Physiological Psychology
All of us spend some time sleeping and we know its necessity. When we sleep, we are not conscious and not able to know what goes around us. When we sleep, we go through physiological changes called physiological correlates of sleep which act according to what we experience when sleeping. There are different levels of sleep such level 4 sleep where people are relax, deeply asleep, and find it hard to wake up. In level 2 sleep, people are a little asleep and could be easily awaken up. They are 4 levels of brain activities that we move from one to another through our sleeping at night. When sleeping at night, we experience 5 to 6 cycles of sleep. A typical night of 7 - 8 hours will let us go through 5 - 6 cycles of sleep where the first cycle of sleep would reach level 4 while the others would decrease levels in each next cycle of sleep. Oddly to what has been said earlier, when a person has gone through a cycle of sleep and goes back to level 1 in the next cycle of sleep, he seems to be deeply asleep as if he were in level 4 and this case is called paradoxical sleep while the other conventional sleep is called orthodox sleep. In paradoxical sleep, people tend to make fast movements in their eyes and tend to report that they have been dreaming. It seems that people dream at this stage of sleep. It has been suggested that in the areas of cerebral cortex in the brain, there is a mechanism called reticular activating system which is responsible for us to focus attention and arousal and sleep or wake up. The above was concluded by performing EEG tests to measure electrical activity in brains of volunteers.
The patterns which we reflect during the 24 hours are called circadian rhythms while diurnal rhythms are of the day and nocturnal rhythms are of the night. Human beings are diurnal creatures as we are active during the day and go to sleep at night. Our internal body clock relies on external clues such time of day, daylight and darkness, temperature but if we are unable to identify them then the 24 hour rhythm could slip slightly but the over all pattern of active and passive periods are still similar. Shift work such nurses who some times work at night has been discovered to be able to adjust to their new time table.
Dreaming: The discovery that people dream during paradoxical sleep or REM for alternative term, gives us the opportunity to investigate this phenomena where investigators could identify different characteristics of dreaming. Study by investigators concluded that all of us dream at night for different periods of time although some times we do not remember it and that is related to the period and sleep cycle in which we wake up from. People who wake up from a period of REM sleep tend to remember their dreams while people who wake up from level 2 or 3 sleep tend to forget them.
There were different investigations regarding the nature of dreaming and it was concluded that dreamers are not completely unconscious to external stimuli or to what was happening around them. One example was spraying lightly some water at the volunteers while they were sleeping and then wake them up who reported that they dreamt about rain or washing. Investigations concluded also that dreams last for longer than what we thought and they are not rapid.
Another kind of dreams is lucid dreams where you are aware that you are dreaming but you carry on dreaming. Investigators who observed volunteers in laboratories got to the conclusion that there was a light electric signal when dreamers got to the REM sleep phase. This signal was not strong enough to wake them up but it would let them know that they were dreaming now and from that moment they are in the lucid dreams phase. The participants of such researches helped to identify eye movements as signals to dreaming where 3 rapid flicks to the left meant the start and 4 would mean the end. The participants were able to control their dreams while they were dreaming and that is by thinking about some thing they wanted it to happen so they would fit it into their scenario of the dream. Another way to control our dreams is by inserting a realistic thing that would fit to the context of the dream.
The Psychoanalytic Approach:
Why do we dream? There were different theories about this matter and Freud's theory in 1901 was the most acceptable saying that in dreams the unconscious part of mind comes to the fore. Dreams express our hidden desires and wishes that are very buried in our minds to the degree that we are not aware of them consciously. These desires need to appear in the dream because our conscious mind is not aware of them so they wear a mask. Freud to this issue created a theory called dream symbolism claiming that the images that we see in our dreams symbolized things that our conscious mind was not aware of. Freud's psychoanalytic theory was mostly based on interpretation of dreams where his theory of personality claimed that mind is made of one part that is the ego that is the consciousness while the id and superego part were in the unconscious mind. Having the superego and id are always trying to reach the ego, the ego tries to defend itself by blocking them as it sees them as threatening factors. In dreams the situation is the same, so the demands of the id and superego have to be done in a disguised way. Dreamwork is a term that Freud uses to describe how these wishes are disguised. Dreamwork uses symbols to show hidden desires.
Some examples to illustrate the point:
1. A tall tower may symbolize a penis
2. Cave could symbolize female genitals
3. Houses may symbolize the womb
4. A vulture may symbolize death.
Freud's theory relies very much on sexual imagery as he considered sex as the most important factor to our behavior.
Freud mentioned other aspects of dream work as he referred to the unconscious mind as capable of creating various images of opposite essence to avoid detection.
Another theory about the functions of dreaming was established by Evans in 1984 saying that we dream to let the brain organize the big number of impressions that we had during a whole day by deciding what should be forgotten and what has to be sorted out.
Tuesday, September 18, 2007
Philosophy and Psychology of Dreams
Philosophy
Dreams to Plato
Plato thinks that dreams come from the individual to express his hidden desires, fears etc. Dreams reflect Psychological processes in which a person goes through while sleeping. This is very close to what Freud thinks about dreams which leads us to think whether he actually cited it from him.
Interestingly, Plato specifies which kind of desires we dream. He teaches that in dreams we lose our gentler part of soul and logic is withdrawn. The beast of us takes control to satisfy our instincts. It will isolate any kind of shame or reason and it will not restrict any kind of thing to its maximum limit. In every one of us there are desires which are revealed in our dreams, horrible in their essence.
Dreams to Aristotle
Aristotle (pupil of Plato) tried to specify dreams as connected to Physiology according to his account of it. Aristotle denied the thought that dreams are visits from God, arguing that stupid people and animals dream. He states that sleep is crucial to keep our common sense (as an organ) restored. Aristotle attributes sleep to evaporation of food and liquid to pass to our head. Dreams are reflected on raging waves and when they are great, nothing can stop them. Dreamers are less critical about their dreams and more sensitive to stimuli. He clarifies how we are more sensitive when we sleep. In the day time, we face stimuli which we do not notice if they were light because of the strong waking impulses but when we sleep, any small stimuli seems powerful and the opposite happens.
Aristotle thinks that it is a good method to diagnose diseases as diseases start small when they visit our body and they are clearer when we sleep because we are more sensitive at night rather than day time.
Aristotle was asked what he thought about prophesies so he noted the need to distinguish between dreams and prophesies saying that dreams are signs of events which occurred. He goes back to the Physiological aspect of it saying that dreams may reflect what is going in our body. He rejected the idea that dreams could mirror prophesy.
Aristotle writes his thesis on dreams by using common sense where he analyses and classifies dreams. One class of dreams is dreams which are affected by past events and have not future importance. The second is dreams which tell about the future and they are divided to three categories:
-Direct prophecies
-Previsions of future events
-Symbolic dreams that need to be interpretated in order to be figured out.
The difficulty in dreams is how to interpret them. If dreams have meanings, then how come we can not see their importance at once, the way we see importance of things when we are awake.
The Psychoanalytic Approach
Dreams to Sigmund Freud
Freud's most basic idea about dreams is that dreams are infantile wish fulfilment. His writings about The Interpretation of Dreams in 1900 tell about his belief that dreams all seek to fulfil one wish which converted to others and that is the wish to sleep. We dream inorder not to wake up because we want to sleep.
But Freud's Theory of Dreams is different completely. Freud believes that dreams are connected to typial characteristics of neuroses so he relates symbolism of dreams to neurosis forms. On a Physiological level, Freud explains why dreams are connected to wishes and experience: he makes significant difference between two mental processes. Primary and Secondary. Primary is the unconscious and the secondary is the conscious. Freud says that the primary process controls dream life while at the same time, the Ego in the process of dreaming is almost none moveable. He mentions that if there was no Ego, then we would not be able to dream.
Freud was trying to find out why dreams are not logical when they imply to our deep nature of the individual. This led him to differentiate between Manifest and Latent contents of dreams. Freud asks also, if we are able to explain why a thought of something wished is reflected in a visionary form. He argues that a thought in dreams is transferred to an image and speech in a direct manner.
In dreams, the excitation moves in a retrogressive direction. Instead of moving towards the motor end of the dream, it moves backward to the sensory end and in final stages, it gets to the perceptual system. It is opposite to what happens in waking life where the direction is progressive in physical terms. In dreams, the direction is regressive. This regression gives us the opportunity to exploit dreams to uncover content of our unconsciousness. In such process, fabric of our dream-thoughts is being converted to its raw material.
It is right to say that when we are sleeping, our physiological state changes and so our excitations to lead to regressions as mentioned before but, in some cases this may occur also in waking state such in patients who suffer from hallucinations, for example in Hysteria. In such case, waking regressions that is of thoughts are converted to images which are connected to oppressed and unconscious memories. Freud believes that in dreams we may be able to retrace our experience as infants. Dreaming is a revival of our childhood, impulsive instincts, methods of expression which were available to us at that time. This would reveal the development of ourselves and circumstances which dominated us.
Freudian Symbols refer to dreams as symbolic accounts of unconscious mental activity with great importance. To him, symbolism in the Theory of Dreams is translation in which allows us to interpret the dream, some times without the need to ask the dreamer. If we are familiar with dream-symbols, the dreamer's personality, the conditions he lives, and the impressions he faced prior to the dream then we will be able to interpret it immediately. Freud Says that this symbolic relation is a comparison though it is a limited one. We can not compare every object or process in a dream as a symbol of it and at the same time, a dream does not symbolize every element of it but certain ones. The idea of a symbol can not be decided completely because it could be a replacement, a representation or a hint. It is a number of symbols that we use to compare but at the same time we may ask: if the dreamer uses them in his dream then how come he does not know their meanings? as mentioned before, the number of things which are symbolic in a dream is not big:
- The Human Body As a Whole
- Parents
- Children
- Brothers and Sisters
- Birth
- Death
- Nakedness
A house represents the human body as a whole. Houses with smooth walls are men and houses with projections and balconies are women. Some times you see yourself climbing a house or holding to it.
Parents are represented as Emperor and Empress or King and Queen or other respectful personalities.
So they represent in this case the good male and female. In case they treat their children brothers and sisters less gently, the parents are represented as small animals and vermin. Birth is represented almost all the time as something to do with water. One is either falls into the water or gets out of it. Dying is replaced in dreams by departure, being dead by unknown and timid hints. So we can see here, the unclear boarders between symbolic and allusive representation.
Freud talks now about the sexual symbolism and its significance saying that male genitals are represented in dreams in various ways called symbolic where the common element between them in comparison is obvious which is the similar shape of objects such unbrellas, posts, trees, weapons etc. Among the less easily understandable male sexual symbols are certain reptiles, fishes, and snake. It is certainly not easy to understand why hats and over coats or cloaks symbolize the same but it is not questionable of their importance. Female Genitals, which are less likely to be symbolized by them, are ships, cupboards, stoves, rooms. Rooms overlap in a certain amount house symbolism so it is more likely to represent them. Apples, peaches, and other fruits symbolize breasts. Jewels and treasure are used in dreams to reflect someone who is loved.
After all, Freud says that dream symbolism should not be taken for granted and that such thing is not that simple especially when we try to practise it on both sexes.
Psychology could never be accurate and there will always be a place to question it and Freud's thinking is not completely original as if we were to review history of Philosophy and Psychology then we could see that older generations of Philosophers and Psychologists have written similar theories such Plato, Aristotle, Albertus Magnus (thirteenth century), Thomas Hobbes (1651), but it seems that Freud developed them to a more advanced level.
Dreams to Plato
Plato thinks that dreams come from the individual to express his hidden desires, fears etc. Dreams reflect Psychological processes in which a person goes through while sleeping. This is very close to what Freud thinks about dreams which leads us to think whether he actually cited it from him.
Interestingly, Plato specifies which kind of desires we dream. He teaches that in dreams we lose our gentler part of soul and logic is withdrawn. The beast of us takes control to satisfy our instincts. It will isolate any kind of shame or reason and it will not restrict any kind of thing to its maximum limit. In every one of us there are desires which are revealed in our dreams, horrible in their essence.
Dreams to Aristotle
Aristotle (pupil of Plato) tried to specify dreams as connected to Physiology according to his account of it. Aristotle denied the thought that dreams are visits from God, arguing that stupid people and animals dream. He states that sleep is crucial to keep our common sense (as an organ) restored. Aristotle attributes sleep to evaporation of food and liquid to pass to our head. Dreams are reflected on raging waves and when they are great, nothing can stop them. Dreamers are less critical about their dreams and more sensitive to stimuli. He clarifies how we are more sensitive when we sleep. In the day time, we face stimuli which we do not notice if they were light because of the strong waking impulses but when we sleep, any small stimuli seems powerful and the opposite happens.
Aristotle thinks that it is a good method to diagnose diseases as diseases start small when they visit our body and they are clearer when we sleep because we are more sensitive at night rather than day time.
Aristotle was asked what he thought about prophesies so he noted the need to distinguish between dreams and prophesies saying that dreams are signs of events which occurred. He goes back to the Physiological aspect of it saying that dreams may reflect what is going in our body. He rejected the idea that dreams could mirror prophesy.
Aristotle writes his thesis on dreams by using common sense where he analyses and classifies dreams. One class of dreams is dreams which are affected by past events and have not future importance. The second is dreams which tell about the future and they are divided to three categories:
-Direct prophecies
-Previsions of future events
-Symbolic dreams that need to be interpretated in order to be figured out.
The difficulty in dreams is how to interpret them. If dreams have meanings, then how come we can not see their importance at once, the way we see importance of things when we are awake.
The Psychoanalytic Approach
Dreams to Sigmund Freud
Freud's most basic idea about dreams is that dreams are infantile wish fulfilment. His writings about The Interpretation of Dreams in 1900 tell about his belief that dreams all seek to fulfil one wish which converted to others and that is the wish to sleep. We dream inorder not to wake up because we want to sleep.
But Freud's Theory of Dreams is different completely. Freud believes that dreams are connected to typial characteristics of neuroses so he relates symbolism of dreams to neurosis forms. On a Physiological level, Freud explains why dreams are connected to wishes and experience: he makes significant difference between two mental processes. Primary and Secondary. Primary is the unconscious and the secondary is the conscious. Freud says that the primary process controls dream life while at the same time, the Ego in the process of dreaming is almost none moveable. He mentions that if there was no Ego, then we would not be able to dream.
Freud was trying to find out why dreams are not logical when they imply to our deep nature of the individual. This led him to differentiate between Manifest and Latent contents of dreams. Freud asks also, if we are able to explain why a thought of something wished is reflected in a visionary form. He argues that a thought in dreams is transferred to an image and speech in a direct manner.
In dreams, the excitation moves in a retrogressive direction. Instead of moving towards the motor end of the dream, it moves backward to the sensory end and in final stages, it gets to the perceptual system. It is opposite to what happens in waking life where the direction is progressive in physical terms. In dreams, the direction is regressive. This regression gives us the opportunity to exploit dreams to uncover content of our unconsciousness. In such process, fabric of our dream-thoughts is being converted to its raw material.
It is right to say that when we are sleeping, our physiological state changes and so our excitations to lead to regressions as mentioned before but, in some cases this may occur also in waking state such in patients who suffer from hallucinations, for example in Hysteria. In such case, waking regressions that is of thoughts are converted to images which are connected to oppressed and unconscious memories. Freud believes that in dreams we may be able to retrace our experience as infants. Dreaming is a revival of our childhood, impulsive instincts, methods of expression which were available to us at that time. This would reveal the development of ourselves and circumstances which dominated us.
Freudian Symbols refer to dreams as symbolic accounts of unconscious mental activity with great importance. To him, symbolism in the Theory of Dreams is translation in which allows us to interpret the dream, some times without the need to ask the dreamer. If we are familiar with dream-symbols, the dreamer's personality, the conditions he lives, and the impressions he faced prior to the dream then we will be able to interpret it immediately. Freud Says that this symbolic relation is a comparison though it is a limited one. We can not compare every object or process in a dream as a symbol of it and at the same time, a dream does not symbolize every element of it but certain ones. The idea of a symbol can not be decided completely because it could be a replacement, a representation or a hint. It is a number of symbols that we use to compare but at the same time we may ask: if the dreamer uses them in his dream then how come he does not know their meanings? as mentioned before, the number of things which are symbolic in a dream is not big:
- The Human Body As a Whole
- Parents
- Children
- Brothers and Sisters
- Birth
- Death
- Nakedness
A house represents the human body as a whole. Houses with smooth walls are men and houses with projections and balconies are women. Some times you see yourself climbing a house or holding to it.
Parents are represented as Emperor and Empress or King and Queen or other respectful personalities.
So they represent in this case the good male and female. In case they treat their children brothers and sisters less gently, the parents are represented as small animals and vermin. Birth is represented almost all the time as something to do with water. One is either falls into the water or gets out of it. Dying is replaced in dreams by departure, being dead by unknown and timid hints. So we can see here, the unclear boarders between symbolic and allusive representation.
Freud talks now about the sexual symbolism and its significance saying that male genitals are represented in dreams in various ways called symbolic where the common element between them in comparison is obvious which is the similar shape of objects such unbrellas, posts, trees, weapons etc. Among the less easily understandable male sexual symbols are certain reptiles, fishes, and snake. It is certainly not easy to understand why hats and over coats or cloaks symbolize the same but it is not questionable of their importance. Female Genitals, which are less likely to be symbolized by them, are ships, cupboards, stoves, rooms. Rooms overlap in a certain amount house symbolism so it is more likely to represent them. Apples, peaches, and other fruits symbolize breasts. Jewels and treasure are used in dreams to reflect someone who is loved.
After all, Freud says that dream symbolism should not be taken for granted and that such thing is not that simple especially when we try to practise it on both sexes.
Psychology could never be accurate and there will always be a place to question it and Freud's thinking is not completely original as if we were to review history of Philosophy and Psychology then we could see that older generations of Philosophers and Psychologists have written similar theories such Plato, Aristotle, Albertus Magnus (thirteenth century), Thomas Hobbes (1651), but it seems that Freud developed them to a more advanced level.
Beauty is in the Eye of the Gene!
Social Psychology
This article concentrates on the Biological-Genetic role for human behavior and in contrast to previous articles; it will not concentrate on Psychological aspects of it. In fact, it will want to convince you of its correctness. As I can not debate all sorts of human behavior, this article will discuss specific human behavior.
So for example, beauty, what is it? It is obvious and visible that beauty is connected to health. Would you prefer to kiss a person with symptoms of disease rather than a person with healthy clear skin? The answer derives from common sense but we do not need our mother to teach us that runny noses are disgusting! Healthy people are universally attractive and better genes live in better bodies and we choose healthy partners. So is beauty genetic? Is our decision for beauty genetic? In this respect we are not different from animals; some species of female rabbits chase males in high speed and for long periods of time so that they would mate. Same like when male and female snakes need to wrestle before they engage in sex. Many male monkeys need to balance themselves acrobatically when they are having an intercourse with a female monkey and no sick male monkey will be allowed to carry out such act. Though, a culture where skin infections are common, appreciates clear skin more than other.
But attracting genes are not limited to skin quality but to others as well. One is Physical Symmetry. Humans have a single genetic blueprint which instructs how to build left and right sides of the body such hands, legs, breasts. Each human's genes work for both sides of our bodies but none of us is completely symmetrical, and there will always be a deviation between both sides such length, width and size. Usually, they are minor and hard to notice. In nature, there is a strong connection between organism symmetry and health, for instance, symmetrical horses run faster than more lopsided horses, symmetrical flowers produce more nectar. Symmetrical animals are found more attractive and sexually desirable than asymmetric animals which grow slowly, die young, and engage in less sexual intercourses. Humans are no different to animals in this respect, they are more attracted to symmetrical humans, men with symmetrical bodies have more lovers as twice, they experience sex 3 - 4 years earlier, their partners are more likely to reach orgasm and different orgasm rates improve the chance to have a symmetrical child. There are many studies which prove the biological connection to attraction where people from different cultures rated attraction in similar ranks when photos of other people were shown to them. Even babies were found to stare at photos of attractive people for longer time.
So to whom do we get attracted to? Mostly, siblings are not supposed to be our spouses! And this is universally agreed and it is biologically orientated. Turn to animals; they also avoid mating with their brothers and sisters because it is not good for their babies. Humans who mate with their siblings bring babies who are likely to die, or survive with serious disorders. This avoidance to fall in love with our siblings derives from the awareness that such act could lead to unhealthy offspring and from our instinctual, unconscious refusal to have a relationship with a person we grew up with from a tiny young age. So brother and sister may fall in love one with another if they never met before but otherwise, they would not fall in love. We aspire to have genetic diversity when we want to mate and mostly have children and it may spread beyond not having an affair with our siblings but even overseas. We are mostly to be attracted to people who are not from our environment and very different from us. Biologically, it is called MHC or HLA and the result is mixture of genes to bring healthy offspring. So we as humans, men and women seek good genes, healthy, symmetrical and non related spouses. We contribute as parents to raising up our children so both sexes look for spouses who could form good parents but the biological difference between male and female affects our behavior as a woman produces four hundred possible fertile eggs in life time while a man brings three hundred million sperm per ejaculation. Because of this difference, men and women behave differently when they engage in a sexual intercourse.
What about men, what are they looking for? Miss America these days has feminine looks; twenty years ago she was thinner, while in the twenties she was fat. So they varied during these years but still waist measures did not deviate drastically. It turned out that shape is more important to us rather than size. Men from all cultures find women with 0.7 ratios are most attractive, but women with such ratios are most fertile so it seems that our genes are attracted to the fertility ability. Men prefer younger women because fertility decreases when they are older and women are more beautiful as a common concept when they are feminine, have thinner jaws, larger eyes, and have a shorter distance between mouth and chin. Makeup and cosmetic surgeries try to increase desirable features such lipsticks and collagen injections to turn lips bigger and youthful, skin products to let the skin look clearer, breast augmentation though larger breasts do not increase milk neither bring healthier children but these techniques have been used since ancient times for example the Egyptian Pharaohs. It seems that these desirable features are genetic. Men like women who show interest in them but how do they know? Poorly, they realize this by trivial signs but actually, when a woman is turned on by a man her pupils dilate and some times with eye drops and this is an involuntary reaction. In addition to better sexual life, beautiful women enjoy higher salaries according to studies but acquire hostility from other women even those who are beautiful as well so they have less female friends.
So women, what are they looking for? Marilyn Monroe dated John F. Kennedy but had sex with him only when he became a president. Status helps humans and studies learn that women who marry better educated men are more successful, their marriage lasted longer, had more children and had happier life. Women use their beauty to join high status men to develop their interests and money is a big attraction to them to a degree that they would prefer ugly rich men to handsome men working in Burger King. Women search for men with secure finance and status but they are not interested in old men. In the States, 40 years old men earn an average of $21000 more than twenty years old guys so the result is that women mate in the end with older men though amusingly, women do not get attracted to older men for their older age. In fact, women avoid old men because of genetic reasons as when a man becomes older; his sperms become copies of copies of copies leading to DNA errors. Women also do not like short guys and in general society goes for tall men. In business, an inch of height is worth more than $1000 a year. 39 out of 41 American presidents were the taller during a campaign for presidency and in general, tall men benefit a lot from this quality. Women prefer men who can provide good resources such food, clothing, shelter, and other goods that money can buy and women who earn more money take into account her partner's finance more seriously and this is the reason why women marry older men. It is reflected in personal ads as well where women mention money ten times more than men. In animal life, many female species mate only with strongest males where for example, cocks fight with other cocks to impress hens before they could mate with them.
Our perception of mates, friends, co-workers, and politicians derives from our animal heritage and our perception of beauty is genetic and so I can not change my genes to be more attractive. One solution is our awareness of our beauty biases so that we control our behavior. Humans unconsciously hold preferences over specific qualities. A study learns that teachers rated good looking pupils as more sociable, more popular, and more intelligent. Some exploit their good looks to manipulate others to get what they wanted and worse than that when they disconnect themselves from them when they get the thing. The phenomenon to favor attractive women is universal and even babies stare at beautiful faces longer. This preconscious beauty filter affects our behavior towards people and some would call us bad because we do this, but can we help it? It seems that it could be possible if we follow some techniques such setting up preventive systems for example the request to put it in writing when we are asked to amend marks bearing in mind that verbal - facial confrontation could be influenced by our subconsciousness. It is unfair to be judged by symmetry and other uncontrollable similar elements but luckily, there are other elements which we can control and which our potential friends would take into account such kindness and understanding which were ranked at top of the list in a study about attractive attributes people seek when they are looking for friendship. Another study shows that men and women seek same traits when they are looking for mates including personality, adaptability and creativity yet men seek good looks in a higher degree. Women, who go to sperm banks, read about donors but usually there is no photo though a lot of details are provided. In a study, it was reported that Canadian and Norwegian women chose their sperm donors for their physical and health attributes though honesty, dependability and consideration were included. These features can be taught and if we see the beauty glass as half empty rather than full and we are considerate and fit, how desirable can we be? So beauty is in the eye of the gene. Beauty is as much in the gene of the beholder as the eye. We are attracted to people who are different from us.
One the other hand, other theories in social psychology claim that we are attracted to people who are similar to us rather than different from us, so self seeking like and this is the reason that there is a lot of narcissism and this is the reason there is some thing that is called nation so we look the same.
This article concentrates on the Biological-Genetic role for human behavior and in contrast to previous articles; it will not concentrate on Psychological aspects of it. In fact, it will want to convince you of its correctness. As I can not debate all sorts of human behavior, this article will discuss specific human behavior.
So for example, beauty, what is it? It is obvious and visible that beauty is connected to health. Would you prefer to kiss a person with symptoms of disease rather than a person with healthy clear skin? The answer derives from common sense but we do not need our mother to teach us that runny noses are disgusting! Healthy people are universally attractive and better genes live in better bodies and we choose healthy partners. So is beauty genetic? Is our decision for beauty genetic? In this respect we are not different from animals; some species of female rabbits chase males in high speed and for long periods of time so that they would mate. Same like when male and female snakes need to wrestle before they engage in sex. Many male monkeys need to balance themselves acrobatically when they are having an intercourse with a female monkey and no sick male monkey will be allowed to carry out such act. Though, a culture where skin infections are common, appreciates clear skin more than other.
But attracting genes are not limited to skin quality but to others as well. One is Physical Symmetry. Humans have a single genetic blueprint which instructs how to build left and right sides of the body such hands, legs, breasts. Each human's genes work for both sides of our bodies but none of us is completely symmetrical, and there will always be a deviation between both sides such length, width and size. Usually, they are minor and hard to notice. In nature, there is a strong connection between organism symmetry and health, for instance, symmetrical horses run faster than more lopsided horses, symmetrical flowers produce more nectar. Symmetrical animals are found more attractive and sexually desirable than asymmetric animals which grow slowly, die young, and engage in less sexual intercourses. Humans are no different to animals in this respect, they are more attracted to symmetrical humans, men with symmetrical bodies have more lovers as twice, they experience sex 3 - 4 years earlier, their partners are more likely to reach orgasm and different orgasm rates improve the chance to have a symmetrical child. There are many studies which prove the biological connection to attraction where people from different cultures rated attraction in similar ranks when photos of other people were shown to them. Even babies were found to stare at photos of attractive people for longer time.
So to whom do we get attracted to? Mostly, siblings are not supposed to be our spouses! And this is universally agreed and it is biologically orientated. Turn to animals; they also avoid mating with their brothers and sisters because it is not good for their babies. Humans who mate with their siblings bring babies who are likely to die, or survive with serious disorders. This avoidance to fall in love with our siblings derives from the awareness that such act could lead to unhealthy offspring and from our instinctual, unconscious refusal to have a relationship with a person we grew up with from a tiny young age. So brother and sister may fall in love one with another if they never met before but otherwise, they would not fall in love. We aspire to have genetic diversity when we want to mate and mostly have children and it may spread beyond not having an affair with our siblings but even overseas. We are mostly to be attracted to people who are not from our environment and very different from us. Biologically, it is called MHC or HLA and the result is mixture of genes to bring healthy offspring. So we as humans, men and women seek good genes, healthy, symmetrical and non related spouses. We contribute as parents to raising up our children so both sexes look for spouses who could form good parents but the biological difference between male and female affects our behavior as a woman produces four hundred possible fertile eggs in life time while a man brings three hundred million sperm per ejaculation. Because of this difference, men and women behave differently when they engage in a sexual intercourse.
What about men, what are they looking for? Miss America these days has feminine looks; twenty years ago she was thinner, while in the twenties she was fat. So they varied during these years but still waist measures did not deviate drastically. It turned out that shape is more important to us rather than size. Men from all cultures find women with 0.7 ratios are most attractive, but women with such ratios are most fertile so it seems that our genes are attracted to the fertility ability. Men prefer younger women because fertility decreases when they are older and women are more beautiful as a common concept when they are feminine, have thinner jaws, larger eyes, and have a shorter distance between mouth and chin. Makeup and cosmetic surgeries try to increase desirable features such lipsticks and collagen injections to turn lips bigger and youthful, skin products to let the skin look clearer, breast augmentation though larger breasts do not increase milk neither bring healthier children but these techniques have been used since ancient times for example the Egyptian Pharaohs. It seems that these desirable features are genetic. Men like women who show interest in them but how do they know? Poorly, they realize this by trivial signs but actually, when a woman is turned on by a man her pupils dilate and some times with eye drops and this is an involuntary reaction. In addition to better sexual life, beautiful women enjoy higher salaries according to studies but acquire hostility from other women even those who are beautiful as well so they have less female friends.
So women, what are they looking for? Marilyn Monroe dated John F. Kennedy but had sex with him only when he became a president. Status helps humans and studies learn that women who marry better educated men are more successful, their marriage lasted longer, had more children and had happier life. Women use their beauty to join high status men to develop their interests and money is a big attraction to them to a degree that they would prefer ugly rich men to handsome men working in Burger King. Women search for men with secure finance and status but they are not interested in old men. In the States, 40 years old men earn an average of $21000 more than twenty years old guys so the result is that women mate in the end with older men though amusingly, women do not get attracted to older men for their older age. In fact, women avoid old men because of genetic reasons as when a man becomes older; his sperms become copies of copies of copies leading to DNA errors. Women also do not like short guys and in general society goes for tall men. In business, an inch of height is worth more than $1000 a year. 39 out of 41 American presidents were the taller during a campaign for presidency and in general, tall men benefit a lot from this quality. Women prefer men who can provide good resources such food, clothing, shelter, and other goods that money can buy and women who earn more money take into account her partner's finance more seriously and this is the reason why women marry older men. It is reflected in personal ads as well where women mention money ten times more than men. In animal life, many female species mate only with strongest males where for example, cocks fight with other cocks to impress hens before they could mate with them.
Our perception of mates, friends, co-workers, and politicians derives from our animal heritage and our perception of beauty is genetic and so I can not change my genes to be more attractive. One solution is our awareness of our beauty biases so that we control our behavior. Humans unconsciously hold preferences over specific qualities. A study learns that teachers rated good looking pupils as more sociable, more popular, and more intelligent. Some exploit their good looks to manipulate others to get what they wanted and worse than that when they disconnect themselves from them when they get the thing. The phenomenon to favor attractive women is universal and even babies stare at beautiful faces longer. This preconscious beauty filter affects our behavior towards people and some would call us bad because we do this, but can we help it? It seems that it could be possible if we follow some techniques such setting up preventive systems for example the request to put it in writing when we are asked to amend marks bearing in mind that verbal - facial confrontation could be influenced by our subconsciousness. It is unfair to be judged by symmetry and other uncontrollable similar elements but luckily, there are other elements which we can control and which our potential friends would take into account such kindness and understanding which were ranked at top of the list in a study about attractive attributes people seek when they are looking for friendship. Another study shows that men and women seek same traits when they are looking for mates including personality, adaptability and creativity yet men seek good looks in a higher degree. Women, who go to sperm banks, read about donors but usually there is no photo though a lot of details are provided. In a study, it was reported that Canadian and Norwegian women chose their sperm donors for their physical and health attributes though honesty, dependability and consideration were included. These features can be taught and if we see the beauty glass as half empty rather than full and we are considerate and fit, how desirable can we be? So beauty is in the eye of the gene. Beauty is as much in the gene of the beholder as the eye. We are attracted to people who are different from us.
One the other hand, other theories in social psychology claim that we are attracted to people who are similar to us rather than different from us, so self seeking like and this is the reason that there is a lot of narcissism and this is the reason there is some thing that is called nation so we look the same.
Obsessions in Psychology
Psychopathology
An Obsessional-Compulsive Disorder is a disabling disorder. Obsessions are viewed as a syndrome in their own right. Meyer (1966) reported a successful behavioural treatment for obsessions by creating Psychological Models to obsessions and suggesting effective behavioural treatments. Models of compulsive behaviour suggested that ritualistic behaviours are a learned avoidance. Meyer's concern was the issue of avoidance in obsessional disorders by noting that it was crucial to prevent this avoidance behaviour instantly by making sure that such rituals did not happen within or between treatment sessions. His approach was cognitive saying that we need to invalid expectations of harm deriving from obsessions and the need to be exposed gradually to the obsessional situations but this is secondary as the most important was preventing ritualizing.
On the other hand, Rachman, Hodgson, Marks (1971) presented treatment based on exposure to feared situations as a main treatment.
In the end, the two approaches were used together to create very good behavioural treatment of exposure and response prevention. In 1988, Salkovskis added that obsessional thoughts are exaggerations of normal cognitive functioning.
Definition of an Obsession:
Obsessions are defined as unwanted and intrusive thoughts, images and impulses. A person who experiences them finds them repellent, illogical, unacceptable, and hard to get rid of. A big number of triggering stimuli could create obsessions. When an obsession happens, a person feels uncomfortable, anxious and the need to neutralize or put right such obsession. Neutralizing is usually expressed by compulsive behaviour and some times with a subjective feeling of resisting to do compulsive behaviour. Compulsive/neutralizing behaviours are often done according to strange "rules" that if such ritualizing was not done, then anxiety would increase. Neutralizing includes change of mental activities by thinking intentionally another thought when an obsessional thought strikes. Add to that, patients develop avoidance behaviours such cases which could trigger those thoughts/behaviours. Patients generally consider their obsessional thoughts and behaviours as senseless or exaggerated.
Clinically, obsessional-compulsive phenomenon was split to two:
1. Obsessional thoughts which are compulsive behaviour free (Obsessional ruminations).
2. Obsessions plus overt compulsions (Obsessional ritualizing).
The Psychological model of obsessions stresses the importance of overt and covert compulsions which are called neutralizing behaviours. So obsessions are involuntary intrusive thoughts, images, and compulses which lead to anxiety while neutralizing is voluntary behaviour to decrease such anxiety or "risk of harm". Covert neutralizing behaviour is similar to obsessional thoughts because both are thoughts but the difference is their essence as it is a serial of intrusion-neutralizing-intrusion-neutralizing-intrusion..... so the function of both is different. Their target is relaxation and this may intensify if a thought happened.
The nature of obsessional thoughts, impulses and images is often of repugnant subjects in a personal manner. In case an intrusive unacceptable thought happened, the more as it is, the more a person feels uncomfortable. Many patients with obsessive-compulsive disorder, share a similar stream regarding future harm and the need to stop it and usually a try to do so.
To give examples of obsessions and compulsive behaviour:
Obsession - Comb of hairdresser had an AIDS virus on it; Compulsive Behaviour - Call doctor, check body for signs of AIDS, wash hair and hands, clean thoroughly things people touch.
Obsession - I will do some thing bad to my child; Compulsive Behaviour - Avoids being by herself with her child, hides knives and plastic bags.
Obsession - I will scream and swear; Compulsive Behaviour - Make sure I control my behaviour, avoidance of social events, ask people if my behaviour was ok.
Obsession - I will rape a woman; Compulsive Behaviour - Tries to prevent thoughts of sex, will not be alone with a woman.
As we can see, there are different categories of obsessions including violence, sex, death, social, religion, contamination, orderliness and this is just a short list.
Content of the Psychological Model of Obsessive-Compulsive Disorder:
Obsessions are mainly featured by:
-Avoiding objects or situations that trigger obsessions.
Obsessions.
-Compulsive behaviours and thought rituals.
Such avoidance does not help and in fact, it may trigger or worsen obsessions and in response, rituals happen. Rituals refer to characteristic obsessional behaviours, especially when they are repetitive and the belief that such rituals would lead to anxiety relief or decreased. As a result, obsessions remain, rituals become wide, and patients neutralize before the obsession happens and by doing so, prevent its event. The above model is the basis as to how we assess and treat patients with obsessional disorder. The way to treat patients who suffer from obsessions is by exposing them to the feared stimuli, encourage them to behave in a way which would not prevent this exposure, reappraise their fear in order they would know that things they fear do not happen virtually.
The Treatment:
Cognitive-Behavior Therapy
Assessments and Interviews before Treatment of Obsessional Disorder:
I. Assessment includes:
Ø A clinical interview
Ø Self monitoring
Ø Home work assignments
Ø Direct observation
II. Aims of assessment are:
Ø To approve of problem list
Ø To arrive to a psychological formulation of each problem; factors which led to the problem and recent maintaining factors
Ø To assess fitness for the psychological treatment
Ø To give tools to assess progress
In cognitive-behavioural treatment, assessment and treatment go together. When the connection between triggers, thoughts, neutralizing and avoidance are understood then the treatment can start immediately. Treatment will be based on exposure and response prevention.
III. Suitability for treatment and primary and secondary obsessions:
First question whether a patient is suitable for treatment would be whether Obsessions are primary problem or secondary to another psychiatric or organic disorder. Second question would be whether a patient is interested in such treatment as some are hesitant to take a treatment; treatment is based on mutual relationship and participation; patient who does not carry out needs of treatment can be convinced cognitively; however if a patient does not want to collaborate actively in such treatment despite cognitive efforts by the therapist then this treatment is deemed to fail its object and better is not to take it.
If an obsession developed after a psychiatric disorder or after it worsened then the primary should be treated first (especially in depression); but it is possible that even a primary problem was treated, an obsession remains. Many times, schizophrenic patients develop obsessions but it is not a rule as the number of schizophrenic people who suffer from obsessions is as the number in the general public and people with schizophrenia** usually do not consider their obsessions as senseless while people who do not suffer from schizophrenia find them senseless. This distinguishing is important as some times people with severe obsessions are labelled as psychotic without justification just because they suffered from schizophrenia in the past.
IV. Interviews:
The first interview starts with open questions like “Could you tell me about the problems you have been facing recently?”, then the therapist limits his question a bit by asking how the problem affected him during the last week; when a general picture of the problem is provided, the stressing goes to current examples of the problem. The therapist then needs to search for hints as to which factors trigger specific thoughts and behaviours, such events. If the patient gives high account for his obsessions, the therapist needs to direct the interview with statements as to the upsetting thoughts which the patient experiences and if he feels that he needs to do some thing about them (implying to obsessive thoughts and compulsive behaviour).
Reminder: Obsessions involve intrusive thoughts, images (mental pictures in contrast to patients who suffer from schizophrenia where they see images/pictures/things which do not exist in reality) and impulses (feeling the need to do some thing which you do not want to do for real); the patient needs to be asked about them.
V. Methods to analyse behaviours:
After the general picture of the problem was provided, the next step is to analyse in details behaviours of the patient using examples to specify the problem. This is based on response systems which the therapist asks about; questions about cognitive (what was going on his mind), subjective (what he felt), physiological (his body’s reaction) and behavioural (how he acted) as to his problem. This is illustrated by direct questions the patient is asked as to what he does in regard with his problem. The therapist concentrates on response system to the specific obsession, triggers, avoidance and ritualizing. Afters the therapist collects information, he repeats them to the patient to be accurate of his perception of them then, he asks the question: “Did I get it right or perhaps I missed some thing?”
VI. Assessing cognition:
When evaluating an obsession which a patient experiences, the therapist needs to concentrate on form of thought, image, or impulse and content of intrusions; content of obsession needs to be assessed in details. The therapist may ask the patient whether those thoughts, images or impulses impose themselves into his mind; which sort of thoughts they are; the last time he was upset with them. It is usual that some patients have their obsessional thoughts during sessions so it would be appropriate to ask them whether they had them just then; what was going on their mind; if the answer is positive, then the therapist asks for their details.
VII. Assessing triggers:
Triggers could be obsessional thoughts or images; others are non-obsessional thoughts or images which refer to things which strike obsessional thoughts. An example would be a woman who had an obsessional thought that she may hurt her children; when she read an article the other day about a mother who abused her children, the article set off her obsessional thoughts; the therapist asks her whether there were other things which could strike those thoughts.
VIII. Assessing rituals:
As mentioned earlier, covert obsessions are thoughts without compulsive behaviour neutralized mentally which should be assessed by asking patients about recent events where the thought set off concentrating on thoughts and images they tried to create to switch their thoughts to others when their obsessional thoughts occurred and the result afterwards.
Reminder: The process in covert obsessions is having a thought (re: obsession), try to neutralize it (switch to another thought when it strikes***), and ritualize as a result (the ritualizing would be mental**** and not behavioural).
IX. The element of avoidance
Cognitively, this refers to thinking of other things and preventing or avoiding from thinking about specific things; this act of preventing exposure to thoughts will only make the problem bigger and the urge to think about the avoided thoughts will increase. Important characteristics of obsessions are mostly subjective and it is necessary to know whether patients reckon that these obsessions are connected to their personality. It is also considered to know how much patients resisted their obsessions and rituals because by this, we could figure out how much they thought their response prevention was rationale. The fact that a person does not resist would not mean that a person is not obsessional but a person who believes that his thoughts are sensible, usually he is considered as not obsessional. Patients believe that their behaviour has a rationale basis but became exaggerated; treatment would want to convince that “risks” which a patient anticipates if he halts his obsessional behaviour do not happen.
X. The element of emotions:
Emotions should be considered and mood changes when an obsession happens. It is supposed that anxiety is the most dominant feeling when as obsession happens but discomfort and depression are assessed as well; significant number of patients report about tension, anger and repugnance as well and questions by therapists should refer to whether mood changes happen prior or after the obsession and behaviour. Illustrated questions for an assessment would include “does it feel as if you were before a work interview?” (Refers to anxiety), or “do you feel you had enough?” (Refers to depression); it is worth noting that obsessions are associated with depression as many patients diagnosed with depression develop obsessions.
XI. The element of behaviour:
Behaviour needs to be assessed; on the other hand, behaviour which could trigger obsessional thoughts needs to be assessed; behaviour which prevents exposure***** needs to be assessed; behaviour which eliminates obsessional thoughts need to be assessed; behaviour which prevents reappraisal needs to be assessed; all these need to be considered carefully. Many times, behaviours form triggers such cases when a driver thought he hit someone when he turned right so he turns around to check no one is hurt; this behaviour triggered an obsession to check when ever he turned right. Avoidance could be passive or active and they should be examined; therapist should ask his patient whether there were things he does not do to prevent obsessions set off (Passive avoidance) and on the other hand, should ask him whether there were things he does do to prevent such obsessions set off (Active behaviour); both cases should be encouraged negatively. Common question which relates to overt rituals is whether the patient tries to “puts things right” or “make sure that nothing goes wrong” when his obsessional thought occurs. If a patient was prevented to make his ritual, he may ritualize covertly; this should be asked about quite often.
XII. The element of reassurance:
Reassurance request is common among obsessional patients; it is another neutralizing behaviour. Reassurance is used by patients to check act and second to burden responsibility on the asked person when answers. Reassurance eliminates exposure to the troubling thought and influences reappraisal. Neutralizing, ritualizing, reassurance and compulsive behaviour could be postponed some times after obsession occurs. The behaviour should be investigated detailing form of the act; how much time it takes; how often; and does it take same shape each time. Elements which increase or decrease such behaviours should be assessed as well; these elements could be of events, influences, cognitive******.
I believe in the school of Behaviourism and much less in the Psychoanalytic school as I find it unscientific and more similar to philosophy and literature: can you prove it? It is all about assumptions of what happens in the inner of the human being. I believe in CBT, as I find it more efficient, than treatment based on the Freudian approach (did it help Marlyn Monro?) I am sure that as time goes on, psychology will lose trust in the psychoanalytic approach (more than it does today) and turn to Cognitive-behaviour therapy as a major way of treatment. Dreams, unconsciousness, anal and phalic, give me a break.
* Cognitive-behavioural treatment is all that is discussed in this article; cognitive refers to areas of thinking, language, memory and perception; in this context, thinking is most related to.
** Schizophrenia is a psychiatric disorder which shows features such hallucinations, delusions, racing thoughts, poor social functioning, disorganised thoughts, concentration difficulties, difficulties in completing tasks, seeing things and hearing voices which do not exist in reality; it demands medical treatment.
*** Or put things right.
**** Or cognitive in this context.
***** Or avoidance.
****** Stages are summarized to three: 1. Interview 2. Assessment 3. Treatment.
Terms:
- Obsession = thought
- Neutralizing = compulsive behavior = ritualizing.
- Obsession/thought leads to neutralizing/compulsive behaviour/ritualizing leads to avoidance behaviour leads to anxiety.
An Obsessional-Compulsive Disorder is a disabling disorder. Obsessions are viewed as a syndrome in their own right. Meyer (1966) reported a successful behavioural treatment for obsessions by creating Psychological Models to obsessions and suggesting effective behavioural treatments. Models of compulsive behaviour suggested that ritualistic behaviours are a learned avoidance. Meyer's concern was the issue of avoidance in obsessional disorders by noting that it was crucial to prevent this avoidance behaviour instantly by making sure that such rituals did not happen within or between treatment sessions. His approach was cognitive saying that we need to invalid expectations of harm deriving from obsessions and the need to be exposed gradually to the obsessional situations but this is secondary as the most important was preventing ritualizing.
On the other hand, Rachman, Hodgson, Marks (1971) presented treatment based on exposure to feared situations as a main treatment.
In the end, the two approaches were used together to create very good behavioural treatment of exposure and response prevention. In 1988, Salkovskis added that obsessional thoughts are exaggerations of normal cognitive functioning.
Definition of an Obsession:
Obsessions are defined as unwanted and intrusive thoughts, images and impulses. A person who experiences them finds them repellent, illogical, unacceptable, and hard to get rid of. A big number of triggering stimuli could create obsessions. When an obsession happens, a person feels uncomfortable, anxious and the need to neutralize or put right such obsession. Neutralizing is usually expressed by compulsive behaviour and some times with a subjective feeling of resisting to do compulsive behaviour. Compulsive/neutralizing behaviours are often done according to strange "rules" that if such ritualizing was not done, then anxiety would increase. Neutralizing includes change of mental activities by thinking intentionally another thought when an obsessional thought strikes. Add to that, patients develop avoidance behaviours such cases which could trigger those thoughts/behaviours. Patients generally consider their obsessional thoughts and behaviours as senseless or exaggerated.
Clinically, obsessional-compulsive phenomenon was split to two:
1. Obsessional thoughts which are compulsive behaviour free (Obsessional ruminations).
2. Obsessions plus overt compulsions (Obsessional ritualizing).
The Psychological model of obsessions stresses the importance of overt and covert compulsions which are called neutralizing behaviours. So obsessions are involuntary intrusive thoughts, images, and compulses which lead to anxiety while neutralizing is voluntary behaviour to decrease such anxiety or "risk of harm". Covert neutralizing behaviour is similar to obsessional thoughts because both are thoughts but the difference is their essence as it is a serial of intrusion-neutralizing-intrusion-neutralizing-intrusion..... so the function of both is different. Their target is relaxation and this may intensify if a thought happened.
The nature of obsessional thoughts, impulses and images is often of repugnant subjects in a personal manner. In case an intrusive unacceptable thought happened, the more as it is, the more a person feels uncomfortable. Many patients with obsessive-compulsive disorder, share a similar stream regarding future harm and the need to stop it and usually a try to do so.
To give examples of obsessions and compulsive behaviour:
Obsession - Comb of hairdresser had an AIDS virus on it; Compulsive Behaviour - Call doctor, check body for signs of AIDS, wash hair and hands, clean thoroughly things people touch.
Obsession - I will do some thing bad to my child; Compulsive Behaviour - Avoids being by herself with her child, hides knives and plastic bags.
Obsession - I will scream and swear; Compulsive Behaviour - Make sure I control my behaviour, avoidance of social events, ask people if my behaviour was ok.
Obsession - I will rape a woman; Compulsive Behaviour - Tries to prevent thoughts of sex, will not be alone with a woman.
As we can see, there are different categories of obsessions including violence, sex, death, social, religion, contamination, orderliness and this is just a short list.
Content of the Psychological Model of Obsessive-Compulsive Disorder:
Obsessions are mainly featured by:
-Avoiding objects or situations that trigger obsessions.
Obsessions.
-Compulsive behaviours and thought rituals.
Such avoidance does not help and in fact, it may trigger or worsen obsessions and in response, rituals happen. Rituals refer to characteristic obsessional behaviours, especially when they are repetitive and the belief that such rituals would lead to anxiety relief or decreased. As a result, obsessions remain, rituals become wide, and patients neutralize before the obsession happens and by doing so, prevent its event. The above model is the basis as to how we assess and treat patients with obsessional disorder. The way to treat patients who suffer from obsessions is by exposing them to the feared stimuli, encourage them to behave in a way which would not prevent this exposure, reappraise their fear in order they would know that things they fear do not happen virtually.
The Treatment:
Cognitive-Behavior Therapy
Assessments and Interviews before Treatment of Obsessional Disorder:
I. Assessment includes:
Ø A clinical interview
Ø Self monitoring
Ø Home work assignments
Ø Direct observation
II. Aims of assessment are:
Ø To approve of problem list
Ø To arrive to a psychological formulation of each problem; factors which led to the problem and recent maintaining factors
Ø To assess fitness for the psychological treatment
Ø To give tools to assess progress
In cognitive-behavioural treatment, assessment and treatment go together. When the connection between triggers, thoughts, neutralizing and avoidance are understood then the treatment can start immediately. Treatment will be based on exposure and response prevention.
III. Suitability for treatment and primary and secondary obsessions:
First question whether a patient is suitable for treatment would be whether Obsessions are primary problem or secondary to another psychiatric or organic disorder. Second question would be whether a patient is interested in such treatment as some are hesitant to take a treatment; treatment is based on mutual relationship and participation; patient who does not carry out needs of treatment can be convinced cognitively; however if a patient does not want to collaborate actively in such treatment despite cognitive efforts by the therapist then this treatment is deemed to fail its object and better is not to take it.
If an obsession developed after a psychiatric disorder or after it worsened then the primary should be treated first (especially in depression); but it is possible that even a primary problem was treated, an obsession remains. Many times, schizophrenic patients develop obsessions but it is not a rule as the number of schizophrenic people who suffer from obsessions is as the number in the general public and people with schizophrenia** usually do not consider their obsessions as senseless while people who do not suffer from schizophrenia find them senseless. This distinguishing is important as some times people with severe obsessions are labelled as psychotic without justification just because they suffered from schizophrenia in the past.
IV. Interviews:
The first interview starts with open questions like “Could you tell me about the problems you have been facing recently?”, then the therapist limits his question a bit by asking how the problem affected him during the last week; when a general picture of the problem is provided, the stressing goes to current examples of the problem. The therapist then needs to search for hints as to which factors trigger specific thoughts and behaviours, such events. If the patient gives high account for his obsessions, the therapist needs to direct the interview with statements as to the upsetting thoughts which the patient experiences and if he feels that he needs to do some thing about them (implying to obsessive thoughts and compulsive behaviour).
Reminder: Obsessions involve intrusive thoughts, images (mental pictures in contrast to patients who suffer from schizophrenia where they see images/pictures/things which do not exist in reality) and impulses (feeling the need to do some thing which you do not want to do for real); the patient needs to be asked about them.
V. Methods to analyse behaviours:
After the general picture of the problem was provided, the next step is to analyse in details behaviours of the patient using examples to specify the problem. This is based on response systems which the therapist asks about; questions about cognitive (what was going on his mind), subjective (what he felt), physiological (his body’s reaction) and behavioural (how he acted) as to his problem. This is illustrated by direct questions the patient is asked as to what he does in regard with his problem. The therapist concentrates on response system to the specific obsession, triggers, avoidance and ritualizing. Afters the therapist collects information, he repeats them to the patient to be accurate of his perception of them then, he asks the question: “Did I get it right or perhaps I missed some thing?”
VI. Assessing cognition:
When evaluating an obsession which a patient experiences, the therapist needs to concentrate on form of thought, image, or impulse and content of intrusions; content of obsession needs to be assessed in details. The therapist may ask the patient whether those thoughts, images or impulses impose themselves into his mind; which sort of thoughts they are; the last time he was upset with them. It is usual that some patients have their obsessional thoughts during sessions so it would be appropriate to ask them whether they had them just then; what was going on their mind; if the answer is positive, then the therapist asks for their details.
VII. Assessing triggers:
Triggers could be obsessional thoughts or images; others are non-obsessional thoughts or images which refer to things which strike obsessional thoughts. An example would be a woman who had an obsessional thought that she may hurt her children; when she read an article the other day about a mother who abused her children, the article set off her obsessional thoughts; the therapist asks her whether there were other things which could strike those thoughts.
VIII. Assessing rituals:
As mentioned earlier, covert obsessions are thoughts without compulsive behaviour neutralized mentally which should be assessed by asking patients about recent events where the thought set off concentrating on thoughts and images they tried to create to switch their thoughts to others when their obsessional thoughts occurred and the result afterwards.
Reminder: The process in covert obsessions is having a thought (re: obsession), try to neutralize it (switch to another thought when it strikes***), and ritualize as a result (the ritualizing would be mental**** and not behavioural).
IX. The element of avoidance
Cognitively, this refers to thinking of other things and preventing or avoiding from thinking about specific things; this act of preventing exposure to thoughts will only make the problem bigger and the urge to think about the avoided thoughts will increase. Important characteristics of obsessions are mostly subjective and it is necessary to know whether patients reckon that these obsessions are connected to their personality. It is also considered to know how much patients resisted their obsessions and rituals because by this, we could figure out how much they thought their response prevention was rationale. The fact that a person does not resist would not mean that a person is not obsessional but a person who believes that his thoughts are sensible, usually he is considered as not obsessional. Patients believe that their behaviour has a rationale basis but became exaggerated; treatment would want to convince that “risks” which a patient anticipates if he halts his obsessional behaviour do not happen.
X. The element of emotions:
Emotions should be considered and mood changes when an obsession happens. It is supposed that anxiety is the most dominant feeling when as obsession happens but discomfort and depression are assessed as well; significant number of patients report about tension, anger and repugnance as well and questions by therapists should refer to whether mood changes happen prior or after the obsession and behaviour. Illustrated questions for an assessment would include “does it feel as if you were before a work interview?” (Refers to anxiety), or “do you feel you had enough?” (Refers to depression); it is worth noting that obsessions are associated with depression as many patients diagnosed with depression develop obsessions.
XI. The element of behaviour:
Behaviour needs to be assessed; on the other hand, behaviour which could trigger obsessional thoughts needs to be assessed; behaviour which prevents exposure***** needs to be assessed; behaviour which eliminates obsessional thoughts need to be assessed; behaviour which prevents reappraisal needs to be assessed; all these need to be considered carefully. Many times, behaviours form triggers such cases when a driver thought he hit someone when he turned right so he turns around to check no one is hurt; this behaviour triggered an obsession to check when ever he turned right. Avoidance could be passive or active and they should be examined; therapist should ask his patient whether there were things he does not do to prevent obsessions set off (Passive avoidance) and on the other hand, should ask him whether there were things he does do to prevent such obsessions set off (Active behaviour); both cases should be encouraged negatively. Common question which relates to overt rituals is whether the patient tries to “puts things right” or “make sure that nothing goes wrong” when his obsessional thought occurs. If a patient was prevented to make his ritual, he may ritualize covertly; this should be asked about quite often.
XII. The element of reassurance:
Reassurance request is common among obsessional patients; it is another neutralizing behaviour. Reassurance is used by patients to check act and second to burden responsibility on the asked person when answers. Reassurance eliminates exposure to the troubling thought and influences reappraisal. Neutralizing, ritualizing, reassurance and compulsive behaviour could be postponed some times after obsession occurs. The behaviour should be investigated detailing form of the act; how much time it takes; how often; and does it take same shape each time. Elements which increase or decrease such behaviours should be assessed as well; these elements could be of events, influences, cognitive******.
I believe in the school of Behaviourism and much less in the Psychoanalytic school as I find it unscientific and more similar to philosophy and literature: can you prove it? It is all about assumptions of what happens in the inner of the human being. I believe in CBT, as I find it more efficient, than treatment based on the Freudian approach (did it help Marlyn Monro?) I am sure that as time goes on, psychology will lose trust in the psychoanalytic approach (more than it does today) and turn to Cognitive-behaviour therapy as a major way of treatment. Dreams, unconsciousness, anal and phalic, give me a break.
* Cognitive-behavioural treatment is all that is discussed in this article; cognitive refers to areas of thinking, language, memory and perception; in this context, thinking is most related to.
** Schizophrenia is a psychiatric disorder which shows features such hallucinations, delusions, racing thoughts, poor social functioning, disorganised thoughts, concentration difficulties, difficulties in completing tasks, seeing things and hearing voices which do not exist in reality; it demands medical treatment.
*** Or put things right.
**** Or cognitive in this context.
***** Or avoidance.
****** Stages are summarized to three: 1. Interview 2. Assessment 3. Treatment.
Terms:
- Obsession = thought
- Neutralizing = compulsive behavior = ritualizing.
- Obsession/thought leads to neutralizing/compulsive behaviour/ritualizing leads to avoidance behaviour leads to anxiety.
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