HD 3700 1st Edition Lecture 20Outline of Last LectureI. Anxiety disordersII. PTSDIII. Trauma and the selfIV. 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 JanIII. Approaching the idea of “personality disorders”Current LectureI. What is healthy functioning?- The “experiential” approach to diagnosiso 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 theoryo 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 Intimacy always involves dependencyo Think of healthy functioning as the degree to which you project distortions onto other peopleo 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”o These projections are common with religion / race etc.  i.e. search Muslims at the airporto Cultures have to face their projections “Black is beautiful” movement Nazi’s projection of blacks/Jews as an inferior speciesII. Levels of “Jan”- Mainstream, heterosexual Cornell graduate- Love: friends, parents/family, romantic partner- Work: career, mentor, skills/performance- Play: weekends, substance use, vacations- Mild Jano 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’sdoing as not being meaningful, argue about the purpose of life, Jan’s mom has always idealized him a bito 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 Jano 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 too 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 buta bit insecure about his work, was criticized for being too cocky at first, hard for him to forget that commento 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 exhaustedo Mother is judgmental, when he has setbacks she gets really coldo Dad is professor who tries to connect with Jan but doesn’t know how too Jan feels slightly uncomfortable around his parents, gets drunk with dad and they are able to communicate bettero 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 Jano 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 3.2o Went to Brooklyn Law, worked pretty hard, after the first year he got a jobat 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 everythingto the last minute, will try to work but he can’t because he feels anxious/irritableo 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 ideao Parents split up in high school, hasn’t spoken to him for a while because he thinks he’s a jerk, mother sufferso On vacation with friends he’s just plastered the whole timeo 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 Jano Representations are split and very disturbedo Needs therapy that helps them to restructure their