HD 3700 1st Edition Lecture 20 Outline of Last Lecture I Anxiety disorders II PTSD III Trauma and the self IV Psychotherapy V Medicating Anxiety Anxiolytics what they are how they work VI Approaching the play within the play Outline of Current Lecture What is psychological health I What is healthy functioning II Varieties of Jan III Approaching the idea of personality disorders Current Lecture I What is healthy functioning The experiential approach to diagnosis o Life is divided into 3 categories Love Work Play o We all have a number of rigid patterns that we can t get ourselves out of these might interfere with achieving our needs wants in love work play Object relations theory o Refers to the internal world where there are representations of the self in relation to representations of the object These inner images may or may not accurately express objects as they actually exist in the real world We have representations of everyone we know that may or may not be accurate The more you need someone you have the greatest opportunity to get to know someone but you also often project onto them Hamlet is projecting all kinds of things onto his mother because he is angry with her o o o o Intimacy always involves dependency Think of healthy functioning as the degree to which you project distortions onto other people These projections can be idealizing or demonizing or just wrong Splitting the internal person is experienced as all good or all bad 4 year olds do this but at this age it is normal I hate you mommy I love you mommy These projections are common with religion race etc i e search Muslims at the airport Cultures have to face their projections Black is beautiful movement Nazi s projection of blacks Jews as an inferior species II Levels of Jan Mainstream heterosexual Cornell graduate Love friends parents family romantic partner Work career mentor skills performance Play weekends substance use vacations Mild Jan o Jan has mild levels of disturbance or conflict Very few people are as un conflicted as this Jan Graduates from Cornell works as a paralegal goes to Columbia law school gets a job at a law firm in litigation Law firm works 80 hour weeks makes a lot of money Jan s strength is his writing Feels like his boss doesn t like his work doesn t get enough praise Has problems over the weekend relaxing because he s so hyped up from work Jan has a girlfriend in advertising graphic design and he really likes that He had a bad breakup in law school this is the first person he s met since then At a point where they re starting to join their lives might have children Pretty close to his parents mother is lawyer father is mathematician gets frustrated by dad who dismisses what he s doing as not being meaningful argue about the purpose of life Jan s mom has always idealized him a bit o This is mildly disturbed Jan Able to form good relationships Clear about career Gets insecure about work if it s not perfect Effective in job A bit afraid of commitment in his relationship with gf Has good relationships with parents for the most part Really unimpeded in love work and play His projections are manageable Moderate Jan o At Cornell a little wild part of a frat with money cocaine and drinking GPA was fine has some best friends from Cornell he still speaks to o Went to law school Buffalo Albany did well in law school buckled down made law review and got hired at a legal firm works very hard but a bit insecure about his work was criticized for being too cocky at first hard for him to forget that comment o Has a girlfriend he s known since Cornell never seemed like the right person but can t break up with her she will do anything he wants because she needs him turbulent relationship never clear what each of them wants or needs lurking question can I do better this relationship doesn t feel healthy gf has periods where she s really low and where she is hyper on vacation they drink a lot and come back exhausted o Mother is judgmental when he has setbacks she gets really cold o Dad is professor who tries to connect with Jan but doesn t know how to o Jan feels slightly uncomfortable around his parents gets drunk with dad and they are able to communicate better o This is moderate Jan Sees himself as someone who might fail Also grandiose at times Representation of gf is she good enough for the great Jan or the weak that goes with the insecure Jan His representations of himself are not clear Troubled relationships with his parent which he s internalized Relationships with boss and girlfriends there is a fair amount of projection Severe Jan o At Cornell drinking a lot hung out with a bunch of guys who partied one of them overdosed they came from troubled wealthy family they are doing okay never really had a gf hooked up a lot graduated with a 3 2 o Went to Brooklyn Law worked pretty hard after the first year he got a job at a firm but they asked him to leave got a job at a lesser firm is given more leeway and is pretty good at the stuff he does but leaves everything to the last minute will try to work but he can t because he feels anxious irritable o Has a gf but she lives in Chicago and they see each other a few times a month he cleans up for her because he thinks she s great she doesn t know that he suffers a lot during the week alcohol and takeout and dragging himself to work o He has a good friend who told him to go to AA but he thinks that s a stupid idea o Parents split up in high school hasn t spoken to him for a while because he thinks he s a jerk mother suffers o On vacation with friends he s just plastered the whole time o Jan Self representations hates himself but sometimes feels good about himself when he succeeds at work Cannot be spontaneously in touch with his own intelligence feels like his admission to Cornell was a mistake Spends a lot of time ruminating Projects every task is a test of his intelligence Relationship doesn t have a lot of content she s very driven He needs to be in therapy he s intelligent verbal Personality Disorder Jan o Representations are split and very disturbed o Needs therapy that helps them to restructure their representations o At Cornell took a medical leave took another o Lives with his mother very turbulent angry relationship with mom wants to punch her afterwards he weeps uncontrollably after dropping out of college she would tell him to leave then let him sit on her lap his father had served jail time for 3rd DUI had been an attorney now does business that is