Fringe Psychology
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The mind is an interesting phenomenon. Physicists reckon the big bang occurred billions of years ago, and since then, a multitude of developments have occurred. The cosmos has formed. Galaxies have come into being. Solar systems have manifested, and planets. Earth is one of those planets.
Life arose. The earth stewed, for several billion years. At some point, animals evolved neurons, and eventually collections of neurons, now referred to as "brains". Fish evolved. Huge lizards, perhaps both peaceful and violent, roamed the earth. They mostly died out; we have alligators now, and if you go to Florida, you can eat them.
Furry animals evolved. From these furry animals human-like animals evolved; eventually, humans evolved. For many thousands of years they did not do a whole lot. They ate, mated, and died. Eventually the population exploded; technology advanced. Agriculture reached a point where humans started to have a lot of spare time, and with this spare time humans began to study things not directly related to their immediate survival. Psychology is one of these things.
This book assumes you have a general understanding of what psychology is and what it is not. Perhaps you've taken some introductory courses in college.
Let's refresh your memory.
Psychology is an academic or applied discipline involving the scientific study of mental processes such as perception, cognition, emotion, personality, behavior, and interpersonal relationships. Psychology also refers to the application of such knowledge to various spheres of human activity, including problems of individuals' daily lives and the treatment of mental health problems.
History of Psychology
editIn 1879, Wilhelm Wundt (1832-1920), known as "the father of psychology", founded a laboratory for the study of psychology at Leipzig University in Germany. The American philosopher William James published his seminal book, Principles of Psychology, in 1890, laying the foundations for many of the questions that psychologists would focus on for years to come. Other important early contributors to the field include Hermann Ebbinghaus (1850–1909), a pioneer in the experimental study of memory at the University of Berlin; and the Russian physiologist Ivan Pavlov (1849–1936), who investigated the learning process now referred to as classical conditioning.
Meanwhile, during the 1890s, the Austrian physician Sigmund Freud, who was trained as a neurologist and had no formal training in experimental psychology, had developed a method of psychotherapy known as psychoanalysis. Freud's understanding of the mind was largely based on interpretive methods and introspection, and was focused in particular on resolving mental distress and psychopathology. Freud's theories became very well-known, largely because they tackled subjects such as sexuality and repression as general aspects of psychological development. These were largely considered taboo subjects at the time, and Freud provided a catalyst for them to be openly discussed in polite society. Although Freud's theories are only of limited interest in modern academic psychology departments, his application of psychology to clinical work has been very influential.
Behaviorism reigned as the dominant model in psychology throughout the first half of the 20th century, largely due to the creation of conditioning theories as scientific models of human behavior, and their successful application in the workplace and in fields such as advertising and military science.
Goals of Psychology
editGoals of psychology include:
Psychology describes and attempts to explain consciousness, behavior and social interaction. Empirical psychology is primarily devoted to describing human experience and behavior as it actually occurs. In the past 20 years or so psychology has begun to examine the relationship between consciousness and the brain or nervous system. It is still not clear in what ways these interact: does consciousness determine brain states or do brain states determine consciousness - or are both going on in various ways? Perhaps to understand this you need to know the definition of "consciousness" and "brain state" - or is consciousness some sort of complicated 'illusion' which bears no direct relationship to neural processes? An understanding of brain function is increasingly being included in psychological theory and practice, particularly in areas such as artificial intelligence, neuropsychology, and cognitive neuroscience.
Various schools of thought have argued for a particular model to be used as a guiding theory by which all, or the majority, of human behavior can be explained. The popularity of these has waxed and waned over time. Some psychologists may think of themselves as adherents to a particular school of thought and reject the others, although most consider each as an approach to understanding the mind, and not necessarily as mutually exclusive theories.
Psychology is an extremely broad field, encompassing many different approaches to the study of mental processes and behavior. Below are the major areas of inquiry that comprise psychology, divided into fields of research psychology and fields of applied psychology.
Although modern psychology attempts to be a scientific endeavour, the field has a history of controversy. Some criticisms of psychology have been made on ethical and philosophical grounds. Some have argued that by subjecting the human mind to experimentation and statistical study, psychologists objectify persons. Because it treats human beings as things, as objects that can be examined by experiment, psychology is sometimes portrayed as dehumanizing, ignoring or downplaying what is most essential about being human. This criticism has come from within the field as well, particularly by existential and humanistic psychologists.
- Not everyone is happy about psychology
A common criticism of psychology concerns its fuzziness as a science. Philosopher Thomas Kuhn suggested in 1962 that psychology is in a pre-paradigmatic state, lacking the agreement on facts found in mature sciences such as chemistry and physics. Because some areas of psychology rely on "soft" research methods such as surveys and questionnaires, critics have claimed that psychology is not as scientific as psychologists assume. Methods such as introspection and psychoanalysis, used by some psychologists, are inherently subjective. Objectivity, validity, and rigour are key attributes in science, and some approaches to psychology have fallen short on these criteria. On the other hand, greater use of statistical controls and increasingly sophisticated research design, analysis, and statistical methods, as well as a decline (at least within academic psychology departments) in the use of less scientific methods, have lessened the impact of this criticism to some degree.
There is also concern from researchers about a perceived scientific gap between empirically based practices. Exponents of evidence-based approaches to psychological practice say that "over the past several decades, the fields of clinical psychology, psychiatry, and social work have borne witness to a widening and deeply troubling gap between science and practice" and "less and less of what researchers do finds its way into the consulting room, and less and less of what practitioners do derives from scientific evidence." Moreover there are many "unvalidated and sometimes harmful psychotherapeutic methods" that have been widely adopted by the profession.
Psychology differs from the other social sciences (e.g., anthropology, economics, political science, and sociology) due to its focus on experimentation at the scale of the individual, as opposed to groups or institutions. Historically, psychology differed from biology and neuroscience in that it was primarily concerned with mind rather than brain, a philosophy of mind known as dualism. However, modern psychological science incorporates physiological and neurological processes into its conceptions of perception, cognition, behavior, and mental disorders.
This book goes beyond a general introduction of psychology and begins to introduce the reader to different topics in psychology. A general understanding of basic psychological principles is presumed.
For the time being, content will be copied to this page, and at a point where it seems prudent, the content will be organized in a more succinct manner.
Thomas Szasz
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Dr. Thomas Stephen Szasz (born April 15, 1920 in Budapest, Hungary), is Professor Emeritus of Psychiatry at the State University of New York Health Science Center in Syracuse, New York. He is a prominent figure in the antipsychiatry movement, a well-known critic of the moral and scientific foundations of psychiatry, and of the social control aims of medicine in modern society, as well as of scientism. Szasz is affiliated with Scientology's anti-psychiatric organizations, though he does not belong to the church itself. He is well known for his books, The Myth of Mental Illness (1960) and The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement which set out some of the arguments with which he is most associated.
While people behave and think in ways that are very disturbing, this does not mean they have a disease. To Szasz, people with mental illness have a "fake disease," and these "scientific categories" are in fact used for power controls. Schizophrenia is "the sacred symbol of psychiatry". To be a true disease, the entity must somehow be capable of being approached, measured, or tested in scientific fashion. According to Szasz, disease must be found on the autopsy table and meet pathological definition instead of being voted into existence by members of the American Psychiatric Association. Mental illnesses are "like a" disease, argues Szasz, putting mental illness in a semantic metaphorical language arts category.
Psychiatry, through various Mental Health Acts has become the secular state religion according to Thomas Szasz. It is a social control system, which disguises itself under the claims of scientificity. The notion that biological psychiatry is a real science or a genuine branch of medicine has been challenged by other critics as well, such as Michel Foucault in Madness and Civilization (1961).
Ego Psychology
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There are different ways of viewing the mind and consciousness. Ego psychology is one of these ways. Many practitioners incorporate ego psychology into their paradigm of the mind and correspondingly, their practice.
The central functions of the ego were traditionally seen as reality-testing, impulse-control, judgment, affect tolerance, defence, and synthetic functioning. An important conceptual revision to Freud's structural theory was made when Heinz Hartmann argued that the healthy ego includes a sphere of autonomous ego functions that are independent of mental conflict. Memory, motor coordination, and reality-testing, for example, ought to be able to function without the intrusion of emotional conflict. According to Hartmann, psychoanalytic treatment aims to expand the conflict-free sphere of ego functioning. By doing so, Hartmann believed, psychoanalysis facilitates adaptation, that is, more effective mutual regulation of ego and environment.
Ego psychology is often confused with self psychology, which emphasizes the strength and cohesion of a person's sense of self. Although some ego psychologists write about the self, they usually distinguish the self from the ego. They define the ego as an agency comprised of mental functions, whereas the self is an internal representation of how one sees oneself. In ego psychology, emphasis is placed on understanding the functioning of the ego and its conflicting relations to the id, superego, and reality, rather than on the subjective sense of self.
Some have also accused Hartmann of proposing a conformist psychology in which the ego is considered most healthy when it adjusts to the status quo. Hartmann claimed, however, that his aim was to understand the mutual regulation of the ego and environment rather than to promote adjustment of the ego to the environment.
Also, Jacques Lacan, a prominent psychoanalyst, had a certain disdain for ego-psychology. He took issue with the movement insofar as his form of psychoanalysis focuses on the unconscious. It also splits the ego and theorizes how one never has a true relation to their ego because it is an illusionary relationship to an ideal image, and is a product of the unconscious itself.
After Freud, a number of prominent psychoanalytic theorists began to elaborate on Freud's functionalist version of the ego. They put much effort into theorizing the ego's various functions and how they can be impaired in psychopathology. Much of their work focused around strengthening the ego so it could better cope with the pressures from the id, super-ego, and society in general.
David Rapaport systematized Freud's structural model and Hartmann's revisions of it. Rapaport argued that the central principle of Freudian theory is that mental processes are motivated and shaped by the need to discharge tension. Clarifying Freud's work, Rapaport portrayed the mind as divided into drives and structures. Drives contain fluid energy that pushes for rapid discharge through the immediate gratification of wishes. Because it is rare that wishes can actually be immediately gratified, the mind develops the capacity to delay gratification or achieve it through detours. Consequently, drive energy becomes tied up in the relatively stable mental structures comprising the ego. Rapaport defined structures as mental organizations with a slow rate of change, slow in comparison with the more fluid drives.
The clinical technique most commonly associated with ego psychology is defense analysis. Through clarifying, confronting, and interpreting the typical defense mechanisms a patient uses, ego psychologists hope to help the patient gain control over these mechanisms.
Arlow and Brenner argued that Freud's earlier theory of the conscious, preconscious, and unconscious systems of the mind ought to be abandoned, and the structural model used as the sole psychoanalytic theory of the mind.
Recent ego psychological authors have taken the approach in a number of directions. Some, such as Charles Brenner, have contended that the structural model should be abandoned and psychoanalysts should focus exclusively on understanding and treating mental conflict. Others, such as Frederic Busch, have argued for an increasingly nuanced and sophisticated concept of the ego.
Many authors have criticized Hartmann's conception of a conflict-free sphere of ego functioning as both incoherent and inconsistent with Freud's vision of psychoanalysis as a science of mental conflict. Freud believed that the ego itself takes shape as a result of the conflict between the id and the external world. The ego, therefore, is inherently a conflicting formation in the mind. To state, as Hartmann did, that the ego contains a conflict-free sphere may not be consistent with key propositions of Freud's structural theory.
Existential Therapy
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Existential therapy focuses on the development of a patient/client’s self-awareness by looking deeply into the issues of our aloneness, meaninglessness, and mortality. The therapist emphasizes the patient/client’s ability to freely make choices in the present, not under the influence of deterministic aspects or past conditioning. The existentialist attempts to convert meaninglessness into meaningfulness, giving the patient/client the courage to make his or her own healthy choices and to lead a socially rewarding life. Existential therapists have their own unique views about human nature, mental dysfunction, wellness, and therapeutic techniques.
Existential psychotherapy is partly based on the existential belief that human beings are alone in the world. This aloneness leads to feelings of meaninglessness which can be overcome only by creating one’s own values and meanings. We have the power to create because we have the freedom to choose. In making our own choices we assume full responsibility for the results and blame no one but ourselves if the result is less than what was desired. The psychotherapist helps his or her patients/clients along this path: to discover why the patient/client is overburdened by the anxieties of aloneness and meaninglessness, to find new and better ways to manage these anxieties, to make new and healthy choices, and to emerge from therapy as a free and sound human being.
Although humans are essentially alone in the world, we long to be connected to others. We want to have meaning in their lives while they have meaning in ours, but ultimately we must come to realize that we cannot depend on others for our validation, and with that realization we finally acknowledge and understand that we are fundamentally alone. The result of this revelation is anxiety in the knowledge that our validation must come from within and not from others. This anxiety is a positive thing, since it makes us aware of the limits of human existence and this makes us capable of reflecting on life instead of living thoughtlessly.
Because we are alienated and isolated our lives are also meaningless. Nothing exists which is greater than ourselves, therefore there are no external sources of values and absolutes from which we can draw. Taken to an extreme we might conclude that there is nothing for which to live, however, there is hope in the possibility of creating our own values and our own meanings and applying them to our condition, giving us feelings of significance and purpose that are strong enough to carry us through life. This freedom we have to choose our own values is another source of anxiety: we must summon the requisite strength and courage to choose our life-meaning and hold fast to it, undoubtedly a task which many find difficult.
Human beings are also mortal. As we come to grips with the fact that our lives are limited, we develop even more anxiety: we are afraid of death. The knowledge that at some point in the future we will cease to be, while frightening, is at the same time invigorating because it is relevant right now. The juxtaposition of life and death is one thing that does give us some certainty.
Finally, humans are responsible. Being isolated, alone, and free to choose means that one cannot assign blame for his or her problems to someone else. The individual alone makes the choices and therefore is responsible for the outcomes. At any point we are free to make different choices and thus re-invent ourselves; we are at once the architect, the planner, and the builder of our lives, throughout our lives.
The existentially-oriented psychotherapist guides his or her patients/clients to confront life’s anxieties. If the patient/client has not been fully exercising the freedom to choose, the counselor will lead a discovering into how and why he or she is stuck. Perhaps the patient/client has been allowing others to make the important decisions which he or she alone should be making. Possibly the patient/client is afraid to take the risks required to grow and is instead choosing an easy and non-threatening path. The counselor will encourage his or her patient/clients to reflect on the aloneness and meaninglessness of life, and to understand that they must find their own ways to cope with these anxieties. The counselor does not try to eliminate these anxieties, but instead encourages the patient/client to face them head-on. Alternative paths can be explored together. The risks entailed with these paths can be evaluated, and then the patient/client will be able to make new, more authentic choices. The existential counselor is not overly concerned with the patient's/client’s past. Instead, the emphasis is on the choices to be made in the present. The counselor and the client may reflect upon how the client has answered life’s questions in the past, but then attention shifts to searching for a new and increased awareness in the present and enabling a new freedom and responsibility to act.
It is possible for people to face the anxieties of life head-on and embrace the human condition of aloneness, to revel in the freedom to choose and take full responsibility for their choices. They courageously take the helm of their lives and steer in whatever direction they choose; they have the courage to be. One does not need to arrest feelings of meaninglessness, but can choose new meanings for their lives. By building, by loving, and by creating one is able to live life as one's own adventure. One can accept one's own mortality and overcome fear of death.
Rollo May
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Rollo May (April 21, 1909, Ada, Ohio - October 22, 1994, Tiburon, California) was the best known American existential psychologist, authoring the influential book Love and Will in 1969.
Although he is often associated with humanistic psychology, he differs from other humanistic psychologists such as Maslow or Rogers in showing a sharper awareness of the tragic dimensions of human existence. May was a close friend of the U.S. German-born theologian Paul Tillich. His works include Love and Will and The Courage to Create, the latter title honoring Tillich's The Courage to Be.
May was influenced by American humanism, and interested in reconciling existential psychology with other approaches, especially Freud’s.
May uses some traditional existential terms in a slightly different fashion than others, and he invents new words for traditional existentialist concepts. Destiny, for example, could be "thrownness" combined with "fallenness"— the part of our lives that is determined for us, for the purpose of creating our lives. He also used the word "courage" to signify authenticity in facing one’s anxiety and rising above it.
He saw certain "stages" of development:
- Innocence – the pre-egoic, pre-self-conscious stage of the infant. The innocent is only doing what he or she must do. However, an innocent does have a degree of will in the sense of a drive to fulfill needs.
- Rebellion – the rebellious person wants freedom, but has yet no full understanding of the responsibility that goes with it.
- Decision- the person is in a transition stage in their life where they need to break away from their parents and settle into the ordinary stage. In this stage they must decide what path their life will take along with fulfilling rebellious needs from the rebellious stage.
- Ordinary – the normal adult ego learns responsibility, but finds it too demanding, and so seeks refuge in conformity and traditional values.
- Creative – the authentic adult, the existential stage, beyond ego and self-actualizing. This is the person who, accepting destiny, faces anxiety with courage.[citation needed]
These are not stages in the traditional sense. A child may certainly be innocent, ordinary or creative at times; an adult may be rebellious. The only attachment to certain ages is in terms of salience: rebelliousness stands out in the two year old and the teenager.
May perceived the sexual revolution of the 1960s and 1970s, as well as commercialization of sex and pornography have influenced society and planted the idea in the minds of adults that love and sex are no longer directly associated. According to May, emotion has become separated from reason, making it socially acceptable to seek sexual relationships and avoid the natural drive to relate to another person and create new life. May believed the awakening of sexual freedoms can lead modern society to dodge awakenings at higher levels. May suggests that the only way to turn around the cynical ideas that characterize our generation is to rediscover the importance of caring for another, which May describes as the opposite of apathy.
His first book, The Meaning of Anxiety, was based on his doctoral dissertation, which in turn was based on his reading of the 19th century philosopher Søren Kierkegaard. His definition of anxiety is "the apprehension cued off by a threat to some value which the individual holds essential to his existence as a self" (1967, p. 72.) He also quotes Kierkegaard: "Anxiety is the dizziness of freedom". In 1956, he edited the book Existence with Ernest Angel and Henri Ellenberger. Existence helped introduce existential psychology to the US.
Fritz Perls
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Fritz Perls was born in Berlin in 1893. He was expected to go into law like his distinguished uncle Herman Staub, but instead studied medicine. After a time spent in the German Army in the World War I trenches, he graduated as a doctor. Perls gravitated to psychiatry and the work of Freud and the early Wilhelm Reich.
In 1930 he married Lore Posner, they had two children together, Renate and Stephen.
In 1933, soon after the Hitler regime came into power, Fritz Perls, Laura and their eldest child Renate fled to the Netherlands, and one year later they emigrated to South Africa, where Fritz Perls wrote Ego, Hunger, and Aggression in 1941 (published 1942). His wife Laura contributed to the book, but she is usually not mentioned. In 1942 Fritz went into the South African army where he served as an army psychiatrist with rank of captain until 1946.
The Perls moved to New York in 1946, where Fritz Perls first worked briefly with Karen Horney, and then with Wilhelm Reich. Around 1947, Perls asked author Paul Goodman to write up some hand-written notes, which together with contributions from Ralph Hefferline and Goodman, were published as Gestalt Therapy.
Fritz Perls moved to California in 1960, where he continued to offer his workshops as a member of the Esalen Institute in Big Sur, until he left the USA to start a Gestalt community at Lake Cowichan on Vancouver Island, Canada, in 1969. Fritz Perls died almost a year later on 14 March 1970 in Chicago of heart failure after surgery at the Louis A. Weiss Memorial Hospital in Chicago.
Social Psychology
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The terms thoughts, feelings, and behaviors include all of the psychological variables that are measurable in a human being. The statement that others may be imagined or implied suggests that we are prone to social influence even when no other people are present, such as when watching television, or following internalized cultural norms.
Social psychologists typically explain human behavior as a result of the interaction of mental states and immediate, social situations. In general, social psychologists have a preference for laboratory based, empirical findings. Their theories tend to be specific and focused, rather than global and general.
Social psychologists have studied attitude formation, the structure of attitudes, attitude change, the function of attitudes, and the relationship between attitudes and behavior. Because people are influenced by the situation, general attitudes are not always good predictors of specific behavior. For a variety of reasons, a person may value the environment and not recycle a can on a particular day. Attitudes that are well remembered and central to our self-concept, however, are more likely to lead to behavior, and measures of general attitudes do predict patterns of behavior over time.
The topic of persuasion has received a great deal of attention in recent years. Persuasion is an active method of influence that attempts to guide people toward the adoption of an attitude, idea, or behavior by rational or emotive means. Persuasion relies on "appeals" rather than strong pressure or coercion. Numerous variables have been found to influence the persuasion process, and these are normally presented in four major categories: who said what to whom and how.
- The Communicator, including credibility, expertise, trustworthiness, and attractiveness.
- The Message, including varying degrees of reason, emotion (such as fear), one-sided or two sided arguments, and other types of informational content.
- The Audience, including a variety of demographics, personality traits, and preferences.
- The Channel, including the printed word, radio, television, the internet, or face-to-face interactions.
Dual process theories of persuasion (such as the Elaboration Likelihood Model) maintain that the persuasive process is mediated by two separate "routes." Persuasion can be accomplished by either superficial aspects of the communication or the internal logic of the message. Whether someone is persuaded by a popular celebrity or factual arguments is largely determined by the ability and motivation of the audience. However, decades of research have demonstrated that deeply held attitudes are remarkably resistant to persuasion under normal circumstances.
Social cognition is a growing area of social psychology that studies how people perceive, think about, and remember information about others. One assumption in social cognition is that reality is too complex to easily discern, and so we see the world according to simplified schemas or images of reality. Schemas are generalized mental representations that organize knowledge and guide information processing. For example, one's schema for mice might include the expectation that they are small, and furry, and eat cheese.
Another major concept in social cognition is attribution. Attributions are the explanations we make for people's behavior, either our own behavior or the behavior of others. An attribution can be either internal or external. Internal or dispositional attributions assign causality to factors within the person, such as ability or personality. External or situational attributions assign causality to an outside factor, such as the weather. Numerous biases in the attribution process have been discovered:
- Fundamental attribution error - the tendency to make dispositional attributions for behavior. The actor-observer effect is a refinement of this bias, the tendency to make dispositional attributions for other people's behavior and situational attributions for our own.
- Just world effect- the tendency to blame victims (a dispositional attribution) for their suffering. This is believed to be motivated by people's anxiety that good people, including themselves, could be victimized in an unjust world.
- Self-serving bias - the tendency to take credit for successes, and blame others for failure. Researchers have found that depressed individuals often lack this bias and actually have more realistic perceptions of reality.
Heuristics are cognitive short cuts. Instead of weighing all the evidence when making a decision, people rely on heuristics to save time and energy. The availability heuristic occurs when people estimate the probability of an outcome based on how easy that outcome is to imagine. As such, vivid or highly memorable possibilities will be perceived as more likely than those that are harder to picture or are difficult to understand, resulting in a corresponding cognitive bias.
There are a number of other biases that have been found by social cognition researchers. The hindsight bias is a false memory of having predicted events, or an exaggeration of actual predictions, after becoming aware of the outcome. The confirmation bias is a type of bias leading to the tendency to search for, or interpret information in a way that confirms one's preconceptions.
The fields of social psychology and personality have merged over the years, and social psychologists have developed an interest in a variety of self-related phenomena. In contrast with traditional personality theory, however, social psychologists place a greater emphasis on cognitions than on traits. Much research focuses on the self-concept, which is a person's understanding of his or her self. The self-concept can be divided into a cognitive component, known as the self-schema, and an evaluative component, the self-esteem. The need to maintain a healthy self-esteem is recognized as a central human motivation in the field of social psychology. Self-efficacy beliefs are an aspect of the self-schema. Self-efficacy refers to an individual's expectation that performance on some task will be effective and successful.
People develop their self-concepts by a variety of means, including introspection, feedback from others, self-perception, and social comparison. By comparison to relevant others, people gain information about themselves, and they make inferences that are relevant to self-esteem. Social comparisons can be either upward or downward, that is, comparisons to people who are either higher in status or ability, or lower in status or ability. Downward comparisons are often made in order to elevate self-esteem.
Self-perception is a specialized form of attribution that involves making inferences about oneself after observing one's own behavior. Psychologists have found that too many extrinsic rewards (e.g. money) tend to reduce intrinsic motivation through the self-perception process. People's attention is directed to the reward and they lose interest in the task when the reward is no longer offered. This is an important exception to reinforcement theory.
An example of cognitive dissonance is smoking. Smoking cigarettes increases the risk of cancer, which is threatening to the self-concept of the individual who smokes. Most of us believe ourselves to be intelligent and rational, and the idea of doing something foolish and self-destructive causes dissonance. To reduce this uncomfortable tension, smokers tend to make excuses for themselves, such as "I'm going to die anyway, so it doesn't matter."
Social influence refers to the way people affect the thoughts, feelings, and behaviors of others. Like the study of attitudes, it is a traditional, core topic in social psychology. In fact, research on social influence overlaps considerably with research on attitudes and persuasion. Social influence is also closely related to the study of group dynamics, as most of the principles of influence are strongest when they take place in social groups.
Conformity is the most common and pervasive form of social influence. It is generally defined as the tendency to act or think like other members of a group. Group size, unanimity, cohesion, status, and prior commitment all help to determine the level of conformity in an individual. Conformity is usually viewed as a negative tendency in American culture, but a certain amount of conformity is not only necessary and normal, but probably essential for a community to function.
The two major motives in conformity are: 1) normative influence, the tendency to conform in order to gain social acceptance, and avoid social rejection or conflict, as in peer pressure; and 2) informational influence, which is based on the desire to obtain useful information through conformity, and thereby achieve a correct or appropriate result. Minority influence is the degree to which a smaller faction within the group influences the group during decision making. Note that this refers to a minority position on some issue, not an ethnic minority. Their influence is primarily informational and depends on consistent adherence to a position, degree of defection from the majority, and the status and self-confidence of the minority members. Reactance is a tendency to assert oneself by doing the opposite of what is expected. This phenomenon is also known as anticonformity and it appears to be more common in men than in women.
A different kind of social influence is the self-fulfilling prophecy. This is a prediction that, in being made, actually causes itself to become true. For example, in the stock market, if it is widely believed that a crash is imminent, investors may lose confidence, sell most of their stock, and actually cause the crash. Likewise, people may expect hostility in others and actually induce this hostility by their own behavior.
A group is two or more people that interact, influence each other, and share a common identity. Groups have a number of emergent qualities that distinguish them from aggregates:
- Norms - implicit rules and expectations for group members to follow, e.g. saying thank you, shaking hands.
- Roles - implicit rules and expectations for specific members within the group, e.g. the oldest sibling, who may have additional responsibilities in the family.
- Relations - patterns of liking within the group, and also differences in prestige or status, e.g. leaders, popular people.
Temporary groups and aggregates share few or none of these features, and do not qualify as true social groups. People waiting in line to get on a bus, for example, do not constitute a group.
Groups also affect performance and productivity. Social facilitation, for example, is a tendency to work harder and faster in the presence of others. Social facilitation increases the likelihood of the dominant response, which tends to improve performance on simple tasks and reduce it on complex tasks. In contrast, social loafing is the tendency of individuals to slack when working in a group. Social loafing is common when the task is considered unimportant and individual contributions are not easy to see.
Social psychologists study a variety of group related, or collective phenomena such as the behavior of crowds. An important concept in this area is deindividuation, a reduced state of self-awareness that can be caused by feelings of anonymity. Deindividuation is associated with uninhibited and sometimes dangerous behavior. It is common in crowds and mobs, but it can also be caused by a disguise, a uniform, alcohol, dark environments, or online anonymity.
Gender Roles
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The process through which the individual learns and accepts roles is called socialization. Socialization works by encouraging wanted and discouraging unwanted behavior. These sanctions by agencies of socialization such as the family, schools, and the communication medium (The Media) make it clear to the child what behavioral norms the child is expected to follow. The examples of the child's parents, siblings and teachers are typically followed. Mostly, accepted behavior is not produced by outright reforming coercion from an accepted social system. In some other cases, various forms of coercion has been used to acquire a desired response or function. In majority of the traditional and developmental social systems, an individual has a choice to what should he or she extent as a conformed representative of a socialization process. In this voluntary process, the consequences can be beneficial or malfunctional, minor or severe for every case by a behavior's socialization influence forming gender roles or expectations institutionalizing gender differences. Typical encouragements and expectations of gender role behavior are not as a powerful difference and reforming social trait to a century ago. Such developments and traditional refineries are still a socialization process to and within family values, peer pressures, at the employment centers and in every social system communication medium (the media).
Still, once someone has accepted certain gender roles and gender differences as an expected socialized behavioral norms, these behavior traits become part of the individual's responsibilities not influential roles in gender relationships on a personal and social levels to the individual's own socializing role or self (identity). Sanctions to unwanted behavior and role conflict can be stressful.
It is observed that even in monolingual, industrial societies like urban North America, some individuals do cling to a "modernized" primordial identity, apart from others and with this a more diverse gender role is recognitized or developed. Some intellectuals, such as Michael Ignatieff, argue that convergence of a general culture does not directly entail a similar convergence in ethnic, social and self identities. This can become evident in social situations, where people divide into separate groups by gender roles and cultural alignments, despite being of an identical "super-ethnicity", such as nationality.
Within each smaller ethnicity, individuals may tend to see it perfectly justified to assimilate with other cultures including sexuality and some others view assimilation as wrong and incorrect for their culture or institution. This common theme, representing dualist opinions of ethnoconvergence itself, within a single ethnic or common values groups is often manifested in issues of sexual partners and matrimony, employment preferences, etc. These varied opinions of ethnoconvergence represent themselves in a spectrum; assimilation, homogenization, acculturation, gender identities and cultural compromise are commonly used terms for ethnoconvegence which flavor the issues to a bias.
Often it's in a secular, multi-ethnic environment that cultural concerns are both minimalised and exacerbated; Ethnic prides are boasted, hierarchy is created ("center" culture versus "periphery") but on the other hand, they will still share a common "culture", and common language and behaviours. Often the elderly, more conservative-in-association of a clan, tend to reject cross-cultural associations, and participate in ethnically similar community-oriented activities. Xenophobes tend to think of cross-cultural contact as a component of gender and assimilation and see this as harmful.
Gender roles have long been a staple of the Nature/Nurture debate: Traditional theories of gender usually assume that one's gender identity, and hence one's gender role, is a natural given. For example, it is often claimed in Western and other societies that women are naturally more fit to look after children. The idea that differences in gender roles originate in differences in biology has found support in parts of the scientific community. 19th-century anthropology sometimes used descriptions of the imagined life of paleolithic hunter-gatherer societies for evolutionary explanations for gender differences. For example, those accounts maintain that the need to take care of offspring may have limited the females' freedom to hunt and assume positions of power.
More recently, sociobiology and evolutionary psychology have explained those differences in social roles by treating them as adaptations. This approach, too, is considered controversial.
A person's gender role is composed of several elements and can be expressed through clothing, behaviour, choice of work, personal relationships and other factors. These elements are not concrete and have evolved through time (for example women's trousers).
Gender roles were traditionally divided into strictly feminine and masculine gender roles, though these roles have diversified today into many different acceptable male or female gender roles. However, gender role norms for women and men can vary significantly from one country or culture to another, even within a country or culture. People express their gender role somewhat uniquely.
Gender role can vary according to the social group to which a person belongs or the subculture with which he or she identifies cultural identity. Historically, for example, eunuchs had a different gender role because their biology was changed.
In many other cases, the elements of convention or tradition seem to play a dominant role in deciding which occupations fit in with which gender roles. In the United States, physicians have traditionally been men, and the few people who defied that expectation received a special job description: "woman doctor". Similarly, there are special terms like "male nurse", "woman lawyer", "lady barber", "male secretary," etc. But in China and the former Soviet Union countries, medical doctors are predominantly women, and in the United Kingdom, Germany and Taiwan it is very common for all of the barbers in a barber shop to be women. Also, throughout history, some jobs that have been typically male or female have switched genders. For example, clerical jobs. Clerical jobs used to be considered a man's job, but when several women began filling men's job positions due to World War II, clerical jobs quickly became dominated by women. It became more feminized, and women workers became known as "typewriters" or "secretaries". There are many other jobs that have switched gender roles, and many jobs are continually evolving as far as being dominated by women or men.
Most feminists argue that traditional gender roles are oppressive for women. They assume that the female gender role was constructed as an opposite to an ideal male role, and helps to perpetuate patriarchy.
For approximately the last 100 years women have been fighting for the same rights as men (especially in the 1960's with second-wave feminism and radical feminism) and were able to make changes to the traditionally accepted feminine gender role. However, most feminists today say there is still work to be done.
Cognitive Psychology
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Cognitive Psychology is the school of psychology that examines internal mental processes such as problem solving, memory, and language. It had its foundations in the Gestalt psychology of Max Wertheimer, Wolfgang Köhler, and Kurt Koffka, and in the work of Jean Piaget, who studied intellectual development in children. Cognitive psychologists are interested in how people understand, diagnose, and solve problems, concerning themselves with the mental processes which mediate between stimulus and response. Cognitive theory contends that solutions to problems take the form of algorithms—rules that are not necessarily understood but promise a solution, or heuristics—rules that are understood but that do not always guarantee solutions. In other instances, solutions may be found through insight, a sudden awareness of relationships.
Cognitive psychology is one of the more recent additions to psychological research, having only developed as a separate area within the discipline since the late 1950s and early 1960s (though there are examples of cognitive thinking from earlier researchers). The cognitive approach was brought to prominence by Donald Broadbent's book Perception and Communication in 1958. Since that time, the dominant paradigm in the area has been the information processing model of cognition that Broadbent put forward. This is a way of thinking and reasoning about mental processes, envisaging them as software running on the computer that is the brain. Theories commonly refer to forms of input, representation, computation or processing, and outputs. Applied to language as the primary mental knowledge representation system, cognitive psychology has exploited tree and network mental models. Its singular contribution to AI and psychology in general is the notion of a semantic network. One of the first cognitive psychologists, George Miller is well-known for dedicating his career to the development of WordNet, a semantic network for the English language. Development began in 1985 and is now the foundation for many machine ontologies.
This way of conceiving mental processes has pervaded psychology more generally over the past few decades, and it is not uncommon to find cognitive theories within social psychology, personality, abnormal psychology, and developmental psychology; the application of cognitive theories to comparative psychology has driven many recent studies in animal cognition.
The information processing approach to cognitive functioning is currently being questioned by new approaches in psychology, such as dynamical systems, and the embodiment perspective.
Because of the use of computational metaphors and terminology, cognitive psychology was able to benefit greatly from the flourishing of research in artificial intelligence and other related areas in the 1960s and 1970s. In fact, it developed as one of the significant aspects of the inter-disciplinary subject of cognitive science, which attempts to integrate a range of approaches in research on the mind and mental processes.
Critical Psychology
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Critical psychology is a branch of psychology that is aimed at critiquing mainstream psychology and attempts to apply psychology in more progressive ways, often looking towards social change as a means of preventing and treating psychopathology. One of Critical Psychology's main criticisms of conventional psychology is how it fails to consider or deliberately ignores the way power differences between social classes and groups can impact the mental and physical well-being of individuals or groups of people.
One of the most important books in the field is the Grundlegung der Psychologie (Foundations of Psychology) by Klaus Holzkamp, who might be considered the theoretical founder of critical psychology. Holzkamp incorporated ideas from Freud´s psychoanalysis and Merleau-Ponty´s phenomenology into his approach. The appeal of critical psychology to socialists is that it is an attempt to come to grips with the social and the historical "conditionality" of human beings. His last major publication before his death in 1995 appeared in 1993 and contained a phenomenological theory of learning from the standpoint of the subject, as well as an extensive analysis on the modern state´s institutionalized forms of "classroom learning" as the cultural-historical context that shapes much of modern learning and sozialization. In this analysis, he heavily drew upon Michel Foucault's Discipline and Punish; in his learning theory, he was inspired by social anthropologists Jean Lave (situated learning) and Edwin Hutchins (distributed cognition).
In the 1960s and 1970s the term radical psychology was used by psychologists to denote a branch of the field which rejected conventional psychology's focus on the individual as the basic unit of analysis and sole source of psychopathology. Instead, radical psychologists examined the role of society in causing and treating problems, and looked towards social change as an alternative to therapy to treat mental illness and as a means of preventing psychopathology. Within psychiatry the term anti-psychiatry was often used and now British activists prefer the term critical psychiatry. Critical Psychology is currently the preferred term for the discipline of psychology keen to find alternatives to the way the discipline of psychology reduces human experience to the level of the individual and thereby strips away possibilities for radical social change.
Starting in the 1990s a new wave of books started to appear on critical psychology, the most influential being the edited book Critical Psychnology by Dennis Fox and Isaac Prilleltensky. Various introductory texts to critical psychology written in the United Kingdom have tended to focus on discourse, but this has been seen by some proponents of critical psychology as a reduction of human experience to language which is as politically dangerous as the way mainstream psychology reduces experience to the individual mind.
There are a now international journals devoted to critical psychology, including the International Journal for Critical Psychology and the Annual Review of Critical Psychology. The journals still tend to be directed to an academic audience, though the Annual Review of Critical Psychology runs as a open-access online journal. There are close links between critical psychologists and critical psychiatrists in Britain through the Asylum Collective. Critical psychology courses and research concentrations are available at Manchester Metropolitan University, Cardiff University, the University of the West of England in Bristol, the University of East London and the University of Adelaide.
One of the criticisms of conventional psychology raised by critical psychology is the inattention to power differentials between different groups - examples include between psychiatrists and patients, wealthy groups and the less financially well-off, or industrial lobbyists and the general public. This inattention to power has resulted in conventional psychology tending to assume that how things are is how they should be, that the current state of affairs is the natural state of things. As a result, conventional psychology has a tendency to uphold the status quo, victim-blame and situate problems within individuals rather than the social context they are embedded in.
Like many critical applications, critical psychology has expanded beyond Marxist roots to benefit from other critical approaches. Consider ecopsychology and transpersonal psychology. Critical psychology and related work has also sometimes been labelled radical psychology and liberation psychology. In the field of developmental psychology, the work of Erica Burman has been influential.
Various sub-disciplines within psychology have begun to establish their own critical orientations.
Critical psychology in the United States and Canada has, for the most part, focused on critiques of mainstream psychology's support for an unjust status quo. No departments of critical psychology exist, though critical perspectives are sometimes encountered in traditional universities, perhaps especially within community psychology programs. North American efforts include the 1993 founding of RadPsyNet Radical Psychology Network, the 1997 publication of Critical Psychology: An Introduction (edited by Dennis Fox and Isaac Prilleltensky), and the action-focused PsyACT (Psychologists Acting with Conscience Together).
The University of KwaZulu-Natal in Durban, South Africa, is one of few worldwide to offer a masters course in critical psychology. For an overview of critical psychology in South Africa, see Desmond Painter and Martin Terre Blanche's article on Critical Psychology in South Africa: Looking back and looking forwards. They have also now started a critical psychology blog.
Community Psychology
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Community Psychology makes use of various perspectives within and outside of Psychology to address issues of communities, the relationships within them, and people's attitudes about them. Through collaborative research and action, community psychologists (practitioners and researchers) seek to understand and to enhance quality of life for individuals, communities, and society. Community psychology takes a public health approach and focuses on prevention and early intervention as a means to solve problems in addition to treatment. Closely related disciplines include Social Psychology, Political Science, and Community development.
Community Psychology found a proposed "conceptual center" in the idea of Psychological Sense of Community (or simply Sense of Community), introduced in 1974 by Seymour Sarason. In 1986 a major step was taken by theoretician David McMillan and operationalizer David Chavis with the publication of their Theory of Sense of Community and Sense of Community Index. Originally designed primarily in reference to neighborhoods, the Sense of Community Index (SCI) can be adapted to study other communities as well, including the workplace, schools, religious communities, communities of interest, etc.
Health Psychology
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Many researchers believe that physical health may be influenced by psychology through a variety of direct and indirect means. There is some evidence that certain negative mental states (such as depression and anxiety) can directly affect physical immunity through production of stress hormones, such as the catecholamines and glucocorticoids. Although this research is widely debated, there is also some indication that negative psychological states may lead to faster disease progression in certain diseases (such as HIV and heart disease) through these direct biological mechanisms. Negative emotional states may also indirectly affect disease processes through their influence on health behaviors. For example, depression has been related to many risk factors for poor health including overeating, smoking, physical inactivity, and poor medication compliance.
Many researchers believe that physical health may be influenced by psychology through a variety of direct and indirect means. There is some evidence that certain negative mental states (such as depression and anxiety) can directly affect physical immunity through production of stress hormones, such as the catecholamines and glucocorticoids. Although this research is widely debated, there is also some indication that negative psychological states may lead to faster disease progression in certain diseases (such as HIV and heart disease) through these direct biological mechanisms. Negative emotional states may also indirectly affect disease processes through their influence on health behaviors. For example, depression has been related to many risk factors for poor health including overeating, smoking, physical inactivity, and poor medication compliance.
- Clinical health psychology (ClHP) adopts a definition reflecting the fact that the field was originally a branch of clinical psychology; it is also a major contributor to the field of behavioral medicine within psychiatry. Clinical practice includes the techniques of education, behavioral change, and psychotherapy; with additional training, a clinical health psychologist can become a medical psychologist in certain countries and, consequently, prescribe medication.
- Organizational health psychology (OHP) is the use of health psychology knowledge and techniques as applied to health and illness in the workplace, at the individual and group levels.
- Public health psychology (PHP) tries to determine causation between psychological factors and health for the population as a whole, and present this information to educators, policy makers, and health care practitioners for the promotion of better public health. It gives prominence to population-level health outcomes and interventions. It is allied to other disciplines in the fields of global and public health including epidemiology, nutrition, genetics and statistics. Interventions are determined and "targeted" using population health statistics which evaluate health needs of various population groups as perceived by health authorities and policy makers. These interventions are "top-down" and tend to have varying levels of effectiveness across diverse population groups.
- Community health psychology (CoHP) approach tries to understand what is happening at a local level. Interventions are generated collaboratively with coalitions of stakeholders and are aimed to facilitate community empowerment to improve the physical and/or mental health of local people outside of any formal involvement of the health care system.
- Critical health psychology (CrHP) is concerned with the distribution of power and the impact of power differentials on health experience and behaviour, health care systems and health policy. It prioritises social justice and the universal right to health of peoples of all races, genders, ages, and socioeconomic positions. A major concern is health inequalities. The CrHPist is an agent of change, not simply an analyst or cataloguer. The field was developed through the foundation of the Journal of Health Psychology and the International Society of Critical Health Psychology.
Health psychology is both a theoretical and applied field. Many different methods are employed including questionnaires, interviews, controlled studies, and actions designed to bring about change using "action research". Health psychologists conduct health interviews with clients that aim to construct a more holistic picture of each person’s health, one that includes their genes, religious beliefs, social supports, living conditions, emotional state, and beliefs of health, etc. They use this information to work alongside a person’s physicians and therapists to develop a treatment tailored for individual needs or to develop greater empowerment among the community's members so that the community is able to strengthen and sustain its own quality of life.
Health psychologists seek to identify the behaviors and experiences that promote health, lead to illness, influence the effectiveness of health care, and recommend improvements to health policy in their light. There are many examples of this. Smoking, diet, and regular exercise all contribute to the formation of disease. There are some minor associations between illness and individual characteristics such as personality. For example, it is claimed that individuals with thrill seeking personalities are more likely to drive fast, making them more likely to injure themselves in car accidents. And also that people distrustful of physicians will not get regular checkups. However there are contextual factors in the form of political, economic, cultural, community, social and lifestyle factors that have a more major influence on the health of particular individuals, although they will not generally recognise these.
Factors that lead to the behaviors that cause illness are of interest because they help psychologists to predict who is most susceptible to illness and why. There are many contributing factors that help determine our behaviors, and all of the dimensions of the biopsychosocial model can be applied to understand these interconnections. Biologically, physical addiction plays an important role in smoking cessation. As does the psychological dependency on tobacco brought about largely by seductive advertising and other forms of tobacco promotion. Psychologically, people with high stress jobs are more likely to develop cardiovascular disease. Socially, people with low incomes have less access to health resources and screening processes. They also are exposed to greater environmental toxigens, lower levels of education, poorer housing, less healthy foods, higher smoking prevalence, and many other toxic socially determined living conditions.
Health psychologists also aim to change health behaviors for the dual purpose of helping people stay healthy and helping patients adhere to disease treatment regimens. Cognitive behavioral therapy and behavior modification are techniques often used for this purpose.
Psychologists work towards promoting health through behavioral change, as mentioned above, but they prevent illness in other ways as well. Practitioners emphasize education as a large part of illness prevention, as many people do not recognize the risk to illness present in their lives. Or they are unable to implement the knowledge that they have owing to the pressures of their everyday existence. A common example of this is anti-smoking campaigns. Those least able to afford tobacco products consume them the most. It is a method for controlling emotional states, the daily experiences of stress that characterize the lives of deprived and vulnerable people.
There is much to know about how disease affects our mental well being. When illness or accidents befall a person, their entire life is affected. A psychologically healthy individual who gets severely injured, say, now has many different practical issues to contend with that will in turn affect their psychological wellbeing. Who will take care of them while they recover? If they can’t work, how will they pay for bills or care for dependents? If this person sees themselves as being self-reliant, how do they handle this new identity? What if they cannot pursue their usual hobbies and interests? All of these possibilities can affect a person’s relationships, self-esteem, stress level, happiness and belief system. Many of these issues are economic and social in nature rather than psychological but they have a direct impact on psychological wellbeing.
This important field of study considers how those with terminal illnesses can lead a better life. When there is little hope of recovery, health psychology therapists can improve the quality of life of the patient by helping them recover their mental well-being.
Critical health psychologists are exploring how health policy can impact on inequities, inequalities and social injustice. This expands the scope of health psychology beyond the level of individual health to an examination of the social and economic determinants of health experience both within and between regions and nations.
Health psychologists attempt to aid the process of communication between doctors and patients during medical consultations. There are many problems in this process, particularly the use of jargon by doctors (using long, complex, usually medicine-specific words often not understood by the patient). Researchers such as Boyle and McKinlay have investigated this process and discovered not only that patient understanding is low (40% of women on a maternity ward understood 13 medical terms that they were given), but that even doctors do not expect their patients to understand their jargon! One main area of research on this topic involves 'doctor centred' or 'patient centred' consultations. Doctor centred consultations are generally directive, with the patient answering questions and taking little part in decision-making. Although this style is preferred by elderly people and others, many people dislike the sense of hierarchy or ignorance that it inspires.
Getting people to obey medical advice and adhere to their treatment regimens is a difficult task for health psychologists. Mostly, people forget to take their pills or find their side effects too difficult to cope with (rational non-adherence), but failing to take prescribed medication costs the Health Service millions of pounds per year, as well as wasting millions of usable, viable medicines that could otherwise be used to help other people.
Positive Psychology
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Positive psychology is the scientific study of optimal human functioning.
Psychology has been criticized as primarily dedicated to addressing mental illness rather than mental "wellness". Several humanistic psychologists—such as Abraham Maslow, Carl Rogers, and Erich Fromm—developed successful theories and practices that involved human happiness despite there being a lack of solid empirical evidence behind their work.
Current empirical researchers in this subfield include Donald Clifton, Albert Bandura, Martin Seligman, Ed Diener, Mihaly Csikszentmihalyi, C.R. Snyder, Christopher Peterson, Shelley Taylor, Barbara Fredrickson, Charles S. Carver, Michael F. Scheier.
Some researchers in this field posit that positive psychology can be delineated into three overlapping areas of research:
- Research into the Pleasant Life or the "life of enjoyment" examines how people optimally experience, forecast, and savor the positive feelings and emotions that are part of normal and healthy living (e.g. relationships, hobbies, interests, entertainment, etc.).
- The study of the Good Life or the "life of engagement" investigates the beneficial affects of immersion, absorption, and flow that individuals feel when optimally engaged with their primary activities. These states are experienced when there is a positive match between a person's strength and the task they are doing, i.e. when they feel confident that they can accomplish the tasks they face.
- Inquiry into the Meaningful Life or "life of affiliation" questions how individuals derive a positive sense of well-being, belonging, meaning, and purpose from being part of and contributing back to something larger and more permanent than themselves (e.g. nature, social groups, organizations, movements, traditions, belief systems).
The development of the Character Strengths and Virtues (CSV) handbook represents the first attempt on the part of the research community to identify and classify the positive psychological traits of human beings. Much like the Diagnostic and Statistical Manual of Mental Disorders (DSM) of general psychology, the CSV provides a theoretical framework to assist in developing practical applications for positive psychology. This manual identifies six classes of virtue (i.e. "core virtues"), made up of twenty-four measurable character strengths.
The organization of these virtues and strengths is as follows:
- Wisdom and Knowledge: creativity, curiosity, open-mindedness, love of learning, perspective
- Courage: bravery, persistence, integrity, vitality
- Humanity: love, kindness, social intelligence
- Justice: citizenship, fairness, leadership
- Temperance: forgiveness and mercy, humility and modesty, prudence, self-regulation
- Transcendence: appreciation of beauty and excellence, gratitude, hope, humor, spirituality
Practical applications of positive psychology include helping individuals and organizations correctly identify their strengths and use them to increase and sustain their respective levels of well-being. Therapists, counselors, coaches, and various other psychological professionals can use the new methods and techniques to build and broaden the lives of individuals who are not necessarily suffering from mental illness or disorder.
Medical Psychology
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Medical psychology (related to Clinical Health Psychology, Psychosomatic Medicine, and Behavioral Medicine') is a branch of clinical psychology where clinicians have trained in the biological aspects of mental illness in relation to physical illness, and are usually qualified to prescribe medication; this last aspect varies from country to country. It adopts the biopsychosocial approach to medicine, which revolves around the idea that both the body and mind are indivisible, and that disease and illness are not identical. Continuing with this line of thought, all diseases whether of the mind or of the physical body must be treated as if they have both been affected. The intent of Medical Psychology is to apply knowledge from all branches of social, psychological, and biological medicine in the prevention, assessment, and treatment of all forms of physical illness and the adaptation to illness; specific behavioral, psychotherapeutic, and pharmaceutical methods are used to help the person respond to illness and prevent further illness through matching coping and management skills to the person’s abilities, character, and personality style.
Some clinical practitioners and philosophers today believe that this Cartesian line of thought is outdated. Some anecdotal evidence has been raised concerning the lack of effective treatment for things such as migraines, pains and cancer and that perhaps the cure should not only be centred on the body but also the mind. Some also raise the argument that most uncurable diseases are brought about not merely by physical ailments, but by mental problems. All evidence is of course unproven and will likely remain as such for a long time to come.
The contribution of medical psychologists to general health care increased with their use as primary care doctors in the world's largest HMO, the California Kaiser Permanente. These psychologists work along with primary care physicians in order to determine optimum treatment plans for all patients with physical and/or mental illnesses.
An important contribution of medical psychology is in the education of patients (psychoeducation) in disease processes. Frequently, such education of the patient and the family insures substantially better adherence to treatment recommendations. Medical psychologists are particularly successful in the treatment of asthma, gastrointestinal illnesses, cardiac conditions, spinal cord and brain injuries, chronic pain, headaches, and addictions (drugs, smoking, eating, alcohol, etc.).
Training in medical psychology entails a doctoral degree (Ph.D., or Psy.D.) in clinical psychology, an internship, and postdoctoral training in one of the branches of medicine traditionally associated with psychological fields: psychosomatic medicine, rehabilitation, neuropsychology (central nervous system functioning - brain functions), substance abuse, pain medicine, among others.
Personality Disorders
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Personality disorders form a class of mental disorders that are characterized by long-lasting rigid patterns of thought and actions. Because of the inflexibility and pervasiveness of these patterns, they can cause serious problems and impairment of functioning for the persons who are afflicted with these disorders.
Personality disorders are seen by the American Psychiatric Association as an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it. These patterns are inflexible and pervasive across many situations. The onset of the pattern can be traced back at least to the beginning of adulthood. To be diagnosed as a personality disorder, a behavioral pattern must cause significant distress or impairment in personal, social, and/or occupational situations.
Personality disorders are noted on Axis II of the diagnostic manual of the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders (DSM, or DSM-IV-TR as it is currently in its fourth edition with a text revision). (Note: Mental Retardation is also noted on Axis II).
General diagnostic criteria for a personality disorder:
To make a diagnosis of a personality disorder, these criteria must be satisfied in addition to the specific criteria listed under the individually named personality disorders.
- Experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
- cognition (perception and interpretation of self, others and events)
- affect (the range, intensity, lability, and appropriateness of emotional response)
- interpersonal functioning
- impulse control
- The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
- The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.
- The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.
- The enduring pattern is not due to the direct physiological effects of a substance or a general medical condition such as head injury.
People under 18 years old who fit the criteria of a personality disorder are usually not diagnosed with such a disorder, although they may be diagnosed with a related disorder. Antisocial personality disorder cannot be diagnosed at all in persons under 18. The DSM-IV lists ten personality disorders, which are grouped into three clusters:
Cluster A (odd or eccentric disorders)
- Paranoid personality disorder
- Schizoid personality disorder
- Schizotypal personality disorder
Cluster B (dramatic, emotional, or erratic disorders)
- Antisocial personality disorder
- Borderline personality disorder
- Histrionic personality disorder
- Narcissistic personality disorder
Cluster C (anxious or fearful disorders)
- Avoidant personality disorder
- Dependent personality disorder (not the same as Dysthymia)
- Obsessive-compulsive personality disorder (not the same as Obsessive-compulsive disorder)
The DSM-IV also contains a category for behavioural patterns that do not match these ten disorders, but nevertheless have the characteristics of a personality disorder; this category is labeled Personality Disorder NOS (Not Otherwise Specified). The revision of the previous edition of the DSM, DSM-III-R, also contained the Passive-Aggressive Personality Disorder, the Self-Defeating Personality Disorder, and the Sadistic Personality Disorder. Passive-Aggressive Personality Disorder is a pattern of negative attitudes and passive resistance in interpersonal situations. Self-defeating personality disorder is characterised by behaviour that consequently undermines the person's pleasure and goals. Sadistic Personality Disorder is a pervasive pattern of cruel, demeaning, and aggressive behavior. These categories were removed in the current version of the DSM, because it is questionable whether these are separate disorders. Passive-Aggressive Personality Disorder and Depressive personality disorder were placed in an appendix of DSM-IV for research purposes.
There are not only personality issues that are raised in psychology there are also factors of mental health that should be treated with causion that of depression, schizophrenia, to name but a few.