Mindstorm
Chapter 1- Unhappy people
Psychotherapy helps unhappy people find purpose and get rid of disturbing factors. Causes of unhappiness:
Therapy:
Anhedonia: Hidden depression: He’s depressed w/o knowing. They don’t enjoy things they used to enjoy. Problem is that medication treats the symptoms and not the problem. Medication depends on the problem. There are those who are only helped this way and there are those who are better off w/o, or w/ both.
Causes of PTSD:
Dissociation- split conscience: Memory gaps, inability to motivate body parts, inability to experience certain feelings. Often resulting from brain damage, there could be a disconnection b/w memories and feelings- w/o remembering, they feel fear.
Explanation of dissociation: Freud said b/c of repression; Ana: Disconnection of pairing of feelings and memories.
[Split personality- psychotherapy;
Schizophrenia- medication]
Therapy:
Personal factors in PTSD- 2 approaches:
-Genetic + trauma
העברת נגד ארוטית/העברה נגד – Emotional feelings or if it’s erotic, attraction to patient. Ha’avara alone is when patient has feelings for therapist. B/c there’s ha’avara and amp; ha’avarat neged, this makes the patient more equal.
Freud: defense mechanism of opposing
unconscious internal world of the patient. We oppose the painful contents
of unconscious. The patient unconsciously tries to fail the therapist
even though she wants the therapy to succeed. Opposition is a way to
lessen pain. Therapist must set limits.
Self-esteem: connected to the environment
in which we were raised and how people related to her, which is more
important than her external characteristics. Therapy: Changing self-image.
Reasons sex w/ patient is forbidden:
When to go for therapy: Emergencies:
-Changing what’s inside the
person will change the external reality. There may be other factors,
but only I can fix things.
Changing from pasive to
active- You yourself doing what someone did to you in past (identification
w/ the aggressor- abused child becoming child abuser).
Empathy- Subjectively
being able to feel what the patient feels.
Who should one go to for therapy?
Panic disorder: They found
people w/ panic disorder have surplus of oxygen in blood. Medication
only rids of the symptoms. Cognitive/behavioral therapy is also used.
Flooding- introducing them all at once to the source of fear (no longer
in use).
Panic disorder symptoms:
Therapy:
Therapy for Borderline personality disorder:
-Therapy-contract is in order
for patient to trust you and you set clear limits (“If you want
to kill yourself, come to emergency treatment center.”) Therapy in
which the therapist is active and patient is passive will fail. If
the patient breaks the contract they negotiate a new contract, but till
then they won’t enjoy the priveliges of patient (meeting on regular
basis). Goal: to develop different coping strategies for coping w/ crises.
Death of parent during adolesence: The child internalized the image of parents and is w/ them even after their death. There are some who say that borderlines behave this way b/c they don’t internalize their parents figures and they constantly need external support like babies.
Censorship (Freud)- lessening anxiety:
Meaning of dreams:
-Most people who committ suicide
suffer from a mental disturbance that distorts their thought, affects
imagination, creativity and ability to express themselves.
Genetic aspects of suicide: Tendency to act impulsively and use of violence during crisis. Especially goes along w/ depression and anxiety. Suicide has a biological setting and therefore the treatment is lithium.
Other aspects:
Childhood experiences such as sexual abuse
Free will: Though the subjective experiences are chosen out of free will, today there’s no doubt that suicide is almost always a disease. Most suffer from a mental disturbance (mostly depression and bipolar disorders- 90%) that distorts their thought!
Anorexia nervosa- refusal
to maintain healthy, minimal body weight (less than 85% of expected
weight according to age/height), and terrible fear of possibility
of gaining weight. Often annorexic women don’t get their periods for
at least 3 cycles, called al-veset.
Types of annorexia:
Q. Why do women suffer from annorexia?
-Societies expectations cause
anxiety, perfectionism and lack of self-esteem and they tend to
punish themselves. They want to feel in control and they do
this through food.
-Therapy for annorexia is very difficult and therapy-contract is needed. Eating disorders are genetic, present w/in same family. Treating bolemia is much easier than annorexia, b/c bolemics aren’t satisfied w/ their behavior. Treatment for both:
Projective identification- when patient unconsciously causes therapist to identify w/ them. It’s important that the therapist be aware of this.
Freud: Mourning and Melancholy:
the depressed individual, as opposed to mourner, suffers from sorrow
and despair as well as from low self-esteem and tends to blame himself
for everything. Medication helps raise self-esteem.
כורח
החזרה- According to Freud we tend to repeat situations out
of the necessity of returning (koreh ha’hazara). Ex. Abused
child marrying an abuser
-According to Yovel, every mental disturbance
is a disturbance in free will and medication expand this freedom.
Medication doesn’t lead to happiness, only expands this free will.
Medication treatment for depression:
-Depression more frequent among Jews than non-Jews
-One stops taking medication
for anxiety only once the reason for anxiety has passed.
Anxiety:
Types of Bipolar disorders:
-Appears during adolesence
so it’s hard to diagnose. Totally genetic!
Treatment:
Causes of Schizophrenia:
Weinberg: Problem w/ the connection
to DA cells on pathway b/w brain stem and parafrontal during embryonic
period and it usually starts out w/ negative symptoms that are caused
by this. (Many factors involved).
-Schizophrenia always causes psychosis
Central nervous system:
brain + brain stem
-The more developed the animal, the larger his brain hemispheres
Left hemisphere: reading and writing (happiness)
Right hemisphere: feelings
and non-verbal nuances (sadness)
Frontal lobe: ability
to plan for future, self and social awareness, abstract thinking and
controlling urges. Ex. Phineas Gage’s frontal lobe was damaged and
he became short-tempered, irritable, unrealistic and impulsive. Frontal
damage cuts of a circle of connections resulting in the above phenomenon,
b/c other locations in the brain also deal w/ this.
- Solamas couple and Luria mapped brain and its influence on mind: Brain divided to 3:
1) Reception/input part of the brain
2) Creative part- part of the brain stem and hypothalamus
-Everything connected to the
id- thirst, hunger and sex
3) The management part- frontal
-Mangages, time-oriented, (unlike
the occipital part that is space-oriented). Ability to forsee results,
regulate behavior, conscience, morals (super-ego). Borderlines suffer
from lowered functioning of frontal areas expressed by violent impulsivity
(also murderers have this). Psychotherapy affects the brain.
Change in behavior after car accident:
-All psychiatric medication affects synaptic activity b/w neurons in brain- affects signalling b/w them. Medication causes changes in the neurotransmitters that affect mood. Memory activity: through long term changes that a neuron causes to another to which it connects. The neurotransmitters connect to receptors and cause a chain of biochemical activity and --- in another neuron, likely to change the characteristics of the neruon long-term.
-There is medication that increases the amount of neurotransmitters by blocking the breakdown process.
Repressed memories…
-In the past, hysteria was
connected to repressed memories.
2 Memory Systems:
Though long-term memory is stored both in hippocampus and amygdalla, there are still differences b/w them:
Childhood amnesia: Hippocampus
isn’t matured yet and amygdalla is. As result, people who experienced
a childhood trauma suffer w/o remembering trauma.
Forgetting after trauma:
-During crisis, NA and cortisol
are secreted. High cortisol levels paralyse the hippocampus and intensify
the amygdalla. If this is prolonged it could cause permanent damage.
Under severe stress, the hippocampus can’t document the event, whereas
the amygdalla “remembers” the accompanying moment well. This is
how the trauma is forgotten, but we still remember the fear and the
stimuli connected to it. (Different stimuli remind us of an emotion).
PTSD sufferers have a smaller hippocampus and worse memory.
-If the hippocampus is active
during the trauma and the person remembers the event, this allows
them to be able to differentiate b/w different events (not generalizing
too many stimuli) and convinces them that the present is different
from the past. If the the hippocampus isn’t active at the time of
the event, the person doesn’t connect b/w the present fear and past
trauma and the feeling causes suffering in the present that they don’t
understand.
Q. How do we remember the repressed event?
A. There is a detail (could
be an object) in the present that is the connection to the repressed
memory.
Reasons for doubting a memory:
-There’s no way to know if
they’re really true.
False memories (Loftus): We remember things that never really happened, b/c hte hippocampus works through associations. When the memory isn’t complete, the hippocampus tries to fill in what’s missing through details close to the truth that explain the bad feeling the amygdalla aroused.
-They found that the D4 receptor
gene was what determines personality differences. Ex. People w/ long
D4 receptors yearn for excitement and new experiences and people
w/ short ones tend to be more conservative.
Q. Does this mean we’re prisoner to our genes?
A. No, b/c there is no gene
that influences personality trait 100% (it varies from 20-80%) and
we can work against our genes. Ex. Not drinking alcohol if we have an
alcoholic gene.
Kroninger’s trait model (he connected traits to biological factors):
Anclytic depression (hospitalism)- sadness, not smiling, no curiousity, social seclusion, a child needs human warmth.
-Prolonged stress leads to
brain damage, b/c it leads to too much CRF (Corticotropin releasing
factor, a short protein) in brain. This causes irritability, anxiety
and depression.
-In OCD the basal ganglia is
overactive and doesn’t strain out worrying thoughts. After therapy/medication,
overactivity of the basal ganglia fades. After treatment, 5HT also changes
in the brain.
Q. The brain changes the sensory info in present in accordance to past experience. Ex. Thinking someone who gained weight stayed skinny. Why is this so?
A. B/c the brain sees things
as it’s supposed to from experience, shortens the process.
Imprinting (הטבעה)- tragic-comic phenomenon existing
in chics that follow and trust 1st figure they see after
birth
Oxytocin and Vazopresine: Love and attachment in animals are connected to these. Oxytocin shrinks the uterus during birth and milk secretion to stimulus. After birth oxytocin is connected to the mother falling in love w/ her child.