Download Personality Disorder

Abnormal Psychology
& Therapy
Chapters 16 & 17
Part I: Psychological
Disorders
A Quick Word before We Begin…
• It is normal phenomenon for students of
psychology and medicine to unconsciously
(or consciously) to diagnose themselves or
others as having a disorder because they
may have experienced related symptoms
in the past (or present). It is VERY
important to fight that urge. We are not
doctors or psychologists! Only they can
make diagnoses!
• We laugh at the behavior NOT the people!
Defining Psychological Disorders
Mental health workers view psychological
disorders as persistently harmful thoughts,
feelings, and actions.
When behavior is unjustifiable, maladaptive,
atypical, and disturbing psychiatrists and
psychologists label it as disordered.
Remember: U-MAD
Deviant, Distressful & Dysfunctional
1. Deviant behavior (going
naked) in one culture may be
considered normal, while in
others it may lead to arrest.
2. Deviant behavior must
accompany distress. Worldclass athletes deviate from
the norm but that does not
cause distress to themselves
or others.
3. If a behavior is dysfunctional
it is clearly a disorder.
In the Wodaabe tribe men
wear costumes to attract
women. In Western society
this would be considered
abnormal.
Medical Perspective
Philippe Pinel (1745-1826) from France, insisted that
madness was not due to demonic possession, but an
ailment of the mind. He suggested humane treatment.
“Lunatic Ball”
Biopsychosocial Perspective
Assumes that biological, socio-cultural, and
psychological factors combine and interact to
produce psychological disorders.
Classifying Psychological Disorders
The American Psychiatric Association rendered
a Diagnostic and Statistical Manual of Mental
Disorders (DSM) to describe psychological
disorders.
The most recent edition, DSM-IV-TR (Text
Revision, 2000), describes 400 psychological
disorders compared to 60 in the 1950s.
The DSM-IV-TR: Multiaxial
Classification
Axis I
Axis II
Is a Clinical Syndrome (cognitive, anxiety,
mood disorders [16 syndromes]) present?
Is a Personality Disorder or Mental Retardation
present?
Is a General Medical Condition (diabetes,
Axis III
hypertension or arthritis etc) also present?
Are Psychosocial or Environmental Problems
Axis IV
(school or housing issues) also present?
What is the Global Assessment of the person’s
Axis V functioning?
Goals of DSM
1.
2.
Describe (400) disorders.
Determine how prevalent the
disorder is.
Disorders outlined by DSM-IV are reliable.
Therefore, diagnoses by different professionals are
similar. Also, insurance companies usually require
a firm diagnosis to cover health care costs.
Others criticize DSM-IV for classifying almost
anything as a disorder/syndrome.
Anxiety Disorders
Feelings of excessive apprehension and anxiety that
cause distress or cause maladaptive behaviors to
reduce the levels of stress.
1.
2.
3.
4.
5.
Generalized anxiety disorders (GAD)
Phobias
Panic disorders
Obsessive-compulsive disorders (OCD)
Post-Traumatic Stress Disorder (PTSD)
Generalized Anxiety Disorder
1. Persistent and uncontrollable tenseness and
apprehension (worrying).
2. Autonomic arousal.
3. Inability to identify or avoid the cause of
certain feelings.
Panic Attack Disorder
Minute-long episodes of intense dread
which may include feelings of terror, chest
pains, choking, or other frightening
sensations.
Anxiety is a major component of panic attack
disorder, making people avoid situations that cause
it. Panic Attack disorder and agoraphobia (fear of
open/public places) usually go together.
Phobia
Marked by a persistent and irrational fear of an
object or situation that disrupts behavior.
Kinds of Phobias
* Agoraphobia
Acrophobia
Claustrophobia
Hemophobia
Phobia of open places. *
Phobia of heights.
Phobia of closed spaces.
Phobia of blood.
Obsessive-Compulsive Disorder
Persistence of unwanted thoughts (obsessions) and
urges to engage in senseless rituals
(compulsions) that cause distress.
Ms. Cohen’s Obsession!!!
Post-Traumatic Stress Disorder
Four or more weeks of the following symptoms
constitute post-traumatic stress disorder (PTSD):
1. Haunting memories
2. Nightmares
3. Social withdrawal
4. Jumpy anxiety
5. Sleep problems
Explaining Anxiety Disorders
Freud suggested that we repress our painful
and intolerable ideas, feelings, and thoughts,
resulting in anxiety.
The Learning Perspective
Learning theorists suggest that
(classical) fear conditioning leads to
anxiety. This anxiety then becomes
associated with other objects or
events (stimulus generalization) and
is reinforced.
Investigators believe that fear
responses can be passed along to
others through observational
learning.
The Biological Perspective
Natural Selection has led our ancestors to learn
to fear snakes, spiders, and other animals.
Therefore, fear preserves the species.
Twin studies suggest that our genes may be
partly responsible for developing fears and
anxiety. Twins are more likely to share phobias.
The Biological Perspective
A PET scan of the
brain of a person
with ObsessiveCompulsive
Disorder (OCD).
High metabolic
activity (red) in the
frontal lobe areas
are involved with
directing attention.
Dissociative Disorders
Conscious awareness becomes separated
(dissociated) from previous memories,
thoughts, and feelings.
Depersonalization Disorder
1. Having a sense of being unreal.
2. Being separated from the body.
3. Watching yourself as if in a movie.
Dissociative Identity Disorder (DID)
Formerly called Multiple Personality Disorder (MPD),
it is a disorder in which a person exhibits two or more
distinct and alternating personalities
(each with its own name, voice, mannerisms, occupations, etc).
Chris Sizemore, the basis for the
movie The Three Faces of Eve
Other Dissociative Disorders
• Dissociative Amnesia – amnesia caused by
some kind of trauma (not by injury)
• Dissociative Fugue – Person totally forgets
who they are and may develop a completely
new identity, personality, etc. in a new
place.
Mood Disorders
Emotional extremes of
mood disorders come in
two principal forms.
1. Major depressive
disorder
2. Bipolar disorders
Major Depressive Disorder
Depression has been called the “common cold”
of psychological disorders.
Slightly/Situationally
depressed mood
Major Depressive Disorder
Gasping for air after a
hard run
Chronic shortness of
breath
Major Depressive Disorder
Major depressive disorder occurs when
signs of depression last two weeks or more
and are not caused by drugs or medical
conditions.
Signs include:
1.
2.
3.
4.
Lethargy and fatigue
Feelings of worthlessness
Loss of interest in family & friends
Loss of interest in activities
Dysthymic Disorder
Dysthymic disorder lies between a blue mood
and major depressive disorder. It is a disorder
characterized by daily depression lasting two
years or more.
Blue
Mood
Dysthymic
Disorder
Major Depressive
Disorder
Bipolar Disorder
Formerly called manic-depressive disorder, it is an
alternation between depression and mania
(highs & lows).
Depressive Symptoms
Manic Symptoms
Gloomy
Elation
Withdrawn
Euphoria
Inability to make decisions
Tired
Slowness of thought
Desire for action
Hyperactive
Multiple ideas
Bipolar Disorder
Many great writers, poets, and composers
suffered from bipolar disorder. During their
manic phase creativity surged, but not during their
depressed phase.
Whitman
Wolfe
Clemens
Hemingway
Explaining Mood Disorders
Since depression is so prevalent worldwide,
investigators want to develop a theory of
depression that will suggest ways to treat it.
Lewinsohn notes that a theory of depression
should explain the following:
1. Behavioral and cognitive changes
2. Common causes of depression
Theory of Depression
3. Gender differences
Theory of Depression
4. Depressive episodes usually self-terminate.
5. Depression is increasing, especially in the
teens.
Post-partum depression
Suicide
The most severe form of behavioral response to
depression is suicide. Each year some 1 million
people commit suicide worldwide.
Biological Perspective
Genetic Influences: Mood disorders run in families.
The rate of depression is higher in identical
(50%) than fraternal twins (20%).
Linkage analysis and
association studies link
possible genes and
dispositions for depression.
Biological Perspective
Neurotransmitters:
A reduction of
norepinephrine and
serotonin has been
found in depression.
Drugs that alleviate
mania reduce
norepinephrine.
Pre-synaptic
Neuron
Norepinephrine
Serotonin
Post-synaptic
Neuron
Biological Perspective
PET scans show that brain energy consumption
rises and falls with manic and depressive
episodes.
Social-Cognitive Perspective
The social-cognitive perspective suggests that
depression arises partly from self-defeating
beliefs and negative explanatory styles.
Depression Cycle
1. Negative stressful events.
2. Pessimistic explanatory
style.
3. Hopeless depressed state.
4. These hamper the way the
individual thinks and acts,
fueling personal rejection.
Explanatory style plays a major role in becoming depressed.
Psychotic Disorders
Schizophrenia
Nearly 1 in a 100 suffer from schizophrenia, and
throughout the world over 24 million people
suffer from this disease.
Schizophrenia strikes young people as they mature
into adults. It affects men and women equally,
but men suffer from it more severely than
women.
Symptoms of Schizophrenia
The literal translation is “split mind” but is not
the same as DID. Schizophrenia is a group of
severe disorders characterized by the following:
1. Disorganized and
delusional thinking.
2. Disturbed
perceptions.
3. Inappropriate
emotions and
actions.
John Nash
Disorganized & Delusional Thinking
This morning when I was at Hillside [Hospital], I
was making a movie. I was surrounded by movie
stars … I’m Marry Poppins. Is this room painted
blue to get me upset? My grandmother died four
weeks after my eighteenth birthday.”
This monologue illustrates fragmented, bizarre
Other with
formsdistorted
of delusions
of or
thinking
beliefsinclude,
(usuallydelusions
of grandeur
persecution
(“someone
following
me”) or It
persecution)
called
delusions is
(“I’m
Mary Poppins”).
grandeur
(“I am a called
king”).“word salad”
also demonstrates
a principle
(jumbling up ideas in sentences).
Disturbed Perceptions
A schizophrenic person may perceive things that
are not there (hallucinations). Frequently such
hallucinations are auditory and lesser visual,
somatosensory, olfactory, or gustatory.
Inappropriate Emotions & Actions
A schizophrenic person may laugh at the news
of someone dying or show no emotion at all
(apathy/flat affect).
Patients with schizophrenia
may continually rub an arm,
rock a chair, or remain
motionless for hours
(catatonia).
Subtypes of Schizophrenia
Schizophrenia is a cluster of disorders. These
subtypes share some features, but there are other
symptoms that differentiate these subtypes.
Positive and Negative Symptoms
Schizophrenics have inappropriate symptoms
(hallucinations, disorganized thinking, deluded
ways) that are not present in normal individuals
(positive symptoms - inward).
Schizophrenics also have an absence of appropriate
symptoms (apathy, expressionless faces, rigid
bodies) that are present in normal individuals
(negative symptoms - outward).
Chronic and Acute Schizophrenia
When schizophrenia is slow to develop
(chronic/process) recovery is doubtful.
Such schizophrenics usually display negative
(outward) symptoms.
When schizophrenia rapidly develops
(acute/reactive) recovery is better.
Such schizophrenics usually show positive
(inward) symptoms .
Understanding Schizophrenia
Schizophrenia is a disease of the brain exhibited
by the symptoms of the mind.
Brain Abnormalities
Dopamine Overactivity: Researchers found that
schizophrenic patients express higher levels of
dopamine D4 receptors in the brain.
Abnormal Brain Activity, Etc.
Brain scans show abnormal activity in the frontal
cortex, thalamus, and amygdala of schizophrenic
patients. Schizophrenia patients may exhibit
morphological changes in the brain like
enlargement of fluid-filled ventricles.
Pre-natal/Neo-natal development
Schizophrenia has also been observed in individuals
who contracted a viral infection (flu) during the middle of
their fetal development.
There is also evidence of people who suffered from
oxygen deprivation at birth and/or poor fetal nutrition may
also have higher rates of schizophrenia.
Malnutrition, methamphetamine and cocaine abuse, and
social conditions (urban life, racial discrimination,
adversity and family dysfunction) have also been
contributed to the development of the disorder.
Genetic Factors
The likelihood of an individual suffering from
schizophrenia is 50% if their identical twin has
the disease.
0 10 20 30 40 50
Identical
Both parents
Fraternal
One parent
Sibling
Nephew or niece
Unrelated
Warning Signs
Early warning signs of schizophrenia include:
1. A mother’s long lasting schizophrenia.
2. Birth complications, oxygen deprivation and
low-birth weight.
3. Short attention span and poor muscle
coordination.
4. Disruptive and withdrawn behavior.
5. Emotional unpredictability.
6. Poor peer relations and solo play.
Personality Disorders
Personality disorders
are characterized by
inflexible and enduring
behavior patterns that
impair social
functioning. They are
usually without
anxiety, depression, or
delusions.
Some Personality Disorders
• Avoidant Personality Disorder – the person commonly
withdraws due to fear of rejection
• Schizoid Personality Disorder – the person is emotionally
disengaged (flat affect)
• Schizotypal Personality Disorder – the person enjoys social isolation,
usually displays strange behavior and thinking
• Histrionic Personality Disorder – the person engages in attentiongrabbing emotional outbursts and tries to gain other’s approval
• Narcissistic Personality Disorder – the person is very self-absorbed
and have delusions of grandeur
• Borderline Personality Disorder – the person has unstable emotions
and relationships and ultimately an unstable identity
• Antisocial Personality Disorder – the person (usually male) exhibits a
lack of conscience for wrongdoing, even toward friends and family
members. Formerly, this person was called a sociopath or psychopath.
• Dependent Personality Disorder – the person is abnormally
dependent on other people
• Paranoid Personality Disorder – the person has paranoid thoughts and
feelings and doesn’t trust others
Understanding Antisocial
Personality Disorder
Like mood disorders
and schizophrenia,
antisocial personality
disorder has biological
and psychological reasons.
Youngsters, before
committing a crime,
respond with lower
levels of stress hormones
than others do at their
age.
Understanding Antisocial
Personality Disorder
PET scans of 41 murderers revealed reduced
activity in the frontal lobes. In a follow-up study
repeat offenders had 11% less frontal lobe activity
compared to non-murders.
Normal
Murderer
Understanding Antisocial
Personality Disorder
The likelihood that one will commit a crime doubles
when childhood poverty is compounded with
obstetrical complications.
Somatoform Disorders
Disorders that usually involve
abnormal bodily sensation or body image:
• Hypocondriasis – believing that you
have illnesses that you don’t really have
• Pain disorder
• Conversion disorder – developing physical
symptoms without an actual biological cause
• Body Dismorphic Disorder – belief that one
or more of the features/parts of your body
are abnormal/grotesque and need to be fixed
Childhood Disorders
• Attention-Deficit Hyperactivity Disorder (ADHD)
– 3 key symptoms
• Inattention
• Hyperactivity
• Impulsivity
– The Big Questions:
• Is it overdiagnosed?
• Is it a real syndrome at all?
• How can it be better diagnosed?
• What causes it?
Childhood Disorders
• Autistic Disorders
– Key symptoms
• Impaired speech or development
• Impaired social interaction (such as decreased eye contact and inability
to carry on a conversation)
• Impaired theory of mind (understanding of others’ point of view)
• Behaviorally inflexible – stick to routine; distress when it changes
• Tends to occur more in males than in females
Asperger syndrome
- “high functioning” form of autism with normal (or high) levels of
intelligence and possible savant syndrome
yet with decreased social functioning
– Possible Causes?
• Differences/damage in the brain’s
neural connections?
• Genetic Factors?
• Mercury in Vaccines?
Other Disorders
• Tic Disorders – facial tics, blurted out words or sounds
– Tourette’s Syndrome
• Factitious Disorders – disorders in which the person fakes
symptoms or inflicts symptoms on self or others to gain
attention/sympathy (malingering = sickness for
personal or monetary gain)
– Munchausen Syndrome – person claims to have symptoms and
undergoes many treatments/surgeries to receive attention
– Munchausen Syndrome by Proxy – person induces illnesses in
others (usually parents do this to kids) to receive indirect
attention
– Causes? Perhaps person was given great care by a doctor
growing up and neglected by parents? Other, underlying
personality disorders?
Rates of Psychological Disorders
Rates of Psychological Disorders
Part II: Psychological
Treatment/Psychotherapy
History of Insane Treatment
Maltreatment of the insane throughout the ages
was the result of irrational views. Many patients
were subjected to strange, debilitating, and
downright dangerous treatments.
History of Insane Treatment
Philippe Pinel in France and Dorthea Dix in
America founded humane movements to care
for the mentally sick.
Philippe Pinel (1745-1826)
Dorthea Dix (1745-1826)
Therapies
Psychotherapy involves an emotionally charged,
confiding interaction between a trained therapist
and a mental patient.
Biomedical therapy uses drugs or other
procedures that act on the patient’s nervous
system, curing him or her of psychological
disorders.
An eclectic approach uses various forms of
healing techniques depending upon the client’s
unique problems.
Psychological Therapies
We will look at four major forms of
psychotherapies based on different theories of
human nature:
1.
2.
3.
4.
Psychoanalytical theory
Humanistic theory
Behavioral theory
Cognitive theory
Psychoanalytic Therapy
The first formal psychotherapy to emerge was
psychoanalysis, developed by Sigmund Freud.
Edmund Engleman
Sigmund Freud's famous couch
Psychoanalysis
Since psychological problems originate from
childhood repressed impulses and conflicts, the aim
of psychoanalysis is to bring repressed feelings
into conscious awareness where the patient can
deal with them.
When energy devoted to id-egosuperego conflicts is released, the
patient’s anxiety lessens.
Psychoanalysis
Freud developed the method of free association to
unravel the unconscious mind and its conflicts.
The patient lies on a couch and speaks about
whatever comes to his or her mind.
Psychoanalysis Criticism
During free association, the patient edits his
thoughts, resisting his or her feelings to
express emotions. Such resistance becomes
important in the analysis of conflict-driven
anxiety. Eventually the patient opens up and
reveals his or her innermost private
thoughts, developing positive or negative
feelings (transference) towards the therapist.
1. Psychoanalysis is hard to refute because it cannot
be proven or disproven.
2. Psychoanalysis takes a long time and is very
expensive.
Humanistic Therapy
Humanistic therapists aim to boost self-fulfillment
by helping people grow in self-awareness and selfacceptance.
Unlike psychodynamic therapies,
humanistic therapies focus on
 The present and future, not past conflicts
 Conscious issues not unconscious conflicts
 Taking responsibility for one’s feelings and behaviors,
not finding what is hidden
 Promoting individual growth, not curing illnesses
- Person in therapy called client (not patient)
Humanistic Therapy
Developed by Carl Rogers, person-centered
therapy is a form of humanistic therapy.
The therapist listens to the needs of the patient
in an accepting and non-judgmental way
(unconditional positive regard) , addressing
problems in a productive way and building his or
her self-esteem. Therapist also demonstrates
empathy and genuineness.
Humanistic Therapy
The therapist engages in active listening and
echoes, restates, and clarifies the patient’s thinking,
acknowledging expressed feelings.
Behavior Therapy
Therapy that applies learning principles to the
elimination of unwanted behaviors.
To treat phobias or
sexual disorders,
behavior therapists do
not delve deeply below
the surface looking for
inner causes.
Behavior Therapy
Counterconditioning is a procedure that conditions
new responses to stimuli that trigger unwanted
behaviors. Expose patients to things they fear and
avoid. Through repeated exposures, anxiety lessens
because they habituate to the things feared.
Mary Cover Jones
Behavior Therapy
Aversive Conditioning
is a type of
counterconditioning
that associates an
unpleasant state with an
unwanted behavior. With
this technique,
temporary conditioned
aversion to alcohol has
been reported (but
doesn’t seem to work
long-term).
Behavior Therapy
Exposure therapy involves exposing people to
fear-driving objects in real or virtual
environments.
Behavior Therapy
Systematic Desensitization is a type of exposure
therapy that associates a pleasant, relaxed state with
gradually increasing anxiety-triggering stimuli
(commonly used to treat phobias).
Behavior Therapy
Operant conditioning procedures enable
therapists to use behavior modification, in
which desired behaviors are rewarded and
undesired behaviors are either unrewarded or
punished.
A number of withdrawn, uncommunicative
3-year-old autistic children have been
successfully trained by giving and withdrawing
reinforcements for desired and undesired
behaviors.
Behavior Therapy
Therapists may create a token economy in
which patients exchange a token of some sort (a
secondary reinforcer), earned for exhibiting the
desired behavior, for various privileges or treats (a
primary reinforcer).
Behavior Therapy Criticisms
Will the desired behaviors continue and/or
undesirable behaviors come back when
the training/reinforcement stops?
Is it really ethical for one human being to
“train” another?
Cognitive Therapy
Teaches people adaptive ways of thinking and acting
based on the assumption that thoughts intervene
between events and our emotional reactions.
Cognitive Therapy
Rational-Emotive Therapy - Albert Ellis developed a theory that
irrational thoughts led to self-defeating emotions.
Ellis developed the ABCD model to explain this:
• A = Activating event that triggers the emotion (e.g. failing a test)
• B = Belief System: how person appraises the event (e.g. “I’m stupid
and no good at this subject”)
• C = emotional/behavioral Consequences of the appraisal in step B
(e.g. feeling worthless and dumb)
• D = Disputing their erroneous beliefs in step B (e.g. “I’m not dumb.
I just did not study hard enough and go in for the extra help that I
needed”) This is what Ellis wanted to train his clients to be able to
do through Rational Emotive Therapy.
Therapists present common irrational beliefs to clients and help to train
them to cognitively restructure/reappraise their thinking.
Cognitive Therapy
Cognitive therapists often combine the reversal
of self-defeated thinking with efforts to modify
behavior.
Cognitive-behavior
therapy aims to alter the
way people act (behavior
therapy) and alter the way
they think (cognitive
therapy).
AP
Psych
Rocks!
Evaluating Therapies
Group & Family Therapy
Group therapy normally consists of 6-9 people
attending a 90-minute session that can help
more people and costs less. Clients benefit from
knowing others have similar problems.
Family therapy treats the family
as a system. Therapy guides
family members toward positive
relationships and improved
communication. Marriage
counseling is a form of this.
Effectiveness of Different Therapies
Which psychotherapy would be most effective
for treating a particular problem?
Disorder
Therapy
Depression
Behavioral, Cognitive, Interpersonal
Anxiety
Cognitive, Exposure, Stress Inoculation
Bulimia
Cognitive-behavioral
Phobia
Behavioral
Bad Habits
Behavior Modification
Alternative Therapies
Seasonal Affective
Disorder (SAD), a form
of depression, has been
effectively treated by
light exposure therapy.
Therapists & Training
Clinical psychologists:
They have PhDs mostly. They are experts in
research, assessment, and therapy, all of which
is verified through a supervised internship.
Clinical or Psychiatric Social Worker:
They have a Masters of Social Work.
Postgraduate supervision prepares some social
workers to offer psychotherapy, mostly to
people with everyday personal and family
problems.
Therapists & Training
Counselors:
Pastoral counselors or abuse counselors work
with problems arising from family relations,
spouse and child abusers and their victims, and
substance abusers.
Psychiatrists:
They are physicians who specialize in the
treatment of psychological disorders. Not all
psychiatrists have extensive training in
psychotherapy, but as MDs they can prescribe
medications.
The Biomedical Therapies
These include physical, medicinal, and other
forms of biological therapies.
1. Drug
Treatments
2. Surgery
3. Electricshock
therapy
Drug Therapies
Psychopharmacology is the study of drug effects
on mind and behavior.
With the advent of drugs,
hospitalization in mental
institutions has rapidly
declined.
However, many patients are
left homeless on the streets
due to their ill-preparedness
to cope independently
outside in society.
Antipsychotic Drugs
Classical antipsychotics:
[Chlorpromazine (Thorazine)]
Remove a number of positive symptoms associated
with schizophrenia such as agitation, delusions,
and hallucinations.
Atypical antipsychotics:
[Clozapine (Clozaril)]
Remove negative symptoms associated with
schizophrenia such as apathy, jumbled thoughts,
concentration difficulties, and difficulties in
interacting with others.
Atypical Antipsychotic
Clozapine (Clozaril) blocks
receptors for dopamine and
serotonin to remove the negative
symptoms of schizophrenia.
Antianxiety Drugs
Antianxiety drugs (Xanax and
Ativan) depress the central nervous
system and reduce anxiety and
tension by elevating the levels of
the Gamma-aminobutyric acid
(GABA) neurotransmitter.
Antidepressant Drugs
Antidepressant drugs like Prozac,
Zoloft, and Paxil are Selective
Serotonin Reuptake Inhibitors
(SSRIs) that improve the mood by
elevating levels of serotonin by
inhibiting reuptake.
Mood-Stabilizing Medications
Lithium Carbonate, a common salt, has been used to
stabilize manic episodes in bipolar disorders. It
moderates the levels of norepinephrine and glutamate
neurotransmitters.
Brain Stimulation
Electroconvulsive Therapy
(ECT)
ECT is used for severely
depressed patients who do not
respond to drugs. The patient
is anesthetized and given a
muscle relaxant. Patients
usually get a 100 volt shock
that relieves them of
depression.
Psychosurgery
Psychosurgery was popular
even in Neolithic times.
Although used sparingly
today, about
200 such operations do take
place in the US alone.
Psychosurgery
(trephination/lobotomy) is
used as a last resort in
alleviating psychological
disturbances. Removal of
brain tissue changes the
mind and psychosurgery is
irreversible
Rosemary Kennedy’s Lobotomy
We went through the top of the head, I think she was awake. She
had a mild tranquilizer. I made a surgical incision in the brain
through the skull. It was near the front. It was on both sides. We just
made a small incision, no more than an inch." The instrument Dr.
Watts used looked like a butter knife. He swung it up and down to
cut brain tissue. "We put an instrument inside," he said. As Dr.
Watts cut, Dr. Freeman put questions to Rosemary. For example, he
asked her to recite the Lord's Prayer or sing "God Bless America" or
count backwards. ... "We made an estimate on how far to cut based
on how she responded." ... When she began to become incoherent,
they stopped.
—James W. Watts
http://www.pbs.org/wgbh/amex/lobotomist/program/