madness and medicine week 8
madness and medicine week 8 PSYC 4039
Popular in MADNESS AND MEDICINE
Popular in Psychology (PSYC)
This 5 page Class Notes was uploaded by Lindsey Notetaker on Monday October 17, 2016. The Class Notes belongs to PSYC 4039 at Louisiana State University taught by A. Baumeister in Fall 2016. Since its upload, it has received 4 views. For similar materials see MADNESS AND MEDICINE in Psychology (PSYC) at Louisiana State University.
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Date Created: 10/17/16
Neuroses o Term coined in 1785 by Cullen o Comes from neuritis—inflammation of nerve o Original meaning—disorder due to undetectable disturbance of nerves o So, neuroses were originally the domain of neurologists o Famous Neurologists: Charcot Founder of modern neurology Linked neuropathology to clinical symptoms I multiple sclerosis; described Lou Gehrig’s disease (aka, ALS and Charcot’s syndrome) Pioneered study of hysteria and use of hypnosis o Hysteria: excess emotionality, especially in women, that was often associated with physical symptoms o Charcot thought that hysteria was caused by a disease in the nervous system o By the end of his career he believed neuroses to be psychogenic o Influenced by Franz Anton Mesmer who believed that natural energetic transfer- called animal magnetism- occurred between people and had healing power; technique for such transfer came to be called hypnosis; he used both hypnosis and magnets for treatment of mental illness o Charcot used hypnosis primarily as a diagnostic tool Beard (1839-1883) American surgeon and neurologist Discovered “neurasthenia” (weak or tired nerves) in 1869 o Symptoms: fatigue, anxiety, headache, impotence, neuralgia, and depressed mood Possibly depression? o Thought disorder was caused by exhaustion of “nervous energy” caused by stress of civilization Pioneered “electrical treatment” (not ECT) for “nervous disorders” Mitchell (1829-1914) American neurologist Invented Rest Cure for “nervous disorders” o Forced seclusion and bed rest-- reduced patients, primarily women, to childlike dependency o Milk (fatty) diet— promoted blood flow to spinal ganglia, wrote “fat and blood” o Electrical stimulation o Massage o Impact of these neurologists Hypnosis suggested to many a “psychological” (psychogenic) etiology or neuroses Rest cure demonstrated importance of psychological influences (psychological dependence on the physician) in therapy Charcot eventually concludes that hysteria is psychogenic Leads to development of systematic psychological theories and therapies The psychoanalytic hiatus almost all of psychiatry moves towards psychological basis Freud 1881recieved M.D. degree Residency in neurology; studied with Meynert 1885 studies hysteria with Charcot 1885 opened neurology practice in Vienna, but had difficulty building the practice Gave a talk at medical school in Vienna on Charcot and hypnosis; talk was widely ridiculed Then joined practice and collaboration with Joseph Breuer Breuer had famous patient “Anna O” whose symptoms included severe cough, paralysis of the extremities on the right side of her body, and disturbances of vision, hearing, and speech, as well as hallucination and loos of consciousness; she was diagnoses with hysteria The beginning of psychoanalysis o 1895 Breuer and Freud publish “Study on Hysteria”; includes famous case of Anna O. introduces “cathartic method”, “talking cure”, “free association” o Psychoanalytic movement begins to grow in Europe The cult of psychoanalysis o System of un-orthodoxed beliefs o Devotion to charismatic leader o System of indoctrination o Intolerance o Prosetytism o Exclusion Freud’s theory in a nut shell o Emphasis on early childhood experience o Development proceeds through a series of stages o Each stage associated with a crisis, often sexual o Crisis resolution critical determinant of adult personality o Stressed importance of the subconscious mind o Insight therapy o From id to ego psychology o Childhood sexual causality: sexual impulses present at birth, early objects of sexuality were incestuous, repressed sexual impulses cause neurosis Refrigerator mothers o Another central theme of psychoanalytic theory is that bad parenting, particularly on the part of the mother, can cause severe mental illness in children and adults o In the past, psychoanalysts blamed a lack of emotional warmth on part of the mother for schizophrenia and autism o Mother’s inability to establish a warm and loving bond with the child was given several names “cold mother syndrome” “schizophrenogenic mother” “refrigerator mother” Psychoanalysis in America o 1909 Freud gives famous lectures at Clark University o Psychoanalysis primarily an urban movement o 1911 Brill founds first local psychoanalytic society in New York o Psychoanalytic societies found training institutes o 1932 American Psychoanalytic Association is formed by joining together local psychoanalytic societies Becomes a national association, sets national standards o 1938 (APsaA) is formed by joining together local psychoanalytic societies o Immigration of psychoanalysts from Europe Political attempts to take over American psychiatry o Psychoanalysts being to take over department chairs in 1940s o Take over the American Psychiatric Association by getting psychoanalysts elected to chair committees o Inroads to psychosis (e.g., the schizophrenogenic mother) o Power of psychoanalysts was disproportionate to their numbers o In 1960 ratio of Members of APsaA to APA was 1 to 12 Why psychoanalysis succeeded o Improvement of the doctor-patient relationship No doctor’s offices before psychoanalysis started o Expansion of psychiatry’s domain o Appeal to the dysphoric middle and upper classes o It made sex a socially accepted topic of conversation o Holocaust o Popular movement Why psychoanalysis failed o Disbelief (poor face validity) o Pseudoscience o Ineffective in psychosis and asylum medicine o Questionable efficacy in neuroses o Duration of treatment o Rise of psychopharmacology The advantage of having a nervous disorder o Although, as originally conceived, “neuroses” were a different set of disorders than psychoses; but, the term became a euphemism for all mental illness- the reasons: Neuroses were often treated outside the asylum (e.g., spas) they were less strongly associated with heredity and degeneration Treated initially by neurologists who were less feared than physicians Neurosis today o Not formally recognized as class of disorders in US o Is recognized in ICD (what is used instead of the DSM in the rest of the world) o Neurotic disorders Anxiety (e.g., phobias) Neurotic depression OCD Hysteria/ hypochondria (somatoform disorders) o Implication of the term today Anxiety based Relatively minor (can probably function in society) Continuum with normality May be considered psychogenic or somatogenic Psychoanalysis today o Approximately 35 psychoanalytic training institutes in the US today o These are accredited by the American psychoanalytic association o About 3000 practicing psychoanalysts in US today o Division 39 of the American psychological association Bad psychotherapy can be harmful o The idea of repressed memory of traumatic events (invariably sexual) is at the core of psychoanalytic theory o A patient’s denial that such events occurred is given little credibility o After years of probing early live experience and suggesting to patients they were sexually abused they often come to believe it, even if it never happened o This has become a common enough occurrence that it has been given a name: “The Repressed” or “False Memory” syndrome o The consequences can be devastating Current status of repressed memory o "The AMA considers recovered memories of childhood sexual abuse to be of uncertain authenticity, which should be subject to external verification.” AMA o "The Council finds that recollections obtained during hypnosis can involve confabulations and pseudomemories and not only fail to be more accurate, but actually appear to be less reliable than nonhypnotic recall.” AMA o "There is no single set of symptoms which automatically indicates that a person was a victim of childhood abuse. There have been media reports of therapists who state that people (particularly women) with a particular set of problems or symptoms must have been victims of childhood sexual abuse. There is no scientific evidence that supports this conclusion.” APA
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