last weeks of 1301

too much flashcards, more flashcards than i expected so here we are...

what is psychopharmacology?

psychiatric medicine to relive symptoms of mental illness. It has kickstarted the deinstitutionalization movement of the 1950s.

Lithium (1949): psychopharmacology

The first one in the market. It was to relieve symptoms of bipolar disorder.

Valium (1963)

The first tranquilizer/anti-anxiety medication, a benzo which has addictive properties.

Xanax (1981)

stronger anti-anxiety medication, a benzo which has addictive properties.

Prozac (1987)

an SSRI to relieve symptoms of depression.

Deinstitutionalization Movement in 1950s

Closing psychiatric hospitals and discharging the patients to live in the community. The reasoning was the public attention the inhumane treatment of Bedlam was gaining, wanted to promote treatment in the community to help patients: promote their independence, can work jobs, be with family; much cheaper.

The psychopharmacology fueled this.

Issues with Deinstitutionalization Movement in 1950s

Huge failure in practice as the individuals who were once patients lacked structure of daily routine and supervision to use meds to be able to “treat“ their mental illness. Individuals stopped taking their own medicine as they believe they are treated (after a short-term daily routine), they don’t like the effects with the treatment, psychosis may lead many to believe that the pill is bad, had no money or time to afford it.

The goals of this movement was mostly assumed on the improvement of their wellbeing. Assumption of close networks and accommodation when no family member was willing to support or had no means to, no shelter (led to homelessness), and shortage of community resources because no one wanted to have these resources installed in their towns.

Tommy Lynn Sells

The serial killer who killed and raped for the adrenaline rush. like the dope feeling On death row for 1 murder but linked to 17 more murders. May have psychopathy: felt no emotion, no remorse or revulsion.

He killed many people (including children) on the basis that he didn’t want the children to go through the same abuse he felt as a child.

Is it hard to control a psychopath?

Yes, it is. They are manipulative that they can change the flow of the conversation to their control.

Joel Rifkin

A psychopathic serial killer. First crime was killing the a prostitute in Manhattan and dismembered her body to clean it up.

Had low activity in prefrontal cortex

Neurolaw

using brain imagery as evidence for psychopaths to have an NCR charge, still up for debate.

Chris benoit

A wrestler who strangled his wife and suffocated his son. He had later killed himself by cord on his weight machine.

Could be because of brain damage (dean neuron cell areas) from hardcore wrestling. But media was focused on his use for steroid use but is not entirely possible as it was not a snap judgement crime. Ch

Chronic Traumatic Encephalopathy

Brain damage from blows to the head. This changes people’s character and behaviour.

James Fallon

Doctor in psychopathic research, a neuroscientist. Has direct. line from Cornell family who has a long list of murderers.

Found out that he had low activity in orbital cortex - brain part that prevented impulsive behaviour, like murderers. He also had warrior genes - genetic markers of psychopaths. Had a wonderful childhood → not a killer ?

Sigmund Freud (1856-1939)

Father of Psychoanalysis. Hist study was mainly focused on functional disorders than organic disorders. He believed that functional disorders resulted from the suppression of painful memories out of memory, into the unconscious mind. This manifests into physical symptoms.

Created the theory of psychosexual development, personality and levels of the Mind.

Functional disorder

cannot explain/pinpoint identifiable cause.

Organic disorder

can explain/pinpoint cause of behaviour.

Anna O

a patient of Freud. She was a nurse to her sick father but one day developed symptoms of cough, difficulty in speech, paralysis, hallucinations without any identifiable cause - a functional disorder.

During therapy with Freud, she talked about her painful, traumatic memories and later, her symptoms went away. Similar to her refusal to drink associated with the memory of a woman drinking out of dog water; began drinking again after sharing memory.

Conscious Mind: Freud’s levels of Mind

present thoughts/feelings/perception of the situation.

Preconscious Mind: Freud’s levels of Mind

where memories/thought that can be recalled. This is also called stored knowledge and available working memory.

Unconscious Mind: Freud’s levels of Mind

biggest part of the iceberg. This is where thoughts/feelings/desires/fears/memories that are suppressed are located. They are not easily available or recallable. This can still influence people’s behaviour.

ID: Freud’s theory of Personality

people are born with this. This is located in people’s unconscious where their urges/impulses/biological and physiological drives reside. It is hedonistic and intends to maximize pleasure and minimize pain.

It operates on the pleasure principle where it intends to get immediate gratification on their needs.

Ego: Freud’s theory of Personality

develops around 3 years old. It is personality that is oriented to the world they live in. It is located in the fully conscious part of the mind.

It operates on the reality principle where it intends to satisfy the ID urges whilst also taking reality into consideration. It is rational and is a mediator between the ID’s needs and superego’s prohibitions.

Superego: Freud’s theory of Personality

develops around 5 years old. It focuses on the prohibition of things. It internalized the morals and values from early social interactions with parents, family, peers, etc.

It operated on the morality principle where the morals and values are working in their behaviour, whether done consciously or unconsciously.

Freud’s stages of psychosexual development

It is associated with an erogenous zone - a place in the body that is sensitive to stimulation and is a source of pleasure.

When a child passes these stages, it results in a healthy personality. When a child experiences a traumatic event during the stage and does not pass, they develop unhealthy behaviours and personality.

Oral Stage: Freud’s stages of psychosexual development

0 to 1 yo.

Children discover the world through their oral. Their healthy weening by their mother determines their pass on the stage. When they are not weened enough, this can lead to a fixation of the oral: manipulation, addiction and excessive chewing.

Anal Stage: Freud’s stages of psychosexual development

1 to 3 yo.

Children learn to control their bladder and bowel movements during this stage - potty training.

It leads to behaviour regarding the relationship with authority (understanding boundaries, fully rebelling or conforming). People can also be anal-retentive where they are too controlling or anal-expulsive where they are messy and disorganized.

Phallic stage: Freud’s stages of psychosexual development

3 to 6 yo.

Understanding the differences with sexes, gender roles and relationship between sexes. Boys are competitive for their mother with their father and girls realize their penis-envy.

In an unhealthy personality, child can have a fixation with their opposite-sex parent. They may have aggression to opposite-sex and competition with same-sex.

Latent Stage: Freud’s stages of psychosexual development

7 to 13 yo.

Libido is suppressed and superego grows stronger. This is where children interact with one another and develop skills through it.

Genital Stage: Freud’s stages of psychosexual development

Puberty to death.

More libido. This is where people understand how to balance social norms and sexual desires.

Free association: revealing the unconscious

where the patient says anything that comes to their mind. The lack of boundaries will allow unconscious thoughts to surface. The unconscious thoughts become conscious and it will lose its unconscious power, freeing the individual.

Dream analysis: revealing the unconscious

It will reveal their unconscious desires through:

• manifest content - obvious meanings

• latent content - hidden meanings that reveal the unconscious.

Freudian Slip: revealing the unconscious

An error in speech that reveals the thoughts/beliefs/desires. The unconscious influences the patient’s words.

Hypnosis: revealing the unconscious

It was later abandoned.

Transference: revealing the unconscious

Patient transfers feelings/attitudes from past relationships to therapist unconsciously.

The therapist may embrace the role to resolve underlying issues with the past relationships and free them from their anxiety.

Projective Test: revealing the unconscious

Rorschach Test - ambiguous image is presented and patient must immediately say what they see.

Thematic Apperception Test - ambiguous image is presented and patient must make up a narrative for the image.

Defense Mechanisms

The unconscious mental strategies that help with internal conflict and help cope with anxiety/stressful situation. Based on Freud’s functional disorder theories.

Repression: Freud’s defense mechanisms

Pushing painful memories/thoughts/desires to the unconscious.

ex. car crash when younger and older, became terrified of cars without knowing why.

Rationalization: Freud’s defense mechanisms

justifying behaviour with a fake reason to avoid the real reason.

ex. smoking.

Projection: Freud’s defense mechanisms

attributes own unacceptable thoughts/feelings to other people.

ex. accusing partner of cheating after flirting with coworker.

Denial: Freud’s defense mechanisms

refusing to accept reality.

ex. boyfriend is distancing in attempt to break up; the girlfriend believing the relationship is going well.

Displacement: Freud’s defense mechanisms

redirecting emotions on another source to a less-threatening substitute source.

ex. boss yells at you, you yell at wife later.

Reaction Formation: Freud’s defense mechanisms

behave in. away that is different from thought/feelings.

ex. laughing at funeral.

Sublimation: Freud’s defense mechanisms

redirect uncomfortable and unacceptable desires to acceptable behaviour.

ex. wanting to fight people, becomes a wrestler.

Regression: Freud’s defense mechanisms

reverting to an earlier stage and acting like a child.

ex. having an argument and throwing a tantrum.

What did Freud believe about the cause of crime?

He believed crime is a result of

• weak ego: it fails to control the id’s urges which leads to poor decision-making.

• overdeveloped superego: excessive guild, committing crime to get caught, engage in self sabotaging behaviour.

What did Aichhorn believe about the cause of crime?

He believed crime is a result of a underdeveloped superego. When a child has no parent present in their role, they are unable to create intimate attachments or moral compass. This leads to criminal behaviour with no remorse.

Leilani Muir

Went to a provincial training school for mental deficiencies for ten years and got sterilized in 1959. Suing the government of Alberta for the damages the school caused in her life.

Grew up in a difficult farm home; locked away from the public, starvation.

Goal of eugenics

An “accurate” method of measuring human value.

populations that targeted for eugenics

• those who were considered mentally deficient.

• had behaviour issues.

• had emotional issues.

• were criminals or poor/in poverty.

• those who were weak or vulnerable in society.

• more women

• those from rural areas.

• extreme operations of removal reproductive organs: those with bad sexual behaviour.

Science was hand-in-hand with morality.

Who kickstarted the eugenics movement in Alberta?

Starting in the 1920s when the United Farmworkers party rose to power. United Farm women wanted to start eugenic sterilization as to resolve the threat of the rising trends of immigration. They lobbied for a sexual sterilization act.

1928 - law was passed.

What was the training schools like?

Confined to the institution like a prison. Many children were brought there; children would be punished into solitary confinement when they did something wrong, given bad shelter, food.

You were not able to leave the place if you did not consent to sterilization (or full removals).The children were not told about the surgeries. Eugenics board would decide the sterilization, an “independent party’, they asked:

• could they be good parents?

• transmitting/contagious diseases.

Justification for eugenics

• seen as a moral commandment - that God has given humans the ability to improve the human population through reproduction.

• castration to use their reproductive organs for research.

Who repealed the Sexual Sterilization Act in Alberta?

In 1972, Government under Peter Lougheed repealed it as it violated against human rights. It was the first time public was aware of the act.

What do prisons become for those with mental illness?

After the psychiatric hospitals, they become homeless as there was no social support to help them. They began to cycle through incarceration and homelessness; no safety net of social support for those with mental illness. They are usually arrested for minor, non-agressive crimes.

It can be difficult for them to get parole because of how difficult treatment or being stable on the outside can be. When they go out, they need mental effort and attempt to find some resources to attain that medication again.

What is life like in prison for those who are mentally ill and have no social support?

They are separated from the prison community to get treatment; prison in prison. Fragile people coming into solitary confinement fall apart. In confinement continuously but gets some treatment, if possible.

Difficulties in managing those with mental illness in prisons.

• Administrating the medicine with consistent regimentation.

• Lots of social support.

• Lots of attention.

• Compliance with medicine.

• prison is not an environment to give mental health treatment - its not a place built for one.

  • will be forced to.