2. History & Theories of Abnormality
Monday, January 14, 20139:00 AM
Theoriesof abnormality
• Difficult to define abnormality from normality, or one mental disease from another
• Difficulty in making a theory that applies to many people, not just one case
• Psychological theories of abnormality are often not "theories" in the sense used by the hard sciences
○ Usually vague
○ Difficult to translate into testable empirical form
○ Sometimes not testable at all; often unfalsifiable
• The term "theory" is instead often used to mean a kind of model
Typesof theories
• Psychodynamic theories
• Behavioral theories
• Cognitive theories
• Humanistic and existential theories
• Biopsychosociological theories
Medicalmodelof mentalillness
• German psychologist, Emil Kraeplin
• Nomenclature of mental disorders based on the medical model of separate diseases
○ Noted that certain symptoms of mental disorders occurred together
○ This implied specific types of illness
○ Believed that as with physical illness, it was necessary to isolate the organic cause, the specific symptoms, the
specific course, and the treatment
• Understand the underlying biological cause, apply treatment, symptoms would disappear
• Possible psychosocial determinants and influences were neglected
• During this era, huge advances in understanding the nervous system
○ Brain pathology underlying some mental disorders-- cerebral arteriosclerosis, senile psychosis, some types of
retardation
○ Promising signs that mental problems will become understood through neurological occurrences (basis)
○ By the early 1900s, it had been proven that a major mental disorder, "general paresis of the insane," was caused
by the syphilis spirochete
• Medical researchers were confident that they would find similar biological causes for all mental disorders
• However, gradually, the medical model of mental illness seemed inadequate
○ Only certain disorders seemed to have biological causes
Thebeginningsof psychotherapy
• Sigmund Freud (1856-1939)
○ Founded psychoanalytic approach
Dominated psychology
○ Psychiatry had viewed mental "illness" to be rooted in biological disorders
○ Demons, divine punishment --> brain pathology (Hippocrates) --> psychological and social factors (Socrates,
Plato, Aristotle) --> demons (Romans) --> Demons --> brain pathology (Pinel, Kraeplin) --> psychological (Freud)
○ Basic premise: psychic determinism
Behavior, normal and abnormal, is product of dynamic processes and conflict with the mind
E.g., conflicts between drives such as sex and aggression on the one hand, and moral norms and the rules
on the other
○ Freud became interested in hysterical patients
Hysterical blindness, paralysis, etc. (recall Hippocrates)
Symptoms often disappeared if patient, under hypnosis, discussed upsetting incidents, and feelings
Lecture Notes Page 1 Symptoms often disappeared if patient, under hypnosis, discussed upsetting incidents, and feelings
associated with them
○ This suggested to Freud the idea of unconscious impulses, thoughts, feelings
○ Freud developed a complex theory that accounted for both normal and abnormal behavior
○ Conceived of a basic psychic structure
• Id
○ Preset at birth; completely unconscious
○ Biological drives, pleasure principle
○ "Primary process thinking"-- conjures up images of desired objects
• Ego
○ Begins to develop in first year of life because fantasy (as a baby) not capable of satisfying needs
○ Seeks to express id's needs in manner consistent with demands of environment; reality principle, secondary
process thinking (planning, when I cry mom comes, etc.)
• Superego
○ Develops gradually as child becomes aware of parents moral standards
○ Operates according to moral principles
○ Punishes through guilt and shame; partly unconscious
Freud'sPsychoanalyticTheory
• Freud viewed id's demands as creating a basic conflict between animal instincts and the restrictions placed by
society. E.g., urination (I want to urinate, why can't I do it in public whenever/wherever I want?)
• Ego caught in squeeze between id and superego
○ Can result in anxiety
○ 3 kinds of anxiety
Reality anxiety (normal)
Neurotic anxiety-- fear of losing control of id impulses
Moral anxiety-- arises when contemplating thoughts of behavior that superego will punish (i.e., Hungry and
stealing food from supermarket-- fully conscious)
• Ego has to handle the conflicts and anxiety; uses defense mechanisms
○ Repression is the fundamental defense mechanism
Recovered memories
No good evidence that repression exists
○ Regression
New brother/sister comes along, older starts acting younger to get more attention
○ Projection
○
Reaction formation
Do opposite of what you want to do
○ Denial
○ Rationalization
○
Displacement
Blame someone else
○ Sublimation
Take conflict and pour it into something useful, like art or music
• Always constant built up between sexual and aggressive energy
• Freud ultimately abandoned hypnosis and used free association and dream analysis (royal road to the unconscious)
to uncover the hidden conflicts
• His theory is very complicated; contains amongst many other elements his stages of psychosexual development
○ Oral, anal (19mo to 3yrs), phallic (3 to 6), latency (6 to 12), genital
○ Oedipal and Electra conflicts (sexual desire for parent of opposite sex)
○ Boys suffer castration anxiety, identify with father
• Freud based his theory on his treatment sessions with upper-class Viennese women; no research per se (and difficult
to generalize to rest of population)
• Freud made important contributions
Lecture Notes Page 2 • Freud made important contributions
○ Stressed that we do not always know why we act as we do
○ Stressed the continuum between normal and abnormal (i.e., slips of the tongue, reflecting some kind of
unconscious process)
○ Stressed the importance of childhood experience for adult personality
○ Stressed the importance of sexual impulses
• Unfortunately, we have come to realize that Freud's theory is fundamentally flawed, and ill-conceived
○ Too much emphasis on unconscious conflicts, on sexual and ag
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