Relationships Stage 4 • Stage 1: Womb – 12 months – Motor Functions and security • Stage 2: 6 months – 2 years old – Mobility and emotion • Stage 3: 18 months – 4 years old – Will and action • Stage 4: 4 – 7 years old – Social Identity • Stage 5: 7 – 12 years old – Social contract • Stage 6: Adolescence – Reconstitution • Stage 7: Early Adulthood and Beyond – Self-knowledge Stage 4: 4 – 7 years Behaviours are consciously adapted to gain or express love Ego development forms the foundation for relationship with others Family provide the first model for relationship formation Internalised family relationships are used for interaction with peers Self-esteem is greatly influenced by these relationships Stage 4: Relationships Conceptual thinking and logic, as a product of the generation of cognitive maps, allows a perception of the world as a complex set of relationships Why does fire burn? Why is he wearing a hat and you aren’t? Self-acceptance allows for the acceptance of others More likely with a secure group Stage 4: Social Identity Social identity (“Persona” – mask) created to interact with others The part of ourselves that the ego allows to rise above the surface, subsequent to consequence (response) control Self-concept initially based on how we are treated Whether we are admired or criticised, identification of self through relationships Maturation includes perception of service to others Self-acceptance expands beyond self-centred needs and embraces external awareness Stage 4: Comparative models Erikson: initiative vs guilt resolution brings direction and purpose Jung: Persona corresponds with archetypal structures – the helper, the pleaser, the entertainer, the lost child, the hero, “good girl/bad girl”, rebel, angel, etc. Stage 4: Comparative models Freud: Phallic Stage Primary erogenous zone is the genitals Oedipus complex: Natural love of parent transfers libidal energy from anal region to genitals. Aggression arises towards father, sexual competition who removed females’ penis (castration anxiety). Life sexual role develops from identification with father in attempt to possess mother Electra complex: Realisation of no penis (penis envy – blaming mother for penis removal), attempted possession of father, always remain slightly fixated at this stage Phallic character: reckless, narcissistic, afraid of close love, possible root cause of homosexuality Stage 4: Trauma Trauma may result in judgemental attitude toward sexual orientation May be caused by parental dysfunction, racial strife, cultural prejudice, war Broken will, inability to communicate – lack of a voice Feelings of rejection and loss (relationship – advanced external connectivity) Feelings of love, the right to love and be loved Bowlby’s Attachment Theory • John Bowlby (1969): Attachment Theory • Early emotional communication between children and their significant attachment figures • Directly impacts mental health in later life Internal working models • Internal working models formed through the shared level of predictability (trust) of infant’s display of signals and parental response ▫ i.e. Treatment should predictably influence the child’s development ▫ Psychodynamic theory including evolutionary and cybernetic theories ▫ Potentially including behavioural genetics Attachment Paradigm • Behaviour patterns in early life will be directly comparable to behaviour patterns in later life ▫ Relationships ▫ Mental Health ▫ Social/Cognitive challenges • Assumptions: ▫ Blank-slate (behaviourist) philosophy ▫ Attachment as evolutionary advantage (survival mechanism) ▫ Assumes all children seek close proximity with their attachment figures ▫ Assumes parent’s role is to orient towards, to comfort, and overall for the survival of the child Ainsworth’s Strange Situation • Ainsworth (1973) : Strange Situation Paradigm • Assesses security of infant-adult attachment by exposing infants to increasing amounts of stress to observe their organisation of attachment behaviours ▫ ▫ ▫ ▫ Secure Insecure-avoidant Anxious-ambivalent Disorganised (Main & Solomon, 1990) • Predictive of behaviour and mental health in later life Adult Attachment Interview (AAI) • Berkeley AAI: Semi-structured interview about childhood attachment relationships and the meaning that the individual currently gives to past experiences in these relationships ▫ ▫ ▫ ▫ Secure Dismissing Preoccupied Disorganised Secure group • Uses one or a few attachment figures as a secure base from which to explore novel environments • Confident of those persons’ availability, responsiveness and competence to serve as a secure base • Learned rules of social interaction from the caregiver • Learned reciprocity and predictability • Child sees caregiver as responsive and accessible which allows for competent social interaction with other people Secure group • Predicts superior problem-solving abilities • Increased persistence and enthusiasm in cognitively challenging situations • Engage in more positive peer interactions • Desire to reengage in interaction and use proponent signals to attract comfort and assistance Secure group • More coherent, elaborate and emotionally open at age 6 • Represent themselves more positively in interviews • More willing to accept less-than-perfect aspects of self Insecure-avoidant • Working model of the caregiver as rejecting or inconsistent • Child later relies on hostile, aggressive, hesitant or impulsive interaction styles • Less likely to engage in exploratory behaviour in their attempts to maintain attachments to rejecting or inconsistent parents may not express needs for closeness Insecure-avoidant • Leads to social isolation including family disengagement • Less socially desirable parenting – overstimulation, rejection or coldness • Increased likelihood of depression (separation anxiety disorders) Anxious-ambivalent • Employment of hyperactivation strategies, hypervigilent for threat and rejection cues due to unpredictable responses of caregivers • Similar outcomes as insecure-avoidant • Likely to play down relationships or the importance of love • Less likely to develop stable relationships etc Disorganised subtype • Contradictory behaviour patterns • Chaotic, conflicted behaviour • Apparent incapability of applying any consistent attachment strategy • Parents may be frightening and do little to ease distress in child Disorganised subtype • May be a result of severe failures in early attachment, abuse and neglect • May not receive any fulfilment of comfort even when best attempts are made to meet their needs (learned helplessness) • Associated with high levels of antisocial and externalised behaviour problems • Impairment in stress and coping-related functions, leading to maladaptive mental health Disorganised subtype • Associated with psychopathology ▫ Personality disorders as extensions of attachment disruptions ▫ splitting: child internalises negative views in order to maintain a false security attachment to a rejecting or abusive parent ▫ leads to negative self-image in later life • Contradictory evidence • Does not offer framework for objective analysis of internal working models • Vast evidence supporting • Continuity of behaviour predictability of adult patterns into adulthood can behaviour change easily (50% of secure infants changed to insecure • Neural corollaries built in styles after experiencing a childhood correspond with negative life event) attachment behaviours • Blank-slate philosophy does not account for genetic • Cognitive evidence of evidence (twin studies etc)… internal working models yet. • Lack of cross-cultural studies and varied sampling Love • Harlow (1958) • Experimental Monkey mothers – groups with surrogates made from cloth or wire, and presented with fearful or stimulating objects ▫ Basic need in infant monkeys for close contact with something soft and comforting ▫ Babies seek out their mothers when afraid ▫ Attachment persists after periods of seperation Harlow (1958) • Fulfilling of biological needs (hunger and thirst) was of almost no importance in the money’s choice of mother. ▫ Contact Comfort • Infants with wire mother did not digest the milk as well and got diarrhea • Criticism: ▫ Attachment is slower in humans ▫ Unethical animal experiments Sexuality In Mental Illness Sex Genotypic (XX female, XY male), and Phenotypic categories (physical and behavioural level) Kelly (1991) reported that 1 in 20,000 males have two X chromosomes and no Y and 1 in 20,000 females have XY chromosomes Sex mosaic genetics can exist whereby a person has some XX and some XY genes male genotype) with androgen sensitivity syndrome (female phenotype), XX individuals with congenital adrenal hyperplasia, manifesting male genetalia Intersex, phenotypic irregularities (including those born with genetalia deemed ambiguous, such as having hypertrophied clitorises, micropenises and interabdominal testes), as distinct from male and female biological categories between 1 and 2 per 1,000 livebirths receive genital reassignment surgery, and 1 in every 1500-2000 people are born with ambiguous genitalia such that sex differentiation specialists are needed true hermaphrodites: develop ovotestes, containing both ovarian and testicular tissue Gender Gender: the sex role to which a person is assigned in a wider social context Gender Identity Disorder: involving individual persistent discomfort with assigned sex or a sense of inappropriateness in the gender role of that sex American law mandates the presence of two sexes which must be labelled at birth, and that label may not be changed so medical categorisation of intersex may be psychologically traumatic Transsexuality: outside of the biological category of intersex 1 in 30,000 adult males and 1 in 100,000 adult females seek sex reassignment surgery 1 in 11,900 males and 1 in 30,400 females in Holland as being transsexual Cross-sex hormones, mastectomy, neophallus surgery and other interventions offer valuable treatment little evidence shows that psychological treatment of gender identity disorder and transsexualism is effective (a comparable disorder but in adults) Orientation Orientation: a person’s entire set of fantasies, romantic emotion and sexual inclinations “the sex of the erotic/love/affectional partners a person prefers” (Diamant & McAnulty, 1995) externalised sexual behaviour is separate, although related, to sex and gender identity degree of measurability on a classification scale between Heterosexual and Homosexual Behavioural manifestations of desires for specific behaviours and fetishes are often forced into non-mainstream, underground culture, as seen in the vast arrays of specific pornographies available on the internet and elsewhere Arousal Integration of psychological and physiological influences, after which psychology guides the response in behaviour Emotions, thoughts, attitudes and beliefs are all integrated in orientation, and arousal likewise incorporates these processes, often with an aim of resolution, be it orgasm or spiritual unification Some evidence shows that women are more likely to engage in sexual behaviours without arousal (Geer & Broussard, 1990), showing emphasis of social factors in determination of behaviour. Arousal Activation of the gonads through stimulation of the anterior pituitary gland by the hypothalamic region of the forebrain, which then releases the gonadotropic hormone, follicle-stimulating hormone and luteinising hormone Estrogen is the predominate gonadal hormone of the female, which, with luteinising hormones and progesterone, stimulate ovulation Testosterone is more linked with sexual arousal and behaviour, seen more dominantly in the male gamete production by the luteinising hormone • Anxious-ambivalent and avoidant children are more likely to have low self esteem and poor relationship skills • Insecure parent-child relationship have been significantly associated with coercive sexual behaviours • Anxious-ambivalent relations show a likelihood of high responsivity to any adult attention, thus being more susceptible to child abuse, which may later influence relationship and sexual development •Physiological arousal patterns act as reinforcers •A person can pair sexual stimulation or arousal with any possible neutral or unconditioned stimulus •Initial sexual experiences may have a disproportionate impact on long-term sexual arousal, especially on association with subsequent sexual experience, such as masturbation •positive and negative reinforcement of masturbation, • whereby a child may masturbate for pleasure, or as a coping strategy to elude negative situations • power and control, • humiliation and expression of aggression Money (1988) also claimed a parallel of sexuality with language development Roche & Barnes (1998) offer a conditioning theory whereby behavioural conditioning may occur through a linguistic process of semantic overlapping pyrolangia, sexual gratification from lighting fires, may be seen as an outcome from connections between sexual arousal and words like “hot”, “burning” and “explosive” Sexual disorders mental illnesses involving apparent violations of social norms of sexuality orientation to include objects, concepts, or in some cases, elements Paraphilias: eight major categories and seven subtypes include attraction to unusual objects or activities, sometimes involving sexually deviant behaviours involving harm Voyeurism, for example, which involves the intense and recurrent desire for sexual gratification through watching others undress or have sex Sadist needs to inflict physical suffering or humiliation in order to achieve sexual gratification only diagnosed if present without another axis-I disorder observation, participation or fantasy must be necessary for the individual to achieve sexual arousal and gratification a diagnosis under the DSM-IV must be inclusive of subjective distress or impairments in normal functioning Pedophilia Orientations are directed towards children under 13 years of age Children deemed too young to understand the requirements for informed consent What is sex, possibilities of psychological and social dilemmas Any pedophile who does act on their fantasies then becomes a child molester and, if legally convicted of this crime, a sex offender Studies of pedophiles show less than 15% of them to be classifiable as having a psychopathology under the Minnesota Multiphasic Personality Inventory (Erickson, Luxenberg, Walbek & Seely, 1987). Only a very small number of pedophiles are actually child molesters, and many child molesters are not, in fact, pedophiles (Diamont & McAnulty, 1995). Inaccurate beliefs, such as a pedophile thinking that a child can consent to and enjoy sex, may be a vital point for therapeutic modulation Childhood Sexual Abuse 13.5% of women, 2.5% of men About half of children exposed to CSA will develop symptoms such as depression, low self-esteem, conduct disorder or anxiety disorders like PTSD. Almost half do not appear to experience adverse short-term effects Childhood Sexual Abuse Can lead to dissociative identity disorder, eating disorders, borderline personality disorder, sexual dysfunction and substance abuse Negative reactions increase when a perpetrator threatens a child, the child blames his/herself, or the family is unsupportive. More pronounced when CSA involves sexual intercourse Childhood Sexual Abuse Psychological Factors Betrayal: Molester is usually not a stranger, which tears the allegiance of the child between the abuser and the fear, revulsion and knowledge that it is wrong Power of authority figures Self-blame Childhood Sexual Abuse Problems with Research Sampling Bias: Over-estimation of role of abuse in treatment, Under-estimation in research with college students Repressed memories cannot always be accepted as real when recovered during therapy Many courts now refuse to allow testimony based on recovered memories Childhood Sexual Abuse Genetic and Environmental Risks: Internal family incest often includes alcohol addiction and other psychopathology, thus it is difficult to isolate the effects of abuse Prevention Teach children to recognise inappropriate adult behaviour. May result in altered manifested behaviour of child May empower the child to tell parents/teachers if they have been abused Dealing with the Problem Great skill required in questioning children to avoid biasing Parents often overwhelmed with shame, guilt, fear or anger Much less likely for internal family incest to be reported When states within the USA first passed legislation requiring healthcare professionals and teachers to report suspected child abuse, confirmed cases rose from 50 to 500%