B06 - lecture 1 - The Rise of a New Specialisation: Medical Psychology

Medical psychology

 a specialized branch of psychology that integrates psychological principles with medical knowledge to understand, prevent, and treat psychological aspects of physical health and illness. This field focuses on the interplay between physical and mental health, aiming to improve patient outcomes by addressing both the psychological and biological factors involved in health and disease.

What is the origin of India's holistic healing system?

Ayurveda, originated over 3,000 years ago and is rooted in religious and health practices recorded in the Vedas

What are the Vedas?

four religious texts (Rig Veda, Yajur Veda, Sam Veda and Atharta Veda) containing religious and health practices. Also provided detailed early descriptions of preservation of will power, different emotions, inspiration and consciousness, as well as early descriptions of emotional states like grief, envy, pleasure, hostility, attachment or laziness

Which Veda is the oldest?

Rig Veda

Which Veda described the mind as the basis of consciousness?

Atharta Veda

What are the three life energies, or doshas, in Ayurvedic medicine?

Vata (space and air), Pitta (fire and water), and Kapha (water and earth), which balance physical and mental health.

Who was Avicenna, and what is "The Canon of Medicine"?

a Persian polymath whose "Canon of Medicine" became a cornerstone in both Islamic and European medicine. He expanded on theories of the mind, linking melancholia to physical and emotional factors.

What is the Charaka Samhita?

it details how to diagnose, cure and prevent disease and promotes Ayurveda as a comprehensive health care system. Is especially important to the field of medical psychology, as it is one of the earliest text to discuss the psychological and physical causes of mental illness

What were the 5 elements, that it was believed that people were made of in Indian religion during the timeperiod?

 fire, earth, water, space and air

What is the "Yellow Emperor's Inner Canon"?

Known as "Huangdi Neijing," this is one of the foundational texts of Traditional Chinese Medicine (TCM). It is over 2,000 years old and describes the body's balance of yin and yang and the importance of harmony with nature for health.

What is the significance of yin and yang in Traditional Chinese Medicine (TCM)?

In TCM, health is seen as a balance between yin (passive, cool, and dark elements) and yang (active, warm, and light elements). Disease results from an imbalance of these opposing forces.

Who was Hippocrates, and what was his influence on medicine?

a Greek physician who promoted humoral pathology, linking health to a balance of bodily fluids, and is known for the Hippocratic Oath.

What are the four humors in humoral pathology?

Blood, phlegm, black bile, and yellow bile, each linked to different temperaments and imbalances in the body, and associated with different diseases.

How did Galen expand on Hippocratic medicine?

advanced Hippocrates’ ideas by associating diseases with specific organ systems and introducing the concept of mental illnesses as stemming from bodily imbalances, thereby influencing early psychological thought.

What was Paracelsus' approach to disease?

a Swiss physician, integrated alchemical concepts into medicine, proposing that diseases have different causes such as astral, mental, and divine influences, rather than just humoral imbalances. He emphasized the importance of chemical substances in treating illness.

What was Andreas Vesalius' contribution to anatomy and medicine?

published "De humani corporis fabrica" (On the Fabric of the Human Body), a detailed anatomy text that corrected many errors in Galenic anatomy and laid the groundwork for modern anatomical studies.

How did Descartes influence medical thought?

separated mind and body (dualism), viewing the human body as a machine and diseases as defects, which influenced the mechanical model of medicine.

What is "The Anatomy of Melancholy," and what remedies did Robert Burton suggest?

is a 17th-century text that analyzes depression (melancholia). Burton suggested remedies like exercise, diet, and social interaction to alleviate symptoms.

Who was Thomas Willis, and how did he contribute to the study of diabetes?

identified the sweet taste of urine in diabetes mellitus, which was one of the first clinical observations used to distinguish this disease from others.

What is the importance of Giovanni Battista Morgagni's work in pathology?

Linked diseases to specific organs and structural changes, shifting medicine’s focus from symptom-based to organ-based pathology.

How did Xavier Bichat contribute to tissue pathology?

identified 23 types of tissues in the human body, arguing that diseases could be linked to specific tissue types, which laid the foundation for histology and modern pathology.

Explain Rudolf Virchow's concept of cellular pathology.

often called the "father of modern pathology," proposed that all diseases can be traced to cellular abnormalities. His work established the idea that diseases are rooted in cellular changes, not just organ-level issues.

What was Hermann Ebbinghaus's contribution to psychology, and what did he mean by "a long past, but a short history"?

pioneered cognitive psychology and emphasized that, although psychology as a formal scientific field began in the late 19th century, the study of topics like cognition, emotion, and behavior has ancient roots. His work was foundational in the study of memory and forgetting.

What is Christian Wolf's concept of "rational psychology"

focuses on the self or Ego as a part of consciousness and relies on introspection and logical reasoning

What is empirical psychology?

relies on observed and measured phenomena, emphasizing experiences and emotions as sources of knowledge rather than theory. Counterpart to rational psychology

What was Immanuel Kant’s critique of rational psychology?

argued that self-consciousness could not be fully understood through pure reason. He instead emphasized introspection

What is introspection?

a method where individuals examine their own mental and emotional states to gain insight.

Who was Johan Heinroth, and what did he mean by "psychosomatic"?

a German psychiatrist, coined the term "psychosomatic" to describe illnesses that involve both mind (psyche) and body (soma). He proposed that prolonged sin or moral failings could lead to mental illness, reflecting the 19th-century Protestant view.

What is the "uberuns" in Johan Heinroth’s model of the psyche?

represents the conscience

What is the "ego" in Johan Heinroth’s model of the psyche?

includes mind, emotion, and will

What is the “fleisch" in Johan Heinroth’s model of the psyche?

represents basic drives and sinful nature

how did Johan Heinroth believe “uberuns”, “ego” and “fleisch” related to mental illness?

He believed that mental illness could result from prolonged "sin" or bodily desires overpowering the moral conscience.

What were Johan Heinroth’s "direct-psychic" treatment methods?

focused on psychological interventions aimed at the patient’s soul

What were Johan Heinroth’s "indirect-psychic" treatment methods?

targeted the body to indirectly affect the mind, often through physical treatments.

Why is Wilhelm Wundt considered the "father of modern psychology"?

established the first experimental psychology lab in 1879, formalizing psychology as a scientific discipline

what did Wilhelm Wundt’s empirical approach emphasize?

emphasized controlled experiments, quantification, and observation of psychological processes under laboratory conditions.

What were Wundt’s use of "introspection" as a research method?

trained subjects to systematically observe and report their conscious experiences in response to stimuli. Although later criticized for subjectivity, this method was pioneering in attempting to make mental processes observable and measurable.

What is "structuralism"?

The approach of breaking down mental processes into their basic components, such as sensations, perceptions, and emotions.

What is Wundt’s "principle of voluntarism" in relation to consciousness?

is the concept that consciousness is an active process, with individuals able to direct their attention and control their thoughts and perceptions. This idea contributed to early studies on attention and awareness.

What role did reaction time studies play in Wundt’s research?

used to quantify mental processes, measuring the speed with which subjects could perceive stimuli or make decisions. This helped establish a quantitative approach to studying the mind.

Who were some of Wundt’s influential students, and how did they contribute to psychology?

Francis Galton (statistics), Hermann Ebbinghaus (memory research), Alfred Binet (intelligence testing), Stanley Hall (first American lab), and William James (founded American Journal of Psychology). Spread his methods internationally, establishing psychology as a science.

What is psychoanalysis?

a theory and therapeutic approach emphasizing the unconscious mind, childhood experiences, and internal conflicts. It focuses on uncovering repressed emotions and memories.

What is Freud’s concept of the "unconscious mind" and its influence on behavior?

the unconscious mind contains repressed thoughts and desires that influence behavior, often leading to psychological distress or neurotic behaviors.

What are Freud’s "psychosexual stages," and how do they impact personality?

identified stages (oral, anal, phallic, latent, genital) where unresolved conflicts could affect adult personality and behavior. Each stage represents different focuses of pleasure and challenges in development.

What are defense mechanisms, according to Freud?

like repression, denial, and projection, are strategies the ego uses to manage anxiety and protect itself from distressing thoughts and feelings.

Describe Freud’s concept of "conversion" in psychosomatic disorders.

theorized that emotional distress could be "converted" into physical symptoms, as seen in cases of hysteria, where unresolved psychological conflicts manifest as bodily symptoms.

What is a "corrective emotional experience" introduced by Franz Alexander?

involves re-exposing patients to past traumas in a supportive therapy environment, allowing them to process and heal from earlier emotional wounds.

How did Ivan Pavlov’s experiments with dogs contribute to the development of behaviorism?

demonstrated that behaviors could be learned through association. By pairing a neutral stimulus (a bell) with food, he conditioned dogs to salivate to the bell alone, highlighting stimulus-response learning.

What is Pavlov’s concept of generalization?

occurs when a subject responds to stimuli similar to the conditioned stimulus

What is Pavlov’s concept of discrimination?

involves distinguishing between different stimuli and responding only to the specific conditioned one.

How did Pavlov’s discoveries influence behavioral therapy?

laid the foundation for behavioral therapy techniques, like exposure therapy and systematic desensitization, which use conditioning principles to modify maladaptive behaviors.

What is "systematic desensitization", developed by Joseph Wolpe and how does it work?

it involves gradually exposing a patient to anxiety-inducing stimuli while teaching relaxation techniques to reduce fear responses over time.

What is "aversion therapy"?

pairs unwanted behaviors with negative stimuli to discourage them. For example, pairing alcohol with an unpleasant reaction like nausea to reduce alcohol consumption.

What is "flooding" in behavioral therapy?

is an exposure technique where patients are directly exposed to intense levels of their feared object or situation without gradual steps, helping to extinguish the conditioned fear response.

What is humanistic psychology?

is a perspective that emphasizes personal growth, free will, and the inherent goodness of people. It emerged in the mid-20th century as a reaction to the limitations of psychoanalysis (focus on unconscious conflicts) and behaviorism (focus on observable behavior).

What are the core beliefs of humanistic psychology?

emphasizes subjective experiences, self-awareness, and the belief that people are motivated by an innate drive toward self-actualization, meaning the realization of one’s full potential.

What is person-centered therapy (client-centered therapy)?

emphasizes empathy, unconditional positive regard, and genuineness. Carl Rogers believed that individuals are the best experts on their lives and that therapists should facilitate personal growth without directing it.

What is the hierarchy of needs?

a five-tier pyramid introduced by Abraham Maslow that categorizes human needs from basic physiological and safety needs up to self-actualization. Maslow’s concept of self-actualization as the realization of one's full potential became central to humanistic psychology.

What is the humanistic theory of personality as highlighted by Maslow and Rogers?

emphasizes free will, self-actualization, and the inherent goodness and self-motivation of individuals. It stresses that achieving self-actualization depends on fulfilling basic needs, self-esteem, and acceptance.

What is the "holistic view of the person" in humanistic psychology?

views individuals as whole beings rather than a set of parts (like the id, ego, and superego). It believes that each person has inherent dignity, worth, and potential for growth.

How does humanistic psychology view free will and personal responsibility?

posits that people have free will and the ability to make choices about their lives, which allows them to shape their identities and pursue personal goals, accepting responsibility for their actions.

What is self-actualization in humanistic psychology?

the highest level of psychological development, where an individual fully realizes their unique potential.

What is positive psychology?

focuses on strengths, well-being, and resilience, shares humanistic psychology’s view of people’s innate capacity for growth and flourishing, emphasizing the potential for personal growth and resilience.

What is Gestalt Therapy created by Fritz Perls?

emphasizes personal responsibility and awareness of the present moment. It encourages clients to explore their thoughts and emotions as they occur in real time to gain insight into unresolved issues.

What is Existential Therapy in the context of humanistic psychology?

Influenced by existential philosophy, it helps clients confront and accept fundamental life issues such as freedom, isolation, and death, promoting authenticity and personal responsibility.

What criticism does humanistic psychology face regarding empirical evidence?

often criticized for lacking empirical evidence because it focuses on subjective experience, which is difficult to measure objectively. Concepts like self-actualization and peak experiences are challenging to quantify.

How is humanistic psychology criticized for its emphasis on individualism?

Critics argue that humanistic psychology’s focus on self-actualization may overlook social, cultural, and economic factors, making it less applicable in collectivist cultures or among individuals facing systemic barriers.

What is Cognitive Behavioral Therapy (CBT)?

is an evidence-based psychotherapy combining principles of cognitive and behavioral psychology. Developed by Aaron Beck and Albert Ellis in the 1960s, it focuses on the idea that thoughts, emotions, and behaviors are interconnected, and changing unhelpful thinking and behavior patterns can improve emotional well-being.

What are the core principles of CBT?

include Cognitive Restructuring, Behavioral Activation, Problem-Solving Skills, Exposure Therapy, and Skill-Building and Coping Strategies.

What is Cognitive Restructuring?

is identifying and challenging unhelpful or distorted thought patterns, like catastrophizing or all-or-nothing thinking. It helps individuals replace negative thoughts with balanced, realistic ones.

What is Behavioral Activation in CBT?

Emphasizes engaging in positive activities to counteract symptoms of depression or anxiety, improving mood and reducing symptoms.

How does CBT use Problem-Solving Skills?

teaches practical skills to break down overwhelming problems into manageable steps and develop strategies to address specific issues effectively.

What role does Exposure Therapy play in CBT?

is often used for anxiety and phobias, where individuals face fears gradually in a controlled environment to reduce avoidance behaviors and decrease anxiety.

What are Skill-Building and Coping Strategies in CBT?

These are techniques like stress management, relaxation methods, assertiveness training, and emotion regulation to help clients manage future challenges independently.

What is the first step in the CBT process?

Assessment and Goal Setting: It involves understanding the client's concerns and setting specific, measurable goals collaboratively, like reducing social anxiety.

What are thought records?

are tools used by cognitive behavioral therapists to help their patients capture, evaluate, and restructure their negative automatic thoughts.

What is behavioral analysis in CBT?

aims to find out whether certain behavioral patterns make your life more difficult or make problems worse

What is the process of Challenging and Reframing Thoughts in CBT?

This involves questioning evidence for negative thoughts and considering balanced viewpoints. For instance, a person thinking "I always fail" may be encouraged to reflect on past successes.

What are Behavioral Experiments in CBT?

Clients test new behaviors in real-life situations to challenge negative beliefs, like a socially anxious person initiating conversations to learn that people respond positively.

What is the role of Review and Relapse Prevention in CBT?

Toward treatment's end, CBT focuses on consolidating gains, recognizing triggers, and developing action plans for setbacks, aiming to prevent relapse.

For what mental health conditions is CBT effective?

Anxiety Disorders, Depression, OCD, PTSD, Eating Disorders, Substance Use Disorders, Chronic Pain, and Insomnia.

What is Dialectical Behavior Therapy (DBT), and how is it related to CBT?

developed by Marsha Linehan, combines CBT with mindfulness and is used for Borderline Personality Disorder and emotional regulation, especially in intense emotions.

What is Acceptance and Commitment Therapy (ACT)?

focuses on accepting thoughts without judgment and emphasizes values-driven actions, helping with conditions like anxiety and chronic pain by encouraging acceptance over control.

Why is CBT considered short-term and structured?

typically lasts 8-20 sessions, making it cost-effective and goal-oriented compared to other therapies.

How does CBT empower clients?

teaches self-help techniques and practical skills, empowering clients to manage mental health independently post-therapy.

What is a major criticism of CBT?

focuses on symptom management rather than exploring deeper issues, like past trauma, which some critics see as a limitation.

What is "shell shock"?

is a term describing symptoms reported by soldiers during and after World War I, including hypersensitivity to noise, tinnitus, amnesia, headaches, dizziness, and tremors. British medical doctor Charles Myers (1873–1946) first coined the term. He observed cases with symptoms like loss of memory, vision, smell, taste, and hearing, as well as sleep problems and crying. Myers tried to treat these soldiers using psychoanalytic techniques like hypnosis but faced resistance as many believed this was untreatable.

What is General Adaptation Syndrome (GAS)?

Hans Selye (1907–1982) developed the concept, describing the body's reaction to stress in three stages:

1. Alarm: A burst of energy in response to a stressor.

2. Resistance: The body attempts to adapt or resist the stressor.

3. Exhaustion: The body's energy is depleted, leading to exhaustion.

Selye’s research on rats showed that extreme stressors can lead to adrenal gland stimulation, thymus deterioration, and even ulcers, leading to what he called "diseases of adaptation" in humans, such as heart disease and high blood pressure.

What are the "Holy Seven" psychosomatic diseases?

Franz Alexander identified the diseases, which he associated with specific personality types and conflicts. The diseases are:

1. Ulcer diodeni (duodenal ulcer)

2. Asthma bronciale (bronchial asthma)

3. Rheumatoid arthritis

4. Neurodermatitis

5. Essential hypotonia (low muscle tone)

6. Hyperthyreosis (overactive thyroid)

7. Colitis ulcerosa (ulcerative colitis)

Modern psychology no longer directly links personality types with specific diseases but rather examines the role of stress and life events in disease vulnerability.

What is the Type A behavior pattern (TABP) and its supposed health risks?

Developed by Friedman and Rosenman in 1950, it is characterized by competitiveness, ambition, work-driven behavior, time-consciousness, and aggression. Initially, it was considered a risk factor for coronary heart disease (CHD), especially among white middle-class men. However, later studies found that the original studies were funded by the tobacco industry to undermine health policies, and did not confirm this link.

What is the Biopsychosocial Model?

was developed by George L. Engel (1913–1999) as a comprehensive approach to health, considering biological, psychological, and social factors. Engel argued that the traditional biomedical model was too reductionist, focusing only on physical causes of illness. It encourages understanding a patient's experience holistically and emphasizes interdisciplinary collaboration in treatment.

What is biofeedback and what functions can it help control?

pioneered by Neal Miller, is a technique that uses electrical sensors to provide people with information about physiological functions, such as heart rate, with the goal of controlling these functions. It can help manage muscle tone, brainwaves, skin conductance, and pain perception, and is effective for treating headaches, migraines, and urinary incontinence. However, its efficacy for sleep problems, hypertension, or ADHD is still debated.

What are third-wave cognitive and behavioral therapies, and what do they focus on?

are particularly sensitive to the context and functions of psychological phenomena, emphasizing broad, flexible coping strategies rather than focusing narrowly on specific symptoms. Examples include Mindfulness-Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT). Other methods include Metacognitive Therapy (MCT), Dialectical Behavior Therapy (DBT), and Compassion-Focused Therapy (CFT).

What is Psychoneuroimmunology (PNI)?

is a field studying the interaction between the psychological processes, the nervous system, and the immune system. Key findings include:

• Mind-Body Connection: Emotions like stress and happiness impact immune responses.

• Chronic Stress and Illness: Chronic stress suppresses immunity, increasing disease risk.

• Role of Social Support: Positive social interactions boost immunity and reduce inflammation.

• Psychological Interventions: Techniques like mindfulness and cognitive-behavioral therapy (CBT) can reduce stress and improve immune function.

What is the brain-gut axis?

is a communication network linking the central nervous system (CNS) and the gastrointestinal (GI) tract, influencing digestion, mood, and immune response. The gut microbiome—trillions of bacteria and other microbes—plays a crucial role, producing neurotransmitters like serotonin and dopamine. About 90% of the body's serotonin is produced in the gut, highlighting the connection between gut health and emotional well-being.

What are digital interventions in health?

use technology (e.g., social media, apps) to improve health by promoting preventive behaviors and supporting self-care. These interventions have potential benefits but can also cause harm if they provide misleading advice, misuse data, or replace more effective treatments. They are used for managing stress, pain, sleep, eating, depression, and post-traumatic stress.

How did health psychology emerge as a recognized field?

In the 1960s and 1970s, psychologists began working more closely with medical professionals to address chronic diseases. The American Psychological Association (APA) formed a Task Force on health psychology in 1973, and the APA Division of Health Psychology was established in 1978. New journals emerged, and training programs developed, such as the first master’s in medical psychology, to better prepare psychologists for medical settings.