PSYCH

1. PSYCH By: Taylor Cordle, Travis Brown and Drew Sibeveih

2. Dissociative disorder Dissociative disorders are conditions that create disruption in memory, awareness, identity, or perception. Also a separation of the individual’s conscious awareness from previous memories and thought

3. Dissociative amnesia • Dissociative amnesia is characterized by extreme memory loss that is caused by extensive psychological stress • SYMPTOMS: Sudden inability to remember past experiences or personal information • Lack of self knowledge • Occurs more often in women rather than men and occurs after natural disasters and/or post war • Treatments: Psychotherapy, Cognitive Therapy, Medication, Family Therapy, Creative Therapies

4. Dissociative amnesia case study The patient was a 19-year-old male military service member who was hospitalized on two separate occasions after he was found to have toxic salicylate levels. Both times, he presented to a primary care clinic with complaints of nausea, disequilibrium, labored breathing, diaphoresis, and hemetemesis. Laboratory evaluations revealed toxic salicylate levels, but the patient denied ingesting any medication, denied memory loss, and was without psychiatric complaint. He was admitted to the psychiatric ward, where he was noted to be polite but anxious, speaking with a stutter, appearing inhibited in the milieu, and avoiding most interpersonal contact. He continued to deny ingestion of aspirin, despite physical signs and laboratory evidence of overdose. At the time of his second hospitalization, he reported finding an empty aspirin bottle in his room. He was also more forthcoming with some of his current stressors. He shared that he had joined the military after September 11 with a sense of patriotism and the fantasy of serving with “heroes.” He had not anticipated the difficulty he would have separating from his family, nor the disappointment he would experience upon finding that his military peers did not meet his expectations of the idealized hero. He disclosed that he had previously witnessed an assault on his roommate by other service members, who had then made threats against his life. Poisoning was considered, but was deemed unlikely since the perpetrators were in jail pending trial. A benzodiazepine-assisted interview was conducted, but it failed to elicit memories of either ingestion. The patient underwent psychological testing to assist in diagnosis. The Minnesota Multiphasic Personality Inventory, Second Edition (MMPI-2) indicated that he was experiencing a significant level of distress. The validity profile suggested over-reporting of symptoms, which was thought to be related to an inability to express his needs in a more sophisticated manner. The Structured Interview of Reported Symptoms (SIRS) suggested that there was a low probability that he was feigning symptoms, and the most prominent theme in the patient's Rotter Incomplete Sentence Blank (RISB) involved feelings of interpersonal rejection and alienation. The patient was discharged from the inpatient psychiatric ward with an Axis I diagnosis of dissociative amnesia and an Axis II diagnosis of avoidant personality disorder. He remained unable to recall details of the ingestions while hospitalized and in the months that followed, and was eventually discharged from active duty service with no further psychiatric sequelae.

5. Dissociative amnesia video http://vimeo.com/14200344

6. Dissociative Fugue • When a person loses sense of personal identity and aimlessly wanders and often becomes confused and asumes new identity • Confused about who they are • Stress and trauma cause dissociative fugue. • SYMPTOMS: impulsive travel, inability to recall important info, confusion of identity, and distress or maladaptivity • Treatment: Hypnosis, medication and helping someone come to terms with who they are

7. Dissociative Fugue case study A thirty-year-old woman with secondary education, married and employed had left the maternity ward with her baby unnoticed on the fourth day after delivery . The patient didn’t remember this fact after finding her and the infant by the police. The patient had no genetic predisposition in her history. She had suffered head injury in her childhood. Her mother lost two of her siblings (miscarriage and early death of infant). The patient miscarried her first pregnancy, and then she had waited several years for the baby. The second pregnancy was at risk, the labor was premature and the infant was born with palatoschisis. In the maternity ward, the patient had difficulties with feeding the baby. She experienced fear about the baby’s life, as well as the feeling of being neglected by the staff. In the psychiatry ward, the patient did not reveal any symptoms of mental illness. A memory gap covered the period of her flight. She had shown interest in her child and was motivated to nurse him by herself. The tendency to use immature defence mechanisms (denial and suppression), as well as mild cognitive dysfunctions were observed in psychological testing. Dissociative fugue was diagnosed.

8. Dissociative Fugue video http://vimeo.com/52456238 –

9. Dissociative Identity Disorder (DID) • Formerly called multiple personality disorder • Disruption of Identity/Memory, awareness, and perception • SYMPTOMS: Depressions or mood swings, Severe headaches, unexplained changes in eating, amnesia, Hallucinations, Anxiety attacks Through multiple tests DID is diagnosed such as x-ray tests and blood test can classify someone as a

10. DID case study Mike (name changed) is a fifty-five year old who gave the following history: The patient was born female to a mother who was a famous show person. The father died shortly after her birth. The mother gave the little girl to another very well known family to raise. The patient now relates that she (as a female child) was severely sexually abused throughout childhood. She says the adopted father would rape her and the step-mother gave her enemas for punishment. When she was nine years old, she confided in a teacher whom she says "got fired for trying to help her." She felt since the adopted parents were so prominent and powerful in the community, there was no hope for rescue. The patient remembers dissociating since age six. She knew that she lost time and sometimes found herself in the boys' line instead of the girls' line at school. The patient knew there were male alter personality states who were good in ice hockey and other activities. At age 11 her biological mother took her back. She was aware of the time lapses but said it was easy to hide them. "If you acted funny, well, people thought you were a show person." There were seven or eight personalities than, 32 or 33 now. Two male alters, John and Mike, began to dominate. The patient cross-dressed for 11 years most of the time. There were simultaneously existing female alters, one who designed jewelry. The patient went to a gender dysphoria clinic in Jacksonville, Florida, where she withheld information about dissociating. Mike and John passed all the tests. Surgeries were done in 1975, 1976 and 1977. In 1986 the patient married a Swiss woman. He subsequently developed diabetes and had a nervous breakdown in 1988 and again in 1989. It was during this last hospitalization that the patient was finally diagnosed DID with psychological testing though it was suspected by his therapist one year before. He now keeps a calendar of time, tries to be more aware and co-conscious with other alters. He is on disability for diabetes and knee replacement, is dating a woman who was also sexually abused, and is in therapy. Two of the 32 male alters are Mike and John and two female alters are Michelle and Jackie. Michelle has a very feminine voice and is mildly suicidal. Jackie is eight years old, has a childlike voice, and likes to play with Barbie Dolls.

11. DID video http://vimeo.com/38762896

12. Psychotherapy

13. Psychotherapy Definition: The treatment of mental disorders by psychological rather than medical means. A few professions involved in psychotherapy: Counselors, Clinical social workers, and any other type of therapist

14. Psychodynamic Therapies A form of depth psychology, the primary focus of which is to reveal the unconscious content. Could be the manifest or latent meaning of a dream and to establish a reason why they are that way.

15. Psychoanalysis and Dream Analysis • Psychoanalysis: The method of psychological therapy originated by Sigmund Freud in which free association, dream interpretation, and analysis of resistance and transference are used to explore repressed or unconscious impulses, anxieties, and internal conflicts, in order to free psychic energy for mature love and work. • It is based on the concept that individuals are unaware of the many factors that do cause their behavior. • It is our minds way of telling us that we are affected by factors in the environment and we learn from our peers, parents, and how society conforms us.

16. Types of Therapies

17. Contemporary Psychodynamic Therapies • Uses psycho and dream analysis to explain the manifest and latent meaning of our unconscious thoughts or dreams • http://www.youtube.com/watch?v=1Vs8uE8_02E • Psychodynamic therapy, also known as insight-oriented therapy, focuses on unconscious processes as they are manifested in a person’s present behavior. The goals of psychodynamic therapy are a client’s self-awareness and understanding of the influence of the past on present behavior. In its brief form, a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from past dysfunctional relationships and manifest themselves in the need and desire to abuse substances.

18. Humanistic Therapies • The humanist movement in general also focuses on the idea that people are innately good and tend toward goodness. In a humanistic therapy context, there is presumption that the true nature of the human is to want to improve, understand himself, and reach high levels of self-perception. This type of thinking influences many methods of therapy today. • Using Maslow’s Hierarchy of needs we can establish therapy methods for slight medical problems like depression or even dysthymic depression. • Operant and classical conditioning are psychological techniques used by psychologists, therapists, counselors and social workers to help clients overcome psychological problems and issues. Though operant and classical conditioning differ in many ways, they also have important similarities. • Conditioning techniques used in business corporations usually give that employee good morale to help them be a top performer and work at a higher rate so that the company can thrive and give that employee a sense of fulfillment

19. Cognitive Therapies and Techniques • Cognitive Therapies Main Focus • All-or-Nothing Thinking: Failing to recognize that there may be some middle ground. Characterized by absolute terms like always, never, and forever. • Overgeneralization: Taking an isolated case and assuming that all others are the same. • Mental Filter: Mentally singling out the bad events in one's life and overlooking the positive. • Disqualifying the Positive: Treating positive events like they don't really count. • Jumping to Conclusions: Assuming the worst about a situation even though there is no evidence to back their conclusion. • Magnification and Minimization: Downplaying positive events while paying an inordinate amount of attention to negative ones. • Emotional Reasoning: Allowing your emotions to govern what you think about a situation rather than objectively looking at the facts. • Should Statements: Rigidly focusing on how you think things should be rather than finding strategies for dealing with how things are. • Labeling and Mislabeling: Applying false and harsh labels to oneself and others. Personalization: Blaming yourself for things that are out of your control.

20. What Cognitive Therapy is used for? • Effective treatment for depression in comparison to anti-depressant drugs and reduces the relapse rate of anti-depressants. There • has also been instances of cognitive therapy that has shown that adolescent depression was treated with cognitive therapy

21. Ellis’s Rational-Emotive Behavior Therapy • A comprehensive therapy which focuses on resolving emotional and behavioral problems and disturbances that enable people to live and lead happier and/or more fulfilling lives. • Focus of REBT is to help the client to understand the connection between their irrational beliefs and present problems • Link to Case Study: http://www.counsellingconnection.com/index.php/2009/09/07/a-case-using-rational-emotive-behaviour-therapy/

22. Therapy Integration • Postural Restoration is an innovative therapy that focuses on the influence of posture and correct body balance as the foundation for healthy living. Postural Restoration therapists assess postural imbalance and movement dysfunction in the areas of respiration, spinal orientation and postural alignment to treat the body as a whole. One cause of imbalance and dysfunction is overusing your dominant side and over developing muscle on that side compared to your opposite side. • Our treatment is based on correcting improper movement patterns, restoring proper breathing and maximizing proper posture and position, to improve ease of movement for function and eliminate strain, pain and degeneration.

23. Sociocultural Approach

24. Sociocultural Approach & Issues in Treatment Sociocultural Approach- An approach to psychology that examines the ways in which social and cultural environments influence behavior. Group Therapy • Usually involves small groups • One or more therapists in the group • Includes things such as support groups for various things Examples: (Anger Management, art therapy, etc.) Family & Couples Therapy • Deals with a variety of issues from family issues to relationship/marital issues • It deals with short and long term issues • Ranges anywhere from 1-24 sessions with therapist

25. Sociocultural Approach & Issues in Treatment Self Help Support Groups • Used to help a person’s mental or physical well being • Also for help with mental illness • Many Self Help groups throughout the world Examples: Emotions Anonymous, Depression and Bipolar Support Alliance, etc Community Mental Health • Provides mental health services to people in the area • Offered in many ways such as in or out of the facility or at home • Offered for people of all ages • 24-hour service for a therapist

26. Sociocultural Approach & Issues in Treatment Cultural Perspective- A composite set of attitudes, principles or ideas belonging to a cultural group. This perspective plays a role in treatments because some cultures have different ways of life, and ways of treatment. Ethnicity and gender- Classifications of people. There are many ethnicities throughout the world. In psychology different ethnicities and genders can play a role on therapy. Some people of different ethnicities or genders could be more sensitive to different things.

27. Sociocultural Approach & Issues in Treatment The Effectiveness of Psychotherapy • Very controversial topic in psychology • It’s short-term effects are helpful, but the issue comes about two to three years later • It helps more depending on what’s wrong with the patient • There are many flaws to the concept Research • Dr. Frederick Neuman said in an article that Psychotherapy may help the patient for up to two to three years but after they could experience more problems with the issue. • 70% improved, 40% received a placebo to help them

28. Sociocultural Approach & Issues in Treatment Common Therapy in Effective Psychotherapy • Therapist motivates the patient to keep coming for treatment • Therapist increases their ability of mastery and competence • Help with arousing their emotions The Therapeutic Alliance • This is the relationship the client and therapist share • If the client does not have confidence that the therapist can not help them, they will not improve • Some patients and therapists engage in rituals to help their bond

29. Sociocultural Approach & Issues in Treatment The Client as an Essential Factor • They have conducted studies to help predict the outcome of the patient • The more participation the client gives the quicker they can improve • Therapists use the patient's strengths, abilities, skills, and motivations to help them improve • They try to bring their strengths into the forefront of their lives Therapies and Health and Wellness • Studies have shown that therapy can help people with the effects of psychological disorders • For example, when someone has cancer therapy can help them cope with the stresses of the disease • Psychotherapy has played a huge role on people with diseases

30. Sociocultural Approach & Issues in Treatment Well-Being Therapy • A short term, problem focused treatment encouraging patients to think positively • The first step to this is realizing that you have a lot of positive things happening in your life • They note even the small pleasures such as having a nice conversation with a friend • Effective treatment to increase a person’s mood, and help them be more optimistic • http://www.thewellbeingtherapycentre.co.uk/is-counselling-in-milton-keynes-right-for-me/

31. What we did Drew- was responsible for all of the Dissociative disorders. Got all of the pics, videos and case studies for the topic as well as the guided notes. Taylor- Responsible for the Sociocultural approach and the issues on the topic and the video and case study Travis- Psychotherapy video and case study that went into my part plus made guided notes

32. Reference "MedlinePlus - Health Information from the National Library of Medicine." U.S National Library of Medicine. U.S. National Library of Medicine, n.d. Web