HD 3700 1st Edition Lecture 10 Outline of Last Lecture I. Projectives and Self-ReportsII. “Joe’s” Psych Testing ReportIII. Shedler and Defensive Mental HealthIV. Class DataOutline of Current LectureI. Projectives and Self-ReportsII. Guide to the PrelimCurrent LectureI. Projectives and Self-Report- How do we diagnose someone? - What is psychologically healthy?o Be able to separate internal thoughts from external realityo Having access to a full range of emotionso Be able to tolerate anxietyo To feel that you can face difficult thingso Feel that your mood is matching your life—not experiencing life through adepressed / bipolar lenso 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 Testo Self Report CES-Depression BDI—Beck Depression Inventory Rosenberg Self-Esteem Inventory DEQ—Dissociative Experiences Questionnaire MMPI—Minnesota Multiphasic Personality Inventory- 567 items, normed on clinical and normal populationso 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 inkblotso 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 unconsciouso 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 scoreso 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)o 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 BDIo This is the group self-report measures will miss He found the limits of self-report measuresII. 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 dreamso Freudian developmental theoryo “The Laughing Man”- Part 3: Freudian Neurosis and signal anxietyo “Fat Lady”- Part 4: assessment and diagnosis –the Reader chapter on psychological testingo Westen’s article on Freudo Shedler on defensive mental healtho Class Assessment Data- How to prepareo Review each section of Freud, make sure you understand the mechanism he is explaining, be familiar with his major exampleso Go over your notes from lectureso Review the readings “Laughing Man”, “Fat Lady”, Shedler, Reader chapter on testingo Review the main findings from the class assessment data- Sample Questionso 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 affairo It’s said the dreamer is always the last to know—explain using Freud’s understanding of dreamworko How do projective tests relate to Freud’s theory of the mind?- Questions?o The dynamic mind: levels/layers of consciousnesso 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 ofyou that is associating at the unconscious level and it forces itself to the surface The mind is layered, consciousness is layeredo 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 anxietyattached 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 itselfo 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 symptomso 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