STUDENT LEARNING OUTCOMES* Demonstrate knowledge and understanding > The Ne-e"y ofpsycmoleg,neung the evolsione# mae ofpayenaiogy ts hooretcal representing appropriate breath and depth in, selected content areas of psychology. Explain major perspectives of psychology (e, behavioral, logical, cogitive, evolutionary, humanistic, psychodranic, and sociocultural. confit, ands sococurual contac APA SLO 1 2bise reno ages 7-25) > Espla7 male perspectives osychelogy iAP SLO 1 ne xtook ape 0-25) | Understanding Psychopathology otten out of bed, had breakfast, gone to 1 ofthe day. enjoyed the company of your friends before dropping off to sleep. It probably did not occur to you that zany physically healthy peaple are not able to-do some. forany of these things. What they have in common is a psyeho= losi associated with distess 0 sponse that ist typical or culty expected ‘exacly what this means, les look at one individ ‘Today you may have class. studio. and ath a igivial sand are situation disorder, psychological dysfuctiy with impairment in functiont JUDY |The Girl Who Fainted at the Sight of Blood Judy, 2 16 year old, w clini after increasin referred to our ansiety disorders pisodes of fainting. About 2 years earlier i Jiudy’s fist biology clas, the tevcher shored movie ofa frog dissection anatomy ‘This was a particulary graphic film, with vivid imapes of blood. tissue, andl muscle. About balfway tarough, Judy fet bit lightheidd and left the mom, But the images did not leave her, She continued to be bothered by them and ooca sionally felt slightly queasy, She began to sid sitations in ‘whi sie might see Hood or injury. Ste Stopped looking st magazines that might have gory pictures, She found it dit «ull to Jook at raw meat, or even Band Aids, because th brought the Feared images to nnd. Eyeatualy, anysing ber Friends or parents sil that evokes! an image of blood or i= jury caused Judy to foe! lightheaded. It got so bad that if one ‘of her fronds esclaizsed, “Cut it out!” se Felt fans Beginning about 6 months betore her visit the clinic. Judy stually unwed wien she unavoidably encountered something bloody. Her family paysician could find nothing ‘wrong with ler, nor could several other physicians, By the time se was referred to our elinic she was fainting 510 10 times a week, often in class, Clearly. this was problematic for her and disruptive in school: each time Judy fainted, the cles Students Pbeked around ber, uying to help, and ess was interupied, Because no one end find anything wrong with he, the principal finaly concluded that she was being. manipulative and sispended her from school, even shougl she was an bomor student Judy was suffering from what we now call blood injury Injection phobic. Her reaction was quite severe Uuereby meeting the ertecia for phobia. a psychological disorder chagscterized by marked and persistent fear of an object or situation, But many people have similar reactions that are not as severe wien they reeeive an injection oF see someone ‘who is inured, whether blood is visible or not. For people ‘who react as severely as Judy, tis phobia can be disablin ‘They may avoid certain eareors, such as medicine or hcl isk What Is a Psychological Disorder? Keeping in mind the seal life problems faced by Judy. let's look more closely at the definition of psychol normal behavior Isis a psychological dysfunction within am ical disorder, or abe individual that is associated with distress or impaimtent in fme= tioning and a response that is not typical or culturally expected {sce ME Pigure [.1), On the surface, these thee criteria may soem obvious, bur they were no o explore what they that no one etiterion has yet b ily arrived st and i is worth sean, Yu will see, importantly sloped that Tully detines Unde ising Psychopathology 1Bisbee or inp Atypical sponse FIGURE 4.1 Tie 0": etning a psychological scree Psychological Dysfunction niko For example, if you are out stab ‘emotional, of bedavioral fuetioni un, But if se home, sere fear happens ening and just want be afraid of and the tious are not function cen though there is noting te properly. However, if all your fiends agree tat the person who asked you oust is unpredictable and ‘dangezous i some way. then it would uot be dyséunctional for You tobe Fearful ad avoid the date For Judy: she fainted atthe sight of ild version ofthis reaction 2A dysfunction was pres blood. But many people experience a Leling gueasy atthe sight of blond) without mecting the criteria imal snd abnormal dysiuncton is often difficult, Por this reas are offen considered to be en a contin her tha te ea these prob mora sries that ate either present or ‘enough to meet the criteria for & Pssehological disorder Personal Distress That the beso must he associated with distess to be classified as abnormal als an important component and seems clear: the upset. We ca certainly say that Judy was disuessed and even sulfered with her Phobia, But remember. by ise normal behavior I is offen quite normal 4 ‘example if someone close to you dies. The sul tt suf not likely tion, suber Feels extromely elated and ma citesion is satisied if dae individual is extreme this criterion does not detine ab be distressed for Hite. This is Te some disorders, y éetini and distros are very muck pa Furterme ind distress ar cli absent. Consider the person hc set impulsively as part of « mani episine As you will ee in Chapter 7, with this problem is that some penple much the > beg Thus, detning psychological disorder by jay the manic stale se are elt Iceaiment or stay Jong in neat ddogsi't work, althoug incept of distress comsibutes to a good definition satisfactory: For example, many people consider themselves shy or lay, Tais doesn't mean that they're abnormal, Bur if you are 2 Chapter t Abnermal Behavior in Historical Context A Diste selves construe ap s and suferag are a natu pat of fe ane do natin ter date or even interact ith » avoid interactions even ind You make every allem, though you would like to have Iriends, chen your social function ing is impsite. Tidy sy clearly impaired by hor phobia, bk many people with simile, less severe reactions are not impaired. This differ in ilusirates the important point that most psycho ne simply exuene expussons of iret neta Atypical or Not Culturally Expected Jorn sine abnormal bnormsal bs serige. The say tht aning thal 1, but tis obvi e is important but also insufficient to de ity by self Atti it oceus something is consider ase it deviates fom the the deviation, the more abnormal iti. You mi tbnormally short or sbmormally tll. height deviates substantially fiom ave ously it's delinition of diserder. Many people are far from the behavior, by sonsidered disor dered. Wer might call them tslented or escemtric. Many ati movie sta, and athletes fall inthis eategory. For esample, it’s not requety rele erage in U few would be roma 4 pla to have blood spat from youu clothes, but when Lady Gaga did this while performing itozly enbanced her celeb rity. The late novelis J.D. Salinger, so wrote Fe Catcher in ye, retvated to a small town sev any outsiders Fr New Hampshire and refised t Jnwed to write, Some male people are well rock singers wear heavy makeup pd and seem 19 enjoy their careers. I most eases, the more productive you ate in the eyes of society, the more excentricities seciviy wil tolerate, Therefore, “deviating from the averig sdoesoLaork well 3 9 definition for abnormal ebavi \sother view is that your behavior is abneumal IT you are vin ‘en ifa number of penple are sympattic This detinition is useful in considering differences in psychological disosders, Por Tating social norm: to your point of view important cok example, 6 en reflects 4 psychological disorder in most 8 1 trance slate and believe you are possessedin many other societies, where the betsavior is accepted and ex pected see Chapter 6). (A cultural perspective is an important point of reference tironghout this book.) An inforsative examph of this view is provided by Robert Sapolsky (2 nent neuroscienti 12), the prom ‘who, during his suies, worked closely with the Masai ibe in Vast Africa, One day, Sapolsky's Mast friend Rica asked int bn Masai vill had bee voiees. The woman had actualy killed a with ler own lands, Supolsky and several Ma subdue her aud transporter to a Joeal bealth eestor. Realizing ta thi opportunity 0 psyeholigical disorders, Sapolsky his joop as quickly as possible to the Where a wonnaat had been acting agaressively and was a am more af the Masa's view of i the following discussion ‘So, Rha” [an lacomeally, “shat do yor suppose was rng ith that woman Se looked at me 30477 wa ad ut how an yo tell ‘he's et (Can't you jas ee fro oe she hss da yea vide that she is crazy’? What di she ‘She hill tha gost “oh” sad sith anthmpologieal detachment, fat Mas ill pats ll the ime She ke ss she sa Jat me asf] wer ano “Only the men bil ‘Wall How ele ao go kno that she ey She hears wees Tae a pain of elf “Ob, but the Mast ea vies somes betone hong cate drives, the Masat eos) And in one sentenge, Bh Ko aboot erss-cltal soetiss!” (Ms tangs dance ad laine ea stim up lf of whal anyone nec peyehiany, Thu she boats voiges al the ston Ga uallhas boon misuse, Com the practice of commiting political dissidents sider, for examp the policies fall of Su such dissident belvior government, which Was common it Lag before Aho stud no Hussein and sow occurs in Ir clearly violated soci stone be cause for commitment Jerome Waketeld 12,1999, 2008), ina thoughtful analysis hora detiniion 1 harmful dystine= tion A rela concept tha i also useful is to datermine whether le bebavior is out of the individual's control (something the per son doesn’t want to dev or aot Widiger & Saniis, 2000), Variants of these approaches are most often used in curtent dignostic tio of the Di practice, as outlined in the text revision, fourth agnostic and Statistical Munwal( DSM-IV TR) American Psyebi attic Association, 2000), which eomiains the cusreat listing of criteria for psyeiological disorders, These approaches, which are clinaged in the fit edition (SMS) bases ide our thinking it tis book, An Accepted Definition 10 detine 08, 1995) noma” and and the debate continues Spitzer, 1995: Wake seepled celimtion used in In conclusion, itis diffe abnonnal {Lilienfeld & Marin 0 Hots, 2001; Klein, Wark, Understanaing Peychopatholeay 3DSW-AV-FREand drs of PSM-5 describes behavioral, psycho Iosical,o¢ biol cultural cnntext and associated with preset distress and impair meat in functioning, or increased risk of suffering. deat impairment. This Getinitio can be usetul across cules subcultures if we pay carefsl altention to what is functional ot sal dysfnctions that are unexpected in their iysfimetional (or ont of eon ina given society Rat ies easy to decide what represents dysfuction, and some scholars od persuasively that the health professions will never be able to satisfactorily deine disease ordiver Lilienfeld & Marino, 1955, 1999) visce, for example Thhe hest we may be able so do is to consider ow the apparent disease or disorder matches a ypieal” profile ofa disorder —for example, major depression of schizophrenia—when most oF all symptoms that experts wkd agree ate putt of the disonder are present. We eal this epic profile a prosoype,and, as deseribed in Chapter 3 the diagnostic criteria from DSM-IVTR as well as the emerging criteria for DSS found throughout this book ate all proteyypes. This ts the pa ddsorder (a minimum number} and sill meat criteria for the disor der becuse is or her set of symptoms is close tothe prototype This co Tully i Chapser 3, whore the di agnosis of psychological disorder is discussed, AS noted abowe, ezcation of the DSW-Fis in progress (Brown & Barlow, 2008; Krueyer, Watson, & Buss, 2045, Re Nanos, Koll, & Kupfer 2009), with publication due in May 2013. But the basic detiniton of psychological disorder will be largely unchanged, may have only some features ee symptoms of the pis described mot bora fina! challenge, tzke the problem of defining abnormal behavior a step further abd consider this: What if Judy passed out so often that after shile neither her classmates nor her teachers Fu sen noticed because she regained eonseionsiess «ichly thermore, what if Judy eantizued to get good grades? Would Fainting all dae time at the meee thought of blood be a disorder Would it be impairing? Dysfunctional? Distessing? What do you tink The Science of Psychopathology Pyychopathology is scientific study of psychological disor ders With this field are specially rained professionals, includ ing clinical and counseling psychologist, psychiatrists, poychiat- Fie social workers, and psychiatric marses, as wel as marrige and Family therapists and mental beulth counselors. Clinical and receive the PhD. de ‘lor of education, or Ps: deetor of psychology) coimsebing psvetioko an BLD, and follow a course of graduate level Study, last 5 year, that uid treatment of psyeto {or sometimes pares them fo conduct researelsinlo the causes eal disorders a to diagnose, ase, uid treat these disorders. Although there isa great del of ove psychologists tend to study aad treat adjustment and vocational issues encountered by relatively healt individuals and clinical psyebologists usually concentrate on more severe ical disorders. Also, pr seashore the degre is often « PSD. Focus on clin psyebolo sl psyel cal truining and de-emphasize or eliminate research training. In contrast, Ph.D. programs in universtis in wid Paychologists with other specialty traning. such 4 Chapter 1 Abnormal Behavior I Historical Context as exporimental and social psychologists, concentrate on invest ling the basic determinants of behavior by treat psychological disorders, Psvehtanists tts earn an MLD, degroe in medical seluool and thea specialize in psychiatry during residency taining that lasts 3 tod seats, Psychiucists also investigate the nature aid causes of psyeholigical disorders, offen from a hiokagies) point of view make diagnoses: and offer weatments, Many psyehiatrsts empha size drugs or ether iological treatments, although most use psy chosneial treatments Well Povehiatrie sor 1) a masters degree in social work as they develop expertise in a anal Fan sition ofthe indivi with a Psyeholigical disorder Social workers ls tea disorders, offen ‘concentrating on Faily prob Psych rie nurses have advanced degrees such as a master’s or even a Ph.D. and specialize in the care and weatment of pation with psychological disorders, usually in hospitals as part ofa treatament tearm Finally counselors tpi collecting information eleva tthe s associated with the famiy therapists and mensal health lly spend 1-2 years earning a master's degree and are employed provide clinical services by hospitals er clin ies. usually under the supereis snot a doctoral level clinician, The Scientist-Practitioner The mos msporsant development in the recent history of psyehop: thology isthe adoption of sciemc mets to leurs more about lie nature of psychological disorders. heir causes and their teatmen Many mental health professionals take a sciemttie apprcach to it elincal work aad thesefone are called se actitioners ‘Meriow, Hayes, & Nelson, 1; Hayes, Baro, & Nelson-Gray Mental heal 190) pricttioners may Finetion ay scientist prictioners in oe of moze of tes ways (see Ml Figure 1.2) FFs, they may Seep up with the latest scieuiie developmests in thir field and therefore use the most curzent diagnostic and treat, ment procedumes. In this sense, they aze consumers of the science of psychopato eal scientist practitioners evaluate their own assessments or tre to the ad wir patents. Sovond ment Mental heath professional Consumer of seience *Enhariong tho praetce Evaluator of science *Doteminng he tesiuor othe practes ‘creator of science sGondoeingreseatch that loads oe ronpsires uso practice FIGURE 1.2 Furcionng =procedures so see lteter they work, They’ ane aeeoustable not paly surance companies er patients but also to the government agencies and in hat pay for the weatments. so they must hat their atmeats work. Third, sceatish practitioners might conduct res that pre demonstrate clearly thus becoming immune to he fas that phasne our Fld, offen at the expense of patients and their families. For example, new iracle cures” for psyehological disorders that are reported several times a year in popular media would not be used by a scientist practitioner if there were no sound seiemife data show ing that they woek, Such data flow fom researc Uhat attempts thee asi riers Things: to deserine psychological dh 1 deter ‘clegoris compose an organizational stracture that recurs through nut ths book and that is formally evide ic disorders beginning in Clap the discussions of 5.A general overview of them derstand abvuormalty ieaer perspective on our efforts 0 un Clinical Description In hospital with a specitic problem or set of prcbl presenti indicat and clinics, we often say that & pationt ws problem, Presents is. taditional shontband way of why the person came tothe clinic, Deserving hudy"s presenting problem is description. w iors, thoughts, and Feelings that fist sip in determining her elinieal h represents the unique combination of behav sake Up 8 sp The word cfinieadfefers Pot to the types of problems or disorders that you would find in neces with assessment an te ile disor ‘Clearly. one important function of the clinical description ist specify wlan makes the disorder different fos: normal behavior or Fron other disonders, Statistical data may also be relevant bor exampl have the disor how many penple in the population a2 whole ? This fg F the disorder. Statistics on ow many new eases occur during a given r Other sists include males and females have the disorder ind, such as & yea, represent the incidence of tbe disonie that is, what percentage of sand the typical age of en sot. which often differs from one disorder to anete In aadition to hav possibly a diferent sex tat and prevalence, most disorders fa: 3 diferent symptoms, age of onset, and Focus eee cssto est eee Torment a os FIGURE 1.3 asoussin of aby studying psychological disorders so cate Jow-a somewhat individual patter, oreourse, or example, some Chapior 13), follow a meuting that they tend te last Jong time, some times a lifetime. Other disorders lke mood disorders (see Chap. ter 7), follow amepasoaic corse, in thatthe individual is Hikely te the recover witha @ few months only to suller a recurren ning the disonie ly short perio ‘Closely related to dilferonces in course of disorders are differ ironset, Some disorers have anacuve ony, meaning that sein suenly; lors develo) gradually over an extends will impeove without treatment in a ela so that we can know what to expect in the future and bow best to dal with the prob portant part of the elinical description, For ex a mild disorder wil d. we m tant to know the typical course of a disorder This isan ample, if someone is sufTering now is time lz ul not wo other wilh expensive weatn will be over soon eno, ik disorder i likely 10 his vial might want to see treatment anda steps. The anticipated course of 3 pnsct tl Dy advise the individ because the prolem it the a Jong time fhecome chronic}, the indi bther appropriate isorderis called theprognosis. common cold. Howeve So we mi meaning the individual will probably oe “the progutosis is guarded.” meaning the outcome deesn't look g The patie ial de sesipton, A nts age may be sil Important part of the ll lic psyclilogical disorder occurring in chil aly fromthe s disorder in adulthood cor old age Children physically il becinne they have difficulty is nol tha they ane batt 2 physically wrong. Because A Chlcren experience pane a ’ ther coactons may se mitakor for sympters. Understanding Peychopatholoay 5their thoughts and Feelings are different from those experienced by adults with ansie and treated for a mslical disord We call the study of chang imental psveh normal beliavine as developmental ps think of development ‘chots studying the behavior of children, However, because wwe cliange throughout our lives, researchers also study develop meat in adolescents, adults, and older adults. Study of absormsal behavior across the & developmental peschopath expanding rapilly and panic, children are often misdiagnosed es in behavior over ogy, and we toler to the sludy of elamges in ab rp Whew you paschology, yom probably picture ire age spat is referred 10 a ve The field is relatively u Causation, Treatment, and Etiology Outcomes Rt h and social dimensions. Bes jology. or the study of 0 ns. has to do with why a disorder ins (What causes it} and includes biological, psycholog suse the elioiogy of psychological disorders i so importat go this ie! (Chapt Treatme swe devote an entice chapter also, is eft important tothe study of psyebologi cal disorders, Ifa new drug or psychosocial teatment is suovess Tul in weating a disorder, it may give us some hints about th ture of the disorder and its causes. For example specific ki a drug wilh a wt effect within the nervous system alleviates a eer tain psychological disorder, we know that son fof the nervous system might either be causi tain it, Silly. if sighed to help clients regain @ sense of eomtre) over ther Hives is cllective with a certain disorder, a diminished seuse of contol mayb a important psyehologieal component of the disorder ‘As you will seein the next chapter. psyeholngy is rarely sim- ple. This is because the efieer does not necessarily imply the se To use a.common example. you might take an aspirin to oped during a grueling dey relieve a tension sams, I ‘ache was caused by a lack of aspirin, Ne people seek treatment for psycliological disorders, and teatment ‘can provide interesting hints shout the nature of the disorder In the past, textbooks empasized treatment approselies in a tution to the disorder being treated lth professional might be cache you general seuse, wit little trained ina single theoretical appzoaeh, such 2s psychoanalysis or behavior therapy (hoth described later in the chapter) and then use that approach on exery disorder. More recently. as ourscience has adsanced, we lave developed specifi effective treatments that do not alays adhere neatly to one theoretical approach of another but that have grown ont of a deeper unersianing of the liver in question, For this reason, there ane ae ters in this book on such {ypesof Wealmest appooaches as psycho imanistic, Rather, the test and mos efetive drug and psychosocial treatments (nonmedial parte chap ddysamis, cognitive behavioral, or treatments that foeus on psychological, socal. and euhural fae tors} are described in the contest of spocilic disorders in keeping ‘with our ineprative multidimensional persp We now surcey many early attempts to normal bebsiior and to comprehend its causes, which wil g scribe and treat a 6 Chapter 1 Abnormal Behavior in Historical Context You a better perspective on current approaches. In Chapter 2. we ‘examine exciting contemporary views of causation and treaien In Chapter 3, we discuss elfons to deseribe, of cassly, abnormal belisior. lac ots to discover the tuths underly ‘we review research methods-—oursystem ddescriptio aie cease sil eaten that allow wy Tn Chapters 5 through 15, we © inine specitie disorde discussion is organized in ezel ease in the now failine wad ‘of description, cause, and treatment, Finals, in Chapter 16 we ‘examine legal professiomal and ethical issues relevant to psycho logical disorders and their weatment today. With that overview in ‘mind, Jet us turn tothe pas Historical Conceptions of Abnormal Behavior For thousands of years, humans have tried to explain ad conteol problematic behaving. But our efforts always derive from the theories or models of bebssior popular atthe time. The purpose of these models is to explain why someone is “ecting like thal TIhrce major models that have guided us date back 10 the begin tings of eivlizaton, Humans i and environment int Iwvays supposed thal nzeuts outside our bodies ¢ nur behaviog, linking, and emotions. These anents, which might be divinities, demons, spits, oF ether phouiome the driv such as magnetie fields or the moon oF the stars, are In auaitio sinee ancient Gizeeee. the mind bis often been called the sol or the psrche and eoasidered separate from the body. Altiough may lave thought thatthe mind can influence tae be turn the body ea inf fore mea behind the superna nie the mind, anos philosophers looked For causes of abnormal behavior in ‘gave rise to 180 traditions of thought shout abnormal behavior Summatized as the biological model and the poveholosic ‘These three models the supernatural the biological, and the psyebological are very old hut continue to be used today Part A Write de Jetlr for any or all of the following definitions of aabsormsality in the blanks: (a) societal norm vination. (b) im psirment in functioning, (e} dysfumetion, and fi dstess. 1. Miguel roveatly began feeling sad and lonely. Although sil le to fnction at work and fui other responsibil ites, he tds himself feeling down mueh ofthe time and he worties about what i happening to him, Which of the otitis of abnormality apply 0 Mi rie or the wher This split Tluree weeks ago, Jane, « 35-year old business executive stopped showering, rlused to leave ber apartment, and satted watching elevision talk shows, Threats of being fired have failed to bring Jane back to reality, and shecontinues to spend her days staring blankly atthe tle Sion screen Which of the definitions seems to describe Jane's behsior? Part B Match the following words that are used in clinical deseeip Fions wi their omesponuding examples a presenting problem, dbp prevalence, ic} incidence, tl) progtosis, te) 3. Maria should recover say. Without eatn ickly with no interventin Jolin will dewriorate rapidly TTince new cases of bulimia have been report in this county during the past onth and only one in the next county, 5. Hlizaboth visited the eampus menta) health center be case of her increasing leelings of guilt and anxi sal an social influences all con disorder Tie patter a disorder follows can be ebro, time lim ited, or episodic 8 How many people int from obsessive-compulsive d 1 population as a whole ster | The Supernatural Tradition or much of our recorded history, devi bel sidered a reflection of the butte between good and evil. When confronted with unexplainable, ational behavine and by suller ing and uplewval, people perceived evil. In fact, in the Groat Persian Empire fiom 900 to 608 ee. all physical and mental disorders were considered the work of he devil (Millon, 2004 Barhara Tuchman, a noted historian, chnoaicled the second half of the Ii century, a particularly dificul ine for humanity. in A Distant Mireor(1978), She ably captures the conieting ties of ‘pinion on the origins and weatment of insanity during that bleak san tumultuous perio Demons and Witches ‘One song eurtent of 0 psychological disorders squarely inthe cealm of the superna Dring the last quarter ofthe 14th century, religious aud lay aw hove fon put the causes and teatment of ssapported these poplar superstitions and society as a wo believe more si Calholie Church had split, and a erged in the south af France to compete with Rome: In reaction to ths schism, the Ro maiz Chureh Fowsht bask against the esil in the world that must hhave hoen behind this beresy Jy i the existence ad power of demons and witches. Th second & rater, complete with & poy People increasingly tumed to magic and sorcery 10 solve their problems, During these turbulent tines, the bizare behavior of people afflicted with psychological disonders was seen as the work ‘of the devil and witches. It followed that individuals possessed by evil spits were px ny mis enced by the exenspeople, which inspired drastic action against the nably responsible for ine exper possessed. Treatments included evoreism, in which sarious rl omied to rid the victim of evil its, Other approaches included shaving the pattem ofa cross inthe baie ofthe lous rtnals were pe ‘victims bead ad securing sulerens to a wall near the front of a hurt so that Trom hearing Mass “The conviction that sorcery and witches ute cases of madness sido evils contin in the Sth century, and evil contin lobe blamed for unexplainable behavior, even aller the founding of the United Stats switch teas vide! Massachusetts by the Sale Stress and Melancholy An oqually sto cnlightened view that insaity 3s « natural phesomenoa, caused by meatal or emotional sess, and tat it was curable «Alewander & hs Maer & Maer, 198Sa). Mental depression id es (Kemip, 19%: Seo symptoms sch as despair and lethargy were often w this period, reflected he alto iented by 1978}, Common twealments were west. slop. and a ealthy and rch with the sin of edi. or sloth Tuchman, happy environment. Orher teatments inchide! baths. ointments sand arious potions, Inde, during the 14th and 15th centuries. poop with insanity, slong wih those with physical deformities or ischilids, were often moved from house to house in medieval sill or ther. We nex kno that this medieval practice of keeping people who have psyebological slisturbanees in heir own community is honefiial (soe Chapter 13) ‘A¥e retum to this sujet ewien we discuss biological and psycho logical models Iter inthis chapter) (One of the chief advisers tothe king of Franee, a ishop and sas neighbors took tums cat Philosopier samed Nicholas Oreste, also suggested that the tlisease of mekanebly (depression) was the source of some bi The Supernatural Traction 7~zasre behavins, rater than demons. Oresme pointed out that much of the evidence for the existence of sorcery and witcheral, par ticularly amon; vwas obiained fom people who were tortured and wo, quite understandably. com those considers Fessed to any These conflicting enmsseuents. of wahural ane supernatural explanations far mental disor or Tess sirongly inv istorical works, depending 0 ‘consulted by historians, Some assumed that demonic inflences ve the predominant explanations of abuormeal belsvior ering the Middle Ages (lor esample, Zilhoore & Henry, 1941 are represented th believed that che supernatural had litle or no indluenee, As we see inthe handling of the severe psyehologieal disoner experienced hy late-Lath-centry King Charles WI of France, both ine CHARLES VI| The Mad King In the summer of 1392, King Charles VI of France was un dlr a great deal of stress, partly because the Catholic Chureb, As he rode wit ince of Britany, « nearby aide dropped his lace Jou clater and the king, tink turned on his own arms, killing several prominent Knights before being subdued from bekind. The amy immediately marched back to Paris, The king's Liewenans and advisers concluded that he was Daring the following samy tothe prow ita o he was under allack, at his worst the king hid in a comer of his castle believing he was made of gloss or roamed the corridors bowing like wo. Aether tes he cco’ remember who o what be ws, He became feat and enraged whenever he saw his own royal coat of arms and would try to destroy iif i was brought near him, “The poople of Paris were devastated by tir leader parent madness. Some thought it reflected Goa’ an cause the king failed to take up ams to end the schism in the Catholie Church: oles thouskt it was God!'s warn st taking up arms: and sil others thought it was divine punish nt Tor leavy taxes (a conelusion some people might miske ay), But most though the king's madness was eased by soneery, tie srewpstiened hy eto die of hist, Merchants claimed their worst losses in 20 years Naturally. the king was given the best care swalable, The mos. famous the ponds a wale inthe fand was a 92-year-old physician iment poe mowiig the king lo one of his residences in the country where the tsb the cleanest inthe lan, The physician prescribed rest relaxation, and recreation, Alter some time, the kin to rocnver: The physician recommended that te ki burdese! with the Fespousibiites of running te ki claiming that if be bad few worries or irttaions, his mind would gradually strengthen and further improve, Uoformmatey, the ply sien died and the King Charles VI aes ram include seomed p not be sued more seriously than before. This 8 Chapter 1 Abnormal Behavior I Historical Context time, however, he came under the inh ossoUrent of supernatural eausatio ‘eof the conllct An unkempt slatan and pseudo mystic named Armaut owed treat Charles on Guillem wis is elim of pose sessing a book given by Gia to Adam by means of which ‘man could overcome all uliction resulting from original sin” (Tuckiman, 197%, p. 5141, Guillem insisted that the King’s malady was caused by sorcery, but hs treatments failed to bring sh A satiety of remedies and rituals of all kinds were tried but none worked. Higtt ranking officials and doctors of the university called for the “sorcerers” to be discovered and punish ell sul a cure ‘On ome occasion, 180 Augustinian fia, alte magic incantations anda liquid Iai Irom powdered pearls, groposed so eu the king's head Whew this was not allowed by the king's ‘council, the friars accused dation of sorvery” (Tue himselé, during the source of madness was evil and sorcery name of Jesus Christ.” he cried. weeping in his szony there is any one of you who is an accomplice to this evil suffer, Ib (Tuchman 10 results fro s¢ who opposed their recom n, 1978. p. 314). Even the ‘omens, came to believe In the © him 0 torture me om Tener blot me de’ 1078, p 515) Treatments for Possession with cone hand and psychological disorders om the ol ‘conclude thatthe sufferer is largely responsible forthe disorder, ‘which might well bea punishment for evil deeds. Does tis sound Familiar? The acquired immune delicieney syindrosse MDS} epi demic way associated with 2 similar belief mong some particularly inthe 1990s, Because ‘sinus (HIV) is. in Wester societies, most pk viduals with homosexual orieatation. many people believe itis a divine punishment for what they consider immoral behavios, Ts hus dissipated as the AIDS virus spresds to other, “Less sin Tu segments of the population, sett persists perceived conection between evil deeds and siv on the people 1 human immunoseticieney valent among indi (fs no aways connected with sn ba may a as involuntary and the possessed individual as Blan Furtiers Painless. Imerestingly. they sometimes work, as do ther forms af Fait ealing, for reasons we explo in subsequent chapters. But what if they did not? In the Middle Apes, if exorcism failed, some. snliites the es have the vitue of being relatively thal steps wen necessary to make the hex tuinhabitabie by evil spirits, and many: people were sibjoo ‘confinement, beatings, and other forms of torture (Kemp, 199% Somewhere along the way! 2 ecided that hanging people ever» pt full of poisonous sil spirits ight out of their bodies (to s4y not the people themselkes}, Str worked; that i the most disturbed, ely bela would su ted bo he scare the of terily sometimes I this. approach individuals fenly come to their senses and experience relief trom their symptoms, iFonly temporarily. Naturally, this was reinfore4 In hyoothorapy, cations we so snake wilt in many institutions, i nents hased on the hypothesized luerapeatic ele meat of sock were developed, including dunkings Mass Hysteria Another fascinating phenomenon is characterized by large-scale outbreaks of bizazce behavior, To this day: these episodes puzzle historians and mental health practitioners. During the Middle Ages, they lent support the notion of possession. f Purope simultane nd jump around in patterns ove als particularly wild party late at night (sil called whole groups oF people a put nthe st as ifthe anv}, but without the music. This bebavior was known by sev feral names, including Saint Vius's Dance and tarantism, 13s ost interesting ual many people belived in this stage way at one. In an attempt to explain the inexplicable, sever foxsons ‘were aflerad in addition to possession, One reasonable guess as reaction to insect bites. Annier possibility was wht we now eal ‘mass hysteria, Consider the following example Modern Mass Hysteria ‘One Frid wv alarm sounded over the public sldress system of community hospital callin all physicians to the ‘Arvising from a local school in a and 4 teachers w iting: mow were byperventilatin All the students and te on exel sie of te hallway. The inci lien a Mt year old git! reported 2 funsy smell that seemed to be com She fell tothe oor, cry acl hur: and ber ey of the teachers in the four adjo fom a 12 and complaining that her stom stung. Soon, many’ oft sfooms, wo could see rieaced similar symptoms, OF susceptible people (82 students and 4 teachers in the four classrooms), 21 patiems (17 students andl 4 texelers) experienced uted at the hospital. Ins symptoms seve tion of no sppareat| use for the reactions, and physical examinations by imate. A the red (Rockney & twams of physicians revealed no physical ab re seat home patients Lemke ‘Mass hystecia may simply demonstrate the phewosienon of ‘emotion contagion, in which the experience of an emotion seems, 9. & Rapson, 1). HP someone nearby becomes tightened ot sat for the my sales. Whew this kind of experience ese to spread to those around us (Hatield, Cacio 199d, Wang, 2 sent You also Will feel fear or ses into full-blown pre, whole communities are affected (Parlow, 2000), People ane also suggestible when they are in saws of high emotion, There Tore, if on probably assume that their own In popular pets identities a “cause” ofthe problem, others will cetions have the same so o.this shared response is sometimes referred The Moon and the Stars sd notions of possession by the devi instead that ul pr Tonetioning. Echoing similar thinking in ancient Greece, Paracelsus speculated that t Fects of the moon on bodily duids might be a possible cause of Uisondets tRotton & Kelly, 1985}. 1 Inspired the word hn e's psyehologi railings ef ment s infuential thenry tom the Lain wort wlll is den 1 You might hear something etary they did lastnight by saying, “Te mast have hoo the full moon.” The belief that heavenly bodies afeet human be- havior sil exists, altaough there is no sciemiis evideuce to sup por it Raison, Klein, & Siockles, 191: Rotion & Kelly, 1983) Despite much ridicule, millions of ps around the world are ol by the stages moon oF the position of the tar, This belie is convinced that their bebsvier is iniluen ofthe Craton are cortagou The Supernatural Trastiontoday in followers of asteology, who hold that their behasior and the major evens in their lives cam be proicted by their day to-day relationsip to the position of the lesidence has ever contimed such connection anets, However, no serious Comments. ‘The supematural traits in psyehopathology is alive and well, alhough itis relegated, for tie most par, to sta eligious sects in this country and fo primitive cultures elsewhere. Members of orga ns in most parts of the wold look to psychology snd medical science for help with major psychological disoalers, in fat, the Rema Catholic Chich repies tha ll health-care pe- sources be exhunstal before sprinal solions sich as exorcism ccan be considered. Nonetheless, miraculous cures are sometimes achieved by exorcism, magic potions and situa, and other meth ‘ads hat seem to sve litle connection with moxkem science, Its Fascinating to explore them when they do eocur, and we return to ure relatively rare treatment lor se this topic in subseyuentchaprers, But such sand almost no one would advocate supeenatur vere psyeliologial disorders except, pechaps, 26a last reso. | The Biological Tradition Physical causes of mental disorders have becn souglit since early in history. Important to the biological dition area man. tes: a disease, syphilis: and the early consequences of sical disorders are biologically caused, Hippocrates and Galen “The Greok physician Hippoerates (460-377 ne.) considered to be the ater of modetn Western medicine. He an his associates left body of work called the Mppoentie Corpus, written be- tween 451 and 350 sc. (Malier & Maher, 19854), in whieh the suggested that pyyeliolngical disorders could be eeated like aay other disc c. They did wot limit their search for the eases of psyebopathology to the general ar believed that p brain patholo ity ¢ Fim, and they have been supported in recent years. Hippocrates considered the brain to be the seat of wisdom, consciousuess, imelligence, and emotion, Therefore, disorders involving these Tunetions would logically be located in the brain, Hippocrates also recognized the importance of psychological and interper sonal coatebutions to psychopathology, suel as the sometimes ‘of “disease.” because they also be caused Dy orliead tra and could be influenced by ered: netics). These ane remarkably astute deduetions for the Ponts foi tee ain The Roman physician Galen (approsizsataly 129-198 4.) later adopted the ideas of Hippocrates and his associates nad de veloped thom further, cating # powerful and infuentil school of though: within the biological tition that extended wel ino te 18th century. One ofthe moe interesting snd intel ciosof the Hippocrati- Galen approach isthe humoral heorvof disorders. Hippocrates assumed thst normal brain functioning vwas relate four holy tics or humors: blood. black bie 10 Chapter Abnermal Behavior in Historical Context yellow ile, and pa fom the spleen, ph fins the liver Physicians heli that disease nose ftom te rnuch of too litle of ne of tae humors: for example too mush black bie was thought to cause melancholia dprssion). ln Eat. the termmelincholer wich moans black bile is sill use tod ints derivative form melanchotvto ner ty aspects of depression gm, Islood came from the bear, black bile sm f¥om the bain, and eboler or yellow bile The hursoral theory was, peraps. the lrst example of associating psyebological disorders with a “chemical imbalance." ax ap proaclr tht is widespread today. “The Four humors were related tothe Grecks" eonception ofthe Tour basic qualities: heat, dryness, moisture. and cold. Each hu: mor was ansociated) with one of these ilies, Terms drives From she for utnons ane sill sometimes applied to personality lusts, For example. sanguine (re, like blood) deseribes someone who is maddy in complexion, presumably trom copious blood flowing through the bedy. and cheerfel and optimistic, although insomnia sad delirium were thougit 19 be 6 blood in the brain, Mefanefufic means depressive depression was thought to be caused by black bile Teoding the brain). A phlegatc personality (Irom the humor phlegm) indicates apatly and sluggisaness but can also mean being calm under stress A choleric person (liom yellow bile of eholer is hot tempered (Maher & Mahe, 19854), sed By excessive A Becdeti restore the tala the ostracton of tc purrs intExcessesof one or more humors were trated by rezulating the ‘environment to increase or decrease beat, dryness, moisture, oF ccold, depending on whicl bumor was out of bi Ki ' WI’ physician moved bim lryside was to restore the balance in ee. Ong reason o the less stfessul coun is humors (Kemp. 199), In ‘poo nition, and exercise develope. none, ble cisurd ‘or bloodlering.a caret n ‘ova from the body. often with leslie. The luer was to induce vomiting; indeed, in a well known tees tise on depression published in 1621, Anatomy of Melancfol Robert Burton recommended eating tohacco and & bal boiled cabbage te induce somiting (Burton, 1621/1977). Wf Judy bad Tive en diagnosed with ill amount of blond was x ness nin disorder, of some other physical problem, perhaps en the proper medical day: bed rest, a healhful diet, exercise, and related to excessive humors, and been gi treaiments of vier ministations as indicate In ancient Chins and through Bor rater than “humor.” the Ci out the boss. Unexpisined me drs were caused by blockages of wind or te presence of eo, dark wind (yin) as opposed to warm, lle sustaining ind (yang Treaiment involved rest methoes, e foeused on the movement ol air or “wind” thr al disor "ng proper ow of wind thgough Various including acupuncture Hippocrates also coined the word fysteri ta describe 2 con cept he Feamed svat from the E: what we now cal the physical symproms appen prs. who had icentiiod thesomatefonn disenders. In these disorders, tobe the result of medical prob Jem for which no physical cause ean be founel, such as paralysis ang! sone inkls of lincess, Because these listers oscurresd primarily in women, the Egyptians (and Hippocrates) mistakenly ted to women, They also prestmed atcause: The empry uterus wandered to various parts of the body in search of conception (the Greek for uterus ishystervnt, Numer cous plysical symptoms reflected the location of the wandering uterus, The prescribed eure might be marriage or, occasional: Tomigation of the to its natural loca Fion (Alexander & Selesnick, 1966}, Knowledge of physiohigy cecentually disproved the wandering uleras theory teudeney to sigmatize dramatic women as hysterical continued ‘unabated well into he 1970s, when mental health professionals became sensitive to the prejudicial stereotype the term implied. pat i ue the uterus As you will leam in Chapter 6 somatoform disorders (and the lusts associated with them are not limited to one ex or the oes ‘The 19th Century ‘The adivion waxed and waned dri siler Hippoerates and Galen hut was re the centuries sorated in the 1th century because of tw Factors the discon of syphilis and. sion Arsevican psycliatrist John P. Grey support ftom the well respected ‘Syphilis Behavioral and cognitive symptoms of what we now Know as advanced sxphilis, a sexually transmitted disease caused by a bacterial mistoor ring the brain, inelnde believing th agains! you ilusion of p. syne is plotting seculion} of you ate God (delusion of grandeur), as well as other bizarre wiors. Although these symptoms ate similar 19 those of psvehosts psychological disorders characterized in part by be Ties iat are not ased in reality delusions}, perceptinns tat are ot ase in ality allusions) ot ball wseacers nized that a subgroup of appar rated scully, hosoming paralyzed and dying within 5 years of fonset. This course of events contrasted with th cote patients, to romalned [atl stable, In 1825. the condition general paresis, bocause it hed consis teat symptoms ipresenation) and 2 consistem course that resulied in ceath, The relationship between general paresis and syphilis of most psy was designated a disea awos only gradually established. Louis Pastemr’s germ theury. of disease, found 1870, fitted the idemifcation ofthe s bacterial mi i that caused sypils ance was the discovery of cure f ‘Of equal imps y paresis. Physictans observed a surprising 200 lara, so they celiber ately injected other patients with blood from a soir who was ill with malaria, Many recovered because the igh fever “burned fou” the syphilis haeteria. Obvious. this type of experiment ‘would not be ethically possible today. Uimately, clinical invest gators discovered that penicillin ems syphilis, but with ‘with general paresis who bad contracted m Iavia cure, “madness” and associated behavioral and cognitive symptoms for he irs nse wore raced dicetly ta eure infe= toa. Many mental bealth professionals then assumed that compa rable causes snd cures might be discovered forall psychological disorders, John P. Grey The champion of the biological ration in the United States wis the most influential American psychiatrist of he time, John P Grey (Bockoven, 1963). In 1884, Grey was appointed superinten- dont of the Utica State Hospital in New Yors. the largest in the ‘country, He also became editor of thea verican Jounal of fsa precursor of the curren A the Bagship publicatio FAPAL Gi nericate Jour of Psvekiaity of the American Psychiatrie Association va was thatthe eases of 3's post insanity were aif rn eated sya: The Bicleaical Traction 11should be con est ot ad ways physical, Therefore, the mentally ill paties treated as physically ll Th proper 100) temperature and ventilation, approaches used for centuries by previous therapists in the biological tradition, Grey ‘cen invented the rolay fan to ventilate is large bospital Under Grey's leadership, the eunditions in hospitals greatly improved and they became more humane, ive insittions. But in subsequent years they also became so lng individual atention was not possible In fact, leaders in psyeliiatry at the end of the 19h century were alarmed al te inet hospitals ad ocommended tht th ted impersonal tat OM years helore the community metal health mewement was sauccessfl in reducing the poration of mental hospitals with the ceoninyversial poliey of Geinsitutionalization, in which patients ‘were released into their communi has ns many negative consequences as postive ones, including a Junge increase in the number of chronically disabled patients homeless on the stssis of our cites, Unfortunately. this practice ‘The Development of Biological Treatments, ‘On the positive side, renewed interest in psychological disonders led, ulisately to derstanding of Bioko the des imers 1¢ biological origin of ally increased wn ‘cal comtibutions to psyehopulholiny and lopment of new teatmen’s. In the 1930s, the physical io ‘Their elfees, of elecric shock and brain s ry were often used andthe effects nf new dnugs, were discovered quite by accident” For example, insulin was occasionally: given 10 stimulate appetite in psyelitie patios who ware not eating, Put italso seemed to elim them dow Tn 1927, a Vientese physician Manfred Sskel, began sing increasingly higher dosiges unt Finally, patients convulsed and heeame temporatly” comatose {Sakel. 1958), Some actually recovered their mental ells. mush to the surprise of everybody. x the convulss 1d their weeovery was sliibuted to s. The procedure became known ay i k slrerp; bat it was abandoned because it was to dangerous, often resting in prolonged coma or even death, Other methoss of producing convulsions liad to be found. Benjamin Franklin made sumerous discoveries during his life with which we are familie, but most people don't know that he discovered accidentally. 175s, «brief convulsion and memory loss (amnesia but otherwise did Tite harm, A Dutch physician who was a friend and eolle Franklin's tried it on bimself and discovered thatthe shock alse mage hits “strangely elated” and wondered if it might be useful treatment for depression (Finger & Zaromb, 2006, . 243), Tnepenently in the 1920, Hungarian payebiatrist Ioseph von Mediu ly fonnal in indie viduals with epilepsy (whicl ultimately did not prove to be tue Some of his follawers coneluded da inluved brain seizwres right cure schizophrenia, Following suggestions on the possible benefits of applying electric shoek diceely tothe brain—notab'y by two Italian physicians, Ugo Cert and Lucio Bini, in 1938 surgeon i Ponon treated a Al shocks direct throug his brain, producin 1980). The patient rovovered. lth 1 uen confirmed experimentally in the ‘ata mild and mesdes elettie shock to the head prosduced observed that schizophrenia was f lepesse patent by sel comvul: aly sions (Hust 12 Chapter t Abnermal Behavior in Historical Context modified. sock treatment is stil with us today. The controversial ulsive therapyate described in Chap. ler 7. Ie is interesting that evea now we have litle kno how it orks. Daring the 1950s, the firs effective drugs for severe psychotic disorders were developed in asy humiber of medicinal substances, eluding opium (derived poppies). ad been used as sedatives. along with countless herbs and folk remedies (Nkexander & Selesnick, 1966, With the dis covery of Raunvolfia serpe another class of drugs called newolepurs (major tranquil llucinstory and delusional thou, could be diminished in some patients; shese drys ase controls ve al atic way, Before that ime. ine thar renamed yeserpine) and processes seitation and aggressive sui nzcliazepines (kn tess her disconeries nclndalPe ots}, which seemed to reduce anit By the 1970s, the as Valium and Libriurs) were amiong the most wid fy such brand names ly prescribad ‘drugs in the world, As dravhaeks and side effects of tranquilizers ame apparent. lon with teil ited effectiveness, prserip tious decreased somewhat (ee discuss the benzodiazepines in me detail in Chapters 5 said 11) “Throughout the centuries, as Alewander and Selesnick point vous, “The fone of inital emhusiasm followed by disap 11966, p. 2871, For examp ‘were used atthe end ofthe 19th century and begi century to text ansiety and other psychological disorders, BY the 1920s, they were reported 2s being effective for many serious psyebological and emotional symptoms. By 1928, one of every jeral pattem of drug therapy for mental illness bas ointment class of sedating drugs, Fe 2h the pospons athe United tates was for omen, Whe ih ie et inlalng ation abe pea mp their overall elfeciveness was relatively modest, bromides lrg slsappeared from the scene [Neutolepties have also hen usa Jess as attention as focused ‘on their many side effects, such as tremors and staking. However, the positive effeets of these dru on some patints® psychotic hhh the search for bioloieal contributions to psychological ise fonders and the search for sand more powertul drugs, a search tha has paid many dividends, as documented in later capt Consequences of the Biological Tradition In the silly we duced or eliminated intrest in weating mental patients because we 1th century, Cirey and his colleagues iro they thought that mental disorders were the result of some as-yet undiscovered brain pathology and wore tuerefore incurable, The only available couse of action was to bospitaize these patients Around the tr of the century, some nurses documented clinical success in treatin nted from meat mental patients but were pre ing others for feat of raising hopes of a cue amo bers, In place of weatment, interest centered on diagnosis, legal ue responsibility of patients for their se ‘riod of insanity, and the study of brain pathol ‘questions concer tions dui itself tml Kraepelin (1856 this poriod and one ofl 1926) was the dominant hers of meadern psyekiaryHe was extremely influential in advocating the major ideas of the biological teaition, but he was litle involved in teatmeat, His lusting comtibution was in the a of diagnosis and classitica tio, whicl we discuss is detail in Chapter 3, Kraepelin 1913), ‘was one of the first co distinguish among various psychological slivers, seeing that each iy have a different age of onset snd Jime corse, with somewhat different chistes ef prese toms, and probably a different cause, Many of his deseriptions of schiznplrenic disorders are stil useful to By the end ofthe 1808, «sciemitic apprach t psychos disorders and tueir classification had by biological causes. Furthermore, teatme principles However there wer ical will the search for was based on mane nang drawbacks dhe mos! une Iunate being that active insersention aad treatment were all but climinated in some settings, despite che availability of some eee tive approaches. Iris to these that we BOW turn, Concept Check |1.2 For thousands of years, humans have tied so understand sand contol abnozzal Pohsvior: Check your understanding of these historical theories and match them to the treatments used to “cure” abnomal helavier: (a) bloodletting; induced oni: (b) patient placed in socially fcilitative environ ments: and (c) exorcism; burning atthe stake, 1. Supersstural causes: evil demons took over te victius bodies and comtolled their bebaviors, —_ = 2 ‘The humoral theory reacted the belie? that norma) fine Uionig ofthe brain required a balance of four bodily Ba ids or hums 3. Maladaptive behavior was caused by poor socal and cul oral influences within the environmest. | The Psychological Tradition In is long leap stom evil spirits to brain pathol fof psyeholoiea disorders. In the i swiss the bly xy asthe cause eninge eomtuties, whore ral that put psychulogieal development, both normal and ahnosmal, in un Fate this approach bas jerpersonal and social context? In jong and distinguished tradition, Pla Forexample, thought that the wo eauses of maladaptive bl wee the social sl cultural induences in one's fie and the leam- ing that took place in that environment. IF something was wroag in the envinonment, such as abusive parents, one's impulses snd ‘emotions wool overcome reason. ‘The best treatment Was fo re educate the individual throug rational discussion ‘would predominate (Maber 8 Mal “This was very much a precursor to modern psychusocial treat= iment approaches to the causation of pyschopathology, wiih to ‘cus not only on psychological factors but o tones a8 well Other well known early philosophers, including Acstote, also emphasized the isiluo and early learn wer of social and cultural o of social enviroment 2, These philosophers ‘wrote about the importance of fantasies, dreams, and eoguitions and thus auticipated. to some extent, Iter developments in psy ie science. They also advocated + individuals with psychological echoanaltc tho humane and slisimrrances ousible eae Moral Therapy Daring the frst half of the 1th century, a sto approach so meatal ésorders called moral therapy became inf- ental, The term PsyeLologieal ly meant emotional rather than a code of conduct, Its asic tenets inclu instiationaliged patients as normally as possible in a sting that fecowniged snd reinfores normal social interaction (ockoven, 1983), hus providing them with many oppertunties for apprapri- ial and interpersonal contac, Relationships were carefully rnuctured. Individual ateation clearly emphasized positive conse quences For appropriate imersetic ans] seclusion were elimi As with the biological taditioa, the principles of moral ther apy date buck fo Plato snd beyond. For example. the Greek Ascle pad Temples of the és century ue, housed the ebronically i Including those with psyebole, ales ons and behavior, and restraint sal disorders, Here, patients were well ewe for, massaged, and provided with soothing musie Similarenightoned practices were evident in Muslin countries in the Middle East (Millon, 2004), But moral therapy as 2 system originated with tse well known Hench psyetiatrist Philippe Pinel (1745-1826) and his close associate Jean Baptiste Pussin (1746 INIT), who was the superintendant of the Parisian bospital La Bicetre (Gerard, 1997: Zilboorg & Henry. 1941) Whew Pinel arrived in 1791, Pussin had already insite ne rarkable reforms by removing ll hans nd Pussin persed Pinel to 1 restrain patients ‘eal interventions es. Much to and then at the women's o join him (Gerard and! instituting uma along with the cha La Bi ge, where be invited Puss Pinel’ credit, he di rs hospital Sapa The Psychological Traction 131097; Maher & Maher: 197), Here again, they instituted a bumane and socially feilitative sumsphere that pro o8sh: Weine duced “miraculous” result Afler Willian Tuke (1 England, Benjamin Rush Founder of Americun psyehiatty 1 Hospital Fe then became thet 1822) followed Pines lead in IT45-1813), often considered the troceed moral therapy it his carly work at Renny rent of choice in the leading hospitals. sy ans had appeared in the Tih ventury, but they were more like prisons than hospital, [ ite United Sta rage asylums labiable and even therapeutic In 1833, Horace Mann, chairman of the board of tustees af the Worcester Stute Hospital, reporiad vwas the rise of moral therapy in Europe thal therapy, cues, and released to theis families. OF 100 patients Who were viciously asseuliive before reatment, no more than 12 tinued 1 be violent a year alter beginning weatent. Be! meat, 40 patients off any ts by attendants: only 8 eontinned this beh treatment. These were remarkable statistics then an sable even today (Bockoven, 1963), res dl routinely clothes provided or after a pote of sould be Asylum Reform and the Decline of Moral Therapy Unfortunately. alter the mid clined because of a comver nh ceatury, humane treatment de ence of factors, Hirst recognized that moral therapy worked best when the nuunber of pligmis in an institution was 200 oF & for 3 great ‘deal of individual attention. After the Civil War, enor waves cof immigrants arrived in the Unite States, yielding thei oan populations of mestally il. Patent loads in exis 2. Be serve the same pEvi soups were thouglit not td 8 a8" tive" American eats earlce!). the en moral etments even when there were suffent hospit ‘A sccond reason for the decline of moral tuerapy bs an un likely: source eal ery sauder Dosot Is 1887) campa for reform in the veatment of insanity. A sehcolteucher who had worked in varios tioas, se ad firsthand know] edge of the deplorah tous imposed on p le condi feos with insanity, and she made it her life's work inform the Ameticin public aml their aders of these abuses. Her work Became known as tal hygiene movement Tn sedition wo impo A oo 14 Chapter Abnermal Behavior in Historical Context Through ber efforts, humaize ueatment became mote Wi siluble in American insitions. As her career drew she was rightly seknowledged as a hero ofthe 191 Unfontumately Fors was a substantial increase This indus lod t 9 sal eae senlury. ogesgen consequence of Dixs heroic ef he number of mental patients id teansition fro therapy to custo hospituls were insdespiately staffed. Dix re formed our asylums and single-handedly tion of numerous new Insitutions here and ped the consirve al But even her tireless effons and advocacy could not ensure sulicient sting to allow the individual attention necessary to ioral therapy. tal blow to the practice of moral t in the hat mental illness was eased by apy was the decisi mille of the 19th eentury brain pathology and, therefore, was ipcursle tradition fay Gosmant for a time, emerge in several different schools of thought in the Th tirst major approach was psychoanalysis, Freud's (1856-1939) elaborate theory and the role of unconseiou The psyetoloei only wore ih century. 1e stucture of the mind in determining behavior The second was hehaviorism, associate vith Jolin B. Watson, 1 Pavlov, cand BF. Skinner, ites Foouses on how learing snd adaptation affect tae development of psychopathology Psychoanalytic Theory Have yo weser heen me felt as ined by a Jook across the classroom Tro a atiful man or Woman, of a stare from a rock musician as you sat down in oat ata concert? Iso, you have something is com ‘mon with the patients of Anton Mesmer (17-1815) and sith nillions of people since his Hime who have been hypnotized spell on you? Have you Mesiner suggested! to his putonts that their problean way case by an undetectable fuid found in all Living organisms called anima! magnetism.” wich could become blocked “Mesmer bad his patents sit ina dark room around ap of chemicals with rods extending fiom it and touch Dressed in Mowing robes, le might then identify and tap various fuer their animal magnetism was block trongly that Uuey were being cured. Because inusval techniques, Mesme swlile suszestin of his rath: oddity and maybe a chatiatan, sn Winter, 1998). fa was considered an ‘opposed y the medical hong less than Be cestablishme Franklin pat brilliant experiment in which patiemis received either mag wales oF nonmagnetized water with sioag. sug they would get beter. Neither the patient nor the therapist kno whic which, making ita double-blind exper Chapter}, When both groups got better, Franklin concluded thse animal maguctig, oF mesmerivn, was nothing mone tan (Gould, 1991: MeNally, 199), Neverthe Mesmer is widely reganded as the Father of hypnosis, a state in which extcemely sua trance “Mau distinguished scientists and physicians were interested in Mesmer’s poweeful methods of suggestion. One ofthe best known, Jean Matin Chareot 1825-189), was eal ofthe Salpetigne He pital in Pais, witere Philippe Pine] had inteduced psycliolog lrouuments several generations eulit, A distinguished neurolo netized stible subjects sometimes appear to be inA nko Meare (9734-1 gestions 19 ous onstrated that ie with a number ome techniques of mesmerism were and ie did much to leitimize the Redeling practice of hypaosi, Significantly: sane fom Views Charcot de ath 1 psychological disonde in 1895 a young maa named Sigmund Freud sud ith Chaz lier rewmning from France, Fremd teamed Brouer (1842-1925), who lid experimented different hypootic procedure, While bis patiests were p with Jose with somewbat highly sug ale of hypnosis, Breuer asked thom to de scribe their problems, confits, and fears in as much etal as they could, Breuer obse sf ts0 extzeely important phenomena Fionl as they talked atk felt yuite relieved ana improved ler emerging fiom the lypnotie hs ate. Second, seldom would they the felaionship between their problems and their psychological disorder. fy Fac. it paychobgical was difficult or impossinle for them te they bad deseribed under byp recall some details nosis, In other Words, the mma terial seemed toe beyond the the patent. With this observation, Bre Freud ad discovered” the mind und its ap parent influence on the ps» Auction of psychological di Fhe most lopment the ‘orders. This is and, indeed ashole A clase secomnl was thet discovery that itis therapeutic to recall and relive emotional teu th lunconscious and to release the ascompanying tension, This 1e ‘emotional materfal bocame known as eaths understanding of the rektinssbip between current cerlier events is efetred to as sight As yo ths book, particule in Chapters Sand 6 on anxiety and somite form disorders, the existenc wemories and sand the importance of prowess ied and realtirmed were based on case observation some of which wene mac th of his eatment of Brower & Freud, 1957), Anna 0. was a bright 2 ‘wma wo was perfectly healthy until she reached 21 years of tines. An excellent example is Titer classic seriptiow Anna uuractive young Inysterieal” symptoms in 1895 er Father developed a hou his il age, Shorlly belore her problems begs! tw his death, Thr ness, Anna O. lsd eared for bi; serinus chronic illness that lo cenless hours at his hedside. Five months afer he fae ill Anna noviced that during the from tine both legs, Soon additional symploms appeased. She began te day her vision Blurred and that time she hexi diiculty moving her right am and experience some diflc and er chavo unpredictable, Shortly th In a sets of treatment sessions, Breuer dealt with one symp. tom ata time through hypnosis and subsequent “talking through, tes ousted Breve sStanees surtout the death of Anna's Father. One at a tie her ing oe behavior a tine fulfills basi reyireniens fr dae scientific conelusions about the effects of treatment i an ind g study. as you will see in Chapter 4, We will rtumn te the Faseinating case of Ann O. in Chapter Freud took these basic observation the psychoanalytic constricted on the development and stactane del, the most comprekensive theary yet sat personalities, wie pment cold a disonders. Alto and produce psycliolog many of Freud’s The Psychological Traction 15‘ews changed over time, the basic principles of mental Functioning that be originally proposed remained constant thro stil applied by psychounalysts th his writings and are Ako mains. unproven psycho Iyic thoory has bad a song sit is sill impor ta te Familiar with fs ta sic eas: what follows is a ory. We focus om its three major facets (1) the structure af the mind an the distinct Einetions of personality that sometimes clash with one anothers (2) the with which the nvind defends itself most of it re brief outline of the defense mechanisms Irom these clashes, 0 fiets; and cealy’ psyelosexual develop 3) the stages of rent that provide pris for the mill of our inner contlcts, The Structure of the Mind “The mind, aecondin te id many from psychoanalysis, has oe major parts oF fusions: These terms, like ‘and Super Fond their way ik on eo may have hiss them ‘Theid is the source of our swag not be aware of th sexual and a wes of energies. I is, basically. the animal within us: if totally unchecked, it would make us all rapists o killers. The energy or drive within the id is the idl Even today, some poople explain low sex drive as libido, 8 less important souree of enerey. not as well conceptual ized by Freud, isthe death in stinet, oF shanates. Th absence of basic drives. toward life and Tultiment ow the owe hand and deal and destction on the other, are continually in opposition “The id operates acvoriing to the pleasure principle, with aan overriding goal of maxi mizing please und elimina conflicts. The goal of pleasure which is particularly promi ay ansociated tension of nent in childhood, often con ficis with social rules ant regulations, as you shall see wa (1266-1909) ter. The al has its own char 3 found of A Somass sided acteristic way of processing ray information: referred 0 as the 16 Chapter t Abnermal Behavior in Historical Context primary process, this type of thisking is emotions, vations i logical, filled wih fantasies, and preaecupied with se, sina, selishness, and ens’ Fortuately Gor all of us, in Froud’s view, the ies sels and ed. In act, only a snow We MUS adapt our basie demands to sometimes dangerous drives do not go uneli Few months ino life. we ths real wold. I other worl, we ns Fd ways mes needs without offesding everyone around us, Put yet another way: ‘we must act realistically, The part of our mind stically is called the ego,aand it operstes secon reali: principle instead ofthe ple ‘operations or thinking styles oft cng eso tal are reer tothe ilgical al ivaonal primary ps “The third important structure within the mind, the Supereg ‘oF What we might eal] eanseienee, represents the moral principles insiled is us by ovr parents and our eulture, Its the voice within us that nags at us wea we know we're doing something Wrong. Because the purpose of the superego is to counteract the poten ually dang Torcontit is sea {ensure act sure principle. sive-and sexual drives of the id, the basis ly apparent “The mle of the ego is to mediate conllict between the i and the ling their demands with the estes of the world TIhe ego Is often referred to as the executive oF manager of our minds. If it mediates suocessfully, we ean go on to the gher ite: Jectual and creative pursuits of life. It is unsuccessful and th id conict will overtake us and ps p. Because these conflicts are all fo 10 as intrapsychic conflicts supeze30. tr superego bevomes to stn chological disorders will devel within the mil they are refer Now think hack to the case of Anna 02, in whieh Breuer ob- served that patios cannot always remember important bat n= pleasant emotional events, From these ankl other ohservations, Freud concepinaized the mental structures describ in this see tow to esp the super unconscious processes. He believed that ihe id anid most entirely unconseious, We are fully aware only of the sovondary processes ofthe ogo, which is a selativel sal part oF the ming) Defense Mechanisms The ego tights a continual bat and supereg Inreatens to overabel the eyo, The aniely ia ig the ey to marshal defense mec processes that keep primitive © stay on tap of the warring id Occasionally, their conliets produce ansiety that a that alerts jons associated with conflicts in cheek so that the ego can continue its conrdinating function, Alto Freud first eoncepwvalized defense mectanisms, it as his daugbier. Anna Freud, wo developed the ideas more fully We all use defense mechanisms st times they are sometimes ulaptive ant at ther times maladaptive, For example, hive youu {ever done poorly on a test hecanse the professor was unfair i the sal ‘mechanism of diplacement. The ex prewing primitive anger at your professor mi iiterest, Because your brother and your di authority to alfeet you in an averse wa, your an And then when you got home you yelled at your brother aps even your dog? This is an example of the defense sulaplively decides that ex not ein your don’t have the ris displaced irom conlliet or constructive outlet such as work, toone of tiem, Some people mas underlying sxiety into 3 moLogica raonal Heaiea ‘emsional inational FIGURE 1.4 Fouts su conscience Projection: Falsely stsibures own un epi Feelings, impulses. or thouglis to another individoal or ject, Moral neon itionalization. Conceals se tue movie tious for actions, thoughts, oF reality through: elaborate reassuring or sell prin serving bu inenereet explanations Reaction formation: Substtes bebsvier Pleasure thous, or feelings that are the direct prinple ‘opposite of unacceptable ones Block Repression: ‘Esturbing wishes thou 1. Diets potentially malay where they may be more efficient beeause of the redirection, Tis process is called sublimation. Moe severe internal confits that proce ant other emotion self Geleatn mon self deleating defensive reactions tht, according to Frou ref at inadequate stempy to deal wit sitvation, Phobic symptoms typically incorpo dan a tie fear of castration: that is, a man's intests conflict iolves a Fear af ca inernally dangerous i elements of the «. For examph poobia may’ be con attacked and cxstrted, 2 fear that is consciously ed and bitten by a fear of being at dog, ewn if Ihe knows the dog is harmless. Defense mechanisms have been subjected to seieuilic study and theze is some evidence that they may be of potential import in the study of psychopathology (Vaillant, Bond, 8 Vaillat 1986), For example, different psyshologieal disorders seom to he associated with different defense Pollack & mechanisms Jltows, 1983}, whl might be im pork DSM NFR incloses an axis of defense mechanisms in the appendix. Vaillant (1476 noted that healthy anisms, suel as humor and sublimatinn. eorreated with psycho. health, Thus, the concept of d coping sive, in contemporary term logic use meclianisms nology-—continnes to be im portant o the study of psycho pathology on DSM-IV-TR, APA. 2000) Den Refuses to acknowl: ele some aspect of objec live reality of sjective experience that is apparent toothers Digphacern Ing abou fan object that causes di se Tash feel of 4 expense A boos Fou ally less threatening, object tive Fel or impulses into socially acceptable behavior Psychosexual Stages of Development Freud also theorized that during infancy and early chikibood we passthrough «nurs ber of psyehosexual stages af development that ave a profound and sting impact. This makes Froud one of the first po take a de normal behaving, which 3 The stapes opmental perspective on the study of ab Took a in detail thooughout this book, ole and genital 1 atify Trasic needs ail sisting oral, al ‘tenes represent Alistinetive putters our drive for physical pe cally ext rg, Bor exaruple, the 0 ing for appeoximately 2 years trom bith. is characwv or food. ln the set of sucking, e. an mot ized by a central focus on the need © lips. 8 Focus of libidinal drives and. theceloce, the principal souree of necessary for ecome the ate gratification during a specitie stage or ia specific stage left. hcl he cermed ji st the sage throughout adult particularly ston ‘viduals personality would life. For exampl sixe thumb sucki ceaing, chewing pencil stage might ces in exc und emphasis on oral. stimulation theo or biting fingernails, Adult persoaality characteristics theoretically associated with oral Fxatio ° dependency and passivity of in teaction to hese tendencies, re belliousness and cynicism One of the more conteoversial and frequently: mention psyehosesval conllcts occurs during the phallic sage (Irom age St age 5 of 6), which chatucterized by early genital sell ws Re y. This conflict is in which: Gcdipu marry his mothe 1 subject of the Greek tragedy O: Fated to Kill his Father anc unk Wy mulation is accompanied by im Freud asserted that boys telve al hy strony feelings of envy an perhaps anor fauers, with whom they ident bul whose place they wish to take. Furthermore, strong fears develop that the Es thee may punisis that lust by cemow thus, the Phonomeson of eastration anviety. [his fear helps the bay koxp ile of the oie anal aa castration anxiety 0m the The plallic sa toward their 2 ‘peas his lustful impulses toward his mother in ebwek, The Iusifl impulses om th other creates 2 confit that i the Oe o passes uneventfully cay The Psychological Traction 17if several things bappea, First, the chil must resolve his ambisa la anger and love he bas fr his fater, [this happens. he may 20 0m his libidinal impulses into eterosex while retaining harmless affection for relationship with his parents and reconcile the simultaneous to cha selationships is moter, The conrerpart confit in girls, called the Electra compes.is ‘even mone comnosersial Frotd viewed the youn girl as wating to rephice ber mo session isthe girl's desire Fora ps Father and brothers the term penis emy. According 10 Freud, the conflicts successfully resolved witen females develop, h relationships and look forward to having baby, whieh he viewed as Neailless to say this particular theory eration over the yeas as being sexist al demea portant remerner that Ht is theory search exists fo support In Froud’s view. all nonps sulted trom underlsin resulted fn Fense moclsanisms, rend or andl possess ber Father. Central to this pos is. so a8 t0 be more Hike her hy heterovexu ealthy substitute for having a penis, 1s provoked marked! con- Is m= ot fact: no systematic te otic psychological disorders re anxiety that those eunits, ane the implementation of ego de sav old term referring to disorders of the unconscious conflicts, th Salled itch isomers meUruses newroric ser, nervous syste Later Developments in Psychoanalytic Thought Freud’ or fied and his st 1 psychoanalytic theories have been greatly modi oped in-a number of different directions, mostly by ‘sor followers, Some theorists simply ook one comp exeloped it more fully. Others of psychoanalytic thoory and broke with Breud and went in entizely new directions ‘Ania Freud (189-1982), Preu!'s daughter, concentrated on the way in which the defersive reactions of the ep determine four behavior. In so do mdr Feld of ego psyelulogy. Her book Fo « nisms of Defense (1946) is sll influential. According 09 Anna Freud, the ineividval Sinely accumulates adaptational capacities, skill in reality testing, and defenses. Abnormal bebavior devel fops when the she was the fist proponent of the the Meck such functions as delaying and controlling impulses of in marsbaling appropriate normal defenses to strong internal conflicts. In anor somewhat lator modification of Freud's theories, Heinz Kobut (191-198 focused on 4 theory of the formation of self concept and the crucial atributes of the sel that allow an lovward bealth. or conversely, to develop neurosis. Ths psycho aanglytic approach became Known as self psvehology (Kol 1977, A related an ject relatinns, Object relations isthe study of how children incor vial to progress that is quite popular inday is referzed to as ube Prorat the images the memories, and sometimes the vules of 4 Person atk sy important to them an to whom they. were for are) emotionally attached, Object in this sense cefers t0 these importast people. and the jecrion,Inirojected objects can become si inte 1s of incorporation is called ino ted pat of the the identity. or sel, For example, your parents may have conflicting views om ‘ego or may assume conflict detezinin relationships oF careers, which, in tam, may’ be diferent fom Your ow point of view. To the estent chat luese varying positions 18 Chapter t Abnermal Behavior in Historical Context have boon incorporated, the potential for conic arises. One dey ou may feel one way about your career direction, and the next ay you may feel quite different. According 1 objeet relations theory, you fend to see the world through the eyes of tae person into your self Object relations theorists focus on how tuese eisparate images come together to make up # person's identity ad om the conflicts that may emerge Carl Jung 875-1961) and Alited Adler (18% students of Freud who came to reject his ideas and form the schools of thought. Jung, rejecting many ofthe sexta pects of Freud's theory, introduced the concept af the collective uncon scious, @ wistos and culture that is fries and passe dow Ev acumuliied by soit fetation to generation, hung also stggesiel that spi jous deives are as much a part of human Urives: this emphasis and the idea of the eollective unconseious, continue to deus the aiteation of mystics. Jung emphasized the importance of enduring personality ais sueh as intoversion the teadeney to be shy and withdrawn) and extroversion Ue ten dency 10 be friendly and outgoing s of inferiority and the striving for Adler focused on Feelin superiority: he created the term inferiority complex, Unlike Feeus, hos Jung and Adler also believed tha the baste quality of human nature is postive and that there is a sicong drive toward set aactualigstion cealiring one's full potential). ung and Adler be Tievod ths nosing bariers to bow Invern ow the individual would improve and Nourish, ers took psyehoasalytical theorizing in different directions ‘emphasizing development over the life span aed the inte cultured society on personality: Kucea Homey (1885-1952) and Eericlt Fromm 1900-1980) are associated with these ideas, but the best known theorist is Ek Erikson (1912-1994), Exikson's sealest contribution was his theory of development across the life span. in ehieh be described is some detail the crises and ‘conflicts thal accompany eight species inning aboot a to mal oes. For example, ithe 65. indi sense of Iust of these stages, the mana age, be viduals review their Lives and atte experiencing buh satisfaction at having. complete somte life ihr. Seite develo ‘chopathel ‘goals and despair at having fled meats have borne out the wislom of considering p 1gy from a developmental point of view Psychoanalytic Psychotherapy Many techniques of psyclicanalytic psyebll he nature of unconscious mental processes and conicts through catharsis and insight, Freud ee s oF free association, it whic! patients are in siructed ta say whatever comes to mind without the usual socially 3. oF psycho ‘eloped techni Fein censoring. Free association is infers te reveal em Hionally charged material that may be nepressed because i isto plntul or threatesing to bring into consciousness. Froud’s pa tients lay on a coueh, and be sat behisd them so that they would tno: be distracted. This is bow the couels came the syimbol of Psyebotierapy. Oter techniques include dream analysis «stil ‘gute popular today in whicl the therapist imorpras the eostent of dreams, supposedly reflecting the primary process dunking of the id, and systematically relates the dreams to symbolic x‘of uncoascious conflicts, This procedure is often difficult hecause the patient may resist the elTorts of the therapist to uncover te and sensitive conflicts and may deny the inerpeetations o of therapy is to help the patient gain insight int the nature ofthe eonfets “The relationship hetweew the therapist, © lyst, an! the patie tionship as it evolves, the Jed the psyehoana- 1 is important, Iv the contest of this elie herapist may discover the nature of the patien's intrapsychic conflict, This is because. in a phenom enon called transference, patiesis come to relate 10 tke ther apist much as they did to important figures in their childhood, iy their parents Patients who resent the therapist but cea verbalize n0 partie resentment oward a parent, More often, the patient will fall deeply h coumierinansferenee, th positive that existed earlier for a parent. In the phenomenon of apists project some oft ‘own per somal issues and feelings, usvally positive, onto the patien ‘Therapists ace tcined to deal with their own Feelings as well as those of their patients, whatever the mode of theraps, and itis sicitly against all ethical caoas of the mental health professions toacceat overtures from patients that might lead to relationships outside therapy. ‘Classical psychoanalysis requites therapy fo lo five times a ‘week for 2 19 5 years to analyze unconscious conflits, resolve tess, and restructure the personality 10 put te ego” ack in eh ical disorders) i Fela ¢, Reduction of symptoms (psychol tively inconsequential because th derlying intrapsychic conics that atise ftom psyehoseswal de- velopmental stages. Thus, eliminating « phobia or depressive episode wold he of Tie vse unless the undetying conlct was dealt with adequately, because another set of syipioms wold wo), Becavse of the alysis, andthe lack of ological disorders, almost eertaily em © symptom subs ‘extraordinary expense of classical psycho cesidence that itis effective in allevin this appronel is seldom used today. 2d, particularly in some ny’ psychotherapists employ a Joos approaches referred to as psychodynamic psychotherapy, Al though condicts and unconscious processes ae sill emphasized, Psychoanalysis is sil practi cit and efforts are made to identify trauma and active defeuse mech anisms aan interpersonal humic psyehotherapy incl rapists use an eclectic mixtre of tactics, with a sockal fly sn the expres sols. Sever laetes thal characterize ps o(1) a focusonal nom of load topics or engage in activities that hinder the progress of therapy: (3) the identical thoughts, feelings. expe sion of pa jets’ emotions: (2) an explora outs atlerps of pattems in patients” setions, Sons on patients” interpersonal ex- ces, aid relationships: (4) an e ison pu r (Tyanexploration of patients’ wishes, dri & Hikentoth, 2000), Two akitional choeynamie psyehotherapy. Firs itis significantly briefer than fences: (6) an emphasis ow the therapeutic relationship and ns oF fantasies (Blagys classical psychoanalysis, Second. psychodynamic erapisis ce emphasize the goal of personality reconstruction, foetsing in steal on relieving the suffering associated with psychological disorders, Comments Pure psyclioanalyss is of historical move than current interest, s been dinuinishing any for years In 1980, the term rewrosis, which specie and classic inp cally implied a psyelnanalstie view of tae causes of psyeholog Irom tle DSM, the official Gasmostic ‘psychoanalysis as a treatment cea disorders, ws droppe system ofthe APA. A major criticism of peyelioanalysis is tht itis asieally un- scionbtc. relying on patient of events that hap pened years a eh te &x perience of theo hhoanalyst in ways that certainly could be questioned and might differ from fone analyst to tie nest. Filly, there has been no careful mea and no obvi fous way to prove or dispnove the basic hypotheses of psscho neat andthe ability to prow or dispnwve a theory are the foundations of the scientilic surement of any of tuese psyehological psesome: analysis, This is important because measur approach, Nevertbcles,p been valuable, not only tothe study of psychopatholo chodynamic psyched Western civilization, Caseiul scienitic studies of psyehopathol yhoanalytic concepts al observations hie 2y and psy apy bul also to the history of ideas in ‘ogy live supported the observation of unconscious meatal pro ceoses. te notion that hasic emotion cred by esponses ae oie tig ind the understanding teat cea be represses and otherwise s. The relatioasip of the ist and the patient, called the therapeusie alliance, is am important area nf Study across most therapeutic strategies. These ‘with the importance of various coping styles ot defense mechanisms, will appear repeatedly tho hook. Freud's revolutionary ideas that pathological ansiety em ‘our doopest and darkest ‘witch tals and ideas of incurable idden or symbolic cues, variety of ingenious w foul this in conneetion with some instincts brought us a long way f brain pathology. Before Freud, the source of good and evil and of usually in the guise nf demons gonirent Since Freud, we ourselvesluave become the hale Forces. and we are inexoranly caught up in Use hate, sometimes ound for these for better and sometimes for worse Humanistic Theory We have already seen that Jung and Adler broke shaxply: with Freud, Their fundamental ds lure of humanity. Freud portrayed Hie as a butleground where sement coagerned te ery ms ig overwhelmed by our dake est forves, Jing arkl Adler, by contrat, emphasized the posiiv ‘optimistic sie of human nature, Jung talked abour setting goals, Iooking toward the future, and re lest potential Adler believed that human nature reaches its fullest potential ‘when we contibute to olber individuals and to society as a whole. He believed that we all rive to reach superior levels of ‘oral development, Nevertheles, both funy al ‘one’s Tul Adler tinea many of the principles of psyehodynaiie thom The Psychotogical Traction 19Tie ‘century by personality theorists and became known as eral philosophies were adopted in the middle of the fie psyeholo Selfsnctualizing 2s the watchword for this movement, The underlying assumption is that all of us could potential, in all teas of functioning, if ich our highest nly we haa ths Fesdom ay Flock our acl itably, a vatioty of eoritons ization, Because every person is basically good and whole, most blocks originate outside the individual. Dificut living conditions or strestul life or inverperso Irom your tue set “ . Abraham Maslow (1908 sev 0) was most systematic in de the siracture of personality. He postulated a erry if needs, beginning with our most hasie physical needs for foosl anging upward lf esigem, Social needs suclr as Triendsuip fall Maslow proatess up the hierarchy until 8 lower levels Carl Rogers (1902-1987) is, stom the point of the most influential humanist, Roge ccontered therapy. aver known as person-centered therapy. In this approach: imerpretations as possible, The point is 10 ef love. and somewhere betwee ypollesized that we cannot we therapist takes a passive role, making as ew the individual a chance to develop during the come of therapy, unfettered by teats to the self. Humanist theorists bave great Fs isthe abil iy of humas relations to Foster this growth, Unconditional posi- tive reg 5d, the eo: sulle mos of the clients feelings andl sotons, s etic to the hua fay is the sympathetic understanding of the File world, The hopes resal plete and almost seplance ol istic approach, En individual's particular view person-centered therapy is that clients will be mone straighten word and honest with: shemselves and wll access their innate oweh ssi, the bursanistic approach lias ad a sib tendencies to Like psyehonna stantial effect on theories of interpersonal relationships. Bor ex © popular it tae 196s etiring. ‘his ample, the hums potential movements nil [5705 were a dinset result of humanistic approach also emphasized the importance of the therapeutic relationship in a way quite different fiom Froud’s approach, Raaer thn seeing the tence), humanistic therapists eli ationsip as a means to an end ttsansler jeved that relationsbips in! the therapeutic relationship, were the single int owth, In fat, Rogers male sub sudy of therapist-client ost posi fence in Facilitating human stantial contributions to the ssientt relationships. Nevertheless, the bu neve information to the fiekl of psy sanistic model contributed relatively Tittle ihology. One feeson for this is that its proponents, wih some exceptions hal ile interest in doing research that would discover of ereate new knowledge Rather, they stressed the unique, nonquamitiahle experiences of the individual, emphasizing that people are more different than alike. As Mes application amon The applicstio chology noted, tbe umnistic model found its scales cal disorders, dividuals wathout psyehok od t sd substantially over the doce, af person-cent apy lisonders has dere uthough cettain variations have arisen petialcally in some steas of psychopathology 20 Chapter 1 Abnormal Behavior in Historical Context The Behavioral Model As psychoanalysis swept the work! at the beginning of the 24h ceontury, events in Russia anid he United Sates would eventually provide an altemative psyehologieal model that w powerful. ‘The behaviaral model which i also Koo as the cde, brought the selopment of 3 more scientific approach ti ical sspects of psyehopathology. Pavlov and Classical Conditioning way dogs salivate before the pre sentation of food. physiningist han Peuovieh Pavlov (1839 136) of St, Petersbure, Russa, initiated the study of elassieal conditioning, «ype ot In his classic study esa earning in which x neutral sizsulus is pulsed with a response until it elicits that response, The word resulted from aut accident Pavlov w afin Russ ato pont that ct nn th sno of he the in sansiation om the origin really tslking ‘ence ofa particular event or stnation (stimulus) in this ea Footsteps of the laboratory assistant al feng time dition is one way in which we acquire ney ssould have been more accurate. Conditioning information, particularly information tha is somewhat emosional in mate, This process s response not as simple as it first seems, and we eontinue to uncover many more Facts about its complexity (Boutoa, 2005; Craske, Herman & Vanstoemwegen, 2006; Reseorla, 1988), BuL it ca rutomatie. Les look ata powerful contemporary example Psychologists work nomenon well Known to many cancer patients, their nurses itd 2 in oncology units have studied a pe physicians, and their Families. Chemotherapy. a common ment for some forms of cance, bas sie eflecls including se sand vomiting, But these patients often experience se the ‘administered the chemotherapy of any ‘equipment associated with the treatment, even on days when their olisered (Mortow & Dobkin, HRN}, For some sand, occasionally, vomiting whea they merely leeaiment is ili that evoke people or things present during chemotherany— anybody in a nurse's uniform or even te sight of the hosp tal, The strength of the te sponse to similar objects or is usually a function of how similar these objects ot Fion because the wespoase gen eralizes to simiter stimuli. In any case, this particular res tion is distressing and ucom Forable, particully if itis associated with a sarily of objects or situations. Pyyeno) ists have had 1 specific tealmients come this response: (Red & Andry kowski, 982) t GevElP yan Penk ‘ea the 20 a raftisring, which ime ceristional disorders,Whether the stimulus is food, as in Pavow’s Isboratory, of chemotherapy. the ckssical conditioning process besius with a Stimulus that would elicit response is amest anyone and ‘gues no learning: no conditions must be preset forthe response to occur For these Feasons, the food or cemssterapy is called the 1s (UCN to this stimulus—in these eases, salvation or med wwsponse }UCRS. New in ddy seen, any person or object associated wi the unconditioned st the incon Kear As we ave alr tunconditiones power to elicit stimulus (ood or cliemotberapy) sequites the 1e same response, bul ow the Fespomse, because it was elicited by the conditional ereonaivioned sistas (CS) is termed a condiionea vesponse (CRD. Ts, the swith the chemotherapy b scouts sensation (upon see as tat experienced during chemotherapy. bec tioned response With uncosditioned stimuli as powerful as elmo itioned response cat fal, However, most learning ofthis type roquizes repeated pairing of the unconditioned stimulus (foe se associate ‘mies conditioned stimulus. The at the nurse), whieh is almost he same the condi Jame in one sample, chemotherapy} and the eoitioned stimu lus (for instance, nurses’ uniforms or hospital equipment, When Paslov 7 ronome for the Tootsteps of his laboratory assistants so dhat he torinvestigate this phenomenon, be substi a ‘could quantify the stimulus more accurtely sd, therefore, sly jsoly, What he also learsed is that py tion of the conditioned stimulus (for example, the metzonos the approsels more p vwithons the fond fora long enough period would eventually elim nate the conaisined response tothe food. Iv ather word, the do learned that tae metmonome no longer meant that & seul might Be fo tie way. This pscess as eal extinetions Becanse Pavlow was a physiologist ib wus ual for bit to study these processes ina labora ory ad 10 be quite ssientite and observing rela tious. Athough this it was uncommon in about it This required prosision in measur and in ruling ou alternative expla sciemtlic approach is common in bilo: psychology at chat time. For example, i was impossible for psy choamalysts 9 measure unconscious conflicts precisely, of even Uoouship: ‘observe thom, Even cally experimental psychologists such as Edward Vitchener (1867-1927) emphasized the study of intros spection. Subjecis simply reported on their inaer thowebis id in stimuli, but the sesulls of this were meonsistent aller experiencing certs psyehol any experimental psychologists uumehair ind discouraging 10 Watson and the Rise of Behaviorism 1, Join BB. Watson (1878-1958, is considered the founder of bebaviorisi. Sto J euly American psychol ly inllucased by the work of Pavlon, Watson decided that «9 base psychology om introspection was to head inthe wrong diction; thal psychology sade as scietilic as physiology’ and that psychology no more needs intospection of other noniguantiiable methods than do chemistry and physics (Watson, 19133, This point of view is, refkted in a famous quote from a seminal article publisaed by Watson in 1913: “Pyyetolngy, as the behaviorist views il is a purely objective experimental branch of watutal science. Its theo al is the prediction and contol of behavior, Intospoc: tiow fogs no esseatal part of its methods” tp. 158), retical Most of Watson's time was spent developing behssioral psy chology ns a racial empirical scieuce, but he did dabble briety in the study of psschopathology. In 1920, he and a student, Rosalie Rayner, presented an 1] mont old oy named Albert with « harmless Dully shite rat to play with, Albert was not altaid ofthe small snimal and enjoyed playing with it. However cesery Hime Abort loud noise bebiind him. Ate first signs of feur if he white rat came near. ‘The experimesters then determined that Albert displayed mild fear of any white Try object. even a Santa Claus mask with a white fuzzy beard You may uot think taat this is surprising, but keep in mind thst this was one of the frst examples ever recone joe! not proviowsly feural, OF to's hed for the rl, te ile a experimenters only five tials, Albert showed the 1 Tabor tory of producing fear of an ‘course. is experiment would be considered unelsical by sails Athos student of Watson's, Mary Cove thought tua if fear could be learned or classically eonltioned in this way, perhaps it could also be ul tinguished. She ‘worked with a boy named Peter, who at 2 years, 10 my ‘was already quite alfuid of fury objeets. Joes decided t bring waite rabbit Into the room where Pal for u short time each day. She also arranged for other ebildren, whom she know did not fear rabbis, to bein ue same zoom. She noted that ly Tach time it brought che rabbit closer. Exentually Peters touch playing with che rabbit Jones. 1924a, 1924), and y Tear ba not remmed jones (1896-1987), Poser’ fear pri ins inished, she The Beginnings of Behavior Therapy The implications of Fane's research were largely ignored for 10 decades, given the fervor associated with more psychoanalytic ‘conceptions ofthe developmeat of fear. But inthe lac 1940s and early 1950s, Joseph Wolpe 1115-187), « pioneering psychi lest from South Aisa, became dissatstied with prevailing psy choanalytic interpretations of psyelopathology and began look ing for someting else, He turned to the work of Pavlow and became familiar with the wider Held He developed a variety of be havior ‘of behavioral psycho procedures for weat many of ‘whom snlfered from pho His hes termed systematic desens ing bis patieats, not Neh ws zation In priseiple, it was Similar 10 the treatment of Title Peter: individuals were sralually introduced to the objects or sitions they so that she fear com iss that is. they ty and soe that noth ing bad happened in the pres tence of the phobic abject oF g tpsyy Cover Jones ene, Wolpe added another gh 8 element by ha 2 his patients noice to use beso ddo something that was incom toshriques to tee a patible with fear while they The Psychoiogical Traction 24‘were in the presence of the dreaded object or simation, Because hhe could no abe phobic object in his office Wolpe hd his pa iy phobic scene, and the response he chose was relaxation because ted a young man with by training im firs ts gelax deeply and the reprodu is carefully and systematically dmgine the it was conveaieat, For example, Wolpe tr 1 phobia of dog maine he ass looking at dog aeross the patk. Grady, he we tue dog across the park and remain relaxed. expe litde or no feat, Wolpe thew had him isvagine that hy closer to the dog. Eventually, the young man imagined that he ‘was fouching the dog while maintaining a relaxed. alos! tance Tike sate Wolpe reported g le applications of the new science of be haviorism to psychopathology: Wolpe, working with fellow pin- neers Hlans Eysenck and Stanley Rachman in London, called this approach behavior therapy. Albough Wolpe’s procedures are seldom used today, they paved tue way for meslern day fear and Phobias ean be ansioly redueti eliminated in as title as T day (soe € procedures in which sever B. F. Skinner and Operant Conditioning smund Freud's influence extended Far beyond psychopath into many aspects of our cultural and intellectual bistory ly one other behavioral scientist his made a simi Burrus Prederie(B, F) Skinuer (19041990, In 1938 he pub lished The Befuvior of Orgaisas, in which he ccomprehieusive mance. te principles of operant condition type of leat Follows the belissior, Skinser observe id out, in a n which behavior changes as a Tonetios of witat com ta ge part tormatically elicited by an unconditioned cof out behavior is nol sinnuls and that we must account for this. Inthe ensaing yeas, Skinner did not confine his ideas to the laboratories of expe Tar and wide in his writings, de scribing. for example, the potential applications of a science of hel ie, Some best known examples of his ideas are inthe novel Walden ivo(Skinner, 1948), in whic 4 fictional society run om the principles of operant conditioning ind Digs + staloment of problems facing meatal psyebology. He ran In another well Known work, Beyond Favedom 11971), Skinner lays outa bro four culture and sige science of behavior sions based on his own view of a sls 80 Skinner was stanly influ I by Watson's ist he hased on observable events and relationships among those events. The work of psychologist, Fudan L. Thomdike (0874-1949) also infiveneee Skinne Thomndike is best Known for the Jase of effect, whieh states that behavior is either srongthoned (likely to be repeated more fee quently) oF weakened (likely to oceur science of human behavior less Feuentl lope fon the eonseytences of that behaaior Skinner took the simple notions that Thomdike bad tested in the animal laboratories. us ing food as a winfoncer, and developed taem ina variety of com, lex ways 10 apply to much of our bebavior, For example. if a 5-year old boy starts shouting atthe top of his lungs in MeDon ald's, mus to the annoyance of due pooplearousd him, its un likely that his behavior Was antomatially filed by an unconai- tioned stimulus, Also, he if is paronts scold bit, Il be less likely to do ik in the future ake him out tothe ear to sit fora it, oF 22 Chapter 1 Abnormal Behavior In Historical Context consistently reinforce more appropriate. bebsvior. Then again, ifthe parents think bis havior is cute and a chances are be will do it agai, Skinner coined! the tem operat ‘ondivioning because chavior eperates nn the envi ronmeat and-changes it in some way, For example, the boys behavior allects his par tenis” bebsvior and probabl the behavior of other custom= crs. Therefore, he © anges bis ‘environment, Most things that we do socially provide the opie to Fespond 10 us ia ole Way oF providing consequences for or bebav ceontext for other p 4.8, F Skier 908 rebtioning, & ais cel i aanoter, hereh physical emsiroumest, al ough the consequences: may be To term (polluting the air ‘eceniually Will poison Us) Ssinner preferred the term reinforces iment to "rewakl” becuse i conoves the efecto the bei ns Skinner once said that be found himsell& bit embarrassed to be talking continually soot reinforcemest, much as Marxists used to see class struggle everywhere. But ke pointed out that all four behavior is governed to some degree by reinforcement, ‘which ean be arranged in an endless variety of Ways. in schedules of winjoncemen Skinner wnove a whole book on different sched lles of reinforcement (Benser & Skinner. 1987). He also be lieved that using punishment asa consequence is relatively inet Fective in the long run and that te primary way to develop new Ipchavior is to positively reinforce desired behavior. Much like Watson. Skinner did not see the need to g0 bes able and quantitable to establish a satisfactory science of behav jo, He didnot ley the inf ond the obser’ eof biology of the existence of subjective sates o emotion of cognition: he simply explained! is of a these pheuomena as celaively inconsequential side ef particular history of reinfozceme ‘The subjects of Skinner's research were usually mosily pigeons and rats, Usin simals his new principles, Skinner and his disciples salsa vatiely of ticks, including dane ing, playing Ping Pong, and playing « toy plano. To do this he used procedure called shaping. 2 process of reinforcing succes sike approximations to inal elias ior or set of ebsaiors, If you ‘wants pigeor to play Ping-Pong, frst you provide it with a pellet, ‘of Food every ime its he slightly toward Bing-Po bull tosse in ts dirvetion, Grady a reygite the p atl it gouehes it vam the pi rove its head ever closer t the Ping Pong bal Finally, receiving the food pellet is onan ting the ball back with its bead Pavlov, Watson, and Skinser contributed significantly 10 be havior therapy (see. for example, Wolpe, 1958) life principles of psychology are applied in which scien clinical problems treatments snd so arenComments ‘The bebavioral mevel has comibuted greatly wo the undersand ing and treatment of psyehopatbolow les that follow. Nevertheless, this mode! is incomplete and nad 1s Is upparent in the clap ‘equate to account for wluat We now know about psychopaths Inthe past, theze was litle or no room for biology i belie he considered, for the most pat mentally determined reactions. T Jno fails ho acconnt al Revent advances in our knowledge of how information is processed, both Tor development of psycho life span ‘consciously and subconsciously, have added a layer of complex ity; Inegrating all these din pssehopatiology ons requires new model of The Present: The Scientific Method and an Integrative Approach As Willian Shakespeate wrote, “What's past is prologue.” We have just reviewed three taditions or ways of thinking about causes of psychopathology: the supersatural, the biological and the psychological further subdivided inco two major historical ‘components: psyelioanalytic and behavioral ‘Supernatural explanations of psyehopa re sill with hs. Superstitions prevail, including helies in the effects oF the moon and the sia on our bebavios, However this tition has Tile inluence on scientists and other professionals. Biologie psychoanalytic. and bebavioral models, by eo: Torker our knowiedge of psychopatholo sist continie 10 ss you will seein the next chapte excl tradition bas failed importa applied 40 the theories anal treatments ways, First, scientiic methods were ‘within @ Wadition, mostly because metas that would have poo duced the evidence necessary to confirm er disprove the theories and ueatments bd not been developed. Lacking suels evidence various fads and superstitions were widely accepted that ul igor useless, New lads olten superseded mately proved to be un truly useful thoories and treatment procedures. King Charles VI was subjected to a variety of procedures, some of which have since been proved useful and olhors tht were mere fads or even harmful. How we use scientit methods to confi or disconfim findings in psychopathology is described in Chapter 4, Second, health professionals tend to look al psychological disoners nar rowly, fom sheir own poia of view alone, Grey assumed that psychological disorders were the result of brain disease and that ‘ther factors had no influence. Watson assumed that all belaviors, dlisordered behav and social influences and includin were the result of psychological sal the eonsibution of biological fae tors was inconseguent Tn the to sed Highton the nate D0, wo developments came together as never before logy: 4 sophistication of scientific tools and metho vgy and (2) the re alization that one iniluencebiologica, bebaioral, eogitive, of social emotional ever oecurs in isolation, Literally, every lime we think, feel, or do something. the brain and the rest of the body are band at work, Perhaps not as obvious, however, is that four thoughts, fe tow and even the structure ofthe brain, sometimes permanent ior, bots norma] and abnontal, is the product of continal int a oe the func is. and actions inevitably ill In other words, our be ition of psyehologieal, biolog an social influences “The view that psychopatholo is multiply determined had its ost notable was Adolf M in of American psychiatry ost professionals during the fs half of tbe cestury thology, Meyerstead ihutions of biological, psych Although Mi hal some proponents i€ Was 100 years before the wistom of his advice was Tully recognized inthe tel, By 2000. a veritable explosion of knowledge about psychopa thology had occurred. The yo nouroscience began to about the brain and about how we process, remember, and use inforsation, Ac dae sume time, stating new findings from behav ioval sence revealed the importance ofe prsent, It was el cealy adherents. Perhaps the UI866- 1950), ote Whereas h Fasily emp) considered the harrow views of th ssined the exile logical, and sociocultural determinis ing felds of cognitive science and vw exponentially 28 we Le sly experionce in dewr sat 8 new model was ater devel inDronces on behavior This appmoach to psychopalholoyy woul from all areas with our rapidly grow standing of how we experience life during different devel tal pecinds, from infancy told age, bp 2014, tue Nati tue of Mental Health (NIMH) instituted & stetegic support further re ‘combine tind shan te afelt and developsient on te insrrelationship| Frontline toatmens settings (Tse), 2000) In the remainder of this book, we explore the reeipsocal influences samong neurosc cognitive science, bolavior scienee, and dev opmental science and Gemonsiate that the only currently valid model of psychopa thology is multidimensional and inte Match the testent withthe eomesponding psychological theory of behavior: (2) belisvioral model, (b} moral therapy (c) psychoanalytic theory. and (dl humanistic theory. 1. Treating instutionalized patients as normally as possi sand encouraging social inieraction and relationssip ée velopment salve Hypnosis, psyelioanalysisTike free association and ddivam ‘analysis, and balance of the id, e20, and superego. 3. Person centered therapy with unconditional postive regard 44. Clinsical conditioning, systematic desensitization, and ‘operant conditionin ‘The Present: The Seientfle Method and an Imegratie Avpreach 23Summary Understanding Psychopathology A psyetnlngical disorder is (1) « pyyetiolngieal dysfunction ‘within an individual that is (2) asoctated with distress or im pirment in functioning and (3) a response that is uot typical ‘or culturally expected. All three basic criteria must he met no cone erterion alone has yer bees ientited that defines the es sence of abnormality fm “The field psycho pals suudy of psychological di y is concerned with the sciemtie ‘ders, Trained mental beslth poo fessionals range fom clinieal and counseling psyeholo peychiatrists and psychiatric social workers and nurses. Each profession requires a specie type of training Using seieniiic methods, mental health profesiousls can function as scientist practitioners, They not only keep up with the lates findings bur also use seieatitc data to evaluate their ‘own work, and they offen conduct research within their clinics co hospitals. ists o 1m Research bow! psyeholoie) disorders falls ite theee basic ccalegories: description, causation, and teatment and out The Supernatural, Biological, and Psychological Traditions Historically, thene have boos three prominent appeosehes to abnormal Peluvier. In the supematural wadition, abnormal havior is attributed to ageats ouside eur bodies of social environment, such as demons, spirits, or the influence of the moon and stars; alhowgh still alive, this wadition boot largely replaced by biological and psychological perspectives Inthe biological tition, disorders ane atrbated to disease ot biochemical imbakances: in the psychological tadition, sbuor mal bobavior is atibuted to faulty sun to social even cltological development Key Terms 1m acl tradition bss its own way of tating individuals who sul fer from psychological disorders, Supersatural te clude evorcism to rid the bo logical t ments in jy ofthe supernatural spirits, Bio sameats typically emphasize physical care and the for meslcal eure, especially digs. Psychological ay proaches use psychosocial teatments, begining with moral therapy and izcluding moders psychotherapy. f= Sigmund Freud. tue founder of psyeluvanalyic therapy. offered an elaborate conception of the unconscious mind, such of ‘whieh is tll conjecture. In therapy. Freud focused om tapping imo ts ay catharss, free sssoetation, an dream analysis. Alshough Freua's followers steered frou his path in many ways, Freud's inthuence can stil be felt today One outgrowth: of Freudian therapy is hursanisie psychology Foc ysleris ofthe unconscious trough sue teclmigues than on psyehologics! disonlers. Therapy. that his evolved fim this approach is known 3s person -cemtered therapy the therapist shows almost unconditional positive regard For the client's feelings and thoughts, fm ‘The belssioral model moved psychology into the realm of scienee, Both research and therapy Focus on things that are The Present: The Scientific Method and an Integrative Approach Wi the {creasing sophistication of our scientific tools, and and neunoscienee, we now gelize that mo conttution to psy chological disorders ever oecurs in isolation, Our bebssier, both normal and shnormal is a preauet of a continual interae cia! inlences lio of psychological, biological, and psychological disorder, 1 phobia. 1 abnormal behasion, 1 psyeliopathology. + scientist practitioner 4 presenting problem, § slinical description, § prevalence, § incidence, § moral therapy, 13 ‘mental hygiene maven psychoanalysis, 1 Tehaviorism, Hb psschwamalytic model, 1S id. 16 40, 16 superegn 16 intrapsschie confits, 16 16 sschosexual stages of develupment, 17 defense mecha psyelisocial treatment 13 24 Chapter 1 Abnormal Behavior in Historical Context ‘castration anvils 17 oss meurosesplurulh 18 ‘ego psychology, 18 salt psychology, 18 seleactoalizing. 20 person-centered therapy, 20 “unconditional positive regard, 20, Iehavioral mode, 20 asic condition jot relations 18 collective uneunssions, 18 0 free association, IS cextincton 21 dream analysis, 18 introspection, 21 psychoanalyst, 19 systematic devensitization, 21 ‘transference, 19 behavior therapy, 22 psychodynamic psselatherapy, 19 reinforcement, 22 shaping, 22Answers to Concept Checks 414 1.2 13 Part a Leda db Tb de de dal tad Lhe Part B Bids dee: Sa 6. Tes by Media Resources =e 7 CourseMate Access an integrated eBook, Abuormal Psychology Videos (formerly Abnormal Psych Live CD-ROM), chapters tive learning tools (lasheads, quizzes ules) and mioge in your Psychology CourseMate available omflogin to link to Cen, iro Go towwwcengage. the Pro-Test for this eb you need to review and eizeet you fooling resources. Ten take the Post I NOW, your online study tool, Fist take sour personalized study plan, whic will Ment topics tind ‘what concepts you have mastered sd What you sill need ork on Video Concept Reviews vsains Mark Duranal’s Concept Reviews on these ebsale topics Concept Chicek —Abuormslity 1m Prognosis Psychopathology fm Supernatural Views Historical fm Mesial Health Professions Supernatural Views Cursent The Scientis!-Practsioner 1 Emotion Contagion = Presenting Problem Llippocrates Prevalence Bodily Humors Incidence Moral Therapy = Course Concept Chock —Inteprative Approach Summary 25Timeline of Significant Events 400 B.c.-1875 _ 18005: Superstition cans ram 40086: Hippocrates su pant and ental ch 600: Blting ad 178 Pion Pel tc: gests that pryehlogcal disor ban meandtch [a Ito ria the 5 moral therapy and makes Sershave bolh Dolbgtaland es ex0% med body unheaty fds and Troneh mental tft, paychalog ea causes tard vit of ex spr restore chemical bales mare 130 Eat 1825-1875 salen suggests tt 1400s: Enlightened view that 150Qe:Paraceluis suggests 1825-1875. Sypils st Formal and abnormal Behavior irsanty caused by mental tt the moan ara the stars fate ated rom ofher types of fre else to ourbexdy u- or emotional tess gains people's psychological psychosis in thal ls calmed ids Sermo momentum, and depression funcionrg. rater than pos hy specie hacer eae ee i a mately, pent ins found Eaby some as deorders, ure sph 1930-1968 fare ton for severe peyohaticdeorders Human 4958: Joseph Wipe eter: 4990: nen snock therapy psyehniogy based on ice Avaly reale patients th po etic shock teatmen's xt 1943¢The Minnesota St Catt deg, se bias using stetematic sen bran sizgery beam tebe Used MuiiphasicPerscnalty ail Rogers gains some siizaon baced on principles [eat patho, Irene sph accuptance ‘of betoral score 1946: na Freud publishes 4952-The fist ation of the 41968: DSi published Egoand the fockansms of Diagnose and. Haya OSH is publste. 4998:B.F Skinner pub Th Gehan of organs thio desces the principles ot operant caning bs1848-1920 4848: Dorathon Dix su 1870: Louis P lop 4913: Emi Krsepain clases eset campaigns Fs germ theory od Yarou payor or Frere humane resent in ‘hich helps dct the bac und Freud pt ima bidoaiea font of view Bmerican mente nstsions, ——taium thar eases Sypris mefancnof are pusshes werk on dlagho en en 1920 4854:John P.Gioy, head of 1896: Jose Steuer tesle the 1904: an Paviow recsnes the New Yorks Utes Hospital Tysteneal sma. leading Nobel Pra teh work on believes thatinsanfy is tne ta Freis development of Ae pinscbogy ctacestin, Ele Abert using 3h fesut ot physeal causes thus pssenearaytc theory ‘shih eas him to ident e-amphasiaing psychological Coneftioned reflexes in dogs treatments 2 yi 1980-2000 49905;norenenal sophie dl rescarch methods re devel ‘pec no one fare calor ondlorrerta {a caise peyehologkca dsorders 4960: D8140 pbished Tribal ftom Peter 2000:0S1-0-7is published iis pubished 1994: DS's publish