Abnormal Psychology [2 ed.] 812070732X, 9788120707320

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ABNORMAL

PSYCHOLOGY

ve Abnormal Psychology

S.K. MANGAL

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STERLING PUBLISHERS New Delhi-110016

PRIVATE LIMITED Bangalore-560052

STERLING PUBLISHERS PRIVATE LIMITED L-10, Green Park Extension. New Delhi-110016

G-2, Cunningham Apartments, Cunningham Road Bangalore-560052

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Abnormal Psychology ©

1984, Dr. S.K. Mangal

First Edition 1984 Revised Edition 1987

PRINTED IN INDIA Published by S.K. Ghai, Managing Director, Sterling Publishers Pvt. Ltd., L-10, Green Park Extension, New Delhi-110016. Printed at Ram Printograph (India), New Delhil 10020

PREFACE

.

This book has been written for use as a basic text-book in an

introductory course in Abnormal Psychology or as a book of general and clinical interest for those who are interested in the care of their own mental health or of others. It covers almost all the basic concepts and information regarding human abnormal behaviour through

the following mainstreams: 1. 2. 3. 4.

Concept of abnormal behaviour and its science. Etiology of abnormal behaviour. Classification and description of abnormal behaviour. Treatment of abnormal behaviour.

In the treatment of the subject,

due care has

been

taken

to

make the book less ponderous and formidable for students, more interesting and meaningful, and more teachable and to bring it up to date with new

developments.

As

far as

possible

a

reasonable

quality of thought and depth of treatment has been retained. In doing so, I have drawn upon three sources: theory, research and Practical experience of various authors and writers, the work of

whom,

l gratefully acknowledge.

Iam also grateful

to my

col-

leagues, students and all those who have shared their experiences with

me during the past several decades and, in doing so, have helped me

learn and grow. I hope that the book will be read by a lot of readers for whom $ it was not specifically designed and they will be benefited by it. They should feel free to write to me or the

tions for the improvement of the book. Rohtak Independence Day 1984

publishers

with sugges-

S.K. Mangal

LIST OF FIGURES 2.1

Diagrammatic representation of the criterion defining normality and abnormality.

2.2

The

4.1

The Motivational cycle.

4.2

Hierarchical Structure of Needs.

5.1

Repeated failure in the attainment of goal may result in Frustration, Conflicts and Stresses leading to abnormality.

5.2

An Approach—Approach Conflict.

5.3

An Avoidance—Avoidance Conflict.

5.4

An example of Approach—Avoidance Conflict.

7.1

Classification of symptoms of the abnormality.

8.1

Son or Daughter?

8.2

Mating of a normal person and abnormal person.

8.3

The mating from which the great majority of abnor-

Distribution of I.Q. in the general population.

mal persons are born.

LIST OF TABLES

9.1 9.2 9.3 9.4 9.5 9.6 13.1

DSM-I Summary of ICD-8 (Section V) DSM-II Summary of ICD-9

(Section V)

DSM-III

Classification of Mental Disorders Level of Retardation.

91 91 92 93 95 96 164

CONTENTS Preface List of Figures List of Tables 1

Abnormal Psychology—Meaning and Scope of abnormal psychology.

Scope Defining abnormal psychology. Importance of abnormal psychology.

Summary.

2 iAionceyt of Normality and Abnormality Normality

and

abnormality

Descriptive

criterion.

cal criterion. criterion. Statistical criterion. Non-statisti Psychological ion. criter al Medic Explanatory criterion.

Conclusion Adjustment criterion. criterion. ary. Summ ion. criter ent differ ing 3

regard,

Psychology The Historical Background of Abnormal superstitions; bright The period of Early Age—era of rali sm; dark period natu period of Middle Age—era of stitions; reapsuper to rn retu Age— of the Middle of reason. —era oach pearance of the scientific appr

14

of modern science; Emergence of modern thought—era s. Summary. trend psychology—Current

abnormal

4 Motivation

Motivation.

Basic

24

and Adjustment

needs.

Drives.

Motives.

The

of a

well-

Freud’s Theories of motivation. motivational cycle. ry of Theo ow’s Masl viewpoint. Adler’s viewpoint. nt. stme Adju . view g’s Snyg and Motivation. Combs

Aspects of Adjustment, Characteristics adjusted person. Summary.

ABNORMAL

PSYCHOLOGY

5 Frustration, Conflict and Stresses Frustration—the

Frustration

causes

Conflicts

of Frustration;

Types of conflicts

38

reaction

to

Sources

of conflict Stresses— Causes and sources of stress Impact of psychological stress. Factors determining severity of strees, summary.

6 Mental Mechanism

51

Important defence-mechanisms. Repression. Regression. Isolation. Withdrawal. Day-dreaming of Fantasy. Negativism. Displacement. Rationalization.

Reaction—Formation.

Sympathism.

Compensation.

Projection.

Summary.

i Symptoms and Snydromes Symptoms. toms

of

Characteristics of symptoms. abnormal

behaviour.

Psychological symptoras.

62 The

Physical

Syndromes.

symp-

symptoms.

Summary.

8 Etiology—The causes of Abnormal Behaviour Predisposing and precipitating causes. Hereditary factors. Biological factors. Psychological factors. Sociological factors.

Conclusion.

74

Summary.

9 Classification of Mental

Disorders Development of the classification systems. The old era. The modern era. The contemporary position. The necessity and purposes of classification. Summary.

10 Psycho-physiological Disorders

Distinction between psycho-physiological disorders and

conversion neurosis. Respiratory disorders. Cardiovascular disorders. Gastro-intestinal disorders. Genitourinary disorders. Skin disorders. Other psychophysiological disorders. A few case-studies. Prevention and treatment of the psycho-physiological disorders. Summary.

90

100

CONTENTS

il

114

Psychoneurotic Disorders Neurotic behaviour as distinguished from Hysterical Anxiety neurosis. behaviour. lsive compu siveObses is. neuros Phobic Neurasthemic neurosis. Depressive Depersonalization neurosis. Hypochondriacal ic Causes and treatment of psychoneurot

psychotic neurosis. neurosis. neurosis. neurosis. disorders.

Summary.

12

134

Psychotic Disorders

rders. Classification Psychotic and psychoneurotic diso the nervous system. of n c disorders. Infectio

of psychoti rs. Disorders due Disorders associated with brain tumo . Disorders associated with epilepsy to head injuries. s rder Diso s. tion reac c Disorders associated with toxi urbances. s rder Diso associated with endocrine dist e associated with degeneration.

disorders paranoid disorders.

Schizophrenia.

Summary.

Affectiv

13

162

Mental Deficiency

Moderate retardaClassification. Mind retardation. ound retardation. Prof Severe retard ation. tion, ardation. Causes

tal ret Common clinical type of men ion and identification of ect Det of mental retardation. n of mental retardation. tal retardation. Preventio

men Treatment or remedial tion.

measures

for mental

retarda-

Summary.

14 Sociopathy

Characteristics of sociopaths.

Treatment.

179

Etiology of sociopathy.

Summary.

15

Criminal Behaviour—Delinquency and Crime Delinquency and ention and treat, Prev crime. Causes. of delinquency. es. Prevention crim ng rlyi unde es ment. Crimes; Caus Sociopathy and criminal behaviour.

and treatment.

Summary.

188

ABNORMAL

PSYCHOLOGY

16 201

Alcoholism and Drug Addiction Alcoholism. The habit of alcoholism. The effects of alcoholism. The causes of alcoholism. Treatment of alcoholism. Drug addiction. Drugs—types and effects. Causes of drug addiction. Prevention and treatment of addiction. Summary. 17

214

Sexual Deviations and Disorders Sexual deviations. Sexual deviation and sexual offence. Sexual deviation and Sexual disorder. Forms of sexual deviations. Causes of sexual deviations. Treatment of

sexual deviations. Sexual disorders. Impotence. Frigidity. Causes and treatment of impotence and frigidity. Summary. 18

Treatment of Abnormal Behaviour

227

Medical or somatic therapy. Drug or chemotherapy. Shock therapy. Psycho-Surgery. _Psycho-therapy. Psycho-analytical

therapy.

Client-centred

psycho-

therapy. Behaviour therapy. Group ` therapy. Family therapy. Dramatic therapy. Socio-therapy. Summary. ` Bibliography

245

Glossary

249

Index

265

GY— ABNORMAL PSYCHOLO MEANING AND SCOPE know himself and his environAN HAS ALWAYS strived to ophy, psychology and other basic ment, Subjects such as philos

task. Psychology, have been instrumental in thisaviour in relation l beh of human especially, has helped in the study better adjustment and adequate a in g n i i py and contended life. The development of the individual for hap er applicati wid y its for pe is gigantic. Psycholog ng into different branches coveri ded divi n bee e, efor ther has, ulness Specific areas and fields of humant psychology, adult psychology, lescen example, child psychology, ado nt psychology, general psychology, pme elo dev y, individual psycholog logy, educational

ical psycho experimental psychology, physiolog para-psychology, y, log cho Psychology, industrial psy Psychology, etc. Defining abnormal psychology

abnormal

defined. Abnormal psychology has been variously sion (of the subject divi subis a Page: Abnormal psychology esses an to the study of the mental proc

psychology) that is limited

behaviour of abnormal people.* Coleman: Abnormal psychology ent which specializes in the developm

is the field of psychology and integration of psycho-

g of abnormal behaviour.* logical principles for the understandin d of logy is a specialized fiel our Kisker:; Abnormal psycho avi beh and ces sonality disturban psychology dealing with per

disorders.$ rmal psychology is an attempt Rosen, Fox and Gregory : Abno rmal within the framework of the to understand and exp: lain the abno

normal and general.*

hology we mean the study _ Mahoney: By abnormal psyc alled normal pattern.§ deviation or variance from a so-c

of

ABNORMAL PSYCHOLOGY

2

All the above

realizing

definitions

that abnormal

of a discipline

which

have

psychology

deals

a common

understanding

in

is a specialized branch or field

with the

behaviour and experiences of

the abnormal people. But some questions remain unanswered: 1, Does abnormal psychology study the behaviour of the normals also along with the abnormals or does it limit itself to the study of the disorganised personality and behaviour of the abnormal people as explained by Page and Kisker in their definitions? 2. Does it limit itself to the formulation of broad principles, theories or techniques for the study of the abnormal behaviour or go further for the prevention and treatment of the abnormality or behavioural disorders? 3

3.

Does

it also care for the environmental set-up of the

abnormals in the study of their experiences and behaviour?

The answers

to these questions will help us to demarcate a

boundary for the subject-matter or scope of abnormal psychology.

Scope of abnormal psychology The scope of this discipline can be discussed as below. 1. The study of the abnormals cannot be undertaken until we decide about the normals and the abnormals, or what behaviour and activities make an individual normal or abnormal, Abnormal psychology should essentially throw light on the concept of normality and abnormality in relation to varying situations and

environmental tion.

Hence

conditions.

The parameter

the study of abnormal

should include the study of the normals

is the normal

psychology,

popula-

to some extent,

along with the abnormals,

for the abnormals should themselves know how to behave and adjust in order to be labelled as normal. 2. All human behaviour has its roots in motives and basic needs. The denial of basic needs and blocking of motives leads to

frustrations, conflicts and stresses ending or maladjustment

which, in turn, results

in maladaptive behaviour in behavioural

disorders.

The subject-matter of abnormal psychology should, therefore, include the study of motives, basic needs, adjustment, frustration, conflicts and stresses.

3.

In order to contribute to preventive

purposes,

abnormal,

psychology should be able to describe and explain the causes 0 abnormal behaviour—the conditions or factors generating maladaptive behaviour, the s ymptoms and syndromes of the various be: havioural disorders. Since there is need for knowledge of common behavioural disorders, abnormal psychology should essentially include

the

study

of abnormalities

or disorders such as

mental

mechanisms (false defence), psycho-neuroses, psychoses, antisocial behaviour like psychopathy, delinquency, crime, drug addiction and

sexual deviation. 4. Abnormal

psychology,

like

its main

stream psychology,

ABNORMAL PSYCHOLOGY—MEANING

3

AND SCOPE

aspect it formulates has both pure and applied aspects. In its pure sts techniques for the sugge and ies theor ates principles, gener

broad people which finds practical study of the behaviour of the abnormal us in taking preventive and helps it where t aspec ed shape in its appli curative measures.

Preventive measures: or s us in protecting ourselves and (i) Abnormal psychology help t tmen djus conditions that lead to mala

others from situations oF

behavioural disorders.

tions and restructuring of (ii) It may lead us to the modifica g circumstances for the ilin, preva and the uncongenial environment al and r nced behaviou leadin g to-a norm

growth of adjusted and bala happy life. Curative measures: hology applies its knowIn its extended stage, abnormal psyc behavioural disorders ous vari of the treatment

ledge and skills for and measures. Moreover, in its by- suggesting practicable therapies like clinical to nourish related fields form, it tries

applied legal work, and social psychiatric psychiatry, ld, psychology, shou gy holo psyc The subject-matter of abnormal to the treatment of psychology. ing lead ts aspec therefore, include all practical good ining normal behaviour and rega and s rder diso r viou beha mental health.

psychology may be considered The subject matter of abnormal ts: pivo g main to revolve round the followin and abnormality. 1. Concept of normality ptive behaviour and behaviour 2. Factors that lead to malada al disorders. of the abnormal behaviour. 3. Symptoms and syndromes n behavioural disorders. 4, Description of the mai avioural disorders. 5. The treatment of beh

al psychology Importance of abnorm ized of this subject can be summar The significance and purpose as under:

1. Prevention and treatment of behavioural (i) helps in mality: Abnormal psychology rests in its inte and s tude atti knowledge, skills, disorders

ral vention and treatment of behaviou them es ulat (ii) encourages OT stim

towards

disorders or abnordeveloping essential students for the pre-

or abnormality, and behaving as normals

mentally healthy individuals, and becoming better adjusted, and

Abnormal the normals: 2. Differentiating abnormals from e differwhil r viou beha rmal abno into ht Psychology provides insig rs from othe or us ng ecti prot entiating it from the normal and’ thus r. viou beha rmal abno ning lear adopting or

ABNORMAL PSYCHOLOGY

3. Knowledge of the caus The causes of abnormality studied in es of abnormal behaviour: abnormal psychology will show abnormality is generally a biol that ogical or Socio-psychological problem. e $ re, be sympathatically considered and helped in getting rid of their abnormalities, _ 4. Correct notions about abnormal ity: The superstitions or misconceptions about abnormality or beha vioural disorders may be

abnormal psychology, for it tells us

6. Knowledge of the

toms and syndromes of abnorm behaviour: The Gage ofthe sym al vat ion to gain knowledge of the symptoms s behaviour disorders leads us. and syndromes leading to the early diagnosis Of specific disorders.

T.

Adopting

pr

measures

study of mental dories

like

for mentally retarded:

retardation

The

may help teachers and educators in Planning schemes for the welfare of such children.

8. Adopting proper measures for

antisocial behaviour.

The Study of abnormal psychology reveals that antisocial behaviour is a sign of caution for the society. It is a social disease that calls for Socio-psychological law.

treatment

e prevention

and

instead

treatment

of being dealt with by he

of such

behaviour

may

carried out through the study of abnormal psychology. Helpful i s: The related applied fields like 9.deal ea ae psychiatric social work, neurology may directly benetit from abnormal psychology. Lawyers and Judges also need knowledge of abnormal behaviour and disorders

for dealing with the cases of anti-social behaviour. 10. Useful in ever

AN

RA

b

i y day life: The principles of abnormal al p psyee have far reaching implications with regard to many problems a dia ap daylife. Education, business and industry, politics, law

ledge, , consell ms:akil Toemen nd learning in ing5 are

application.

some of the areas where know‘ ise: diet

8 ìn abnormal psychology exercise

In this way, abnormal ps chology has useful purposes to ser the cause of individuals ve and the socie. By its stots nature and utility it may be defined as the Spe cialised field, pure and app of Psychology which dif lied, fer experiences of the abnorm entiates and explains the behaviour and al People, within the fra me-work of the normals, in relation to thei r environment and Sugges ts ways and

ABNORMAL PSYCHOLOGY—MEANING

techniquess for the prevention

behavioural disorders.

and

AND SCOPE

5

treatment

of abnormality

and

Summary field

Meaning; Abnormal psychology is a specialized branch of psychology which helpsin studying the behaviour

abnormal people in relation to their own

or of

environment for helping

them in their adequate adjustment and better development.

Scope: The scope or subject matter of abnormal psychology may centre round the following main pivots: Concepts of normality and abnormality. Causes of abnormal behaviour. Symptoms and syndromes of abnormal behaviour. Description of the main behavioural disorders. The A a e treatment of behavioural disorders.

The study of abnormal psychology helps in: Understanding the true meaning of abnormality.

Importance:

Differentiating the abnormals from the normals.

Studying the causes of abnormal behaviour. Modifying environment for the growth of normality, Studying symptoms and syndromes of abnormal behaviour. a a Undertaking the prevention and treatment of behavioural 7.

8.

disorders. Understanding

its applicability

in many related fields or

Í branches. life. ay everyd in use Understanding its REFERENCES

1. James D.

Page;

Abnormal

Psychology,

New

Delhi: Tata McGraw-Hill,

1976, p. 16.

D.B. Psychology and Modern Life, Bombay: i . James C. Coleman; Abnormal Taraporewala & Sons, 1970, p. 21. McGraw-Hill, Interna- George W. Kisker; The Disorganised Personality,

tional Students Edition III, 1964, p. 21. Saunder’s International . E. Rosen, Fox and Gregory; Abnormal Psychology, š 1. p. 1972, II, n Student Editio Harper & sco: Franci San , ology Uü WAN Michael J. Mahoney; Abnormal Psych Row, 1980, p. 14.

2 CONCEPT OF NORMALITY ABNORMALITY ABNORMAL PSYCHOLOGY

AND

lays emphasis on the

behaviour and experiences of the abnormal people.

study

of the

In its practi-

cal aspect,ittries to describe some preventive and curative measures for the treatment of abnormal behaviour or disorders. It implies that advances in abnormal psychology can only be made if we are aware of or have clear concepts about the terms normality and abnormality.

“The term ‘normal’ seems to be derived from the word ‘norma’ which means a carpenter’s square or rule. A norm, therefore, became a rule, pattern or standard, and it was in this-sense that the

term ‘normal’ was introduced

into the English lexicon.( The term

abnormal’ with its prefix ab (away from) thus came to signify the deviance or variation from the normal,)Anything not normal must, therefore, be abnormal. But ‘there is some difficulty

in deciding what is normal. In the basic or medical sciences, it is easy to decide what is normal. In examining the temperature

of the body, blood pressure, the amount of sugar in the blood,

pulse

Tate, beating of the heart, etc., are standard universal norms. On a psychological front, however{ we can’t have an ideal or ideal behaviour to be used as standard norm.

model

,

behaviour is or

is not

As a result, normal

has

the problem proved

to be adifficult one. However, several

attempts have been made for abnormal.

of deciding what

of man

describing

what

is normal

or

Normality and abnormality crit eria The criteria used for defining normality and abnormality can be grouped into the following Wa broad categories: y i

_A. Descriptive criteria:

They indicate the

types of behaviour considered normal or abnormal B. Explanatory criteria: These are concerned with the assum-

ed processes underlying abnormal behaviour, that is, with the way

CONCEPT OF NORMALITY

AND ABNORMALITY

7

in which abnormal behaviour differs from normal they tell us why the behaviour is abnormal.

The descriptive criterion may be further groups—statistical

or

mnon-Statistical

behaviour.

sub-divided

Under

the

Or;

into two

non-statistical

criterion we may place methods or approaches like ethical or moral view point, social conformity, ideal or perfectionism and legal view point, whereas under explanatory criterion, come criteria like Pathological or medical explanation, „psychological explanation and the explanation in terms of adjustment. This classification can be represented diagramatically: Normality and analy Descriptive criteria

(tell which types of behaviour are ab-

-

criteria

Explanatory criteria

(explain why the behaviour is abnormal).

normal).

|

i

Statistical criterion

Non-statistical criterion

| | criterion

Criterion of social conformity

Fig: 2.1.

|

]

Psychological | criterion

Adjustment criterion

|

|

|

| Ethical or moral

Js.

|

Pathological o o medical criterion

Criterion of ideal

Legal criterion

or perfection

the criteria defining Diagramatic representation of normality and abnormality.

Discriptive criterion

a. Statistical criterion According

to this criterion,

‘average’ is normal. A person is

abnormal when he or she deviates from the

i

‘average’.

For

example,

The distribution of I.Q. in the general population, (1.Q.

me 234 75 termed subnormal and those above 115 as abnormal.)

8

ABNORMAL

PSYCHOLOGY

there is an average height and an average weight for normal human beings and those who come close to this average are considered

normal

while

those

who

deviate

from

the average are considered

abnormal. The statistical criterion may be properly explained through a normal distribution curve. Here the distribution of I.Q. in the general population is being illustrated. The bell shaped curve

illustrates that the cases falling around the middle of the are to be abnormal.

termed

as

normal

and

those

Unfortunately, the statistical criterion

distribution

at the extreme ends as

is inadequate

in several

aspects.

First, according to this criterion, (any deviation from the average or majority would be abnormal.A genius would be as abnormal as a mentally retarded person.’ The inadequacy of the Statistical criterion is self evident as we can’t label the people who deviate in a positive or favourable way as abnormal. They may be

called ‘superior’ or ‘above average’ but not ‘abnormal’.

Second, we are all deviant (or different) from one another in some dimensions. Notwo individuals are alike in interests, abilities or physical appearance. These are all potential dimensions

of difference and an individual may sometimes deviate seriously from the norms or average set by us. Uf we take deviation from the average as the only criterion of abnormality then, perhaps, Gandhi, Vivekanand, Christ, Prem Chand, Newton, and Pythogoras would

surely be listed as abnormal.) people

Third, to label as abnormal we compare the deviance of the from the average which may change from time to time

or from group

to group.

in a particular society

or

Behaviours which are considered normal

culture

may

be labelled

abnormal in a

different society or culture. (What was considered abnormal in the

nineteenth century may fit well in the prevalent time, (for example, widow remarrige, the use of modern birth control measures). Therefore, abnormality is not simply a deviation from some average as advocated by the statistical criterion.

Fourth, the inadequacy of statistical criterion

also lies in its

variability for the analysis of personality disturbance or mental illness. It becomes more pronounced when we come to know that these methods, however sophisticated they may be, hardly tell us

why people become abnormal.

b The statistical criterion, in fact, is based on the false assumption that all personality traits and human variations can be expressed as quantitative deviations. But the difference between the disturbed

or undisturbed

all maladjusted or

is qualitative

affected

people

rather than quantitative. Not

are high

or low on a dimension of personality and consequently statistical criterion given faces difficulty in separating the abnormals from the litative aspects of the personality are involved.

normals

where

qua-

CONCEPT

OF NORMALITY

AND ABNORMALITY

9

b. Non-statistical criterion l. Ethical or moral criterion: (According to this criterion, a Person is considered to be abnormal if he or she acts in an immoral

manner. This criterion is solely based on the value judgements made by people who observe benesiony For being taken as normal, the behaviour should be appropriate and desirable from the view of normality and abdescription This morality. or ethics point of normality carries the following defects:

(i) The major problem with this perspective is that morality F is not an absolute conceptWhat is ‘moral’ gr ‘immoral’ may change from place to place and from time to time. (ii) A person who is known to have high morality may show disorders, while many people who behavioural signs of known may not exhibit any immoral deviant gically psycholo as are labelled behaviour. To be affected with anxiety or depression cannot be in any way, morality can’t Therefore, labelled as immoral. a behaviour as normal or deciding for criterion a be made

abnormal. social conformity: (According to this criterion, Criterion of Æ. those who conform to societal norms are considered normal and those

is based who do not care for them are labelled abnormal)This yview people the of majorit the what on the assumption that normality is

hair, tight approve of or follow. For example, if wearing short taken as be may it jeans, or a sleeveless blouse gets social approval, adopt we if Hence, l. abnorma labelled be normal or else it would

social conformity

of deciding

as the sole criterion

abnormal,

a behaviour

we will have to change our decision from

as normal or Place to place or culture to cuiture and in the same culture or place from time to time as we

can’t

resist changes

what is socially acceptable and normal. 3. Criterion of ideal or perfection: tion, normal

few

attained

behaviour

persons

by the

attain

masses.

in

attitude

towards

According to this crite-

. is equated with perfect or ideal behaviourbe

a_

level

They

for labelling as normal. A major

of

perfection

difficult

to

become ideals and serve a model flaw

in this criterion

lies in the

fact that there exists nothing like absolute ideals or perfection. The think the judgement is purely subjective, for example, one may life and behaviour of Gandhi as ideal but for the activists and

Tevolutionaries not he but Subhash Chandra Bose or Bhagat Singh on what ideal may be the ideals. Besides, this approach is based behaviour ought to be and not what it is. The model ofideals vary from situation to situation and, ina situation, from time to time,

The behaviour which is considered ideal fora particular agein a Particular situation may altogether be labelled abnormal in a different age or in a different situation. rion a law abid4. Legal criterion: According to this crite 5

ing citizen is normal but the one who violates the law is labelled abnormal. Behaviours like murder, rape, burgalary or prostitution

ABNORMAL

10

from

come

2B

this

and

definition

are

PSYCHOLOGY

labelled

definitely

antisocial or abnormal, But what is legal or illegal is again

a matter

of controversy. In a “dynamic society, laws change fast. Hence they are not absolute but change from society to society, place to place and even from time to time. Moreover, the mere absence or presence of a few evidences may declare an act or behaviour legal or illegal. Therefore, the legal criterion cannot be made a reliable or valid criterion for the judgement of normality or abnormality. B.

Explanatory criterion a. Pathological or medical criterion of According to this criterion, the normality or abnormality system. nervous the of ning functio the upon depends ur the Behavio In this way all abnormal people are affected

with some mental illness

or disease.yConsequently, they should be sent to the mental hospito tals as patients for treatment by persons who are trained cure

them.

has a wide appeal and has been responsible

This view

how for arousing a mass feeling that abnormal behaviour is some an indication of an illness or disease.

However, the inadequacy ofthis criterion has now also been d do proved. Most: people who are found to be mentally disturbe these of sense usual the in ‘illness’ or ‘disease’ the from suffer not ion in terms. They show no signs of structural damage or dysfunct

their nervous systems. Therefcre, pathological or medical criterion

clearly that the a reliable and

it may be seen does not make

valid criterion for the definition of normality or abnormality.

According

b. Psychological criterion to this criterion, psychological

functioning—

factor of the abnormal whether defective on normal— is the deciding ty then is not in rmali “Abno or normal behaviour.) Eysenck writes,

terms of people

causes;

it

suffering from mental diseases produced by definite

is rather

in torms

of defective

psychological systems.”* ever

On analysing this criterion, itis

kind

of certain

or form

functioning

ofcertain

seen that abnormality, what-

it may have,işlinked with some malfunctioning

psychological

systems.

Abnormal

people

are definitely

is not psychologically handicapped individuals, but their behaviour In ) causes. ogcial sociol the exclusive product of psychological or out

any case

biological

or physiological

factors

may

not be ruled

in the explanation of the behaviour of abnormal people. c.

Adjustment criterion According to this criterion, a person is said to be normal or abnormal to the extent he feels adjusted or maladjusted with his self and his environment.\Normal people get along well with themselves and their environment

with their self as well surrounding them. The

while the abnormal

ones are on the warpath

as with human or physical environment normal people always integrate or adjust

CONCEPT OF NORMALITY AND ABNORMALITY

motives,

their needs,

emotions,

interests,

li

aspirations

and

other

cognitive aspects with those of other members of the society and thus exercise a proper balance between their own self-actualization

and their contribution towards social welfare and progress. The abnormal people on the other hand, are neither able to achieve proper self-actualization nor do they care to contribute towards the wellintenbeing and progress of the society. In many cases either their tions or actions threaten their own self (by causing injury to their self), or the society (by breaking social norms).

Conclusion regarding different criteria The different criteria discussed above represent the many approaches for understanding the ‘normal’ and ‘abnormal’. and Ways complete (No criterion may be termed absolute criterion foral thebehaviour. abnorm or normal the of ation explan or tion descrip

s One section of these views only describes and the other only explain As far as the criteria which behaviour is not normal or n ormal. y related are of morality, social conformity, perfection or legalit or

concerned,

they are purely subjective, and hence, no reliability

validity may be placed in their utility for the judgement of normal ion or abnormal behaviour. Statistical criterion, which takes deviat

from some average as the deciding factor for abnormality, also suffers sed

cannot be expres from serious defects. Human behavio ur which l or abnormal norma as ged as quantitative deviation cannot be adjud through

this

Moreover,

criterion.

deviation

on any scale does not

of devianecessarily imply abnorma lity. On account of the theory The val. disappro social received have people l abnorma tion, the nment enviro y the health modern approach advocating the need for disregards as the preventive an d curative measure for the abnormals t ofthe concep the with it ces repla and the theory of deviation in this views rn such mode variance. According to Mahoney? (1980), . respect may be summarised as below are ghts, behaviours or feelings which 1. There are no thou i rn patte or act y any of alit . norm The inherently crazy or abnormal

is ‘relative’ to many

other factors, and it does not depend solely on

the event itself. behaviours and feel2. All organisms vary in their thoughts, abnormal persons and l ings. Presumed differences between eenorma (and not of categories) of degr with do to (or actions) have

Variance.

there are no Empirical studies have now established that al’ people on ‘abnorm and scale Normal’ people on one end of the ur, even in the other as suggeste d by statistical criterion. Behavio

p

fluctuate between normal and abnormal may start drinking at times of stress. For € xample, a normal person after an unhappy love affair, death of spouse or loss in business. give an cidHow Therefore, (statistical criterion does not Picture or lineof distinction between abnormals and normals) Howthe other subjective criteria for ever, its relative usefulness over Normal

individuals, may

12

ABNORMAL PSYCHOLOGY

describing normality or abnormality cannot be questioned and for this reason the authors like Eysenck, Cattell and Guilford have demonstrated the effectiveness of the statistical criterion as compared to other criteria. We will now evaluate the effectiveness of other criteria such as pathological or medical criterion, psychological criterion and adjustment criterion, in explaining normal or abnormal behaviour.

It may be easily concluded that we can’t depend upon

any of these

criteria

abnormal.

in determining

an

individual

as

normal

or

In

some cases, pathological or medical approach helps in the diagnosis of abnormality, while in the other, the abnormality, in the absence of any organic cause, may be detected through the malfunctioning of certain psychological systems. _ The pathological and psychological criteria lead us to the adjustment criterion which appears to be the only practicable crite-

tion or

so far for describing as well as explaining the normal

known

behaviour.

abnormal

The

causes

of

remains that the maladjustment

may

maladjustment

psychological, sociological or pathological in character

be

but the fact

brings about abnormality,

behaviour

self and

disorders

or

tribution

towards social welfare and progress, the lack of adjustment

illness. While

mental

one’s environment either harms

adjustment

leads to the proper

the self of an

against his environment

individual

to one’s

self-actualization

and con-

him to rebel

or compells

and social systems making in both cases

his behaviour anti-social or self-damaging. In order to determine the extent to which one’s behaviour may be termed normal or abnormal, the degree of his total adjustment or maladjustment

{involving his self and his environment) in view of his self actualization and contribution towards the welfare and progress of the

Society must be identified. Devices like adjustment inventories, projective techniques for the assessment of the various personality characteristics

may

us

help

in this direction. With the help of such

techniques we may not only come to know the extent to which

one’s

one

faces

behaviour

may

be termed

normal

or abnormal but also the special

areas or aspects of one’s personality or behaviour difficulty

in adjustment

where

or malfunctioning. The intensive diagnostic

approach may then lead us to the root causes of the behavioural isorder and from there to a suitable remedy or treatment which may

be planned with the help of experts,

Finally, we may say that normality or abnormality is a relative

concept. To Some extent, deviation from the known through statistical criterion may help in identifyingaverage which behaviour is at or which is not normal. But for the explanation as well as er phan of the normal or abnormal behaviour the criterion of adjustment has been found to be the most effective and practicable AS. Malfunctioning of the nervous system or the psychological ae Whether de to organic .

actin

or socio-psychological

he maladjustment: of an

causes,

surely

individual

which,

individual and results in the

ilization of mental or psyche balance of the

13

CONCEPT OF NORMALITY AND ABNORMALITY

m

üri ultimately leads to abnormality, behaviour disorders or men-

tal

illness.

Summary The term ‘normal’ stands for a set rule,. Simple meaning: ‘abnormal’ for the deviance-or variation while standard or pattern from the normal. or abCriterion of normality and abnormality: Normality

normality

is a relative concept.

For deciding what is normal-and

as descriptive and abnormal the different criteria may be grouped which describe to try a criteri tive explanatory. While descrip tell us criteria atory explan the al, abnorm or normal is ‘behaviour why the behaviour is abnormal.

ical and. Descriptive criteria may be further divided into statist a. criteri cal atisti non-st l and any ccording to statistical criterion, average is norma

This criterion may deviation from the average would be abnormal. (a bell shaped) curve. be explained through a normal distribution separating abnormals in The main limitation of this criterion lies personality are from

normals

where

qualitative

aspects

of

the

have criteria related. Under non-statistical criterion we may and legality. They are with morality, social conformity, perfection reliability or validity much more or less subjective criteria and hence

cannot be placed in them. into pathological Explanatory criteria may be divided rion and adjustment criterion. medical criterion, psychological crite

or

the normality or abnorAccording to pathological criterion, the functioning of the nervous mality of the behaviour depends upon from some specific mental r suffe system. Abnormals are those who by the psychological illness or disease. This assertion is ruled out certain

malfunctioning of criterion which links abnormality with the

Psychological systems.

According

to adjustment

criterion, a person is said to be

maladjusted normal or abnormal to the extent he feels adjusted or be adjudged may it , with his self and his environment. By all meansion for describing and criter as the most satisfactory and practicable iour. behav rmal abno or explaining the normal

REFERENCES

n mal Psychology, Oxford: Isaac Pitma ology, Psych 1. H.J. Eysenck; Handbook of Abnor mal Abnor am; -mug Shan T.E. & Sons Ltd. 1960, as cited by 1981, p. 1. New Delhi: Tata McGraw Hill,

2. Mahoney, op. cit., p.8.

OF

THE HISTORICAL BACKGROUND ABNORMAL PSYCHOLOGY

Tue HISTORICAL perspective of a subject presents a fascinating story of its development. Abnormal psychology, the science of the

behaviour of the abnormal people, has reached its present stage through a long developmental process. Its historical perspective would

not only

give an

understanding

insight into

its past but also provide a base for

its present and equip us for setting the direction and

trends for evaluating,

preventing

and

curing abnormal

behaviour.

The history of abnormal psychology can be divided into the following sections:

A. B. C.

A. _

D.

The early age—era of superstitions. The bright period of the Middle Age—era of naturalism. The dark period of the Middle Age—return to superstitions. Reappearance of the scientific approach—era of reason.

E.

Emergence of modern thought—era of modern science.

The early age—era of superstitions The attitude of the people towards abnormal behaviour, centu-

ties ago was completely dominated

by superstitions.

They believed

devils, evil spirits and other supernatural beings to be responsible for abnormal behaviour. Archaeological discoveries have led to many

ancient skulls with*small

holes which support the probability that

these were made to allow the evil spirits to escape. Surgical operations consisting of chipping away a circular area ofthe skull by the available crude instruments, stone or iron, were performed for the treatment of the so-calléd abnormals or the mentally ill. The early writings of the Egyptians, Chinese, Hebrews, Greeks and Indians indicate that in the era of superstitions all mental disorders were attributed to demons and evil spirits. The treatment was usually given by priests and tantriks and consisted of the various techniques to make the evil spirits leave the body of the sufferer. Some were treated by prayer, charms and sacrifice in

_

THE HISTORICAL BACKGROUND

OF ABNORMAL PSYCHOLOGY

15

order to appease the gods who had taken possession of them. Some were treated through mantras and magic and-in the case of others measures like noise making, flogging, starving, burning, forcing to take wine, dung or urine were used in an attempt to make the body of the sufferer so unholy or unpleasant a place that good or

bad spirits would be driven out.

B.

The bright period of Middle Age—era of naturalism

The Greek and Roman civilizations during their golden era gave a considerable thought to the problem of mentally disturbed individuals and developed a humane outlook and naturalistic medical Hippocrates (450-357 Bc), the Greek approach for their treatment. Physician who is called the ‘father of the modern medicine’, along

to this with his followers developed ‘naturalism’. According doctrine demons, spirits and heavenly bodies had nothing to do Mental illness or disorders were the with the mental disorders. results of natural causes requiring treatment like any other disease. Hippocrates initiated pathological or medical approach by explainHe also eming abnormality in terms of the disease of the brain.

phasized that hereditary predisposition, environmental and emotional stress can damage both body and mind. He classified all mental melancholia and disorders into three general categories—mania, For the treatment, he advocated regular clinical obserphrenitis. vations

proper

with

record.

In

this

Hippocrates

way,

brought

about a revolution in the history of abnormality by introducing a more humane approach involving pathology. However, he was handicapped by the restricted knowledge of anatomy and physiology Of the time for adequate pathological definition of abnormality. The doctrine and views propagated by, Hippocrates were later

supported by the great Aristotle

extended

(3842332

Greek

figures like Plato (427-347 BC),

Bc) and ‘Galen (130-200 ap).

They,

in

turn,

and carried it to the Romans who adopted the patholo-

gical approach

for the understanding and

treatment

of mental

Notable among the Roman physicians who followed the disorders. were Asclepiades (124 Bc) and Aretaeous Hippocratic tradition (second century AD). Asclepiades was the first to discriminate between acute and chronic mental illness and to distinguish between illusions, delu-

sions and

hallucinations.

He was opposed to

the

undesirable

measures like bleeding, purging and mechanical restraints and strongiy advocated and practised the need for making the patients more

He favoured comfortable. use of music as a therapy.

humanitarism

and

recommended

the

Aretaeous is known for the insight he gained in the importance of emotional factors and in the pre-psychotic personality of the He was the first to describe the various phases of mania patient. and melancholia, and to consider these two pathological states an expression of the same illness.

ABNORMAL PSYCHOLOGY

16 Thus,

the

bright

period of the Middle Age contributed much

to abnormal psychology through Hippocrates, his followers and other Greek and Romans physicians. Many of our modern concepts of mental illness and its treatment have unique resemblance with the views advocated during this period.

C.

The dark tions

period of the Middle Age—return to supersti-

The dark ages in the history of abnormal psychology begin with the death of Galen in 200 ap and collapse of Greek and Roman civilisation in the fifth century aD. The contributions and landmarks of the bright period of the Middle Age, known for its early scientific approach towards abnormality, were soon lost in superstitions. The treatment of mental disorders reverted to the same practices prevalent in the early age of superstitions and demonology. The advent of Christianity and the dominance of religious heads paved the way for utter ignorance and blind superstition. Some of the so-called religious heads or saints declared themselves

to have special powers in getting rid of the evil spirits or demons

Possessing the people. They established sacred shrines where the poor victims were taken for cure. Here the curative measures were

varied. Somewhere

tified ointments,

holy water,

relics,

visit

to

ashes,

laying on

holy places

of hands,

sanc-

were thought to have

a magic effect for curing mental illness. At other times, inhumane tortures like burning, starving. flogging, painful immersion in hot or cold water were resorted to in forcing the evil spirits to Jeave the body and mind of the mentally disturbed people. . The later part of this period (fifteenth to seventeenth century) Witnessed a peculiar trend in mental illness involving ‘mass madness in which

groups

of people were found to be the cases of hysteria.

In Italy it was known as Tarantism in which the whole group suffered

from

Germany

dance

manias.

The

dancing

mania

later

spread

to

and the rest of the Europe where it was known as St.

Virtus’ dance.

Other mania like biting and acting as wolf were

also

Teported in some parts of Europe. During this period beliefs concerning the excessive domimance of religion, evil spirits and demons took a turn for the worse. The old belief that the disturbed people were unwillingly seized by the evil Spirits as a punishment by God for their sin was replaced

by the belief that the individual, willingly,

with Satan, the devil.

had a pact or friendship

The mentally ill came to be considered

as

heretics and witches responsible for storms, floods, ruination of crops, injuries to their ememies, sexual impotence or death and diseases. Consequently, Measures were taken for the detection and punishment of the witches and witchcraft. The unfortunate mentally ill were thus subjected to unimagined tortures like the cutting

of the tongue,

twisting delicate

beheading, strangling or mutilati ng.

The concept

and

part

es

A

i

live Bac

horror of the witchcraft considering mental

THE HISTORICAL BACKGROUND

illness, as a deliberate

OF ABNORMAL PSYCHOLOGY

17

association with the devil dominated almost

all civilizations of the world up to the end of the eighteenth century. However, the Arabs, during this period of darkness, followed a

more enlightened approach towards mental illness. Their treatment was comparatively more humane than it was in Europe or The notable personality in Arabian medicine named as America. the “Prince of Physicians’? was Avicenna (1980-1037 AD).

D.

Reappearance reason

of

the

scientific

approach—era

of

a This period in the history of abnormal psychology witnessed of men great the by launched life, the of risk the at even struggle, their time for challenging and proving the hollowness of the concepts of witchcraft and demonology in explaining the behaviour of the mentally ill. With their continuous struggle, they eventually succeeded in establishing the era of scientific chinking and reasoning, and thus paved the way for the development and emergence of modern thought in this field. first to _ Paracelsus (1490-1541), a Swiss chemist, was one of the good or of n creatio a not was mania dancing the that Point out

bad spirits but a form of disease. He also put forth the idea of psy-

chic causes for mental illness and advocated which later became hypnosis, in its treatment.

“bodily magnetism ’, However, his views,

brain, show how like the supernatural influence of the moon on the ed exercis an overwhelmTeligious or theological notions at that time He paid dearly for ctuals. intelle of ing ing influence over the reason views with his life under continuous persecuhis unconventional

tion,

by was raised S In the same period, the other voice of reasoning a ed publish He 588). (1515-1 Physician and writer Johann Weyer of number rable conside a that out pointed and ft witchcra on ook

sick, re: were really as witches were those imprisoned, tortured an d burned of the first specialists in mental

Mentally or

disorders.

physically.

He was one

For his progressive views on mental illness, he is regarded

Being ahead of his time, as the real founder of modern psychiatry.condem nation and his works

e also met with vehement protest and the twentieth were banned by the Church and remained so until century, ry of witchcraft Reginalt Scot (1538-1599), published Discove A

ion with he wrote that the mental disorders had no connect diseathe but nothing were witches the while spirits demons or evil melanlike illness mental Sed, unfortunate women suffering from Choly. His views were also attacked and King James I of England in which

his book. Personally refuted and ordered the burning of life condemned demo3 his of risk the Another person who at

He le Paul (1576-1660). nology and witch horror was St. Vincenta ly bodi t from eren diff boldly declared that mental diseases were no the of t treatmen humane and medical the diseases and advocated

mentally ill.

18

ABNORMAL PSYCHOLOGY

Thus, the fifteenth and sixteenth centuries witnessed the struggle for the introduction of reason, in place of superstition and ignorance which paved the way for the return of naturalistic, nontheological, physical treatment of mental disorders and also helped in diminishing the influence of religious heads in dealing with the mentally disturbed. As a resultyfor the first time in the history, Henry VIII, the king of England, was inspired to convert the monastery of St. Mary of Bethlehem in London, into a mental hospital in 1547. Such hospitals called asylums were also established later in other parts of Europe and in America. But the early asylums were run like prisons and the patients were treated more like wild animals than sick human beings. They were placed in dark cells and chained to Posts, walls and beds in such a way that they could eat from bowls food fit only for animals. Severe measures like stravation, solitary confinement, cold baths and other methods of torture were often resorted to exercise control

came

places where

over

the

inmates.

These

asylums

the unfortunate inmates lived and died

the most inhuman conditions. The

first to raise

voice

against

physician Philippe Pinel (1745-1826).

be-

amidst

these asylums was a French

As in-charge of the La Bicetre

mental hospital in Paris, he started treating the inmates of this asylum as sick human beings and insisted on their chains being removed. The authorities, who were very reluctant to approve the daring plan, were astonished to see the success of the humanitarian approach. In England William Tuke (1732-1822) established the “York

Retreat”, an asylum for treating the mentally ill with kindness and consideration.

The success of the experiments of Pinel and Tuke prepared the ground for revolutionizing the treatment of the mentally ill through-

out the civilized world. Asa result, America witnessed a genuine humanistic approach for dealing with the mentally ill through BenJamin Rush (1745-1813), the father of American psychiatry. The views and methods advocated by him paved the way for scientific theories and therapies for the understanding and treatment of the mentally ill people which, in turn, led to the mental hygiene movement for prevention and cure of mental disorders and preservation as well as promotion of mental health E.

Emergence of modern thought—era of modern science

The age of ignorance and superstition followed by the age of

reasoning finally gave way to scientific thinking which gradually ushered ries

and

in the era of modern thought consisting of advanced theotechniques

based

on

sound

Scientific

reasoning.

These thoughts represented two view points—the organic and the psychol o-

gical or socio-psychological.

The

first

systematic

presentation

of

the

organic

view

THE HISTORICAL BACKGROUND

OF ABNORMAL PSYCHOLOGY

19

point was made by the German physician William Griesinger (18171868) who asserted that every mental illness or abnormality could be explained on the basis of brain pathology. Griesinger was followed by Emil Kraepelin (1856-1926) who furnished a classification of mental diseases and disorders in terms of organic basis.

He regarded

mental

diseases or disorders to be characterized

by a

group of symptoms called syndrome. He also emphasized that each mental illness was distinct from others with causes of its own, and symptoms, course and outcome in much the same way as of meas-

les, small pox and similar other physical ailments. His assertion, that schizophrenia was caused by the chemical imbalance in the body and the manic depressive psychoses due to irregularity in metabolism, is evidence of his organic or pathological view point for the explanation of mental disorders. -The organic view point advanced by Kraepelin firmly established itself with the discovery of the nature and origin of syphilis and its relationship with general paresis. The germ theory of disease initiated by Louis Pasteur, a French scientist, further strengthened organic or physiological base for the

interpretation of mental illness.

The second view point involving psychological and socio-psychological approach was the result ofthe failure of revealing a satisfactory organic cause in a number of cases. This new approach excaused by psychological rather plained that mental illness was than organic factors. Historically, this view point first came from

Mesmer (1734-1815), an Austrian physician practising Anton “Mesmerism’ a form of hypnosis, to cure hysteria. The method that

he followed to induce mesmerism was so crude that he was branded

acharlatan by his medical colleagues and was forced to flee the country. However, Mesmer’s contribution, during the later part of the Nineteenth century, aroused the interest of the medical practitioners French physicians like Liebeault (1823-1904) and in hypnosis.

Bernheim

(1840-1919) were able to demonstrate the success of the

hypnosis (suggestion technique).

Another personality

who became

interested in the research on hysteria during this period was Jean He subsequently did Charcot (1825-1893), a French neurologist. Much to promote an understanding of the role of psychological factors in different mental disorders. Pierre Janet (1859-1947) was another Frenchman whose findings on hysteria further served to po-

Pularize the psychological view point. The use of psychological approach got further support from Joseph Breuer (1842-1925), a physician in Vienna. He introduced a new method, known as catharsis, for curing hysteria. In this method the patient is made to discharge emotional tension associated with the repressed traumatic material by taking it out freely. Sigmund Freud (1856-1939), a Viennese physician got interested in hypnosis and catharsis as a method of curing mental disorders. He joined Joseph Breuer in the practice of treating hysteria using catharsis and With his collaboration published Studies in Hysteria, an important

landmark

in the history

of abnormal

psychology.

This

book

20

ABNORMAL PSYCHOLOGY

advocated the doctrine of non-organic interpretation of mental disor-

ders. Going further, Freud put forward the doctrine of psychoanalysis in which he replaced catharsis with a new technique known as free

association.

It consisted of (i) encouraging the patient to say freely

whatever came into his mind without regard to logic or decency, Gi) analysing and interpreting what the patient said and did, and (ili) helping him to gain insight and achieve a more adequate adjustment-

In this way Freud tried to advocate successfully the psychological view point in relation to mental illness.

Freud was followed by his students Alfred Adler (1870-1937)

and C.F. Jung (1875-1961). While agreeing with the psychologicak approach to the problems of mental disorders, they differed with the views of their teacher and ultimately developed their own systematic

approaches

known

as

the

‘individual

psychology’

and ‘analytical

psychology’. The view points emphasized by these two eminent medical men, coupled. with the unique contribution of Freud, tried to establish sufficient grcund for understanding and curing mental illness or abnormality on the basis of psychological and socio-psychological Causes. Proceeding (1849-1936), a

differently, the Russian, and

psychologists such as Ivan Pavlov J.B. Watson and B.F. Skinners,

Americans, forwarded a view point that normal or abnormal iour

is a

behav-

learned act and many ofthe mental disorders are the pro-

duct of some or the other learning. These ideas have contributed significantly to our understanding of abnormal behaviour and established the role of psychological or socio-psychological factors in

relation to behavioral disorders.

Finally, it would be well to mention the role ofthe great American psychatrist Adolf Meyer (1966-1850) who tirelessly advocated an eclectic approach through which he emphasized a fusion of organic, psychological or socio-psychological view points for the lagnosis, understanding and treatment of a mentally ill patient’ s

behaviour. The abnormal psychology and psychiatry and apply this eclectic approach in the study of abnormtoday, accept al behaviour and mental diseases.

Abnormal psychology—current tren ds This brief description of the historical background of abnormal psychology reveals how our understanding, diagnosis, preven-

tion and treatment of mental illness or mental disorders have

ed from barabarism and superstition to naturalism, humanit changarianism and empiricism, developing finally into an eclectic approach or tendency incorporating organic as well as socio-psychological points

of view. Abnormal Psychology, as we find today, is the result of the continuous struggle, experimentation and innovations of the great

men of the time. Some ee day abnormal

of the major features and trends of Psychology may be summarised as.

THE HISTORICAL BACKGROUND

1.

Emphasis on empiricism:

psycho-

In the current abnormal

towards empiricism,

logy, there is a trend

2I

PSYCHOLOGY

OF ABNORMAL

the

view that knowledge

must be based on experiences and evidences rather than speculation. Experimentation and observations based on scientific method are becoming the major tools for the empirical research on the causes of abnormal behaviour. There has been a fusion 2. Emphasis on eclectic approach:

of organic and socio-psychological view points to mental illness or disorders into an eclectic approach emphasizing the following:

Integrating behaviour and personality For the understanding of a behaviou' r—normal or abnormal— an eclectic approach is essential, that is, the total personality of an individual should be studied. b. Integrating internal and external factors a.

_ Both internal and external factors (within the individual and outside him) are needed for diagnosis, understanding, treatment and prevention of mental illness or abnormal behaviour. Integrating related areas of knowledge Eclectic tendency of the present day abnormal psychology is from the fact that there is a tendency of taking help evident also bio-chemistry, from all areas of knowledge like genetics, anatomy, ology, anthrop y, sociolog gy, psycholo neurology. physiology, and medicine and other related disciplines for the development logy. understanding of abnormal psycho c.

d. Integrating various therapies For

therapy

the treatment

or general

of abnormality or mental illness, no single

approach

is recommended.

There has been a

trend for the combination of hyponotic and non-hyponotic techniThe various forms of therapies like psycho-analysis, client ques. approach and behaviour therapy are now used separately d centre ation with the aim of helping the troubled. combin in or It has been realized that 3. Emphasis on humanitarianism:

normal and abnormal behaviour are indivisible in categories but merely a the difference is of degree only. Mental illness is not base gical sycholo socio-p a has but m proble biological or pathological all with dealt are now people ed disturb or ill y also, The mentall

essential sympathy involving humanitarian attitude.

4. Emphasis on dynamics of behaviour or personality: MaladUnderstanding of this justment brings abnormality in behaviour. maladaptive process in its totality is, therefore, essential for the prevention and treatment of mental illness. A mere knowledge of the

symptoms

abnormal

for this purpose

is not

sufficient.

ays attention towards

psycholo

Pa ECER T. vegt Bangs: $

MA

PE

224 -2G

a

7

Hence,

the underlyin

current

ying d

so

z Fi Wey

FaN

ure principle and reg the only driving arrived at the pleas as ct, instin life gratification the hard core of the

maintained that from birth onforce for the human behaviour. He sex gratification. Sex, therefore,ards, human beings experience the ultimate cause of all activity. Adler’s view point

e views of Freud Without agreeing with the extrem , Alfred Adler, a our avi beh human nas as the basis of own system of psychology, known as teud, developed his ngs are motivated

regarding

student of individual

primarily bei He assumed that human primary as ngs bei ered human sid con ud Fre le Whi siders: con He es, Y social urg primarily social. femal, Adler considered them as our. It is the Psychology.

an behavi as the basis of allindhum . he need for security dual, all his life, to act. ivi the tes iva mot ch whi ple ve sim dri ic the s bas beside Single a margin of safetyrgin of safety through e individual requires es this ma oirity from

danger.

He achiev

Omination and superiority.

ll, In order not to feel inferior or sma

uggle for eriority. Therefore, Dthe strare really e strives or struggles for sup wili l to dominate or pow er or the the tus s, sta Thu t en and em ty. ev uri hi ac for sec damental need end fun gle sin a the h oug of thr ed h wt ors ro tg be an ou our may Motivation of human behavi ve OT motive or in terms of a single urity dri asic drive known as sec ity. secur Need, the need for Motivation Maslow’s Theory of

In his book

Motivation and Personality’

tional ivang motlyi that a imp that

Maslow

emphasizes:

satisfy many needs at the same behaviour, may multi-motivated’ yet it 1s the total act is

an total person motivated d to activity. It isduathe rre sti is t Organism tha a part. T the far as motivatión of l, as ivi refore, the jnd and not just viewed as time

ered, should be personality is consid is behaviour thisor sens a child is motivated as a that see to e hav We e, In a whole. uld be motivated as a sho ker wor or 4 Whole for learning a skill, not just one or the other organs of his. Whole for doing his job and of basic needs in a definite body and mind. He proposed five sets motivation.

g human ierarchical order for understandin

each ds are closely related to elo aslow, human neelowe pdev est Accordi high the to st Other and ches pha from the from the satisfaction of the Ment of the personality. Starting vidual strives for the satisfaction of Physiological needs, eveTY indi motivation

the other needs of higher order-

This striving causes the

30

ABNORMAL PSYCHOLOGY

of their behaviour. A need that has been satisfied is no longer a need. It ceases to be a motivating force and, therefore, the satisfacV.

SELF-ACTUALIZATION

IV

ESTEEM NEEDS

NEEDS

AN

INDIVIDUAL

AND HIS NEEDS Ill.

LOVE NEEDS

1l.

SAFETY

1

PHYSIOLOGICAL

Fig.

NEEDS

4.2.

NEEDS

Hierarchical structure of needs.

tion of one need leads an individual to try for the satisfaction of other needs. In this way the motivational behaviour of a person

is always dominated not by his satisfactions wants, desires or needs.

but by

his unsatisfied

The motivational behaviour the hierarchical structure of needs

of most of the people fits well in proposed by Maslow and conse-

needs only when

other basic physiological needs are

quently for them a need of a higher order does not appear until a need of a lower order is gratified. They can think of the other the food

and

A hungry person cannot think of the welfare of the well gratified. society or attainment of salvation through remembering God.

Similarly, one who is insecure or unsafe

may

hardly be motivated

for the gratification of love or esteem needs. ._ But as it happens, there is a room for exception in Maslow’s hierarchy of needs. The history of mankind may point out countless heroes, saints and other great people who have always stood for the

ideals, religious

or

social

values

of life without

‘Satisfaction of biological or other lower needs.

caring for the

__Itseems that the effects of gratification of a need are more stimulating and important than the effect of deprivation. The gratification of lower order needs motivates an individual to strive for the higher order needs. An individual, as Maslow emphasized, can actualize his potentialities as a human. being only after meeting the

higher

level

needs

like

love and

esteem.

The need of self-

actualization thus seems to be the ultimate aim of human life and

that is why Maslow has tried to Place it at the top of his hierarchy of needs. It is the Master motive which encircles all the lower order needs for motivating human behaviour.

MOTIVATION AND ADJUSTMENT

31

Combs and Snygg’s view point

A.W.

Combs and

D.

phenomenological approach

Snygg for

the

advocated

perceptual

understanding

or the

of human

be-

haviour. Instead of explaining the individual’s behaviour in terms of the situations to which he is. reacting, this approach seeks to understand his behaviour from his own

point

of view.

It attempts

to observe people, not as they seem to outsiders, but as they seem to themselves. The phenomenal or perceptual field is the entire universe including the self as it is experienced by the individual at the time of action. It is unique for an individual and by all means responsible for his every behaviour. Emphasizing this point of view Combs and Snygg write that, “All behaviour, without exception, is completely determined by, and

pertinent

to, the perceptual field

of the behaving organism.””*

The perceptual field is always expressed by an individual with teference to his need and the ways of satifying these needs. Consequently, the human need or needs decide and direct the

human behaviour. Clarifying their stand on this issue of basic human Combs and Snygg define man’s basic need as ...a

need for adequacy... expressed in man’s

at every instant of his existence. Asleep us is engaged in an insatiable quest for find its expression may This quest of behaviour aimed...at the maintenance or

needs,

every behaviour

or awake, each of personal adequacy. in a wide variety enhancement of our

perception of personal worth and value. Other authors have spoken of this need as a need for self-actualization or selfrealization, In the field of psychotherapy this need has been described as a need for growth—whenever we refer to man’s basic need we mean that great driving, striving force in each of us by which we are continually seeking to make ourselves more adequate to cope with life.” Thus, the need for adequacy is the only basic driving or It has two principal components, (i) the mainMotivating force. (ii) the enhancement of the self. The tenance of the self and Maintenance of the self does not only involve the satisfaction of

physiological needs but also the needs for maintaining one’s perception of the self, An individuai, from birth to death, is vitally con-

cerned with preserving his selfas he perceives that self. In accordance with this need, he selects from his perceptual field aspects

which are meaningful for him, and which reinforce his picture of himself, While maintaining his self, the individual at the same time also feels the need to be more adequate, to grow, to be able to deal

more effectively with life by enhancing or actualizing his self as much as possible.

The various view points discussed above reveal that motivation of the behaviour is the output of the drives or motives-which are

ABNORMAL PSYCHOLOGY

32 generated by the wants or basic we have seen,

itasa

needs

over emphasized the

prime motive

or drive

of the organism.

importance

Freud, as

of Sex by declaring

for the determination

of human

behaviour. He ignored man as an organism with social needs and placed his emphasis upon the instinctual and biological needs.

Adler stressed upon the social urges and reduced the basic human needs toa single need for security and thus replaced Freud’s

sex motive by security or power motive. Maslow, while proposing five sets of basic needs, placed self-actualization at the top of his hierarchy of needs and thus

emphasized the self-actualization

as a prime motive for the human motivation. This the concept of adequacy by Combs and Snygg.

was replaced by

It is difficult to differentiate Maslow’s self-actualization from Comb’s and Snygg’s “need for adequacy”. The American psychologist Carl Rogers has also named a similar single force “drive for

growth” as a potent factor in the motivation of human behaviour. Essentially, basic human needs are nothing but demands or crav-

ings, for which we strive hard to satisfy. , A need in its true sense does not necessarily represent a lack or involve deprivation. For example, the need for food may not necessarily be the result of hunger pangs but for the pleasurable taste sensations. Similarly, the need for sex may not necessarily be the result

of the deprivation but the effect of the strong stimulus or favourable environment for seeking pleasure. Therefore, when we talk about

the potentiality of needs asa geneyating base for the strong motives or

drives, we see that our needs are not only concerned with the preserva-

tion or maintenance of the self but with the promotion and enhance-

ment of the self also. A human being is motivated not in parts but as a whole and

the motivation,

his entire self is involved in the process or outco me of

Whether primary or secondary, physiological socioPsychological, all types of needs help in the two-way or task of the maintenance and enbancement of the self. Our actions or behaviour generated through needs, drives or motives are meant for the

welfare of the self, that is, its preservation and promotion.

The Proper satisfaction of our needs helps us in actualizing our potentialities or ensuring our pro er adequate, g proper development so that we be come or feel Adjustment

: “Life Presents a continuous

survival,”

says Darwin.

chain of struggle for existence and

The observation is apt since everyone of us Strives for the satisfaction of his needs. In struggling to achie

ve something, ifone finds that results are Not satisfactory, one either changes one’s goal or the Procedure. While doing so one protects

one’s self from possible injury to one’s ego, failure or frustration. more

It is like shifting to

defensive position in challenge of circumstances after the initial failur order to face the e. This special feature

MOTIVATION

33

AND ADJUSTMENT

of the living organism is termed as adjustment. organism F Shaffer: Adjustment is the process by which a living s that stance circum the maintains a balance between its needs and ® needs. these of influence the satisfaction process by which Gates and Jersild: Adjustment is a continual us relation-

a more harmonio a person varies his behaviour to produce ® ent. ronm envi his and elf hims ship between as ‘psychological survival’ Gilmer: We can think of adjustment ogist uses the term adaptation to in much the same way as the biol ?° describe ‘physiological survival’.

Let us analyse these definitions. ss on needs and their satisfac1. Shaffer’s definition lays stre one’s needs are gratified or tion. One feels adjusted to the extent vidual tries to change his indi The in the way these are gratified. iculties in the realisation of his circumstances to overcome the diff m of his needs so that he Sometimes he reduces the quantu needs. nt. ted resources of his environme may feel satisfied within the limi nce between his needs and the In this way he tries to keep 4 bala As long as this balance is mains. capacity of realising these need moment it is disturbed, he drifts The . sted adju s ain rem he ed, tain towards mal-adjustment. t akes adjustment as a signal of 2, The second definition One man and his environment. a harmonious relationship between by changing in s stance circum ling prevai the has to adjust oneself to ourselves to the certain demands some way to adapt or accommodate being in a co-

in the environment of our environment. The conditions fit in the realm of nature. Thus, to ves ntinuous flux, we mould oursel uous process. We try to change the process ot adjustment is a contin ‘an understanding between about or modify our behaviour to bring For example, an urban girl married ourselves and our environment. and ways of behaviour, her habits to a rural boy has to change her . village a in live to life if she is made clue from Darwin’s 3. The last definition takes

theory of

ting that organisms capable of adap evolution. Darwin maintained ive. Hence, the individuals who surv r to the changed circumstances to

adjust

themselves

to

the changed

situations in thei

As harmony and lead a happy life. taenvironment can live in perfect adap for e hologicai term, is a new nam such, adjustment. as a psycwor ld. l ica tion used in the biolog leads us 10 a happy Adjustment, therefore, is a process which are

able

between our needs and the and contented life: maintains a balance us to change our way of capacity to meet these needs ; persuades and gives us strength tion; life according to the demands of the situa our environ-

tions of and ability to bring desirable changes in the condi

ment.

34

ABNORMAL PSYCHOLOGY

Besides the demands of one’s basic needs, society also demand s a particular mode of behaviour from its members. Were one to think only of one’s needs while ignoring the norms, ethics and cultural traditions of one’s society, one would not be adjuste d to one’s environment. For adjustment one needs one’s conformity to the demands of

one’s culture and the society. In this way, adjustment does not only cater to one’s own needs but also to the demands of the society. Therefore, adjustment is a conditi on or state in which one feels that one’s needs have been (or will be) fulfilled and one’s behaviour conforms to the requirements of one’s culture and society.

Aspects of adjustment

The following are the main aspects of adjustment : 1. Health adjustment: One is said to be adjusted to one’s physical development if the physical abilit ies are in conformity with those of others of the same age and there is no difficulty in progressing due to defects or incapabilities of physical organs, 2. Emotional adjustment: in one’s adjustment to self and to be emotionally adjusted if he

Em otions play an important part envi ronment. An individual is said is a ble to express his emotions in a

proper way at a proper time. development and proper trai It requires one’s ni ng

balanced emotional

in the outlet of emotions.

environment. Social adj ustment. re qualities and virtues in an indiv should be social enough to live in harmony ny country,

and obligations

towards `

with others

and

feel

his fellow beings, society and

faction and security to jts me

5.

Schoolproccupational adjust ment: Whereas in thé adjust ment of adults, their o i i a great role, the school or college environment casts its j influence over How

far a

student is satisfied Phe cipline, time-table, co-curricular í class and school mates, head of the institution, teachers and contribute Significantly towards his total

activities, methods

; : ~. degree of satisfaction with the choice of occupation , working _condition s, Telationship with boss, financial -satisfaction colleagues and and

35

MOTIVATION AND ADJUSTMENT

contributes adjustment to one’s occupation and

significantly towards

one’s overall adjustment.

djasted person Characteristics of a well-a A well-adjusted ristics: acte char

person

is supposed

to possess the following

A well strengths and limitations: 1. Awareness of one’s ownengths and weaknesses. He tries to his str epting his limitaadjusted person knows ets in some areas by acc ass his of out

make capital tions in the other.

dislike for one’s f and others: The i ust sel s 0 ne’ g tin pec individual Res 2 maladjustment. An adj ed self is a typicat symptom of l as for others. self as wel is has respect for one’s His level of aspiration iration: asp of el lev and te ths qua eng ade str own 3. An high in comparison to his and also does not neither too low nor too rs sta the for ch rea to abilities. He does not try course for advancement. ier eas an ing ect sel r repent ove basic organic, emo-

His ng the basic needs: 4. Satisfactionds ofare fully satisfied or in the process of bei nee ial ial soc soc and and g tional cravin suffer from emotional satisfied. He does not his self-esteem. ins nta mai and ure sonably sec isolation. He feels rea knows to appreciate lt-finding attitude: He He does not try fau or al tic cri No 5, activities. objects, persons or ific rather the goodness in the observation is scient His . lts fau and qualities, ss ir kne the wea ires to search for He likes people, adm ve. iti pun or al tic than cri ion. attitude and wins their affect He is not rigid in his

behaviour: f to the 6. Flexibility in his te or adapt himsel behavda mo co ac ily eas his He can or way of living. ces py making necessary changes in

changed circumstan iour. He is not with odd circumstances: will struggling of sufficient has Capable and 7. to ve odd circumstances has an dri the nt by re he in easily overwhelmed d fight odds. j He

st a0 it. and courage to resii passively accept nt rather than nme iro stic dlis a rea master his env rld : He hol

eption of the wo He always plans, thinks 8. A realistic perc yven to flights of fanc vision and is not gilly. and acts pragmatica A well adjusted s surroundings: hi h wit me ho He fits well at his 9, Feeling at his surroundings. surroundings. As a th wi ed fi is at S ls social individual fee ied ourhood and other and feels sataisflov e home, family, neig school. school-mates, teachers s ha he , on si es his of hə enters a pr student he likes utine. . en ds od y av sm despite he with his daily ro his zeal and enthusia

for it and maintains

justed pe p rson of life: Aa well adJ hy op os il J ph e while keeping in An adequate es cirection to his lif

10, giv has a philosophy whicb

5 FRUSTRATION,

CONFLICTS

AND

STRESSES

NEEDs, DRIVES or motives play a decisive roll in the. motivation of human behaviour which helps an individual to attain the Boe

set for the satisfaction of needs or motives. This apparently simple process does not always bring positive or favoureble result: Frequently, there are possibilities that the path of attaining the goal is. blocked leading

to ultimate

the goal further aggravates flicts and stresses that may

abnormality,

—

failure.

Repeated

failure in attaining

the situation leading to frustration, a end in the person’s maladjustment an

MOTIVATIONAL

BLOCKADE

BEHAVIOUR

OBSTACLE,

OR

=f

Fig. 5.1.

oon |

Repeated failure in the attainment of goal may result in frustration,

conflicts and stresses leading to abnormality-

Sometimes these troubles are the result of an unique state which: is created by typical fights going on in between the needs or motives

of an individual. This state also leads to stresses. The psychological meaning and mechanism of the terms frustration, conflict and, stresses being important from the point of view of abnormal psycho--

logy, we will discuss them in the following pases. Frustration

Man is ambitious by nature.

to be fulfilled. He plans and

He has aspirations and desires

strives hard for their realisation, but

it may be possible that despite his best planning and efforts he may not get the desired success.

At

times

he finds himself

in a state of

confusion with all the paths ahead blocked. With repeated failures,

he reaches a state or condition of frustration defined thus by eminent ` writers.

Carroll: A frustration is the condition the satisfaction of a motive.*

of being thwarted in

39

FRUSTRATION, CONFLICTS AND STRESSES Good:

Frustration

means

emotional

the blocking of a desire or need.* is

Kolesnik: | Frustration

h

the

feeling

resulting from

tension

blocked

being

of

or

a goal that the individual thwarted in satisfyinga need or attaining perceives as significant.® interference with our goalGilmer: When there is some n.‘ directed behaviour, the result is frustratio when our motives are thwarted, Coleman: Frustration results progress _. either a al.

obstacle that blocks or impedes our by some absence of an appropriate desired goal, or by the

Barney and Lehner:

Frustration

refers to failure to satisfy

external conditions in the individual or a basic need because of either

obstacles.®

These definitions reveal

frustration

that (i)

is that stage or

state inates the attempts, (ii) ina condition in which failure dom or obstacle in the satisfaction of one’s frustration one feels a maj goal; (iii) the

of

t of one’s cherished basic needs or in the attainmen eases the ength of the blockade incr str both in significance of the goal and lies ion trat frus of e (iv) the caus degree of frustration; and nt.

nme the individual himself and his enviro The causes of frustration

major heads— on may be stud ied under The causes of frustrati factors. external factors and internal A. External factors factors environmental also called nment. iro env External factors are ’s or con ditions present e.1n one ernal ext n mai These are the situations ivi The outsid dual from ind the ct affe They factors are as follows. obstacles, or calamities, Natural l ts, 1. Physical factors : Jd such as hailstorms, floods, : drough physical wor an events in their earthequakes, fire,

accidents, €tc.

They

cause

individual.

frustration

forces

in

and the social

factors: Social 2. Social and societal the path of an individual either in the of one’s environment may also block ant goal or in the satisfaction ort imp e som of ntial t pote men ain the att this way, they become a e, mpl basic needs and desires. In exa For individuals.

ted source for frustrating motiva may impose bar on the marriages ity mun - Particular society oF com a young school may cause frustration in

ch and desires to of school mistressesdeepwhi love with a handsome boy mistress who is in er may feel care ht brig of man Similarly, 2.young Marry him. the grounds on rse a cou

ission to frustrated when he is denied adm condition the il fulf he does not

that

Social factors

also

include

the part

played

of

bonafide residence.

by other

persons in

ABNORMAL PSYCHOLOGY

40

blocking the desires of the motivated individuals. A child may feel frustrated when he is denied permission to go to a movie with his friend, or to a dance or picnic. 3. Economic factors: Economic

and financial factors cons are there when a Instance ls. individua ng tribute much in frustrati frustration suffered the of result a as suicide ed young man committ by a long interval of unemployment, or a mother kills herself and her children by jumping into a well due to the utter frustration

Similarly, the caused by the continuous denial of basic need—food. the result of often are set-up political or social the revolts against

frustration suffered due to severe economic deprivation.

B. Internal factors

Internal factors are those which frustrate an individual from within. These are also called personal factors as the person himself is the cause of such frustration, The main factors in this category are as below:

1. Physical abnormality or defects: Too small or too big a stature, very heavy or lean and thin body, an ugly face or dark complexion, some glandular or bodily defects (such as being squint-eyed, blind, Deficiency deaf or dumb) may constitute a source of frustration.

in one’s intelligence or backwardness in a particular subject may

also frustrate an individual who is motivated to learn a particular course or choose a particular vocation. 2. Conflicting desires of aims: Frustration is also caused by

the mutually conflicting desires of aims.

For example, a man wishes

to marry a girl whom he loves but he also wishes to avoid it since for higher studies. it interferes with his ambition of going abroad However, he! has to make a choice-and, a choice of one at the cost A simiof the other may become a cause of frustration for him. to aspires who woman young a by felt be may on frustrati lar become a mother but avoids it due to the fear of losing her job or spoiling her career.

3. The individual’s morality and high ideals: An individual’s moral standards, code of ethics and high ideals may become a

source of frustration to him. He is always caught between his superego and Id. At thesame time when his ego fails to maintain a balance between the two he becomes frustrated. Due to the weight of the moral standards of his conscience, he possesses the unnecessary feeling of guilt or an unusual fear of punishment. For example, he may like to become friends with a girl but his moral standards do not allow him to do so. Similarly, one may be denied to smoke, to ‘see a sex movie, only because of his code-of ethics or high ideals. The inhibitions and the possible conflicts may give rise to emotional tension in him and consequently he may feel frustrated.

4.

Level of aspiration too high:

One

may

aspire very

high

in spite of one’s incapabilities or human limitations. For example, a voung man may aspire to become the captain of a cricket team

FRUSTRATION, CONFLICTS AND STRESSES

41

in spite of the fact he does not even know how to play this game. Such aspirations are bound to result in frustration. 5.

Lack of persistence

and

sincerity

in efforts: Frustration

may be caused by one’s own weakness in putting continuous and Persistent efforts with courage, enthusiasm and will-power at one’s

command. One may read a book with no sincere willingness to understand it. After sometime he takes another book and do the same thing with it also. He complains that he is not able to grasp anything after reading too much and thus gives reasons for the feeling of inadequacy that ultimately lead to frustration.

Reaction to frustration Frustration, depending on its intensity and nature, results in various types of reactions of the individual. Some have frustration tolerance

to the extent that they bear the consequences with a little

injury to self or society, while others, or former in special situations, become violent and aggressive. These reactions to frustration may be

classified into two major categories—simple reactions and violent reactions. A. Simpe reactions

Under these reactions we may include the following: 1. Increasing trials or improving efforts: Duriag the period Of frustration, some individuals go through introspection and for Overcoming the obstacles either increase their efforts or bring about improvement in their behaviour or processes. Repeated failure in one 2. Adopting compromising means:

on of his direction may lead the individual to change the directihis failure, after may, I.A.S. for t aspiran an , example efforts. For tion. examina service civil ial provinc direct his energies to pass the boy me handso a to r daughte her marry A girl’s mother failing to ion. complex e tolerabl a by ed may be content The individual learns to move away from the 3. Withdrawal: A child withdraws himself Situation that causes him frustration.

from the game that he does not know.

A youngman

may

refuse

to marry because of his sexual incompetency.

f 4. Submissiveness: Here the individual surrenders himsel tion. g frustra ions causin condit and accepts his defeat before the

A child may become much submissive after failing

in his attempts

in some direction.

eee : . i B. Violent reactions the individIn addition to the above mentioned simple reactions

ual becomes

emotionally tense and resorts to aggressive activities.

his aggression is of two types—external and internal.

as Carrol aggression,” “This aggression: 1. External Observes, “may be directed towards either the person or persons who caused the frustration or towards the substitute or substitutes.”?

ABNORMAL

42

PSYCHOLOGY

A clerk in his frustration of not getting promotion may quarrel witlr his officer or rebuke his wife or beat his children. A boy experiencing frustration in the playground may try to hit the boy denying him the chance of carrying the ball or may use his younger

brother or parents as substitute for relieving his tension. 2. Internal aggression: It is an aggression that is turned. inward towards the self. Instead of releasing one’s emotional tensions by attacking others, one resorts to the attack of one’s self. Instead of blaming others, the individual blames himself. Although self criticism does not do any harm, but the excessive aggression

Eventually, the person

towards the self is destructive for the self.

becomes neurotic or tries to find escape through suicide. As far as the well-being of the individual is concerned, this inward aggression is far more dangerous than outward aggression. Conflicts

There may be conflicts beThe term conflict is variously used. tween the ideologies of two sects, cultures, religions and organisations. Conflicts may also arise between husband and wife; father and his son, and teacher and the taught. They may also show their presence sisters, members and of an organisation or brothers among community, states of a country and countries of the world at

Apart from these external or outer conflicts there

large.

or internal

to

his

conflicts

well-being.

within

These

the

man

conflicts

which

are

are

more

called

are

inner

dangerous

psychological

conflicts.

Douglas and Holland: Conflict means a painful emotional state which results from a tension between opposed and contra-

dictory wishes.® Barney and Lehner:

Psychological conflict is a state of tension the individual of two or more opposing in presence the by bronelt esires, . L. S. Shaffer: Conflict may be defined as a state of affairs in which two or more incompatiable behaviour trends are evoked that cannot be satisfied fully at the same time.?° Coleman: Conflict is the anticipated frustration entailed in the choice of either ulternative.™

Conflict, in the light ‘of the above painful state or condition of an

individual;

definitions, (ii)

may be(i) a

intense

emotional

tension during this state; (iii) the result of the presence of two or more desires or wishes in the individual; and (iv) due to the individual, being at the cross roads, not able to choose between the two opposing desires, becomes tense and restless. In view of the

above

characteristics,

the

term

conflict

may

be defined as a painful tense state of an individual aroused on account of the indecisiveness in making a choice between two or more opposing or contradictory desires.

43

FRUSTRATION, CONFLICTS AND STRESSES

Types of conflicts

ts an. 1. An Approach-approach conflict: In this type of conflic _ n. betwee choice a g makin of m proble the with faced is dual indivi

ting and important. two or more positive goals almost equally motiva between reading am choose to have may For example, a child ~ A young man may . cricket interesting novel or_ going out to play equally qualified, two n betwee experience such conflict in choosing ts of this type conflic The ge. marria for girls beautiful and respectable

are oflittle danger and temporary

in character

since a step taken

to the automatic towards realisation of one goal leads of attraction for the other.

diminishing.

+

+ |

TNDIVIDUAL

GOAL WHICH

ONE

con|

TO CHOOSE A

ct. Fig. 5.2. An Approach-Approach Confi

one feels great difficulty However, there are occasions when > es. For example, a desir tive posi in making a choice between two and at the same time desire

ly young girl may be devoted to her famim she loves which is not accepwho caste her anot of boy a y

to marr

lexity arises in the cases where one table to her parents. Similar comp between loyalty to one’s mother , tion is torn between duty and ambi present satisfactions and future and to one’s wife, or between Prospects. am conflict: In this type of conflicts 2. An Avoidance-Avoidance two r between choose must he where individual is caught in a situation of action. He is torn between or possibly more negative courses a choice

two unattractive

goals.

In other words,

he is faced with

where.he cannot win either way.

GOAL

INDIVIDUAL

GOAL

WHICH ONE TO AVOID? oidance Fig. 5.3. An Avoidance-Av

Conflict.

at the does not want to study and For example, a child who final the in ing fail please his parents by s not wish toe dissuc er may box a y, larl same timeondoemay Simi . lict conf h enc experi examinati the hands of his rival or, ween his fear of defeat at bet It is like have to choose of the respect of his admirers. threat if he does not fight, the loss the 'to Due sea. the devil and deep ive and act being caught between ion both c hoices are equally unattr situat

involved in such a e from them or to do nothing. Inr hence the natural tendency to escap decision, he is likely to suffe take to d case when one is compelle

Usually, this type of of avoidance—av cidancethe type. -approach type of oach appr are more serious than

the conflict

Conflicts Conflicts,

ABNORMAL PSYCHOLOGY

44

3. An Approach-ayoidance conflict:

in this type of conflicts one

is faced with a problem of choice between approaching and avoiding tendencies-at the same time. In such a conflict an individual is

both attracted to and repelled by the same goal or course of action.

An

individual

may

towards

be motivated

a kind of behaviour or

activity which he perceives to be wrong, evil and degrading, but at the same time the attraction of behaviour is so strong that he becomes restless without doing it. To masturbate or not to

masturbate, to marry

the

or not to marry, to tease

girls or not, to

repel

purchase a scooter or not, are some of the situations that may and attract an individual simultaneously. OWNERSHIP (PURCHAGING A SCOOTER)

INDIVIDUAL a INCREASING

FIG.5.4,

DEBT

OF APPROACH-AVOIDANCE

AN EXAMPLE

~ Approach-avoidance type of

conflicts

are

CONFLICT,

distinctly the most

serious of the types discussed here as they bring about the most ‘severe emotional tension and give rise to anxieties and complexes. Sources of conflict We have seen that

the

conflicts

are

dissatisfaction felt by an individual due to the

the

creation

non-fulfilment

of the of his

two contradictory desires. The forces of the environment are, 10 fact, responsible for these conflicts as they provide necessary ground for their occurrence but at the same time the teachers, parents and ‘society

may also be responsible for them.

1. Home environment: The faulty upbringing at home, unhealthy or unpleasant relationships among the family members are the

potential

sources

of

conflicts

in children.

Over-protection,

dominance, submissiveness or negligence on the part of parents does

not help children cope with the experiences during social contacts

with other children at schooi and thus they become victim of the opposing desires in future. Uncongenial and unsuitable. environment as well as relationship among the family members also lead to numer-

ous conflicts in the adults.

The hard necessities of life also add to

the many conflicting situations in the home environment.

ment,

2. School environment: Uncongenial school or college environdominant or submissive role of the teachers, faulty methods

of teaching, denial of opportunities for self-expression, contradictory demands of the teachers and class-mates are some of the bases of conflicts in the youngsters.

45

FRUSTRATION, CONFLICTS AND STRESSES

For many adults, their occu _ 3. Occupational environment: ce of conflict. The uncongenial sour peel environment proves a nt, dissatisfaction with the worknme iro env g kin wor er rop imp tionships i fulfilment, unsatisfactory rela

ng conditions- and career ion with the authorities, dissatisfact s and dent ee the colleagues or with acci age. old in of security the wages and salary, lack onal maladjustment may prove potential. ati voc of ms for er oth similar ` sources of conflicts among adults.

ironment nment: The social env of Social and cultural enviro prove @ potential source also that son rea the and cultural values may for s m are the sex conflict the: conflicts. Chief among the been well adjusted to 4.

culture have not the the demands of ourindividual. The taboos, inhibitions, and the sexual needs of conflicts sex y man of e caus s sex isthe pattern of conflictNegative attitude toward as well as adults. The th you our of is responsible for2 in the minds ure cult our society and in ting exis es valu on one hand we give ing licts. For example, cooperanumber of other conf on the other advocate lack of and s gain ve iti pet com the incentive to stration suffered due to tion and submission. Fru s. The social le for many conflict vides him a sib pon res also are al pro opportunities therefore, of an individu and cultural environment,

s. number of sources for conflict

Stresses

on

both

selves in and actualise our Weall strive to maintal levels. Our needs, motives and goal_ chologica Success is not the biological and ourpsyare ed towards this end. ect dir avi beh and enhancing. directed , while maintaining external. It may ore ref the d, ‘an life nal or essence of ed with obstacles—inter seen earlier, OT the conOurselves, we are fac e hav We as frustration may lead us result in a state of needs or valued goals

or more tradiction between two situations. some conflicting

, We are not In such a Situation ions. An normal condit to or as We usually do in said to be working are expected to strive we ht on us and ironenv or f sel own our We try to adjust to s does. behaving under stress. the consequences of the stress. When thi g rin bea le whi sed ment, djusted and disorgani ent in at least two differ bgy d in psycholo ili use is equ dis s’ res ot ‘st et rd ups wo l ica The

s the state of psycholog and other ways. First it is defined-angs caused by frustrations, conflicts to do and bei at Wh n ma . hu tium in the l as external strains and pressures questions depict. internal as wel Where to g0? Suchexpected to act or o? to w Ho what not to do? er which one 1S of stress und the individual the stage or state ion of the stress, dit con s iou ser seriously affected, Ina more behave. physical processes are the c. re whe nt poi a s Teache tional state is chaoti confused, and the emo are ses h ces ic pro wh i tal the men a class of stimul ess is regarded as str ces ban e, cas tur dis ond sec se In the thus cau l in some way and threaten an individua stresses are the factors. , way s thi ng 1

in his behaviour.

Thinki

46

ABNORMAL PSYCHOLOGY

or causes that behaviour.

lead

to

maladaption

and

disorganisation

of the

Here, we will use the term stress in both of its meaning, one asa

‘state of upset behaviour.

and the other as a stimuli

causing

disturbances

in

Causes and sources of stress

1. Stress as the state of psycholocial upset: According to Coleman’? frustration, conflicts and pressures are the three important sour‘ces of stress. A wide range of environmental obstacles, both physical

and social and the internal factors in the form of personal limitations,

biological

frustration

conditions, of

our

and

psychological

needs,

barriers

motives and efforts.

Place a great deal of stress upon many of us.

may

lead to

Such frustrations

Similarly,

conflict of

Motives and- desires may also cause frustrating and stress situations. In choosing of either alternative from the contradictory needs, a person may be forced to postpone a: decision for days, weeks or Perhaps months before he decides what to do. An approach avoidance conflict is likely.to cause more severe stress. This is essentially true where a considerable feeling of guilt is involved. teenager who has a natural curiosity of reading a sex magazine

seeing a movie

A or meant for adults faces a_ stress situation on account

of the feeling of guilt and embarrassment associated with his motives. Such conflicting situations may lead to tensions and inner turmoil that the individual can’t resist stress and eventually developes into a disorganised personality. _ Apart from

frustrations

and

conflicts,

internal as well as

‘environmental pressures also prove a major source of causing stress. Internal pressures are caused by our own self for maintaining the

Picture’ of

ourselves—as

we

think

we could and should be.

We

strive bard to reach the top, to achieve success, and in doing So put an unreasonable pressure on ourselves. On the other hand, the €nvironmental demands, social obligations, family responsibilities,

aspirations and demands of the person who concern us and the problems of the complexities of life exert a good deal of pressure. Such pressures SS,

force us to striveand

struggle

resulting in severe

2. Stress as a class of stimuli: Let us now consider the sources of

‘stress in the Case where stress is considered as a class affect the individual and bring about stress situations. of stimuli that

: Every one of us is faced many times each day with minor stresssituations. Breakfast or lunch is not served in time, the bus is not available, students are not attentive, the supply of electricity or cooking gas is very poor. Such situations are very common to every one and often cause some or the other type of frustration or disappointment resulting in irritation, sadness or annoyance. But such happenings and results are easily forgotten. r The A story does not end with such easily faced or easily foregotten situations. We are often faced wit h stress situations of of a much

47

FRUSTRATION, CONFLICTS AND STRESSES

impact on our physimore serious nature which have a considerable ties of life like calami and ds ‘cal and mental health. The hazar or the death of illness severe a ty; proper or losing a job, money e; marital incom one’s d ‘someone close; financial liabilities beyon threatening such are ions situat and events discord and similar estimated. ignored or under ‘stimuli or stresses of life which cannot be ing about behaviour bring of le capab Such stress situations are a of serious nature.

disorders and personality disorganisations Impact of psychological stress or psychological in nature. Stress situations may be biologicalry and otber stresses like inju At the biological level, physical s result in the organic adjustpain ues, fatig , ases dise physical illness, placed on a “war footing” is body an hum ive. reactions. The iding biological defences prov l contributing to the adaptive potentia against stress. severe ones, upset the psychoPsycholocial stress, especially reactions to ium of an organism. His logical balance or equilibriolo gical and psychological in nature. both phys

such stresses are The physiological

stresses

m of may be reflected in the for cle mus sed rea inc like s tem sys

endocrine nge in changes in the nervous and r into the blood stream, cha suga ed stor of g pin pum fact is tonus, This ds. glan of perspiration and secretion than e mor er _ breathing, und criminals who, being of utilised in the interrogation of m for the in s tion reac nite physical d bloo ng risi ordinary stress, exihibit defi thing,

d and irregular brea faster beating of heart, rapielectrical conduction of the skin. Such pressure, and change in the the lie detector or polygraph for the changes may be recorded by to stress situations. siological reactions identification of the phy

stresses, as t, the reactions to severe On the psychological fron sified as task-orientated reactions, clas Coleman observes, may be .

d reactions and ego defence-oriente one feels s to a stress situation, In the task-oriented reaction ng changes in oneself or one’s by bringi competent to handle it warrant. This the situations tever wha , both or nt nme (i) Attacking enviro ms: for ing low behaviour takes the fol reaction promising com (iii)

behaviour;

(ii)

withdrawal

behaviour;

and

behaviour. in comparicted and unjustly treated ss. _As a Tf a female child feels reje stre re seve to may fall victim she r, the bro her k-oriented to tas son w the following types of reaction she may then sho behaviour. ch is level of hostile tension whi (i) She may build up a high

our. discharged in deliquent behavi

drawal rather than attack the (ii) She may simply resort to with herself Consequently, she will be limited to of frustration.

sources passive. by being an introvert and

48

ABNORMAL PSYCHOLOGY

(iii) She may compromise with the situations by thinking that she is a girland has to adjust in a male dominated society, where

the sons are likely to get more affection and attention and therefore she need not be perturbed. Ego defence-oriented reactions usually come into picture when we feel a threat to our integrity. All ofus under stress use these ego defence mechanisms, for maintaining and enhancing ourself. Like task-oriented reactions, these reactions may involve attacking, withdrawal or compromising behaviour. For example, the person may defend himself by attacking and blaming others for his mistakes. He may escape from the painful truth by denying it or by pushing it to his unconsciousness or he may bargain a compromise by admitting itin his consciousness in such a distorted way that it no longer hurts.

The responses,

defence-oriented are

reactions,

essential for

Stress situations.

the

as

protection

unconsciously

learned

of one’s self

from the

Although they involve self deception and reality

distortion, they may still be considered quite normal and even desirable except in cases where they are used to such an extreme degree that they begin to injure the self instead of protecting it.

Factors determining severity of the stress r Stresses are common in our life. We often face stress situa~ tions some time or the other. We usually overcome these moments

or situations by spending more

energy, effort and resources at our

disposal or bring change in our goals or methods of dealing with these situations. We use our adjustive capacity to meet the emerging demands of the stress, but sometimes the severity of the stress crosses the limit of one’s ,adjustive capacity. It then becomes a

devastating situation to the self. The severity of the stress depends

upon its intensity and tolerance capacity as described

A,

below.

The intensity of stress

It is the intensity of the stress that makes it severe and it

depends on the following factors:

1. Duration of stress:

The

length

stress may turn it into a mild or severe stress.

or the duration of a

: 2. Number of stress: Facing a number of stresses at the same time will result in a more severe situation than if these stresses are suffered separately.

:

3.

Amount of anticipated stress: How much the individual suffers as a result of the stress situation if these are not met in a

positive

way,

depends

on

the degree of anticipation which may in-

crease or decrease the severity of stress.

4. Strength and quality of the sources of stress: The nature of the stress will also depend upon the strength and quality of frustration, conflicts, pressures or other stimuli originating the stress

events or situations.

FRUSTRATION, CONPLICTS AND STRESSES B.

49

Stress tolerance capacity

It has been observed that people are able to weather severe significant psychological adverse circumstances without showing damage. They are able to handle the most threatening situations

without much difficulty while others break down under relatively mild stresses. Therefore, the severity of a given stress depends on one’s tolerance capacity. The term stress tolerance thus refers to the amount of stress stress. one can tolerate before breaking down under the pressure of to

Individual differences in the stress tolerance capacity are not easy involve the explanation may While a biological explain. assumption that more stable neuro-endocrine systems show a greatwill er resistance to stress situations, psychological interpretation Two situation. stress the of ion evaluat ual’s individ the involve tion of seryoung lecturers on probation may view their termina for one, it ways: t differen quite in ment manage private a by vices

severe may seem a humilating failure leading to frustration and sense the in te, fortuna but painful a it view may stress. The other that he may get an opportunity to work in a better institution or try for another good job. In a

true

sense,

people learn to perceive stress events in the

ous experiences which may condition a person to regard

light of previ Consequently, such a person will have life events as threatening. person who has been conditioned to the than less stress tolerance and less personal way. Tegard such events in a more philosophical

Summary Frustration:

resulting

from

n Frustrati on is the state of _emotional tensioof ment attain the in de blocka or the repeate d failure

a desired goal. ration lie both in the individual Causes: The causes of frust ent (external). Internal factors ronm envi himself (internal) and his abnormalities, conflicting may include the elements like physical equacy in the

high ideals, inad desires, moral standard, ethics and stence and sincerity in efforts. persi of lack and on level .of aspirati ical factors, social facExternal factors may be categorized as phys

tors and economic factors.

reacre sults in simple as well as violent i his ove impr al to incividu s may force an indi his ept tions, Simple reactionmis acc or l awa hdr wit ns, seek efforts, adopt compro ing mea to aggressive actidefeat. Under violent reactions one may resort the self or Results:

Frustration

vities. This aggression may

be turned inward towards

or its substitute. outward towards the source of frustration is a painful tens e state of an individual aroused

Conflict: It aking a choice between two or ount of the indecisiveness 10 M: acc on desires.

tory more opposing or contradic

50

ABNORMAL PSYCHOLOGY

Types 1. : Approach-Approach conflicts involve the problem of makinga choice between two or more positive goals almost equally motivating and important.

2. Avoidance-Avoidance conflicts involve choice between two or possibly more negative courses of action.3. Approach-Approach conflicts involve choice between

approaching and avoiding tendencies at the same time. Sources: Environmental forces and situations at home, school, world of work, and social or cultural surrounding may prove a potential source of conflicts. aes

Stresses:

and

pressures.

The

term

stress

carries

two meaning.

In one way

it is used for the state of psychological up-set caused by some strains In another

way,

it is regarded as a class ofstimuli

threatening and thus causing disturbances in one’s behaviour. Causes and sources: set,

is very

often

Stress,

caused

as the

state of psychological up-

on account of frustration, conflicts,

and

internal as well as environmental pressures. Stress, as a class of Stimuli, is generated through the hazards and calamities of life having considerable impact on one’s physical and mental health.

Reactions: The reactions to Severe psychological stresses may be classified as task-oriented and ego defence-oriented. In task oriented reactions, one is able to bring changes in oneself or one’s

environment or both through attacking, with-drawal or compromising behaviour. Ego defence-oriented reactions involve the use of defence mechanisms for maintaining and enhancing one’s self. „ Severity of the stress: How severe a stress is, may bejudged by (i) its intensity and force

of loss, and (ii) stress

involving

duration, frequency, amount

strength and quality of the sources of stress;

tolerance

capacity involving

ing the strain of the stress.

one’s

capacity

and

for tolerat-

REFERENCES - Carroll; op. cit., p. 33,

. Carter V. Good; Dictionary of Education, McGraw-Hill.

. Walter B. Kolesnik; Educational Psychology, p. 397. . Gilmer, op. cit., p. 304. . Coleman, op. cit., pp. 82-83.

Barnay,

Katz and

G.F. Lehner; Mental Hygi

York: The Ronald Press Company, 1953, p. De Carrol, op. cit., p. 34.

PN DMAP PHO.B.

Douglas

i

ivi

te: Modeen Liine Ne

w

& B.F. Holland; Fundamentals of Educational Psychology,

New York : The Macmillan Co. 1947, p. 216. 9. Katz & Lehner, op. cit., p. 30. 10. L.S. Shaffer, cited by Boring, Longheld and Weld, op. cit., p. 523.

11. Coleman; op. cit., pp. 83-84. 12. Colemen; op. cit, p. 82.

MENTAL

MECHANISM

[rt IS NOT always possible to achieve all that we desire in life. There are many situations when we fail in our attempts and get frustrated. Our failures and frustrations may bring injury to our ego and cause anxiety and feelings of inferiority.

of frustration

In such

moments

most of us do not like to face the reality by accept-

ing our shortcomings and failures but tend to resort to certain mechanisms for defending our inadequacies or anxieties. These defence mechanisms or devices are called mental mechanisms, mechanisms, or adjustment mechanisms. These have been defined as follows: Page: When psychological equilibrium is threatened by severe emotional traumata, frustrations, or conflicts, the mind resorts to a variety of protective subterfuges and detours called mental mechanisms or dynamisms.t resorted to in Carroll: An adjustment mechanism is a device that tension so need a of action satisf ct order to achieve an indire

will be reduced and self-respect maintained.”

for Arkoff; Certain patterns of behaviour that are employed

Protection against threat or anxiety are called defence mechanisms Sometimes they are referred to as or adjustment mechanisms. they serve to defend the ego or the since isms’ “ego defence mechan

self from threat.®

as ‘self protecMcCall: Defence mechanisms may be defined tive manoeuvers’, pertaining to perception and motivation, mental or se what Psychic, yet largely unconscious, designed to soften or disgui

is unacceptable in or to the self.*

These definitions reveal the following things regarding nature cteristics of ‘defence mechanisms.’ chara and

1.

Defence

mechanisms

are devices in the form of a certain

Pattern of behaviour. g 4 P against whatever 2. These mechanisms provide protection threatens our ego or self-esteem. ‘3. There are many situations in our environment and also

:

ABNORMAL PSYCHOLOGY

52

cal equilibrium. As within ourselves which threaten our psychologi ation, conflicts or frustr y, anxiet to a result, we fall victim help us to defend other psychological upsets. Defence mechanisms ts,

ourselves from the possible injury in such delicate momen a state of ten4. Unfulfilled desire, need or motive may bring respect. The self one’s to y injur ble possi sion leading towards the form of indirect way out is provided by the defence mechanism in the

satisfaction of that need. by anything in con~ 5. Defence mechanisms may be evoked _ be. must self the what of ideal mum mini our flict with 6.

frustration

Since

or conflicts are experienced by everyone

ego or self respect, and since everyone is compelled to maintain by us whether norused it follows that the defence mechanisms are mal or abnormal at some time or the other. They do 7. Defence mechanisms are largely unconscious. fact they In way. atic autom tend to operate in a machine-like or at are always, in corresponding degree, self-deceptive and thus aim softening or disguising .what is unacceptable to us in terms of our failure or inadequacies. symp8. Defence mechanisms should not be confused with

toms of neuroses or

other abnormal conditions.

are purely psychic

or mental

devices or

ways

mecha-

These

of perceiving

nisms e or have and desiring. Here the. individual is helped to perceiv regard. self his to threats of free him make to a matching wish to the psychic but On the other hand, symptoms are not limited our physiologi-~ disturb may and attach themselves to our behaviour cal as well as our psychological functioning.

Important defence mechanisms ce mechanisms. It is difficult to ascertain the number of defen ology or adjustA survey of the books available on abnormal psych ms are variable anis mech ce defen of lists the that ment may reveal

in length.

Commenting

t on this variability Hilgard, a prominence

psychologist, had remarked

that the length of the list of defen

mechanisms that an elementary psychology student knows

“depends

will upon who his teacher is and which text book he reads.” theWe princisome of therefore not insist upon the appropriateness of pal mechanisms discussed below, on account of the subjectivity.

1. Repression: The automatic inhibition of a threatening £ impulse is called repression. It is an unconscious forgetting OF

blocking from consciousness of internal impulses, feelings OF thoughts which are unacceptable to the conscious self. In this way, repression as a defence mechanism is that mechanism in which the threatening

or

anxiety producing experiences,

conflicts

and

unful-

filled wishes are pushed down into one’s consciousness and, as 2 result, one tries to forget the things that might be painful or threatening to one’s self.

53

MENTAL MECHANISM

intment with a friend 5orgetting one’s date of marriage or appo TA person who has painA , fu. e associated with such repression may not be able to

=

experiences attached to his school or teacher In another ecall even the name of the school or teacher.

a girl who affair

the painful memories

has repressed not

may

husband.

Therefore,

be

able

repression

to write

serves

later,

situation,

of her first love

a love

by providing

letter to her

relief, though

by making one believe from the tension or anxiety from ucing situation does not exist. It saves us

temporarily,

that the tension prod engaging in certain actions distressing thoughts, feelings, and from It helps us to hide our ul. painf which might prove dangerous or from ourselves just as we somethoughts and. feelings and actionsconceal certain things from others. to mpt times more consciously atte However, in certain cases,

repression as a defence may

prove

detri-

repressed may prove more mental in the long run. What has been . Commenting on this stage later a at dangerous and threatening ed desires, fantasies, and exPossibility Carroll writes: “Repress times light, sometimes heavy, Periences constitute a burden, some some the burden becomes which each human being carries. For the strain which may be to too heavy and responses are made ssional help.” neurotic or psychotic. Such persons need profe going backward or return2. Regression: Regression means : a retreat for an individual from ing to the past. It is, in a way, an earlier and simpler form of to the complexities of the present period of one’s life. behaviour or a more fortunate and pleasant ed as a mechanism defin ession may be Thus used as a defence, regr ier periods of his happ er, earli for ing by which an individual, long ate to his earlier opri more appr life, begins to behave in a manner atening

ecting himself from the thre age or period of life for n,protconfl ict, anxiety or tension. Situations involving frustratio

resorts to regression when he failing in his love affair older boy may regress when his exhibites his love for a doll. An hough feels neglected or deprived. Altst that new brother is born and he s, suddenly he may insi A man

ral year He he has been walking for seve is too small and must be carried. he that so, do to he is unable An ing. feed st brea on st insi and habits may even abandon the toiletthe family may also show signs of regresadult earning member of ed he wants to be nurtured, pamper sion when, after a hard day, to said be may an A young wom and otherwise cared for at home. nt’s pare her to rns retu she ism when resort to the regression mechan her marriage

to meet the demands of home after finding it impossible

and the new environment.

regression is introresorts to the mechanism of secure only in old s feel fidence. He verted, timid and lacks self-con ces. He avoids rien expe new d avoi to and tried situations and strives and retreats to und aro re, turns A person

adventure

who

and, fearful

the world of his past.

of the futu

54

ABNORMAL PSYCHOLOGY The

extreme

cases

into a disorganised very early patterns

vih reality and

of regressive

behaviour

tend

to develop

personality where the individual may retreat to of behaviour so successfully that he loses touch

believes

as well as behaves

like a child or

an

infant.

3.

Isolation:

Isolation

may

be

defined

as the cutting off or

blunting off what is unacceptable in the whole situation Therefore, while resorting to isolation as defence, the individual may exhibit the following types of behaviour:

z In spite of being in the possession

of all the

facts

of a

situation, he may not recognize them for what they are. * He may not view the situation to present a derogatory or painful picture. A mother of a severely retarded child resorts to such mechanism when she regards her child’s behaviour a little different from that of other children. The long-suffering wife of a drunkard or gambler uses this mechanism when she thinks her husband’s trouble only in being a little too sociable, and a dark complexioned girl by avoiding the company of her good looking friends. In such situations, iso-

lation proves helpful in defending ourselves from the threatening situations created on account of the deficiency in ourselves or in those close to us. The excessive use of isolation is a danger signal. It may cause great harm to the individual or those close to him, especially if it

is coupled with too much day-dreaming or escapism from reality. 4. Withdrawal: In using this mechanism an individual tends

to withdraw himself from the situation that causes frustration or failure. He makes himself safe and secure by'running away from the difficulties. For example, a child may refuse participation In games for fear of failure and may deceive himself by believing that

he could do well if he had participated. Similarly, there may be one or more things where he may feel inadequate or suffer from the fear of failure or criticism. In such circumstances he tries to deceive himself by „not involving in the real testing situations, instead of accepting his limitations. In the extreme instances, the use of withdrawal as defence may

lead to a condition described by James D. Page in Abnormal Psychology as pseudofeeble-mindedness. In this condition the policy of nothing ventured, nothing failed or punished for, is followed and the individual eventually acquires a reputation for being stupid when actually he may be of average or superior intelligence. 5. Day-dreaming or fantasy: Day-dreaming or fantasy isa kind of withdrawl of one’s self in a private and satisfying world of imagination.

Thus,

instead

of facing

satisfied with unreal, imaginary

success

the realities he may become

or satisfaction that he gets

55

MENTAL MECHANISM

m roaming through

of make-believe and imagination.

the world

ommenting on the use of this mechanism Arkoff writes: escape “As a defence, our fantasy life provides us with an our In world. real the m of boredo and , from the dangers, threats fantasies we can meet our unmet needs and reach our unreached

We

goals.

can

picture ourselves as a different sort of person and

the world as a different sort of world.”® or fantasy when the An individual may turn to day-dreaming and frustrating. Fantasy present he is living in is uninteresting exciting things occur, where permits him to escape to a dream-world s. desire he ve what and he is able to achie types of day-dreaming or In general, there are three common hero, and suffering hero ng ueri conq g in the past, fantasies—roamin or martyr type.

while evaluating the preIn the roaming type, an individual, into his happy past. In roam to tries sent as bitter and painful, again happy experiences such fantasies, the elderly pers on may live more pleasant than even them king out of his past, sometimes ma they really were. In the

conquering

the individual imagines that he

hero type,

s situation. , He says and does all the Hething isa s. ience exper l actua the g durin do that he failed to say and player of hockey, ‘a gold is the master of some

managing director ofa factory,

a great

or a great cine actor. He is applaudmedal winner in a convocationafter. In such day-dreaming a : younged, acclaimed and sought imaginex about thee love affair, may d rie man who fails to get mar be shared with a beautiful girl who Marriage and ihe affection ato marriage party. Similarly, a single beautiwas once seen by him in married, has a good husband, woman may dream that she is

ful children and a decent home.

of day dreams, the individual In suffering hero or martyr type some situation. It is resorted himself to be the victim of

child who imagines pities himself. As a result, ae himself as to by the individual who gin home may ima feels that he gets maltreatment at y, an adult may see himself larl Simi ., dead even or y ill ousl seri ries and thus get satisfaction by undergoing great hardships or mise victim of the circumstances. The

the imagining himself a martyr ordream ing suffering

hero type of day

inward Tal therefore Quering hero type.

may

prove

is a form of aggression turned conmore dangerous than the

prove detrimental when it becomes Day dreaming or fantasy may the actual efforts for achievements. a substitute for the real world andage of precious time and energy but dekh 5 3 Not only does it lead to wastl of also paves the way for maladaptive behaviour and disorganisation the personality. _ 6. Negativism: It is as an aggressive withdrawal to which the individual resorts for gaining attention and enhancing his self-

56

ABNORMAL PSYCHOLOGY

esteem. Negativism manifests itself in various forms such as refusal to eat, refusal to listen, refusal to speak, refusal to do work, and

at times,

in doing the

exact -opposite

of what has been asked or

requested.

A young child or an adolescent often uses such mechanisms as

a means of establishing themselves as independent

persons,

and to

make the parents or elders, feel that they are right or important. Negativism is often used by adults or mature persons. A wife may use it to revolt against the authoritarian attitude of her husband, or an unemployed youth for expressing his resentment against nearly everything in the social set-up. _ . 7. Displacement: It refers to a process of displacing or shifting

of thought,

to another.

When

an

feeling or action from

individual is unable

one person or situation

to react or express his

emotion or impulse in a particular situation, he may resort to displacement mechanism for relieving himself of the anxiety or frustration by its transfer or displacement to another situation or object neutral, vulnerable, or less dangerous than the original, for example: * A youngster rebuked by the mother, being unable to attack or react directly, may trample her flower-bed. * A little boy, beaten by one of his school mates, may kick or slap his younger brother on returning home. A

clerk,

being

maltreated

by his boss,

may displace his

anger towards the peon or his wife or children. * A child who fears his father or teacher may displace this fear to animals. * An inherent fear of committing suicide may be transferred to a fear of knives and other sharp instruments.

* A boy who is unable may

male.

turn

his attention

,

to get attention from” his father to a teacher or

some

other

adult

In this manner, displacement is a kind of substitution of one outlet for another, and works as a safety valve for the pent-up emotions and impulses which otherwise may prove harmful to the self and the society. Sublimation is also a kind of displacement which involves rechanneling a drive, emotion, impulse or action in some socially acceptable form. Thus, the emotion of love or impulse of lust may be displaced towards love for humanity or God. A woman who has trouble with the roles of a wife and mother may direct her energies to

social

or

professional

activities,

or

a

youngman

may

write

beautiful poems and in this way discharge (sublimate) part of the strong sexual desire he is unable to discharge directly to his beloved. 8.

Rationalization:

It is a defence

mechanism

in which

a

person tries to justify his otherwise unacceptable social behaviour or

MENTAL MECHANISM

57

and thus attempts to act by giving socially acceptable reasons for it reasons to explain his good ting deceive others and himself by inven will view and explain conduct. Thinking on this line a rationalizer as caution, his severe dice cowar his idleness as needed relaxation, his child’s own good. A child and arbitrary discipline policies for his give lame excuses for

to makes use of rationalization when he tries ambiguity Or rness unfai He may blame e.

his failur

of the ques-

health and ailments and thus tions, teacher or parents or his poor deficiency. try to disguise his own weakness and st universal. We all, at one The use of rationalization is almo on, viour in an acceptable or reas

beha time or the other, interpret our threat to our sense of well-being and able way in order to prevent a We often offer the enhance our image. thus try to maintain or even ally motivated by actu is h whic reasons for behaviour

noblest. of ization is well played by statesselfish desires. The game of rational gramme a government In announcing a specific pro men or nations. ally its social ‘good of all, when actu may assert that it is for the power to it. objective stands for bringing more

by a zation may be well illustrated The mechanism of rationali es which are known as the sourof two special typ

consideration grapes.and sweet-lemon attitudes. d on the fable of the fox and In sour-grapes mechanism,le base obtain what he wants, tries to to unab the grapes, an individual,

that he did disappointment by maintaining avoid the bitterness of The post saves the get to fails who man g youn not want it any way. the job. want ly real not he did face and self-respect by declaring that tains main team ket cric ol on his scho A boy failing to win a place to waste his time playing. Similarly, a that he actually did not want that he did not his fiancée may maintain up to his stanyoungman rejectedmarrby ure meas not did, y her as she actually desire to anations and excuses help the dards. All such justifications, expl ion by playing

the tension or frustrat individual for getting relief of g the unpalatable ones. down the.good aspect and stressin the individual maintains that In sweet-lemon type reactions,or whatever he has obtained is whatever happens is all for the best denied the obtain. A senior lecturer is blow to the best of all he could re seve isa fact in h post whic Promotion to the principal’s is more he that frustration by saying secuhim, but he adjusts to this e mor y ivel arat re he enjoys comp of are welf happy in his present post whe more time to devote for the rationalize Tity of service and also gets may boy ed app handic his family and writing. Similarly, a providing

as a blessing in disguise for. by thinking ofhis broken legup with his studies. ch him an opportunity to cat ion is a kind ion : Whereas rationalizatied inadequacy 9. Reaction-formatnt impl of on” ati lan exp or of “refutation by argume mation is a “refutation by action”h or unworthiness, reaction-forway s that are sharply in contrast wit Here one strives to behave in for protecting one’s self-esteem. the ways that he tends to behave

ABNORMAL PSYCHOLOGY

58

By utilising reaction-formation as defence, one tries to inhibit, mark or overcome certain impulses that threaten one’s self or general welfare by emphasizing the opposite or contradictory ones. A mother may hate her.child, but by using reaction-formation as defence she may be able to inhibit or mark or overcome unworthy

impulses and thus turn into an attentive, solicitous and over protective in her behaviour towards him. A person who is strongly

motivated by undesirable sex needs may react by being extremely puritanical, avoiding almost all association with the opposite sex and even criticising others for their sexual activities. In this way he may strive to feel, think and act in ways contradictory to his own Similarly, reaction-formation towards real wishes and motives. selfish tendencies may be manifested in extreme generosity.

Thus, by resorting to reaction-formation as defence an individspite of suspected meanness, may behave so very nobly that in ual,

no one may possibly doubt the purity of his motives. It may be added that his self reaction-formation is not, however, to be confused with hypocritical pretence. The individual casually resorts to such

mechanism

rather

than

with

awareness and there

full

little doubt of the sincerity of his desire eousness.

for moral

and

It is in fact the extremity of the desire

is usually

or social

right-

for the

care

protection of his self-esteem which compels him to resort to reaction-formation instead of facing the things as they are or behaving as he tends to behave.

teem by way 10, Compensation: If something threatens the self-esined away “expla be cannot which hiness unwort or ncy of deficie perhaps it can (rationalization) or “acted away” (reaction-formation),

Compensation may, |thus, be

he made up or compensated for.

described as a defence mechanism which helps balance or cover-up his deficiency or inadequacy

exhibiting his strength in another field.

an individul to 1n one field by

For example,

and secures

an

unattract-

the top position in

ive girl who becomes a book-worm comthe class is said to make use of such mechanism in order to result a as win to unable is she that e mand the respect and prestig of her looks.

“Compensatory behaviourss,”

of aggression turned outward.

frustration.

Carroll maintains, “is a form

It represents active resistance against

It isa fighting attempt to maintain the ego, and is

frequently a. powerful motivating force in achievement.”?

Napoleon’s achievements, to some extent,

are said to be the

result of his compensatory behaviour for an early feeling of inferiority concerning his short stature and faminine build. Similarly, Hitler, Changej Khan and Tamoor Lang are also said to have compensated

for their feelings of inadequacies.

In-over-compensating

their feel-

ings of inferiority, they developed a superiority complex by becoming rude, aggressive and terrible figures of their time. The compensatory behaviour is quite common among students.

59

MENTAL MECHANISM

feeling

While

inferior

on

frustrated

being

in

attempt

an

ism: to win recognition, one may resort-to the compensatory mechan man-typical ng affecti g, clothin r peculia g by boastful talk, wearin nerism, disobeying orders and engaging in delinquencies. times, found to Parents, guardians or teachers may be, many gh their compensate

for their own

failures

and

frustrations

throu

to be an I. A.S. officer children and students. A father who wanted pt to force his son attem may sion profes er anoth but now serving in r who fails to mothe A n. to strive hard for the I. A.S. competitio may bring to nd husba her with onship establish a harmonious relati and considive careful, attent bear pressure upon her daughter to be behaviour

This type of compensatory erate to her husband. the children. for creates serious problem lses, traits A person may have inferior impu Projection: 11. tion. For situa ing in a threaten or motives which can involve him the mec hanism aof] ction by proje of to rt his defence, he may now g reso r perothe 1n ves moti the unacceptable attributing to or observin ies impl on ecti proj nce, defe d as sons. Arkoff points out that “use or fealings or actions which are ghts that a person has certain thou then deniei s are his and instead attrihe h whic him, to threatening

butes to others.”®

tcomings observes and criticizes When a person with some shor make use of projection as the failings of others, he may be said to caught cheating in the been has who ent defence. Similarly, a stud that others also have ng elf by sayi examination may defend hims urge may denounce al sexu able cept unac an cheated. A person with think in terms of to try or may others for their sexual propensities who is tempt-

world around him. A man ns’ and sex for everything in the try to accuse his wife for her ‘flirtatio of her ed to be unfaithful may tery adul the t ably worried abou se the wife may be consider ted to be a homosexual, may accu temp is who boy A husband, . others for making indeçent advances It is not necessary persons.

that the objects

Animals, natural

and

of one’s

projection must

supernatural

forces

or

serve as well. A student may even inanimate objects may also may attribute ure. A badminton player blame his fortune for his fail boy after falling off the chair may

always

be

et. The his failure to his rackbein g responsible for his fall. kick the chair for

ptable is is undesirable or unacceted t wha n tio jec pro in (as in s, Thu ionalization) nor counterac Neither explained away (as in rat r (as in compensation), but one reaction-formation) or made u „fo(attributing Or observing in) on g it gets rid of it by projectin Others. ble or by pr ojecting the undesira One gets satisfactionit may be explained through the following unacceptable on others and

benefits derived :

by or unacceptable undesirable a > thoughts i) One can get Ti d of the5 ble .”). dirty (“I don’t have such undesira

denying

PSYCHOLOGY

ABNORMAL

60

Gi)

Offense is the best defence.

In projection

opportunity for attacking the unacceptable and thereby distance from that (“I can’t tolerate or go on with the have such mean thoughts. ”).

(iii) One may feel satisfied

by

emphasizing

are similar or even worse. (“So, what if Ihave such “80, every body often feels and does the same.”)

one

gets an

establishing people who

that

others

feelings or done

(iv) One may decei one’s self or others by, enicising. or sometimes preventing otherves from practising the undesirable. (“See, I

am against these ideas, I will not allow the thing s going on in such

immoral fashion.”’).-

Projection may also prove detrimental in the long run. For defending ourselves, we project our undesirable behaviour —feelings,

thoughts and actions—on others and then try to act

in accordance

with this projection. It ultimately leads to disharmony and Hr ness, for while attempting to hide our weaknesses and undesirable motives, we are unable to face the realities of life and thus remain

victims of poor adjustment,

13. Sympathism: It is a kind of defence mechanism in which an individual ties to get satisfaction by seeking sympathy and pity

from others for his own failures and inadequacies. Such persons always magnify the difficulties or obstacles hindering their on and thus persuade

others

to pity them.

who is not nursing her children

well may

For example, a ge

4

be satisfied with ot ere

sympathy which she may evoke by telling them about how busy, oa is, how the members of her family do not cooperate with her, or h

her family is passing through great trouble, person

All these defence

mechanisms

to protect himself, although Psycholog danger The are ical

s,

y

are

used

unconsciously

aia

timeentbeincur g, e “er not for the the perman 0 tl ia

trouble as Morgan observes, but “they merely conceal or disguise t |

real problem. again.”®

It is still there, ready to produce

In this way

defence

mechanisms

anxiety again

may be

reg

an

arded as temporary defence against anxiety and ina deq uac ies . Mor eov er, the use of such mechanisms may create new difficulties for the ind ividual who frequently resorts to them.

Summary Mental mechanisms: Mental mechanisms or defenc e mechanisms are resorted to defend the ego or the self from threat of anxiety. They are purely Psychic or mental devices—ways of perceiving and desiring. They may be regarded as temporary defenc e

against anxiety and inadequacies, Important mental machnisms

Repression: In this mechanism, threatening or anxiety producing experiences and unfulfilled wishethe s are pushed down to the

MENTAL MECHANISM

61

level of unconscious mind in order to forget what is painful or threatening to one’s self. Regression: It is a mechanism of behaving in a manner more appropriate to earlier happier periods of life for protecting oneself from the threatening situations of the present. Isolation: It is a defence mechanism which makes an individual protect one’s self by cutting off or blunting off what is unaccept-

able in the whole situation.

_

Withdrawal:

withdraw

In this

himself from

mechanism

the

situation

the

individual

that causes

tends

to

frustration

or

failure. Day-dreaming: In such behaviour, instead of facing realities, the individual tries to seek satisfaction by roaming through the world of make-believe and imagination. Negativism: It is as an aggressive withdrawal. Its various forms of manifestation are refusal to eat, listen, speak, work, and, at times, in doing the exact opposite of what has been asked or requested,

Displacement: It refers to a process of relieving oneself from the anxiety or frustration by transfering or displacing it to another

situation or object. Rationalization: In this mechanism a person tries to -justify his otherwise unjustified behaviour by giving socially acceptable reasons for it.

Reaction formatian:

Here,

one strives to behave in ways

that

are sharply in contrast with the ways that he tends to behave for

protecting one’s self-esteem. Compensation: This defence mechanism helps an individual balance or cover up his deficiency or inadequacy in one field by exhibiting his strength in another.

Projection:

In this mechanism

a person defends himself by

attributing to or observing in other persons or objects his own inferior impulses, weaknesses or unacceptable motives. Sympathism: In this defence mechanism a person tries to derive satisfaction by seeking sympathy and pity from others for his own failures and inadequacies.

:

. Page, op. cit., p. 39. Carroll, op. cit., p. 53. Abe Arkoff, Adjustment

eye

REFERENCES . and Mental Health,

New

York : McGraw-Hill,

i , 1968, p. 138. d,” The PsychoRe-2xamine Mechanisms Defence “The McCall d J. 4. R wbos of Adjustment, Walter Kat-Kovsky & Leon Gorlow, ed., McGra Hill, 1976, p. 271. 5. Carroll, op. cit., p- 75-

6. Arkoff, op. cit., p- 162T: Carroll, op. cit., p- 54

. Arkoff, op.cit., p-156. 9.a CT. Morsan, oduct

, to Psychology, McGraw, Hill, 1961, p. 143.

7 SYMPTOMS AND SYNDROMES health and AN INDIVIDUAL is said to be in a satisfactory mentalsatisfied with feels he considered to be normal to the extent balance himself and his environment. The disequilibrium of this

leads to maladjustment, behaviour disorders, and mental illness. Defence mechanisms, as we have seen in the previous chapter, were nothing but temporary measures for defending or protecting one’s or behaviour disorders. self from the possible maladjustment prove successful or get not do Temporary defences often either

damaged in the long run paving way to serious behaviour disorders or mental illness.

y How can one decide that an individual has become mentall 4 is lity abnorma or s ill or developed serious behaviour disorder OF _

question which we will now attempt to answer. Every illness disorder—physical or mental—is identified or diagnosed with the help ofcertain symptoms or a group of symptoms called syndromes known to be associated with that particular illness or disorderSymptoms

The word “symptom” means “sign”. Therefore in medicine it z is an indication of sickness. Inthe words of Brown, “A symptom

is a surface sickness. It is the maladjusted behaviour.”, Let us try to analyse this definition. A person who has become physically ill may. be declared so on the basis of the

symptom stands to mean

symptom, the fever.

a surface sickness.

The fever as

It is not at all the

actual sickness. In depth, as usually happens, there lies a disequilibrium in metabolism caused by an infection which is a struggle between the organism and some hostile invading forces. Similarly, headache or pain in the stomach also represents the surface sickness, the symptom of an illness or disease. In the field of mental illness and behaviour disorders also, the For diagnosis is made with the help of the related symptoms. example, vague and unreasoned fear is a psychological symptom that represents a surface mental sickness. It is not the actual mental

illness but only an indicator or sign of a sever malfunctioning of the

behaviour or disorganisation of the personality.

SYMPTOMS AND SYNDROMES

63

to cure the symptom A decision has to be arrived at—whether surface sickness or of cure The ss. {surface sickness) or actual sickne in a temporary cure. symptom as may be understood can result in fact a mere sign of is which The removal of the symptom itself, We may temporarily sickness, is at the best a temporary procedure. fever, but it will the ing remov or treat an ailing person by reducing lie merely in the not does cure nent perma not be a lasting cure. The l illness or actua the of ment treatment of the fever but in the treat ment of treat the arly, Simil s. cause disease by investigating the root only will s, illnes l case of menta the symptom, unreasoned fear in a l of signa a only is fear unreasoned prove ą temporary cure. The reduction the fore, There der. disor the mental illness or behaviour not fever in physical illness, may of the fear, like reduction of the but also ation ganis disor iour behav or only fail to cure mental illness ons resulting in accute mental create more problems. and complicati of the term diseases or disorders.

For understanding the meaning

stics may be examined. ‘symptom’, some of its characteri

Characteristics of symptoms

ptoms, ve and objective nature: Sym ective 1. Symptoms have subjecti subj as to rred refe be can s, from the point of view of diagnosi ion illness or disorder. The condit dtire or objective manifestation of an or r fea n, sio res dep son like

ill per of an abnormal or mentallyve symptoms, whereas objective symptoms ness are called the subjecti which are memory, unreasonable fear are symptoms like faulty in his behaviour.

‘observed and usually revealed 2.

indicator : A symptom is the sign org causes. Symptoms have cause ch yin erl und nite defi has kness or disease whi

of the sic dache or. fever has of a stomach-ache, hea A symptom in the form ical symptoms are log cho Similarly, psy es. caus or se cau ted roo destabilization of ‘deep ations, happenings and the the results of some situ the equilibrium of the psyche. D € my: Symptoms an econo significance and an a is re the 3. Symptoms have a t It indicates, tha has a meaning. , rly ila Sim . ion ect are significant. Fever inf e som m caused by mental disequilibrium in metabolis , has a meaning indicative of bia pho or r fea ble ona unreas proves m pto sym A r. behaviou illness or malfunctioning of the ss. A illne or t tmen djus mala of ng the’ state disoror rder meaningful in indicatints diso r towards a partijcula specific symptom, poi .ty. Zanisation of the personali ends of the sick. lysed, are the best friorg anism and is, in Symptoms, when anaof disease within the The eee ksa symptom ading forces inv The an curing itself. org the of s ces fever. By pro the fact, yed through the mechanism of

ect his causing infection are destro r, the individual tries to prot developing the symptom of feve It is like protecting one’s self from e. Metabolism and his existenc

ler ones. by facing or bearing the smal the greater risks and troubles s symptoms of behaviour disorder Similarly, the psychological

ABNORMAL pSYCHOLOGY

64

or mental illness are the friends of the affected person since these save the person from the more unhappy and sad situations. Take the case of the old maid considered to be suffering from anxiety

neuroses, and habituated to looking under her bed at night for fear of someone being there. Her anxiety or fear reactions help her in seeking new equilibrium. Actually the old maid’s fear or anxiety She really means that she is the result of her sexual frustration.

should have someone with her at night, but she can’t afford to admit the demands of her sexual urges and the social consciousness of the from the

consequences.

To protect herself

anxiety which

help her to function and exist

tension,

of this conflict and

she

develops

damaging consequences

the symptom of fear or gracefully.

Similarly,

for a person suffering from schizophrenia, flight from reality proves helpful and economical as it prevents him from committing suicide. l A physical and psychological symptom may therefore prove beneficia least at continue to psyche troubled a enabling and economical by

temporarily

worth liying.

or partially adjusted and thus make life tolerable and

4. Symptoms hardly occur alone: The diagnosis about the illness, mental or physical, can only be made from the symptoms. A particular symptom is a sign of a particular disturbance, disequi-

librium or disorder

of the body

or psyche.

In a diagnosis

of a

Particular disorder or illness, therefore, help is taken from a number accordof symptoms related to that disorder or illness. “Symptoms”, occur rather but y isolatedl and ing to Brown, “‘scarcely occur alone

together in fairly well organised groups.”*

Thus cold, sore throat,

headache, pain in parts of the body, high fever and certain other symprarely in toms appear in the disease known as influenza, Similarly,

actual practice do we find isolated mental symptoms. In a particular

mental together, disorder

or illness sitit

i isa

group of symptom: s that

occur

5. A single symptom may appear in many disorders: It is true that symptoms rarely cree isolation "and a particular

symptom isa sign ofa particular disorder or malfunctioning, but if does not mean that a symptom should occur or appear only in one disease or disorder. Any single symptom may occur in quite

different disorders just as the

symptom of headache

or fever may

occur in many organic diseases.

The symptoms

of abnormal

behaviour—mental

illness and

In the diagnosis of mental illness and behaviour knowledge of the related symptoms is essential. The of symptoms is important on account of the fact that person either does not know or will not admit that he

disorders, the careful study the affected is mentally ill

behaviour deviation

or abnormal. Consequently, there are cooperation in the diagnosis of his case.

little chances of getting his. Also, the symptoms related

to normality and abnormality differ in degree rather than in kind. Generally, however, somewhat fixed and persistent symptoms

65

SYMPTOMS AND SYNDROMES indicate

serious

illness

abnormalities or mental

in the affective

as shown in Figure 7.1. persons. These symptoms can be classified

Abnormality of the human behaviour pe

|

eS

Physical or organic symptoms Fig. 7.1.

A.

Ee

B | Psychological symptoms

A 2. Motor

1. Mental symptoms

3. Emotional

symptoms

4, Total be-

symptoms

haviour symptoms

ity. Classification of symptoms of abnormal

Physical symptoms The body and mind

are always closely as-

in an individual

psyche are not only manifested sociated. The problems of the toms but bodily signs or physical symp through the mental symptoms, the mental illness or disorders

often successfully exhibit or indicate such as:

e and respiration. * Change in temperature, puls the weight of the body. * Unusual or extreme changes in etite and thirst. * Loss of or abnormal app dache and dizziness. * Nausea, vomitting, hea body pains and abnormal * Cough, excessive fatigue,

pupilary

activity.

*Motor incoordination.

B.

Psychological symptoms

concerning

abnormalities

in

human behaviour is quite ill or disturbed person in the the behaviour of the mentally found are behaviour

his abnormalities in all abnormal. These behaviour, that is, cognitive,

domains of his

conative and

affective.

and disorders in these processes There are definite disturbances symptoms. definite give rise to following 1. Mental symptoms

which

of the cugnitive processes) (concerning abnormalities be listed as below. These symptoms can Sensory the sensation: ning disorder of cer con ch and s tou tom g, smell, X ses of sight, hearin t but decreased in sen the Eg np Se processes be absent, presen . It may in the taste may be disturbedin distorted. For example, Or ity ens int ibit exh y ma on rs pe intensity, increased ed ia, the troubl ter hys n sio ver con led cal neurosis of his vision as under m concerning disorderTof One or the other sympto eals no casual ati physical examin on rev his t tha t fac the of (in spite for these symptoms).

organic process to acount unable to see; (i) may be completely

ABNORMAL PSYCHOLOGY

66

(ii) may have reduced vision; (iii) may complain that things are too bright and intense; and (iv) may have distorted vision like double vision etc..

The disorders of the sense of touch are quite frequent in the cases of abnormality and mental illness. A common symptom known as ‘anesthesia’ concerns loss or absence of sensation of touch. It may be both organic and functional. b. Symptoms concerning disorder of perception: attached with some definite meaning or interpretation perception. Illusions end hallucinations represent the common symptoms of mental illness or disorders based on bances of perception.

Sensation is taken as two most the distur-

l Illusion is the mistaken perception where objects are not perceived as they really are. There is.always misinterpretation of the external and real stimuli which leads to the distortion of what is As a result, fellow patients seen, heard, touched, smelt or tasted. and hospital employees are mistaken for relatives and friends, a piece of rope may become a snake, and a rustle of leaves may be misinterPreted for human voices. _. Hallucinations represent such false perceptions where the individual perceives an object without any basis in reality. They are

thus imaginary perceptions.

As a result, an individual sees an object

where no object is present; he hears voices, bells or other sounds but others cannot; he experiences taste sensations without food and seems to experience muscular sensations that are not present.

c. Symptoms concerning disorders of the memory: Lossof memory known as ‘amnesia’ isa well known symptom concerning disorders of memory. Amnesia usually occurs after a precipitating event such as head

injury or

severe

emotional shock.

As a result,

the individual may be unable to recall events, preceding or following

the shock or both.

There is another symptom

known as ‘fuge

concerning distortion of. memory where the individual losing his memory assumes a new identity and name and may start life anew by adopting new modes of living like vðration and family.

d. Symptoms concerning disorders of thought: These symptoms

may include the following:

_(1) Flight of ideas and word hash (salad): Flight of ideas

consists of a series of rapid jumps from one idea to another. One has extreme rapidity of association of ideas but in no ordered train of thought. If the associated ideas then the term ‘word hash’ or ‘a salad

symptoms.

have no logical sequence also of words’ is used for such

‘Neologism’ is the extreme case

of ‘word hash’ where

the individual tries to coin new words such as ‘radimony’, a fusion cf ‘radio’ and ‘money’ which are meaningless except for him. (2) Blocking of the thought processes or delay of the mental

associations:

Blocking refers to the sudden stoppage of the sequence

SYMPTOMS AND SYNDROMES

67

It is a kind of sudden failure in the sequence of mental

of thought.

associations.

may respond,

When asked, “Why did you go there ?? a mentally ill “I went there

for...”

Beyond the word

‘for’ he can

Say nothing.

ing of the mental Retardation or delay differs from blockad of being stopped, associations in that the associations here, inste

The patient's thinking is slow and laborious. characteristic of depression while Retardation as a symptom is usually blocking is fairly common 1n schizophrenia. loss of an individual’s power (3) Agnosia: It is related with the

occur but very slowly.

the world around him. to perceive existing relationships in g vidual’s loss of understandinhis (4) Aphasia: It denotes an indi lose may al vidu indi an t, resul a or of producing language. ` AS aphasia), or he may be unable

to use spoken language (motor In ‘alexia’ he may lose his his ability to write (agraphia).in sensory ‘aphasia’, the loss of to read the written word or, . to understand the spoken word d Fixed ideas denote a distorte (5) Fixed ideas or obsession:. or ds wor of ence sequ or s idea mental association where some tal association process that it phrases are so preserved in the men -are one step

ability to use ability ability

them. Obsessions becomes very difficult to remove ideas in the association process. d fixe of t of a further than the preservation as persistent unwelcome though tional An obsession may be defined irra be to individual recognizes : fairly specific nature which the no control. or but over which he has little and conflict-generating in elcome An obsession is always unwtealizes that his belief or thought son the sense that the affected perFor example, a mother may be constantity. real ial soc is contrary to an may be l her little baby, or a youngm ly haunted by the idea to’ kil on looking gh hou alt his’ hands are dirty individan Obsessed with the idea that , rly ila Sim n. clea perfectly ous, son at them he sees that they are poi are the belief that certain foods ual may be obsessed bywor nt. ine ld is imm or that the end of the of judgeare significant disorders e beliefs (6) Delusions: Delusions

or fals d as persistent thoughtsieving them to be ment. They may be defineend bel . by y usl oro vig s which the individual def cal absurdity or proof to the contrary, and logi The absolutely true despite with his social adjustment. ich (wh despite their serious interference s ief bel se the in the -corrections individindividual never stands for often inconsistent with. theSome of are and ity” real in is bas son have no eal to rea ence) by an app ual's knowledge and experi usi del on are as under:

the common types of

grandeur, the Under the influence of ow his n attributes exaggerated belief in unrealistic andtly is a person of he t tha es person has an gin , he ima Consequen or achievements. the mind,r the individMerely ) by a twist of fluence. Meret great power or infl universe, agreat onaire, the ruler of the ual, he, becomes 4 milli (i)

Delusion of grandeur:

ABNORMAL PSYCHOLOGY

68

His behaviour reflects what

, a noted historian or even God.

inventor he imagines to be, the attitudes and actions of the one with whom he identifies himself and he demands from others the attention that is appropirate to his exalted position.

Gi)

Delusion of persecution:

This type of delusion runs exactly

Here the affected person imagines

opposite to that of grandeur.

himself the most incapable, unworthy or insecure creation in the world. Consequently, he may think himself as the object of hatred,

jealousy, enemity and malicious or destruction of his welfare.

influence aimed at interference with For example, an individual may

imagine that his enemies are trying to spread malicious rumours about him, poisoning his food, and in many other ways planning to harm him. He may imagine strangers condemning him and the casual comment of a friend as a personal insult.

_

_ üi)

In this type of delusion, the

Delusion of hypochondriasis:

individual persistently believes and complains that he is suffering from some incurable physical or mental diseases without actually being affected by them.

thus complain

An individual with an intact digestive system may

being rotten.

of his entire intestine

Others

may

similarly complain that their blood is turning into water, their bones

becoming fragile, or they are affected with cancer or tuberculosis.

Gv)

The person suffering from this

Delusion of melancholia:

for. punishtype of delusion has a deep-rooted guilt feelings or need really been has iour behav As a result, the person whose ment.

believe that he has committed an unfor-

exemplary may persistently

givable crime or a moral

of his time condemning

sin.

Consequently,

himself and

he may spend much

attempting

to set right the

wrongs he never committed. 2. Motor symptoms

(abnormalities of the conative processes)

The abnormalities of the conative processes are concerned with

the motor activities of the individual in doing the opposite of what is normally expectrd from him. The general symptoms belonging to this type may be categorized as below:

a.

Disorders of muscular activity:

muscular acts and

a functional basis.

muscular

tonus

may

The disorders

of simple

concerning

this type 1S

occur on an organic or on

A significant symptom

‘paralysis’ which indicates the stage of the complete loss of motor

functicns of the muscles. A less complete loss is called ‘paresis’. Inadequate or maladjusted muscular activity may also indicate abnor-

mality or mental illness. In this category the mentionable symptoms are ‘tremors’, ‘tics’ and ‘choreas’. The tremors found in neurotic anxiety and hysteric reactions refer to continuous involuntary, spasmodic contractions, or trembling, in a small group of muscles.

Tics are spasmodic twitchings of small groups of muscles particularly of the face, neck and shoulders and are usually found im

SYMPTOMS

AND SYNDROMES

69

spasmodic compulsion neurosis, Chorea is an irregular involuntary origin. in c organi movement and may be hysteric or of this b. Disorders of motor language habit: The disorders listed as be may ality abnorm of oms as specific sympt oe w: words. G) Motor aphasia: Loss of the ability to speak write. to ability Gi) Agraphia: Loss of the

;

ure.

Gii) Amimia: Loss of the ability to express thoughts in ges-

alities in writing. (iv) Writing peculiarities: Concerning abnorm stuttering, persistent (v) Speech disturbances: Stammering, or phrase, halting speech or refusal to talk.

Tepetition of any word A display of unaccustomed (v) Use of objectionable language: age. langu ene) vulgarity or of profane (obsc motor behaviour: This catec. Disorders of voluntary acts or

‘gory may include the following: These symptoms relate to G) Increased psychomotor activity: istently engaged in a conpers the condition wherein the individual is whispering.

stant motion, crying, laughing, shouting or ity: These symptoms maniGi) Decreased psychomotor activ on—hesitation or indecision moti of fest themselves in the slow down d without

lity to walk or stan (abulia), rigidity (catalepsy), and inabi

support (astasia-apasia). ted The term ‘abulia’, closely rela

to the emotional symptoms

be or weakness of the will. It may, or of depression, refers to lack of hing anyt do patient does not have a will to

‘to generalized where the tendency like merely not willing may cover some specific action eat’ or ‘to get-up’catapostures as in catalepsy. In Rigidity refers to fixity ofof cata ibility is flex y wax ed call y leps tonic schizophrenia, a type sual person may be seen in the most unu s found in which the affected arm The rt. omfo disc ite ods desp Positions or postures for long peristretched out, or body bent as if ds lepsy, and legs may be elevated, han tion made of wax. In rigimd cata the person were an automa which he fro tion posi ly bodi or ural post the person takes a definite e. can be removed only by extreme forc pe:

(iii) In this

Constant

category

repetition

of symptoms

of

We

the

have

motor behaviour a mechanical reptitious rep eatedly clench may t ien pat Here the being catch hold of his ears without this in fall s also ism ner man ed Stereotyp

same

act—stereoty

‘automatism’

which

is

` carried out unconsciously. or lips his fist, touch his aware of what he is doing. category of symptoms in

tures ly Or unconsciously grimaces, ges which the patient conscious mes eti som may . He titively or move his entire body stiffly and repe cr movements of the hands que as h shows peculiar mannerism suc

g gait. and shoulders or a shufflin

PSYCHOLOGY

ABNORMAL

70

(iv) Impulsive or unduly responsive motor behaviours: These that is impulsive or behaviour the motor symptoms concern by echopraxia— shown as suggestion external unduly responsive to the persistent repetition of the movements or words of another or negativism in which the patient refuses to cooperate_ with a request

For example,

or behaves in a manner opposite to that requested. he may stand up when requested to sit down.

One of the most

(v) Compulsive motor behaviour:

common

Compulmotor behaviour disturbances is known as compulsion. nature specific fairly and t persisten a of sions are defined as acts

which the individual recognizes to be irrational, irrelevant and inappropriate to social reality but over which he has little or no control. Compulsions are to obsessions as acts are to thoughts. As acts and thoughts should proceed side by side, therefore, compulsions and obsessions are usually present in the same patient.

An individual, after being obsessed with the idea that his hands

are dirty, feels an overwhelming wrge to wash his hands and consequently acts in compulsion (going and washing his hands) many times during the day even if on looking them he sees they are

perfectly clean. Similarly, an individual may be compelled to return and check the lock on the door many times while proceeding to his office

or

market.

There

are

specific

some

compulsions

like kleptomania, the act of stealing regardless of value, Pyromania, the act of starting fires without any reason.

3. Emotional symptoms (abnormalities of the affective processes) (aff An irrational excessive increase in the emotional

and

reactions

(affective experiences) conscious and unconscious form the outstand-

Ing symptoms for many mental disorders or illness. The mentionable apathy, i dep the reactions concerni ing elation and depression, are anxiety, and fear. anger a.

Elation

and

depression:

Elation

is

related

with

the

exaggerated feelings of well-being in an individual. Consequently, there is a display of an unnatural state of happiness that shows itself in singing, dancing, excited talking and much laughter despite the objective situation. In ‘euphoria’ we have extreme elation where one has no cares or worries and usually a mood to view the world

through rose coloured glasses.

Depression is the

opposite of the

elevation.

There isa morbid

everything

is impossible

sadness

and

individual’s dejection,

an

mood

of

increased

perception of physical pain and guilt consciousness. The expression of worry, sighs, weeping, crying, refusalto eat or to speak are the usual signs of depression. In deep depression, the individual feels that and

nothing

in life is worth

extreme cases it leads to the suicidal depressions. Thus in elated mood the individual feels

fit and

living.

In

fine,

in

SYMPTOMS AND SYNDROMES

7

cases depressed mood he feels sick and gloomy. n some mental and elation between mood the of tion fluctua unusual there is an depression and vice versa. b. Apathy: It manifests feels neither happy nor sad.

flatness’ with

a

positive

experiences and situations.

a decrease in affection where one It is, in fact, a state of emotional

attitude

of

indifference

Thus events that normally

towards

evoke

all

anger,

have no effect upon the happiness, sadness, shame or sympathy person affected by apathy. are marked by c. Anxiety: The symptoms concerning anxietya, rapid pulse, nause r, apprehension, tension, restlessness, tremo under the dual indivi The . palpitation and profuse perspiration or may may he that er disast or r dange a pates antici ty effect of anxie be able to describe clearly.

not

known as ‘panic’ in which

the

Extreme forms of such anxiety are

whole

and physical reality

social

r. is considered a possible source of dange wh ere tion, situa ral d. Anger: In a natu

ronment,

one is threatened by one may attempt to attack it

stimuli from the envi In case of pathological or with the accompanying feelings of anger. emotion of anger as a. generabnormal anger, the person exhibitsve thetowards everyone and every

some

alised disposition to be, aggressi fic person without any thing, or it may be focussed on a speci behaviour. ve essi reasonable basis of showing such aggr is another symptom Pathological fear called phobia e. Fear: al and obsessive tion irra an is ia of mental illness or disorder. Phob words of Brown as “a persistent fear and may be define djs innottheobjectively a source of danger but fear of something which he real fear despite the fact that which the patient reacts to with e.” realizes this reaction is inappropriat or

the important phobias related Some of physical situations are listed below: (i)

Gi)

to specific objects

s. Acrophobia—fear of high place

d places. Claustrophobia—fear of close

(iii)

places. Agroraphobia—fear of open

(vi)

strong light Photophobia—fear‘of the

of blood. (iv) Hematophobia—fear darkness. (v) Nyctophobia—fear of the

ses or of some particular (vii) Pathophobia—fear of disea or of some particular animal. (viii) Fenphobia—feat of animals (ix) (x)

Hydropbobia—fear of water. poisoned. Toxophobia—fear of being 4. Total behaviour symptoms s

behaviour of an individual) (abnormalities concerning total rmalities related tioned the symptoms of abno

We have men

ABNORMAL PSYCHOLOGY

72

to cognitive, conative and affective processes of the human beIn this last category, we point out the symptoms of haviour. How does mental disorders of an individual’s total behaviour. one react, in toto,

to

or

his environment

the

outside | world

is

important and should be taken into account for describing one’s normality or abnormality and consequently the following types of

behaviour will

be taken as symptoms of behaviour disorders and

malfunctioning: (i)

Antisocial acts and crimes.

(ii) Diminished, over emphasized or perverted (iii) Alcohol and drug addiction. (iv)

:

sex-behaviour.

Mental deficiency.

Syndromes

We have described the various symptoms for mental illness or disorders under specific categories like mental, emotional or motor

symptoms. This categorization is however quite arbitrary and should in no way be confused with syndromes. The term ‘syndrome’ represents a fairly well organised group or cluster of symptoms that may be found ina particular mental disorder or disease. In actual practice, symptoms scarcely ever occur in isolation but rather occur together in organised groups or clusters. It is these clusters are known as syndromes.

or

complexes

of symptoms

Syndromes, in this way, are not confined to one categories of the symptoms like mental, described above but may include symptoms

or the other

physical, or emotjona from any number 0

exhibit

“A mentally ill person, therefore, may

the above categories.

which

a definite cluster of symptoms (syndrome) drawn from the categories

of physical, mental, motor, emotional or total behaviour symptoms. Hence, in the diagnosis of a mental illness or disorder, it is the knowledge or the identification of particular syndromes that

usually play the desired role and not the individual symptom as the latter may show its presence in a number of unrelated disorders or

illness.

The

identification

and

classification

of

syndromes

thus serves not onlya diagnostic purpose but also provides valuable help in the classification of mental disorders or abnormalities. Summary

s Every

illness 7

or

disorder—mental

or

ee

physi

sical—is

ified

identifie:

or diagnosed with the help of related symptom ee syndromes.

_

Symptoms:

justed behaviour.

A symptom is a surface sickness. In the world

or indicator of some sickness. listed

below:

of medicine

It is the malad-

it is used

as

a sign

Characteristics of symptoms may be

1,

Symptoms have subjective and objectve nature.

2.

Symptoms have cause.

SYMPTOMS AND SYNDROMES

73

3.

Symptoms have a significance and an economy.

4. 5.

Symptoms hardly occur alone. A single symptom may appear in many disorders.

Symptoms of abnormal behaviour: Symptoms indicative of serious abnormalities may be broadly classified as physical and

phychological symptoms.

Physical symptoms involve signs such as

change

in tempera-

weight, state ture, pulse rate and respiration, unusual change in excessive cough, of appetite .and thirst, nausea, vomitting, headache, fatigue, body pains, motor incoordination, etc. as a mental, motor, 1 Psychological sy mptoms may be grouped emotional and total behaviour symptoms involving all aspects of

human behaviour.

e Mental symptoms Concer: ning abnormalities of the cognitiv percepof disorders the to related s om processes may include sympt word hash, tion, sensation, memory and th ought (flight of ideas, etc.) delusion delay of the mental association, obsession and may tics

abnormalities

concerning

Motor symptoms processes tremors,

of the

activity (speech

involve disorders of muscular etc.), motor language habit

conative (paralysis, or writing

or decreased psychomotor abnormalities), motor behaviour (increased sive motor behaviour). compul and ve impulsi ype, activities, stereot of the affective Emotional symptoms concerning abnormalities

concerning elation processes may involve anxiety and the reactions fear. and r ange and depression, apathy, Total behaviour

symptoms

concerning

total behaviour may involve maladaptive behaviour,

crime,

sexual

deviance

drug addiction, mental deficiency etc.

abnormalities of the

behaviour like antisocial

and disorders,

alcoholism and

cluster represent a fairly well-organised group or Syndromes er or disord l menta ular partic ina of symptoms that may be found disease. or disorder, it is the In the diagnoses of a mental illness d

that usually play the role desire knowledge of particular syndromes The individual symptom may om. sympt and not the individual l I d disorders or illness. unrelate f 0 er numb a in show its presence in the In addition, the

syndromes also

provide valuable

help

malities. classification of mental disorders or abnor

REFERENCES 1.

J.F. Brown,

The psychodynamics of Abnormal behaviour

Publishing House Pvt., Ltd; 1969, Indian reprint, p. 71.

Brown, op. cit., p. 74. 3. Brown, op. cit., p. 132.

New Delhi: Asia

ETIOLOGY—THE CAUSES OF ABNORMAL BEHAVIOUR

[HE TERM

‘etiology’ in abnormal psychology concerns the a

does a particu | of the causes of abnormal behaviour. Why maladjusted oe get our, behavi individual exhibit abnormality in his What argi turns into a mentally ill or disorganised personality? different

factors

e

such trouble.

cause

that

determinants

or

answer to such questions is the subject-matter of etiology.

like the behaviour

The abnormal behaviour of an individual,

reaction of any normal person, is the product

environment. therefore

be

The

factors

categorized

causing

abnormal

hereditary

as

of both

and

heredity

behaviour

a

Sayeeeacnt ae

Environmental factors may further be divided into psycho =A cal and sociological factors and the factors falling midway gen hereditary and environmental biological standing, following A. B. C. D.

influences

may be

described eed

Generally, therefore, for convenience, in un he factors. the causes of abnormal behaviour are classified in t broad categories: Hereditary factors Biological factors Psychological factors Sociological factors.

Predisposing and precipitating causes In the study of the causative factors of abnormality one should

and also be able to distinguish between the predisposing, grov fertile a e provid precipitating causes. The predisposing causes e t provid They ality. abnorm of for the germination of the seeds tating

of the precipi base and set the stage for the triggering action The predispos” ability. ve adjusti causes by lowering an individual’s usually Sen and r initiato the be to said re ing causes are therefo

quite remote in time

from

their

affects.

On the other

hand, “

their eee precipitating causes occur immediately or shortly before prove t i which ons conditi or ons situati specific nt They represe They 4 ed. organis and much for the individual to remain intact

75 ORMAL BEHAVIOUR ETIOLOGY —THE CAUSES OF ABN i . ispossing ignitiing the fire (oriigiginated by predispo diate a gents for ignit

the imme

causes) dormant in the individual.

heredity provides a base for the a is interesting to note that one’s strong determinant towards a and y tes, Tucture of one’s personalit In the study of the ity of his behaviour. there ise ormality or abnormal fore, serves a ity, hered the iour, uses of abnormal behav

rve both ironmental factors may ese or age of stag Predisposing cause while env r ula tic par ting causes. At a Predisposing and precipita houlld be suppos) ed to be al behaviour shou orm abn s one’ al, i individu and environment.

een L e result of the interaction betw

happens et us try to study how it Of causative factors.

A.

his heredity

through

the various categories

Hereditary factors

to the offspring from of all that is transferred the i Heredity consists chromosomes at the and of genes form the in nts pare e diat es, that is twentyimme it acquires 46 chromosombei ng derived from time of conception when air h p

romosomes—one ofhereac ir lies on each chromothree pairs of chone from the fat . The the mother and thousand, each of which two to one ing ber some genes num transmission of hereditary characteristics. contributes to the

T

mes. s are called autoso pairs of chromosome ics. The remaining The first twenty-two physical ist character the l's sex

the individua hey determine nked pair decidese chi -li sex led member cal o r pai ird twenty-th In the mal child,ld, one . ics ist ter rac cha d contribnke e) -li in siz and other sex romosome (usually big me (compratively ch X is r pai d nke moso Of the sex-li t he other is Y chro Uted by the mother and

FATHER

7

77

7

off

s SS 7 ` ~.

Pá

SS.

'

)

SON

ABNORMAL PSYCHOLOGY

76

In the female child both

‘smaller than X) contributed by the father. of these

sex-linked

each

from

one

chromosomes,

parent, are X

chromosomes. by tHe sexAbnormalities are found to -be transmitted both les are as examp few A linked chromosomes and the autosomes. under.

osome. 1. One possible genetic anomaly is a missing sex chrom who person a This abnormality, called Turner’s Syndrome, produces usually has has the superficial anatomical appearance of a female but subsequent

abnormality identified).

sexual

immature

XO

been

have

development

and

types

(all

examples of this

no YO types have

been

2. The presence of extra sex chromosomes also cause abHere the affected normality diagnosed as Klinefelter’s Syndrome. XXXY, XXXXY (XXY, somes chromo female person has too many

etc.) instead of the usual

composition

has the superficial appearance of a male

penis, but very

small testes,

characteristics, such

and may

as developed

twenty-two

presence

autosomes

of extra

(three

Such

an individual

usually a normal size

also possess

many female

breasts, faminine face and

little body hair. Such males are always emotional difficulties and may show antisocial behaviour.

3. The

XY.

and

chromosome

instead

voice,

sterile, usually suffer from symptoms:of psychosis and

of the

in any pair of the

usual two) has been

form of mental retardation in found to cause Mongolism—a ngsevere a flat face and other characeyes, slanti has dual indivi the

which

teristics that

produce a

superficial

resemblance

to

Mongoloids.

The role of genes

Genes, like chromosomes, occur in pairs. An individual may be found to derive a gene pair in one of the following forms: A dominant gene from one of the parents and a recessive gene from the other (Form Dr). * Dominant genes from both the parents (Form DD).

*

* Recessive genes from both the parents (Form rr).

For purposes of distinction, pure DD (completely dominant) Of

sr (completely recessive) gene pairs are called homozygotes

hybrid, Dr pairs are referred to as heterozygotes Defective genes transferred to the offspring

an

are in many ways

who responsible for the transmission of abnormalities. A child bot from e) recessiv or nt (domina genes receives defective paired

parents runs a high risk of being affected with abnormality. Figures 8.2 and 8.3 depict the transmission of genes. A few notable examples of the degeneratious ,

or hereditary

diseases through the transmission of genes are also cited on the next

page.

17

ETIOLOGY—THE CAUSES OF ABNORMAL BEHAVIOUR ABNORMAL

PARENT

NORMAL

PARENT

ABNORMAL TRAIT

ABNORMAL

HETEROZYGOUS FOR A RECESSIVE i

HETEROZYGOUS FORA ‘RECESSIVE

\

í

NORMAL

CHILD

Fig. 8.3.

MOTHER

“Ss. HETEROZYGOTE

ABNORMAL TRAIT

ABNORMAL CHILD

h the great majority of abnormal The matin:g from whic person are born.

y to mainof coordination and inabilit 1. Ataxia: It causes lacork walking. tain balance while standing eneration is marked by

2.

speech

Huntington’s Chorea:

impairment,

This deg

impairment

intellectual

disturbance. 3. Idiopathic epilepsy. es: 4. Muscular Dystrophi

and

emotional

disorder involving paralysis of i muscles. pheral nerves. peri of rder diso A Š 5. Neuralatrophy: disease: Both relate to3 imer’s dise ase and Pick’s cortex: occurs. ala ‘ whic! h atrophy of the cerebr in iy n sis o cho e psy OR ile sen pre urs in localized foci, brain degeneration occ disease degeneration In Pick’s A cease; area r’s s while in Alzheime mostly in the frontal

n. is diffused throughout the brai

A

78

ABNORMAL

7.

Schizophrenia.

A functional

disorder

PSYCHOLOGY

in which heredity

plays a part of strong predisposing factor.

8. Psychophysiological disorders: Certain psychophysical disorders like hyper thyroidism, peptic ulcers and essential hypertension have been found to possess strong hereditary bases.

B.

Biological factors While hereditary factors are more or

the biological factors environmental

(falling midway

influences)

constitute

less predisposing factors,

between both

hereditary predisposing

and and

precipitating factors. a. Predisposing factors Under

this

category

all the

factors

covered

by the term

“constitution” are included. There are two classes of constitutional factors—structural and physiological. Structural factors are concerned with the structure of the body (physique), and physiological factors with the functioning of the nervous system, endoerine glands, sense organs and other body systems like respiration, circulation etc. There are two types of predisposing biological factors. _ 1. Structural factors: To get adjusted with himself and his environnient an individual must be reasonably satisfied with his somatic structure or physique. Any serious deviation from the norms, whether in terms of height, weight, body proportions or appe-

arance, may create a serious adjustment problem and this in turn

may

develop

behaviour, An ugly face,

short

for the individual

malfunctioning or disorders of the

stature,

deformities

and imperfec-

tion of the body and various other variations extreme and devaluating in nature as we find in everyday life situations, influence the adjustive reactions of the individual and other people’s reactions to him. Dissatisfaction with one’s somatic structure coupled with the unusual remarks or reactions of the other people lead to many complexes, guilt feelings and frustrating encounters. Therefore, it is true that Physique or body structure does play an important role in the proper or improper functioning of the behaviour.

_

. 2. Physiological

individual also,

factors:

Physiological

factors

within

to a great extent, influence his personality,

tendencies and adjustive behaviour. summiarized as under:

Some such

influences

an

reaction

can

be

(i) Individuals with a high biological energy level are inclined to discharge tension through neuromuscular activity, whereas individuals with a low energy level are more inclined to discharge tension through ideomotor or fantasy.

(ii)

Either

an excess or a deficit of autonomic reactivity may

lead to abnormality. An individual who is more autonomically reactive will be more prone to develop over-action to minor stresses and formation of unnecessary conditioned fears and anxieties while the

19

RMAL BEHAVIOUR ETIOLOGY —THE CAUSES OF ABNO

to inadequate socialdeficient emotional reactivity presumably leads ocial behaviour and a anti-s ess, siven ization characterized by impul lack of inner controls. (iii) Constitutional defects in the cause disease and other stresses may likely

body’s defences against Normally abnormality.

infections, but the faulty our body produces antibodies to resist g mechanism may leave the ucin functioning of the anti-body prod diseases, of the nervous system. ve erati degen the body vulnerable to individual for psychological Similarly, the tolerance capacity onofan account of the disruptions in the n. stress may also be lowered lved in the functioning of the brai various biochemical systems invo ivity of the endocrines or duct y bod e, (iv) Overactivity or underact ctur stru tic ations in the soma less glands causes extreme devi encies of an individual. One may tend our avi become functioning and beh lethargic while the other may ocrine end turn to be quite passive and the of unt acco irritable on anxious and restless or tired and play an important role in the es crin endo defect in their imbalances. The the body and mind Any which, in growth and development of ies mal ano l ant physiologica ific sign to s lead ing tion ised personalifunc for the growth of disorgan turn, provide fertile ground adrenal glands vity of the secretion of ties. For example, overacti ine physique cul mas lop deve w beard and an adult ina of may cause a woman to gro ty and sexual maturi and may exhibit the physical Similarly, pituitary gland imbalances d. height), dwarfs three or four year old chil ht (seven to nine feet in e and abnormal heig in ease incr anc ear may lead to app like a gorilla(two to four feet in height), ities so produced

rmal behaviour. The abnojest , social isolation and sex characteristicsmadand , cule redi of ct obje an e be to le liab e a variety of are t which, in turn, causs. son harsh and unfair treatmen per ed behaviour of the affect abnormalities in the s

tor b. Precipitating fac s are noxious precipitating factor l ica log bio e bl na The mentio nature. ions of biological agents, and deprivat o ects or situations al obj ernnal are the extter e es Th : r: nts age i dividual. The abno 1. Noxious well-being ofan in led toxic psychoses. the to ous uri inj cal which are in noxious agents are malities resulting from memory loss, difficulty

oning. are some of mental functi Disorientation cti ons and hallucinations e noxious usi ill ual vis , ons fun abl ual not intellect psychoses. The

of toxic of the common symptoms agents are as under:

i

Seuss e

i teria. dis d ease pro) ducing bac as in are : se The dy the bo icroorganisms: the brain alongwith aeni 8 may infect others may affect the

d syphilis while the pneumonia, malariina meanningitis. brain directly as s s: The chemici al alls: icica

l

aa

ii

i chem

eoa

monoxide, carbon

suc! h

as

ad, lead,

y thyl meth me

ting tetrachloride and intoxica

JEEEE

n

ABNORMAL PSYCHOLOGY

80

They affect the function-

drugs and other material produce toxicity.

ing of the brain and may result in behaviour disorders.

(iii) Physical injury: Physical injury and trauma may cause damage to the brain either directly or through interference with its blood supply and thus may result in brain disorders—structural or functional.

Deprivation of necessary biological 2. Biological deprivation: necessities such as oxygen, food, water, vitamins, harmones, sleep and rest and the like may precipitate a functional disorder, or may cause Some of the important deprivations structural changes in the brain. are malnutrition, oxygen and sleep. (i)

Malnutrition:

Severe malnutrition during early embryonic

and infantile stage has been found to

brain structure and growth

lower

body

of intelligence.

the malnutrition death of the infant

have

resistance, affect

Post mortem studies of revealed

the

content of

their brain cells to be sixty percent less than that of the normal content. Pellagra, a mental disorder, is found to be caused by

vitamin deficiency. Inthe same manner, the deficiency of certain vitamins, glucose and harmones has been found to cause many abnormalities—structural or functional.

(ii) Deficiency

of oxygen:

supply to the tissues—has

Anoxia—a deficiency of the oxygen

been found

ties. Human nerve cells are very sensitive May result in structural damage to the

to cause many abnormali-

to lack of oxygen and brain or life-long mental

deficiency or affect drastically the complex mental functions such

as

immediate memory.

7

(iii) Sleep deprivation:

important

precipitating

Sleep

deprivation

is considered

an

biological factor causing abnormality under

stress. The prolonged sleep symptoms in the behaviour

deprivation brings typical abnormal of an individual such as irritability,

feeling of persecution, inability to concentrate

and

periods

of dis-

orientation and misperceptions, illusions and hallucinations. In some cases it may also bring about certain neurological changes an autonomic nervous system effects.

C. Psychological factors

Besides hereditary and biological factors,

psychological

causes

often prove to be the cause for the development of abnormal behaviour

and

mental

illness All types of frustrations, conflicts, stresses,

and pressures brought about upbringing personality

and and

by faulty psychological

development,

in disorganise socialization of the child result abnormal behaviour. Truely speaking, in the satis-

faction of needs lies the welfare of the individual. When one feels frustrated in the satisfacation of his psychological needs, his behavjour reactions turn into maladaptation and abnormalities. how it happens.

1. Psychological

deprivations of the early age:

Let us see

Psychological

81

ETIOLOGY—THE CAUSES OF ABNORMAL BEHAVIOUR

deprivation during infancy and_ early childhood contributes predisor posing causes for the abnormal behaviour at the later stage

sometimes works as a precipitating cited as follows:

cause.

Such

situations

may

be

(i) Oral deprivation: The individuals who are deprived of the opportunity of seeking grati fication from sucking behaviour in infancy may be found to be emotiona lly unstable and disturbed at the later stage. ion has been (ii) Parental deprivation: Loss of parental affect maladjustof t opmen devel the in role icant found to play a very signif both has a or r mothe or father of loss The y. malit ment and abnor does not He child. the of very damaging effect on the well-being should he as care and ion attent ion, affect get adequate love and tic neuro ops devel re, insecu otherwise get. In such situations he feels stress to tible suscep es becom thus or psychotic tendencies and

damaging in the case situations in later life. The condition is more the parents. Here the en betwe ce divor of separation, dessertion or onment for his

cal envir child cannot get the appropriate psychologi e reaction tendenaptiv malad ops devel ly quent conse and t developmen n in the form of in-

cies. Inadequate

mothering,

due

to any reaso

cause tense, unsatisfied difference, rejection, overprotection etc.of may children which may develop

and negativistic behaviour on the part

stage. into a deviant behaviour at the later frustrations on account of the Anal (iii) Anal deprivation: are reported to cause early and rigorous toilet training of early age in later life. lems prob ral viou emotional difficulties and beha experiences: Most of the 2. Faulty learning and horrible rilt the resu of our learning and expe Patterns in our behaviour are habits, attitudes, interests or other ences. In the case of learning of et-

al, emotional and social comp acquired traits and physical mentt learning results in adjustment, encies, where the adequate and righ creates difficulties in one’s and

inadequate

adjustment. us

take

faulty

learning

for example

The the learning of sex behaviour.

fearful. He may think that child may learn that sex is shameful or r. Such faulty acquisition, viou he is not fit for normal sex beha of the sex-related informag ndin rsta unde g Misconceptions and wron viour such te to Jearning maladaptive behawhic tion are found to contribucy, h may etc., ency tend al draw with equa as homosexuality, inad Let

of the personality. further result in serious disorganisation age, are ces, especially in the early ly Certain painful experien heal. lete comp r neve that bound to leave psychological wounds dog ous vici a with r unte enco an riences like

Sometimes such expe rience with a gang of robbers or a bull, sexual assault, or expe ned fear response which may itio may be sufficient to establish a cond and mental illness. Tesult in certain types of abnormality parental attitude: Parent3. Defective family environment und of defective

al attitude and uncongenial family environment full

ABNORMAL PSYCHOLOGY

82

source for the models, conflicts and stress situations,prove a potent following adthe tion connec this In ur. behavio al abnorm causes of

verse situations may be cited as examples.

The parents and other senior members

(i) Negative models: of the family

may

be emotionally

unstable, inconsistent, and dis-

parents turbed in their usual bebaviour or antisocial. These . children their for models e negativ set to d destine are elders and (ii) Undesirable parental attitude: Parental attitudes towards the child may be defective and erroneous such as (a) rejection, (b) over protection, (c) over indulgence, (d) prefectionism—unrealistic ambitions for child, (e) much dominance or strictness and (f) much leniency or carelessness. A Gii) Unhappy conditions: The family environment may be uncongenial due to (a) broken homes as a result of death, divorce, desertion or separation, (b) marital discord of the parents due to conti-

nued disagreement

between

the parents in the form of quarreling,

bickering, nagging and general tensions, (c) sibling rivalry

amount-

ing to the feeling in a child that his brother or sister is getting more parental affection and attention than himself, and (d) poor resources involving poor economic conditions and finances, cultural and social

deprivation, lack of education of the parents and bad reputation of

the family.

In all the above defective

ment, the child fails to

situations

get favourable

in the family environ-

conditions

for his

adequate

adjustment and development. He neither gets balanced love and affection nor adequate safety, security and resources for the satis-

faction of his essential needs. He is therefore always starved of one or the other of his physical or emotional needs. Predisposed in this manner, the unfortunate happenings concerning the treatment towards him and the members of the family are bound to make

his behaviour and reaction patterns quite deviant from the normal and thus he drifts towards abnormality and mental illness. Adolescence is a crucial 4. Maladjustment in adolescence: age of storm and stresses. The varying physical and socio-psychological needs of this age have to be satisfied for the adjustment

between

moving

independence

versus

dependence.

realism

versus

idealism, parental affection versus peergroup norms, age temptations versus

social

taboos

etc. The

adolescent

must

himself reasonably with his body development,

be made to satisfy

somatic

variations

and organic and psycho-physical changes. He must be helped in the

proper exercising of his emotions and channelising the stream o his valuable energy. Adolesents are very sensitive and should therefore be treated and cared for adequately according to their needs an problems

of their

age.

An

attack

on

their situation may invite4

hostility shou! host of problems. Their resentment, indifference beandhelped to establish should not be misunderstood but rather they But follow. to conduct of standards meaningful self-identity and

83

ETIOLOGY—THE CAUSES OF ABNORMAL BEHAVIOUR

generathis is not always possible and there starts “the conflict of the are not s problem their rstood, misunde then are tion”. Adolescents cared for and

their aspirations

tensions and frustrations among

thwarted.

the

to abnormalities and mental disorders.

5. Maladjustment

in adulthood:

It gives rise to conflicts,

adolescents,

and

thus

leading

sum a minim Adulthood need

the problems level of maturity and adequate competencies for facing uacies in this inadeq and cies peten of a responsible family life. Incom turn result in which ips hardsh and ations regard may bring frustr situaating devast the of in abnormality and mental illness. orSome age marri (ii) ent, justm malad tions may be: (i) marital disharmony or vocational nt loyme unemp g, earnin poor (iii) or sex-frustrations, family and unnecessary heavy maladjustment, (iv) largeness of the ent or deprivation of social justm malad social (v) responsibilities, safety to one’s well-being and interaction, (vi) lack of security and from the children or other ations frustr members of the family, (vii) illness and chronic diseases of dependents, (viii) continued physical , and (ix) insecurity: and family the one’s own or the members of fear of the old age. uation: Stress refers to 6. Psychological stresses and self-deyal cted to constant failures, subje ndividual a psychic condition ofan i pressures. Stresses, as we have frustrations, tensions, conflicts and causes which disintegrate the noticed, constitute the precipitating The stress tolerance capacity of n. personality of the affected perso ing factor and depends upon an individual is an important decid and biological makeup, and the early upbringing, psychological e-state. ourable environment and psych Present favourable or unfav stress situations causing personality Still the outcome of the severe

disorders cannot be questioned. in maladjustment and disorders The central facto r causing raith loses One feeling of self-devaluation. himself unworthe stress situations is the and capacities and thinks ies in one’s integrity, abilit Some self-devaluating and thy, unwanted and good-for-nothing.

may be cited as under: devastating stress situations l for shortcomings: An individua his f d with (i) Personal limitations and to be reas onably satisfie ld adequate adjustment, s hould learn No one is perfect in this worand omings. rtc sho and ns tio ns ita tio lim ita lim own w one’s ts, one should toknoone ’s self. The person In additionm soto asonenot’s toassecau age dam se accept the acities avoids the

own cap itions well within his se who aim to reach who plans hisrabamb tho le , whi ons ati str fru le risk of undesi fer from selfthe earth are destined to suf the stars with their feet on devaluation. tion and the feelings of self-devalua Much of our unhappiness and failure to appreciate our are the result of our ignoranceuation as well as worries about our assets, and unnecessary. condeme short stature, dark.complexion and limitations such Poor vision etc.

as a big nos

ABNORMAL PSYCHOLOGY

84

accidental

and

failures

Repeated

and losses:

Failures

(ii)

to losses lead to strong feelings of inferiority and self-devaluation attempt may boy the extent that one may “‘go to pieces”. A school suicide as a result of his successive failures, or an unemployed youth may turn into a split personality on account of his repeated failures to get a job and the subsequent sufferings.

The losses relating to human or material resources are painful and frustrating in their effects especially on account of the fact

that there is nothing one can do about them once they have occurred. appreciable financial’ loss, damage to one s As a result of an loss

status,

of social

loss

property,

of friendship and company

of

our dearest and death of the loved ones, one may feel frustrated, even to the extent of losing the will to live.

The feelings of guilt leading to self-de-

Gii) Guilt feelings:

valuation are associated with the cases The

disorders.

mental

reactions

pulsive neurosis

does

of abnormal

is washing

who

lady

so

on

behaviour

and

her hands under com-

account

of some

inherent

guilt feelings. Similarly, early sexual experiences and tragedies may: lead to feelings of guilt, sinful attitude and self-devaluation and other personality thus cause abnormality of sex behaviour and disorders.

(iv) Unreasonable comparisons: We are more sad, unhapPy and unworthy on account of the fact that we are in the habit of making unreasonable comparisons of our gains and other people of resources and capabilities. We seldom

in this world who

appear

of great diversities

ard differences

status with realise that

there are people

to enjoy more facilities than ours, but there are others

also who are not fortunate enough to make both ends meet. Therefore, one has to be content with a level suited to his own resources an

capabilities,

People

who

fail

to

develop such maturity and reason-

able outlook are bound to suffér from self-devaluation, inferiority feelings and frustrations which lead them to abnormality. `

to do

(v) Severe conflicts: not

or what

Many times conflicts in the form of what

to do, out of the given choices or alternatives»

frustrations and become sources of

that

stresses

ultimately

lead

to

the development of abnormality and behaviour disorders. The central idea behind any conflict—the choices to make—is the inability to determine what is good or bad, desirable or undesirable.

Sometimes the conflicting situations are loaded with extreme anxiety, feeling of threat insecurity and indefiniteness. Under such stresses one is likely to fall victim to abnormalities or mental disorders.

(vi) Severe pressures: are often

generated

or outer source.

without strain, sation

severe

pressures stemming from inner

While mild pressures

may be tolerated with oF

the excessive and severe one’s lead to

of behaviour.

cited here:

through

Stress situations affecting our behaviour

Some of the pressure

the

disorgani-

generating situations are

85

BTIOLOGY—THE CAUSES OF ABNORMAL BEHAVIOUR _ a The desire petitive endeavors.

_

of excelling

others or reaching the top in com-

demands b. The unreasonable and excessive

of the work en-

. vironment—educational or occupational

marital or family life. c. The stressful demands of the

_,

4. The stressful

and adjusted demands of living as an efficient of modern ns itio demanding cond

citizen in the complicated and age.

life. e. The hazards and calamities of

D. Sociological factors

the psyogical influences from It is difficult to separate sociol al and soci the in p ted roo s al 1 factor the chological ones as the sociologic on ct impa an individual cast their l ica log cho psy cultural environment of aud c ani org through the behaviour of an individual ity and behaviour. However, for the sake channels of one’s personal e of the social and ld be dealing with som of convenience we wouss situations responsible for the faulty develcultural factors and stre viour. of one’s persona’ lity and beha opment and disorganisation consists of and cultural environment ghbourhood, An individual's social hin nei , ily fam e, hom his all the external factors wit work, society and community, caste of ld wor ege, coll behavand school ntry etc. His personality and

the cou of the interaction and religion, state and dev elopment is a product his of ge sta iour at any his socio-cultural h wit p e-u logical mak

psycho of his biological and environment. acquired abnormal behaviour is an individual our of h muc hat t true It is a result of what an

aviour. As disposition or learned hebehbecomes conditioned to through formal t wha behavfor experiences or io-cultural environment, his soc his in ts tac ties con ali al orm orm abn the and inf ordingly. Consequently, iour patterns get fixed accthe cause and result of the defective and and mental disorders aretural environment. Most of the maladaptiveg unfavourable socio-cul s like antisocial behaviour, alcoholism, dru and psychotic and abnormal behaviour s and disorder, neurotic addiction, sexual deviationed, may be found to possess deep-rooted disorganisations, if analysus cite a few devastating situations particLet cultural socio-cultural causes. our ive and pathogenic socioect def hin wit ng ormal lyi abn rly ula and perpetuation of environment

for

the

growth

behaviour. world of work with earning of living: s The an individual. 1. Problems related str for ion stress situat provides many times pingongcountries like ours, the earning of one’s elo

Particularly in the dev lions of our frustrations and stresses. Mil living is a source of m allof unemployment and under-employment. youth face the proble plications into so many troubles and com urges of ong It is bound to push them str h wit d Frustration couple and personality disorders.

PSYCHOLOGY

ABNORMAL

86

ve the satisfaction of the basic needs either makes them aggressi on aggressi their turns or ment environ ltural socio-cu towards their inward for the development of suicidal tendencies and neurotic or psychotic split-up of the personality. The rising corruption, nepotism, favouratism, provincialism and day-to-day interference of the political bosses is adding to

surprise

occupational problems. Under these circumstances it is no

to find the cases of

illness or behaviour disorders among

mental

the frustrated employed as well as unemployed individuals. Such abnormalities of behaviour are the result of emerging socio-cultural

conditions related with the earning of one’s livelihood. The conscious2. The caste considerations and minority status:

ness about minority

with the caste

country may be said to be a

in our

major source offrustrations, conflicts

attached

factors

socio-economic

status and

considerations

stresses.

and

reli-

Linguistic,

gious and cultural minorities face a great deal of adjustment problems particularly in a specific and awkward situation when majority

groups are in the grip of linguistic, religious or sectarians

sentiments

and divisive forces. In such a situation, their security and safety is threatened and their self-esteem injured. It leads them to un-

adjustive defensive behaviour resulting in malfunctioning oftheir behaviour. _ The caste groups falling into specific lower categories in the hierarchy of castism, besides

their

low

socio-economic

status,

are

maltreated and become victims of apathy and even scorn from the upper caste groups. This creates in them the feclings of inferiority, frustration, resentment and other behavioural disorders.

A new dimension has been emerging from the problems created by caste considerations in our country. It concerns the reservation

of seats for the backward

and scheduled

classes

in educationa

institutions and career openings. The youth belonging to the upper castes are giving rise to a peculiar frustration, resentment an feelings of self-devaluation on account of this policy of reservation.

They get more disturbed in a situation when the facilities of reserva-

tion are enjoyed by the wards of more privileged and economically sound members of the lower castes.

_., 3.. Effect of urbanisation

and modernization:

Heavy

indus-

trialization, increasing urbanisation, and rapid modernization have

disturbed our usual socio-cultural pattern. The family structure has shrunk, the village culture is being trounced by the typical urban

ways, old cultural

values are

being lost and

the new

generation

has | adopted the ways of the western culture in the name of modernAll this has created a new socio-cultural environment ization. without caring for its ill effects which are obvious. The gulf between

the poor

and the rich, or

the

privileged and the unprivileged has

widened. The village farmers have been forced to become factory workers and labourers and live in the most unhygenic and depressive conditions. The emotional feed back and feelings are missing

ETIOLOGY—THE

87

CAUSES OF ABNORMAL BEHAVIOUR

today in our society. A next door neighbour or even inmates of the same building are strangers to each other. No body is there to listen or sympathise for the sufferings and inadequacies. The parents have no time for their own children and sons have no timer re-

sources to look after their aged parents.

Urbanisation,

industrializa-

tion and modernisation have been the causes of insecurity, emotional cravings, self-devaluation, conflicts and frustrations leading towards

the disorganisation of behaviour and personality.

4. Cultural _ widely affect the culture through by most of its

and social evils; Cultural setting profoundly and development of personality and behaviour. Every

traits and behaviours shared its established norms of members provides a basic model of living. The culfamily organisatural patterns like the child rearing practices, the traditions, resand beliefs status, marital es, practic sex tions, the youngesters, or elders the g trictions and taboos, ways of treatin superstitions

etc.,

differ

from

culture

to culture.

These

patterns

self-devaluation cause frustrations, complexes, feelings of guilt and ted by them. genera s stresse and ts depending upon emotional conflic like dowry system, The social evils attached to our society daughter, the malthe over son the to ment the preferential treat dox views, treatment of a widow, typical superstitions and ortho a genede provi cases many in unreasonable dominance of religions y and malit abnor of t opmen devel the for r facto ing rating or precipitat behaviour disorganisations. bility: Marital adjustment 5. Marital discord and family insta true. Marital discords, as also is se rever is a key to happiness. The bound to result in are gs,

may be witnessed in day-to-day happenin n and severe psychological utter disillusionment, self-devaluatio | harmful not on ly to the well-being wounds. These situations are to ing stat deva e prov to but are destined

of the marriage partners their children also.

depends upon marital harmony. The stability of family life lead to destabilise the equilibrium tion Divorce, separation, and deser s Similarly, untimely death of a spouse bring of the mental peace. ns uatio fluct omic Econ er. partn severe stress situations to the other mother on account of earning the and staying away of the father or tions often

All such situa living may disrupt the usual family pattern.depen dents. their and ts paren the prove detrimental to atrophies like onal catastrophies: The cats 6. Natural and nati , economic wars ms, stor hail floods, fires earthquakes, droughts, situations ss stre re seve te crea is depressions and acute national cris perty, pro of es e loss to the affected groups Or individuals, Hug of the social institurganisations deaths, physical ‘deformities, diso phies disturb the lives of tions brought out by such catastro reaing consequences resulting in unfortunate millions. It has far nment for the development of iro the pathological socic-cultural env ims and their dependents. the behaviour disorganisation of the vict

ABNORMAL PSYCHOLOGY

88 Conclusion

It must be emphasized that both predisposing

or

precipitating

causes work in the development of maladaptive behaviour. The predisposing factors of heredity, pathogenic biological makeup, defective family patterns and socio-cultural settings lower the stress tolerance capacity of an individual by contributing towards inadequate personality development and maladaptive behaviour. The precipitating factors either . initiate or intensfy the distres. Most ofthe psychological and socio-cultural factors generating severe stress

situations,

frustrations,

conflict,

devaluation and suicidal tendencies

feeling

of guilt

and

self-

come into this category. Mental

illnessor abnormality of behaviour is rarely caused by asingle causative factor. It is generally the result of the interaction between oramong the multiplicity of factors—hereditary, biological, psychological, and socio-psychological. What a person inherits and afterwards acquiresinthe form of his physical and psychological makeup as a result of the interaction with the variqus environmental

forces decides the normal or abnormal functioning of his behaviour

and mental set-up. Summary

Causes of abnormal behaviour: Abnormal behaviour is caused as a result of the interaction between predisposing and precipitat-

ing causes.

Predisposing

Precipitating causes

prove

causes the

provide immediate

the

base

ignition

and agent

causation of abnormalities. Causative factors responsible

stage. for the

for abnor-

mal behaviour may be grouped as hereditary, biological, psychological and sociological. Hereditary factors provide pre-disposing causes. Chromosomal deviations may cause abnormalities like Turner’s syndrome, Klinefelter’s syndrome and Mongolism. Similarly, defective genes transferred

to the

offsprings

are

in many ways responsible for the

transmission of abnormalities like Huntington’s and Pick’s

disease,

schizophrenia,

ataxia,

chorea,

idiopathic

Alzheimen’s epilepsy

and

certain psychophysiological disorders like peptic ulcer, hyperthyroidism etc. _ _ Biological factors may provide both predisposing and precipitating causes. Predisposing causes are provided by structural

and physiological factors, while the structural

factors are concerned

with the structure of the body (physique), physiological factors inendocrine glands, system, volve the functioning of the nervous sense organs and other systems like respiration, circulation etc. The proper or improper functioning of one’s behaviour depends upon the normality or abnormality of these structural and physioloare noxious gical factors. Some biological precipitating factors agents, and deprivations of biological nature like malnutrition, deficiency of oxygen and sleep deprivation.

_ _

Psychological factors may provide both predisposing and pre-

cipitating causes. They may be studied under various heads:

ETIOLOGY—THE CAUSES OF ABNORMAL BEHAVIOUR

89

1. Psychological deprivations of the early age (in the form of oral, parental and anal deprivations). 2. Faulty learning and horrible experiences. 3. Defective family environment and parental attitudes.

4. Maladjustment in adolescence and adulthood. 5. Psychological stresses and self-devaluation. Sociological factors involve devastating situations

within

our defective socio-cultural enyironment. They may include: 1. Problems related with earning or living. 2. The caste considerations and minority status. 3. Effect of the urbanisation and modernization. 4. Cultural and social evils. 5. Marital discord and family instability. 6. Natural and national calamities.

Conclusion

osOne’s maladaptive behaviour is the interaction of the prodisp ation of he combin t gh throu ted genera causes tating ing and precipi different factors.

9 CLASSIFICATION

OF MENTAL

DISORDERS

HERE IS no limit to human variance. The abnormalities of behaviour, therefore, are innumerable. However, for the sake o. diagnosis, prevention and treatment of these disorders it becomes essential to put them into some definite categories. The attempts for classification of mental disorders, abnormalities and diseases, therefore, have been the right steps in this direction. Development of the classification system A. The old era: The historical evidences of establishing some classification of behavioural disorders take us to the attempts made

by Hippocrates, nearly 2,500 years ago.

He divided behavioura

disorders into three categories—mania, melancholia and phrenesis and developed a theoretical account of their appearance. In India too, the rishis, much earlier than the Hippocrates’ era, gave a far reasonable classification in the disequilibrium Tamoguna).

of the abnormal behaviour in terms of and Rajoguna gunas (Satguna, three

However, the credit for giving a formal systematic classification of mental disorders as prevalent today goes, in the later part O nineteenth century, to the German psychiatrist Emile Kraepelin. e linked all forms of disorders and mental illness to hereditary and biological factors and provided a classification based on causes, prognosis and symptoms of mental diseases.

B.

The modern era: The two world wars tore apart millions of

families, social organisations and individuals.

With such increase

cases of mental disorders and diseases and the subsequent

expansion

of psychiatric services all over the world, the need for a standardize classification system was widely felt. The American Psychiatric

Association in 1948 set up a committee

to develop such a system

This system was further refined for classifying mental disorders. and an official Diagnostic and Statistical Manual of Mental Disorders It acknowledged three main groups (DSMI) was published in 1952. 9.1. table in indicated as of disorders

91

CLASSIFICATION OF MENTAL DISORDERS

Table 9.1 a annn DSM-I

ction Disorders of brain tissue fun

A.

B.

e

o

a.

Acute

b.

Chronic

Mental deficiency

Familial or hereditary Idiopathic clearly defined physiDisorders of psycho; genic origin (no cal cause)

a. b.

C.

a.

Psychotic disorders i) Involutional reaction (ii) Affective reactions (iii) Schizophrenic reactions (iv) Paranoid reactions (v) Other

b.

Psychophysiologic

c.

Psychoneurotic

d.

personality disorders. Transient situational

e.

Personality disorders

Statistical American

Diagnostic and Psyhiatric Association Adapted from : American of Mental Disorders, Washington D.C., Manual 1952. Psychiatric Association,

`The problems

d universality

h of the

As a result in

concerning

d the need for ought out a classisystem DSM-I, create ganisation (WHO) br Or th al of Diseases He d rl Wo ssi 1965, the ational Cla fication

Table 9.2

n as the Intern fication system know n V on

viour disorders. Sectio tion ofbeha ntaining D.. IC -8) a‘co (ICD sec s summary of thi Presents Table 9.2

assification D -8 (Section V) cl Summary of IC Mental disorders "290-315

290-299

Psychoses

l

l

=

290 291

dementia Senile and pre-senile Alcoholic psychosis

292 Psychosis associated 293

294

infection Psychosis associated condition, ed Psychosis associat condition

with

intracranial

with other

cerebral

al with other physic

92

ABNORMAL

PSYCHOLOGY

295 Schizophrenia 296 Affective psychoses 297 ‘Paranoid states 298 Other psychoses 299 Unspecified psychoses, neuroses, personality disorders and other non-psychotic mental disorders 300 Neuroses 301 Personality disorders 302 Sexual deviations 303 Alcoholism 304 Drug dependence 305 Physical disorders of presumably psychogenic origin 306 Specified symptoms 307 Transient situational disturbances 308 Behaviour disorders in childhood 309 Mental disorders not specified as psychotic associated with physical conditions. 310-315 Mental retardation.

310

Boarderline mental retardation

311

Mild mental retardation Moderate mental retardation Severe mental retardation Profound mental retardation Unspecified mental retardation.

312

313 314 315

Dissatisfied with their earlier classification DSM-I the American Psychiatric Aésociation, in 1968, brought out a more comprehensive

system of classification known as DSM-II. It gave ten major categories of mental disorders, instead of three given under DSM-I as shown in Table 9.3. Table 9.3

DSM-II 1.

Mental retardation

2.

Organic brain syndromes

CLASSIFICATION OF MENTAL DISORDERS

3.

93

Psychoses b.

a.

Schizophrenia Major affective disorders

c.

Paranoid

d.

Other psychoses.

states

4,

Neuroses.

wv

Personality disorders a. Personality disorders b. Sexual deviations c.

Alcoholism

d.

Drug dependence.

6

Psycho-physiologic disorders

7. 8

Special symptoms

9

10.

Transient situational disturbances adolescence Behaviour disorders of childhood and ric disorder. Conditions without manifest psychiat S e

eS Se Adapted from:

C.

Diagnostic and Statistical American Psychiatric Association, Washingtom ed.), DSM-II, Manual of Mental Disorders (20diatio n. 1968. Assoc c iatri Psych ican Amer D.C.:

: The contemporary position

] on acc subjected to wide criticism ing form patti uni e mor a giv For and shortcomings.

tion and common world, WHO

terminology

l of the ies ntr cou t eren diff the for

brought out, towards

the end

of 1979, an improved

classification known as ICD-9.

dealing with mary of the Section V of ICD-9 Table 9.4 gives a summen tal diseases. the classification of Table 9.4

290-319

290-294

Organic psychotic condition

(Section V) Summary of ICD-9 Mental disorders

e psychiatric condi290 Senile and pre-senil y 291 292

293

tions Alcoholic psychosis Drug psychosis

condition Transient organic psychotic

ABNORMAL PSYCHOLOGY

94 294

Other

organic

psychotic

conditions

(chronic)

295 296

Affective psychoses

297

Paranoid states

298

Other organic psychoses

299

Psychoses, neurotic disorders,

Schizophrenia

personality

disorders and other non-psychotic disorders

mental

300

Neurotic disorders

301

Personality disorders

302 303 304

Sexual deviations and disorders Alcohol dependence syndrome Drug dependence

305

Non-dependence, abuse of drugs

306

Physiological malfunctioning arising from mental disorders

307

Special symptoms classified elsewhere

snydromes

not

308 309 310 311

Acute reaction to stress. Adjustment reaction Frontal lobe syndromes Depressive disorders not classified

else-

or

where

312

Disturbance of conduct not classified elsewhere 313, Disturbance of emotions specific to childhood and adolescence

314 315 316 317-319

Hyper kinetic

syndrome of childhood

Specific reading retardation Specified arithmetical retardation Mental

retardation.

like WHO,

also tried

to improve its DSM-II classification by setting up a new

The American Psychiatric Association,

committee.

The new system is called It resulted in the emergence of DSM-III. a “multiaxial classification system” because it allows classification on five separate dimensions (axes) as in Table 9,5,

95

CLASSIFICATION OF MENTAL DISORDERS Table 9.5 DSM-III

psychiatric Clinical other conditions

Axis I:

syndrome(s)

and

Organic mental disorders Drug use disorders

s ke Schizophrenic disorder eS Paranoid disorders Affective disorders ified Psychoses not elsewhere class Anxiety disorders Factitious disorders Somato form disorders Lonne

=S Axis Il:

Dissociative disorders and specific Adult personality disorders ers ord developmental dis

1. Personality disorders ers 2. Psycho-sexual disord g in childhood or 3, Disorders usually arisin adolescence elsewhere classified 4. Reactive disorders not control not elsewhere 5, Disorders of impulse

classified 6. Sleep disorders conditions 7. Other disorders and

Axis IIL: Axis IV : Axis V: Adapted sii

:

disorders Non-mental medical ial stressors Severity of psychosoc adaptive functioning. recent Highest level of

Diagnostic and Statistical ps: chiatric Associaticn, d ed.) e DSM-III Wasnington American (3rd Disorders nual o. of Mental MaeT ociation, 1980. Ass ic atr chi Psy D.C.: IO iota

years en in use for many and DSM-II have be suiting the syndromes

modifications the reliability of the rld with some con throughout the spewocif ditions, al loc to ic ted, and illnesses DSM-III, is yet to beertes 9 mb some. ssifications, 1CD- and contemporary ssicla ever, these cla fications, how

are technical and cu al All for the beginners in abnorm ult fic l ona cti Their comprehension may be dif fun d an . ple sim t page is a nex : the On n ve Gi . gy Psycholo Classification (Table 9.6).

ABNORMAL PSYCHOLOGY

96 Table 9.6

Classification of mental disorders

Mental disorders (affecting

either the mind or the body)

|

|

i

Psychosomatic or psycho-

Psychological disor-

physiological disorders (affecting the body)

ders (affecting the | mind) i

|

Psychological disorders associated with

all

illness or disease.

with specific illness or disease.

=

re S

Organic brain Functional syndromes disorder a. Acute con| fusional state | generally cur| able 1 or rever| sible) |

b. Intermediate c. Chronic

(irreversible and incurable)

Mental Tetardation

Anti social behaviour

|

|

L

| a. Sexual deviations and disorders. b. Alcoholism and

| j

drug addiction. c. Delinquency and

| i | _—__—__

Neuroses

|

Psychological disorders not associated

Crime. d. Sociopathy or psycho-pathy.

Psychoses

Le Fe

l

Anxiety neuroses

Phobias

are

bye . Depressive

ee

ee

psychoses

neuroses (neurotic depression)

pakili

psychoses

Obsessive compul-

sive neuroses. Hysteria a. Dissociation. b. Conversion.

vos

The necessity and purposes of classifica tion

The classification of mental disorders of diseases is based on

the following similarities :

i)

Similarity of the causative factors or aetiology.

CLASSIFICATION OF MENTAL DISORDERS

97

(ii) Similarity of the symptoms and syndromes. (iii) Similarity of the treatment techniques. (iv) Similarity of the possibilities of improvement. In the light of the above the commonly recognised functions or purposes of the classification of mental disorders or diseases may be summarized as below:

disorders

1. Diagnosis purposes: The classification of mental helps the diagnosis on the following grounds.

Symptoms and syndromes related to the specific class can be properly investigated. (ii) The possible factors contributing in the development or maintenance of the disorder can be identified. purposes: Classification of mental disorders Treatment 2. tenders valuable help in the treatment task: G)

G)

It suggests appropriate

therapeutic techniques

and other

treatments.

(ii) It helps in the prediction of the affected person’s chances (b) with of improvement (a) without treatment and . ments treat variqus (iii) It helps in evaluating the improvement

or change

in the

behaviour of the affected person during a course of treatment or with the passage of time. The knowledge Descriptive and communicative purposes:

3. that a particular mental disorder lies in a particular class or categoryc bing the disorders in terms of some general or specifi

helps in descri

What should be the nature of that mental How can he be disorder? Flow can the affected person react? In short, nt? t exte wha to up nt and stme helped in seeking his adju ingful mean te a brief but the categorization tries to communica to the on pers cted affe the summary of the problem or problems of ons. pers onal concerned professi of mental disorThe why and how of the classification

behavi

tterns.

of the following examples. ders may be further explained in the light terrified by lizards. In spite Case 1: Bimla, a housewife, was harm ed by them, the mere be of being aware that she could

not

tremble with fear. sight of a lizard was enough to make her Case 2:

Surendra,

a youngman of 30 years,

d not be able to swallow.

feared

that he

The severe and overwhelming

woul him to believe anxiety sometimes escalated to a panic attack leading e knowing Whil die. d woul he and ing that his heart would stop beat over his ol contr he had no the absurdity of his fear and anxiety

feelings,

Case 3:

Savita a hostler and college student 22 years

of age,

be poisoned. She was unable developed a belief that she would soon why. Her fear and anxiety and who would poison her

to explain

PSYCHOLOGY

ABNORMAL

58

developed to the extent that she stopped taking anything

the

from

mess and began to cook her food herself and even make her purchases herself.

Case 4:

Prem Singh, a retired army

personnel, believed that

the British government was after him as he had been in association with Azad Hind Fauz.

The

government

of free India should

take full responsibility of protecting him from

now

being kidnapped and

killed by many people in police uniform spying for the British He wrote to the government. D.I.G. police for s appropriate He also screening of the district police to identify the British spies

wrote to the Prime Minister and President of India, requesting them for his adequate protection.

Gradually, his anxiety and fear became

so intense that he confined himself in a locked

room

closing all the

windows and ventilators so that none could get at him.

Case 5: Ramesh Chandra, 23 years

of age, reported for psy-

chiatric help. He believed that he would be unable to perform normal sexual act as he was impotent. Therefore, his fiancee should not suffer unnecessarily on account of him. He insisted on

her forgetting him and to marry someone else. On medical examination it was found that there was nothing wrong with his sex organs and his fear had no organic cause. All the five cases cited above are obviously the cases of mental disorders. Their diagnosis, understanding and treatment definitely Tequires some classification since it would be futile to group them

in a broad category—mental disorder. The cases have some ai and also dissimilarities. Let us classify them on this asis. The symptoms of fear and anxiety are common to all. In the cases of Savita and Prem Singh, the disorder is inthe thought pro cess

(delusion

or

hallucination).

They

have

beliefs

which

are

irrational and baseless. There is a gross distortion or misrepresentation of external reality in both these cases which is significantly absent in the remaining three cases. These two cases may then be classified as psychotics. i

The other three cases show neurotic symptoms but the last one

typically differs in some characteristics with the cases of Bimla and Surendra. The behaviour patterns in the case of Ramesh Chandra

are significantly attached to his sex

behaviour.

In the absence

°

any organic cause his problem is concerned with psychic impotence—

the common psycho-physiological disorder associated with sex. The remaining two cases of Bimla and Surendra may then be classified 45 neurotics. On further classification, we may differentiate the cases of Bimla and Surendra by distinguishing the particular type 9 neurosis. Similarly, the psychotic cases of Savita and Prem Singh

may also be further differentiated. The problem of differentiation

and classification

is a typical

99

CLASSIFICATION OF MENTAL DISORDERS

l one in any attempt of the diagnosis and treatment of the menta ent differ Even lap. over! and disorders. The symptoms often

diseases Take the case of diagnoses may have symptoms in common. delusions and have may t patien ular partic re a He a. schizophreni the neurotic oms sympt tic psycho these hallucinations but along with sion and depres hysteria, symptoms like excessive fear, anxiety, lly, the Typica t. presen be also obsessive-compulsive reactions may ers. disord cases of mental anxiety symptoms may occur in all

reactions will not serve Therefore a mere diagnosis of anxiety The other symptoms on. cati sifi any useful purpose for some clas ces typical to a particular class related to the similarities and differen ttherefore definitely to be ave or category of mental discorders have ification. searched out for an appropriate class

Summary Classification of mental disorders of mental disorders may be Attempts for the classificatio: n n era and contemporary moder era, old s of the

studied in term

Position. fication (mania, melancholia i classi In the old era, Hippocrate es’ and (Satguna, Rajoguna on phrenesis), Indian classificati on are important. These are and sificati Tamoguna) and Kraepelin’s clas

of purely historical interest.

sificas the development of three clas stical The modern era witnesseand stati and ic nost Diag Il. DSM8 tion systems—DSM-I, JCDknown as DSM was developed by Manual of Mental Disordersociation. The first attempt as DSM-I Ass the American Psychiatric in 1968. ICD-8, the

second as DSM-II was was done in 1952 and the ern onal Classification of Diseases, ati Int of m for ed iat rev abb Organisation. developed by the World Health of contemporary

position

witnesses

the

development

fication in the improved systems of classi ICD-9 and DSM-III as thetively. The reliability of these contemyear 1979 and 1980 respec be tested. The

yet to Porary classifications is and functionable classifications, a simple ped. elo Apart from these dis dev orders may also be categorization of mental classifica-

es of classification: The tThe necessity and purpos the diagnosis process and trea tion of mental disorders helps in a brief but meaningful summary It also communicates ment task. essional persons. the patient to the concerned prof of the problem of

10 PSYCHO-PHYSIOLOGICAL

DISORDERS

PsycHO-PHYSIOLOGICAL disorders have been known as psycho-somatic disorders which implies that the mind (psyche) deter-

mines the disease or disorders of the body (soma). In fact this wider conception regarded “mind” and “body” as inseparable aspects of

functioning organism and established a close relationship

the whole

between psychological state of the mind

relationship aspects. :

1.

may

The

be studied

effect

and

sickness.

bodily

This

in the light of the following two

of psychological

attitude on body sickness: The

positive psychological attitude reflected in “fighting spirit” and “faith healing’ helps recovery in serious diseases and accidents. Even in

such diseases as tuberculosis or cancer the favourable attitude of the patient increases the chances of his recovery. On the other hand, the negative attitude reflected in the belief that he cannot get well or for not getting well cast the negative intention his inherent effect. 2. The effect of body sickness on psychological attitude: The

persons who are seriously ill or suffering with acute or painful body

diseases are often scen mentally upset and emotionally disturbedIn their cases the anxiety and pessimism, resulting from their bodily sickness, is readily displaced to other situations making them disturbed and maladjusted. In this way, there seems a close body-mind relationship if

determining the causes and treatment of mental disorders or disabili-

ties suffered

by an

organism.

Where

bodily

diseases may have

psychological causes the psychological ailments may also arise from

organic diseases. Generally, such diseases or disorders may divided into the following three categories: 1. Predominantly organic or physiological: The diseases like

tuberculosis, cancer and physical injurits like a broken leg belong t,t° treatmen category. They have no psychological origin but their

thi,

toa great extent, is influenced by the psychological state or attitude of the patient. 2. Predominantly psychological or psyche: The disorders having

no

significant

organic

cause

and

predominantly

affecting

101

PSYCHO-PHYSIOLOGICAL DISORDERS

ence mechaof the organism (such as def ysis of the psychological functioning anal e clos A o this category. am) may be included int category may reveal that they are not at this to ing ong iorden bel or abnormal health. s bodily state—normal all uninfluenced by one’ y significant: tor chological fac s equallthe behaviour psy and c ani org h Bot t of _ 3. disorders or maladjustmen anic and psychoThis category includes ch both org individual in whi ir origin and or personality of an usly significant in the

in cuo spi con giolo are ysi -ph s tor cho fac psy as logical disorders are termed their treatment. These cal disorders. on publicaPsychiatric Associati

American terized by physical According to the p disorders are charac al ic og ol si hy op involve a single ch sy “p s n tio emotional factor andtem innervation. by sed cau are t symptoms tha c nervous sys y under autonomi ly accomorgan system, usuall anges involved are those that normal nges are ch cha | l siologica orders the

phy these dis nal states, but in pany certain emotio ense and sustained.’”*

The

more - int This

definition

psycho-physiological

ics llowing characterist leads us to the fo

of

disorders:

or the always exhibit one ers ord dis al ic og y in ol ult si fic ng, dif 1. Psycho-phy ms like pain, vomiti tress caused by to mp sy al sic phy l of the dis other typica ical . It is the severity etc individual to seek breathing, diarrhoea ally compells the usu t tha these symptoms

med

elp.

t of developed on accoun physical symptoms ilar to those reflected in the 2, ar sim the visceral ical disorders appe the psycho-physiolog states (anxiety, anger etc). Yet pronounced SO l na io are ot certain em se disorders the body’s strucl conflict in the effects of emotiona eversible damage may be done to disorder turns irr d oT cal illness gi that actual an lo ho yc ps led cal pathology. 4 soture. In this way s OF disorder with identifiable tissue into “a real” illnes emotional conflicts al disorders the ic og ol which has si hy -p ho yc 3. In ps mic nervous systemsympathetic no to au the h ug ro th and para are as sympathetic ons known si nervous system vi di c mi no in to ma au o tw the ns ic tems of the it nd in normal co n such a way that approximate balance. It in pt ke o systems are effects of the tw ominance of eit! ed pr results in the Although

thetic activity floo

exclusively disorders are neither t in all cases bu psycho-physiological c ni The ga or 4, nic s nor by the hological factor holgical and orga caused by psyc about by an interaction of psyc they are brought d con-

tory, etc.

factors.

disorders an ho-phys iological yc ps ? ee tw Distinction beurosis: symptoms and are the version ne ers involve bodily rd so di e es th Both

ABNORMAL PSYCHOLOGY

102

consequences of poorly handled emotional conflicts. However, the following distinctions may be made between these two disorders,

1.

In psycho-physiological disorders the physical

disturbances

are related to the autonomic nervous system and hence are pe vet

under one’s voluntary control, while in conversion neurosis P symptoms involve the sensory and motor nerves of the central ne

ous system and are hence subject to voluntary control. 2. Conversion neurosis produces physical disabilities thai

lack an adequate organic basis, whilein the psycho-physiolog disorders the “adequate organic basis” is present.

3.

In psycho-physiological disorders the physical disturbances

are real enough and not merely symbolicsod. in nature as in : the case of conversion neurosis.

4. Whereas psycho-physiological disorders i i i result from the = Prolonged effect of natural reaction to emotional stress, the conve sion neurosis‘ often results from an unconscious : symbolici expres; sion of emotional conflicts.

5.

Psycho-physiological

i disorders may

very

in often result t

actual and irreversible damage to the body’s structure which soe

life-threatening, sion neurosis,

whereas

such happenings

are quite rare in co

The main psycho-physiological disorders

The classification system DSM-II of the American ie ara

Association has mentioned physiological disorders: _

the

following ten categories of psyc

Respiratory disorders Cardiovascular disorders Gastro-intestinal disorders Genito-urinary disorders

Skin disorders Endocrine disorders

Hemic and lymphatic disorders Musculo-skeletal disorders NAADWH WH Neurological disorders =S Sensory disorders,

1. Respiratory disorders:

Respirator

y disorders are se cerned with the malfunctioning or dysfu nction of the respirators system. A few common Psycho-physiological disorders are following: ey (a) Asthma: The main symptom involves difficulty in ae thing (wheezing) and a sense of constriction of the chest. In PSYC ihe physiological cases of asthma, the muscles in the bronchi (tubes

in

walls of derthe lungs) contract because of the relative un

PSYCHO-PHYSIOLOGICAL DISORDERS

relative over-activity activity of the sympathetic system or of the the parasympathetic system. (b) muscular

103

of

the It consists of the inflammation of Common cold: profuse diswith t throa and nose the of s membrane

charge.

ious inflammation and swelling (c)Rhintis: It involves no n-infect ng, sneezing and profuse watery of the nasal mucosa with itchi secretion from the nose. some sort of allergic reac(d) Hay fever: It concerns with nes of the nose become membra the mucous in which tion inflamed. thing”. Literally it means “over brea open () Hyperventilation: th mou the with g thin brea deep y It consists of episodes of fairl iness, results in the sensations of dizz or rapid shallow breathing and ling of or numbness in the exting chest pain, blurred vision and tremities. been orde rs of the respiratory system has What causes such dis are s cause mon com the of Some igation. a matter of wide invest given below. rit a editary cause); One may inhe (i) Genetic influences (her one e mak weakness which may tendency towards respiratory em. syst ory irat resp ctions of the prone to allergies and infe are often ns Respiratory disorders (ii) Allergies and infectioctions of the respiratory system. infe caused by allergies and occur when itivity reactions that sens are s rgie alle , the case of In Physiologically ues. tiss body

contact with to substance certain substances come in ns with the hypersensitivitysmell, food or cer con it s rder diso ry ato or pir res a particular odour (like dust, ragweed. smoke, ingested. or d drink etc), which are inhale tors work both tors: Psychological fac the respiratory (iii) Psychologicall fac for ses precipicating cau as predisposing as wel as g the. utmost lin fee by by ill be to Many individuals learn ng ill may gain them attention disorders.

ir becomi necessity of falling ill as the wish to secure it) and or freedom from y the om wh om (fr ble state of or affection disturbances and unfavoura nal tio Emo s. and lation dem e som irritation, neglect or iso

n, anger, mind like anxiety, depressio respiratory disorders through innervaate cre may is may be and frustration tem. For example, rhinit

s sys tion of autonomic nervou

emotional disturbances. growing out of theatin n tio ges con the by g causes by lowering sed cau tors work as precipit i

ing him susceptible to h n dividual and thus makder psy treatment, and i chological disorders OF hin ing N o o me e g the state of the the trouble or worsenin g sin rea inc by ly ond Sec . under stress situation individual especially es of disorders sorders: Today the cas di ar ul sc va io rd Ca 2. the increase. The ne

and vascular system are on and diseases of the heart

ABNORMAL PSYCHOLOGY

104

factors are major cardiovascular disorders with psycho-physiological

angina pectoris, migraine and conorary disease. pressure. a. Hypertension: Itis a chronic state of high blood the with erence interf It may have organic causes in the form of the c cause can

hypertension,

circulatory function of the kidneys. When no such organi ension, be found the condition is referred to as essential hypert indicating that it is caused by emotional factors. In the b. Angina pectoris: It is severe pain in the chest. of cient supply — insuffi an with related is c it cause organi form of individuals the cases, many in But s. muscle heart the to oxygen

stabbed

experiencing anginal pain and a feeling of being

in the

heart, usually do not show any signs of organic disturbances indicating that they may also be caused by psychological factors. c. Migraine: It involves extremely painful headaches. The pain usually occurs on the side of the head. Sometimes it is associated with nausea and blurred vision.

attack

The

than twenty four hours and is often much

rarely

more

lasts

It is generally

briefer.

caused by the sympathetically innervated contraction followed by dilation Qf blood vessels in the brain. The present emotional

disturbante, the early psychological experineces and the genetic influences may be the other causes of migraine disorders in addition or absence of the known bodily causes. Diseases of the heart like clotting d. Coronary diseases:

blood (thrombosis) blocking one of the

vessels

serving

to of

heart

the

involves both physiological and psychoiogical factors. On account of the psychological stress situations, the rate of blood clotting Is

usually increased.

Anxiety, anger and

result

excitement

in

the

increase of heart palpitation which in turn increases resistance to the

flow of blood and speeds up blood clotting. The presence of such psychological factors, thus, may work as predisposing or precipitating causes for the coronary diseases or heart disorders.

3.

Gastro-intestinal disorders:

According

to

disorders of the gastro-intestinal system may be roughly

Mahoney"

divided into

three types—anorexia nervosa, disgestive problems and peptic ulcer and colitis. a. Anorexia nervosa, Loss of appetite is known as anorexia. In the absence of organic disorder when it is caused by emotiona factors it is referred to as anorexia nervosa. The more sever cases

of anorexia nervosa

are characterized by weight loss to the point ©

This disorder is much more frequent among girls an emaciation. young women of the middle and upper socio-economic classes with symptoms of ‘menstrual disturbances, slow heart beat rate an

constipation. Its onset often occurs during or shortly after adolesce” nce, at which time the young girl becomes very conscious of her She goes on “crash” starvation diets. As she starves weight. herself ever thinner she may adamantly deny that she is underweig

aii

my seem almost phobic about weight gain.

Consequently, she

105

ORDERS PSYCHO-PHYSIOLOGICAL DIS

times complainary self-starvation many choking on it or unt vol of d kin a to s ort res aid of her, or that she is afr ing that food disgusts f-induced vomiting are sel es cas e som In . ing eat r afte ng iti after the ‘sin’ of of vom e one’s body of food frequent rituals to cleans e writers anorexia nervosa is often related According to som onset of puberty, eating. patient’s life history—the to sexual events in thewith sexual activity or fantasy etc. A desire guilt felt in connection child than a responsiand being a favoured d with impregnation, ed lop eve und ain rem foo to cious association of r the ble adult, an uncons ated by parents ove cre m vis ati neg ood ldh ogi chi hol of continuation may be some ot

rishment gastro-intestinal child’s health and noutow s malfunctioning of thi s ard ing but factors contri system.

Emotional factors with digestive problems:delicate balance of b. Disorders related a serious alteration of honey? are responsible for the acids in our body which in turn, as Ma d an . s ms me le zy ob en pr estive digestive to the following dig observes, give rise wel movements. frequent liquid bo a— oe rh ar bowel Di (i) casionally painful

(ii)

(iii) (iv)

quent and oc Constipation—infre movements. minent vomiting. te and feeling of im ti pe ap of s os —l stomach Nausea of the lining of thea burning on ti ma am fl in d an d an Gastritis— an excess stomach aci offten associated with sensation.

c.

and colitis represent

colitis: Peptic ulcer and Peptic ulcer and th structural damage to the stomach wi ed at ci s asso

the disord. er

e lining ed wound) on th am fl in n (a re portion so r en pe op (the up Peptic ulcer is an ly in duodenum nt ue ich a eq wh fr in pa re mo is omach or symptom

intestines

‘An important d only by small intestine). er meals and which can be ease . There in pa aft s th ce along wi ng ti mi person experien vo or ea action of us ere may be na by the corrosive

of the st

ofthe

the eating. Th is caused digestive acids on severe cases. It is bleeding in and excessive secretion of the e. in st te in and small the overactivity of the stomach ional and organic s ne ra mb me us interplay of emot protective muco logical from a complexélosely related to the physio st se ari rs ce ul e e Th ar tes stained sta su d l an Emotiona strong factors, ility or e of ulcer. A us host us ca of e th y r ) ll fo ua , le ib À response 4 fact ronic emo tional sion 10 some confliOre TOP res chbility to reduce the emotional ten annelization) ina Ye proper ch ury by its ee e mechanisms or

ceptible to inj ys (lihke ordefenc harmlessthewast duodenum to be sus und that the ac om ses fo cau

persistent been en activioft em st has sy It s ou ions. nomic nerv to au d secret ing ult of res own ioaci ion the d ret sec emot nal stress an and excessive ity us co tiv mu rac ove the the g in for en onsible They cause ulcer by weak ties areive respaci It is also ds. digest the digestive tissues. wn do ng ki ea br d membranes an ———

PSYCHO-PHYSIOLOGICAL DISORDERS

109

older than him, and parents who provided him much attention. When he was thirteen, his brother died and about two years later he

lost his father. Following the death of his father, his mother became psychologically dependent on him, consulting him about important problems and requiring him generally to substitute for both his older brother and his

father, a

situation for which he was

completely unprepared intellectually and otherwise. While maintainand his Ing a secure outer appearance, he was aroused emotionally excessive the by intensified repeatedly were emotional reactions

At the age of eighteen he experienced. a expectations of his mother. short period of stomach discomfort which was followed by the initial Davision and haemorrhaging of a duodenal ulcer. (Adapted from

Neale, 1978).

Case 3: (A case of anorexia nervosa), A young girl Kamini an emaciat25 years of aze, reported for medical help. She was depressed was She feet. five of height a and kg 28 g ed girl weighin fat and her ng becomi not with pied preoccu totally be to seemed and well with her about her diet. Hisparents could not reason be normal until she was 21 years of to traced was she y toricall

and family memage. With an occasional remark oftooherfat friend as attractive as not and was she that feel to bers, she begain match for her. good a of her friends. Her parents were in search

going Mer belief about her figure became more pronounced after started to usly rigouro She ws. intervie nial matrimo few a h throug after slim and became fussy about her diet. Her periods stopped last For the thin. and weak became she ly an year and gradual ty carry-

six months she had been emaciated to work and felt difficul

ing out her daily routine.

Kanchan, 30 years of | Case 4: (A case of frigidity): A woman, derived no satisfacshe that r age, complained to alady docto ination it was found that shex tion from the sexual act. After exami (any mental or physidid not have any organic cause for the same It was found normal. also was and Her husb cal abnormality). from age marri e befor revealed that the patient had an affair which

about

place. sional course

she

had

derived

some

pleasure.

Her

parents

lover, the affair and made life impo ssible for her who er teach a ied marr At the age of 22, she She got no pleasure and rigid in all matters. eight years and often of iage throughout her marr

found

out

who left the was obsesfrom interobjected to

place two or three his mechanical approach. Intercourse took never made any inly certa She . times in a month at his insistence

advances,

There were no children.

an 22 rder): Kamla, a married wom Case 5: (A case of skin diso e she had thre of age the At t. tmen trea the years age approached for ition remained both arms and hands. This cond developed eczema on year of seven, when age the at up red s then clea Problematic for two had eczema n agai arms and s band Her . nant preg was er her moth

menstruation for a period of three with the onset ofsheherhadfirst severe skin eruption associated with the

Months.

Recently

GY ABNORMAL PSYCHOLO 10

absence from her husband.

impending

As the date of his epatite

worsened approached, her symptoms gradually

and eventually

was hospitalized.

Case6 : (illustrating

the impact of stresses)

:

Richard

s

Nixon

the repeated attacks or the President o aea, suffered with n on account of the ba phlebitis in 1974 soon after his resignatio

£ blood clots in his le gate scandal. He developed a number of 1a fur ent prev to ry surge y and one large clot required emergenc President Nizan

Historically, ıt was revealed that complications. Predisposed to se phlebitis attack in 1965. first his suffered ed by the stress n avat aggr ably prob disorder, his phlebitis was prestige on accoun and ion posit , power of loss situation like sudden r, 1977). of his forced resignation. (Adapted from G.W. Kiske facts: An analysis of these cases reveals the following

in the 1. Genetic or hereditary factors play some part ers. al disord ologic -physi development of psycho ies and 2. Body structure, its chemical functioning, allerg ers. disord the of infections may initiate and precipitate many

l factors, 1. Apart from these organic factors, psychologica severity the ine by all means, initiate, control, precipitate and determ ica solog o-phy psych of these disorders. Many and occurance t.

rcemen disorders can be caused through conditioning and reinfo home from stay to d allowe edly repeat is who child a e, For exampl to be rewarded school when he has an upset stomack may learn suffer chroni may ife housew from chronic indigestion. Similarly, a

backache or asthma on account of her conditioning to get sympathy and attention due to her illness. Emotional factors and pychological stresses have always been found to play a significant role in all types of psycho-physiologica disorders. They may relate to the patient’s childhood experiences, behaviour and treatment got from the parents, the early inconveninial familia ences, deprivation and accidents in one’s life, the unconge

environment,

family

unhealthy

parent-child

life of the parents.

predisposing

the newly

factors

emerging

for these

demands

All

relationships

of

disorders.

them

prove

and

unhappy

to be ered

In the subsequent years; ©

and perplexties

of the adolescents.

problems life and many of the stresses and strains of adulthood pose phypsychothe of ation and conflict situations for the perpetu t found been have ns situatio stressful siological disorders. These g followin the in s disorder ogical physiol psychotowards ute contrib ways:

(a)

By affecting unfavourably the autonomic nervous

system

and thus the body chemistry and metabolism.

the fighting capacity of an individual against (b) By reducing ‘the disease spreading virus and bacteria. e P ‘ isita (c) By creatiA ng a precipitating and immediate cause to th

Ill

PSYCHO-PHYSIOLOGIVAL DISORDERS

ge In such cases the physical dema already predisposed individual. life the of s nse emotional stres is said to be triggered by the inte

events.

loponable escape through deve (d) By providing a goodto reas be ill. desire ing and intensifying a logical disatment of the psyc ho-physio

Prevention

and tre

orders

interaction disorders are caused by the the prevenThe psyco-physiological ica , ore ref l factors. |The

log of the organic and phychothe se tion

and

treatment

of

disorders

lie in caring

for

these

factors.

y are beyond luences are concerned, the As far as the genetic inf sence as a predisposing factors can Hence, their pre psychological trol.

one’s con never be ruled out. For factors we may adopt a form of the provision tion for good physical

tors and the other biological fac tive measures in the ven pre good number of ilities and educaof better environmental fac isfactory living. sat and mental health and ches have been

approa these disorders various Regarding treatment of

suggested:

disorders measures: In psycho-physiological anic problems, org l rea 1. Biomedical not are re The nt. are app al the illness is real and require “medical-cum-biologic

body which ific beliefs and diagnodisturbancesDepinendthe ing on the therapist’s spec many

treatment.

ication. In range from surgery to med may ng ent atm tre the sis heart diseases, bleadi al disorders likency medical treatment is gic olo ysi -ph cho psy of cases disorders emerge ulcers, severe urinary it becomes desirin the others also, gs and medicines le Whi ed. uir req urgently s types of dru certein stag e when variou Sometimes the physi-

able at a

i ease. e dis l the severity of th diet, monodifying the ro nt co I environment to ed us e ar nging the cha by ored g the growth rest sin s i cau cal health ical conditions log bio te na TOT and ealt is So of virus and bacteria. point tic aly -an ures: From the psycho psym al gic olo ysi 2. Psycho-analytic meas -ph cho psy aging

dam f-punisha painful and health sym of view, res bolical aggression OT sel cious ons rep ents some sort of unc h wit d ble impulses associate is treatment, | the patient ment for the unaccepta tom

psychoanalytic ct which lies at conflicts, Therefore, in e the unconscious confli olv res and gale helped to confront panies the root of the symptom.

sycho-physiologica modification measures: daptive behaviour. iour learning of mala pe caused by therapy attempts are made to unlearn the — the nforceification In behaviour modrni tion aod differential rei lea ng through extinc se of a child-who happened ta unfavourable exa the mple, For ment, ng and 1 wheezing) atL bed 4s of ast hma (heavy i coughi rapy in the

our the exhibit prepared to induce behavi time, “The eur were

following two ways:

ABNORMAL n

PSYCHOLOGY

to ignore systematically (extinguish) the child’s asthmatic i responding. ' incentive some with Gi) to reward more normal breathing

G)

(love and affection, good food and sometimes money). The results were encouraging as the child gradually got rid of

the maladaptive responses.

4. Psycho-therapic measures: Emotional factors and psjeho logical stresses prove predisposing as well as precipitating causes a

the psycho-physiological disorders. A proper training of the are

tions and helping the patient to learn well adaptive normal wa ie cope with his conflict and stressful situations may bring, avourta i results. As far as possible, attempts should be made to Imp ms patient’s life situations by modifying his environment so as to reau

daily stress. Measures like short term psycho-therapy may also

P

the patient for the release of his tension, anxiety and similar or = factors making him unhappy. These measures prove helpfu ess least in decreasing the patient’s vulnerability to subsequent str and improving his mental health. Recently, biofeed back measurer 5. Bio-feed back measures:

have been studied to control many muscular

Biofeed

of the psycho-physiologic®

like headaches, back aches, irregular heart beats, —

disorders

spasms,

back

teeth

grinding,

epilepsy,

refers to procedures

processes such as heart rate, muscle tension

special instruments

sexual

impotency ‘al

etc., are

amplifie' Bi

in which selected eae

ay

may be made a

so that the individual

them (in the form of signals such as lights or sounds) and then

ae

be trained to control their occurrence. For example, blood preson

or pulse rate can be measured and amplified so that the pe ze knows them through suitable signals. By getting training 1n cali ing down the tones of such signals, the person may learn to Se he voluntary control over these functions and thus may be helped in treatment of related disorders.

Summary Psycho-physiological disorders:

The term

.

scal

psycho-physiologica

dissidens: includes those disorders or maladjustment of the behaviowt or personality of an individual in which both organic and, pse in

logical factors are conspicuously significant in their origin an

their treatment.

These disorders differ from conversion neurosis in terms af ~~

H involvement of nervous system, presence of adequate organic ba 5 4! stress emotional to reality of physical disturbances, reaction damage to the body’s structure.

ies

Description

malfunctioning

p

of the disorders:

;

Respiratory

of the respiratory system.

5 rs disorde

; vej invol

Asthma, common

rhintis, hyperventilation, hay fever etc., are such disorders. ġ 3 Cardiovascular disorders (disorders of the heart and

vascu Jar

113

PSYCHO-PHYSIOLOGICAL DISORDERS system): include

the disorders

like hypertension,

angina

pectoris,

migraine and conorary disease.

of the gastro-intestinal Gastro-intestinal disorders (disorders peptic ulcer and colitis. ems, probl tive system) anorexia nervosa, diges of genito-urinary system) Genito-urinary disorders (disorders P

include urinary, menstrual and sexual disorders. orders like acne Skin disorders include the dirs

and eczema

(alergic).

ing) orders of the glandular functionendoEndocrine disorders (dis r . othe the or one of vity acti involve the underactivity or over crine glands. s s are related with the disorder Hemic and lymphatic disorder are s rder eletal diso

Musculosk of the blood and lymph systems. muscles y ntar volu and es bon the associated with

of the body

such

itis. as backache, muscle cramps and arthr ed byy a close ological di sorders X are caus Causes: Psycho-physi s) like body tor ‘ fac l ica log bio er oth interaction of organic (genetic andng, allergies and infections and oni

structure, its chemical functi ment, e conditioning and reinforce psychological factors. (likblems and psychological stress). deprivations, emotional pro : Prevention and treatment

Genetic

early

’s influences are beyond one

cised over able control may be exeron. control. However, reason enti prev logical factors for the biological and other psycho measures like these disorders there are of ent atm tre -therthe , For _ tic, behaviour modification psycho

biomedical, psycho-analy apic and biofeed-back.

REFERENCES ~ . American

Psychiatric

Mahoney, op. cit., p- 228-

Association,

Mahoney, op. cit, P- 243.

Ibid., p. 245.

Rey Kisker,

op. cit., pp-

222-223.

DSM-II,

1968, p. 46,

as cited by

11 DISORDERS

PSYCHONEUROTIC

disorders

SYCHONEUROTIC

are

purely

psychological

dis-

orders. There is no relevant organic pathology present ka these disorders of the behaviour and thus may be clearly distin as guished from the psycho-physiological disorders which are known the disorders Of the psyche as well as body. The illness diagnosed in as 10 the psycho-physiologica! disorders is more real than apparent neurosis a Thus disorders. psychotic or rotic psychoneu of case the by no means may be labelled as a disease entity.

In the sequence of the disorders of behaviour, neurosis falls and psychotic midway between minor emotional maladjustment

disorders.

Consequently,

it is known as more serious than a, si

disor S:; emotional maladjustment and less serious than a psychotic

Neurotic

disorders in a real sense represent the typical waye a

dealing with frustrations and conflicts and the anxiety which from these frustrations and conflicts.

“Anxiety,”

resu Sad

as described in DSM-II, “is the chief characteris?

It may be felt and expressed directly, or it. may of neuroses. ir controlled unconsciously.”! It is in this context that George rs behavio tive maladap of pattern “a as Kisker has defined neurosis in wbich a person responds to life stress with persistent anxiety ° other behaviour representing attempts to control the anxiety.’ r Anxiety is closely linked to an individuals needs and motive esterni self , security n, If the essential needs linked with affectio

achievement and freedom are not satisfactorily gratified, it may Bits rise to the feeling of excessive anxiety or guilt which in tura pate ERY in a neurotic behaviour. But it is not be concluded that anxiety reaction leads

to

neurotic

behaviour.

We are occasioni at

quite anxious, irritable, down or restless, but it does not mean t a ? we are neurotic. It is only when the anxiety behaviour pattern

become

more

persistent and interfere with our ability to lead 2 pane

adjustment mec mal life and thus depict “break downs” in the anism, that they are usually labelled ‘‘neurosis.”” y HOU sect

r tic behaviour is Oe In spite of its extreme anxiety content neuro ality. It c# person split a disorganised nor is neurotic personalitly

PSYCHONEUROTIC DISORDERS

115

ality in safely distinguished from the psychotic behaviour or person ing ways: the follow Neurotic and psychotic behaviour not defective. 1. The relation of a neurotic person to reality is of external tion distor d marke show not does He talks rationally and , range. reality., He perceives his environment well within the normal

hallucination or illusion, Since he is not affected with bizarreofideas, : thought. it is not difficult to follow his train

lasting disturbances"of 2. In neuroses, there are no deep and neuroses are mild in s rtion disto l iona emot , affect. In other words For examble, a neurotic may at and not so severe as in psychoses. is not so severe as to affect ssion depre his times be depressed, but viour as in the case seriously his thought processes and general beha

acteristics like of psychotic personality. The char ession. depr otic neur in d stupor are not foun

sever

agitation

or

relatively mild in neuroses. 3. The cognitive distortion is otic personality more or less a neur The intellectual potentialitiesininpsychotic behaviour the cognitive remain unaffected, whereas nt of the intellectual funcdistortion is severe and causes impairme tioning.

otic behaviour are not much 4. The social T elations in neur c behaviour. A neurotic, hoti psyc of disturbed as in the case some other in live not does although disturbed and disorganised, ped by his icap hand h muc not is He . world asa psychotic does adjustment impossible.

his social behaviour pattern as to make 5.

In neuroses

personality, as in no severe disorganisation of relatively well s remain

rotic therefore proves less psychoses, is found. A neu to a psychotic, the nevroticdeviation are n iso par com In d. ate egr int the symptoms of his behaviour

harmful to others and for care and attenanxiety to others. The need case of neurotics not severe to cause al the in felt y all is not usu

tion in a mental hospit

as it is for psychotics.

ic Specific forms or types of nevrot

behaviour as men tioned in the The major types of neurosis

classification

system DSM Il-are as follows: 1. 2.

Anxiety neurosis

version type, and Hysterical neurosis—a. Con tive type. Phobic neurosis neurosis Obsessive compulsive

Depressive neurosis Neurasthemic neurosis

rosis Depersonalization neu

is w SNA Hypochondriacal neuros

b. Dissocia-

ABNORMAL t6

Anxiety neurosis:

PSYCHOLOGY

a pekas

The anxiety neurosis represents

He by anxiety reactions which interfere with viour dominated ve invol ty anxie The . tment adjus l socia individual’s personal and wing: here is a free floating anxiety characterised by the follo

(i)

the individual for his anxiety reac

be given by

can

explanations tions.

(ii)

that no relevent or, justified

It is irrational in the sense

Quite often, a very minute

danger

gives rise individual,

or

anxiety

to disproportionately strong

stress

ae

reactions

in

anxiety A (iii) In anxiety neurosis, unlike other neurosis, the phobias 0 of form the in ctly experienced directly and not indire

compulsions.

An individual suffering from anxiety neurosis Symptoms: may exhibit the following symptoms for no apparent reason: (a) Physiological

G) Mild nausea, loss of appetite and some loss of weight. blood Gi) Heart palpitations, feeling of heart burn, elevated ies 1

pressure and breathing.

increased

pulse rate,

suffocation

and

difficult

Cold Sweat, headaches, muscle tension or pain, dryness

Gii)

of the mouth, trembling of hands and lips and frequent sighing.

dissatis-

Speach disorders, sleep disturbances and sexual

(iv) faction.

oea, (v) Inappropriate eating habits, chronic mild diarrh P ion. frequent urination and difficulties in digest (vi) Excessive use of alcohol, tranquilizing drugs or sleeping

pills. (b) Psychological:

(i) Disturbances

in

thinking:

individuals often complain of lack

The

neurotically

of concentration

interest in life. They are always uncertain

in

anxious

work

an

and fearful of making

mistakes. As a result they prefere making no decision than making &

wrong one.

(ii) Disturbances in feeling: Anxiety neurosis is chara os terized by extreme and generalized apprehension by a feeling 1l ha to likely are neurotics anxiety The . helplessness and resentment pronounced feelings of dread and apprehension no matter how ES

things scem to be going. They are convinced happening but can't tell what happen.

of something

it will be or even why

The lengths-to which they go to find things to worry

is remarkable.

As

soon

as

one

cause

for worry

tern

it shou t

is removed,

abou? they

find another until their kith and kin lose patience with them. Similarly, while suffering from the feeling of helplessness» am

117

PSYCHONEUROTIC DISORDERS

turn. Heis sure that anxiety neurotic does not know which way to is likely to be depenHe . failure in result will anything he attempts resentment wells up So, do. to on others, which he does not like dent ds the self as he towar ssion aggre in s result tely ultima within him and whom he is upon those attack to does not possess enough courage dependent.

Examples of anxiety neurosis Case 1:

of age, reported A married working woman, 37 years

she was the second of five Her case history revealed thatquarrelles when she was a child. _ uent siblings. Her parents had freq and had a girl chi of 20 She was married at the age

e on at the age o birth. It 22. She reported that illness cam uced since the daughter’s red . Her that intercourse had been asm org out with then and

in a year occurred two or three times reported that she had been ill for some an ssm ine bus busy a. husband, but she had become worse in the time, possibly two or three years, she developed a cancer at times when

it, few months, past everything —‘‘you name Before that she worried over d it. At times she’s nasty phobia. can’t understan she worries about it—I completely selfput up with it.” He was and that d tan ers und I but contained and introverted. of age, sought help for his An engineer, 50 years Case 2; sweating. He began s, frightened, tense and problem. He was anxiou to a rate of 102 per up d speede

which had to worry about his heart,as if chocking. He had diarrhoea. His hanus felt he ed penis. minute, At times

dry. He had a deform trembled and his mouth was for 26 years, that he had been married wife and he The case history revealed sexual intercourse. His able of atres together but had never been cap life of clubs, parties and the he had been s uou tin ago had an almost con fectly happy. Two months and they had been per He became concerned and he and his wife . ion by-passed for promotsocial functions and theatres. (Adapted from Worths, 1972, stopped going to Psychiatric Investigation, pp. 18-21.)

J.H. Price London: Butter

to a pychiatric r-old girl was referred es eight months Case 3: An 18 yea iti hor aut attention of the clinic. She first came to the interview, she. was ted suicide. At the time oflessened somewhat earlier, when she attempble tens ion. The anxiety found under consideraed encourag ement and reassurance. Eventeat part around her in the face of rep hich revolved for the most

ry W stmother had fruan ually, she told a dstotha d told her that her, but ha y he t ed ni de sai e she Sh . her fat her another time, he kissed

rated him sexually. At

ABNORMAL

PSYCHOLOGY

ug

further advances. She admitted having frequent dreams and nightmares most of which involved the father.

Her anxiety

became so great that she insisted that her

should

mother

sleep with her. Before going to bed, she went eae ritual of barricading the bedroom door. She could sleep as oran

her mother kept an arm over her. At the same time she Se Š had ofthe mother and occasionally hesitated to eat anything ec all

prepared,

and was sometimes so fearful that-she remained awa

night in order to watch her mother.

The problem got intensified by the father’s advances when

i attempted to molest her and by the mother’s passive reactio n E her situation. The girl had deeply ambivalent feelings about bot f fear father and her mother. In spite of her repeated expressions ith and hatred for the father, she was found to be preoccupiedO Tife thoughts of him both in her waking fantasies and her dream itte(Adapted from Kisker, 1977, p. 197.)

2. the

Hysterical neurosis Hysterical neurosis represents such neurotic reaction in Which person resorts to conversion or dissociation for controlling, al

anxiety or solving psychological conflicts. hysteria:

Conversion

Asa

result hysterie

to be of two major types—conversion type aD

neuroses are said dissociative type.

This type of hysterical neurosis erat

ents behaviour disorder in which a person’s anxiety or Psy aia into a physical symptom like paransi

is converted

logical conflict

of legs or inability to hear. Actually, it is a sort of learned a

to frustration in which the individual tries to seek a neurotic

ace

€e P

by a psychogenic impairment of bodily sensation or action. He ae distinction needs to be made between

conversion

hysteria

and

chophysiological disorders discussed in the previous chapter.

is

In

words of Kisker it may be summarized as below:

“When

motor

the symptom

pathways

is expressed

of the central

called a hysterical

nervous

through

the sensory

=

system, the condition i

conversion

neurosis.

However,

when

ara: ve

symptoms:

Conversion symptoms may i

symptoms involve the autonomic nervous system, the maladapt! behaviour is called psycho-physiological disorder.”* g 4 ; 0 Symptoms: Conversion symptoms appear mainly 10 tw areas, namely sensory and motor. any

1.

Sensory

of the senses, Anesthesia

most common

conversion

(lack of skin sensation) is one ©

reaction.

ae

As a result, the person the

longer feels pain even when sharp objects are pressed in al affected parts. Contrary to anesthesia, a person may feel pain sensations that are difficult for him to describe in some areas © ion

body

especially

reactions

when

involving

the area visual

and

is stimulated. auditory

senses,

In the convers the person

m

119

PSYCHONEUROTIC DISORDERS

s which or deaf for being unable to see or hear thing a soldier for al he actually does not like to see or listen to. It ish natur optic and eyes the thoug to develop . conversion blindness (even by apart , blown friend close very a g seein after nerves are normal)

become

blind

may give such a an exploding shell. Similarly, a traumatic experience his ears for fear use to dare not may e h that shock to an individual a conversion ops devel he y and consequentl

of what he may hear

deafness. 2.

involves Conversion hysteria frequently Motor symptoms: or or trem like les musc ed roll symptoms of the voluntary cont raction of muscles

motor cont shaking, tick-like movements, minor cramps, ulsive seizures etc. conv and s limb d lyze para disorders of speech, es b becomes useless and so mak

lim In conversion paralysis, toa escape from what is to him an al vidu indi the for ible n paralysis it poss many cases, the converansioexa ation. Thus in chi mple we As impossible situfer ss. stre ng to becomes a pre red way of rea er

may

ord became paralyzed when the zaly par cite the case of a soldier who got s whose arm to attack the enemy oF à person ches of the

his wife from the cult ed when he could not protect : antisocial elements. was given

se

is with the conversion paralysis The interesting thing to note ional disorder. Here too, the loss } that it usually amounts to à funct another Similar is t he case with suf e. ctiv sele be may ing on fer cti s the fun of as writer’s cramp. Person conversion disorder known the same use to able are but e writ mp cannot iter’ of cards fro pack a ile shuf to for example, Pian he ee activities,

or to play a harmonium.

motor e one of the = camani Disorders of speech constitut ia. gy ee ie age is manifestation of conversion hyster g, 1n the mAn y ch CASEYn, able to speak only in whispers. Stutterin l reasons. oie ‘bitio

logica is known to result from the psycho be ne thing ae Pe e | spe wro the ing say ac the individual, afraid of normal functioning © which interfere Organs.

with

the

epilepsy. The ts, resembles 2 i many respects, i : 10 happens seizure, aval sive unconcious. This

weapons ad may become

imself around, ‘Although he may throw bip his When others are present. does unaffected; always his pupillary reflex to light remains nearly is he and in epilepsy,

as nsually happens tongue careful not to injure himsett.

.

EE

of conversion 5 s . addition to these two types

, omisome

writes tomelad visceral BPM choking,sensations, In

eae

9

2 psychobreathing, belching. nausea in ps these coughing classify culty in disorders neurotic rather than along with Physiolo iel disorders autonomic nervous system ify

pro;

Symptoms

also

like ” symptoms

involve

the

the body involuntary muscles of

ABNORMAL

20

PSYCHOLOGY

tion

In some cases of conversion hysteria, there exists an exaggeraof actual organic symptoms. Thus, an individual who has a

this

foundation.

minor organic disorder may build Therefore,

an hysterical

in actual sense,

superstructure

on

all hysteric individuals

attempt to convert their psychological disturbances into physical disorders or diseases and thus seem to resort to an escape mechanism for justifying their otherwise unjustified behaviour. The following example illustrates the mechanism of the conversion reactions. : A fifty year-old successful businessman, married to an attrac-

tive and considerably young wife, suddenly developed a paralysis of his arm. On medical examination no organic cause was found for his disorder. The psychological evaluation of the patient reveale that while he seemed anxious to be cured of his disorder, he displayed his arm with some satisfaction, demonstrating the lack o

sensation by touching his lit cigarette to the affected part. With the possibility

mended.

of a converison reaction,

psychotherapy

was recon

It resulted in the removal of the symptom but it ret

a few days later. However,

the psychological nature

of the disorde

had been proved and psychotherapy was continued. It became clear to the therapist that the patient had been using his neurot symptoms to solve his problems. His young and attractive wile was fond of night clubs, while the patient merely wanted to come

home at night, have dinner, read his paper and go to bed. The difference in age and interests resulted in serious conflict. Finally, the wife began to go out without her husband and it was at thi point that the symptom appeared.

The therapist concluded that his paralysis

was serving P

a

number of purposes such as (i) good excuse for staying home in night, (ii) forcing the wife to spend more time with him at home 1 the evenings, (iii) seeking sympathy and attention of friends an relatives, and (iv) a good excuse for coming home from his office any: Dour of the day as he was jealous of his wife and suspected her elity.

Interestingly, the eventual cure in this case was brought

aboni

by the sudden disappearence of his wife with a police officer. wW A he was convinced that his wife would never return to him, his syne tom disappeared spontaneously as he had no problem of living wi

his wife now. (Adapted from Kisker, 1977, p. 208.)

Dissociative hysteria:

The hysterical

disociative

neurosis J]

maladaptive cognitive behaviour in which a person tries to con If his anxiety or psychological problem by the dissociation of bis se r Disturbances in consciousness and /or loss of personal indentity Fr the main characteristics of such dissociative reactions. The tor major types of such reactions are somnambulism, amnesia, fog and multiple personality. J

Somnambulism refers to a condition in which times

carries out

a person

mea

specific acts at specific times during the night 1

PSYCHONEUROTIC

ee

eg state after he has gone

i uring

121

DISORDERS

sleep-walking,

to sleep in a normal

his eyes are

manner.

open and he responds more or

not awake. The person finally ess well to commands, yet he is in the morning remembers nothand sleep returns to his bed and to ons are . In their sleep-walking, pers ing of the events of the night . ities activ lex comp many do and s ance known to travel long dist

tive amnesia, loss of memory. In dissocia _ Amnesia refers to the are associatch whi ces rien expe all ly the individual forgets temporari It may be et. ch he intends to forg cannot son per ed with the kind of self whi the m plete for

in its com partial or complete. his name. He ut his earlier life—not even actual age or abo ng thi remember any his and friends, forgets cannot recognize his family basic habit patterns such as the ability to his yet ess, in a state residential addr remain intact. He may remain walk, talk, read and reason .

days minutes, for hours, or for of amnesia for just a few flight. In this of amnesia and physical A fugue is a combination ues for a long period of time (may be of identity contin

the state the loss accompanied by actual flight from e, hom for several years) and it is e leav ly den The person may sud customary sorroundings. imes begin a ‘‘new life.” somt and travel to another area gs in a state may illustrate the happenin The following example of amnesia or fugue. her hus-

help by brought for medical state. Her husbA married woman was se ten and y much confused ver a in was while he was She ago band. home two weeks t lef had she t could not tha and reported help of police but she

He took the cripaway from his work. received a report that a woman of her des and re he the t day wen One he . en ced Wh tra y. be ed in another cit est arr her n bee ow kn had n tio did not at first recognize him, not any did or she , her her to d identifie happened

remember what had been arrested name, and could not to the police, she had ing ord Acc to com: f. ice sel pol her about 105 called the thing“res orting” after a motel owner had she had m roo for l mote the ted t men had visi young The . lor sai plain that several differen y ofa On before 1n the compan . nts eve d ege all se rented three days the remember any of her to ize ble ogn una rec to med e see cam woman e. -therapy, gradually she him to take her hom the use of psycho ted ues req and ly ter bit t wep d, ban hus 0, p. 261.) (Adapted from Mahony, 198 e the person resorts ng, in the above cas escape from an aki spe y ll ca gi lo ho ic rot Psyc

a neu or nesia or fugue for the loss of identity to the stalete ofsitam . ion e uat bl ga na ma un rab intole ion against the is utilize

physical flighty growing OU neurotic anxiet

dis the tr ex an is y in it n al Multiple person erical neurosis. It refers to a conditio ctly st sociative type of hy y alternately behave in two Or more distin ma on rs pe e th e O which

usually unawar different patterns. He is

ABNORMAL PSYCHOLOGY

122 personality.

He

may

change

from

personality to another for

one

periods ranging from a few hours to a few years. The different personalities are often extreme opposites, that in one he may be an

In such acase, while asking extrovert and the other an introvert. the patient his name, (who was in real sense Sudarshan—a reserved,

gentle end tradition bound

person) he may reply that he is, Me

and thus may behave differently exhibiting altogether a differen personality (a vocal and fashionable youth). Sometimes, a person may experience change of personality of three, four or more different characters within a span of time (days, months or years). In these cases the person usually does not remember what happene in the other case and thus multiple personality mechanism proves a complete escape from one’s real self for keeping away the intolerable anxiety, fear or conflict situations. It should be remembered that 1n multiple personality disorder reaction, the person never assumes tne

identity of a famous person (Jawahar Lal Nehru, Napoleon 0 Cleopatra) and it is in this sense that it may be differentiated from split personality (schizophrenia). 3.

Phobic neurosis:

means

The term “phobia” comes from the Greek word phobos which panic, flight or fear. Phobic neurosis may be defined ee

disorder of the behaviour in which a person experiences persistent: intense, irrational fear cf a specific situation or object, In spite Ot

his rational knowledge that his fear is unrealistic and oe whelming, he is forced to experience great apprehension and anxie y

symtoms while in contact with the phobic object or situation.

In a natural sense fear reactions are very common to every Ane

of us. It is normal and indeed adaptive to be fearful of situation: which pose real danger. Fear does not become a phobia unless it bi

irrational. It turns into neurotic disorder when it becomes so juten” as to interfere with the person’s normal activities and to afec his mental health. Some of the common phobias with their technic: names and inherent meaning are listed below: Acrophobia Agoraphobia

— —

fear of high places. fear of open places.

Aichmophobia

—

fear of short and pointed objects.

Algophobia

—

fear of pain.

Astraphobia

—

fear of storms, thunder and lightning:

Claustrophobia

—

fear

of

closed

5

spaces

or

ment.

Hemotaphobia Hydrophobia Lalophobia Mysophobia Nyctophobia

— — — — =

fear fear fear fear fear

of the sight of the blood. of water. of (public) speaking. of dirt or contamination. of darkness.

confine

123

PSYCHONEUROTIC DISORDERS

Ochlophobia Pathaphobia Photophobia Pyrophobia

Thanato phobia Toxophobia Xenophobia Zoophobia

= — — —

— — —

fear fear fear fear fear fear

of crowds. of disease or illness. of intense light. of fire. of death. of being poisoned.

fear of strangers.

fear of animal.

animals

or some

particular

or object may involve any situation It is clear that phobias for age, ect resp no eover, they have hada nce sorrounding one’s life. Mor Fra of Ill ry Hen . position t of sigh intellectual level or social the at d ifie g eggs and became terr razors of fear peculiar phobia concernin a had er, oph los German phi them. Schopenhauer, the er than shave it.

rath

e his beared and thereby perferred to sing put a person ially morbid fears. They causation and ms All phobias are essent e.. The nature, sympto the in a typical abnormal featurmay be understood through some of is ros neu bic pho of the following illustrations: wds.

of cro had ochlophobia—fear Case 1: A yomg womanple about her, she was afraid that she y peo Whenever there were manfrom suffocation. In spite of the knowledge to travel by train or tional, she was not able movies. d social parties or visit her on, ati oci ass free On er in her home. son pri had l tua she vir d a chil her a d ood. As This kept childh r house d to her early rcus parade go by he unt of ci e th h co nission to watc ac ow it into town. On warned not to foll into the ade par is and followed the on all d wde cro f sel her she soon found re whe man tle n gen tow d kin the centre of began to cry. A fear her e tim a i er Aft . row a front s cus © dis out not her helped she could

experience returned home. subsided and she eri parents. The entire ational fear her h wit es enc exp irr her terrifying giving rise to an into the unconscious,

the early experience was r gradually helped of the source of feafro dge wle kno the m Page, 1970, and (Adapted recalled ri her to get

was

repressed

of crowds. Due

to its

p. 142). Case 2;

years of age hadhad agoraphobia A young woman 30 so serious that she . The phobia became a ed hom e at all times. Psychor job and p remainin early teens she had been the fear i of open heplace that had i i tiga tion Tevealed logi e i boys in the neighbourhood. In ral seve

behadher lope iy Promiscuous with ced intense guilt feeling about deve h rien whic expe ia she phob life The r it. late of her es ori Viourand x epressed all mem

ABNORMAL

124

PSYCHOLOGY

later in her life was based on the fear that she might lose contact of herself and be led into a life of prostitution. These repress ed memories were revived by the sight of a group photograph and the knowledge of the source of her phobia made her treatm ent quite possible. (Adapted from Kisker, 1977, p. 200.)

Case 3: A youngman had a phobia of being grasped from behind. In social gatherings he arranged to have his chair against the wall. It was impossible for him to enter crowd ed places or go to a movie. When walking on the road, he would look back over his shoulder at intervals to see if he closely followed. Psychological investigation revealed that aswasa young boy he used to steal

peanuts from a grocery store. The owner, determined to know

was

who

stealing his peanuts, hid himself behind a barrel, Just as the boy put his hand in the pile of peanuts, the owner jump ed out and grabbed him from behind.

the side walk. The

terrifying

The boy screamed and fell fainting on experience was repressed into conge phobi

clousness and the present pias) experience, (Adapted ; p. Causes of phobias As

may

be evident

a was the result of that earlier from Davision & Neale, 1978,

from

the above

three

cases, the real cause of the phobia is either unknown to the patient or forgotten on account of being repressed into his unconscious. In general, there

are three main causes of phobia: 1. A forgotten terrifying fear experience

case

one above

the

young

woman

had a

of early age:

phobia

crowds on account of her terrifying childhood experience.

In

concerning

Similarly,

an individual frightened by an accident involving a dog; horse OF an insect in his childhood may develop a zoopho bia. 2. Neurotic defence against anxiety generuted by unconscious

conflict: According to Psychoanalysts, phobias are merely defence reactions against the anxiety generated by unconscious conflicts

related to sexual and aggressive feelings and impulses. In case tw above the young woman was using her phobia of open places as a defence to

save herself from the situation of being led into a life

prostitution. Similarly, a housewife may develop aichmopho © fear of sharp and pointed objects, and refuse to keep kitchen bia, knives

and scissors in the house on account of her repressed impulses to cut her husband’s throat. A husband may develop hydrophobia so that he may keep himself away from rivers because of his repressed feelings of drowning his wife. 3. Learned pattern of maladaptive behaviour: Phobias, toa great extent, represent the learned pattern of maladaptive behavio ur

either on account of conditioning or social learning. A conditioned response to a fear producing situation (usually experienced during early chidhood) may result in a peculiar phobia. In case three, the

youngman

may

be seen

to develop phobia of being grasped from

125

PSYCHONEUROTIC DISORDERS

behind on account of the classical conditioning. Similarly, a child unpleasant experience associated with a fearful reaction to an the cat. Afterwards, he may of afraid be to learn may cat a with develop

an

irrational

fear of the cats which may include the word

cat as well as the sight of it or other animals resembling it. Operant conditioning in which

inadequacies

or

avoidance

of

symsomething may be reinforced by the positive reinforcer like contof means others, from nce assista and pathy, attention, help be rolling or dominating others or excuse for the failure may also

responsible for many phobias.

serve as

Fearful parents, members of the family or teachers becomes terrormodel for social learning o. f phobias. A mother whocommunicate her may r thunde and ing lightn of t accoun on sticken reinforced in the later fears to her children and later on, after being fear of thunder hobia— astrap p develo may she years of one’s life, and lightning.

4.

Obsessive-compulsive neurosis

ive behaviour in which Obsessive behaviour represents maladapt rrence of unwelcome, recu nt iste pers the an individual is haunted with ght. For example, a wife may absurd and disturbing idea or thou g her husband, a

bing or poisonin have an obsessive idea of stab a son of wishing his mother’s girl, little her ing mother of hurt wife down a flight of stairs. his ing push death, a husband of the absurdity and irrelevance of such

Although the patient realizes rid of them. Thei more desperately thoughts, still he is una ble to get , the more they persist. he tries to rid himself of them sive step further, becomes compul Obsessive behaviour, as a fact an overt manifestation of the Compulsion is in ns are behaviour. . In other words compulsio in this obsessive thought or an idea , e behaviour ated into action. Compulsiv obsessions transl a person is y iour in which avi beh ve pti P ada mal as t nature van ele way, may be defined irr and ble ona eas acts of unr such

as

to sleep.

repeated again, checking the alarm washing bis hands again and d, or returning to his woun been has it i he door has been locked n detail before going

Such pat

d that they are unneces ac compulsive his of the absurdity

unless he performs the compulsive act. t without compulsion, ive behaviour may exis i without obsession. It is e inat orig can’t even N P pulsorily precede action. true that thoughts or ideas must com the ut as fi ane Sympt

1S _ concerned, ‘obsessive-compulsive neurosis behaviour ; are presJeent ve ulsi comp psessive and

ing definitiom in rN ass on a be evident from the follow 8ivien in DSM-II.

ABNORMAL 126

PSYCHOLOGY

ence In this reaction the anxiety is associated with the persist acts m perfor to es impuls ive repetit of and ideas of unwanted The patient which may be considered morbid by the patient. himself may regard his ideas and behaviour as unreasonable but nevertheless is compelled to carry out his rituals.

Some examples of obsessive-compulsive behaviour obsessive1. An adolescent boy was found to have an unique as pyro known cally techni fire, compulsive behaviour concerning

“

He was preoccupied with the idea of fire and possessed

mania.

uence: A overwhelming urge to set fires without caring for the conseq rty prope e to g damag causin fires rable He admitted setting innume and lives but could not give any reason for his strange crimina behaviour.

2.

A pretty young woman of a rich family was found

to Be

suffering from an obsessive compulsive behaviour, Foe ieee oo (uncontrollable urge to steal). Whenever she attended dinner parti i she

could

not

resist herself

from putting selected

spoons

10

ne!

handbag. She had a record of 200 stolen spoons. At one time when she was seen picking the spoons by a friend and asked why she He

it, she felt humiliated but replied, “I don’t know

why

it happe?

but something compels me to do it.”

¥t 3. Samuel Johnson suffered from an obsessive-compuls! his e wo obscen utter to urge strong a had He lia. behaviour, coprola for ation explan no had He ted. humila often was he for which strange conduct. 4. A principal of a girls college was found to suffer from ar al behaviour related with contaminatio obsessive-compulsive é seve baths take and hands She used to wash her cleanliness.

times a day. her clothes.

After going outside it was necessary for her to chank

Whenever a visitor came to her drawing

room,

she h

the room cleaned and sprayed with disinfectant.

5. As reported by Freud, an eleven year-old boy was found $ be engaged in a typical obsessive-compulsive ceremony every ef before going to bed. He did not sleep until he had told his mot 0 in the minutest detail all the events of the day, there must aor ©. scraps of paper or other rubbish on the carpet of the bedroom, stand must bed must be pushed right to the wall, three chairs and the pillows must lie in a particular way. In order to sleep, he first kicked about a certain number of times with both and then lay on his side. When asked why he did these things» was unable to give a satisfactory reason.

6. A middle-aged man was found to suffer with an obs compulsive-behaviour related with the drinking of tea. not drink his tea for fear that a pin might have been droppe?' it. He was forced to pour his tea back and forth several tim

make certain that it did not contain any pin.

127

PSYCHONEUROTIC DISORDERS

was brought for help 7. A school boy, theirteen years of age, rituals. When he urinated on account of his obsessive-compulsive on his socks he washed put to had he he had to wash four times, if hing with one hand, he had seven times, and if he touched somet no reason for observing give could He to touch it with the other. . ritual such methodical

The causation

behaviour is a thing of concern. te What causes such maladaptive ors are not observed to contribu

Hereditary or other biological fact anything

to

the

development

of

obsessive-compulsive

is predominantly

neurosis.

a learned reaction

behaviour variety of environmental Conditioned learning, in a pattern. ities for the origin and rtun oppo enough beginnlearning situations, provides essive-compulsive rituals. The result development of the many obs the be may erns patt behaviour ing in such maladaptive

This maladaptive

ites: of one of the following possibil

ession ve a ct mayy be a direct exprby the 1. An obsessive-compulsi ed ept impulse. What is not acc of an undesirable motive or the unconscious, may become conscious ego and thus repressed in re that it represents fulfilment of his but the individual is not awa pyromania (compulsion to set fire) For example, desire. own ted behaviouron to kill) may be interpre trations and homicedalmania (compulsi frus c arising out of the basi r C ally as arevenge reaction provide oppo! ons conflicts. These reacti e feelings and achieveoutlet for the aggressiv isfaction. of hostile thoughts, sat of power and a sense ment of some kind of ation associated lt and self-condemn gui of gs lin y also fee 2. The the present misdeeds ma

mes with with the past, or sometiive-compulsive behaviour. As a result, an ess obs f of guilt by give rise to an counteract or cleanse himsel to ced for hand be y ma l pul dua indivi mple, the com sive wash sive rituals, for exa

attempt to taken as a symbolic r , undesirable xual ‘or othe i 1 away a feeling O g behaviour of Lady complsive hand washin re, ratu lite In . our behavi s Macbeth, illustrates racter in Shakespeare’ essive guilt feeling Macbeth, the prime cha our. She had anderexcof king Duncan and namics of such behavi mur means of compul y washing ritual. It ma

the dy on account

be

10 the of her participation

to cleanse nothing but an attempt was ng shi dwa han her compulsive ary blood spots. her hands of the imagin ons are generated ve-compulsive reactimation mechanism. si ss se ob es tim ny on-for 3. Ma based on the reacti as defence reactions ways which are directly in s ve ha l be dua ivi ind the s, ion uat sit h erous thoughts or In suc ocial or otherwise dang himself from nd contradictory to his uns fe de one may ndemde a ong attitu of code impulses. AS by developing a strrly fend y ma e on , abnormal sexual desire ila Sim it S s rd by wa to son e or Nation e impulses towards his wif himself against his hostil

PSYCHOLOGY

ABNORMAL

128

acts becoming obsessively thinking and compulsively dcing some demonstrating concern for their safety. with the feeling of inadequacy 4. Indecisiveness coupled be

may

the

reason

for certain

behaviour.

obsessive-compulsive

It may breed compulsive doubts and one may

be forced

to engage

in such rituals such as returning again and again to check the lock on the door or cleaning the plates again

again

and

before eating.

behaviour for his feeling of inadequacy Or compensatory The to such to resort individual helplessness may also force an

compulsive behaviour as compulsory stealing,

killing

or

protecting

himself from the unknown enemies and dangers.

The basic element in obsessive-compuisive behaviour is the personal satisfaction which an individual derives in performing such acts. In doingsohe gets himself relieved of the immediate anxiety tension or pressure. He feels satisfied with a sense O

achievement in the form of fulfilment of his desires which, in turn,

further reinforces

his compulsive

pattern involving

tion

the person

and

behaviour

obsessive-compulsive

becomes

and gradually a reac-

neurosis

is developed

fixed to behave in a peculiar way in spite

of being aware that his behaviour is irrational.

5.

Depressive neurosis

This is a neurotic disorder

characterized

by disproportionate

reactions to distressing stress situations like the death of a loved one, In such distressing an occupational failure or a financial set-back. stress

situation,

there

is nothing abnormal to have feelings of grie

these feelings It is when and despair in a reasonable amount. become much exaggerated in intensity and duration and begin to interfere with personal or social adjustment of an individual, that they turn into behavioural disorder—neurotic and psychotic.

Neurotic depression may be considered halfway between normal depression and psychotic depression. Neurotic depressive reactions are neither too severe in degree or in duration as the psychotic depressive reactions nor as mild and simple as in normal depressive reactions. is found to be a great healing factor in normal Time The memories of normal stress situation depressive reactions,

become hazy with the passage of time, coupled with the creation

In worth living once more. becomes Life interests. of new neurotic depression, however, the depressed mood does not return to normal even after a reasonable period of time as it ordinarily Here the symptoms concerndoes in normal depressive reactions. The patient may have ing depression of mood are also severe. There intensive feelings of dejection, discouragement and sadness. is a high level of anxitey and apprehensivness and extreme feelings The person is unable to concentrate an of self-condemnation. In its more severe his level of activity and initiative is lowered.

form, the anxiety and desperations are heightened to such

on extent

129

PSYCHONEUROTIC DISORDERS

that the person

is unable

to work, and sits in despair viewing the

side of life alone’ and

dark

sometimes

thinks

of

committing

suicide. and incurable as in However the situation is not so severe hallucinations, ions, delus like psychotic depression. The symptoms agitation, severe sses, proce ht thoug the of retardation marked are states otic psych in actual suicidal attempts etc. often found . ssion depre tic neuro significantly absent in as hostility or anger directed Depression may be viewed Instead of being turned outward. against the self instead of the disand loss es himself for the blaming others, the person blamsness of guilt raises his level of ion tressing situation. This consciou and forces him to relieve his tens anxiety and apprehensiveness -criticism and a relatively continued through the mechanism of self formula for neurotic depression is the mood of depression. Thus rnal loss precipitated in the case of exte an plus n atio demn -con self hostility and traits as inability to express dependence, predisposing personality s, submissivens directly and outwardly, aggression of neurotic case In self-criticism. sensitivity to criticism andbe viewed as punishing himself by feeling depression, the person may for the distress situations. or responsible for the loss ressive al the characteristics of dep The following examples reve neurosis. m neurotic nd to be suffering fro A young woman was fou n married for one year when her had she bee sion. Hardl k he had taken at ining by drinking mil son poi of d in the milk pot and fecband die nd fou was oing to bed. A lizard i was to blame for the death theyoung woman that shethat she had murdered her es She often thought boiling the of her husband. the milk pot while she had not covered ness, she sad ince or ef normal gri ing enc l eri exp of d husband oe instea depression. ic developed neurot haviour in the above urotic depressive be re is considerable the The dynamics of ne n process starts whe í the f responsible. h the person thinks himsel ic ‘e s o e ‘ io camp h the feelings wit ed elm rwh ove If and is i a defence emotions is ed on then employ

x

;

nwhen

he

inflicts punishment on himself

In some cas: es it turns pere perio d of depression. . which satisfies the ued when

an illness ed as the is adopt dark among es he onn ee ilverandlining this of ess me person seesTig life. The seriousnwhen many and frustra ntensification of suicide. 6.

despair

especially of despair clouds illness increases

patients attempt

neuro: sis Neurasthenic rm “neurasthenia” is “nervous ing of the te an me by come l ra te li The akness”. It is characterized

“nerve exhaustion” or

we

ABNORMAL PSYCHOLOGY

130 plaints of easy

fatigabilty

(mental

and

of energy, chronic weakness and pains of the

body.

aches

feature

chief

the

However,

physical), irritability, lack

and

and weakness is its selective nature.

in diffreent

parts

of neurasthenic fatigue

Its patient

has

all the energy

to do things of his interest but feels faitigued and exhausted when asked to do something that does not interest him. This type of neurotic disorder is common among women particularly house-

wives who

are bored and

feel neglected by their husbands.

is why it has often been called ‘housewives’

nerurasthenic neurosis is a psychological

neurosis”.

disorder

which

That

Their

serves

to

provide secondary gains and relief from unpleasant situations.

7.

Depersonalization neurosis This type of neurotic behaviour is chacterized by the feelings of unreality and “estrangement from the self, body or surroundings”. Consequently, the patient does not feel real or feels that what is being done by him is a play rather than an actual life event. In case of a young man suffering from depersonalization neurosis, reported by an investigator, one of the most bizarre experiences during his illness was the unique feeling described thus : “I am two

separate persons—one that thinks and one that acts. When I feel like this it’s like being in a bad dream and I didn’t know what is real and I don’t know if I am the thinking person or the acting one.”

8.

Hypochondriacal

neurosis

This type of neurosis is characterized by an excessive concern for physical health and persistent intense fear of illness, disease OT dysfunction, The symptoms of this neurotic disorder are given below:

(i) The patients believe

that they have physical illness oF

disease even when there is no such evidence.

(ii) Patients often detail how extensively their affected them, and they seldom discuss anything symptoms. (iii)

They

are

often

frustrated

when

are negative and feel convinced that the doctors

result, they move

from

one doctor

treatment.

(iv)

medical examinations

have

to another

erred.

The patients are anxious and found to exhibit

(vi)

cases the patient

The symptoms

AS a

seeking “better

compulsive behaviour with regard to their supposed illness. (v) In severe he will not recover.

illness has but their

obsessive

hasa strong conviction that

concerning non-existent illness are

nO-

tished by the patient like valuable assets for seeking desired atten

tion, care and sympathy from means for wish fulfilment.

his

family

and

also

as convenien

PSYCHONEUROTIC DISORDERS

131

Causes and treatment of psycho-neurotic disorders are The most important causative factors of all neuroses reoften ns reactio ic neurot psycho We see that Psychological. The faulty upPresent learned maladaptive behaviour patterns. home and enial uncong nces, bringing, improper childhood experie d in the school cnvironment, and the stresses and strains suffere for causes tating precipi and osing predisp nt later life provide sufficie

learning neurotic reactions.

An individual feels satisfied in behav-

ing neurotically as it helps him

He derives pleasure

needs. care

from

his well-wishers

and

reinforced

attention

and

or even strangers for his limitations on

account of his illness or disease. make

to fulfil his otherwise unsatisfied

in seeking sympathy,

Thus his neurotic symptoms severe

more

his disorder

in intensity

are

and

duration.

in respect of their nature The psycho-neurotic disorders vary causation. no Therefore and ) (characteristics and symptoms ders. disor such all for treatement may be prescribed common le. They respond general, neurotic patients are curabpsychotherapy than” in However, apy and more favouably to behaviour ther rders or functional psychoses. diso uct cond from ring patients suffe sumr types of neurosis may be a The treatment adopted for majo in d usse disc are Details of various therapies marized below. separate chapter. anxiety patients may be readily Anxiety neurosis: Neut otic lisers. In sedatives or mild tranquil may also be by chemical therapy;y may y The en. helped giv be chronic cases insulin therap tive psychotherent through (i) suppor given psycholoical treatm erapy; and (iv) -th cho (iii) group psy y; rap the t igh ins (ii) apy; patient’s drives.

the finding other outlets for hysterical symptoms of many an indiviof e Hysterical neurosis: d The eas rel nosis. The may be alleviate by hyp ive psychoneuroses dual from

an emotionally supportive

stress situation

psychotherapy,

and intens

group

therapy

and

re-

results. therapy measures needed for better the are y rap the ive cat are edu therapeutic measures like

ing neurosis: The follow orders: Phobic dis se the of ent S adopted for the treatm ‘ccc on a. Insight therapy e —Th ng) (decon itioni ion itizat ens des and gs, and dru p of hel h n mes the wit tio eti d som axe rel nt îs s Se b

, starting to the phobic situation, d uce rod F int ly dua ED then gra 7 kind. ying with the least terrif ion (or flooded)

i i

therapy—

he’ patient is immedi-

ion ghtening phobic situat in the most fri reget r. experiences fea until he no longer or ient observes (in real life tion therapy—The pat . ion uat sit his phobic

handling Sia) someone else

ABNORMAL PSYCHOLOGY

132

a “Thought stopping” is neurosis: Obsessive-compulsive Even lobotomy, @ technique which is of help in such disorders. brain operation, in which the nerve pathways between the frontal lobes of the brain and the thalamus and hypothalamus are cut, has resulted

often

helpful

in this

neurosis.

Psychotherapy

measures

are the other better alternative. Depressive neurosis: The following methods, often in combination, are useful in the treatment of neurotic depression: a. b. c. d.

Drug therapy Electro-convulsive therapy (ECT) Psychotherapies like supportive psychotherapy and insight psychotherapy. In extreme Modiying the stress environmental situation. cases of depression electric shock therapy is used.

Hypochondriacal neurosis:

This disorder is difficult to treat as

the person resists recognizing that the problems are not physica! He derives satisfaction in being ill. The circle can be broken and the person no Jonger remains a hypochondriac when he no longer needs the symptoms concerning his self-created illness. However, the

psycholological treatment

proves useful.

Summary Psychoneurotic disorders or neuroses: These are purely psycho; logical disorders. There is no relevant organic pathology present and the illness is more apparent than real as in the case ot psycho physiological disorders.

Among

psycholoical

disorders, they are more

minor emotional maladjustment and disorder. The feeling of excessive central core of a neurotic behaviour.

serious than

less serious than a psycho anxiety or guilt makes me However, this behaviour„1

not disorganised and a neurotic personality is not a split personality as in the case of psychosis.

Types of neurosis Anxiety neurosis represents a behaviour dominated by 4 ie floating anxiety interfering with the individual’s personal and a

adjustment.

Apart from the anxiety ridden physiological symptom’,

the person also exhibits definite psychological symptoms in terms disturbances in thinking and feeling.

person

Hysterical neurosis represents neurotic reaction in which n of resorts to conversion or dissociation for controlling

anxiety

or solving psychological

conflicts.

There

are two types

hysterical neurosis—conversion hystertia and dissociative hyster Dissociative hysteria may

further be classified as somnambulis™

amnesia, fugue and multiple personality.

Phobic

neurosis

represents

disorders

in

which

a pers?

133

PSYCHONEUROTIC DISORDERS

fic situation

fear of a speci experiences persistent intense irrational al activities and affects his norm er object which inter feres with his d by early terrifying health. They are generally cause on account of condimental ed learn or ts unconscious conflic

experiences and tioning or social learning.

Obsessive compulsive g viour in which a person

thought or upon it.

idea

and

ptive behaneurosis represents malada of absurd ce is haunted by the recurren to act led pel com be may as 4 result

characterized by

a! neurotic disorder Depressive neurosis is ing stress situa_ ctions to so me distfess rea e siv res dep ate ton al adjustment dispropor erfere with perso nal or soci

tions, so intense as to int of an individual.

aints of easy is characterized by compl sis neuro and pains c heni east ess Neur ic weakn irritability, lack of energy, chron

fatigability, parts of the body. and aches in different

f lings of d by the fee rosi: s is characterize neu n io . at ngs iz ndi al on rou rs sur Depe body or gement from the self, unreality and estran an excessive is characterized by rs of illness, is ros neu l ca ia fea Hypochondr and persistent intense

concern

for physical health

disease or dysfunction. important caudisorders: The most e early unhappy ic ot ur ne ho yc ps of Th Causes logical. neuroses are psycho tiate the sative factors of all d wishes aed unresolved conflicts ini strain and es nces, stress Inmany unfavourable circumsta process. Later, tthecause for learning neurotic reactions. ladaptive ma ien d fic learne Provide suf ctions often represent cases psychoneurotic rea

behaviour patterns.

vary from each eurotic disorders -n ho yc ps common treatTreatment: and causation. Noorders. However, ure nat ir the to on ati dis other in rel refore be prescribed for all these favourabl A y can theÈ me They respond more ie nt 2 curable. The

than,s. the patienss theraalpies o tion psychosi creepy aid other s psych R or func suffering from conduct disorder REFERENCES 39. DSM-II, 1968, patric Associaton, chi Psy an ic er Am 1. 2. Kisker, op. cit., 194. 3. Ibid., p. 206,

12 PSYCHOTIC DISORDERS Psycuotic disorders or psychose s are of the mind and in this sense Tepresent more “ serious disorders” major illness in comparison with the minor illnesses of neurotic behaviour is characterized by a serio turbance in which the patient shows pe

disorders.

A

psychotic

The general characterist ics of the psychosis as summarized Thorpe and Katz, are as follows:

by

1. The individual's

that he is incapable of carmental functions are usually so disturbed rying out his daily activi ties, 2. The individual manifests symptoms of severe nature in the form of delusions , onen , hallucinations, stupor,

violent reactions.

3. The reality.

individual

is more

or less out of

4. The individ appreciate or realize ual usually lacks insight; the psychological nature disabilities,

5. The

incoherence, O.

contact

with

that is, he does ser

of his symptoms an

individual’s behaviour may be injurious to himself or to society, or both: he usua lly must be placed under or in confinement, as in guardianship a mental hosp

ital.

Psychotic and Psycho neurotic disorders 1. Psychoneurotic dis order: the individua l

b

135

PSYCHOTIC DISORDERS

such serious disorders of the mind where the patients lose contact with reality. Neurotic patients, on the other hand, never lose contact with reality and are able to make a reasonably adequate adjustment with their environment. 3. Psychotics are considered to be a potential danger to themselves and others. Very often their behaviour is unpredictable and uncontrollable.

For

this reason,

their

hospitalization

is essential

irrespective of the fact whether the patient wants to go toa

hospital

or not. In the case of neurotics hospitalization is seldom necessary.

4. Neurotics build castles in the air, while psychotics actually . live in them. It signifies that in contrast to neurotics, the world of psychotics is unreal. While a neurotic does not deny reality but merely attempts to ignore it, the psychotic, on the other hand, snbstiimtes the reality with something else by completely denying it. 5. Psychotics get completely caught in their disturbances and lose perspective. They rarely have insight into the nature of their behaviour. Neurotics, on the other hand, usually have insight into the nature of their behaviour. They are likely to be aware of the symptoms, if not why they exist. ms of 6. Psychotic behaviour is characterized by the sympto and stupor or , coma nations halluci severe nature like delusions, ions percept s, thought of r disorde such atly, severe agitation. Signific and affects are seldom present in neurotic behaviour.

Classification of psychotic disorders Psychotic disorders are generally groups—the organic and the functional.

classified

into two major

iated with, and are most likely The organic psychoses are assoc pathology. These disorders ic organ due to, some demonstrable al nervous system. While cause considerable damage to the centr tissue remains intact, in in all other psychiatric disordes the brain l physical damage of the the organic

brain tissue.

brain

disorders, there is actua

not associated with -any The functional psychoses are pathology. They are not caused demonstrable or observable organic organic psychoses

ic

defects.

While

in

observable organ structural changes abnormality can be distinguished in terms of the no demonstrable is there osis psych in the brain, in functional What is important in such abnormality of the structure of the brain. its function, and that is why they psychoses is the abnormality of s. are known as functional psychose by any

Organic psychoses

wn as organic disdisorders are also kno Organic psychoses orga or organic brain s rder diso al ment nic of the brain,

orders n may be classified as acute, syndromes. These disorders of the brai

136

ABNORMAL PSYCHOLOGY

intermediate or chronic. An acute disorder is likely to be temporary and reversible, whereas a chronic disorder is irreversible because of permanent damage to the nervous system . In general, a disorder

takes the form of acute, intermediate or chroni c in proportion to the tissue loss and impairment of the functi on ofthe brain. General symptoms: Disintegration cause d by the brain damage is generally chara

cterized by the following symptoms:

a. Impairment of the mental processes: Impa irment cognitive funct ions,

for

example,

impa

of the all

irment of concentration, memorization, comprehension, judg ement, planning, learning ability, numerical ability and impairment of orientation related with time, place and person etc.

~

b. Impairment of affective

responsas : Depression, irritabi crying and laughfing without lity, adequate cause. c. Impairment in general behaviou r: Carelessness and negligenc of Personal „appearance, e neglect of and failure to and Tesposibilities, loss assume duties of normality or deterioratio n of character. Caus K ative factors: The most freq uent factors which cause organic psychoses may be listed as under: 1. Infection

2. Trauma, natal and pos central nervous system,t-natal physical injuries affecting the

3. 4, 5» 6. T

Malnuitrition Intoxicaa tion—dru gs, poisions, alcohol etc, Endocrine disturban ces Circulatory dysfunctions

For coonv nveenienc be grouped in differ e, th e common ent c] asses,

lining

of the Tson

or ganic mental disorders can

irectly through mucous mem -

mouth

during

or the genital track. sexual

intercourse,

PSYCHOTIC DISORDERS

137

kissing or from direct contact with open syphilitic sores or lesions; pig oa can be transmitted from an infected motherto the

ild in her womb. organ of the body.

The

infection

causes damage to any tissue or : j

The term neurosyphilis indicates that the syphilitic infection has been transmitted to some part of the brain or the spinal cord. General peresis is an example of neurosyphilitic disorder. It is caused by the progressive infiltration and destruction of brain tissue by the spirochetes of syphilis. It is also known as general paralysis of the insane or paresis. The brain of a paresis patient looks diffeTent to the naked eye. This disorber develops only in about five per cent of untreated syphilitics and is found to be more common among men than among women. Its onset occurs when the infected person is about fifty years old. Symptoms: A person suffering from paresis usually manifests the following physical or psychological symptoms:

Physical: (i) A shaky,

crude

and

illegible handwriting

with

a lot of

mistakes. (ii) Speech disturbances involving stumbling, stuttering, omitting important syllables, mispronunciation and slurred speech.

(iii) Non-contraction of the eye lids to light. (iv) Tremors of the muscles, arms, eye, tongue and lips.

(v) Disorders of the movement such as dragging of feet, walking witha shuffling gait, having trouble in keeping balance, absence of the knee jerk reflex etc. about, (vi) Peculiar mannerisms such as grimacing, dancing , gruntng lips, of ng smacki , ceaseless rubbing and picking g. sighin and chewing Psychological:

(i) Impairment of memory and judgement. (ii) Deterioration behaviour.

of personal

habits i

and a

moral

social

(iii) Emotional instability and unpredictability.

(iv) Loss of abstract thinking.

(v) Delusions and hallucinations.

should be made in the Treatment: For all the purposes efforts measures against ntive Society for the adoption of positive preve Infection, It is always better to have an early detection and treation of the serum Ment where infection has taken place. Examinat of neurosyphilis. sis digno for sary and the cerebrospinal fluid is neces iotic penicilantib the of e cours full (a py n thera cilli peini nt àt prese lin) js considered an effective and preferred treatment for neurosive Syphilis. Penicillin is highly effective in large doses, is expen

138

ABNORMAL PSYCHOLOGY

and is practically without short. i In encephalitis,

risk and the course of treatment

there

is also

is inflamation ofthe brain tissue while

meningitis involves an infection of the thin protective membranes that cover the brain and spinal cord. In both encephalitis and meningitis the infection may be caused by a wide range of microorganisms—such as bacteric, fungi, protozoa and virues—some of which are carried by insects. For example, one form of encephalitis is transmitted by mosquitoes.

Symptoms of encephalitis usually involve fever, drowsiness and ocular-pupillary disturbances, insomnia, restlessness, agitation, irritability and excitability. Similarly, meningitis is characterized by a wide range of symptoms involving the central nervous system, resulting in coma, delirium, emotional instability, convulsions, and disturbances of mobility. In the acute phase of encephalitis the

patient is lethargic and appears to be sleeping all the time. Because of fhissymptom, the disease is sometims referred to as the “sleepi ng sickness.”

(b) Disorders associated with bram tumours

Brain tumours

or neoplasms

involv

e abnormal growths of the tissue or masses of cells in the brain. brain tumour may cause behavioural disordEven a relatively small directly through damage to brain centres and thus disruptingers norma l intellectual functioning or indirectly through disturbances in blood circulation or Increased intracranial pressure of cerebrospinal fluid.

Psychological symptoms are usually th

of the brain and therefore, t

ad

Symptoms:

eadache,

The

vomiting,

usual mental

i

early

i

“cw allesse tlk

symptoms

involve

tumours

persistent

As the tu E ne may be carele elesssn snes esss in personal habits, ; loss of all concepts of tim and place, irritability, ime convulsive hallucinations, apathy and i an over. functions. The severity of a brain

: eee rowth. Serious brain tumours lly those with psychiatric complications, are most common, especia ee the frontal, temporal and parietal

lobes. In the well advanced stage of brain tumours, the treatment becomes difficult, Trea 4 tment: Brain tumours are treat ed imari urgicical a operations and the chances of primarily ize, by location sirg u rest OF recovery pon y the of the growth a and on the Samoun size, t be removed with the tumour,

of the brain tissue

which need to iii

139

PSYCHOTIC DISORDERS

(c) Disorders due to head injuries injuries may

Head

be considered as one of the major causes

such injuries are: (i) of mental disorders. The common causes of crashes, train wrecks plane nts, accide usual accidents like automobile (ii) falls and blows (iii) incidents involving

and industrial blows;

a birth injury during an surgical removal of brain tissue; and (iv) instrumental delivery. s usually cause damage to The above cited accidents or incident orrhages over large areas haem the brain which as a result of (a) tiny d vessels, (c) swelling of the of the brain, (b) rupture of major bloo trat-

to brain centres through pene brain tissue, or (d) direct damage ing wounds. te symptom of any serious head Symptoms: The immediate accu = severe nce of consciousness. In more injury is likely to be a disturba herance and hallucinations. Usualinco cases it may involve delirium, ability a few days or weeks leaving irrat they in up clear that ly, these symptoms ies bilit there are also possi and weakness as a residual, but al causing impairment of intellectu s rder diso ges. may develop into chronic chan ity onal pers serious

and motor functions or bringing Treatment: The į immediate treatment.

supplemented

patient suffering In severe cases,

head injury must be given medical treatment must be

and rehabilitation. The by long range re-education e with his impaired sube to adjust in accordanc

patient may be mad ough psychotherapy. normal capacities thr

Environmental as well as t. important ro! le in such treatmen

also play an y to recover and i the ory ‘abilities andid will sat pen The versality, com ls of functionability to regain former leve ’s one in ors fact education and nt reica nif Sig te Similarly, an appropria Personality

factors

to able life situation toin thewhichcomour Fav and mme gra pro on ing rehabilitati e factors for return

ing are Teturn

important.

are

other

favourabl

or impairments. munity with relatively min

epilepsy associated with (d) Disorders ing Greek word mean derived from the is ’ psy n ile a ‘ep r o ed term p scar Epilepsy gin The at epilepsy was called it ris, Epi epsy in ap 1 seizure. fer i ne sources or evil sprits. div me so by ‘vi 0 ed us ease ca dis eral refers to a disorder of the nervous Sy: den and recurring gen characterized by sud

mainly disturConvulsive behaviour ousness ‘accompanied by sci con of s los oF ng udi in. episodes of clo l activity of the bra in the electro-chemica ances

slight lapse of may Tange from a ulsions. The er rd so di s thi nv Symptoms of s with severe co s of consciousnes erical convulst los hy to om fr s es ed en iat ar ent aw fer dif be n ca seizures me and at any genuine epileptic occur at any ti ds that they can genera Ily occur only in the presennce io ns vulsIsio nria symptoms like ao ace ontihe pro i ning sympathy. The gai f Ss © ns ica ter mea hys a e whi , as ersle of oth

140

ABNORMAL PSYCHOLOGY

frothing at the mouth and pupillary

disturbances present in genuine

seizures are also not found in hysterical convulsions. Types of epilepsy: On the basis of the area and the degree of brain damage the epileptic seizures can be classified into the following four main types:

1.

Grandmal

(Great illness): It represents

the most dramati

and common form of epilepsy consisting of four phases, namely, c the ‘aura’ phase, the ‘tonic’ phase, the ‘clonic’ phase and the ‘coma’ phase. :

The ‘aura’ phase is a sort of warning or „signal stage consis ting of psychological, sensory or motor symptoms in the form of illusions and hallucinations, fear and dizziness, unpleasant ideas, thoughts or impulses to do Strange acts. This period gives the person enough time to sit or lie down. convulsions in which the Ness is lost, breathing is suspended, the become wide open and the pupils dilate. lasts for about half a minute only.

l the attack or he may slip and activities after a few seconds. fall. The the attack. He May thin t k that his

Ps all his activities, and stares . He maintains his posture duri ng He, however, resumes his nor mal Patient may not even be awar e of mind has gone blank for a few

seconds. Usually, this type of epile psy is most

and teenagers, 3. Psychom EEG disturb;

var y ies greatly from

involve loss of cons $

|

violently assaultive

common

It may

pru .

i

in children

or may

not

tacks, eiin may be

l acts like climbing up

So ati T A to mutilate themselves

or

treat.

Jackso kson; nian:this Nam logist 4. H. Jac its dis $ ed after its di coverer an Eng i lish neuro-

ype of epilepsy is much like a modified

i nail

PSYCHOTIC DISORDERS

grandmal seizure.

141

or one side of the The attack begins in one part or a finger, with arm one or side of the face

body. For example, one These musor a burning sensation. muscle twitches or numbness, of the body side the over then spread side also. cular or sensory disturbances r even sometime the othe on which they originate and ciousness and then the attack usually cons There is a gradual loss of seizure. al ndm gra to lar becomes simi an

plays is evidence that heredity Causes of epilepsy: There epilepsy. Many investigators have 2 ology of important role in the eti tic brain waves are to be found in close lep epi reported that typical relatives of epileptics. uma ital deformity, birth tra

s like congen be associated Other biological factorgs have also been found to ocial theory dru and ins rol neu a head injury, tox to epilepsy. According with the causation of t about as a result of ory’, epilepsy is brough tex. the cor called the ‘irritation irritation of the cerebral direct stimulation or cts, frustrations s in the form of confli The psychological factor gger in precipitating seizures in many act as a tri very often the convuland stresses usually disposed to epilepsy, pre y all gin his frustration Ori s. son per resents a reaction to rep tic lep epi an of sive behaviour uation. from an intolerable sit or a form of escape and psychoon of medical treatment es surgical cas e Treatment: A combinati som In epileptics. for l wel ny of the ks Ma wor y . ive remedy logical therap nd the only effect fou etylurea, lac n thy bee e has nyl phe ent treatm ethosuximide, e lik to be gs dru nd fou d ere am are newly discov epoxide and diazep iaz ord chl a, pin i carbamaze . To cases of epi is very much needed effective with many er ord dis his to ity ess t nec ien pat r the the ano of is orientation in his environment} ion cat ifi mod ary ess bring nec world o accompolito adjust to his and to help him uld be satisfactorily sho t tha r task

situation is the furthe

techniques like advanced preventivein preventing as the of me so rs yea In recent te effective ice are proving qui e person 1s warned so that Th pocket size radio dev -

shed.

epileptic seizures. or to take appropriate medica well as controlling rest to find a place to ques like brain pace-maker, the he may be able hni tec ed advanc seizures. When tion. In the more d ped in controlling the

tely hel ed on an patient may be adequa nal ofa seizure, the device is switch ain. sig br g tack is sent to the he feels the warnin forstalling the at

ulus an electrical stim

xic reactions sociated with to as s er rd so Di y (e) estion of a variet be caused by the ing and heavy metals. y ma s er rd so di Mental gs, gases such as alcohol, dru of toxic substances ed by the consump-p of the body is affect c an org brain í and n sue five major types of Every tis! believed to cause is It l. oho alc of tion

142

ABNORMAL PSYCHOLOGY

disorders, namely (1) pathological intoxication, (2) delirium tremens, (3) alcoholic hallucinosis, (4) alcoholic deterioration, and (5) Korsakoff’s syndrome.

The disorder pathological intoxication often named as “crazy drunk” is found among the people who are emotionally unstable. A small amount of alcohol is sometimes enough.to throw the susceptible persons intoa state of violence, confusion, agitat ion and excitement.

Delirium tremens develops after prolonged period s of heavy drinking. It is marked by delirium and halluc inations. There isa marked tremor of the hands and tongue and somet imes of the facial muscles as well. Hallucinations are primarily be tactile as well. Unpleasant creatures like cockrvisual but they may oaches and spiders may appear to be crawling up the wall or all over the alcoholic’s body. The major symptom in alcoholic hallu cinosis is the auditory hallucination, in which the person responds by attacking his or her supposed tormentors after listening voice s seem to be making insulting accusatory and derogatory remarks.

Korsakoff’s syndrome associat ed with alcoholism involves Psycholo gical Symptoms

1

f

indifferent, negligent,

for difficulty in sleeping and getful, loses his se morale. Similarly, amph develop etamine drug (benz in tension and appreh ension,

the chronic state like memory

ms. The

of

adi

eee

ee

slowly Tesulting detter in e ioration, » person an intellectual al inefficiency and g eneral det eter e: i: oratio10n n of the

Other toxic agents such as lead, mercury, maganese, carbonmonoxide, copper and arse nic can seriously impair brain functioning

143

PSYCHOTIC DISORDERS

be definite psychotic In serious cases of lead poisoning there may lsions, hallucinations, convu rs, tremo symptoms such as headaches, brain and behaviour. delirium, and progressive deterioration of both blindness. In children and ge dama It may result in extensive cortical lead based paints) the chronic (often victims of chewing old toys and lsive seizures and mental convu lead poisoning may result into ning, the brain In cases of mercury and maganese poiso retardation. are irritability, signs first The and spinal-cord are badly affected. ntration. Then the gait and conce memory loss and difficulties in becomes restless and emotionally speech are affected. The patient psychological and personality upset leading towards irrepairable disturbances.

e disturbances (£) Disorders Associated with endocrin their hormones directly into the The endocrine glands secret these etions or under secretions of bloodstream. Either over secr disorders. al glands may cause various ment etion of the hormone thyroxin Thyroid disorders: An oversecr hyroidism or Graves’ disease e hypert by the thyroid gland may caus n Robert Graves) marked by the icia phys h Iris an r afte (named nces, tenseness, ht, tremors, sleep disturba may lead to symptoms like loss of weig excitability. Chronic cases delusions. insomania and emotional and s tion by halucina s marked nerurosis or even psychosi

er sec Hypothyroidism, an und myxe led cal ion dit con a bring about al and symptoms like physic

mental

f sluggishness,

memory defects,

E even ws increase in weight and r is lost from the eyebro hai and brittle the skin becomes dry andAt møre severe stage, the depression may In children, this and the genital area. d leading to psychosis. become highly pronounce tal retardation. disorder may cause men secretion undersecretion of cortisone Adrenal disorders: Anes Addison’s disease (named after an produc by symptoms by the adrenal cortex Addison). It is marked itability and mas Tho ian sic phy irr h Englis ng of blood pressure,

ous loweri ing of skin and muc like loss of weight,reduce d sex drive, darken iamb e, of igu k fat lac , our and headaches ression. loss of vig dep te era es. mod cas s, e ne som ra in mb me inations and delusions tion, and even halluc may lead toa the hormone cortisone sex characterisof n tio cre rse ove An ondary ic changes in sec

dramat pment of number of rare and in females or develo ions in ce an ar pe ap al sic phy cat s lead to compli tics like masculine in males. Such change may eventuate in a wide s female characteristics thu d an a rare stment

life adju the individual’s ctions. psychopathological rea

More

particularly,

ican rvey Cushing, the Amer rome (named after Ha been found to be caused nd sy ’s ing Cus e eas dis n has ing young womeTh mptoms of e patient shows sy neuro surgeon) affect tisone.

range

of

by over

secretion

of cor

144

ABNORMAL PSYCHOLOGY

severe unpleasant mood swings and depr ession which a state of anxiety, agit

may

lead to ation and irritabili include obesity, muscle wasting, chan ty. Physical symptoms may ges in skin, colour and texture and bone porosity which may cause spinal deformity. (g) Disorders associated with degeneration The

brain

and

the central

nervous syst

em deteriorate abnormally fast in such circumstances Causing varying degree of personality diso rganisations. Generally, such diso rders of advancing age can be classified into three groups—prese nile disorders, senile disorders and cerebral arte riosclerosis,

Presenile disorders: The ment al the senile age (usually betwee n 45 and pres

disorder occurring before 65, 60 years), are referred to as

enile disorders or presenile disease, Parkinson's disease dementias. Alzheimer’s disease, Pick’s and Huntington’s chorea are such disorders, Alzheimer’s disease: This disease was first described German neurologist. Alo by the is Alzhcimer in 1860. In this discase, the brain tissue deteriorates rather Tapidly than in Pick’s disease.

Pick’s diseas

e: . This Presenile dis order was first descri Czechoslovak Psychi bed by a atrist, Arnold Pick in 189 disorders of the centra i l nervous

tive process, the tot brain may be re al Weig duced. The „Patie nt usually exhibits diht of the remembering, ina bility to deal with fficulty in new loss bilitya and mrention, re Problems and situations. stless irr anita ity, dibilon

speec

Isturbances,

and

ness, easy fatiga bility, la ck of in inssi i ght. int ino hisis

Parkinson’s disease: This Parkinson in 1817. It is a ch nervous g system invo invo!lving particularly the thala mus, ba an e d ee rect e iculaar oe activati Thng e sy ista emn . ao Its usua I onset iiss betw sal gangliai be een 50 Si anndd (1978) are:

145

PSYCHOTIC DISORDERS The

primary

symptoms

are severe

and continual

muscular

eight movements tremors, usually occuring at a rate ‘of four to hands, neck limbs, the agitate ically per second, which rhythm arm, spread or hand one in begin may tremor The and face. and face, and finally to the leg ofthat side, then to neck, jaw, are at rest are that s muscle Only limbs. to the two other are engaged in a that those not subject to tremors, however, eventually be may skills l manua But coordinated movement. ous. Other labori are g lost, and speech, swallowing, and chewin akinesia-—an

ar rigidity, physiological effects include muscul defects in balance. The and ents— movem inability to initiate sionless, the gait stiff

expres face later becomes masklike and the body moving forward of part upper and distinctive, with the ental may have difficnlsy inl conc ahead of the legs. The individu socia contact. from s draw with and c, heti rating, become apat inson’s disease are

patients with Park About 90 per cent of per cent intellectual depressed, and in 30

deterioration

1s

3 , evident” d by an ribe desc first was disorder Huntington’s chorea: This It usually . gton in 1872 neurologist George Huntin and thereafter deterioraAmerican in the thirties begins when the individual is s eventually ending

od of 10 to 20 year tion is progressive over a peri tic inheriibytable to defective gene attr generation. to in death. This disease is n tio era gen m fro in families atrophy „of nly tance and thereby runs mai in this disease consists The actual brain pathollogyganglion cells of the corpus striatum. The or degeneration of smal reiform movements ist of the choreic or cho Physical symptoms cons ry irregular spasmodic twiching and y involunta (uncontrollable The patient has diffculty s, trunk and head). bod limb of loss 1 a tot jerking of the isa re outing. Eventually, the aki racterized by violent4ie i cha are ms to mp sy our e avi ae e beh , e ory The mem l. a r tro con Ti lty, confusion, poo sui ega mre bursts, depression, irritabi icid s rostitution, , delusion A P y, c. i ran vag Vag , ent i j gem t there poor jud lucinations. At presenr a variety of drugs like hal and ts, emp att and n’s chorea. Howeve treatment For Huntingtoopropazate hydrochloride appear most effecthi chlorpromazine and violent choreic movements. tive in controlling the f i y a characterisis chichefl mentiaia1S de i ile Sen : 1n : ; ers di. ord d l decrease ile dis ile dua in which there 1sa gra patient shows ile sen Poe ile age group the of in tic bra e Th es. iti cil There n,a et ok phy oa in the frontal lobes. y all eci esp oa h p O e narrow mental and tical convolutions rep cor the the ra e, y siz ed in lac bra cells are reduction in l ona cti fun and lity en abi ual between them wid decrease 1n intellect per ed rk ma a era sev t per ibi exh are J ms The senile patientsfor recent events. Other 3 sympto ality an s a again), circumstanti mi thing again and comes careless in are sa e th te fo e Fo e The individual be viour. rambling speech. or unexpected beha l ua us un y ce pla ran dis ation, intole hygiene and may rent speech, disorient

, lessening of alertness

incohe

146

ABNORMAL PSYCHOLOGY

for change, losing control ofs2xual impul ses, a psycho somatic disorders, amnesia are some of cases the deterioration leads to sever the other symptoms. Im -pme e psychotic or Fe eam A tions. Gradually, the physical and intellectual deteriorati to a stage incoherent,

3.

where

the Patient

is bed

Cerebral arteriosclerosis:

disorder of old age.

Men

This

ridden,

are affected

incontinent

is another

about

arteriol i es and ca illa illarries i which i reduce the supply rain resultin

g H intracerebral bleeding. The disorder may be sudden or gradual.

and

major iain

three times m

of] bloo d to the actual onset of the

with Sorroundings,

tion, restlessness, seizure or paralysis of one side of the body, emoIn cases where from

person

the onset is gradual, the ile psychosis. The duration of to person. In some case s it is

Many years, s the chronic illness may However, the average last duration is considere about three to five’ d to be years after which d eath usually occurs.

Functional Psychoses Mental disorders exh ibiting a change onl the brain and not y in the function of in the bra in i structure included in the functional Psychoses like organic psychoses are of this category are: . The three major dis orders * Schizophrenia * Affective disorder s * Paranoid disord ers,

In frequency

and organic,

or seriou

sness, ETIOUS or severe Consequently, the of the functional it may be ho sp i (ten to forty-five zophrenic patients Psychoses. years) is longer y other group. The term schizoph erenia literally Here splitting of means splitting of the amnesia and mult the mind d split Personality mind. iple Personality, as in self from reali y. but a marked se “T pa he ra ti on te rm of sc hi zo th “is now used to include a group phrenia,” according to Coleman,e there are fundam of psychotic Teaction ental disturb: s in emotional and int lity relationships which elluctual Processes,?? i and in 2 e. Schizophre nics i sta number significant ones of asS a Tule of ş mptoms, which are; the ym p

PSYCHOTIC DISORDERS

147

Lack of coherence in the thought process. Disorganised patterns of thinking and feeling. Apathy—absence of feeling. Disorganised patterns of speech. Pecularties of movements or bizarre actions. Autism—preoccupation with private fantasy.

Withdrawal from reality or seclusiveness. Neglect of conduct and personal habits. Delusions and hallucinations. CP PNAWAYWNY of diagnosis as well Types of schizophrenia: For the purpose sub-divided into the be may as treatment, the schizophrenic disorders following four major types: * Simple schizophrenia * Hebephrenic schizophrenia * Catatonic schizophrenia » Paranoid schizophrenia.

Simple

schizophrenia;

Simple

schizophrenia

is charac-

or in advanced ' stages terized by an attitude of indifference, begins with a decrease! y by extreme apathy. The disorder usuall during adolescence or early life of ies activit interest in the normal into loss of ambition, emoadult life and.then gradually develops social relations. The indivifrom awal tional indifference and withdr and seclusive, begins to obtain dual becomes increasingly indifferent and eventually sinks into an eaming is his satisfaction through day-dr he does not care at all. There apathetic state. At this stage fight for. He has no connection to nothing to wish for, nothing is content to lead a simple,

ibility and with realities to assume responsdep endent life. and ent ffer irresponsible, indi may be distinguished from Simple schizophrenic disorder the the ground that it rarely shows s s, other types of schizophrenia on disorientation, ; delusion

such as symptoms dramatic more Simple of language or action. nces urba or dist on hallucinations, rded reta ally ment for mistaken schizophrenics are sometimes ence, lack of concentration, low level ffer may account of their apathy, indi Psychological tests, however, . ence llig inte and is ty icul diff of motivation r the ally retarded. Ano reveal that they are not ment simple schizophrenia from inadequate ing e with encountered in differentiat between the two is that thos ce eren diff The ctively effe personality. tion func to may appear to try inadequate personality all. not try at while schizophrenics do disease usually a: The onset of this Hebephrenic schizophreni disorder the this In and develops gradually. ressing to reg by occurs in adolescence e Jif of from the stresses a fantinto ng affected person retreats aviour and by withdrawi a silly, childish level ofthbehaccompanying emotiona ionlal disintegration

asy world of his OWA, wi

148

ABNORMAL PSYCHOLOGY of the Personality with most dramatic psychotic symptoms _lik symbolic language disturbances e and symbolic actions hallucinatio Particularly ns, auditory, and delusions of a sexual, religious hypochondriacal and pers ecutory nature. Hebephrenia Tepresents withdrawal in an extreme The patient no longer rema form. ins interested in the worl d around him. His silly and

inappropriate gigg does not result from exte ling, weeping or laughing behaviour rnal stimuli but from stimuli from within the imaginary worl d in which he lives. In severe withdrawal and Tegression cases the is so extreme that the pers on behaves in many ways like an infant. It is an incurable stage and the pati Continues to exist on the leve ent l of his choice in the strange his own creation, world of Catatonic Schizophr The catatonic sch diagnosed mainly on theenia: is patient’s behaviour fluctuizophrenia ating between i i i Conseq behaviour may be inhibi ted (stupor) or alternate uently, his motor ly he may break out Into an inexplicable tur st of overactivity (catat onic excitement),

> Some

other.

steps

5 : or s typical schizophreniMot c thinking and aff. the catatonic patients. ect, They may ieau enidy s involving ideas of

149 PSYCH OTIC DISORDERS

term paranoid literally means CR Paranoid schizophrenia: The paranoid is said to bea person beside onself.” Consequently, a special relationship with other who believes ‘himself to have a intensely preoccupied with his is people. The paranoid patient gh this relationship may be. thou bad le, peop r othe to ship tion rela is diagnosed mainly by the Asa result, paranoid schzophrenia g systematic delusions and _ involvin of disorders of thought content aty nature resulting in loss ecut pers of ly uent freq ns hallucinatio r, table behaviou critical judgement and an unpredic beginning,

the individul

who

develops

paranoid

ofinferiand suffers from the feeling schizophrenia feels unworthy e mechanism of blaming others for enc ority. He resorts to the def extremes by He carries this defence to e. eiv that they ain his failure to ach extent that hə feels cert dually grow distrusting everyone to the gra ers oth of . Suspicioas have desigas against him turn, become and ideas ofreference, in nce ere ref of into ideas delusions of persecution. paranoid ons of persecution of the Hallucination and the delusi forms sometimes of very peculiar many schizophrenic may take y believes that an event has a particular sel nature. The patient falividually. He may believe .that the events are oblique significance for him ind the television ?

In the

reader on s ngs about him in described by the new the newspapers say thi s and glances ; life own nod references to his the ning for him in

mea code; there is a special train. the on exchanged by others

try combine to and the element of mys ure the patient. inj or kill with plots to n tio upa occ pre get rid of him a to trying produce e that his partner was sur was r a rubber an wea ssm to ine d bus use A ther patient The

persecutory beliefs

ed pany. Ano and take over the com t himself from the rays of an “influenc . tec him pro t to ins aga e hom directing suit at. spiteful neighbour wasgoing to lower him into machine” which a e wer ple peo that some The more interesting A labourer declared hot iron out of him.t “one of the doctors e mak and d aci hot tha

patient who remarked is going to use it to case is of a woman of my head and he out min my len has sto . make a lot of money” very verbal about c is inclined to be eni phr izo sch lly alert, id no ra The pa patients are genera aid. At and beliefs. Such afr as and ide ed her fus or his e but also con siv res m, they agg the , y ive tro kat agitated, tal t someone wants to des

de jeve tha s. The hostile attitu rder to save themselve h suc ts e paranoid patients reflec apar the e. tim deteriorates with and aggression as the thetic rather me withdrawn and apa trends. However, s ic nonid schizophen than aggréssiveon) phrenia (causati dies to Aetiology of schizo have been many stu Genetic- factors

(heredity):

There

150

ABNORMAL PSYCHOLOGY

support the claim that schizophrenia is inherited. These studies may be grouped into three major types: family-risk studies, twin studies, and studies of adopted children. It has been observed in family-risk studies that the families of schizophrenics had a disproportionately large number of schizophrenic cases. The fact that the disorder runs in families has led to the

conclusion that schizophrenia is inherited. In twin studies where one of the twin pair has schizophrenia,

then the chances

of the other twin having schizophrenia are higher

when he is identical than when he is non-identical. Since identical twins are genetically the same in comparison with the non-identical ones, the findings suggest that hereditary influences play a part in the inheritance of schizophrenia. The studies carried out with the children of schizophrenic parents adopted by normal parents and children of normal parents

adopted by schizohrenic parents also suggest that there are genetic influences in schizophrenia. It was noticed that when the child of schizophrenic parents was Separated from his family soon after birth and nurtured in a Proper environment by normal parents, he was still found to be affected with this disorder . In spite of the evidence put forwar d by hereditarians, the hereditary influences provide only suffii cient ones - Genetic influences the necessary causes but not the are not the sole cause of schizophrenia. to schizophrenic parents of families are not bound to become schizophrenics. There are instances of one 10t being schizophrenic though both „parents or one of them were schizophrenic. If schizophrenia itself i

n one identical twin should

ence in the other identical twin. On the other hand, there are

some psychiatrists who would that the genes and chromosom deny es may be loaded for schizophrenia . in theI children of sc hizo vhre nics . Therefore, the controversy not in the existence of lies hereditary influences : in schi on the extent of this influ nia i but

ence.

Sayi PRIMES

stresses of life.

7 In summar I y, hereditar unimportant in the develo y influences a Ppear pment of schizophernia. predisposed

to scheizophrenia

through

to

be

Whether

relatii vely a child

his genetic influences will

151 PSYCHI OTIC DISORDERS

i nmental ends upon the enviro become sch1izo phrenici or not depd in future.

infl i ue-

ose neces to which he shail be exp s, researchers Besides genetic influence disturbances al Environmental factors: mic che h bio phrenia with the sibility has. not ave tried to link schizo the body. But this pos of schizophrenia in ors ory and metabolic err the The accepted causal causes inherent in made much headway. of the psycho-social aks spe rs yea reactions are ent rec eni in the that schizophr c s ert ass It e way in nt. one’s environme are acquired in the sam

results behaviour and learned patterns of our is acquired. These patterns are the of els avi mod beh er mal rop nor imp which environment, lty fau ng, ngi bri . of defective uptic experiences of life

ly trauma imitation and emotional to withdraw reality may learn om fr ing fly c ion where he feels A schizophreni A y and sociai isolat tas fan The of d rl wo e state of regression. into a privat world or in his eatenthr e vat of pri e nc his da oi in av safer ents an drawal often repres and failure. schizophrenic with ism tic cri s, hip ations development ing interpersonal rel portant role in the im an s ay pl t en ips prevailing Family environm improper relationshand father on e Th r. ou vi ha be of schizophrenic s, particularly between the mother the other, may in familial situation tween parents and the child on phrenia. zo be one hand and velopment of schi ground for the de towards their s er provide sufficient of the moth r ou vi ha be the The non-verbal In many cases @ sufficient cause.s verbal behaviour. as ed er id ns co children may be e mothers does no t match their depe3ndence and at ON in behaviour of thes to be reje j cting, stressing _selfar pe -protection and with ap er ov y ma n, io ct They fe af d le ow up time may sh “double bind” dilemma co the same maladapThis attitude. irrational and g an in lt sacrificin su re d may parents may uently, @ chil discord between of the fsprings. Conseq of tive behaviour learn: relationships; interpersonal * to avoid close r; otional behaviou and * jmproper em) suspicious nature; * indecisiveness an d to sorders. lly develop in * thought di rly life gradua ea he t in ns ng patter All such learnibehaviour. c ter life may be ni re schizoph in early or laating factor for e ag st y an ipit ituations at ip nt. prec n nervous brainA and i ed pos dis o. pre gee one ly etical gen 3 at ¢as In changes , c + li metabo ered ophrenia. consid chemical and series mi he i Y W ( (t s es e stress h T . s the m o causing schizotrPess of t ty p m ri schizophreulnituc resy context), 10 the maljo lationships. in E “c e na re t so aya th erns of trinatteiorpnser of one’s life in , tensions, anxiety the ripaortt igsty in in y, frus it fe us ence in his elin of ses, ca Tcahe ” algo cause fe ay lose confid m o h w al du vi the indi titul and y fearful at

152

ABNORMAL PSYCHOLOGY

abilities, isolate himself and become

suspicious

of everything in his environment and may learn to attack others in imaginary selfdefence. In conclusion, it can be said that genetic influences are a necessary, but not sufficient cause, for the development of schizophrenia. What is acquired as Pred isposition to the disorder in the form of genes and biological structure is further subjected to enviornmental influ ences. The early childhood expetiences and family situa

tions coupled life act as causative as well precipit with the stress events of later ating factors in the development of schizophrenic behaviour. The likelihood of an individu al becoming a schizophrenic depends upon

the magnitude or degree of the genetic predisposition (here dity) and stress (environment),

Physical methods involve the use of insulin coma therap shock, Psychosurgery and y, electric che energisers and anti-anxiety motherapy, that is the use oftranquillizers, drugs. In view of the risk involved, insulin

}

therapy works

are particul

arly agitated ophrenia is well as most of the a disorder of arousal, drug drugs like phenothiazin es, the raw-wolfi

utyrophenoes, and diazepam (valium)

a alkaloids, tri and Other tranquillizers fluoperazine (stelazine) decrease arousal. Principal characteristic of the 3 Psychological Tealme It follows that the principal nt should therefore be relapsychoanalytically ori therapy should not be used. ented psychoThe unconvering 4 technique remov l s involve great es schizophrenia in of risk of mre s and overt Prence cipita Previously boarderli of ne or latent cases, ting use Individual

tolerate the hostility of the patient Withou

PSYCHOTIC

DISORI DERS

hostility.

Persons who

153

care

for the tr eatment

i ophreni of schiz

after alt uman ees always remember that schizophrenics are to “punitive ively negat nd respo they ns, perso l norma Like A should They ing. stand under and ment and positively to warmth = and ideas their le, possib as far as and, stood under b False ie oe ally gradu be d shoul they But eliefs should never be challanged. made to come to terms with reality.

Affective disorders

n are characterized by Affective disorders of psychotic t,origias the emotional state is disturbances of mood (or affec

severe either excessively elated and high known technically). The patient is ely depressed and low in spirits in spirits (manic state) or excessiv show.a combination of ups and (depressive state). Sometimes he may pressive state. Disturbances in in downs of mood resulting in manic-de , are accompanied with changes emotional state, that is, the mood cpreo be may equently, the patient the patient’s thought process. Cons concerning disease, proverty, ghts thou nt easa Cupied with unpl , of grandeur. _He may suffer ideas lops deve unworthiness or guilt or delusions Or hallucinations. from misrepresentation of reality, lead to changes in the

throught contents activity, Changes in mood and show signs of abnormal overmay He r. viou beha patients lf. some times harming others or himse disorders Schizophrenic and affective the differences rlapping of symptoms, In spite of much ove : are ers ive disord

ect between schizophrenic and aff reat from reality. there is a complete ret ment. On the (i) In schizophrenia ust adj his as a simple means for The patient adopts it individual appears to be the , ers ord dis ive ect uation. The reaction other hand, in aff something about the sit in depression, there n desperately trying to do Eve ic state.

in man is that of fighting as seen n. sio res agg t of men is an ele quent than the orders are more frepatients entering dis c eni phr izo Sch (ii) izophrenic The percentage of sch with affective disorders. e than the patients mor es tim r fou to ee thr is als pit mental hos affective disorders. e extroverted ive disorders are mor ect aff 3 h wit ts ien pat The

Gii) n schi zophrenics. and less withdrawn tha patients are of affective disorder marry. e tag cen per ge lar (iv) A cs never most of the schizophreni phremarried. In contrast, er patients, schizo

to affective disord s v) In comparison for a long peri od of timr e. The ; possibilitie zed F ali s. ve pit si hos es ©) manic-depr nics remain is much less than the of their improvement n than in more CoO: mmon in wome are s der or: dis . (vi) Affective cs are found to be men the sc hizophreni men while most of

154

ABNORMAL

PSYCHOLOGY

Classification of affective disorders According to DSM-II, affective disorders may be classified three categories: * Manic disorder * Depressive disorder. Bipolar affective disorder (manic-depre ssive disorder).

into

1. Manic disorder; Manic disorder or mania is associated with the elation of mood and excessive exci teme nt. The patient is high in spirits, overactive and bursting with energy. Manic behaviour is of three degrees: hypomania, acutemania, and hyperacute or delirious mania.

his fingers

or

his feet while others are uming with talking. The dent and energetic. His pleasant topics or wish fulfilling fantasies,

keeps moving

ally on i as of unworthiness, the pati with hypomania has ideas ent of grandeur. Instead of illness, he denies the fact that he is currently ill Simi worrying about remaining within his mea larly, instead of ns, he is liable to spend lavishly. All seems to be going well with such indi high spirits, and ideas of gra viduals. But overactivity, exciteme it, ndeur compell an individu al to behave ause the patient is out of He must therefore be saved from the stage when : ur and being frustrated by s leading to acute Stages of this disease. The acu ac te mania „is a mor e sev ere degree. While hos form of manic disorder pitalization is rare] in from hy Pomania, when

Testlessness

extreme.

There

the acute manic is alw ays a case or excitement is

j

i

i

for hospital i

care

Y, uncooperative, ins ensitive, i le, vulgar,

He resents any form of

Hyperacute or deliri manic disorder. The pat ous mania is the most extreme form of ient becomes very restle ss and excited. experiences hallucina He tions and delusions of Both persecution grandeur and loses all con tacts with reality. and In his wild excitemen t,

155 PSYCHOTIC DISORDERS

s and is stantly, tear his clotheHe, con h ug la and ut then, sho y theipar ma imself and to others ; bothm. to him gerous roo dan ed in a t eisolat to Kepom

e

2.

ig

polar © osite of ression is the Depressive disorder: Dep spirits, feels SE east ote sad. low The patient remains in may even neglect things around him and

become slow. oses his interest in > . The patient’s movements appuntato and body carenothing or even remain in bed ina form of hygiene. e may either sit doing and need for food and

roundings Stupor ignoring his sorretardation of thought process, he talhas ks ked ve is a maring energy to think. patienets with ugh eno mon sum } culty By contrast, some hesitantly or not at all. They pace up and tation. slowly and also show signs of agi an ae depression may ng their hands in despair. Agitation anget ngi of wri t y men ssl ele tle res e Th n ow on elements also. sed individual may on have some comm

res retardati sent in both as the dep The . (rage) is likelyto beinwpre dly war out ardly and

er

common

oth r is a severe ou vi ha be ed tat ed or agi ard ret h ug ro th ted ibi ght and constipa~ feature exh s of appetite, loss of weiand the patient 19 Los . rgy ene ful use of nish lack om al desire tends to dimi ent suffers fr tion are common. Sefrixugid or impotent. The patiter in d un fo ic ist me likely to beco fulness is a charac

express

hostility

rning wake insomnia. Early mo sive disorder. res dep of severe forms ucinations delusions and hatll may hear rder also involves The patien

he ideas related

y mind is dead,” Declarations like “mbeen taken away”, “my liver has her en turned to lead”,disorder in individuals. Anotpesbe ve ha gs le y “m d ive an ce en id nf is loss of co d not o e ur at fe for the patients an my on oo mm gl co oks

O wor Id lo simistic outlook. The profo und helplessness and ideas contemplation of e e iv Th ss pa or to the gives delight. suicidal attempts may lead to ty suicide. e degree of severi rder: Based on th ssified under three’ so di ve si es pr de may be cla Sub-types of upor depressive disorder e th , (iii) depressive st ms to d mp an sy e, ut ac ) of the (ii , e) (simpl age subheads: (i) mild zes the initial st

aracteri le depression ion ch the symptoms characterizing The mild or simp depressive erh their peak in depresa of of the disord , extreme form are depression stupor.

S and no es ir qu re ve si pres While a mild de

e most ve stupor 1S th e i , The depressi sponsive re un is t en e the patisent

wher sive reaction forced feeding. treated as an es ir qu re y n usuall ion and is ofte

hospitalizat

OU

0 tionless lies mo

156

ABNORMAL PSYCHOLOGY

dipressive needs hospitalization and supervision for guarding agains suicidal attempts. In the

stupor Stage, the need for look ing after the patient becomes much ` pronounced and the treatmen t becomes most difficult. 3. Bipolar affective disorder (manic-depressive disorder): Thi category of ‘affective disorder s involves reactions which are neither

elation (excitement and ove and despair. The classical ractivity) accompanying morbid ideas signs of manic depressive illness as

._ fi) Sudden, unexplai to either sadness or elation, ned, often profound, changes with no degree by degree shift. (ii) The illness occurs with out any appropriate stimulus, (iii)

(iv)

in mood external

Depression is at its worst in the early morning.

When

ill, the Patient is out of tou such times one cannot ch with reality. At reason with him. (v) The manic Phase has the appropriate ecstasy, euphoria, flight characteristics— ofideas, Overactivity and expansiveness. 3 (vi) In the dep jobs or may give up ressive episode, patients often resign fro m their all their possessions. (vii) Illness is known to respond to electro-c onvulsive therapy. (viii) _Manic-depressive Psy cho sis is Classically a illness, and inheritan ce follows the domi genetic nant single autoso mal gene, (ix) The additional clinical features are som atic delusions and i » “My bowels are blocke d,

(x) The major ris ear : ly morning when the k of the illness is suicide, particularly in patient has no one wit his problems, h whom he may shathe re _ Causes and trea tment of affective Studies have e disorders: A numb er of ion, either

separately

157

PSYCHOTIC DISORDERS

attention, brings the child learns that his depressed state catches adopts depreses,.he relativ and friends from sympathy and support life experiences

The early sion as a preferred pattern of behaviour. trigger incidences of the often years later and stress events of the love and The inherent guilt feelings, lack of affective disorder. ts conflic to rise giving ions situat frustrations, affection, l an

tensions and stresses all produce

which may

hostility

expression or individual either to seek its outward

inward

compel

sufferings

s. as found in most of the affective psychose s involves both the physical The treatment of affective psychosi Electro-convulsive therapy ods.

In as well as psychological methical methods of treatment. constitute the phys medication depanti c ycli tric the tly (mos nt drugs depressive disorder, antidepressa e the use of tranquillizers is recomwhil , used ly wide are ) on a ressants In the agitated type of depressi . s mended in the manic disorder time some depressant drugs is i of tranquilizing and anti Som

seful.

ers treatme nt of depressive disord In psychological methods of raphy, insight oriented therapy, e the psychotherapies like supportiv ctively used. effe may y rap the g enin list and

the insight neither supportive nor In the case of mania, Hospitalization is just the first need. _ . oriented therapy works well anised psychological approach known org l wel A andi ts. ien pat h for suc I hip between therapist ations ment of interpersonal rel of manic

as manage

nd the patient has been fou

useful in

the

treatment

Patients.

Paranoid disorders desc bing lee descri anoid has been used whi id disorder par m ter the r pte cha In this between parano a. The distinction ised as under: paranoid schizophreni mar sum be enia may and paranoid schizophr disorders are also izophrenia, paranoid sch id no ra pa e Lik 1. e are more systema, but the delusions idhersch ons usi del by d izophrenia. ise ter rac cha parano

errelated than in mind, tized and closely int is splitting of the izophrenia there ara2. In paranoid sch the personality showing a marked sep no of is ion re sat the ani , org ers that is, dis in paranoid disord

but the self from reality, personality. tion of the of ion sat such disorgani ectual functioning and

ration in intell himself away from

reality.

in a particular area.

deterioBesides, there is no cut not s doe t patien

the al and normal He pretends to be ration

groups (i) paranoia b-divided into two su are ers ord dis Paranoid te. and (ii) paranoid sta is rare. This disorder ed true paranoia, ll ca s me ti me acterized as. so Paranoia, been found to be char

develops below.

gradually and has

158

ABNORMAL PSYCHOLOGY

Nature of delusions

G)

The patient shows highly systematized and

stable delusions of persectution and of grandeur. ` i) i The delusion i system in i paranoiaia is is skilfu skilfully l y andanc logical ly 2 penser by the patient. In fact the Paran oiac has a high intelligence to give logical and convi Personality organisat ion

ncing reasons for his behaviour.

(i) There is little Present in the paranoiacs, or no general personality disorganisation F The patien (ii) Tt sibi le and coherent in in his y thinking and1 behaviour and features isliksen e hal lucinations and gr assessment of adaptive behaviour in the identification and demarc tion of the level of mental subnormality has been realised.

Adaptive behaviour as a means of classification

This criterion describes one’s adaptive behaviour, expe of, his age and cultural group, in two ways for the required asse

ment:

* the degree to which the individual is able to function and maintain himsel

f independently, and satisfactorily the culturally ed demands of perso: nal and social responsibility. Attempts have been made to devise measures for the aa

* the degree to which he meets impos ment

of deficiency

in adapti

ve behaviour through Vineland Socia! Maturity Scale, Adaptive Behaviour Scale (AAMD), and Maxfield Buck Holz Social Maturity Scale. The consideration of deficiency in adapt ive behaviour along with the very low scor development of an

es on an intelligence test resulted in the altogether new classification of sub-no rmality.

The terms moron, imbecile, or idiot are now completely avoided for determining the level of retardation. The new terminology in-terms of obtained IQ on different tests scale is represented below.

TABLE

13.1

Level of retardation

Level of retardation

Intelligence Standford Binet

Profound Severe Moderate

Under 20 20—35 36—51

Mild

52—67

In view of their

Quotient E Wechsler scales Under 25 25—39 40—54

55—69

typi

cal subnormal intelligence adaptive behaviour these and deficient categories are described bel ow, Mild retardaticn: A Maj ority of a cent of the cere | individuals

retard speed telong to th attain Intellectual Jevelsis category.

In adult

life, these

M ENTAL DEFICIENCY

165

in schools as slow learners and are frequently required to repeat early grades. Speech disturbances are common among them. , In comparison with normal individuals, the mildly retarded exhibit immature behaviour, have poor control over their impulses, lack judgement, and fail to anticipate the consequence of their

actions, Their sexual behaviour and adjustment, in spite of the leads normal sexual development and fertility, is unpredictable and to a variety of problems and difficulties. any The mildly retarded individuals generally do not show 1 dered consi are They ision. superv organic pathology and require little ance, and aid to be educable. With early diagnosis, parental assistnable degree reaso a of special classes, they can be expected to reach an adequate social and of educational achievement and to make economic adjustment in the community. ten per cent of Moderate mental retardation: Approximately ry. In adult life catego this to g belon ded the total mentally retar

that of the average these individuals attain intellectual level similar to suffer from motor y. clums six year old child. Physically they appear and somewhat vacuous incoordination and present an affable, dull defi-

development and personality. As a result of their inadequate as ‘trainable’ instead ded regar are they ies abilit cient capacities and ed. From early infancy or of being ‘educable’ like the mildly retard n in almost all areas of datio retar of childhood they show signs e to speak, their, rate of learndevelopment, and though they manag e to do any work that requires ing is too slow. They are unabl or consistent ng, memory thinki ct abstra ality, origin initiative, read-

re the basic skills of attention, and cannot be expected to acqui ing and writing. However,

with early diagnosis,

parental

help and adequate

rately retarded can achieve training and support, most of the moderes of life. Nevertheless, they able independence in all sphe

consider support and need institutionalizaTequire constant supervisionralandlevel of adaptive behaviour. tion depending on their gene Severe

retarded

mental

retardation:

individuals—mostly

Nearly

children

3.5

and

per

cent

of the total

adolescents—belong

to

n an intellectual level greaterto than this category. They neveryearattai high old child. The mortality rate due that of the average four

viduals. is quite high among these indi to disease Susceptibility onncy infa or birth from ent They are grossly tetarded in developm ion. Sensory

motor and speech retardat rity of them word and show severe icap s are common. The majo defects and motor hand

of in their sorroundings and many display relatively little interest ing feed like s tion func and s skill y them never master even the necessar and bowel control. and dressing themselves, Or bladder ‘educable’ nor are neither The severe mental retardates t on others nden them remain depe ‘trainable’ and the majority of of others ion rvis supe and care throughout their lives. They need

166

ABNORMAL PSYCHOLOGY

with a great need for institutionalization. They may profit with proper care, timely treatment and specialized training and managing their own physical well-being and doing manual labour. Profound mental retardation: This group makes 1.5 per cent of the total mentally retarded population. It is characterized by the most

severe

symptoms

of mental

retardation. The

individuals be-

longing to this category never attain in adult life an intellectual level greater than that of the average two year old child. They are severely deficient both in their intellectual capacities and adaptive behaviour. The symptoms associated with them are retarded growth, physical

deformities, pathology of the central nervious system, mutism, severe speech disturbances, motor in-coordination, deafness and convulsive seizures. They are unable to protect themselves against common dangers and are unable to manage their own affairs and satisfy their physical needs. Their life span, as a result of their low resistance, is too short. Such individuals are completely depen-

dent on others and need the care and sypervision given to an infant.

Essentially,

they

need

to be institutionalized

deteriorates on account of the biased Stress demands of their environment.

as

their

condition

attitude of the parents

and

Common clinical types of mental retardation The knowledge of well-known categories of mental deficiency or retardation based on a number of clinical symptoms and syndro-

mes is useful Tetardates.

in

the

identification,

treatment

and

care of the

Mongolism: The mental deficients whos e facial characteristics bear a superficial resemblance to memb ers of the mongolian race are classified as mongols. The retardatio n in them ranges from moderate to severe (IQ approximatel y 20-50). iis The Mongoloids tend to be short in stature with small round eads, abnormally short neck, thumbs and fingers, with slanting

almond shaped eyes, and short flat noses. poe

They usually have a small , fissured and dry lips and tongue. Their hands and feet are toad and clumsy, and they have a deep voice. Motor coordination is awkward. They are handicapped in any learning or training, but most of them can learn self hel skills, acceptabl i and routine manual skills, iour p i i nee eens The

causes Of mongolism are faulty heredity (possible chromosomal anomalies, and metabolic facto rs (glandular imbalance often involving Pituitary glands). But once it occurs, it is irrev ersible. There is no effective treatment or work able preventive measures.

Cretinism: This mental Severe retardation resultes from the disorder depends on the well as the degree and duration

deficiency ranging from moderate to thyroid deficiency. The severity of age at which the deficiency occurs as. of the deficiency.

167

MENTAL DEFICIENCY

, The physical symptoms in the case of persons suffering from cretinism consist ofa dwarf-like, thick-set body, coarse and thick

skin, short and stubby extremities, abundant hair of wiry consistency and thick eyelids that give a sleepy appearance. Other pronounced symptoms include a broad, flat nose, large and flabby ears, a protruding abdomen and failure to mature sexually. Early timely treatment in the form of injection of thyroid gland extract produce favourable results in all cases except those of long standing where developthe damage to the nervous system and to general physical ment is beyond repair. with Microcephaly: It refers to mental deficiency associated impaired the of account on size failure of cranium to attain normal an unusually development of the brain. The microcephalic has of seventeen circumference a small head which rarely exceeds

twenty-two inches, as compared with the normal of approximately cone-shaped usual the with d inches. In addition, he is short stature upon the degree skull and receding chin and forehead. Depending into the profall of severity of mental retardation. microcephalics mental retardation. found, severe and moderate categories of

opas well as non-genetic factors impair devel r prope no is There ly. cepha ment of the brain and thus cause micro imbeen has there if ly cepha micro for medical treatment available paired brain development. Both

genetic

ciency results from the acHydrocephaly: This mental defi of cerebrospinal fluid within nt amou cumulation of an unusually large : of the brain andanc enlargement the brain the cranium, causing damage to s from varie rder diso this in ion skull, The degree of mental retardat al damage neur of nt exte the upon g moderate to profound dependin the age of onset, the duration and which, in turn, depends upon the size of the skull. haly consists of the gradual The chief symptom in hydrocep es seem to be genetic as . The caus increase in the size of the skull birth or cases the disorder is present at prenatal some In tic. gene nonas well of nt ccou on-a h birt after the head begins to enlarge soon y or disorder develops during infanc disturbances. More often, the ine acut or lasm neop nial acra of intr early childhood on account

i flammatory brain : disease.; : atment shows favou: tre ical surg per pro and s An early diagnosi brain tissue. However, ng further damage of the

able results in checki

atment and does not respond to any tre x the advanced acute stage th. eventually results in dea l; has a ‘ genetic base and (PK U): This disorder uria

h

a recessive

gene

carrying

throug ; yme Prenit toA bs transmitted ult the child at birt is assumed a s an enz b h lack £ resu't a As ce. ban tur proin i nd fou acid metabolic dis no ami 1 , an ylalanine of ion lat umu needed to breakdown P hen ormal acc

e is an abn tein foods, Consequently, ther ue. g damage to the brain tiss sin cau phenylalanine in the blood

ABNORMAL PSYCHOLOGY

168

The symptoms such as vomiting, a peculiar musty ona infantile eczema and seizures, motor incoordination, signs of menta retardation and neurological manifestations relating to severe brain

damage are found to be common with this disorder. However, the’ diagnosis of the disorder is primarily made on the basis of the presence of phenylpyruvic acid in the urine.

The treatment

of PKU

diet, low in phenylalanine,

depends on

early detection. Special

is recommended to the affected infants.

Timely treatment helps im restraining or preventing brain damage.

Amaurotic idiocy: It is a rare hereditary disorder of fat metabolism transmitted as a simple recessive characteristic. It is never transmitted directly from patient to offspring, because death generally occurs before puberty. The only mode of transmission is through the mating of persons who, although free of overt symptoms, are carriers of the defective genes. This disorder has been described to occur in two different forms—infantile and juvenile— depending on the ages at which it occurs, The major symptoms of this disorder include muscular weakhess, inability to maintain normal posture, loss in the ability to grasp objects, visual difficulties leading to progressive blindness,

seizures and neurologic manifestations. Infantile

amaurotic

idiocy,

also

known

as Tay-Sachs disease

is common among infants. The disorder appears at about six months

of age

and

death

occurs

between the ages of two and three years.

Juvenile amaurotic idiocy occurs at five or six years of age and patient may live up to thirteen years. Causes of mental retardation

, tion

lt is difficult to postulate standard causes

applicable

to cause mental

for mental

the

retarda-

to every such case. A number of factors are believed

retardation

which

categories—

may be divided into two broad

A. Organic or biological factors

B. Socio-psychological factors. A. Organic or biological factors Causes listed in this broad category are described below.

1. Genetic factors:

genetic

factors

operative

Mental deficiency may

be established by

at the time of conception in two ways—

either through transmission of some defective genes in the chromosomes of one or both parents, or on account of chromosomal aberrations. The transmission of defe Ctive genes gives rise to many disorders causing mental deficiency: Me ntal retardation or deficiency attributable to a dominant gene is ver y Tare because the persons affected are generally incapable of reproduction. It is often the result of the

169

MENTAL DEFICIENCY

ve recessive pairing of two defective recessive genes. When defecti, necessary enzyme an of tion produc the PKU, genes are paired, as in ed. This in for an important metabolic process, is usually disturb mental causes and embryo the of pment turn, affeets the develo mental deficiency , disease chs Tay-Sa like cases, some In ncy. deficie genes. recessive may also be transmitted by the pairing of single mental retardation Several chromosomal anomalie s determine

or mongolism is one chromosomal aberraby caused such disorder which is said to be n are found to have childre oid tions. The majority of the mongol of chromosonumber The 46. usual the of 47 chromosomes instead osomes 21 (during

at the time of conception. Down’s syn drome

of chrom mes increases as a result of tripling osomes of pair 21 become chrom the egg the the fertilization of ple of chromosomal abnormathree instead of two). Another exam an ext ra X chromosome is which in r’s syndrome

lity is Klinefelte s usually at fault. This disorder occur

only

in males and

symptoms

the testes remain small and are usually noticed at puberty when y sex characteristics such as the boy develops faminine secondar enlarged breasts and round hips. also be the result of many 2. Infection: Mental retardation can measles) lla (German rubbe lis, syphi infectious diseases like tissue and the which can damage brain ion. toxoplasmosis, or encephalitis e mental deficiency or retardat sever in g ltin nervous system resu tious infec these of r othe the one or If the mother suffers from s. ction to the developing foetu infe smit tran may she diseases

at birth

or afterwards

may be infected with diseases

itis and mental subnormality. Encephal age an which cause life-long dam n brai meningistis cause irreversible y childhood. Besides meningococal earl in infancy or indieven death if contracted ues, such infectious diseases may tiss n brai ng agi ical phys directly dam al enit cong normality by causing . rectly lead to mental sub epsy epil and s lysi para ness, defects such as blindness, deaf by intoretardation may be caused mercury, 3. Intoxication: Mentalc age de, oxi mon bon car like nts A

child

xication. A number of toxi anus serum OF logical agents like anti-tet lead and various immuno may result in e cin vac d hoi typ rabies and large doses the use of small pox, y, larl Simi pment after birth. brain damage during develo in the abdominal í region of the pre€ gnaut rapy of X-ray in radio the during pregnancy, incom-

to the mother mother, drugs administered ween mother and foetus, an overdose of bet es ty and brain patibility in blood typ infant also lead to toxici drugs administered tO the damage. on account ardation may be caused ries prior to 4. Trauma: Mental ret inju

m of to the brain in the for of physical dame age h. birt ing low fol or ry, birth, at the tim of delive

nervous affect the brain and thedamage is h Prenatal injuries adversely suc f © of the main causes system ofthe foetus. One

ABNORMAL PSYCHOLOGY

170

ia which results from oxygen deprivation and consequently oaiian of the tissues. It is accounted for by the comCE pression of the umbilical cord which supplies the foetus with blood

carrying oxygen and nutrition from the mother. Another example of prenatal injury is the damaging effects of irradiation on the uterus of the pregnant mother.

Abnormal delivery and birth injuries make for another cause of mental retardation. Difficulties during labour result in damage to the infant’s brain. Any abnormal delivery also involves the risk of brain injuries.

An

abnormal

position ofthe foetus, breech extraction, the

use of forceps and other obstetrical procedures cause of the brain and thus lead to mental retardation.

haemorrhage

Premature birth exposes the child to an increased risk of brain damage

from

mechanical

trauma

and anoxia (condition

associated

with the changes in oxygen supply). Similarly, postmature birth also results in an increased risk of anoxia for the child, during the later weeks of pregnancy and child birth. Another birth trauma in the form of anoxia resulting from delayed breathing of the newborn infant or as a result of anesthetic accidents may also damage the brain. Anoxia may also occur after birth as a result of cardiac arrest associated with operations, heart. attacks, gas poisoning or near drowning. Accidental brain injuries received in infancy, childhood or later in life, causing damage to the brain also lead to serious mental retardation. 5. Metabolic and endocrine disorders: Mental retardation may be caused by various disturbances in metabolism by which body cells are built up and broken down, and by which energy is made available for their functioning. The chemical errors involving metabolism of fat cause Tay-Sachs disease while disturbed protein metabolism causes PKU. Both these disorders lead to severe mental retardation. Similarly, metabolic disorders like galactosemia involving an inability to metabolize galactose and maple syrup urine disease, involving chain amino acids lead to mental retardation.

Several metabolic disorders involving endocrine imbalances may also result in various degrees of mental retardation. Hypothyroidism (usually referred disorder.

6.

Tumours:

to as cretinism)

is one

of the such

Mental retardation may

metabolic

be caused by brain

damage associated with brain tumours and other new growths. Tuberous sclerosis or epiloia is characterized by numcous nodules and tumours throughout the brain and other parts of the body. A butterfly shaped rash initially appearing on the face, spreads wider area. It may finally lead to convulsions and

retardation.

Similarly,

Macrocephaly

(large

over a mental

headedness); microce-

phaly (small headedness) and hydrocephalus (accumulation of an abnormal amount of cerebrospiaal fluid in the cranium) are some of

MENTAL

i

oe

DE FICIENCY

i mental the other conditions resulting g in

subnormalityi

caused by tumours.

that =

Socio-psychological factors with adverse socio-cultural s Psychological factors coupled tion as well as perpetuacausa the E play a leading role in r denied the satisfacare who ren Child n. l retardatio B.

ion of menta e over sensitive to tion of their psychological and social needs becom t with vitamin patien the as way psychological stress in the same hood deprivachild The early deficiency is susceptible to infection, and parental care results in a tion like lack of adequate mothering

retarded rate of devlopment.

environment the children are In an inadequate socio-cultural , of life for their proper physical deprived of the basic necessities ridden, rty pove A ent. lopm deve al soci and intellectual, emotional provides ngenial family environment and deprived, crowded and unco ion inat germ the for ds n! grou sufficient as well as necessarytend ers memb The deprived ality. perpetuation of mental sub-norm their poverty compells them and es selv them like to marry spouses re environmental deprivation in the form of to suffer. The seve cially during and intellectual poverty espe physical, cultural, emotional ts in the retardation of the child’s al. infancy and childhood resul when his potential at birth is norm intellectual development even account on ty abili al verb ng in developi lack of emoThe child may have difficulty ent or may suffer from ronm envi able vour unfa adapt to the to of such able be not may and thus tional and social maturity needs of his environment. has adverse e of the school system development In some cases, the failur tends to retard the School maladjustment ed as a slow learner Or retarded on affects. ell lab e rate of the child who, onc , achievement test scores and observable the basis of speech, IQ scores the perpetuation of noral on account of behaviour, becomesandsubcomplexes. inferiority feelings ardat ion n of mental ret Detection or iden tificatio retarded or arrested concerned with the is on ati ard ret functioning or with the Mental nt of one’s intellectual nmental needs. The pme elo dev and wth gro behaviour to the enviro , inability to adapt one’s a genetic basis to biochemical, neurolAogical at m Wh fro . ge nts ran r ina erm ‘ Causes may psy¢ ho logical det iosoc and s and iou n ect accidental, inf ation, its preventio early severity of the retard at an ever the degree of detection and identification

treatment Stage.

involves

ci tain testss in whici h a By means of f cer th: bir ined, re fo be n io loping foetus is examro 1. Detect ve de e th g in nd ou morr so ch e small amount the fluideen metabolic diseasSes OT the incurabl

itis possible to sscraffecting the developing foetus. somal abnormalitie 2.

Detection

at the time of birth:

Most

of the metabolic

172

ABNORMAL

PSYCHOLOGY

iseases and developmental defects causing mental retardation may oS ae soon after birth. For example, Phenylketonuria A ree may be easily diagnosed through the detection of phenylpyruvic

ina new simple

born

blood

S

infant with the help of the urine test or a relatively

test.

Similarly,

congenital

biological disorders for the mental

cerebral defects

retardation

causing

like macrocephaly,

microphaly, hydrocephaly may be detected soon after birth.

3. Collecting history of the causation or

developmnt of mental

retardation: Useful information about the history of the causation and development of mental retardation can help in the identification

of disabilities among the retarded. This may be in the form of genetic information, the prenatal history of the child and the mother’s condition and experiences during pregnancy, history of labour and delivery, blood group incompatibility, exposure to infections and chronic diseases, happenings in the form of accidents, seizures and impairment in motor and intellectual development , emotional episodes and Psychological stresses. 4. Assessment of intellectual functioning: Intelligence test Scores in terms of IQ are used not only for identifying or segregating individuals with subnormal intellectual capacities but also for classfying the severity of their mental retardatio n into various categories (like moron, imbecile and idiot) or degre es (like moderate, severe and profound), However, the diagnosis. of subnormal intellectual Capacity cannot be made merely on the basis of a relatively low IQ. The following

characteristics should also be kept in mind:

(i) Men tally subnormal children observation, iMagination, thinki ng and generalize,

Jack much in the power of

reasoning,

and

(ii) They are poor at abstract ion and can only think of concrete objects and situatio ns,

ability to in terms

(iii) They are slow learners . It has been found that they take longer to learn a skill. (iv) They are poor at followin general verbal instructions, ‘unless these are repeated at freq uent intervals, (v) Their rate of inte llect ual deve parison with children of the ir own age. lopment is too slow in eom-

_ . (vi) limited.

The areas of their interest, apti tudes

P (vii) children.

The

creactivity

aspect

is

almost

and choices are absent

in

such

173

MENTAL DEFICIENCY

and theirir rights ri i personalities. ; The: y do not realize obligations towards others and often have deficient moral deem and suffer from character disorders.

maladjusted ladji

Most

of these

retardates

are

dependent

and

experi

_ the weet difficulty in managing their affairs. In be severe cases, le of incapab are they that limited so is of personal independence -

. Persona protecting themselves against common physical dangersur may be behavio e adaptiv of terms lity problems and deficiency in of tests like:

with the help assessed through a keen observation, or Developmental ota Minnes and Scale ur Adaptive Behavio ming System.

Program-

Prevention of mental retardation Attempt should Prevention is said to be better than cure.s. for exercising me asure therefore be made to adopt preventive O f mental retardation. t opmen devel and ence occur the over contro!

are listed below. Some preventive measures 1. Genetic counselling and voluntary factors play

birth control, Genetic tion of mental retardairing of defective

Chromosomal aberrations tion. recessive genes prove detrimenta This knowledge may be helpfu functioning. W. There are tests to identify parents material. genetic inferior or defective and help in determining whether blood test may mal or is a carrier

ent

and

of the receslly nor prospective parent is genetica disease. Similarly, there are tests that sive gene causing Tay-Sachs foetus wi ill be the victim of some g reveal whether the developin or not. They should be informed on ati ard arded child. specific mental ret ed in raising a mentally ret about the problems to be fac d about the risk they run in begetting lle Such parents may be counse

children.

care of the her and child: Adequate 2. Proper care of the mot is essentia! for the prevention of nt mother and the new born infa should be a provision of l, there era gen In on. ati ard All routine mental ret ant and nursing mothers. the infants. and adequate diet for all expect mothers should be adapted for the health measures prevention of possible the for en, tak be uld sho care Proper birth, at the time of form of injuries prior to physical damage in the following birth. birth or immediately after birth:. stimulating environment. ’s socio3. Providing normal and one sent in urable conditions pre Uncongenial and unfavo psychological deprivations especially in For cultural environment and tal retardation. se OF perpetuate men cau may for d ood nee ldh t chi grea e ly ear h consequences, there le isamembers the of sib the prevention of suc : pon res andd other get normal as. educating the parents sible, the children should pos as far society. As

174

ABNORMAL PSYCHOLOGY

well as stimulating environment for the proper growth and development of their innate capacities, Illiteracy and poverty of the parents, and poor defective family environment should not come in the way of the satisfaction of their basic needs. They should not be allowed to develop inferiority feelings, complexes, frustrations on account of their limitations.

4. Provision of public education: An attempt should be made for arousing the public into adopting preventive measures for controlling mental retradation. For example, by giving the right infor-

mation about the correlation of mother’s age and mongolism, public opinion may be built in favour of avoiding childern after forty. Similarly, retardation caused by toxic agents may be prevented by providing information and education to the public so that they may be saved from their evil effects. In the field of environmental modifications, and pollution control, programmes of public education may bring effective results which, in turn, may prevent and control mental retardation. Public education can also help in educating the masses about the need and importance of nutritious and balanced diet, controlling infectious diseases and taking measures for the welfare of the mother and infants. The hazards of accidents may also be controlled by making the public aware about the possible safety measures.

Remedial measures

for mental retardation Whatever preventive measures we may adopt, it is neither possible nor feasible to eliminate completely the possibility of the occurrence of mental retardation. Neither can we exercise much control over hereditary influences nor can we avoid accidental hazards, and traumas. Moreover, we also feel handicapped in controlling the evil influences. of defective socio-cultural environment and are unable to overcome the deficiency of psychological deprivations. Therefore cases of mental retardation hence we have to think and plan the treat are bound to exist and ment and remedial mesures for the mental retardates. One thing which should be made clear while seeking treatment of mental retardation is the fact that there is no cure for mental deficiency. Mental Tetardates are essentially incurable in the sense that they cannot be given more intelligence and made normal. No amount of train ing or medical care can transform a mental retardate intoa normal indivi dual. Mentally subnormals should never be confused with the person s who are mentally ill or suffer from a mental disease. In this connection, the observation of Wechsler is worth quoting: “Ment al deficiency unlike typhoid fever or paralysis is not a disease. A mentally deficient is not a person who suffers from a specific disease process but one who by reasons of intellectual arrest or impairment is unable to cope with his environment to the extent that he needs specia l care, education and institutionalization.”* It will be appropriate to consider

175

MENTAL DEFICIENCY

ilitaremedia l measures for the adjustment, tehab the of light the in fded, tion and education of the men tally reta 7 above observations. i datioi n, to : Ment: al retar res: J measu M cal or physical 1. Medi wing’ oedieal follo The problem. extent, is said to be a medical the

treatment

measures

or

may prove helpful in some cases:

(i) E Cretinism:

This mental

retardation

resulting

from

de-

its early if recognised at birth or in n O tutio insti rates in thyroid secretion, t he or controlled by ifestations, may be corrected :

ns

thyroid therapy.

syphilis:

Children

infected

with congenital.

ere mental subto be suffering from sev syphilis are usually found ion and prompt penicillin therapy is found (ii)

Congenital

ect normality. An early det ting as well as control of many effects of ven pre the in l to be helpfu congenital syphilis. the early detection with g ria (PKU): On sin onu cau ket nyl Phe rder diso (iii) A , a metabolic PKU , test e nt, urin exte to a greate elp of a simple be checked or controlled, mental retardation may on a special diet relatively free of phenyl nt infa the g cin by pla n foods. the alanine found in most protei resulting from Hydrocephalus, hin wit s: lu id ha flu ep oc l dr ina Hy osp (iv) of cerebr abnormal amount treatment accumulation of an ation. Surgical ard ret tal men It is in er. s ord ult res dis s m thi craniu the treatment of the in l ive ina ect osp eff ebr y tion of cer is found to be ver or the normal produc de of cka blo ion uct ng red ovi fluid by rem aimed at the nneling of the or post-natal fluid or to the cha from congenital malformations ing obstraction result infections. tients subject to , the ca se of pa In : es ur iz se nv!ulsant medication coonv i-i-c (v) Epileptic stration of ntant ni mi ad e ctual deterith , es minimizing 1 ntelle d epileptic seizur an ng li ol tr on l in ¢ may prove helpfu ‘oration. l inistration of adm behaviour : The disturbed and disturbed (vi) Controlling use:ful in controlling hyperactiv e ves pro tranquillizers mental retardates. k behaviour among account of the linl ca t ; Often on gi en lo tm ho ea yc tr ps l s, ca tor gi 2. Psycholo; yc ological fac ormality and ps al oF group psychotherapy between mental su bn m © f indi vidu d for mental the for in medial measures Te g in treatment 1n id their ov pr be useful in be helped in s olving problems ofmental is found to Ch n ir ca the ing ildren ent an d resolv retardation. al maladjustm es. ci so d an l ur emotiona l meas lfare, h psychologica Iso help in the we ose, conflicts throug : rp pu s nt s re thi pa r e Fo > al retardates. 3. Educating tmthent of the ment trea as es ll ic we rv se as g re in ca un.sell r proper CONN there is a need fo r emotional involvement the P ei th on account of

ABNORMAL

176

PSYCHOLOGY

f a . o comings and deficiency of their children and waste a lot in the hope that some magic cure wallbe toana eT Toe A or the deficiency will be automatically eliminated with the iape s es ibiliti respons the by ed disturb become they time. Sometimes, looking

after their

mentaily

retarded

child.

Such

disappointe H

an insecure and guilt-ridden parents begin to demand ee intellectual achievement beyond the abilities of the child who is often abused, snubbed and punished for no fault of his. Some parents adopt an over protective approach in their effort to Sme) the child from challenging situations and thus make him complete y dependent by interfering with the development of whatever abilities or capacities he may have.

Jt is therefore essential that parents should first realize the truth about their child. They should accept the child’s limitations and the mental deficiency in the sense that the child cannot be given more intelligence and made normal. Secondly, they should be educated to behave normally with their mentally subnormal child without being over protective or rejecting the child. Thirdly, the parents should be given training and education for handling the emotional and social adjustment problems of their children. They should never compare their achievements and abilities with their normal siblings or other children in the home and neighbourhood. It should be szen that he is not to be unnecessarily criticised or ridiculed by others. Forthly, they should be educated to provide essential training

at home to their mentally

retarded

child.

How

to train

him

to

manage his affairs independently, how to make the child to develop and seek maximum utilization of his subnormal capacities are some of the areas where useful education and training can be provided by the parents. Finally, the parents should be made to realise that if needed there is no harm in sending their children to special schools meant for the mental retardates. It is the best place for their education and training. 4. Provision of special education and training: It is a cardinal educational as well as psychological error to educate or train the

mental retardates with the normals.

The involved attitud of the parents at home also interferes with the development of the e retard ed

child. The remedy lies in the provision of special education or training for them. The institutes or boarding schools meant for subnormal children serve a useful Purpose in this direction. For better results, the Special institutes or schools must be manag ed keeping in view the following considerations : (i) There should be proper grouping and classification of the mentalli y retardedÀ children on the basis of the d egree ofthe severity

of their retardation.

177 MENTAL

DEFICIENCY

the ‘trainable’ The ‘educable’ should be educated and ble or trainable educa easily er neith are trained. Those who them for cared for and efforts should be made to train . affairs their essential day-to-day essential environment for , (iii) The schools should provide capacities of all mental and maximum development of the abilities and tools for evaluaing, teach of ods retardates. Curriculum, meth (ii) shes be ould be managing

idual needs. tion should be adjusted according to the indiv hers ion for specially trained teac (iv) There should be.a provis hniques for their education or tec able to utilize new materials andto deal with the special problems of

training. They should be able sympathetically, and help them to these children, understand them grow with their deficiencies. be placed on greater emphasis should be provided (v) In these schools and d shoul the children l cocurricular experiences of their emotional and socia ways the ing learn s. habit opportunities for nal virtues and desirable perso adjustment, imbibing moral vocational uld have the provision for be trained sho ons uti tit ins se The ) uld (vi sho The mental retardates education and training. according to their ons ati voc ed liz cia spe and for manual work, crafts abilities. y handicapped needs The general at protected, rediculed ed, hiz pat not to be sym are y rengths The d. nge cha ithi to be i g an

win but to be helped in gro ng s ir education or traini The ns. tio ita lim and may ons uti tit ools or ins

the s Thereafter special sch ng. The society, and adjustment. education and traini and on ati abilit ponsibility for their reh

take res

Summary

ty : It is a retarded, ation or subnormali ard ret nd or y, enc ici def Mental pment, of one’s mi uate growth and develo deq ent ina ici OT def s or tie l aci ma cap subnor ernal bnormal i f inherent or ext brain exhibiting su ou acc on t en nm ro ation of vi fic en ssi cla the to the on for ti adapta imbecile, idiot m erate, , , mod likee mildmild The terms moron, factors, aced by new te rms ssifici ation 1S baseS d pl re en be ve ha y it cla al y w sub-norm i n. : The ne with rdatio severe and profoun d retadeficiency 10 adaptive behaviour along n of intelligence test. on the consideratio scores on an in low le ab er id retardation ns co the riees of mental tegori ca ed fi si as cl toms and syndell-known ble clinical symp haly, phenylha is gu in st di of hr M mber inism, microcep ee as mongolism, cret romes may be listed d amaurotic idiocy. an of organic and ketonuria (PKU), may be the result clude factors n io at rd ta re al nt Causes : Me c causes in auses. The organi , trauma, socio-psychological cif § concepjs tion, infection, intoxication hological yc Of Ps the time mours.

operative at thetabolic and

endocrine

disor ders and

tu

ABNORMAL PSYCHOLOGY

178

factors coupled with adverse socio-cultural’ environment are said play a significant role in the causation as well as perpetuation mental retardation. The detection and identification requires efforts in the form (the tests before birth, and at the time of birth, (ii) collection

the history of the causation or development of mental

to of

of of

retardation,

(iii) assessment of intellectual functioning, and (iv) assessment in terms of adaptive behaviour. Preventive measures may be listed as (i) genetic counseling and voluntary birth control, (ii) proper care of the mother and the child, (iii) providing normal and stimulating environment after birth, and (iv) provision of public education. Treatment involves (i) medical or physical measures, (ii) psychological treatment, (iii) providing education to the Set (iv) provision of special education and training to the

parents, subnor-

mals,

The education or training should begin at home. Thereafter special schools or institutions may be involved. The society and the state should take the responsibility for their rehabilitation and adjustment.

REFERENCES Page, op. cit, p. 354. . Rosen, Fox and Gregory, op. cit. p. 356. Ames ai : à ee Nm à a on Mental Deficien cy (1973), as cited by Kisker;

4, Pecan Mental Deficiency Act, 1929 as cited by Shanmugam, 5. Wechsler, D. Bane ci Deli: Roata

op.

op. cit, pp.

i l Foundations i oon NK, Psychologica P of Education,

14 SOCIOPATHY ciation, antito the Ameri can Psychiatric Asso CCORDING irresponsible e, lsiv impu by ed ` social behaviour is, “characteriz without ests inter e and narcissistic behaactions satisfying only immediat Such ”. nces cit social conseque ent concern for obvious and implithe lopm deve adequate personality viour is not only harmful for stadju l socia their ts als but also affec and well-being of the individu to the society. The following are the ment and proves detrimental

four types of antisocial behaviour. * Sociopathy or psychopathy

quency an d crime * Criminal behaviour-delin

addiction * Alcoholism and drug disorders. * Sexual deviations and

the antisocial name for characterizing pathy. The new Sociopathy is a new ins tead of the term psycho our is a social s behaviour of personalitie tisocial behavi

terminology stresses rather than a psycho!

carry the same meaning

i an

the terms justment. Actually, both rchangen used inte

ably.

may be defined as n brings them repe: t whose behaviour patterapable 0 inc irress, are lou y cal The h, y. fis sel iet soc grossly per values. They are groups, Or social to ble una to and nd [ , ive uls imp le, tolerance ponsib n io at tr us r. Fr ou vi ha . be i nt ns for their ence and punishme plausiible rationala izatio blame others or offer ated legal or socia repe A mere history of justify this diagnosis.”*

sociopa ths wellCharacteristics of andd cjwrecitklineygs of some insgs an indnding ch fi ar ne se or re Th , e 9) th 95 (1 on Clec. Based k ogists like o hologists and sociColeman , 3) 96 (1 d r wa e on r aat (1959), He nown

(1964), and Rosen,

Fox &

ABNORMAL PSYCHOLOGY

180

Gregory

(1965), the characteristics

of sociopaths

may

be sum-

marized as below : 1. Superficial charm and intelligence: A sociopath charm.

He talks well and gives

the

impression

shows his of being alert and

clearheaded. His pleasant manners and a good sense of humour help him in exploiting others through superficial charm and tall tales. 2. Lack of control: A sociopath exhibits a complete lack of control through his emotionally unstable, ego-centric, impulsive and irresponsible tehaviour. His interest lies in immediate pleasure and he has no absolute purpose or long range goals. He is unable to exercise his responsibility and is impatient of routine work and thereby changes his jobs or fields of interest frequently. : He may drift into sexual deviations, crime, alcoholism or drug addiction not because of an urge to do such antisocial acts but because of his lack of control, false adventurism, absence of long range perspective and

regard for consequences. 3. Lack of anxiety, shame or guilt:

Sociopaths

also exhibit

complete absence or minimal outward evidence of anxiety, shame or guilt. They commit an antisocial act, but are not ashamed of it nor do they repent for the harm done to other people or the society by their antisocial behaviour. Instead of feeling guilty they try to

justify their conduct. Sociopaths generally do not exhibit any symptom of unusual anxiety or guilt during or after their antisocial behaviour. This unique characteristic combined with innocent and sincere appearance enables sociopaths to escape suspicion and detection for their antisocial activities.

4. Inatility to profit frem social rewards or punishments : General behaviour responds favourably to social rewards and is ofter corrected through punishments. But in the case of sociopaths, social rewards or punitive means fail to produce desirable results. A sociopath never takes his behaviour seriously and does not respond emotionally after ccmmitting an act. The lack of effective reaction results in the sociopath’s inability to learn from experience particularly to avoid punishment or get a reward.

5. Incdequate ard impreper sccial adjustment: In a socioPsychological sense, sociopaths are victims of social maladjustment. antisccial l per: sonality and selfish behaviour results in their Their : inadequate social adjustment and defective social relationships. The self is always great fer them and this makes them self centered.

Outwardly they may show friendship and concern for others but

true loyalty, sitcerity and intimacy are alien to their nature. They are usually ubsympathetic, urgrateful, incapable of love and remorseless in their dealings with insensitive, others. They suffer from Insiccerity

and incapacity for love and attachment. 6. Hostility towards authority and discipline : Sociopaths are unusually aggessive and hostile towards authority and social

SOCIOPATHY

181

regulations. They come into conflict with authority right in their childhood. They feel hostile towards their parents, particularly the father. Later, their hostile attitude creates difficulties with school and college authorities, employers, police, military and other law

enforcement authorities.

Their maladjustment

leads to truancy, job

instablity, nomadism (pathological roaming from place to place) and their hostility towards law and discipline causes them to drift into

Criminal activities. a very low 7. Low frustration tolerance : Sociopaths exhibit level of frustration tolerance. They are quickly bored by almost any serious and sustained efforts that give no- immediate result or pleasure. A little frustration causes much resentment leading to hostile action and deep depression in them. As a result, they threaten to harm themselves or distroy others.

8. Early onset and long persistence : Antisocial behaviour is, to a great extent, a learned reaction pattern and as such it usually Starts early in life.

In no case does onset go

once caught in antisocial

behaviour,

beyond early twenties.

it becomes difficult to get rid

of it.

9.

No genuine

suicide attempts:

Sociopaths,

generally, have

no history of genuine suicide attempts. They threaten suicide or make a suicidal gesture in order to manipulate the behaviour of Others for achieving their personal ends. In fact, sociopaths rarely commit suicide. In case it happens it is more often impulsive than planned. 10. Deviant sex life and behaviour: Sociopaths suffer sexual maladjustment and abnormalities. Their incapacity for love and attachement, selfish nature, defective super ego, insincerity, lack of Temorse or shame and hostile attitude towards social conventions and regulations, make them lead on unconventional and unrestrained sex life, They lead trival, impersonal, poorly integrated promiscuous

lives, and are in the habit of changing their life partners. 11.

Use of rationalization

and projection

for

defending

anti-

Social behaviour: A sociopath is an expert in defending his socially disapproved and unjustified behaviour by using the mechanism of rationalization and projection. He is a pathological liar and lies

readily even when it is obvious that he will be found out. He justifies his behaviour by inventing excuses or reasons apparently reasonable and at times blames others (persons or situations) for his antisocial

activities. 12. Absence of symptoms of psychosis and neurosis: SocioPaths apparently look like neurotics or psychotics, But sociopathy is different from these functional disorders. Sociopathy never affects the body of an individual as in neurosis or psychosis. In sociopathy there is absence of nervousness, neurotic anxiety, or other psychoneurotic manifestations.

nations and other common

Sociopathy.

Similarly,

irrationality,

symptoms

delusions, halluci-

of psychosis

are

absent

in

182

i

ABNORMAL PSYCHOLOGY

13. Absence of ideals and goal of life: Sociopaths live in the present for the satisfaction of the immediate needs. They have no absolute ideals or goals in life and seldom plan for the future. Their life style is haphazard which . suits their self interest. Their life is disorganised and unplanned. °

14. Addiction to alcohol and drugs: Sociopathy usually leads to alcohol and drug addiction. Social maladjustment, defective relationships, adventurism, law tolerance for frustration, absence of ideals, hostility towards social regulations, and bitterness in life created by selfish nature compels a sociopath to take to alcohol and drugs, gradually leading to addiction. 15. Absence of judgement and insight : The main characteristic ofa sociopath is the absence of judgement and „the inability to act intelligently. He is unable to` reach at a decision based on logic. This illustrates the emotional development of the illness which prevents him from acting in a logical manner. The presence of all the above symptoms or characteristics is not essential for identifying an individual as sociopath. However, the severity of the sociopathic behaviour, to a large extent, depends upon the multiplicity and the severity of these characteristics, Etiology of sociopathy

Heredity and biological factors Defective genes, physique and body constitution, defective intelligence, mental deficiency, brain disorders and similar other biolo-

gical determinants have been held responsible for sociopathic behaviour. But there is no convincing evidence of heredity being responsible

for sociopathy. Behaviour, in all aspects, is an acquired characteristic and learned pattern. Nothing substantially is known about the tole played by genes and chromosomes in the transmission of sociopathic reaction.

Similarly,

there is dearth

of research and

experi-

mental evidence for proving the positive correlation between Sociopathy and defective biological make up like a poor physique, ill health, glandular imbalance, low intellectual capacity and brain

Pathology. At the most, biological factors lead to emotional

social maladjustment leading

to uncontrolled

and

, unconventional antisocial behaviour. In some cases of sociopathy, biological factors may a signifi such play bela vo c ant role but they y are in i no way the sole cause fior

Environment or socio-psycholog ical factors

Sociopathy

as a

behavi

problem involves social and Psychological maladjustment, oural A iie ico ath learns other personality traits and behaviour characterist ics. Like every one of us sociopaths have a unique life style. The y of living (defensive or retailat follow a consistent learned pattern ory) which tends to be self ing. Since learning is env perpetuatironme ntal

in character,

sociopathy as a

|

SOCIOPATHY

183

learned pattern of behaviour is liable to be caused by environmental factors inherent in one’s

community.

family,

neighbourhood, school,

society or

_ Parents and family: Uncongenial family environment characterized by sociopathic behaviour of the parents or other members of the family, unhealthy .relationships prevailing between the parents and other members of the family, lack of emotional and social secu-

tity, denial of the facilities for the satisfaction of essential primary and secondary needs, poverty, emotional and social traumas within the family may leada child to learn specific reaction pattern of antisocial behaviour which enables

Centric, self-perpetuating life. following ways. _

l. The children

him to lead an

All this may

of sociopaths are

anxiety free, ego-

happen in some of the

likely

to be antisocial in

their behaviour not due to hereditary transmission but on account of the indelible impressions that are lefton the young minds. The Child imitates the role of his or her sociopath father or mother by

accepting it as a model and is gradually conditioned to behave

antisocially. _ 2. The elder members of the family can become a model for Sociopathic behaviour. An economically and socially deprived `

family may be engaged in domestic violence, street brawls, drunkenhess, drug addiction, promiscuity and other antisocial behaviour. he children in such families are conditioned to learn the behaviour

Of adults who reject the norms of the wider society and Self interest and a disregard for the rights of others.

exemplify

3. Broken homes on account of the death of one of the Parents, separation, desertion, divorce or prolonged parental absence

are likely to breed sociopathy.

In such situations

the child, placed

1n a foster home or orphanage, or brought up by a single parent or Telatives in severe economic, social and emotional deprivations has No chance to develop primary emotional relationships with the Parents and other members of the family. As a result his emotional and social needs may be frustrated and, ina desperate bid for

Perpetuating himself, he may adopt a sociopath life style. _4. Homes that are not broken but emotionally disturbed

also

germinate and perpetuate a large number of sociopaths.

The parents

their children may frequently quarrel leading to marital

disharmony

With different opinions about the

rearing, education

and career of

and strained relationship between them. The parents may also be Careless, over indulgent, over-bearing with their children. In some Cases rejection or inadequate supervision of the child by the parents May lead to disaster. In such circumstances, the child is unable to Pil the identification needed for an adequate super ego or the

ae Pathy for close human relationships.

He feels neglected,

rejected

is unwanted, and turns to antisocial elements, or sociopaths from att Peergroup or other members of the society from whom he gets ention, admiration and reward for his undesirable behaviour.

ABNORMAL PSYCHOLOGY

184

ce of the parents may also prove harm’ ful. i y, over indulgen imi Similarl Such Daems allow the child to express his aggression and other

needs without inhibition.

The child who is not taught

share but only to take and snatch becomes a sociopath. On many occasions, double

from

others

standard

lacks

to give and control

and

or the inconsistencies

shown by the parents in their behaviour, especially their children, may lead a child to sociopathy.

in dealing with The child may

encounter inconsistencies in the behaviour of one or the both parents.

At one time he may be punished for a particular behaviour but rewarded another time for the same. He may be scorned and disliked by one ofthe parents for a particular habit or act but appreciated by the other. In such circumstances the child does not learn to develop reliability and consistency of behaviour. With a defective super ego and lack of control he does not imbibe values and ideals. He is likely to suffer lack of judgement and insight leading to antisocial behaviour.

Environmental

factors outside the family

The consequences of defective family environment are further perpetuated and nourished in the environment outside the home. The neighbourhood, peer group and the antisocial climate in one’s community become a substitute for what is denied to a child at home and he learns what comes to him in the form of undesirable or sociopathic behaviour of his associates. Sometimes the availability of cheap literature, movies and mass media provide models of thrilling „and undesirable experiences to the youngsters in an already vitiated environment. Treatment : Sociopathy, besides being a legal problem, is a behavioural disorder and social problem. Hardened measures in the form of capital punishment, depriving them of the essential ‘eens tetas qe custody prisons do not show any vourable results. Proper medical and socio-psychological measures need to be taken fo problems $ T providing them reliefPyfrom their litats

aaa

them

into becoming

useful

members

of the

| trends. But drug administration can cause side

men ime not it asso dite c efesi if 3

reaction to drugs and situations must be P articula: T drug should i be contii nued only

185

`

SOCIOPATHY

and win the sociopath’s confidence as the latter does not trust him like ty authori of ntative represe another as considers the therapist

sociopaths Moreover, parents, teachers, policemen and jailors. insight. of lack and ent, judgem poor generally have a defective ego,

The They seldom feelthe need for a change in their life style. realisation of the usual therapeutic goals like establishing identifica-

tions with

emotional sociopaths.

acceptable

bonds

models,

with

developing

controls

is therefore

others

and

difficult

satisfying

with

the

be underThe treatment or reform of sociopaths can neither behaviour need they fact, In jails. in nor als hospit mental taken in modification with consistent self imposed discipline carried out in a

therapy controlled and well supervised special institutions. Behaviour of sociopaths. cation modifi iour behav in s result shows favourable ra? through the

One such measure has been following three steps :

suggested

by

Bandu

of reinforcement punishment for antisocial * Withdrawal behaviour. and * Modelling of desired behaviour by changing agents for cers reinfor or s reward of system d the use ofa grade

imitating such behaviour. incentives and rewards as the of material * Reduction increasingly brought under contis our behavi individual’s rol of self-administered symbolic rewards.

aths t¢ Evidently, the above approach aims to help the sociop control. al extern on dence depen ng reduci develop inner control by an imand ly steadi but slowly place takes iour behav in e The chang

Proved

sociopath serves as a model to other sociopaths by acting

as agent of change.

the _ The task of behaviour modification and supervision ofeffort and e patienc skill, great sociopaths in the institutions needs el. The the part of the therapist and other institution personn

On the therapist and nursing staff should be prepared to tolerate threats, abuse, ion, aggress d repeate ng behaviour involvi Sogiopath’s , fights with staff and public. negativistic behaviour, refusing Assaults The progress Medication, absconding, drunkenness and theiving.

in treatment can be judged from :

* the development of emotional interest in others; and

attachment or the sociopath’s

* by not committing criminal, social or moral offences.

It shouldbe remembered

that it is the stage by stage pro-

Speedy ress which is more fruitful in the treatment of sociopathy. , ng disaster in Progress exposes them to unmanagable stresses resulti

i he treatment is stopped when the patient is observed to react ably

© normal life situations and can support himself.

186

ABNORMAL PSYCNOLOGY

It has been found that the sociopaths in many cases abandon their customary mode of behaviour on reaching the age of forty even when no treatment is given. This is perhaps due to a decrease in the strength of instinctual biological drives, to the gaining of some insight into their own behaviour, and to the accumulated effect of social conditioning. They are then termed as “burned out sociopaths as they give up their undesirable mode of living and become better socialized. However, it is undesirable to wait for this

natural burning of antisocial designs through aging, for much damage

of the society may be caused by them before they burn out. Attempts should therefore be made for their early treatment and rehabilitation.

Summary

The terms sociopathy and psychopathy carry the same meaning. These are used for the antisocial behaviour of individuals who are

besically

unsocialized

and

whose

repeatedly into conflict with society. following characteristics.

behaviour

pattern

They are

brings

found to exhibit

them

the

1. Superficial charm and intelligence.

Lack of anxiety, shame or guilt.

Lack of control and false adventurism. Inability to profit from social rewards or punishment, Inadequate

social

adjustment and

improper

tionships. Hostility towards authorities and discipline, 7. Low frustration tolerance. 8. Early onset and long persistence of the behaviour,

social

rela-

anti-social

9. No genuine suicide attempts, 10. Deviant sex life and behaviou r.

11.

Using rationalization social behaviour,

and

projection

for defending

anti-

12. Absence of accepted symptoms of psyc hosis and neurosis. 13. Absence of ideals and goal of life. 14. Addiction to alcoho l and drugs. 15, Absence of judgement and insight.

_ „Etiology : There seems to be no Significant positive correl ation between sociopathy and defective heredity or biolo gical make up. Sociopathy is a behav

psychological maladjustment ioural Problem involving social and and, as a learned pattern of behaviour, is liable to be

caused by environmental factors inherent family, neighbourh in one’s ood, School, society or community. The child

187 SOCIOPATHY

or other our of his father, mother ongenial avi beh l cia iso ant the e The unc may imitat accepting it as a model. erty, broken or pov members of the family by of t oun acc on nt ironme relationships, ld and defective family env chi ent es, faulty par hom bed tur dis ly nal emotio needs may put a child and denial of the basic ironmental improper up-bringing, aviour. Thereafter, env dency by beh l cia iso ant of ck this ten on the tra perpetuate and nourish factors outside the family into learning sociopathic behaviour. encourging and luring him ourable results. measures show no fav therefore to be ve iti Pun ; ent atm Tre es need in io-psychological measur Proper medical or soc or depressant drugs may be used for relief in ant ps uls hel taken. Anti-conv sociopaths. It hy, bed behaviour of the the episodes of perturand reducing antisocial trends. Psychotherap h wit ive ect eff ch mu stablizing behaviour prove measures, does not sociopaths, under psychological r, modification of the our avi beh for ve we e should Ho sur s. mea ath s Thi sociop d ws favourable results. behaviour therapy sho and well supervised special institution instea d lle tro con a be taken in

al. of a jail or a mental hospit

REFERENCES

p. 224. Davison & Neele, op. cit., 1. DSM-II, p. 43, cited by nmugam, 0P- cit. pSha 2. Bandura, as cited by

15 CRIMINAL

BEHAVIOUR—DELINQUENCY AND CRIME

"THE TERMS sociopath or sociopathy in contrast wit h the legal base of the terms criminal or crime have Psy Psychiatric grounds. Whe reas all sociopaths genchological and criminal behaviour, it is erally exhibit minor) should be sociopath not essential that all criminals (adults or s. The following points mak tion between criminals and e a distincsociopaths: Criminals

1. Criminals usually sho w nor mal or extra-ordinary con cen

tration, 2. Criminal Offences are planned and well organised. 3.

Criminals

operate

Sociopaths

Foe 1, Sociopaths exhibit complete lack of concentration, 2. The offences are usu ally impulsive, offen Poorly carried

out.

under

a

3,

There is no evidence conscience peculiar to of a the mcon science selves and are loyal in sociopathic to each behaviour, Sociopaths eyen other, but not to societ y, by do not hesitate to steal whom they frequentl from y `fee] fellow patients, The Tejected. They may y may be be hostile observed to wander ene gee from wogrou xe man to woman, having I y, but maection societ many of nthe y ‘be e chiilldren and supportini g no to others. one, ; not eve even n ththemselves ves. , A crItimin is alnoe t essential for the 4 - Socii opaths are us ‘ all forms toof beh inadeq in ually i avi ou,!uate d quate in sa ade i all forms inof i behaviour. 5 Criminals exhi bit skill and 5 a te Age Sociopaths are ls a very Serious about th not | eir criminal Mittin: a crime, They ar behavi e Tuthless m aeoffencesaean Same dd ne Ir veen r leth aren

ES

O

CRIMINAL BEHAVIOUR—DELINQUENCY AND CRIME

189

Criminals Sociopaths nie i YE RO i their approach which is their work. They act with judge-

from their past experiences. They suffer from poor judge-

ment and keen insight. 6.

N

ment and lack insight.

Criminals have an affect; this means that they commit

6.

Sociopaths have shallowest affect.

an offence with a motive and frequently care for their family and children. They get upset and punish children if they commit crimes.

only the They show

no serious concern for their life partners, family or children. For them self is always great.

Delinquency and crime The terms ‘crime’ and ‘delinquency’ are legal ones and their Meaning varies from country to country and in the same country from one state to another. In India, any person of 21 years and above convicted by the court for violating the .provision of Indian Penal Code (IPC) and the Criminal Procedure Code (CPC) is a criminal. Of course, there are state laws which vary from State

to

state.

For example, in some states or part of a state liquor

Consumption, except for medical reasons, may be considered a crime, whereas in others it may not be so. Similarly, for legally labelling an individual in the age group. Seven to eighteen as delinquent, he must be convicted by the court

Violating the provisions of the Children’s Acts, the IPC and.

e

CPC, The individuals between 18 and 21 who violate of IPC and CPC are midway between criminals and are labelled ‘young’ or ‘youthful’ offenders. y the court, they are sent either to the institution lepending

on

Circumstances.

the

seriousness

or

nature

of

the provisions and deliquents After the trial or to prisons. crimes

their

and

The individuals below the age of seven—even although commit_ ting such offences as covered legally in the term delinquency—

are not labelled delinquents but are termed

problem children,

for-

it is felt that they are not mature enough to distinguish between:

the legal and the illegal or between right and wrong.

Delinquency Criminal

behaviour

Society of nation,

Children

and

is not

adolescents

or tendency

to commit

also.

individuals

crime

in any

only found among the adults, but minor These

are

known

as

Juvenile or young delinquents. (Juvenile delinquents, therefore, are criminal in age legally from seven to eighteen in our minor Country) and usually referred to as minors with major problems..

199

ABNORMAL PSYCHOLOGY

They violate the law of the land and commit offences like thefts. gambling, cheating, pick-pocketing, murder, robbery, dacoity, destruction of property, begging, kidnapping,

violence and assault, intoxication, vagrancy, abduction, and sexual offences. The term

‘juvenile dilinquent’ or ‘young delinquent’ means a child or yout {minor in age) who deviates seriously from the norms of his culture or society and commits offences such as murder and robbery or those that are strictly age related such age drinking liquor and sexual activities. Juvenile delinquency should, therefore, be considered a serious challenge to the well-being of the society. The young delinquents, if not the society.

handled

properly,

become a source of

concern for

‘Causes of deliquency 1. Hereditary factor: The early researches held heredit y Tesponsible for delinquency. The claim of heredit arians like Henry, Maudsle

y, Tredgold, and Dugdale that delinquency Was tested by William Healey, Cyril Burt, Conrad is inherited and Jones, Wingfield and Sandiford. They concluded that delinqu ency is not inherited and theref

ore it is unjustified to blame heredity for ‘delinquent behaviour, _ 2, Constitutional or Physiological factors: Defective constitution or glandular s;ystems were also thought to be the cause of delinquent behavio: ur. Udai Shank er observes that “poor health,

‘short or too big stature or some deformity which of inferiority, dispose one to More aggression give rise to feeling , as a compensatory

Teaction for his inadequacies,”2 Consequently, quent

this leads to delin-

behaviour. Apparently this alienation seems to be well founded but it is not so, for not much scientific evide nce has been reported 1n its support so far. However,

in some cases, it may be taken as one of the causes of delinquent behav iour. While earlier writers like Lombroso at the

most

important cause of delin-

ade mentality, Burt, Healey, Bronner, hat delinquents are mentally retarded. In

ship between intelligence and delinquency b ce is no guarantee for good behaviou r. ‘Often persons with superior intelligence have be:

*

anne

gence

may

lead

to delinquency

in one situation and may be a barrier to it in another situation. Penc e, low intelligence alone cannot be held responsible for delin quent aviour.

191

CRIMINAL BEHAVIOUR—DELINQUENCY AND CRIME

proved that _ 4, Environmental and social factors: It has beenuents do not Delinq n. reactio d learne a delinquent behaviour is but are ors inherit delinquent characters from their parents or ancest conditions. social and nment enviro enial made so by the uncong

ed: it is the Udai Shanker observes that “delinquency is not inherit ally a essenti is and Product of social and economic conditions ity. commun the and ual individ the n coefficient of the friction betwee nThe most important causes of antisocial behaviour are enviro unconthe re therefo is It mental and sociological in character.”* neighbourhood and geneial environment of the family, school,

uent behaviour of the society which should be blamed for the delinq situations. We shall such child ‘since he picks up delinquent traits in uent character delinq now see how environment is responsible for the ion . among minors format a. Home environment and delinquency

is a fertile ground A defective and deficient family environment r of fact, family matte a As y. quenc delin for the germination of ngs of various studies life and delinquency are closely related. Findie the following relationwher indicate that the family environment, y. ships or conditions prevail, is most susceptible to delinquenc is incomplete due to (i) Broken home—where the family ce. death, desertion, separation or divor

Gi) (iii)

Improper parental control. g the siblings or Unusual jealousy and rivalry amon like, “My parents s children within the family and reaction me.” gave him more love than they gave

(iv) (v)

(vi) (vii) (viii) (ix) (x)

The delinquent

or and criminal behaviour of the parents

other family members. Domestic conflicts. the family. Economic difficulties and proverty of environment. Dull, monotonous and uninteresting home endence to the Denial of reasonable freedgm and indep youngsters.

i

youngsters. Maltreatment and injustice done.to the security. Lack of proper physical-and emotional

In these situations and environment

the child does not get

of his basic needs. He becomes the opportunity for the satisfaction infer iority, insecurity, jealousy like ional problems

victim of the emot

maladjusted individual and or being thwarted which make himle,a rebellious- and antisocial hosti a consequently turn him into conditions deserve to be personality. Thus, uncongenial home all circumstances the root in blamed for juvenile delinquency and tigated in family backinves be cause of delinquent behaviour must ent. ronm envi home ground and

192

:

ABNORMAL PSYCHOLOGY

b. Uncongenial environment outside the home Whereas home provides the roots for the delinquent behaviour,

the social environment outside the home

some

substitute

for the satisfaction

nourishes

it by supplying

of unsatisfied basic needs and

urges. For example, the peer-group or gang presents itself as a substitute for family love and belongingness. It also satisfies the need ror recognition and gives an individual the opportunity for

self-dependence and adventurism. Delinquent acts of peer-group lead him to delinquent behaviour and engage in delinquent acts. Neighbour hood and the places

where

the elder members

of social

contracts

and

situations

of the society engage in antisocial activi-

ties, or the mass media like newspapers, books, magazines and cinema that acquaint children with immoral and anti social acts, provide temptation for the youngsters to become delinquents.

c. Maladjustment in school In many cases of delinquency, uncongenial can be a significant stimulating factor. It bring schco! environment s about serious maladjustment and consequently increases the Probability of delinquent character formation. Such environment may involve the following elements: * Defective curriculum. * Improper teaching methods. * Lack of cocurricular activiti es. * Lack of proper discipline and control. * Slackness in administration and organisation. * Antisocial or undesirable beh aviour of the teachers. * Maltre

atment and injustice done to the child,

* Failure or backwardness ,

._

10 conclude, delinquency is an envi ronmental Delinquent acts

disease.

Pormal

;

are learned and acquired acts.

chldr

against parents,

they al

ioral

d

Tmal

needs

a nd

eaction

I

4

i . desires

and

They are i Like other

or resentment

iti

social

No child is

against

It is a revolt

chers or social Organi ions whi Provide them theteaesse ch do not ntial environment sat for the satisfaction of their basic needs and urges. Prevention and treatment Delinquency, besides bein l i psycho-social problem. All d eliE a lega i nquentsga areprob basi call esslem, entialis ly mal adj usty eda

CRIMINAL BEHAVIOUR—DELINQUENCY AND CRIME

193

maltreatment. personalities and the result of faulty up-bringing and and curative tive The solution of the problem requires preven measures.

Preventive measures nmental Initially these involve improvement of the social or enviro of the needs basic the of ction conditions which thwart the satisfa in well work may tions sugges ing follow Some of the individual. this direction. should be aware of the Parents 1. Parental education: can treat and handle their they psychology of delinquency so that an environment for the them e provid and ing children with understand It requires parental urges. satisfaction of their basic needs and ce services, clinics guidan gh throu education which may be provided s. service social and voluntary

Farents, family members and school 2. The child’s company: the activities and social authorities should keep a close watch on so that they do not fall care take and n environment of the childre out Antisocial elements and criminals often seek in bad company. save to made be should ts Attemp youngsters for their own purpose. in keeping away the children from them and they should be educated from such elements.

3.

Substitute environment:

It is difficult to bring a change in

influences of the neighbourthe defective family environment or the ces children should be mstan In such circu hood and peer group. placed either in foster and t onmen envir removed from their original they

and special schools so that homes or well-managed reformatories onmen t for their emotional and envir y be provided with health may

social adjustment. School environment: 4. Rectifying school education and um, icul curr The nial. environment should be healthy and conge er teach the of r viou beha om s-ro methods of teaching, discipline, clas so fied ol. should be recti and the social atmosphere of the scho l socia and l iona emot in es that children do not involve themselvof their se impo who ers teach ude attit maladjustment problems. The basic needs should authority on children and do not understand their should be familiar ers teach the be changed. The headmaster as well as

delinquency. with the- psychology of individual difference and Curative measures

d not be regarded The problem of juvenile delinquency shoul problem. Juvenile re welfa as panel problem. It is an educational and ed through the treat and bars d behin delinquents should not be put

ucation Delinquents require rehabilitation and re-eddealings panel system. legal The made. be d for which special legal provisions shoul changed inthe progressive with the juvenile delinquents have been g Person’s Act” communities of the world. The “Children’s and Youn

194

ABNORMAL PSYCHOLOGY

of U.K. can be adopted with some modif ications in our country. Its essential features are as follows: (i) Establishment of special juvenile court magistrate to deal with the juvenile delinq s with trained uents. Gi) Appointment of trained social workers or probation officers for taking charge of delin quent cases.

(iii) Taking help from clinical Psych ologists and _pychiatrists for understanding the delinquent behaviour of children.

(iv)

Establishment of special scho ols where the education, correction and rehabilitation is Possible, (v) Provision of Keeping the children in the cus tody of responsible persons or soci al agencies,

(vi)

Est

ablishment of remand hom ents are placed while the es where juvenile delinquy wait for their trial approved school Placem ent or for being given or for to the

approved schools. The provision of ‘special schools’ or ‘approved Special mention in this These scho trained staff. The curricProgramme. ulum is flexible and pro for self expression, rec v. rea tion, manual

em

schools’

work and

|

of delinquency

child welfare have

stence.

and rehabilitati on. Crime

needs

been

Some

d fora I ange in our attitude nei ee

Crime may be defi ned as an act proh ibited by law of a country

QUENCY CRIMINAL BEHAVIOUR—DELIN

AND CRIME

195

perform an act part of an individual to or state or a failure on the . Ina legal sense, person of 21 years that is prescribed by that lawcourt of law for violating the provision’ the illegal and above convicted by the a criminal in our country and of IPC and CPC is labelled ted is known as crime. Any behaviour

vic act for which he is con ng, burglary, robbery, theft, dacoity, bli like pickpocketing, gam suicide, murder, riots, abduction, attempts at , cheating, rape, kidnapping and sexual assault, prostitution are termed ty, per pro r’s the ano g yin destro enue etc., to deposit taxes and rev counterfeiting, failure

criminal behaviour.

ime Causes underlying cr

become a criminial for a delinquent to Although it is not essent me has been found to show a history ult cri al yet, in many cases, -ad Both delinquency and crime have a similar cy. of aggression of juvenile delinquen que reaction pattern uni by d ize ter rac are therefore tendency cha causes underlying crimes The . -up set ial soc the „against inquency. similar to those of del and intelligence, like- defective heredity , have not been s tor fac l ica log bio The turbances e-up Or glandulat dis poor constitutional mak stantial role in the causation of criminal

been to play any sub n has almost t a criminal is bor tha w tors vie fac l The nta . nme our iro behavi l env the socio-psychologica an individual. discarded in favour of in the criminal tendency being responsible for may have t criminal behaviour ge from an tha ed erv obs be It should ty. It may ran and degree of severi e-time to alife style of a variety of forms lif a in id once

found

te log offence which is commitnce the pathology involving socio-psycho al. He min cri . to our and criminal criminal behavi by a from crime to crime cal causes also varies is not necessarily generated and developed aviour

A criminal beh s. single factor OF factor maladjustment the victims of social and unfavourays alw are als min The cri conditions be ective environmental these situations may arising out of the def of me So . life of s nce sta able circum ow: summarized as bel fessional 1. Learned as a pro act or nal sio fes pro any e lik learned the or s ent par haircutting from the of ion uat pet per nity or race. The

our may be art; Criminal behavi work, or art like tailoring, wood commu, ily fam members of the behaviour a particular criminal certain

among theft, or bootlegging , ion tut sti pro ry, like burgla examples. es are some other tribes, castes or rac The uncongeniive family environment: 2. The impact of defect formation. It is ter minal charac cri to es but tri con nt , divorcee, separaal home environme homes through desertion ken ive bro of ult res the often Moreover, the defect or both parents. ilial fam raint ble ura tion or the death of one avo by unf and

deficient

environment

created

parental tensions and conflicts, lax

rivalries, control, poverty, sibling

196

ABNORMAL PSYCHOLOGY

is insufficient to fulfil t he ; basic physiologigical ar i cal and mia PEAP of children in the family. 23 order fo grati fy Boei pea l pres} and emotional DN needs they sical, on to the path of crime. al members of the fami ily but adults alsop bag a EAT of criminals on account of ac the — ee om tions e e family environment donshipn, and unhealthy ne 2a For example,

sex frustration may lea oe — to prosm éeaity > prostitution or even causing murder, rape or o similar offence. b. ore,omicicomfac toriti s: :on Poverty, unemp pet ment, 5 to earn money loy by any desire forr the A

ERT

i

4.

all contribute

behaviour.

an

means, evils af

individual

Degradation of mora l

degradation of mora l eharacter formation.

5.

in pushing

towar:

values: Th values in the societe crisis of character and Crimes such as the y also cause criminal-

Environmen

t outside the environment an d circumstances Jamily: Whereas defective provide the home ironment Outs basic causes for criminal ide the home nourishes needs and ch e gratification erished goals. of unsatisfied i Neigh criminal charac are Opportunit community, places te ies for mixing world of crime, rs attract and even push with th e he individuals un healthy impact cheap liiteterature, o in to the of th e mass Media, bscene Pictures, age individuals especially Ph towards crim ot og ra ph s and films e. encour6. Social Sy stem and deni system and al of trad justice: The learns crimin itions lead to Circum defective soci stances Wh a behaviou al ere r, Na

nce of men For example, an in the Social the dowry Sy individual set up, the st stem, domiatus of a wi OW, give rise © to gu lf betwee S,

hatred

i dless farmers relationships an d crimes,

towards

n

th

Other commun e rich ities,

by landlords » the exploita of Often lead a p tote Strained

7. Mental il crimes are Committe lness ang abnormal State d by the Mentally o state of mi ill pe ff minmind:as S imes nd. The co Smeiin es

of the neurotic s

mpulsive

be

viours lead to crime. and abnormal behaviouha ke r Of the seli epto nia Si mi xual dekl la rl y, viantsmama i sane may Ps ally in yc ho ti c y in di vi commita d ua ls classified r; y y of variyaet situation and the st as offences de Pe criminate of thei T min nding d, Under th e influenc upon the e of liquo r

CRIMINAL BEHAVIOUR—DELINQUENCY

AND CRIME

197

and drugs, offences are committed not by the professional criminals ər socially and emotionally maladjusted individuals but by normal people. Individuals suffering from senile brain degeneration and mental deficiency may also be found

responsible

committed in an abnormal state consequences of their behaviour.

of

of certain offences

mind without realizing the

Prevention and treatment

The remedy

for criminal behaviour

demands preventive and

curative measures, Peevention: The preventive measures involve improvement of social factors and environmental conditions that are responsible for the germination and perpetuation of criminal behaviour. The problem is a gigantic one and needs the cooperation of parents, members of the family, neighbourhood, community, school or college

authorities, religious heads, police and government officials responsible for the social and psychological environment of the inhabitants of a society, The following measures may be fruitful in the Prevention task: 1. Since today’s delinquents are tomorrow’s criminals, maximum efforts should therefore be made for the prevention, control and treatment of all the identified delinquents.

2. There is a great need for social reforms and breaking social and caste barriers. 3. The task of narrowing the gulf between the rich and the Poor, linguistic groups and religious sects should be given priority.

4. The importance of moral values should be inculcated. There should be an end to thecrisis of character threatening the existence of the moral base and legal codes of our society. 5. The system of education and national planning rethinking and re-modification of our youth and adults.

for minimising

economic

need

difficulties

6. The problem fo unemployment has to be checked and the professional dissatisfaction as well as frustration affecting the vast population of the younger generation should be curbed. 7. Attempts should be made to minimize undesirable influence of literature, films and other mass media.

8. The parents, elders, government authorities, social, religious, educational and political leaders should be such that they be-

come ideals of socially desirable behaviour. 9.

The society should

feel the necessity of providing

social

and legal justice to its citizens. In case of environmental deprivations

and hazards of life, the affected individual should be helped, Protected and rehabilitated. _ Thus there is a need for modifying the environmental conditions so that

one

does

not

fall victim

to social

and

emotional

ABNORMAL PSYCHOLOGY

198 maladjustment or lured by the criminals behaviour to commit crimes.

and

drifted

by instinctive

Treatment and rehabilitation: The old notion that a criminal is born and nothing can be done for reforming and rehabilitating him still holds its ground. The law enforcement is still _largely punitive and revengeful. Even in many civilized societies and developed countries the treatment meted out to criminals is ‘Still in

terms of tooth for tooth and eye for eye. The criminals are isolated from society, kept in prisons and punishments such as lashing, severing of hands and legs, hanging are given in public not to deter the criminal from further offences but also to prevent others from indulging in such acts. However, as a result of an increase in the

knowledge of human behaviour and criminal psychology, there have been changes in the attitude of the general public, police officials and government authorities towards criminals and crime. It is now felt

that for most criminals, their behaviour is a part ofthe larger pattern of personality maladjustment. Criminal behaviour is nothing but a social disease and criminals are ill primarily in terms of their

inability to conform to the social milieu. With serious psychological and psychiatric problems, they need hospitalization, medical and Psychological treatment as curative measures for their illness.

The change in attitude has ushered a new era in the management of jails which are now called correctional institutions. The Progressive prison authorities are now adopting a construc tive attitude towards criminals. In addition to the custodial care, the responsibilities in terms of the possible attempts to resocialize, readjust and rehabilitate the criminals are clearly felt. The emphasis is on the study of each prisoner as an individual, as a victim of circumstances and to provide him the medical aid and psycholo gical treatment, training and help needed for his restorat ion to society as a self-supporting and law-abiding citizen. The effectiveness of the curative and reformatory measures lies in modifyi ng the behaviour of a criminal and equipping him with the necessary art and skill for playing a useful role in the societ y. Some of the measures used in this new constructive reformatory approach are:

' 1. The crimes committe: also by the relatively normal adults durin g and deprivation have very lit

periods

of acute

stress

a life criminal. Attempts p them out of pris ons by granting ‘probation and making provisions for their adequat € supervision by competent probation officers. 2.

The constructive a Pproach calls for change C in the environand tre: atment of prisoners asA human bein gs in

ment of the prison

CRIMINAL BEHAVIOUR—DELINQUENCY

need of sympathy problems.

and

affection

199

AND CRIMB

in understanding their behavioural

3. Many countries are now experimenting with open prisons which do not have fence or outer walls and their dormitories are neither locked nor guarded. There are open fields with situations

where prisoners are provided opportunities to work for which they are

paid. Their expenses are met out of their earnings which are partly sent to their families. Occasionally, they too are sent to meet their

families. There is an environment of mutual love, understanding and

trust prevailing in the prison providing sufficient opportunities for the

modification

of their behaviour.

They are made

to learn useful

social skills and readjustment in the society. 4. The ideal humanitarian approach that all prisons should be converted into hospitals—the criminals are usually mentally ill, socially maladjusted and psychologically handicapped individuals— Efforts are also being is taking root in prisons of many countries. gate its causes, and to investi to ur, behavio l crimina made to study

find ways modifying it. The cooperation

trist, social worker,

of the physician,

psychia-

legal authorities is well sought by prison autho-

ities for the treatment of abnormal and inmates.

antisocial

behaviour of the

ammes are 5. In some countries useful rehabilitation progr y, the countr our In ls. crimina of e welfar the being adopted for aya Sarvod by valley al rehabilitation of the dacoits of the Chamb

leaders may be cited as a good attempt in providing life. for leading a self-supporting and law-abiding

opportunities

Summary

criminal or crime has Criminal behaviour involving the terms psychiatric grounds cal and ologi a legal base in contrast to the psych . pathy socio of the terms sociopath or ling. legal The violation of the law of the land and commit exhibits who person the and iour behav al offences is termed crimin comare es offenc such such behaviour is termed a criminal. When to seven from sense legal n age—i in minor Mitted by individuals, and not uents delinq d terme are, ey ry—th count our in eighteen years delinquency. criminals, and their criminal behaviour is known as

and unCauses of delinquency are inherent in one’s defective l condinmenta Congenial home, family and other socio-cultural enviro ors. fact al ogic tions instead of hereditary or biol

provided by While the causes for the delinquent behaviour are envir onment social the t, onmen envir family uncongenial home and outside the home nourishes it by supplying substitute for the satisfac-

tion of unfulfilled desires and needs.

Prevention and treatment : Delinquency is not so much a legal Problem as it is a psycho-social problem arising out of the faulty

200

ABNORMAL PSYCHOLOGY

upbringing and maltreatment of the youngsters. The solution séquires preventive and curative measures. Preventive measures aim at improving the social or environmental conditions and may involve parental education, protecti ng the child from bad

company and

antisocial environment,

providing substitute for the defective environment and rectifying the school education and environment. Curative measures aim at rehabilitation and reeducation of the

delinquents by government or voluntary

organisations.

Delinquency, instead of a panel problem, should be treated as a socio-psychological problem. It Tequires a change in attitude towards delinquents and delinquency. A change taking place in our country consists in the provision of Children Act, reforrmatories, approved schools, foster-care programmes and remand hom es, on the pattern of other developed countries.

Criminals are always the victims of social maladjustment arising out of the defective environmental Criminal beha-

Prevention : The preventive mea sures involve the improveme of Social and environmental nt conditions that are responsi ble for the germination and perpetuation of the criminal behaviour, a change

in outlook

The basic requirement demands and attitudes towards criminal s and crimes so h hospitalization, medical and

Psychiatr sympathetically, Studied indic probl ividual] y, treated medicall gically, trained a nd hel y and Psycholoped educat

finally, rehabilit ated citizens,

1. 2.

to become

io nally as well as

self-supporting

vocationally,

and

and

law-abiding

REFERENCES Udai Shanker, Proble m Children, Delhi, Atm a Ram & Sons, Udai Shanker, loc, cit. , p. 30,

1958, i

p. 30. aa

16 ALCOHOLISM

AND

ADDICTION

DRUG

ALconotism and drug addiction have been a source of serious behavioural problems for thousands of years in the world. Excessive indulgence in them has been considered undesirable or criminal behaviour. From time to time in almost all the countries the law of the land has been given teeth for dealing with this Menace but alcoholism and drug addiction are not so much the law Recent studies have established that these are and order problems. psychological and social problems than anyic, More ofa psychiatr and thing else which ruin the individual and the society emotially

economically. Alcoholism

Alcoholism is usually referred to excessive drinking or depenfor many people drink which beverages. dence on alcoholic should not They styles. and ons situati Teasons and in many ways, (WHO) ation Organis Health World The cs. all be considered alcoholi on ence depend whose s drinker ive “excess as ics alcohol defined has mental ble noticea show they that alcohol has attained such a degree and bodily

disturbance or an interference with their

mental

functioning, or who show the prodromal €velopments.”?

(beginning)

their interpersonal relations and their smooth

and

social

signs

health,

economic

of such

The habit of alcoholism

The

habit

of excessive

drinking

‘dependence

on alcoholic

beverages is perpetuated gradually. E.M. Jellinek (1971), an authoTity on alcoholism has pointed out the following four stages in the

evelopment of alcoholism. 1. Pre-alcoholic

phase:

This

initial

phase

lasts from

two

Months to two years. The beginner who drinks for social reasons or Merely on account of curiosity finds that it relieves him of anxiety

and tension and as a result learns to use alcohol as a relief measure.

Gradually, he begins tp experience an increased tolerance for alcoho! and needs a large amount to reach the same stage of sedation.

202

ABNORMAL PSYCHOLOGY

This phase is characterized by a gradual light to frequent or heavy drinking. Prodromal phase: At this stage

shift from

infrequent

or

alcohol begins to be used more as a drug and less as a beverage with dependency on it increasing and manifested through the following behavioural phenomena :

* The individual becomes preoccupied with drink ing, worrying where and when he will have his next drink. * He feels guilty about drinking and usually avoids references to alcohol in conversations. At the same time he feels a strong urge to drink and thereby often resorts to surrep titious rather than open drinking.

* Thereis a Sudden onset periods of drinking.

of

‘blackouts’

for some

of the

* There is considerable memory impa irment. One may remain conscious at the time of drinking but later unable to recall the events. $ 3. The crucial phase : The The dependency on alcohol increases to third stage is alarming. of an individual losing everything the extent that there is a danger that one values.

and peace.

r makes him hostile ad environment completely ruin ing his harmony

to consume any liquid con

tonic, spirit or a medical taining alcohol preparation. He loses con behavi trol upon his li our and¢ proprlon ged bouts of intoxic o ‘ation often lead to marked ethical deterioration (charact personal appearance and con er disorders), complete neglect of cer for otthers, impairment Processes and even alcoholic ps; nycho mental ses in some cases. Inofcomp ari-

tolerance for alcohol

usually when even E

defeat and unless he receives

results- in the loss of a small amount leads to » the alcoholic admits

treatment is unlikely to give up

203

ALCOHOLISM AND DRUG ADDICTION

The effects of alcoholism urbances of physiological, Alcoholism may result in severe dist below : as given psychological and social functions of Almost every tissue and organ 1. Physiological damage: ly large c holi alcohol. Since an alco the body is adversely affected by diet. ce of food, he neglects his sour r majo a as A es. depends upon alcohol ienci defic nal itfo nutr and min vita . Consequently, he suffers from of liver the of osis cirrh protein causes drastic reduction in the intake ds glan e crin endo the ge dama can Prolonged consumption of alcohol ammation of

, shrinking and infl or cause heart failure, hypertension llary haemorrhage. It can also capi and the lining of the stomach,over all resistance to disease as a result of lead to the lowering of ced. an alcoholic is considerably redu on r which the life expectancy of occu may cs holi of alco case The incidence of death in the suicide; to ing lead on essi depr of account

especially from

respiratory

intercurrent

infection,

and injections: liver or cardiac failure;

inhalation of vomitus.

This damage may result in : 2. Psycho-physiological damage tic disorders (brain syndromes) psycho lic a number of neurological and ion, delirium tremens, alcoho cat oxi int cal ogi hol pat me. such as dro syn f’s Kof sa n and Kor

hallucinosis, alcoholic deterioratio deterioAlcoholism can cause severectioning. age: fun _ 3. Behavioural damces tual llec inte age dam and ration in the thought pro ses out’ causing lead an individual to ‘black Sufficient intoxication may he said or did. inability to remember what account of the is adversely affected on Motor behaviour the power and ech rdination, balance, spe deterioration in motor coo

of sensation and perception.

There ity or character disorders. It may cause severe personal personal habits, a lack of regard

n of is likely to be a deterioratiomag e and self respect. f-i sel e, anc appear

Following release for one’s emotional and of t of judgement, loss of inhibitions, impairmen erence to self iff ind and n bance in self evaluatio s irresponsiard motor control, distur tow lics easily drift Caused by intoxication, alcoho

. ble behaviour and anti-social acts

of an indivicts the sex behaviour Intoxication adversely affe incapacity ual Sex family.

rest in the dual who is likely to lose inte her deteriorate the situation. Frustrafurt may m moral judgecaused by alcoholis defective intellectual and i tion, lack of inhibitionsualanddeviations and crimes. ment may result in sex age

l dam chological and physiologica Thus alcoholism causes psy ulable personal and social loss. ulting in incalc uences are toan individualdireressoci al, occupational and family conseq sical or s lic oho For alc phy of ms ter ruined in inevitable. They are likely to be relationships and economic atiloss al soci and nal tio mental health, emo misery and frustr on

ds one to and moral degradation. Itfamlea and society. ily the m and alienates him fro

š

204

ABNORMAL PSYCHOLOGY

The causes of alcoholism

Since no person is born alcoholic, the causes of alcoho therefore to be found within the environment of an individ lism are The beginning of the drinking habit and later its Continuation ual. isa learned pattern of maladaptive behaviour. Drinking is learned and

acquired like other personality traits and later maintained for its physiological and psychological dependence, One learns many things from the envir onment. The behaviour patterns of the elder members of the famil y and the society work asa model for the younger ones. Ther efor e the first drink may be taken in a social gathering with other members or secretly without the knowledge of the elders. The child or a yout h may be ccount of the curiosity or for n the form of stories, fiction and the observed behaviour of the paren ts and

me

sa learned response to develop of isolation and loneliness; to pleasure; to boost one’s ego, courageous by acquiring feel ings of

adequacy;tọ seek relief from tension

i

i

without feeling guilty; and to incr and for acquiring a feeling of sexual adequacy. j y as a result of its rewarding effect. As a sedative alcohol i

i

i

t reality. Gradually, it lead s to ing in psysiological, psycho _ _Once an individua l becomes drinking become: 1

he

nausea, S to gi easing

P drinking and this xi him to drink still :Consequently, more Physiolo gical dependen ce compels Treatment of alcoholism

There is no sin t r alcoholism. In some cases individual, he vih tie problem of because of the fear of: being arrested and i i lism is in fact a medical and Psychologicaal son ed. prob lem ratBut her alc thaoho n -a

ALCOHOLISM

AND DRUG

205

ADDICTION

law and order problem.

Attempts

should

therefore

be made

to

tackle it on medical, social and psychological levels. While resorting to treatment one should havea clear knowledge of the early symptoms of alcoholism. These may include continuous and heavy drinking or uncontrolled episodic bursts of drinking; morning drinking; blackouts; gaining no pleasure in

drinking;

and

undesirable,

uncontrolled

extreme

behaviour.

It is

then time to take corrective nreasures given below:

l.

It is better to

hospitalization:

and

Institutionalization

arrange institutionalization and hospitalization for the treatment of In many cases, acute alcoholic intoxication. compulsory hospitalization

is not

needed,

but it is

important

to

keep

the

alcoholics away from aversive life situations and keep their behaviour under control.

2. full blood

It should include investigations like

Clinical investigation: count,

chest

and

skull

radiography,

liver function tests

and asa result proper medical treatment should be provided for the dificiency and damage.

3. Deintoxication:

The first step in treating alcoholics

is

deintoxication, that is, removal of alcoholic substances from the At this stage much body and treatment of withdrawal symptoms. care should be taken to compensate the alcoholic’s dietary deficien-

cies. 4.

Deterrent

deterrent measures

measures: in the form

After

deintoxication

the following

therapy are

of aversion

commonly

used for restraining the patient from drinking. The patient may be given drugs like disulfiram (Antabuse) or citrated calcium carbimide (Abstem) for helping him resolve not to drink. These drugs cause episode of intense illness if the individual drinks alcohol and thereby act as strong deterrents in preventing drinking. In making the patient develop a hatred for alcohol a substance which produces nausea and vomiting when taken with an alcoholic

drink is given. With repetition, it results in a to alcoholic drinks. Shock therapy may

cause aversion for liquor.

also

be used

as

an

conditioned

aversion

effective measure

to

Sometimes the shocks received from the

adverse life situations may prove valuable in treating alcoholics.

5. he may

Psychotherapy: When the patient has stopped drinking, be given group or individual psychotherapy for helping him

gain insight into his behaviour. and develop more effective adjustMent techniques other than alcohol or drug addiction. However, its use is not recommended with alcoholics who are basically sociopathic. A therapist has to work hard with alcoholics. The chronic alcoholics are usually liars and unable to keep their promises of never

ABNORMAL PSYCHOLOGY

206 inki

in.

Fruitful

results can

be achieved

by making

the

id Sigh or learn that a life without alcohol can be more satisfying than a life completely submerged init. In every case the basic

personality must be evaluated with the reactive events leading the

drinking and the pattern of alcoholic behaviour.

support from families ard whether the employment or

The

up to

amount of

work

is still

open to them require investigation.

6.

Sociotherapy:

This

treatment

involves

the modification

of environmental situations, change in attitude, and the provision of healthy social gatherings and groups. It is directed towards counselling the patient’s wife or family and helping him make a readjustment in the family and community setting. To heal their social contacts in the form of a religious gathering, social clubs emphasizing inspirational and spiritual elements may also prove

useful in the treatment of alcoholics. The staging of plays, cultural programmes, showing of movies emphasizing the ill effects of alcoholism and the tranquillity of life may also prove valuable.

Religious gatherings purify the path of an individual.

He may

be helped by the Almighty or religious ideas, certainly a power greater than himself, for admitting his mistakes, controlling his

drinking with the provision of emotional support. The participation in the social groups like Alcoholic Anonymous (a group composed of people who have given up drinking) may also prove useful for alcoholics to enjoy social fellowships to gain insight into their behaviour and overcome their addiction. 7. Duration of treatment and follow-up: The duration of treatment in the case of alcoholics depends largely on the severity of the case. If they remain away from alcho hol for five years, they can .usualy be regarded as cured. But there are many chances and incidences for relapse which is frequ ent in the first two years. Great care should thus be taken in follo w up when treatment is over. Drug addiction _ Drug addiction, like alcoholism, individual, and the society.

is also

detrimental

to the

With prolonged habituates to the particular drug so that larger to maintain similar intoxicating effects,

dual develops an increasing physiological dence: on them to: the nt els i miserable whenever particular drug is not

a

207

ALCOHOLISM AND DRUG ADDICTION

for a particular drug which he tries to gratify regardless of conseWhen this happens, the individual is said to be addicted quences. y

to a particular drug.

This drug addiction is a state of acute intoxication, detrimental

and to the individual and to society, produced by the prolonged rized by excessive use of a drug, natural or synthetic, and characte or consume it to obtain (a) ar intense craving Or compulsion the dosage increase to tendency a (b) ences; consequ regardless of

nce on the with time; (c) physiological and psychological depende withdrawal ar particul of ation effects of the drug; and (d) manifest symptoms

on abrupt discontinuation of the drug.

Drugs—types and effects Depending upon the nature of their

effects, drugs

may be

g). classified as stimulant, sedative and deliriant (mind blowin

1.

Stimulant

drugs:

These

drugs

stimulate

the

brain

and

in sympathetic nervous system resulting in alertness and increase y categor this of drugs major response and motor activity. The ne, are nicotine, cocaine, caffeine, and amphetamines like benzedi dexedrine and methedrine.

ual depenThe addiction to stimulant drugs makes an individ ing doses increas ever its on lly, logica psycho dent, physiologically and long runit the In organs. sense of ation stimul uous contin for the pation, increased results in severe loss Of appetite and weight, consti ment of inimpair l gradua ation, depriv sleep lity, irritabi and y anxiet m. deliriu of es episod c tellectual functioning and periodi

ies of an or2. Sedative drugs: These drugs slow down the activit us system. nervo and brain the of nse respo the ganism and diminish may

sleep inducers and As a result they are used as pain relievers and narcotic drugs be classified as narcotics and hypnotics. The majorand methadrone. ol demer e, codein , are opium, morphine, heroin tal, hypnotic drugs include barbiturates like amytal, nembu and l chlora e dehyd paral and des, bromi like s urate arbit seconal, and non-b

hydrate. increasing tolerThe prolonged use of sedative drugs leads alto cravin g for them. logic pycho as well as l ance and physiologica pain and from relief The immediate effects are pleasant and therebyis euphoria. But these wed follo ents lessening of voluntary movem a negative phase of craveffects are short-lived and are followed by

ill effects. ing for more of the drug and the consequent

of appetite and The addiction to narcotics results in loss social interests. and e desir sexual of lack on, weight, constipati hypnotics other and es turat barbi to tion addic the ics, Unlike narcot

primarily affects the brain resulting in intellectual disturbance of the motor functions

The

Withdrawal

sudden

impairment and

dependent on the cerebellum.

withdrawal of sedative drugs results in dangerous

symptoms

like

restlessness,

nervousness,

excessive

208

ABNO RMAL PSYCHOLOGY

perspiration, nausea, vomiting, diarrhoea, severe headache, marked tremors, cardio-vascular collapse | and painful muscular cramps.

In the case of hypnotics the

epileptic

seizures and delirium.

withdrawal

Teactions may

If not treated in time,

lead to

the seizures

can cause death. Tranquillizers like meprobamate also result in addiction and have the same results as with most of the sedatives.

3. Deliriant or mind-blowing drugs: These drugs produce transient states resembling psychoses resulting in marked confusion,

distortion in thought processes, delirium, illusions and hallucinations .

Marijuana produces a euphoric state involving increased self confidence and a pleasant feeling of relaxation characterized by floating imagination. There is a considerable distortion of the sense of time and space. In some cases the individual becomes irritable. There is a marked impairment in the motor and intellectual functioning but the users usually thinks that their efficiency has increased. This false sense of adequacy gives rise to incidents of reckless driving and other antisocial episodes. In many individuals the intoxictation of marijuana may produce acute Psychotic reactions as found with hallucinogenic drugs

.

of well-being a

d dependence, Anothe r dru g of this category 1 oe ine reed) taken in thewhich is most abused is i methform of intravenous inj 1 turban dis ged ce use ection. oP ofthe this ‘oe drug g resultsį in malnutrititi ion, brain i dam age, 2 thythm, and a $ i parano

id unpredictable behaviour,

nd

a

dangerous

impulsive,

Causes of drug addiction

The behaviour is reinforce alse impression of adequacy d and rew. d and well- tei fonng, tem he porme ary reliefar fro aie m

209

ALCOHOLISM AND DRUG ADDICTION

state of anxiety, pleasant reverie, and short-lived pleasing effects or are doses larger and larger ly, euphoria created by the drug. Gradual ogically physiol nt, depende s become one and results same needed for what begins as well as psychologically, on a particular drug. Thus . disaster in ends ent experim ous as an innocu factor in turning an According to experts, stress is a great r titive, success compe y highl individual into a drug addict. The

oriented

number style of living today creates many odds for a large ion in iorat deter is crisis of character and

of young people. There life and values of the elders are meanvalues. While the aims of rare. The educas, the job opportunities for the youth are

ingles itions and taboos. All tion serves no purpose and there are inhibtries to seek instant relief this leads one to stress situations. One by resorting to

and depression from frustration, tension, anxieties elves from their inhibitions, thems free to Others use drugs drugs. shame, anxiety or disguilt, of se to drugs becau

and some turn appointment in life. ction Prevention and treatment of addi r problem as is imagined in Drug addiction is not a law and orde social and psychological problem. certain circles. It is predominantlyd a from criminals who supply them Addicts should be distinguishe y of addicts is that

The iron With drugs and live off their misery. pathological craving so powerof nt exte the they depend on drugs to drug regardless of legal or the they try and manage to get

ful that Other obstacles.

the treatThe following measures prove fruitful in

Ment of drug addicts. 1.

Compulsory

hospitalization: Compulsory

tion and hospitalization

_institutionaliza-

of drug é e in the treatment is a maj jor step effecs seek ily the patient voluntar

If the doctor waits until

g addicts wait until the patient dies.r Dru tive treatment, he may wellthey roundings sor thei in and s drug want addicts.

not want treatment, s. The admission in and environment they can’t be deprived of drug or risks: maj g owin the foll

do

that

Gi)

can

neither under-

harder drugs or mixed The tendency to go on todisaster. d effect may lead to

drugs to

get the desire

ient on account ling himself by thee pat is a risk of kilcom Thelre ove n profoundly whe Gii)identa cid g sui tin mit rdose OT of an acc cts of drug. under the intoxicating effe depressed or a misadventure plications of infection or other com ger dan a is re The (iv) the body by the individual.

When he drug is injected in

Attempts should drying-out the patient: be achieved 2. Deintoxicating or may It t. out the patien be made to deintoxicate or dry

210

ABNORMAL PSYCHOLOGY

through (i)i the {i‘cold turkey i procedure, that is, i sudden total | discondisce o ay drugs; (ii) giving the patient progressively diminishing doses of drug leading towards complete cessation; and (iii) substituting a less addictive drug and later seeking gradual reduction of intake. 3. Medical measures: With some patients, specially psychotic

addicts, ECT or tranquilizing drugs may prove quite helpful . Adequate care is to be taken for the Provision of antibio tics as there is an inherent danger of possible infection. The withdrawal reactions

should

also

be controlled

as

they

lead

to physical or mental disaster. Adequate dietary measures in the form of glucose and vitamins are to be ascertained for compensating the drug deficiency and also adequate feeding and fluids should be ensured.

4. Psychological treatment:

addicts needs sociotherapy

problems drug.

and

patience and

is essential

time.

Psychological

Long

if the patient

seek adjustment

‘

range

treatment

of drug

psychotherapy and

is to learn

to face

his

in the society without the use of the

5. Long-term therapy and rehabilitation: The long-term therapy is also essential. It may be achieved as follows: (i) Re-personalization: The drug addicts should be helped to form a proper relationship with thera pists, doctors and nurses before they can re-establish any personal identity. (ii) Specific therapy: Wit should be well guarded against hdrawal reactions a nd complications with the hel p of specific drugs, example, epileptics may For need anti- convulsants or schizophrenics may need phenothiazines. (iii) Re-socialization: The dru g addicts must lear and adjust without the n to socialize aid of drugs. (iv) Re-occupation: Once cured, the drug add helped in seeking icts should be employment and occupational They need to be tra adjustment. ined in the job skill and in Persistence so that they may be accepted by their employers. , (v) ReF housing: They shon uld be helped in gettin family adjustment and i g adequate re-establish themselves by learni date and fend for themse ie lves, PAE Se ered

ading to frustrations, tensions

211

ALCOHOLISM AND DRUG ADDICTION

and anxieties among the youth. Job opportunities have to be increased and the education system reshaped to include job-oriented and youth employment-based courses. The energies of students and and creative projects like should be channelized into constructive rural reconstruction, welfare of the society and nation, and helping the needy and the poor. This will give them a sense of purpose, they seek an opportunity for adventure and new experiences which drug

control by taking drugs. In outlining measures to prevent and C. Gopalan, Dr by headed ee committ a of report the addiction

enunciaDirector-General, Indian Council of Medical Research, has purpose: this for points ted the following five basic being that (i) Society can never be free of drugs, the reason

drugs have specific individual and social purposes and as long as they are not met by other healtheir means, drug use or abuse will continue to exist. the drug evil to the _ , Gi) Efforts should be made to reduce all along the line , minimum by attacking it at various points

instead of concentrating the significant efforts at one point. deviance, cannot be (iii) Drug abuse, which is a term ofdevia nce and an attempt of forms other from treated in isolation the abuse will be of ol contr the for nery machi al at creating any speci

counter-productive.

tic

and create gigan (iv) One should not lose one’s perspective whose signifilems prob drug the and costly structures to dea l with lems facing prob al other cance is limited in compariso n with sever

the country.

form

(v) All the drugs

a continuum

any over zealous

and

an increase effort to control one drug may lead to another drug.

in the use of

al ministries in India each At present there are several centraddic tion. For controlling dealing with a particular aspect of drug committee has given the iency effic ing lack of co-ordination and bring

the following suggestions: There

advisory

should

board with

be

an

integrated

machinery

the health minister as

like

national

its chairman,

and

ministries and professional comprising representatives of all other It will help in the for-

problem. Organisations concerned with the bala nced policy to prevent and and e nsiv rehe mulation of a comp

Control drug abuse.

and a single central The committee suggested legislation the problem resulting from law instead of many laws dealing with of control and regulaity sever the dependence-producing drugs. The in tion should depend upon the extent to which the drug finds use

gravity of the conseMedical practice, its potential for abuse, and the hallucinogens like that sted sugge quences. On this basis it has been

212

ABNORMAL PSYCHOLOGY

LSD, heroin, hashish and charas should be prohibited are harmful and have no medicinal value.

since

these

The committee wants deterrent penal Provisions against the smuggling of and trade in drugs on the lines of other leading countries like Japan, U.S.A. and Singapore. Whereas addicts should be regarded with sympathy as sick persons and should be permitted, under certain conditions, to Possess specified drugs in

specific quantities, the traffickers should be dealt with firmly.

Summary 1. Alcoholism: The term alcoholism excessive drinking or dependence on alcoholic bever refers to ag es to the extent of disrupting life and malfunctioning of the beh aviour causing severe physiological, Psychological and social damage.

3. Effect: An alcoholic is like ly to be ruined in terms of physical L or mental health, his economic and moral assets, em otional and social relationships, and 4. Causes: „No person is born a sn are purely environme ntal. : € any per ta ag its physiologica sonality traits and later maintained on acl and Psycho

logical

dependence

that it

Alcoholism is a med ica a law and order pro l and psychological ble: m. F or treatment, eginning is made with the dia te

1

Bes

away

alcoholics

1 on (ii) providing for essential their clinical investigations; (iii) behaviour; deintoxicat-

Drug addiction Hon::

Yt is a State of acu to he individual and to society, 4 excessive use of a dru g. Drugs may be classi and deliriant depend i ing the stimulants like nic upon the natare of sive sedatives like opium, otine, cocaine, caffej mental

morphaine,

heroin and

i tee

methadrone;

and

213

ALCOHOLISM AND DRUG ADDICTION

non-barbiturates, deliriants like hypnotics like barbiturates, and mine. marijuana, LSD and menthampheta are purely environmental Causes of drug addiction: These learned behaviour, and an er of and drug addiction is a matt ses of life and style of living. stres the to nt inadequate adjustme ation It involves measures like (i) educ Prevention and control: addicdrug of nces eque cons and es caus nd of the public to understa

ction althy environmental and reduamong s tion; (ii) restructurization ofto unhe etie anxi and ion tens ion, frustrat in the problems leading the citizens; (iii) prohibition

drugs: (iv) deterrent

of low

medicinal

value

and

harmful

gling of and panel provisions against the smug

trade in drugs.

hospitalization; (ii) It involves (i) compulsory ures; (iv) introduction Treatment: _ cal meas deintoxicating; (iii) adoption of medi nging for long-term therapy arra (v) and t; tmen of psychological trea and rehabilitation.

REFERENCE op.cit., p. 228. 1. World Health Organisation (1969) as cited by Shanmucam,

17 SEXUAL

EVIATION

DEVIATIONS

is a term used

AND DISORDERS

for

explaining significant differen from the average or nor ce m. A deviant behaviour is or contrary to the est apart from ablished or acc

3 prostitution, may be » promiscuity, Tegarded acceptable and cultures and Societies normal in some , Sexual deviation has been defined as follow s: George W. Kisker: Sexual behaviour is more e considered abno likely to rmal or i it i

An Antthhoony Storr: as failure in the qu ite

ex, is a sexual deviat » genital ion?

coitus

Sexual deviation can only be i i

with

an

understood

Sex is one of the major instinctu al driv Sa es and essential needs. Although People live in spite o;

O

sexual deprivation,

yet they may

SEXUAL DEVIATIONS AND DISORDERS

215

never live life to the full without its gratification. To enable one to gratifv one’s sex need may be a natural instinct but to seek its gratification in some socially desirable ways is the matter of one’s

learning from elders and environment.

ly acceptable, conditions:

In addition

to being

social-

a normal sexual behaviour should fulfil the following

* Sexual gratification is to be received from the adult members of the opposite sex. * Genital coitus is to be preferred to other modes ofsexual gratification. * It should not be engaged in the attitude of shame, disgust, fear, guilt or inferiority. * It should neither cause harm to the individuals concerned nor to others. * It should not cause personal or social maladjustment. This means that sexual deviation may be understood in terms Of learned persistent habit patterns of sexual behaviour which com-

Pel an individual to seek sexual gratification from unconventional Sources and means other :han the genital coitus with an adult

Member of the opposite sex irrespective of the fact that such natural ratification is available. Sexual deviation and

sexual

offence

It is important to distinguish between “sexual deviation” and sexual offence”. Although most deviations are also sexual offences and vice versa, yet it is not always true. The genital intercourse with an adult member of the opposite sex is considered normal behaviour. =

ut sexual

intercourse

with the

adult member

of

the opposite

Sex without his or her consent cannot be termed deviance sexual assault. In but a sexual offence in the form of rape and

Some countries forcible intercourse even with one’s spouse is termed Similarly, extra marital intercourse even with an a sexual offence. of the opposite sex is a sexual offence, whereas member willing adult diviation or perversion in the strict sense sexual called it cannot be be made Of the term. -A further distinction between these terms may nce in persiste or stress unique an is there where that ground the On

habit patterns in the case of sexual deviations, an occasional deparlegal ture from an accepted norma! sexual behaviour of the society or offence. sexual a it lable to Code is enough f Sexual deviation and sexual disorder

rns of comSexual deviation refers to persistence habit orpatte for the means objects l ntiona uncove Pulsive preference for the adult an with urse interco genital than other cation gratifi Sexual his of our behavi Member of the opposiie sex. One engages in such own will and purpose and seeks satisfaction of the strong sex urge Or compulsion.

Phenomenon.

Sexual

deviation

in

this

way,

is a psychological

t

216

ABNORMAL PSYCHOLOGY

On the other hand, sexual disorders like impotence or frigidity involve the physiological systems too. There is lack of coordination between the sympathetic and parasympathetic systems in impotence and frigidity. They may also be the result of psychological factors like anxiety or guilt. The individua! is unable to derive gratification on account of the feeling of inadequacy or a state of incapacity caused by physiological or psychological factors. Such disorders cannot be

termed sexual deviation as the individual does not deviate from the norms of the sexual behaviour. Moreover, sexual deviations cannot be termed sexual offences and are not punishable by law as they are

not social or legal offences. Forms of sexual deviations Sexual deviations may take various forms. In some cases a a person of the same sex, or a child ora very close relative or a corpse is used as an object for the sexual act. In others, although the partner may be adult and of the opposite sex, genital intercour se is avoided and some other act substituted for it, Likewise, in some others, no second person is directly involved, but sexual gratification

is obtained from objects other than

people or from

observing the sexual activities of others or exhibiting one’s genital organs. In still others, the person himself acts as an object for deviation as found in autoerotic masturbation, transvestism and transsexualism.

The following are some of the major sexual devia tions: 1. Pedophilia : takes a child, girl or bo and or genital. The d

2. Homosexuality: : In is 2 iatiion, sexual pleasure i“derivedng members of thethi type of deviat same sex. This deviation ag occur aa i on sexes, males and fem ales. The words ‘lesbian’ and pp. e someti mes used to describe erotic lov e between women.

Overt tio i n, oro genhom Iia osecm xuality tima e y tak e the form and sodomy (intercourse per anus usu: sexuality). It is quite fr a

of mutual masturba-

attempting intercourse, the active their passive homosexual] partner

One may ask whether the er otic love between the two partners of the same sex may be termed s exual deviation. The accidental or occasional homosexuality occurr; ing under circumstances where the

SEXUAL DEVIATIONS AND DISORDERS

individual has no

access

217

to the opposite

sex (as found in military

service, prisons and boarding schools) cannot be termed sexual deviation in the strictest sense. Similarly, homosexual partnership for women who, for whatever reasons, have no access to male partners

Should not be taken as deviant behaviour. It becomes deviation only when homosexual partnership is preferred even when the heterosexual partnership is available.

3.

Herterosexual

oralism and analism : In this type of devia-

tion the individual, in spite of an adult member of the opposite sex 28 sex partner, does not perform genital intercourse but tries to seek sexual gratification with the exclusive reliance on the anus instead of the vagina for penile insertion. Such a behaviour is termed sexual analism.

When the deviant depends exclusively on oral genital

is

tency. always results in sexual failure

causing disappointment, anxiety and self devaluation to one or both the partners. In some cases the feelings of hostility give rise to lack

224

ABNORMAL PSYCHOLOGY

ire ME erotic love and and resentment anxiety related

and

non-cooperation in the sex act leading to frigiA failure and dissatisfaction in a single acf oF intercourse may either lead to unnecessary o ity towards the other partner _or it may develop fear, to one’s inadequacy. A vicious circle thus sara

the fears and doubts about one’s inadequacy and feeling or hostility or frustration may make one less adequate and more hostile or apathetic towards other. Prevention of sexual disorders: It is diffic ult to control sexual disorders caused by physiological factors like physi cal injuries to the sex

organs,

damaging

of

the

bances of the body chemistry.

nervous

system,

or

severe

The preventive measures

may

distur-

prove useful in such cases but not always, The on account of the physical factors is incur permanent damage done able and therefore much attention has to be paid to the sexual disor ders caused by psychological factors. The following measures prove fruitful in the prevention of Psychological impotence and frigidity :

* Proper sex-education

of parents and other members of the society. * Proper sex-education of the youngste rs, adult members before marriage. * Proper sex-education of the married couple ideal

for maintaining sexual relationship emphasizing the kno wle dge and skill of love-play and Sex-techniques.

behaviour therapy, client cen gestalt therapy, and gro tred therapy, family and couple therapy up psychotherapy may this purpose, be attempted for In attempting the treatm ent, a therapist must that leaving aside a take it for granted few exceptions th frigid Women. They are the victims o. behaviour is a conseq uence of unhappy sexquate sex knowledge. Therefore, it

SEXUAL DEVIATIONS AND DISORDERS

225

Major sexual deviations:

1. Pedophilia

involves

the deviant behaviour

in which

adult picks up a child, girl or boy for sexual activity. 2. Prefers

Homosexuality to obtain

Sex. 3.

refers

sexual

Oralism is the

to

pleasure

the from

dependence

deviation the

on

in

which

one

members of the

oral

genital

an

same

contacts

for

gratifiying sex needs. 4. Analism refers to exclusive reliance on the anus instead of the vagina for penile insertion. 5. Sadism is sexual gratification from the infliction of pain upon the sexual partner.

6.

Masochism is sexual gratification from

being punished

or

experiencing pain.

7.

Fetishism is acompulsive and

irrational

and obtaining sexual gratification from inanimate the body other than the genitals, 8. Bestiality means using animals Sexual excitation and gratification.

sexual

attraction

objects or part of

for the achievement

5 9. Necrophilia is obtaining sexual gratification through ing or actually having sexual relations with a dead body.

of

view-

10. Incest is sexual activity between close blood relations. 11. Exhibitionism is sexual gratification obtained by exposing the genitals publicly usually to member of the opposite sex or to children who are involuntary observers or complete strangers.

12.

Voyeurism is sexual gratification

obtained

through

peep-

ing, observation of the genitals or sexual behaviour of others.

13.

Frotteurism is sexual gratification obtained by rubbing or

pressing against

a member of the opposite

sex.

14. Transvestism is sexual gratification clothes appropriate to the opposite sex. 15. Transsexualism change of his or her sex.

is behaving

Causes of sexual deviations:

extent, produced by the

and

obtained believing

Sexual deviations

interaction of several

by wearing firmly in the

are, toa

great

psychological factors.

The dynamics ofthese factors involves the patterns like (i) pathogenic family environment, (ii) earlier traumatic sex-experiences, (iii) generalized inhibitions, and sexual ignorance, (iy) deprivations of outlet for normal sex behaviour, (v) fear and complexes associated

with opposite sex and normal sex-behaviour; and (vi) conditioni ng and fixation of suitable abnormal pattern of sex behaviour.

Treatment: Treatment measures are psychological. Psychotherapies like behaviour therapy, analytical therapy and group

226

ABNORMAL PSYCHOLOGY

thera ive i dealing rove effective i i in with the sexual deviaiates. These3 paycliste nicaltreatments should be followed by an adequate follow: up programme of proper rehabilitation.

Sexual disorders: These are es ees that interfere with the full enjoyment of the conventional sexua relations. Impotence and frigidity are the two main disorders of such nature.

Impotence causes an impairment in desire for „sexu

al gratification in a man or an inability to achieve it. Frigidity, the counterpart of impotenee, is found in females. It creates in them a lack of interest and desire for sexual gratificatio n or difficulty in achieving it. Causes:

buted to physical

In some cases, impotence and frigidity may be attri-

damage to sex

organs

or nervous system. But more often they are caused on account of psychological effects resulting from the interaction of one’s These disorders involving the feeling of inadequaci environment. es are the learned responses involving factors like sex guilt, fear, complexes, depressions, confli cts, frustrations, sexua

Prevention:

l perversion and bed-room mista kes,

Preventive measures

Should be adopted for the avoidance of physical injury to the sex organs and nerv ous system. In psychological measures of Prevention, proper sex education of Parents, and adult member s (before and after the Marriage) may Prove fruitful.

1. 2. 3.

REFERENCES

Kisker, Op. cit., p. 168. Rosen Fox Gregory, op., cit., p. 273, Anthony Storr, Sexual Deviation (Penguin Book, 1964), p. 78.

18 TREATMENT

BNORMAL

OF ABNORMAL

BEHAVIOUR

behaviour is undesirable and harmful to the indivi-

dual as well as to the society.

Every care therefore

needs to be

taken to avoid the occurrence of such behaviour through preventive measures. However, the cases of abnormality in behaviour or mental illness are bound to occur and therefore, suitable curative measures are to be taken essentially for helping the maladjusted and sick individuals, Mental illness or abnormality in behaviour is an individual as well as situational problem and itis not possible to lay down a general treatment. Moreover, the illness needs to be treated in terms of superficial symptoms as well as at the root causes. Therefore, the problem ofthe treatment of mental patients or abnormals should include medical, psychological and sociological procedures. In this way the therapies of abnormal behaviour may be grouped into three broad categories: * Medical or somatic therapy

**Psychological therapy * Sociological therapy. Medical or somatic

therapy

Medical therapy concerns the physiological treatment of abnormal behaviour. Some of the main measures in this category are drug or chemotherapy, shock therapy and brain surgery. Drug or chemotherapy

There has been a widespread use of psycho-therapeutic drugs derived from chemical substances in the treatment of mental illness. These drugs can be grouped

quilizers,

(ii)

minor

into

the

categories—(i)

tranquilizers,

(iii)

major

anti-depressives,

tran-

(iv)

sedatives, and (v) hallucinogenics. Major tranquilizers are

used

with

psychotic patients but may

be found useful in the case of alcoholic and senile patients also, They diminish anxiety, agitation, aggressive behaviour, hallucinations and delusions and thus help to control

without

impairing

intelligence

or

various psychotic

clarity

of

symptoms

consciousness,

228

ABNORMAL PSYCHOLOGY 5

:

E

s

Chlorpromazine, a drug derived from phenothiazine and reserpine, pal ae alkaloid extracted from Rauwolfia serpentina, are the two notable tranquillizers which have been found effective.

Minor tranquilizers like meprobamate and chlordiazepoxide reduce anxiety, apprehension and tension. Usually, they have no

effect on psychotic symptoms but are widely used psychosomatic patients.

with neurotic

and

Anti-depressive drugs like phenelzine, isocarboxazid, impramine,

and amitriphyline

diminish

apathy and

lethargy and are therefore

widely used in controlling depressive reactions.

Sedative drugs like phenobarbital, reduce anxiety, overactivity and insomnia. Sedatives carry side effects such as interference with clarity of consciousness, and causing drowsi ness and therefore in many cases, the

use of

tranquilizers

is widely recommended

in place of sedatives. Depressants like lithium ca tbonate are mainly used in the treatment of agitated depression. Anticonvulsant drugs like trimethodi diphenyl hydantoinate are found to be effective in one, sodium controlling several types of epilepsy. Hallucinogenic dru gs such as LSD and mescaline, are useful in the treatment of schizop hrenic patients particularly children. The use of drugs has been effective in reducing the severity of symptoms and making the manageme nt of the patients convenient in the hospital or at home. It has made possible for many patients to function in the community

instead of remaining in the hosp ital. The drugs make many more pati ents: accessible to Psychological sociological treatment. and

‘

to be

psychological measures,

supplemented iy

ca

Shock therapy

wi

With:

other

It involves an artifici al induction of deep comas, or both by shock inducing drugs or electric current.

is recommended to patie nts who benefit from drug therapy. (ICT),

In Insulin

Shock Therapy

convulsions

This.

therapy are difficult to control or do not

(IST) or

I nsulin Coma Therapy the patient is given insulin injectio n in tramuscularly early in

229

TREATMENT OF ABNORMAL BEHAVIOUR

the morning causing decrease in the blood sugar level. Asa result, he passes through the stages of restlessness, unconsciousness, convulsions and eventually goes into a coma in which he does not respond He remains in this even to a pinprick or other painful stimulation. sugar level is blood his then and stage of coma for about an hour contents sugar giving by or y chemistr body own his raised through Although insulin resulting in the end of the insulin shock episode. t of shock therapy was formerly used extensively in the treatmen newer drug by either replaced largely been has it renia, schizoph therapies or electro convulsive

therapy.

ed to as Electro In Electro Convulsive Therapy (ECT), also referr passing electirc by ced produ is lsion convu Shock therapy (EST), se he is purpo this For t. current through the brain of the patien each side on placed are odes electr and bed placed on a comfortable and 200 100 en betwe of his head and an alternating current, usually seconds. two about of period a for volts, is passed between them administering before nt relaxa e muscl given lly genera Patients are and limbs of the While inducing current, the shoulders ECT. a rubber gag and ants attend and nurses patient are held lightly by

is placed between his teeth to prevent

injury during the convulsion.

times a week dependAbout five to ten ECT’s are given two to three is a confusion and There ion. situat the of ing upon the requirement before and after y iatel immed period the g durin y loss of memor

treatment, but it gradually returns in a few weeks.

has been found helpful for depression, involutional The ECT schizophrenia and other psychotic reactions. mania, holia, melanc and

sion It is quite popular for controlling cases of agitated depres respond not do who ts patien for useful found is a and schizophreni

well to drug therapy. Psycho-surgery

It involves surgical operation of the patient’s biain and aims to destroy or isolate certain maladaptive cell complexes in the frontal areas of the brain responsible for undesirable emotional

responses and mental disorders.

This is done in one of the following

ways:

* Some of the nerve connections are severed between the frontal lobes and the thalamus. This technique is known. as lobectomy or prefrontal lobectomy (Jeuctomy),

* Certain parts of the frontal lobes are actually removed. This technique is known as topectomy. ® Certain nerve tracts in the thalamus are severed by the insertion of a surgical electric needle. This technique is known as thalectomy. The removal of maladaptive cell complexes in the frontal lobes or the cutting of nerve pathways between the prefrontal lobes of the brain and the thalamus or hypothalamus by the

surgical operations

230

ABNORMAL PSYCHOLOGY

scribed i above results in i reduciing the emotioi ite thoughts, apathy, delusions and halluc nal tormen t of distly, psychosurgery may be found useful with inations. Consequena wide range of mental patients including schizophrenics, involutional melancholics, antisocial personalities, alcoholics, manic depressives and patients suffering from reactions.

stubborn

obsessive

and

other

severe

neurotic

with whom everything else has b improvement at all may be consider Psychotherapy

The majority of cases of behavioural disorders or illness may be adjudged as mental pro duc ts of severe maladjustment by Psychological factors. caused Physical or medical treatm ent in such cases oes not prove much usef ul. Suc h patients need Psychologica treatment for solving thei l better Personality adjustmenr Psychological difficulties and achieving t. This form of Psycho is known as Psychotherap logical treatment y.

establishing a Purpose of Solving 3 the adequate Personality patient’s emotional di growth an d adjustme nt,

A bebaviour therapy and group therapy,

r

, cli cieakeened therapy,‘

The founder of the psycho analytica] th F reud W who era; pyy was developed the Sigmund theory and te ch hnique of ps yc ychhoanalysy: is.

TREATMENT

real

causes

OF ABNORMAL

BEHAVIOUR

of the present

231

problem

by uncovering

the repressed

conflicts. In the technique of free association, the patient is made to lie on a couch, with the analyst (therapist) sitting out of his range of

sight. The patient is asked to ‘free associate’, that is, to speak freely about whatever comes into his mind, no matter what it is, and to go on talking about his thoughts and feelings as subsequent associations reveal themselves. He is expected to talk frankly. He must not hold back past or present events, attitudes towards the therapist or fantasies, no matter how unpleasant or embarrassing they may be. In case the patient remains silent or claims that ‘nothing comes to mind’ it may be his resistance to treatment. He is told that all thoughts and feelings are important to the treatment process. If he insists that he is really trying, it may be postulated that the resistance

is caused by unconscious parts of his mind. Such resistances themselves provide clues io the patient’s conflicts. Dream analysis is another major technique used in psychoanalytical therapy for uncovering unconscious motivation and Tepressed

lowered,

conflicts.

allowing

During

repressed

sleep

the

material

defences

of the ego

to reach the conscious.

are

For

this reason, dreams, to some extent, may by taken as the ‘royal road” to the unconscious. The contents of the dreams are usually symbo-

lic and a proper interpretation of the symbols analyst may provide conflicts of the patient.

invaluable

clues

to

by an expert psychorepressed

desires and

Consequently, through the analysis of material produced by means of free association and patient’s dreams, the analyst begins to get all the clues about the possible underlying causes of the behavioural disorder of his patient. For the most part, the analyst has to rely for his subject matter on the verbal responses based on the memories of the patient, Later, some more direct evidences become available. The patient’s personality is reflected in the way he behaves during the analytic period. His habitual patterns of behaviour his way of looking at things, his likings and love, his prejudices and bias, may all affect the way in which he deals with his analyst His total behaviour is to be analysed by the therapist for going deep into his problem.

Many

times

on

account

of the phenomenon of transference

the patient’s attitudes and behaviour towards his therapist is unreal-

istic. During the interaction in the process of psychoanalytical therapy, the patient and therapist develop a complex emotionally charged relationship. Asa result, the patient usually transfers his deepest emotions to the analyst, the analyst becoming the love object or the hate object depending upon the early experiences of the

Patient with his parents or other important persons.

For example, a

female patient may view the analyst as an ideal husband and lover or may exhibit feelings she had as a child towards her father. The

232

ABNORMAL

i

of transference

is important

in effecting

PSYCHOLOGY

the cure of

merenn as it allows letting of repressed feelings towards persons resembling husband, lover or father figures. The analyst intelligen-

tly establishes rapport unresolved

conflicts

and

and

relationships for the uncovering of the

repressed feelings and tries to make inter-

pretations based on the emotional attitude and behaviour shown the patient towards the analyst.

In brief, the psychoanalytical

by

therapy rests on the following

assumptions and techniques. (i) Abnormal behaviour of the patient is the result of the repressed desires or conflicts experienced earlier in one’s life. (ii) Through free association and recalling day to day dreams the patient is given an Opportunity to uncover his unconscious desires

and repressed conflicts. (iii) The mechanism of transfe rence helps in the task of uncovering the conflict as it is once again made into an interpe rsonal One, this time between the patient and the therapi st. (iv) The analysis of free association, dreams, transference and overall behaviour of the patient helps in knowing the abnormal behaviour of the patient. (v) The therapist tries to show the patient how some early experiences affected his emotional life and finally helps him to achieve new and more adaptive modes of adjus tment in order to lead a normal

life.

(vi) Finally, the therapist tries to break the bond of interPersonal relationship between himself and his patien t in order to make the patient face the realities of life and solve his problems independently (after developing an Problem) without any emotional suppo impressive insight into his rt from the therapist. mode

of Psychoanalytical

therapy

has

been any ways dox psychoanalysis propagated by Freud and his followers.fromTheortho face to face interview has replaced

i

I

tions, interpersonal such treatment adj and hypnosis instead of bein

e more likely to

relationships and

Client-centred psychotherap y

This is also known as non-directiv

e therapy and is the outcome of the philosophy and experiences of an American psychologist Carl Rogers who had full faith in the worth and competencies of the human individual. His assum ption was that people are innately g and effective. They have

an innate tendency for self actualization, that

is, to realize their potentials,

As the self has an innate tendency

233

TREATMENT OF ABNORMAL BEHAVIOUR

towards ‘self actualization, the most important evaluation should a person accepts Jn case where come from the self of a person. evaluation from others and if these evaluations are negative or conditionally positive the result is conflict between self evaluation and the evaluation of others. This type of conflict may give rise to undue anxiety and tension and thus in due course cause abnormaligirl may develop ties. For example, a newly married normal abnormal behaviour by considering herself worthless after being

repeatedly criticized by her mother-in-law or husband.

Consequently, Rogers’ therapy demands from the individual to return to his basic nature of evaluating himself positively. It believes that the client (Rogerians use this term for patient) is quite

competent

to resolve

for self-actualization

his conflict as he has within himself resources

and

healthy

adjustment.

deep affectional relationship with the therapist to

He

needs

learn

how

only a to use

his resources. Rogers’ therapy involves very strong conviction about The the client's worth and his basic urge for self-actualization.

therapist is there not to direct but merely to help the client direct himself for his healthy adjustment. On account of this non-directive role of the therapist, Rogers’ therapy is known as non-directive

It is known as client-centred because it revolves totally therapy. around the client as may be seen in some of the following steps associated with this therapy.

the 1. In Rogers therapy, the client himself approaches stress. cal psychologi some of rid get to order in therapist for help During the first interview, the therapist instead of solving his difficulty himself, assures him of his help in working out the own solutions.

2.

client’s

In the next interview, the client is encouraged to talk about

his most deeply felt emotions negative feelings that have Here out into the open. creates suitable therapeutic

as freely as possible. In this way, the been bottled up inside the client come the therapist does not intervene but conditions which would facilitate the

client to talk in a more honest and emotional way

about himself and

his problem. 3. The next move is concerned with helping the client to _ gain an insight into his emotional conflicts. It involves acceptance, recognition and clarification of the feelings of client by the therapist.

Here attention is paid to the emotional aspect rather than to what the client says. The therapist tries to provide environment for removing the emotional conflicts which are blocking self actualization by selecting and focusing on statements and feelings expressed by the client. It is a sort of help rendered by the therapist to the client for learning suitable ways to evaluate himself and his environment in a true perspective.

As a result, the client gains insight by (i) understanding the causes behind his behaviour, (ii) recognising and accepting his self

234

ABNORMAL PSYCHOLOGY

in its real position, and (iii) working towards his positive self-growth and better adjustment. 4. After gaining insight into his problem, the client is helped in seeking some minor positive actions for the solution of his problem. Here also the therapist is not to direct or lead but > recognize and render clarification about the possible courses o

action. The minor positive actions bring Satisfaction and develop self confidence paving the way for more Positive action and thus helping the client in his self-actualization. 5. Finally comes a stage when the client, after gaining confidence in his self, feels that he does not need further therapeutic interviews. As such the decision for ending the therapeutic relationship comes from acquire

his original

the client.

At this Stage, he is known

to drive for self actualization by learning positive

ways of understanding and promoting his self. Evidently, from around the client. H Jeading role. The therapist enc oura

gon

st be genuinely and not supe rficially in - He should be what he is. Anything elationship, can be seen

byA his client. He should sbe ab direct perso with his client, meetiíng him on a person to person basisnal encounter ,

own, without losing the “as if” quality, is empath be able to communica y, te some of the understandin

He should also

g, (ii) The therapist must experiience a tance towards what is wa rm, positive, accepin the client - He must praise and respect his client as a person and thus pay a positive reg ard. As far as possible, this positive regard should be unconditional.

The therapist acts in the genuineness of the accept such a way that his client may perceive experiences for him. T

—

TREATMENT OF ABNORMAL BEHAVIOUR

235

The acceptance, positive regard and clarification of the feelings of the client by the therapist is properly reciprocated resulting in the removal of the discrepancy between his ideal self and present self and thus paving the way to his healthy adjustment and better selfactualization. As far as the suitability of the therapy is concerned, Rogerian therapy may not, in fact, be appropriate for a severe psychological disorder. It may, however, work well with mildly disturbed people

if handled

properly

by a therapist

in appropriate environment of

interpersonal relationship. Behaviour therapy Like

psychoanalytically

therapy does not patients

aim

abnormal

to root

behaviour.

based

out

psychotherapy, the behaviour

the underlying

It merely

causes

sets itself

to

of the

remove

individual pieces of behaviour that are disabling. The basic assumption underlying behaviour therapy is the belief that all behaviour is learned. The abnormal behaviour grows

out of maladaptive or defective learning. Therapy, in turn, becomes an attempt to provide corrective learning experiences for the removal of the outward symptoms of abnormal behaviour. In this way,

the removal of the symptom constitutes the real cure instead of analysing or rooting out an underlying conflict as in analytical therapy. As a term, behaviour therapy denotes the use of experimentally established principles of learning for the purpose of changing unadaptive or abnormal behaviour. As far as the origin of the maladaptive or defective learning is concerned, it is traced either in classicial conditioning as advocated by Pavlov or in operant conditioning as explained by Skinner. Based on these two approaches, various Methods of behaviour therapy have come into existence. 1. Counterconditioning One may learn maladaptive or abnormal behaviour through conditioning. As a result, a person may show fear responses in the Presence of certain normally neutral stimulus objects and events. When that happens we say that he has developed some unrealistic fear or phobia. Fear of animals, height, water, darkness, closed or open places, all such phobias may be seen as a result of defective learning

or improper conditioning.

The treatment of such behaviour lies in

its counterconditioning.

For

illustration,

let us

take

the case of a child who has

developed a generalized fear of rabbits through conditioned fear responses. In this case, the treatment may be worked out by associating some pleasant or favourable responses with the

presence

of a rabbit. The child may be given his most liked eatables or allowed to listen to the most enjoyable tune or play the game in the presence of a rabbit. The rabbit may be kept at some distance and then gradually moved closer on successive responses can thus be gradually eliminated.

occasions.

The

fear

ABNORMAL PSYCHOLOGY

236

i i igidity, impotence and cany early sexual dysfunctions like frigidity, j ees may also be treated by the process of Se aa ae Most often such dysfunctions are the result of anxiety w a

oepees sexual

inhibition.

Thus

the

treatment

process

invo

conditioning as below:

P z fg f * To attempt sex relations only when there is a minimum o: anxiety, for example, in situations in which there is a clear desire.

* To

attempt

cooperation

partner,

sex relations or

assistance

only is

when available

desirable from

soppor, the

se

Graduall y the reaction of anxiety to sexual experiences may be eliminated because they will now not be permitted to happen, and adequate sexual responses may in time be strengthened resulting in the treatme nt ofa particular sexual dysfuncti on.

2. Desensitization methods

Conditioned anxiety responses are the root for mwe development of many abnormal;ties in the behaviour causes of indiv idua 5

The treatment of such abnormalities may involve a variety O techniques designed to increase the individual's capacity to tolerate an anxiety-provoking situation. Two such techniques are describ

ed. below: (i) Systematic desensitization: This technique was developed by Joseph Wolpe, an Ameri can psycholo gist. It aims to reduce levels of anxiety related to an a nxiety-p rovoking situation progressively through some well-planne d systematic steps like relaxation, outlining hierarchy of individual’s anxieties , and desensitization. In this initial st age, attempts are made to : develop an anxiety hierarchy. For this purpose, the patient’s anxities are studied and ranked according to the intensity of anxiety to the different stimu li Tanging from most to least frightening. Side by side, in the Session of therapy, the r patient is made to learn the art of relaxearlie ation of the muscles ofthe body.

When the patient desensitization process

has mastered the relaxation technique, the begi i i

237

TREATMENT OF ABNORMAL BEHAVIOUR

There may be certain variations

of the desensitization

proce-

dure. Instead of imagining a situation, the patient may be exposed to the real stimuli which evoke anxiety. This is termed as desensitization in vivo. In such a procedure, a patient who has a fear of humiliation at making mistakes may be made to commit minor errors and then progressively more serious ones in the presence of the therapist in each instance until all feelings of anxiety disappear. In another variation. desensitization may be done using a tape-recorder or video film eliciting anxiety-provoking situations.

(ii) Flooding or implosive therapy: In this method

of desensiti-

zation, the patient is exposed immediately to the greatest anxietyprovoking situation. He is not gradually introduced to the anxietymost as in provoking situations starting from the least to the

ing systematic desensitization but is encouraged to face the frighten much how of ss regardle there, remain and n or distressing situatio anxiety is generated, until a spontaneous decrease in anxiety takes place.

A through that his used to

child who fears rabbits may be confronted with a rabbit a videotape or by way of real-iife situation. It may be seen peak anxiety does not last very long and he eventuaily gets it and feels that his fear was irrational. 3. Aversive conditioning

Aversive conditioning involves

patterns

through

the modification

pain or punishment.

This

of behaviour

treatment has proved

acts, thinking, compulsive obsessional effective in overcoming eating, over sm, alcoholi s, deviation sexual other and ality homosexu smoking, drug dependence, gambling, etc.

The method consists of administering a noxious stimulus (resulting in an unpleasant response) to the patient in an appropriate to which aversive conditioning is time relation to the stimulus treatment is that the patient will such of n assumptio desired. The

gradually learn to avoid abnormal pattern of

a more desirable and for homosexuality, the

behaviour

and

prefer

normal one. For example, in treating a man aversive conditioning would involve an in-

troduction of apunishment (electric shock or some other punishment) while he is made to look at the picture of an attractive male female or some but would be permitted to look at the picture ofa punished. being without figure female a of parts attractive sexually Similarly, in the treatment of chronic alcoholism aversion conditioning may be achieved with the help of a drug antabuse. The person who is chronic alcoholic is presuaded to take the drug. A drink of alcoholic beverages, after taking the drug, results in strong unpleasant and discomfortable physical reactions like increased pulse rate, difficulty in breathing, severe headache and nausea. The repetition of such unpleasant experiences results in the avoidance of alcoholic beverages.

238

ABNORMAL PSYCHOLOGY 4. Modelling Modelling

is a therapy

haviour normal

technique

in which

a

patient’s be-

is modified as a result of observing the appropriate and behaviour of other people used as models. One may use modelling therapy for eliminating a child’s fear of rabbits by making him observe that the other children are playing with the rabbits without

fear. Similarly, one’s phobia of snakes may also through modelling therapy. Such patients may be be overmade to observe both come

real and filmed incidents of people (models ) and in which people (models) may be seen approaching the snakes gradually with no signs of anxiety and fear. The modelling as a technique may also be used for learning more adaptable and desirable ways of personal and social adjus tment. People may also be helped in the treatment of sexual dysfunctions by means of films

snakes

or live models depicting practical techniques and normal sex beha viour.

5.

Method of positive reinforcement

In this method, carefully selected rewards and schedules of reinforcement are used to modify a patient's behaviour in the direction of socially desirable well adap tive behaviour, Anorexia nerv osa, a cond

ition

in which the

person affected refuses to eat, has been found to be successfully treated by arra nging for eating to be followed a proper schedule of by

positive reinforcement or rewa rds such as to be allowed to go toa movie, play a favourable game, use ofa radio or provision of a good compan y etc, A technique known as ‘token economy’ is also method for treating abnorm use al beh aviour. It is based on the d as a of positive reinforcement. principle In this method, plastic are used as rewards or metal tokens

for

reinforcing the positive behaviour shown by and desirable the patients, These tokens may, exchanged for special later, be Privileges such as tel evision viewing, single room accc ommodation, to o btain special foo d, etc. This token econom ve y as a behaviour modifimagazines orT novels been foundd mos cation technique has most t effect ef e ive in improvin g and modifying of people in institutions the viour All

these

or hospitals. treatment methods

ae

Bii

have one- to-one relation involving one helping person ship (the therapist) and for help (the patient pist) an one person coming

Group therapy

In contrast with such

one-to-one relationship grou thera dem e ands 5 the involvement ofagro P grou Py TOUP ((two or more pers with a single or ons)p at a time several therapists,

A

TREATMENT OF ABNORMAL BEHAVIOUR

239

In group therapy, a group usually consists of six to twelve mem-

bers who meet one or more times a week. This group is somewhat homogeneous with respect to age, sex and type of disorder. Usually The different therapeutic measures the group is led by a therapist. like psychoanalytical therapy, client-centred therapy and behaviour therapy used in individual therapy may also be successfully used in

group therapy which may take several forms. There are differences in objectives, approaches and techniques. Some groups are conducted in the format of individual therapy, others are essentially

educational, featuring the presentation of certain materials which the A few groups are members discuss and apply to themselves. largely inspirational, others seek to promote insight to release experiences or problems, pent up emotions or unconscious impulses to facilitate self-discovery or to teach social skills.

In modern group therapy a group situation known as ‘encounter group’ is used for the treatment of maladaptive behaviour. In such a group the patients are encouraged to behave in an unguarded fashion. They get immediate and open feedback from fellow members and the therapist or the group leader. In some encounter groups the members engage in group activities like singing, games, physical exercises, physical intimacy, dance, dramas and other entertainment programmes. The idea behind such group activities is to induce fatigue or pleasure in order to break resistances for the closer group interaction, and proper sublimation of their unconscious improper motives.

apy,

catharsis

or

Group therapy has many advantages over the individual therthe foremost being the economy in terms oftime, labour and

financial resources as the treatment may

be given

to a number

patients in the group affected with the same disorder.

the group therapy provides an

environment

of

Beyond this,

for the learning of

desirable social skills and unlearning of maladaptive behaviour through the use of group dynamics. It also permits persons with common problems to support and help one another. However, group therapy does not necessarily work well with all types of disorders and patients. For example, some people find

it impossible

to talk about themselves and their problems in group.

In some cases of agitated depression or psychotic disturbances the group encounter may prove dangerous. As a result, there is a need for considerable skill on the part of therapist who deals with a group of patients. It is his competency, art of group dynamics, and understanding between him and his patients which prove helpful in

bringing encouraging results of group therapy. Family therapy

\

Family therapy is a variation of group therapy in which two or more members of a family are treated together as a unit. The family group in this therapy may consist of a troubled married couple, or it

may be a set of parents and one or more

of their children.

Some-

times it is the whole family being treated in a clinic or in its natural habitate—the home.

240

ABNORMAL PSYCHOLOGY mily

na

therapy

a

has grown

out

of the realization izati

that

family is influenced by every other member.

eac h

Usually,

unhealthy intrafamilial relationships are responsible for the maladaptive abnormal behaviour of an individual. On the other hand, a abnormal

family

may

prove

uncongenial

a potent factor in turning the environment

and

thus paving the way

for making

o

other

members maladjusted and abnormal. A proper treatment procedure must care for the related factors

in one’s family along with his treatment. In order to bring about a desirable modification in the behaviour of an individual we have to take care of the intrafamilial relationships within his family. If we attempt to change the patient without changing the others in family, we may find family circumstances conspiring to keep him as he is.

That is why, many patients who improve in the hospital or clinic are fcund to manifest a reappearance of symptioms when they return to their families.

Family

therapy isa

challenging

and promising approach.

helps the family members to discuss their attitudes with each other It and acquire insight in the intrafamilial relationship. It brings desirable changes în the whole family interaction, ensuring that changes in one person will not be counteracted by the behaviour of others. This approach brings all or a large portion of the family under study and thus helps in maintaining the family’s equilibrium and allows the family

to work its adjustment problems as they oc cur. The treatment through family ther apy often reveals that the patient who first seeks help or is referred for help is not necessarily the most

maladjusted.

He

may the victim of

the maladjustment or defective interpersonal relationship of his parents or other members

of the family. For example, difficulti es in the marital ralationship of the parents may cause difficulties in Paren ting and it may, in turn, cause behavioural abnormalities in the childrren. In such cases, improvement in marital relationship of the Paren ts through a well planned family therapy alwa ys brings desirable improvement in the behaviour of a child patient. Dramatic therapy

when

Dramatic

problems

therapy uses the enactment

are acted out

instead

of roles

and

incidents,

of being talked about. Role

play.ng and psychodrama are examples of such therapy.

In role playing, the patient acts out t he behaviour of individu In doing so he either repeats his own al previous behaviour or gives indication of his Poss ible situation. In this way, role play gives t he pati behaviour in that opportunity to gain insight into the pa tient ent and therapist an ’s behaviour. It also provides an opportunity and stage to achi eve catharsis and to practise more adaptive ways of one’s behaviour. Psychodrama involves a more elal borate Proc edure than role play for acting out behaviour. It general] y involves five elements on the

in a certain situation.

241

TREATMENT OF ABNORMAL BEHAVIOUR pattern of a dramatic

setting:

a stage, the therapist in the role of

persons or director, the patient as a hero, helping characters (otherto act out his made is patient The therapists) and the audience. in the All concerned persons are made to participate problems. the patient’s acting out of problem situations related to

oo

ife.

Sociotherapy

measures may also be This treatment involving sociological According to Coleman, termed situational or milieu therapy.modification of the environ“Sociotherapy refers primarily to some in which the patient has a ment in order to provide a life situation *

stment.” reasonable chance of making a successful adju hotherapy focus on the Thus while medical therapy and psyc cal and social milieu physi to patient, sociotherapy shifts the focus to bring about desirable (environment). Here attempts are made setting s—concerned changes in the situations—physical and social

with a patient. by the psychiatric social Sociotherapy is usually carried out voluntary social welfare worker with the help of voluntary and nonon the

agencies.

The

treatment

in this approach

usually

works

ical and social—have a assumption that one’s environment—phys well-being. An unhealthy and considerable bearing on one’s happiness maladjustment and develops and defective social environment causes if we want to modify or maladaptive behaviour pattern. Therefore, r, we must direct our viou beha ive dapt bring changes in one’s mala ronment or providing attempts towards modifying the defective envi involve attempts at may anew and more favourable one. This relationship betal mari tive defec the improving or restructurizing

behaviour problems. tween the parents in order to treat a child with the child in a fosterof some cases it may demand the placement

In uctive nature of the home or boarding house on account of the destr involve the modimay it , cases other In ent. ronm child’s family envi one’s neighbourng erni conc fication or alteration of the situations ent. ronm envi work or ent ronm envi ge hood, social and colle ist analyses therap Here the Home. and family environment: rs of the membe the among ng interpersonal relationships existi

le guidance and assistance family. The parents may be provided valuab problems. Sometimes concerning child. rearing, marital and other life whole family

e in the the defective family environment needs a chang improvement in the ble desira a be may there environment so that isa broken family or if behaviour of the family members. In case it with a new environment ded provi there is no family, the individual is ution or other resideninstit ing board , family which may be a foster tial setting, serving as a semi-family. mal behaNeighbourhood sorroundings : Many times, the abnor e malidabl unavo his of t accoun on caused is dual viour of an indivi ood. bourh neigh the is, adjustment to his immediate milieu, that

242

ABNORMAL PSYCHOLOGY

In such cases ii is essential to remove neighbourhood or to modify it.

the individual from this

School and college environment: An educational institution has its own distinctive atmosphere composed of things and people in complex interaction. A defective physical, social and educational environment of an institution may result in maladjustment and maladaptive behaviour. Social therapy, in sucha situation, demands desirable improvement in the physical sorroundings, interpersonal relationships, curricular and co-curricular programmes of the institution. In some cases it recommends the placing ofthe student in another school or college which provide opportunities for better adjustment.

ment

Work environment:

caused

physical

or

Professional

and occupational

by improper-interpersonal

social

structures

impairment of the physical

maladjust-

relationships and defective

of the work-

and mental health of the employees.

such circumstances, social in the physical as well as social sorroundings For this purpose it may attem cheerful sorroundings, healthy working conditions, invo and enhancement of pow

In

of the world of work.

tal hospital. In order to ach set-up of the hospital may ie w

vironment. The interaction with the comy CC f following positive achiev clo-therapeutic attempts may result in the ements: * Members of the com munity, at large, develop more positive attitudes towards mental

Ş

patients and mental hospit 5 als. There is, an incr ease inj the proportioi n of : vol unt ary admissions. : Treatment of men tal r illne ss is regarded essential and convenient as for physical ailments,

Lí

tional,

anges in his

physical, social, educaprofessional, and therapeutic environment. Moreover, these 3

systematic care

e the development of programmes for the of patients after their discharg e from the hospitals.

243

TREATMENT OF ABNORMAL BEHAVIOUR

The socio-therapist renders valuable guidance to the family members about what to expect of the patient and how to react to him. With his periodic visits he is able to help many patients to adjust satisfactorily in the community and thus minimise the chances of their relapse Besides, by seeking cooperation and dependence on hospitalization. government or some voluntary agencies, he from the community, may also help the patient to find mployment. In cases where where patient returns to his previous job, he may help him in his occupational adjustment by advising the employer to understand the patient’s illness and recovery. Summary

The treatment of abnormal

behaviour

may

be classified into

l therapy three broad categories namely, somatic therapy, psychologica and sociological therapy. treatment Somatic or medical therapy concerns the physiological ng to belongi es measur Some of the main of abnormal behaviour. brain and therapy shock , herapy chemot or this category are drug

`

surgery.

Various drugs prove effective in reducing the severity of sympin the toms and make the management of the patient convenient

But the drugs also carry severe side-effects and. hospital or at home. behavithe treatment does not remove the actual causes of abnormal phyother by mented supple be to re therefo has Drug therapy our. sical or psychological measures.

Shock therapy involves an artificial induction of deep comas, Insulin shock therapy has now been convulsions or electric current. has been found useful for agitatwhich ECT by d replace ely complet

schizophrenia and other psychotic reactions. Psychosurgery involves surgical operation of the patient’s brain for reducing the emotional torment of disturbing thoughts, apathy, risk delusions and hallucinations. However, it involves considerable ed depression,

and

negative

consequence

and should be taken as a method of last

resort.

is a method of treatment of psychological Psychotherapy by a trained problem or disorder of an individual (known as patient) ch in the approa oural behavi a h throug st) therapi as person (known

the purpose of form of establishing a psychological relationship for te adjustadequa ing achiev ties, difficul nal emotio solving the patient’s client ic, analyt Psycho health. mental better g gainin ment, and psycho major the ute constit y centred, behaviour and group therap therapies. repressed desires or assumes that Psychoanalytical therapy real source of the the are life one’s in earlier nced experie s conflict

produced causation of abnormal behaviour. The analysis of material helps in s measure other and dreams tion, by means of free associa . The disorder ur behavio getting clues for the underlying causes of

244

ABNORMAL PSYCHOLOGY

therapist then tries to acquaint the patient with the effect of his early experiences and helps him to achieve new and more adaptive modes of adjustment. Client-centred psychotherapy is centred around the client, It creates proper therapeutic environment for helping him to discover ways of self actualization by gaining insight into his problem, removing discrepancy between his real self and his idealized self-

image and developing confidence in his self for his healthy adjust-

ment.

Behaviour therapy principles of learning

denotes the use of experimentally established

for

the

purpose

of changing | unadaptive

or abnormal behaviour. Based on the classical conditioning or operant conditioning, it involves important methods like counter conditioning, desensitization, flooding, aversive conditioning , modelling and method

of positive reinforcement.

Group therapy is a method of treatment in which a number of people are treated simultaneously or in which group dynamics are used in the treatment of one person. In modern group therapy a group situation—encounter group—has proved effective in treating behavioural disorders. Family therapy is variation of group therapy in which two or more members of a family are treat ed as a unit.

, „_7 Dramatic therapy makes use of the enactment of roles and incidents. Here the problems are a cted out instead of merely talking about them. Role playin g and Psychodrama are examples such therapy, of Sociotherapy refers primarily to modification of the environment in order to provide a life situa tion in which the patient has a Teasonable chance of makin 8 a successful adjustment.

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PSYCHOLOGY

Sternbach R.A.; Principles of Psychophysiology, New York: Academic Press, 1966. Storr, Anthony; Sexual Deviation, Penguin Books,

1964.

Szasz, T.S.; The Myth of Mental Illness, New York: Norton, 1961. Thorpe, Louis P & Katz, Barney; The Psychology of Abnormal Behaviour, New York: The Ronald Press Company, 1948. Toffler, A.; Future Shock, New York Random House, 1970. Toch, H.; Violent Men, Chicago: Aldine, 1969. Verma, Paripurnand; Sex Offences in India and Abroad , B.R. Publishing House, 1979.

New

Delhi:

West, D.J.; Homosexuality, Harmondsworth: Pengu ine Books, 1960. White, R.W.; The Abnormal Personglity, New York: Ronald Press Co., 1964.

Wiseman

Jacqueline

P.; The Social Psychology of Sex, New York: Harper & Row, Publishers, 1976. Wolpe, J.; The Practice of Behaviour Ti herapy, New York: Pergamon, (Second edi), 1974, Wolman, B.B. (ed.); Hand Book of Clinical Psycholo y, New York: McGraw-Hill, 1965

oe

Glossary

Acrophobia: Acute disorder:

Adaptability: Adaptation:

Addiction: Adjustment: Adrenal glands: Adrenalin: Affect: Affective disorder:

Agitation:

Fear of heights. Disorder with sudden

onset

and

of short

duration. Flexibility in meeting changed circumstances or demands.

In general, adjustment to environmental conditions, Physiological or psychological dependence on alcohol and drugs. A person’s interaction with his environment. Endocrine glands located at the upper end of the kidneys. Hormone secreted by adrenal glands. Emotional feeling, tone or mood. Personality disorder marked by extremes mood.

Marked

restlessness

and

in

psychomotor excite-

ment.

Agnosia: Agoraphobia: Agraphia: Alcoholism: Alcoholic hallucinosis: Alexia:

Algophobia: Allergy:

Alzheimer’s disease: Amnesia: Androgens: Anorexia nervosa: Anoxemia:

Inability to recognize persons or objects. Morbid fear of open places, Loss of ability to put language in writing.

Addiction to alcoholic beverges to the extent of hampering one’s life adjustment. Brain syndrome due to alcoholism.

Inability to understand written language. Morbid fear of pain. Hypersensitivity of body tissue to some external substances like dust, smoke or chemical agent. A presenile brain disorder. Loss of memory. Male sex harmones,

Loss of appetite due to psychological reasons, Insufficient supply of oxygen in the blood and tissues.

250 Antabuse: Anti-depressant drugs: Anxiety:

Aphasia:

Approach-

Approach-conflict: Approach-avoidance conflict: Arteriosclerosis:

Asthma: Ataxia: Autonomic nervoussystem:

ABNORMAL

Drug used in the treatment of alcoholism. Drugs used to treat depression.

A feeling of painful or apprehensive uneasiness

accompanied by various forms of physiological arousal. Impaired ability to understand or use language

meaningfully. ; Simultaneous attraction to several incompatible courses of action. Simultaneous

Aversion therapy: Aversive stimulus:

attraction

to

a course of action.

and

A physiological disorder marked

repulsion for by hardening

of the arteries. A respiratory physiological disorder. Impairment of muscular coordination arms and legs.

of the

A part of the nervous system that is not sub-

ject to voluntary control

bodily

Autosome:

PSYCHOLOGY

charges

during

and regulates internal

emotion

or

stres

s. It includes sympathetic and parasympathetic system. Chromosome that does not affect the sex of an individual.

A form of therapy in which Some other aversive stimulat punishment or ion is used to eliminate undesired response s.

A stimulus that evoks physical or psycholo-

gical pain or discomfort.

Avoidance-Avoidanc e conflict: Simultaneous

Barbiturates: Behaviourism:

Bestiality:

Bio feed-back:

Birth trauma:

tor

Commonly used sed ative drugs.

The school

of psychology which overt behaviour as its field of study. A 3 sexualf dey iation inv olv

with animals. Providing a person

considers

ing sexual relations

with

information about the control of the autonomic nervous system, like heart rate blood pressure ete, An individual sex ually attracted to both males and fem

bodily

Bisexual:

repulsion

several courses of action, but to escape one, another must be carried out.

functions

ales. Shock of birth.

under

GLOSSARY

Blocking: Brain pathology: Bronchi: Cardiovascular:

Catatonia:

Catharsis: Central nervous system:

251

Involuntary interference in the chain of thought

or speech due to emotional factors. Diseased or disturbed conditions of the brain. Blood vessels in the lungs helping the passage of air. Pertaining to the circulatory system of the body.

A type of schizophrenia marked by decreased motor activity, mutism and periods of waxy flexibility. The therapeutic event invoiving the re-experiencing and purging of recalled experience during psychoanalysis. The brain and the spinal cord.

emotional

Cerebral arteriosclerosis:

Hardening of the arteries in the brain.

Chemotherapy:

Use of drugs or chemicals in the treatment of mental disorders.

Chloral hydrate: Chlorodiazepoxide: Chlorpromazine: Chorea:

Chromosomes:

Chronic: Classical conditioning:

Claustrophobia: Client-centred psychotherapy:

Cocaine:

Sedative drug. Minor tranquilizer. A commonly used transquilizing drug. A disturbance of the central nervous system causing involuntary spasmodic movements of

the head and extremities. Minute rod-like structures that carry the genes. Human cells normally carry twenty three pairs of chromosomes. A relatively permanent maladaptive pattern. Basic form of learning associated with Pavlov in which a previously ineffective stimulus (the conditioned stimulus) comes to elicit a response after having been paired with on unconditioned stimulus that innately elicits. the

Tesponse. Irrational fear of closed places.

A form of psychotherapy designed by Rogers in which the client—rather than the therapist’s interpretation of the client’s feelings and actions—is the focus of attention. Drug obtained from the leaves of the cocapiant that has stimulating and pain reducing results.

Coitus:

Sexual intercourse.

252

ABNORMAL

Coma:

A serious (stupor).

Compensation:

A defence mechanism used feriority. Unwelcome repetitive action.

Compulsion:

Confabulation:

Conflict: Congenital: Conscience:

condition

of’

PSYCHOLOGY

unconsciousness to

overcome

in-

Distortion of memory in which the person fills in memory gaps with false and often irrelevant details. Competition among several patterns of behaviour. Existing since birth.

A _person’s ideas of right and wrong which

influence his behaviour. Constitution: Conversion reaction: Convulsion: Cortin:

Counterconditioning:

Total biological make-up of an individual. Neurotic state in which anxiety is converted unconsciously and symptoms.

symbolically

into

physical

Pathological muscular contraction.

A collective name for the several hormones secreted by the adrenal cortex, The teaching of new behaviour using a particular stimulus to establish a more adaptive

response,

Covert: Cretinism:

Criterion: Cunnilingus: Defence mechaanism:

Concealed or disguised. A form of mental retardation resulting from thyroid insufficiency during foetal life or early infancy. A measure or event that serves as a stan dard for judging other measures or event s. Opposition of mouth to the female genitals.

Technique

used

by

Criminal

Delirium:

18 years of age). Confused and excited

marked

Dementia:

individual

to defend

tening or anxiety provoking situations.

Delinquency:

Delusion:

an

or protect himself from the unpleasant, behaviour

threa-

of a minor (person below state

by incoherence,

of organic

illusions,

origin

hallucina-

tions and disorientation. Firm but false belief con and held in spite of evi trary to reality dence and commonse.

A severe mental disorder inv olving of mental functioning.

impairment

253

GLOSSARY

Demonology:

Belief that mental illness is caused by possession by the evil spirits.

Depersonalization:

Loss of sense of reality or identity in which

Depression:

Desensitization:

individual

an

may feel his body rotten or dead or

someone else’s. A psychological state marked by lowered activity, gloomy thoughts, anxiety, feelings of worthelessness, and an inability to deal effectively with life.

Therapeutic technique of reducing intensity of traumatic experiences by repeatedly exposing the individual to them in a mild form.

Detoxification:

Directive therapy:

Disintegration: Disorientation: Diplacement: Dissoviative reaction:

Dixygotic twins:

Down’s syndrome: Dramatic therapy: Dysfunction: Dyslexia:

Ego-centric:

Ego involvement: Electroconvulsive therapy (ECT) Electroencephalography (EEC): Empathy:

Treatment

directed towards

ridding the body

of alcohol or other drugs. Therapy in which therapist provides direct solutions to problems and takes up the res-

ponsibilities of directing the course of action. Loss of organisation in any organised system.

Mental confusion about time, place and person. ` The defence mechanism by which emotions are transferred from original source into a more acceptable substitute. of splitting involving reaction Neurotic epensemi-ind more or two into sness consciou

dent parts (multiple personality; amnesia or somnambulism). Twins that develop from two separate ova (fraternal twins).

A type of mental retardation associated with

chromosomal anomalies.

Psychotherapy involving use of the

enactment

of roles and incidents. Abnormal functioning. Impairment of the ability to read. Self-centred, having little interest

and

concern

for others.

Perception

of a situation in terms ofits im-

portance to the individual. Treatment involving passage

of an

electric

current through the brain.

Graphic recording and interpretation of brain wave patterns.

Sensing and understanding thoughts of another.

the feelings Š

an

i

254 Empirical: Encephalitis: Encounter group:

Endocrine glands:

Enuresis: Epilepsy:

ABNORMAL

PSYCHOLOGY

Pertaining to observable and tangible events. Inflammation of the brain. A therapeutic group technique in whic h personal and ‘nterpersonal problems are worked

out through direct expression of feelings among Participating members, Ductless glands that secrete harmones into the blood.

Involuntary discharge of urin e. A group of disorder characterized

by

convulsive seizures, disturbances of consciousness, or

both,

Erotic: Essential hypertension: Estrogen:

Etiology: Euphoria: Exhibitionism:

Extinction:

Familial: Family therapy: Fantasy:

Pertaining tion.

to

sexual stimulation and gratifica-

High blood pressure chiefly of a psychological orig

in. Female sex hormone. A systematic study of the cau ses or origins of a disease or disorder, An exaggerated feeling of well-being. Sexual deviation for obtain ing gratification by exposing the genitals, pub licly. Decrease in behaviour resulting from lack of reinforcement, Pertaining to the family , hereditary. Group Psychotherapy involving two or more members ofa family rather than any sin gle member,

A defence

Mechanism

for finding satisfaction constructions such as makebelieve Play, reveries and daydreams.

in Imaginary

Fetistism:

Foetus:

Fixation:

A sexual deviation for obtaining gratification rom inanimate obj other than the gen ects or Parts of the body itals, Human J embr Yo after the sixth

conception.

week following

Persistence of an Immature level. .ideas without logical

Flight of ideas: Flooding:

direct exposure to str ess a high level of an xiety,

technique

involving

situations leading to

255

GLOSSARY

Focal lesion: Frigidity: Frustration tole-

A defect that is localised to a specific area. Inability of the female to enjoy sexual intercourse. Level of one’s ability to accept frustration.

rance: in

which

amnesia and

Fugue:

Dissociative reaction physical flight occur.

Functional disorders:

Disorders of the behaviour without clearly defined physical cause or structural changes in the brain. Inherited influence or disposition.

General paresis: Genitals: Gonads: Grandmal: Hallucination:

Hallucinogen: Hebephrenia: Heroin: Heterosexuality:

Homeostasis: Homosexuality:

A term used for the sexual organs of reproduction. The sex glands. Major convulsive seizure.

external Perception without an appropriate stimulus, that is, hearing of voices in a completely silent room. A drug or chemical substance capable of pro-

ducing hallucinations. A sub-type of schizophrenia marked by deluand inappropriate sions, bizarre behaviour, emotional responses.

Narcotic drug derived from morphine. Sexual interest or behaviour directed towards a person of the opposite sex. Maintenance of a balance or equalibrium in physiological processes. Sexual interest or behaviour directed towards

Huntington’s chorea: Hydrocephaly:

a person of the same sex. A doctrine or approach giving supremacy to the human interests values and dignity. An incurable organic brain syndrome presumably of hereditary origin. A condition characterized by unusually enlarged head due to excess of cerebrospinal fluid in the cranium resulting in mental subnormality.

Hypertension:

High blood pressure.

Hyperthroidism: Hyperventilation:

Overactivity of the thyroid glands. Rapid and deep breathing associated with in-

Hypnosis:

Sleep-like

Humanism:

tense anxiety.

highly suggestible state induced by

an artificial process called hypnotism.

256 Hypnotism: Hypochondria: Hypomania:

Hypothyroidism: Hysteria: Id:

Identical twins: Identification:

Idiopathic epilepy: Illusion:

Implosive therapy:

Impotence: Incest: Tacoherence: Insanity:

Insomnia:

Involutional’ melancholia: Jacksonian epilePsy:

Kleptomania: Korsakoff’s syndrome:

ABNORMAL

PSYCHOLOGY

A term coined by Braid to Teplace the term ‘Mesmerism’. Persistent and exaggerated concern abou t heaIth and illness, Earliest stage in the development of the manic

Teaction. Under activity or thyroid gland. A neurotic syndrome. associated with conversion or dissociation reactions.

One: of the three major

divisions

of pers

onality proposed by Freud represen ting the most inaccessible, Primitive and plea sure seeking Port

ion of one’s personality. Twins developed from a single fertilized egg.

A defence mechanism in which Satisfaction from the Successe a person derives. s and achievements of another person by identifying or associat ing himself with him. Convulsive disorder of unknown

causation Presumed to be inherent in the individual’s constitutional make-up. Misinterpretation or false perception of a real Sensory experience.

Behaviour therapy in achieved by flooding the which desensitization is individual’s life with such eve nts or situations which cause disorder in the individua l. Inability of the male to perform intercourse,

specific

sexual

Sexual Telations be tween close relati ves of Opposite sexes like brother and sister, Disconnected and unrelated thoughts. Legal term for me ntal illness implying he indiviinability

act.

to

Difficulty in slee ping, Depressive Psycho tic middle age.

be

Tesponsible

reaction

= epilepitic seiz ure localised ce,

for

of the

his

late

in arm, leg or

Compulsive urge to steal.

emOrganic psycho sis

associated

with

alcoho-

257

GLOSSARY

Lesbian: Lesion:

Lethargy: Labectomy:

LSD-25:

Macrocephaly: Malinger: Mania: Marihuana: Masochism:

Masturbation: Melancholia: Meningitis:

Menopause: Metrazol: Microcephaly: Migraine: Milieu therapy:

A female homosexual. Injury or wound. Morbid drowsiness; inaction and apathy. Form of psycho-surgery which involves the cutting of nerve fibres that connect the frontal

lobes to the thalamus. Lysergic acid diethylamide;

hallucinogen. A form of mental

a widely

subnormality

used

characterized

by large headedness resulting from excessive growth of supportive cells in the brain. To pretend to be ill. A state of great excitment, activity, and violence. A drug obtained from the hemp plant. Sexual deviation in which sexual pleasure

is obtained by inflicting pain upon one’s self. Sexual pleasure obtained by manual or mecha-

nical stimulation of the genitals. Severe depression. A virus infection of the membranes covering

the brain and the spinal cord. Natural end of the menstrual cycle. A drug used in convulsive therapy. A form of mental subnormality characterized by small headedness and retarded development of the brain. Severe form of familial headache. Social therapy involving modification of the or immediate patient’s life circumstances environment.

Modeling: Mongolism:

Morbid: Morphine:

Technique for behaviour modification involving the imitation of a model behaviour. A form of mental subnormality in which the

patient has the facial characteristics of a mem-

ber of the mongolian race. Unhealthy, pathological. Narcotic drug derived from opium.

lity:

Dissociative reaction in which an individual takes two or more personality systems independent of one another.

Mutism:

Inability or refusal to speak.

Muitiple persona-

258 Narcissism: Narcotic: Necrophilia:

Negativism: Nervous breakdown:

Neurasthenia:

Neurosis:

Neurosyphilis:

Non-directive therapy:

Nymphomania: Obsession:

Obsessive cotmpul-

sive neurosis: Organic brain syndrome: Orgasm: Overt behaviour:

Oxycephaley: Paranoid disorder s:

Parasympathetic system: Paresis: Parkinson’s disease:

ABNORMAL

PSYCHOLOGY

Excessive self-love. Sedative drug Producing sleep. A sexual deviation in whi ch one gets sexual pleasure from the dead bod ies. A form of aggressive Withdr awal which involves refusal to obey or doi ng the opposite of what has

been asked, A term loosely applied to vari ous conditions in which the Person is acutely incapicitated by his anxieties, frustrations and conflicts. Neurotic disorder with com plaints of general fatigue and wea

kness. Psychological disorder by excessive use of avoida characterized nce behaviour and defence mechanism for con trolling anxiety. Syphilis of the nervous system. Rogers’ technique of Psychotherapy in which the therapist refrains from advice or direct ion of the therapy.

Insatiable impulse for sexual gratifica tion in women. Persistent recurrence of an unwanted thought or impulse. idea, A neurotic disord er marked by persistent obsessional thoughts, compulsi

ons or both. Mental disorders as sociated with brai n pathoogy. Peak sexual tensio n followed by re laxation. Behaviour or activi tie s wh ic h can be observed by an outsider., Distortion of the shaped appearan skull giving the head a steeplece,

Psychotic disord er ed and stable s j delusions

of

Segment of the autonomic nervou s system. Syphilic in

fection of A chronic progress the brain. ive disease nervous syst

em

characterized

of the central

by severe

and

259

GLOSSARY

continual Pathogenic:

Pathology: Pedophilia:

muscular

tremors

and

mask-like

expressionless face. Factors conducive to abnormal

condition or disorder. Any manifestation of disease or abnormality. Sexual deviation in whicb an adult takes a child for sexual activity.

Phenobarbital:

A type of epileptic seizure in which the patient loses consciousness for a few seconds but does not suffer convulsion. A widely used sedative drug.

Phenylketonuria

Disorder

(PKU):

ciated with mental retardation. An irrational obsessive fear. A presenile brain disorder caused by progres-

Petitmal:

Phobia: Pick’s disease:

Pituitary: Play therapy:

metabolism usually asso-

of protein

sive degeneration of the central nervous system,

mainly involving frontal and temporal lobe atrophy. Endocrine gland located at the base of the brain. Treatment of children involving play material.

Posturing: Precipitating cause:

Predisposing cause: Prenatal:

Prodromal: Prognosis:

Projection:

Psychiatry: Psychoanalysis: Psychodrama:

Maintaining unusual postures for long periods. occuring stress or event The particular before its effects or shortly immediately (producing a disorder). A cause that occurs quite early but paves the way for the appearance of a disorder. Senile brain deterioration occuring at premature age. Pertaining to anearly indication or warning sign of a disease or disorder. Prediction of the course and outcome of a disorder. A defence mechanism, involving attribution of one’s own negative qualities to other. Branch of „medicine specially dealing with

the diagnosis and treatment

of mental

dis-

orders. A term invented by Freud to refer to his theory of personality and his method of psychotherapy. Psychological treatment in which a patient is made

to

act

out

deliberately

emotions and conflicts.

his

feelings,

260 Psychogenic: Psychomotor:

Psychopath:

ABNORMAL

Pertaining to Psychological orig in.

Motor behaviour associated with Psychological Processes.

The old term used for Sociop ath

or antisocial

Personality.

Psychophysiologic or psychosomatic disorders: Psychosis:

Disorders of the behaviour invo lving organic and Psychological factors. Severe

contact

Psychosurgery:

Psychotherapy: Puberty: Pyromania: Rapport: Rationalizatjon:

PSYCHOLOGY

mental

with

disorder

reality,

both

the

involving loss, of

delusion,

hallucina, tions ete, Brain surgery for treating ment al disorder.

Treatment of mental disorders

and behavioural problems by psychologica l methods. Period during early ado lescence when secondary sex characterstics appear. Compulsive urge to set fire. A feeling of reciproca l emotional acceptanc e between two people such as therapist and patient. Defence

mechanism

in which

a person tries by giving socially accept unjustified behaviour able reasons for it. Defence „mechanism in which one strives to ehave in ways tha t are sharply in con trast with the ways in whi ch he tends to be Defence mechanism. of behaving in a man more appropriate ner to the to justify his otherwise

Reaction-formation:

Regression:

Rehabilitation: Reinforcement: Rejection: Remission:

Repression:

Resistance: Retardation:

of life. Providing

earlier, happier per iods

Te-

education and suitable ment in dealing wit h criminals and del environinquents. The strengthenin g of a response,

Lack of accept necessary attentioance, or failing n and care,

to provide

Period of improv ement in the co urse of mental disorder,

Defence mechanis m anxiety producing in which the threatening or experiences and wishes are pushed down into the la unfulfilled conscious mind. yer of uny to ntain symptoms and treatment by notmaicoo resist perating with the therapist. Slowing down of th inking and overt act ivity.

261

GLOSSARY

Role-playing:

Dramatic therapy in which the person acts out the behaviour of a certain individual in a particular situation.

Sadism:

Sexual deviation in which sexual gratification is obtained by inflicting pain on others.

Sadomasochism:

The term used for the coexistence of both sadism and masochism (sex deviations) in an individual.

Schizophrenia:

A group of psychotic reactions in which there are fundamental disturbances in reality relationships

and

in

emotional

and

intellectual

processes.

Secondary gain:

Secondary or indirect advantages like excessive care, sympathy derived from a neurotic symptom.

Sedative:

Self-devaluation:

Drugs used to induce relaxation and reduce tension. Fulfilment of one’s potentialities to the maximum level. Lowering one’s self-esteem and feelings of

Self image:

One’s conception of his own

Senile: Senile dementia:

Pertaining to old age. A form of psychoses caused by progressive degeneration of the old age. Unconventional sex behaviour. Inability or incompetency to give or share sexual gratification. Workshops where mentally subnormal or other

Self-actualization:

worth.

Sexual deviation: Sexual inadequacy: Sheltered workshops: Shock therapy:

Sibling: Sibling rivalry:

Sociogenic: Sociopath:

Sociotherapy:

worth in terms of

his traits.

handicapped persons can engage in community work. Use of shock in treating mental disorders. Children of the same parents. Rivalry between the children of the same

parents. Of sociological in origin. Term used for the antisocial

behaviour

of

individuals who are basically unsocialized and whose behaviour pattern brings them repeatedly into conflict with society.

Treatment of the mental disorder by improving social

relationships

environment.

and

modification

of the

262 Somatic: Somnambulism: Stereotype mannerism: Stress: Stressors: Stress tolerance: Stupor:

Sublimation:

Substitution: Suicide: Superego:

Supportive therapy: Supression:

Symptom:

Symptomatic:

Syndrome:

Systematic disensitization:

ABNORMAL

PSYCHOLOGY

Pertaining to the body. Walking in a sleep-like stat e. Conscious grimace, gesture or movement of the whole body. Any condition that puts strain on the coping capacities of an individu al.

Events or conditions causin g stress.

A term

used for indicating the

amount of stress one can tolerate befo re breaking down under the pressure of stre ss. , State of

lethargy and immobility with partial or complete consciousnes s. . Gratification of Primitive imp ulses in a socially approved manner or asa defence expression of a frustrated motive in socially sanctioned

ways. Acceptance of Substitu te goals or gratification in place of those orig inally aimed or desired. Taking one’s own life. In psycho analysis, the perfection seeking, ethical moral arm of one’s personality, Psychological treatment designed to remove symptoms by reinforci ng existing personality defences,

Deliberate inhibition An observable manifeof threatening stimuli. station, sign or indica cation of some Sickne ss, Pertaining to a Spe cific sy Term used for rep mptom. resenting a fairly wel organi l sed group or cluste r of Symptoms may be found in a Particular disorder.

that

Tay-Sach’s disease:

Therapeutic community:

Therapy: Thyroid: Thyroxine; Tic: Token economy:

Term fora modern group and milieu mental hospital that employsand gives patients. considerable resp therapy onsibility, Treatment.

263

GLOSSARY

Tonic phase:

with tokens that can be exchanged for desired items or privileges. convulsion, First phase of the grandmal

Toxic:

Poisonous.

Traits:

Tranquiliser:

Transference:

Trans-sexualism:

Transvestism: Trauma: Tremor: Unconscious: Visceral:

Voyeurism:

Waxy

flexibility:

Withdrawal symptoms:

Word salad: Worry:

Zoophilia

muscular rigidity.

Lasting and consistent characteristic of an individual which can be observed or measured. and A drug used to calm and relax a person or d excite ed, agitat s, anxiou less him make aggressive. Process in psychotherapy in which the clients

to project attitudes and emotions applicable ist. therap the to on person another significant Behaving and believing firmly in the change of one’s Sex,

Sexual-deviation of obtaining sexual gratification by wearing clothes appropriate to the opposite sex. Shock or injury. Rhythmic and involuntary muscle movements. Without awareness. Pertaining to the internal organs. Sexual deviation in which sexual gratification is obtained through peeping, that is, observation of the genitals or sexual behaviour of others.

Condition in which a person will maintain the position in which his limbs are placed for an

unusually long period of time. Physical and psychological symptoms associated with the attempt to stop the use of alcohol or other drugs. Jumbled and incoherent use of words by psychotics or disorganised persons. or Persistent concern about past behaviour anticipated dangers.

Sexual relations with an animal.

bestiality: Zygote:

Fertilized ovum.

INDEX

Abnormal 64-72;

Behaviour,Symptoms Causes

of,

of,

74-89; Types of,

74; Treatment of, 227-44 Abnormal Psychology, Definition of, 1-2;

Scope

of, 2-3; Importance of,

3-5; Historical background of, 12-23; Current Trends in, 20-3

Abnormality, 5; Concept of, 6-13

Acrophobia, 122 Adjustment, 32-7; Definition of, 33-4; Characteristics Aspects of, 34-5;

of, 35-6

Adjustment inventories, 12

Adler; pa fred, 20, 23; on motivation,

Adolescent Ps

Adulthood, ai

child Psychology, 1 Clanstraphobia, 1 Client-Centred Psychotherapy, 232-8 Compensation, 58, 61 of, Conflicts, 42-5; Definition Types of, 43-4; Sources of, Conversion Neurosis, 101

Crimes,

179,

194-9;

Difference

42-3;

with

195-7; Sociopath, 188-9; Causes of, 197-9 Prevention and Treatment of, 188-200 Criminal Behaviour, 179, Crime, 189-90; Delinquency, 179; and vention and Pre 2; Causes of, 190-

Treatment of, 192-4

Delusions, 67-8 , 115, 130 Depersonalization Neurosis

i

Adult Psychology, 1

Affective Disorders, 146, 152-7; Causes and Treatment of, 156-7; Classification of, 154-7

Agnosia, 67

Agrophobia, 122 Aichmophobia, 122

Alcoholism, 179, 201-13; Definition of,

201; Effect of, 203; Causes of, 204; Treatment of, 2!

Alzophobia, 122

erican Association of Mental

ciency, 162

American Phychiatric Association,

An? 931,94; 95, 99,179

Defi-

90,

nalism, 217

Depression, 70, 116 155 Depressive Disorder, 154, 128-9, 132 Depressive Neurosis, 115, 1 Development Psychology, cal Manual of Diagnostic and Statisti 93-5,

90-1, ‘Mental Disorders (DSM), 99, 114, 115, 125, 162, 179 17 Discovery of Witchcraft, 61 56, , ent cem Displa A Treatment of Dramatic Therapy, , 240-1 our avi Beh Abnormal Drives, 26, 36, 38 , 228; n, 179, 201, 206-13 Drug Addictio Effects of, 207-8;

Causes of 208-9; of 209-12 Prevention and Treatment,

y, 1 Educational Psycholog

Anziety Neurosis, 115, 116-18, 131 phasia, 67, 69 etaeous, 15 Aristotle, 15 Asclepiades, 15

Elation, 70

Biporar Affective Disorder, 154-156

Fantasy, 54, 61 å Fetishism, 21 Motivation, On 23; 19, d, mun Sig ud, Fre 29, 6 Frigidity, 223: Causes of, 223-

Astraphobia, 122 Avicenma, 17

se, Subhas Chandra, 9

Breuer, Joseph, 19, 23 British Mental Deficiency Act, 162 Capsiovascalge Disorders,

102, 103-4,

Catatonic Schizophrenia, 147-8

Changej Khan, 58

y (ROD); 152 Electroconvulsive Therap70-1, , ms, pto Sym Emotional 108, 112 Endocrine Disorder, 102, Etiology, 74-89, 182, 186 1 Experimental Psychology,

Frotteurism, 219 Frustration, 38, 50; Definition

Causes

41-2

of, 39-41;

of, 38-9;

Reaction

to,

266

ABNORMAL

Functional Psychoses, 146-9 len, 15 Se ial Disorders, 102, 104-6, 113 Genes, 76-7 Genitourinary Disorders, 102, 106-7, 113 Griesinger, William, 19, 23 Group Therapy, A Treatment of Ab-

normal Behaviour, 238-40

Hebephrenic Schizophrenia, 147 Hemic and Lymphatic Disorders,

108, 113 Hematophobia, 122 Homosexuality, 217 untington, George, 145

102

115,

130,

Hysterical Neurosis, 115, 118-22, 131 Impotence, 222; Causes of, 223-6 Individual Psychology, 1

Industria] Psychology, 1 Inte rnational

Classification

of Diseas-

Isolation, 54, 61

Kisker, George, Kreapelin, Emil, W., 110, 114, 214 19, 23, 90 Lalophobia, 122 Lymphatic Disord ers, 102, 108, 113 Manic Disorders, 15 4 aslow, on Moti va asochism, 217 tion, 29-31, 36 Melancholia, 68 Memory, 66 Menstrual Diso rd esmer, Anton, ers, 106 Mental Defici 19 ency, 162-78; of, 162-3; Classi Definition f ati i Mental Disorder, SL-61,n 65.65e 163:6

of, 51-2; Types of, 52267

134;

tophobia, 122

Neurosis,

115,

Ochlophobia, 123 Organic Psychoses, 135 -46

Paracelsus, 17, 23 Paranoid Disorders, 157 -60

Paranoid Schizophreni a, 147, 149 Pathaphobia, 123

Paul, St., Vincentata, Paulov, Ivon, 20, 23 17, 23 Persecution, 68 Personality Assessment, 12

122-3 Photophobja, 123 Physiology Psycholog y, 1 Pinel, Philippe, 18

Plato, 15

Perception, 66

Projection, 59, 61 Projective Techniques for

Assessment, 12 Psychoanalytical The

Personality

rapy, A Treatment of Abnormal Behavi Psychoneurotic Disord our, 230-2 ers, 5; Causes and Treatment 114-33, 134of, 131-2 Psycho-Physiolo

gical Disorders, 100-14 ;

Psychosurgery, A Trea men t of Abnorm: 3

Definit;

ypes

Pefinition

Causes of, 168-71; Identificati 171-3; Prevention A medial Measures for, 174-7 -4; Mental Symptoms, 65-8, 71

Meyer, Adolf, 20, 23 otives, 36; Definition of, 26-7 Motivation,

36

115,

€vrasthenic Neurosis, 115, 129 -30 Newton, 8 Normality, 5; Concept of, 6-13 Nyc

65-68, 73, 90-

Mechanism, 51-61;

Mental Retardation;

114,

Types of, 115-30

s, 71; Causes of, 124-5; Types of,

Jung, C.F., 20, 23

400,HUES, 125, 136

Naturalism, 15

Negativism, 55, 61 Neologism, 66 Neurosis, 144-33 eurotic Behaviour,

Phobic Neurosis, 115, 122-4, 131 Phobia

Janet, Pierre, 19, 23

Mental

Motivation Cycle, 28 Motor Symptoms, 68-70, 73 Mysophobia, 122

Obsession, 67 bsessive-Compulsive 125-8, 132

Hydrophobia, 122 Hypochondriacal Neuros is, Hypochondriasis, 68

PSYCHOLOGY

24-37; Theories of, 28-32,

Psychotic Disorders, 134 -61; Classification of, 135-48

thogoras, 8

Rationalizatio

n, 56, 61 €action-Form at gression, 53 ion, 56-61 , pression, 52 61 -61

Respiratory Disorders, 102 -3, 113

267

INDEX

Rush, Benjamin, 18 Sadism, 217 Schizophrenio, 146-53 Scot, Reginalt, 17, 23 Self-Actualization, 26 Self-Assertion, 26 Self-Devaluation, 83 Sensation, 65

Sexual Deviations and Disorders, 179, 214-26; Definition of, 213-5; Forms of, 217-9; Causes of, 219-21; Treat-

ment of, 221-2 Shock Therapy, A Treatment of Abnormal Behaviour, 228-9 Skin Disorders, 102, 197 Skinners, B.F., 20, 23 Sociopathy, i79-87; Characteristics of, 180-2; Etiology of, 182-6; Defference with Crime, 188-9 Sociotherapy, A Treatment of Abnormal Behaviour, 241-3

Stresses, 45-50, 110; Causes and Sources of, 46-7; Impact of, 47-8; Factors Determining Severity of, 48-9

Symptoms,

62-72; Definition

64-75;

Syndromes, 72-3

Thanatophobia, 123 Total Behaviour Symptoms, 71-2 Toxophobia, 123 Transuetism, 219

Tuke, William, 18 Urbanisation, 86 Urinary Disorders, 106 Voyeurism, 218 Watson, J.B,, 20-23 Weyer, Johann, 17, 23 Witchcraft, 17 Withdrawal, 54, 61

Wong gealt

Xenophobia, 123

Studies in Hysteria, 19

Sympathism, 60

of 62-35

For Abnormal Behaviour, Classifications of, 65-72

Zoophobia, 123 Zoophilia, 218

Organisation

(WHO),