AS: abnormality
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Individual differences

An overview

This topic looks at abnormal behaviour, in particular the following aspects:

  • How do we decide whether or not a behaviour is abnormal?
  • How do psychologists try to explain abnormal behaviours?
  • How do psychologists try to explain eating disorders?

Some titbits to hopefully grab your attention and set you thinking?

  • If someone has a very high level of anxiety we consider their behaviour abnormal.  However, should we similarly consider a very low level of anxiety as abnormal?
  • Why are eating disorders confined almost entirely to Western Society and far more common in middle class girls?
  • It is said that the easiest way to cure an American of schizophrenia is to bring him to Britain, since we are far less likely to diagnose schizophrenia on this side of the Atlantic!
  • Do we learn to be abnormal or is it in our genes?
  • Homosexuality was considered an abnormal behaviour up until 1980 by the World Health Organisation!

A case study in abnormality?  (Courtesy of Gross & McIlveen)

William Buckland (1784-1856) was an interesting man.  He was Oxford University’s inaugural professor of geology and the first person in England to recognise that glaciers had once covered much of the northern parts of the UK.  Buckland supervised the laying of the first pipe drains in London and was responsible for introducing gas lighting to Oxford.

He also ate bluebottles, moles and, having been shown it by a friend, the embalmed heart of the executed King Louis XIV of France!

                                               

Text Box: William Buckland … genius, geologist and gastronome!

Is this abnormal behaviour?  Most of us would consider it odd at the very least!   However, when I say ‘us’ who am I referring to?   Western society is about the only culture on Earth that does not consume insects.  Other people would find it odd that we do not eat such invertebrates, since we consider their watery cousins (prawns, cockles etc.) such a delicacy!  Similarly moles are a mammal.  We eat cows, pigs, sheep, how are moles any different?  We find it disgraceful that cat or dog is so favoured in some parts of the World whilst other cultures find it appalling that we eat cows or pigs!  Many of these tastes are culturally relative and are due to conditioning and the way we have been brought up!   However, I reserve judgement on Louis XIV’s heart!

I spent some of my mid twenties in Mansfield, Notts. (a town famed itself for its strange and often aggressive inhabitants).  I spent many a happy evening in a bar called the Brig-o-doon, oft chatting to a ruddy faced old chap Mick Grimmer.   He was famed locally for his bizarre fund raising activities, one of which I read about some years later in an old copy of the Daily Mirror!  Mick had spent two weeks in a local public house sat on a toilet, wearing a woman’s nightgown, eating nothing but cold baked beans (hence the toilet presumably) and listening to Des O’Connor records.  Was Mick abnormal.  Even if we consider it abnormal does it constitute mental illness… lots of questions; so few answers!

 

 Defining abnormality

Why do we bother?  You’d think that it would be obvious, and in some cases perhaps it.  However, there are lots of cases when things are not so clear cut; William Buckland (above) for example.  

We all feel down from time to time or have swings in mood or feel anxiety at times when we wouldn’t expect to.  At what point does this become depression, manic depression or clinical anxiety?  The issue is further clouded by cultural differences and history.  Behaviours we find odd in this country don’t get a second look in others and behaviours that were once seen as abhorrent are now accepted by the vast majority.  Similarly actions requiring immediate institutionalisation in the lower classes are seen as merely eccentric in the upper classes!

In less ‘enlightened’ times abnormal behaviour was considered the work of the devil and of being possessed by evil.  Techniques such as exorcism (still practised) were developed.  During the Dark Ages abnormality was attributed to witchcraft with the person being cursed.  Odd people were tried (sometimes by dubious techniques) and if found guilty burnt at the stake; a sure-fire cure!                                                                                   

 

Text Box: Linda Blair before her exorcism!
Impressive bit of spinning… even for a Blair!
 
 

 

In more recent times we have seen the advent of asylums to house the abnormal or mentally ill.  These have given way in the West to hospitals for the mentally ill or clinics.  Admission to these places is governed by at least doctors and by a third person such as a social worker.

When defining ‘abnormality’ we will consider the way definitions differ between cultures (even within Western Societies), how definitions change over time and how what is considered ‘abnormal’ and worrysome in one place at a particular time is considered ‘normal’ or even desirable elsewhere at a different time.

We shall start this topic by looking at possible ways of defining ‘abnormal’ none of which, on there own, really tell the whole story.

 

Deviation from statistical norms

Put simply, if few people in a given population behave like you then you’re abnormal!  This appears to have ‘face validity’ in that it appears to make obvious sense at first sight.  However when we dig a little deeper it fails miserably.

Let’s start with a physiological example.  If we take 5’ 9’’ as the average height of an adult male in the UK, surely it is safe to assume that 4’ or 7’ is abnormal since a tiny percentage of the population fall into these categories. 

However, when we consider psychological characteristics things are not so clear cut.  Let’s consider IQ (intelligence quotient).  Within a population this is normally distributed.  When plotted on a graph it assumes the familiar ‘bell-shaped’ curve.

The average IQ in the UK is maintained at 100 with a standard deviation of 15.  For the innumerate amongst you that means in simple English that 67% of the population have an IQ of between 85 and 115 (one standard deviation below the average and one standard deviation above the average).

By the time we reach 3 standard deviations below the norm, an IQ of 55 (3 x 15 =45 and 100 -45 =55), are you still with me, we are talking less than 1% of the population.  Surely we can consider these to be abnormal since they are so rare. 

 

Text Box:  
But what about those with an I.Q. of 145 or over?  They are equally rare in statistical terms so must also be abnormal!  Many behaviours and human characteristics seem to fit a normal distribution curve.  
 

Evaluation

 

1.       Where do we draw the line?  If we assume that an IQ of 100 is normal and one of 45 is abnormal at what point between do we cease to be normal, 75, 65, 60…?  Our decision has to be arbitrary and will probably be on mathematical grounds such as standard deviation. 

2.       Is the behaviour desirable?  We tend to associate abnormality with undesirable or unwanted behaviour, but statistically rare will encompass desirable characteristics such as genius, very low levels of stress and anxiety etc.

3.       Rare or not reported?  It is thought that some disorders appear rare in a culture simply because they are not reported.  Cohen (1988) believes that few mental illnesses are reported in India because mental illness is seen as a curse so sufferers are looked down upon.  Similarly, Rack (1982) believes that depression is far more prevalent in Asian culture than the figures would suggest.  Asians tend to report physical illness but mental illness is dealt with within the family to avoid stigmatisation.

One final point to ponder.  In 1994 Kessler et al reported that 48% of Americans had suffered a period of mental illness.  Using the statistical infrequency definition it can only be a matter of time before that figure reaches and exceeds 50% meaning that those without mental illness are in a minority… and presumably as a result abnormal!

 

Deviation from social norms

In some ways this is similar to the previous definition and has some of the same advantages and drawbacks. 

It considers a behaviour abnormal if ‘Society’ considers it unacceptable or undesirable.  In this way it appears to overcomes the ‘desirability’ criticism of the statistical infrequency approach.  For example a genius, although statistically rare is not considered abnormal by this approach since their defining characteristic is not out of line with social norms.

Evaluation

  1. Social norms change over time.  Behaviour that was once seen as abnormal may, given time, become acceptable and vice versa.  Examples: drink driving was once considered acceptable but is now seen as socially unacceptable whereas homosexuality swung the other way (!).  Until 1980 homosexuality was considered a psychological disorder by the World Health Organisation (WHO) but today is considered acceptable (at least by enlightened societies and individuals).  Having children out of wedlock was once seen as socially unacceptable and women were locked up in institutions because of it. 

As an activity consider behaviours seen as acceptable today that may been seen as deviant or abnormal in a hundred years time.

  1. Desirability.  Within some societies a behaviour may be considered undesirable, and as a result treated as abnormal, even though it is seen as desirable by others.  Dissidents in the former Soviet Union were considered undesirable because they opposed the system of government.  As a result they were imprisoned in the so called Gulags for their beliefs and actions.  However, the rest of the world considered these people heroes, or at least desirable.  Other similar examples would include those that stood against apartheid in South Africa or opposed the Nazis in 1930’s Germany.

Text Box: Dissidents who objected to Communist rule in the former Soviet Union were  seen as abnormal and interned (without trial) in the infamous Gulags of Northern Russia and Siberia.
Nobel prize winner Solzheitsyn was imprisoned for many years by the Soviet regime.

 

 

  1. Cultural issues.  As well as the issue of desirability varying between cultures there are other cultural issues with social norms.  For example in Japan those who do not submit to the country’s strong work ethic are considered abnormal.   Cohen (1988) reports that ‘loony bins’ (quoting here) are used to imprison those unwilling to conform to Society’s expectations.  On being released the former inmates are not allowed to work as cooks or bakers and are prevented from holding a driving licence.  Controversially Szasz (1960) believed that all mental illness is socially constructed by governments as a means of controlling the behaviour of those it sees as a threat!

 

Failure to function adequately

Most people suffering from psychiatric illness are in some way unhappy. 

  • Depression leads to very low mood, apathy, despair and in extreme circumstances sufferers seek to end their lives.
  • Anxiety disorders lead to excessive feelings of stress resulting in the patient being too fearful to lead a ‘normal’ life.

Society (that word again), recognises or sets the standard for how people should lead their lives, a failure to meet this standard of functioning could therefore be regarded as abnormal.  Some see this approach as the most humane since it is left to either the person themselves, or those close to them, to decide if professional help is required.

Sue et al (1994) believed that most people seeking psychiatric help are suffering from a sense of distress or discomfort as a result of their problem.   This is supported by the view of Miller & Morley (1986) who saw distress as the primary motivation behind seeking help. 

However distress alone is not a good indicator of abnormality:

  1. There may be a logical explanation for distress such as bereavement or broken relationship
  2. Some mental disorders (most notably schizophrenia and Alzheimers) cause distress to others rather than to the patient themselves.

Rosenhan & Seligman (1989) decided on seven criteria for ‘failing to function’.  It is important to remember that any one, or even small number of these, is by no means unusual.  However, if a person is experiencing many or all of them, then this would constitute cause for concern.

Many of these depend upon context, brightly coloured hair would be fine at a fancy dress or punk reunion, exposing body okay on a nudist beach or rugby club!  

At various times most of us will adopt at least some of these behaviours, swearing in a pub, behaving in a dangerous way, showing mood swings, talking to ourselves etc.  Deciding on abnormality using this method is very subjective, open to interpretation and very context dependent.

 

 

Suffering:

The patient may themselves may suffer as a result of their condition (e.g. depression) or may inflict suffering on others (deliberately or otherwise).

Maladaptiveness

 

 

 

 

 

 

 

 

 

 

 

 

Deviation from ideal mental health

This is the approach adopted by the humanist branch of psychology.  How shall we describe humanists?  I think of them as the Lib Dems. of psychology.  They are fundamentally nice people with a positive outlook on human development and have lots of useful and interesting ideas, but they are so dull!  No Freudian sex, no behaviourist experiments and certainly no drugs or surgical procedures!

There approach to abnormality is different to the others considered so far.  Being so positive about life they prefer to first of all outline what is normal and healthy.  If a person then doesn’t fit this description we shall consider them abnormal.

Maslow’s hierarchy of needs

If you do PE or Business Studies chances are you’ve already come across this one.  I won’t bore you with detail but basically Abraham Maslow believed that the healthy person is looking to better their lot by striving for higher and higher goals or targets.  We start with the basic needs such as food and drink.  Having satisfied these we move onto personal safety and so on.  Eventually, having satisfied all of our needs for love, knowledge, self esteem and aesthetics we may acquire the elusive self actualisation, the Holy Grail of contentment!

                                                                                               

Text Box: A simplified version of Maslow’s hierarchy.  
Maslow believed that few people ever accomplish self actualisation.  He named a few including Abraham Lincoln and Eleanor Roosevelt (first lady).  Most of the others were people he knew personally.  
Modern equivalents might include Nelson Mandella and Mother Teresa.  People who during their life accomplished everything that they wanted and seem(ed) totally at peace with themselves.

 

Marie Jahoda (1958) incorporated Maslow’s work into her six characteristics of ideal mental health:

Self attitudes

These should be positive and include self respect, self reliance, self confidence and self esteem.  However these need to be realistic.  Many very bright, attractive, socially fluent people lack self confidence and self esteem.

Disorders such as depression, anxiety and eating disorders appear to be associated with low self esteem.

Self actualisation

As mentioned above.

Integration (resistance to stress)

t is important to consider that Jahoda means our ability to cope with stress not the amount of stress we endure. 

Those unable to cope with stress are more prone to disorders such as depression.

Autonomy

A person should be independent and not reliant on others for their well being.  They should accept responsibility for their own actions and not look for excused elsewhere.

This is the most culture-bound of Jahoda’s criteria.  Independence like this is very much a product of individualistic (Western) societies in contrast to Asian/African cultures were the emphasis is placed more on cooperation with others and on responsibility via the extended family.

Perception of reality

Jahoda stressed a realistic outlook on life, i.e. not overly optimistic or pessimistic.  Being overly optimistic is likely to lead to abuse by others and to disappointment whereas being overly pessimistic could lead to morbidity and depression.

However, some psychologists and philosophers argue that ‘reality’ is a product of our own making and is therefore not an objective measure.  Speak to Miss Brooker for more details!

Adaptability

The ability to change to suit the conditions (physical, social etc.) that you find yourself in.  As an example can you imagine ‘Tim…nice but dim’ lasting more than a few minutes in a Barnsley public house on Friday night?

 

Evaluation

 

In its favour it does adopt a positive outlook seeking first to define ‘normal.’  Deviation from this is then seen as abnormal.

But

Subjective:  The characteristics measured such as self esteem and self actualisation are very difficult to measure.  Questionnaires abound but these are notoriously subjective and not always valid or reliable.

Culture-bound:  The measures adopt a very western approach to ‘normality.’  As already mentioned autonomy is seen as far from ideal in other cultures.  Similarly the emphasis on self attitudes would seem alien to them.  As a result, using these criteria, it would be likely that those from other cultures would be more likely to be judges as abnormal.

 

    

The most famous and influential of Humanist Psychologists, and inventor of ‘unconditional positive regard.’

The very nice Mr Carl Rogers.

 

          

Culture, sub-culture, race and gender

The blue book isn’t so hot on this section of the course so I will provide an overview, that as well as being interesting in its own right may also help with your deeper understanding of ‘abnormality’ has an issue in psychology.

As we have already seen culture plays an important part in our understanding of abnormality.  An apparently normal and acceptable behaviour in one culture can be seen as unacceptable in others.  Think of the HSBC advertisements on television.  In some countries it is considered rude to show the soles of your feet in public.  In East Africa it is not considered odd to pick your nose whilst talking to someone.  Even turning and having a pee mid conversation is seen as acceptable.  To this extent normal and abnormal is very much a social invention (or more correctly construct) and as a result will change between cultures and over time.

 

a. Culture and abnormality

Clearly a broken leg or heart disease is a universal disorder and can be observed or measured using objective and physical measures.  However, psychological illness is not so clear cut or well defined. 

Depression is very rarely reported in Asian culture.  Does this mean that they are a happy and contented lot or are there other explanations?

Rack (1982) reports that Asians rarely consult their doctor with emotional problems, preferring to sort these out within the extended family unit.  When they do visit the doctor they only report the physical symptoms of stress such as tiredness, lack of sleep and appetite etc. 

Because mental illness carries such a stigma it is very unusual for Chinese doctors to diagnose such disorders in their patients (Rack 1982).

 

Culture-bound syndromes

Koro: confined to SE Asia, this is the morbid fear that the penis or nipples will grow inwards and cause death.

Amok: characterised by furious outbursts of anger and aggression followed by sleep and a forgetting of the act.  Again the diagnosis is confined to SE Asia but can perhaps be recognised as the symptoms of some infamous western killings such as Dunblane, Hungerford and Columbine.  In the west however, this sort of behaviour is more likely to be attributed to schizophrenia.  (Note: the term to run amok is derived form this).

Anorexia nervosa is a particularly interesting one in that it is confined almost entirely to western culture.  However, the twins of anorexics who themselves do not suffer the same disorder often show signs of other psychiatric illnesses such as depression.  This has led to the idea that our genes may predispose us to psychiatric illness but the precise from that takes may be determined by cultural issues.

A little evidence for the claims made by Szasz 1960) and mentioned earlier:

In 1851, the psychiatric condition ‘drapetomania’ was constructed by an American psychiatrist to control black slaves.  The symptom was ‘running away!’

 

b. Social class and abnormality

In the UK the middle classes are far more likely to be diagnosed with depression and eating disorders whereas the lower classes are more likely to be diagnosed with schizophrenia.

Possible explanations for schizophrenia:

Diagnosis:  Johnstone (1989) found that doctors were far more likely to diagnose psychotic illnesses such as schizophrenia in the lower classes even when they reported similar symptoms to those from higher social groups!

Social causation hypothesis: the higher levels of stress due to poverty, poor housing etc., experienced by the poor is more likely to lead them to psychiatric illness.

Social drift hypothesis:  Perhaps psychiatric illness such as schizophrenia causes people to become poorer since they can’t hold down responsible jobs etc.   Good example of cause and effect: is the poverty causing illness or is the illness causing poverty!!!

 

c. Gender and abnormality

Anorexia nervosa:  over 90% of sufferers are women (in fact young girls). 

Depression:

  1. Clinical depression is twice as common in women as it is in men
  2. Manic depression is equally common in both sexes, although women tend to have more bouts of depression and men more bouts of mania.

Autism: about 80% of sufferers are boys.

Possible explanations for the sex differences:

Different diagnosis

Perhaps doctors and psychiatrists have different expectations for the sexes.  Certainly doctors seem to describe the healthy characteristics of men and women differently.  According to Boverman et al (1981) doctors believe that men should be assertive and decisive and women should be dependent and emotional.  Perhaps their ideas on abnormal characteristics vary similarly.  Look at Sandra Bem’s gender inventory as a perfect example of this!

Physiology

An obvious difference between the sexes is their hormones, women with their oestrogen and men with our dreaded testosterone.  Oestrogen has been implicated in some forms of depression.

Traditional roles (the feminist explanation)

Women traditionally stayed at home and looked after the children whereas men were out at work and socialising.  Perhaps isolation like this is a factor in depression for women.  A similar explanation relating to media has also been suggested as a possible explanation of eating disorders.

Diet

Recent studies have suggested a possible link with teenage diets and later depression.  Low calorie diets can deprive the body of certain amino acids.  At least one of these has been implicated in the production of serotonin, the brains ‘feel-good’ neurotransmitter!

 

Models of abnormality

These seek to explain how psychological disorders develop.  Broadly speaking with mental disorders explanations can be split into two types:

Biological or medical explanations:  These see psychological illnesses as similar to physical illnesses in that they have a physical cause.  Psychiatrists tackle mental illness from this perspective.

Psychological explanations:  These adopt the view that psychological illnesses have their root cause in the mind and seek to explain them using a variety of different psychological theories, some of which we have come across before.  The main psychological approaches are:

Psychodynamic  
  1. Their main assumptions about psychological illness
  2. The way they seek to explain psychological illness
  3. An evaluation of the model
  4. Treatments suggested by the model
  5. Ethical implications of the model

 

Behaviourist
Cognitive
Humanistic

Each has its own unique perspective and we shall consider each in more detail later. For each explanation, medical and psychological we shall consider:

It is worth mentioning that no one model offers a perfect explanation of any disorder and that often a combination of theories offers the best way forward.  Until recently the medical model has been dominant but psychological models are being used more and more.  In a clinical setting the psychiatrist would normally employ the medical approach whereas the clinical psychologist would adopt one of the psychological methods.

 

Medical model (also referred to as biological)

1.  Assumptions

  • Psychological illnesses have a physical cause (genetic, chemical, anatomical etc.)
  • Treatment of psychological illness will require a physical intervention (surgery or drug treatment for example).

The medical model believes that psychological illness can be caused by one of the following physical causes:

2. Explanations

Genetic

Put simply, mental illness is inherited from parents.  This could be shown if there is a tendency for an illness to run in the family or if a particular gene can be identified as being responsible for the disorder. 

Usual methods of study include family, twin or adoption studies that look for links between individuals with a similar genetic make up.  However, this is psychology, and nothing is ever that simple!  At best what we can say is there appears to be a genetic predisposition in some people to develop a particular disorder.  For example if one twin has schizophrenia there is on average about a 42% chance that their identical brother or sister will also develop the disorder.  This obviously suggests that schizophrenia is not 100% genetic, but it also suggests that there is a genetic element to it.

Biochemistry

The brain relies on various chemicals to help it communicate, these are called neurotransmitters.  Examples include adrenalin, serotonin and dopamine.  Perhaps an imbalance in these chemicals can lead to psychological disorders.  We know that LSD can cause similar symptoms to being schizophrenic and we know that LSD is chemically similar to the brain chemical dopamine. 

Dopamine hypothesis of schizophrenia

It appears that the schizophrenic brain is overly sensitive to this neurotransmitter so as a result messages get passed on that would be blocked out in a ‘normal’ brain.  Drugs such as chlorpromazine, used to treat some of the symptoms of schizophrenia make the brain less sensitive to dopamine.

Prozac, used to treat depression appears to work by increasing the brain’s levels of serotonin.

Neuroanatomy

This approach considers the possibility that abnormal behaviour may be caused by a problem with the structure of the brain.  We know that brain damage can cause catastrophic alterations to performance and behaviour, for example Clive Wearing or Phineas Gage.  But can more subtle alterations to structure lead to mental illness?

Generally speaking there is less evidence to support this aspect of the theory.  Possible exceptions are a link between enlarged ventricles (fluid filled chambers in the brain) and some of the symptoms of schizophrenia, and a possible link between the hypothalamus (yes again) and eating disorders. 

Infection

Infections can clearly cause physical illness such as colds, flu, meningitis etc., but can they cause psychological illness?  In the 19th century it was found that the syphilis bacterium was responsible for a disorder known as general paresis which resulted in delusions and forgetfulness.  Today there is a viral theory of schizophrenia.  Some evidence has suggested that influenza during the middle section of pregnancy (second trimester), can lead to an increased incidence of schizophrenia when the child reaches maturity.

3.  Treatments

If the problem is caused by a physical problem then we require a physical procedure to put it right.  If there is a problem with brain structure then perhaps surgery.  If the problem is caused chemically the perhaps a drug can redress the balance.

Drug type

Effect on the brain

Used to treat

Prozac or SSRIs (selective serotonin reuptake inhibitors)

Increase brain levels of serotonin

 

Depression

Neuroleptics for example chlorpromazine

 

Block the brains dopamine receptors

Type I schizophrenia

L-dopa

 

Increases brain levels of dopamine

 

Parkinsons

 

Typically psychoactive drugs take at least three to four weeks to start working.

Surgery

ECT or electroconvulsive therapy is still used in emergencies to treat depression.  The patient is anaesthetised and given a muscle relaxant before an electric current is passed through one lobe of the brain (although it used to be both).  How the treatment works is not fully understood and their can be side effects such as memory loss.

More extreme measures include removing or cutting brain areas.  Frontal lobotomies were widely used in America to calm violent men.  Again there can be drastic side effects ranging from apathy to death!!!   Various techniques have been used over the years to treat epilepsy.

Today surgery and drugs are usually accompanied by psychological treatments.

 

4. Evaluation of the medical model

The model has lead to a number of widely used and effective treatments for various disorders.  Drugs have the added bonus of being quick and easy to take compared to psychological treatments that can take months and be very costly.

With much of the research there is the problem of cause and effect.  For example if we carry out a post mortem on a schizophrenic and find enlarged ventricles, can we be certain that these caused the schizophrenia?  Perhaps the schizophrenia has caused enlargement of the ventricles. 

‘Treatment aetiology fallacy.’  Sounds complicated!!  You have a headache so you take aspirin.  As if by magic the headache disappears.  Conclusion lack of aspirin must have caused the headache!   Unlikely, but that is what the medical model suggests time and time again with its research.  Prozac increases the levels of serotonin therefore lack of serotonin  must have been the cause of the depression.

There is the danger that if we concentrate on physical definitions and physical treatments that we ignore the root causes of psychological illness such as poverty, stress and inequality (Szasz).

 

5. Ethics of the medical model (philosophical)

If we decide that schizophrenia is a physical disorder caused by a person’s genetic make up or the structure of their brain, then can we hold them responsible for their illness any more than for example we can blame a diabetic for their inability to control their blood sugar levels?  If that is the case then what happens on those rare occasions when a schizophrenic harms someone?  Surely the person cannot be blamed!

The flip side to this however is that it does label people, this can be unhelpful, particularly since generally speaking schizophrenics do not have a good press.  Come to think of it sometimes neither do depressives (think of the appalling treatment of Frank Bruno by the Sun!).  Additionally, the behaviourist approach (considered later) believes that once a person has been labelled they begin to take on the characteristics of that label.  This can be subtle: I’m a Libran.  I know from books, magazines etc. how I am supposed to behave because of this label.  As a result I look for those tell tale characteristics in my personality.  I notice if I play devil’s advocate in a discussion or try to see both sides of an argument.  I take particular pride in my appearance (but perhaps not noticeably so lol!).  As a result I start to behave as a Libran should.  Labelling theory believes that happens with people who have been labelled depressed or overly anxious etc.  

In a similar vein, if you know that a particular disorder is partly genetic and there is a history of it in the family then it is only natural that you will start to look for signs of it in your own behaviour.  We have a self-fulfilling prophecy!

 

Psychological Models

These methods are generally used by clinical psychologists working alongside psychiatrists in psychiatric hospitals and institutions.  Each method is based on one of the psychological models of abnormality seen briefly in attachments.  Psychologists attempt to explain human behaviour (normal and abnormal) with one or more of these methods.

Psychodynamic Model of abnormality

The approach originally proposed by Sigmund Freud in the late nineteenth century and the first attempt to explain the complexities of human behaviour.  Other psychologists have based their theories around Freud’s original.

1. Assumptions

  • Abnormal behaviour is often the result of conflicts between different aspects of our unconscious mind such as the id and the superego or libido and Thanatos.
  • Childhood is a crucial time in the development of personality.
  • Treatment requires that unconscious conflict is accessed and confronted using techniques such as free association, dream therapy and hypnosis.

2. Explanations

The explanations tend to be based around:

  • The three aspects of personality
  • The Psychosexual stages of development
  • Ego defence mechanisms such as repression

The Id, Ego and Superego revisited!

Freud believed there are three components to personality.  The id is the selfish, uncaring aspect that seeks satisfaction and pleasure at whatever cost.  The superego is the caring, socially aware aspect that acts as our moral conscience.  The Ego is the ‘piggy in the middle’ that operates using the reality principle to keep the other two aspects happy. 

Think of situations were you have a strong desire to behave in a selfish or socially unacceptable way but your conscience is giving you severe pangs of guilt so as a result you plump for a compromise action. 

According to Freud if the Ego is weak then either the Id or Superego can become dominant and cause abnormal behaviour.  A dominant Id will result in a disobedient child or a psychopathic adult whereas a dominant Superego will result in neurotic behaviours such as over anxiety.

The Psychodynamics!

Prizes for the best collective noun for a group of psychoanalysts!

                            

Siggie                           Siggie and daughter       Carl Gustav Jung            Erik Erikson

                                                Anna

The psychosexual stages of development in brief

The child is born into the oral stage and in possession of an id, no ego or superego at this stage.  The child is therefore pleasure seeking and selfish and the id derives pleasure by eating and sucking. 

During the anal stage the child is potty trained and for the first time its actions may bring it into conflict with its parents if it fails to behave appropriately.  The Id is demanding instant gratification and pleasure (now centred on pooing!) and parents would rather the child follows protocol and waits for potty time!  The Ego develops to resolve this conflict. 

The Superego develops during the Phallic stage to resolve the Oedipus Complex in boys or the Elektra Conflict in girls.  We each, according to Freud, develop an unconscious desire for the opposite sex parent and eventually realise that must identify with the same sex parent in order to grow up and satisfy our lust.

Defence mechanisms

The anxiety caused by unconscious conflict can be damaging to the Ego which as a result develops various methods of protection.  These include:

repression (as seen in memory) were unpleasant or traumatic thoughts and experiences are hidden in the unconscious mind. 

regression were the adult may during stressful times return to an earlier psychosexual stage of development such as the oral stage. 

reaction formation  where a person becomes ashamed of a particular desire and as an extreme form of denial takes an outward stance that is very anti to their desire.  Usual examples are men with homosexual desires developing very homophobic behaviours.

 

3. Treatments

The basis of all treatments is giving the patient an insight into their unconscious mind.  Once a person had gained access they would be able to integrate or come to terms with whatever was at the root of their problem and cope with life better. 

Freud collaborated with Josef Breuer, another physician and physiologist. Breuer had a patient, known as Anna O, suffering from hysteria, which apparently paralyzed her. During her treatment, Freud and Breuer discovered that recalling traumatic experiences with the help of hypnosis would help relieving her symptoms. In 1895, Freud and Breuer published Studies in Hysteria, which documented "the cathartic method", also known as the "talking cure".

Initially Freud used hypnosis as a way of tapping into the patient’s unconscious mind but later went on to use dream therapy.  In 1901 Freud published his classic book ‘The Interpretation of Dreams,’ in which he outlined how the mind disguises unconscious desires behind symbols while we sleep.  Freud called dreams ‘the Royal road to the unconscious.’ 

Text Box: Later still he used free association, the technique for which he is most famous.  Patients (usually middle class, middle aged, neurotic women) would lie on his couch (left) and talk about anything that came into their mind.  Freud believed that eventually this would uncover unconscious thoughts.  Pauses in their train of thought would be an indication that they were getting close to the repressed material.  
 

 

 

4. Evaluation

A positive point for starters.  Freud’s theory was the first to consider psychological illness as having psychological causes.  Prior to Freud mental illness was considered to be the result of possession by the devil or earlier still due to witchcraft. 

However, there are a number of problems with Freud’s theory, method and treatments.

  1. The model is subjective and lacks any sort of scientific rigour.  Freud’s theory was developed from his own interpretations of his patients thoughts and cannot be verified using objective or scientific methods. 
  2. In a similar way his theory is said to be unfalsifiable.  It is impossible to prove or disprove.  In interpreting dreams, if the patient agreed with Freud’s interpretation this would be seen as supporting evidence.  If the patient did not agree then Freud saw this as the patient’s denial or inability to come to terms with the nature of their repressed thoughts!
  3. Freud places too great an emphasis on childhood experiences whilst ignoring more recent adult events and similarly, according to later psychodynamic theorists places too great an emphasis on sex.  Erik Erikson (1963) describes psychosocial stages of development rather than psychosexual and believes that emotional conflict can arise from adult events just as much as childhood events.
  4. Treatment tends to be time consuming and as a result costly.  ‘Shrinks’ do not come cheap.  Typically patients are expected to have up to five consultations a week initially reducing to one or two over time.  Treatment can go on indefinitely!!!

 

5. Ethical implications of the psychodynamic approach

Like the medical model it is deterministic.  It sees the abnormal behaviour as being out of control of the individual who Freud sees as a prisoner of their past and of their unconscious forces.  As a result people should not be blamed for their psychological illness.  However, since childhood experience is crucial in determining psychological well being later in life then surely parents, according to this approach, are partly to blame for disorders.  This can cause problems for the patient undergoing therapy. 

As mentioned in memory, there is also the issue of false memory syndrome were repressed material has been uncovered using psychoanalytic techniques and led to accusations of child abuse etc. that cannot be independently verified.

Behaviourist approaches:

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Learn by association                  Learn by reward and punishment                                  Learn by imitation

 

Behaviourist model of abnormality

This approach to explaining human behaviour developed out of an unhappiness with the psychodynamic approach, particularly the lack of scientific methods used.  Early behaviourists included Ivan Pavlov and John Watson of ‘Little Albert’ fame.  Later BF Skinner and others added their thoughts.  (Note; very really used the BF stands for Burrhus Frederic).

 

1. Assumptions

Behaviourists believe that all behaviour is learned and that includes abnormal behaviour

Learning occurs through the processes of conditioning or modelling (imitating).

Behaviours can be unlearned, which is the method used for treatment.

 

2. Explanations

Classical conditioning (learning by association)

We learn by associating things together.  Classic (pardon the pun) examples include Pavlov’s dogs and Little Albert.

Pavlov’s dogs learned to associate a bell with food so that eventually the sound of the bell alone would cause the dogs to salivate.  Little Albert learned to associate white rabbits with loud and frightening noises so that eventually furry toys would cause fear too. 

In this way, according to behaviourists we can learn undesirable or strange responses to all sorts of situations.  The most common application of this aspect of behaviourist psychology is to the explanation of phobias.  Picture yourself as a child in the kitchen with mummy (sorry bit of sexist stereotyping going on here, first why isn’t daddy in the kitchen and secondly…), mummy sees a spider and screams very loudly!   Even though you may not have been fearful of spiders before in future you may be since you may associate them with fear in future. 

Evaluation

This approach offers a simple and testable theory of learning. 

However it is seen as far too simplistic.  It may offer an explanation of phobias but how can you learn delusions, depression or hallucinations by association?

Even in the case of phobias it is often not possible for people to think of any incident like this that may have triggered the phobia in the first place.  Menzies & Clark (1993) reported that only 2% of children who had hydrophobia (a fear of water, not necessarily rabies!) had suffered a traumatic event involving water.

Operant conditioning (reward and punishment)

If we’re rewarded for a behaviour we are more likely to repeat it in future, if we’re punished we’re less likely to do it in future.  (Who says psychology isn’t rocket science?).  This is the method used to teach sniffer dogs, dolphins in wildlife parks and of course students to behave appropriately in class!

Lewinsohn (1974) believed that depression could result from lack of social support or hostility from others.  People may see this as punishment for the way they were behaving so avoid social situations.  As a result they get even less positive feedback and eventually they become depressed.  Not one of the better theories of depression it has to be said!  Learned helplessness, as seen with Seligman’s dogs may also contribute to depression, as people realise that they have little or no control over their situation.

Evaluation

It does concentrate on current events rather than childhood, but according to this approach removing the punishment or providing reinforcement should stop abnormal behaviour.

Social Learning Theory (Modelling)

The idea that we acquire behaviour by copying others.  It also has elements of operant conditioning since it recognises the importance of vicarious conditioning.  If a person is observed behaving in a certain way and is then rewarded for their behaviour then the observer is far more likely to copy that behaviour.  The classic experiment in this area is Bandura’s bobo doll procedure in which children watched adults beating up a rubber doll!!!

The most useful applications in explaining psychological disorders has been in phobias and in eating disorders.  Mineka et al (1994) showed monkeys video footage of other monkeys who were clearly frightened of snakes.  When exposed to snakes it was found that the observers had also developed a fear of snakes. 

We shall return to the role of modelling in development of eating disorders in the critical issue.  However, the hysterical media coverage of slim superstars such as Kate Moss and Victoria Beckham (aaaaaaaaaarghhh… sorry lost the will to live briefly there!) may help explain the desire to be thin in teenage girls.

3. Treatments

Basically since the abnormal behaviour has been learned (according to behaviourists) then treatment concentrates on unlearning inappropriate behaviour and replacing it with the learning of new behaviours.

a. Behaviour therapies (based on classical conditioning)

These are often used to treat phobias and involve the patient learning (that word again) to associate (that word again too) their phobic stimulus (spider or whatever) with relaxation. 

Systematic desensitisation is a nice way of doing this.  The patient undergoes relaxation therapy, perhaps involving muscle relaxation and breathing exercises.  They are then exposed to a photograph of a small spider and relaxed.  Gradually over sessions the pictures are of bigger spiders and eventually a real (but small) spider is introduced.  At each step the patient goes through the relaxation procedure.  Eventually the person sits with a huge tarantula perched on their hand. 

Flooding is the nasty way.   Imagine a scene from ‘I’m a nonentity…’ in which the patient may be locked in a small cupboard full of spiders.  The theory is that the person suffers massive panic (3 Fs at its worst) but that this can only last so long.  The adrenal response is short lived and soon the person calms due to lack of adrenaline.  Hopefully in future they will associate this chilled response with spiders rather than panic. Not one to use on children or old people though!

Aversion therapy is probably the most controversial method since it teaches the person to associate their undesirable behaviour with something unpleasant.  For example teaching an alcoholic to associate their favourite tipple with being violently ill.  Usually this involves an emetic (a drug that induces vomiting) being added to their drink.  Controversially this technique was used in early attempts to ‘cure’ homosexuals.  They were shown male pornography and then given the drug.  Needless to say it is mostly ineffective as a treatment.

b. Behaviour modification techniques (based on operant conditioning)

These reward people for appropriate behaviour in the hope that it will be repeated. 

Token economy is a method used in psychiatric hospitals and prisons.  If a patient or inmate (or both!) behaves in a desirable way they are given a token that can be used to purchase tobacco or some other luxury item.  Paul & Lentz (1977) found that schizophrenics treated in this way were more cooperative and needed less medication.

Modelling is based on SLT and can be used to treat phobias.  The patient watches the therapist or other person coping well with a phobic situation such as using a lift or holding spiders.  Afterwards the patient may feel far more comfort