PSYCHOPATHOLOGY IN HISTORICAL CONTEXT:Free association, Dream analysis

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Abnormal Psychology PSY404

LESSON 04

PSYCHOPATHOLOGY IN HISTORICAL CONTEXT

1. Psychological Model

It is a long leap from

a. Witch craft and Demonological concepts

b. From notorious biological methods (Insulin shock therapy, Lobotomy, Electroconvulsive therapy)

of 1920's and 1930's.

Plato listed two causes of mental disorders (a). Social and cultural influence's in one's life. (b). learning that

took place in the environment.

Moral therapy a treatment approach of the 18th century, the term Moral really meant emotional or

psychological rather than code of conduct. Moral therapy proposed humane treatment and responsible care

of institutionalized psychologically disturbed individuals.

Moral therapy also advocated providing opportunities for appropriate social and interpersonal contact.

Mental Hygiene Movement with heroic efforts of Dorthea Dix improved and reformed the asylums and

inspired the construction of new institutions in America and in other countries as well.

The Psychological tradition was dormant/dead for some time but in 20th century is reemerged in form of

several schools of thought.

Freudian psychoanalytic model

Jungian analytical psychology model

Adlerian Individual psychology model

Humanistic model

Behavioral model

Cognitive model

Psychoanalytic or Psychoanalysis or psychodynamic approach pioneered by Sigmund Freud (1856-1939)

emphasized on internal mental processes and childhood experiences. The core elements of this approach

include.

Analysis of mental structures in conflict.

ii.

Levels of consciousness

iii.

Defense mechanisms

iv.

Psychosexual stages of development.

Id→ Pleasure Principle

Mental Structures

Ego →Reality Principle

Super Ego → Moral Principle

The human psyche consists of id, ego and super ego, the thoughts attitudes and behaviors of three are in

state of conflict called intra-psychic conflict.

Id is the unorganized reservoir of wishes or passions related to our sexual and aggressive drives, it strives

for immediate gratification that bypasses demands of reality, order logic and reason. The Id is like a child

when it wants something it wants it there and then without regard for consequences, so Id operates on

pleasure principle.

Abnormal Psychology PSY404

This refers to Greek concept of hedonism meaning pleasure. The energy within the Id is labeled as the

libido. The Id has its own characteristic way of processing information, cognitive style referred as primary

process. The thinking patterns of Id are illogical, irrational, emotional immature and purely selfish.

Ego the selfish and dangerous drives of id do not go unchecked ego ensures that we must find ways to

meet our basic needs with out offending everyone around us. The ego operates according to the reality

principle and the cognitive operations of the ego are characterized by logic, reason and are referred as the

secondary process.

The ego is the master control, it tries to resolve conflicts between the demands of Id with in the permitted

boundaries of super ego.

The ego has the role to mediate conflict between the Id and super ego according to realities of the world. If

it mediates successfully, we see an intelligent, creative individual who is well adjusted while if ego is

unsuccessful either Id or super ego will be strong.

If Id is strong, we see an antisocial criminal and if super ego is strong we see a pure, rigid, nonflexible

individual. Super ego is the storehouse of moral and ethical standards taught by parents, teachers and

culture (it also refers to the conscience of the psyche). It operates according to the moral Principle when we

do something wrong, when ethical, moral standards are violated than super ego generates guilt.

Example

You go to a garden where you see red roses you face intra-psychic conflict

Id→

Ego↔

Super Ego

I want red rose and I want I can afford to buy red roses Stealing is bad. The sign says

it now.

from flower shop

don't pluck flowers.

Example

You go to a store you see a lovely jacket but the price is high but no one is looking you face intra-psychic

conflict:

Example

Id→

Ego↔

Super Ego

I want the jacket and I want I have to be realistic I Stealing is bad.

it now.

cannot afford the jacket.

Levels of Consciousness:

Consciousness

Preconscious/

Sub conscious

Unconscious

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According to this triangle, the top smallest part is the conscious experience the middle small layer is

subconscious and the largest portion is unconscious.

According to Freud that part of the mind about which we are aware is consciousness but it is a small part of

mental life. You are listening to me it is your conscious mental activity. The preconscious comprises of

thoughts or activities that are easily made conscious by an effort to remember or say, you have the present

lecture's handout in front of you and you are conscious that you are writing on it. The largest segment is the

unconscious not easily reachable yet it gives rise on to important needs and influences our behavior.

Example

All your nightmares, phobias, fears influence you and you can not get rid of them because they lie in

unconscious. Freud suggested techniques of reaching the unconscious

Free Association

Dream Analysis

Means of Tapping

Transference

Unconscious

Analysis of humor

Analysis of Freudian Slips

Example

You stand near a river, the top water is the conscious part, fill out some muddy water in container, it is the

sub-conscious and when you dug the river bed and find something buried in it well that is the unconscious

part.

Defense Mechanism

The ego fights a battle to stay on top of id and super ego. The conflicts between id and super ego produce

anxiety that is a threat to ego. The threat or anxiety experienced by ego is a signal that alerts the ego to use

unconscious protective processes that keep primitive emotions associated with conflicts in check. These

protective processes are defense mechanisms or coping styles.

↓

Coping styles

Ego

↑

Super ego

Defense Mechanisms

Denial

Displacement

Projection

Rationalization

Reaction formation

Repression, sublimation

Abnormal Psychology PSY404

Protect ego

Defense Mechanism

Distort Reality

Operate at unconscious level

Humour and sublimation are defense mechanisms that correlate with psychological health

Who uses these defense mechanisms?

Normal and abnormal?

Both?

Psychosexual stages of development

Freud theorized that during childhood we pass through a number of psycho sexual stages of development.

Oral Birth to 2 years

Anal

2 to 3 years

Oedipal

Complex

Psychosexual stages of

Phallic

3 to 5 years

development

Latency

5 to 12 years

Electra

Complex

Genital

12 years (Puberty)

Each stage of development represent a specific period of development where our basic needs arise and an

under or over gratification of the needs at any stage leaves a strong impression on the individual in form of

a fixation or psychopathology reflected throughout his adult life.

In the oral stage the major source of pleasure is the mouth where the infant sucks, bites, through mouth,

any fixation at this stage appears in form of nail biting , chewing pencils, paper etc. smoking cigarettes. In

the Anal stage, which extends from one to three years toilet training begins. Any conflict or fixation at this

stage appears in form of a person who is very neat, clean and strict in following rules/norms.

Phallic stage begins at the three years and goes up to five years, boys have oedipal complex a wish to have

sexual attachment with their mother while girls shift away from mother and get closer to father an

experience labeled as Electra complex.

Abnormal Psychology PSY404

Latency stage is where interest in sexual drive is less but it is the Genital stage where interest in opposite

gender develops tendency to impress the opposite gender is more. One is more preoccupied to make a

good impression on opposite gender through one's looks, dress and conversation. Often you see a young

growing up standing in front of the mirror and either trying to focus how to look even better etc. Each

stage of development is important for moral healthy adjustment any fixation at any stage may result in form

psychopathology or an immediate behavior.

Neo-Freudians

Carl Jung (1875-1961)

Alfred Adler (1870-1937)

Karen Horney (1885-1952)

Carl Jung and Alfred Adler were followers of Freud but they drifted away from him and disagreed on the

concept of sexuality. Jung conceived humans as having a collective unconscious or archetypes i.e. a

collection (store) of primitive ideas, images that are inherited and shared across the human race. So

collective unconscious is wisdom accumulated by society and culture and passed down from generation to

generation. Alder advocated that humans are social beings motivated by social needs than by sexual needs.

Karen Horney believed that environmental factors and childhood relationships are the most important

factor in secure psychological adjustment.

Techniques of Psychoanalysis

Psychoanalysis is a therapeutic process which reveals unconscious mental process and conflicts through

catharsis and insight.

Free association the patient is asked to lie on a couch and the therapist sits behind the client, then the

patient is asked to give a running account of his thought pattern uninterrupted without social censoring it.

This technique brings to the conscious level emotionally loaded material that at times can be painful,

threatening to be discussed at conscious level.

Dream analysis refers to the process in which the contents of the dream usually the id impulses (wishes)

related to the unconscious conflicts. The therapist interprets the contents of dreams and relates them to

various unconscious wishes.

Example

Suppose you go to the bazaar and you want to buy a very expensive pair of shoes, costing a fortune. Your

mother refuses to buy and says that you are out of your mind. So at night, you dream that you are owner of

that shoe shop so your id desire has been fulfilled in a dream.

The relationship between the patient and the therapist /clinician/psychoanalyst/counselor is very

important.

Patient

→

therapist

Relationship

The patient may relate with therapist positively as with an important person in his life like parents, teachers,

and friends. We label it as positive transference phenomenon.

The patient may relate negatively with the therapist with anger resentment or dislike. We say negative

transference has occurred. The patient may at times like the therapist while at times resent him so an

ambivalent transference takes place. The therapist (is human) he also at times project his feelings, emotion

usually positive ones towards the patient this is counter transference. This should not happen.

Therapist

←

Client

Ambivalent positive negative

Therapist

→

Client

Counter transference

Abnormal Psychology PSY404

Freudian slips means you wanted to say something but you said something wrong or embarrassing say

Freud went to USA to deliver lectures on psychoanalysis and a professor introduced him as Dr. Fraud,

though he apologized but that is a Freudian slip.

Humor is an essential part of psyche. What sort of humor do you read and enjoy? For Freud humor is

mostly related to death and sex two unknown areas of your life about which you are not sure

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