A Lexicon of Psychology, Psychiatry and Psychoanalysis

Jessica Kuper, Jessica Kuper

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317387169
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Originally published in 1988, this volume provides a broad and eclectic view of psychological theory, methods and practice, covering not only the main branches of academic psychology but also psychiatry, psychoanalysis and other psychotherapies. Although some research and practices will inevitably have moved on, it will still be an ideal companion for students and a useful work of reference for mental health professionals, and indeed for anyone interested in contemporary scientific thinking about the human brain, mind and personality.

Pain

Pain research and therapy have long been dominated by specificity theory, which proposes that pain is a specific sensation subserved by a straight-through transmission system from skin to brain, and that intensity of pain is proportional to the extent of tissue damage. Recent evidence, however, shows that pain is not simply a function of the amount of bodily damage alone, but is influenced by attention, anxiety, suggestion, prior conditioning, and other psychological variables (Melzack and Wall, 1982). Moreover, the results of neurosurgical operations which cut the so-called pain pathway – a natural outcome of specificity theory – have been disappointing, particularly for chronic pain syndromes. Not only does the pain tend to return in a substantial proportion of patients, but new pains may appear. The psychological and neurological data, then, refute the concept of a simple, straight-through pain transmission system.

In recent years the evidence on pain has moved in the direction of recognizing the plasticity and modifiability of events in the central nervous system. Pain is a complex perceptual and affective experience determined by the unique past history of the individual, by the meaning of the stimulus to him, by his ‘state of mind’ at the moment, as well as by the sensory nerve patterns evoked by physical injury or pathology.

In the light of this understanding of pain processes, Melzack and Wall (1965) proposed the gate-control theory of pain. Basically, the theory states that neural mechanisms in the dorsal horn of the spinal cord act like a gate which can increase or decrease the flow of nerve impulses from peripheral fibres to the spinal cord cells that project to the brain. Somatic input is therefore subjected to the modulating influence of the gate before it evokes pain perception and response. The theory suggests that large-fibre inputs tend to close the gate while small-fibre inputs generally open it, and that the gate is also profoundly influenced by descending influences from the brain. It further proposes that the sensory input is modulated at successive synapses throughout its projection from the spinal cord to the brain areas responsible for pain experience and response. Pain occurs when the number of nerve impulses that arrives at these areas exceeds a critical level.

Melzack and Wall (1982) have recently assessed the present-day status of the gate-control theory in the light of new physiological research. The theory is clearly alive and well despite considerable controversy and conflicting evidence. Although some of the physiological details may need revision, the concept of gating (or input modulation) is stronger than ever.

The subjective experience of pain has well-known sensory qualities, such as burning, shooting and sharp. In addition, it has a distinctly unpleasant, affective quality. It becomes overwhelming, demands immediate attention, and disrupts ongoing behaviour and thought. It motivates or drives the organism into activity aimed at stopping the pain as quickly as possible. On the basis of these considerations, Melzack and Casey (1968) proposed that there are three major psychological dimensions of pain: sensory-discriminative, motivational-affective, and cognitive-evaluative. Recent physiological evidence suggests that each is subserved by a physiologically specialized system in the brain. Recognition of the multidimensional nature of pain experience has led to the development of a paper-and-pencil questionnaire (the McGill Pain Questionnaire) to obtain numerical measures of the intensity and qualities of pain (Melzack, 1975).

Many new methods to control pain have been developed in recent years (Melzack and Wall, 1982). Sensory modulation techniques such as transcutaneous electrical nerve stimulation and ice massage are widely used in the attempt to activate inhibitory neural mechanisms to suppress pain. Psychological techniques have also been developed which allow patients to achieve some degree of control over their pain. These techniques include biofeedback, hypnosis, distraction, behaviour modification, and the use of imagery and other cognitive activities to modulate the transmission of the nerve-impulse patterns that subserve pain. A large body of research demonstrates that several of these techniques employed at the same time – ‘multiple convergent therapy’ – are often highly effective for the control of chronic pain states, particularly those such as low back pain which have prominent elements of tension, depression and anxiety.

Ronald Melzack

McGill University

References

Melzack, R. (1975), ‘The McGill Pain Questionnaire: major properties and scoring methods’, Pain, 1.

Melzack, R. and Casey, K. L. (1968), ‘Sensory, motivational and central control determinants of pain: a new conceptual model’, in D. Kenshalo (ed.), The Skin Senses, Springfield, 111.

Melzack, R. and Wall, P. D. (1965), ‘Pain mechanisms: a new theory’, Science, 150.

Melzack, R. and Wall, P. D. (1982), The Challenge of Pain, Harmondsworth.

See also: nervous system.

Paranoid Reactions

Paranoid reactions are a group of pathological responses to emotional stress. They may stand alone, be mixed with other psychopathological states, and even be found in everyday life.

The core of the paranoid reaction is the psychological defence of projection. The essence of this defence is the attribution to the external world of those wishes, impulses, feelings and thoughts that are unacceptable to the individual, though emerging from within him. For example, a person experiencing unacceptable hostility towards other people may project (attribute outward) this feeling and believe himself to be the object of hostility or persecution from without.

These reactions, like many mental symptoms, have a restitutive function; that is, they serve a reparative purpose in the mental economy of the individual. An example might be a person suffering from intolerable depression through loneliness, who may project his wish for company in a disguised way by viewing himself as the object of a great deal of attention (though not necessarily benign attention) from others, thus: ‘The FBI is following me everywhere, tapping my phone, reading my mail and sending signals through the TV.’ As this last example shows, paranoid reactions may become extreme and elaborate, encompassing hallucinations and delusions, which may occasionally be grandiose.

The example also hints at a very common form of paranoid reaction, the false belief that one is the subject of an interaction that has no actual relation at all to oneself; formally, this delusion that a neutral event refers to oneself is termed an ‘idea of reference’. Other hallmarks of paranoid reactions are suspicion, mistrust, and guardedness of manner, understandable as reflections of a person’s mistrust of his own feelings, projected onto others.

Thomas G. Gutheil

Harvard University

Program in Psychiatry and Law, Boston

Further Reading

Freud, S. (1911), ‘Psychoanalytic notes upon an autobiographical account of a case of paranoia’, Collected Papers, Volume III, ed. J. Strachey, London.

Knight, R. (1940), ‘The relationship of latent homosexuality to the mechanism of paranoid delusions’, Bulletin of the Menninger Clinic, 4.

Waelder, R. (1951), ‘The structure of paranoid ideas’, International Journal of Psychoanalysis, 32.

Parapsychology

Parapsychology in general is concerned with paranormal events – events which cannot be explained according to the usual laws of science. Such events range widely, from the Lochness monster to UFOs (unidentified flying objects), astrological predictions and ghosts. However, the term parapsychology is usually employed in a rather more limited sense, to refer to four major phenomena. These are: (1) telepathy: the acquisition of information about another person, at a distant place, by means not involving the known senses or logical inference; (2) clairvoyance: similar to telepathy, clairvoyance involves the acquisition of information about an object or event, rather than a person; (3) precognition: this refers to a similar kind of information acquisition, but of information which will only exist in the future, such as knowledge about a person’s death two weeks ahead, or an accident to take place in the future; (4) psychokinesis: the influence of the human mind, by direct action of will, on another person, or event, not mediated by any physical force yet known.

Spontaneous parapsychological phenomena have been reported over centuries, but in the nature of things are hard to submit to scientific scrutiny. This is due to the impossibility of treating the data statistically. A person may dream that a particular horse would win the Derby, or a particular team the cup final; if the horse, or the team, actually succeeds, this might be interpreted as indicating precognition. However, it is not known how many people may have dreamed about the wrong horse, or team, coming out in front, nor do we know much about the actual probability of the given horse, or team, winning. Such stories are intuitively convincing to some people, but have no scientific value. Another difficulty is that such stories are usually only publicized after the event; there is no guarantee that the dream predicting the event actually happened. It would require written notification before the event in order to take the dream seriously as evidence of precognition.

Such reports do exist. Consider the Aberfan disaster in 1966, when 128 children and adults died in a cataclysm, a coal tip sliding down the mountain side and engulfing a South Wales mining town. A number of people reported precognitively, and in the presence of witnesses, having had dreams or other premonitions accurately describing the disaster. Many other authenticated cases have been described in the literature, making spontaneous parapsychological events acceptable to scientific study.

Much more convincing scientifically would of course be experimental evidence collected in the laboratory. The first to do this on any large scale was an American biologist, Joseph Banks Rhine, who started the first parapsychological laboratory at Duke University. Most of his work was done using packs of twenty-five cards, each bearing one of five different symbols (circle, star, wavy line, plus sign and square). Subjects were asked to guess the symbol on each card, under many different kinds of conditions. The probability of guessing correctly is of course one in five, and it is possible statistically to evaluate the chances of guessing at a higher rate than that. Conditions of testing might be with the experimenter looking at a given card, and the subject guessing (telepathy); or the stack of cards lying in front of the subject, but with no one looking at the faces of the cards, and the subject calling out the sequence (clairvoyance). In precognition trials the subject might have to call out the sequence of the twenty-five cards, as this would be after shuffling; having recorded the subject’s calls, the experimenter would then shuffle the cards, and compare the resulting sequence with the calls made by the subject before the shuffle. There are many combinations and subtle changes in these procedures, but on the whole there is much evidence that extra-chance results can be obtained, particularly by a small number of specially gifted subjects.

Psychokinesis was tested by Rhine and his associates by means of a dice, either thrown by the experimenter or in an automatically revolving box. Subjects would try to influence the dice to come at either with a high or a low (6 or 1) number, and again the data published in the literature suggest that extra-chance results have been obtained in many cases. These data might be called the direct evidence in favour of parapsychological events, also sometimes called ESP (extrasensory perception), or PSI.

There are indirect types of evidence showing phenomena predictable from well-known psychological laws. Thus it has been found that a general tendency exists for scoring rates in all these types of test to decline over time; in other words, a kind of fatigue effect. Motivational factors have been shown to be important, as has personality and attitude. Extroverts tend to do better than introverts, and people who believe in the existence of PSI tend to do better than people who disbelieve it.

A tremendous amount of research has been done since the days of Rhine’s early pioneering work, and much of this has been concerned with devising automating procedures and making them foolproof. Thus, to take one example, Helmut Schmidt generated random targets, registered subject’s guesses and recorded all relevant data in a computerized manner. The radioactive decay of the isotope strontium-90 was used to generate random targets for use in PSI-testing, and with the help of his machine Schmidt showed that many people were able to guess when such emissions would or would not take place. The completely automatic nature of the data-gathering and analysing precluded any accidental or wilful errors which might have caused departures from chance.

Critics of parapsychological beliefs have pointed out the ever-present possibility of fraud, the lack of foolproof laboratory procedure that always generates positive data; the possibilities of errors in transcription and analysing; the difficulties inherent in statistical analysis of such data; and the apparent waxing and waning of the parapsychological abilities of even the best subjects. Recent advances have overcome many of these criticisms, and there is now no doubt about the statistics used by parapsychologists, the experimental controls exerted, or the abolition of errors through automation. Fraud is an ever-present danger in all scientific experiments, and there certainly have been cases where fraud has been proved to have occurred in parapsychological experiments. However, it seems unlikely that hundreds of well-known scientists, with a reputation to consider, would risk their good standing in order to fabricate meaningless data, or intentionally defraud the public. On this point, of course, every student of the subject must decide for himself.

H. J. Eysenck

Institute of Psychiatry

University of London

Further Reading

Eysenck, H.J. and Sargent, C. (1982), Explaining the Unexplained, London.

Pavlov, Ivan Petrovich (1849–1936)

The great Russian physiologist and founder of the study of conditioned reflexes, I. P. Pavlov, was the great-grandson of a freed serf and son and grandson of village priests. His sixty-two years of continuous and active research on what he came to call ‘Higher Nervous Activity’ profoundly and immutably altered the course of scientific study and conceptualization of the behaviour of living organisms, and for the first time established appropriate contact between philosophical empiricism and associationism and laboratory science. The young Pavlov won a gold medal for his second experiment (‘The nerve supply of the pancreas’), one of eleven publications before his graduation in 1879 from the Imperial Medico-Surgical Academy in St Petersburg. After completing his doctoral dissertation (‘Efferent nerves of the heart’) in 1883, he was appointed lecturer in physiology, spent two years in postdoctoral research with Ludwig in Leipzig and Haidenhain in Breslau, became professor of pharmacology in the Academy and director of the Physiological Laboratory of the new St Petersburg Institute of Experimental Medicine in 1890, and, in 1895, professor of physiology in the Academy. In 1924 he was appointed director of a new Institute of Physiology, created by the Soviet Academy of Sciences especially for his burgeoning research enterprise. He remained in this post until his death, in Leningrad, in 1936.

Pavlov was fifty-five when in 1904 he won the Nobel Prize for his work on neural regulation of digestive secretion — the first given to a Russian and to a physiologist. A special surgical technique he developed during this period, the Pa...