Psychological Defence In Different Age. Deviative Behavior.

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Psychological Defence In Different Age. Deviative
Behavior.
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Defense mechanisms

• Defense mechanisms are helpful and, if used in a
  proper manner, are healthy. Some disorders, such
  as personality disorders and psychosis, may in
  fact be caused in part by inadequate use of
  appropriate defensce mechanisms. However, if
  misused, the defense mechanisms may also be
  unhealthy.
• The maladaptive use of defense mechanisms can
  occur in a variety of cases, such as when they
  become automatic and prevent individuals from
  realizing their true feelings and thoughts or
  when they put the person in actual danger. For
  example, someone who is in denial about the
  possibility that a new sexual partner could carry
  an STD may not take appropriate precautions to
  protect their own sexual health.

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Defense mechanisms

• Defense mechanisms can also be maladaptive when
  they are continually used in a way that disrupts
  reality-testing. Repeated denial and paranoid
  projection use can cause people to lose touch
  with the real world and their surroundings and
  consequently isolate themselves from it and dwell
  in a created world of their own design. For
  example, people with addictive behaviour are
  known to misuse such defense mechanisms as
  denial. Defense mechanisms can also be harmful
  if
• There are too few defenses which can be employed
  in coping with threats
• There is too much superego activity, which causes
  the use of too many defenses.

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List of defense mechanisms

• Sigmund Freud was the first person to develop the
  concept of defense mechanisms, however it was his
  daughter Anna Freud who clarified and
  conceptualized it.
• She has described various different defense
  mechanisms.
• The list of particular defense mechanisms is huge
  and there is no theoretical consensus on the
  amount of defense mechanisms. It has been
  attempted to classify defense mechanisms
  according some of their properties (ie.
  underlying mechanisms, similarities or connexions
  with personality).

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Compensation

• Compensation occurs when someone takes up one
  behavior because one cannot accomplish another
  behavior.

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Denial

• An ego defense mechanism that operates
  unconsciously to resolve emotional conflict, and
  to reduce anxiety by refusing to perceive the
  more unpleasant aspects of external reality.

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Displacement

• An unconscious defense mechanism, whereby the
  mind redirects emotion from a dangerous object
  to a safe object.
• In psychoanalytic theory, displacement is a
  defense mechanism that shifts sexual or
  aggressive impulses to a more acceptable or less
  threatening target redirecting emotion to a
  safer outlet.

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Intellectualization

• Concentrating on the intellectual components of
  the situations as to distance oneself from the
  anxiety provoking emotions associated with these
  situations

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Projection

• Attributing to others, ones own unacceptable or
  unwanted thoughts and/or emotions.
• Projection reduces anxiety in the way that it
  allows the expression of the impulse or desire
  without letting the ego recognize it.

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Rationalization

• The process of constructing a logical
  justification for a decision that was originally
  arrived at through a different mental process

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Reaction formation

• The converting of unconscious wishes or impulses
  that are perceived to be dangerous into their
  opposites

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Regression

• The reversion to an earlier stage of development
  in the face of unacceptable impulses

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Repression

• The process of pulling thoughts into the
  unconscious and preventing painful or dangerous
  thoughts from entering consciousness.

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Sublimation

• The refocusing of psychic energy (which Sigmund
  Freud believed was limited) away from negative
  outlets to more positive outlets. These drives
  which cannot find an outlet are rechanneled. In
  Freuds classic theory, erotic energy is only
  allowed limited expression due to repression, and
  much of the remainder of a given groups erotic
  energy is used to develop its culture and
  civilization.
• Freud considered this defense mechanism the most
  productive compared to the others that he
  identified. Sublimation is the process of
  transforming libido into social useful
  achievements, mainly art. Psychoanalysts often
  refer to sublimation as the only truly successful
  defense mechanism.

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Undoing

• A person tries to 'undo' a negative or
  threatening thought by their actions.

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Suppression

• The conscious process of pushing thoughts into
  the preconscious.

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Dissociation

• Separation or postponement of a feeling that
  normally would accompany a situation or thought.

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Humor.

• Refocuses attention on the somewhat comical side
  of the situation as to relieve negative tension
  similar to comic relief.

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Idealization

• Form of denial in which the object of attention
  is presented as "all good" masking true negative
  feelings towards the other.

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Identification

• The unconscious modeling of one's self upon
  another person's behavior.

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Introjection

• Identifying with some idea or object so deeply
  that it becomes a part of that person.

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Inversion

• Refocusing of aggression or emotions evoked from
  an external force onto one's self.

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Somatization

• Manifestation of emotional anxiety into physical
  symptoms.

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Splitting

• Primitive defense mechanism-when a person sees
  external objects or people as either "all good"
  or "all bad."

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Substitution

• When a person replaces one feeling or emotion for
  another.

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Introduction and History of Mental Illness

•  Our earliest explanation of what we now refer to
  as psychopathology involved the possession by
  evil spirits and demons.  Many believed, even as
  late as the sixteenth and seventeenth centuries
  that the bizarre behavior associated with mental
  illness could only be an act of the devil
  himself.  To remedy this, many individuals
  suffering from mental illness were tortured in an
  attempt to drive out the demon. 
• Most people know of the witch trials where many
  women were brutally murdered due to a false
  belief of possession.  When the torturous methods
  failed to return the person to sanity, they were
  typically deemed eternally possessed and were
  executed

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The medical model

• By the eighteenth century we began to look at
  mental illness differently.  It was during this
  time period that "madness" began to be seen as an
  illness beyond the control of the person rather
  than the act of a demon.  Because of this,
  thousands of people confined to dungeons of daily
  torture were released to asylums where medical
  forms of treatment began to be investigated.
•  Today, the medical model continues to be a
  driving force in the diagnosing and treatment of
  psychopathology, although research has shown the
  powerful effects that psychology has on a
  person's behavior, emotion, and cognitions.  This
  chapter will discuss the various ways mental
  illness is classified as well as the effects of
  mental illness on the individual and society.

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Classifying Psychopathology

• Mental illness is classified today according to
  the Diagnostic and Statistical Manual of Mental
  Disorders, Fourth Edition (DSM IV), published by
  the American Psychiatric Association (1994). 
• The DSM uses a multiaxial or multidimensional
  approach to diagnosing because rarely do other
  factors in a person's life not impact their
  mental health.  It assesses five dimensions as
  described below

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The DSM

• Axis I Clinical Syndromes
• This is what we typically think of as the
  diagnosis (e.g., depression, schizophrenia,
  social phobia)
• Axis II Developmental Disorders and Personality
  Disorders
• Developmental disorders include autism and mental
  retardation, disorders which are typically first
  evident in childhood 
• Personality disorders are clinical syndromes
  which have a more long lasting symptoms and
  encompass the individual's way of interacting
  with the world.  They include Paranoid,
  Antisocial, and Borderline Personality Disorders.

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The DSM

• Axis III Physical Conditions which play a role
  in the development, continuance, or exacerbation
  of Axis I and II Disorders
• Physical conditions such as brain injury or
  HIV/AIDS that can result in symptoms of mental
  illness are included here. 
• Axis IV Severity of Psychosocial Stressors
• Events in a persons life, such as death of a
  loved one, starting a new job, college,
  unemployment, and even marriage can impact the
  disorders listed in Axis I and II.  These events
  are both listed and rated for this axis.
• Axis V Highest Level of Functioning
• On the final axis, the clinician rates the
  person's level of functioning both at the present
  time and the highest level within the previous
  year.  This helps the clinician understand how
  the above four axes are affecting the person and
  what type of changes could be expected

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Psychiatric Disorders

• Let's discuss the first two axes in more detail
  now as these are what we typically think of when
  we think of mental illness or psychopathology. 
• The DSM IV (American Psychiatric Association,
  1994) identifies 15 general areas of adult mental
  illness.  We'll discuss each one briefly.  For
  more information about a specific category, open
  Psychiatric Disorders on the Main Menu and follow
  the links provided.

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1. Delirium, Dementia, Amnestic, and Other
Cognitive Disorders

• The primary symptoms of these disorders include
  significant negative changes in the way a person
  thinks and/or remembers. 
• All of these disorders have either a medical or
  substance related cause and are therefore not
  discussed in detail in this chapter.

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2. Mental Disorders Due to a Medical Condition

• Like those above, all disorders in this category
  are directly related to a medical condition. 
• If symptoms of anxiety, depression, etc are a
  direct result of a medical condition, this is the
  classification used.  

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3. Substance Related Disorders

• There are two disorders listed in this category
  Substance Abuse and Substance Dependence.  Both
  involve the ingestion of a substance (alcohol,
  drug, chemical) which alters either cognitions,
  emotions, or behavior.  
• Abuse refers to the use of the substance to the
  point that it has a negative impact on the
  person's life.  This can mean receiving a DUI for
  drinking and driving, being arrested for public
  intoxication, missing work or school, getting
  into fights, or struggling with relationships
  because of the substance.
• Dependence refers to what we typically think of
  as 'addicted.'  This occurs when (a) the use of
  the substance is increased in order to get the
  same effect because the person has developed a
  tolerance, (b) the substance is taken more
  frequently and in more dangerous situations such
  as drinking and driving, or (c) the person
  continues to take the substance despite negative
  results and/or the desire to quit, or (d)
  withdrawal symptoms are present when the
  substance is stopped, such as delirium tremors
  (DTs), amnesia, anxiety, headaches, etc.

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4. Schizophrenia and other Psychotic Disorders

• The major symptom of these disorders is
  psychosis, or delusions and hallucinations.  The
  major disorders include schizophrenia and
  schizoaffective disorder.
• Schizophrenia is probably the most recognized
  term in the study of psychopathology, and it is
  probably the most misunderstood.  First of all,
  it does not mean that the person has multiple
  personalities.  The prefix 'schiz' does mean
  split, but it refers to a splitting from
  reality.  The predominant features of
  schizophrenia include hallucinations and
  delusions and disorganized speech and behavior,
  inappropriate affect, and avolition.  There is no
  known cure for schizophrenia and is without doubt
  the most debilitating of all the mental
  illnesses.
• Schizoaffective Disorder is characterized by a
  combination of the psychotic symptoms such as in
  Schizophrenia and the mood symptoms common in
  Major Depression and/or Bipolar Disorder.  The
  symptoms are typically not as severe although
  when combined together in this disorder, they can
  be quite debilitating as well.

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5. Mood Disorders

• The disorders in this category include those
  where the primary symptom is a disturbance in
  mood.  The disorders include Major Depression,
  Dysthymic Disorder, Bipolar Disorder, and
  Cyclothymia.
• Major Depression (also known as depression or
  clinical depression) is characterized by
  depressed mood, diminished interest in activities
  previously enjoyed, weight disturbance, sleep
  disturbance, loss of energy, difficulty
  concentrating, and often includes feelings of
  hopelessness and thoughts of suicide.

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5. Mood Disorders

• Dysthymia is often considered a lesser, but more
  persistent form of depression.  Many of the
  symptoms are similar except to a lesser degree. 
  Also, dysthymia, as opposed to Major Depression
  is more steady rather than periods of normal
  feelings and extreme lows.
• Bipolar Disorder (previously known as
  Manic-Depression) is characterized by periods of
  extreme highs (called mania) and extreme lows as
  in Major Depression.  Bipolar Disorder is
  subtyped either I (extreme or hypermanic
  episodes) or II (moderate or hypomanic episodes).
• Like Dysthymia and Major Depression, Cyclothymia
  is considered a lesser form of Bipolar Disorder.

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6. Anxiety Disorders

•  Anxiety Disorders categorize a large number of
  disorders where the primary feature is abnormal
  or inappropriate anxiety.  The disorders in this
  category include Panic Disorder, Agoraphobia,
  Specific Phobias, Social Phobia,
  Obsessive-Compulsive Disorder, Posttraumatic
  Stress Disorder, and Generalized Anxiety
  Disorder.
• Panic Disorder is characterized by a series of
  panic attacks.  A panic attack is an
  inappropriate intense feeling of fear or
  discomfort including many of the following
  symptoms heart palpitations, trembling,
  shortness of breath, chest pain, dizziness. 
  These symptoms are so severe that the person may
  actually believe he or she is having a heart
  attack.  In fact, many, if not most of the
  diagnoses of Panic Disorder are made by a
  physician in a hospital emergency room.

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6. Anxiety Disorders

• Agoraphobia literally means fear of the
  marketplace.  It refers to a series of symptoms
  where the person fears, and often avoids,
  situations where escape or help might not be
  available, such as shopping centers, grocery
  stores, or other public place.  Agoraphobia is
  often a part of panic disorder if the panic
  attacks are severe enough to result in an
  avoidance of these types of places.
• Specific or Simple Phobia and Social Phobia
  represents an intense fear and often an avoidance
  of a specific situation, person, place, or
  thing.  To be diagnosed with a phobia, the person
  must have suffered significant negative
  consequences because of this fear and it must be
  disruptive to their everyday life.

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6. Anxiety Disorders

• Obsessive-Compulsive Disorder is characterized by
  obsessions (thoughts which seem uncontrollable)
  and compulsions (behaviors which act to reduce
  the obsession).  Most people think of compulsive
  hand washers or people with an intense fear of
  dirt or of being infected. 
• These obsessions and compulsions are disruptive
  to the person's everyday life, with sometimes
  hours being spent each day repeating things which
  were completed successfully already such as
  checking, counting, cleaning, or bathing.

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6. Anxiety Disorders

• Posttraumatic Stress Disorder (PTSD) occurs only
  after a person is exposed to a traumatic event
  where their life or someone else's life is
  threatened.  The most common examples are war,
  natural disasters, major accidents, and severe
  child abuse. 
• Once exposed to an incident such as this, the
  disorder develops into an intense fear of related
  situations, avoidance of these situations,
  reoccurring nightmares, flashbacks, and
  heightened anxiety to the point that it
  significantly disrupts their everyday life.

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6. Anxiety Disorders

• Generalized Anxiety Disorder is diagnosed when a
  person has extreme anxiety in nearly every part
  of their life.  It is not associated with just
  open places (as in agoraphobia), specific
  situations (as in specific phobia), or a
  traumatic event (as in PTSD). 
• The anxiety must be significant enough to disrupt
  the person's everyday life for a diagnosis to be
  made.

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7. Somatoform Disorders

• Disorders in this category include those where
  the symptoms suggest a medical condition but
  where no medical condition can be found by a
  physician.  Major disorders in this category
  include Somatization Disorder, Pain Disorder,
  Hypochondriasis.
• Somatization Disorder refers to generalized or
  vague symptoms such as stomach aches, sexual
  pain, gastrointestinal problems, and neurological
  symptoms which have no found medical cause.
• Pain Disorder refers to significant pain over an
  extended period of time without medical support.
• Hypochondriasis is a disorder characterized by
  significant and persistent fear that one has a
  serious or life-threatening illness despite
  medical reassurance that this is not true.

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8. Factitious Disorder

• Factitious Disorder is characterized by the
  intentionally produced or feigned symptoms in
  order to assume the 'sick role.' 
• These people will often ingest medication and/or
  toxins to produce symptoms and there is often a
  great secondary gain in being placed in the sick
  role and being either supported, taken care of,
  or otherwise shown pity and given special rights.

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9. Dissociative Disorders

• The main symptom cluster for dissociative
  disorders include a disruption in consciousness,
  memory, identity, or perception.  In other words,
  one of these areas is not working correctly
  causing significant distress within the
  individual.  The major diagnoses in this category
  include Dissociative Amnesia, Dissociative Fugue,
  Depersonalization Disorder, and Dissociative
  Identity Disorder.
• Dissociative Amnesia is characterized by memory
  gaps related to traumatic or stressful events
  which are too extreme to be accounted for by
  normal forgetting.  A traumatic event is
  typically a precursor to this disorder and memory
  is often restored.

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9. Dissociative Disorders

• Dissociative Fugue represents an illness where an
  individual, after an extremely traumatic event,
  abruptly moves to a new location and assumes a
  new identity.  This disorder is very rare and
  typically runs its course within a month.
• Depersonalization Disorder, occurring after an
  extreme stressor, includes feelings of unreality,
  that your body does not belong to you, or that
  you are constantly in a dreamlike state.
• Dissociative Identity Disorder (DID) is most
  widely known as Multiple Personality Disorder or
  MPD.  DID is the presence of two or more distinct
  personalities within an individual.  These
  personalities must each take control of the
  individual at varying times and there is
  typically a gap in memory between personalities
  or "alters."  This disorder is quite rare and a
  significant trauma such as extended sexual abuse
  is usually the precursor.

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10. Sexual Dysfunctions,  Paraphilias, and Gender
Identity Disorders

• These disorders are all related to sexuality,
  either in terms of functioning (Sexual
  Dysfunctions), distressing and often irresistible
  sexual urges (Paraphilias), and gender confusion
  or identity (Gender Identity Disorder. 
• It should be noted that for these, as well as
  many other categories, a medical reason should
  always be ruled out before making a psychological
  diagnosis.

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10. Sexual Dysfunctions,  Paraphilias, and Gender
Identity Disorders

• Sexual Dysfunctions include Hypoactive Sexual
  Desire Disorder (deficiency or absence of sexual
  fantasies and desire for sexual activity), Sexual
  Aversion Disorder (persistent or recurring
  aversion to or avoidance of sexual activity),
  Sexual Arousal and Male Erectile Disorder
  (Inability to attain or maintain until completion
  of sexual activity adequate lubrication (in
  women) or erection (in men) in response to sexual
  excitement),
• Orgasmic Disorder male female (delay or
  absence of orgasm following normal excitement and
  sexual activity), and Premature Ejaculation
  (ejaculation with minimal sexual stimulation
  before or shortly after penetration and before
  the person wishes it).

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10. Sexual Dysfunctions,  Paraphilias, and Gender
Identity Disorders

• Paraphilias include Exhibitionism (the intense
  urge to expose oneself to an unsuspecting
  stranger), Voyeurism (the intense urge to watch
  an unsuspecting person in various states of
  undress or sexual activity), Fetishism (intense
  sexual fantasies, urges, and behaviors involving
  an inanimate object), Pedophilia (sexually
  arousing fantasies. urges, and behavior involving
  a prepubescent child), Sexual Masochism (intense
  sexual fantasies, urges, and behavior involving
  the act of being beaten, humiliated, and/or
  bound), and Sexual Sadism (intense sexual
  fantasies, urges, and behavior involving the
  infliction of pain and/or humiliation on another
  person).
• The final category, Gender Identity Disorder, is
  characterized by a strong and persistent
  identification with the opposite sex and the
  belief that one is actually the opposite sex due
  to an extreme discomfort in one's present sexual
  identity.

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11. Eating Disorders

• Eating disorders are characterized by
  disturbances in eating behavior.  There are two
  types Anorexia Nervosa and Bulimia Nervosa.
• Anorexia is characterized by failure to maintain
  body weight of at least 85 of what is expected,
  fear of losing control over your weight or of
  becoming 'fat.'  There is typically a distorted
  body image, where the individual sees themselves
  as overweight despite overwhelming evidence to
  the contrary.
• The key characteristics of Bulimia include
  bingeing (the intake of large quantities of food)
  and purging (elimination of the food through
  artificial means such as forced vomiting,
  excessive use of laxatives, periods of fasting,
  or excessive exercise).

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12. Sleep Disorders

• All sleep disorders involve abnormalities in
  sleep in one of two categories, dysomnias and
  parasomnias.
• Dysomnias are related to the amount, quality
  and/or timing of sleep.  Examples of sleep
  disorders include insomnia (inability or reduced
  ability to sleep), hypersomnia (excessive
  sleepiness and prolonged sleep without physical
  justification), and narcolepsy (irresistible
  attacks of sleep).
• Parasomnias refer to sleep disturbances related
  to behavioral or physiological events related to
  sleep.  Disorders in this subcategory include
  nightmare disorder (occurance of extremely
  frightening dreams which result in awakening and
  resulting distress), sleep terror disorder
  (similar to nightmare disorder but the fear is
  more intense and the person is often unresponsive
  during the episode), and sleepwalking disorder
  (walking or performing tasks during sleep without
  recollection once awakened).

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13. Impulse Control Disorders

•   Disorders in this category include the failure
  or extreme difficulty in controlling impulses
  despite the negative consequences.
• Specific disorders include Intermittent Explosive
  Disorder (failure to resist aggressive impulses
  resulting in serious assaults or destruction of
  property), Kleptomania (stealing objects which
  are not needed), Pyromania (fire starting for
  pleasure or relief of tension), Pathological
  Gambling (maladaptive gambling behavior), and
  trichotillomania (pulling out of one's own hair). 

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14. Adjustment Disorders

• This category consists of an inappropriate or
  inadequate adjustment to a life stressor. 
• Adjustment disorders can include depressive
  symptoms, anxiety symptoms, and/or conduct or
  behavioral symptoms.

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15. Personality Disorders

• Personality Disorders are characterized by an
  enduring pattern of thinking, feeling, and
  behaving which is significantly different from
  the person's culture and results in negative
  consequences. 
• This pattern must be longstanding and inflexible
  for a diagnosis to be made.

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15. Personality Disorders

• There are ten types of personality disorders, all
  of which result in significant distress and/or
  negative consequences within the individual 
  Paranoid (includes a pattern of distrust and
  suspiciousness, Schizoid (pattern of detachment
  from social norms and a restriction of emotions),
  Schizotypal (pattern of discomfort in close
  relationships and eccentric thoughts and
  behaviors), Antisocial (pattern of disregard for
  the rights of others, including violation of
  these rights and the failure to feel empathy),
  Borderline (pattern of instability in personal
  relationships, including frequent bouts of
  clinginess and affection and anger and
  resentment, often cycling between these two
  extremes rapidly), Histrionic (pattern of
  excessive emotional behavior and attention
  seeking), Narcissistic (pattern of grandiosity,
  exaggerated self-worth, and need for admiration),
  Avoidant (pattern of feelings of social
  inadequacies, low self-esteem, and
  hypersensitivity to criticism), and
  Obsessive-Compulsive (pattern of obsessive
  cleanliness, perfection, and control).

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Stigma, Stereotyping, and the Mentally Ill

•  Mental illness can have a devastating effect on
  an individual, his or her family and friend, and
  on the community in many ways.  How it affects
  the individual is obvious, reduced ability to
  care for oneself, strong negative emotions,
  distorted thoughts, inappropriate behavior, and
  reduced ability to maintain a relationship are
  only a few possible outcomes. 
• On friends and family, it can be a major
  responsibility to care for someone suffering from
  a mental illness, the emotional and behavioral
  components of some illnesses can be very
  difficult at times to understand and to deal
  with.  Mental illness also effects the community
  due to the high incidence of homelessness and
  unemployment in some serious disorders such as
  schizophrenia.

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Obvious effects of mental illness

• These are the obvious effects of mental illness,
  but there are less obvious effects due to the
  misperception of the mentally ill.  Not too long
  ago when people heard the term mentally ill, many
  thought of severe cases and associated these
  individuals with bizarre behavior, violence, and
  a lack of caring about themselves and the world. 
  In this sense, people with mental illness were
  almost dehumanized.  They were avoided and
  feared.  
•  This is changing now as people understand that
  mental illness effects many people in many
  different ways.  We as a society are starting to
  see that depression doesn't mean weakness, that
  anxiety doesn't mean fear, and that schizophrenia
  doesn't mean violence.  We are finally
  understanding that needing help for mental or
  emotional reasons does not represent a character
  flaw.

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The early stages

• We are in the early stages of this enlightenment,
  however, and many people continue to stereotype
  the mentally ill population.  The effects of this
  are twofold.  First, imagine being labeled as
  weak, fearful, violent, or flawed.  What would
  this do to your self-esteem?  Certainly nothing
  positive. 
• These misguided beliefs can eventually reach the
  individual suffering from a mental illness and
  cause a drastic shift in their belief system. 
  They may begin saying to themselves "Everyone
  can't be wrong, I must be a terrible person to
  let this happen."  The results are a deeper
  depression, increased anxiety, lower self-esteem,
  and isolation, to name only a few.

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The groundwork for the cycle of many mental
illnesses

• Second, due to the stigma associated with mental
  illness, many people do not seek out help.  This
  is especially true for mood and anxiety disorders
  which, ironically, have very well researched  and
  successful treatments available. 
• These two factors lay the groundwork for the
  cycle of many mental illnesses to continue and to
  strengthen.  I'm a weak person, I feel worse
  about myself and can not possibly seek help
  because I would be ridiculed, humiliated, and
  shamed.