HD 3700 1st Edition Lecture 10 Outline of Last Lecture I Projectives and Self Reports II Joe s Psych Testing Report III Shedler and Defensive Mental Health IV Class Data Outline of Current Lecture I Projectives and Self Reports II Guide to the Prelim Current Lecture I Projectives and Self Report How do we diagnose someone What is psychologically healthy o Be able to separate internal thoughts from external reality o Having access to a full range of emotions o Be able to tolerate anxiety o To feel that you can face difficult things o Feel that your mood is matching your life not experiencing life through a depressed bipolar lens o Whose mood is much a response to the world as it is to their own thoughts How does the therapist diagnose a client o Projective measures Rorschach Inkblot Test what do the blots look like TAT Thematic Apperception Test stories are elicited by photos and pictures Draw a Person Test Early Memories Test Narrative Completion Test o Self Report CES Depression BDI Beck Depression Inventory o o o o o Rosenberg Self Esteem Inventory DEQ Dissociative Experiences Questionnaire MMPI Minnesota Multiphasic Personality Inventory 567 items normed on clinical and normal populations A psychologist comes to do a testing what s in her bag IQ test Weschsler Adult Intelligence Scale MMPI yes no questions computer scored Hamilton Depression Rating Scale structured interview TAT projective pictures that prompt narratives Rorschach Test projective series of inkblots Why the objective wing hates projectives Patients don t answer them the same way Their data can t be easily quantified The data only captures one moment in time Data can be misinterpreted over interpreted by the tester Used by psychodynamic clinicians who rely on out moded ideas of the unconscious Why projective hates objective Patients are forced to answer complex questions on a 4 or 7 point rating scale Patients can t refine the questions or qualify their answers The data doesn t convey anything idiosyncratic or personal about the patients That data relies on the patient to be truthful It is uses by cognitive behavioral clinicians who measure success by lower numbers on self report depression scores The Rise of the Objective Wing 50 s and 60 s the projective wing ruled psychology Cognitive revolution in the 70s began to build an empirical understanding of the mind The rise of the objective wing has led to Rejecting the use of projective tests and not teaching them to new clinical students Leaving Freud out of the curriculum Emphasizing only objective tests Teaching only empirically validated manualized psychotherapy techniques An emphasis on the here and now as opposed to an interest in the childhood of patients and their unconscious Shelder s Answer to the Objective Wing His aim to show empirically the limits to self report depression measures specifically BDI Data BDI score Physiological measures of stress Early Memories Test scored by clinicians then by students Main findings For many subjects low BDI low stress positive memories For some subjects high BDI high stress negative memories For a subset low BDI high stress negative memories This third group is displaying Defensive Mental Health o Couldn t recognize their depression on BDI o This is the group self report measures will miss He found the limits of self report measures II What the Prelim will look like Made up of 4 sections each worth 25 points Part 1 Brief identification questions from readings Part 2 You will choose two short answer questions from each of these 3 topics o Freudian slips and dreams o Freudian developmental theory o The Laughing Man Part 3 Freudian Neurosis and signal anxiety o Fat Lady Part 4 assessment and diagnosis the Reader chapter on psychological testing o Westen s article on Freud o Shedler on defensive mental health o Class Assessment Data How to prepare o Review each section of Freud make sure you understand the mechanism he is explaining be familiar with his major examples o Go over your notes from lectures o Review the readings Laughing Man Fat Lady Shedler Reader chapter on testing o Review the main findings from the class assessment data Sample Questions o Explain signal anxiety and apply it to Freud s case about the woman who could not rid herself of the idea that her husband was having an affair o It s said the dreamer is always the last to know explain using Freud s understanding of dreamwork o How do projective tests relate to Freud s theory of the mind Questions o The dynamic mind levels layers of consciousness o Slips of the tongue Freud s revolutionary idea was taking them seriously because they were intrusions into our unconscious mind Conflict Conflict between what you re going to say and the part of you that is associating at the unconscious level and it forces itself to the surface The mind is layered consciousness is layered o Dreamwork Our only experience of the unconscious directly Our best glimpse into the unconscious Freud dreamwork is a mental mechanism that takes thoughts you re having while asleep takes them and illustrates them in a way that both disguises and expresses those thoughts through condensation or displacement or distortion Freud by creating the dream you re not woken up by the anxiety attached to these thoughts When you associate you can work your way back to the dream thoughts this is the latent content The manifest content is the dream itself o Neurotic Symptoms Traumatized then later you develop hysterical symptom Freud found that that symptoms symbolized the earlier trauma The same way that the dream content is symbolic to the dream thought Bringing the trauma to consciousness through associations relieves the symptoms o The developmental model the drives According to Freud s model we a fundamentally rewarded by pleasure if we do things that are evolutionarily adaptive Nursing feels good so babies do not die Sex feels good allows us to procreate and create familial bonds to enable us to raise children We are aggressive animals by nature certain pleasure in dominating other species people who look different from us Freud says we have civilization because we learn to sublimate these drives Taboos in various cultures promote sublimation incest murder etc o Psychosexual stages Must civilize children the way humans civilized themselves over time Teach to sublimate their drives o Fat Lady o o Counter transference Therapist irrational when it comes to women who are overweight Hoping he ll get