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MADNESS:
MENTAL STATES
by Dr. ALEC GILL MBE
PSYCHIATRIC LABELS AND DESCRIPTIONS
My simple definition of mental problems is: 'Normal behaviour
taken to extremes'.
PERSONALITY DISORDERS
1. ASOCIAL - Pay little attention to social needs, but not usually anti-social.
Unable to form lasting or meaningful relationships - withdrawn.
2. SCHIZOTYPAL (Borderline schizophrenic) - Marked oddness of behaviour, thinking, or
emotional reaction. It is common to find a strong belief in supernatural or ESP
(extrasensory perception). Disordered speech processes (vague), suspicious, isolated, and
emotionally aloof.
3. HISTRIONIC (Latin: actor) - Excessive, open, attention-seeking, lack of genuine
feelings.
4. NARCISSISTIC (character in Greek mythology doomed to fall in love with
himself and pined away until he died) - Excessive love of oneself. Extreme arrogance, disregard for
social rules and rights of others, unrealistic confidence and selfish exploitation of
people. Narcissists love themselves, but cannot love others (Kernberg).
Joke: Some people think that I am infatuated with myself. But it is not
true. With me, it's the real thing.
5. UNSTABLE - Unpredictable, erratic and rapid mood swings which disturbs their
personal relationships and own sense of identity. Inability to maintain relationships,
although they may enter many intimate and highly intense affairs. Display sudden burst of
impulsive anger; frequently embark on excessive behaviours in the areas of spending,
drinking, gambling and sex. They hate being alone and soon get depressed. Tend to lose
friends and jobs - thus leading to further self-deprecation and depression.
6. AVOIDANT - Show excessive anxiety about social situations (social phobia).
Although withdrawn they have a deep desire for an intense, warm social relationship. But
they fail to achieve this because they are hyper-sensitive to social criticism. This
intense fear of humiliation and rejection makes them avoid close relationships.
7. DEPENDENT - An overwhelming need to be closely associated with others and
surrounded by supportive people. Tend to be self-effacing, highly tolerant, non-assertive
and passionately committed to not being alone.NEUROTIC
EVERYONE is prone to degrees of mental disturbance or levels of anxiety. In
neuroses, however, these states become so exaggerated and persistent that they interfere
with daily life and can create personal misery. Sufferers, unlike psychotics, are aware
they have a problem, even though they might not know its root cause. Most would like
to get rid of their 'symptoms'. There is a joke that:
People with Personality Disorders
talk about 'Castles in the Air';
Neurotics build castles in the air;
and
Psychotics live in them.
Whatever the case, Psychiatrists collect the ground rent.
Central to most neurotic's problems is an intense anxiety. They are either in a
state of anxiety or desperately trying to avoid becoming anxious. They bounce
from one dilemma to the next.
1. WHEN ANXIOUS - they have:
- poor concentration;
- cannot sleep (insomnia);
- indecisive;
- sexually impotent.2.TRYING TO AVOID ANXIETY - they have:
- compulsive rituals (hand-washing)
- amnesia; and are
- strict conformists (rule-bound). 3. HYSTERIA - Unconscious psychological impairment of bodily functions (e.g., unable
to walk, hysterical blindness). Another form is 'dissociative reactions' when parts of a
person's personality are cut off from conscious awareness. This is a type of amnesia where
large areas of the past are blocked out. The name is confusing because it was originally
thought that only women became hysterical and so this neurosis was given the Greek name
for 'womb'. 4. PHOBIA - Irrational, intense fear of specific objects or situations. Phobias can
persist although the person knows they are groundless. There are thousands of different
phobias because a person can become excessively fearful of anything. Common examples are
CLAUSTROPHOBIA (closed places) and ACROPHOBIA (high places). Behaviour therapists claim
the highest success rate at dealing with this type of neurosis. Phobic
people tend to make irrational, fearful associations between two un-associated
aspects of their environment / experience. 5. OBSESSIVE-COMPULSIVE - People swing between these two behaviour patterns.
a. OBSESSIONS - are recurrent thoughts, words, or impulses that a person cannot
control (e.g., "Have I locked the door?" "Have the gas-taps been turned
off?" etc).
b. COMPULSIONS - are repetitive actions that an individual feels impelled to carry
out (e.g., hand-washing "to get rid of germs" - portrayed by Lady Macbeth).
A rough distinction between these two symptoms is that: Obsessions are more to do
with disturbed thoughts (THINKING);
while Compulsions are often physical acts (DOING).
Such actions can soon become rituals that have to be performed.
6. ANOREXIA NERVOSA - Excessive pursuit of thinness, mainly among adolescent girls,
but cases of boys are being researched. Symptoms are a morbid fear of fatness, distorted
body-image (although very thin, they believe themselves over-weight -
another dilemma, if ever there was one). Polite and quiet,
but often hyper-active; then swings over into apathy from chronic malnutrition. Intense
pre-occupation with food (might cook elaborate meals for others, but do not
eat themselves). Depression may deepen to
the point of suicide (15/100 anorexics die of starvation or exhaustion).
The label 'neurosis' is based upon the Latin word for nerves. My mother often
described herself as "a bag of nerves". She was not clinically
neurotic, but she had a nervous disposition - as people used to say. The label
'psychotic', however, is based upon the Latin word for mind - a much more
serious and deeper arena of dilemmas.
PSYCHOTIC
DEFINITION: A major behavioural disturbance involving the disintegration of the
personality and decreasing contact with reality. It is highly disruptive to personal and
social life. Prior to becoming psychotic, there is a tendency toward conformity, social
respectability and to have very high standards. When they fall short, they become
self-critical, discouraged and guilty because they let down their parents or others.
1. AFFECTIVE - This word has special meaning in that it refers to feelings,
moods and emotions. A strong emotional reaction can be provoked by a particular person or
situation. This kind of 'affect' produces drastic changes in mood, such as depression.
2. DEPRESSION - Low or no self-worth; indirect communication (vague, inappropriate);
rigid and inhuman about rules; and contact with society is fearful and blaming.
3. MANIC - Has boundless optimism and high feelings of grandiosity - denies any
blame, mistakes or misfortune.
DEPRESSIVE = HOPELESS
and
MANIC = BLAMELESS
4. BI-POLAR (formerly known as MANIC-DEPRESSIVE) - Severe mood swings
between the above two extremes. When in an elated state they act as if
under extreme pressure, get over-excited, and jump rapidly from one idea to the next. High
activity leads to weight loss and insomnia. Once the false optimism is shattered (e.g.,
gamblers), they plunge back into deep despair. The manic over-compensates for an
underlying pessimism.
5. SCHIZOPHRENIA
Of all the vague categories outlined so far, the most difficult to identify is that
of Schizophrenia.
There is such a broad range of puzzling symptoms: from bizarre speech and ideas to
strange behaviours. Psychiatrists look for a cluster of symptoms in which only some are considered delusional, some language unclear and hallucinations might only occur
occasionally.
Curiously, regardless of culture (WHO 1975), one percent of any population in
the world is
found to be schizophrenic. It effects males and females alike. They tend to have above
average intelligence (IQ>200). And the peak incidence occurs between 25 and 35 years.
There are four types of schizophrenia:
a. SIMPLE - Socially withdrawn, loss of interest and emotional apathy. Gradual onset.
Own family usually unaware of changes. Drawn toward solitary jobs. Some become
vagrants or prostitutes.
b. HEBEPHRENIC - Stereotype of schizophrenia: silly mannerisms, inappropriate affect,
hallucinations and bizarre delusions. Often giggle at odd times and talk to themselves or
unseen companions.
c. CATATONIC - Alternates between a stupor and extreme excitement. In a stupor, they
assume a peculiar posture or rigid stance for hours on end. In extreme cases, they remain
still and mute for several years and appear completely oblivious of their surroundings,
cut off from the world. Later, however, they may repeat conversations and events
which occurred while they were 'out of touch with reality'. When
at the opposite excited extreme, speech is often repetitive, difficult to understand, and
their wild outbreaks can be dangerous.
d. PARANOID - The swing here is between DELUSIONS of persecution and grandeur - some
remain in one state only. They feel that people are talking about them and plotting behind
their backs. Normal situations are distorted to fit in with this belief. Delusions are
supported by hallucinations (God's voice orders them to rid the world of prostitutes -
Peter Sutcliffe 'Yorkshire Ripper'; or Martians send messages over the radio
or internet). They can be
overly sensitive, ego-centric and suspicious.
Visions
of Grandeur - Adolf Hitler's Master Race of Nordic Germans exterminating
the Jews, Slavs, gipsies, etc., is a dramatic paranoid example. Figures people adopt are
those of Jesus Christ, Napoleon, or Caesar. FOOTNOTE: A TV documentary in 1994 showed that
during the previous year, Paranoid Schizophrenics committed twelve murders in the UK (one
per month), and around fifty suicides were committed. The full effects of 'Care in the
Community' were beginning to work their way through the system!
MY Little THEORY:
Why should it be that, regardless of culture, one percent of any
population are schizophrenic?
What does this tell us about human nature? Could it not be that what AVERAGE PEOPLE take as "normal and sane" is really only a societal- and self-created
DELUSION? Might not those we label MAD be really seeing what is "real"? And come
a time when our social order breaks down, is it then when we will turn to an intelligent
schizophrenic visionary to lead us from our apparent chaos, and thus save humanity from
oblivion?
WHY THE OSCILLATIONS? The swings between extremes; being
disturbed by dilemmas; bouncing between opposites; highs verses lows; the ups
and the downs; optimistic v. pessimistic; guilt over the past; anger at the
present; worry about the future.
Answer: All these erratic and irrational
behaviours are the perfect strategy to avoid living in and dealing with the NOW.
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TREATMENT: THERAPY The two predominant ways of treating mental problems in Britain
1. MEDICAL MODEL (Physical)
a. CHEMO-THERAPY = Drugs distort / change the brain.
b. ELECTRO-CONVULSIVE THERAPY (ECT) = strong shocks / currents passed through
the brain.
c. PSYCHO-SURGERY = removal of parts of the brain.
2. BEHAVIOUR MODIFICATION (Programming)
a. BEHAVIOUR ELIMINATION:
I. Systematic Desensitisation
II. Aversion Learning
b. BEHAVIOUR FORMATION:
I. Reinforcement ( + and - )
II. Token Economy
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