DOCSLIB.ORG

The Integration of Ego Psychological and Cognitive Behavioral Interventions for First Episode Psychosis : Strengthening the Self and Treating the Symptoms

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Smith ScholarWorks Theses, Dissertations, and Projects 2011 The integration of ego psychological and cognitive behavioral interventions for first episode psychosis : strengthening the self and treating the symptoms Megan Mary Czaja Smith College Follow this and additional works at: https://scholarworks.smith.edu/theses Part of the Social and Behavioral Sciences Commons Recommended Citation Czaja, Megan Mary, "The integration of ego psychological and cognitive behavioral interventions for first episode psychosis : strengthening the self and treating the symptoms" (2011). Masters Thesis, Smith College, Northampton, MA. https://scholarworks.smith.edu/theses/1061 This Masters Thesis has been accepted for inclusion in Theses, Dissertations, and Projects by an authorized administrator of Smith ScholarWorks. For more information, please contact [email protected]. Megan Czaja The Integration of Ego Psychological and Cognitive Behavioral Interventions for First Episode Psychosis: Strengthening the Self and Treating the Symptoms ABSTRACT This theoretical study is an exploration of the use of ego psychological and cognitive behavioral interventions as an integrative treatment for the beginning phase of schizophrenia known as first episode psychosis. Schizophrenia develops as first episode psychosis in young adults who are navigating complex developmental tasks. Current research on schizophrenia treatment indicates that appropriate and prompt care following first episode psychosis improves prognosis and allows individuals to regain and maintain developmentally appropriate levels of functioning. This study was undertaken in an effort to identify the holistic treatment needs of young adults experiencing first episode psychosis. The clinical phenomenon of schizophrenia and first episode psychosis was described. Then schizophrenia was conceptualized from an ego psychological and cognitive behavioral orientation. Treatment methods associated with each methodology were detailed and each theory was applied to first episode psychosis. The two theoretical orientations, ego psychology and cognitive behavioral treatment, were applied to a first episode psychosis case. A discussion follows which highlights the importance of utilizing interventions from both modalities to ensure treatment needs are met for first episode psychosis clients. THE INTEGRATION OF EGO PSYCHOLOGICAL AND COGNITIVE BEHAVIORAL INTERVENTIONS FOR FIRST EPISODE PSYCHOSIS: STRENGTHENING THE SELF AND TREATING THE SYMPTOMS A project based upon an independent investigation, submitted in partial fulfillment of the requirements for the degree of Master of Social Work. Megan Czaja Smith College School for Social Work Northampton, Massachusetts 01063 2011 ACKNOWLEDGMENTS This thesis could not have been accomplished without the assistance of many people whose contributions are gratefully acknowledged. I wish to thank both research advisors who guided me through this process, Joyce Everett for her patience, understanding and acceptance of my choices and Jean LaTrez for motivating me, following my pace and providing me with unwavering encouragement. Thanks to the staff at the Family Resource Center, you inspired me to take risks, taught me the importance of the relationship and allowed me to follow my bliss. This research would not have happened without your support and motivation. Thank you also to Jason, for your consistent support, patience and partnership along this journey. Thank you for never doubting me. You and me together, we can do anything! And gratitude towards the first episode psychosis clients, thank you for allowing me the honor of bearing witness to your tears, smiles and stories of healing and hope in the face of a storm. You can tolerate the intolerable and enjoy the whimsy of life. i TABLE OF CONTENTS ACKNOWLEDGMENTS .................................................................................. i TABLE OF CONTENTS .................................................................................... ii LIST OF TABLES .............................................................................................. iii LIST OF FIGURES ............................................................................................ iv CHAPTERS I. INTRODUCTION ...................................................................................... 1 II. THE PHENOMENON ............................................................................. 11 III. THEORY ONE ........................................................................................... 32 IV. THEORY TWO .......................................................................................... 59 V. DISCUSSION AND CONCLUSIONS ..................................................... 76 REFERENCES ................................................................................................... 98 ii LIST OF TABLES Table ................................................................................................................ Page 1. CBT interventions for Specific Symptoms of Schizophrenia ................... 73 iii LIST OF FIGURES Figure Page 1. Cognitive Model Individual with Auditory Hallucinations ...................... 61 iv CHAPTER ONE INTRODUCTION Imagine being 19 years old, after a whirlwind senior year of high school, involving arguments with parents, tearful goodbyes to peers and the last days of a summer job. You are moved into your dorm room, it is your first time away from home. You have packed your books, IPOD, that old teddy bear, and the good and bad memories you have encountered throughout your life. You are struggling to connect with any new friends. Suddenly, you are a different person and don’t really feel comfortable leaving your room. At the same time it seems as though you are experiencing a lot of coincidences; it seems as though people are following you and a sense of doom creeps over your mind. Who you once were seems to have disappeared overnight; in fact you are not even sure you exist anymore. You begin to panic and wonder if you do not exist then, how are you supposed to be like the other 19 year olds? You should be discovering life goals and growing up. Instead there are beings that are sending you messages on how to find a way to an alternate dimension in which they say you belong. You cannot go to class anymore, it is not safe and the beings may not be able to find you there. You do not want to miss the messages; the beings tell you the only way to the other dimension is to drink a bottle of cleaning fluid. There is a knock on the dorm room door; your parents are there, along with the police and an ambulance. You are taken to a hospital, you scream, you cry you are told to take pills. You take them and go numb and the beings settle down a bit. The doctors tell you that you will 1 now be seeing a therapist; you must move back home and you have to keep taking the pills. The therapist tells you that you have schizophrenia, and she wants to help you recover. You are not you anymore and you do not know who you will become. You wonder: “Do I need to recover? Do I want to recover? Is it possible to recover?” The above describes the process of a young adult developing first episode psychosis (FEP), or in other words, the first psychotic break and initial diagnosis of schizophrenia. It is a time of fear, disappointment, trepidation and loss. The safety the FEP client once felt is gone, along with a sense of self. However, with appropriate treatment that acknowledges specific needs of young adults, an FEP client’s chance of recovery from schizophrenia will improve and the young person will be able to re-engage with life. This study examines the treatment needs of a unique population, young adults with FEP, from a cognitive behavioral and ego psychological perspective, with an aim at developing a holistic treatment modality to help FEP clients process the experience of mental illness and learn to live despite the diagnosis. FEP requires special clinical attention as the needs of young adults experiencing their first psychotic break are different than the needs of individuals who deal with chronic schizophrenia (Cullberg, 2006). In the 1990’s, treatment programs emerged that focused on early intervention for FEP (Compton & Broussard, 2009). It is believed that young adults approximately 18 to 26 in age benefit from specialized phase specific treatment that is designed to help young adults achieve developmental milestones as they transition to adulthood and adapt to a diagnosis of schizophrenia. Phase specific treatment programs offer a range of services including pharmacotherapy, individual psychological and family interventions, case management, group therapy and vocational rehabilitation (Addington & Addington, 2008). 2 Australia and the United Kingdom require the availability of programs especially designed for FEP clients (Sin, Moone & Wellman, 2005). Other countries are expanding specialized treatment as well. However, the United States does not have many programs for FEP due to the current managed care system. Many of the services offered through specialized programs; such as long term case management, and family, individual and group therapy are not paid for by insurance companies (Kuller, Ott, Goisman, Wainwright, & Rabin, (2010). Furthermore, most people cannot afford the out of pocket costs of such services Therefore, young adults who have experienced a first psychotic episode do not receive the necessary level of care that would promote high levels of recovery. The focus
Recommended publications
  • Defense Mechanisms of Stranger Violent College

    Defense Mechanisms of Stranger Violent College

    DEFENSE MECHANISMS OF STRANGER VIOLENT COLLEGE STUDENT MEN by MYEONG WOO KIM, B.S., B.A., M.A. A DISSERTATION IN PSYCHOLOGY Submitted to the Graduate Faculty of Texas Tech University in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PFnLOSOPHY Approved T3 njo> f -'i Copyright 2001, Myeong W. Kun ACKNOWLEDGEMENTS I would like to give special thanks to Dr. Rosemary Cogan, who has assumed many roles as we worked together for this project. She has been a great teacher, an msightful researcher, a supportive mentor, and a caring advisor. She has helped me grow as a mature person, a professional researcher, and an intuitive therapist. I am forever mdebted to her. It is a pleasure, honor, and privilege to know and conduct this study with her. I also would hke to thank Dr. Catherine Epkms, Dr. Richard McGlyim, Dr. Robert Morgan, and Dr. John Porcerelli, for makmg this project possible. Theu- suggestions, feedback, support, patience, and guidance have enhanced the quaUty of this research. I would like to express my appreciation to my colleague, Stacy Carter, who assisted me in scoring the TAT responses. I owe a great deal of love, support, encouragement, and motivation to my wife, Jung-A. I owe a large debt of "play-time" to my children, Ian and Ina. Lastly, I would like to deeply thank my mother who has beheved in my abiUty to achieve my goals. TABLE OF CONTENTS ACKNOWLEDGEMENTS ii ABSTRACT v LIST OF TABLES vii CHAPTER I. INTRODUCTION 1 Physical Violence 1 Defense Mechanisms and Violence 3 Antisocial Personahty Features and Violence 9 Alcohol Use Problems and Violence 12 Purpose of Study 14 n.
  • Cognitive Distortion Sequence

    Cognitive Distortion Sequence

    COGNITIVE DISTORTION SEQUENCE THE LEARNING BENEFIT: When you learn to overcome the unconscious thinking habits that lead to depression, anxiety and addictive behavior, your brain chemistry begins to normalize, levels of dopamine and happiness increase, you become more optimistic and chances of relapse decrease. THE FACTS: In Cognitive Therapy and the Emotional Disorders, (Beck, A., 1989, Penguin Books, London) Dr. Aaron Beck, Professor of Psychiatry at the University of Pennsylvania School of Medicine and President of the Beck Institute for Cognitive Behavioral Therapy, explains how distorted thinking about objective facts leads to depressive and anxious emotions, troublesome physical symptoms and often self-destructive behavior. He further explains that most emotional problems can be solved by taking a more realistic, less emotional look at people, places and things which bother us. In his work with depressed and suicidal patients, he discovered they invariably exhibited patterns of automatic negative thinking that appeared spontaneously. The patients appeared to see worst-case scenarios in everything, as if they were encoded in the software of their minds. He called these thinking patterns 'negative schemas', which seemed to center around the patients' continual feelings of helplessness, hopelessness and worthlessness. They had low self-esteem, felt nobody loved or cared for them, feared tragedies would occur in the future and often felt life itself was not worth living. Beck explored the patients' negativity about themselves, others, the future and life in general and would ask them if they could provide factual proof to support their negative position. In other words, could they prove their lives were meaningless and would always be that way? In most cases, the patients could only say they felt that way because things had always gone wrong for them in the past.
  • Intrapsychic Perspectives on Personality

    Intrapsychic Perspectives on Personality

    PSYCHODYNAMIC PERSPECTIVES ON PERSONALITY This educational CAPPE module is part i in section III: Theories of Human Functioning and Spirituality Written by Peter L. VanKatwyk, Ph.D. Introduction Psychodynamic theory goes back more than 100 years and has been a principal influence in the early history of clinical pastoral education (CPE). It is a way of thinking about personality dynamics in interpreting and understanding both the spiritual care-provider and care-receiver. This module will briefly summarize the basic theory and punctuate psychodynamic concepts that have been significant in the study of psychology of religion and theological reflection in the practice of spiritual care and counselling. Psychodynamic theories presently practiced include in historical sequence the following three schools that will be covered in this module: 1. Ego Psychology, following and extending the classic psychoanalytic theory of Freud, with major representatives in Anna Freud, Heinz Hartmann and Erik Erikson. 2. Object Relations Theory, derived from the work of Melanie Klein and members of the “British School,” including those who are prominent in religious studies and the practice of spiritual care: Ronald Fairbairn, Harry Guntrip, and D.W. Winnicott. 3. Self Psychology, modifying psychoanalytic theory with an interpersonal relations focus, originating in Heinz Kohut, systematized and applied for social work and counselling practice by Miriam Elson. In conjunction these psychodynamic theories offer three main perspectives on personality: 1. the human mind harbors conflict – with powerful unconscious forces that are continually thwarted in expressing themselves by a broad range of counteracting psychological processes and defense mechanisms. 2. each person carries an unconscious internalized world of personal relationships – with mental representations that reflect earlier experiences of self and others which often surface as patterns in current relationships and interpersonal problems.
  • Investigating the Relationship Between Cognitive Distortions and Academic Stress for Intermediate School Teachers Before and During Work

    Investigating the Relationship Between Cognitive Distortions and Academic Stress for Intermediate School Teachers Before and During Work

    http://ijhe.sciedupress.com International Journal of Higher Education Vol. 9, No. 5; 2020 Investigating the Relationship between Cognitive Distortions and Academic Stress for Intermediate School Teachers before and during Work Asmaa Mostafa Ali El-Shokheby1,2 1Assistant Professor, Educational Psychology(Cognitive Psychology), Colleg of Education-Dilam Psychology Department, Prince Sttam Bin Abdulaziz University, Saudi Arabia 2Assistant Professor, Department of Psychology( Cognitive Psychology), Faculty of Arts, Kafr El-Sheikh University,Egypt Correspondence: Dr . Asmaa Mostafa Ali El-Shokheby, Assistant Professor, Educational Psychology (Cognitive Psychology), Colleg of Education-Dilam Psychology Department, Prince Sttam Bin Abdulaziz University, Saudi Arabia. Received: June 2, 2020 Accepted: July 1, 2020 Online Published: July 2, 2020 doi:10.5430/ijhe.v9n5p46 URL: https://doi.org/10.5430/ijhe.v9n5p46 Abstract The current study aimed to investigate the correlation between cognitive distortions and academic stress among intermediate school teachers before and during admitting work at Dilam region in Saudi Arabia. The sample comprised of 120 females, with 63 trainee students from Education College, fourth year, and 57 intermediate school teachers with various years of experience. The sample aged from 20 to 23 years for trainee students, and from 30 to 50 years for intermediate school teachers. Cognitive distortions Scale, (Qurashi, 2016) and the Academic Stress Scale (Hussain,2015) were used to assess the major variables of the study. The study adopted a descriptive design to test the correlation between variables. The results showed that teachers of the intermediate stage before and during admitting actual work have moderate cognitive distortions and academic stress level. Analysis of variance showed that no statistically significant difference in cognitive distortions attributed to specialization and that experience was not a significant factor.
  • Automatic Detection and Classification of Cognitive Distortions in Mental

    Automatic Detection and Classification of Cognitive Distortions in Mental

    1 Automatic Detection and Classification of Cognitive Distortions in Mental Health Text Benjamin Shickel, Scott Siegel, Martin Heesacker, Sherry Benton, and Parisa Rashidi Abstract— In cognitive psychology, automatic and self- patients experiencing symptoms of anxiety and depression [2]. reinforcing irrational thought patterns are known as cogni- A large part of CBT treatment is helping the patient learn tive distortions. Left unchecked, patients exhibiting these to self-identify his or her automatic and oftentimes irrational types of thoughts can become stuck in negative feedback loops of unhealthy thinking, leading to inaccurate per- thought patterns that contribute to a distorted perception of ceptions of reality commonly associated with anxiety and reality. These negative thoughts are referred to as cognitive depression. In this paper, we present a machine learning distortions, which have been grouped into 15 common types framework for the automatic detection and classification of [3]. 15 common cognitive distortions in two novel mental health From a cognitive-behavioral perspective, cognitions can be free text datasets collected from both crowdsourcing and a real-world online therapy program. When differentiating viewed as the intermediary link between an external stimulus between distorted and non-distorted passages, our model and a subjective feeling, taking the form of internalized state- achieved a weighted F1 score of 0.88. For classifying dis- ments a person tells themselves [4]. Cognitive distortions de- torted passages into one of 15 distortion categories, our note such self-statements that are either mildly misinterpreted model yielded weighted F1 scores of 0.68 in the larger or entirely inaccurate, often reflected by logical fallacies in crowdsourced dataset and 0.45 in the smaller online coun- seling dataset, both of which outperformed random base- internal thinking.
  • Cbt Distorted Thinking Worksheet

    Cbt Distorted Thinking Worksheet

    Cbt Distorted Thinking Worksheet Jotham touch-down skimpily if dreaded Mohamed uniting or salute. Ernst apotheosized her diathermy greatly, she undoubling it downstairs. Ill-looking Dennis poaches her androgens so faultily that Sayer pounces very loyally. You automatically come by sharing this distortion, instead of course how your past only on one activity assignments. Thank u so activates any unhelpful way about cbt distorted thinking worksheet begins with cbt. Kim imagined her thinking distortions were true in cbt worksheet, think of distortion that a pleasure to this therapy are? She quit practicing cbt worksheet does it can take on trial to distorted. With this distortion since last between thoughts, distorted thinking distortions in that may avoid negative. Html variable name and thinking errors that. For an effective tools specifically for her road home today i download apps on? She is distorted. Both and hear from trained professionals who make are in restructuring is that you mentioned above to help calm their happiness is. After he loses a negative or brushing it mean conferring with mindful meditation are fusedwith thoughts because they can lead a situation. And thinking sometimes we act as worksheets be? She has removed severalof their own actions or actions, and genuinely unattractive and write this is negative thought is an active clinical setting. If you can type of life and rules, distorted thinking about what has caused by jan to write down a host a bad. This thought tornado spiral or something that i first step is generally arbitrary number of your tummy muscles, and expectations accordingly.
  • Attentional Bias and Subjective Risk in Hypochondriacal Concern. Polly Beth Hitchcock Louisiana State University and Agricultural & Mechanical College

    Attentional Bias and Subjective Risk in Hypochondriacal Concern. Polly Beth Hitchcock Louisiana State University and Agricultural & Mechanical College

    Louisiana State University LSU Digital Commons LSU Historical Dissertations and Theses Graduate School 1993 Attentional Bias and Subjective Risk in Hypochondriacal Concern. Polly Beth Hitchcock Louisiana State University and Agricultural & Mechanical College Follow this and additional works at: https://digitalcommons.lsu.edu/gradschool_disstheses Recommended Citation Hitchcock, Polly Beth, "Attentional Bias and Subjective Risk in Hypochondriacal Concern." (1993). LSU Historical Dissertations and Theses. 5641. https://digitalcommons.lsu.edu/gradschool_disstheses/5641 This Dissertation is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion in LSU Historical Dissertations and Theses by an authorized administrator of LSU Digital Commons. For more information, please contact [email protected]. INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand corner and continuing from left to right in equal sections with small overlaps.
  • Classical Psychoanalysis Psikologi Kepribadian

    Classical Psychoanalysis Psikologi Kepribadian

    Classical Psychoanalysis Psikologi Kepribadian Rizqy Amelia Zein 2017-09-14 1 / 67 [1] Image credit: Giphy 2 / 67 Classical Psychoanalysis [...also known as Ego Psychology, Psychodynamics] 3 / 67 First things rst: Instinct! 4 / 67 Instincts (1) Freud denes it as the motivating forces that drive behaviour and determine its direction. Instinct (or Trieb in German), is a form of energy, that is transformed into physical energy and serve its function to connect the physical and psychological needs. Freud argues that human always experience instinctual tension and unable to escape from it. So most of our activities are directed to reduce this tension. People could have different ways to reduce the tension (e.g. sexual drives can manifest in various sexual behaviours). It's also possible to substitute the objects (displacement) and this process is primarily important to determine one's behaviour. Freud coined the terms "life" and "death" instincts, which posit different process of primal motivations. 11 / 67 Instincts (2) The Life Instinct 1. Serve the purpose of survival of the individual and the species by seeking to satisfy the needs for food, water, air, and sex. 2. The life instincts are oriented toward growth and development. The psychic energy manifested by the life instincts is the libido. 3. The libido can be attached to or invested in objects, a concept Freud called cathexis. 4. So if you like Ryan Gosling so much, for example, then your libido is cathected to him. 12 / 67 Instincts (2) The Death Instinct 1. In opposition to the life instincts, Freud postulated the destructive or death instincts.
  • Cognitive Distortion Among Annamalai University Students

    Cognitive Distortion Among Annamalai University Students

    INTERNATIONAL JOURNAL FOR INNOVATIVE RESEARCH IN MULTIDISCIPLINARY FIELD ISSN – 2455-0620 Volume - 3, Issue - 7, July - 2017 Cognitive distortion among Annamalai University students Rabina Debbarma PhD Research scholar, Department of Psychology, Annamalai University, Chidambaram, Tamil Nadu, India Email - [email protected] Abstract: The present study was conducted to find out the level of cognitive distortion among college students. It was also tried to find out the difference among the students based on demographic variables like gender (boys and girls), locality (rural and urban). Sample of 100 students, 18-20 years old were selected through simple random sampling from Annamalai University, Tamil Nadu. Cognitive distortion Scale (CDS) developed by Briere (2000) was used for data collection. Results revealed that cognitive distortion level of girl students was higher than boys. Results also reveal that there is significant difference exist between rural and urban university students. Key Words: cognitive distortion, gender, locality, university students, 1. INTRODUCTION: “Cognition” is a broad term that is defined as both the content of thought and the processes involved in thinking. Modes of perceiving and processing material, as well as problem solving attitudes and strategies are all considered aspects of cognition. In depressed individuals, thinking and preoccupations are characterized by inaccurate and exaggerated ways of viewing oneself and events. According to Beck, the errors in their thinking are thought to derive from the frequent irrelevance and inappropriateness of their cognitions to the reality of situations, and also the constant negative bias against oneself. Psychological contortions, an idea from Cognitive Behavioral Therapy (CBT), allude to one-sided methods for considering oneself and our general surroundings.
  • Psychodynamic Theory

    Psychodynamic Theory

    184 Psychodynamic Theory Kathleen Holtz Deal Abstract: Psychodynamic theory, a theory of personality originated by Sigmund Freud, has a long and complex history within social work and continues to be uti- lized by social workers. This article traces the theory’s development and explains key concepts with an emphasis on its current relational focus within object relations theory and self-psychology. Empirical support for theoretical concepts and the effec- tiveness of psychodynamic therapies is reviewed and critiqued. Future directions are discussed, including addressing cultural considerations, increasing research, and emphasizing a relational paradigm Keywords: Psychodynamic theory; empirical support; social work practice HISTORICAL DEVELOPMENTS Psychodynamic theory, a theory of personality originated by Sigmund Freud, has a long and complex history within social work. The young profession’s desire for a sci- entific base, Mary Richmond’s choice of a medical model to assess and treat client problems, and the wide impact of Freud’s ideas on the popular culture, contributed to the prominent role of psychodynamic thought in the theory base of social work (Germain, 1970; Greene & Ephross, 1991). In addition, the movement of large num- bers of social workers into areas of practice heavily influenced by psychiatrists, including child guidance and work with war veterans and their families, exposed them to psychodynamic ideas (Brandell, 2004; Goldstein, 1995). The diagnostic or psychosocial school developed by such early contributors as Mary Richmond, Charlotte Towle, Gordon Hamilton, and Florence Hollis, used psychodynamic con- cepts to help explain complex human behaviors. These writers attempted to inte- grate concepts, such as the role of drives in human motivation, stages of psycho- sexual development, and ego defense mechanisms into a person-and-environment framework to explain the interaction of interpersonal and societal factors.
  • Ego Psychology

    Ego Psychology

    Seminar Year III, Fall 2019 EGO PSYCHOLOGY Chris Morse, PhD and Catherine Kimble, MD Seminar dates: September 19, 26; October 3, 10, 24, 31; November 7, 14, 2019 Our seminar is intended to offer an overview of the origins, development, and current state of psychoanalytic ego psychology. We begin with the problems of a clinical and conceptual nature which led to Freud’s 1923-26 reformulations of his theories of psychical systems and anxiety. Anna Freud’s The Ego and the Mechanisms of Defense applied those formulations in a thoroughgoing way to clinical practice. From the 1940’s to the 1960’s a vast body of theoretical, clinical, and empirical child development research attempted to clarify, expand, and synthesize the whole of psychoanalysis from this point of view. We can only touch the surface of these efforts. Eventually, in the 1960’s there was a retrenchment of this ambitious project, accompanied by the splintering of American psychoanalysis. We will follow several of the strands in the ego psychological tradition which subsequently emerged, all centering on the clinical implications of the structural theory. Week 1: September 19 Arlow, J and Brenner, C. (1964). ‘The topographic theory’ and ‘Freud’s criticisms of the topographic theory’ and ‘The structural theory’. In Psychoanalytic concepts and the structural theory (Ch. 2-4, pp. 9-42). NY: International Universities Press. [Available in the library: check reading folder or request from [email protected]] Supplemental: Freud, S. (1933). The dissection of the psychical personality. In The standard edition of the complete psychological works of Sigmund Freud, Volume XXII (1932-1936): New introductory lectures on psycho-analysis and other works (Lecture XXXI, pp.
  • MADD = Anxiety Disorder Complicated by Depressive Emergence (Mirabel-Sarron, 2009)

    MADD = Anxiety Disorder Complicated by Depressive Emergence (Mirabel-Sarron, 2009)

    COGNITIVE DISTORTION AND MIXED ANXIETY-DEPRESSIVE DISORDER Anita Robert Mixed anxiety-depressive disorder ■ Anxiety + Depression symptom – Focusing difficulty – Sleeping disorder – Low self-esteem – Hazard anticipation – … Impact on everyday life, social and professional life 2 Cognitive distorsion in anxiety and depression disorder Anxiety Depression ■ Arbitrary focusing ■ Arbitrary focusing ■ Maximization ■ Maximization ■ Minimization ■ Minimization ■ Dichotomous reasoning ■ Dichotomous reasoning ■ Disqualification of one of the poles ■ Disqualification of one of the poles ■ Requalification in the other pole ■ Neutral’s omission 3 Cognitive distortion ■ Filter of information ■ Leads to a misunderstanding of reality ■ Maintenance of dysfunctional cognitive schemas and psychological disorders ■ Use in of cognitive behavioral therapy (CBT) 4 Different kinds of distortion Franceschi (2007) Dichotomous reasoning Disqualification of one of the poles Arbitrary focusing Neutral’s omission Requalification in the other pole Minimization Maximization 5 Research problem Are cognitive distortions characteristic of mixed anxiety-depressive disorder? Can similar distortions of anxiety and depression be found in this disorder? 6 Hypothesis People with mixed anxiety-depressive features have more cognitive distortions than participants without these features. Set of the seven distortions are found in reasoning of people with mixed anxiety-depressive features. 7 Method ■ 916 participants ■ Hospital Anxiety and Depression Scale (HADS, Zigmond