Psychopathology is the study of the nature, development, and treatment of psychological disorders.
There is a lot of stigma surrounding with psychological disorders. Stigma is the destructive beliefs and attitudes that are attributed to groups that are seen as different. It has four elements:
A group of people is labelled, and this label distinguishes them from others.
Society links the label to abnormal and undesirable characteristics.
The label makes people with the label seem different from those without the label.
The label makes the people with the label being unfairly discriminated against.
In this century psychological disorders are still the most stigmatized conditions.
The best definition of psychological disorder has the following aspects:
The individual has the disorder within himself.
There are difficulties in thinking, feeling and/or behaving that are of clinical significance.
It often involves a kind of personal distress.
There is impairment in processes that support mental functioning, such as: psychological, developmental, and/or neurobiological.
The problems are not a culturally specific reaction to an event.
The problems are not only a result of conflict with society.
Each aspect covers a part of psychological disorders. Four aspects will be further discussed.
If a person’s behavior causes him/her enormous distress, the behavior may be classified as disordered. A lot of psychological disorders causes distress, but not all of them.
Disability is an impairment in some important aspects of life. Psychological disorder can also be characterized by disability. Just like distress, a lot of psychological disorders can involve disability, but not all of them. There is no rule to determine which disability belongs to the study of psychopathology and which do not.
If a behavior violates social norms, it can be classified as disordered. This definition of psychological disorders is both too broad and too narrow. It is important to note here that social norms are different among cultures and ethnicity.
The DSM considers developmental, psychological and biological dysfunctions as interrelated.
Demonology is the doctrine that a person can have an evil being dwell within himself, and this being can control his mind and body. This doctrine was mostly seen in times before the age of scientific inquiry. In these times events beyond human control were seen as supernatural.
The first to separate medicine from religion and superstition was Hippocrates. He believed that mental illnesses had natural causes and should be treated as such. He also believed that mental illnesses were caused by a disbalance between four fluids of the body: blood, black bile, yellow bile and phlegm.
When the church gained in influence after the Greek and Roman civilization ceased to exist, the believe in supernatural causes of psychological disorders returned. A lot of psychological disorders was ascribed to witchcraft. Witchcraft was seen as a denial of God.
In Europe there were a lot of hospitals for patients with leprosy until the fifteenth century. The old leprosy hospitals were turned into asylums, when the attention shifted from leprosy to psychological disorders due to disappearance of leprosy in Europe. Asylums were buildings used to give housing and care to people with psychological disorders.
Around 1817, the hospitals provided humane treatment, known as moral treatment. The people in the hospitals had close contact with their supervisors and talked a lot with them. They lived their life as close to normal as possible and took care of themselves most of the time. You can compare the moral treatment to mental hospitals nowadays.
At first the biological approaches. Biological approaches gained credibility when a link was made between infection, damage to the brain and a form of psychopathology. This happened for the first time in 1905, when the microorganisms causing syphilis were discovered. Francis Galton was one of the first to ascribe many behavioral characteristics to heredity as a result of his studies with twins in the late 19th century. He talked about differences in nature (genetics) and nurture (environment). Some researchers became interested in the idea of heritability in psychological disorders and started studying it.
Cerletti and Bini introduced electroconvulsive therapy (ECT), which uses electric shocks in the head to induce seizures. Nowadays, it is used as treatment for schizophrenia and severe depression.
Secondly, the psychological approaches. Breuer was a Viennese physician who thought of the cathartic method. Catharsis is reliving an earlier emotional trauma and by expressing previously forgotten thought about the event, emotional tension was released.
Freud was a younger colleague of Breuer. Freud theorized that psychopathology is caused by unconscious conflicts in the individual. This is often referred to as psychoanalytic theory. He divided the psyche into three main parts: id, ego and superego. The id wants immediate gratification of its basic urges. Also known as the pleasure principle. Tension is produced when the urges of the id are not satisfied.
After six months of life, the ego starts to develop. The contents of the ego are mainly conscious. It needs to deal with reality and thus is driven by the reality principle. The ego mediates between the demands of the id and the demands of reality.
The superego can be seen as a person’s conscience. The superego develops throughout childhood. It incorporates the values of the parents to receive the pleasure of the parents’ approval and avoid the pain of disapproval. Freud and his daughter Anna see defence mechanisms as a strategy of the ego to protect itself from anxiety. There are several forms of defence mechanisms.
Psychoanalysis
Psychoanalysis is the psychotherapy based on Freud’s theory. The therapist’s goal is to understand the early-childhood experiences of the patient, the nature of important relationships, and the patterns in current relationships. The therapist pays attention to emotional and relational themes that surface again and again. A key aspect of psychoanalytic therapy is the analysis of transference. The responses of a patient to his analyst sometimes seem to reflect ways of behaving toward important people in the patient’s past. This is what transference is.
Jung was a Swiss psychiatrist who proposed that a part of the unconscious is common to all people. That part is called collective unconscious. Alfred Adler is known as the founder of individual psychology. An important part of his work was on helping people change their dysfunctional ideas and expectations.
Freud’s influence is most visible in the next three well-known assumptions:
Adult personality is partly shaped by childhood experiences. The focus lies often on the parent-child relationships.
Behavior is also influenced by unconscious processes.
It is not always obvious what causes human behavior or what the purpose is of one’s behavior.
Behaviorism
Observable behavior is the center of behaviorism rather than consciousness is of mental functioning. The behaviorist approach was influenced by three types of learning:
Classical conditioning. A neutral stimulus is linked to another stimulus (unconditioned stimulus, UCS) that automatically elicits a certain response (unconditioned response, UCR). The neutral stimulus becomes a conditioned stimulus (CS) after repeated trials. The conditioned stimulus elicits the same response (conditioned response, CR).
Operant conditioning. Thorndike’s law of effect states that if behavior is followed by consequences that are satisfying the individual, that behavior will be repeated. In contrast, behavior with unpleasant consequences will be discouraged. Skinner formulated the following reinforcements. Positive reinforcement is increasing the change a certain behavior will re-occur by presenting a pleasant event. Negative reinforcement strengthens a reaction by the removal of an unpleasant event.
Modelling. Modelling is learning via watching and imitating others.
Behavior theory is based on the principles of classical and operant conditioning. In this kind of therapy, the clinicians try to change behavior, feelings and thoughts by the use of methods and discoveries made by experimental psychologists. A disadvantage of the behavioral approach is that there was no room for emotion and cognition.
Cognitive therapy emphasizes the idea that a major determinant in psychological disorders is how people see themselves and the world. According to the cognitive approach, people feel, think and behave.
There are different kinds of mental health professionals: clinical psychologists (study of human behaviour), psychiatrists (medical degree), psychiatric nurses and social workers (focus on psychotherapy).
