Anxiety Disorders, Obsessive Compulsive Disorders & Trauma - & Stress-Related Disorders

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Anxiety Disorders, Obsessive Compulsive Disorders & Trauma - & Stress-Related Disorders
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Neurotic Beh -Anxiety-based -No distortions in reality -Recognizes problem -No great personality disorganization Psychotic -Gross distortions in reality (e.g., perception) -Some personality disorganization -Does not recognize problem BorderlineBorderline
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Neurotic Behaviour v Doing the same thing over and over expecting a different outcome v You yourself produce the thing you fear the most most v Deals with anxiety-based disorders including: Generalized Anxiety Panic Obsessive Complusive Phobias Others that have anxiety as a basis
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Neurotic Behaviour v Maladaptive behaviour pattern that does not involve gross distortions in reality or marked personality disorganization v Person recognizes that behaviour is unacceptable or irrational (ego dystonic apart from the ego)
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Neurotic Anxiety v Central component of anxiety disorders and anxiety-based disorders v No obvious danger or threat v Event or stimulus is, objectively, minor or insignificant (e.g., mouse, thunder, shopping mall, etc.)
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Neurotic Paradox I v Neurotic evaluates innocuous events as anxiety provoking inordinate anxiety response v Deals with anxiety in defensive fashion, usually avoidance reduces anxiety in short term
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Neurotic Paradox II v This defensive behaviour results in self- defeating behaviour: Does exactly opposite of what is healthy or adaptive
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Neurotic Paradox Outcomes v Blocks personal growth v Relationship problems (especially intimacy) v Anxiety focus of life v Lack of energy and enthusiasm v Egocentric concerns
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Neurotic Paradox Process v Maximize pleasure v Minimize pain v Immediate Effect: Reduce Anxiety v Long Term: Dont resolve the actual problem v E.G. Doug, the Graduate Student
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Neurotic Styles: Characteristics v Deficit in behavioural repertoire (Inhibition) v Behaves in an inflexible and exaggerated manner opposite to the deficient behaviour v Behaviour does not fully contain the anxiety
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Neurotic Styles v Aggression/Assertion Inhibition v Responsibility/Independence Inhibition v Compliance/Submission Inhibition v Intimacy/Trust Inhibition
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Aggression/Assertion Inhibition v Person uncomfortable with aggression and/or assertion and avoids situations where need to engage in this behaviour v Irrationally clings to cooperative stance v Thought to result in problems such as hypertension,ulcers, migraines, other stress-related disorders v Potential sudden aggressive outbursts
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Responsibility/Independence Inhibition v Person has aversion to autonomy v Avoids situations where they are in charge or in control other others or themselves v Appear incompetent in simple tasks to pull direction by others v Poor relationships, helplessness, depression
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Compliance/Submission Inhibition v Neurotic is often the rebel and avoids submission to authority v Need to be non-compliant (i.e., self- reliant, independent, free-thinking, to a fault)
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Intimacy/Trust Inhibition v Retreats from closeness and withdraws from people who want deeper relationships v All relationships short-term to avoid intimacy v End relationships at crucial points in the establishment of intimacy (not just romantic relationships, friendships too)
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Interpersonal Consequences v Some will result in depending too much on others that results in others feeling used and manipulated v Unpredictable demands on others that results in others feeling angry, frustrated, guilty, etc.
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Interpersonal Aspects of Neurotic Styles I v Extremely sensitive to acts, opinions, feelings of others v Lack of spontaneity (stilted, controlled, mechanical) v Superficial relationships if any v Relationships often stormy v Private life is one of turmoil and inner torment
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Interpersonal Aspects of Neurotic Styles II v Dont have large networks of enduring relationships v Speculation that some complementary hooking up is match made in hell Two people with aggression/assertion inhibition One with responsibility/independence style and one with compliance/submsission style
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Anxiety Disorders - Symptoms v Mood Sx: Anxiety, tension, panic, apprehension v Cognitive Sx: Reflects the apprehension and concern about the doom v Somatic Sx: Immediate Delayed v Motor Sx: Reactivity
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Anxiety Disorders: DSM-V v Specific Phobias v Panic Disorder v Social Anxiety Disorder v Agoraphobia v Generalized Anxiety Disorder v Selective Mutism
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Phobias v v Persistent, excessive, irrational fear of a specific object, activity, or situation v v Fears have no justification in reality or are out of proportion v v Aware of the irrational nature of the fear v v Avoidance is common response
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Phobias Effects 1. Avoidance can result in unfortunate consequences 2. If feared object cannot be avoided, person may experience overwhelming and uncontrollable fear and panic E.G. Student in class example
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Types of Phobias v Agoraphobia: Anxiety in open spaces v Social Phobia: Anxiety regarding being criticized v Specific Phobia: Anxiety regarding object or situation other than open spaces or personal criticism (heights, pain, storms, blood, etc.) Steve Social Phobia
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Clinical Examples v Woman in Gananoque
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Panic Disorder v Brief periods of exceptionally intense spontaneous anxiety Steven Panic 1, 2, 3
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Panic Disorder v Recurrent unexpected panic attacks v Persistent concern about additional attacks for one month v See Text & Student Guide
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Obsessive-Compulsive Disorder v Involves recurrent obsessions and/or compulsions OCD Chuck 1,2,3
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Obsessions v Obsessions: persistent idea, thought, image, impulse that person cannot get out of his/her mind and that tend to be repugnant v Examples: Thoughts of violence, contamination, doubting ones actions
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Compulsions v Behaviours performed in stereotypic fashion that reduce anxiety related to the obsessions v Examples: handwashing, counting, checking, touching
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Obsessive-Compulsive Disorder v Involves recurrent obsessions and/or compulsions OCD2
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Obsessive Compulsive Disorder: Cases v Shoemaker (Handwashing) v Seventeen year old religious boy v Police Officer/Lawyer v Classical Concert audience member
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Post Traumatic Stress Disorder v Existed throughout history v Major feature: Re-experiencing of a traumatic and disturbing event v Differ from other disorders in that source of anxiety is external v Extremely debilitating: May re- experience event for months, years, decades
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Shell Shock, Battle Fatigue, PTSD
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Noncombat Casualties
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Post Traumatic Stress Disorder v Severe psychological reaction to experience of a trauma v Often events involve actual or threatened death, or serious injury v These events can include natural disasters (floods) or human made disasters (war, rape, assault) v Can involve actual involvement with event, witnessing or being indirectly involved
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Characteristics v May take form of recurrent painful memories, dreams, nightmares v Flashbacks v General numbing of responsiveness and decreased involvement with external world
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Post Traumatic Stress Disorder v Trauma persistently re-experienced by person v Person persistently avoids stimuli associated with the trauma v Persistent symptoms of increased arousal v Impaired concentration and memory v Depression, social withdrawal, decreased sexual interest, numbness
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Post Traumatic Stress Disorder v Differ from other disorders in that source of anxiety is external v Extremely dibilitating: May re- experience event for months, years, decades v Symptoms appear usually quickly after the event v May be incubation period
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Post Traumatic Stress Disorder: Cases v Five year old & Daughter v Jessica Russell Case v Heather Thomas Case v Marine Case v RCMP (Airline, vehicle deaths)
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PDM Approach v Include Anxiety Personality Disorders Characterological anxiety: u Phobic Personality Disorder u Anxious Personality Disorder u Obsessive-Compulsive Personality Disorder v Describes the internal experience of anxiety disorders (conscious & unconscious) Some similar to Sx in DSM but also include relationship problems that arise from them Fears of rejection, guilt, blaming, dependency, smothered v Great Importance on Trauma and PTSD Spectrum

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