Clinical Psychology and Mental Health

what does cultural relativism mean

the view that behaviour cannot be judged properly unless you view it in the context of the culture it originates from. Therefore behaviours should be judged relative to the specific culture and western ideals shouldn’t be used to judge other cultures

mental illness as deviation from ideal mental health

by Jahoda, ideal mental health is:

• a positve attitude towards oneself

• the opportunity to self-actualise(acheive your potential)

• ability to resist stress and adapt to your environment

• an accutrate perception of autononmy

• personal autonomy(not being too reliant on others)

limitations of the deviation from ideal mental health approach

• criteria is too demanding→everyone would be considered mentally ill to some extent→few people reach self actualisation or resist stress all the time

• ethnocentric and describes individualistic cultures rather than collectivitst→collectivist cultures think personal autonmy is far from ideal as you are expected to work together, not independantly→perceptions of reality can depend on cultural and religious beliefs e.g rituals→may result in incorrect diagnosis of mental illlness cross culturally

• accurate perceptional of reality is not a characteristic of mental health→depressed patients percive the world more accurately→sadder but wiser/depressive realism where depressed pts make more accurate assesments of their place in the world→mentally healthy people create positive illusions to protect themselves from reality→accurate perception of reality idea is flawed

• perception of reality changes with time and new knowlege→people used to believe that the earth was flat and the first people to challenge it were considered mentally ill→by this definition mental illness would change over time and be inconsistent

mental health as a deviation from social/cultural norms

Society has rules about what are acceptable behaviours, values and belief. Behaviour is considered mental illness if it deviates from some notion of what society considers proper or acceptable

limitations of the deviation from social norms approach

• moral standards vary over time because social attitudes are constantly changing →e.g in Britain having children out of wedlock was not acceptable and single women were locked in psychiatric instituions→homosexuality was considered a mental illness until 1973→by this definition mental illness would change over time and be inconsistent

• lacks cultural relativism→social standadrds vary accross cultures and you can’t use one society’s norms to define another as abnormal→some view western behaviour such as birth control as abnormal→this definition may result in incorrect diagnosis of mental illness

mental illness as a failure to function adequately

behaviours that prevent people from copying with the demands of everyday life:work, realationships, motivation to care for yourself are considered mental illness

This can be assessed on the Global assessment of Functioning Scale(GAF) 1000-life’s problems never get out of hand, 10 - persistent danger of hurting self or others, suicidal acts, 60-moderate symptoms e.g occasional panic attacks, or moderate diffuclty in social, occupational or school functioning e.g few friends

limitations of mental illness as a failure to function adequately

• involves making subjective judgements about others and what consitutes as failure to function adequately→ethical issues with doctors making judgments as it involves labelling people→individuals such as schitzophrenics and those with eating disordres often deny having a problem

• many mentally healthy people fail to cope with the demands of life at certain times e.g stressful exams, bereavement→if someone does cope well after a death they might be considered mentally ill→depends on situations

mental illness as a statistical infrequency

behaviour is considered a mental health issue if it is statistically rare. This is based on the idea that behaviour is normally distributed and those who are 2 standard deviations above or below the mean e.g extreme 2% of population, are mentally ill

limitations of mental illness as stattistical infrequency

• doesn’t take into account desirability of behaviour→desirable behaviours such as genius or low anxiety are beneficial and do not require treatment so not mental illness→some behaviours that aren’t beneficial are statistically frequent e.g. depression

• relies on having accurate statistical data→gender bias is an issue and may be a reflection of male and female socialisation than a true reflection of the frequency of a given disorder-→females are more liekley to consult doctors about anxiety whilstmales are more likely to bottle up their anxiety→socialisation of men has created masculine stereotypes that alienate men from seeking help→flawed

definition of phobias

Irrational fears that produce a concious avoidance of the feared object or situation. Type of anxiety disorder so primary characteristic is extreme anxiety

3 of the different types of phobias are: specific phobias- e.g fear of snakes, spiders ect. social phobias- fear of talking to a group of people and interacting with others in social situations, agoraphobia-fear of being out in public with no escape

emotional, behavioural and cognitive characteristics of phobias

emotional(how you feel):

• unreasonable, excessive persistant fear

• anxiety and panic brought on by the presence or thought of the object/situation

• feelings of anxiety are out of proportion to the actual danger proposed

behavioural(how you behave/what you do):

• phobic avoids the situation/object

• may show fight or glight response if in contact with stimulus(freeze/faint)

• avoiding the fear leads to dirsruption of normal routine e.g ability to work, relationships

cognitive(how you think):

• irrational thought processes and are resistant to rational arguments(e.g that planes are safest mode of transport)

• they recognise that their fear is irrational

behavioural approach to explaining phobias

initiation-classical conditioning:

• phobias are learnt though association, seen by Little albert case study

• UCS (loud noise) →UCR(crying/fear)

• NS(rat)→no response

• UCS(loud noise by hitting a steel bar w a hammer)+NS(rat)→UCR(crying/fear)

• after repetitions NS(rat) becomes CS→CR(fear/crying)

maintenance-operant conditioning:

• explains why fear continues and why people avoid the feared object

• Avoiding the feared object reduces fear. Reduction in fear is rewarding and since rewards reinforce behaviour, the person repeats the behaviour and continues to avoid the feared object. This is negative reinforcement

strengths of behavioural model

• based on scientific lab experiments→Pavlov’s fogs and skinners rats support classical and operant conditioning→validity to the theory that other behaviours such as phobias can be learnt→supported by Little Albert case study as he learnt his phobia through classical conditioning→behaviourist approach to phobias follows the scientific method

• lead to effective treatments→abnormal behaviour can be reduced by unlearning behaviours→flooding and systematic desensitisation both involve exposure to the phobia to break learnt associations→SD has a 75% success rates→positive implications

weaknesses of behaviourist approach to phobias

• reductionist→reduces phobias to learnt behaviours→other explanations such as people scared of spiders are more likely to cite modelling as the cause→evolutionary explanation suggests we are genetically programmed to make associations between potentially life-threatening stimuli and fear→we rarely develop phobias of dangerous modern objects e.g cars→infants in one study failed to learn a fear of building blocks when paired with a loud bell→behaviourist approach is too simplistic

• deterministic→suggests ppl have no control over phobais and it is determined by environment→says a learnt association will lead to a phobia, but it might not e.g not everyone bitten by dogs has a dog phobia→diathesis stress model proposes we have a genetic predisposition to certain mental illnesses such as phobias but there must be an environmental trigger→this approach does not allow for free will