Abnormal Psychology Lecture Notes

2/1/99

Psychoanalysis

-formation of symptoms is due to anxiety –allay the anxiety

1900 to today à change in definition of psychoneurosis

predominant theme à difference in treatment over the century

-1900’s psychoanalysis as major form of treatment

-middle of century advent of minor tranquilizing drugs; can manage symptoms

Changes in kinds of neuroses:

1. neurasthenia à diagnosed in women; weakened nervous system; fatigue
2. success neurosis (1950’s-1960’s) à work is begun but not completed
3. neurotic depression à anxious, hostile, angry, depressed, not likely to be suicidal
4. existential neurosis (1970’s) à common in college students during Vietnam war, alienated, disillusioned, bored, confused, uncertain about life and death and identity, mild depression

-these neuroses are very rarely diagnosed today; shows how certain syndromes appear and disappear during different times

As with PTSD, change in symptomology; shift between WWI and WWI: greater understanding of nervous system, distinction in psychiatric community

Diagnosis goes with the times – determined by what someone will diagnose = what good is the diagnosis if it isn’t stable over time?

Psychoanalysis kept everything in a small theoretical framework – everyone thought the same thing

Psychoanalysis:

• psychic determinism
• abnormal behavior is not random: no discontinuity between normal and abnormal
• have to decode through psychoanalysis
• neuroses are defenses against anxiety (primary gain)

topology of personality

super | ego

________ |___________________________

|

ego | id

superego is both conscious and unconscious

ego is conscious

id is unconscious

superego is the conscience

originally said that id functioned under pleasure principle (Eros)

WWI – changed due to emergence of PTSD – trauma could influence the system (adult as well as childhood) – had to look at the nature of the trauma

Now added thanatos – death instinct; seek pain and death

Superego punishes with guilt and propensity to die

Filter between id and ego to allow ego to see actions of the id – changes the structure of the forces = defense mechanisms (primary gain to allay anxiety)

All id at birth -> ego -> superego

What happens if you don’t develop a superego and conscience? Unremorseful, little anxiety, antisocial

Examples of defense mechanisms:

1. repression – component of all defense mechanisms

-hiding the problem to avoid distress

2. projection – places the thought on someone else
3. displacement – transfer of emotional content from one person to another

-frequently occurs in dreams – can’t focus on the actual object so focus on something else that will allow the emotion

4. rationalization à socially acceptable reasons for irrational acts
5. reaction formation à one does the opposite of desires
6. isolation
7. intellectualize
8. undoing
9. identification
10. sublimation à transform socially unacceptable impulses to acceptable ones

****these are all unconscious acts ****

Psychosexual development:

-at birth, primary sensual focus is oral à analà phallicà latentà genital

-regression: going backwards

-system of designating personality characteristics

Criticisms of theory:

1. based on limited population of patients à Viennese people, rich, Victorian morality
2. not representation of contemporary times
3. suggestion that children fantasized seduction by adults – wavering on whether it was sheer fantasy or actual occurrences

2/3/99

Dissociative and somatoform disorders

dissociative: theoretical viewpoint

somato (body) form: description

conversion reaction à psychoneurosis in dramatic form

• neurological nonsense
• doesn’t occur when the person is distracted
• ex. sudden blindness in non-typical way; nothing is neurologically wrong
• ex. tunnel vision – only 2 cases recorded actually due to brain injury

- disorder appears rapidly

• person is less concerned about the disorder than the people around them = "la belle indifference"
• deals with magnitude of primary and secondary gain à secondary is very strong
• resistance to treatment is great

Video:

multiple personality disorder à 2 or more different, separate personalities with separate memories

• example of a dissociative disorder

First patient à one personality was soft-spoken, sad, innocent; was raped while her mother was passed out drunk; second personality showed discomfort with men, angry, loud, onlder-sounding

-some clinicians deny the authenticity of MPD; more common now than the 1920’s – you have some clinicians willing to make the diagnosis

Note that alter (other personality) can be evoked by psychiatrist (iatrogenesis).

primary personality à other personality – primary personality has no memory of activities while under another personality, reports time gap