A Cybernetic Theory of Psychopathology

Abstract

Cybernetics, the study of principles governing goal-directed, self-regulating systems, offers a useful approach to understanding psychopathology or psychological dysfunction, overcoming limitations of other naturalistic approaches. Whereas influential theories of psychopathology have relied on definitions of dysfunction rooted in evolution and fitness, we define psychopathology in terms of cybernetic dysfunction, failure to make progress toward important goals. Cybernetic function in organisms is not identical to evolutionary function, despite their causal phylogenetic relationship. We define psychopathology as persistent failure to move toward one’s goals, due to failure to generate effective new goals, interpretations, or strategies when existing ones prove unsuccessful. This definition allows a thorough integration of dimensional approaches to psychopathology and personality and provides a new perspective on the nosology of mental disorder. We review evidence that the major dimensions of psychopathology correspond to major trait dimensions of personality, but we assert that extremity on these dimensions is neither necessary nor sufficient for psychopathology, which requires cybernetic dysfunction. Drawing from psychological and neurobiological research on personality and psychopathology, we present a theory of the mechanisms underlying the five major dimensions of psychopathology, some of their subdimensions, and the general risk factor for psychopathology. We conclude by discussing implications of our theory for research, diagnosis, and mental health interventions.     

The mental pain of the psychoanalyst: A personal view

Abstract

Mental pain is a common concern of psychoanalysts in their professional life. Combining her clinical experience with previous contributions by others, the author presents a personal overview of the patient-triggered mental pain of the analyst. Countertransference is considered to be the major source of the analyst's work-derived mental pain. This type of mental pain is not to be avoided or discarded by the analyst. Rather, the analyst will benefit from tolerating and even welcoming professional mental pain: in most cases, mental pain will bring with it rich clinical material that, upon interpretation, will help him or her to offer previously intolerable contents back to the patient in a transformed version that now becomes acceptable. The analyst's mental pain may emerge in his dreams; clinical examples of this phenomenon are presented. It is suggested that there is an increased chance of the analyst undergoing mental pain when treating patients suffering from severe psychopathology, and a clinical case is reported to illustrate this assertion. The author proposes that a lifelong effort is to be expected from analysts in terms of enhancing their threshold of tolerance to professional mental pain. In situations of mental pain, analysts must be particularly aware of the need to modulate their interpretations before transmitting them to the patient. The capacity of analysts to transform their mental pain (Ta, according to Bion) will depend on the plasticity of their container functions, the quality of their transformation abilities and, in particular, their threshold of tolerance to mental pain.     

Clinically significant religious impairment

Recent psychodiagnostic practice, as embodied in the DSM IV, requires that psychopathological features result in a "clinically significant impairment" to qualify as a "mental disorder" in many cases. The impairment must be in social, occupational, or other important areas of functioning. The current proposal is that clinicians should consider the potential impairment in religious functioning arising from mental disorders in diagnostic process. It is suggested that psychopathology may result in a clinically significant religious impairment that is defined as a reduced ability to perform religious activities, achieve religious goals, or to experience religious states, due to a psychological disorder. Various existing approaches to studying the relationship between religious functioning and psychopathology are briefly reviewed and roughly categorized as either focused on 'symptomatic religiosity' or reflecting a 'religiously sympathetic' posture. Yet, in both of these approaches, religion has predominantly been construed as an exogenous variable contributing to mental health in some fashion (for good, for ill, or for both). The current proposal suggests that clinicians should also consider religion in endogenous perspective. So construed, religion is a significant domain of adaptive functioning, which may be adversely impacted by psychopathology. A discussion of various clinical, research and ethical issues involved in realizing the proposal is provided.     

Interpersonal-relational psychoanalysis: An introduction and overview of contemporary implications and applications

Abstract

For half a century Interpersonal psychoanalysis has developed relatively independent of the tradition of Freud and his followers. The Interpersonal movement was founded by Harry Stack Sullivan, Clara Thompson and others who believed that the psyche could not be understood as an entity that evolves without input from the external environment. The Interpersonal view is that interactions between people influence every aspect of the individual's experience, and that no person can be studied without simultaneously noting the ongoing impact between the observer and the observed. This line of thought has led to conclusions concerning personality, psychopathology and clinical technique that depart from traditional psychoanalysis. The paper illustrates a number of these differences, emphasizing that the current emergence of the “two-person model” of the psychoanalytic situation offers a potential rapprochement between the Interpersonal and more classical views.     

Eating disorders in elite female distance runners: Effects of nationality and running environment

ObjectivesTo compare UK and Kenyan athletes and to examine the influence of nationality and involvement in elite distance running on the presence of eating disorders, eating disorder psychopathology and menstrual dysfunction, in young women.DesignIndependent groups, with nationality and running status as independent variables.MethodsElite female distance runners were identified based on their performances in track, road and cross-country events. Questionnaire packs were sent to UK athletes and Kenyan athletes were approached at race meetings or a training camp. In all, 82 UK and 75 Kenyan athletes participated (70% and 90% of those invited) along with 97 and 101 non-athlete, age-matched controls from the two countries. All participants completed the Eating Disorder Examination Questionnaire (EDE-Q) and assessments of dieting, mental health, self-esteem and menstrual function.ResultsUK women had significantly higher levels of eating disorder psychopathology and more probable present and past eating disorders than enyan women. Overall, 19.5% of the UK runners had a probable present or past eating disorder, confirming the results of our earlier study (Hulley & Hill, 2001). Kenyan runners had the lowest proportion of probable cases compared with all other groups and the least eating disorder psychopathology. Athletic participation was associated with less regular menstrual periods, regardless of nationality.ConclusionThese findings confirm that participation in distance running at an elite level does not in itself predispose to an eating disorder. Eating disorder risk is better represented as a combination of cultural values, elite sporting environment and person variables.     

Reciprocal relationships between State gratitude and high- and low-arousal positive affects in daily life: A time-lagged ecological assessment study

ABSTRACT

This study assessed whether state gratitude and high and low-arousal positive affect show reciprocal relationships in daily life, and whether these relationships are dependent of inter-individual differences in positive mental health or psychopathology. 106 participants reported on momentary gratitude and positive affects throughout 7 consecutive days, using the Experience Sampling Method. Multilevel time-lagged regression analyses showed that state gratitude, cheerfulness and satisfaction reciprocally predict one another from one moment to the next. The strength of the prospective relationships between state gratitude(t-1) and both cheerfulness(t) and satisfaction(t) did not vary as a function of inter-individual differences in positive mental health or psychopathology. However, the prospective effects of both cheerfulness(t-1) and satisfaction(t-1) on state gratitude(t) were significantly stronger for individuals with low vs. high levels of psychopathology. In addition, the prospective effect of cheerfulness(t-1) on state gratitude(t) was significantly stronger for those with high vs. low positive mental health.     

How to Think about ‘Mental Ability’ in Running and Other Sports

ABSTRACT

Coaches and athletes often talk about ‘mental abilities’ that improve athletic performance in a way distinct from physical talents. But the existence of distinct mental abilities in sport is prima facie implausible since (dualists aside) all mental states are physical states of the brain, and all physical bodily movements are the results of mental guidance. Yet it still seems useful and important to talk about a distinctly ‘mental’ aspect of athletic performance. In this paper, I try to clarify what a distinctly mental realm of sports would be and discuss how we can talk about it in ways that can help athletes improve.     

Do time in abstinence,emotional intelligence and psychopathology predict the sensation of craving in persons with SUD?

IntroductionSubstance use is a global health problem. Craving is one of the main predictors of relapse. If the presence of psychopathology and the deficit of emotional intelligence are combined, the course and outcome of the disease can worsen.ObjectiveThe aim is to analyze the impact of time in abstinence, psychopathology, and emotional intelligence on the sensation of the craving in people with substance use disorders in treatment, comparing two methodologies (hierarchical linear regressions and comparative qualitative analysis).MethodThe participants, after signing the informed consent, were assessed in abstinence, psychopathology (SA-45), emotional intelligence (TMMS-24), and craving.ResultsThe results showed that craving was positively associated with psychopathology, shorter abstinence times, and younger age. Increased emotional attention was associated with increased psychopathology. Craving was explained by less time in abstinence using hierarchical regression models. In QCA models, high levels of craving were predicted by the interaction between high levels of psychopathology, shorter abstinence times, lower emotional repair, and high emotional attention. Low levels of craving were due to less psychopathology, prolonged abstinence, and emotional intelligence.ConclusionThe methodologies are complementary because combining them makes it easier to understand the problem of consumption.     

Religious experience and mental health: anthropological and psychological approaches

ABSTRACT

Moreira-Almeida, Sharma, van Rensburg, Verhagen and Cook have written a very comprehensive position statement pertaining to religion and psychiatry. While presenting a good overview of studies of religion, spirituality and mental health it does not include the important area of the health implications of religious experience which is the focus of this piece. I begin by discussing definitions of religious experience before examining the work of William James. The second part of this paper focuses upon specific religious experiences and psychopathology with a focus on mysticism, hallucinations and culture.     

Big men feeling small: Childhood bullying experience, muscle dysmorphia and other mental health problems in bodybuilders

ObjectivesMuscle dysmorphia (MD) is a preoccupation with the idea that one's body is insufficiently lean and muscular and considered as a body image disorder in men. This study aimed to investigate the relationship of MD with childhood bullying victimization experiences and mental health problems in a nonclinical sample of male bodybuilders.DesignA cross-sectional study was conducted with a sample of 100 male bodybuilders.MethodsParticipants completed a questionnaire battery consisting of the muscle dysmorphic inventory (MDI), and scales on childhood bullying victimization, self-esteem, and psychological problems including depression, anxiety and obsessive-compulsive (OC) symptoms.ResultsHigh scores on the MDI and bullying victimization in childhood predicted global psychopathology and low self-esteem. Psychological functioning and self-esteem were most strongly adversely affected if the men were victims of bullying and scored high on the MDI (significant moderation effect). Structural equation modeling (SEM) analyses furthermore found an indirect linkage of victimization with global psychopathology and self-esteem via MDI (mediation effect).ConclusionsChildhood bullying victimization and MD are strongly associated with concurrent anxiety, depressive and obsessive-compulsive symptoms and low self-esteem.     

Parent–child warmth as a potential mediator of childhood exposure to intimate partner violence and positive adulthood functioning

Background and Objectives: Links between childhood exposure to intimate partner violence (IPV) and adult functioning are clear, but less research has examined the potential underpinnings of this association, especially the long-term effects of the parent–child relationship on adult well-being. We hypothesized that (i) childhood exposure to IPV would be negatively related to parent–child warmth and positively related to symptoms of psychopathology during adulthood and (ii) the relationship between IPV exposure and positive outcomes in adulthood (i.e., high life satisfaction and low psychopathology) would be mediated by parent–child warmth. Design: Participants included 703 Swedish adults (20–24). Methods: Participants responded to a self-report survey assessing violence exposure, parental warmth in childhood, and current mental health and well-being. Using multivariate regression and path analysis, models of the relationships between IPV exposure, parent–child warmth, symptoms of psychopathology during adulthood, and life satisfaction were examined. Mediation models were considered exploratory. Results: IPV exposure was related to lower levels of parent–child warmth, higher levels of psychopathology symptoms, and lower life satisfaction. The relationship between IPV exposure and positive outcomes in adulthood was mediated by parent–child warmth. Conclusions: Warm parent–child interactions may play a key role in long-term positive functioning for those exposed to IPV during childhood.     

Distinction between mental pain and psychic suffering as separate entities in the patient's experience

Abstract

Mental pain and psychic suffering are herein defined as two separate concepts in psychoanalysis. The concept of mental pain lies at the core of psychoanalysis; it was introduced by Freud and was further elaborated by a number of investigators, mostly by Bion. Mental pain refers to a pain that the patient reports as being impossible to describe in words, and lacking any associations, whereas psychic suffering can be both named and described by the patient. Mental pain is derived from non-tolerance on the part of the psychic apparatus when it is harmed by very painful emotions. In contrast to psychic suffering, mental pain resists elaboration and transformation by dream-work. How to address and transform the patient's mental pain is a major challenge facing the analyst in his clinical work because mental pain may halt or slow the progression of the analytical process. To overcome this hindrance, the work of the analyst is focused on helping patients to modify their mental pain into psychic suffering, that is, to reactivate in the patient the chain of transformations that generates thought. The analyst is also challanged with the mental pain of the patients because he has himself to tolerate the mental patient induced by counter transference. Suggestions for the analyst on how to deal with the mental pain of the patient during psychoanalytic therapy are proposed.     

A feasibility study of psychological strengths and well-being assessment in individuals living with recurrent depression

Current conceptualizations of mental illness focus on assessing psychopathology. A balanced approach would assess strengths that individuals bring to coping with illness. This study measures psychological strengths in individuals with recurrent depression, their coping strategies, and their perceptions of the usefulness of strengths assessment as a component of psychological assessment. Individuals (N?=?112) with recurrent depression completed an online questionnaire measuring several psychological strengths, including gratitude, forgiveness, spirituality, and hope. Participants also described their use of coping strategies and their reaction to the utility of the two-continua model of mental health. A subset (n?=?10) completed a follow-up telephone interview. Higher levels of gratitude, self-forgiveness, hope, and spirituality and lower levels of optimism were indicative of higher life satisfaction. Self-forgiveness, spirituality, and gratitude were predictors of happiness. Higher levels of hope and self-forgiveness predicted positive affect whereas lower levels of self-forgiveness predicted negative affect. Participants reported using a range of coping resources and indicated that they valued strengths assessment, perceiving the two-continua model of mental health as empowering. The researcher discusses implications for clinical practice.     

Tactical steering behaviour under irrevocable visual occlusion

ObjectiveTo investigate the extent of a driver’s mental model with irrevocable visual occlusion and analysing the distance to crash.BackgroundDrivers have a mental model of the immediate surroundings which allows them to predict their own as well as others’ travel paths. To navigate safely through traffic, this mental model has to be updated frequently to remain valid. In between information sampling events, the mental model will become outdated over time, as the traffic system is dynamic.MethodA simulator study with 22 participants was conducted to investigate the information decay in the mental model. This was implemented by extending visual occlusion until the driver collided with another vehicle or ran off the road, thus providing an estimate of how long it takes until the mental model becomes obsolete.ResultsAn analysis of variance with the factors curve direction, curve radius and traffic showed that curve radius did not influence the distance to crash. Without traffic, drivers veered off the road sooner in right curves. Adding traffic eliminated this difference. Traffic ahead led to a shortened distance to crash. Compared to a tangential travel path from the current lateral position at the time of the occlusion, drivers crashed on average 2.6 times later than they would have, had they not had any mental model of the situation.ConclusionsThe drivers’ mental representation of the future situation seems to include information on how to act, to alleviate deviations in yaw angle, including and considering the presence of other road users.     

Taming the Brain Weasels: Reducing Self-Criticism Through Externalization and Compassion

ABSTRACT

Self-criticism is a natural process occurring across mental health disorders. When self-criticism is excessive, vulnerability to mental health disorders such as depression and anxiety increases. Compassion-focused approaches can effectively address a variety of concerns; however, highly self-critical individuals might balk at the idea of self-directed compassion due to shame, self-blame, or discomfort with positive emotions, resulting in treatment resistance. The brain weasel is an intervention strategy that uses the Narrative Therapy technique of externalization as an intermediate step toward compassion-oriented work. Through creative externalization and therapeutic humor, self-critical individuals can decenter and explore their self-critical dialogue. This article contains several ways to introduce and use the brain weasel personification in counseling.     

Psychological research questions about yoga

There are two kinds of scientific questions about procedures such as yoga: ‘process' questions and ‘outcome’ questions. Research on the effectiveness of yoga indicates that it has a variety of beneficial effects, but there is more doubt about whether it has unique effects. A broad range of procedures which combine physical stillness with mental alertness seem to have comparable effects. More subtle questions arise concerning the ‘processes' by which yoga achieves its effects, and both mental and physical processes need to be investigated. Concerning physical aspects, attention needs to be given to the under-explored effects of posture on states of consciousness. Concerning mental aspects, the ‘focusing’ of consciousness is likely to be important; an unusual aspect of many forms of yoga is the somatic focus of consciousness. Also relevant are the critical comments of Jung about appropriateness of yoga in the West. Though Jung's views on this should not be accepted uncritically, they can be taken as setting an agenda for a research programme.     

Notes on Time and Aspect

Abstract

What is time? Neither the numbering of the motion of things nor their schema, but their way of being. In language, time shows itself as tense. But every verb has both tense and aspect. So what is aspect? Irreducible to tense, it is the way in which anything is at any time whatsoever. Thus the way things are, their being, is not merely temporal – for it is just as aspectual.     

Eye movement inductions influence health behaviour: the working memory account of persuasion

Abstract

Objective: Because the working memory (WM) has a limited capacity, the cognitive reactions towards persuasive information in the WM might be disturbed by taxing it by other means, in this study, by inducing voluntary eye movements (EMi). This is expected to influence persuasion.

Methods: Participants (N?=?127) listened to an auditory persuasive message on fruit and vegetable consumption, that was either framed positively or negatively. Half of them was asked to keep following a regularly moving dot on their screen with their eyes. At pretest, cognitive self-affirmation inclination (CSAI) was assessed as individual difference to test possible moderation effects.

Results: The EMi significantly lowered the quality of the mental images that participants reported to have of the persuasive outcomes. With regard to self-reported fruit and vegetable consumption after two weeks, EMi significantly lowered consumption when CSAI was high but it significantly increased consumption when CSAI was low.

Conclusions: The results verify our earlier findings that induced EM can influence persuasion. Although it remains unclear whether the effects of EMi were caused by disturbing mental images of persuasive outcomes or self-regulative reactions to these images, or both, the WM account may provide new theoretical as well as practical angles on persuasion.     

Ethical and Legal Considerations in the Training of Mental Health Professionals

Summary

A discussion is provided regarding ethical and legal considerations that relate to the training of mental health professionals. A training program which emphasizes a proactive approach to identifying and resolving potential ethical and legal problems, and their close connection with clinical issues is described, as are the responsibilities of supervisors and supervisees in such a program. For illustrative purposes, a training vignette and a clinical vignette conclude the article.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.