Psychology 2316: Personality Notes from Comer (2014), 8 th edn 1

Chapter 1: Abnormal Psych Past & Present We know the problem is in the mind Think of the terms: crazy > maladjusted; abnormal; mental illness Known about since ancient times Famous people Part of culture 2

Louis Wain

Abnormal Psychology Studied by clinicians Clinical practitioners – professionals who see patients (pts) Assess – Diagnose – Treat Psychiatrists (MDs) or psychologists (PhDs) 4

What is Abnormal ? This is controversial Comer uses the 4 Ds: deviant, distressing, dysfunctional, dangerous Deviant – different – maybe strange Distressing – pt is uncomfortable Dysfunctional – prevents pt from living “normally” Dangerous – may/may not be case - harmful 5

Deviance Society & norms What are the rules ? Customs ? Traditions ? Culture & sub-cultures (Goths, punks…) Context –time & place  Everything can change  Specific situations – especially stressful; trauma 6

Distress Does the behavior create a problem ? No problem > beh may continue If distress > pt may seek help 7

Dysfunction Someone unable to live, work, communicate, have relationships, enjoy life…etc Some may live differently from us, but not be mentally ill 8

Danger Harm to self, others Violence, etc This danger state is rare – but newsworthy 9

Abnormality Szasz – mental illness is a myth > coping mechanism Issue is social control Certain beh not abnomal, but common > binging on etoh The right to be eccentric – cat ladies Us ??? 10

Treatment Treatment Tx Focus of therapy – curb the beh, symptoms (sx) – does that help ? J. Frank – basics of therapy A. pt & clinician B. clinician a professional C. helpful contact for the pt 11

disagreement Clinicians disagree about every aspect of psychology Is abnormality a mental illness ? 12

Views Past & Present Mental distress always been common – America today, 30% get help annually Ancient times Demons, magic, good v evil Trephination – open the skull – brain surgery ? Bible refers to it Exorcism shamans 13

Greeks & Romans Hippocrates – Greek – illness is natural – mental illness comes from the body – natural, physical causes > others believed > humors – 4 liquids in or out of balance Too much black bile = melancholia (depression) Reduce it – veg diet – give up sex – do exercises Blood-letting 14

Middle Ages Fears about the Devil, evil Phenomena > mass madness ~ panics Tarantism – St. Vitus’s Dance – associated w spiders Vampires, lycanthopy Cure > exorcism, torture 15

Old friends They’re here 16

Renaissance As govts grew, religion became less important Education > rise of doctors Weyer – pioneering “psychiatrist” – maybe the 1 st Weyer said mental illness is a disease (dz) Religious organizations cared for the ill > similar to today’s community mental health programs 17

Renaissance & Later s – growth of larger asylums – part hospital/part prison – “madhouses” – London’s Bethlehem – aka Bedlam 1800s – Reform & Moral Treatments Asylums were rehabilitated – better care Paris – La Bicetre under Pinel > less punishment, more tx 18

Enlightenment s UK – William Tuke created York Retreat – like a country resort US – Founding Father Benjamin Rush – talked to pts Moral Tx – care, respect, religious flavor – goal: restore productive people 19

End of Moral Treatment Died out 1850s why ? Not all cured Funding & staffing Overcrowded conditions Prejudice > MI associated w/ immigrants, minorities 20

Twentieth Century 2 concepts Somatogenic theory – physical causes for MI Psychogenic theory – mental causes for MI E. Kraepelin – classified symptoms (sx) & syndromes (clusters of sx) > linked MI to physical causes 21

20 th Century Medicine & bio advanced – but not enough known SOMATIC Perspective Biological example – syphilis can lead to paresis (psychosis & paralysis) > fever therapy > Krafft-Ebing – German MD – studied sex Physical or somatic tx – bio-based Not very effective 22

Somatic treatments Lobotomy, hydrotherapy, surgery Sterilization & eugenics mvmt > social biology > > biological control of society – prevent the mentally ill, others from reproducing 23

20 th Century PSYCHOGENIC PERSPECTIVE Interest in hypnotism – was that the Unconscious (Unc) ? Hyp used by early psychoanalysts Psychoanalysis – mental disorders caused by unc mental conflict Sigmund Freud worked w depressed, anxious pts – his techniques helped 24

Current Interest in social issues – poverty, broken homes, etc Positive psychology – teaching clients to be happy, less focus on sx Multicultural psychology > USA diverse country > different ways to view diversity 25

Current Issues Who pays for care ? > managed care – offered by insurance co – this limits choices, but they pay > 2011 parity laws – insurance must recognize MI 26

Current Theories Biological Behavioral Cognitive Psychodynamic humanistic 27

Who gives therapy Psychiatrists (MDs) Psychologists (PhDs) LPCs (Master’s-level) MSWs nurses 28