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PSYCHOPATHOLOGY
PSYCHIATRY II
Psychopathology
Psychopathology refers to problematic
patterns of thought, feeling, and behavior
Disrupted functioning at home, work, and in
the persons social life
Patterns that cause distress in the person or
in others
Psychopathology literally means sickness of
the mind
Psychopathology varies between and
within cultures
1999 John Wiley and Sons, Inc.
Understanding Psychopathology
What is abnormal?
The definition of ABNORMAL used in
DSM-IV-TR (Diagnostic and Statistical
Manual of Mental Disorders, 4th edition)
Abnormal describes behavioral,
emotional, or cognitive dysfunctions that
are unexpected in their cultural context
and associated with personal distress or
substantial impairment in functioning.
Psychoanalysis
Freud
Office-based psychiatry
Drive theory
Structural model of the mind (ego,
id, superego)
Unconscious
Psychoanalysis in practice
Free association
Transference
Resistance
Psychoanalytic Theory of
Personality
Sigmund Freud
Components of Personality
Defense mechanisms
Psychosexual stages
Sigmund Freud
(1856-1939)
Jewish background, though
avowed atheist
Lived in Vienna until Nazi
occupation in 1938
Had medical background-
wanted to do
neurophysiological research
Private practice with specialty in
neurology
Private practice in nervous and
brain disorders
Early 1900s published many
Freud works--
Interpretation of Dreams (1900)
The Psychopathology of
Everyday Life (1901)
1905 concept of sexual drive
being most powerful
personality component
1906 Psychoanalytic Society
formed
Many works burned in Nazi
occupation (starting 1933)
Left Austria, fled to England
1938
Died of jaw cancer 1939
http://www.pbs.org/wgbh/aso/databank/entries/bhfreu.html
Freud's Path
Topographic theory
Structural theory
Topographical Model
Freuds first model of psychopathology
Division of the mind into three different
layers of consciousness:
Unconscious
Preconscious
Conscious
Topographic Model
Conscious (cs)-the part of the mind that
interacts with the external world, and which
can reflect on itself.
Repression
Reaction formation
Projection
Isolation
Undoing
Regression
Introjection (internalization)
Turning against the self
Reversal
Sublimation
Displacement
Classification of Defenses
Mature
Immature
Narcissistic
Neurotic
Mature Defenses
Altruism
Anticipation
Humor
Sublimation
Suppression
Sublimation
Healthiest defense
mechanism
Compromise
Takes socially
unacceptable
impulses and turns
them into something
positive & acceptable
Altruism
Unselfishly assisting others to avoid
negative personal feelings
Anticipation
Magical Thinking
A thought is given great power, deemed
to have more of a connection to events
than is realistic
Ex. Thinking about a disaster can bring it
about
Psychosexual Development
Children pass thru a series of age-
dependent stages during development
Each stage has a designated pleasure
zone and primary activity
Each stage requires resolution of a
particular conflict/task
Psychosexual Stages
Failure to successfully navigate a
stages particular conflict/ task is known
as Fixation
Leaving some energy in a stage
Specific problems result from Fixation,
depending on which stage is involved
Fixation may result from environmental
disruption
Psychosexual Development
Stages of development in which conflict
over Ids impulses plays out
Ego must control these impulses
If not resolved, psychological issues can
emerge later in life
Psychosexual Stages
Freud's stages are based on clinical
observations of his patients
The Stages are:
Oral
Anal
Phallic
Latency
Genital
Freudian Psychosexual
Stages
Oral stage (First year of life)
Focus on primary gratification through oral means
Anal stage (2-3 yrs)
Focus on primary gratification through holding on & letting
go, corresponds with toilet training
Phallic (Oedipal) stage (3-5 yrs)
Focus on primary gratification through genitals; awareness
of erotic feelings for parents; emergence of triangular
relationships
Latency stage (5 or 6 through puberty)
Focus on repression of erotic feelings
Genital stage (puberty through adulthood)
Focus on primary gratification though meeting adult sexual
needs
Psychosexual Stages
Oral Stage (0-18 months)
Pleasure centering around the mouth
(sucking, biting etc)
Focus: weaning- becoming less dependent
Not resolved? aggression or dependency
later in life-- fixation with oral activities
(smoking, drinking, nail biting etc.
Psychosexual Stages
Oral (0-18 months)
Anal (18-35 months)
Fixation on bowel and bladder elimination
Focus: search for control
Not resolved? anal retentive (rigid and
obsessive personality) or anal expulsive
(messy and disorganized personality)
Psychosexual Stages
Oral (0-18 months)
Anal (18-35 months)
Phallic (3-6 years)
Focus: genital area and difference btwn
males and females
Electra Complex or Oedipus Complex
Complexes in the Phallic
Stage
Oedipus Complex (boys)
Unconscious sexual desires towards mother,
father is competition
Simultaneously fears the dad- castration anxiety
Electra Complex (girls)
Unconscious sexual desires towards father and
mother is completion
Penis envy
Resolution?
Kid identifies with same sex parent
Psychosexual Stages
Oral (0-18 months)
Anal (18-35 months)
Phallic (3-6 years)
Latency (6 yrs to puberty)
Sexual interest is repressed
Kids play with same sex others-- until
puberty
Psychosexual Stage
Oral (0-18 months)
Anal (18-35 months)
Phallic (3- 6 years of age)
Latency (6 yrs to puberty)
Genital (puberty and beyond)
Sexual urges awaken
If developed properly develop these urges
towards opposite sex members with fixation on the
genitals
Key Contributions of Freud
Psychic Determinism/ Dynamic Model
Topographical Model of the Mind
Unconscious, Preconscious, Conscious
Stages of Psychosexual Development
Structural Model of the Mind
Defense Mechanisms
Transference and Countertransference
Eriksonian Ego Psychology