Thursday, October 10, 2019
If the motives of organisms were all immediately and easily satisfied, there would be no need for adjustment. Various hindrances, however, tend to thwart the direct satisfaction of motives. A dog may not find food available and ready to be eaten every time that the pangs of hunger assail.The human, impelled by such motives as those of mastery or social approval, is frequently unable to reduce his drives immediately. He meets with thwarting in the form of material obstacles, of competition from other similarly motivated individuals, and of hindrances resulting from his own lack of ability. But a strong motive, once aroused, tends to keep the individual in a state of activity. Stimulated by the drive-tension, the individual makes one reaction after another until at length some response is found which will reduce the drive.This exploratory activity which begins when a drive is aroused and ends when the drive is extinguished :s probably the most general pattern of animal and human behavi or. It may be termed the adjustment process. NORMAL AND ABNORMAL MODES OF ADJUSTMENT PROCESS There are three main elements in the process of adjustment. A. Motive. The process of adjustment begins with some inspiration or need present in an individual. B. Thwarting Conditions. If environmental factors do not hinder the fulfillment of needs, adjustment probably comes about and there are no problems.But thwarting circumstances steer forward the process of adjustment. C. Varied responses. In the event of non-fulfillment of needs, an individual reacts in many ways. These responses can be normal as well as abnormal. As a result of these reactions, the individual makes an adjustment with his environment. The process of adjustment begins with inspiration. Inspiration is objective-oriented. As a result, individual performs activities aimed at the objective. Many a time obstructions confront these activities.These obstruction evoke different responses in different individuals, the response m ay vary for trying work harder to giving it up to thinking an alternative plan to meet the objective. Evaluations of an individual's personality adjustment can be done as per the following criteria: a. Balance of Personality. The main criterion of personality adjustment is the formulation of personality. All the mental faculties like intelligence, emotions, desires and determination are fully involved in it and these function in unison.A well-developed personality is flexible, determined and cohesive. The ability to adjust is proportionate to the integration of personality. An individual with well-adjusted personality is balanced and realistic. He is not easily upset by failures an disappointments, and his emotions, needs, thoughts ND other mental activities are also balanced. On the other hand, a maladjusted individual's personality is imbalanced. His life is devoid of peace and he deprives others too of their peace. B. Minimal tension. Another sign of well-adjusted personality is minimal tension.Non-fulfillment of needs gives rise to tension. This tension lasts till needs are fulfilled. In other words,the adjustment of an individual can be gauged from the amount of tension he has. C. Harmony between Needs and Environment. The amount of harmony is directly proportionate to the amount of adjustment. An individual with a well-adjusted personality keep his needs and desires in consonance with the state of his environment and alters his environment according to the demand of his needs. Thus achieving mutual adjustment from both the sides accounts more success.Five groups of adjusting responses may be distinguished on this basis. These groups represent only a convenient arrangement arising from the practical necessity of making some division. They should not be interpreted as fundamentally distinct types of adjustment. 1 . Adjustment by defense. This adjustment mechanisms characterized by excessively aggressive conduct, usually involving group participation often of an undesirable or antisocial character. The defense mechanisms, by reducing the fear tensions and satisfying the original drives, lead to an adjustment of a sort.Since all persons have* deficiencies of varying degrees, defensive behavior is a normal and almost universal human trait. Only when defense mechanisms become exaggerated in character and excessive in scope do they present serious psychological problems. 2. Adjustment by withdrawing. This is considered the defensive adjustments that how a marked failure to participate in social activity, either in the form of passive exclusiveness or of active refusal. These are usually accompanied by substitute satisfactions of an individual and symbolic sort in the form of fantasy.Another way in which many individuals respond to thwarting is by retreating from the situations in which they experience adjusting difficulty. Withdrawing is a normal form of adjustment in a statistical sense, for practically all persons make use of it to some extent. Exclusiveness, like all other forms of defense, is a maladjustment only in reapportion to the degree of its employment, being normal when it does not seriously interfere with an individual's social effectiveness, pathological when he withdraws to such an extent as to affect his perception of reality.The exclusive type of adjustment originates from the same psychological pattern as do the other types. Confronted with the frustration of some strong motive, the individual makes varying responses until some form of behavior is discovered that will reduce his emotional tensions. In many instances the satisfying action is found in exclusiveness and timidity which are voiding responses to the stimuli responsible for the maladjustment. The exclusive behavior is adjusting, for by avoiding the attempt to cope with his environment, the individual eliminates the possibility of failure.The logic of exclusiveness is that, by not trying, failure is avoided. In the early or Ã¢â¬Å"varied r esponseÃ¢â¬ stage of adjustment to thwarting, it is typical for the reaction of timidity to alternate with the more aggressive types of defense. For an individual to be shy and exclusive at one moment, and to be bold and overbearing in the next, often seems inconsistent, but it has psychological coherence since both forms of response indicate attitudes of inferiority and fears of social criticism.Since shy and withdrawing persons are not as much of a nuisance to those around them as are the more aggressive individuals, their maladjustments often escape notice* This is especially likely to be true of school children, for teachers quickly discover the annoyingly active child who compensates, rationalizes or lies, while the withdrawing youngster is often considered as a model of perfect deportment. For the same reasons, the seriousness and extent of outdrawing forms of adjustment is usually underestimated by teachers and parents. 3. Adjustments involving fear and repression.Although fear is a factor in all maladjustments, it appears with special prominence in phobias, which are irrational specific fears. Repression, another general characteristic of maladjustment, will also be investigated in this section. Strong emotional responses of an undifferentiated character are natively elicited by stimulation to an excessively intense or tissue- injuring nature. Rather early in childhood a number of more specific emotional tatters emerge from the diffused matrix of primitive emotion, this individuation arising from the operation of processes of adjustment and learning.The responses to overwhelming situations such as loud noises and violent loss of support, toward which the child can make no effective adjusting response, become crystallized into the pattern of emotion, disorientation and flight that may be designated as fear. Many situations in the common experiences of older children and adults also call forth a normal fear response. In some instances fear is the resp onse to a danger signal or symbol of impending possible injury.Because he has learned the consequences of various situations, the individual may react to the menace of prospective injury with the same emotional quality as to the injuring situation itself. The greatest number of fear experiences of normal adults probably occur in situations involving a narrow escape from catastrophe, such as occur occasionally when driving an automobile. Fear responses are most readily aroused in adults when an intense stimulation is presented very suddenly, under circumstances that permit the use of no habitual adjustment that would enable the individual to cope with the situation.Repression as adjustment, a viewpoint which supplements the foregoing account in a valuable manner is that which regards repression as a variety of adjustment or species of defense mechanism. The event the memory of which is repressed was a stimulus for a fear of disapproval, hence when the recall occurs it acts as a symbo l or substitute for the original guilt or shame-provoking situation. The fear of social disapproval thwarts one of the strongest of the common motives and therefore calls for adjusting behavior. The individual must adjust to the substitute symbol as he would to the disapproval itself. Adjustment by ailments. The most spectacular forms of adjustment are those which ape physical ailments, including pains, paralyses and cramps. These mechanisms constitute a large part of the field of the psychoneuroses and lie in the borderland between psychology and medicine. 5. Persistent nonadjustable reactions. If all forms of adjustment fail, the individual may show states of exhaustion, anxiety and Ã¢â¬Å"nervousness' which are the result of an unreduced emotional tension In Karen Horned adjustment to basic anxiety, she has categorized three patterns or modes of adjustment: 1 .Moving Towards People In this pattern of adjustment, individual moves towards people in order to satisfy his needs for af fection and approval, for a dominant partner to control one's life and to live one's life within narrow limits. This is a type of person who is complaint type, who says that if I give in, I shall not be hurt. This type of person needs to be liked, wanted, desired, loved, welcomed, approved, appreciated, to be helped, to be protected, to be taken care of and to be guided. This type of person is friendly, most of the time and represses his aggression. 2. Moving Against PeopleIn this adjustment mode, the neurotic need for power for exploitation of others is for prestige and for personal achievements are to be fulfilled, when an individual moves against people. This hostile person thinks that if he has power, no one can hurt him. 3. Moving Away from People In this adjustment mode, the neurotic need for self-sufficiency, perfection, independence and UN-salability are classified. This person is a detached type, who says that if I withdraw, nothing can hurt me. These three adjustment patte rns are basically are incompatible, for example, one cannot move against, towards and way from people at the same time.The normal person has greater flexibility he uses one adjustment mode to another as conditions and situations demand. The neurotic person cannot easily move from one adjustment mode to another, rather he is less flexible and ineffective in moving from one adjustment mode to another. Fraud's ego defense mechanisms and Karen Hornet's adjustment techniques are the same. However, Karen Horned has added few new and usable techniques of adjustment, which are: I-Blind Spots Let us take an example, Ã¢â¬Å"you are extremely intelligent student and you responded to our teacher's question very stupidly, so this experience hurts your ego'.Therefore, you are going to deny it and ignore it because it is not in accordance with your idealized self image of an intelligent person. Now this experience is a disowned one and it will reappear as a blind spot in your personality. You will not accept it and it will reappear as a problem in your personality. This is similar to Sigmund Fraud's repression. 2-Rationalization It is giving good reasons or making good excuses to protect your ego. So rationalization by Freud and Horned are the same. Let us take an example: A student arks very hard for his CSS exam but fails in it.He says, Ã¢â¬Å"l don't want to be a civil servant, all civil servants are corrupt since I am an honest person I do not want to be a civil servantÃ¢â¬ . The story of the fox and the grapes is another example of rationalization. 3-Excessive Self-Control Excessive self-control is actually rigid self-control at all costs. It is guarding one's self against anxiety by controlling, any expression of emotion. In real life a puritan character has been created who maintains tight emotional control under all circumstances. Example: An individual under extreme grief and depression expresses no emotion.An individual under state of extreme happiness shows no e motion. 4-compartmentalizing It means dividing your life in to various compartments; one set of rules controls one compartment and another set of rules controls another compartment. For example, a teacher does not permit his students to cheat in the class, but the same teacher while playing a game of cards cheats with his colleagues. So there is one set of rules which applies to one compartment and another set of rules which applies to another compartment of his personality. 5 Ã¢â¬â Sterilization Sterilization is similar to Fraud's projection.In projection, individual blames others for his own shortcoming. For example, a student did not prepare for his exams properly, and after getting a low grade, would say, the teacher was against me or the question paper was out of the course, instead of seeing the fact that the preparation was insufficient. Our team lost the match, because the umpire was against us while the fact is that our penalty corner conversion was poor. 6- Arbitrary Ri ghtness To the person utilizing this adjustment technique, the worst thing a person can be is indecisive or ambiguous.When issues arise that have no clear solution one way or the other, the person arbitrarily chooses one solution, thereby ending debate. An example would be when a mother says Ã¢â¬Å"You're not going out Friday night and that's the end of itÃ¢â¬ A person using this adjustment will arrive at a position and when doing so all debate ends. The position the person takes becomes the truth and therefore cannot be challenged. The person no longer needs to worry about what is right and wrong or what is certain and uncertain. 7 Ã¢â¬â Elusiveness This technique is the opposite of arbitrary rightness.The elusive person never makes decision about anything. If one is never committed to anything, one can never be wrong, and if one is never wrong, one can never be criticized. If a person decides to go to college and fails, there is no excuse. If, however, the decision to go to college is delayed, because of lack of money, or any other reason, this technique is called elusiveness, where the person never makes a decision about anything. 8 Ã¢â¬â Cynicism Cynics are individuals who do not believe in the value of anything rather they try to make every individual realize the meaninglessness of their goals and objectives.Karen Horned believed that Cynics are individuals who derive pleasure by making an individual realize that he is worthless and his goals and aims in life are meaningless. Personality Disorders DEFINITION Personality is one's set of stable, predictable emotional and behavioral traits. Personality disorders involve deeply ingrained, inflexible patterns of relating to others that are maladaptive and cause significant impairment in social or occupational functioning. The disorders include marked limitations in problem solving and low stress tolerance.Patients with personality disorders lack insight bout their problems; their symptoms are either e go-synoptic or viewed as immutable. They have a rigid view of themselves and others and around their fixed patterns have little insight. Patients with personality disorders are vulnerable to developing symptoms of Axis I disorders during stress. Personality disorders are Axis II diagnoses. Many people have odd tendencies and quirks; these are not pathological unless they cause significant distress or impairment in daily functioning.DIAGNOSIS AND ADSM-IV CRITERIA 1 . Pattern of behavior/inner experience that deviates from the person's culture and is manifested in two or more of the following ways: _ Cognition Affect Personal relations Impulse control 2. The pattern: Is pervasive and info expiable in a broad range of situations _ Is stable and has an onset no later than adolescence or early adulthood _ -?+ significant distress in functioning _ Is not accounted for by another mental/medical illness or by use of a substance The international prevalence of personality disorders is 6%.Per sonality disorders vary by gender. Many patients with personality disorders will meet the criteria for more than one disorder. They should be classified as having all of the disorders for which they qualify. CLUSTERS Personality disorders are divided into three clusters: Cluster A-?schizoid, psychotically, and paranoid: Patients seem eccentric, peculiar, or withdrawn. _ Familial association with psychotic disorders. Cluster a-?antisocial, borderline, histrionic, and narcissistic: emotional, dramatic, or inconsistent. Familial association with mood disorders.Cluster C-?avoiding, dependent, and obsessive-compulsive: or fearful. Patients seem Patients seem anxious _ Familial association with anxiety disorders. Personality disorder not otherwise specific deed (NOSE) includes disorders that do not fit onto cluster A, B, or C (including passive-aggressive personality disorder and depressive personality disorder). Personality disorder criteria-? CAPRI Cognition Personal Relations ETIOLOGY _ Biological, genetic, and psychosocial factors during childhood and adolescence contribute to the development of personality disorders. The prevalence of personality disorders in minimization twins is several times higher than in dogmatic twins. TREATMENT _ Personality disorders are generally very dif cult to treat, especially since few patients are aware that they need help. The disorders tend to be chronic and feeling. _ In general, pharmacological treatment has limited usefulness (see individual exceptions below) except in treating coexisting symptoms of depression, anxiety, and the like. _ Psychotherapy and group therapy are usually the most helpful.Cluster A These patients are perceived as eccentric or hermetic by others and can have symptoms that meet criteria for psychosis PARANOID PERSONALITY DISORDER (PDP) Patients with PDP have a pervasive distrust and suspiciousness of others and often interpret motives as malevolent. They tend to blame their own problems on others and s eem angry and hostile. They are often characterized as being pathologically jealous, which leads them to think that their sexual partners or spouses are cheating on them. Diagnosis requires a general distrust of others, beginning by early adulthood and present in a variety of contexts. At least four of the following must also be present: 1 . Suspicion (without evidence) that others are exploiting or deceiving him or her. 2. Preoccupation with doubts of loyalty or trustworthiness of acquaintances. 3. Reluctance to confine De in others. 4. Interpretation of benign remarks as threatening or demeaning. 5. Persistence of grudges. 6. Perception of attacks on his or her character that are not apparent to others; quick to counterattack. 7. Recurrence of suspicions regarding FL delimit of spouse or lover.DIFFERENTIAL DIAGNOSIS _ Paranoid schizophrenia: Unlike patients with schizophrenia, patients with paranoid personality disorder do not have any fixed delusions and are not frankly psychotic , although they may have transient psychosis under stressful situations. _ Social disenfranchisement and social isolation: Without a social support system, persons can react with suspicion to others. The differential in favor of the diagnosis can be dad by the assessment of others in close contact with the person, who identify what they consider as excess suspicion, etc.COURSE AND PROGNOSIS _ Some patients with PDP may eventually be diagnosed with schizophrenia. _ The disorder usually has a chronic course, causing lifelong marital and Job-related problems. Psychotherapy is the treatment of choice. Patients may also benefit from antiquity medications or short course of antispasmodics for transient psychosis. SCHIZOID PERSONALITY DISORDER Patients with schizoid personality disorder have a lifelong pattern of social withdrawal. They are often perceived as eccentric and reclusive. They are quiet and unsociable and have a constricted affect. They have no desire for close relationships an d prefer to be alone.Unlike with avoiding personality disorder, patients with schizoid personality disorder prefer to be alone. A pattern of voluntary social withdrawal and restricted range of emotional expression, beginning by early adulthood and present in a variety contexts. _ Four or more of the following must also be present: 1 . Neither enjoying nor desiring close relationships (including family) 2. Generally choosing solitary activities 3. Little (if any) interest in sexual activity with another person 4. Taking pleasure in few activities (if any) 5. Few close friends or confidants (if any) 6. Indifference to praise or criticism 7.Emotional coldness, detachment, or flattened affect _ Paranoid schizophrenia: Unlike patients with schizophrenia, patients with schizoid personality disorder do not have any fixed delusions, although these may exist transiently in some patients. _ Psychotically personality disorder: Patients with schizoid personality disorder do not have the same ec centric behavior or magical thinking seen in patients with psychotically personality disorder. Psychotically patients are more similar to schizophrenic patients in terms of odd perception, thought, and behavior. COURSE Usually chronic course, but not always lifelong.Similar to paranoid personality disorder: Psychotherapy is the treatment of choice; group therapy is often beneficial. _ Low- dose antispasmodics (short course) if transiently psychotic, or antidepressants if combine major depression is diagnosed. PSYCHOTICALLY PERSONALITY DISORDER Patients with psychotically personality disorder have a pervasive pattern of eccentric behavior and peculiar thought patterns. They are often perceived as strange and eccentric. The disorder was developed out of the observation that certain family traits predominate in FL rest-degree relatives with schizophrenia.A pattern of social deaf cists marked by eccentric behavior, cognitive or perceptual distortions, and discomfort with close relations hips, beginning by early adulthood and present in a variety of contexts. _ Five or more of the following must be present: 1 . Ideas of reference (excluding delusions of reference) 2. Odd beliefs or magical thinking, inconsistent with cultural norms 3. Unusual perceptual experiences (such as bodily illusions) 4. Suspiciousness 5. Inappropriate or restricted affect . Odd or eccentric appearance or behavior 7. Few close friends or confine daunts 8. Odd thinking or speech (vague, stereotyped, etc) 9.Excessive social anxiety Magical thinking may include: Belief in clairvoyance or telepathy Bizarre fantasies or preoccupations Belief in superstitions Odd behaviors may include involvement in cults or strange religious practices. _ Paranoid schizophrenia: Unlike patients with schizophrenia, patients with psychotically personality disorder are not frankly psychotic (though they can become transiently so under stress), nor do they have fixed delusions. _ Schizoid personality crosier: Patients with schizoid personality disorder do not have the same eccentric behavior seen in patients with psychotically personality disorder. Course is chronic or patients may eventually develop schizophrenia. Personality type for a patient with schizophrenia. Performed Psychotherapy is the treatment of choice to help develop social skills training. Short course of low-dose antispasmodics if necessary (for transient psychosis). Antispasmodics may help decrease social anxiety and suspicion in interpersonal relationships. Cluster B Includes antisocial, borderline, histrionic, and narcissistic personality disorders.These patients are often emotional, impulsive, and dramatic Patients diagnosed with antisocial personality disorder show superficial conformity to social norms but are exploitive of others and break rules to meet their own needs. Lack empathy and compassion; lack remorse for their actions. They are impulsive, deceitful, and often violate the law. They are skilled at reading social cu es and appear charming and normal to others who meet them for the FL rest time and do not know their history. Pattern of disregard for others and violation of the rights of others since age 15.Patients must be at least 18 years old for this diagnosis; history of behavior as a child/adolescent must be consistent with conduct disorder _ Three or more of the following should be present: 1. Failure to conform to social norms by committing unlawful acts 2. Deceitfulness/ repeated lying/manipulating others for personal gain 3. Impulsively/failure to plan ahead 4. Irritability and aggressiveness/repeated FL sights or assaults 5. Recklessness and disregard for safety of self or others 6. Irresponsibility/failure to sustain work or honor FL uncial obligations 7. Lack of remorse for actionsDrug abuse: It is necessary to ascertain which came FL rest. Patients who began abusing drugs before their antisocial behavior started may have behavior attributable to the effects of their addiction. Usual ly has a chronic course, but some improvement of symptoms may occur as the patient ages. _ Many patients have multiple somatic complaints, and coexistence of substance abuse and/or major depression is common. _ There is t morbidity from substance abuse, trauma, suicide, or homicide. Symptoms of antisocial personality disorder-?