PSYCHOLOGY MADE SIMPLE

Is a brief introduction to psychology for college students

© August 2008

Author
Alan E Masakhalia
+254 722 33 05 11
[email protected]
A former lecturer at PREMESE AFRICA DEVELOPMENT INSTITUTE
CHAPTER 1
Introduction and Definition ………………………….…………….…….… 4
Relevance of psychology…………………………….……………………...4
Scope……………………….……………………………………….……….5
Conscious and Unconscious situations....………………..……….…………7

CHAPTER 2 – PSYCHOLOGICAL PERSPECTIVES.

The two schools of thought ………………………………………………..10
Psychoanalytic theory……………………………………………….……..13
Defense Mechanisms……………………………………………..………..21

CHAPTER 3 – PERSONALITY AND SOCIAL DEVELOPMENT.

Personality ……………………………….….……………………………..26
Freudian concept of personality…………….……………………..……….27
How personality develops to abnormality…..……………………….……..28

CHAPTER 4 – PROGRESSION OF ABNORMAL BEHAVIOUR.

Stress….…………………………………..………..………………………30
Depression………….………………………………………………………35
Psychoses………………………….…………….…………………………37
Neurosis………………………………………………….…………………38
Mental illness………………………………………………………………41

CHAPTER 5 – PSYCOTHERAPY AND OTHER THERAPIES

Counselling…………………………………………………………………47
Introduction to Psychotherapy………………………………………..……50
Relevance of therapy………………………….……………………………51
Types of therapy……………..…………..…………………………………51

BIBLIOGRAPHY …………………………………………..……………57

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DEFENITION OF TERMS.

Consciousness – acting while sober and in charge acts done

knowingly/intentionally

Personality – a persons characteristics as concerns behaviour ,motivation

traits etc

Abnormality – acts that are inconsistent with societies expectations and

norms

Psychotherapy – the talking cure, no pills

Freudian – belonging to Sigmund Freud e.g. his theories

Oedipus complex – situation where the boy child admires the mother and
views the dad as ―competition‖

Cognitive – thought processes

Thantos – the death/self destructive drive

Electra complex – the girl child being closer to the father as opposed to the
mother

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COURSE OBJECTIVES.

By the end of the course, the learner should be able to comfortably define
what psychology is as well as discuss its scope and relevance to society.
The learner should also be able to contribute to the raging debate as concerns
whether human behaviour is natural or whether it is nurtured. The concept of
personality should also be clear to the learner by the time he/she finishes this
module.
As concerns mental problems and ailments, the student should be able to
comfortably explain how mental instabilities are interlinked, for example
how a stress patient may end up being depresses and eventually being
psychotic. The learner should also be well versed with the various remedies
as far as mental illnesses are concerned.

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 CHAPTER 1
INTRODUCTION

What Is Psychology?
Psychology is both an applied and academic field that studies the human mind and
behavior. It has also been defined concisely as the scientific study of the mind.
Research in psychology seeks to understand and explain thought, emotion, and
behavior.

Psychology evolved out of both philosophy and biology. Such discussions of the
two subjects date as far back as the early Greek thinkers such as Aristotle and
Socrates. Infact the word psychology is derived from two Greek words psyche,
meaning 'soul' or 'mind' and ology, meaning to study hence it is a study of the
soul or mind.

Psychologists attempt to explain the mind and brain in the context of real life,
Psychologists study such phenomena as perception, cognition, emotion,
personality, behavior, and interpersonal relationships. Psychology also refers to
the application of such knowledge to various spheres of human life, including
issues related to daily life e.g. family, education, and work and the treatment of
mental health problems.

Relevance of Psychology
Psychology is of utmost importance; for starters it is a gateway to several career
prospects. Studying psychology thus avails job opportunities. One can end up as a
probation officer, counsellor, psychiatrist, lecturer etc

Since Psychology studies man‘s behaviour and thinking processes, it enables those
studying it to understand people‘s behaviour and character. They are thus able to
appreciate and cope with the varying characters various people hold. They thus fit
well into society.

Thanks to Psychology, it is now possible to generalize human behaviour. With

various studies on human behaviour being conducted successfully, it has been
proved that human behaviour and actions are universal. For example greed and

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selfishness can be generalized as human traits, this is so since we have thieves,
conmen, fraudsters etc world over.

The ‗father of psychology‘ Wundt believed that properly trained individuals would
be able to accurately identify the mental processes that accompanied feelings,
sensations, and thoughts. Psychology thus makes it possible to predict human
actions and behaviour. We are thus able to accurately predict situations where man
is likely to steal, kill, lie or even run away.
Human resource officials in industries and in organisations in general benefit a lot
from psychology as they know what motivates and what demotivates staff. Armed
with tactics on how to identify discontent, strikes may be averted. They will also
be able to hire and promote high achievers.

Psychology is also very vital in the academic scene, teachers are for example able
effectively control the students. They are well advised as concerns punishments
e.g. which punishment is best suited in which situation and to which category of
students.

Psychiatrists and clinical psychologists in general are able to explain the causes
and effects of ones behaviour. They are thus able to diagnose and give
prescriptions and other corrective measures for mental ailments.

The scope of Psychology

Psychology has a very broad scope, since it concentrates on man‘s thinking
processes it delves into much of man day to day activities. It thus includes many
sub-fields of study and application concerned with such areas as human
development, sports, industry, media, law, mental health treatment, performance
enhancement and many other areas affecting health and daily life

Branches of Psychology
Psychology is a broad and diverse field. A number of different subfields and
specialty areas have emerged. The following are some of the major areas of
research and application within psychology:

Abnormal Psychology is the study of abnormal behavior and psychopathology.

This specialty area is focused on research and treatment of a variety of mental
disorders and is linked to psychotherapy and clinical psychology. It seeks to
describe, predict, explain, and change abnormal patterns of functioning. It attempts
to draw the line between which behaviors are considered normal and which ones
are not. Generally, abnormal behaviors are those that are infrequent and
unjustifiable in relation to the overall population. Abnormal behaviour may also
be termed as deviant and not socially acceptable.

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Biological Psychology, also known as biopsychology, studies how biological
processes influence the mind and behavior. This area is closely linked to
neuroscience and utilizes tools such as MRI and PET scans to look at brain injury
or brain abnormalities. It strives to understand how the structure and function of
the 'brain' relate to specific behavioral and psychological processes. Since all
behavior is controlled by the central nervous system, it is reasonable to study how
the brain functions so as to understand behavior.

Clinical Psychology is focused on the assessment, diagnosis, prevention and

treatment of mental disorders.

Cognitive Psychology is the study of human thought processes and cognitions.

Cognitive psychologists study topics such as attention, memory, perception,
decision-making, problem solving, and language acquisition. It studies cognition
and the mental processes underlying behavior. It uses information processing as a
framework for understanding the mind.

Comparative psychology is the branch of psychology concerned with the study

of animal behavior. The study of animal behavior can lead to a deeper and broader
understanding of human psychology. It focuses on the mental life of animals as a
way of gaining an insight into human psychology. For example, isn‘t it true that all
animals are protective of their young ones be it dogs, chicken etc, isn‘t the same
true for humans?

Developmental Psychology is the branch of psychology that looks at human

growth and development over the lifespan. The theories often focus on the
development of cognitive abilities, morality, social functioning, identity, and other
life areas. It seeks to understand how people come to perceive, understand, and act
within the world and how these processes change as they age. In addition to
studying human growth, developmental psychologists also study aging and
processes throughout the life span, especially at other times of rapid change (such
as adolescence and old age).

Industrial-organizational psychology is the area of psychology that uses

psychological research to enhance work performance, select employee, improve
product design, and enhance usability. It looks at how organizations impact and
interact with individuals so as to improve, evaluate, and predicting job
performance. It
answers questions regarding things such as who to hire, how to define and
measure successful job performance, how to prepare people to be more successful
in their jobs, how to create and change jobs so that they are safer and make people
happier, and how to structure the organization to allow people to achieve their full
potential.

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Personality Psychology looks at the various elements that make up individuals
personalities. Freud‘s structural model of personality is a good example of
personality a theory.

School Psychology is the branch of psychology that works within the educational
system to help children with emotional, social, and academic issues. It is
dedicated to helping young people succeed academically, socially, and
emotionally. School psychologists collaborate with educators, parents, and other
professionals to create safe, healthy, and supportive learning environments for all
students. It focuses on how humans learn in educational settings, the effectiveness
of educational interventions, thus advises on appropriate teaching methods and
educational practices.

Social psychology is a discipline that uses scientific methods to study social

influence, social perception, and social interaction. Social psychology studies
diverse subjects including group behavior, social perception, leadership, nonverbal
behavior, conformity, aggression, and prejudice. It studies causes of human social
behavior, with an emphasis on how people think towards each other and how they
relate to each other.

Human factors psychology also known as Engineering Psychology is the study

of how thinking processes affect our interaction with tools and objects in the
environment. The goal of research in human factors psychology is to better design
objects by taking into account the limitations and biases of human mental
processes and behavior.

Conscious and Unconscious situations.

Psychology being the scientific study of the mind and human behaviour in general
is therefore keen on human intentions, fears, beliefs that may either be conscious
or unconscious. Psychiatrists also use both conscious and unconscious methods of
diagnosis.

Consciousness
Consciousness comes from the Latin conscientia meaning moral conscience.
The conscientia was described as the act by which we apply practical and moral
knowledge to our own actions.

Today consciousness denotes being awake and being responsive to one's

environment as well as the prioritization of alternatives, problem solving, decision
making, action control, error detection, planning, learning and adaptation. Simply

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put consciousness reffers to self-awareness and the ability to make observations
for oneself

Psychologists therefore asses peoples behaviours and fears that are Conscious and
intended and then offer appropriate solutions. The behaviour assessment is usually
done via a personality quiz, which is a series of questions (usually multiple-
choice) intended to reveal something about the person who answers them

Unconscious
This is the reverse of consciousness, a person isn‘t awake or aware of his/her inner
self. Hence a person‘s feelings, fears and beliefs are not directly known to himself.

Dreams for example are probed so as to identify a persons inner strengths, fears,
weaknesses, beliefs etc. This is so since dreams are a way in which we
unconsciously relate with reality.

Psychiatrists also use art as a way of diagnosing mental instabilities, worries,

fears, phobias, etc children may for example be asked to make drawings about the
community – those with hostile personalities may come up with images of
destruction, war etc. those from stable and happy families will come up with
images of success, triumph etc.

Sigmund and the unconscious

Freud argued that there existed an unconscious mind yet during the 19th century,
the dominant trend in Western thought was positivism, ie, the belief that people
could ascertain real knowledge concerning themselves and their environment and
judiciously exercise control over both. Freud, however, suggested that such
declarations of free will are in fact delusions; that we are not entirely aware of
what we think and often act for reasons that have little to do with our conscious
thoughts.

The concept of the unconscious as proposed by Freud was considered by some to

be groundbreaking in that he proposed that awareness existed in layers and that
some thoughts occurred "below the surface."

Dreams, which he called the "royal road to the unconscious," provided the best
access to our unconscious life and the best illustration of its "logic," which was
different from the logic of conscious thought. Freud developed his first topology
of the psyche in The Interpretation of Dreams in which he proposed the argument

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that the unconscious exists and described a method for gaining access to it. The
preconscious was described as a layer between conscious and unconscious thought
and which could be accessed with a little effort. Thus for Freud, the ideals of the
Enlightenment, positivism and rationalism, could be achieved through
understanding, transforming, and mastering the unconscious, rather than through
denying or repressing it.

Crucial to the operation of the unconscious is "repression." According to Freud,

people often experience thoughts and feelings that are so painful that they cannot
bear them. Such thoughts and feelings—and associated memories—could not,
Freud argued, be banished from the mind, but could be banished from
consciousness. Thus they come to constitute the unconscious.

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 CHAPTER 2
PSYCHOLOGICAL PERSPECTIVES

Nature vs. Nurture

You got your black eyes from your mother and your freckles from your father. But
where did you get your thrill-seeking personality and talent for singing? Did you
learn these from your parents or was it predetermined by your genes? While it's
clear that physical characteristics are hereditary, the genetic part becomes tricky
when it comes to an individual's behavior, intelligence, and personality.
Ultimately, the old argument of nature vs. nurture has never really been won. We
do not yet know how much of what we are is determined by our DNA and how
much by our life experience. But we do know that both play a part.

The Nature vs. Nurture debate (the two schools of thought) argues about the basis
of our behaviour, personality, fears, attitude etc. Are our traits inborn (natural) or
are they learnt and acquired from society (nurture).

Some scientists think that people behave as they do according to genetic

predispositions or even "animal instincts." This is known as the "nature" theory of
human behavior. Other scientists believe that people think and behave in certain
ways because they are taught to do so. This is known as the "nurture" theory of
human behavior.

The fast-growing understanding of the human genome has recently made it clear
that both sides are partly right. Nature endows us with inborn abilities and traits;
nurture takes these genetic tendencies and molds them as we learn and mature.
However the debate doesn‘t end here. The "nature vs nurture" debate still rages on,
as scientist fight over how much of who we are is shaped by genes and how much
by the environment.

The Nature Theory

This theory argues that we are what we were born to be. Our personalities,
character traits etc are thus believed to be inborn.
Scientists have known for years that traits such as eye color and hair color are
determined by specific genes encoded in each human cell. The Nature Theory
takes things a step further to say that more abstract traits such as intelligence,

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personality, aggression, and sexual orientation are also encoded in an individual's
DNA. Hence they are not learnt but are inborn.

The search for "behavioral" genes is the source of constant debate. Many fear that
genetic arguments might be used to excuse or justify criminal acts as thieves may
argue that they were born that way.

Proponents of the nature theory have for example argued that we marry only
because of maturity and the ensuing biological needs, plus the wish to procreate.

The Nurture Theory

Although "nurture" has historically been referred to as the care given to children
by the parents, with the mother playing a role of particular importance, this term is
now regarded by some as any environmental (not genetic) factor in the
contemporary nature versus nurture debate.

Thus the definition of "nurture" has been expanded in order to include the
influences on development arising from prenatal, parental, extended family and
peer experiences, extending to influences such as media, marketing and socio-
economic status. Nurture is thus the socialization we get from the society.

While not discounting that genetic tendencies may exist, supporters of the nurture
theory believe they ultimately don't matter - that our behavioral aspects originate
only from the environmental factors of our upbringing. Studies on infant and child
temperament have revealed the most crucial evidence for nurture theories.

American psychologist John Watson, best known for his controversial experiments
with a young orphan named Albert, demonstrated that the acquisition of a phobia
could be explained by classical conditioning. A strong proponent of
environmental learning, he said: Give me a dozen healthy infants, well-formed,
and my own specified world to bring them up in and I'll guarantee to take any one
at random and train him to become any type of specialist I might select...regardless
of his talents, penchants, tendencies, abilities, vocations and race of his ancestors.
Hence all that we do is learnt, irrespective of talents.

A psychologist, F. Skinner's conducted experiments that produced pigeons that

could dance, do figure eights, and play tennis. Today known as the father of
behavioral science, he eventually went on to prove that human behavior could be
conditioned in much the same way as animals. Current studies even suggests
that sense of humor is a learned trait, influenced by family and cultural
environment, and not genetically determined. It is even argued that we marry, not
out of our own liking – rather we marry so as to conform, we marry since society

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demands that we do so. Society will for example show surprise at a 50 year old
who is unmarried.

If environment didn't play a part in determining an individual's traits and

behaviors, then identical twins should, theoretically, be exactly the same in all
respects, even if reared apart. But a number of studies show that they are never
exactly alike, even though they are remarkably similar in most respects.

On the other hand, such traits as one's native language are entirely
environmentally determined: linguists have found that any child (if capable of
learning a language at all) can learn any human language with equal facility.

So, is the way we behave engrained in us long before we are born? Or has it
developed over time in response to our experiences? Researchers on all sides of
the nature vs nurture debate agree that the link between a gene and a behavior is
not the same as cause and effect. While a gene may increase the likelihood that
you'll behave in a particular way, it does not make people do things. Which means
that we still get to choose who we'll be when we grow up. And our ability to
choose is also acquired via socialization.

Pro nurture scholars such as Herrnstein and Murray have summed up the nurture
vs nature debate by stating that
"Mother Nature has plainly not entrusted the determination of our intellectual
capacities to the blind fate of a gene or genes; she gave us parents, learning,
language, culture and education to program ourselves with."

Critics such as Judith Harris argue that "nurture," as traditionally defined in terms
of family upbringing does not effectively explain the variance for most traits (such
as adult IQ) in general populations. Why do people brought up in the same society
have varying levels of reasoning?.

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Psychoanalytic theory

Sigmund Freud

Sigmund Freud (1856 – 1939), was an Austrian neurologist and psychiatrist who
founded the psychoanalytic school of psychology. Freud is best known for his
theories of the unconscious mind and the defense mechanism of repression.

Freud is commonly referred to as "the father of psychoanalysis" and his work has
been highly influential — popularizing such notions as the unconscious, the
Oedipus complex, and defense mechanisms. Freud even won the Goethe Prize in
appreciation of his contribution to psychology in 1930.

Freud and Psychoanalysis

After experimenting with hypnosis on his neurotic patients, Freud abandoned this
form of treatment as it proved ineffective for many, in favor of a treatment where
the patient talked through his or her problems. This came to be known as the
"talking cure", as the ultimate goal of this talking was to locate and release
powerful emotional energy that had initially been rejected, and imprisoned in the
unconscious mind. Freud called this denial of emotions "repression",and he
believed that it was damaging to normal functioning and could also retard physical
functionin. The "talking cure" is widely seen as the basis of psychoanalysis.
The overall goal of Psychoanalysis, was thus to bring to consciousness repressed
thoughts and feelings.

Psychotherapy
Most importantly, Freud popularized the "talking-cure"—an idea that a person
could solve problems simply by talking over them, something that was almost
unheard of in the 19th century. Even though many psychotherapists today tend to
reject the specifics of Freud's theories, this basic mode of treatment comes largely
from his work. Hence modern practice in psychiatry still reflect his influence.

Psychosexual development

Freud used the Oedipus conflict to point out how much he believed that people
desire incest and must repress that desire. The Oedipus conflict was described as a
state of psychosexual development and awareness.

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Freud also believed that the libido developed in individuals by changing its object,
a process codified by the concept of sublimation. He argued that humans are born
"polymorphously perverse", meaning that any number of objects could be a source
of pleasure. He further argued that, as humans develop, they become fixated on
different and specific objects through their stages of development—first in the oral
stage (exemplified by an infant's pleasure in nursing), then in the anal stage
(exemplified by a toddler's pleasure in evacuating his or her bowels), then in the
phallic stage. Freud argued that children then passed through a stage in which they
fixated on the mother as a sexual object (known as the Oedipus Complex) but that
the child eventually overcame and repressed this desire because of its taboo
nature. (The lesser known Electra complex refers to such a fixation on the father.)
The repressive or dormant latency stage of psychosexual development preceded
the sexually mature genital stage of psychosexual development.

For Freud, the unconscious always desires the phallus (penis). Males are afraid of
castration - losing their phallus or masculinity to another male. Females always
desire to have a phallus - an unfulfillable desire. Thus boys resent their fathers
(fear of castration) and girls desire theirs. For Freud, desire is always defined in
the negative term of lack - you always desire what you don't have or what you are
not, and it is very unlikely that you will fulfill this desire. Thus his psychoanalysis
treatment is meant to teach the patient to cope with his or her insatiable desires.

The life and death instincts

Freud believed that humans were driven by two conflicting central desires: the life
drive (libido) (survival, propagation, hunger, thirst, and sex) and the death drive
(Thanatos). Freud's description of Cathexis, whose energy is known as libido,
included all creative, life-producing drives. The death drive (or death instinct),
whose energy is known as anticathexis, represented an urge inherent in all living
things to return to a state of calm: in other words, an inorganic or dead state. He
recognized Thanatos only in his later years and develops his theory on the death
drive in Beyond the Pleasure Principle. Freud approaches the paradox between the
life drives and the death drives by defining pleasure and unpleasure. According to
Freud, unpleasure refers to stimulus that the body receives. (For example,
excessive friction on the skin's surface produces a burning sensation; or, the
bombardment of visual stimuli amidst rush hour traffic produces anxiety.)
Conversely, pleasure is a result of a decrease in stimuli (for example, a calm
environment the body enters after having been subjected to a hectic environment).
If pleasure increases as stimuli decreases, then the ultimate experience of pleasure
for Freud would be zero stimulus, or death. Given this proposition, Freud
acknowledges the tendency for the unconscious to repeat unpleasurable
experiences in order to desensitize, or deaden, the body. This compulsion to repeat
unpleasurable experiences explains why traumatic nightmares occur in dreams, as
nightmares seem to contradict Freud's earlier conception of dreams purely as a site
of pleasure, fantasy, and desire. On the one hand, the life drives promote survival

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by avoiding extreme unpleasure and any threat to life. On the other hand, the death
drive functions simultaneously toward extreme pleasure, which leads to death.

Id, ego, and super-ego

Id, ego, and super-ego are the three parts of the 'psychic apparatus' defined in
Freud's called 'structural model' of the psyche; they are the three 'structures' in
terms of whose activity and interaction mental life is described.

THE ID

The term id (inner desire) is a Latinised derivation from Groddeck's das Es, and
translates into English as strictly "it". It stands in direct opposition to the super-
ego. It is dominated by the pleasure principle. It is thus characterised by
selfishness.

The mind of a newborn child is regarded as being completely "id-ridden", in the

sense that it is a mass of instinctive drives and impulses, and demands immediate
satisfaction. This view equates a newborn child with an id-ridden individual—
often humorously—with this analogy: an alimentary tract with no sense of
responsibility at either end.

The id is responsible for our basic drives such as food, sex, and aggressive
impulses. It is amoral and egocentric, ruled by the pleasure–pain principle; it is
without a sense of time, completely illogical, primarily sexual, infantile in its
emotional development, and will not take "no" for an answer. It is regarded as the
reservoir of the libido or "love energy".

Freud divided the id's drives and instincts into two categories: life (Eros) and death
(Thanatos) instincts - the latter not so usually regarded because Freud thought of it
later in his lifetime. Life instincts are those that are crucial to pleasurable survival,
such as eating and copulation. Death instincts, as stated by Freud, are our
unconscious wish to die, as death puts an end to the everyday struggles for
happiness and survival. Freud noticed the death instinct in our desire for peace and
attempts to escape reality through fiction, media, and substances such as alcohol
and drugs. It also indirectly represents itself through aggression.

THE EGO

The word ego is taken directly from Latin, and is translated as "I myself" to
express emphasis.

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In Freud's theory, the ego mediates among the id, the super-ego and the external
world. Its task is to find a balance between primitive drives, morals, and reality
while satisfying the id and super-ego. Its main concern is with the individual's
safety and allows some of the id's desires to be expressed, but only when
consequences of these actions are marginal. Ego defense mechanisms are often
used by the ego when id behavior conflicts with reality and either society's morals,
norms, and taboos or the individual's expectations as a result of the internalization
of these morals, norms, and their taboos.

In modern-day society, ego has many meanings. It could mean one‘s self-esteem;
an inflated sense of self-worth; or in philosophical terms, one‘s self. However,
according to Freud, the ego is the part of the mind which contains the
consciousness. Originally, Freud had associated the word ego to meaning a sense
of self; however, he later revised it to mean a set of psychic functions such as
judgment, tolerance, reality-testing, control, planning, defense, synthesis of
information, intellectual functioning, and memory.

The ego is the mediator between the id and the super-ego, trying to ensure that the
needs of both the id and the super-ego are met. It operates on a reality principle,
meaning it deals with the id and the super-ego; allowing them to express their
desires, drives and morals in realistic and socially appropriate ways. It is said that
the ego stands for reason and caution, developing with age. Sigmund Freud had
used an analogy which likened the ego to a rider and a horse; the ego being the
rider while the id being the horse. The horse provides the energy and the means of
obtaining the energy and information need, while the rider ultimately controls the
direction it wants to go. However, due to unfavorable conditions, sometimes the
horse makes its own decisions over the rocky terrain.

When the ego is personified, it is like a slave to three harsh masters: the id, the
super-ego and the external world. It has to do its best to suit all three, thus is
constantly feeling hemmed by the danger of causing discontent on two other sides.
It is said however, that the ego seems to be more loyal to the id, preferring to gloss
over the finer details of reality to minimize conflicts while pretending to have a
regard for reality. But the super-ego is constantly watching every one of the ego's
moves and punishes it with feelings of guilt, anxiety, and inferiority. To overcome
this, this ego employs methods of defense mechanism.

THE SUPER-EGO

Freud's theory implies that the super-ego is a symbolic internalization of the father
figure and cultural regulations. The super-ego tends to stand in opposition to the
desires of the id because of their conflicting objectives, and is aggressive towards
the ego. The super-ego acts as the conscience, maintaining our sense of morality
and proscription from taboos. Its formation takes place during the dissolution of

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the Oedipus complex and is formed by an identification with and internalization of
the father figure after the little boy cannot successfully hold the mother as a love-
object out of fear of castration.

The super-ego retains the character of the father, while the more powerful the
Oedipus complex was and the more rapidly it succumbed to repression (under the
influence of authority, religious teaching, schooling and reading), the stricter will
be the domination of the super-ego over the ego later on — in the form of
conscience or perhaps of an unconscious sense of guilt.

Oedipus complex
The Oedipus complex in Freudian psychoanalysis comes from the Greek myth of
Oedipus, who unknowingly kills his father and married his mother,

For girls Freud came to regard the relationship with the mother as of great
importance in understanding her psychosexual development, which affects her
entry into the Oedipus complex. As understood today, the Freudian Oedipus
complex has two poles. The "positive pole" implies hatred and a death wish for the
parent of the same sex(father for boys and mother for girls), and love and
attachment towards the parent of the opposite sex. The "negative pole" implies the
hatred and death wish directed at the parent of the opposite sex, and love for the
parent of the same sex. A common misunderstanding of the Oedipus complex is
"hatred for the father and love for the mother" in both sexes. This is wrong. In fact,
most individuals lie somewhere between the two poles of the Oedipus complex,
rather than on a single pole. The Oedipus complex is manifested only in very
young children.

The Oedipus complex tends to refer only to the experience of male children, with
female children experiencing an Electra complex in which they regard their
mothers as competitor for the exclusive love of their fathers.

Freud considered the successful resolution of the Oedipus complex to be key to

the development of gender roles and identity. He posited that boys and girls
resolved the conflicts differently as a result of castration anxiety (for males) and
penis envy (for females). Freud also held that the unsuccessful resolution of the
Oedipus complex could result in neurosis, pedophilia, and homosexuality. Females
later abandon this desire for their mother, and shift their sexual desires to their
fathers. Freud believed that this stems from their disappointment in discovery that
their mother lacks a penis.

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Freud's Psychosexual Stages of Development

Freud advanced a theory of personality development that centered on the effects of

the sexual pleasure drive on the individual psyche. At particular points in the
developmental process, he claimed, a single body part is particularly sensitive to
sexual, erotic stimulation. These erogenous zones are the mouth, the anus, and the
genital region. The child's libido centers on behavior affecting the primary
erogenous zone of his age; he cannot focus on the primary erogenous zone of the
next stage without resolving the developmental conflict of the immediate one.
A child at a given stage of development has certain needs and demands, such as
the need of the infant to nurse. Frustration occurs when these needs are not met;
Overindulgence stems from such an ample meeting of these needs that the child is
reluctant to progress beyond the stage. Both frustration and overindulgence lock
some amount of the child's libido permanently into the stage in which they occur;
both result in a fixation. If a child progresses normally through the stages,
resolving each conflict and moving on, then little libido remains invested in each
stage of development. But if he fixates at a particular stage, the method of
obtaining satisfaction which characterized the stage will dominate and affect his
adult personality.

A newborn baby, according to Freud, is bubbling with energy (libido; psychic

energy). However, this energy is without focus or direction, which would not
allow for survival. How, then, does the child develop the ability to control and
direct his/her energy?

Psychic energy is an important concept in Freudian psychology. The structure of

the mind and development all revolve around how the individual attempts to deal
with psychic energy. Raw libinal impulses provide the basic fuel that the mind
runs on. But the vehicle (mind) needs to well-formed and well-tuned in order to
get maximum energy.

In order to understand development (and neuroses), then, we should ―follow the

energy‖ and see where it goes. As with physical energy, psychic energy cannot be
created or destroyed in a big picture sense, however it may be dealt with in non-
obvious ways.

So, where does the infant‘s, then the child‘s, the adolescent's, and adult's energy
get focused? Freud believed that as development occurs the baby begins to focus
on first one object then another. As the infant‘s focus shifts the style and type of
gratification being sought changes.

The focal objects for the developing child's energy serves to define five main
stages of psychological development:

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 oral (0-18 months)
anal (18 months - 3 1/2 years)
phallic (3 1/2 years - 6 years)
latency (6 years – puberty)
genital (puberty - adulthood)

The Oral Stage (birth to about 18 months)

The oral stage begins at birth, when the oral cavity is the primary focus of libidal
energy. The child, of course, preoccupies himself with nursing, with the pleasure
of sucking and accepting things into the mouth. The oral character who is
frustrated at this stage, whose mother refused to nurse him on demand or who
truncated nursing sessions early, is characterized by pessimism, envy, suspicion
and sarcasm. The overindulged oral character, whose nursing urges were always
and often excessively satisfied, is optimistic, gullible, and is full of admiration for
others around him. The stage culminates in the primary conflict of weaning, which
both deprives the child of the sensory pleasures of nursing and of the
psychological pleasure of being cared for, mothered, and held. The stage lasts
approximately one and one-half years.

The Anal Stage (18 months to about 3 1/2 years)

At one and one-half years, the child enters the anal stage. With the advent of toilet
training comes the child's obsession with the erogenous zone of the anus and with
the retention or expulsion of the feces. This represents a classic conflict between
the id, which derives pleasure from expulsion of bodily wastes, and the ego and
superego, which represent the practical and societal pressures to control the bodily
functions. The child meets the conflict between the parent's demands and the
child's desires and physical capabilities in one of two ways: Either he puts up a
fight or he simply refuses to go. The child who wants to fight takes pleasure in
excreting maliciously, perhaps just before or just after being placed on the toilet. If
the parents are too lenient and the child manages to derive pleasure and success
from this expulsion, it will result in the formation of an anal expulsive character.
This character is generally messy, disorganized, reckless, careless, and defiant.
Conversely, a child may opt to retain feces, thereby spiting his parents while
enjoying the pleasurable pressure of the built-up feces on his intestine. If this tactic
succeeds and the child is overindulged, he will develop into an anal retentive
character. This character is neat, precise, orderly, careful, stingy, withholding,
obstinate, meticulous, and passive-aggressive. The resolution of the anal stage,
proper toilet training, permanently affects the individual propensities to possession
and attitudes towards authority. This stage lasts from one and one-half to two
years.

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The Phallic Stage (3 1/2 years to about 6 years)
The phallic stage is the setting for the greatest, most crucial sexual conflict in
Freud's model of development. In this stage, the child's erogenous zone is the
genital region. As the child becomes more interested in his genitals, and in the
genitals of others, conflict arises. The conflict, labeled the Oedipus complex (The
Electra complex in women), involves the child's unconscious desire to possess the
opposite-sexed parent and to eliminate the same-sexed one.
In the young male, the Oedipus conflict stems from his natural love for his mother,
a love which becomes sexual as his libidal energy transfers from the anal region to
his genitals. Unfortunately for the boy, his father stands in the way of this love.
The boy therefore feels aggression and envy towards this rival, his father, and also
feels fear that the father will strike back at him. As the boy has noticed that
women, his mother in particular, have no penises, he is struck by a great fear that
his father will remove his penis, too. The anxiety is aggravated by the threats and
discipline he incurs when caught masturbating by his parents. This castration
anxiety outstrips his desire for his mother, so he represses the desire. Moreover,
although the boy sees that though he cannot posses his mother, because his father
does, he can posses her vicariously by identifying with his father and becoming as
much like him as possible: this identification indoctrinates the boy into his
appropriate sexual role in life. A lasting trace of the Oedipal conflict is the
superego, the voice of the father within the boy. By thus resolving his incestuous
conundrum, the boy passes into the latency period, a period of libidal dormancy.
On the Electra complex, Freud was more vague. The complex has its roots in the
little girl's discovery that she, along with her mother and all other women, lack the
penis which her father and other men posses. Her love for her father then becomes
both erotic and envious, as she yearns for a penis of her own. She comes to blame
her mother for her perceived castration, and is struck by penis envy, the apparent
counterpart to the boy's castration anxiety. The resolution of the Electra complex
is far less clear-cut than the resolution of the Oedipus complex is in males; Freud
stated that the resolution comes much later and is never truly complete. Just as the
boy learned his sexual role by identifying with his father, so the girl learns her role
by identifying with her mother in an attempt to posses her father vicariously. At
the eventual resolution of the conflict, the girl passes into the latency period,
though Freud implies that she always remains slightly fixated at the phallic stage.
Fixation at the phallic stage develops a phallic character, who is reckless, resolute,
self-assured, and narcissistic--excessively vain and proud. The failure to resolve
the conflict can also cause a person to be afraid or incapable of close love; As
well, Freud postulated that fixation could be a root cause of homosexuality.

Latency Period (around six years until puberty)

The resolution of the phallic stage leads to the latency period, which is not a
psychosexual stage of development, but a period in which the sexual drive lies
dormant. Freud saw latency as a period of unparalleled repression of sexual
desires and erogenous impulses. During the latency period, children pour this

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repressed libidal energy into asexual pursuits such as school, athletics, and same-
sex friendships. But soon puberty strikes and the genitals once again become a
central focus of libidal energy.

The Genital Stage (puberty onwards)

In the genital stage, as the child's energy once again focuses on his genitals,
interest turns to heterosexual relationships. The less energy the child has left
invested in unresolved psychosexual developments, the greater his capacity will be
to develop normal relationships with the opposite sex. If, however, he remains
fixated, particularly on the phallic stage, his development will be troubled as he
struggles with further repression and defenses.

Defense Mechanisms
In the Freudian psychoanalytic theory, defense mechanisms are psychological
strategies brought into play by various entities to cope with reality and to maintain
self-image. Healthy persons normally use different defenses throughout life. The
purpose of the Ego Defence Mechanisms is to protect the mind/self/ego from
anxiety, social sanctions or to provide a refuge from a situation with which one
cannot currently cope.

Defense mechanisms protect us from being consciously aware of a thought or

feeling which we cannot tolerate. The defense only allows the unconscious
thought or feeling to be expressed indirectly in a disguised form. Defense
mechanisms are our way of distancing ourselves from a full awareness of
unpleasant thoughts, feelings and desires.

Defense mechanisms may hide any of a variety of thoughts or feelings e.g. anger,
fear, sadness, depression, greed, envy, competitiveness, love, passion, admiration,
criticalness, dependency, selfishness, grandiosity, helplessness.

Defense mechanisms include

Denial is the refusal to accept reality and to act as if a painful event, thought or
feeling did not exist. It is considered one of the most primitive of the defense
mechanisms because it is characteristic of very early childhood development.

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Denial characterizes failing to recognize obvious implications or consequences of
a thought, act, or situation. Examples: (1) a person having an extramarital affair
gives no thought to the possibility of pregnancy. (2) persons living near a volcano
disregard the dangers involved. (3) a disabled person plans to return to former
activities without planning a realistic program of rehabilitation.

Fantasy, when used as a defense mechanism, is the channeling of unacceptable or

unattainable desires into imagination. This can protect ones self esteem as when
educational, vocational or social expectations are not being met, one imagines
success in these areas and wards off self condemnation.

Projection is the misattribution of a person‘s undesired thoughts, feelings or

impulses onto another person who does not have those thoughts, feelings or
impulses. Projection is used especially when the thoughts are considered
unacceptable for the person to express, or they feel completely ill at ease with
having them. For example, a spouse may be angry at their significant other for not
listening, when in fact it is the angry spouse who does not listen. Projection is
often the result of a lack of insight and acknowledgement of one‘s own
motivations and feelings.

Acting out is performing an extreme behavior in order to express thoughts or

feelings the person feels incapable of otherwise expressing. Instead of saying,
―I‘m angry with you,‖ a person who acts out may instead throw a book at the
person, or punch a hole through a wall. When a person acts out, it can act as a
pressure release, and often helps the individual feel calmer and peaceful once
again. For instance, a child‘s temper tantrum is a form of acting out when he or
she doesn‘t get his or her way with a parent. Self-injury may also be a form of
acting-out, expressing in physical pain what one cannot stand to feel emotionally.

Idealization is the overestimation of the desirable qualities and underestimation of

the limitations of a desired object. Examples: (1) a lover speaks in glowing terms
of the beauty and intelligence of an average-looking woman who is not very
bright. (2) a purchaser, having finally decided between two items, expounds upon
the advantages of the one chosen.

Displacement is the redirecting of thoughts feelings and impulses from an object

that gives rise to anxiety to a safer, more acceptable one or a less threatening one.
Being angry at the boss and kicking the dog can be an example of displacement.
Another example may be a mother who yells at her child because she is angry with
her husband.

Dissociation is the Splitting-off a group of thoughts or activities from the main

portion of consciousness. Example: a politician works vigorously for integrity in
government, but at the same time engages in a business venture involving a
conflict of interest without being consciously hypocritical and seeing no

22
connection between the two activities. The politician thus disassociates himself
with his corrupt/unacceptable co-curricular activities.

Some dissociation is helpful in keeping one portion of one's life from interfering
with another (e.g., not bringing problems home from the office).

Isolation is the splitting-off of the emotional components from a thought.

Example: a medical student dissects a cadaver without being disturbed by thoughts
of death. Isolation may be temporary (affect postponement). Example: a bank
teller appears calm and cool while frustrating a robbery but afterward is tearful
and tremulous. In short you "think" the feeling but don't really feel it.

Intellectualization is the use of a cognitive approach without the attendant

emotions to suppress and attempt to gain mastery over the perceived disorderly
and potentially overwhelming impulses. An example might be an individual who
when told they had a life threatening disease focuses exclusively on the statistical
percentages of recovery and is unable to cope with their fear and sadness.

Reaction Formation is the converting of wishes or impulses that are perceived to

be dangerous into their opposites. Black Americans for example proudly took up
the name ―nigger‖ yet it was intended to be an abuse meant to hurt and annoy
them.

Repression is the unconscious blocking of unacceptable thoughts, feelings and

impulses. The key to repression is that people do it unconsciously, so they often
have very little control over it. ―Repressed memories‖ are memories that have
been unconsciously blocked from access or view.

Altruism is the individual deals with emotional conflict or internal or external

stressors by dedication to meeting the needs of others. Unlike the self-sacrifice
sometimes characteristic of reaction formation, the individual receives
gratification either vicariously or from the response of others.

Humor is evidenced when the individual deals with emotional conflict or external
stressors by emphasizing the amusing or ironic aspects of the conflict or stressors.
Humor reduces the intensity of a situation, and places a cushion of laughter
between the person and the impulses.

Sublimation is the channeling of unacceptable impulses, thoughts and emotions

into more acceptable outlets. For instance, when a person has sexual impulses they
would like not to act upon, they may instead focus on rigorous exercise.
Refocusing such unacceptable or harmful impulses into productive use helps a
person channel energy that otherwise would be lost or used in a manner that might
cause the person more anxiety.

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Fantasy, when used as a defense mechanism, is the channeling of unacceptable or
unattainable desires into imagination. For example, imagining one‘s ultimate
career goals can be helpful when one experiences temporary setbacks in academic
achievement. Both can help a person look at a situation in a different way, or focus
on aspects of the situation not previously explored.

Suppression The conscious process of pushing thoughts into the preconscious;

the conscious decision to delay paying attention to an emotion or need in order to
cope with the present reality, for example a student goes on vacation worried that
he may be failing; she decides not to spoil her holiday by thinking of school.

Rationalization is the cognitive reframing of ones perceptions to protect the ego

in the face of changing realities. A person comes up with various explanations to
justify the situation (while denying his feelings).
Rationalization involves putting something into a different light or offering a
different explanation for one‘s perceptions or behaviors in the face of a changing
reality. For instance, a woman who starts dating a man she really, really likes and
thinks the world of is suddenly dumped by the man for no reason. She reframes
the situation in her mind with, ―I suspected he was a loser all along.‖

Undoing is the attempt to take back behavior or thoughts that are unacceptable.
An example of undoing would be excessively praising someone after having
insulted them. A person try to reverse or undo your feeling by doing something
that indicates the opposite feeling. It may be an act or communication which
negates a previous one.

Regression is the reversion to an earlier stage of development in the face of

unacceptable impulses. For an example an adolescent who is overwhelmed with
fear, anger and growing sexual impulses might become clinging and begin thumb
sucking or bed wetting. A person reverts to an old, usually immature behavior so
as to ventilate his feeling.

Compartmentalization is a lesser form of dissociation, wherein parts of oneself

are separated from awareness of other parts and behaving as if one had separate
sets of values. An example might be an honest person who cheats on their income
tax return and keeps their two value systems distinct and un-integrated while
remaining unconscious of the cognitive dissonance.

Compensation is a process of psychologically counterbalancing perceived

weaknesses by emphasizing strength in other arenas. By emphasizing and focusing
on one‘s strengths, a person is recognizing they cannot be strong at all things and
in all areas in their lives. For instance, when a person says, ―I may not know how
to cook, but I can sure do the dishes!,‖ they‘re trying to compensate for their lack
of cooking skills by emphasizing their cleaning skills instead. When done
appropriately and not in an attempt to over-compensate, compensation is defense
mechanism that helps reinforce a person‘s self-esteem and self-image

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Assertiveness is the emphasis of a person‘s needs or thoughts in a manner that is
respectful, direct and firm. Communication styles exist on a continuum, ranging
from passive to aggressive, with assertiveness falling neatly in between. People
who are passive and communicate in a passive manner tend to be good listeners,
but rarely speak up for themselves or their own needs in a relationship. People
who are aggressive and communicate in an aggressive manner tend to be good
leaders, but often at the expense of being able to listen empathetically to others
and their ideas and needs. People who are assertive strike a balance where they
speak up for themselves, express their opinions or needs in a respectful yet firm
manner, and listen when they are being spoken to. Becoming more assertive is one
of the most desired communication skills and helpful defense mechanisms most
people want to learn, and would benefit in doing so.

Affiliation, here the individual deals with emotional conflict or internal or external
stressors by turning to others for help or support. This involves sharing problems
with others but does not imply trying to make someone else responsible for them.

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 CHAPTER 3
PERSONALITY AND SOCIAL
DEVELOPMENT

Personality
Personality can be defined as a dynamic and organized set of characteristics
possessed by a person that uniquely influences his or her cognitions, motivations,
and behaviors. The word "personality" originates from the Latin word persona,
meaning mask

Personality studies in psychology focuses on personality based on theories of

individual differences or similarities, eg how and why people differ from each
other, and also examines human nature and how all people are similar to one other.

Psychologists seek to explain why people behave the way they do, they seek to
answer questions such as do we act the way we do on our own will (free will) or
are all our actions predetermined even before we are born (determinism)?, are
our personalities determined by genetics and heredity, or are they determined by
environment and experiences (nature versus nurture)?

Personality psychologists also focus on the study of personality types, personality

traits, individual differences and personality alteration (brainwashing). They also
conduct personality tests so as to describe aspects of a people‘s characters,
thoughts, and feelings.

Personality development is also an area of interest to psychologists as it looks at

human personality development over time. Infact it has been argued that an
individual's personality is an aggregate conglomeration of decisions he made
throughout his life (Bradshaw).
There are inherent natural, genetic, and environmental factors that contribute to
the development of personality; however, in the pursuit of a more defined persona,
many individuals enroll in courses offered in colleges to further or enhance the
image they intend to project to others. These classes assist in identifying one's
conscious traits and contrasting them with what he intend to exhibit. According to
process of socialization, "personality also colors our values, beliefs, and
expectations...Hereditary factors that contribute to personality development do so
as a result of interactions with the particular social environment in which people
live.

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Freudian concept of personality
Psychoanalytic theories explain human behaviour in terms of the interaction of
various components of personality. Sigmund Freud was the founder of this school.
Freud drew on the physics of his day (thermodynamics) to coin the term
psychodynamics. Based on the idea of converting heat into mechanical energy, he
proposed that psychic energy could be converted into behavior. Freud's theory
places central importance on dynamic, unconscious psychological conflicts.

Freud divides human personality into three significant components: the ego,
superego, and id. The id acts according to the pleasure principle, demanding
immediate gratification of its needs regardless of external environment; the ego
then must emerge in order to realistically meet the wishes and demands of the id in
accordance with the outside world, adhering to the reality principle. Finally, the
superego inculcates moral judgment and societal rules upon the ego, thus forcing
the demands of the id to be met not only realistically but morally. The superego is
the last function of the personality to develop, and is the embodiment of
parental/social ideals established during childhood. According to Freud,
personality is based on the dynamic interactions of these three components

The channeling and release of sexual (libidal) and aggressive energies, which
ensues from the "Eros" (sex; instinctual self-preservation) and "Thanatos" (death;
instinctual self-annihilation) drives respectively, are major components of his
theory. It is important to note that Freud's broad understanding of sexuality
included all kinds of pleasurable feelings experienced by the human body. Freud
believed that adult personality is dependent upon early childhood experiences and
largely determined by age five. Fixations that develop during the infantile stage
contribute to adult personality and behavior.

One of Sigmund Freud's earlier associates, Alfred Adler, did agree with Freud that
early childhood experiences are important to development, and believed that birth
order may influence personality development. Adler believed the oldest was the
one that set high goals to achieve to get attention back that they lost when the
younger siblings were born. He believed the middle children were competitive and
ambitious possibly so they are able to surpass the first-born‘s achievements, but
were not as much concerned about the glory. Also he believed that the last born
would be more dependent and sociable but be the baby. He also believed that only
children love being the center of attention and mature quickly, but in the end fail
to become independent.

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How personality develops to abnormality

Personality disorders
Personality disorders also known as character disorders are enduring patterns of
inner experience and behavior that deviates markedly from the expectations of the
culture of the individual who exhibits it. Simply put, they are long-lasting rigid
patterns of thought and actions

These patterns, as noted, are inflexible and pervasive across many situations, due
in large part to the fact that such behavior is ego-syntonic (i.e., the patterns are
consistent with the ego integrity of the individual), and therefore, perceived to be
appropriate by that individual. The onset of these patterns of behavior can
typically be traced back to the beginning of adulthood, and, in rare instances, early
adolescence.

It is important to state that personality disorders are enduring patterns that are not
due to the direct physiological effects of a substance or a general medical
condition such as head injury.

Personality disorders are pervasive chronic psychological disorders, which can

greatly affect a person's life. Having a personality disorder can negatively affect
one's work, one's family, and one's social life. Personality disorders exists on a
continuum so they can be mild to more severe in terms of how pervasive and to
what extent a person exhibits the features of a particular personality disorder.
While most people can live pretty normal lives with mild personality disorders (or
more simply, personality traits), during times of increased stress or external
pressures (work, family, a new relationship, etc.), the symptoms of the personality
disorder will gain strength and begin to seriously interfere with their emotional
and psychological functioning.

Those with a personality disorder possess several distinct psychological features

including disturbances in self-image; ability to have successful interpersonal
relationships; appropriateness of range of emotion, ways of perceiving themselves,
others, and the world; and difficulty possessing proper impulse control. These
disturbances come together to create a pervasive pattern of behavior and inner
experience that is quite different from the norms of the individual's culture and
that often tend to be expressed in behaviors that appear more dramatic than what
society considers usual. Therefore, those with a personality disorder often
experience conflicts with other people and vice-versa.

These patterns of behavior that deviates markedly from the expectations of the
individual's culture may include

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 Paranoid personality disorder where the person is dramatic, emotional, or
erratic
 Sadistic Personality Disorder is a pervasive pattern of cruel, demeaning,
and aggressive behavior.
 Nistrionic personality disorder exhibiting superficial charm, insincerity,
egocentricity and manipulation
 Narcissistic personality disorder exhibiting grandiosity, self-focused lack of
empathy for others, exploitativeness and independence.
 Obsessive-compulsive personality disorder hence perfectionism, excessive
devotion to work, rigidity, stubbornness and dictatorial tendencies.
 Antisocial personality disorder
 Avoidant personality disorder
 Dependent personality disorder
 Obsessive-compulsive personality disorder
 Emotionally unstable personality disorder
 Obsessive-compulsive personality disorder
 Anxious (avoidant) personality disorder
 Dependent personality disorder
 Aggressive Personality Disorder
 Self-defeating personality disorder

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 CHAPTER 4
PROGRESSION OF ABNORMAL BEHAVIOUR

Mental ailments progress from minor to severe, hence the progress may rise from
stress, to depression and even to psychosis.

Stress
Stress is an internal response to stimuli or pressures that challenge an organism's
ability to adapt or cope, disrupting homeostasis (internal balance). Stress may be
mental, physiological, anatomical or physical. Stressful stimuli, also known as
stressors, range from chemical agents to medical illnesses to a hectic lifestyle.
Psychologically, the level of stress can depend on the emotional or cognitive
appraisal that a person makes of a situation and of himself. Stress typically
involves activation of the fight-or-flight response. Stress has been shown to cause
neurochemical, hormonal and physiological changes.

Stress is thus a psychological and physiological response to events that upset our
personal balance in some way. When faced with a threat, whether to our physical
safety or emotional equilibrium, the body's defenses kick into high gear in a rapid,
automatic process known as the ―fight-or-flight‖ response. We all know what this
stress response feels like: heart pounding in the chest, muscles tensing up, breath
coming faster, every sense on red alert.

We all face different challenges and obstacles, and sometimes the pressure is hard
too handle. When we feel overwhelmed, under the gun, or unsure how to meet the
demands placed on us, we experience stress. In small doses, stress can be a good
thing. It can give you the push you need, motivating you to do your best and to
stay focused and alert. Stress is what keeps you on your toes during a presentation
at work or drives you to study for your midterm when you'd rather be watching
TV. But when the going gets too tough and life's demands exceed your ability to
cope, stress becomes a threat to both your physical and emotional well-being.

Stress may simply be viewed a feeling that's created when we react to particular
events. It's the body's way of rising to a challenge and preparing to meet a tough
situation with focus, strength, stamina, and heightened alertness.

Signs of Stress

People who are experiencing stress overload may notice some of the following
signs:

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  anxiety or panic attacks
 a feeling of being constantly pressured, hassled, and hurried
 irritability and moodiness
 physical symptoms, such as stomach problems, headaches, or even chest
pain
 allergic reactions, such as eczema or asthma
 problems sleeping
 drinking too much, smoking, overeating, or doing drugs
 sadness or depression

Keeping stress under Control

 Take a stand against overscheduling. If you're feeling stretched, consider

cutting out an activity or two, opting for just the ones that are most
important to you.
 Be realistic. Don't try to be perfect - no one is. And expecting others to be
perfect can add to your stress level, too (not to mention put a lot of pressure
on them!). If you need help on something, like schoolwork, ask for it.
 Get a good night's sleep. Getting enough sleep helps keep your body and
mind in top shape, making you better equipped to deal with any negative
stressors. Because the biological "sleep clock" shifts during adolescence,
many teens prefer staying up a little later at night and sleeping a little later
in the morning. But if you stay up late and still need to get up early for
school, you may not get all the hours of sleep you need.
 Learn to relax. The body's natural antidote to stress is called the
relaxation response. It's your body's opposite of stress, and it creates a
sense of well-being and calm. The chemical benefits of the relaxation
response can be activated simply by relaxing. You can help trigger the
relaxation response by learning simple breathing exercises and then using
them when you're caught up in stressful situations. (Click on the button to
try one.) And ensure you stay relaxed by building time into your schedule
for activities that are calming and pleasurable: reading a good book or
making time for a hobby, spending time with your pet, or just taking a
relaxing bath.
 Treat your body well. Experts agree that getting regular exercise helps
people manage stress. (Excessive or compulsive exercise can contribute to
stress, though, so as in all things, use moderation.) And eat well to help
your body get the right fuel to function at its best. It's easy when you're
stressed out to eat on the run or eat junk food or fast food. But under
stressful conditions, the body needs its vitamins and minerals more than
ever. Some people may turn to substance abuse as a way to ease tension.
Although alcohol or drugs may seem to lift the stress temporarily, relying
on them to cope with stress actually promotes more stress because it wears
down the body's ability to bounce back.

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  Watch what you're thinking. Your outlook, attitude, and thoughts
influence the way you see things. Is your cup half full or half empty? A
healthy dose of optimism can help you make the best of stressful
circumstances. Even if you're out of practice, or tend to be a bit of a
pessimist, everyone can learn to think more optimistically and reap the
benefits.
 Solve the little problems. Learning to solve everyday problems can give
you a sense of control. But avoiding them can leave you feeling like you
have little control and that just adds to stress. Develop skills to calmly look
at a problem, figure out options, and take some action toward a solution.
Feeling capable of solving little problems builds the inner confidence to
move on to life's bigger ones - and it and can serve you well in times of
stress.

Causes of stress
Major life changes

Major life events are stressors. Whether it be a divorce, a child leaving home, a
planned pregnancy, a move to a new town, a career change, graduating from
college, or a diagnosis of cancer, the faster or more dramatic the change, the
greater the strain. Furthermore, the more major life changes you‘re dealing with at
any one time, the more stress you‘ll feel.

Daily hassles and demands

While major life changes are stressful, they are also relative rarities. After all, it‘s
not every day that you file for divorce or have a baby. However, you may battle
traffic, argue with your family members, or worry about your finances on a daily
basis. Because these small upsets occur so regularly, they end up affecting us the
most.

Daily causes of stress include:

 Environmental stressors – Your physical surroundings can set off the stress
response. Examples of environmental stressors include an unsafe
neighborhood, pollution, noise (sirens keeping you up at night, a barking
dog next door), and uncomfortable living conditions. For people living in
crime-ridden areas or war-torn regions, the stress may be unrelenting.
 Family and relationship stressors – Problems with friends, romantic
partners, and family members are common daily stressors. Marital
disagreements, dysfunctional relationships, rebellious teens, or caring for a
chronically-ill family member or a child with special needs can all send
stress levels skyrocketing.

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  Work stressors – In our career-driven society, work can be an ever-present
source of stress. Work stress is caused by things such as job dissatisfaction,
an exhausting workload, insufficient pay, office politics, and conflicts with
your boss or co-workers.
 Social stressors – Your social situation can cause stress. For example,
poverty, financial pressures, racial and sexual discrimination or harassment,
unemployment, isolation, and a lack of social support all take a toll on daily
quality of life.

Internal Causes of Stress

Not all stress is caused by external pressures and demands. Your stress can also be
self-generated. Internal causes of stress include:

 Uncertainty or worries
 Perfectionism
 Pessimistic attitude
 Low self-esteem
 Self-criticism
 Excessive or unexpressed anger
 Unrealistic expectations
 Lack of assertiveness
or beliefs

Symptoms of Stress

 Stress usually first affects the inner emotions. Initial symptoms may include
the following feelings:

o Anxiousness

o Nervousness

o Distraction

o Excessive worry

o Internal pressure

 These emotional states can then begin to affect a person's outward

appearance:

o Unusually anxious or nervous

o Distracted

o Self-absorbed

o Irritable

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  As the stress level increases, or if it lasts over a longer period of time, a
person may begin to feel more severe emotional or physical effects:

o Excessive fatigue

o Depression

o Sometimes even think of hurting yourself or others

o Headaches

o Nausea and vomiting

o Chest pain or pressure

o Heart racing

o Dizziness or flushing

o Tremulousness or restlessness

o Hyperventilation or choking sensation

In most cases, these symptoms are very minor and don't last very long. If they
become more severe or increase in frequency and severity, seek medical help.

Effects of stress on Health

 Chronic pain  Heart disease  Infertility
 Migraines  Diabetes  Autoimmune
 Ulcers  Asthma diseases
 Heartburn  PMS  Irritable bowel
 High blood pressure  Obesity syndrome
 Skin problems

Emotional effects

Chronic stress grinds away at your mental health, causing emotional damage in
addition to physical ailments. Long-term stress can even rewire the brain, leaving
you more vulnerable to everyday pressures and less able to cope. Over time, stress
can lead to mental health problems such as:

 anxiety
 depression
 eating disorders, and
 substance abuse.

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Depression
What is a depressive disorder?

A depressive disorder is a syndrome (group of symptoms) that reflects a sad

and/or irritable mood exceeding normal sadness or grief. More specifically, the
sadness of depression is characterized by a greater intensity and duration and by
more severe symptoms and functional disabilities than is normal.

Depressive signs and symptoms are characterized not only by negative thoughts,
moods, and behaviors but also by specific changes in bodily functions (for
example, crying spells, body aches, low energy or libido, as well as problems with
eating, weight, or sleeping).

Causes of Depression
Some of the more common factors involved in depression are:

 Family history. Genetics play an important part in depression. It can run in

families for generations.

 Trauma and stress. Things like financial problems, the breakup of a

relationship, or the death of a loved one can bring on depression. You can
become depressed after changes in your life, like starting a new job,
graduating from school, or getting married.

 Pessimistic personality. People who have low self-esteem and a negative

outlook are at higher risk of becoming depressed. These traits may actually
be caused by low-level depression (called dysthymia).

 Physical conditions. Serious medical conditions like heart disease, cancer,

and HIV can contribute to depression, partly because of the physical
weakness and stress they bring on. Depression can make medical
conditions worse, since it weakens the immune system and can make pain
harder to bear. In some cases, depression can be caused by medications
used to treat medical conditions.

 Other psychological disorders. Anxiety disorders, eating disorders,

schizophrenia, and (especially) substance abuse often appear along with
depression.

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Symptoms of depression
 Persistently sad, anxious, angry, irritable, or "empty" mood
 Feelings of hopelessness, pessimism
 Feelings of guilt, worthlessness, helplessness
 Loss of interest or pleasure in hobbies and activities that were once enjoyed
 Insomnia, early-morning awakening, or oversleeping
 Decreased appetite and/or weight loss, or overeating and/or weight gain
 Fatigue, decreased energy, being "slowed down"
 Crying spells
 Thoughts of death or suicide, suicide attempts
 Restlessness, irritability
 Difficulty concentrating, remembering, making decisions
 Persistent physical symptoms that do not respond to treatment, such as
headaches, digestive disorders, and/or chronic pain

 Poor school performance

 Persistent boredom
 Frequent complaints of physical problems such as headaches and
stomachaches

Treatments available for depression

 Antidepressant medications
 Electroconvulsive therapy (an electric current is passed through the brain to
produce controlled convulsions/seizures).
 Psychotherapy

NEUROSIS and PSYCHOSIS

The terms neurotic and psychotic are both used to describe conditions or illnesses
that affect mental health. Though neurotic and psychotic are both relative to
mental health, there are differences between neurotic and psychotic conditions.
The terms neurosis and psychosis are sometimes used interchangeably with
neurotic and psychotic disorders.

A neurotic disorder can be any mental imbalance that causes or results in distress.
In general, neurotic conditions do not impair or interfere with normal day to day
functions, but rather create the very common symptoms of depression, anxiety, or
stress. It is believed that most people suffer from some sort of neurosis as a part of
human nature.

36
As an example, some people are afraid or unable to speak in front of large crowds.
As a result, any situation that might warrant public speaking can cause symptoms
from nervous nausea to vomiting, or from trembling to excessive perspiration.
Some people suffer more severe symptoms of neurosis than others, and some
forms of neurosis are more marked, such as obsessive-compulsive disorder.
However, neurosis is not as severe as psychosis.

Psychosis, or a psychotic disorder, is believed to be more of a symptom than a

diagnosis. As a psychiatric term, psychosis refers to any mental state that impairs
thought, perception, and judgment. Psychotic episodes might affect a person with
or without a mental disease. A person experiencing a psychotic episode might
hallucinate, become paranoid, or experience a change in personality.

Generally speaking, the psychotic state is not permanent. Psychotic behavior

differs from psychopathic behavior, and psychotic episodes rarely involve the
violence associated with psychopathic behavior. Psychotic is also not the same as
insane, which is both a medical and a legal description for a person who cannot be
held accountable for his or her actions.

In essence, the primary difference between neurotic and psychotic is the manner in
which they affect mental health. Neurotic behavior can be naturally present in any
person and linked to a developed personality. Psychotic behavior can come and go
as a result of various influences. The effects of some drugs can cause psychotic
episodes, or a traumatic situation that affects a person‘s psychological well-being
might trigger the episode. Distinguishing between neurotic and psychotic
conditions or disorders is accomplished through an evaluation by a psychiatrist or
psychologist, who may treat symptoms with medication or therapy.

Psychosis
Psychosis is a loss of contact with reality, usually including false ideas about what
is taking place or who one is (delusions) and seeing or hearing things that aren't
there (hallucinations). A person is thus is unable to distinguish between reality
and their imagination.

Possible causes of psychosis include

 Alcohol and certain drugs such as cocaine (intoxication and withdrawal

effects)
 Brain tumors
 Dementia (including Alzheimer's)
 Epilepsy
 Manic depression (bipolar disorder)

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  Depression
 Schizophrenia
 Stroke
 Sleep deprivation has been also been linked to psychosis.

Symptoms

 Abnormal displays of emotion

 Confusion
 Depression and sometimes suicidal thoughts
 Disorganized thought and/or speech
 Extreme excitement (mania)
 False beliefs (delusions)
 Loss of touch with reality
 Mistaken perceptions (illusions)
 Seeing, hearing, feeling, or perceiving things that are not there
(hallucinations)
 Unfounded fear/suspicion

Treatment of psychoses

Treatment for psychosis involves using a combination of antipsychotic medicines

and psychological therapies.

Antipsychotic drugs, which reduce "hearing voices" (auditory hallucinations) and

delusions, and control thinking and behavior are helpful. Group or individual
therapy can also be useful.

Antipsychotics

Antipsychotics are usually recommended as the first-line treatment for psychosis.

Antipsychotics work by blocking dopamine's effects on the brain.

There are two main types of antipsychotics:

 typical antipsychotics - the first generation of antipsychotics that were

developed during the 1950s, and
 atypical antipsychotics - a newer generation of antipsychotics that were
developed during the 1990s.

Atypical antipsychotics are usually recommended as they have less potential to

cause side effects. However, they are not suitable, or effective, for everyone.

Antipsychotics can usually reduce feelings of anxiety, or aggression, within a few

hours of use, but they may take several days, or weeks, to reduce other psychotic
symptoms, such as hallucinations, or delusional thoughts.

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Both typical and atypical antipsychotics have side effects, although not everyone
will experience them and their severity will differ from person to person.

The side effects of typical antipsychotics include:

 drowsiness,
 shaking,
 trembling,
 muscle twitches, and
 spasms.

Side effects of both typical and atypical antipsychotics include:

 weight gain,
 blurred vision,
 constipation,
 lack of sex drive, and
 dry mouth.

Psychological treatment

Psychological treatment, such as counseling, or cognitive behavioral therapy

(CBT) can help to reduce the intensity and anxiety caused by psychosis.

CBT is based on the assumption that most unwanted thinking patterns and
emotional and behavioural reactions are learnt over a long period of time. The aim
is to identify the unhelpful thinking that is causing your unwanted feelings and
behaviours, and to learn to replace this thinking with more realistic and balanced
thoughts.

Prevention
Prevention depends on the cause. For example, avoiding alcohol abuse prevents
alcohol-induced psychosis.

Avoiding Cannabis

Research has shown that regular cannabis users are twice as likely to develop a
psychotic illness, such as schizophrenia, than people who do not use the drug.

Cannabis is known to increase the levels of dopamine in the brain, so long-term

use may cause permanent changes in your brain's chemistry that could lead to
psychosis.

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People who regularly use 'skunk' - the herbal type of cannabis which is specifically
bred for its increased strength - are thought to be most at risk.

You should also avoid using other recreational drugs, such as cocaine, or ecstasy
because these will also increase your risk of developing psychosis.

Avoiding stress and depression

Experiencing prolonged bouts of stress can trigger an episode of depression, and

both stress and depression are a major risk factor for psychosis.

The advice below may help to reduce your levels of stress, preventing depression
and a subsequent psychotic episode.

 Use a problem solving approach to deal with stresses and worries.

 Try to identify negative thoughts and change them to positive thoughts.
 Assess your symptoms regularly and consult your doctor and/or counsellor
if problems arise.
 Take regular exercise. Exercise can trigger the release of the brain chemical
serotonin, which boosts your mood.
 Learn how to relax using relaxation exercises and tapes.
 Practice yoga and meditation, or have a massage to help relieve tension and
anxiety.
 Join a self-help group and discuss your feelings and concerns. This can help
you to feel less isolated.
 Avoid smoking, illegal drugs, and alcohol. These may appear to make you
feel better in the short-term, but they can make you feel worse in the long-
term.

Neurosis
Neurosis is a term that refers to any mental imbalance that causes distress, but,
unlike a psychosis it does not prevent or affect rational thought.

Neuroses are characterized by such symptoms as anxiety, insecurity, depression,

and unreasonable fears. Most people have these feelings occasionally. But a
person who suffers a neurotic disorder has them frequently or even constantly.
Such feelings interfere with the individual's life and relations with others.

Anxiety neurosis (panic disorder) is a disorder characterized by intense, baseless

worry. Phobias are unreasonable fears of certain situations or activities, such as
open spaces or travelling in aeroplanes. Hypochondriasis is an abnormal fear that

40
one has a disease. Obsessions and compulsions are senseless thoughts and acts that
a person feels forced to repeat.

Neurotic disorders seldom disable a person totally. Individuals who have a

neurotic disorder recognize the symptoms as unacceptable and strange. Unlike
those with more severe mental illnesses called psychoses, people with a neurosis
can distinguish between reality and imagination. Neurotic disorders do not include
mental problems that seem to have a physical cause. One such problem is the loss
of memory that sometimes occurs with aging.

To Sigmund Freud the term neurosis describes a neurotic process that produces
certain symptoms. The process begins with an unconscious conflict between
opposing desires or between a desire and a prohibition. For example, an
unconscious feeling of aggression, such as a desire to harm someone physically,
might conflict with feelings of guilt. The unconscious awareness of the conflict
produces a mental barrier called a defence mechanism. This barrier keeps
unwanted feelings out of a person's conscious awareness. To avoid feeling guilty,
an individual might repress (hold back) a desire to harm someone. Such a defence
mechanism, in turn, produces a symptom. For example, the person might have an
abnormal fear of objects that could be used to actually carry out the repressed
desire to cause harm. Freud believed that such disturbances arose from distressing
experiences that had occurred during childhood.

Simply put, the neurotic is the worrier, somebody that lets society impose itself
upon him, and hence suffers stress, anxiety etc accordingly.

Treatment can be carried out through psychotherapy, behavior therapy, and

various drugs to alleviate the symptoms. Antidepressants and anti-anxiety
medications will help the sufferer, and some drugs will boost up self-worth and
self esteem.

Perspectives on Abnormal Behavior and Mental

disorder
Mental disorder or mental illness are terms used to refer to a psychological or
physiological pattern that occurs in an individual and is usually associated with
distress or disability that is not expected as part of normal development or culture.
The recognition and understanding of mental disorders has changed over time.
Definitions, assessments, and classifications of mental disorders can vary.

Probably no aspect of behavior is more challenging to understand than

psychopathology (the study of mental disorders). In everyday life, people often

41
talk about "mental illness", a term which echoes the medical background of many
mental health practitioners. This medical model (embraced by the Biological
approach) assumes that the cause of psychopathology is to be found in physical
malfunctions of the brain and nervous system. However, not all approaches agree
that all disorders have purely physical causes; indeed, the other approaches
generally argue that learning often contributes to behavioral problems (such as
phobias and stress). In order to avoid prejudging the cause of observed problems,
the term "abnormal behavior" is preferable to terms like "mental illness".

Names are important when it comes to discussing abnormal behavior, because in

everyday life, the use of terms related to pathology can often have negative social
effects, called stigmatizing. Even among professionals, there is a tendency to
equate the problem with the person, so that one speaks of "a schizophrenic" rather
than "a person with schizophrenia". Issues like this demonstrate that the social
dimension of how we respond to abnormal behavior is important, and not easily
separable from the behavior itself.

The reality is that public understanding of abnormal behavior is fairly limited.

While it has improved since the days of early asylums like Bedlam (in London)
and Bicetre (near Paris), most people tend to be wary or even frightened when
they encounter behavior which seems very atypical. This is most obvious when
considering disorders like schizophrenia, where the individual may experience
hallucinations and severe delusions, but it is also true that most people have little
understanding of mood disorders like depression, or the real nature of drug
addiction, or many other problems described as "abnormal behavior". In some
respects, the Internet is helping, by making it easier for people to access
information about both health and pathology, but the reality is that right now we
still don't have all the answers when it comes to understanding and treating
abnormal behavior.

Perspectives on Aetiology and Treatment

If one seeks to understand abnormal behavior, it is useful to start with a definition

of what is "abnormal". In the past abnormality was linked to demonic possession.
Today, diagnostic criteria tries to consider behavior in terms of the person's ability
to function and reported quality of life (i.e., maladaptiveness and suffering). The
use of diagnostic categories, based primarily on symptoms, is an attempt to group
together similar cases, in much the way that early botanists categorized similar
plants. (In both cases, the assumption is that categorizing is the first step towards a
deeper understanding.) The most widely used systems for diagnostic classification
are Diagnostic and Statistical Manual IV (DSM_IV) and the International
Classification of Diseases (ICD).

Diagnosis, of course, is normally seen as the first step to understanding the cause
(aetiology) of the abnormal behavior, and therefore to identifying an appropriate
treatment. While this process has proven very successful in dealing with

42
communicable diseases like influenza and measles, it has had less overall success
in dealing with abnormal behavior. In part, this reflects theoretical disagreements
among the five approaches about aetiology, and therefore about how best to treat a
problem. A second factor which hampers the effectiveness of diagnosis based on
symptoms is that similar behaviors may result from different causes. (For
example, an elderly person showing delusions may be suffering from paranoia, or
may simply have an undiagnosed hearing impairment which leads them to
misinterpret the words and actions of others!)

Even the process by which health practitioners (and society) diagnose problems
and disorders can pose problems--for example, you are less likely to be accurately
diagnosed if the practitioner is from a different cultural or ethnic background than
your own. In fairness, the groups that publish the most widely used standards for
diagnosis, the American Psychiatric Association (DSM-IV) and the World Health
Organization (ICD-9), are aware of the difficulties, and are striving to improve the
accuracy and reliability of diagnosis, but the present system is far from perfect.

Causes of mental disorders

A common view is that disorders often result from genetic vulnerabilities

combining with environmental stressors. A mix of models may be used to explain
particular disorders.

Genetic studies have indicated that genes often play an important role in the
development of mental disorders, via developmental pathways interacting with
environmental factors. The reliable identification of connections between specific
genes and specific categories of disorder has proven more difficult.

Environmental events surrounding pregnancy and birth have also been implicated.
Brain injury also increases the risk of developing certain mental disorders.

Social influences have been found to be important, including abuse, bullying and
other negative or stressful life experiences. The specific risks and pathways to
particular disorders are less clear. Aspects of the wider community have also been
implicated, including employment problems, socioeconomic inequality, lack of
social cohesion and even problems linked to migration..

Examples of mental disorders include

Affective Disorders

Affective disorders are the most common groupings of psychiatric disorders. The
primary symptom is that of changed affect or mood. These mood disorders may be
manic-depressive illness (bipolar), in which the person swings between extreme

43
high and low moods, or severe depression (unipolar) in which the person has
persistent low moods. This happens when there is a disruption in normal brain
processing. The most common affective disorder is depression. Some sources
differentiate between reactive depression (in reaction to some traumatic life event)
and endogenous depression (no apparent precipitating factor). Recent research
suggests that all depressive symptoms may be triggered by the body's response to
external events. Depression is most apt to strike people in the prime of life--ages
25 to 44, but can affect people of any age. With appropriate treatment, 80% of
people with depression improve.

Anxiety Disorders

When apprehension and tensions interfere with a person coping effectively with
family, job, school or other demands of daily life, the condition must be regarded
as a serious psychiatric disorder and should be treated as such. The group of
illnesses includes phobias, panic disorders, post-traumatic stress syndrome and
obsessive-compulsive disorders. Anxiety disorders often manifest themselves
through such physical symptoms as excessive perspiration, shortness of breath,
palpitations and rapid heart beats, dizziness, tension headache, and many other
accelerated or slowed-down body functions. Probably no single situation or
condition causes anxiety disorders. Rather, physical and environmental triggers
often combine to create a particular anxiety illness. Medication, behavioral
therapy, psychotherapy, or combinations are used to treat anxiety disorders.

Phobias range from simple phobias such as fear of specific objects or situations
(fear of snakes or flying or of closed spaces) to agoraphobia, the fear of being
alone in a public place where there is no escape (fear of being on a bus or in a
crowded store). Panic disorders involve recurrent attacks of panic or anxiety.
Obsessive-compulsive disorders can result in ritualistic behavior involving
cleanliness resulting in showering or washing hands excessively each day;
repeating word patterns; overwhelming concerns about being meticulous; hoarding
seemingly useless items which are repeatedly counted and stacked; or performing
a series of complicated steps in an exact order or repeating them over and over
again until the steps are done perfectly. Currently, researchers are exploring the
linkages and differences between obsessive-compulsive disorder and depression.

Dementias

Dementias cause loss of intellectual abilities, especially memory and personality

changes. Subtle changes such as memory loss of recent events are seen first, with
more dramatic memory loss following; e.g., names of old friends or relatives are
forgotten. Alzheimer‘s disease, which affects 15% of people over age 65, is
included in this classification.

Loss of nerve cells and brain atrophy are responsible for many of the dementias. A
series of small strokes, over a period of time, can also result in symptoms of

44
dementia. Genetics seems to be a predisposing factor. In recent years, acquired
immune deficiency syndrome (AIDS) has also become recognized as a cause for
progressive dementia.

There are no well-established plans for treatment of dementias. Medications such

as the antipsychotic and antidepressants are given to counter such symptoms as
irritability, agitation, suspicion and depression. Socialization programs and
activity therapy are helpful for many who suffer from dementia.

Schizophrenia

The medical cause is due to a chemical imbalance or structural changes in the

brain. Research points to a genetic predisposition, as well as cultural,
environmental and psychological factors. Schizophrenia generally occurs between
the ages of 17 and 30, and rarely after age 45. People with schizophrenia do not
have a "split personality." People experiencing an acute episode of schizophrenia
have a sudden onset of severe psychotic symptoms, i.e. they are out of touch with
reality, or unable to separate real from unreal experience. They can experience
periods of a distorted sense of reality or ability to think, and also hallucinations
and delusions. People with schizophrenia sometimes exhibit an emotion that is
inconsistent with their speech or thoughts. They may show "blunted" or "flat"
affect, i.e., a severe inability to express any emotion. While medications can
usually control the most flamboyant symptoms of schizophrenia, none can cure it.
People who have this illness benefit from a combination of medications and a
variety of programs and therapies. One third of all people in treatment will recover
completely. One third will improve, needing only occasional hospitalization. One
third has long-term, recurring schizophrenic episodes requiring hospitalization.

Of all the forms of abnormal behavior, perhaps no disorder is more challenging

than schizophrenia. One of the potentially most disruptive disorders, in terms of
affecting the individual's ability to function, it can present symptoms which are
disturbing to both the sufferer and others: hallucinations, delusions, confused
thought and speech, inappropriate emotions, strange gestures, and so on. (Note
that these symptoms do not normally all appear in a single case!) Affecting about
1% of the adult population in both developed and developing nations, it is a
complex and challenging disorder.

The word schizophrenia comes from the Greek for "split personality"; it was
coined by a doctor named Eugen Bleuler to describe the strange disconnection
between thought processes and emotions that is often found in the disorder.
However, the literal translation has often been misinterpreted by the general
public, thinking it refers to individuals who show more than one personality--a
rare condition properly described as multiple personality disorder. Unfortunately,
the media often perpetuate this confusion: for example, the recent movie, "Me,
Myself, and Irene", which presents Hollywood's version of multiple personality
disorder, identifies the main character as suffering from schizophrenia!

45
As with other disorders, there is an intense debate about what actually causes
schizophrenia. There is a variety of research that suggests neurological factors
contribute to, if not actually causing, schizophrenia, but no single mechanism has
been consistently identified, fuelling debate about its aetiology. More and more,
the evidence is pointing towards several potentiating factors at a physiological
level, which then interact with adverse environmental factors to produce
schizophrenia. Despite the debate, there is no doubt that today, new medications
offer the possibility of alleviating the most severe symptoms, while reducing the
side-effects associated with earlier drugs (and which often led to suffers curtailing
taking the medication, leading to relapses).

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 CHAPTER 5

PSYCOTHERAPY AND OTHER THERAPIES

FOR MENTAL DISORDERS AND AILMENTS

Mental disorders and ailments can be treated via medication (pills), counselling
and psychotherapy

Counseling
The word counseling comes from the word counseil, ie to take counsel, consult.
Counseling can be defined as a relatively short-term, interpersonal, theory-based
process of helping persons who are fundamentally psychologically healthy resolve
developmental and situational issues.

Types of counselling

How to choose a type of counselling

The type of counselling you have will depend on

 What you feel most comfortable with

 How serious the issues are that you want to discuss
 How long you have been having the problems
 The type of issues you have (e.g. general worries about not coping,
relationship problems, phobias)

The important thing to remember is to tell your counsellor if you feel

uncomfortable. For example, if the counsellor asks you questions that you don‘t
want to answer. Or they delve into past events that you don‘t feel are appropriate.

If you don‘t feel that you‘re getting on very well with your counsellor, you can
always try someone else. Personality clashes do happen. It doesn‘t mean that
counselling won‘t help you or that the counsellor is bad at their job. It‘s just life
and most counsellors will understand.

Supportive one to one counselling

You may just need some ‗one to one‘ supportive counselling sessions. This

47
basically means that you need a caring and patient person to talk your worries over
with in privacy, knowing that what you say is confidential. You may have some
practical issues that you want help in sorting out. The counsellor may not use a
particular counselling method here. But they‗re a trained person who will listen to
you, and help you work out some solutions. This can be very helpful.

Cognitive Behavioural Therapy

You may hear the terms ‗cognitive therapy‘ or ‗cognitive behavioural therapy‘
(CBT). Cognitive describes the mental process that people use to remember,
reason, understand, problem solve and judge things. Behaviour describes your
actions or reactions to something. CBT aims to help you change how you respond
to situations or emotions.

It helps you understand how your thought patterns may be contributing to feeling
depression or fear. This therapy also teaches you how to calm your body and
mind. This helps you to control your feelings more, think more clearly and
generally feel better about things.

CBT is often used to help people overcome

 Difficulty in keeping emotions such as anger, sadness, fear and guilt under
control
 Feeling very stressed
 Addictions
 Depression
 Panic attacks and phobias
 Anxiety
 Insomnia and other sleep problems
 Low self esteem

Group counselling

There is also group counselling, sometimes called ‗group therapy‘. This means
joining in a group where everyone discusses their problems together. Usually,
everyone in the group is facing similar problems, but not always. The counsellor
will facilitate the group and encourage people to express their feelings within it.
Some people find it very helpful to learn that they are not alone with their
worries. But this method doesn‘t suit everyone, especially if you have some very
personal and painful issues you want to discuss.

Family counselling

Because cancer often affects the whole family it can sometimes help if you all see
a counsellor together. Family members may be too scared to express to you how

48
they really feel about your illness. You may not feel well enough or have the time
to sit and talk honestly with your partner and children. Talking to children about
cancer can be very difficult and upsetting. Having the support of a family
counsellor may help make these things easier.

Children may be keeping a lot of their feelings to themselves for fear of upsetting
their sick parent. They‘re likely to be trying to deal with the parents illness as well
as keeping up with schoolwork, looking after younger siblings and wanting to feel
supported and accepted by friends.

How a child deals with a parent being ill will depend very much on their age.
Very young children may not be emotionally developed enough to express their
real feelings in words. They often express their feelings through play or their
mood rather than in words, and they are often spontaneous in the way they do
this. They may not be able to tap into how they are feeling on a specific occasion.
A family counsellor may be able to help you recognise what your child is actually
feeling. And suggest the best ways to support them.

Children aged between 8 and 12 have some understanding about a serious illness
and how it will affect them. You have to be sensitive but straightforward. If
you‘re too subtle, they will lose the point. It may help to understand that children
of this age may feel guilty when a parent is seriously ill. As if it‘s somehow their
fault. Or they might feel angry with a parent for not being there. Having said that,
children can often react in a positive way too, reacting in a more mature way than
you thought they could.

Being a teenager can be a time of emotional ups and downs. Teenagers often feel
confused and unsure about themselves anyway. This can make the way they deal
with a parent‘s illness very different to that of a younger child. And their reactions
are likely to be more intense than an adult's. It‘s very important that they have the
time to grieve about the illness and be included in what‘s happening. They may
become anxious, angry, moody, depressed or pretend that they‘re coping very well
when actually inside they‘re feeling very scared and lonely. Equally many
teenagers behave in a mature and supportive way, and remain or become very
close to their parents.

Seeing a counsellor together allows you all a set time to listen to each other‘s
worries. It can really help give everyone in the family a better understanding of
what is happening. It can also bring you much closer together and encourage you
to give each other more support.

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Psychotherapy
Before the 18th century serious mental disorders were treated as demonic or
medical conditions requiring punishment and confinement until the advent of
moral treatment approaches. This brought about a focus on the possibility of
psychosocial intervention - including reasoning, moral encouragement and group
activities - to rehabilitate the "insane". Hence the birth of psychotherapy

What is psychotherapy?

Psychotherapy is a general term for a way of treating mental and emotional

disorders by talking about your condition and related issues with a mental health
professional. It's also known as talk therapy, counseling, psychosocial therapy or,
simply, therapy.

It involves a process, a relationship between a patient/client and a therapist.

During psychotherapy, a person with a mental illness talks to a licensed and
trained mental health care professional who helps him or her identify and work
through the factors that may be triggering their illness.

The therapist is usually someone trained to:

 Listen deeply
 Reflect empathically
 Offer insight
 Provide feedback
 Help the person explore alternatives
 Serve as a guide or companion on the journey of exploration into the depths
of emotions and experiences.

Many different goals have been identified by psychotherapists, such as:

 Developing insight into problems

 Learning to communicate more effectively
 Learning to resolve both internal and interpersonal conflicts
 Managing, reducing or relieving symptoms of emotional distress
 Changing behaviors to improve social, relational or vocational functioning
 Personal growth and development
 Reconstructing a life damaged by faulty early life experiences

How Does Psychotherapy Help?

Psychotherapy helps people with a mental disorder:

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  Understand the behaviors, emotions, and ideas that contribute to his or her
illness.
 Understand and identify the life problems or events -- like a major illness, a
death in the family, a loss of a job or a divorce -- that contribute to their
illness and help them understand which aspects of those problems they may
be able to solve or improve.
 Regain a sense of control and pleasure in life.
 Learn coping techniques and problem-solving skills.

Types of Therapy

Therapy can be given in a variety of formats, including:

 Individual: This therapy involves only the patient and the therapist.
 Group: Two or more patients may participate in therapy at the same time.
Patients are able to share experiences and learn that others feel the same
way, and have had the same experiences.
 Marital/couples: This type of therapy helps spouses and partners
understand why their loved one has a mental disorder, what changes in
communication and behaviors can help, and what they can do to cope.
 Family: Because family is a key part of the team that helps people with
mental illness get better, it is sometimes helpful for family members to
understand what their loved one is going through, how they themselves can
cope, and what they can do to help.

Common types of psychotherapy include:

Art therapy

Art therapy, also called creative art therapy, uses the creative process to help
people who might have difficulty expressing their thoughts and feelings. Creative
arts can help you increase self-awareness, cope with symptoms and traumatic
experiences, and foster positive changes. Creative art therapy includes music,
dance and movement, drama, drawing, painting and even poetry.

Behavior therapy

Behavior therapy focuses on changing unwanted or unhealthy behaviors, typically

using a system of rewards, reinforcements of positive behavior and
desensitization. Desensitization is a process of confronting something that causes
anxiety, fear or discomfort and overcoming those responses. If you have a fear of
germs that triggers you to excessively wash your hands, for instance, you might be
taught techniques to stop your excessive washing.

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Cognitive therapy

Cognitive therapy is designed to help you identify and change distorted thought
(cognitive) patterns that can lead to feelings and behaviors that are troublesome,
self-defeating or self-destructive. It's based on the premise that how you interpret
your experiences in life determines the way you feel and behave. If you have
depression, for instance, you might see yourself and your experiences in negative
ways, which worsens the symptoms of depression. Like behavior therapy,
cognitive therapy focuses on your current problem, rather than addressing
underlying or past issues or conflicts. Unlike behavior therapy, however, your
experiences are an important part of the cognitive therapy process.

Cognitive-behavior therapy

Cognitive behavioral therapy focuses on modifying everyday thoughts and

behaviors, with the aim of positively influencing emotions. The therapist helps
clients recognise distorted thinking and learn to replace unhealthy thoughts with
more realistic substitute ideas. It helps people with mental illness to identify and
change inaccurate perceptions that they may have of themselves and the world
around them. The therapist helps the patient establish new ways of thinking by
directing attention to both the "wrong" and "right" assumptions they make about
themselves and others.

Cognitive-behavioral therapy is recommended for patients:

 Who think and behave in ways that trigger and perpetuate mental illness.
 With mild-to-moderate depression as the only treatment or in addition to
treatment with antidepressant medication
 Who refuse or are unable to take antidepressant medication.
 Of all ages who have mental illness that causes suffering, disability, or
interpersonal problems.

Dialectical behavior therapy

Dialectical behavior therapy (DBT) is a type of cognitive-behavior therapy. Its

primary objective is to teach behavioral skills to help you tolerate stress, regulate
your emotions and improve your relationships with others. It was originally
designed for people with borderline personality disorder, who often have suicidal
behavior. But DBT has been adapted for people with other conditions, too,
including eating disorders and substance abuse.

Dialectical behavior therapy is derived, in part, from a philosophical process

called dialectics, in which seemingly contradictory facts or ideas are weighed
against each other to come up with a resolution or balance. For instance, you
might learn about accepting who you are while at the same time making changes
in your thoughts and behaviors.

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Exposure therapy

Exposure therapy is a form of behavior therapy that deliberately exposes you to

the very thing that you find upsetting or disturbing. It's especially useful for people
with obsessive-compulsive disorder or post-traumatic stress disorder. Under
controlled circumstances, exposure to the event or things that trigger your
obsessive thoughts or traumatic reactions can help you learn to cope with them
effectively.

Interpersonal therapy

Interpersonal therapy focuses on the behaviors and interactions a patient has with
family and friends. The primary goal of this therapy is to improve communication
skills and increase self-esteem during a short period of time. It based on the view
that our current problems are maladaptive behaviors rooted in our previous
interpersonal relationships. It usually lasts three to four months and works well
for depression caused by mourning, relationship conflicts, major life events, and
social isolation.

Iinterpersonal therapy helps patients resolve mental illness caused by:

 Loss (grief)
 Relationship conflicts
 Role transitions (such as becoming a mother, or a caregiver)

Play therapy

Play therapy is geared mainly for young children at specific developmental levels.
It makes use of a variety of techniques, including playing with dolls or toys,
painting or other activities. These techniques allow children to more easily express
emotions and feelings if they lack the cognitive development to express
themselves with words.

Psychoanalysis

In psychoanalysis, you examine memories, events and feelings from the past to
understand current feelings and behavior. It's based on the theory that childhood
events and biological urges create an unconscious mind that drives how you think,
feel and behave. In this type of therapy, you explore those unconscious
motivations to help make changes to improve your life. You might also do dream
analysis and free association — talking about whatever happens to come to mind.

Psychoanalysis is a long-term, intensive therapy that often involves several

sessions a week with a psychoanalyst for several years. In formal psychoanalysis,
you lie on a couch and the therapist sits unseen behind you. The practice evolved
out of theories developed by Sigmund Freud.

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Psychodynamic psychotherapy

Psychodynamic therapy is based on the assumption that a person is mentally ill

because of unresolved, generally unconscious conflicts, often stemming from
childhood. The goal of this type of therapy is for the patient to understand and
cope better with these feelings by talking about the experiences. Psychodynamic
therapy is administered over a period of three to four months, although it can last
longer, even years.

In general, it involves such typical constructs as:

 An orientation toward the past – childhood experiences, sexual feelings,

fears, jealousies, relationships with parents, etc. – as the source of problems
in the present
 Traditionally, a couch for the patient to lie on, with the therapist outside of
the line of sight (however, most modern therapists now use chairs and sit
face to face)
 The therapist (or analyst) as a blank screen – no personal photos or objects
– to allow the patient to project any thoughts or conceptions onto the
therapist (this is known as "transference")
 "Free association"– letting the mind wander aloud and seeing what
connections arise
 Little interaction between the analyst and patient, until the analyst offers
interpretations of what the patient is experiencing, and the reasons behind
certain ideas or actions (although again, modern therapists often engage in
greater interaction)
 Creating a safe space (or "holding environment") that allows the client to
explore depth issues with as little fear as possible
 Long-term treatment, sometimes several times per week (although modern
accommodations are often more brief)

Psychoeducation

Psychoeducation focuses on teaching you — and sometimes family and friends —

about your illness. Psychoeducation explores possible treatments, coping strategies
and problem-solving skills for your condition. You might learn about resources in
your community, such as support groups or housing options. You can also learn
about symptoms that might indicate a potential relapse so that you can take steps
to get appropriate treatment. Psychoeducation can be especially useful for people
with chronic or severe illnesses, such as schizophrenia.

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NB

Difference between psychotherapy and counseling

Psychotherapy is usually mistaken for counseling and vice versa. The two are
however very different. Counseling is viewed as a more limited, direction-
oriented, problem solving approach, while "therapy" works at more depth of
understanding of what is underneath behavior patterns.

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Assessment Test

1. Name and describe any 5 defense mechanisms used by individuals to

distance themselves from full awareness of unpleasant thoughts,
feelings and desires.

2. Discuss widely Sigmund Freud‘s psychosexual stages of

development

3. What do you deem to be the strengths of psychotherapy?

4. Write short notes on the following

 Social psychology
 Role theory
 Depression
 Super ego

5. Explain the differences between Neurosis and Psychosis

6. Do you find psychology to be of any significance in the contemporary

Kenyan society?

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