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Approaches to understanding psychopathology - part 2

by J. Jeyaseelan, Department of Psychology, University of Peradeniya

Phobias can be learned through modelling. For example, a child whose mother displays a particular kind of phobic disorder might learn to have the same unrealistic fear towards something as a result of observational learning. In addition, children of poorly functioning parents may themselves develop maladaptive reactions because of their exposure to inadequate parental models. For instance, if a child's father is repeatedly critical of others, the child might be critical of virtually every person with whom he or she enters into close relationships.

Cognitive approach

The cognitive approach of abnormality assumes that cognitions (people's thoughts and beliefs) are central to a person's abnormal behaviour. So to understand abnormality we must take into account the contents and processes of human thought. This model has its formal beginning in the early 1960s when Aaron Beck and Albert Ellis proposed cognitive theories of abnormality. Abnormal functions can result from several kinds of cognitive problems.

Maladaptive Assumptions: some people irrationally assume that they are abject failures if they are not loved or approved by virtually everyone. Such people constantly seek approval and repeatedly feel rejected. All their interactions and interpretations may be affected by this assumption and might lead to disturbed behaviour patterns. Ellis called this process as "basic irrational assumption". Specific Upsetting Thoughts: as we confront different life situations numerous thoughts come into our mind, some comforting and some upsetting. Aaron Beck referred to these unbidden cognitions as "automatic thoughts". When a person's stream of automatic thoughts in overwhelmingly negative, Beck would expect that person to become depressed. Another theorist Donald Meichenbaun suggests that people who suffer from anxiety have inadvertently learned to generate counter productive self-statements during stressful situations and as a result react to any difficult situation with automatic fear and discomfort.

Illogical Thinking Process: Beck has found that some people habitually think in illogical ways and keep drawing self-defeating and even pathological conclusions. Beck has identified a number of illogical thought processes characteristic of depression. One such process is overgeneralization, drawing broad negative conclusions on the basis of a single insignificant event.

Humanistic existential approach

Psychologists who subscribe to the humanistic model of abnormality emphasize the control and responsibility that people have for their own behaviours even when such behaviour is abnormal. This model concentrates on what is uniquely human, viewing people as basically rational, oriented toward a social world and motivated to get along with others. Humanistic approaches focus on the relationship of the individuals to society, considering the ways in which people view themselves in relation to others and see their place in the world.

Carl Rogers, one of the leaders of humanistic psychology thinks that healthy people are those who move away from roles created by the expectations of others - that is, they do not pretend to be something they are not. Instead, they learn to trust themselves and reject the false selves that others have created for them. Neurotic and psychotic people, on the other hand, have self-concepts that do not match their experiences. They are afraid to accept their own experiences as valid, so they distort them either to protect themselves or to win approval from others.

The existential model believes that people are free to choose among alternative courses of actions. Existentialists emphasise self-determination, choice and responsibility of the individuals to rise above environmental forces. If this is true why are so many people unhappy and dissatisfied? Why does maladaptive behaviour exist? For one thing, not everyone chooses wisely. Furthermore, a person can choose to act authentically or inauthentically. To act authentically means to freely establish one's own goals. To act inauthentically means to let other people dictate those goals. If people are not making their choices wisely and are not self-determined and are not able to rise above environmental conditions, but let others and the environment overpower them, then they can become empty and lonely. As a result they may resort to a series of maladaptive tendencies.

Socio cultural approach

The socio cultural model of abnormality make the assumption that people's behaviour -both normal and abnormal - is shaped by the kind of family group, society and culture in which they live. According to this view, the kinds of relationships that evolve with others may support abnormal behaviour and even cause them to occur.

Consequently, the kinds of stresses and conflicts people experience as part of their daily interactions with others in their family and society can promote an abnormal behaviour. For example, if a particular family has rigidly enmeshed structure in which the members are grossly overinvolved in each other's activities, thoughts and feelings, then children from this family may have great difficulties and other crises in establishing autonomy in life. A series of maladaptive behaviour patterns may be associated with this situation.

Support for the position that socio cultural factors shape abnormal behaviour comes from statistics that show that some kinds of abnormal behaviours are far more prevalent among certain social classes than others. For instance, diagnoses of schizophrenia tend to be higher among members of lower socio economic classes than among members of more affluent groups. According to M. Pines (1981) poor economic times tend to be linked to general declines in psychological functioning. In addition, socio phenomena such as homelessness have been found to be associated with psychological disorders.

We have seen the major theoretical perspectives on abnormal behaviour and we could definitely notice some sort of value in each of them. If someone tries to decide which is the 'best' theory among all, it would only be an insane approach. In fact, none of the models discussed above has proved consistently superior to the rest. Rather, each perspective helps us to appreciate a critical dimension of human functioning, and each has important strengths as well as serious limitations.

During the past two decades there had been a dramatic shift away from narrow clinical approaches that are rooted in a single theoretical model. For example, an advanced biological model recognises psychopathology as a joint product of three types of disordered processes: first, disordered bodily processes, for example, a hormonal deficiency. Second, disordered psychological functioning, for example, tendency towards shyness. Lastly, disordered social environment - a high unemployment rate in the community, for example.

Clinicians are increasingly embracing diathesis-stress explanations of abnormal behaviour - the view that a person must first have biological, psychological or socio-cultural predispositions to a disorder and must then be subjected to an immediate stress to develop and maintain certain forms of abnormality.

Today clinicians who investigate the cause of mental disorders look into different areas rather than dwelling upon a particular area. For example, clinicians investigating schizophrenia study the following personal variables and environmental factors.

* A reduced capacity for information processing in situations requiring attention to complex stimuli.

* Hyperactivity of the autonomic nervous system to aversive stimuli in the environment.

* Poor social and coping skills.

* Stressful life events.

* A non-supportive social network.

Research has shown that, it is particular combinations of these personal vulnerabilities and environmental handicaps, and not their personal existence, that pose various types of maladaptive behaviour.

No single theory of etiology can explain all mental disorders or even all those of a particular type. Moreover, the same type of disorder may have different causes in different patients. For instance, an obsessive-compulsive disorder such as compulsive hand washing or repetition of particular words or phrases may have its origins in a biochemical imbalance, in an unconscious emotional conflict, in faulty learning process or in a combination of these. Therefore, a complete and wise approach to understanding pathological processes in mental health requires an interactional, integrative and complementary model.

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