What is Normal?

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What is Normal?

• A Discussion for some a challenge for others

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Define Normal Behavior

• Normal refers to a lack of significant deviation
  from the average.
• The phrase "not normal" is often applied in a
  negative sense (asserting that someone or some
  situation is improper, sick, etc.)
• Abnormality varies greatly in how pleasant or
  unpleasant this is for other people.
• The Oxford English Dictionary defines "normal" as
  'conforming to a standard'.
• Another possible definition is that "a normal" is
  someone who conforms to the predominant behavior
  in a society. This can be for any number of
  reasons such as simple imitative behavior,
  deliberate or inconsistent acceptance of
  society's standards, fear of humiliation or
  rejection etc.

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Who Determines if we are Normal?

• Personal Decisions
• Values
• Societal
• Statistical

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Ways Psychologists Define Abnormal

• Behavioral emphasizes the role of learning,
  particularly conditioning experiences on the
  development of psychological disorders
• Cognitive emphasizes cognitions (expectations,
  values, beliefs) in determining the responses a
  person will make in confronting life's situations
• Medical relates disorders to biological
  abnormalities

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History of Mental Illness
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Stigma of Mental Illness Today

• CBS News- Breaking the Stigma
• Silver Linings Playbook

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How is Abnormal Defined?
Diagnostic and Statistical Manual of Mental
Disorders
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DSM-V Codes

• Covers all mental health disorders for both
  children and adults. It also lists known causes
  of these disorders, statistics in terms of
  gender, age at onset, and prognosis as well as
  some research concerning the optimal treatment
  approaches
• The DSM uses a multidimensional approach to
  diagnosing because rarely do other factors in a
  person's life not impact their mental health. 

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Diagnosis of new disorders is ever changing

• Diagnosis/categorization of mental illnesses can
  be very subjective
• Homosexuality was a mental disorder until 1973
• Cultural Norms also dictate disorders
• Koro Southeast Asia Men can develop a fear that
  ones penis will withdraw into ones abdomen,
  causing death
• Southeast Asian cultures, men have been known to
  experience what is called amok, an episode of
  murderous rage followed by amnesia
• Middle East there is zar, a condition related to
  spirit-possession beliefs that brings forth
  dissociative episodes of laughing, shouting and
  singing.
• Winigo Algonquin Indian hunters intense fear of
  being turned into a cannibal by supernatural
  monster

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Why do we need the DSM?

• Reliability and Consistency between psychologists
• Remove individual biases based on culture,
  gender, race etc.

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Changes to DSM V

• New Disorders
• Gambling Disorder
• Binge Eating Disorder
• Body Dysmorphic Disorder
• Hoarding
• Excoriation (skin picking disorder)
• Other OCD disorders
• Body Focused Repetitive Behavior Disorder
• Obsessional Jealousy

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Changes to DSM V

• New Names and Changes
• Mental Retardation -gt Intellectual Disability
• Aspergers and Autism -gt Autism Spectrum Disorders
• Hypchondriasis - gt Illness Anxiety Disorder or
  Somatic Symptom Disorder
• Sexual and Gender Identity Disorders -gt Gender
  Dysphoria
• Social Phobia -gt Social Anxiety Disorder
• Adjustment Disorders

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Not added yet...but... areas for further
research

• Internet Addiction
• Hypersexual Disorder

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Can we over diagnose?

• Many fear that there will be less of a definition
  of normal than abnormal because of the ever
  changing disorders
• Can you diagnose anyone?!

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What would you recommend for Martin?

• Martin is a 40-year-old manager, husband, and
  father of three who works fourteen hours a day
  and brings work home on the weekends. His wife
  complains that he is more interested in work than
  he is in her and the children. Martin has trouble
  sleeping, is often irritated by small
  inconveniences, wishes he spent more time with
  his family, and has been diagnosed as having a
  stomach ulcer.

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What constitutes a psychological disorder?

• 1. The person experiences significant pain or
  distress,an inability to work or play, an
  increased risk of death, or a loss of freedom in
  important areas of life.
• Dividing line has to do with severity, intensity
  and frequency of symptoms, duration of symptoms,
  and, especially, functional impairment
• 2. The source of the problem resides within the
  person, due to biological factors, learned
  habits, or mental processes, and is not simply a
  normal response to specific life events such as
  the death of a loved one.
• 3. The problem is not a deliberate reaction to
  conditions such as poverty, prejudice, government
  policy, or other conflicts with society.

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Manifestations of Mental Disorders

• Disturbances of thought and perception
• Dysregulation of mood
• Inappropriate anxiety
• Impulse control and behavioral problems
• Cognitive dysfunction

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The Dangers of Labeling . . .

• Rosenhan (1973) study
• Mentally healthy confederates were admitted with
  schizophrenia into psychiatric hospitals
• They presented with neurotic symptoms and
  paranoia on the first day.
• They then behaved normally in the hospitals, but
  their normal behavior was interpreted as
  pathological based on their diagnosis
• What does this say about labeling?

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Types of Disorders

• Somatic Symptom disorders
• Feeding and eating disorders
• Sleep-wake disorders
• Sexual dysfunction disorders
• Gender Dysphoria
• Disruptive, impulse control and conduct disorders
• Substance- related and addictive disorders
• Neurocognitive disorders
• Personality disorders

• Neurodevelopmental disorders
• Schizophrenia spectrum and psychotic disorders
• Bipolar disorders
• Depressive Disorders
• Anxiety Disorders
• Obsessive Compulsive disorders
• Trauma and stressor related disorders
• Dissociative disorders

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Neurodevelopmentaldisorders

• Intellectual disability
• Autism Spectrum disorders
• Motor disorders
• Learning disorders

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Schizophrenia

• Group of disorders
• Positive, negative, and psychomotor symptoms

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Bipolar and Related Disorders

• Bipolar Disorder
• Cyclothymic Disorder

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Depressive Disorders

• Major Depressive Disorder
• Persistent Depressive Disorder

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Anxiety Disorders

• Panic Disorder
• Generalized Anxiety Disorder
• Agoraphobia
• Social Anxiety Disorder
• Specific Phobia Disorder
• Separation Anxiety Disorder

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Obsessive Compulsive Disorders

• Obsessive Compulsive Disorder
• Trichotillomania and Excoriation
• Body Dysmorphic Disorder
• Hoarding

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Trauma and Stress Related Disorders

• Adjustment Disorders
• Post Traumatic Stress Disorder

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Dissociative Disorder

• Dissociative Identity Disorder
• Dissociative Amnesia

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Somatoform Disorders

• Somatic Symptom Disorder
• Illness Anxiety Disorder
• Conversion Disorder

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Feeding and Eating Disorders

• Anorexia Nervosa
• Bulimia Nervosa
• Binge eating disorder

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Disruptive, Impulse-Control and Conduct Disorder

• Oppositional defiant disorder
• Conduct disorder
• Intermittent explosive disorder

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Substance-related and addictive disorder

• Gambling disorder
• Substance abuse and dependence

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Neurocognitive Disorders

• Delirium
• Dementia

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Personality Disorders

• Antisocial
• Borderline
• Narcissistic

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Celebrities

• http//health.howstuffworks.com/mental-health/ment
  al-disorders/15-celebrities-with-mental-health-dis
  orders2.htm

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Types of Therapy
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What makes a good therapist?

• Therapists- teach people that they are the ones
  that can solve their own problems
• Eclectic approach-choose from different types of
  therapy and choose the best one for the case
• 1.        persons behavior is based on choice-
  not fixed
• 2.        people must understand their
  problem-where the problem comes from
• 3.        help patients find alternatives to
  unsatisfactory behaviors

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What makes a good therapist?

• 1.        good listener
• 2.        empathy-warmth and understanding
• 3.        psychologically healthy
• 4.        experience in dealing with people
• 5.        trustworthy

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Psychoanalytic Therapy

• Freudian Therapy
• Psychoanalysis- based on teaching of Sigmund
  Freud-said psychological disturbances are due to
  hidden conflict and anxiety in the unconscious
  personality
• Psychoanalysts-make people aware of their
  feelings- INSIGHT
• Free association- relax and talk about anything
  that comes to mind
• Resistance- behavior that impedes the course of
  therapy
• Transference-when patient begins to feel to the
  psychologist as they had to another person
• Becomes aware of real feelings and motivations

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Behavior Therapy

• Therapy Session
• Reaction to All talk and no action
• To find what is immediately wrong and fix it
• Patient has learned behavior- therapist helps to
  unlearn
• Systematic desensitization

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Group Therapy

• Group
• Used with the help of others
• People are struggling with similar problems can
  share those experiences and feel less alone
• Used with Eating disorders, grief, substance abuse

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Client Centered Therapy

• Frances 400
• Equal relationships between therapist and client
• Therapist listen, encourage, avoid giving
  opinions to the clients
• Unconditional positive regard-continually
  encourage
• Set realistic goals and reach them

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Rational Emotive Therapy

• Session
• People behave rationally and deliberately based
  on assumption on life
• Emotional problems occur when people think
  irrationally
• Get patient to think realistically
• Therapist-model correct behavior, humor for
  irrational thoughts, persuasion
• Break old habits, self-discipline

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Example My boyfriend/girlfriend broke up with
me so that means I am ugly and unlovable and
will be alone forever Example I didnt get
into my first choice college because I am dumb
and Will never get into a good college
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Gestalt Therapy

• Feeling
• Emphasizes personal responsibility,
• Focuses upon the individual's experience in the
  present moment, the therapist-client
  relationship, the environmental and social
  contexts of a person's life, and the
  self-regulating adjustments people make as a
  result of their overall situation.

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Cognitive Behavioral Therapy

• Goal to help a person learn to recognize
  negative patterns of thought, evaluate their
  validity, and replace them with healthier ways of
  thinking.
• Focuses on the immediate present what and how a
  person thinks more than why a person thinks that
  way.
• CBT is goal oriented. Patients working with their
  therapists are asked to define goals for each
  session as well as longer-term goals
• Therapists also teach important coping skills,
  such as problem solving and scheduling
  pleasurable experiences. This includes homework
  outside of session

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Psychopharmacology