Psychodynamic approach to schizophrenia PDF

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Amelia Hallsworth Using your own knowledge, analyse and evaluate the psychodynamic explanation of schizophrenia [10] Freud based his own explanation of schizophrenia around Daniel Paul Schreber, a German judge who was diagnosed with schizophrenia. Freud read Schreber’s memoir he wrote whilst in a psychiatric hospital, Freud never met with, or talked to Schreber so his theory cannot be entirely scientific. During the oral stage of psychosexual development, the libido receives satisfaction from stimulation of the lips and mouth. Most of the time the libido’s urges are satisfied by feeding from the mother’s breast. However, if an infant receives too much or too little oral stimulation during this phase, they may become fixated. Freud proposed that individuals with schizophrenia become fixated. Freud proposed that individuals with schizophrenia become fixated during the first one to two months of the oral stage of development. As an adult, most people satisfy any oral desires through activities such as kissing, smoking, chewing gum, etc. However is, as an adult, an individual experiences excessive amounts of stress the individual may indeed regress back to the oral stage. Regression is an ego defence mechanism which causes the ego to retreat back to an earlier stage. This may just be temporary or may continue over the long term. During the oral stage the ego is not well developed. The role of the ego is to control the id’s impulses and to try to balance the demands of the id with the moral limitations imposed by the superego. However if an individual regresses back to a point where the ego effectively doesn’t exist, there is nothing stopping the id from operating completely unimpeded. Symptoms of schizophrenia, such as hallucinations and delusions, then supposedly represent the unchecked activities of the id. The person supposedly represent the unchecked activities of the id. The person loses touch with reality, being unable to distinguish between reality and their desires and fantasies. This state is little better than that of a newborn infant, and as such the individual with schizophrenia is typified by the primary narcissism seen in all newborns. Whereas well-adjusted adults have well-developed egos that set limits on fantasy activity, this is not the case in adults with schizophrenia. Psychodynamic theorists consider the mother-child relationship to be one of the crucial factors in the development of schizophrenia. Freida Fromm-Reichmann (1948) wrote ‘ The schizophrenic is painfully distressful and resentful of other people due to the severe early warp and rejection he encountered in important people in his infancy and childhood, as a rule mainy in a schizophrenogenic (schizophrenia causing) mother.’ This concept proposes that the mothers of individuals who develop schizophrenia are overprotective and controlling, yet rejecting and distant. The mother’s overprotection stifles the child’s emotional development, while her emotional distance deprives the child of personal security, thereby leaving an individual who is very vulnerable when faced with stress. Freudian concepts are out of date. In the first half of the 20th century, psychology was dominated by psychodynamic explanations. However, as the century progressed, psychologists became dissatisfied with the unscientific, unfeasible nature of psychodynamic concepts. The psychodynamic approach has difficulty producing testable hypotheses, which has meant that the explanation it offers for disorders like schizophrenia is now viewed as being little more than an interesting historical footnote. If we cannot demonstrate the existence of the basic

Amelia Hallsworth psychodynamic concepts such as id, ego and superego, therefore we cannot trust psychodynamic concepts to explain the existence of complex disorders. As Freud himself notes at the end of the monograph he wrote about Schreber, ‘It remains for the future to decide whether there is more delusion in my theory than I should like to admit.’ From the start, Freud believed that individuals with schizophrenia were not suitable candidates for psychoanalysis, as many individuals with schizophrenia lacked insight necessary for this talking treatment. Later psychodynamic researchers, such as John Rosen (1947), proposed that schizophrenia could indeed be treated with psychoanalytical techniques. However, research (Strupp, 1977) found that psychoanalytical therapies actually can lead to deleterious and harmful, rather than beneficial effects in those with schizophrenia. This may be because psychoanalytic techniques often require the patient with schizophrenia to experience memories and insights that they are emotionally incapable of dealing with, and trying to do so is distressing for the patient. Ultimately this suggests that if an effective therapy cannot be established from the theory, then the underlying principles of the explanation has no merit. Although the idea of the schizophrenogenic mother was quite a popular concept from the 1940s to the 1970s, the research base on which it resides is, at best, tenuous. Early research included one study by Jacob Kasanin et al. (1934). He examined hospital case records and reported that he has found evidence of maternal overprotection in 33 out of 45 cases of schizophrenia. This means that almost a third of the cases didn’t have an overprotective mother, making it rather unconvincing evidence. Furthermore his judgments may have been biased as he was not ‘blind’ to the hypothesis and may have lacked objectivity. Psychodynamic explanations suggest that the development of schizophrenia is the consequence of early experience, therefore a problem of nurture. However, there is strong evidence of biological factors in schizophrenia, for example dopamine levels. Evidencealso comes from the adoption studies. For example, Leornard Heston (1966) reported on the diagnoses for schizophrenia in 47 adoptees who had a biological mother with a diagnosis of schizophrenia and 50 adoptees who did not have a biological mother with schizophrenia. Heston found that 10.6% of those who had a biological mother with schizophrenia were also diagnosed with schizophrenia, whereas 0% of those who did not have a biological mother with schizophrenia had also been diagnosed. This suggests that it might be the co-occurrence of shared genes between mother and child, rather than how the mother raises the child, that is responsible for schizophrenia. In conclusion, the psychodynamic approach to the theory of schizophrenia is not scientific enough to be classed as a real, classified theory. Despite there being research done this approach does not think of the scientific reasoning behind the cause of schizophrenia. It focuses on putting the blame on the mother, causing this approach to also be sexist. The research done isn’t accurate enough as the sample sizes are not reliable....