Chapter 2: Psychological Health

Psychological Health

Defined as our capacity to think, feel, and behave in ways that contribute to our ability to enjoy life and manage illnesses

Psychological Health vs. Psychological Normality

Health: the presence of mental wellness, not determined by symptoms alone or how people look on the outside

Normality: close to average, psychological diversity is valuable

Maslow’s Hierarchy of Needs

• described as an ideal of mental health

• those who make it to the top = self-actualization

Qualities in Maslow’s Hierarchy of Needs

• realism

• acceptance (of self and others)

• autonomy

• capacity for intimacy

• creativity (being emotionally open)

What are the pillars in Maslow’s Hierarchy of Needs?

1) Physiological needs

2) Safety and Security

3) Love and Belongingness

4) Self-Esteem

5) Self-Acutalisation

Maslow’s Hierarchy of Needs

Level 1: Physiological Needs

• food and water

• shelter

• sleep

• exercise

• sex

Maslow’s Hierarchy of Needs

Level 2: Safety and Security

• safe surroundings

• protection by others

• knows to avoid risks

Maslow’s Hierarchy of Needs

Level 3: Love and Belongingness

• loved

• loving

• connected

Maslow’s Hierarchy of Needs

Level 4: Self-Esteem

• as a person

• as a doer

• in relationships

Maslow’s Hierarchy of Needs

Level 5: Self-Actualization

• high levels of openness to feelings

• striking a balance in all aspects of life

• resilience: the ability to recapture a sense of psychological wellness within a reasonable time after encountering a difficult situation

• bouncing back from life’s challenges

What are the Qualities of Self-Actualization?

(4 - A, A, CF, C)

1) Autonomy

2) Authenticity

3) Capacity for Intimacy

4) Creativity

Self-Actualization

Autonomy

• independence

• inner direction

• internal locus of control

Self-Actualization

Authenticity

• no fear of judgement

• genuine

Self-Actualization

Capacity for Intimacy

Not being afraid of the bonds in every relationship formed being broken

Self-Actualization

Creativity

• openness to new ideas

• no fear of uncertainty

• appreciation for the world around them

When does Self-Esteem Begin?

In childhood

Integration

Feeling that one has created their own self-concept rather than adopting an image that others have created, developing a sense of self over time

Stability

Depends on the integration of the self and its freedom from contradictions, challenge in youth can end in lack of stability and shaky sense of self

What is Self-Esteem?

Where can foundations of SE be traced back to?

• critical component of psychological wellness

• improves SE may offset self-destructive behaviours

• Improved SE means finding a balance between your ‘idealised self’ and where you are now

• Foundations of SE can be traced to childhood

Hardiness

Works with self-esteem to enhance one’s levels of psychological health

Hardiness:

3 Important Traits (The 3 Cs)

• commitment

• control

• welcoming challenge

Hardiness:

Commitment

High level, to a religious group, family, etc., values and sense of purpose, provides structure and direction in the face of stressors

Hardiness:

Sense of Control

Orchestrate the situations in their lives to the best of their abilities, only worrying about the things one can control in their life

Hardiness:

Welcoming Challenge

Ability to take control of change and shape it to fulfil their own personal growth and development

Anxiety Disorders:

Simple (Specific) Phobias

• fear of something definite

• stemmed from biological factors and life events

• 13% of Canadians will experience a simple phobia

• 5% of children, 16% of adolescents will experience a simple phobia

On average, how many Canadians will experience a simple phobia?

13% of Canadians

On average, what percentage of children will experience a simple phobia? What percentage of adolescents?

• 5% of children

• 16% of adolescents

Anxiety Disorders:

Social Phobias

Fear of embarrassment or humiliation in public settings

What percentage of Canadians will experience a social phobia?

8 - 13% of Canadians

Anxiety Disorders:

Panic Disorder (Agoraphobia)

• sudden surge of anxiety paired with other symptoms

• Agoraphobia: fear of being in a public place and not being able to escape

What percentage of Canadians will experience a panic disorder in a given year?

In their lifetime?

• 2% in a given year

• 4% in their lifetime

Anxiety Disorders:

Generalized Anxiety Disorder (GAD)

• Worries are not unjustified, but they do persist more than usual

• accompanied by depression

What percentage of Canadians (15 years and older) experience GAD?

About 8.7%

Anxiety Disorders:

Obsessive Compulsive Disorder (OCD)

• Obsessions: recurrent, unwanted thoughts or impulses, improbable fears

• Compulsions: repetitive, difficult-to-break, actions that are usually associated with obsessions (handwashing by the fear of contamination and dirt)

What percentage of Canadians have OCD?

1% of Canadians

Anxiety Disorders:

Behavioural Addictions (role of compulsions)

• Role of compulsions is small but significant

• Intense urges to engage in specific behaviour, feeling relief and elation when doing activity

Anxiety disorders:

Post-Traumatic Stress Disorder (PTSD)

• Reacting severely to a traumatic event (physical violence to oneself or loved ones, etc.)

• Personal assaults (rape, military combat), natural disasters (floods, etc.), and tragedies (fires, vehicle crashes)

What percentage of Canadians are estimated to experience PTSD at some point in their lives?

10% of Canadians

When do PTSD symptoms usually decrease?

Within 3 months. Individuals usually recover in about 6 months

Anxiety Disorders:

Treatment

• Psychological interventions

• Drug treatments (not intended for simple phobias)

• Cognitive-behavioural therapy

Mood Disorders:

Depression

Mental state of low mood and aversion to activity

What is the Root Cause of Depression?

Pessimism

(thoughts of incapability of success, dismissing accomplishments, failure an rejection, etc.)

What percentage of Canadians does depression effect?

15% of Canadians

Depression in women vs. men

(Percentages)

• women have a higher likelihood

• women: 14% likelihood

• men: 8.5% likelihood

Mood Disorders:

Depression (Symptoms)

• feeling of sadness or hopelessness

• loss of pleasure in doing usual activities

• poor appetite and weight loss

• insomnia or disturbed sleep

• restlessness or fatigue

• thoughts of worthlessness and guilt

• trouble concentrating or making decisions

• thoughts of death or suicide

Mood Disorders:

Depression (Dysthymic Disorder)

Depression symptoms persist mildly or moderately for 2 years or longer

Mood Disorders:

Depression (Treatment)

(ECT)

• Electro-Convulsive Therapy

• Epileptic-like seizure is induced by an electrical impulse transmitted through electrodes placed on the head

• Patients are given an anaesthetic and a muscle relaxant to rescue anxiety and prevent injuries associated with seizures

• 3 treatments per week, 2 - 4 weeks

Models of Human Nature:

The Biological Model

• depends entirely on the brain (organic structure)

• activity of neurons, mediated by complex chemical reactions, gives rise to our most complex thoughts

Models of Human Nature:

The Biological Model (Placebo)

• chemically inactive substance

• patient responds as if the drug was chemically active

Models of Human Nature:

The Biological Model (Pharmacological Therapy)

• antidepressants

• mood stabilizers

• antipsychotics

• anxiolytics (antianxiety agents)

• stimulants —> ADHD

• anti-dimentia drugs

Models of Human Nature:

The Behavioural Model

• Focuses on what people do, rather than brain structures and chemistry or on thoughts and consciousness

• Psychological problems, bad habits, etc.

• Analysed by stimulus, response, and reinforcement

• Aim is to discover what reinforcements keep an undesirable behaviour going, trying to change those reinforcements

• Changing behaviour → expose yourself to your fears, don’t turn away and hide

Models of Human Nature:

The Cognitive Model

• The effect of ideas on behaviour and feeling

• Behaviour results from complicated attitudes, expectations, and motives

• Tries to expose and identify false ideas that produce negative feelings, such as anxiety and depression

Models of Human Nature:

The Pscyhodynamic Model

• Emphasises thoughts

• Thoughts cannot be changed directly because they are fed by other unconscious ideas and impulses

• Symptoms are not isolated pieces of behaviour, rather the result of a hidden complex set of desires and emotions

• In therapy, patients will speak as freely as they can t the therapist to try and understand the basis of their feelings, gaining insight can help to overcome maladaptive behaviour

Cognitive Behavioural Therapy (CBT)

• Typically focuses on changing problematic patterns of thinking

• Involves individual and/ or group session with a therapist

• Has been shown to produce significant improvements

• Has been combined with drug therapy for depression and anxiety

Defence and Coping Mechanisms:

Projection

Reacting to unacceptable inner impulses as if they were from outside the self

Ex. A student who dislikes a roommate feels that the roommate does not like them

Defence and Coping Mechanisms:

Repression

Expelling from awareness an unpleasant feeling, idea, or memory

Ex. The child of an alcoholic, neglectful father remembers him as a loving person

Defence and Coping Mechanisms:

Denial

Refusing to acknowledge to yourself what you really know to be true

Ex. A person believes that smoking cigarettes won’t hurt them because they’re young and healthy

Defence and Coping Mechanisms:

Passive-Aggressive Behaviour

Expressing hostility toward someone by being covertly uncooperative or passive

Ex. A person tells a co-worker, with whom they compete for a project assignments, that they’ll help with a report but then never follows through

Defence and Coping Mechanisms:

Displacement

Shifting your feelings about a person to another person

Ex. A student who is angry with a professor returns home and yells at a housemate

Defence and Coping Mechanisms:

Rationalisation

Giving a false, acceptable reason when the real reason is unacceptable

Ex. A shy student decides not to attend a dorm party, telling themselves they’d be bored

Defence and Coping Mechanisms:

Substitution

Deliberately replacing a frustrating goal with one that is more attainable

Ex. A student having a difficult time passing courses in chemistry decides to change majors

Defence and Coping Mechanisms:

Humour

Finding something funny in unpleasant situations

Ex. A student whose bicycle has been stolen thinks how surprised the thief will be when they start downhill and realise the brakes don’t work

Assertiveness

Expression that is confident and direct but not hostile

Erikson’s Stages of Development

Trust vs. Mistrust

Infancy from birth to 18 months

Erikson’s Stages of Development

Autonomy vs. Shame and Doubt

Toddler: 18 months to 3 years

Erikson’s Stages of Development

Initiative vs. Guilt

Preschool Years: 3 - 5

Erikson’s Stages of Development

Industry vs. Inferiority

Middle School Years: 6 - 11

Erikson’s Stages of Development

Identity vs. Confusion

Teen Years: 12 - 18

Erikson’s Stages of Development

Intimacy vs. Isolation

Adult Years: 18 - 40

Erikson’s Stages of Development

Generativity vs. Stagnation

Middle Age: 40 - 65

Erikson’s Stages of Development

Integrity vs. Despair

Older Adulthood: 65 years - death

What percentage of Canadians are diagnosed with schizophrenia in their lifetime?

1% of Canadians

Suicide and Language

Unacceptable Terms

• “successful suicide”

• “commit suicide”

• “failed suicide attempt”

Suicide and Language

Acceptable Terms

• “die by suicide”

• “non-fatal suicide attempt”

• “suicide attempt”

How many students in Canada will experience a mental health problem?

1 in 4 students in Canada

Percentage of Stress that Negatively Affects Academic Performance

51.5%

Percentage of Anxiety that Negatively Affects Academic Performance

43.3%

Percentage of Depression that Negatively Affects Academic Performance

30.4%

Percentage of Students Reporting to be in “Serious Psychological Distress”

33.4%

Percentage of Students Reporting to be Diagnosed with Anxiety

32%

Percentage of Students Reporting to be Diagnosed with Depression

24.6%

Stigma

a set of negative and often unfair beliefs that a society or group of people have about something; negative stereotype, quite common

Harmful Effects of Stigma

reluctance to seek help or treatment, lack of understanding from friends and families, fewer opportunities for work, bullying, harassment, belief that one will never succeed

IS PATH WARM?

I…?

Ideation

Threatened or communicated

IS PATH WARM?

S…?

Substance Use

Excessive or increased

IS PATH WARM?

P…?

Purposelessness

No reason for living

IS PATH WARM?

A (1)…?

Anxiety

Agitation/ Insomnia

IS PATH WARM?

T…?

Trapped

Feeling there is no way out

IS PATH WARM?

H…?

Hopelessness

Feeling that things will never get better

IS PATH WARM?

W…?

Withdrawal

From friends, family, and society

IS PATH WARM?

A (2)…?

Anger

Rage, seeking revenge

IS PATH WARM?

R…?

Recklessness

Risky acts, not thinking about safety

IS PATH WARM?

M…?

Mood Changes

Dramatic