Personality disorder

BEHAVIOR
DISORDER AND
THEIR TREATMENT

CHARACTERISTIC OF SUBCLASSES OF
MENTAL DISODER
NEUROSIS or PSYCHONEUROSIS
 Less severe, yet an occasions, personally the most debilitating variety of variety of behavior
deviation.
PSYCHOSIS
 Popularly termed insanity, refers to the much more severe type of behavioral disorder in
which there is a chronic disorganization of personality requiring radical treatment and
usually hospitalization.
PERSONALITY DISORDER
 Includes one or various deviations from normal social behavior as well as such major
problems as alcoholism and drug dependence.

NEUROSIS
Inadequately controlled anxiety is the
central feature of the neurosis or
psychoneurosis. Aside from anxiety, other
symptoms of neurotic person include
unreasonable fear, a sense of inadequacy,
loss of appetite, and insomnia.

ANXIETY REACTIONS
The anxiety may be persistent, or it may come in sudden
attacks that last for a few hours or a few days. The precise reason
for the anxiety is not clear either to the victim or to his family, thus
requiring the services of a psychotherapist to bring out the cause.
Anxiety reactions can take other forms. The person becomes
hypochondriac, developing physical complaints that are
groundless or exaggerated. Another anxiety reaction is
neurasthenia or nervous weakness; neurasthenic persons find
themselves unable to do anything as they are too tired or worn out
by anxiety. Other physical symptoms may also appear; trembling
hands, dizziness, insomnia, and so on.

PHOBIC REACTIONS
As we have discussed in the previous unit covering
“control of the emotions,” this individuals with phobias show
an extreme fear of specific objects or situations – nyctophobia
– fear of darkness; pathophobia – fear or disease. A person
with a phobia copes with anxiety by displacing his or her
feelings on a particular object or situation that is believed as
responsible for the discomfort. (In neurosis the cause of
anxiety is objectless or free-floating).

OBSESSIVE-COMPULSIVE
REACTIONS
Persons with obsessive-compulsive reactions may
experience without knowing why, recurring unwanted ideas
(obsession) or they may feel compelled to carry out undesired
or inappropriate act (compulsions). Obsessive thought may
prompt such undesired acts. For example a woman may have
a recurring thought of a fort coming disaster or revolution.
Obsessed with the thought of an uprising, she may
compulsively pack essential foods, clothing, and family
belongings from day to day.

NEUROTIC DEPRESSION
The individual who suffers from neurotic depression
reacts to distressing event with more than usual sadness and
fails to recover within a reasonable length of time. Almost
everyone feel depressed as times such as when one losses
job, when there is the death or rejection of a loved one.
Depression is termed neurotic only when it is out of proportion
to the event and continues past the point where most people
begin to recover.

A THEORY OF NEUROSIS
All neurotic reactions can be viewed as attempts to cope with stress by means of
avoidance behavior. They are exaggerated forms of normal defense mechanisms.

PSYCHOSES
Neurotic behavior has been seen as an attempt to cope with demands in the
environment. Psychotic behavior, on the other hand, tends to be so impaired that the
suffering individual is unable to cope with the demands of daily living. His perception,
thinking, and emotional reactions are usually so disordered that we say he has lost
touch with reality. The types of psychosis to be briefly described in the following
sections are affective reactions, paranoid reactions, schizophrenic reactions, and
chronic brain syndromes.

AFFECTIVE REACTIONS
Affective psychosis or affective reactions are disorders of mood expressed as extreme
mania, depression, or both at different times. The manic person is frequently
aggressive and hard to handle. The depressed individual feels melancholic, worthless,
guilty, and hopeless.
Affective psychosis has a strong genetic basis. It runs in families. The fact that it
occurs in episodes which are not closely related to casual events also indicates that it
has a physiological basis. Treatment includes electroshock (regulated jolts of electrical
current passes through the brain), anti-depressant drugs for the depressive patient,
and calming drugs for the manic.

PARANOID REACTIONS
Paranoid reactions are a rare type of psychosis that in highly characterized by delusions,
usually some combinations of imagined grandeur or imagined persecution. The person
appears normal until something happens to trigger the delusional thinking.

SCHIZOPHRENIC REACTIONS
Schizophrenic reactions, most prevalent among psychotics, consist of
disturbances of thought, mood, and feeling leading to manifestations of withdrawal
from reality and sometimes to delusions and hallucinations. People in their late teens
or early twenties compose the cases admitted to mental hospitals for treatment of
schizophrenia. These correspond to 15-20% of the total number of hospital cases.
Although modern

CHRONIC BRAIN SYNDROMES
The previous psychoses discussed functional psychoses where nothing is physically wrong
with the patient; in contrast, organic psychoses are caused by organic disorders. The brain
is always affected, thus these psychoses are also called chronic brain syndromes. The
sources of brain damage are any of the following: physical blows to the head, disturbances
of the blood supply to the brain, brain tumors, disorders and metabolism, physical changes
in the brain with old age, and chemical changes such as poison, drugs, or alcohol. The two
common types of these syndromes are senile psychosis and intoxication psychosis. The
former is cause by the general deterioration of the brain due to constant loss of nerve cells
that are not replaced (a process that speeds up in old age), and impaired circulation of
blood to the brain; the latter, by the long term effects (heavy drinking from 10 to 30 years)
of alcohol. The symptoms include disorientation, confusion, memory disorders, and
impulsive.

THEORIES ON THE CAUSES OF
PSYCHOSES
Some reported possible cause of functional psychoses are genetic factors, biochemical
irregularities, discernible family patterns, certain personality structures of the patient or
of the patient’s mother, and so on. A genetic predisposition and environmental stress
were found to trigger the development of a psychotic disorder. Chemical changes
produced by drugs may be much like the chemical disorders that interfere with brain
functioning in psychotics. Several drugs have been found effective in treating
psychosis; hence, by determining why and how these drugs work, researches can
soon identify the biochemical basis of psychosis. On the whole, both heredity and
environment underlie psychotic behavior.

PERSONALITY DISORDER
Some of the symptoms of personality
disorders resemble those of psychoses, but the
person neither had delusions nor hallucinations,
and maintains contact with reality. Personality
disorders are mainly characterized by deviant
(different from what is considered to be normal),
lifelong personality traits.

SCHIZOID PERSONALITY
The Schizoid manifest withdrawal from other
people, eccentric thinking, and lack of normal
aggressiveness in relation with others. He is rarely seen in
public, preferring to come and go when people are not
about. As a child, the schizoid is usually quiet, shy,
obedient, sensitive and retiring. He is frequently more
withdrawal at puberty, manifesting traits of an introvert
such as quietness and unsociability, often with eccentricity.

PASSIVE AND AGGRESSIVE
PERSONALITY
Passive-dependent persons are helpless. They want and
expect other people to dominate them. They cling to others just as a
dependent child clings to adults. Passive-Aggressive individuals
utilize passive mean of expressing rebellion and resentment: pouting,
stubbornness, procrastination, inefficiency, and passive obstruction.
Aggressive people can extremely dangerous in that they habitually
burn with resentment and irritability. Oftentimes, they can be
identified by their temper tantrums and violent attacks as they act
out their hostility upon their surroundings.

ANTISOCIAL PERSONALITY
The so-called “morally insane” and
“psychopathic deviate” belong to this category.
They do not manifest any sense of responsibility,
loyalty, or conscience. They have little feelings for
others or for the rights of others. Many things that
healthy people have learned – a sense of
responsibility, a sense of self, a conscience, or a
tolerance of anxiety – are definitely not within the
learning experiences of antisocial people.

DRUG DEPENDENCY
There are two forms of behaviors disorder
resulting from excessive dependence on drugs:
addiction (a state of periodic or chronic intoxication
produced by the repeated consumption of a natural
or synthetic drug), and habituation (a condition
resulting from the repeated consumption of a
drug).

UNDERSTANDING
PERSONALITY DISORDER
Personality Disorder result when people habitually put their own desires before
the demands of society. The sociopaths are not usually motivated by anxiety and stress
(as in neurosis) or by a need to escape or to protect themselves (as in psychosis).
Sociopaths choose to behave normally and are often almost entirely amoral – they do no
care to ignore or disobey the laws or customs of society. They suffer little or no guilt or
anxiety in the manifestation of their behavior.
Antisocial behavior in childhood persists when children’s parents do not show
them affection and acceptance. They eventually behave antisocially and consequently,
psychopathic behavior develops. It is understandable then why this behavior is difficult
to treat. By the time the psychopath is identified, the sociopathic behaviors are deeply
ingrained in the person personality.

The common experiences borne by those who suffer from the various
psychopathological symptoms or behavior disorder presented in the preceding
paragraphs are distress, pain and unhappiness. There are cases where these feelings
pass with little effort. Very often, however, efforts at self-improvement seem futile. At
this point, the people concerned usually seek professional help in the form of
psychotherapy.
Psychotherapy is the general term for a relationship in which one individual (the
patient or client) seeks help from another (the therapist), who provides treatment that
is based primarily on psychological principles. Client and therapist usually sit facing
each other, and the client is urged to discuss the problems for which he seeks help. By
and large, therapists do not give advice – they would rather help clients come to their
own conclusions and implement them in their own way. Clients who are relatively well-
motivated for treatment can usually expect gains in self-esteem, contentment,
interpersonal relationships, feelings of competence, and pleasure in life.

CLASSIFICATION OF
PSYCHOTHERAPISTS

PSYCHOTHERAPISTS ARE GENERALLY CLASSIFIED
INTO ONE OF THE FOLLOWING TYPES:
1. Clinical psychologists – these are people trained in psychological methods. They
have earned a Ph. D. and do not necessarily have a medical degree. They have
undergone extensive training in therapy.
2. Psychiatrists – these are qualified, licensed physicians who have done their
postgraduate work and residency in psychiatry.
3. Psychoanalysis – this group of psychotherapists practice according to a
psychoanalytic theory of personality. They maybe psychiatrists or clinical
psychologists. Freud, a psychoanalyst himself, believed that medical training is
unnecessary for psychoanalyst.

4. Psychiatric social workers – these usually have earned a master’s degree in social
work. They have been trained to gather information helpful in the psychiatrist or
psychologist in prescribing treatment. They often represent patients in their dealings
with social agencies. They may also work in school systems as counselors.
5. Nurses and mental health aides – these people are given increasing responsibility for
therapy in hospital settings.

The initial interview between the therapist and the client should enable the former to
obtain sufficient valuable information about latter from whose “revelations” he can base
what treatment he should employ. Essential sources of information include the following:
1. The life history of patient as it is reported by him and his friends and relatives.
2. A physical examination and evaluation of his health history.
3. Psychological examinations, including tests of the intelligence, personality, and vocational
abilities.
4. The reasons why he has come to seek professional help.
A comprehensive knowledge of the case will enable the psychotherapist to
determine the origin and causes of the client’s problems which could stem from
environmental barriers, personal frustrations, motivational conflicts, deeply rooted
personality disorders, inadequate learning of necessary skills, or learning of inappropriate
behaviors.
Descriptions of some forms of treatment used by clinical psychologists and
psychiatrists in their attempt to help persons with psychological disorders find solutions
to their problems are presented here briefly.

Freud’s theory of personality is the basis of this form of therapy, which is one of the most
important psychotherapeutic methods. Intensive sessions between the psychoanalyst
and the patient are held an our a day, four or five time a week, or more often
depending on the nature and scope of the problem. The psychoanalyst attempts to
help the client uncover and resolve his emotional problems and conflicts and to
determine his motives for representing them.

FOUR BASIC PSYCHOANALYTIC
TECHNIQUES MAY BE IDENTIFIED:
1. Free Association – this method involves instructing the patient simply to focus on a
symptom or an event in the past and to “associate freely” to it – to say anything that
came to mind, no matter how trivial or embarrassing it might seem. Patients are
encouraged to be less inhibitive, to respond freely and to speak out their ideas. This
technique can often successfully reveal repressed thoughts and hidden motives.
2. Dream Analysis – through this technique , the latent content of a dream (unpleasant
and painful unconscious thoughts) based on knowledge on its manifest content
(remembered portion of the dream as recalled by the personafter awakening) may
be uncovered by the psychoanalyst.

3. Resistance – the psychoanalyst utilizes the person’s refusal (resistance) and reveal
foolish and embarrassment thoughts so that basic unconscious feeling that underlies
his problem may be uncovered.
4. Transference – as treatment progresses, the patient often develops an emotional
relationship with the analyst and this is called the Transference neurosis. He transfer to
the therapist the characteristic of important people in his childhood conflicts. The
analyst modifies the relationships and enables the patient to acquire insights into his
emotional reactions and the nature of his psychological defenses and to respond more
realistically to his present and deep-seated conflicts.

THERAPIES BASED ON
SELF-ACTUALIZATION

These forms of therapy allow the client to talk about anything that interest him. The
therapists helps clarify and rephrase what the client says. Two techniques fall under
this major heading: client-centered and existential therapy.
In client-centered therapy, the unction of the therapist is to understand his client and to
reflect his feelings so that he (the client) feels understood and accepted. The therapist
avoid as an authoritarian or judgmental expert. The client gains confidence as he is
allowed to dominate the session without being contradicted or judged by the therapist.
He continuously talk and progress can be made if he is well-motivated.
In existential therapy, again the primary concern is the client’s feelings. The therapist
works with the client’s immediate experiences to help him determine what it means to
be alive as a unique human being. His goal is not necessarily to reduce anxiety since
this is a natural part or existence, but rather, to help the client see that the anxiety
associated with seeking new experiences can be a healthy stimulus to self-
actualization.

This is an electric or flexible approach in the treatment of behavior disorder. In contrast to
the two proceeding methods, here the therapist play an active, directing role –
identifying the problem and prescribing activities that will enable the patient to adjust.
Hours or aimless pursuit are cut down through planned action. The disturbed person is
led to find solutions quickly and efficiently. Giving him tasks to perform makes him an
active and involved

Group therapy gives people a chance to submit their thoughts, their problems and their
entire self-image to the understanding of their peers. By listening to others in their
group, people may find solution to personal problems or the ymay learn to adjust thei
values to those as the society as defined by their group.
There are two forms of group therapy which are:
1. Psychodrama
2. Play Therapy

PSYCHODRAMA
People act out scenes from their own lives. This allows them to express deep-seated
feelings that they have been unable to express in real-life situations. It also gives them
the opportunity to try our new methods of coping.

PLAY THERAPY
It is a special form of psychotherapy for young children. Here, emotional conflicts, and
insecurities are revealed by the children as they play, while the therapist talks to them
about the feeling reflected in their actions. Young children gain some insights into their
own behavior through play therapy which emphasizes the principle of catharsis, the
release of pent-up feelings and desires that they have been afraid to express toward
an object. Instead of telling the child what to do, the therapist or the child may tell a doll
(the object) what to do.

Changing, adjusting, or modifying the behavior of disturbed person is the main thrust of
this therapeutic approach. Treatment is based on the idea that people can be taught
appropriate responses to replace the maladaptive ones that they have learned. The
first step in this method is the identification of the environmental variables that elicit
and reinforce the person’s undesirable behavior. The therapist then sets up a program
that introduces reinforcement for the old, maladaptive response. Some forms of this
application of learning theory to the treatment of behavior disorders are presented in
the following paragraphs.

SYSTEMATIC DESENSITIZATION
TECHNIQUE
This therapeutic technique is based on Pavlov’s classical conditioning principles. Here,
the client is reconditioned to respond in relaxation instead of an anxiety to a certain
fear-evoking situation. The state of relaxation may be achieve when the patient
remains undisturbed, and each succeeding team on the anxiety hierarchy is presented.
Eventually, the original maladaptive response is overcome. From then on, under
normal conditions, the client will be relax in situations that formerly produced fear or
anxiety in him

AVERSION THERAPY
People are relaxed about certain self-destructive behavior are reconditioned to respond
to it with fear. For example, to conditions alcoholics to avoid alcohol they are given
drugs that will make them nauseous if they drink alcohol. They are the shown alcohol
and made to smell it. When the alcohol is been repeatedly associated with nausea, the
patient becomes repelled by it even though previously, it was a pleasant stimulus.
Eventually, alcohol may induce nausea without the presence of the drug.

OPERANT CONDITIONING OR
OPERANT THERAPY
• This consist of programs of psychological rehabilitation that effectively use the principle
of reinforcement. The general procedure is to establish a set of desirable response,
such as fixing one’s room, cleaning or shining shoes, hanging up clothes properly, and
participating in the activities of the institution where the client it confined. Patients learn
that they will be rewarded each time they make a desirable response. Many different
types of rewards or tokens are made possible. By establishing a token economy, the
therapist creates a real-world activities. It is expected that in all token programs, social
acceptance will come to replace tokens as the reinforcement device.

MODELING
Another important technique of behavior modification is modeling or imitation. Anyone
who was acquired the skill of imitating others may acquire new responses by
observation. Modeling can accelerate the development of new responses and
reinforcement can serve to maintain them.

COGNITIVE INFLUENCE
Behavior therapist are starting to realize the role of cognitive factors play in learning.
Attention is paid to possible ways in dealing with imagery, perception, and thinking to
modify the thought patterns responsible for a person’s maladjusted behavior. Therapist
concentrate on getting their patients think logically and reject irrational ideas. It is
reported that cognitive approaches to psychotherapy have been proven to work out
well in juvenile delinquents and in public school programs thereby generating less
delinquencies.

Personality disorder

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