Chapter 11: Personality

What is Personality?

• A relatively stable pattern of psychological characteristics called traits

• Traits- enduring and consistent patterns of thoughts, feelings, attitudes, and behaviors

  • Shy, peaceful, extroverted, etc.

Christian Worldview of Personality

“A theory of personality that is consistent with a Christian worldview must recognize Mankind’s sinful nature; it must acknowledge that our personality changes following our “new birth” in Christ; and it must recognize that only through the supernatural influence of the Holy Spirit can we have “right” personality.” -pg. 141

Historical Theories of Personality

• Astrologers- believe personality characteristics are set at birth by the “sign” of the zodiac

• Earth Elements- water, wood, fire, earth, metal

• “Humors”- Hippocrates 400 BC- personality determined by 4 temperments thought to be associated with body fluids

  • Sanguine- extroverted/cheerful (blood)

  • Phlegmatic- relaxed/cautious (phlegm)

  • Melancholic- introverted/sad (black bile)

  • Choleric- quick tempered/dominating (yellow bile)

Freudian Personality Theory

• Unconscious, pre-conscious, and conscious

  • Most of the personality operates at the unconscous level

• Two competing inborn life-forces:

  • Eros- sexual life-force, dive for gratification called libido

  • Thantos- death force, drive for aggression called destrudo

• Id- instinctive and unconscious aspect of personality that seeks immediate gratification

  • Id operates on the “Pleasure principle” and is primitive and completely selfish

• Ego- our sense of self, the public and private expression of our personality; rational

  • Operates on the “reality principle” and wants to find satisfaction for the Id, but in ways that are reasonable and rational

• Superego- is the judge or supervisor of the personality. Internalizes values and morals and unconsciously applies them to our behavior

  • Superego insists that we behave according to the highest ideals we have been taught- the idealistic principle

• Ego-Defense- conflicting desires of the id, ego, superego cause anxiety. The ways we cope with this can form our personality

  • Denial- the refusal to admit something happened

  • Rationalization- making up good-sounding, but wrong explanations

  • Intellectualization- detached, logical approach to emotionally uncomfortable issues

  • Projection- we see our own unpleasant impulses in others

  • Displacement- focusing unpleasant emotions somewhere else than where they belong

  • Reaction Formation- we don’t like initial reaction, so form another

  • Repression- pushing uncomfortable memories into the unconscious

  • Sublimation- channeling primitive impulses into socially acceptable activities

  • Regression- effort to defend the ego from stress by reverting to behavior to characteristics of a younger age

• Personality Disorders

  • Oral Personalities- making up for missed oral gratification (overeating, smoking, gum chewers)

  • Anal Retentive- overly neat

  • Anal Expulsive- messy and disorganized

  • Oedipal Complex- boys have erotic feelings toward their mothers

  • Electra Conflict- girls have erotic feelings toward their fathers

  • Penis Envy

  • Castration Anxiety

Carl Jung Personality Theory

• Carl Jung was a student of Freud and many of his theories are directly parallel to Freud

  • Conscious=Ego

  • Personal Conscious=Id

  • Collective Unconscious=Superego

• Freud focused on unconscious and sex and Jung focused on unconscious and barely mentioned sex

• p. 146

Alfred Adler Personality Theory

• Adler believed the driving force in personality is “striving for perfection”

• Inferiority Complex- paralyzing feelings of inferiority

• Birth order and sibling rivalry are important contributing factors to personality development

• Personality formed by age 6

Other Personality Theories

• Behavioral- Personality is nothing more than learned patterns of behavior

• Trait Theories- focus on ways personalities differ

• Multiple people have developed various lists of personality traits

  • Gordon Allport

  • Hans Eysenck

  • Raymond Cattrell

“Big Five” Personality Traits

• Extroverted or introverted

• Agreeable or antagonistic

• Conscientious or negligent

• Emotionally stable or emotionally unstable

• Open to new experiences/ideas or closed to new experiences/ideas

Assessing Personality

• Self-Report Inventories

  • Minnesota Multiphastic Personality Inventory (MMPI)

  • Myers-Briggs Type Indicator (MTBI) (most popular self-report today)

    • Describes ways of thinking and acting in terms of 16 possible combinations of 4 dichotomous preferences

Projective Personality Assessments

• Personality tests intended to reveal the content of the content of the unconscious mind

  • Rorschach Inkblot Test

Chapter 12: Abnormal Psychology

What is Abnormal?

• “One’s perspective on sin, personal responsibility, and moral absolutes has huge implications on one’s view of the causes of abnormal thoughts, feelings, and behaviors.” pg. 155

• Are mental disorders best understood s the result of disunity with God, chemical imbalance, brain illness, trauma and life experiences, or some combination?

• Are mental disorders best treated from a spiritual or a medical perspective?

• Can Christians safely borrow techniques from modern psychology to help those in mental pain?

• Modern Psychology’s worldview is that pain, difficulty, or hardship are abnormal, absurd, and are to be avoided at all costs.

• Thoughts, emotions, and behaviors are generally considered abnormal if they are:

  • Maladaptive- harmful to the individual or make it difficult to function

  • Disturbing- either to the individual or others

  • Unusual- not shared by many other people

  • Irrational- doesn’t make sense to most people

• Definition of what is “abnormal” has changed over time

  • 1970s homosexuality was listed as a mental illness. Now, not considered abnormal

  • 1900s Dementia Paralytica- mania, poor judgement, apathy, convulsions and was fatal. Eventually realized this was actually symptoms was of third stage of syphilis.

  • 1800s Drapetomania- name given to “illness” that caused slaves in the south to run away from their masters. Not a mental illness

What Causes Abnormal Thoughts and Feelings?

• Behavioral- learned by reinforced and punished behavior

• Cognitive- disordered patterns of understanding and interpreting experiences

• Freudian Psycho-dynamic- the result of unconscious psychic conflicts

• Humanist- develops when circumstances block one’s progress toward self-actualization

• Evolutionary- thoughts that today cause problems used to have adaptive advantage in the past

• Biological- diseases of the brain

Classifying Mental Illness

• Diagnostic and Statistical Manual of Mental Disorders (DSM)

• Labels and Diagnoses describe, but do not explain, mental disorders and do not offer treatment suggestions

• DSM-5 contains 19 different categories of mental disorders

1. Neurodevelopmental Disorders

Refers to Disorders of growth and development of the brain. These disorders interfere with normal cognitive and social development in learning, communication judgement, and social interactions.

• Intellectual Developmental Disorders

• Down Syndrome

• Communication Disorders

• Motor Disorders

• Autism Spectrum Disorders

• Attention Deficit/Hyperactivity Disorder

2. Schizophrenic Spectrum and Other Psychotic Disorders

Defined by “psychosis.” Basically means a break from reality. Disturbance in:

• Perception (hallucinations)

  • Hallucinations- experiences of stimuli that do not exist

  • Can be sound, sight, touch, taste, or smell. Most common is auditory

• Thought (paranoia and delusions)

  • Delusions- beliefs that are false, but are firmly and persistently believed to be true

  • Delusions of Grandeur- exaggerated beliefs in one’s importance or belief that one has special powers

  • Persecutory Delusions- beliefs that one is being controlled, persecuted, followed, cheated, drugged, spied on.

• Speech, emotion, mood, orientation, organization or serious disturbance in daily functioning

• Positive Symptoms- symptoms that are “added” to the mind. Examples would be delusions or hallucinations

• Negative Symptoms- symptoms that are “subtracted” from people with schizophrenia, such as limited emotional expression, unable to experience happiness

3. Bipolar Disorders

Characterized by symptoms of both depression and mania

• Major Depressive Episode

• Manic Episode- abnormally and persistently elevated expansive or irritable mood

  • Inflated self-esteem

  • Decreased need for sleep

  • Flight of ideas

  • Excessive involvement in pleasure activities with a high potential for painful consequences

• Moods alternate between these two types of episodes. (Rapid cycling means 4 episodes in 12 months.)

4. Depressive Disorders

• Characterized by symptoms of depression:

  • Feelings of depressed mood most of the day, every day

  • Less interest in usual activities

  • Changes in sleep patterns

  • Fatigue

  • Feelings of worthlessness or guilt

  • Difficulty concentrating

  • Recurrent thoughts of death and suicide

• Also lesser forms of depression (dysthymia) and possibly with specific triggers, such as substance use or menstrual cycle or bereavement

5. Anxiety Disorders

• Anxiety can be related to something specific of to a generalized groundless feeling

• Various Diagnoses Include:

  • Panic Attacks

  • Specific Phobia

  • Agoraphobia- anxiety due to an environment’s openness or crowdedness

6. Obsessive-Compulsive Disorders

• Obsessions- unwanted recurrent intrusive thoughts

• Compulsions- unwanted and irrational urges to repeat certain behaviors

• Section also includes Body Dismorphic disorders, hoarding, and other body-focused recurrent behaviors (hair pulling)

7. Trauma and Stressor Related Disorders

• These disorders are the result of a specific traumatic or stressful event

• PTSD- Post-Traumatic Stress Disorder is the result of an extremely traumatic event that involved could have caused death or serious injury

  • Reliving the trauma

  • Nightmares

  • Avoidance of places or events

  • Guilt, depression, emotional numbness

• Reactive Detachment Disorder- disturbed and inappropriate social behavior in most contexts and is characterized by serious problems with emotional attachments

  • Often diagnosed in children that have experienced severe neglect or abuse

8. Dissociative Disorders

• Dissociative disorders are characterized by discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, etc.

• We all “zone out” from time to time but this is referring to a “split” in one’s consciousness or memory (split personalities)

• Still lots of disagreement about whether these disorders are “real.”

9. Somatic Symptom and Related Disorders

• Disorders that are primarily somatic (physical) symptoms. Most often seen and treated in a medical setting and not a psychological setting

• Conversion Disorder- altered voluntary or motor function that doesn’t match the neurological or physical findings

• Factitious Disorder- falsely acting like you have an illness, even when there’s no obvious gain.

10. Feeding and Eating Disorders

• Disturbance of eating or eating-related behavior

• Pica- eating of non-food substances that is inappropriate to developmental level

• Anorexia Nervosa- restriction of food intake leading to significantly low body weight with intense fear of becoming fat

• Bulimia Nervosa- recurrent episodes of binge eating followed by compulsory behaviors to avoid weight gain (self-induced vomiting, misuse of laxatives, diuretics or other medications.)

11. Elimination Disorders

• Enuresis- repeated passing urine in inappropriate places

• Encopesis- repeated passing of feces in inappropriate places

12. Sleep-Wake Disorders

• Disorders that encompass the sleep/wake cycle of cause difficulties during the “wake” time

• Insomnia

• Narcolepsy

• Sleep Apnea

13. Sexual Dysfunctions

• Multiple disorders that are characterized by a clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure

14. Gender Dysphoria

• A new diagnosis with the DSM-5, it refers to a marked incongruence between a person’s experienced/expressed gender and their assigned gender. Can be a diagnosis in both children and adults

15. Disruptive, Impulse Control, and Conduct Disorders

• Conditions that involve problems in the self-control of emotions and behaviors. These result in behaviors that violate the rights of others, such as aggression or destruction of property

  • Oppositional Defiant Disorder- children with a pattern of hostile defiant behavior and blame others for their mistakes

  • Conduct Disorder- pattern of aggression toward people or property

  • Intermittent Explosive Disorder- inability to resist impulsed of acts of violence and aggression

16. Substance Related and Addictive Disorders

• Recurrent substance use that results in failure to fulfill major obligations, legal problems, social/interpersonal problems

• Also includes Gambling Disorders

17. Neurocognitive Disorders

• Conditions that involve disturbances in thinking, memory, language, and awareness of surroundings

• Dementia (Alzheimer’s Disease)

• Amnesia

18. Personality Disorders

• Enduring, pervasive and inflexible patterns of thinking, feeling, and behaving that deviate substantially from the expectations of culture

  • Cluster A: paranoid, schizoid, schisotypal

  • Cluster B: antisocial, borderline, histrionic, narcissistic

  • Cluster C: avoidant, dependent, obsessive-compulsive

19. Paraphyllic Disorders

• A type of atypical sexual urge, fantasy, or behavior involving objects activities or situation

• In the DSM-5, having these behaviors is not necessarily considered a disorder, only if it causes the person distress about them

• The only exception to this is situations where there is another person’s distress, injury or death, or where the other person is unwilling or unable to give legal consent. Those are still considered a disorder

Chapter 13: Treatment

Treatment and Worldview

• Your worldview about what causes abnormal thoughts, feelings, and behaviors greatly influences your beliefs about treatment

• You can understand an approach to a treatment without accepting the underlying explanation of the cause of the problem

Historical Approaches to Treatment

• Early Cultures- religion/magic and treated with Shamans

• Time of Christ- Cornelius Celsus, treated with starvation, chains, and flogging

• 1247- Bethlem Royal Hospital founded in England -Bedlam- word to describe chaos and disorder

• US- first Asylum was built mid-18th century

• 17th and 18th Centuries- “lunatics” kept in hospitals, asylums, and madhouses

  • Mattress, chamber pot, iron ring in the wall they were chained to

• 19th Century- started to see people as “sick” and not “evil” (Moral Management)

• Created more facilities that resembled homes

• After civil war, veterans caused overpopulation

Early 1900s Treatments

• Lobodomy- removal or severing of the frontal lobe of the brain

• Convulsive Therapies- idea that following high fevers and seizures, no symptoms, so tried to replicate

  • Insulin overdose, chemicals, microwaves, oxygen deprivation, electrical currents to induce brain seizures

Later 1900s Treatments

• Psychpharmacology- accidentally discovered use of Thorazine (calms and less anxious)

  • Approved by the FDA in 1954

• Alleviated hallucinations and delusions, allowed many to leave institutions

• Started a “pharmacological revolution”

Classification Psychiatric Medication

• Anti-Psychotics- used to treat psychotic symptoms by blocking dopamine receptors

• Anti-Depressants- treat depression by increasing norepinephrine and/or serotonin

• Anxiolytics- treat anxiety symptoms by increasing GABA which slows down neurons

• Mood Stabilizers- have anti-mania and anti-depression qualities

De-Institutionalization

• Medication allowed a lot of people to live on their own

• 1955-1980 population of psychiatric hospitals dropped from 500,000 to 50,000

• Today you can’t be hospitalized against their will unless they are a threat to themselves, threat to others, or are a minor

• Unintended consequences

  • Communities are not prepared to deal with them

  • Increase in homeless mentally ill

  • Jails and shelters serve as “de facto mental institutions”

Types of Therapy

• Freudian (Psychoanalytic)

• Talk-Therapy

• Behavioral Therapy

• Cognitive Therapy

• Cognitive-Behavioral Therapy

• Humanistic Therapy

• Family Therapy

• Spiritiual Treatments

• Christian Counseling

Freudian Psycho-Therapy

• Believed in the “talking cure” and involved talking to people while they reclined on the couch

• Helps people focus on bringing unconscious to conscious so they can be addressed and dealt with

• Typical patient would be treated 4-5 days a week for years

Talk Therapy

• General term for techniques that involve therapist entering in a relationship with a patient for the purpose of helping a patient with symptoms of mental illness

• Can be short term or long term, face to face, over the phone, over internet

Behavior Therapy

• Establishes rewards and reinforcements to change unwanted thoughts, feelings, and behavior

• Exposure Therapy- deliberately exposed to disturbing situation to learn coping

• Systematic Desensitization- taught relaxation and then gradually exposed to source of fear

Cognitive Therapy

• Seeks to correct irrational or distorted thinking

  • Emotional- Emotion Alone

  • Dichotomous Thinking- (all or nothing)see situations in the extremes

  • Catastrophizing- expecting and looking for the worst

  • Filtering- focusing on and magnifying the negative while ignoring or minimizing the positive

  • Personalization- tendency to believe that it is “all about me” and take responsibility for negative events

  • Mind-Reading- assuming we know what others are thinking or feeling

Cognitive-Behavioral Therapy

• Uses techniques from both cognitive and behavioral approaches. Based on the idea that the way we think about a situation and the way we behave in a situation are more important than the situation itself

Humanistic Therapy

• Strive to create an environment that is accepting, non-judgmental, and non-directive so that the innate goodness in the person will help guide them to the correct decisions and choices

Family Therapy

• Focus on the system or relationships between people and the belief that difficulty in the system is the main reason for individual difficulties

Spiritual Treatments

• Any myriad of “spiritually” focused treatments

  • Past-life therapy

  • Polarity therapy

  • Therapeutic touch therapy

  • Organic process therapy

Christian Counseling

• Three schools of thought:

  • Psychology is bad and should be rejected

  • Biblical counseling should only involve using the Bible to counsel. Any other book or resource technique is wrong

  • Integrated- believes that valid findings of psychology and accurate interpretations of the Bible will not ultimately contradict, so can use both

Non-Talk Therapy

• Play Therapy-used most often with children

• Music/Art Therapy

• Animal Therapy