Adult Psychological Problems

An Introduction

Lorna Champion,Michael Power

• Publisher: Taylor & Francis
• Year: 2014
• ISBN:
  9781135481407
• Edition: 2
• Topic: Education
• Subtopic: Education General

First published in 2000. Provides an introductory overview of a range of influential theories and treatment approaches to the main psychological problems experienced in adulthood.

CHAPTER ONE

Models of psychological problems: An overview

Mick Power

Department of Psychiatry, University of Edinburgh, UK

Lorna Champion

Department of Clinical Psychology, Royal Edinburgh Hospital, UK

INTRODUCTION

What is “psychology”? Not only is it a difficult word to spell, but it is also a difficult word to define. The problem, as we shall see, is that the definition depends on the view of psychology to which you subscribe. For example, the behavioural approach might define psychology as the “study of behaviour” whereas, in contrast, a cognitive psychologist might define psychology as “the science of mental life”. It is possible of course that a full definition might have to incorporate all of these elements such as in the definition “the science of behaviour and mental life…”. Although the focus of the present book is on adult psychological problems, the different views about psychology are reflected in the different approaches to and models of these disorders. However, for most disorders it seems likely that no particular model is sufficient in itself, but a number of models may need to be integrated together in order to provide a full account of the problem.

So why are you interested in psychology? When asked this question early in their studies, most psychology students do not report a burning interest in visual perception in the frog, or a fascination for vestibular balance mechanisms in the guinea pig. Instead, they say that they may have read something about Freud and found it interesting, or that a friend or relative had psychological problems, or even, in the more honest and insightful cases, that they were aware of personal problems that they hoped psychology would address. Catch the same students a few years later, however, and either they will tell you that Freud is not worth a jot because he is not a scientist and that their heroes are now people with strange names whom nobody has ever heard of but who are doing wonderful things with the caudate nucleus (wherever that is!), or, alternatively, they will say that psychology had nothing to offer them personally, which is why they are now joining a leading advertising firm in The City. Between these extremes, however, we believe that psychology does have something to offer on both a personal and a scientific level. The purpose of this book is to demonstrate both of these sides of psychology—the personal and the scientific—and to show how the various theories and therapies can contribute to our understanding of the problems that can beset us all during our adult lives.

Psychology is a very strange subject. Like politics and religion there are as many opposing views as there are psychologists. Unlike politics and religion, no wars have yet been started in the name of psychology. Nevertheless, battles are waged daily throughout the civilised psychological world in books, academic journals, lecture rooms, and conference halls between the supporters of opposing approaches to psychology. As will be evident from the contents of their chapters, some of the contributors to this volume have clearly identified which side they are on, Cavalier or Roundhead, the righteous or the infidel. We believe, however, that each approach has something to offer, has something of value, has good theoretical constructs and bad theoretical constructs, has good practitioners and bad practitioners.

To return to the question of what psychology is, the student who comes from a scientific background will be shocked, even disturbed, by the lack of incontrovertible fact, by the contradictory nature of the theories, and by the importance of opinion and choice. The student from an arts background will be thrown by numbers and statistics, the use of computers and animals. In order to examine the question therefore of “What is psychology?”, we must first examine the question “What is science?” in order to understand some of the disagreements. In so doing, we will see that two views of science can be identified: first, the traditional view taught in schools, which emphasises fact, experiment and measurement and which has had a strong influence on behavioural psychology, and, second, a modern view of science, which emphasises subjectivity, unpredictability, and non-deterministic processes. This modern view is more compatible with Cognitive Psychology.

WHAT IS SCIENCE?

The traditional view of science emphasises a number of basic principles, which have proven of great value in the history and development of science. In fact, 19th-century scientists thought that they had answered all of the major problems of science and that only the details were left to be filled in: witness the achievements of Newton’s mechanics, thermodynamics, Darwin’s theory of evolution, and so on. The basic principles on which these developments were considered to depend are outlined in the following points.

Observation and fact. Facts are observable measurable properties of the world: Tigers are indigenous to India; the eye is sensitive to light: water freezes at 0 degrees centigrade. A large part of any science therefore is the routine accumulation of facts and observations; thus, the modern computer can store a vast number of facts about weather conditions, star positions, activity in a bubble chamber, or amino acid sequences in proteins. Of course, even traditional science was aware that “facts” do not always turn out to be what they appear to be. The earth was originally thought to be flat because it looked flat, besides which if it wasn’t flat you would fall off the edge; then astronomers discovered that the earth was round. Later on we learned that the earth was not perfectly round but flattened at the poles; finally, science told us that in fact the earth is geoid-shaped (i.e. the fact is the earth turns out to have been “earth-shaped” all along!).

Description and classification. If science only consisted of observation and fact, it would turn out to be like one long boring gossip session with little meaning or use. “Have you heard that water consists of hydrogen and oxygen?” “No, really!” “Two parts hydrogen, what’s more!” “Get away.” Instead, the next step is finding the appropriate level of description which can be meaningfully included in a classification system. For example, Linnaeus’ classification of living things provided a magnificent taxonomy that helped to advance biology; the appropriate level of description seems relatively straightforward in that individual plants or animals provide the lowest level of description, which, in turn, can be grouped together at more general levels (species, phyla, etc.). Classification systems may nevertheless contain surprises that are counter to common sense: Whales are animals, tomatoes are fruit.

A second example of a classification system that had powerful predictive properties was Mendeleev’s periodic table which provides a meaningful classification of chemical elements. The original Greek classification of the four “elements”— earth, air, fire, and water—proved to be an inappropriate one for science in that each of these so-called “elements” was divisible into more basic elements in the way that salt is divisible into the elements sodium and chlorine. The power of Mendeleev’s system, which classified elements by atomic weight, was that it revealed gaps or missing elements which had not been discovered at that time, but which have subsequently been discovered.

Theory and hypothesis. Theories group together facts and descriptions in a way that provides an overall working model relevant to the domain in question. A good theory, in the philosopher Karl Popper’s terms, is both useful and falsifiable; thus, a good theory should generate hypotheses that may be novel and surprising and that can be tested in artificial or “natural” experiments. For example, Einstein’s theory of relativity predicted that light would bend in a gravitational field, a prediction that was dramatically upheld when the light from a distant source was shown to bend as it passed the sun.

Popper and others used his notion of falsifiability to argue that certain “theories” such as psychoanalysis are not scientific theories at all because they are not falsifiable. Whatever happens in the rest of science, theories in psychology are rarely if ever rejected because of evidence to the contrary, but rather they go out of fashion. We will return however to Popper’s allegations about psychoanalysis later in the chapter.

Experiment. Hypotheses derived from scientific theories may be tested in artificial and natural experiments in order to decide whether or not the experimental outcome is that predicted by the hypothesis. Experiments have to be carefully designed in order to be sure that the variable that the experimenter manipulates is truly the one that leads to differences in the variable that is measured. If the experimental outcome is due to some other confounding variable rather than the one that is manipulated, then the experiment is invalid. Psychology experiments on human subjects are notoriously difficult because what the subject thinks the experiment is about can be more important that what the experimenter thinks the experiment is about. In addition, many of the advances in psychology and medicine come not from experiments in which the experimenter manipulates one or more variables, but rather from “experiments of nature” such as road traffic accidents, strokes, life events, and natural disasters, the tragic consequences of which can provide insights into how the mind works.

The modern view of science (see Penrose, 1989) does not reject the role of facts, measurement, observation, hypothesis, classification, and experiment, but it does point to some severe limitations which draw modern science and modern psychology closer together. To begin with, let us take the building blocks of science, that is, “facts” or “observations”. These holy objects have the status of absolute truths in traditional science, but modern science has emphasised their possible subjective nature and the role that inference as well as observation plays in making a fact a fact. For example, our sensory experience tells us the “fact” that the sun rises in the East and sinks in the West. The fact is, however, that it is not the sun that rises and falls, but the earth that rotates on its axis. Every schoolchild knows about the existence of electrons, protons, and neutrons, but nobody has ever observed these particles directly. Instead, it is both useful and necessary to infer their existence from other observations such as pathways in a bubble chamber.

Traditional science has emphasised prediction and control in deterministic systems, that is, the idea that outcomes are always knowable if all of the initial conditions are known. In contrast, modern science emphasises unpredictability and non-deterministic systems. Even at the atomic level, Heisenberg’s uncertainty principle tells us that we cannot know both the position of an electron and its momentum, because the measurement of one affects the other; at best all we can do is make probabilistic statements about what might or might not happen. In a similar manner in psychology we can study the rules that people use to construct sentences and participate in conversations but we can never determine what any speaker will say on any particular occasion. Meteorologists face similar problems even for short-term weather predictions and may gain public notoriety for the extent of their inaccuracy, as when the British meteorologist Michael Fish’s immortal words “there will not be a hurricane tonight” were followed by the worst storm in 200 years! The problem faced by the complex systems that meteorologists and psychologists study is that very small differences in initial conditions can make a considerable difference to outcome: The developments in so-called “chaos” or “catastrophe theory” in the physical sciences demonstrate vividly how even simple systems can have unpredictable outcomes (see e.g. Gleick, 1988).

The moral of this tale for psychology is that both the traditional and the modern views of science have their advantages and disadvantages. Behavioural and experimental psychologists have focused on observation and measurement and, as we shall see, have made considerable contributions to our understanding of the laws of learning and the acquisition and treatment of a range of behavioural disorders. However, many psychoanalytic and cognitive psychologists have come to emphasise the importance of subjective factors and how they influence an individual’s thoughts and actions. The focus in psychoanalysis on factors that are both subjective and unobservable does not imply that psychoanalysis is unscientific, contrary to what some psychologists and philosophers would have us believe. The aim of this book is to demonstrate how each approach to psychology has something to offer for our understanding of psychological disorders. In the next section, therefore, the basic principles of psychoanalysis, behaviourism, and cognitive psychology will be outlined, and in a subsequent section the relationship between psychology and biological and social models will also be examined.

THREE APPROACHES TO PSYCHOLOGY

In this section three key approaches to psychology will be outlined each of which has had a general impact on the theory and treatment of adult psychological disorders. These three areas are psychoanalysis, behaviourism, and cognitive psychology. The purpose of the section is to provide the key concepts for each approach without covering too much detail about specific applications. The specific applications of these and other approaches will be provided in subsequent chapters.

Psychoanalysis

The key figure in the development of psychoanalysis was Sigmund Freud (1856–1939). Freud’s early career was as a neurologist; he invented the gold chloride method of staining nervous tissue, he was almost the first to discover the use of cocaine as a local anaesthetic, he published a book on aphasia and coined the term “agnosia” (the inability to name objects), and was one of the world’s leading authorities on childhood paralyses, all before the age of 40! He even at the age of 21 spent a summer dissecting male eels in order to search for their apparently elusive gonads, an early sign perhaps of his later interests. The general point, however, is that Freud was very much a scientist working in a scientific tradition and it was this scientific rigour that he brought to psychoanalysis. In fact, one of his early unpublished works called “Project for a Scientific Psychology” (1895/1966) outlined a set of scientific principles which in many ways provided the basis for the subsequent developments in psychoanalysis. Unfortunately, he became disillusioned with the Project, left the manuscript with his friend Wilhelm Fliess, and never asked for it back.

In order to understand the basic concepts that underpin psychoanalysis, an outline of the following will be provided: the unconscious, psychic energy, repression, developmental stages, transference and countertransference, and the free association tech...

Table of contents

• Front Cover
• Half Title
• Title Page
• Copyright
• Contents
• List of contributors
• Series preface
• 1 Models of psychological problems: An overview
• 2 Depression
• 3 Anxiety
• 4 Drug and alcohol dependence
• 5 Eating disorders
• 6 Obsessive-compulsive disorder
• 7 Couple and sexual problems
• 8 Family problems
• 9 Schizophrenia
• Author index
• Subject index