Why Can’t the Prince Walk? There is an ancient Persian legend about a physician named Rhazes who was called into the palace for the purpose of diagnosing and treating a young prince. Apparently, the prince could not walk. After the usual examination, Rhazes determined that there was nothing wrong with the prince’s legs, at least not physically. With little more than a hunch, Rhazes set out to treat what may be the first recorded case of conversion. In doing so, he took a risk: Rhazes unexpectedly walked into the Prince’s bathroom brandishing a dagger and threatened to kill him. Upon seeing him, “the startled prince abruptly fled, leaving his clothes, his dignity, and undoubtedly part of his self-esteem behind.”

Somatoform Disorders Characterized by complaints of physical problems or symptoms that cannot be explained by physical causes. Illnesses are not purposefully “faked,” they seem to serve a psychological need; hence, they are classified as psychological disorders.

Types of Somatoform Disorders Type of Disorder Description Associated Features Conversion Disorder Change or loss of a physical function without medical cause Emerges in context of conflicts or stress Hypochondriasis Preoccupation with the belief that one is seriously ill -Fear persists despite medical reassurance -Tendency to interpret minor aches and pains as serious illness Somatization Disorder Recurrent, multiple complaints about physical symptoms that have no clear organic basis Body Dysmorphic Disorder Preoccupation with an imagined or exaggerated physical defect -Person may believe that others think less of them because of the perceived defect -May engage in compulsive behaviors that aim to correct the perceived defect Pain Disorder Persistent physical pain believed to be associated with psychological factors Pain severe and persistent enough to interfere with daily functioning; medical conditions and psychological factors may play important roles in accounting for the pain

Culture-Bound Somatoform Disorders Koro Syndrome: a culture-bound somatoform disorder, found primarily in China, in which people fear that their genitals are shrinking. Dhat syndrome: a culture-bound somatoform disorder, found primarily among Asian-Indian males, characterized by excessive fears over the loss of seminal fluid.

Somatoform Disorders: Treatment Psychoanalysis: seeks to uncover and bring unconscious conflicts that originated in childhood into conscious awareness. Behavioral therapy: removes sources of secondary reinforcement (sympathy, etc.). Cognitive-behavioral therapy: restructures distorted beliefs to help people replace exaggerated illness- related beliefs with rational alternatives; also employs exposure with response prevention.

Munchausen Syndrome A form of feigned illness in which the person either fakes being ill or makes himself ill. Differs from somatoform disorders because the symptoms are intentionally induced. Munchausen by proxy: a pernicious form of child maltreatment in which people intentionally falsify or induce physical or emotional illness or injury in a child or dependent person. Named for an 18 th century German Baron who was famous for entertaining his friends with tales of outrageous adventures.

Dissociative Disorders Dissociative disorder: a disorder in which a person experiences alterations in memory, identity, or consciousness Depersonalization Disorder: characterized by the persistent or recurrent episodes in which the sufferer experiences feelings of unreality or detachment from one’s self or one’s body. Dissociative fugue: a dissociative disorder in which a person suddenly and unexpectedly travels away from home or work and is unable to recall the past. Dissociative Identity Disorder: a person exhibits two or more personality states, each with its own patterns of thinking and behaving Dissociative amnesia: the inability to recall important personal events or information; is usually associated with stressful events

Dissociative Amnesia NameCharacteristicsExample Localized Amnesia Events occurring during a specific time period are lost to memory Person cannot recall events for a number of hours or days after a stressful or traumatic incident Selective Amnesia Only the disturbing particulars that take place during a certain period of time are forgotten A soldier recalls most of a battle, but not the death of his friend. A person recalls the period of life during which he had an affair, but not the affair itself. Generalized Amnesia* *very rare Entire life is forgotten; cannot recall personal information, but usually retain habits, tastes and skills Person cannot recall any events or names from his life. Cannot remember elementary reading teacher’s name, but can still read. Continuous Amnesia The person forgets everything that occurred from a particular point in time up to and including the present Person cannot recall anything from the last four weeks, including the conversation they just finished. Systematized Amnesia Memory loss is specific to a particular category of information Person cannot recall anything having to do with his older brother.

Dissociative Identity Disorder At least two distinct personalities exist within the person, each having a relatively enduring and distinct pattern of perceiving, thinking and feeling. Two or more of these personalities repeatedly take complete control of the individual. There is a failure to recall important personal information too substantial to be accounted for by ordinary forgetfulness. The disorder cannot be accounted for by the effects of a psychoactive substance or a general medical condition.

The Three Faces of Eve Real Name: Chris Sizemore Eve White: timid housewife Eve Black: libidinous and antisocial personality Jane: integrated personality who can accept her aggressive urges, but still engage in socially appropriate behavior. Therapy led to the integration of the three personalities. Later, however, Sizemore’s personality later fractured into 22 individual personalities, and she reentered therapy.

Sybil Assignment: Who is Sybil? What was her disorder? Was it successfully treated? How?