Modern Perspectives on Anomaly

2021-07-14 04:38 PM

The utopian model holds that only people who achieve their maximum potential in life are free of mental health problems.

This book focuses on factors related to mental health problems and their treatment. Despite the name, it includes people who are considered “anomalous” if they are defined as anomalous in the sense of “standard deviation”. Of course, there are many different definitions of anomaly, but there is no one definition that covers all aspects of mental health problems.

Statistical anomalies imply people who are statistically different from the norm: the further away from the standard, the greater the anomaly. However, this also does not necessarily mean that it is a mental disorder. People who are extremely impressive, participate in extreme sports or achieve very special achievements in their work are all extraordinary people. However, they are not people with mental health problems.

Psychometric anomalies are understood as deviations from statistical standards such as the population mean IQ of 100. In the case of IQs below 70-75, it can be defined as having mental difficulties. learning and adapting to life. However, the problems related to low IQ of individuals are also very different because it depends on the living circumstances of those individuals. Furthermore, if a person scores high on the other side of the IQ spectrum, for example, more than 30 points above the norm, it cannot be said that they are anomalies, and much less have disorders. mental.

The utopian model holds that only people who reach their maximum potential in life are free of mental health problems. Yet even those who propose such a model (e.g., Rogers, 1961) admit that only a very small number of people reach their full potential. And following this model it can be concluded that most of the population is deviating from the optimal mental state and to some extent have mental health problems. It does not rule out that mental health poverty be the norm.

The presence of abnormal or deviant behavior is probably closest to simple models for understanding anomaly as aspects of mental health problems because it implies notice deviant behaviors. However, such a simple criterion is not enough. Not all people with mental health problems are deviant, and not all deviant behavior is a sign of a mental health problem. More complex models of anomaly view abnormal behavior as a sign of mental health problems when:

It is the result of faulty psychological processes.

It is a cause or effect of stress and/or dysfunction.

It goes beyond a conventional response to specific situations.

The fourth criterion is: an individual can put himself in danger of having a distorted view of the world, although this is also less common in people who are considered to have mental health problems. These criteria can be generalized to “4D” (Deviance - standard deviation; Distress - grief; Dysfunction - dysfunction and Dangerous - danger). In general, these standards hold true, but there are important exceptions. For example, child molestation is not caused by a personal stress disorder, and people with psychopathic behavior do not feel remorse for their actions.

Although these standards provide a general overview of what is and isn't a mental disorder, such standards may differ in different groups, societies, and periods. The definition of psychosis, deviance, or anomaly is social and such definitions are not absolute. In some countries, people who see themselves and talk to themselves are considered wise, having a special power. In some other countries, such people are considered to have psychosis and need to be treated. For example, in Puerto Rico, it is normal for someone to believe that there are many spirits around him. In England, with such convictions, he must be hospitalized with schizophrenia.

In some cases, an individual's unusual behavior can be labeled eccentric - a label much more bearable than "crazy" and "mentally ill". So what label might change how different an individual is from the norm, how much of his behavior is anomalous, and how others perceive those behaviors. However, these ascribed labels have a huge impact on the individual. A very special example can be cited in the classic study of Rosenhan (1973). In this study, he instructed a group of students to pretend to be psychotic by claiming that they heard voices in their heads - hallucinations. This experiment is intended to study the diagnostic and hospital inpatient process. As Rosenhan predicted, most of the students were admitted to the hospital with a diagnosis of schizophrenia. What's more surprising is that after students stop acting and confess their jokes, many psychiatrists use it as proof of "illness". It also took several weeks for the students to be discharged from the hospital and some with a diagnosis of "schizophrenia in remission".

Historical overview

Explanations for "madness" have existed for a long time in history, and it has also changed significantly from time to time. Records of the ancient Chinese, Jews, and Egyptians describe strange acts of the devil. Until the first century B.C., explanations were mainly biological. For example, Hippocrates suggested that anomalous behavior is an imbalance between four types of body fluids: yellow bile, black bile, blood, and mucus. For example, an excess of yellow bile causes mania; Excess black bile causes depression. Treatment is aimed at reducing the level of the corresponding fluid in a variety of ways. For example, reduce the levels of black bile by living a quiet life, eating mostly vegetables, not drinking alcohol, exercising and abstaining from sex.

Until the Middle Ages, religious ideologies dominated, and the clergy and clerics all believed that anomalous behavior was the work of the devil. The treatment is mainly done by the monks. For the sick to be delivered from the devil, people pray, listen to hymns, drink holy or bitter water. More brutal ways include: insulting the devil, being left cold, stretching or whipping. Perhaps the most tragic way of dealing with possessed people is the Catholic Church's Malleus Malforum (witch's hammer), which guides how to identify and deal with witches, who charged when a certain disease appeared in the community. The manual states that the immediate removal of demonic possessions and burning is one way to get rid of the devil.

By the end of the Middle Ages, power was again transferred to the clergy and so biological views on mental health issues once again prevailed. Care facilities for people with mental health problems have been established. However, the initial results of the insane asylums led to overcrowding. This entails a decline in the quality of care and is increasingly inhumane. One of such well-known facilities is the Bethlem Hospital in London. Here the patients were chained and on certain moons, some were stretched by the chains to avoid disturbance. The treatment was brutal and inhumane. The hospital became one of the famous tourist attractions in London. People pay to see crazy people.

In the 19th century, there was a fundamental change in the care of the mentally ill. William Tuke in England and Phillipe Pinel in France offered more humane treatment. Although there is still an insane asylum, the mentally ill can move freely in it. Therapy includes working closely with the patient, reading and talking to them, and taking them for regular walks. Many people were released from the hospital because their health condition was good. Such an “ethical” approach to treating people with mental illness is based on the notion that if all people with mental health problems could receive humane treatment, they could make good progress. even then no further treatment is required. However, the success rate is not optimal and then it is found that not all people who are treated in this way recover and the attitude is biased towards people with health problems. mental health increased. And again for a long time, the detention of the mentally ill became the norm.

The entity trends and cause

At the beginning of the 20th century, the theory and treatment of mental disorders were divided into two directions: physical etiology and psychogenic etiology. The somatogenic approach assumes that mental anomalies are all biological disorders of the brain. The most influential person in this approach is Emil Kraepelin. He was also the first to devise a modern classification of mental disorders. He grouped symptoms into different groups, named diagnoses, and described their course. He next measured the effectiveness of different drugs on mental disorders. Although this view was adopted quickly, the many types of interventions that emerged from there, such as the tonsillectomy, brain surgery (see chapter 3), all showed the ineffectiveness of this view.

The psychoanalytic approach holds that the primary cause of mental disorders is psychological. The first person to initiate this approach was Friedrich Mesmer, an Austrian physician. In 1778 he founded a clinic in Paris to treat people with hysteria disorders. His therapeutic views are known as mesmerism. In this way, the patient can sit in a dark room and listen to music. Then Mesmer appeared dressed in glitter, used a special cane and touched the problem area of ​​​​the patient's body. In this way he succeeded in many cases. However, he was still considered a charlatan and his Paris clinic was closed. Other famous figures of the psychoanalytic approach were Jean Charcot and later Sigmund Freud, who used hypnosis to treat hysteria disorders. The typical process of this therapy is to put the patient under hypnosis and then encourage them to identify the triggers of the symptoms and re-experience the emotions then. This process is also known as clearance. Freud later abandoned this method, turning to free association and psychoanalysis.

The second half of the 20th century saw a revolution in the treatment of mental health problems and the proliferation of both approaches: biological and psychological. The humanistic therapies initiated by Carl Rogers complemented Freud and psychoanalysts. This was followed by the emergence of behavioral and cognitive approaches, led by such theorists and clinicians as: Hans Eysenck and Stanley Rachman in the UK, Aaron Beck and Donald Meichenbaum in the US and Canada (see chapter 2 ). Psychotherapy is increasingly effective for disorders as diverse as depressive disorders, anxiety disorders and schizophrenia.

Community care

Modern treatment modalities have allowed thousands of people with chronic mental disorders who in the first half of the 20th century needed hospital care to now be treated in the community. The shift in hospital-to-community care began in the UK in the 1950s, then peaked in the 1970s. During that time, so many people have stayed for years, even decades. in the hospital, gradually being transferred back to the community, where they have since been admitted. This is not a simple process because such a change needs to be legislated and many patients already suffer from the hospital stay syndrome. These people are used to acting according to hospital rules, which are generally more accepting of differences than the general public. They themselves also have little self-care skills because, over a period of many years, they are not responsible for cooking, washing and other self-care tasks. Many times the prolonged life in the hospital makes them more disabling than the disease itself. This is no question as to whether they wander or possibly become unmarried mothers. Because of these factors, before returning the patient to the community, it is necessary to teach them how to live in a non-hospital environment. Otherwise, there will be a lot of trouble after the patient is discharged from the hospital and can eventually lead to a vicious cycle: quickly returning them to the community and quickly being hospitalized again. laundry and other self-care tasks. Many times the prolonged life in the hospital makes them more disabling than the disease itself. This is no question as to whether they wander or possibly become unmarried mothers. Because of these factors, before returning the patient to the community, it is necessary to teach them how to live in a non-hospital environment. Otherwise, there will be a lot of trouble after the patient is discharged from the hospital and can eventually lead to a vicious cycle: quickly returning them to the community and quickly being hospitalized again. laundry and other self-care tasks. Many times the prolonged life in the hospital makes them more disabling than the disease itself. This is no question as to whether they wander or possibly become unmarried mothers. Because of these factors, before returning the patient to the community, it is necessary to teach them how to live in a non-hospital environment. Otherwise, there will be a lot of trouble after the patient is discharged from the hospital and can eventually lead to a vicious cycle: quickly returning them to the community and quickly being hospitalized again. Because of these factors, before returning the patient to the community, it is necessary to teach them how to live in a non-hospital environment. Otherwise, there will be a lot of trouble after the patient is discharged from the hospital and can eventually lead to a vicious cycle: quickly returning them to the community and quickly being hospitalized again. Because of these factors, before returning the patient to the community, it is necessary to teach them how to live in a non-hospital environment. Otherwise, there will be a lot of trouble after the patient is discharged from the hospital and can eventually lead to a vicious cycle: quickly returning them to the community and quickly being hospitalized again.

To avoid such difficulties, modern therapy seeks to reduce inpatient facilities and increase management of patients in the communities where they live. People with mild to moderate mental health problems, mostly mild to moderate anxiety and depression, refer to a general practitioner who treats them in the primary health care system. Even those with severe mental health problems can be treated at home by a mixed team of specialists. Only bring the patient to the hospital when they have had crises or the problem has become severe and then return them to the community as soon as possible.

The mixed team of specialists is usually led by a psychiatrist who is medically responsible for the patient. The doctor is the one who prescribes for the patient. Nurses on mixed teams must have specialized training in mental health care. They must be multi-functional: monitoring the patient's progress, guiding medication adjustments, performing basic psychotherapy and, when needed, acting as a lawyer for the patient. Experts from other fields can also join the mixed team. Occupational therapists can also help individuals maintain and develop life skills such as cooking or ways to deal with stress. Clinical psychologists provide therapy for complex problems, assisting other professionals in client therapy through clinical supervision and training in therapeutic skills. Finally, social workers will help individuals deal with social problems that may aggravate their problems, such as money or unemployment.