Yes, we skipped chapter 13 on purpose. We will be doing chapter 14 and 15. We will be watching Zimbardo today. He did an interview with Jon Stewart. There's one on youtube or Comedy Central. His book is called <i>Satan Effect</i>, and it's about the treatment of prisoners. Zimbardo was the guy who did the Stanford prison experiment. Today he will be going over the category of diseases and how they are related. He talks about a bunch of stuff that we will not bring up again, but be expected to know. 

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1-800-LEARNER<br /><br />

Discovering Psychology with Philip Zimbardo<br /><br />

"I don't think anybody can help me. [Have you felt like this before]?"

Schizophrenia, agoraphobia, depression, these are just a few of the ways in which the brain can turn itself again. Because we can love, we can be jealous, because we can remember the good, we can remember the bad, because we can think about the future, we can think about the uncertainities. There is one side of the psychological coin that mocks the other. Psychopathology is the study of mental disorders, or clinically significant psychological syndrome or pattern, that occurs in an individual, associated with painful symptoms or impairments in important areas in functioning. Several long-term studies show that 20% of Americans suffer from some recently diagnosed mental disorder, that's tens of millions of people in the U.S. alone. These statistics may underestimate the problem. If we are going to help people with mental disorders, how are we going to help them? We have to classify mental problems. Their problems have to be clearly abnormal. Some aspect of their mental functioning must be off-base. We must analyze, observe, diagnostic tasks, reports from people, etc.

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Mental health specialists are trained to make these judgments, such as clinical psychologists, psychiatricists, medical doctors, psychoanalysts (Freudian techniques in their therapy), they then determine what criteria are met by an individual: are they suffering, working against well-being, creating discomfort? Other criteria come into play with more severe disorders: schizophrenia (irrationality, unpredictable, extremely unconventional), the key here is a matter of degree: how often and how much behavior matches these parameters. We need to classify because knowing what type of disorder a person has, helps us plan an appropriate treatment. Second, for legal reason, some courts may use psychiatric assessment to assess competence. Third, for research purposes, to evaluate treatments and to work with psychopathology. And for economic reasons: so that we can do health payments. 

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Madness has been part of the human condition since the very beginning. Some prehistoric skulls had holes, primitive attempts to release demons from the brain. Previously, people thought that mad people were just animals and not worth it. It was not until the 18th century that people with psychiatric problem were finally seen as 'sick'. "Mental ill, far from people deserving punishment, are sick people ... suffering humanity." Such enlightement was rarely shared. The label of madness was given to anybody who challengd the status quo. In more recent times, Soviet dissidents were medically treated. Blacks were said to suffer from sensory disease, which made them insesisitive from disease when being punished, rapidomania -- the obsession to seek fredom.

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Mental illness is a myth -- mere excuses to oppress people, people who violate social norms. There is no underlying mental illness. Zas. Jaz? Something like that. A provocative suggestion: what's normal and what isn't? A different kind of criticism has been levelled by David Rosenhan. A group of colleagues gained admission into hospitals. We said that we heard voices. And they said "empty thud foot". The moment we were admitted to the hospital, we abandoned the symptom and behaved normally. This was dehumanizing. Nobody talks with you. Nobody touches you. There was 6 and a half minutes of contact per day. Nobody comes to visit. There was 41 times the first time. My wife constituted 4 of the 7 visitors over the weekend. Psychiatric hospitals are storehouses for people in society whom you really don't want, who you really don't understand, and for whom you have lost a great deal of sympathy. The question was: would anybody detect that we were insane? Nope. We were discharged with paranomia schizophrenia in remission. In remission does not mean the same thing as "sane". Is it inevitable for patients to be treated that way? Staff constantly need to be reminded, and it's hard to remind them. They need to be reminded that the people who are their charges, are not just collections of symptoms, they are people with spouses, children, jobs, mortgages and bills to pay, that they are in the fullest sense of the word: fully human, and fully inhappy.

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Anybody can be diagnosed as mentally ill, depending on the situation. Mental disorders are not figments of imagination, however. There is real suffering involved. Three of the major types account for 25 million cases in the U.S. alone: anxiety (phobias), affective disorders (disturbance in mood: depression, mood), and schizophrenic disorders. <br /><br />

Anxiety disorders have three common symptoms: arousal (heart, respiration, muscle tightness), feeling of tension, tremors and shaking, and intense apprehension that something bad is about to happen. Our anxieties become phobias when we suffer persistent and irrational fears of specific situations. This fear is completely out of proportion of the real danger. The most common and crippling fear is agoraphobia, the extreme fear of public spaces and open spaces. Between 3 and 6 million people (mostly adult women) suffer from agoraphobia. For a solid year, I continued to have massive panic attacks, could not speak, mutter my name, there was no way to convey to another human being what was happening to me.

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There is no specific phobic object as a focus of fear in anxiety attacks. You feel like your whole system is about to shut down. Any moment you were about to fall over and die. It was the most frightening thing that anybody could go through.

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While some researchers think that it is organically based, Freud thought that a narotic individual thought that people were not resolving infantile conflicts that had been previously repressed. There is no clear dividing line between the narotic, normal and so on, in Freud's ideas, it's just a degree.

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Affective disorders, from which the great dutch painter Vincent Vango, was a great record of the illness, extreme elation, deep depression, during a manic episode people are full of optimism and taking needless risks and promising everything. Almost always, a manic person also gets drained of energy and has feelings of sadness, guilt and failure, and suicide becomes more likely. Most depressed people do not kill themselves. Depression has been characterized as the common cold of psychopathology: it is experienced by almost everyone. An individual may require drug therapy or hospitalization. Depression accounts for the majority of admissions into mental hospitals. The majority of people suffering from clinical depression never get treatment at all. Neurosis is not used for affective or chronic disorders, because it is too general and too imprecise, but on the other hand it is understood by many other people.

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Psychosis is another factor. As this artwork shows, people with psychotic disorders show, people suffer from losing touch with reality, they require intensive treatment and often hospitalization. A major subclass of psychotic disorders is schizophrenia, full-blown madness. Less than a third improve with treatment. Half are sick on and off throughout their lives, and the other half never improve. The symptoms include delusions of grandeur, intense jealousies and so on. Language is often used in strange ways. Thoughts are unconnected it, and personality degrades. 

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Psychological and biological approaches.

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Fuller Torrey -- bio theory -- Schizophrenia is just like Alzheimer, Parkison's, Asperger's, etc. This is a disease like diabetes, it is simply a disease of the body, except the brain is a part of the body that is affected. One biological factor is genetics. Genes that are passed on in some families can cause neuro problems. Hormonal imbalances.
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The psychological approach assumes psychosocial variables, and that the key relies in personal experiences, trials and conflicts, and among those that stress psychological factors, there's Hans Strup at Vanderbilt University. He does not think that psychosocial variables cannot be unrelated to schizophrenia. Various people see this as a complex interaction between many factors, such as genetics, hormones, the brain, psychosocial stresses, disorders, such as University of Virginia and the genetics of schizophrenic twins, and he thinks there's a path. Irving Gottesman. But we couldn't fill in the details. This is one of the early sets of twins, with more of the more marked differences on the ventricle. Gottesman is collaborating with somebody, at St. Elizabeth's Hospital in Washington DC. What is there about the brain of a schizophrenic twin that is different from his or her identical co-twin, where the co-twin does not have schizoprhenia? We are bringing 60 sets of twins from all over North America. In 30 sets, there's one with schizophrenia, the other 30 there's both schizophrenics, and then some controls, etc. In identical twins, and when one does not, whatever the disease is that the one has, is by definition nongenetic, because they start off with the same genes. <font color="red">Yes, but what about expression factors?</font>

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These two twins came for an intense week of brain MRI, blood tests, indepth interviews with the staff, these tests were taken during the tests at the hospital, their parents were also interviewed about their childhood. One new technique is caled "<b>spect-analysis</b>" -- the way the blood flows through the brain, when working on different types of problems. They are seeing on a TV screen various different problems that they have to solve differently, and then we see different blood flows and we record this with this device. In those twins, in which one is schizophrenic and the other is not, in every case we have actually seen differences in the brain, especially in the MRI. We see the person who has schizophrenia will have larger ventricles to the brain. The ventricles are the spaces in the brain carrying the fluid. The normal twin has normal ventricles, these are normal, there is no loss of brain tissue, on the other hand, they are as twice as large, s twice as large as the well twin, meaning that some brain tissue has been lost, and the fluid has been expanded. Something has gotten in the brain and changed the structure of the brain, that's part of the disease with schizophrenia. Genes are very important in the vast majority of cases. They are not enough by themselves to produce these devastating forms. There have to be environmental factors: psychological, biological, genetic-expressional, ... having a severe viral infection, influenza, automobile accident with concussions, LSD, PCP, other kinds of street drugs (which are not recommended), these could be enough to push you over a threshold.

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interactionist approach

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Psychopathology cultural factors. Teresa La Framboise. The major issue is the influence of American culture. The clash of American culture on other cultures. Indian people have been forcibly removed, cross-country, their children have been removed in order to assimilate them, some people have been removed from their homelands, three times in a lifetime, most of the problems in any community in terms of psychological problems are in terms of depression and alienation, and with rampant poverty and high unemployment rates (80%) and underachievement in terms of education, there's just not a lot happening and not a lot of hope that things will help get better. 

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Mental illness may be influenced by personal factors, cultural factors, psychosocial, psychological, biological, genetic, there's suffering. In our next show, we will focus on how that suffering can be alleviated by psychotherapy: pills, electroshocks, verbal modification, groups or individually, usually this is the only chance for people to overcome the problems : psychotherapists, the healers of the mind. 


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In the past, whatever illness you had, it was either your fault, your parent's fault, or you were a sinner, demon possessed, malformed and you had to be killed. Most mental illnesses are directly tied to brain biochemistry and neurosci. It's just an imbalance. 


Zoloft<br />
Effector<br />
Zanax<br />
They make these appealing so that, ideally, people with the disorder will go get checked out, but ... the people with disorders are not likely to get it. <br />
Intern's disease<br />


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One in three people have a mental disorder? Wait, how accurate is this anyway? That's nearly 50%. So how is that useful?

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Movie night - the 7th - next Monday.

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Girl Interrupted<br />
One Flew Over the Cocoo's Next<br />
The Secretary - a cutter? spanking?<br />
The Aviator<br />
Mania - young man with bipolar disorder, process of being institutionalized<br />

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Disabilities Accomodation Act - if they can perform the job, then yes, but if they have an impairment, <br /><br />


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