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Difference between classical and operant conditioning



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Difference between classical and operant conditioning
Classical – natural and reflexive response is elicited by a learned stimulus e.g. woman who has undergone three session of chemotherapy becomes nauseated as she enters hospital for the fourth session….Its elements include

  • Unconditioned stimulus- something that produces response automatically without having to be learned e.g. odor of food.

  • Unconditioned response – natural reflexive behavior that does not have to be learned e.g. salivation in response to the odor of food.

  • Conditioned stimulus – Something that produces response following learning e.g. sound of the lunch bell

  • Conditioned response – learned behavior e.g. salivation in response to lunch bell


Operant – Behavior is determined by its consequence for the individual…The likelihood that behavior will occur is increased by reinforcements and decreased by punishment.
Positive reinforcement- introduction of positive stimulus that result in increased behavior.

Negative reinforcement- removal of averse stimulus that results in an increase in rate of behavior.

Punishment – introduction of averse stimulus aimed at reducing unwanted behavior.
More stuff….
Classic conditioning: person is put in relaxed state then shown that phobia isn’t harmful.

Biofeedback (operant conditioning): through process of operant conditioning, the person is given ongoing physiological information (e.g. b.p measurement), which acts as reinforcement when bp drops.
Low yield facts:

Averse conditioning: Pairs maladaptive but pleasurable stimulus with an averse or painful stimulus (e.g. shock) so that the two become associated…..eg used for paedophiles

Systemic Desensitization: increasing dose of fear- provoking stimulus are paired with a relaxing stimulus to induce a relaxation response.

Flooding: The person is exposed to actual (flooding) or imagined (implosion) overwhelming dose of the feared stimulus.

LEARNING THEORY

Classical Conditioning

&

Operant (Instrumental) Conditioning


Ivan Pavlov
Classical conditioning:

  • basic form of learning in which simple responses (e.g. salivation) are associated with a new or conditioned stimulus

  • forming an association between the neutral stimuli of the waiting room and the painful stimuli of immunizations or teeth drilling

  • now it’s the neutral stimuli that triggers the fear

Basic Findings:



  • Ivan Pavlov (1849-1936)

    • Unconditioned reflex: unlearned reflex, an association between the unconditioned stimulus and unconditioned response

    • Unconditioned stimulus: a stimulus that produces an unconditioned response in the absence of learning (food in mouth)

    • Unconditioned response: an unlearned response to an unconditioned stimulus (salivation)

    • Conditioned stimulus: a stimulus that becomes associated through learning with the unconditioned stimulus (i.e. tone- a neutral stimulus)

    • Conditioned reflex: the new assoc between the conditioned stimulus (the tone) and the unconditioned stimulus (sight of food) causing the conditioned response (salivation)

    • Conditioned response: a response (salivation) which is produced by the conditioned stimulus after a learning process

Pavlov’s apparatus:

-Diagram of the apparatus used by Pavlov for his study of conditioning with dogs (adapted from Yerkes & Morgulis, 1909)
Operant conditioning:


  • a form of learning in which behavior is controlled by rewards or positive reinforcers or by unpleasant or aversive stimuli

  • Can you think of any examples?

B.F. Skinner (1904-1990)



  • skinner believed that what we learn and how we behave in everyday life are both very heavily influenced by the conditioning experiences we have had throughout our lives

    • the training of circus animals

    • the treatment of PT’s suffering from various mental disorders: token economies

    • biofeedback


TOKEN ECONOMIES:

  • Here Pt’s who behave in desirable ways receive tokens which can be exchanged for various rewards

  • Token economies have proved useful in the treatment of Pt’s with schizophrenia or anti-social personalities

Basic findings:



  • skinner box for rates, showing chart recording of lever pressing.

Skinner: Schedules of Partial Reinforcement:



  • fixed ratio schedule

  • variable ratio schedule

  • fixed interval schedule

  • variable interval schedule

To recap….



  • learning is acquisition of new behavior pattern

  • method of learning include classical and operant conditioning

  • classical and operant conditioning are the basis of behavioral techniques, such as, systematic desensitization, aversive conditioning, flooding, biofeedback, token money and cognitive therapy.

Classical (Pavlovian) Conditioning

Behaviors are linked to external stimuli, and are likely to reoccur in the presence of those stimuli



  • Ex. Pavlov’s Dog

  • Ex. Fear of nurse and needles

  • Ex. Fear of white beards after being assaulted by a man with a white beard

Operant (Instrumental) Conditioning – behavioral responses occur more frequently or less frequently as a function of a pleasurable or noxious consequence


  • Ex. Touching a hot stove negatively reinforced

  • Ex. A man’s working out is positively reinforced by positive feedback from females

  • Ex. An individual who receives secondary gain by playing the sick role is more likely to take on the sick role


Some Learning Terminology

  • Reward

  • Operant

  • Superstitious conditioning;

  • Stimulus generalization

  • Extinction

  • Positive reinforcement

  • Negative Reinforcement

  • Systematic Desensitization

  • Aversive Conditioning

  • Successive Approximations/Shaping

  • Learned Helplessness


Learning Theory and Behavior

  • The principles of conditioning are clearly relevant to clinical medicine, and classical conditioning is especially important in the acquisition of physiological responses and behavioral responses

  • Behavior and physiology are intimately linked

  • maladaptive responses can lead to psychosomatic disease.

CLASSICAL CONDITIONING

  • A NATURAL OR REFLEXIVE RESPONSE IS ELICTED BY LEARNED STIMULUS AFTER REPEATED PAIRING OF NATURAL AND LEARNED STIMULUS

  • THE PAVLOVIAN EXPERIMENT PAIRED THE RINGING OF BELL WITH THE BRINGING OF FOOD SO THAT, EVENTUALLY, SOUND OF THE BELL ELICTED THE SALIVATORY RESPONSE, WHICH PREVIOUSLY OCCURRED ONLY AT THE SIGHT OF THE FOOD.

  • PATIENT RECEIVING CHEMOTHERAPY, WHICH INDUCES NAUSEA. EVENTUALLY, SIGHT AND SOUND OF THE HOSPITAL ALONE ELICIT NAUSEA.

  • 4 ELEMENTS OF CLASSICAL CONDITIONING.

Classical Conditioning

  • UCS

  • CS

  • UR

  • CR



CERTAIN FACTORS ASSOCIATED WITH CLASSICAL CONDITIONING
STIMULUS GENERALIZATION:

  • AN ORGANISM’S TENDENCY TO RESPOND TO SIMILAR STIMULI WITH SIMILAR RESPONSE.

  • A NEW STIMULUS RESEMBLING THE CONDITIONED STIMULUS CAUSES THE CONDITIONED RESPONSE

  • PATIENT ON CHEMOTHERAPY, MEETING THE PHYSICIAN OUTSIDE THE HOSPITAL CAUSES NAUSEA.

EXTINCTION

  • AFTER LEARNING HAS OCCURED , REMOVAL OF THE PAIRING BETWEEN THE UCS AND CS RESULTS IN DECREASED PROBABILITY THAT THE CONDITIONED RESPONSE WILL OCCUR

  • BREAKING THE PAIRING BETWEEN CHEMOTHERAPY AND THE HOSPITAL ANDMEDICAL SETTING BY GIVING CHEMOTHERAPY AT HOME

  • IF THE FOOD IS GIVEN WITHOUT RINGING THE BELL FOR A TIME

DISCRIMINATION:



  • THE PROCESS OF RECOGNIZING AND RESPONDING TO DIFFERENCES BETWEEN SIMILAR STIMULI

  • LEARNED OVER TIME


B. F. Skinner

OPERANT CONDITIONING

  • BEHAVIOR IS DETERMINED BY ITS CONSEQUENCES FOR THE INDIVIDUAL.

  • A BEHAVIOR THAT IS NOT A PART OF INDIVIDUAL NATURAL REPERTOIRE CAN BE LEARNED THROUGH REWARD AND PUNISHMENT

  • IN THE B. F. SKINNER EXPERIMENT, PRESSING THE LEVER RESULTED IN DELIVERY OF FOOD. AFTER RECEIVING FOOD, THE BAR PRESSING BEHAVIOUR INCREASED.

TYPES OF REINFORCER

A POSITIVE REINFORCER:

  • IS A STIMULUS THAT, WHEN APPLIED FOLLOWING AN OPERANT RESPONSE, STRENGTHENS THE PROBABILITY OF THAT RESPONSE OCCURING.

  • INCREASED PAY RESULTS IN INCREASED WORK BY THE EMPLOYEES

  • INCREASED COMPLAINING LEADS TO INCREASED ATTENTION FROM THE NURSING STAFF



A NEGATIVE REINFORCER:

  • IS THE STIMULUS THAT, WHEN REMOVED FOLLOWING A OPERANT RESPONSE, STRENGTHENS THE PROPABILITY OF RESPONSE OCCURING.

  • CHILD LEARNS THAT HE CAN STOP HIS PARENT NAGGING BY CLEANING UP THE ROOM

  • ACTIVE AVOIDENCE OF AN AVERSIVE STIMULI INCREASES DESIRED BEHAVIOR

  • AVERSIVE STIMULI SUCH AS LOUD NOISE, BRIGHT LIGHT, SHOCK CAN OFTEN BE NEGATIVE REINFORCERS.



PUNISHMENT:

  • BEHAVIOR IS DECREASED BY SUPPRESSION

  • LIKE NEGATIVE REINFORCEMENT USES A NOXIOUS STIMULI

  • PHYSICAL PUNISHMENT OF CHILD WILL SUPRESS NAUGHTY BEHAVIOR

  • DELIVERY OF AN AVERSIVE STIIMULUS DECREASES UNWANTED BEHAVIOR RAPIDLY BUT NOT PERMANANTLY.

EXTINCTION:

  • BEHAVIOR IS ELIMINATED BY NON REINFORCEMENT

  • CHILD STOPS HIS HITING BEHAVIOR WHEN BEHAVIOR IS IGNORED BY PARENTS

  • EXTICTION IS MORE EFFECTIVE THAN PUNISHMENT FOR LONG TERM REDUCTION OF UNWANTED BEHAVIOR

REINFORCEMENT SCHEDULES

CONTINOUS REINFORCEMENT:

  • EVERY RESPONSE IS FOLLOWED BY REINFORCEMENT (REWARD)

  • RESULTS IN FAST LEARNING

  • RESULTS IN FAST EXTINCTION WHEN REINFORCEMENT IS STOPPED

  • A TEENAGER RECIEVES A CANDY BAR EACH TIME SHE PUTS A DOLLAR INTO THE VENDING MACHINE. ONE TIME SHE PUT A DOLLAR IN AND NOTHING CAME OUT. SHE NEVER BUYS CANDY FROM THAT MACHINE AGAIN.



  • FIXED RATIO REINFORCEMENT:

  • DELIVERS REINFORCEMENT AFTER FIXED NUMBER OF RESPONCES

  • PRODUCES HIGH RESPONSE RATE

  • MAN IS PAID A CERTAIN AMOUNT FOR EVERY FIVE SHIRTS MADE. HE MAKES AS MANY SHIRTS AS POSSIBLE DURING HIS SHIFT




  • FIXED INTERVAL REINFORCEMENT:

  • DELIVERS REINFORCEMENT AFTER DESIGNATED PERIOD. IRRESPECTIVE OF AMOUNT OF WORK DONE.

  • THE RESPONSE RATE INCREASES TOWARDS THE END OF EACH INTERVAL

  • CRAMMING BEFORE THE EXAM OR WORKING EXTRA HARD BEFORE BONUS AT THE HOLIDAYS.



VARIABLE RATIO REINFORCEMENT:

  • DELIVERS REINFORCEMENT AFTER RANDOM AND UNPREDICTABLE NUMBERS OF RESPONSES

  • PRODUCES GREATEST RESISTANCE TO EXTINCTION

  • GAMBLING: A LARGE NUMBER OF RESPONSES MAY BE MADE WITHOUT A REWARD. SINCE ANY RESPONSE MAY BE A LUCKY ONE, PERSON KEEPS OM TRYING SLOT MACHINES

VARIABLE INTERVAL REINFORCEMENT:

  • DELIVERS REINFORCEMENT AFTER RANDOM AND UNPREDICTABLE TIME PERIOD

  • HIGH RESISTANCE TO EXTINCTION

  • HIGHER STEADY RATE OF RESPONDING

  • POP QUIZES OR SURPRISE BONUS AT WORK

  • FISHING

MODELING & OBSERVATIONAL LEARNING

  • WATCHING SOMEONE ELSE GET REINFORCED IS ENOUGH TO CHANGE BEHAVIOR

  • FOLLOWS THE SAME PRINCIPLE AS OPERANT CONDITIONING

  • CORRELATING THE EFFECTS OF WATCHING VIOLENCE ON TV WITH COMMITING VIOLENCE IN THE REAL WORLD STEMS FROM THIS CONCEPT

  • PARTLY WHY GROUP THERAPY WORKS

  • OTHER APPLICATIONS:

  • ASSERTIVENESS TRAINING

  • SOCIAL SKILLS TRAINING

  • PREPARING CHILDRENS FOR PAINFUL SURGICAL AND MEDICAL PROCEDURE.

BEHAVIORAL THERAPIES

THERAPIES BASED ON CLASSICAL CONDITIONING

SYSTEMATIC DESENSITIZATION:

  • USED TO TREAT ANXIETY AND PHOBIAS

  • INDIVIDUAL IS EXPOSED TO FRIGHTENING STIMULI IN INCREASING DOSE IN CONJUNCTION WITH RELAXATION TECHNIQUES.

  • WORKS BY REPLACING ANXIETY WITH RELAXATION


THERAPIES BASED ON CLASSICAL CONDITIONING

EXPOSURE (flooding or implosion):

  • SIMPLE PHOBIAS CAN SOMETIMES BE TREATED BY FORCED EXPOSURE TO THE FEARED OBJECT

  • EXPOSURE IS MAINTAINED UNTIL THE FEAR RESPONSE IS EXTINGUISHED

  • Exposed to actual (flooding) or imagined (implosion)

  • FEAR OF HIEGHT TREATED BY HAVING TO RIDE UP IN THE ELEVATOR


THERAPIES BASED ON CLASSICAL CONDITIONING

AVERSIVE CONDITIONING

  • OCCURS WHEN A STIMULUS THAT PRODUCES DEVIANT BEHAVIOR IS PAIRED WITH AN AVERSIVE ATIMULUS

  • USED IN TREATMENT OF ALCOHOLISM AND SEXUAL DEVIANCE

  • ALCOHOLICS ARE GIVEN NAUSEA INDUCING DRUG, DISULFIRAM, SO WHENEVER HE DRINKS, IT CAUSES NAUSEA, EVENTUALLY DRINKING GETS PAIRED WITH NAUSEA, AN UNPLEASENT EVENT.

  • THUMB SUCKING AND CHILLI PEPPERS

THERAPIES BASED ON OPERANT CONDITIONING

SHAPING:

  • ACHIEVES FINAL TARGET BEHAVIOR BY REINFORCING SUCCESSIVE APPROXIMATIONS OF THE DESIRED BEHAVIOR

  • REINFORCEMENT IS GRADUALLY MODIFIED TO MOVE BEHAVIORS FROM MORE GENERAL TO MORE SPECIFIC RESPONSES DESIRED.


THERAPIES BASED ON BOTH TYPES OF CONDITIONING

EXTINCTION:

  • DISCONTINUING THE REINFORCEMENT THAT IS MAINTAINING AN UNDESIRED BEHAVIOR

  • IF COMPLAINING RESULTS IN PATIENT RECEIVING LOT OF ATTENTION, STOPPING THE ATTENTION WILL EVENTUALLY STOP THE UNDESIRED BEHAVIOR

  • INSTITUTING A ‘TIME OUT’ WITH CHILDREN WHO ARE ACTING INAPPROPIATELY


THERAPIES BASED ON OPERANT CONDITIONING

STIMULUS CONTROL:

  • SOMETIMES STIMULI INADVERTENTLY ACQUIRES CONTROL OVER THE BEHAVIOR. WHEN THIS IS TRUE, REMOVAL OF THAT STIMULUS CAN EXTINGUISH THE RESPONSE

  • PERSON EATING BEHAVIOR IS TIED TO WATCHING TV. REDUCING THE TIME WATCHING TV SHOULD REDUCE THE AMOUNT EATEN.

  • INSOMNIAC IS PERMITTED IN HIS BED ONLY WHEN HE IS SO TIRED THAT HE FALLS TO SLEEP ALMOST AT ONCE.


THERAPIES BASED ON OPERANT CONDITIONING

FADING:

  • GRADUALLY REMOVING THE REINFORCEMENT WITHOUT THE INDIVIDUAL DISCOVERING THE DIFFERENCE

  • PROMOTING SMOKE CESSATION BY REDUCING THE NICOTINE CONTENT OF THE CIGARETTES GRADUALLY AND SILENTLY OVER A PERIOD OF TIME

  • GRADUALLY REPLACING POSTOPERATIVE PAINKILLERS WITH THE PLACEBO


BIOFEEDBACK

  • TECHNIQUE THAT ALLOWS A PERSON TO GAIN CONTROL OVER THEIR PHYSIOLOGICAL PARAMETERS SUCH AS, HEART RATE, BLOOD PRESSURE , TEMPERATURE, ETC

  • BIOFEEDBACK INVOLVES PROVIDING THE PERSON WITH THE INFORMATION ABOUT HIS INTERNAL RESPONSES TO STIMULI AND METHODS TO CONTROL OR MODIFY THEM.

BIOFEEDBACK

  • IT WORKS BY MEANS OF TRIAL AND ERROR LEARNING AND REQUIRES REPEATED PRACTICE TO BE EFFECTIVE.

  • MOST BIOFEEDBACK AFFECTS THE PARASYMPATHETIC SYSTEM

  • USES: HYPERTENSION, MIGRAINE, RAYNAUDS SYNDROME, ANXIETY, ETC.

Stanley Milgram’s Experiment: “Obedience and Individual Responsibility”: Defense based on “obedience” that they were just following orders of their superiors.


Bad Bloo: Tuskegee syphilis study: unethical


Psychoanalytic theory and ALL THE DEFENSE MECHANISMS!!!

Should be able to differentiate: some examples and asked what defense mechanism is showing:
Defense mechanism 6.2
Acting out – to get attention e.g. having multiple sexual partners after parent’s divorce.

Altruism- assisting others to avoid negative personal feelings e.g. social worker with poor self image helps out at the youth club on weekends.

Denial- not accepting aspects of reality that the person finds unbearable e.g. alcoholic insists that he’s only a social drinker

Displacement- moving emotions from a personally intolerable situation to one that is personally tolerable e.g. Surgeon mistreats female patients cos of unacknowledged anger towards his mother.

Dissociation- teenager has no memory of accident which killed his girlfriend and he was the driver.

Humor- A man concerned about his erectile dysfunction makes jokes about Viagra

Identification – a man terrorized by his gym teacher becomes a critical gym teacher.

Intellectualization – using mind’s higher function to avoid experiencing emotion e.g. medical student does extensive research on a patient’s condition before going to tell her about her illness.

Isolation- woman tells her family sad news about her cancer without showing any emotions.

Projection- a man who fancies his wife’s sister begins to accuse the wife of cheating.

Rationalization – Man looses one arm and says it was good cos it kept him from getting in trouble with the law.

Reaction formation- woman unconscious of child rearing overspends on the child

Regression – acting like a young child eg grown man asking for mummy before his operation, or 5 yr old child wets bed after mum has a new baby.

Splitting – categorizing of people or situations into fabulous or dreadful….seen in borderline personality disorder patients

Suppression – medical student studying for USMLE, mentally changes the subject when her mind wanders to the exam during a lecture.

Undoing – Believing that one can magically reverse past events caused by incorrect behavior e.g. HIV positive drug use patient stops using drugs, and starts exercise and healthful diet program.

DEFENSE MECHANISMS

• DEFENCE MECHANISMS ARE THE PRIMARY TOOL OF EGO, USED TO

MANAGE THE INTERNAL CONFLICTS BETWEEN DEMANDS OF ID AND

RESTRICTION OF SUPEREGO. THEY ARE THE MEANS BY WHICH THE EGO

WARDS OFF ANXIETY AND CONTROL INSTINCTIVE URGES AND

UNPLEASENT AFFECTS(EMOTIONS).
ALL DEFENCES ARE UNCONCIOUS

• REPRESSION, PUSHING UNACCEPTABLE EMOTIONS INTO THE

UNCONSCIOUS, IS THE BASIC DEFENSE MECHANISM ON WHICH ALL

OTHER ARE BASED

• MAINLY DIVIDED INTO FOUR TYPES:

– NARCISSTIC

– IMMATURE

– NEUROTIC

– MATURE
NARCISSISTIC DEFENSE

MECHANISM

USED BY CHILDREN AND PSYCHOTIC

ADULTS
PROJECTION

• PERSON ATTRIBUTES HIS OWN PERSONALLY

UNACCEPTABLE FEELINGS TO OTHERS

• ASSOCIATED WITH PARANOID SYMPTOMS

AND PREJUDICE

– MAN WHO HAS COMMITED ADULTRY BECOMES

CONVINCED THAT HIS WIFE IS HAVING A AFFAIR

EVEN THOUGH THERE IS NO EVIDENCE OF THAT.

– A GIRL TALK ABOUT HER DOLL HAVING CERTAIN

FEELINGS, WHICH ARE REALLY WHAT THE GIRL

FEELS.

-a man with unconscious homosexual impulses begins to believe that his boss is homosexual


DENIAL

• NOT BELIEVING ASPECTS OF REALITY

THAT PERSON FINDS UNBEARABLE

– AFTER SURVIVING A HEART ATTACK, A

PATIENT INSISTS ON CONTINUING HIS

LIFESTYLE AS IF NOTHING HAD

HAPPENED.

– A CHILD WHO IS ABUSED INSISTS THAT

SHE HAS BEEN TREATED WELL.

-an alcoholic insists that he is only a social drinker


SPLITTING

-categorizing people or situations into categories of either “fabulous” or “dreadful” b/c of intolerance of ambiguity

PEOPLE AND THINGS IN THE WORLD

ARE PERCIEVED AS ALL GOOD OR ALL

BAD.THE WORLD IS PICTURED IN

EXTREME TERMS.

• SEEN IN PATIENT WITH BODERLINE

PERSONALITY DISORDER

– THIS DOCTOR IS MIRACLE WORKER BUT

THAT DOCTOR IS TOTALLY INCOMPETENT

– ‘HE IS JUST SO PERFECT AND

WONDERFUL ” SAYS A TEENAGE GIRL IN

LOVE.

IMMATURE DEFENSES

USED BY ADOLESCENTS, DEPRESSIVE,

OBSESSIVE AND COMPULSIVE

INDIVIDUALS

-A patient tells the doctor that while all of the doctors in the group practice are wonderful, all of the nurses and office help are unfriendly and curt


BLOCKING

• TEMPORARY OR TRANSIENT BLOCK IN

THINKING OR INABILITY TO REMEMBER

• BLOCKING IS DISRUPTIVE AND

EMBARRASING.

– AS STUDENT IS UNABLE TO RECALL THE FACTS

NEEDED TO ANSWER THE QUESTIONS ,

ALTHOUGH HE RECALLS THEM AS HE WALKS

OUT OF THE EXAM.

– IN THE MIDDLE OF CONVERSATION, A WOMEN

PAUSES, LOOKED CONFUSED, AND ASKS ‘WHAT

WAS I JUST TALKING ABOUT”
REGRESSION

• RETURNING TO EARLY STAGE OF

DEVELOPMENT

• REGRESSION IS COMMON WHEN PEOPLE

ARE TIRED, ILL OR UNCOMFORTABLE

– A PATIENT LIES IN A BED CURLED UP IN A FETAL

POSITION

– A HUSBAND SPEAKS TO HIS WIFE IN ‘BABYTALK’

– ENURESIS IN PREVIOUSLY TOILET TRAINED

CHILD FOLLOWING BIRTH OF A SIBLING

-a 5 year old child who was previously toilet-trained begins to wet the bed when his mother has a new baby


SOMATIZATION

• PSYCHIC FEELINGS ARE CONVERTED INTO

BODILY SYMPTOMS

• EXTREME FORMS ARE SOMATIZATION ARE

DIAGNOSED AS SOMATOFORM DISORDERS

• SYMPTOMS ARE PHYSICALLY REAL AND NOT

IMAGINED

– GETTING HEADACHE WHILE TAKING EXAM

– FEELING NAUSEATED BEFORE ASKING SOMEONE

OUT ON THE DATE
INTROJECTION

(IDENTIFICATION)

• FEATURES OF EXTERNAL WORLD AND

PERSONS ARE TAKEN IN AND MADE

PART OF SELF.

• INTROJECTION IS WHY CHILDRENS

ACT LIKE THEIR PARENTS

– A RESIDENT DRESSES AND ACTS LIKE

THE ATTENDING PHYSICIAN

– A TEENAGER ADOPTS THE STYLE AND

MANNERISMS OF A ROCK STAR.
ANXIETY OR NEUROTIC DEFENSE

MECHANISMS

SEEN IN ADULTS UNDER STRESS
DISPLACEMENT:

Moving emotions from a personally intolerable situation to one that is personally tolerable

• CHANGING THE TARGET OF AN EMOTION

OR DRIVE.

• PHOBIAS ARE RESULT OF DISPLACEMENT

– A MAN WHO IS ANGRY AT HIS BOSS POUNDS ON

HIS DESK RATHER THAN TELLING HIS BOSS

HOW HE FEELS

– AN ATTENDING PHYSICIAN SCOLDS A RESIDENT

WHO LATER EXPRESSES HIS ANGER BY YELLING

AT THE MEDICAL STUDENT

-a surgeon attending with unacknowledged anger toward his mother is abrasive to the female residences on his service


REPRESSION

• AN IDEA OR FEELING IS ELIMINATED FROM

CONSCIOUSNESS.

• CONTENTS ARE USUALLY NOT

RECOVERABLE WITHOUT SOME TRAUMA OR

PSYCHOANALYSIS

– A MAN WHO SURVIVED 6 MONTHS IN

CONCENTRTION CAMP CANNOT RECALL

ANYTHING ABOUT HIS LIFE DURING THAT TIME

PERIOD

– A CHILD WHO WAS ABUSED BY HER MOTHER

AND WAS TREATED FOR ABUSE, NOW HAS NO

MEMORY OF ANY MISTREATMENT BY HER

MOTHER.
ISOLATION OF AFFECT

• REALITY IS ACCEPTED, BUT WITHOUT THE

EXPECTED HUMAN EMOTIONAL RESPONSE TO

THAT REALITY.

• THE BLAND AFFECT OF SCHIZOPHRENICS, LA

BELLE INDIFFERENCE SEEN IN CONCERSION

DISORDER IS MAINIFESTATION OF THIS

MECHANISM.

– A CHILD WHO HAS BEEN BEATEN DISCUSSES THE

BEATING WITHOUT ANY DISPLAY OF EMOTIONS

– A PATIENT WHO HAS HAD A FINGER SEVERED IN

AN ACCIDENT DESCRIBES THE INCIDENT TO HIS

PHYSICIAN WITHOUT ANY EMOTIONAL REACTION

-without showing any emotion, a woman tells her family the results of tests which indicate that her lung cancer was metastasized


INTELLECTUALIZATION

• AFFECT IS STRIPPED AWAY AND REPLACED BY AN

EXCESSIVE USE OF INTELLECTUAL PROCESS

• INTELLECT IN PLACE OF EMOTION

• OBSESSIVE COMPULSIVE ANXIETY DISORDER IS

BASED ON THIS MECHANISM

– A PHYSICIAN TELLS THE PATIENT ABOUT HIS

POOR PROGNOSIS AND TALKS A GREAT DEAL

ABOUT THE TECHNICAL ASPECTS BY WHICH

PROGNOSIS WAS DERIVED

– A SAILOR WHOSE BOAT IS ABOUT TO SINK

EXPLAINS THE TECHNICAL OF THE HULL

DAMAGE IN GREAT DETAILS TO ANOTHER CREW

MEMBERS.
ACTING OUT

• MASSIVE EMOTIONAL OR BEHAVIORAL OUTBURST

TO COVER UP UNDERLYING FEELING OR IDEA

• AVOIDING PERSONALLY UNACCEPTABLE EMOTIONS

BY BEHAVING IN ATTENTION GETTING OFTEN

SOCIALLY INAPPROPRIATE MANNER

• COMMONLY SEEN IN BODERLINE AND ANTISOCIAL

PERSONALITY

– WHISTLING IN THE DARK HIDES THE REAL UNDERLYING

FEAR

– A DEPRESSED 14 YEAR OLD GIRL WITH NO HISTORY OF

CONDUCT DISORDER HAS SEXUAL ENCOUNTERS WITH

MULTIPLE PATNERS AFTER HER PARENTS DIVORCE
RATIONALIZATION

• RATIONAL EXPLANATIONS ARE USED TO

JUSTIFY ATTITUDES, BELIEFS OR

BEHAVIORS THAT ARE UNACCEPTABLE.

• USE TO RELIEVE GUILT AND SHAME

• OFTEN ACCOMPANIES OBSESSIVE

COMPULSIVE BEHAVIOR

– YES, I BELIEVE KILLING IS WRONG BUT I KILLED

HIM BECAUSE HE DESERVED IT

– A MAN WHO IS UNFAITHFUL TO HIS WIFE

BELIEVES THAT THIS AFFAIR WILL MAKE HIM

APPRECIATE HIS WIFE MORE

-a man who loses an arm in an accident says the loss of his arm was good b/c it kept him from getting in trouble with the law


REACTION FORMATION

• AN UNACCEPTABLE INPULSE IS

TRANSFORMED INTO ITS OPPOSITE

• FIND IN MANY ANXIETY DISORDER

– A STUDENT WHO ALWAYS WANTED TO BE A

PHYSICIAN EXPRESS RELIEF AND SAYS ‘THIS IS

A BEST NEWS I EVER HEARD’, AFTER NOT BEING

ACCEPTED TO A MEDICAL SCHOOL.

– A TEENAGER BOY INTRIGUED BY ‘DIRTY

PICTURE’ ORGANIZES AN ANTIPORNOGRAPHY

COMPAIGN.
UNDOING

• ACTING OUT REVERSE OF THE

UNACCEPTABLE FEELINGS

• SEEN IN OBSESSIVE COMPULSIVE

DISORDER

– A MAN WHO IS SEXUALLY AROUSED BY A

WOMEN HE MEETS IMMEDIATELY LEAVES

AND BUYS FLOWERS FOR HIS WIFE

– SUPERSTITIONS SUCH AS ‘KNOCK ON

WOOD’ AFTER WISHING SOMEONE WELL

-a woman who is terminally ill with AIDS caused by drug abuse, stops using drugs and alcohol and starts an exercise and healthful diet program


PASSIVE AGRESSIVE

• NONPERFORMANCE OR POOR

PERFORMANCE AFTER SETTING UP THE

EXPECTATIONS OF PERFORMANCE.

• OFTEN USED BY BODERLINE PERSONALITY

DISORDER AND YOUNG CHILDRENS

– A STUDENT AGREES TO SHARE CLASS NOTES

BUT GOES HOME WITHOUT SHARING THEM

– A PHYSICIAN IGNORES OR DOES NOT ANSWER

QUESTIONS OF THE PATIENT THAT HE FINDS

ANNOYING.

• THE FEELINGS OF HOSTILITY ARE

UNCONCIOUS AND THE PERSON USING THE

DEFENCE IS GENERALLY UNAWARE OF THEM
DISSOCIATION

• SEPERATING SELF FROM ONE’S

EXPERIENCE.

• IN EXTREME FORMS , BECOMES

DISSOCIATIVE DISORDER, FUGUE STATE,

AMNESIA AND IDENTITY DISORDER.

– A WOMAN WHO WAS RAPED REPORTS THAT IT

WAS AS IF SHE WAS FLOATING ON THE CEILING

AND WATCHING IT HAPPEN

– THE SURVIVOR OF AN AUTOMOBILE ACCIDENT

TELLS OF THE FEELING THAT EVERYTHING

HAPPENED IN SLOW MOTION

MATURE DEFENSE MECHANISMS

USED BY NORMAL ADULTS

-a teenager has no memory of a car accident in which he was driving and his girlfriend was killed


ALTURISM

• ASSISTING OTHERS TO AVOID

NEGATIVE PERSONAL FEELINGS

• UNSELFISHLY ASSISTING OTHERS

• A WOMAN WHO HAS A BREAST

CANCER LEADS A SUPPORT GROUP

FOR OTHER WOMENS WITH BREAST

CANCER

-a man with a poor self-image, who is a social worker during the week, donates every other weekend to charity work


HUMER

• EXPRESSING PERSONALLY

UNCOMFORTABLE FEELINGS WITHOUT

CAUSING EMOTIONAL DISCOMFORT

– A MAN LAUGHS WHEN HE IS TOLD HE IS

GOING TO FIRED

– A TERMINALLY ILL CANCER PATIENT

MAKES FUN OF HIS CONDITION

• LAUGHTER COVERS PAIN AND

ANXIETY
SUBLIMATION

• IMPULSE GRATIFICTION IS ACHIEVED

BY CHANNELING THE UNACCEPTABLE

IMPULSES INTO SOCIALLY

ACCEPTABLE DIRECTIONS

– AN EXECUTIVE WHO IS ATTRACTED TO A

FEMALE ASSOCIATE BECOMES HER

MENTOR AND ADVISOR

– A MAN WHO GOT INTO FIGHTS

REGULARLY AS A TEENAGER, GROWS UP

TO BECOME A PROFESSIONAL FIGHTER.
SUPPRESSION

• DELIBERATELY PUSHING PERSONALLY

UNACCEPTABLE EMOTIONS OUT OF

CONSCIOUS AWARENESS

• ONLY DEFENCE MECHANISM THAT USES

SOME ASPECT OF CONSCIOUSNESS.

– A STUDENT DECIDES TO FORGET ABOUT THE

PENDING EXAM TO GO OUT AND HAVE A GOOD

TIME FOR AN EVENING

– A TERMINALLY ILL CANCER PATIENT PUTS ASIDE

HIS ANXIETY ANS ENJOY FAMILY GATHERING.

-a medical student taking a review course for the USMLE, mentally changes the subject when her mind wanders to the exam during a lecture




Sample q’s by Dr. Gall

Name Piaget’s Stages of Cognitive development?

Sensorimotor (0-2 years)

Preoperational (2-7 years)

Concrete (7-11 years)

Formal (11- End of adolescence)


What is the law of conservation and which stage is it seen?

This law states that the child becomes to the realization that changing the shape does not alter the quantity of the object: seen in CONCRETE STAGE.


In which stage is a child said to be egocentric?

Preoperational


In which tanner stage are breast buds seen?

Tanner stage 2


A midlife crisis may lead to?

A change in profession or lifestyle

Infidelity, separation, divorce

Increase use of alcohol or drugs

Depression

SAMPLE Q’S USED IN CLASS BY DR. OMAR

  
  Topic: Defense Mechanisms


  
  
  Answer Choices:
  A. Undoing
  B. Splitting
  C. Projection
  D. Denial
  E. Reaction Formation
  F. Isolation of Affect
  G. Displacement
  H. Acting Out
  I. Introjection
  J. Regression
  
  
  Statements/Answers
  1. Alcoholic claims he is simply a social drinker --> D
  2. A resident begins to dress like his/her attending --> I
  3. An abused child throws a temper tantrum --> H
  4. Two co-workers constantly bicker, but in reality, have feelings for each other --> E
  5. The day is nurse is very good, but the night nurse is horrible --> B
  6. Man cheating on his wife suspects his wife is also cheating on him without any evidence --> C
  7. Person angry with boss pounds his desk rather than talk to his boss --> G
  8. Child pees his bed when he's ill --> J
  9. A beaten child is able to discuss his experiences without any emotion --> F
  
  

Then Freud’s theory: toprogialh and

Super ego, ego: what’s the difference between superego and ego,

What the difference is between conscious, unconscious

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