avoided. The
feared object symbolizes some unconscious anxiety. The person is able to cope with the anxiety
by avoiding the symbolic substitute for the anxiety.
2) Conversion (hysterical neurosis)—bodily symptoms which look like organic
ailments, such as, paralysis of a limb, numbness in some part of the body,
deafness, visual defects, tics, speech defects, and muteness. Like phobias, these symptoms symbolize
psychic tensions.
3) Dissociation—feeling of alienation or estrangement, trance-like states,
somnambulism (sleep-walking), total amnesia, multiple personality. Also called depersonalization neurosis.
4) Obsessive-compulsive neurosis—persistent thoughts which the person can’t got rid
of, absurd or irrational actions or rituals which the person feels he must
perform, self doubts, scrupulosity, excessive need for cleanliness and order.
5) Dejection—self disapproval,
feeling of futility, guilt, and gloom.
Some are irritable and cranky; others will be lonely and discouraged.
6) Hypochondria—persistent and exaggerated concern about diminished health even though
no organic problem can be found. These
people are sincere not pretending. If a
person pretends to be sick, it is not hypochondria; it called malingering.
All neurotic disorders have
two purposes. These are called the primary gain and the secondary gain. The primary gain is to reduce anxiety. The secondary gain is to get attention,
sympathy, and support. Needless to say,
these maneuvers are unconscious.
On a scale or continuum that
measures healthy and unhealthy mental health, three levels of control can be
pointed out. The top level is called
mobilization. Here I am using various of
the eight coping strategies. I am using
my energies efficiently, like a football team on the offense. All is mobilized to get me where I want to
go. My life style is flexible and
stable. Then because of some stress or
pressure in my life, I may begin to use more of the defense mechanisms. This is called the defense level because I’m,
defending myself from external and internal threats or pressure. My pathology here is mild; In fact Freud
called this level the psychopathology of every day life. My reality awareness is only slightly, dimmed
by the defense mechanisms. (Each of the
defense mechanisms deny or distort reality in some way.) Likewise, my emotional and cognitive control
is only slightly diminished, so I can function quite well. If the stress is not relieved, I may begin to
suffer anxiety or neuroses. This is
called the level of dyscontrol. Even
here my pathology is only of moderate severity.
Many people live productive lives in spite of the discomfort of anxiety
and neurosis. However, I will have to
curtail the scope of my activities; my energies are being used a bit
inefficiently and my controls are weakens.
Usually people can maintain themselves at this level. Further deterioration will bring the person
to a condition of marked severity. Here
the dyscontrolis so severe that the patient can no longer function in normal
life. Some of these conditions are
called psychotic disorders which will be discussed later.
Vocabulary: Solicit, Disintegrate, Affect,
Irrational, Schizoid, symbolize, Mute, Tic, Ailment, Alienation, Amnesia,
Depersonalization, Multiple personality, Absurd, Futile, Cranky, Malinger,
Maneuver, Continuum, Mobilize, Flexible, Cognitive, Marked, Dyscontrol,
Psychotic.
Definitions: Affect—feeling tone or mood.
Primary gain—reduction of anxiety through a neurotic
disorder.
Secondary gain—advantages gained through a neurotic
disorder other than reduction of anxiety, such as attention, support, affection.
Amnesia—total or partial loss of
memory.
If
the defense mechanisms of a person almost totally collapse, one of three conditions can
occur. These states are called
schizophrenia, cyclophrenia, and paraphrenia.
The personality patterns have to a large extent decompensated
(deteriorated). The patient has lost
control, and has become a social invalid, and must be cared for like a
child. Reality awareness has become so
weak that cannot distinguish between fantasy and objective reality. Cognitive control is gone; the unfortunate
person displays for the most part irrevelent and bizarre notions, along
oftentimes with delusions and hallucinations.
These conditions are called pathology of marked severity. If the condition continues downward it can reach
a state of profound severity. This is
called the terminal personality because the patient has given up all effort at
self-care and self-determination, and it looks like the fabric of the
personality structure has completely decayed.
The prognosis appears totally hopeless.
These patients must remain permanently hospitalized if they are to
survive. In the conditions of marked
severity mentioned above, the pitiful patients all have a common symptom. This is a feeling of estrangement or
depersonalization. It is like one
sometimes feels in a dream. He is
wandering in a vague and frightening world at the mercy of strange and puzzling
powers. He sees himself as foreign,
strange, and unknown, a frightening creature he can no longer recognize. He stands alone, confused and helpless.
16. Because of this common symptom, cyclophrenic, and paraphrenic patients
are often labeled as schizophrenic.
However, there are differences in their behavior and inner
feelings. True schizophrenics develop
only from detached personalities, that is, the apathetic and sensitive
personalities, #1 & #2.
Cyclophrenics come only from dependent and ambivalent personalities,
that is, cooperative, social, conforming, and vacillating personalities, #3,
#4, #7, #8. Likewise, paraphrenics
emerge only from independent and ambivalent life styles, that is, self-assured,
self-assertive, conforming, and vacillating interpersonal styles, #5, #6, #7,
#8.
If a personality pattern
weakens, say that the sensitive person becomes evident, and the self-assertive
becomes an aggressive person. These
would be called personality patterns of mild severity. If unfortunately these people through the
years become more unstable they will rarely go all the way down to a
personality of marked pathology mentioned above. More often they will remain at a halfway
point of moderate severity, called a borderline personality. These are called schizoid, paranoid, or
cycloid personalities depending on which of the patterns they develop
from. In spite of their fragility and
instability, these patients maintain reality contacts, and albeit poorly, often
manage to function as a member of society. However, as mentioned above, their
fragility required the use of defense mechanisms and these will not succeed in
protecting then anxiety, neurotic disorders, and psychosomatic ailments.
However, their greatest
danger is that from time they will suffer psychotic disorders. These differ from the decompensated
personalities, that is, those of marked severity in that the condition is acute
and not chronic. The patient and the
symptoms look like it is a schizophrenic, cyclophrenic or paraphrenic
condition; however, the psychotic disorders tend to be of relatively short
duration, and not permanent, as the personality of marked severity tends to be.
Based on the symptoms they
display, eight psychotic disorders can show up in pathological
personalities. Each of these will be
briefly described. In the first three
the symptoms look like schizophrenia except that they are passing and not
permanent.
1) Impassivity disorder—withdrawn, lifeless, remain bent-over in one
position for hours. Therefore it is called
catatonic type.
2) Fragmentation disorder—disoriented, confused, unclear as to time,
place or identity. Giggling, peculiar
movements. Word salads.
3) Motor rigidity disorder—clenched fists, gritted teeth, fixed
position: therefore, called catalepsy.
Patient seems stubborn and uncooperative.
Vocabulary: Invalid, Irrelevant, Bizarre, Profound, Terminal, Estrangement,
Vague, Borderline, Giggle, Girt, Catatonic, Catalepsy, Schizoid, Cycloid,
Paranoid.
Definitions: Word salad—an incoherent
jumble of words.
Cyclophrenic personality—a markedly severe
pathological personality developing from dependent and ambivalent coping strategies.
Paraphrenic personality—a markedly severe
pathological personality coming from independent and ambivalent coping
strategies.
Schizophrenic personality—a
markedly severe pathological personality associated with detached coping
styles.
The
next three
psychotic disorders display symptoms similar to cyclophrenic patients. Again the behavior is transitory, and not
like usual state of the person as it is with the styles of marked severity.
4) Retarded depression disorder-—low dragged out speech, seems exhausted,
profound gloom and dejection, guilt for past failures, only a few hours of
sleep at night, dreads the coming of a new day.
5) Euphoric excitement disorder—scattered ideas and emotions,
disorganized, yet exuberant, has zestful energy, jovial mood, humor, can be
mischievous, clever, and witty.
6) Agitated depression
disorder—agitated pacing, wringing of hands senses impending disaster, has a
desperate need not attention, incessant despair, sometimes self-hate, sometimes
demanding and irritable, not relieved by reassurances.
The last two psychotic
disorders look like paraphrenic states.
As with the six disorders described above, these also are passing and
not deeply embedded like the states of marked severity.
7) Delusional disorder: false beliefs, image of superiority and
omnipotence, feels persecuted, suspicious and jealous. 8) Hostile excitement disorder—explosive
rape, will abuse, curse, and attach with fury, sees others as stupid and
contemptible. Usually, tranquilizers are
needed to control these patients.
Infantile autism is a
childhood version of schizophrenia. It
usually begins at birth. Almost always
these infants are attractive and appear highly intelligent. They often learn to walk without going
through the crawling stage. However,
they are completely unresponsive to their parents or other human beings or even
to pets. Rather they give their
attention to mechanical objects, blocks, and various inanimate objects. About half of these children never develop
speech, and those who do learn do not use it for communication. The words “I” and “yes” are difficult to
bring into their vocabulary. They are
insensitive to pain; they are agile and graceful and rarely fall or hurt
themselves. The prognosis is poor;
however, a few have recovered to become gifted composers and
mathematicians. Bruno Bettelheim is
known for his work with these children, especially his book, THE EMPTY
FORTRESS.
17. The final illness to be discussed is the sociopathic
disorders. This group of syndromes is
characterized by a distain for social responsibility and customs, and a lack of
interpersonal loyalty. These people
believe themselves to be above authority and rules. At the same time they know how to wear a
social mask of sincerity and maturity.
They are unwilling or unable to change even when they are caught or
punished. Many of them are unable to
delay pleasure and act without thinking.
They are not concerned about the needs or distress of others, and even
enjoy causing others pain and misery.
Instead of feeling guilt or remorse for hurting others they feel
satisfaction. It seems that the
sociopath instead of controlling instincts, acts then out. The sociopath tends to be a “loner” with no
genuine loyalty to anyone or anything.
This disorder can spring from three personality types. The assertive personality produces the
antisocial sociopath who can be cold-blooded and ruthless. If opposed one can expect raw brutality and vengeful
hostility. The expletive sociopath comes
from the self-assured personality. This
person is not brutal. Rather we see an
indifferent conscience, and a person who is above ruth and social
responsibility. These people leave a
trail of swindling, sexual excesses, cunning lies, and fraud. They have a talent for deception and a total
indifference to the rights of others.
The impulsive sociopath who springs from the social personality is a
thrill-seeker, attached briefly to one thing or person after another. There is a lack of loyalty and gross
undependability. There is no regard for
agreements and when someone is offended or hurt, the reaction is
indifference. These people leave behind
them a trail of broken promises and contracts, abandoned spouses and children,
and frustrated employers.
Vocabulary: Paraphrenic, Cyclophrenic,
Transitory, Euphoria, Exuberant, Zestful, Jovial, Mischievous, Wring,
Incessant, Reassurance, Embedded, Contemptible, Infantile, Version, Ruthless,
Vengeful, Fraud, Gloom, Gross, Cold-Blooded, Agile.
Definitions: Stupor—state of lethargy or unresponsiveness.
Lethargy—heavy drowsiness, lack of energy.
Sociopath—a person who disdains social
responsibility and customs, and lacks interpersonal loyalty.
Rigid—ability to change behavior to accord with
changing circumstances.
Self-image—the person’s conception of his or her own
traits and their self worth.
Jungian psychology offers a
four-stage schema of human development, or individuation as Jung would call it.
Authenticity I Persona
Encounter (Intimacy) Thou Anima-Animus
Creatureliness (Community) We Collective unconscious
Significance
(Religion) God Archetype of God
In the first stage the
person must separate himself from the persona, and try to sense what one is
really intended to be. He must contact
the core of his person, the self that is buried deep inside. These self-discovery results in a genuine
person no longer identified with the persona.
In the second stage one learns to share his or her life in marriage or
friendship, with some other person. One
is brought from isolation into communion. The person finds that his very nature is meant
to be in dialogue. In the third stage
one has the experience of human community.
The person’s eyes are opened, and he realizes that for better or for
worse we are all members of the human race; our life is only a temporary
thing. The person senses the solidarity
of our common humanity, and knows that we are all brothers and sisters. The primitive images of the archetypes speak
to him in a thousand voices about our common origin and common destiny. The person begins to learn compassion and
this frees him form self-absorption in the closed world of self. In the fourth stage, the person is able to
break through the archetype of God. The
primitive archetype of God is a mixture of good and evil, light and darkness,
God and devil. The image is fascinating
and terrifying. In Christianity, when
one meets Christ, he is confronted with a divine person. In the person of Jesus, he begins to see
through the archetype, and now separates the light from darkness, evil from
good. Evil assumes the form of a fallen
angel. Through Jesus we find the God of
goodness in whose light we can walk. In
the psyche a Thou-relationship with God emerges. He becomes the beloved. Jung believed that this process rarely
flowers into maturity before midlife.
Eric Berne, a Freudian
psychiatrist is the founder of Transactional Analysis. Berne
derived his parent, adult and child from Freud’s superego, ego, and id. However, these concepts are by no means
identical with Freud’s, only similar.
Freud’s are much more complicated.
Berne ’s purpose was to speak in a
language that ordinary people could understand.
T.A. is a popular therapy. It
enables people to understand themselves and others in terms of these three
functions. Berne
published his best seller, Games People Play in 1964. Later he wrote two other popular books, What
Do You Say After You Say Hello, and Scripts People Live. The book I’m O.K. You’re O.K. by
Harris is based on Berne ’s T.A. Theory. Berne died
around 1972.
18. III. The
phenomenological approach: It is also called humanistic
psychology. Similar to the intrapsychic
methods in that they do not insist on strictly scientific and empirical data as
the basis for their methods. They
believe that less rigorous methods and notions are appropriate and more helpful
in the early stages of a science. They
believe that environment is more important than heredity, but not to the
extremes we will later see in the behavioral approach. The major distinction between to intrapsychic
and phenomenological people lies in their emphasis upon the unconscious versus
the conscious processes. These people
hold that what a person reports about his inner life and behavior is the most
significant and this report is to be taken at face value. Each individual perceives the world
differently, and therefore reacts differently.
This appreciation of the uniqueness of the individual is one of the main
reasons this branch of psychology avoids theories, and rather than
depersonalize subjective experiences of people into abstract categories, tries
to grasp how events are actually perceived by this person. In other words, they believe that the verbal
statement of the individual accurately reflect what reality is for this
person. Gordon Allport, and American
personologist (1897-1967) strongly influenced the belief that personality is
best conceived as unique and highly integrated system. Rather than work in research laboratories
humanistic psychologists work in clinical settings, in schools as counselors,
for companies and corporations to improve efficiency and satisfaction of
employees, as marriage counselors, in hospital ministry and so forth.
Vocabulary: Authenticity,
Encounter, Creature, Significant, Fore, Absorb, Primitive, Rigorous,
Transactional, Analysis, Unique, Abstract, Subjective.
Definitions: Empirical—pertaining to observable and tangible
events.
Those who follow the
phenomenological approach believe that dissonance is the cause of unhealthy
mental functioning. When a person holds
two beliefs or attitudes that are inconsistent with each other, discomfort
occurs. Dissonance is like two musical
notes that don’t match. This happens
when a person believes or feels one thing is right, and yet does something
else, or when his needs are in conflict with values imposed by others. This causes a separation from self because
dissonance leads to anxiety, and anxiety produces defense reactions which
alienate the person from his true feelings and beliefs, when the person denies
his real feelings he experiences and state of nothingness, a state of inner
emptiness and purposelessness.
These people believe that the really basic human need
is for the person to relate to self.
This makes them different from Freud who said that the heart of the
matter is in the biological urges, that is, the pleasure principle; and
different from Karen Horney who put the prime stress on interpersonal
relationships. They say that pathology
results from a person’s estrangement or separation from self.
Carl Rogors, American, born
1902, is one of the funding fathers of humanistic psychology. He teaches that each person has a
self-concept or self-image. The infant
has a need for love (positive reward).
When this is given by the mother the child develops self-regard or self
esteem. The self-image thus formed
influences the perceptions, memories and thoughts of the individual. Positive regard means the approval and
affection of others. This is necessary to develop a self-regard, which means a
good self- image. Also the self-concept
can be broad and the individual will be open to a variety of experiences;
conversely, a restricted self-image can tolerate only a small range of
experience.
Unfortunately this self-actualizing tendency is a
small weak internal voice that is easily muffled. Rogers
Rogers also explains the problem of the ideal self vs. the self. The ideal self is the person I would like to
be. When the ideal self and self differ
too much from each other, when the gap is too great, then excessive discomfort,
dissatisfaction, and neurotic difficulties will arise. The solution is to learn to accept oneself as
one is. Accepting oneself as one
actually is, not as one wishes to be, is a sign of mental health. The paradox of this is that when a person
does accent himself, then he is able to grow and change, and not-acceptance of
self is an obstacle to personal growth.
The A.A’s simple prayer seems to conceptualize this philosophy: “God
grant us the serenity to accept the things we cannot change, the courage to
change the things we can, and the wisdom to know the difference.”
Carl Rogers founded client-centered counseling, also
called non-directive counseling. In this kind of therapy, he avoids the
doctor-patient relationship. In the
client model of counseling, there is an equality implied. The counselor is an active and significant
person for the client, but the counselor cannot heal. He can only help to create the conditions in
which the client discovers his own powers.
In this kind of atmosphere people are usually able to set their feeling
in order, regroup their attitudes, and reassert their individual
personalities. In other words the client
is the expert and not the therapist when it comes to assessing and directing
his or her own development. The
counselor helps not by giving advice but by what can be called active
listening.
Vocabulary: Inconsistent,
Alie, Ate, Perception, Self-Regard, Intergrated, Serenity, Relate, Model,
Self-Actulization, Disorganiaed, Discomfort, Regroup
Definitions: Dissonance—Attitudes, emotions, and events that are
incompatible
19.
This begins by letting the person know
the he (the therapist) does sense and understand what the person’s inner life
is like. The counselor listens as the person describes his
experience and problems, without evaluating good or bad. In this way the helper becomes present for
the person. This begins to form a
relationship between the counselor and client, and it is this relationship that
heals. This personal experience of real
contact with another human being heals, that is, a healthier and more
integrated person results, precisely because of a healthy contact with another
member of the human race. Rogers
Rogers believes that in
counseling, words like medications must be used with care. Words are to be used sparingly. The person only rarely needs advice. More often what is needed is a
listening. Words are the physician of
the diseased mind, but words from the patient, not from the physician. In other words, the client becomes his own
doctor, “Physician cures thyself.” For Rogers
What happens in the
relationship is different on sympathy or consolation. The listening and response of the
therapist rather be called accurate empathy. Accurate empathy means that I sense the
person’s inner world as if it were my own, and let him know this. The counselor’s reply is usually concrete and
brief. In short it is getting into
another person’s shoes and walking around for a while, totting into another
person’s skin, and letting that person know I know how it feels to be him. Even if I fail, that is, if I am only trying
to understand his meanings, it shows that I value him as a person, and I
believe that his feeling and meanings are worth understanding. Loving our
neighbor means making room for them in life, so that they can find their own
way. It means letting them BE.
Rogers talks about unconditional
positive regard. This is the
attitude that the counselor tries to have for the client. It means that I try to accept that person as
he is, and not evaluating or judging the person. In the to and from of the relationship, the
counselor in a sense become the figure of Christ to the client, that, a person
who won’t strike back. The word respect
sums up the attitude of the counselor toward the client. Rogers
Finally, respect means that the
therapist is willing to work with the client, and believes that the investment
of time and energy is worthwhile. The
word unconditional means that I accept this person as he or she is without
conditions. Good parents love their
children not because they are good or bad, but simply because they are their
children. And this is the way God loves
us, without conditions. We don’t have to
win his love.
To be effective the
counselor must be genuine. I have to let myself be a person—real and
imperfect—in relationship with this individual.
In the relationship the therapist is what he is, without front or face,
openly accept the feelings and attitudes, which at the moment are flowing
through him. The counselor is aware of
these feelings, and is able to communicate them if it is appropriate. In other words he lives in and communicates in
the present moment, the here—and—now. By
living his feelings in the relationship, he comes into direct personal
encounter with the client. If I dare to
be real, the client will usually speak more genuinely. In counseling, one must learn to enjoy
psychological closeness, and be willing to commit one-self to others.
Vocabulary: Appropriate, Precisely
Unconditional, Resourse, Client, Counselor.
Definitions: Self-actualization—the drive to realize one’s inherent potentials.
Attitude—a readiness or
disposition to perceive and react in a particular way to a person, object or situation.
Antidepressive – pharmaceuticals designed to relieve
dejection or depressive moods.
Aura—sensations signifying an impending convulsion.
Detachment—social withdrawal, or self-alienation.
Flight of ideas—skipping for one verbalized but
unfinished idea to another.
Depersonalization—feeling of self-estrangement or
unreality.
Drive—innate or learned forces that prompt certain
behavior and response.
Genuineness: The genuine person is spontaneous, while
being tactful (as a part of his respect for others) assertive without being
aggressive, free without being impulsive.
A person can be genuine and at the same time non-defensive, for example
if the client expresses negative feeling toward him…the client may say, “why
should I be wasting my time coming here?”
The counselor could reply, “You’re the one wasting time, you don’t want
to improve.” Or “That’s your decision.”
Or he could try to understand what the client is feeling: “There has
been no pay off for you here. It seems
like a lot of dreary (boring) work with no results.” He continues to work with the person, rather
than sticking back.
Concreteness: Another of the skills that the
therapist uses, and helps the client to use, is concreteness. A person
speaks concretely when he deals with definite feelings behaviors and
events. Similar to empathy, statements
contain two parts: content and feeling. Concreteness brings intensity and
energy into the session; without it the session becomes boring. “I’m not feeling so good” is vague. “That terrible fight with my wife last month,
the memory seems to fill me with hatred and confusion” is very concrete.
The use of language brings
one closer to or distant from people.
Using the pronoun I is more direct and concrete than using you or
we. “You just wonder what will happen to
these poor children.” What is meant is
“I just wonder what will happen to those poor children." “You feel left out when people ignore you.” Why not say, “I feel left out when people
ignore me. “Or in a homily, “We must learn to trust in God.” “I must learn to trust in God” is more
direct, concrete, and personal.
20.
Questions: Another skill that a counselor uses is
questions. If the counselor has to use
questions, he must use them in. If you
do question, avoid the word why. A why
question puts the client into the past but it is more important to stay in the
present moment rather use the words how, what, where, when, or what
feeling? Instead of “Why did you two
start fighting?, say, “What happens when you two fight?” or How does it feel
when you fight? Or “where do you have these fights?” Also, make questions
open-ended rather than closed questions.
A closed question can only be answered by yes or no, or by a single
definite answer. How many children do
you have? Or Do you live in Nagori?
These questions only have one answer.
“Can you well me something about your family? This has a thousand answers. Closed questions direct the conversation
according to what the counselor wants to hear.
They in some ways tell more about the inner world o the counselor than
the client. Better yet, avoid questions
and make statements. Rather than, “Did
John hurt you? Say, “I have a feeling you were hurt by someone. I would like to hereabout what
happened.” Rather than, “Do you want to marry
Jacinta? Say, “You seem to be worried about whether to get married before you
leave for Moscat. Declarative statements are better than questions.
If the client begins to
ramble and get into long storytelling, it will be well if the therapist
interrupts frequently with lean and concrete responses. These responses will give the disclosure some
focus and concreteness. Good counseling
includes a good deal of dialogue. We have discussed the four counseling skills,
which help the client explore himself: empathy,
genuineness, respect and concreteness.
Before going on I want to
mention a few physical or material realities that can help or
harm counseling, such as the location of the meeting and posture
of the therapist. The place is to be
comfortable, but luxurious, set up for work, not relaxation. Counselors who sit behind desks are not fully
available to there clients. The desk
emphasizes the role of the counselor end the counseling process is to be
role-free. The rule is that there is to
be nothing between the counselor and the person who comes to him for help.
Involvement: The therapist’s posture is a
posture of involvement. It says
to the person, I am available to you.
Face the person equally. Second,
maintain eye contact. This can be done
without staring. Third, maintain
open posture. Crossed legs, or crossed
arms, or closed hands communicate a defensive attitude. Open posture says, “I
am open to communicate with you directly.
Lean
Vocabulary: Encounter, Tactful,
spontaneous, nondefensive, impulsive, Payoff, Declarative, Statement, Ramble,
Lean, Vague, Posture, Role-Free, Impulsive, Stare.
Latent-pertaining to a
disposition that is dormant or inactive. Canglig—a nerve not or knot, most
often located outside the spinal cord toward
the person. This shows you are present,
available, and involved. Slouching shows the opposite. While all this puts a demand on both the
client and oneself, the counselor remains relatively relaxed. The things that I am saying about posture are
to be integrated into your own style.
Don’t think that you have to do it this way all of the time. Just be conscious how your posture does,
affect people. When you practice these
things, at first they will seem artificial, but if you persevere, they will
become natural and become part of your style, just as when you learn to play
football, ride a bicycle or dance. I
also want to mention that the lighting in the room is important. Make sure that the light from the window or
lamp is not glaring in the person’s eyes.
Advanced
Empathy: The second stage of this model leads the client
not only to self-understanding but to behavioral change. This stage also has four skills. The first is called advanced empathy. Here the counselor gets at feeling and
meanings that are somewhat buried, hidden, and beyond the reach of the
client. In the first stage, empathy
looks at what is expressed; advanced empathy looks at what is only
implied. Client: “I’m so sad that my
husband didn’t visit me today.”
Counselor: “I think you’re also a bit angry.” Here the counselor also
picks out themes that seem to run through the client’s presentation; “From all
that you are saying, I gather that there are very few people you feel you can
trust.” He can also piece things
together for the client, or summarize what has been said. This will help the
client to see the bigger picture, and can give the client a different
perspective, and he will see the problem from different angles.
As you can see, this second
stage is more directives. In fact each
of the four skills come form of confrontation.
This stage is a modification and development of Rogers
Self-disclosure: The second skill is self-disclosure. Here the
helper is willing to share his own experience with the client, if sharing it
will actually help the client understand himself better. However, I must be brief and low-keyed, or I
will be upsetting the client, and even laying an additional burden. This person
who has come for help.
In the mid-sixties, Rogers
began to drop “one to one” counseling, and devoted himself to developing
encounter groups, formerly called T-groups or training groups, also known by
such names as sensitivity training, human potential groups, human development
groups. In the encounter groups
self-disclosure received much more emphasis.
One if the devices they use is worth noting. It is called Johari’s window, because it was
created by Luft and Harry Ingram.
Myself Others
|
Known to
|
1
OPEN
|
2
BLIND
|
|
Unknown to
|
3
SECRET
|
4
UNCONSCIOUS
|
Window
No.1 is visible to self and others. It
is the public area. Contains material I am willing to share. Windows No.2 is unknown to self and known to
others. When people confront us, we
learn about this area. Window No.3 is
visible to self and invisible to others.
I know things about me that I may not want you to know. This is the area of self-disclosure. Revealing my feelings and true self is
sometimes called leveling. I love with
you when I take the risk of letting you really know me. I group therapy it is one the main techniques
in self-discovery. Window No.4 is the
unconscious and is invisible.
Self-disclosure
and confrontation often result in a glimpse into the unconscious. It is a bonus and not a goal of group
therapy. Some psychologists, namely, O.
Hobart Mowrer and Sidney M Jourard use self-disclosure as the mainstay of
them. In our model it is used sparingly
and with caution by the counselor. Rather it is a stage in the therapeutic
process, and indeed self-disclosure can release a good deal of healing forces
and resources in the client. Adequate
self-disclosure by the client forebodes well for the outcome. However, self-disclosure on the part of the
counselor is sometimes not helpful.
Sometimes it will frighten the client.
So care must be taken in using it.
The third skill in this second stage is confrontation. It is to be used in a caring way, and is not
an attack or punishment imposed on the client.
Confrontation is an invitation to the person to examine his or her
behavior and what it means. For example,
“Jacinta, you see yourself as an assertive person and good organizer. And it is true people admire you for it. But sometimes when you tell me to do things I
see you as pushy and demanding.
Confrontation can help a person recognize his unused resources. “John, when you speak there is almost always
an edge of hostility in your voice. Yet
I see you as a person, who is always for others, a person who wants to
help. Maybe you are also afraid of
tenderness and closeness.” This skill can show the client a different frame of
reference for viewing self, others, and the world. “Education is much more than grades and
degrees.” or “Life can be seen as a challenge, rather than just pain and
suffering.” or “You seem really sarcastic, not just witty.” or “You are afraid
to act, rather an unable to act.”
Confrontation helps people to explore area they would rather not look
at. “So far you have told me nothing
good about your marriage it might be helpful at his point to examine some of
the positive aspects of your marriage.”
Eric Berne’s T.A. is method of confronting people with the fact that they are playing
games rather than facing life. In stage one; the counselor can create an atmosphere in which games are not easy
to play. For example, if he has avoided
giving advice. Giving advice is often a
sure way to start game-playing.
Confrontation is different from advice because like advanced empathy it
comes from a deep understanding of the person’s feelings, and from an
involvement with the person.
Confrontation makes demands
on the client. However, the therapist
does this by confronting not the weaknesses of the client, but by confronting
the person’s unused strengths, capabilities and resources. The counselor must sense when to challenge, when to
unmask, and when it will do no good. Some counselors hesitate to respond in any
negative way to the client. As a result
their effectiveness is watered down.
Like most people they don’t like to give bad news. It is often strong medicine for the client to
take; yet counseling is a process in which the client is confronted with those
areas of life in which he is living less than effectively. It is the job of the counselor not to force
the client, but to help him to a caring way to take this medicine.
Immediacy: The fourth and final skill is
immediacy, or direct mutual talk, also called you-me talk. The helper and helpee discuss about what is
going on right now in their relationship, lack of trust, too much dependency,
liking or disliking, attraction, distance or closeness, their different styles
in relating (organized or free and easy) etc.
People seeking counseling usually present a wide variety of
complaints—depression, anxiety, sleeplessness, boredom, physical symptoms,
failure experiences, etc. But no matter
what the complaint, that fact emerges that they are also having trouble with
interpersonal relationships. The skill
they need to explore interpersonal relationships is called “direct mutual
communication” or immediacy. It is he
ability to discuss directly and openly with another person what is happening in
the here-and-now of an interpersonal relationship.
Vocabulary: Adequate, Forebode, Pushy,
Resourse, Hostile, Tenderness, Frame of Reference, Sarcastic, Atmosphere,
Unmask, Water Down, Boredom, The Here-and-now.
Definitions: Serendipity-the art of accidental discovery.
Resistance-opposition to therapeutic efforts, especially
a defense reluctance to explore repressed material.
Remission-a period of significant improvement
following a pathological condition.
Erotic-pertaining to sexual impulses.
Delirium-a markedly confused state characterized by
excitement, incoherence, and disorganization; illusions and hallucinations
often present
Catharsis-recalling and describing painful
experiences, and venting associated emotions.
21. The purpose of immediacy is to help the client
understand himself more clearly, especially what he is doing in the here-and now of the counseling
interview. By observing the counselor
the client can learn to use direct mutual talk in his relationships outside the
counseling sessions. As a matter of
fact, direct, personal, mutual communication, although it has great potential
for stimulating interpersonal growth, is quite rare in everyday life. Hopefully the client will learn that it can
be growth-producing both to be told how he is being experienced in a
relationship, and to tell another how he is experiencing him in a
relationship. Again since this mutuality
does not happen often in everyday life, it is usually a new and quite demanding
experience for the client. Therefore, it
must be used with care, or it may frighten the helpee. For example, “I get the feeling that it is
still hard for you to talk to me—as if you’re still wondering whether I’m on
your side.” or “I’m beginning to feel that you don’t trust me. It makes me feel as if my hands were
tied. I’m not sure whether it’s herd for
you to trust anyone or whether you have a special problem with me.” or “I am bit nervous saying this, but I feel
that it’s hard for you to admit to yourself that you might need a little help
at this point in your life. I feel you
are fighting me—or maybe just fighting being helped. And so we’re going around in circles.” or “We
seem to be out of contact with each other today. Maybe we should talk about what’s going on
between us.” Immediacy is not an end in itself.
It is employed from time to time whenever it is seen useful to “process”
a relationship. Especially, in times of
stress and when the relationship seems empty, or aimless and directionless, the
counselor and the client should engage in direct mutual communication.
The third stage in this
model is an action program for constructive behavior change. The problem is identified and clarified. If there are a number of problems a working
priority is established. Concrete
workable goals are decided upon.
Effective means are chosen, those that have the highest probability of
success. Establish criteria by which
success or failure can be evaluated. The
ultimate criterion for judging the process is whether or not it actually does
help the client to change.
Under the phenomenological approach there are various
other popular therapies. Gestalt Therapy
was founded by Fritz Perls
(1893-1970). This therapy stressed
confrontation. It is done in small groups
like many of the contemporary therapies.
Perls defined mental health as self-support and self-regulation, rather
than being controlled and supported by one’s environment. During the sessions
he develops self-awareness in the participants.
He insists that they stay in the here-and-now, that they focus on
becoming aware of their present experience, rather than dealing with the past
or future. His little saying or poem
tells a great deal about what he is trying to do and what he considers
healthy. He calls this the prayer of
Gestalt Therapy, “I do my thing, and you do your thing. I am not in this world to live up to your
expectations, and you are not in this world to live up to mine. You are you and I am I, and if by chance we
find each other, it’s beautiful. If not,
it can’t be helped.”
In his sessions Perls would
act as a skillful frustrator to help the person see how he or she is
consistently avoiding awareness, playing roles, living in the past and so
forth. He places great stress upon the
feeling aspect of the situation. He
speaks about the “wisdom of the organism” which is based more in emotion than
in the intellect.
Psychodrama is sometimes used in these various types
of group therapy. It was invented by
Jacob L. Moreno who used it in 1920, in Vienna ,
Austria America
Vocabulary: Helpee, Aimless, Mutual, Priority,
Probability, Criteria, Consistent, Migrate, Purge, Obsolete, Confidential,
Feedback, Organism, Ineffective, Catharsis.
Abraham Maslow, (1908-1970) another of the humanistic
psychologists, developed what he calls Self-Actualization Psychology. Maslow, like Rogers
Self-actualization means the
full use and development of one’s talents and potentialities. Maslow had two teachers who were deeply
fulfilled and creative both in their private and professional lives. He kept a notebook filled with date about
their attitudes, values, motivation, emotions, thinking, perceiving and so
forth. Although the man and women had
very different personalities, he found they were similar in many ways. He added sixteen more of these very
self-actualized people to his study.
Half were historic and half were contemporaries. They included Abraham Lincoln, Eleanor
Roosevelt, Ablert Einstein, Albert Schweitzer, and such like.
He discovered fifteen characteristics of
self-actualizers. Some of these are:
acceptance of self and others, simplicity and naturalness (spontaneity),
problem centered rather than ego-centered, detachment (need for privacy),
independence of culture (autonomy), continued freshness or appreciation (the
feeling of wonder), mystic and peak experiences, the feeling of kinship and
union with others (community), deeper and more profound interpersonal
relationships, democratic in outlook, discrimination between ends and means and
between good and evil, philosophical sense of humor, creativeness, resistance
to enculturation (transcendence of any particular culture). Maslow believes that for psychological
health, certain basic needs must be fulfilled.
These are five in number: physiological needs (hunger, sleep, and so
forth), safety needs (order, stability), love and belonging needs (family,
friendships), esteem needs (self-respect, recognition), self-actualization
needs (development of capacities). The
earlier needs must be fulfilled first and then the higher needs emerge.
22. Viktor Frankl from his traumatic experiences in Nazi
concentration camps created Logo therapy.
Here the relationship between the patient and therapist, characterized
by mutual acceptance and self-revelation, enable the client to discover
authentic meaning in existence. Frankl
used the paradoxes and suffering of life as a way of discovering self-meaning and
purpose. He teaches that what people
need most of all is a goal in life. They
don’t need to be freed from suffering but need something to suffer for. What
happens to me makes no difference; what count is the way I accept it; it is not
the conditions of life that make the difference, but rather the decisions one
makes. Humans are self-determining; what
they become is what they make out of themselves. This type of treatment is called existential
therapy. Rollo May is another well known
and influential exponent of this approach, although his terminology and
philosophical emphasis differs. From
Frankl.
Another kind of therapy
which is phenomenological is the confrontational directive type. However the underlying philosophy differs
sharply from Rogers, Frankl or Maslow.
Patients are viewed to be inept, irresponsible or sick, and therefore
unable or unwilling to choose the course they must take for their own
well-being. The therapist not only
assumes full authority for deciding the objectives of treatment, but confronts
the patient with the irrationalities of his thinking; moreover, he employs
commanding tactics to indoctrinate the patient with a value system that is
considered most beneficial. The
therapist tries to instill positive thinking and selfless altruism. In the Reality Therapy of William Glasser,
and the Integrity Therapy of O.H. Howrer, it is assumed that
Vocabulary: Virtual, Pioneer, Peak
Experience, Kinship, Capacity, Exponent, Paradox, Inept, Tactic, Indoctrinate,
Instill, Altruism, Integrity, Terminology.
Definitions: Case
history-all available biographical data that facilitate the understanding of a
patient’s current state.
Cardiovascular-pertaining to
the circulatory system (heart and blood vessel.
Blocking-involuntary
interruption of a train of thought or speech.
Allergy-hypersensitivity of
body tissue to physical or chemical stimuli.
Discrimination-the ability
to detech differences.
Patients are sick because
they are irresponsible. They are as it
were under socialized because they have failed to adhere to the rigid
moralistic standards of society. Their
anguish stems not from too much guilt, but from an unwillingness to admit
guilt, sin and responsibility. The task
of therapy is to confront the patient with his past misbehaviors and
irresponsibilities and make him confess his wrongdoings. He can then rectify past mistakes and find a
more moralistic and responsible style of life.
By facing reality the person regains self-integrity.
Another well-known
confrontational type therapy takes and opposite stance from the outlook of
Mowrer and Classer. Albert Ellis the
founder of Rational—Emotive Therapy believes hat people are too harsh on
themselves and tend to blame and judge themselves more severely than
necessary. Ellis finds that many people
have unrealistic and illogical thinking, and self-defeating beliefs. For example he is constantly telling himself,
“It is necessary to be loved and approved.”
or “To be a worthwhile person I must be thoroughly good and
competent.” or “I am no good and deserve
to suffer.” The principle goal of
therapy is to destroy these beliefs and negative thinking, and to free the
person from irrational shame and guilt so that the person can learn to live
life fully despite social obstacles or the disapproval of others. For example, he learns that not everyone has
to like him, or it’s OK not to be perfect.
Family Therapy has become
popular because of increased awareness that the interlocking attitudes and
behaviors of a family can be healthy or unhealthy. The therapist brings several members of the
family together, explores major areas of conflict, and exposes the destructive
behaviors that have perpetuated their difficulties. The therapist clarified misunderstandings,
dissolves barriers to communication and neutralizes areas of prejudice,
hostility, guilt, and fear. Virginia
Satir is known for the research and teaching she has done to encourage and
develop family therapy. Her work has helped many families to explore healthier
patterns of relating, and to develop new and more wholesome attitudes and
behaviors among husband and wife, parents and children, and all members of the
family.
Marriage Encounter is a type
of family therapy popular with Catholic couples. It is meant primarily for the husband and
wife so that they can develop and deepen their relationship. They meet regularly in small groups to
discuss their married life, and to support one another in difficulties. Often a priest is their facilitator.
IV. The behavioral approach: This is also
called Learning theory. The therapy is
known as behavior modification. Rather
than trying to change global attitudes, or to reconstruct the patient
personality, behavioral psychologists work on changing specific behaviors. They tend to look at the human organism as an
unopened box which is controlled by environment. Therefore, it is unnecessary to look inside
and try to change structures and rebuild foundations as the intrapsychic people
try to do. They distrust feelings, the
unconscious, anything subjective. Repair
rather than reconstruction is all that is necessary. Therefore behavior alone is studied. Like the biophysical people, they insist on
the objective approach, measurable evidence, exactness, clarity and facts. In this system there is no self,
Vocabulary: Anguish, Stem, Interlocking, Perpetuate,
Clarify, Neutralize, Global Moralistic, Barrier, Obstacle, Illogical,
Unrealistic, Organism, Reconstruct.
Definitions: Biophysical level-Data and concepts about the
biological causes of psychological functioning.
Intrapsychio level-data and concepts about processes
that take place beneath the level of awareness.
Phenomenological level-data
and concepts about the observable response and actions of patients.
23. Biophysical
treatment-pharmaceutical, electrical, and surgical methods employed to alter the biological
causes of behavior, emotion, and thought.
Intrapscchic therapy-therapies designed to make the
patient aware of his unconscious drives and conflicts, and to alter them so as
to reorganize the person’s personality.
Phenomenological therapy-therapies help to redirect
the person’s self-defeating attitudes toward life.
Behavioral modification-therapies based on learning
theory, used to change behavior rather than subjective feelings or unconscious
processes.
No ego, no personality. The goal is to predict and control
behavior. Behaviorists traditionally
work in laboratory settings with animal subjects. Influenced by Darwinism, they assume that
humans do not essentially differ from other animals. B. F. Skinner, born 1904, is considered he
most influential American psychologist.
He did experiments with rats, Pigeons, and dogs. He found that animal behavior can be
predicted and controlled completely.
Skinner believes that humans are only more complicated animals. Therefore, by creating the proper
environment, an ideal society can be produced.
For him free will, freedom, responsibility, dignity, are fictions of the
mind. Everything can be explained by the
external events (environment), which control the individual. He admits that if there were free will,
prediction and control would be impossible.
Until the coming of Skinner,
behaviouristic psychology was based for the most part on of Ivan Pavlov, the Great
Russian physiologist (1849-1936). By
experimenting on dogs, he demonstrated the conditioned reflex or learned
response (the salivation of the dog), and the conditioned stimulus or learned
signal (the bell). This is called
response conditioning. The actions that
you do automatically, things you have learned to do without thinking, are
conditioned reflexes. These are your
helpful habits, such as putting your foot on a brake, latching your door as you
go out, catching a basketball, typing, eating with a fork or hand, and so
on. Because of Skinner’s research and
writings, grater emphasis has been given to operant conditioning. Here the stimulus comes after the behavior
has occurred, in the form of positive or negative reinforcement. If I give a poor man Tk. 100, this is
positive reinforcement for him to return again.
If a student receives a 20 on a quiz, this is negative reinforcement for
spending every evening socializing with his friends.
William of Ockham, the
English Philosopher of the 14th century taught that reality should
not be multiplied with necessity. In
other words the simplest solution is the true solution. In that case the behaviorists win the
day. With a small number of concepts,
that is, response conditioning, operant conditioning, and reinforcement they
attempt to answer all the questions of psychology. They, of course have been accused of
oversimplifying the complexity and variety of human nature. Not all behaviorists are as extreme as
Skinner, and there is much more to be said about this approach. As a therapy, behavior modification is very
effective, and the principles and methods are used to some extent by all
psychologists. In fact, these are
methods which all parents use to raise their children, as all educators use to
run their schools and classrooms.
Skinner believes, or rather
he demonstrates that reward improves learning, and directs behavior toward
goals. Punishment on the other hand,
informs the person what he should not do, rather than what to do. At the same time punishment does not do away
with behavior; it only causes these behaviors to return in a disguised
form. Punishment in fact is a major
obstacle to effective learning. This is
why prisons do not reform prisoners. In
behavior therapy the symptom is the disease.
No underling physical cause, emotional, mental, or unconscious cause is
sought. Whether it is smoking, drug
problems, drinking, phobias, sociopathic disorders, hypochondria or so on, it
is the behavior that is worked on, and not underlying physical or mental
causes. Either maladaptive behaviors are
eliminated or desired behaviors are formed, or both.
A method called
desensitization has been developed to cure fears and phobias. The person is taught a technique of relaxing
all the muscles of the body. Then he is
asked to imagine the thing or situation that is feared, and if the muscles get
tense to relax them. Since fear and
relaxation are incompatible, the fear reaction is eliminated. (Pease get on this Topic from internet and
other books and present elaborately)
Pure behaviorists like
Skinner will not consider emotions or mental processes. Instead of saying “He is angry”, they will
say “He shouted and struck the man with his fist.” Instead of saying, “He is intelligent”, they
would say, “He is reciting Tagore from memory.” or “He is solving a difficult
mathematical problem.” Values are also
described by behavior. Reading many
books would describe my value for reading.
Paying just salaries and establishing cooperatives would describe one’s
value for social justice. Praying every
day would tell about one’s value of prayer.
Vocabulary: Fiction Reflex, Saliva, Reinforcement,
Desensitize, MaladaPtive.
Definitions: Conditioning—a process or learning in which a response is elicited by
a stimulus that formerly did not elicit that response.
Stimuli—events that impinge
upon an organism
Reinforcement—any condition
that alters the strength of a response.
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LIFE STAGE
|
TASK
|
CRISIS
|
|
(1)
Infancy (birth-2)
|
Social attachment |
trust/mistrust
|
|
(2)
Toddlerhood (2-4)
early
childhood
|
Locomotion, Speech, Self-control |
Autonomy/shame
or doubt (fooling of Competence or incompetence)
|
|
(3)
Early school age (5-7) middle childhood
|
Locomotion skills, sex identification (how it feels to be a boy/girl) |
Initiative/guilty
(feeling of self-esteem or guilt about one’s self wishes)
|
|
(4) Middle school age (8-12) late childhood
|
Group play (sports)
First
friend skills of culture (fishing, farming, cooking, writing.)
|
Industry/inferiority (attitude toward work)
motivated to achieve or not to try.
|
|
(5) Early adolescence (13-17)
|
Membership in peer group, physical maturation (Sexual awakening). |
Group identity/loneliness (feeling of belonging or
of alienation, social isolation).
|
|
(6) Later adolescence (18-22)
|
Autonomy from parents, career choice, internalized morality, financial independence. |
Individual identity/identity confusion (feeling of
a place or role in the community, or confusion).
|
|
(7) Early adulthood (23-30)
|
Marriage, childbearing, work (career development), life style, social living. |
Intimacy/isolation (feeling accepted or alone,
socially component or incompetent.) doubts about choice.
|
|
(8) Pre middle age transition (30-35)
|
Re-evaluation, re-dedication, re-commitment (dealing with the long road ahead) in regard to one'’ career and promised to others |
Renewal/resignation FEELING of new life or
weariness and desire to quit (divorce, resign)
|
|
(9) Pre-middle age (36-50)
|
Mid-life evaluation, children leave home (the empty nest) menopause, changes in relationship with spo Use, involvement beyond one’s family. |
Achievement & meaning in social
living/incompetence and meaninglessness feeling of strength and purpose or
loss of nerve or direction.
|
|
(10) Middle age Middle adulthood (51-65)
|
Service to the human family confrontation with personal mortality, winding down no’s career, resolving conflicts (mellowing) relying on cognitive rather than physical skills to be committed to improve life conditions for future generation. |
Generativity/stagnation, lasting commitment
through involvement with others/self-centered stagnation, (involvement in
community service, teaching, advising, experiencing all people as one’s
brothers and sisters or self-centeredness..
|
|
(11) Later Adulthood (65-death)
|
Increased dependence on others, evaluation of one’s life, dealing with the death of others and own death dealing with aging and illness, capacity to say goodbye and grieve re-directing one’s energies (grandparent) accepting one’s life. |
Integrity/despair feeling that one’s life has
meaning and worth or despair, retaining zest for life, or discouragement and
gloom (bitterness). A sense of compassion rather then self-righteousness in
spite of failures and disappointments life makes sense.
|
1) LIFE STAGES—specific periods
or age—spans in the life—cycle—usually defined chronologically but sometimes
determined by psychological or biological onsets.
2) IDENTITY AWARENESS—emergent
self—definition which results after each growth crisis.
3) PSYCHOSOCIAL MODE—major
themes in human interaction. Principal
way of “being” oneself in the world.
4) BASIC VIRTUES—human
strengths that vitalize and animate—the “soul” of the organism likely to
characterize life at this specific point.
5) RADIUS OF SIGNIFICANT
RELATIONSHIPS—persons who form the major focus of interpersonal relationships.
6) NUCLEAR GROWTH CRISIS—“stage
appropriate” or “phase specific” life concerns that emerge at given life
stages. A necessary turning point when
development must move on. A favorable
ratio is important to healthy growth.
Stages of
Moral Development
Our
spiritual life passes through
definite developmental stages. Not many
people reach the highest stage; that of fully internalizing Christ’s message,
the stage which St. Theresa calls the seventh mansion, in which the soul has a
special kind of knowledge which sees things clearly and simply and realizes
what they actually mean. But, sadly,
many adults who are capable of living a more mature, satisfying, spiritual life
are content to remain at immature levels of development.
The stages are not easy to
describe precisely. Each reflects a combination of ideas, attitudes and decisions
which represent a band in the broad spectrum of spiritual growth.
EXTERNALIZED RELIGION—The
motives for acting are outside one’s self.
Level 1 – The motive is pain or pleasure which someone or something gives us.
Stage 1: People act out of fear of punishment.
Stage 2: People act because they are seeking a reward, pleasure.
Level 2 – The motive is conformity or conventionality.
Stage 3: People do things because
they want others to think well of them, to accept them.
Stage 4: People do things because of the law.
They follow the law and maintain it but accept no responsibility for it.
INTERNALIZED RELIGION – The
motives for acting are one’s own. They
come from the heart.
Level 3 – The motive is an internal principle by which we judge our actions.
Stage 5: People begin to be involved in making decisions for themselves. They accept personal responsibility and make
personal commitments. This is the
contractual stage, in which people still see the need for law, but it is no
longer absolute. They believe it can be
changed in certain circumstances and that their behavior is guided by contracts
they make with others.
Stage 6: People live out their principles.
For the Christian, the central principle is that of charity, which
directs all his actions, influences his ideas and attitudes. Belief and action become one.
|
Faith/Joy
before decrease & death vs. miserliness
|
SELF
RESPECT vs. self negation
|
Openness
vs. rigid adherence to past
|
Wise
expression vs. self defeat
|
Inna
meaning vs. failing ability & lost meaning
|
Mutual
support vs. selfish demanding
|
Courage
& trust vs. titter negation of life
|
Ego
integrity vs. despair
|
UNI???
ENPRESSIVE INTEGRAED
|
|
Calmness
vs. defensiveness
|
Self
assertion vs. fear of risk
|
Creativeness
vs. repetition
|
Perseverance
vs. discouragement
|
Values
vs. fluctuating emotional needs
|
Sharing
vs. using
|
Generativity
vs. stagnation
|
INTEGRATIVE
QUIET CONTEMPLATIVE HOSPITABLE WAITING
|
|
|
hope
vs. bitterness
|
commitment
vs. vacillation
|
self
expression vs. the acceptable
|
Interpersonal
striving vs. manipulation
|
Decision
vs. sentimentality
|
Intimacy
vs. isolation
|
RELATIONAL
VITAL LIEF-GIVING EXPANSIVE
|
||
|
Curiosity
vs. familiar
|
Independency
vs. dependency
|
Exploration
vs. Security
|
Self
development vs. extrinsic evaluation
|
Identity
vs. role confusion
|
INDIVIDUAL
LISTENING RESPONSIVE ADJUSTING
|
|||
|
Open
to experience vs. need to succeed in crowd
|
Competitive
striving vs. non-involvement
|
Leading
vs. following
|
Industry
vs. inferiority
|
VOCAL
SHARED COMMUNITY ADAPTIVE
|
||||
|
excitement
vs. fear
|
open
to fail vs. need to be accepted
|
initiative
vs. guilt
|
|
|||||
|
acceptance
vs. non-acceptance
|
autonomy
vs. shame and doubt
|
FORMAL
STRUCTURED FIXED MEDITATIVE
|
||||||
|
basic
trust vs. mistrust
|
|
|||||||
posted by Johnastine @ 00:27
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