Abnormality, Therapy, and Social Issues

What is “abnormal”? If we say that abnormal is any behavior significantly

different from the average… Then what about the effect of life stressors or situations? Then what happens when “average” changes over time? What about positive (but non-normal) behaviors?

If we say that abnormal is any emotion significantly different from the average….

Don’t we all feel sad, anxious, angry occasionally? Extremely happy people would be considered mentally ill?

If we say that abnormal is any thought significantly different from the average…

We all have strange thoughts from time to time?

If we say that abnormal is anything that is undesirable… Aren’t there some undesirable but normal behaviors?

If we say that abnormal is when people feel like they are distressed…

What about people who think they have a problem, but actually don’t? What about people who don’t have a problem, but believes they do?

If we say that abnormal is based upon the cultural rules… Each era and society has had its own interpretations of abnormal behavior?

Classifying Psychological Disorders

The DSM-IV - Diagnostic and Statistical Manual of Mental Disorders

This manual has been created to establish uniform definitions and standards for diagnosis.

It lists acceptable labels for all psychological disorders.

It lists symptoms and criteria for making diagnoses and contains information on differential diagnosis – how to distinguish a particular disorder from others that are similar to it.

Classifying Psychological Disorders

The DSM-IV - Clinical disorders = Axis I.

Classifying Psychological Disorders

The DSM-IV – Personality Disorders = Axis II

Classifying Psychological Disorders

The DSM-IV Axis III is for general medical conditions that may

influence the person’s mood or behavior. Axis IV is for psychosocial and environmental

problems that may increase the person’s level of stress.

Axis V is a 1-90 scale called the global assessment of functioning. The lower the number assigned by the assessing clinician, the less likely it is that the person being diagnosed is able to function without treatment and support.

According to one extensive survey, about half the people in the United States will suffer at least one psychological disorder at some time.

Psychotherapy

Psychotherapy is a treatment of psychological disorders by methods that include an ongoing relationship between a trained therapist and a client.

Psychotherapy is provided by… Clinical psychologists Counseling psychologists Psychiatrists Clinical social workers Psychiatric nurses Counselors

There are many techniques of psychotherapy, but all of them seem to depend in large part on the client’s motivation to improve.

Schools of Psychotherapy

(1) Psychoanalysis Psychoanalysis is the oldest “talk” therapy. It attempts

to bring unconscious thoughts and emotions to awareness, and help people understand their own thoughts and actions.

Schools of Psychotherapy

(2) Behavior therapy Behaviorists believe that human behavior is learned

and can be unlearned. Uses learning theories like classical conditioning and

operant conditioning, such as systematic desensitization and aversion therapy

Schools of Psychotherapy

(3) Cognitive Therapy These are therapies that focus on thoughts and

beliefs, and seek to improve people’s functioning by changing how they think and interpret events

Schools of Psychotherapy

(4) Humanistic therapy The source of psychological distress is perceived

incongruence between the way an individual’s self-concept and his or her ideal image of self.

The therapist tries to be genuine, empathetic and caring, and tries not to interpret the client’s thoughts or feelings or offer advice.

Schools of Psychotherapy

(5) Psychopharmacotherapy Antianxiety - Valium, Xanax, Buspar Antipsychotic - Thorazine, Mellaril, Haldol Antidepressant - Elavil, Tofranil, Prozac, Paxil, Zoloft Mood stabilizers – Lithium, Valproic acid

Psychotherapy

How effective is psychotherapy? Meta-analysis of many studies of psychotherapy suggests that

a majority of people do show improvements after therapy. No one method of therapy stands out as better than the

others.

Why is it effective? Because of the treatment? Because of the relationship with the therapist? Social

support? Because of encouragement on regular basis? Because client engages in self-examination? Because reinforcing client’s desire to change and improve.

Psychotherapy

How to choose a therapist? No one way of doing psychotherapy is right for every

client. You need to use your knowledge to “shop” for the therapist who will work best with you.

As with any other “remedy” be skeptical of overconfidence and claims of amazing results.

Expect at least some small improvement within a couple of months of starting, and don’t be afraid to ask for your therapist’s input if this doesn’t happen.

Be an active participant in your own treatment – nobody “fixes” you, rather, you receive help in changing your own life.

What is self-help?

Self help = any instance where an individual or a group attempts self-guided improvement, typically through publicly available information.

Books Audio cassettes DVDs Video DVDs Internet

Motivational speakers Seminars Programs Personal coaching Support groups

How extensive is self-help information?

Billions!

Ingrained into culture “Twelve step program” Self-help books -- “Dummies” Guide “self help psychology” returned over 12million+

hits on Google

Why is it so extensive? (benefits) Within therapy

Therapist uses to give client more information More information “out-of-office” Client uses for day-to-day continuing education

Beyond therapy Can provide help that therapy can not Experiential knowledge from more experts Experiential knowledge from people going through

the same thing (support group) Support groups also provide sense of belonging,

friendship, identity, peer-to-peer support

Criticisms of self-help? (risks)

Without therapist, no trained professional so… Improper assessment Inappropriate treatments Failure may make it worse

Without scientific data to confirm validity, then.. possibly misleading and inaccurate potentially harmful and dangerous pseudo-scientific assertions offering "easy answers" to difficult personal problems

Do the risks outweigh the benefits?