Welcome to Clinical Psychology and Mental Health!
In this chapter, we are going to explore what it means to be "abnormal" and how psychologists understand and treat mental health conditions. This is a fascinating part of psychology because it deals with real-world issues that affect millions of people. We will look at three specific conditions: Phobias, Depression, and Obsessive-Compulsive Disorder (OCD).
Don’t worry if some of the terms seem big at first—we will break them down step-by-step using simple analogies and memory tricks!
1. Defining "Abnormality"
Before we can treat someone, we need to decide what is "abnormal." Psychologists use four main ways to define this. Think of these as different "lenses" through which we view behavior.
A. Statistical Infrequency
This is the "numbers" approach. If a behavior is rare, it is considered abnormal. For example, if we measured the IQ of everyone in the country, most people would be in the middle. Those with a very low score (below 70) are statistically rare and might be defined as abnormal.
Quick Review: If it doesn't happen often, it’s statistically infrequent.
B. Deviation from Social Norms
Every society has unwritten "rules" about how to behave (norms). If you break these rules, people might see your behavior as abnormal. For example, wearing a bikini to a funeral would deviate from social norms in the UK.
Common Mistake: Remember that social norms change depending on the culture and the time (what was abnormal 50 years ago might be normal now!).
C. Failure to Function Adequately
This looks at whether a person can cope with everyday life. Can they hold down a job? Can they look after their hygiene? Can they maintain relationships? If their behavior prevents them from living a "normal" life, it’s considered abnormal.
D. Deviation from Ideal Mental Health
Instead of looking at what is wrong, this looks at what is "right." Marie Jahoda suggested we are "normal" if we meet certain criteria, such as having a positive self-image and being able to handle stress. If you don't meet these, you deviate from ideal mental health.
Key Takeaway: There is no single "perfect" definition of abnormality. Each one has strengths and weaknesses.
2. Characteristics of Phobias, Depression, and OCD
To diagnose these conditions, psychologists look for three types of characteristics. Use the mnemonic B-E-C to remember them:
1. Behavioural (How the person acts)
2. Emotional (How the person feels)
3. Cognitive (How the person thinks)
Phobias
Analogy: Imagine you are terrified of spiders.
- Behavioural: You run away (avoidance) or freeze in terror (panic).
- Emotional: You feel extreme anxiety and fear that is "out of proportion" to the actual danger.
- Cognitive: You can't look away from the spider (selective attention) and you might have irrational beliefs (e.g., "that tiny house spider will definitely kill me").
Depression
- Behavioural: Low energy levels, sleeping too much or too little, and withdrawing from friends.
- Emotional: Feelings of worthlessness, constant sadness, or even anger.
- Cognitive: Focusing on the negative, and "black and white" thinking (e.g., "If I’m not perfect, I’m a total failure").
OCD (Obsessive-Compulsive Disorder)
- Behavioural: Compulsions (repetitive actions like hand-washing) to reduce anxiety.
- Emotional: Extreme anxiety caused by obsessions, often accompanied by guilt or disgust.
- Cognitive: Obsessions (intrusive, recurring thoughts) like "I have germs on my hands" and an awareness that these thoughts are excessive.
Did you know? Compulsions are the actions (washing), and obsessions are the thoughts (germs). The action is usually done to make the thought go away!
3. Explaining and Treating Phobias (The Behavioural Approach)
The Two-Process Model
Psychologist Hobart Mowrer suggested that phobias are learned in two steps:
1. Acquisition (Starting): Learned through Classical Conditioning. If you are bitten by a dog (unpleasant stimulus), you associate the dog with pain/fear. Now, dogs = fear.
2. Maintenance (Staying): Kept going through Operant Conditioning. Every time you see a dog, you run away. This makes you feel better (negative reinforcement). Because running away reduces your fear, you keep doing it, and you never "unlearn" the phobia.
Treating Phobias
1. Systematic Desensitisation (SD): This is like a slow staircase. You learn relaxation techniques, create an anxiety hierarchy (from looking at a photo of a spider to holding one), and gradually work your way up while staying relaxed.
2. Flooding: This is like jumping into the deep end. The patient is exposed to their fear all at once (e.g., put in a room with spiders) for a long time. Because the body can’t stay in a state of "panic" forever, the person eventually calms down and realizes they are safe.
Key Takeaway: SD is gentle and slow; Flooding is fast and intense. Both aim to replace fear with relaxation.
4. Explaining and Treating Depression (The Cognitive Approach)
Beck’s Negative Triad
Aaron Beck suggested depressed people have a "negative schema" (a negative lens through which they see the world). They suffer from a Negative Triad of thoughts:
- Negative view of the Self ("I am useless")
- Negative view of the World ("Everyone hates me")
- Negative view of the Future ("It will never get better")
Ellis’s ABC Model
Albert Ellis said depression is caused by irrational beliefs. He used this model:
- A (Activating Event): Something happens (e.g., you fail a test).
- B (Belief): Your interpretation (e.g., "I must be perfect, so I'm a failure").
- C (Consequence): Emotional response (depression).
Treatment: CBT (Cognitive Behavioural Therapy)
CBT is a talking therapy. The therapist helps the patient identify their "faulty" or irrational thoughts and challenges them. They might set "homework" (e.g., "Go to a cafe and see if anyone actually stares at you") to prove the negative thoughts are wrong.
Quick Review: Cognitive = Thoughts. The goal is to change "stinky thinking" into realistic thinking.
5. Explaining and Treating OCD (The Biological Approach)
Genetic and Neural Explanations
The biological approach says OCD is "in the body."
- Genetic: Some people inherit genes that make them more likely to develop OCD (it's "polygenic," meaning many genes are involved).
- Neural: This looks at brain chemistry. Low levels of the neurotransmitter Serotonin are linked to OCD. Also, parts of the brain (like the orbitofrontal cortex) may be overactive, sending "worry signals" that don't turn off.
Treatment: Drug Therapy
The most common treatment is SSRIs (Selective Serotonin Reuptake Inhibitors).
- How they work: They increase the levels of Serotonin in the brain by preventing it from being reabsorbed. This helps "smooth out" the communication between neurons and reduces anxiety symptoms.
Key Takeaway: If the cause is biological (low serotonin), the cure is biological (drugs to increase serotonin).
Summary Checklist
Before you move on, make sure you can:
- [ ] Name the 4 definitions of abnormality.
- [ ] List the Behavioral, Emotional, and Cognitive traits of Phobias, Depression, and OCD.
- [ ] Explain how a phobia is "maintained" (Negative Reinforcement).
- [ ] Draw Beck's Negative Triad (Self, World, Future).
- [ ] Explain how SSRIs work for OCD.
Don't worry if this seems like a lot to take in! Focus on one disorder at a time, and remember: Psychology is all about understanding people!