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Chapter 1

PSYCH 2AP3 Chapter Notes - Chapter 1: Psychopathology, Karen Horney, Countertransference

Course Code
Richard B Day

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- Case Study: Jody – The Boy Who Fainted at the Sight of Blood
Jody had what is known as blood-injury-injection phobia
A phobia is a psychological disorder characterized by marked and
persistent fear of an object or situation
Many people are uneasy when receiving a needle or seeing blood,
however a phobia is much more severe and disabling
What is a Psychological Disorder?
- A psychological disorder is a psychological dysfunction within an individual that
is associated with distress or impairment in functioning and a response that is not
typical or culturally expected
- No one criterion has yet been developed that fully defines abnormality
Psychological Dysfunction
- Refers to a breakdown in cognitive, emotional, or behavioural functioning
- Determining the line between normal and abnormal dysfunction is extremely
oWhere do you draw the line between normal queasiness at the sight of
blood and a full phobia?
- For this reason, these problems are often considered to exist on a continuum or as
a dimension, rather than as categories that are either present or absent
- This is one reason that just having a dysfunction is not enough to meet the criteria
for a psychological disorder
Personal Distress of Impairment
- That the disorder or behavior must be associated with distress adds an important
component and seems clear: the criterion is satisfied if the individual is extremely
- However, the human condition is such that suffering and distress are very much
part of life
- For some disorders, suffering and distress are absent (i.e. manic episodes)
- For this reason, defining psychological disorder by distress alone does not work,
although the concept of distress contributes to a good definition
- The concept of impairment is also useful, though it is not entirely satisfactory
oE.g. many people consider themselves shy or lazy but this does not mean
they are abnormal
- Most psychological disorders are simply extreme expressions of otherwise normal
emotions, behaviors and cognitive processes
Atypical or Not Culturally Expected
- At times, something is considered abnormal because it occurs infrequently: it
deviates from the average
- The greater the deviation, the more abnormal it is
oI.e. abnormally tall, talented, etc.

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- In many cases (typically celebrities), the more productive you are in the eyes of
society, the more eccentricities society will tolerate
- Therefore, deviating from the average doesn’t work well as a definition
- Another view is that your behavior is abnormal if you are violating social norms,
even if some people are sympathetic to your point of view – this definition is very
useful in considering important cultural differences in psychological disorders
oI.e. entering a trance and believing you are possessed would suggest
mental disorder in most Western cultures, but in many other societies the
behavior is accepted and expected
- Masai Tribe in East Africa – Robert Sapolsky (2002)
oWoman was acting aggressively, hearing voices, and killed a goat with
bare hands
oSapolsky asked member of the tribe what they believed to be wrong with
the woman
oThey responded, as if it were obvious, that she was crazy because only
men were supposed to kill goats and she heard voices at the wrong time
oThis proves that social standards associated with what is normal have been
- Wakefield’s Analysis
oHarmful dysfunction
oHis defines psychological disorder as being caused by a failure of one or
more mechanisms to perform their evolved function and the dysfunction
produces harm or distress
oAdvantage of Wakefield’s notion is that it provides a potentially
objected/scientific view of dysfunction along with allowing a
subjective/culturally bound consideration of harm and distress
- A related concept that is also useful when considering the definition of
psychological disorder is to determine whether the behavior is beyond the
individuals control
- It is nearly impossible to differentiate between normal and abnormal
- Some scholars argue that there will never be a satisfactory definition for disease
and disorder
- Perhaps the best we can do is consider how the apparent disease or disorder
matches a “typical” profile of a disorder
oE.g. Major depression or schizophrenia – when most or all symptoms that
experts agree are part of the disorder are present
oWe call this typical profile a “prototype”
- Some controversial figures such as Thomas Szasz and George Albee are highly
critical of medical diagnoses being used in the case of psychological disorders
- In 1960, Szasz advanced his position that mental illness is a myth and that the
practice of labeling mental illness should be abolished
oHe argued that fundamental difference exists between the use of diagnoses
for physical disease and their use in mental illness

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- Albee argued that the biggest mistake made by the clinical psychology profession
was uncritically accepting the concept of “mental disease” and using the medical
model and associated diagnoses in conceptualizing abnormal behavior
The Science of Psychopathology
- Psychopathology is the scientific study of psychological disorders
- Clinical psychologists typically receive a Ph. D following a course of graduate-
level study that lasts ~5-7 years
oThis education prepares them to conduct research into the causes and
treatment of psychological disorders and to diagnose, assess, and treat
these disorders
oClinical psychologists sometimes receive a Psy. D
- In Canada, regulation of the psychology profession is under the jurisdiction of the
provinces and territory – depending on the jurisdiction, a psychologist may either
have a doctoral or a master’s degree
- The labels “psychotherapist” and “therapist” are not regulated by the provincial
psychology boards or colleges – thus, in Canada, the label of “psychologist”
conveys info about the training and qualifications of the professional, whereas the
label of “psychotherapist” does not
- The terms “therapist” and “psychotherapist” are not specific to a particular
oA social worker, psychologist and psychiatrist may all refer to themselves
as psychotherapists
- Psychologists with other specialty training, such as experimental and social
psychologists, concentrate on investigating the basic determinants of behavior but
do not assess or treat psychological disorder
- Counseling psychologists tend to study and treat adjustment and vocational issues
encountered by relatively healthy individuals, whereas clinical psychologists
usually concentrate on more severe disorders Psychiatrists first earn an M.D. in
medical school and then specialize in psychiatry during a 3-4 year residency
training program
- Psychiatric social workers typically earn a master’s degree in social work as they
develop expertise in collecting information relevant to the social and family
situation of the individual with a psychological disorders
- Psychiatric nurses have advanced degrees, such as a master’s or Ph. D. and
specialize in care and treatment of patients with psychological disorders
- Marriage and family therapists and mental health counselors typically spend one
to two years earning a master’s degree and provide clinical services in hospitals or
The Scientist-Practitioner
- Many mental health professionals take a scientific approach to their clinical work
and are therefore referred to as scientist-practitioners
- Mental health practitioners may function as scientist-practitioners at least one of
three ways
1. Consumer of Science
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