Creating Waves of Awareness
BASIC FUNDAMENTAL INTRODUCTION:
DEVELOPMENTAL PSYCHOLOGY: Basically, psychologists had divided the developmental psychology into 3 parts. They are id, ego, and super igo. This is mainly a Freudian concept.
He was the first to classify these terms.
ID: Id is the personality of an infant. It is all the drives and motives with which we are born. Freud calls it as “psychic energy and instincts” in case of adult id is a part of personality. It is a pleasure principle which is primitive, illogical, and has a lack of contact with reality. When the drives and motives are not satisfied there is a tension unpleasant and a person seeks relief by innate reflexes, which satisfy the drive. It is the wish – fulfilling fantasy, called AUTISTIC THINKING which lacks contract with reality. This is also called as primary process.
Since an organism cannot be satisfied by primary process alone after his development, there arises a secondary process called EGO.
EGO: To exist in the objective, external world, we must possess a reality principle. Hence a part of id is converted into ego, to meet up the demands of reality by the use of secondary process. It replaces realistic thinking in place of an autistic thinking. Ego is capable of logic and reasoning.
A strong ego can make an id to wait until a socially favorable situation is achieved to satisfy. But an ego is not powerful enough to deny id completely.
SUPER IGO: It uses a part of id for its development. Layman calls this super igo as “conscience”. This conscience is obtained in a man by his parents, other surroundings and by himself by his mistakes. Introjection is a process of taking over standards of other persons as his own. When a man does wrong his conscience will hurt. Moral standards of super Igo will suppress and ignore the id f sex and hostility.
PSYCHOSIS: Psychosis is a psychological trouble in which there is loss of touch with important aspect of reality which is shown by symptoms like delusions, hallucinations, and confusion.
Schizophrenia or dementia praecox is a psychiatric syndrome (not a single disease) which includes fundamental disturbances in reality, relationships, emotional, and intellectual process and which manifest themselves in severe disturbance of the ego.
1. Reality- form & content of thought (delusions, hallucinations, illusions).
2. Relationships – sense of self and relation to external.
3. Emotional – abnormal emotional reaction & affected mood.
4. Intellectual & behavior- apparently purposeless.
HISTORY OF SCHIZOPHRENIA:
In 1860, Dr.Morel of Belgium had named it as “Demence precoce”. Later Dr. Kraeplin had named it as “dementia praecox”, where dementia means the lasting mental deterioration and praecox means which occur in the younger. As this disease condition was prevalent among the young people during that period, he had naked it likewise. Later psychologists had found that it also occur in older persons.
Later in 1911, a Swiss psychologist named Dr. Bleuler had coined the name “schizophrenia”, which literally means the splitting of personality.
POLAR TYPES: Based on the polarities schizophrenia had been divided into 2 types, a process syndrome and a reactive syndrome.
1. Process syndrome: these types are of gradual onset, and have a pre-psychotic personality, which is unstable and of a schizoid type. This type has more psychotic signs, and has a poor prognosis.
2. Reactive syndrome: these types have a sudden onset, and a relatively normal personality. It has a fewer psychotic signs, and a good prognosis.
Dr. Bellak says, it is a psycho bio social disturbance, which has its manifestations in two aspects.
1. Purely psychogenic weakness of ego.
2. Afflictions of functional disturbances of ego : brought by, Infections, toxic, traumatic, enzymatic, constitutional, genetic disturbances.
MANIFESTATIONS OF EGO DISTURBANCES:
1. DISTURBANCES WITH REALITY:
Patient is unable to adjust socially and withdrawn from most human relationships, which can be known by increased inappropriateness of the response. The inner subjective needs which distorts the reality, cannot distinguish between world of fantasy and reality. And at the end there is loss of reality of his body and his existence [DEPERSONALIZATION].
And the patient will get feelings of unreality like he is hollow, solid or dead.
2. LOSS OF CONTROL OVER DRIVES AND EMOTIONS:
In early stages there are episodes of loss of control over drives and emotions. For example a quiet, common person may suddenly turn into a noisy and boisterous one. In cases of aggressive sexual excitement there are a quick hallucinations and delusions. In severe case there may be losing bladder/ bowel control, indulging in all manners of sexual perversions.
- A study of hallucinations and delusions may suggest which drives are difficult to control.
- Patient is apathetic, emotionally shallow.
- Until there is an ego disturbance he can sense the reality correctly.
- Inability to contact with people will also prevent from understanding the reality.
- Loss of control can be ascertained by inappropriateness of patients’ emotional expressions.
- In such a cases, for a small stimulus the patient instead of startling, he presents with a great fear of panic.
3. THOUGHT PROCESS DISTURBANCES:
After the loss of emotional control and drives, the patient has a thought process disturbance. The thought processes in schizophrenics’ are similar to that of the small children which is called as primary process by Freud. It is a wish fulfilling nature, with lack of logic. The autistic logic is not bounded by any reality.
4. BREAKDOWN OF DEFENSE MECHANISMS:
The thoughts & responses which are anxiety arousing and of emergence are restrained from a person by means of several defense mechanisms. Some of them are mechanism of repression, denial, rationalization, projection. These mechanisms protect and enhance the ego.
But in case of too much dependence on these mechanisms will breakthrough the material which they wanted to repress. In case of schizophrenia, in primary process the defense mechanism is much broken and there is little adjusting. For example, an aggressive and hostile response will lead to delusion of persecution.
5. ABILITY TO ORGANIZE AND CREATE:
In case of a normal person, there is an ability of formation of Gestalten. I.e. The ability to form well organized and meaningful wholes.
The highest intellectual attainment of an organism is the ability to organize and use for association and better adaptation.
In case of schizophrenics, there is looseness of associations, and lack of well organized thinking, difficult with cause and effect relationship, orientation of time and place and correct perception of figures.
The diagnostic criteria are made on severity of ego disturbance. Each and every person in their life time they will undergo one or the other malfunctioning of ego.
For example, fear of dogs, or large area of water, etc.
1. Characteristic behavior: in early stages it is difficult to diagnose by these behaviors as these changes are less marked but in case of late stages it may be an easy task to diagnose. An apathetic, withdrawn, inactive, or passive person may change into impulsive, silly laughs, or weeping. In other words, emotional shallowness may change into lability.
2. Hallucinations: about more than half of schizophrenics are hallucinated which is a wish fulfilling, autistic fantasy. Hallucinations may be mostly auditory or visual, rarely olfactory, gustatory, and tactual hallucinations are present.
3. Delusions: these may be with hallucinations and without hallucinations. In case of young patients there may be delusions of bizarre nature with overtones of self deprecation & depersonalization. In case of older persons, there may be delusions of persecution & of sins, religious, jealousy, and magic.
4. In later stages, poor communication & refusal to speak. Speech is irrelevant, loosening associations, and coining new words called NEOLOGISM means meaningless, incoherent, nonsensical, word salads.
5. In uncommunicative cases, there may be cataleptic stupor, which means a muscular rigidity for long times- a waxy flexibility.
6. Social withdrawal: - Lack of skill & maladjustment.
- no ambition and little interest in schooling,
- desire to be alone in room with secret reveries.
- Quite, polite, pleasing, shyful, and sensitive.
- These persons may suddenly change into the other extreme of impulsive, boisterous behavior.
7. Early symptoms of depersonalization: It’s a state of loss of personal reality. Odd statements and behavior, a feeling of body and mind were separated, extremities turning into a stone, failure to recognize close friends and relatives. Puzzled on commonplace events.
8. Physical characteristics: these are not sure enough to use for the diagnosis. The physical characteristics may be hereditary factors and the type of built they have, mostly schizophrenics have an ectomorphic built.
PSYCHOLOGICAL TESTS FOR DIAGNOSIS:
1. Rorschach ink blot test:
In case of sever ego disturbances, the patient seems an object in blot, not corresponding to actual structure and there is a poor form responses indicating “primary thought process”, and on asking these patients reveal irrelevant confabulatory answers.
2. Wechscler- bellevue test:
In this test the following results are obtained.
There is a discrepancy between verbal and performance IQ.
Comprehensive score is greater than information score.
The most important thing to be remembered is these tests doesn’t give the final diagnosis.
The American psychologist association gives about 9 types of classifications of schizophrenic patients. Those are,
7. Acute undifferentiated,
8. Chronic undifferentiated, and
9. Residual type.
- Onset is gradual.
- In this type there is absence of any complicating symptoms such as hallucination, delusions, and bizarre manner.
- Apathetic, little interested, shy and hypersensitive.
- Patient is highly dependent on his family.
- He is seclusive and personal habits absent.
- Mode of answering and conversations shows partial contact and unable to adjust. Answering shows dulling a\effect and detachment.
- Some patient may regress to primary process and no logical answering.
- The family members can be able to recognize that they are odd but severity cannot be ascertained.
- There is a strong familial history of psychosis like broken and hated homes.
- This is the least serious and complicated of the 4 types.
- There is an oddness of appearance and change of motor activity of a catatonic type where the muscle tone is decreased (waxy flexibility) or complete loss (akinesia). This is a process of negativism
- The other type of progress in this type individuals is an overactivity, where there is repeated series of movements which are stuporous and excited.
- Hallucinations are present.
- There is normal memory, but the patient answers in general or single syllable “yes or no”.
- Patient repeats the last word or syllable said to him. This condition is termed as ECHOLALIA.
- There is normal perception and reporting.
- In this type the prominent symptom is a delusion or systematized false belief.
- The patient is unable to do logical thinking.
- The delusions may be of two extreme types. The feeling of inferiority complex will lead to defensive and self assurdness and it creates a complex that never to be crossed or contraindicated (superiority complex).
- When there is an inferiority complex the patient is withdrawn, meek, afraid to everyone and passive.
- When the patient feels superior, then there is a delusion of grandeur and as if being poisoned.
- He is aggressive, talkative, ego – centered.
- He is a possessor of “cheap superiority complex”
- The patient has a sensation that others can read his mind and know his thoughts. Someone sending filthy messages to him by telepathy or x- ray.
- His motives and feelings are impossible to control.
- Dr. Freud says that homosexual conflict arises as behavior prior to the conflict.
- This is the severest form of schizophrenic disturbance.
- Behavior: silly, childish arguments, odd, irritable and hypochondriacal, impulsive.
- Speech: incoherent, unintelligible and emotional lability.
- The type which doesn’t suits exactly into other types will come under this type.
- There is presence of hallucinations.
- This type has a gradual onset and develops mostly from simple ore paranoid type of schizophrenics.
- This is a type with severe ego disturbances.
- These patients are seclusive, quarrelsome, tempered, and have a bizarre behavior.
- It is classified into 2 types: Early infantile autism, symbiotic child psychosis.
EARLY INFANTILE AUTISM: There is withdrawal from interpersonal relationship as early in 6 months of age. And development of skill in dealing with inanimate objects but not with people.
- There is a severe language disturbance.
- These patients feel happy to play with toys but shrink to apathy at approach of persons.
- No delusions or hallucinations.
- Mainly there is a lack of warm, human qualities of personality.
- SYMBIOTIC CHILD PSYCHOSIS: Symbiosis is a process of living together in mutual dependence.
- In case of normal child has a conception of himself & it separates and become independent from the mother.
- Here the child fails in its ego development and clings parasitically.
- And if the needs are not met there is a state of panic and unable to distinguish between.
SCHIZO AFFECTIVE SCHIZOPHRENIA:
- It is a combination of schizophrenia and manic depressive psychosis.
- There is a disturbance in thought process.
- It shows the real feelings of elations or depression without dulling and shallowness.
- There is a feeling of unreality and complaints of dis- integrating mind.
- Hallucinations of anxiety and guilty.
- Delusions: that other people controlling/ influence him in a mysterious way. (PASSIVITY FEELING)
ACUTE UNDIFFERENTIATED (ACUTE CONFUSIONAL TYPE):
- ONSET: Sudden.
- CAUSES: - Stress of battle/wartime.
- insoluble personal problems.
- Any expression emotionally traumatic.
- C/F: state of panic,
- bewildered by what is occurring,
- dazed and perplexed,
- asks question buts accepts answer with great suspicion,
- feelings of depersonalization/ unreality.
- Hallucinations/ delusions centered around sex and religion.
- It has a short duration which disappears with long course.
- It has an increased degree of ego disturbance, but it cannot be called as “full-fledged case of schizophrenia”
- The condition is chronic but not severe enough to differentiated into one of the types, since it has a mixture of symptoms.
- In childhood these patients have a schizoid personality, poor social relations, not affectionate.
- There is thought process and lack of control.
- Neologisms, illogical thought sequences and deviant sexual practices.
- This type includes the patients who are well enough to leave the hospital but have permanent residue of schizophrenic behavior.
THERAPY AND PROGNOSIS:
1. Based on the different causes there is a difference in the mode of treatment.
2. When the physician is not sure of the causes he has to alleviate the symptoms directly.
3. The treatment must be aimed at to strengthen the weaken ego and to relieve it from the pressures of id and super ego. This strengthening is difficult incase of uncommunicative patients.
4. SHOCK TREATMENT: This treatment of schizophrenics is of two types, insulin shock and electric shock.
In case of insulin shock a high amount of insulin is injected into the patients’ body which produces a insulin-shock condition. And incase of electric shock, a specific amount of low volume current is passed into the patients temporal region.
These treatments are aimed at the idea that the patient becomes communicative for a time and more receptive to psychotherapy.
5. Other kinds of treatments are occupational therapy, recreational therapy, music therapy, dancing, arts and handicrafts.
6. The curability and alleviation of specific cause in case of hereditary/ constitutional types is difficult and in case of a severe maltreated is an easy task.
7. Hospitalization with physical and psychiatric assessment.
8. Promoting emotionally neutral atmosphere.
9. Neurolectic drugs which blocks the dopamine receptors.
Schizophrenia generally has a poor prognosis. It has a good prognosis in case of acute onset and paranoid & catatonic types and in people whose ego can withstand facts of reality.
And bad prognosis in case of gradual onset and if ego disturbances go back to childhood or before (autism).
SCOPE OF HOMOEOPATHY:
Generally schizophrenia has a very good scope in Homoeopathy. In Homoeopathy we deal with a lot of delusional states which are found in many repertories, which can be made use of for all or any type of schizophrenic cases.
Schizophrenia and Homeopathy Part 2
Adrienne's Discussion on Schizophrenia
Dr Biju's Blog on Mental Disease
There is so much that homeopathy can do.
The Delusions, Fears and Mind symptoms can be found in the Repertory and Materia Medica.
WDDTY | What Doctors Don't Tell You: Healthy.net
Healing Through Homeopathy: Schizophrenia
A Case of Schizophrenia