Gale Encyclopedia of Psychology clear version in English

four personality types are still in common use today. The ploring unconscious thoughts, motivations, and conflicts theory of temperaments is among a variety of systems through the use of free association and other techniques. that deal with human personality by dividing it into Another distinctive feature of Freudian psychoanalysis Personality types. A widely popularized (but scientifically dubious) is its emphasis on the importance of childhood experi- modern typology of personality was developed in the ences in personality formation. Other psychodynamic 1940s by William Sheldon, an American psychologist. models were later developed by colleagues and followers Sheldon classified personality into three categories based of Freud, including Carl Jung, Alfred Adler, and Otto on body types: the endomorph (heavy and easy-going), Rank (1884-1939), as well as other neo-Freudians such mesomorph (muscular and aggressive), and ectomorph as Erich Fromm, Karen Horney, Harry Stack Sullivan (thin and intellectual or artistic). (1892-1949), and Erik Erikson. Trait theory of personality Phenomenological theory of personality A major weakness of Sheldon’s morphological clas- Another major view of personality developed during sification system and other type theories in general is the the twentieth century is the phenomenological approach, element of oversimplification inherent in placing individ- which emphasizes people’s self- perceptions and their uals into a single category, which ignores the fact that drive for self-actualization as determinants of personali- every personality represents a unique combination of ty. This optimistic orientation holds that people are in- qualities. Systems that address personality as a combina- nately inclined toward goodness, love, and creativity tion of qualities or dimensions are called trait theories. and that the primary natural motivation is the drive to Well-known trait theorist Gordon Allport (1897-1967) fulfill one’s potential. Carl Rogers,the figure whose extensively investigated the ways in which traits com- name is most closely associated with phenomenological bine to form normal personalities, cataloguing over theories of personality, viewed authentic experience of 18,000 separate traits over a period of 30 years. He pro- one’s self as the basic component of growth and well- posed that each person has about seven central traits that being. This experience together with one’s self-concept dominate his or her behavior. Allport’s attempt to make can become distorted when other people make the posi- trait analysis more manageable and useful by simplifying tive regard we need dependent on conditions that require it was expanded by subsequent researchers, who found the suppression of our true feelings. The client-centered ways to group traits into clusters through a process therapy developed by Rogers relies on the therapist’s known as factor analysis. Raymond B. Cattell reduced continuous demonstration of empathy and unconditional Allport’s extensive list to 16 fundamental groups of inter- positive regard to give clients the self-confidence to ex- related characteristics, and Hans Eysenck claimed that press and act on their true feelings and beliefs. Another personality could be described based on three fundamen- prominent exponent of the phenomenological approach tal factors: psychoticism (such antisocial traits as cruelty was Abraham Maslow,who placed self-actualization at and rejection of social customs), introversion-extrover- the top of his hierarchy of human needs. Maslow focused sion, and emotionality-stability (also called neuroticism). on the need to replace a deficiency orientation, which Eysenck also formulated a quadrant based on intersecting consists of focusing on what one does not have, with a emotional-stable and introverted-extroverted axes. growth orientation based on satisfaction with one’s iden- tity and capabilities. Psychodynamic theory of personality Behavioral theory of personality Twentieth-century views on personality have been heavily influenced by the psychodynamic approach of The behaviorist approach views personality as a pat- Sigmund Freud . Freud proposed a three-part personality tern of learned behaviors acquired through either classi- structure consisting of the id (concerned with the gratifi- cal (Pavlovian) or operant (Skinnerian) conditioning cation of basic instincts), the ego (which mediates be- and shaped by reinforcement in the form of rewards or tween the demands of the id and the constraints of soci- punishment. A relatively recent extension of behavior- ety), and the superego (through which parental and so- ism, the cognitive-behavioral approach emphasizes the cial values are internalized). In contrast to type or trait role cognition plays in the learning process. Cognitive theories of personality, the dynamic model proposed by and social learning theorists focus not only on the out- Freud involved an ongoing element of conflict, and it ward behaviors people demonstrate but also on their ex- was these conflicts that Freud saw as the primary deter- pectations and their thoughts about others, themselves, minant of personality. His psychoanalytic method was and their own behavior. For example, one variable in the designed to help patients resolve their conflicts by ex- general theory of personality developed by social learn- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 491

The concept of personality refers to the profile of Personality development ing theorist Julian B. Rotter is internal-external orienta- stable beliefs, moods, and behaviors that differentiate tion. “Internals” think of themselves as controlling among children (and adults) who live in a particular so- events, while “externals” view events as largely outside ciety. The profiles that differentiate children across cul- their control. Like phenomenological theorists, those tures of different historical times will not be the same be- who take a social learning approach also emphasize peo- ple’s perceptions of themselves and their abilities (a con- cause the most adaptive profiles vary with the values of the society and the historical era. An essay on personali- cept called “self-efficacy” by Albert Bandura). Another characteristic that sets the cognitive-behavioral approach Puritan would have listed piety as a major psychological apart from traditional forms of behaviorism is its focus on learning that takes place in social situations through ty development written 300 years ago by a New England trait but that would not be regarded as an important per- observation and reinforcement, which contrasts with the sonality trait in contemporary America. dependence of classical and operant conditioning mod- Contemporary theorists emphasize personality els on laboratory research. traits having to do with individualism, internalized con- Aside from theories about personality structure and science, sociability with strangers, the ability to control dynamics, a major area of investigation in the study of strong emotion and impulse, and personal achievement. personality is how it develops in the course of a person’s An important reason for the immaturity of our un- lifetime. The Freudian approach includes an extensive derstanding of personality development is the heavy re- description of psychosexual development from birth up liance on questionnaires that are filled out by parents of to adulthood. Erik Erikson outlined eight stages of devel- children or the responses of older children to question- opment spanning the entire human lifetime, from birth to naires. Because there is less use of behavioral observa- death. In contrast, various other approaches, such as tions of children, our theories of personality develop- those of Jung, Adler, and Rogers, have rejected the no- ment are not strong. tion of separate developmental stages. There are five different hypotheses regarding the An area of increasing interest is the study of how early origins of personality (see accompanying table). personality varies across cultures. In order to know One assumes that the child’s inherited biology, usually whether observations about personality structure and for- called a temperamental bias, is an important basis for the mation reflect universal truths or merely cultural influ- child’s later personality. Alexander Thomas and Stel- ences, it is necessary to study and compare personality laChess suggested there were nine temperamental di- characteristics in different societies. For example, signif- mensions along with three synthetic types they called the icant differences have been found between personality difficult child, the easy child, and the child who is slow development in the individualistic cultures of the West to warm up to unfamiliarity. Longitudinal studies of chil- and in collectivist societies such as Japan, where chil- dren suggest that a shy and fearful style of reacting to dren are taught from a young age that fitting in with the challenge and novelty predicts, to a modest degree, an group takes precedence over the recognition of individ- adult personality that is passive to challenge and intro- ual achievement. Cross-cultural differences may also be verted in mood. observed within a given society by studying the contrasts between its dominant culture and its subcultures (usually A second hypothesis regarding personality develop- ethnic, racial, or religious groups). ment comes from Sigmund Freud’s suggestion that vari- ation in the sexual and aggressive aims of the id, which Further Reading is biological in nature, combined with family experi- Allport, Gordon W. Personality and Social Encounter: Select- ence, leads to the development of the ego and superego. ed Essays. Boston: Beacon Press, 1960. Freud suggested that differences in parental socializa- Eysenck, Hans. The Structure of Human Personality. London: tion produced variation in anxiety which, in turn, leads Methuen, 1970. to different personalities. Mischel, Walter. Introduction to Personality. 4th ed. New York: A third set of hypotheses emphasizes direct social Holt, Rinehart, and Winston, 1986. experiences with parents. After World War II, Americans and Europeans held the more benevolent idealistic con- ception of the child that described growth as motivated by affectionate ties to others rather than by the narcis- sism and hostility implied by Freud’s writings. John Personality development Bowlby contributed to this new emphasis on the infant’s The development of the beliefs, moods, and behav- relationships with parents in his books on attachment. iors that differentiate among people. Bowlby argued that the nature of the infant’s relationship 492 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

to the caretakers and especially the mother created a pro- Influences on personality development file of emotional reactions toward adults that might last The influence comes from a variety of tempera- indefinitely. ment but especially ease of arousal, irritability, fearful- A fourth source of ideas for personality centers on ness, sociability, and activity level. The experiential con- whether or not it is necessary to posit a self that moni- tributions to personality include early attachment rela- Personality development tors, integrates, and initiates reaction. This idea traces tions, parental socialization, identification with parents, itself to the Judeo-Christian assumption that it is neces- class, and ethnic groups, experiences with other children, sary to award children a will so that they could be held ordinal position in the family, physical attractiveness, responsible for their actions. A second basis is the dis- and school success or failure, along with a number of un- covery that children who had the same objective experi- predictable experiences like divorce, early parental ences develop different personality profiles because death, mental illness in the family, and supporting rela- they construct different conceptions about themselves tionships with relatives or teachers. and others from the same experiences. The notion that The most important personality profiles in a particu- each child imposes a personal interpretation to their ex- lar culture stem from the challenges to which the chil- periences makes the concept of self critical to the child’s dren of that culture must accommodate. Most children personality. must deal with three classes of external challenges: (1) An advantage of awarding importance to a concept unfamiliarity, especially unfamiliar people, tasks, and of self and personality development is that the process of situations; (2) request by legitimate authority or confor- identification with parents and others gains in signifi- mity to and acceptance of their standards, and (3) domi- cance. All children wish to possess the qualities that their nation by or attack by other children. In addition, all culture regards as good. Some of these qualities are the children must learn to control two important families of product of identification with each parent. emotions: anxiety, fear, and guilt, on the one hand, and on the other, anger, jealousy, and resentment. A final source of hypotheses regarding the origins of personality comes from inferences based on direct obser- Of the four important influences on personality— vations of a child’s behavior. This strategy, which relies identification, ordinal position, social class, and parental on induction, focuses on different characteristics at dif- socialization—identification is the most important. By ferent ages. Infants differ in irritability, three-year-olds six years of age, children assume that some of the char- differ in shyness, and six-year-olds differ in seriousness acteristics of their parents belong to them and they expe- of mood. A major problem with this approach is that rience vicariously the emotion that is appropriate to the each class of behavior can have different historical an- parent’s experience. A six-year-old girl identified with tecedents. Children who prefer to play alone rather than her mother will experience pride should mother win a with others do so for a variety of reasons. Some might be prize or be praised by a friend. However, she will experi- temperamentally shy and are uneasy with other children ence shame or anxiety if her mother is criticized or is re- while others might prefer solitary activity. jected by friends. The process of identification has great relevance to personalty development. The current categories of child psychopathology influenced the behaviors that are chosen by scientists The child’s ordinal position in the family has its for study. Fearfulness and conduct disorder predomi- most important influence on receptivity to accepting or nate in clinical referrals to psychiatrists and psycholo- rejecting the requests and ideas of legitimate authority. gists. A cluster of behaviors that includes avoidance of First-born children in most families are most willing unfamiliar events and places, fear of dangerous ani- than later-borns to conform to the requests of authority. mals, shyness with strangers, sensitivity to punish- They are more strongly motivated to achieve in school, ment, and extreme guilt is called the internalizing pro- more conscientious, and less aggressive. file. The cluster that includes disobedience toward par- The child’s social class affects the preparation and ent and teachers, aggression to peers, excessive domi- motivation for academic achievement. Children from nance of other children, and impulsive decisions is middle-class families typically obtain higher grades in called the externalizing profile. These children are most school than children of working or lower-class families likely to be at risk for later juvenile delinquency. The because different value systems and practices are pro- association between inability of a three-year-old to in- moted by families from varied social class backgrounds. hibit socially inappropriate behavior and later antiso- cial behavior is the most reliable predictive relation The patterns of socialization used by parents also in- between a characteristic scene in the young child and fluence the child’s personality. Baumrind suggests that later personality trait. parents could be classified as authoritative, authoritarian, GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 493

Personality disorders or permissive. More competent and mature preschool and are not motivated to change it. Although the DSM-IV lists specific descriptions of ten personality disorders, children usually have authoritative parents who were these conditions are often difficult to diagnose. Some nurturant but made maturity demands. Moderately self- characteristics of the various disorders overlap. In other reliant children who were a bit withdrawn have authori- tarian parents who more often relied on coercive disci- cases, the complexity of human behavior makes it diffi- pline. The least mature children have overly permissive cult to pinpoint a clear dividing line between pathology and normality in the assessment of personality. There also parents who are nurturant but lack discipline. has been relatively little research done on some of the personality disorders listed in DSM-IV . Jerome Kagan Ph.D. The most effectively-diagnosed personality disorder is the antisocial personality. The outstanding traits of this Further Reading disturbance are an inability to feel love, empathy,or Ainsworth, M. B. S., M. C. Blehar, E. Waters, and S. Wall. Pat- loyalty towards other people and a lack of guilt or re- terns of Attachment. Hillsdale, NJ: L. Erlbaum, 1978. Bowlby, J. Attachment. New York: Basic Books, 1969. morse for one’s actions. Due to the lack of conscience ———. Loss: Sadness and Depression. New York: Basic that characterizes it, the condition that is currently Books, 1980. known as antisocial personality disorder was labeled ———. Separation: Anxiety and Anger. New York: Basic moral insanity in the nineteenth century. More recent Books, 1973. names associated with this personality type are psy- Erikson, E. H. Childhood and Society. New York: W. W. Nor- chopath and sociopath. Unable to base their actions on ton, 1963. anything except their own immediate desires, persons Kagan, J. Birth to Maturity. New York: Wiley, 1962. with this disorder demonstrate a pattern of impulsive, ir- ———. Galen’s Prophecy. New York: Basic Books, 1994. responsible, thoughtless, and sometimes criminal behav- ———. The Nature of the Child. rev. ed. New York: Basic ior. They are often intelligent, articulate individuals with Books, 1994. an ability to charm and manipulate others; at their most Rothbart, M. K. “Temperament in Childhood.” n G. A. Kohn- dangerous, they can become violent criminals who are stamm, J. E. Bates, and M. K. Rothbart, eds. Tempera- ment in Childhood. New York: Wiley, 1989, pp. 59-73. particularly dangerous to society because of their ability Thomas, A. and S. Chess. Temperament and Development. to gain the trust of others combined with their lack of New York: Brunner Mazel, 1977. conscience or remorse. There are both biological and psychosocial theories of the origin of antisocial personality disorder. Two of the major components of the antisocial personality—the Personality disorders constant need for thrills and excitement and the lack of anxiety about punishment—may be at least partially ex- Long-standing, deeply ingrained patterns of social- ly maladaptive behavior that are detrimental to plained by research suggesting that antisocial individuals those who display them or to others. experience chronic underarousal of the central and auto- nomic nervous systems. In one experiment, anticipation of an electric shock produced a dramatically lower in- Personality disorders constitute a separate diagnos- crease of tension in teenagers diagnosed with antisocial tic category (Axis II) in the American Psychiatric Associ- personality disorder than in other individuals. In terms of ation’s Diagnostic and Statistical Manual of Mental Dis- environmental influences, connections have been sug- orders (DSM-IV). Unlike the major mental disorders gested between the antisocial personality and various (Axis I), which are characterized by periods of illness and patterns of familial interaction, including parental rejec- remission, personality disorders are generally ongoing. tion or inconsistency and the retraction of punishment Often, they first appear in childhood or adolescence and when repentance is claimed. persist throughout a person’s lifetime. Aside from their persistence, the other major characteristic of personality Some personality disorders resemble chronic but disorders is inflexibility. Persons affected by these disor- milder versions of the mental disorders listed in Axis I of ders have rigid personality traits and coping styles that DSM-IV . In schizotypal personality disorder, for exam- they are unable to adapt to changing situations and that ple, the schizophrenic’s hallucinations or voices are impair their social and/or occupational functioning. A moderated to the less extreme symptom of an “illusion” further difference between personality disorders and the that others are present when they are not. Speech pat- major clinical syndromes listed in Axis I of DSM-IV is terns, while not incoherent like those of schizophrenia, that people with personality disorders generally do not tend to be vague and digressive. Similarly, avoidant per- perceive that there is anything wrong with their behavior sonality disorder has characteristics that resemble those 494 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

of social phobia, including hypersensitivity to possible Further Reading rejection and the resulting social withdrawal in spite of a Beck, Aaron. Cognitive Therapy of Personality Disorders. strong need for love and acceptance. The paranoid and Guilford Press, 1990. schizoid personality disorders are usually manifested Millon, T. Disorders of Personality. New York: Wiley, 1981. Personality inventory primarily in odd or eccentric behavior. The former is characterized mainly by suspiciousness of others, ex- treme vigilance against anticipated misdeeds, and insis- tence on personal autonomy. The latter involves emo- Personality inventory tional coldness and passivity, indifference to the feelings A method of personality assessment based on a of others, and trouble forming close relationships. questionnaire asking a person to report feelings or Several personality disorders, including antisocial reactions in certain situations. personality, are associated with extreme and erratic be- havior. The most dramatic is the histrionic personality Personality inventories, also called objective tests, type, which is characterized by persistent attention-get- are standardized and can be administered to a number of ting behavior that includes exaggerated emotional dis- people at the same time. A psychologist need not be pre- plays (such as tantrums) and overreaction to trivial prob- sent when the test is given, and the answers can usually lems and events. Manipulative suicide attempts may also be scored by a computer. Scores are obtained by compar- occur. Narcissistic personality disorder consists primari- ison with norms for each category on the test. A person- ly of an inflated sense of self-importance coupled with a ality inventory may measure one factor, such as anxiety lack of empathy for others. Individuals with this disorder level, or it may measure a number of different personali- display an exaggerated sense of their own importance ty traits at the same time, such as the Sixteen Personali- and abilities and tend to fantasize about them. Such per- ty Factor Questionnaire (16 PF). sons also have a sense of entitlement, expecting (and tak- The personality inventory used most often for diag- ing for granted) special treatment and concessions from nosing psychological disorders is the Minnesota Multi- others. Paradoxically, individuals with narcissistic per- phasic Personality Inventory,generally referred to as sonality disorder are generally very insecure and suffer the MMPI. It consists of 550 statements that the test taker from low self-esteem. Another personality disorder that has to mark as “true,” “false,” or “cannot say.” Answers is characterized by erratic behavior is the borderline are scored according to how they correspond with those personality. Individuals with this disorder are extremely given by persons with various psychological disorders, unstable and inconsistent in their feelings about them- including depression,hysteria, paranoia, psychopathic selves and others and tend toward impulsive and unpre- deviancy, and schizophrenia. The MMPI was originally dictable behavior. developed (and is still used) for the diagnosis of these and other serious psychological problems. However enough Several personality disorders are manifested primar- responses have been collected from people with less se- ily by anxiety and fearfulness. In addition to the avoidant vere problems to allow for reliable scoring of responses personality, these include the dependent, compulsive, from these persons as well. Many people with no severe and passive-aggressive personality disorders. Persons disorder are now given the MMPI as an assessment tool with dependent personality disorder are extremely when they begin psychotherapy, with scoring geared to- passive and tend to subordinate their own needs to those ward personality attributes rather than clinical disorders. of others. Due to their lack of self-confidence, they avoid asserting themselves and allow others to take responsi- The California Psychological Inventory (CPI), based bility for their lives. Compulsive personality disorder is on less extreme measures of personality than the MMPI, characterized by behavioral rigidity, excessive emotional assesses traits, including dominance, responsibility, self- restraint, and overly conscientious compliance with acceptance, and socialization. In addition, some parts of rules. Persons with this disorder are overly cautious and the test specifically measure traits relevant to academic indecisive and tend to procrastinate and to become over- achievement. Another inventory designed to measure a ly upset by deviations from rules and routines. Passive- spectrum of personality variables in normal populations aggressive personality disorder involves covert aggres- is the Personality Research Form (PRF), whose mea- sion expressed by a refusal to meet the expectations of surement scales include affiliation, autonomy, change, others in such areas as adequate job performance, which endurance, and exhibition. The Neuroticism Extrover- may be sabotaged through procrastination, forgetfulness, sion Openness Personality Inventory, Revised (NEO-PI- and inefficiency. This disorder is also characterized by R) also measures common dimensions of personality irritability, volatility, and a tendency to blame others for such as sensitivity and extroversion, but it differs from one’s problems. other tests in its inclusion of both “private” and “public” GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 495

versions. The questions in the private version are an- The incidence of pervasive development disorders Pervasive developmental disorder (PDD) swered like those in other personality inventories, but the (PDDs) in the general population is estimated at 1%. public version consists of having another person ac- These disorders are thought to be genetically based, and quainted with the test taker answer questions about him there is no evidence linking them to environmental fac- or her. Significant discrepancies between the two ver- tors. Many children who are diagnosed with PDDs today sions can be an important source of information for those would have been labeled psychotic or schizophrenic in interpreting the test. the past. The most serious form of pervasive develop- mental disorder is autism,a congenital condition charac- Further Reading terized by severely impaired social interaction, commu- Cronbach, L.J. Essentials of Psychological Testing. New York: nication, and abstract thought, and often manifested by Harper and Row, 1970. stereotyped and repetitive behavior patterns. Sundberg, N. The Assessment of Persons. Englewood Cliffs, NJ: Prentice-Hall, 1977. In addition to autism, several other conditions are considered pervasive developmental disorders by the American Psychiatric Association. Rett’s disorder is characterized by physical, mental, and social impairment that appears between the ages of five months and four Pervasive developmental years in children whose development has been normal up disorder (PDD) to that point. Occurring only in girls, it involves impair- ment of coordination, repetitive movements, a slowing of A group of conditions involving serious impair- ment in several areas of development, including head growth, and severe or profound mental retardation, physical, behavioral, cognitive, social, and lan- as well as impaired social and communication skills. guage development. Childhood disintegrative disorder is marked by the deteri- This autistic child is encouraged to interact with the guinea pig in an effort to improve his social interaction. (Photo by Helen B. Senisi. Photo Researchers, Inc. Reproduced with permission.) 496 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

oration of previously acquired physical, social, and com- Lewis, Vicky. Development and Handicap. New York: B. munication skills after at least two years of normal devel- Blackwell, 1987. opment. It first appears between the ages of two and 10, usually at three or four years of age, and many of its symptoms resemble those of autism. Other names for this Philosophical psychology disorder are Heller’s syndrome, dementia infantilis, and Phallic stage disintegrative psychosis. It sometimes appears in conjunc- tion with a medical condition such as Schilder’s disease, See Psychosexual stages but usually no organic cause can be found. Asperger’s disorder includes many of the same so- cial and behavioral impairments as autism, except for difficulties with language. Children with this disorder lack normal tools of social interaction, such as the abili- Philosophical psychology ty to meet someone else’s gaze, use appropriate body The area of study where psychology and philoso- language and gestures, or react to another person’s phy intersect, focusing on metaphysical and specu- thoughts and feelings. Behavioral impairments include lative problems in the study of mental processes. the repetitive, stereotyped motions and rigid adherence to routines that are characteristic of autism. Like child- One of the central questions in philosophical psy- hood disintegrative disorder, Asperger’s disorder is chology has been the relationship between the mind and thought to be more common in males than females. body, a perennial area of inquiry throughout the history of philosophy. Other topics considered in this discipline Research based on autopsies and magnetic resonance include memory, perception, and consciousness; the imaging (MRI) of live patients shows that PDDs are con- nature of the self; the existence of free will; the relation- nected with specific abnormalities in the brain. These ship between thought and emotion; and so-called irra- conditions are usually evident in early childhood and tional phenomena, such as self-deception. often cause some degree of mental retardation. They are not curable, but there are a variety of treatments that can The study of the mind and mental processes was tra- alleviate specific symptoms and help children function ditionally the province of philosophers, but philosophy better in daily life. Drugs like Prozac, Zoloft, and Luvox, and psychology began to diverge with the advent of ex- all selective serotonin reuptake inhibitors (SSRIs), can re- perimental psychology as practiced by such figures as duce aggression and repetitive thoughts and improve so- Gustav Fechner (1801-1887) and Wilhelm Wundt cial interaction. Attention problems and hyperactivity re- (1832-1920) in the nineteenth century. In the twentieth spond to psychostimulants, such as Ritalin, Dexedrine, century, the separation of the two disciplines became and Cylert, which can make children more responsive to standard in American universities, resulting in the estab- other types of intervention. Behavior therapy has helped lishment of professional associations and journals devot- children with PDDs minimize negative behavior, such as ed to psychology and its practitioners. This schism was repetitive activities and persistent preoccupations, and further entrenched with the rise of behaviorism, which group therapy has helped improve social skills. advocated behavior as the sole focus of psychology and rejected introspective inquiry and the study of conscious- Education is an important component in the treat- ness. In 1925, the prominent American behaviorist John ment of PDDs. Special education programs that address Watson predicted the demise of philosophy as a field of all types of developmental problems—social, linguistic, inquiry altogether. and behavioral—are mandated by federal law and avail- able to children from the ages of four or five. Even those In the 1950s, however, psychologists and philoso- children with PDDs who can be enrolled in regular class- phers increasingly found themselves once again on com- es can benefit from supplemental special instruction pro- mon ground. The “cognitive revolution” shifted the grams. Speech, language, and occupational therapy can focus of psychology back to mental processes and such help children with PDDs, including autism, function at topics as language acquisition and mental representation. the highest level possible. In many cases, appropriate ed- In turn, philosophy has demonstrated a growing interest ucation and therapy from the earliest age can save these in the empirical side of psychology; philosophers have children from institutionalization. studied the clinical foundations of psychoanalysis as well as topics such as behavior modification. Represen- Further Reading tative journals in philosophical psychology include Phi- Haskell, Simon H. The Education of Children with Motor and losophy of Science, Mind, British Journal of Psychology, Neurological Disabilities. New York: Nichols, 1989. and The Philosophical Review. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 497

Phobia Further Reading fear of being in public places in unfamiliar settings. Some agoraphobics fear open spaces, like large bodies of water Russell, Bertrand. The Analysis of Mind. New York: Macmil- lan, 1921. Strawson, Peter. Individuals: An Essay in Descriptive Meta- or open fields without fences. Most agoraphobics fear more than one situation, which contributes to the dis- physics. Garden City, NY: Doubleday, 1959. abling nature of the disorder. The list of fears is long and extensive: public transportation, bridges, tunnels, crowd- ed theaters, or simply being home alone. Agoraphobia rarely begins before age 18 or after 35. Sometimes it ap- pears to be precipitated by major illness or stress. Phobia Like other anxiety disorders, phobias can be treated An excessive, unrealistic fear of a specific object, with drugs, behavior therapy or both. Drug therapy situation, or activity that causes a person to avoid usually includes minor tranquilizers like Librium or Vali- that object, situation, or activity. um, taken before a situation in which a phobia is likely to be introduced. Behavior therapy attempts to reduce a Unlike generalized anxiety, phobias involve specif- patient’s anxiety through exposure to the phobia. For ex- ic, identifiable but usually irrational fears. Phobias are ample, patients are guided step-by-step from imaginary common occurrences among a large segment of the pop- confrontation of the phobia (visualizing a snake, for ex- ulation. People with phobias recognize that their fears ample) to actually experiencing it (holding a real snake). are irrational, yet avoid the source to spare themselves of Gradualdesensitization is most successful in treating the resultinganxiety. Phobias are classified as disorders simple phobias. only when they interfere substantially with a person’s daily life. Further Reading Psychologists have identified three categories of Atkinson, Rita L.; Richard C. Atkinson; Edward E. Smith; and Ernest R. Hilgard. Introduction to Psychology. 9th ed. San phobic disorders. The first, simple phobia, is defined in Diego: Harcourt Brace Jovanovich, 1987. Diagnostic and Statistical Manual of Mental Disorders Goodwin, Donald W. Anxiety. New York: Oxford University as a persistent, irrational fear of, and compelling desire Press, 1986. to avoid, an object or a situation other than being alone, Zimbardo, Philip G. Psychology and Life. 12th ed. Glenview, or in public places away from home (agoraphobia) or of IL: Scott, Foresman, 1988. humiliation or embarrassment in certain social situations (social phobia). Simple phobia causes considerable dis- tress when confronted because the person realizes that the fear is excessive and irrational. Such phobias are not indicative of other mental disorders. Almost any object Phrenology or situation can be the cause of a simple phobia. Com- An approach, primarily of historical interest, to de- mon phobias include fear of snakes (ophidiophobia), en- scribing the thinking process based on the belief closed places (claustrophobia), and spiders (arachnopho- that different mental capacities are controlled by bia). Fear of heights, doctors and dentists, loud noises, specific locations in the brain. storms, and the sight of blood also are experienced by large numbers of people. Animal phobias, the most com- Although people recognize the brain as the center mon type of simple phobia, usually develop in early of mental processes, this contemporary view has not al- childhood. Most people do not seek treatment for simple ways been accepted. Philosophers and scientists have phobias; they simply avoid the object or situation. proposed different ideas throughout history about the The second category of phobic disorders are social process of thinking that have since been rejected as inac- phobias. People with social phobias avoid social situa- curate. One such rejected approach was phrenology. tions because they are afraid of embarrassing them- Phrenologists believed that our different mental capaci- selves. Fear of public speaking, fear of using public toi- ties were controlled by specific locations in the brain. lets, and fear of eating in public are common social pho- Although scientists today recognize the general validity bias. Most social phobias develop over a period of time, of this belief, the problem was that the phrenologists de- beginning in adolescence or the early 20s, and rarely veloped ideas that did not really describe the way the over the age of 30. brain functions. Agoraphobia, the third category of phobic disorders, German scientist Franz Joseph Gall (1758-1828), a is the most disabling and the most difficult to treat. Ago- recognized expert on anatomy, proposed the initial ideas raphobia can be defined as the fear of being alone, or the on phrenology. He proposed that some areas of the brain 498 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

were highly developed in certain individuals, which lead to specific behaviors. For instance, he claimed that pick- pockets were acquisitive (i.e., possessed the desire to own things) because of excess development of an area on the side of the head. One of Gall’s contemporaries, Jo- Physiological psychology hann Spurzheim (1776-1832) identified 35 different mental faculties and suggested the location in the brain that related to each one. Each trait was claimed to lead to a certain behavior; the inclination toward that behavior could be detected by assessing the bumps on a person’s skull. Scientists now recognize that the shape of the skull does not relate to the shape of the brain. From the start, phrenology was controversial. For instance, the Roman Catholic church pressured the Aus- trian government to prevent Gall from lecturing in an area that the Church regarded as materialistic and atheis- Bust showing the traits that phrenologists assigned to the tic. This tactic apparently served to increase the interest different parts of the skull. (Brooks/Brown. Photo in phrenology. Although Gall developed his ideas with a Researchers, Inc. Reproduced with permission.) serious scientific perspective, Spurzheim was more of an entrepreneur. He coined the term phrenology (which physicians of the day showed that the specific locations Gall never accepted), popularized it, and brought it to the deemed important by the phrenologists were not associ- United States. Spurzheim’s goal was to reform educa- ated with specific mental processes. Similarly, careful re- tion, religion, and penology using principles of phrenol- search in the area revealed that phrenologists were sus- ogy. He died shortly after arriving in America, however. ceptible to biased observations in cases in which the re- Spurzheim’s work was continued by the British phrenol- search supported phrenological claims. During the 19th ogist George Combe (1788-1858), whose book on century, at the height of phrenology’s popularity among phrenology, Constitution of Man, was quite popular. Ac- the general public, scientists regarded the field with dis- cording to psychology historian David Hothersall, dain and characterized it as a discipline dressed up to Combe was highly respected by scientists in the United look like science. Nonetheless, phrenology exerted a States. He was elected to the National Academy of Sci- positive influence on the fields of physiology and, later, ences. Interestingly, at one point he was asked to justify biology, and sparked research on the relationship be- slavery on the grounds that people of African descent tween the brain and behavior. had “inferior” skulls. Combe refused, noting that educat- ed slaves were the intellectual equals of white people. Further Reading Similarly, Combe rejected the second-class status of Cooter, Roger. The Cultural Meaning of Popular Science. women, asserting that they were not intellectually or Cambridge, Eng.: Cambridge University Press, 1984. emotionally inferior to men. Hothersall, David. History of Psychology. 2nd ed. New York: McGraw-Hill, 1990. Two enterprising brothers, Orson and Lorenzo Fowler, marketed phrenology as a means by which peo- ple could improve themselves. Unlike Gall, who be- lieved that heredity dictated one’s strengths and weak- nesses, the Fowlers preached the environmental message Physiological psychology that people could improve themselves by practice and The area of experimental psychology concerned could overcome weaknesses by virtue of their will. They specifically with how biology shapes behavior and wrote extensively for popular audiences and published a mental processes. journal of phrenology that existed from the 1840s to 1911. They also set up a clinic in New York where The area of experimental known as physiological clients could be tested; they toured the United States, psychology has evolved in the 1990s. Increasingly, the giving advice wherever they went; and they emphasized field is being referred to as behavioral neuroscience, re- the practical vision of phrenology, minimizing the scien- placing physiological psychology and biological psy- tific aspects of their field. chology. Nonetheless, the goals of psychologists in this Meanwhile, scientists and philosophers quickly dis- field remain the same: to utilize basic research to explain missed phrenological ideas. Leading biologists and behavior in physiological terms, working on the assump- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 499

Jean Piaget tion that for every behavioral event there is a correspond- ing physical event or series of events. The physiological psychologist (or behavioral neu- roscientist) is also concerned with the functioning of the adrenal glands and with the physical processes involved in sensation. Although physiological psychology is con- cerned with physical organisms, it is distinguished from such life sciences as physiology and biology by its focus on behavior. Researchers may investigate questions such as how the brain controls physical movements or regu- lates eating; the role of sex hormones in violent behav- ior; the effects of drugs on memory and personality; the physiological basis for sleep and dreaming; and the areas of the brain devoted to language functions. Physiological psychology overlaps with the field of neurobiology, which is the study of the nervous system and its func- tions. A related field is psychopharmacology, the study of drugs and behavior. Another subfield of physiological psychology, psy- chophysiology, deals with the measurement of physio- logical responses as they relate to behavior. Practical ap- plications include lie detector tests; clinical tests of vi- sion and hearing; tests of brain activity in individuals with mental retardation and neurological and behav- ioral disorders; and biofeedback training. Jean Piaget (Farrell Grehan/Corbis. Reproduced with permission.) Further Reading Asimov, Isaac. The Human Brain: Its Capacities and Func- tions. New York: Penguin, 1994. Piaget was born in 1896 in the French-speaking Guiley, Rosemary. The Encyclopedia of Dreams: Symbols and Swiss city of Neuchâtel, the son of an agnostic medieval- Interpretations. New York: Crossroad, 1993. ist and a religious mother with socialist leanings. After Mind and Brain: Readings from Scientific American Magazine. completing a doctoral thesis in natural sciences (1918), New York: W.H. Freeman, 1993. and studies in psychology and philosophy in Zurich and Paris, he joined the Rousseau Institute of Geneva in 1921, which was founded by Edouard Claparède as a center for research on child development and education. He later taught experimental and developmental psy- Jean Piaget chology, sociology, and history and philosophy of sci- ences, mainly at the University of Geneva. Piaget died in 1896-1980 French psychologist, philosopher, and naturalist. 1980. His interdisciplinary International Center for Ge- netic Epistemology (established in 1955) closed in 1984. Jean Piaget is universally known for his studies of As an adolescent, Piaget published numerous papers the development of intelligence in children. Although he on the classification of mollusks. During World War I, he is one of the creators of child psychology as it exists was active in socialist and Christian student groups, and today, psychology was for him only a tool of epistemolo- sketched a theory of organic, psychological, and social gy (the theory of knowledge). He identified his domain phenomena aimed at providing a scientific basis for post- as “genetic [i.e., developmental] epistemology.” He thus war reconstruction. Much of his later thinking built di- studied the growth of children’s capacity to think in ab- rectly on his youthful speculations and values, but its em- stract, logical terms, and of such categories as time, pirical impetus derived from his own reaction against the space, number, causality, and permanency, describing an metaphysical and mystical tendencies of his adolescence. invariable sequence of stages from birth through adoles- cence. A prolific author, he wrote over fifty books and Piaget devised a “clinical method” that combined hundreds of articles. standard intelligence tests and open-ended conversations 500 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

with school-age children. In his first five books, he stud- Vidal, F. Piaget Before Piaget. Cambridge: Harvard University ied children’s language, reasoning, conceptions of the Press, 1994. world, theories of causality, and moral judgment. He Philippe Pinel found that children are at first “egocentric” (incapable of taking another person’s point of view) and attached to concrete appearances, but that they gradually move away Philippe Pinel from egocentrism and become capable of abstract think- 1745-1826 ing. Piaget’s observations of his own children led to The French physician and one of the founders of psy- Origins of Intelligence (1952) and The Construction of chiatry. Reality (1954), where he describes how basic forms of intentionality, and of the categories of object, space, Philippe Pinel was born near Toulouse, France, the causality, and time evolve between the onset of the new- son of a surgeon. After first studying literature and theol- born’s reflex activities and the emergence of language at ogy, he pursued medical studies at the University of about 18 months; Play, Dreams, and Imitation (1951), Toulouse, receiving his M.D. in 1773. In 1778, Pinel deals with the development of mental representation up moved to Paris, where he worked as a publisher, transla- to the age of six. In these three classics, Piaget expound- tor of scientific writings, and teacher of mathematics. He ed the notion of intelligence as a form of adaptation to also wrote and published articles, a number of them the external world. Starting in the 1940s, Piaget and about mental disorders, a topic in which he had become Bärbel Inhelder studied the development of logical and interested due to the illness of a friend. In 1792, Pinel formal thought in various fields (conceptions of move- was appointed chief physician and director of the Bicêtre ment, speed, time, space, geometry, chance, and proba- asylum, where he was able to put into practice his ideas bility). One of his major works, Introduction to Genetic on treatment of the mentally ill, who were commonly Epistemology (1950), remains untranslated. kept chained in dungeons at the time. Pinel petitioned to Piaget and his collaborators created many original the Revolutionary Committee for permission to remove and ingenious problem-solving situations that became the chains from some of the patients as an experiment, paradigms for research all of the world. In one famous and to allow them to exercise in the open air. When these experiment, children sat facing a scale model of three steps proved to be effective, he was able to change the mountains and were asked to choose from a series of pic- conditions at the hospital and discontinue the customary tures the one that represents the mountains as seen by a methods of treatment, which included bloodletting, purg- doll sitting at other positions. Younger subjects systemat- ing, and physical abuse. ically identified the doll’s viewpoint with their own. Rejecting the prevailing popular notion that mental Studies of “conservation” provide further notable exam- illness was caused by demonic possession, Pinel was ples: the child is presented with two identical balls of among the first to believe that mental disorders could be clay; the shape of one is modified, and the child is asked caused by psychological or social stress, congenital con- whether the amount, weight, or volume of clay has ditions, or physiological injury. He strongly argued for changed. Other situations involve manipulating blocks or the humane treatment of mental patients, including a pouring identical quantities of liquid in differently friendly interaction between doctor and patient, and for shaped containers. the maintenance and preservation of detailed case histo- Most of the research Piaget inspired is disconnected ries for the purpose of treatment and research. In 1795, from the theoretical goals of genetic epistemology. His Pinel was appointed chief physician at Salpêtrière, where work had some direct impact on mathematical and moral he effected reforms similar to those at Bicétre. Pinel re- education, and reinforced the belief that instruction must mained at Salpêtrière for the remainder of his career. His be adapted to the child’s developmental level. But it is student, Jean Esquirol, succeeded him and expanded his Piaget’s investigative techniques, formulation of new reform efforts throughout France. The success of Pinel’s problems, insightful observations, and emphasis on the methods also influenced practices in other countries, in- development of cognitive capacities that form some of cluding England. the bases of contemporary child psychology. In 1795, Pinel was appointed to the faculty of the newly opened medical school in Paris, where he was Further Reading professor of medical pathology for the next 20 years. He Boden, M. Jean Piaget. Penguin Books, 1979. Gruber, H., and J. Voneche, eds. The Essential Piaget. New was elected to the Academy of Science in 1804 and the York: Basic Books, 1977. Academy of Medicine in 1820. Besides his work in hos- Piaget, J. Genetic Epistemology. Trans. E. Duckworth. New pitals, Pinel also treated patients privately as a consulting York: Norton, 1970. physician. Although he is regarded today as a pioneering GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 501

Placebo effect emphasized the importance of physical hygiene and ex- ercise, and pioneered in recommending productive work for mental patients. In addition, Pinel concerned himself with the proper administration of psychiatric facilities, including the training of their personnel. Placebo effect In research, a scientifically significant response that cannot be explained by physiological variables and is assumed to be psychological in origin. Placebos are substances with no known pharmaco- logical value that are given to members of a control group in an experiment. In studies determining the ef- fectiveness of a particular drug, for example, the experi- mental group is given the drug being studied and the control group is given a placebo, which is made to look exactly like the actual drug. Neither group, nor the re- searchers, knows which received the drug and which the placebo. If the members of each group show similar re- Philippe Pinel (The Library of Congress. Reproduced with sponses, the placebo effect has been produced. For rea- permission.) sons not completely understood, the patients given the placebo have experienced the effects of the drug without actually taking it. In such cases, the drug itself is consid- figure in psychiatry, during his lifetime Pinel was known ered ineffective. chiefly for his contributions to internal medicine, espe- cially his authoritative classification of diseases in the The placebo effect has been noted since ancient textbook Nosographie philosophique (1798), in which he times, when animal parts or other naturally occurring divided diseases into five classes—fevers, phlegmasias, substances were given as treatment for various human hemorrhages, neuroses, and diseases caused by organic diseases and ailments. Throughout medical history, pa- lesions. Pinel’s extensive contributions to medical re- tients have recovered from illnesses after healers em- search also include data on the development, prognosis, ployed substances or methods that scientifically should and frequency of occurrence of various illnesses, and ex- have no effect. It is believed that patients’ expectations periments measuring the effectiveness of medicines. that their condition will improve plays a major role in Pinel established an inoculation clinic at Salpêtrière in producing the placebo effect. 1799, and the first vaccination in Paris was given there in The use of placebos in psychotherapy is controver- April of the following year. sial, with some critics contending that it links therapists In addition to transforming psychiatric facilities with “quack” treatments rather than legitimate, scientifi- from prisons into hospitals, Pinel did much to establish cally measurable methods. However, most researchers psychiatry formally as a separate branch of medicine, agree that the placebo effect, while not completely un- publishing numerous articles on the topic which were derstood, plays a major and beneficial role in both physi- collected in “Recherches et observations sur le traite- ological and psychological treatment. ment moral des aliénés” (1799) and his book Traîte medico-philosophique de l’aliénation mentale (Medical- Further Reading Philosophical Treatise on Mental Alienation or Mania, Atkinson, Rita L.; Richard C. Atkinson; Edward E. Smith; and 1801), which is considered a classic of psychiatry. Ernest R. Hilgard. Introduction to Psychology. 9th ed. San Pinel’s practice of interacting individually with his pa- Diego: Harcourt Brace Jovanovich, 1987. tients in a humane and understanding manner represent- Zimbardo, Philip G. Psychology and Life. 12th ed. Glenview, ed the first known attempt at psychotherapy. He also IL: Scott, Foresman, 1988. 502 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

which objects are made to repeatedly disappear and Play Play reappear. As children learn more about the properties of objects and learn how to manipulate them, they begin to Activity that is not required, but is enjoyed. monitor the effects of play on their environment, and their relationship with that environment becomes in- While the term “play” may refer to an extremely creasingly systematic. varied range of activities, certain broad, defining charac- The preoperational stage (ages 2-7 years) is marked teristics have been noted. Perhaps the most basic one is by the ability to master symbolic functions, including that play is something that is not required. Although the the association of objects with words, and the transition enjoyment derived from it may be needed emotionally, from an egocentric focus to an awareness that events no single play activity itself is necessary for survival. have causes outside themselves. At this stage, children Thus, play is referred to as “autotelic”—it is engaged in begin to engage in make-believe games marked by the for its own sake, with the reward inherent in the activity use of objects for purposes other than their intended itself. Nevertheless, in spite of its detachment from sur- function. Between the ages of 4 and 7, when their think- vival and financial gain, play is engaged in wholeheart- ing is still dominated by intuition rather than logic, chil- edly. During the time allotted to play, it commands a per- dren first become interested in games characterized by son’s entire attention. rules, structure, and social interaction. As they move Play takes place in a realm divorced from ordinary through the concrete operational stage (ages 7-11), dur- reality and governed by its own rules, which may be ing which categorizing activities and the earliest logical more complex and absolute than those of many “serious” operations occur, the types of rules governing their play activities. It is also bound in terms of both time and and the reasons for following them change. At first, rules space. The period during which one engages in play has are centered on the sensorimotor aspects of play and time limits: it begins, proceeds, and inevitably ends largely provide structure and repetition. Gradually, they when one returns to “real life.” Play is also set apart in become more focused on the social aspects of play and space—a person generally goes somewhere special (even are connected with acceptance by the group. By the if it is only the “play room” or the “playground”) to en- fourth, or formal operations stage (ages 12 and higher), gage in play. The relationship between play and tension with the gradual emergence of a mature ability to reason, has also been noted. While tension is not absent from competitive games and games with codes of rules begin play itself, the ultimate result is the reduction of tension to predominate. and conflict. Based on this feature, play has often been While other psychologists have proposed schemes viewed as a “safety valve” for the harmless discharge of that vary from this one theory, there is general agreement tensions and conflicts. on its broad outlines. Some additional categorizations of In children, play is a necessary vehicle for normal children’s play that have been proposed include diversive physical, social, and cognitive development. The well play, composed of aimless activities that serve as a diver- known early 20th-century American psychologist G. sion when a child is bored; mimetic play, which is repeti- Stanley Hall (1844-1924) viewed the evolution of chil- tious, structured, and symbolic; and cathartic play, which dren’s play as recapitulating the evolution of the human is therapeutic in nature. species. Individually, play develops in stages that corre- One of the first to use play in therapy with children spond to a child’s social and cognitive development. Ini- was Hermine Hug-Hellmuth in 1921, following Freud’s tially, a child’s play is solitary in nature. Next comes par- work with “Little Hans,” a five-year-old boy with a pho- allel play, where children are in each others’ company bia. British psychoanalyst Melanie Klein used play as a but playing independently. Socially, the final stage is co- source to a child’s unconscious from which she could operative play, which consists of organized activities make interpretations, starting in 1919. Just as adults used characterized by social roles. free association to communicate about their uncon- Jean Piaget formulated a series of developmental scious and talk to communicate about their feelings, the- stages of play that corresponded to the successive stages orists reasoned that children communicate through their in his influential theory of cognitive development in chil- natural play what they cannot yet verbalize. Play therapy dren. The sensorimotor stage (birth to approximately was used by Anna Freud to help children develop a two years old), when children are focused on gaining closer connection to the therapist. A more structured ap- mastery of their own bodies and external objects, is char- proach came about in the 1930s with David Levy using acterized by “practice play” consisting of repeated pat- play therapy to help children work through and re-enact terns of movement or sound, such as sucking, shaking, stressful situations to release them. In keeping with Carl banging, babbling, and, eventually, “peekaboo” games in Rogers’ non-directive play work in the 1940s, Virginia GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 503

Pleasure principle These Columbian girls are engaged in cooperative play, the final stage of playing activities. (AP/Wide World Photos. Reproduced with permission.) Axline used non-directive play to allow a child to freely Moyles, Janet R. The Excellence of Play. Philadelphia: Open be himself or herself, working toward self-realization. University Press, 1994. By the 1960s, schools had introduced guidance and Hughes, Fergus P. Children, Play, and Development. Boston: counseling services. A number of counselors, including Allyn and Bacon, 1991. Garry Landreth urged in writings that school counselors incorporate play therapy to meet the developmental needs of all children. The International Association for Play Therapy formed in 1982 and now has 3,300 mem- Pleasure principle bers worldwide. Play therapy has grown in its applica- tions, expanding to include adults and families and into The theoretical principle that humans make deci- sions to seek pleasure and minimize pain. hospitals as well. The therapy usually occurs in a play- room, specially designed for children and furnished with toys and equipment to facilitate children’s play. Among other principles, Freudian psychology states that there is a basic human tendency to seek pleasure and See also Cognitive development avoid pain. It arises from the desire for unrestrained ex- pression of both the life instinct (Eros) associated with Further Reading sexuality and the death instinct (Thanatos) associated Dolinar, Kathleen J. Learning Through Play: Curriculum and with aggression and destructiveness. Freud described Activities for the Inclusive Classroom. Albany, NY: Del- the pleasure principle in terms of the need to discharge mar, 1994. or reduce tensions—experienced as pain or discomfort— Gil, Eliana Play in Family Therapy. New York: Guilford Press, created internally or by external stimuli. The id, which 1994. operates on the pleasure principle, is the instrument for Landreth, Garry L. Play Therapy: The Art of the Relationship discharging these tensions. However, it is held in check Muncie, Indiana: Accelerated Development Inc., 1991. by the ego, operating on the opposed reality principle, 504 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

which mediates between the primitive desires of the id shifting moral connotations of the concept of sexual ob- and the constraints of the external world. scenity, it is not possible to completely and objectively de- fine the term pornography, and that, in the final analysis, The promptings of the pleasure principle, which are pornography is in the eye of the beholder. often compared to the demands of a child, seek immedi- ate gratification and are ungoverned by social or moral Further Reading rules. The reality principle opposes many of these Hunter, Ian. On Pornography. New York: St. Martin’s Press, promptings, denying them altogether or postponing grat- Post-traumatic stress disorder (PTSD) 1993. ification either until a socially appropriate time (waiting until a meal to eat) or so that greater pleasure may be achieved in the long run (studying for a degree or train- ing for a sport). Post-traumatic stress disorder Further Reading Freud, Sigmund. New Introductory Lectures on Psychoanaly- (PTSD) sis. New York: W. W. Norton, 1933. A psychological disorder that develops in response Hall, Calvin S. A Primer of Freudian Psychology. New York: to an extremely traumatic event that threatens a Harper and Row, 1982. person’s safety or life. Although the term post-traumatic stress disorder is relatively new, the symptoms of PTSD can be recognized Pornography in many guises throughout history, from the reactions to the great fire of London that Samuel Pepys (1633-1703) Any printed or pictorial material containing repre- described in the 1600s to the “shell shock” of soldiers in sentations of sexually obscene behavior, intended World War I. Some psychologists suspect that the “hys- to sexually arouse its audience. terical” women treated by Josef Breuer (1842-1925) and Sigmund Freud at the turn of the twentieth century may There is an obvious and necessary imprecision in this have been suffering from symptoms of PTSD as a result definition of the term pornography, in the sense that what of childhood sexual abuse or battering by their husbands. is considered to be sexually obscene behavior, and, for Post-traumatic stress disorder has been classified as that matter, what might sexually arouse an audience, vary an anxiety disorder in the American Psychiatric Associa- quite widely from time to time, from place to place, and tion’s Diagnostic and Statistical Manual of Mental Dis- from individual to individual. Nearly all modern societies orders since 1980. People suffering from PTSD repeat- have laws that prohibit the possession or distribution of at edly re-experience the traumatic event vividly in their least some forms of pornography, although the statutory thoughts, perceptions, images, or dreams. They may be suppression and criminalization of sexually obscene mate- aware that they are recollecting a previous experience, or rial is a relatively recent phenomenon, and is significantly they may have hallucinations, delusions, or dissociative predated by the legal censorship of material that was flashbacks that make them feel as though the trauma is judged to be sacrilegious or antireligious (religiously ob- actually recurring in the present. Children may engage in scene) or seditious or treasonous (politically obscene). repetitive play that expresses some aspect of the trauma. Generally, laws against pornography have been based on A related symptom is the consistent avoidance of people, the controversial assumption that exposure to pornogra- objects, situations, and other stimuli connected with the phy morally corrupts individuals and is a cause of sexual event. PTSD sufferers usually experience heightened crimes. In the United States, legislation concerning arousal in the form of agitation, irritability, insomnia, pornography dates from the middle of the 19th century. difficulty concentrating, or being easily startled. In con- Since that time, the admittedly elusive legal definition of trast, they often “shut down” emotionally and become what constitutes pornography and can be regulated by law incapable of expressing certain feelings, especially those has evolved into material that portrays sexual conduct in a associated with affection and intimacy. Children who patently offensive way and appeals to prurient interest in have been traumatized may stop talking altogether or sex, as judged by an average person applying contempo- refuse to discuss the traumatic event that affected them. rary community standards, and which, on the whole, does They may also experience physical symptoms such as not have serious literary, artistic, political, or scientific headaches or stomach aches. value. When necessary, the judgment of whether or not material is pornographic is usually made by a jury. Many Events that may lead to post-traumatic stress disor- authorities have concluded that, because of the constantly der include natural disasters (earthquakes, floods, hurri- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 505

Post-traumatic stress disorder (PTSD) A Bosnian man with post-traumatic stress disorder talks to a therapist. (AP/Wide World Photos. Reproduced with permission.) canes) or serious accidents such as automobile or plane matic stress disorder is thought to be related to changes crashes. However, PTSD is most likely to be caused by in brain chemistry and levels of stress-related hor- traumas in which death and injury are inflicted by other mones. When a person is subjected to excessive stress human beings: war, torture, rape, terrorism, and other levels on a prolonged basis, the adrenal glands—which types of personal assault that violate one’s sense of self- fuel the “fight-or-flight” reaction by producing adrena- esteem and personal integrity. (PTSD also tends to be line—may be permanently damaged. One possible result more severe and long-lasting when it results from trau- is overfunctioning during subsequent stress, causing hy- mas of this nature.) In addition to the direct experience perarousal symptoms such as insomnia, jumpiness, and of traumatic events, PTSD can also be caused by wit- irritability. The brain’s neurotransmitters, which play a nessing such events or by learning of serious harm to a role in transmitting nerve impulses from one cell to an- family member or a close friend. Specific populations in other, may be depleted by severe stress, leading to mood which PTSD has been studied include Vietnam veterans swings, outbursts of temper, and depression. and Holocaust survivors. Post-traumatic stress disorder can affect persons of Among the disorders listed in the Diagnostic and any age and is thought to occur in as many as 30 percent Statistical Manual, the diagnosis for PTSD is unique in of disaster victims. In men, it is most commonly caused its focus on external events rather than internal predispo- by war; in women, by rape. Symptoms usually begin sitions or personality features. Studies have found that within one to three months of the trauma, although in such factors as race, sex, socioeconomic status, and even some cases they are delayed by months or even years. If previous psychiatric history have little to do with the in- left undiagnosed and untreated, PTSD can last for cidence of PTSD. Whether a person develops PTSD is decades. However, over half of all affected persons who much more closely related to the severity and duration of receive treatment recover completely within three the traumatic event experienced than to any preexisting months. Short-term psychotherapy (12 to 20 sessions) characteristics or situations. Physiologically, post-trau- has been the single most effective treatment for PTSD. It 506 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

may be accompanied by medication for specific purpos- Rollo May has written about power in terms of in- es, but medication alone or for extended periods is not dividual human potential, referring to the roots of the recommended as a course of treatment. Sleeping pills word “power” in the Latin word posse, which means Preconscious may help survivors cope in the immediate aftermath of a “to be able.” May distinguishes among five levels of in- trauma, anti-anxiety medications may temporarily ease trapsychic power. The most basic level, the power to emotional distress, and antidepressants may reduce be, is literally the power to exist, which is threatened if nightmares,flashbacks, and panic attacks. one is denied the basic conditions of human sustenance. The second level, self-affirmation, goes beyond mere The primary goal of psychotherapy is to have the survival and involves recognition and esteem by others, person confront and work through the traumatic experi- while the third, self-assertion, refers to the more strenu- ence. Hypnosis may be especially valuable in retrieving ous affirmation of one’s existence that is required in the thoughts and memories that have been blocked. One face of opposition. The next level of power, technique used by therapists is to focus on measures that aggression,develops when one’s access to other forms PTSD sufferers took to save or otherwise assert them- of self-assertion is blocked. In contrast to self-asser- selves in the face of traumatic events, thus helping to tion, which May views as essentially defensive, aggres- allay the feelings of powerlessness and loss of control sion involves the active pursuit of power or territory. that play a large part in the disorder. Behavioral tech- The endpoint in May’s continuum of power is violence, niques such as relaxation training and systematic desen- which, unlike the other levels, is divorced from reason sitization to “triggering” stimuli have also proven help- and verbal persuasion. ful. Support groups consisting of other persons who have experienced the same or similar traumas have facilitated Power in its other sense—that of power over oth- the healing process for many persons with PTSD. ers—is a fundamental feature of all relationships, whether each party has a certain degree of power over See also Combat neurosis the other (which is usually the case) or all the power re- sides with one party. Power may be based on force, ac- Further Reading knowledged expertise, the possession of specific infor- Matsakis, Aphrodite. I Can’t Get Over It: A Handbook for Trauma Survivors. Oakland, CA: New Harbinger Publica- mation that people want, the ability to reward others, or tions, 1992. legitimization (the perception that one has the right to McCann, Lisa. Psychological Trauma and the Adult Survivor: exercise it). Theory, Therapy, and Transformation. New York: Brun- Other bases for power include identification with ner/Mazel, 1990. those who wield it and reciprocity (indebtedness to the Porterfield, Kay Marie. Straight Talk about Post-Traumatic wielder of power for providing a prior benefit of some Stress Disorder: Coping with the Aftermath of Trauma. sort). May has described various types of interpersonal New York: Facts on File, 1996. power, ranging from harmful to beneficial: exploitative Further Information (characterized solely by brute force); manipulative (vari- The International Society for Traumatic Stress Studies. 435 ous types of power over another person); competitive North Michigan Ave., Suite 1717, Chicago, IL 60611, (power against another); nurturing (power for another (312) 644–0828. person); and integrative (power with another person). Further Reading May, Rollo. Power and Innocence: A Search for the Sources of Violence. New York: W. W. Norton, 1972. Power Tillich, Paul. Love, Power, and Justice: Ontological Analyses and Ethical Applications. New York: Oxford University One’s capacity to act or to influence the behavior Press, 1960. of others. Power may be defined in both personal and interper- sonal terms. In the first sense, it refers to one’s physical, intellectual, or moral capacity to act. In the second, it de- Preconscious notes the ability to influence the behavior of others. In psychoanalytic theory, knowledge, images, emo- Philosophers have often described power as an integral tions, and other mental phenomena that are not facet of human existence. Psychologist Harry Stack Sul- present in immediate consciousness but are quick- livan (1892-1949) has claimed that power is a more cru- ly accessible and can be brought into conscious- cial motivation than hunger or thirst. ness easily without the use of special techniques. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 507

Sigmund Freud theorized that the human mind was Prejudice and discrimination divided into three parts: the conscious, preconscious, and overall impressions based on the assumption that all members of a group possess similar attributes. unconscious. This schema first appeared in his earliest Various theories have been proposed to explain the model of mental functioning, published in his classic causes and dynamics of prejudice. In the 1940s, a Uni- work, The Interpretation of Dreams (1900). Freud be- versity of California study on anti-Semitism and other lieved that the preconscious functions as an intermediate forms of prejudice created a profile of a particular per- or transitional level of the mind—between the uncon- sonality type—the authoritarian personality—believed scious and the conscious—through which repressed ma- to be associated with prejudice. Persons fitting this terial passes. tant parents who exact rigid adherence to rules and Freud described this arrangement spatially, depicting commands. Obedience is ensured through both verbal the unconscious as a large room crowded with thoughts profile are typically raised by strict, emotionally dis- and the conscious area as a smaller reception room, with and physical punishment, and independent thought a doorkeeper between the two rooms selectively admit- and action are discouraged. As adults, people fitting ting thoughts from the unconscious to the consciousness. this personality type define their world in terms of a Those thoughts that are restricted to the unconscious area social hierarchy, deferring to persons of higher status remain repressed, meaning that they are totally invisible and acting with hostility and contempt toward those to the conscious self, and can be recovered only by hyp- they regard as inferior. They often discriminate against nosis, free association, or some other technique. Not all or overtly persecute those whom they perceive to be of thoughts allowed into the “reception area” necessarily be- lower status. It has also been suggested that they may come conscious, however. Rather, they become available also be projecting their own weaknesses and fears onto for consciousness, with one or another becoming con- the groups they denigrate. Other traits associated with scious at a given time when attention is drawn to it in this personality type include strict obedience to rules some way. Thus, the smaller room might more properly and authority, conformity, admiration of powerful fig- be thought of as a preconscious area, in which are gath- ures, and inability to tolerate ambiguity. The Califor- ered all of the thoughts that are not deliberately repressed. nia study also found that those who are prejudiced Because of their relative closeness to each other, Freud against one group are likely to be prejudiced against actually grouped the conscious and preconscious systems other groups as well. together in contrast to the unconscious, emphasizing that Investigators have also studied prejudice as a pattern thoughts in the conscious and preconscious categories do of learned attitudes and behaviors. People are not born not differ in any essential way and can be distinguished prejudiced: many prejudices are formed against groups only functionally. A preconscious thought can quickly be- with which a person has never had any contact. They ac- come conscious by receiving attention, and a conscious quire prejudiced views by observing and listening to oth- thought can slip into the preconscious when attention is ers, particularly one’s parents and other elders. Cultural withdrawn from it. influences such as movies and television may also create or perpetuate stereotypes. The ways in which women, Further Reading ethnic groups, and racial minorities are represented in Firestone, Robert. Psychological Defenses in Everyday Life. the media and by the entertainment industry have been New York: Human Sciences Press, 1989. the target of much discussion and criticism. Cognitive Goleman, Daniel. Vital Lies, Simple Truths: the Psychology of theories have proposed that stereotypes are unavoidable Self-Deception. New York: Simon and Schuster, 1985. because they help people categorize and make sense of a complex and diverse society. It is a popular belief that prejudices can be over- come by direct contact between people of different back- grounds. However, social psychologists have noted that Prejudice and discrimination contact alone cannot eliminate stereotypes and preju- A positive or negative attitude toward an individual dice—in fact, some types of contact can even reinforce based on his or her membership in a religious, prejudiced beliefs. For change to occur, contact between racial, ethnic, political, or other group. different groups must meet certain conditions: 1) mem- bers of the groups should be of equal status. 2) The inter- Prejudice has cognitive, affective, and behavioral action should move beyond the confines of ritualized in- components. Based on beliefs, it can affect one’s emo- teractions (such as those between employer and employ- tions and behavior, sometimes leading to discrimination. ee or customer and salesperson) and into personal ac- Prejudiced beliefs primarily take the form of stereotypes, quaintance. 508 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Prejudical attitudes led whites to designate water fountains for “colored” people before the civil rights movement of the Premenstrul syndrome (PMS) 1950s and ‘60s. (The Library of Congress. Reproduced by permission.) Exposure to persons who dispel or contradict stereo- types about a particular group can also help a prejudiced Premenstrual syndrome person to rethink his views. For example, the growing (PMS) willingness of gays to be open about their sexual orienta- tion has helped dispel the stereotype that all gay men are Symptoms that occur several days before the onset, and sometimes during the first day of, menstruation. effeminate. Another important element in overcoming prejudice is the social support of one’s community. Dur- Premenstrual syndrome (PMS) exhibits both physi- ing the civil rights struggles of the 1950s and 1960s, the ological and psychological symptoms. The primary lack of community support for desegregation and school physiological symptoms are water retention and bloat- busing further increased prejudiced feelings and behav- ing, slightly enlarged and tender breasts, and food crav- ior among some individuals. Finally, cooperative effort is ings. Psychological symptoms include irritability and an effective way of reducing prejudice. Working together depression. The full range of symptoms that have been toward a common goal can bring different groups of peo- attributed to PMS is extremely broad: as many as 150 ple together. have been identified. Because the symptoms are so var- See also Racism ied from one woman to another (and even within the same woman at different times) it has been very diffi- Further Reading cult to arrive at a clinical definition of PMS. In addi- Adorno, Theodor, et al. The Authoritarian Personality. New tion, researchers disagree over whether PMS consists York: Harper and Row, 1950. solely of symptoms that disappear completely at the Allport, Gordon. The Nature of Prejudice. Reading, MA: Addi- onset of menstruation or of the premenstrual intensifi- son-Wesley Publishing Co., 1954. cation of symptoms or conditions that are present, al- Terkel, Studs. Race: How Blacks and Whites Think and Feel About the American Obsession. New York: New Press, though to a lesser degree, during the rest of the month. 1992. Most women with premenstrual syndrome typically GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 509

Primal therapy suffer from more than one symptom during each men- A therapeutic technique that claims to cure psy- Primal therapy strual cycle. Although there is no conclusive evidence that PMS chological disorders by encouraging people to feel is caused by hormone imbalances, some women have been successfully treated by hormonal therapy, which early in life. consists of oral contraceptives and monthly injections of deeply the pain and trauma they experienced very progesterone. Recent research has linked premenstrual syndrome to an inadequate number of progesterone re- Primal therapy was pioneered by Dr. Arthur Janov in ceptors or to the failure of those receptors to function the late 1960s. Janov describes it as a “natural therapy” properly, suggesting that PMS may be a disorder of based on his hypothesis that most psychological distur- progesterone response rather than progesterone deficien- bances are disorders of feeling which can be traced back cy. Other studies have posited a link between PMS and to the traumas of conception and childbirth. The theoreti- brain opioid (opiate-like) activity, based on alleged sim- cal basis for the therapy is the supposition that prenatal ilarities between the symptoms of PMS and those of experiences and birth trauma form people’s primary im- heroin withdrawal. Regular aerobic exercise, which pressions of life and that they subsequently influence the helps stabilize opioid levels in the brain, has been shown direction our lives take. The “natural” part of the theory to decrease PMS. is based on Janov’s belief that these early primary expe- riences imprint on the human central nervous system, The physiological effects of PMS can be reduced creating physiological and psychological problems in the through natural means, including stress management, di- future. Primal therapy is designed to enable clients to re- etary changes, acupressure massage, yoga, regular exer- experience those critical moments. By doing so, it is as- cise, and adequate rest. Nutritional supplements, such as sumed that underlying tensions are released, problems vitamins A, E, and B-6 have been shown to aid in the are alleviated, and psychological and physiological well treatment of PMS, as have calcium and magnesium. being are restored. Some physicians prescribe diuretics to treat water reten- tion or tranquilizers for the treatment of irritability and The component of primal therapy with which most mood swings. Recent research has suggested that drugs people are familiar is “The Primal Scream”—also the which increase the brain’s serotonin levels, such Prozac, title of Janov’s first book on primal therapy (New York: may also be helpful in treating PMS. Perigee Books, 1970). The book describes how, with pri- mal therapy, clients are encouraged to fully feel their Although PMS has received much attention from original traumas (namely those of birth and conception) the medical establishment, some women’s health experts and to scream in response to the intense pain these “re- believe that its severity and significance have been exag- pressed memories” are thought to elicit. These memories gerated, and claim that only a small percentage of women are believed to be so intense that they can only be ex- have premenstrual symptoms so disabling that it inter- pressed with loud screaming. The process is best under- feres with work or other aspects of their lives. They also taken in a safe and controlled environment—a room with contend that the increased awareness of PMS contributes dim lighting, a padded floor, and padded walls. to a cultural bias that disproportionately attributes a woman’s fluctuations in mood to her menstrual cycle, Using these techniques, Janov claims that primal when the moods of both males and females will fluctuate therapy reduces or eliminates a host of physical and psy- within the course of a month for many reasons—both chological ailments in a relatively short time with lasting physiological and environmental—that have nothing to results. In fact, Janov reports that ridding the mind of so- do with menstruation. In a recent investigation into the called repressed early childhood or infant traumas has link between a woman’s psychological characteristics and been scientifically linked to the reduction of many seri- premenstrual syndrome, it was noted that whether or not ous medical problems including stress, anxiety, depres- women report PMS has less to do with the number and sion, sleep disorders, high blood pressure, cancer, drug severity of their actual symptoms than with their general and alcohol addiction, sexual difficulties, phobias, obses- outlook on life, including levels of self-esteem and the sions, ulcers, migraines, asthma, and arthritis. Unfortu- ability to express feelings and manage stress. nately, there exists no scientific evidence to support these claims; Janov’s assertions of scientific linkage are based Further Reading on uncontrolled case histories and personal observations. Dalton, Katharina. PMS: the Essential Guide to Treatment Op- tions. London, Eng.: Thorsons, 1994. Truth be known, primal therapy cannot be defended PMS: It’s Not in Your Head. [videorecording] Omaha, NB: En- on scientifically established principles. This is not sur- vision Communications, 1993. prising considering its questionable theoretical rationale. 510 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

For instance, clinicians at one Canadian psychotherapy Originally introduced in the mid-1950s by behavior- clinic specializing in primal therapy make the claim that, ist B.F. Skinner, programmed instruction is a system if a child is conceived through rape, the mother’s egg and whereby the learner uses specially prepared books or the father’s sperm are “imprinted with the specific feeling equipment to learn without a teacher. It was intended to state about the incident and pass this ‘memory’ on to the free teachers from burdensome drills and repetitive prob- Programmed learning child’s every cell.” This supposedly causes the child a lem-solving inherent in teaching basic academic subjects lifetime of pain and psychological trouble unless he or like spelling, arithmetic, and reading. Skinner based his she learns to express his or her real feelings about the ideas on the principle of operant conditioning, which memory of this event. Evidence from research on memo- theorized that learning takes place when a reinforcing ry and emotions, however, does not support the existence stimulus is presented to reward a correct response. In of retrievable memories of birth trauma. In short, “cel- early programmed instruction, students punched answers lular” memories of conception are a scientific fiction. to simple math problems into a type of keyboard. If the Moreover, even if infant memories were retrievable, there answer was correct, the machine would advance to an- is no evidence to suggest that they should have such a dis- other problem. Incorrect answers would not advance. proportionate impact on people’s lives. A recent survey of Skinner believed such learning could, in fact, be superior the opinions of 300 clinicians and researchers regarding to traditional teacher-based instruction because children psychotherapeutic techniques revealed that primal thera- were rewarded immediately and individually for correct py was the technique whose soundness was most often answers rather than waiting for a teacher to correct writ- questioned. Likewise, an evaluation of primal therapy ten answers or respond verbally. Programmed instruction commissioned by German courts concluded that primal quickly became popular and spawned much educational therapy is not a valid therapeutic technique. research and commercial enterprise in the production of programmed instructional materials. It is considered the In Dr. Janov’s latest book, The Biology of Love, pri- antecedent of modern computer-assisted learning. mal therapy is discussed in the context of neuroanatomy and neurochemistry. This relationship is, however, scien- Two types of programmed learning can be com- tifically tenuous. For example, although it is accepted pared. Linear programming involves a simple step-by- among neuroscientists that working yourself into a frenzy step procedure. There is a single set of materials and stu- and screaming can lead to the subsequent release of en- dents work from one problem to the next until the end of dorphins that produce feelings of relaxation and well- the program. Branching programming is more complex. being, there is no evidence to support Janov’s assertion Students choose from multiple-choice answers and then that this relaxation can be attributable to the release of re- are prompted to proceed to another page of the book de- pressed memories. A far more likely explanation is that pending on their answer. If a correct answer is given, stu- the endorphins are released, much like in “runner’s high,” dents move on to another page with more information to in response to the strenuous activity involved. Primal learn and more questions to answer. An incorrect answer therapy remains essentially unaltered from what it was 30 leads to comments on why the answer is incorrect and a years ago—a creative theory and an interesting approach direction to return to the original question to make an- to therapy, but one lacking scientific substantiation. other selection. Just as the programming developed more complexi- Timothy Moore ty over the years, so did the teaching machines them- selves. Early, simple machines were little more than electronic workbooks. Later machines allowed students Further Reading Cunningham, J. “Primal therapies—stillborn theories.” In to be instructed on more complex material that required Feltham, C. et al., eds. Controversies in Psychotherapy more than one-word or one-number responses. In some, and Counselling. London; Sage Publications Ltd., 1999, students could write their responses and move ahead by 25-33. comparing their answers to acceptable answers. Pro- Janov, A. The Biology of Love. Amherst: Prometheus Books, grammed-learning books differ from traditional work- 2000. books because they actually teach new information through this step-by-step stimulus-response method rather than simply offering practice material for already- learned skills. Research has shown that programmed learning often Programmed learning is as successful, and sometimes more successful, than A method of self-instruction that enlists machines traditional teacher-based learning because it recognizes or specially prepared books to teach information. the different abilities and needs of individual children. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 511

Projective techniques Students who have mastered the material can move what is happening at the moment shown in the picture but also what events led up to the present situation and ahead more quickly, while those who need more practice what the characters are thinking and feeling. They are are repeatedly exposed to the problems. Programmed encouraged to interpret the pictures as freely and imagi- learning also allows teachers more time to concentrate natively as they want and to be completely open and on more complex tasks. One criticism of programmed learning centers on the lack of student-teacher interac- honest in their responses. As with the Rorschach test, the tion. It has been shown that some students thrive more focusing on any recurring themes in responses to the dif- fully with the human motivation inherent in more tradi- ferent pictures. However, scoring methods have also tional learning situations. psychologist often interprets the test results subjectively, been developed that focus on specific aspects of the sub- Further Reading jects’ responses, including aggression,expression of Bower, Gordon H., and Ernest R. Hilgard. Theories of Learn- needs, and perceptions of reality. ing. Englewood Cliffs, NJ: Prentice-Hall, 1981. Still another type of projective technique is the sen- tence completion test. Many tests of this type have been developed, some of which investigate particular person- ality features. Others are designed specifically for chil- Projective techniques dren or adolescents. Subjects are asked to complete sen- Unstructured tests used for personality assessment tences with such open-ended beginnings as “I wish . . .” that rely on the subject’s interpretation of ambigu- or “My mother . . .” Although the same sentence begin- ous stimuli. nings are shown to different test takers, there are no norms for comparing their answers to those of previous Projective techniques involve asking subjects to in- subjects. Still other types of projective tests have been terpret or fill in visual stimuli, complete sentences, or re- developed, including some that ask the subject to create port what associations particular words bring to mind. drawings or complete a story. Because of the leeway provided by the tests, subjects Compared to the more objective questionnaire-type project their own personalities onto the stimulus, often personality assessments, projective tests are difficult to revealing personal conflicts, motivations, coping styles, score, and questions are often raised about their degree and other characteristics. of reliability and validity. In most cases, not enough re- The best known projective test is the Rorschach test, search has been done on such tests to determine scientifi- created in the 1920s by Swiss psychologist Hermann cally how effective they actually are in assessing person- Rorschach (1884-1922). It consists of a series of 10 ality. Results of the Thematic Apperception Test ob- cards, each containing a complicated inkblot. Some are tained by different scorers have proven relatively reliable in black and white, some in color. Subjects are asked to when specific features (such as aggression) are mea- describe what they see in each card. Test scores are sured. However, the reliability of the Rorschach test, based on several parameters: 1) what part of the blot a which has also been researched, has generally proven person focuses on; 2) what particular details determine unsatisfactory because test results are dependent on the the response; 3) the content of the responses (what ob- psychologist’s judgment. Different interpretations of the jects, persons, or situations they involve); and 4) the fre- same set of responses may vary significantly. Although quency with which a particular response has been given newer scoring systems—including one that allows for by previous test takers. A number of different scoring computer scoring—may yield greater reliability, free in- methods have been devised for the Rorschach test, some terpretation of the test is valuable to clinicians. aimed at providing greater objectivity and validity for In addition to their weaknesses in terms of reliability this highly impressionistic form of assessment. However, and validation, projective tests also require more time and many psychologists still interpret the test freely accord- skill to administer than more objective testing methods. ing to their subjective impressions. Some also take into However, they continue to be employed because of their account the subject’s demeanor while taking the test (co- usefulness in helping psychologists obtain a comprehen- operative, anxious, defensive, etc.). sive picture of an individual’s personality. The results are Another widely used projective test is the Thematic most useful when combined with information obtained Apperception Test (TAT) introduced at Harvard Univer- from personal observation, other test scores, and familiar- sity in 1935 by Henry Murray. Test takers look at a se- ity with a client’s previous history. In addition, projective ries of up to 20 pictures of people in a variety of recog- tests make it especially difficult for subjects to skew their nizable settings and construct a story about what is hap- answers in a particular direction as they sometimes at- pening in each one. They are asked to describe not only tempt to do with other types of assessment. 512 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

See also Holtzman inkblot technique; Rorschach technique Psychiatry/Psychiatrist A physician who specializes in the diagnosis and Further Reading treatment of mental disorders. Cronbach, L.J. Essentials of Psychological Testing. New York: Psychiatry/Psychiatrist Harper and Row, 1970. Psychiatrists treat patients privately and in hospital Sundberg, N. The Assessment of Persons. Englewood Cliffs, settings through a combination of psychotherapy and NJ: Prentice-Hall, 1977. medication. There are about 41,000 practicing psychia- trists in the United States. Their training consists of four years of medical school, followed by one year of intern- ship and at least three years of psychiatric residency. Psychiatrists may receive certification from the Ameri- can Board of Psychiatry and Neurology (ABPN), which Psyche requires two years of clinical experience beyond residen- cy and the successful completion of a written and an oral In psychology, an individual’s consciousness. test. Unlike a medical license, board certification is not legally required in order to practice psychiatry. The term psyche actually takes its meaning from an- cient myth. In Roman mythology, Psyche represented Psychiatrists may practice general psychiatry or the human spirit and was portrayed as a beautiful girl choose a specialty, such as child psychiatry, geriatric with butterfly wings. Psyche was a beautiful mortal de- psychiatry, treatment of substance abuse, forensic (legal) sired by Cupid, to the dismay of Cupid’s mother Venus. psychiatry, emergency psychiatry, mental retardation, Venus demanded that her son order Psyche to fall in love community psychiatry, or public health. Some focus with the ugliest man in the world. Cupid refused and their research and clinical work primarily on psychoac- loved Psyche himself, visiting her only by night and tive medication, in which case they are referred to as commanding that she not look at him. Eventually, Psy- psychopharmacologists. Psychiatrists may be called che broke Cupid’s rule and lit a lamp to look upon his upon to address numerous social issues, including juve- face. For this disloyalty, Cupid abandoned her and Psy- nile delinquency,family and marital dysfunction, legal che wandered through the world in search of her lover. competency in criminal and financial matters, and treat- Eventually she was reunited with Cupid and made im- ment of mental and emotional problems among prison mortal by Jupiter. inmates and in the military. The modern day use of the concept of psyche still Psychiatrists treat the biological, psychological, and incorporates the meaning of the human soul or spirit. It social components of mental illness simultaneously. can also refer to the mind. Many different branches of They can investigate whether symptoms of mental disor- science may have an interest in studying matters of the ders have physical causes, such as a hormone imbalance psyche. An online academic journal titled Psyche illus- or an adverse reaction to medication, or whether psycho- trates the wide range of study around the concept of psy- logical symptoms are contributing to physical condi- che; participants come from the fields of cognitive sci- tions, such as cardiovascular problems and high blood ence, philosophy, psychology, physics, neuroscience, pressure. Because they are licensed physicians, psychia- and artificial intelligence. The magazine refers to its trists, unlike psychologists and psychiatric social work- mission as an “interdisciplinary exploration of the nature ers, can prescribe medication; they are also able to admit of consciousness and its relation to the brain.” Topics patients to the hospital. Other mental health profession- discussed regarding psyche in this diverse forum have in- als who cannot prescribe medication themselves often cluded animal consciousness, the visual brain, and the establish a professional relationship with a psychiatrist. triangular circuit of attention. Psychiatrists may work in private offices, private Psychiatrist Carl Jung (1875–1961) believed that psychiatric hospitals, community hospitals, state and the psyche was self regulating, and that it became more federal hospitals, or community mental centers. Often, defined as a person went through the process of “individ- they combine work in several settings. As of 1988, 15 uation.” Jung’s theories, which he called analytical psy- percent of psychiatrists belonged to group practices. In chology, also included recognition and exploration of a addition to their clinical work, psychiatrists often engage “collective unconsciousness.” in related professional activities, including teaching, re- search, and administration. The American Psychiatric Catherine Dybiec Holm Association, the oldest medical specialty organization in GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 513

Psychoactive drugs the United States, supports the profession by offering behavior. Currently, a major (and highly publicized) issue in psychiatry is the use of Prozac and other special- continuing education and research opportunities, keep- ized serotonin reuptake inhibitors (SSRIs), a new class ing members informed about new research and public policy issues, helping to educate the public about mental of antidepressants that has fewer side effects than drugs previously used to treat depression. These drugs have be- health issues, and serving as an advocate for people af- come controversial because of their potential use for fected by mental illness. “cosmetic psychopharmacology,” the transformation of Traditional psychiatry has been challenged in a vari- mood and personality in persons with no diagnosable ety of ways since the end of World War II. The most mental disorder. Both psychiatrists and others in the widespread and significant change has been the removal medical and mental health professions must confront the of the psychiatric hospital from its central role in the issue of using psychoactive drugs as “mood brighten- practice of psychiatry. This development resulted from a ers” to make clinically healthy individuals more ener- number of factors: the financial inability of state govern- getic, assertive, and resilient. ments to remedy the deteriorating condition of many in- stitutions; the discovery of new, more effective drugs en- Another contemporary development with wide- abling patients to medicate themselves at home; social ranging implications for psychiatry is the growth of activists’ charges of abuse and neglect in state mental fa- health maintenance organizations (HMOs) and managed cilities; and activism by former mental patients protest- care programs, whose cost-containment policies have al- ing involuntary institutionalization and treatment. In ready had a significant effect on the way psychiatry is addition, a growing movement, led by Karl Menninger, practiced. Expensive long-term psychotherapy is dis- sought to replace state mental hospitals with communi- couraged by such organizations, and medication is gen- ty mental health centers. The Community Mental Health erally favored over therapy. Recently, concern has been Centers Act of 1963 allotted federal funds for the estab- expressed over the practice of promoting cheaper med- lishment of community treatment centers, which provide ications over more expensive ones, even when those that a variety of services, including short-term and partial cost more offer greater benefits. hospitalization. The establishment of these centers has contributed to the growing trend toward the deinstitu- Further Reading tionalization of mental patients. Coles, Robert. The Mind’s Fate: A Psychiatrist Looks at His Profession. Boston: Little, Brown and Co., 1995. In the 1960s and 1970s radical critics within the Kramer, Peter D. Listening to Prozac: A Psychiatrist Explores profession, such as Thomas Szasz and R. D. Laing, Antidepressant Drugs and the Remaking of the Self. New challenged basic assumptions about psychiatric treat- York: Viking, 1993. ment and about the medical model of mental illness it- Laing, R. D. Wisdom, Madness, and Folly: The Making of a self. Sociologists, including Erving Goffman and Psychiatrist. New York: McGraw-Hill, 1985. Thomas Scheff, produced critiques of mental institutions as a form of social control, and the anti-psychiatry ideas of French philosopher Michel Foucault gained currency among American intellectuals. Psychiatry also came Psychoactive drugs under fire from the feminist movement, which saw it as a Medications used to treat mental illness and brain vehicle for controlling women. Feminist authors Kate disorders. Millett and Shulamith Firestone have portrayed psycho- analysis as instrumental in suppressing the original fem- inist movement of the late 19th and early 20th centuries Overview and use by labeling women’s legitimate dissatisfaction and agita- The role of psychoactive drugs, also called psy- tion as hysteria and providing an intellectual theory that chotherapeutic agents or psychotropic drugs, in the treat- aided in legitimizing society’s continuing subordination ment of mental illness is dependent on the disorder for of women. Published in 1972, Phyllis Chesler’s Women which they are prescribed. In cases where mental illness and Madness was a landmark in feminist criticism. is considered biological in nature, such as with a diagno- Advances in neuroscience, endocrinology, and im- sis of bipolar disorder or schizophrenia, pharmaceuti- munology have had a major effect on the way psychiatry cal therapy with psychotherapeutic drugs is recommend- is practiced today. The study of neurotransmitters— ed as a primary method of treatment. In other cases, such chemicals in the brain that are related to anxiety, de- as in personality disorder or dissociative disorder, psy- pression, and other disorders—have been significant choactive medications are usually considered a sec- both in the development of new medications and in the ondary, companion treatment (or adjunct) to a type of way psychiatrists think about mood, personality, and psychotherapy, such as cognitive-behavioral therapy. In 514 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

these situations, medication is used to provide temporary Side effects symptom relief while the patient works on the issues There are a number of side-effects associated with leading to his illness with a therapist or other mental psychotherapeutic agents. These can include, and are not health professional. Psychoactive drugs limited to, dry mouth, drowsiness, disorientation, deliri- Psychoactive drugs can be classified into seven um,agitation, tremor, irregular heartbeat, headache, in- major categories. These include: somnia, gastrointestinal distress, nausea, menstrual irreg- • Antianxiety agents. Drugs used to treat anxiety disor- ularity, weight gain, weight loss, loss of sex drive, skin ders and symptoms. These include benzodiazepines rashes, and sweating. Patients should inform their such as alprazolam (Xanax), lorazepam (Ativan), di- healthcare provider if they experience any of these side azepam (Valium), and chlordiazepoxide (Librium), and effects. In some cases, a dosage adjustment or change of other medications including buspirone (BuSpar) and prescription can alleviate any discomfort caused by paroxetine (Paxil). them. Additional medications may also be prescribed to address severe side effects (e.g., anticholinergic medica- • Antidepressants. Prescribed to treat major depressive tion may be prescribed for muscle spasms caused by an- disorder, dysthymic disorder, and bipolar disorder. Pop- tipsychotic medications). ular antidepressants include venlafaxine (Effexor), ne- fazodone (Serzone), bupropion (Wellbutrin), MAOI in- Tardive dyskinesia,a condition characterized by in- hibitors such as phenelzine (Nardil) and tranyl- voluntary movements of the mouth and other locations cypromine (Parnate); selective serotonin reuptake in- on the body, has been reported in some patients who take hibitors (SSRIs) such as fluoxetine (Prozac), paroxetine antipsychotic medication on a long-term basis. In some (Paxil), and sertraline (Zoloft); tricyclic antidepressants cases, the condition is permanent, although discontinu- such as amitriptyline (Elavil), doxepin hydrochloride ing or changing medication may halt or reverse it in (Sinequan), desipramine (Norpramin), and per- some patients. phenazine/amitriptyline combinations (Etrafon). Agranulocytosis,a potentially serious illness in • Antimanic agents. This category includes medications which the white blood cells that typically fight infection used to treat mania associated with bipolar disorder (or in the body are destroyed, is a possible side effect of manic-depressive disorder) such as divalproex sodium clozapine, another antipsychotic. Patients taking this (Depakote) and lithium carbonate (Lithium, Eskalith, medication should undergo weekly blood tests to moni- Lithobid, Tegrator). tor their white blood cell counts. • Antipanic agents. Prescribed to treat the panic symp- toms that are a defining feature of many anxiety disor- ders. Medications include clonazepam (Klonopin), paroxetine (Paxil), alprazolam (Xanax), and sertraline Precautions (Zoloft). Psychotherapeutic agents can be contraindicated • Antipsychotic agents. Also known as neuroleptic (not recommended for use) in patients with certain med- agents, these medications are used to manage psy- ical conditions. They may also interact with other pre- chosis related to schizophrenia, delusional disorder, scription and over-the-counter medications, either mag- and brief psychotic disorder. They include clozapine nifying or reducing the intended effects of one or both (Clozaril), haloperidol (Haldol), loxapine (Loxitane), drugs. In some circumstances, they can trigger serious, molindone (Moban), thiothixene (Navane), risperidone even life-threatening, physical side effects. For this rea- (Risperdal), and olanzapine (Zyprexa); also includes son, individuals who are prescribed psychoactive med- phenothiazines such as prochlorperazine (Compazine), ication should inform their mental healthcare provider trifluoperazine hydrochloride (Stelazine), and chlorpro- and any other prescribing doctor of all medications they mazine (Thorazine). are taking, and of any medical conditions they have not yet disclosed. • Obsessive-compulsive disorder medications. Drugs used to treat OCD include fluvoxamine (Luvox), paroxetine Monoamine oxidase inhibitors (MAOIs) such as (Paxil), fluoxetine (Prozac), and sertraline (Zoloft). tranylcypromine (Parnate) and phenelzine (Nardil) block • Psychostimulants. Also known as central nervous sys- the action of monoamine oxidase (MAO), a chemical tem stimulants, these medications are used to treat at- agent of the central nervous system. Patients who are tention deficit disorders (ADD and ADHD) and nar- prescribed MAOIs must eliminate foods high in tyra- colepsy. They include methylphenidate hydrochloride mine (found in aged cheeses, red wines, and meats) from (Methylin, Ritalin) and methaamphetamines (Desoxyn, their diets to avoid potentially serious hypotensive side Dexedrine, and DextroStat). effects. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 515

Patients taking Lithium, an antimanic medication, Psychoanalysis must carefully monitor their salt intake. Diarrhea, sweat- from a Viennese contemporary the idea of getting a pa- tient to simply talk about his or her problems. Freud ex- panded upon this practice, however, by creating the idea ing, fever, change in diet, or anything else that lowers the of “free association,” in which a patient is encouraged to level of sodium in their system can result in a toxic build speak in a non-narrative, non-directed manner, with the up of Lithium, which can result in slurred speech, confu- sion, irregular heart beat, vomiting, blurred vision, and possibly death. hope that he or she will eventually reveal/uncover the unconscious heart of the problem. This sort of unbri- dled, undirected self-exploration became one of the sig- Certain psychoactive drugs are lethal in excessive nature tenets of psychoanalysis. doses, and therefore may not be a viable treatment op- tion for patients at risk for suicide unless they can be dis- Continuing his research of the mind and the uncon- pensed in a controlled manner. scious, Freud published The Interpretation of Dreams in Many psychoactive drugs are contraindicated in 1900. In this work he outlined his ideas about the construc- pregnancy, particularly in the first trimester. Patients tion of the mind and human personality. This book was should check with their doctor about the risks associated followed by the now basics of the Freudian canon: The with psychotherapeutic medications and possible treat- Psychopathology of Everyday Life in 1904 and A Case of ment options when planning a pregnancy. Hysteria and Three Essays on the Theory of Sexuality, both in 1905. By the second decade of the 20th century, Freud had become an internationally renowned thinker, and psy- Paula Ford-Martin choanalysis had emerged as a significant intellectual achievement on par with the work of Albert Einstein in Further Reading physics and in many ways comparable to the modernist Medical Economics Company. The Physicians Desk Reference movement in the visual arts. Psychoanalysis was in its (PDR). 54th edition. Montvale, NJ: Medical Economics prime and it became something of a fad to undergo psy- Company, 2000. choanalytic treatment among the Western world’s elite. Further Information National Institute of Mental Health (NIMH). 6001 Executive Psychoanalysis and the development of Boulevard, Rm. 8184, MSC 9663, Bethesda, MD, USA. 20892-9663, fax: (301)443-4279, (301)443-4513. Email: personality [email protected]. http://www.nimh.nih.gov. Freud believed that human personality was con- structed of three parts: the id, the ego, and the superego. The id, according to this schema, is comprised largely of instinctual drives—for food and sex, for instance. These Psychoanalysis drives are essentially unconscious and result in satisfac- tion when they are fulfilled and frustration and anxiety A method of treatment for mental, emotional, and behavioral dysfunctions as developed by Sigmund when they are thwarted. The ego is linked to the id, but is Freud. the component that has undergone socialization and which recognizes that instant gratification of the id urges is not always possible. The superego acts in many ways Developed in Vienna, Austria, by Sigmund Freud like the ego, as a moderator of behavior; but whereas the (1856-1939), psychoanalysis is based on an approach in ego moderates urges based on social constraints, the which the therapist helps the patient better understand superego operates as an arbiter of right and wrong. It him- or herself through examination of the deep personal moderates the id’s urges based on a moral code. Having feelings, relationships, and events that have shaped moti- theorized this framework of human personality, Freud vations and behavior. Freud developed his theories dur- used it to demonstrate how instinctual drives are in- ing the end of the 19th and the early part of the 20th cen- evitably confounded with strictly social codes (by the turies in Vienna, Austria, where he was a practicing ego) and by notions of morality (by the superego). This physician specializing in neurological disorders. Freud’s conflict, psychoanalytic theory supposes, is at the heart interest originated in his medical practice when he en- of anxiety and neuroses. countered patients who were clearly suffering physical symptoms for which he could find no organic, or biolog- In dealing with these conflicts, Freud’s psychoana- ical, cause. Freud’s first attempt to get at the psychologi- lytic theory suggests that the human mind constructs cal cause of these patients’ pain was through hypnosis, three forms of adaptive mechanisms: namely, defense which he studied in Paris in 1885. He found the results to mechanisms, neurotic symptoms, and dreams. Freud be- be less than he’d hoped, however, and soon borrowed lieved dreams were vivid representations of repressed 516 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

urges: the id speaking out in wildly incongruous night- Freud’s critics time parables. He considered dreams to have two parts, From nearly the beginning, Freud and his construc- the manifest content, the narrative that one is able to re- tion of psychoanalytic theory have faced intense criti- member upon waking, and the latent content, the under- cism. His most famous dissenter is Jung, his former dis- lying, largely symbolic message. Because Freud be- Psychological Abstracts ciple. Jung split with Freud in 1913 over a variety of is- lieved dreams to represent unfulfilled longings of the id, sues, including, but certainly not limited to, Freud’s em- psychoanalysis deals heavily with dream interpretation. phasis on infantile sexuality. Jung had a different view of Psychoanalytic theory also sees various neurotic the construction of human personality, for instance, and symptoms as symbolic acts representing the repressed had different ideas about how dreams should be inter- longings of the id. For Freud, a neurotic symptom was preted and viewed as part of psychoanalysis. Alfred what we now consider a psychosomatic disorder, some Adler, another disciple of Freud, broke with the master physical symptom that has a psychological, or in Freud’s over infantile sexuality, positing a view that infants and terms, neurological, origin. Psychoanalytic theory sug- children are driven primarily by a need for self-affirma- gests that conditions like blindness, paralysis, and severe tion rather than sexual gratification. In modern times, headaches can result from unfulfilled longings that the Freud has been the target of criticism from many cor- patient is unable to confront on a conscious level. Be- ners. Feminists especially criticize his understanding of cause of this inability, the patient develops some accept- “hysteria” and his theory of Oedipal conflict. able symptom, such as headaches, for which he or she Freudian psychoanalysis focuses on uncovering un- can then seek medical attention. conscious motivations and breaking down defenses. The final adaptive mechanism Freud suggested are Many therapists feel that psychoanalysis is the most ef- defense mechanisms. Freud identified several defense fective technique to identify and deal with internal con- mechanisms, such as repression, displacement, denial, flicts and feelings that contribute to dysfunctional behav- rationalization, projection, and identification. Each has ior. Through psychoanalysis, the patient increases his its own peculiar dynamic but all work to distance a per- understanding of himself and his internal conflicts so son from a conflict that is too difficult to confront realis- that they will no longer exert as much influence on men- tically. These conflicts, according to psychoanalytic the- tal and emotional health. ory, originate during one of the four developmental stages Freud identified. These stages, and the infantile Further Reading sexuality he identified as occurring within them, are Hall, Calvin S. A Primer of Freudian Psychology. New York: some of the most controversial aspects of psychoanalytic Harper and Row, 1982. theory. Freud suggested that adult neuroses was a result Menninger, K. and P.S. Holzman. Theory of Psychoanalytic Technique. New York: Basic Book, 1973. of and could be traced back to frustrated sexual gratifica- Mitchell, Juliet. Psychoanalysis and Feminism. New York: Vin- tion during these stages, which are: the oral stage, birth tage Book, 1975. to one year; the anal stage, 1-3 years; the phallic stage, 3-5 years; and latency, five years to puberty. Each of these stages is in turn divided into sub-stages. In each of the major stages, the infant has sexual needs which, be- cause of social mores, are left largely unfulfilled, causing Psychodrama neuroses to originate. See Role playing/psychodrama It is during the phallic stage that Freud hypothesized the development of the Oedipus complex, easily the most renowned and controversial theoretical construc- tion of the Freudian canon. The Oedipus complex sug- gests that during the phallic stage, a child begins associ- Psychological Abstracts ating his genitals with sexual pleasure and becomes erot- ically attracted to the parent of the opposite sex while at Monthly journal published by the American Psy- the same time developing an intense jealousy of the chological Association. same-sex parent. While Freud’s original theory excludes consideration of females, his contemporary, Carl Jung Founded in 1927, Psychological Abstracts contains (1875-1961), expanded this particular dynamic and theo- nonevaluative summary abstracts of literature in the rized an Electra complex for women in which the same field of psychology and related disciplines, which are psychodrama of erotic attraction and jealousy is played grouped into 22 major classification categories. It in- out from the young girl’s point of view. cludes summaries of technical reports as well as journal GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 517

Psychological disorder articles and books. Each edition is collected into a cu- ate normality solely on the basis of whether or not a person is made unhappy or uncomfortable by his or her mulative volume every six months, with an index listing own behavior. both the volume’s contents and the national and interna- tional journals in which the abstracted literature appear. The official standard for the classification of psy- These journals are cited within the volume by codes list- chological disorders is the American Psychiatric Asso- ed in each monthly issue. A table of contents near the ciation’s Diagnostic and Statistical Manual of Mental beginning of each issue guides readers to broad general areas that they may wish to investigate, while the sub- as DSM-IV. Its five dimensions, or axes for evaluating ject indexes in the cumulative volumes refers them to Disorders, whose most recent edition is also referred to behavior and thought patterns, provide a thorough con- articles on a particular topic. text in which to assess an individual’s psychological In addition to research articles, Psychological Ab- profile. Axis I lists major mental disorders that may af- stracts features theoretical discussions and reviews of fect a patient. Axis II is for assessing of personality other investigations, and alsocontains an author index for disorders—lifelong, deeply ingrained patterns of be- readers who would like to follow up their research by havior that are destructive to those who display them or studying additional articles or books by a given author. to others. Axis III deals with any organic medical prob- lems that may be present. The fourth axis includes any PsycLIT®, the CD-ROM version of Psychological environmental or psychosocial factors affecting a per- Abstracts, became available in 1993, and is used by son’s condition (such as the loss of a loved one, sexual many academic and large public libraries. PsycLIT®, a abuse, divorce, career changes, poverty, or homeless- two-CD set which is updated quarterly, includes over ness). In Axis V, the diagnostician assesses the person’s 670,000 records. PsycLIT® indexes and abstracts arti- level of functioning within the previous 12 months on a cles dating from 1973 from 1,300 professional journals. scale of one to 100. The database also indexes and abstracts books and book chapters dating from 1987. Conditions that would formerly have been described as neurotic are now found in five Axis I classifications: Further Information anxiety disorders, somatoform disorders, dissociative EBSCO Publishing. 10 Estes Street, Ispwich, MA 01938, disorders, mood disorders, and sexual disorders. Anxiety (800) 653–2726. disorders—conditions involving longstanding, intense, or disruptive anxiety—are the most common of psycho- logical disorders among Americans. These include pho- bias (a strong fear of a specific object or situation); gen- Psychological disorder eralized anxiety (a diffuse, free-floating anxiety); panic disorder (an acute anxiety attack often accompanied by A condition characterized by patterns of thought, agoraphobia, or fear of being separated from a safe emotion, or behavior that are maladaptive, disrup- tive, or uncomfortable either for the person affect- place); and obsessive-compulsive disorder (a repetitive, ed or for others. uncontrollable behavior triggered by persistent, unwant- ed thoughts). While psychological disorders are generally sig- Somatoform disorders are characterized by psy- naled by some form of abnormal behavior or thought chological problems that take a physical, or somatic, process, abnormality can be difficult to define, espe- form. A person suffering from a somatoform disorder cially since it varies from culture to culture. Psycholo- will show persistent physical symptoms for which no gists have several standard approaches to defining ab- physiological cause can be found. Included among normality for diagnostic purposes. One is the statistical these disorders are hypochondriasis (a strong, unjusti- approach, which evaluates behavior by determining fied fear of contracting a serious disease); pain disor- how closely it conforms to or deviates from that of the der (severe pain with no apparent physical cause); and majority of people. Behavior may also be evaluated by somatization disorder (complaints about a variety of whether it conforms to social rules and cultural norms, physical problems). Another somatoform condition, an approach that avoids condemning nonconformists as conversion disorder (formerly called conversion hyste- abnormal for behavior that, while unusual, may not vi- ria), is characterized by apparent blindness, deafness, olate social standards and may even be valued in their paralysis, or insensitivity to pain with no physiological culture. Yet another way to gauge the normality of be- cause. Conversion disorders, which are most prevalent havior is by whether it is adaptive or maladaptive—and in adolescence or early adulthood, are usually accom- to what extent it interferes with the conduct of everyday panied by some form of severe stress and often appear life. In some situations, psychologists may also evalu- to elicit surprisingly little concern in the patient. Disso- 518 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

ciative disorders involve the fragmentation, or dissocia- tion, of personality components that are usually inte- Psychological testing grated, such as memory, consciousness, or even identi- ty itself. These disorders include amnesia, dissociative See Assessment, psychological identity disorder, and dissociative fugue (in which Psychology/Psychologist amnesia is accompanied by assumption of a new identi- ty in a new location). Mood disorders (also called affective disorders), are characterized by extremes of mood, abnormal mood Psychology/Psychologist fluctuations, or inconsistency between mood and the sur- The science which studies behavior and mental rounding events or environment. The two leading mood processes. disorders are depression and bipolar disorder. Major depressive disorder is characterized by feelings and be- As psychology has grown and changed throughout haviors that many people experience at times—sadness, its history, it has been defined in numerous ways. As guilt,fatigue, loss of appetite—but it is distinguished by early as 400 B.C., the ancient Greeks philosophized their persistence and severity. Major depression may be about the relationship of personality characteristics to accompanied by feelings of inadequacy and worthless- physiological traits. Since then, philosophers have pro- ness, weight loss or gain, sleep disturbances, difficulty posed theories to explain human behavior. In the late concentrating and making decisions, and, in the most se- 1800s the emergence of scientific method gave the vere cases, delusions and suicidal impulses. Depression study of psychology a new focus. In 1879, the first psy- is a major problem in the United States; one-third of all chological laboratory was opened in Leipzig, Germany, psychiatric outpatients suffer from depression. The per- by Wilhelm Wundt (1832-1920), and soon afterwards centage of Americans who will experience at least one the first experimental studies of memory were pub- major depressive episode during their lives has been esti- lished. Wundt was instrumental in establishing psycholo- mated at between eight and 12 percent for men and be- gy as the study of conscious experience, which he tween 20 and 26 percent for women. Bipolar disorder viewed as made up of elemental sensations. In addition (also known as manic depression) is characterized by the to the type of psychology practiced by Wundt—which alternation of depression with mania, an abnormally ac- became known as structuralism—other early schools of tive and elated emotional state in which a person be- psychology were functionalism, which led to the devel- comes overly optimistic, energetic, and convinced of his opment of behaviorism, and Gestalt psychology. The or her own powers and abilities. Manic episodes can re- American Psychological Association was founded in sult in impulsive and unwise decisions, and may even 1892 with the goals of encouraging research, enhancing pose physical dangers. professional competence, and disseminating knowledge about the field. The DSM-IV list of mental disorders also includes psychotic disorders,which are severe conditions char- With the ascendance of the Viennese psychologist acterized by abnormalities in thinking, false beliefs, and Sigmund Freud and his method of psychoanalysis early other symptoms indicating a highly distorted perception in the twentieth century, emphasis shifted from conscious of reality and severe interference with the capacity to experience to unconscious processes investigated by function normally. Probably the best known of these dis- means of free association and other techniques. Accord- orders is schizophrenia, which seriously disrupts com- ing to Freud, behavior and mental processes were the re- munication and other normal functions, including pro- sult of mostly unconscious struggles within each person found disturbances in thinking, emotion, perception, and between the drive to satisfy basic instincts, such as sex or behavior. About one percent of Americans suffer from aggression, and the limits imposed by society. At the schizophrenia. Other mental disorders listed in DSM-IV same time that Freud’s views were gaining popularity in include eating and sleep disorders; impulse control and Europe, an American psychology professor, John B. Wat- adjustment disorders; substance-related disorders; cog- son, was pioneering the behavioral approach, which fo- nitive disorders, such as delirium, and dementia; and cuses on observing and measuring external behaviors disorders usually diagnosed in infancy, childhood,or rather than the internal workings of the mind. B.F. Skin- adolescence, such as hyperactivity, mental retardation, ner, who spent decades studying the effects of reward and and autism. Personality disorders,which are listed in punishment on behavior, helped maintain the predomi- Axis II of DSM-IV, include narcissistic, dependent, nance of behaviorism in the United States through the avoidant, and antisocial personality types. This axis also 1950s and 1960s. Since the 1970s, many psychologists includes developmental disorders in children. have been influenced by the cognitive approach, which is GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 519

Psychophysics concerned with the relationship of mental processes to pects of physical illness, investigating the connections between the mind and a person’s physical condition; and behavior. Cognitive psychology focuses on how people consumer psychologistsstudy the preferences and buying take in, perceive, and store information, and how they habits of consumers as well as their reactions to certain process and act on that information. Additional psychological perspectives include the In response to society’s changing needs, new fields neurobiological approach, focusing on relating behavior advertising. to internal processes within the brain and nervous sys- of psychology are constantly emerging. One new type of tem, and the phenomenological approach, which is most specialization, called environmental psychology, focuses concerned with the individual’s subjective experience of on the relationship between people and their physical the world rather than the application of psychological surroundings. Its areas of inquiry include such issues as theory to behavior. While all these approaches differ in the effects of overcrowding and noise on urban dwellers their explanations of individual behavior, each con- and the effects of building design. Another relatively tributes an important perspective to the psychological new specialty is forensic psychology,involving the appli- image of the total human being. Most psychologists cation of psychology to law enforcement and the judicial apply the principles of various approaches in studying system. Forensic psychologists may help create person- and understanding human nature. ality profiles of criminals, formulate principles for jury selection, or study the problems involved in eyewitness Along with several approaches to psychology there testimony. Yet another emerging area is program evalua- are also numerous subfields in which these approaches tion, whose practitioners evaluate the effectiveness and may be applied. Most subfields can be categorized under cost efficiency of government programs. one of two major areas of psychology referred to as basic and applied psychology. Individual psychologists may Depending on the nature of their work, psycholo- specialize in one of the subfields in either of these areas. gists may practice in a variety of settings, including col- The subfields are often overlapping areas of interest rather leges and universities, hospitals and community mental than isolated domains. Basic psychology encompasses the health centers, schools, and businesses. A growing num- subfields concerned with the advancement of psychologi- ber of psychologists work in private practice and may cal theory and research. Experimental psychology em- also specialize in multiple subfields. Most psychologists ploys laboratory experiments to study basic behavioral earn a Ph.D. degree in the field, which requires comple- processes shared by different species, including sensation, tion of a four- to six-year program offered by a universi- perception, learning, memory, communication, and moti- ty psychology department. The course of study includes vation. Physiological psychology is concerned with the a broad overview of the field, as well as specialization in ways in which biology shapes behavior and mental a particular subfield, and completion of a dissertation processes, and developmental psychology is concerned and an internship. Students who intend to practice only with behavioral development over the entire life span. applied psychology rather than conduct research have Other subfields include social psychology, quantitative the option of obtaining a Psy.D. degree, which does not psychology, and the psychology of personality. entail writing a dissertation. Applied psychology is the area of psychology con- See also Behavior therapy; Cognitive therapy; cerned with applying psychological research and theory Counseling psychology; Developmental psychology; Ex- to problems posed by everyday life. It includes clinical perimental psychology; Health psychology; Research psychology, the largest single field in psychology. Clini- Methodology cal psychologists—accounting for 40 percent of all psy- chologists—are involved in psychotherapy and psycho- logical testing. Like clinical psychologists, counseling psychologists apply psychological principles to diagnose and treat individual emotional and behavioral problems. Psychophysics Other subfields of applied psychology include school The subfield of psychology that deals with the psychology, which involves the evaluation and place- transformation from the physical to the psychologi- ment of students; educational psychology, which inves- cal through detection, identification, discrimina- tigates the psychological aspects of the learning process; tion, and scaling. and industrial psychology and organizational psycholo- gy,whichstudy the relationship between people and their Psychophysics originated with the research of Gus- jobs. Community psychologists investigate environmen- tav Fechner (1801-1887), who first studied the relation- tal factors that contribute to mental and emotional disor- ship between incoming physical stimuli and the respons- ders; health psychologistsdeal with the psychological as- es to them. Psychophysicists have generally used two ap- 520 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

proaches in studying our sensitivity to stimuli around us: measuring the absolute threshold or discovering the dif- CONCEPTS IN PSYCHOPHYSICS ference threshold. In studying the absolute threshold using the method of constant stimuli, an experimenter Absolute threshold: as the stimulus strengthens Psychosexual stages will, for example, produce an extremely faint tone which from the undetectable, the point at which the person the listener cannot hear, then gradually increase the in- first detects it. tensity until the person can just hear it; on the next trial, Signal detection theory: theory pertaining to the the experimenter will play a sound that is clearly heard, interaction of the sensory capabilities and the decision- then reduce its intensity until the listener can no longer making factors in detecting a stimulus. hear it. Thresholds can also be ascertained through the Difference thresholds: at which point can one dif- method of constant stimuli. In this approach, stimuli of ferentiate between two stimuli. This point is termed just- varying intensity are randomly presented. Although an noticeable difference. observer’s measured threshold will change depending on methodology, this technique gives an estimate of an indi- Scaling: using rating scales to assign relative values vidual’s sensitivity. (for example, rating on a scale of one to ten) to sensory experiences. A different psychophysical approach combines the concept of sensory abilities with the decisions and strate- gies that an observer uses to maximize performance in a difficult task. Rather than try to identify a single point The final area of interest to psychophysicists is for the threshold, psychophysicists who employ the sig- scaling, the activity of deciding how large or small nal detection theory have developed ways to measure something is or how much of it is present. Any sensory an observer’s sensitivity to stimuli in ways that go be- experience can be scaled. For instance, if the attractive- yond the simple concept of the threshold. Some psy- ness of a painting is rated on a scale of one to ten, it is chophysical research involves the identification of stim- being scaled. If the painting is rated nine, it is consid- uli. There may be no question as to whether we can de- ered more attractive than a painting rated eight. This tect a stimulus, but sometimes we cannot identify it. For simple example gives the concept underlying scaling, example, people can often detect odors but cannot identi- but psychologists have developed more complicated fy them. Research in this area has centered on determin- techniques and sophisticated mathematical approaches ing how much information is needed to allow a person to to scaling. identify a stimulus. Identification constitutes a relatively small part of psychophysical research, although such re- search has important practical applications. For example, in the development of useful telephones, researchers had to assess how much “noise” or unwanted sound could Psychosexual stages accompany speech in a phone conversation so that a lis- Psychoanalytical theory of development based on tener could understand what was said—that is, identify sexual impulses. the spoken words accurately. Austrian psychotherapist Sigmund Freud described A third area of psychophysics involves discrimina- personality development during childhood in terms of tion of different stimuli, or difference thresholds. No two stages based on shifts in the primary location of sexual physical stimuli are absolutely identical, although they impulses. During each stage libidinal pleasure is derived may seem to be. The question of interest here is how from a particular area of the body—called an erogenous large must the difference be between two stimuli in order zone—and the activities centered in that area. If the for us to detect it. The amount by which two stimuli problems and conflicts of a particular stage are not ade- must differ in order for us to detect the difference is re- quately resolved, the child—and, later, the adult—may ferred to as the JND, or just noticeable difference. Re- remain fixated at that stage. A fixation consists of a con- search has indicated that for stimuli of low intensity, we scious or unconscious preoccupation with an area of the can detect a difference that is small, as the intensity in- body (such as the mouth in a compulsive eater), as well creases, we need a larger difference. Sometimes psy- as certain personality traits. Freud believed that some chophysicists use reaction time as a measure of how degree of fixation is present in everyone and that it is an different two stimuli are from one another. When two important determinant of personality. stimuli are very similar, it takes a longer time to decide if they are different, whereas large differences lead to fast During the three pregenital stages that occur in a reaction times. child’s first five years, sexuality is narcissistic: it is di- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 521

Psychosexual stages of elimination becomes physically possible and is incul- cated through toilet training. This is a child’s first major experience with discipline and outside authority and re- quires the subordination of natural instincts to social de- mands. Experiences at this stage play a role in determin- ing a person’s degree of initiative and attitude toward authority. A child who is harshly disciplined in the course of toilet training may later rebel against authority or become overly fastidious, controlled, or stingy. Con- versely, a child who is rewarded and praised for at- tempts to control elimination is more likely to develop a willingness to “let go” that is associated with generosity and creativity. Between the ages of two and three years, the focus of a child’s attention and pleasure shifts from the anal to the genital area, initiating what Freud termed the phallic stage. During this period, important changes take place in the child’s attitude toward his or her par- ents. Sexual longings are experienced toward the parent of the opposite sex, accompanied by feelings of rivalry and hostility for the same-sex parent. Freud called this situation the Oedipus complex for its similarity to the plot of the Greek tragedy Oedipus Rex, in which the central character unknowingly kills his father and mar- ries his mother. While the broad outlines of the Oedipal stage are similar for both sexes, it takes a somewhat different course in male and female children. A boy fears that his father will punish him for his feelings to- ward his mother by removing the locus of these feel- ings, the penis. This fear, which Freud called castration Babies derive pleasure from sucking and mouthing various anxiety, causes the boy to abandon his incestuous at- objects, including their own toes, like this infant.This tachment to his mother and begin to identify with his illustrates the oral stage. (Lousasa/Petit. Photo Researchers, father, imitating him and adopting his values, a process Inc. Reproduced with permission.) that results in the formation of the boy’s superego. To describe the experience undergone by girls in the Oedi- rected toward the child’s own body as a source of plea- pal stage, Freud used the term “Electra complex,” sure rather than outward. In the oral stage, which occu- which was derived from the name of a figure in Greek pies approximately the first year of life, pleasurable im- mythology who was strongly attached to her father, pulses are concentrated in the area of the mouth and Agamemnon, and participated in avenging his death at lips, the infant’s source of nourishment. The child de- the hands of her mother, Clytemnestra. Paralleling the rives pleasure from sucking, mouthing, swallowing, castration anxiety felt by boys, girls, according to and, later, biting and chewing food. The mouth is also Freud, experience penis envy. The girl blames her used for exploring. The primary emotional issues at this mother for depriving her of a penis and desires her fa- stage of life are nurturance and dependency. A person ther because he possesses one. Ultimately, the girl, like who develops an oral fixation—for example, by being the boy, represses her incestuous desires and comes to weaned too early or too late—is likely to focus on forms identify with the same-sex parent, the mother, through of oral gratification such as smoking, drinking, or com- the development of a superego. pulsive eating. Personality traits may include excessive As the phallic stage ends, its conflicts are resolved dependency and desire for the approval of others or a or repressed, and it is followed by the latency period, drive to acquire possessions that recalls the infant’s during which sexual impulses are dormant. The latency drive to incorporate food. period separates pregenital sexuality from the genital The next stage—the anal stage—takes place during stage, which begins with adolescence and lasts through the infant’s second year. At this point, voluntary control adulthood. In the genital stage, narcissism is replaced by 522 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

focusing sexual energy on a partner of the opposite sex, ing use, abuse, or withdrawal. Certain prescription med- ultimately resulting in sexual union and extending to ications such as anesthetics, anticonvulsants, chemothera- Psychosis feelings such as friendship, altruism, and love. peutic agents, and antiparkinsonian medications may also induce psychotic symptoms as a side-effect. In addition, Further Reading toxic substances like carbon dioxide and carbon monox- Freud, Sigmund. New Introductory Lectures on Psychoanaly- ide, which may be deliberately or accidentally ingested, sis, Chapter Five. New York: W. W. Norton and Co., 1933. have been reported to cause substance-induced psychotic Hall, Calvin S. A Primer of Freudian Psychology. New York: disorder. Harper and Row, 1982. Schizophrenia and its related disorders (schizo- phreniform disorder and schizoaffective disorder), men- tal illnesses with strong psychotic features, are thought to be caused by abnormalities in the structure and chem- Psychosis istry of the brain and influenced by both social and ge- A symptom of mental illness characterized by a netic factors. Delusional disorder, another mental illness radical change in personality and a distorted or di- defined by psychotic episodes, is also thought to have a minished sense of objective reality. possible hereditary and neurological base. Abnormalities in the limbic system, the portion of the brain on the inner edge of the cerebral cortex that is believed to regulate Characteristics emotions, are suspected to cause the delusions that are a Psychosis may appear as a symptom of a number of feature of psychosis. mental disorders, including mood and personality disor- Psychosis is characterized by the following symp- ders, schizophrenia, delusional disorder, and substance toms: abuse. It is also the defining feature of the psychotic dis- orders (i.e., brief psychotic disorder, shared psychotic • Delusions. An unshakable and irrational belief in some- disorder, psychotic disorder due to a general medical thing untrue. Delusions defy normal reasoning, and re- condition, and substance-induced psychotic disorder). main firm even when overwhelming proof is presented to disprove them. Patients suffering from psychosis are unable to dis- • Hallucinations. Psychosis causes false or distorted sen- tinguish the real from the unreal. They experience hallu- sory experience that appear to be real. Psychotic pa- cinations and/or delusions that they believe are real, and tients often see, hear, smell, taste, or feel things that they typically behave in an inappropriate and confused aren’t there. manner. • Disorganized speech. Psychotic patients often speak in- coherently, using noises instead of words and “talking” Causes and symptoms in unintelligible speech patterns. Psychosis may be caused by a number of biological • Disorganized or catatonic behavior. Behavior that is and social factors, depending on the disorder underlying completely inappropriate to the situation or environ- the symptom. Trauma and stress can induce a short-term ment. Catatonic patients have either a complete lack of psychosis known as brief psychotic disorder. This psy- or inappropriate excess of motor activity. They can be chotic episode, which lasts a month or less, can be completely rigid and unable to move (vegetative), or in brought on by the stress of major life-changing events constant motion. Disorganized behavior is unpre- (e.g., death of a close friend or family member, natural dictable and inappropriate for a situation (e.g., scream- disaster, traumatic event), and can occur in patients with ing obscenities in the middle of class). no prior history of mental illness. Psychosis can also occur as a result of an organic Diagnosis medical condition (known as psychotic disorder due to a Patients with psychotic symptoms should undergo a general medical condition). Neurological conditions thorough physical examination and detailed patient his- (e.g., epilepsy, migraines, Parkinson’s disease, cere- tory to rule out organic causes of the psychosis (such as brovascular disease, dementia), metabolic imbalances brain tumor). If a psychiatric cause is suspected, a psy- (hypoglycemia), endocrine disorders (hyper- and hy- chologist or psychiatrist will usually conduct an inter- pothyroidism), renal disease, electrolyte imbalance, and view with the patient and administer clinical assess- autoimmune disorders may all trigger psychotic episodes. ments. These assessments may include the Adolescent Hallucinogenics, PCP, amphetamines, cocaine, mar- Behavior Checklist (ABC), Anxiety Disorders Interview ijuana, and alcohol may cause a psychotic reaction dur- Schedule for DSM-IV (ADIS-IV), Psychotic Behavior GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 523

Psychosomatic disorders Rating Scale (PBRS), and the Chapman Psychosis The American Psychiatric Association’s Diagnos- Psychosomatic disorders Proneness Scales. Physical illnesses that are believed to be psycho- Treatment logically based; also referred to as psychophysio- logical disorders. Psychosis caused by schizophrenia or another men- tal illness should be treated by a psychiatrist and/or psy- chologist. Other medical and mental health profession- als may be part of the treatment team, depending on the IV) classifies psychosomatic illnesses under “Psycho- severity of the psychosis and the needs of the patient. tic and Statistical Manual of Mental Disorders (DSM- logical Factors Affecting Physical Conditions.” Physi- Medication and/or psychosocial therapy is typically em- cians have been aware that people’s mental and emo- ployed to treat the underlying disorder. tional states influence their physical well-being since Antipsychotic medications commonly prescribed to the time of Hippocrates. In the twentieth century, the treat psychosis include risperidone (Risperdal), thiori- discoveries of psychologists have shed new light on dazine (Mellaril), halperidol (Haldol), chlorpromazine how the mind and body interact to produce health or (Thorazine), clozapine (Clozaril), loxapine (Loxitane), illness. Sigmund Freud introduced the idea that un- molindone hydrochloride (Moban), thiothixene (Na- conscious thoughts can be converted into physical vane), and olanzapine (Zyprexa). Possible common side- symptoms (conversion reaction). The formal study of effects of antipsychotics include dry mouth, drowsiness, psychosomatic illnesses began in Europe in the 1920s, muscle stiffness, and hypotension. More serious side ef- and by 1939, the journal Psychosomatic Medicine had fects include tardive dyskinesia (involuntary movements been founded in the United States. Eventually, sophis- of the body) and neuroleptic malignant syndrome ticated laboratory experiments replaced clinical obser- (NMS), a potentially fatal condition characterized by vation as the primary method of studying psychoso- muscle rigidity, altered mental status, and irregular pulse matic illness. Researchers in the field of psychophysi- and blood pressure. ology measured such responses as blood pressure, Once an acute psychotic episode has subsided, psy- heart rate, and skin temperature to determine the phys- chosocial therapy and living and vocational skills train- iological effects of human behavior. Animal research ing may be recommended. Drug maintenance treatment have also contributed to the growing body of knowl- is usually prescribed to prevent further episodes. edge about psychosomatic disorders. Three theories have been particularly popular in explaining why cer- Prognosis tain persons develop psychosomatic disorders and what determines the forms these illnesses take. One The longer and more severe a psychotic episode, the theory contends that psychological stress affects bodi- poorer the prognosis for the patient. However, early di- ly organs that are constitutionally weak or weakened agnosis and long-term follow-up care can improve the by stress. Another links specific types of illness with outcome for patients with psychotic disorders. Schizo- particular types of stress. Still another theory suggests phrenia has a 60% treatment success rate. that physiological predispositions combined with psy- See also Neurosis chological stress to produce psychosomatic illness. The parts of the body most commonly affected Paula Ford-Martin by psychosomatic disorders are the gastrointestinal and respiratory systems. Gastrointestinal disorders Further Reading include gastric and duodenal ulcers, ulcerative colitis, and irritable bowel syndrome. (Anorexia nervosa and American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 4th ed. Washington, D.C.: bulimia are sometimes considered psychosomatic American Psychiatric Press, Inc., 1994. disorders, but they also appear under the category of “anxiety disorder—eating disorders” in DSM-IV. ) Further Information Respiratory problems caused or worsened by psycho- National Alliance for the Mentally Ill (NAMI). 200 North logical factors include asthma and hyperventilation Glebe Road, Suite 1015, Arlington, VA, USA. 22203- syndrome. Cardiovascular complaints include coro- 3754, (800)950-6264. http://www.nami.org. nary artery disease, hypertension, tachycardia (speed- National Institute of Mental Health (NIMH). 6001 Executive Boulevard, Rm. 8184, MSC 9663, Bethesda, MD, USA. ed-up and irregular heart rhythm), and migraine 20892-9663, fax: (301)443-4279, (301)443-4513. Email: headaches. Psychosomatic disorders also affect the [email protected]. http://www.nimh.nih.gov. skin (eczema, allergies, and neurodermatitis) and 524 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

genitourinary system (menstrual disorders and sexual dysfunction). Psychosurgery Probably the most well-known psychosomatic con- Highly controversial medical procedures where Psychotherapy nection is that of stress and coronary heart disease. The areas of the brain are destroyed or disabled term “Type A” has been used for over twenty years to through surgery as treatment for mental illness. describe the aggressive, competitive, impatient, control- ling type of person whom researchers have found to be Psychosurgery involves severing or otherwise dis- more prone to heart disease than people who are more abling areas of the brain to treat a personality disorder, easygoing and mild-mannered and less hostile and con- behavior disorder or other mental illness. The most cerned with time. In 1981, a panel appointed by the Na- common form of psychosurgery is the lobotomy, where tional Heart, Lung, and Blood Institute found that Type the nerves connecting the frontal lobes of the brain and A behavior poses a greater risk of coronary heart dis- the thalamus or hypothalamus are severed. Performed ease and myocardial infarction (heart attack) than do first in the late 1930s, by the 1940s lobotomies were rec- cigarette smoking, age, hypertension, or a high serum ommended for patients diagnosed with schizophrenia, cholesterol count. severe obsessive-compulsive disorder,severe depres- sion, and uncontrollable aggressive behavior. Other psy- Emotional stress can also affect the immune sys- chosurgeries also involve severing nerve connections to tem, raising the risk to the body from such foreign in- the hypothalamus, since it plays a key role in controlling vaders as bacteria, viruses, and cancer cells. People emotions. Psychosurgery has been recommended less under stress are more likely to develop infectious dis- frequently as more effective drugs for treatment of psy- eases, including those stemming from the reactivation of chological disorders have been developed. latent herpes viruses. It is known that several of the body’s reactions to stress, including the release of corti- Further Reading sol, adrenaline, and other hormones, suppress the activ- Rodgers, Joann Ellison. Psychosurgery: Damaging the Brain ity of the immune system. A special field, psychoneu- to Save the Mind. New York: HarperCollins Publishers, roimmunology, studies how the interaction of psycho- 1992. logical and physiological reactions affects the function- Valenstein, Elliott S. The Psychosurgery Debate: Scientific, ing of the immune system. Legal, and Ethical Perspectives. San Francisco: W. H. Freeman, 1980. People suffering from psychosomatic disorders have been helped by treatment of either their physical symp- toms, the underlying psychological causes, or both. If the disorder is in an advanced stage (such as in severe asthma attacks, perforated ulcers, or debilitating colitis) Psychotherapy symptomatic treatment must be undertaken initially as The treatment of mental or emotional disorders and an emergency measure before the emotional component adjustment problems through the use of psycholog- can be addressed. Psychological approaches range from ical techniques rather than through physical or bio- classic psychoanalysis, which addresses a person’s early logical means. traumas and conflicts, to behavior therapy that focuses on changing learned behaviors that create or increase Psychoanalysis,the first modern form of psy- anxiety. Medications such as tranquilizers or antide- chotherapy, was called the “talking cure,” and the many pressants may be effective in relieving symptoms of varieties of therapy practiced today are still characterized psychosomatic disorders. Hypnosis has successfully by their common dependence on a verbal exchange be- been used to treat hyperventilation, ulcers, migraine tween the counselor or therapist and the person seeking headaches, and other complaints. Today, psychologists help. The therapeutic interaction is characterized by mu- commonly treat psychosomatic ailments with the aid of tual trust, with the goal of helping individuals change de- such relaxation techniques as progressive relaxation, au- structive or unhealthy behaviors, thoughts, and emotions. togenic training, transcendental meditation, and yoga. It is common for experienced therapists to combine sev- Biofeedback has been used in treating a number of dif- eral different approaches or techniques. The most com- ferent clinical problems, including tachycardia, hyper- mon approaches are discussed below. tension, and both tension and migraine headaches. Psychodynamic approach Further Reading Mind, Body, Medicine: How to Use Your Mind for Better Freudian psychoanalysis places emphasis on uncov- Health. Consumer Reports Books, 1993. ering unconscious motivations and breaking down de- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 525

Family and group therapy Psychotic disorders fenses. Therapy sessions may be scheduled once or even number of emotional and adjustment problems. While twice a week for a year or more. This type of therapy is Family therapy has proven effective in treating a appropriate when internal conflicts contribute signifi- cantly to a personís problems. (For more information, the clientís immediate complaint is the initial focus of see entry on Psychoanalysis). attention, the ultimate goal of family therapy is to im- prove the interaction between all family members and enhance communication and coping skills on a long- Behavioral techniques term basis (although therapy itself need not cover an ex- In contrast to the psychodynamic approach, behav- tended time period). Group therapy, which is often ior-oriented therapy is geared toward helping people see combined with individual therapy, offers the support and their problems as learned behaviors that can be modified, companionship of other people experiencing the same without looking for unconscious motivations or hidden problems and issues. meanings. According to the theory behind this approach, once behavior is changed, feelings will change as well. Therapy is terminated when the treatment goals Probably the best-known type of behavioral therapy is have been met or if the client and/or therapist conclude behavior modification, which focuses on eliminating that it isn’t working. It can be effective to phase out undesirable habits by providing positive reinforcement treatment by gradually reducing the frequency of thera- for the more desirable behaviors. py sessions. Even after regular therapy has ended, the client may return for periodic follow-up and reassess- Another behavioral technique is systematic desensi- ment sessions. tization, in which people are deliberately and gradually exposed to a feared object or experience to help them Further Reading overcome their fears. A person who is afraid of dogs Engler, Jack and Daniel Goleman. The Consumer’s Guide to may first be given a stuffed toy dog, then be exposed to a Psychotherapy. New York: Fireside, 1992. real dog seen at a distance, and eventually forced to in- Kanfer, Frederick H. and Arnold P. Goldstein, eds. Helping teract with a dog at close range. Relaxation training is People Change: A Textbook of Methods. New York: Perga- another popular form of behavior therapy. Through mon Press, 1991. such techniques as deep breathing, visualization, and progressive muscle relaxation, clients learn to control fear and anxiety. Psychotic disorders Cognitive methods A diagnostic term formerly used in a general way to designate the most severe psychological disor- Some behavior-oriented therapy methods are used to ders; now used in a much narrower sense in con- alter not only overt behavior, but also the thought pat- nection with specific symptoms and conditions. terns that drive it. This type of treatment is known as cognitive-behavior therapy (or just cognitive therapy). Formerly, all psychological disorders were consid- Its goal is to help people break out of distorted, harmful ered either psychotic or neurotic. Psychotic disorders patterns of thinking and replace them with healthier were those that rendered patients unable to function nor- ones. Common examples of negative thought patterns in- mally in their daily lives and left them “out of touch clude magnifying or minimizing the extent of a problem; with reality.” They were associated with impaired mem- “all or nothing” thinking (i.e., a person regards himself ory, language, and speech and an inability to think ra- as either perfect or worthless); overgeneralization (arriv- tionally. Neurotic disorders, by comparison, were char- ing at broad conclusions based on one incident, for ex- acterized chiefly by anxiety; any impairment of func- ample); and personalization (continually seeing oneself tioning was primarily social. Psychotic conditions were as the cause or focus of events). attributed to physiological causes, neurotic conditions to In cognitive-behavioral therapy, a therapist may talk psychosocial ones. Other distinguishing features associ- to the client, pointing out illogical thought patterns, or use ated primarily with psychotic disorders were hospital- a variety of techniques, such as thought substitution, in ization and treatment by biological methods—medica- which a frightening or otherwise negative thought is dri- tion and electroconvulsive therapy. With the develop- ven out by substituting a pleasant thought in its place. ment of new types of psychoactive drugs in the 1950s Clients may also be taught to use positive self-talk, a repe- and 1960s, medication became a common form of thera- tition of positive affirmations. Cognitive therapy is usually py for anxiety, depression, and other problems catego- provided on a short-term basis (generally 10-20 sessions). rized as neurotic. 526 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

”Psychotic” and “neurotic” are no longer employed 14 and in boys between 12 and 16. Between these ages as major categories in the American Psychiatric Associa- both sexes grow about nine inches. The average girl Puberty tion’s Diagnostic and Statistical Manual of Mental Dis- gains about 38 pounds, and the average boy gains about orders (DSM-IV) . Instead, disorders that formerly be- 42. One reason for the awkwardness of adolescence is longed to either one category or the other appear side by the fact that this growth spurt proceeds at different rates side in Axis I of the manual under the heading “Clinical in different parts of the body. Hands and feet grow faster Syndromes.” The term “psychotic” still appears in DSM- than arms and legs, which, in turn, lengthen before the IV, most prominently in the categorization “Schizophre- torso does, all of which create the impression of gawki- nia and Other Psychotic Disorders.” The disorders in this ness common to many teenagers. In addition, there can section have as their defining feature symptoms consid- be temporary unevenness of growth on the two sides of ered psychotic, which in this context can refer to delu- the body, and even facial development is disproportion- sions, hallucinations, and other positive symptoms of ate, as the nose, lips, and ears grow before the head at- schizophrenia, such as confused speech and catatonia. tains its full adult size. The growth spurt at puberty is not In other parts of DSM-IV, “psychotic” is also used to de- solely an external one. Various internal organs increase scribe aspects of a disorder even when they are not its significantly in size, in some cases with observable con- defining feature, as in “Major Depressive Disorder with sequences. Increases in heart and lung size and in the Psychotic Features.” total volume of blood give adolescents increased strength and endurance for athletics and for recreational Further Reading activities such as dancing. (During puberty, the heart Hales, Dianne, and Robert E. Hales, M.D. Caring for the doubles in size.) Teenagers’ ravenous appetites are relat- Mind: The Comprehensive Guide to Mental Health. New ed to the increased capacity of the digestive system, and York: Bantam Books, 1995. the decrease in respiratory problems (including asthma ) is associated with the fact that the lymphoid system, which includes the tonsils and adenoids, actually shrinks in adolescence. Yet another change, the increase in secre- Puberty tions from the sebaceous glands, triggered by the growth hormone androgen, is responsible for acne, which affects The process of physical growth and sexual matura- about 75% of teenagers. The excess oil from these tion that signals the end of childhood and the ad- glands clogs pores, and they become inflamed, causing vent of adolescence. (Also, the period during which this process takes place.) the reddening and swelling of acne. The word puberty is derived from the Latin puber- Following the beginning of the growth spurt, the tas, which means adulthood. Puberty is initiated by hor- sexual organs begin to mature and secondary sex char- monal changes triggered by a part of the brain called the acteristics appear. In girls, the uterus and vagina be- hypothalamus, which stimulates the pituitary gland, come larger, and the lining of the vagina thickens. The which in turn activates other glands as well. These first visible sign of sexual maturation is often the ap- changes begin about a year before any of their results are pearance of a small amount of colorless pubic hair visible. Both the male reproductive hormone testosterone shortly after the growth spurt begins. Over the next and female hormone estrogen are present in children of three years, the pubic hair becomes thicker, darker, both sexes. However, their balance changes at puberty, coarser, and curlier and spreads to cover a larger area. with girls producing relatively more estrogen and boys Hair also develops under the arms, on the arms and legs producing more testosterone. (sufficiently so that most girls start shaving), and, to a slight degree, on the face. Around the age of 10 or 11, Most experts suggest that parents begin short and “breast buds,” the first sign of breast development, ap- casual discussions about puberty with their children by pear. Full breast development takes about three or four the age of seven or eight. Offering the child reading ma- years and is generally not complete until puberty is al- terials about puberty can impart information to the most over. The single most dramatic sign of sexual young person without the awkwardness that may charac- maturation in girls is menarche, the onset of menstrua- terize the parent-child conversations. Parents can then tion, which usually occurs after a girl’s growth rate has offer their children opportunities to ask questions or to peaked. In virtually all cases it occurs between the ages discuss any aspects of puberty and sexuality that may of 10 and 16, with the average age in the United States arise from their reading. being 12.8 years. The first menstrual periods are usual- The first obvious sign of puberty is a growth spurt ly anovulatory, meaning that they happen without ovu- that typically occurs in girls between the ages of 10 and lation. Periods remain irregular for a while, and for at GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 527

Puberity TRIGGERS PUBERTY more dramatic (and less controlled) in boys, whose voic- es occasionally break, producing an embarrassing high- HORMONE SURGE pitched squeak. The sequence and age range of the developmental A point in child development known as adrenar- changes associated with puberty can vary widely. Al- che—the beginning of adrenal androgen activity—may though most children begin puberty between the ages represent the beginning of the process of puberty. Two University of Chicago researchers, Dr. Martha K. Mc- of 10 and 12, it can start at any age from 8 to 16. The Clintock and Dr. Gilbert Herdt, believe that puberty is most obvious determining factor is gender; on average, triggered by dihydroepiandrosterone (DHEA), a hor- puberty arrives earlier for girls than boys. Heredity mone produced by the adrenal glands. According to also appears to play an important role. Compared to an data the two gathered from three separate studies, overall age range of nine to 18 for menarche, the age DHEA levels begin to increase at around the age of six difference for sisters averages only 13 months and for and reach a critical level around age ten. The re- identical twins, less than three months. Body weight is searchers characterize these hormonal changes as trig- a factor as well: puberty often begins earlier in heavier gering a number of cognitive, emotional, and social children of both sexes and later in thinner ones. The changes in around fourth or fifth grade. Students in onset of menstruation, in particular, appears to be relat- these grades begin to engage in boy-girl teasing, exhibit ed to amounts of body fat. Girls with little body fat, es- a significant increase in abstract reasoning skills, and experience vulnerability to embarrassment. The three pecially athletes, often start menstruating at a later- studies also gathered data on subjects’ (who were most- than-average age. Over the past 100 years, puberty has ly in their mid 30s) first recollected feelings of sexual at- tended to begin increasingly early in both sexes (a phe- traction. The mean age reported by the subjects was nomenon called the secular trend ). In 1997, the results around 10 or 11 . This finding has led the researchers to of a study led by Dr. Marcia E. Herman-Giddens of postulate that sexual development moves along a con- University of North Carolina at Chapel Hill School of tinuum, beginning with attraction, progressing to desire, Public Health provided evidence that the average age of and leading to the willingness and readiness to act on menarche was declining. Instead of occurring between the desire. McClintock, quoted in the New York Times, the ages of 12 and 14, as is typical in the late 1990s, noted: “Our culture regards middle childhood as a time girls’ first menstrual periods commonly appeared be- of hormonal quiescence. Freud called it ‘latency.’ But tween the ages of 15 and 17 in the 19th century. Puber- actually a great deal of activity is going on.” ty in boys usually didn’t begin until the ages of 15 or 16 (in the late 18th and early 19th centuries, boy sopra- nos in their mid-to-late teens still sang in church least a year after menarche young women’s fertility lev- choirs). Explanations for this pattern have ranged from els are very low, and they are prone to spontaneous evolution to better health, especially as a consequence abortions if they do conceive. of improved nutrition. In boys, as in girls, the first outward sign of sexual An important aspect of puberty is the development maturation is often light-colored pubic hair around the of body image. Teenagers are often critical of their time the growth spurt begins. The testes and scrotum bodies during this period, either because they feel they begin to grow, and the scrotum darkens, thickens, and are maturing too early or too late, or because they fail becomes pendulous. About a year after the testes begin to match the stereotyped ideals of attractiveness for to increase in size, the penis lengthens and widens, tak- their sex (i.e., tall and muscular for men, fashionably ing several years to reach its full size. Sperm production thin for women). Girls who mature early have a hard increases, and ejaculations—the male counterpart to time initially because they feel self-conscious and iso- menarche in girls—begin, occurring through nocturnal lated, but they adjust well and even gain in status once emission, masturbation, or sexual intercourse. (It takes their peers begin to catch up. Some research even sug- from one to three years until ejaculations contain enough gests that girls who mature early may ultimately be sperm for a boy to be really fertile.) Boys’ pubic hair, better off than those who mature late because the tur- like that of girls, gradually becomes thicker and curlier moil of their early teenage years helps them develop and covers a wider area, and facial hair appears, first in coping skills that stand them in good stead later on. the mustache area above the upper lip and later at the For boys, the relative positions of early and late matur- sides of the face and on the chin. As a boy’s larynx ers is reversed. Those who are already tall and athletic grows and the vocal cords lengthen, his voice drops in junior high school feel better about themselves than (roughly an octave in pitch) and changes in quality. Al- those who remain short and skinny. Researchers have though girls’ voices also become lower, the change is linked late physical maturation in boys to the develop- 528 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

ADOLESCENTS WHO HAVE BECOME SEXUALLY ACTIVE* Sexually active All All Boys Boys Girls Girls by age (Number) (Percent) (Number) (Percent) (Number) (Percent) Ethel Dench Puffer 13 749 8.6% 389 14.7% 350 2.7% 14 509 17.7% 263 24.6% 246 10.8% 15 320 31.2% 166 35.0% 154 27.3% 16 169 54.9% 82 63.1% 87 47.1% 17 78 68.6% 38 72.1% 40 65.8% *This table reports data on the number and percent of adolescents who have become sexually active by a certain age. Data were gathered by the National Longitudinal Survey of Youth, 1988-92. ment of both positive personalitytraits (humor, per- ceptiveness, flexibility, creativity, and leadership Ethel Dench Puffer skills) and negative ones (restlessness and lack of 1872-1950 poise). In most cases, adolescents gradually become American educator and psychologist. more accepting of their bodies in the years following junior high school. Ethel Dench Puffer was born in Framingham, Mass- achusetts, the eldest of four daughters. Her family was of Further Reading Bell, Alison, and Lisa Rooney. Your Body Yourself: A Guide to native New England stock and highly educated by the Your Changing Body. Chicago: Contemporary Books, standard of the era. After graduating from Smith College 1993. in 1891 at the age of 19 and teaching high school for one Bourgeois, Paulette, and Martin Wolfish. Changes in You and year in New Hampshire, Puffer returned to Smith as an Me: A Book About Puberty, Mostly for Boys. Kansas City: instructor of mathematics, where she taught for the next Andrews and McMeel, 1994. three years while developing a keen interest in psycholo- Children’s Television Workshop. What Kids Want to Know gy. In 1895, Puffer traveled to Germany to study aesthet- About Sex and Growing Up. Los Angeles, CA: Pacific ics under Hugo Münsterberg (1863-1916), then a profes- Arts Video Publishing, 1992. (One 60-minute videocas- sor of psychology at the University of Freiberg. On the sette and one 20-page parent’s guide.) strength of her research, she was awarded a fellowship Chirinian, Alain. Boys’Puberty: An Illustrated Manual for for graduate study by the Association of Collegiate Parents and Sons. New York: Tom Doherty Associates, Alumnae. Enrolling in Radcliffe College in 1897 and 1989. working again under Münsterberg at Harvard University, Feldman, Shirley, and Glen R. Elliott, eds. At the Threshold: she earned a certificate stating she had completed work The Developing Adolescent. Cambridge, MA: Harvard equivalent to that of a doctoral candidate for the Harvard University Press, 1990. Ph.D. Because of the restrictions against granting the Gilbert, Susan. “Early Puberty Onset Seems Prevalent.” New Harvard degree to women, however, Puffer was forced to York Times 146, April 9, 1997, p. B12. make a special appeal to Radcliffe to grant her the doc- Jukes, Mavis. It’s a Girl Thing: How to Stay Healthy, Safe, and toral degree. In 1902, she was one of the first four In Charge. New York: A. Knopf, 1996. women to be offered the Radcliffe Ph.D. Marano, Hara Estroff. “Puberty May Start at 6 as Hormones Surge.” New York Times 146, July 1, 1997, p. B9+. Restricted from many research opportunities because Nathanson, Laura. “Prepuberty Coaching.” Parents Magazine of her gender, Puffer returned to teaching psychology at 72 (March 1997): pp. 110+. Radcliffe, Wellesley, and Simmons Colleges, and pub- ———. Changes in You and Me: A Book About Puberty, Most- lished a book, The Psychology of Beauty, in 1905, based on ly for Girls. Kansas City: Andrews and McMeel, 1994. her research in aesthetics. In 1908, her marriage to Ben- Steinberg, Laurence, and Ann Levine. You and Your Adoles- jamin Howes further impacted her career due to cultural cent: A Parent’s Guide for Ages 10-20. New York: Harper norms of the period which did not permit married women & Row, 1990. to work outside of the home. She continued to write schol- What’s Happening to Me? A Guide to Puberty. Los Angeles, arly articles through her forties while raising two children. CA: LCA, 1986. (Video recording) Puffer’s published reflections of the role of women and the GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 529

Punishment conflict between marriage and career in the Atlantic social stigma, etc.) does not appear to deter unwanted be- havior. In addition, psychologists have identified other Monthly in 1922 brought attention to one of the basic “downsides” to using punishment. For instance, people dilemmas confronting educated women of that time. use punishment inappropriately, decreasing its effective- Further Reading Scarborough, Elizabeth and Laurel Furumoto. Untold Lives: ness. People punish when they are upset or angry. The re- cipient experiences anxiety, fear,rage, or hatred. The use The First Generation of American Women Psychologists . of punishment can lead to more resistance and aggres- New York: Columbia University Press, 1987, pp. 70-90. sion on the part of the one being punished. The punish- ment can also backfire—instead of serving to punish a child, for example, spanking brings the wanted attention of a parent. In addition, corporal punishment defeats its own purpose by modeling aggressive or physical behav- Punishment ior, the very behavior it is often attempting to correct. Penalty imposed on another as a result of unwant- Most current promoters of punitive discipline in the ed behavior. United States espouse nonphysical forms of control, such as the use of reinforcements, logical consequences, Punishment is defined as the administration of aver- or penalties. With children, behavior modification tech- sive stimulus to reduce or eliminate unwanted behavior. niques such as time-out have proven very effective in It can be either physical or nonphysical. Punishment dif- modifying disruptive behaviors such as hitting, grabbing, fers from negative reinforcement in that the latter in- talking back, or tantrums. creases the frequency of behavior by removing a nega- tive event. Punishment can be as simple as giving elec- Further Reading tric shocks to lab rats to prevent them from touching a McCord, Joan, ed. Coercion and Punishment in Long-Term lever or as complex—and controversial—as placing Perspectives. Cambridge/New York: Cambridge Universi- criminals in jail for breaking the law. The use and effec- ty Press, 1995. tiveness of corporal punishment have also been debated Straus, Murray, Richard Gelles, and Suzanne Steinmetz. Be- by psychologists, parents, teachers, and religious leaders hind Closed Doors: Violence in the American Family. New York: Anchor Press/Doubleday, 1980. for many years. Research studies have found that punishment is ef- fective in suppressing or eliminating unwanted behavior. But in order for punishment to be effective it must hap- Pyromania pen immediately after the behavior, be severe, and occur Irresistible urge to start fires. every time the behavior occurs. Detractors of the use of punishment have pointed out that, outside the laboratory Little is known about pyromania. The term comes setting, it is almost impossible to consistently administer from the Greek words pyr (fire) and mania (madness). It punishment in this manner. is a rare condition, listed under the heading of impulse Even when punishment is administered “properly,” control disorders. Pyromania is not the same as arson psychologists have questioned the value of punishment in (deliberate fire-setting), and not all arsonists (fire-setters) truly changing behavior, arguing that the desired outcome are pyromaniacs. Fires are often started by individuals is only temporary. As evidenced by increasing crime rates with this disorder deliberately and with careful planning, in most major cities, punishment (fines, imprisonment, rather than by accident. A key feature of this disorder is the presence of repeated association with fire, but with no evidence of a reason or motivation for the fire (such PUNISHMENT as profit or to hide criminal activity). Nearly all pyroma- niacs are male. Pyromania may begin in childhood,but Positive punishment Negative punishment there is no conclusive data regarding the typical age of When the subject—a When the subject—a onset. Similarly, there is no documented link between person or animal— person or animal— fire-setting in childhood and adult pyromania. engages in a behavior engages in a behavior See also Impulse control disorders and something negative and something positive is is applied as a result, taken away, that behavior Further Reading the behavior is less is less likely to be Morrison, James. DSM-IV Made Easy: The Clinician’s Guide likely to be repeated. repeated. to Diagnosis. New York: Guilford Press, 1995. 530 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

Q Focus groups are commonly used by marketing or Qualitative methods advertising agencies to derive information about peo- ple’s reactions to a particular product or event. A small Research methods that emphasize detailed, per- number of people, often fewer than 10, are asked their sonal descriptions of phenomena. opinions. A focus group engaged by the marketing de- partment of a breakfast cereal company, for example, Research psychologists can collect two kinds of in- might be asked how appealing the cereal looks, whether formation: quantitative data and qualitative data. Quan- the box would make them consider buying it, and how titative data are often represented numerically in the agreeable the cereal’s texture and taste were. A facilita- form of means, percentages, or frequency counts. Such tor would encourage the participants to share their opin- data are often referred to as “measurement” data, refer- ions and reactions in the context of a group discussion. ring to the fact that we often like to measure the The session would be taped and transcribed. Researchers amount or extent of some behavior, trait, or disposition. would then use the information to make their product For example, shyness, test anxiety, and depression more appealing. Naturalistic observations involve study- can all be appraised by means of paper-and-pencil tests ing individuals in their natural environments. One com- which yield numerical scores representing the extent of mon variant consists of participant observation research shyness, anxiety, etc. that resides in the individual tak- in which the researcher, in order to understand it, be- ing the test. A psychologist interested in the relation- comes part of a particular group. George Kirkham was a ship between test anxiety and grade point average criminologist who took a year off from his university po- would collect the appropriate quantitative information sition to work as a police patrolman. He then wrote on each of these two variables and conduct statistical about the changes in his attitudes and values that oc- tests that would reveal the strength (or absence) of the curred when he worked in high-crime neighborhood. relationship. The term “qualitative research methods” refers to a There are several drawbacks to qualitative methods variety of ways of collecting information that is less of inquiry. Firstly, the results are always subject to per- amenable to quantification and statistical manipulation. sonal biases. A person who is interviewed, for example, Qualitative methods differ from quantitative methods is stating their version of the truth. Personal perspectives largely because their ultimate purpose is different. The invariably affect what the individual believes and under- goal of qualitative research is to arrive at some general, stands. Similarly, the results reported by the researcher overall appreciation of a phenomenon—highlighting in- conducting a naturalistic observation will be tainted by teresting aspects and perhaps generating specific hy- that researcher’s individual interpretation of the events. potheses. In contrast, quantitative research is typically Further, while case studies are rich sources of informa- designed to test relatively specific predictions. Qualita- tion about individuals, it is risky to assume that the infor- tive research thus provides an initial description of a phe- mation can be generalized to the rest of the population. nomenon, whereas quantitative research aims to investi- Moreover, analyzing the data from qualitative research gate its various details. Some examples of qualitative can be difficult, since open-ended questions and natural- methods include focus groups, surveys, naturalistic ob- istic observation leave room for so much variability be- servations, interviews, content analyses of archival mate- tween individuals that comparisons are difficult. Finally, rial, and case studies. What these approaches share is an although it may be tempting for researchers to infer emphasis on revealing some general pattern by observ- cause and effect relationships from the results of natural- ing a few particular cases. istic observations, interviews, archival data and case GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 531

Qualitative methods studies, this would be irresponsible. Qualitative methods ally would in their natural surroundings if they are stud- ied in a laboratory. rarely attempt to control any of the factors that affect sit- uations, so although one factor may appear to have Another important application of qualitative re- caused an event, its influence cannot be confirmed with- search is in the study of new areas of interest, or topics out conducting more precise investigations. There is thus about which not very much is known. Qualitative re- a tradeoff between flexibility and precision. search usually yields a lot of information. In contrast qualitative researchers is usually broadly focused. This The advantages of doing qualitative research are with quantitative research, the information gathered by numerous. One of the most important of these is that the means that qualitative methods can yield information flexibility of qualitative data collection methods can about the major factors at play, highlighting areas that provide researchers access to individuals who would be might warrant more in-depth quantitative study. Al- unable or unwilling to respond in more structured for- though many researchers believe quantitative methods to mats. For this reason, much research on children is qual- be superior to qualitative methods, the two are probably itative. Naturalistic observations of children are some- best seen as complementary. Qualitative research can times undertaken to assess social dynamics. For exam- suggest what should be measured and in what way, while ple, covert videotaping of elementary school play- controlled quantitative studies may be the most accurate grounds has revealed that bullying and aggression are way of doing the actual measuring. far more common than most teachers and parents real- ize, and that bullying is not uncommon among girls. Timothy E. Moore Similarly, comparative psychologists learn a lot about the social, behavioral, and cognitive abilities of animals Further Reading by studying them in their natural habitats. A further ad- Murray, J. “Qualitative methods.” International Review of Psy- vantage of this type of research is that the validity of the chiatry, vol 10, no. 4 (1998): 312-316. results is not jeopardized by the laboratory environ- Marecek, J. “Qualitative methods and social psychology.” ment. An animal or child may not act the way they usu- Journal of Social Issues vol 53, no. 4 (1997): 631-644. 532 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

R tensive programs may make a large difference in disad- Race and intelligence vantaged children’s intelligence quotient (IQ) scores. The problem with this split is that unrecognized dif- Throughout human history, people have tended to ferences in either genetic inheritance or environment divide each other into groups. Most often, physical char- might skew otherwise carefully crafted studies of race acteristics are used to distinguish between groups, and and intelligence. This problem will haunt nearly every the groups are called races. Some people have long be- single study we discuss. lieved that many characteristics about a person could be determined by simply looking at the person’s race. Intel- ligence is one trait that has been studied in an attempt to Race and IQ: not so clear correlate it to racial groups. In fact, at present the best The question of whether human races possess differ- evidence does not strongly support the idea that the peo- ent intellectual capacities comes, at least in part, from an ple of any race are more or less intelligent than those of early twentieth-century observation that African Ameri- any other race. In addition, intelligence testing is an im- cans’ IQ scores were, on the average, 15 points lower perfect science. Traditional tests are skewed to favor cer- than those of white Americans. Recently, the black/white tain segments of society. IQ difference has decreased; today it’s closer to 10 points. It’s difficult to see how a five-point change in the IQ Genes and intelligence: a clear verdict difference between black and white Americans could Saying that intelligence is partly genetic—pro- have come about in less than a century if genetics caused grammed in the genes and inherited from one generation the difference entirely. Even more interesting, Americans to the next—is vastly different than saying that genes un- and western Europeans today score 15 points higher on derlie any racial differences. To give a classic example, identical IQ tests than their great-grandparents did. A 15- scatter two identical groups of seed on a rich and a barren, point difference in IQ is significant (an IQ of 100 is “av- dry plot of land. Within the rich plot, genetics will deter- erage,” 130 “gifted”); but we clearly aren’t more intelli- mine any difference in seed growth. But environment gent than our great-grandparents. It seems that environ- will cause most of the difference between the two plots. mental factors can and do play havoc with our attempts to measure intelligence. Studies estimate that genes account for between 30 and 80% of our intelligence. Using meta-analysis—a sta- A number of researchers have undertaken studies to tistical method that allows researchers to compare data uncover the source of the 10-point IQ difference between from different experiments—a group of researchers the races. One type of study measures the IQs of children showed that, when all these studies are taken together, of different racial backgrounds who are raised in similar genetics appear to determine roughly half of intelligence, environments. African Americans, on the average, have environment the other half. Interestingly, the meta-analy- 70% African and 30% European ancestry. If whites were sis also suggested that pre-birth environmental factors genetically more intelligent than blacks, we would ex- such as the mother’s nutrition, which are difficult to pect black children with more European ancestry to have measure in any study, might underlie most of the envi- higher IQs than those with more African ancestry, even ronmental difference. when they’re raised in the same family. These results make some common sense. We know Psychologists have used three ways to estimate white that intelligent people tend to have intelligent children— ancestry in African Americans. (It is worth noting that but not always. Some studies have also suggested that in- there are no “pure” racial groups.) Skin color is an imper- GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 533

Racism fect measure, because not all native African peoples have Jencks, Christopher and Meredith Phillips, eds. The Black- White Test Score Gap. Washington, D.C.: Brookings Insti- dark skin. Also, children with lighter skin may be treated tution Press, 1998. differently, even in the same family. Family histories of white ancestry may or may not be accurate. Possibly the McGue, Matt. “The Democracy of the Genes.” Nature 388 best method tests blood groups; different racial groups (1997): 417-18. Plomin, Robert. “Genetics and General Cognitive Ability.” Na- have different rates of certain blood groups, allowing one ture 402 (supplement) (1999): C25-C29. to make a statistical estimate of ancestry. Plomin, Robert and Stephen A. Petrill. “Genetics and Intelli- The results of these studies suggest little, if any, in- gence: What’s New?” Intelligence 24, no. 1 (1997): 53-77. telligence difference between the races. The skin-color Wickelgren, Ingrid. “Nurture Helps Mold Able Minds.” Sci- ence 283, no. 5409 (1999): 1832-834. studies do tend to show a slight advantage for lighter- skinned children—with all the reservations about chil- dren with lighter skin getting different treatment. But family history and blood group studies show no differ- ence in IQ, apart from the skin-color effect. Racism Another approach to these studies measures the IQs The belief that members of one (or more) races are of black children brought up in white families. In one inferior to members of other races. study of black, interracial, and white adopted children raised in white families, the white children showed the Racism is most commonly used to describe the be- highest IQ scores, with interracial children scoring in the lief that members of one’s own race are superior physi- middle. But it’s not clear whether the white families cally, mentally, culturally, and morally to members of treated the black children differently; whether the black other races. Racist beliefs provide the foundation for ex- children had suffered from IQ-reducing environments tending special rights, privileges, and opportunities to before they were born; or whether the older average age the race that is believed to be superior, and to withhold- of adoption for the black children in the study prevented ing rights, privileges, and opportunities from the races a fair comparison. believed to be inferior. No scientific evidence supports racist claims, although racism exists in all countries and Another study, of black West Indian (Caribbean) cultures. The definition of racism has evolved to describe children and English children raised in an orphanage in prejudice against a group of people based on the belief England, found that the Caribbean children had higher that human groups are unequal genetically, and that IQs than those from England, with mixed-race children members of some racial groups are thus inferior. Sociol- scoring in between. But were the black children given ogists distinguish between individual racism, a term de- more attention by orphanage staff? Were particularly in- scribing attitudes and beliefs of individuals, and institu- telligent Caribbeans emigrating to England for better tional racism, which denotes governmental and organi- economic opportunity? zational policies that restrict minority groups or demean Finally, a study of black children adopted by white them by the application of stereotypes. While such poli- versus black families in America showed that the black cies are being corrected to eliminate institutional racism, children raised by whites had higher IQ scores than those individual racism nonetheless persists. raised by blacks—suggesting an environmental cause. Scientists have acknowledged individual differences When the studies are taken together, the many caveats among ethnic and racial groups, citing the importance of involved with the role of genetics and environment make environment in shaping performance and measurable it hard to draw firm conclusions. But the balance of data ability. When test results appear to indicate differences in suggests no racial difference in intelligence. ability and performance that follow racial lines, the effect See also Intelligence quotient; Culture-fair test of environment must be considered in interpreting the re- sults. In addition, tests and other instruments for evaluat- ing ability may be biased to favor knowledge and experi- Kenneth B. Chiacchia ences of one racial or ethnic group over others. Thus, test scores must be analyzed with great caution with regard to patterns of performance and their relationship to race. Further Reading Devlin, B., Michael Daniels, and Kathryn Roeder. “The Heri- By studying genetic patterns in humans, scientists tability of IQ.” Nature 388 (1997): 468-71. have demonstrated that genetic differences between Holloway, Marguerite. “Flynn’s Effect.” Scientific American races are not very significant. As humans migrate from (January 1999). continent to continent and ethnic groups intermingle, 534 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

racial categories will have less meaning, but prejudice is the resident expert on mythology, literature, and philoso- not likely to disappear. phy. With financial support from Freud, Rank earned his Ph.D. from the University of Vienna in 1912, with the first Otto Rank See also Ethnocentrism; Eugenics ever dissertation on psychoanalysis. Entitled The Lohen- Further Reading grin Legend, it was published in 1911. Rank was the first Balibar, Etienne. “Racism and Anti-Racism.” UNESCO Couri- psychoanalyst without a medical degree. er (March 1996): 14+. Rank lived with Freud and together they trained Dawes, Kwame. “Clothed Against Naked Racism.” World psychoanalysts from all over the world. However as Press Review (April 1996): 32+. Freud’s favorite, he engendered the anger and jealousy Jacquard, Albert. “An Unscientific Notion.” UNESCO Courier of other Freud disciples. Rank edited Freud’s The Inter- (March 1996): 22+. Wieviorka, Michel. “The Seeds of Hate: Racism and National- pretation of Dreams, co-edited their psychoanalytic jour- ism After World War II.” UNESCO Courier (March nals, and became director of their publishing house. In 1996): 104+. 1918 in Poland, while serving in the Austrian army, Rank married Beata “Tola” Mincer, who also joined Freud’s circle and became a psychoanalyst. Their only child, a daughter, was born in 1919. Otto Rank 1884-1939 Breaks with Freud Austrian psychoanalyst and collaborator of Sig- mund Freud, who developed theories of will and In The Trauma of Birth, published in German in birth trauma. 1924 and in English in 1929, Rank extended Freud’s ideas to mother-child relationships. He viewed the Otto Rank was Sigmund Freud’s closest collabora- child’s separation from the mother at birth and weaning tor for 20 years. Later, he strongly influenced the devel- as the basis of neurosis and argued that the male sex opment of psychotherapy in the United States. He was drive was a desire to return to the womb. Rank’s therapy the first psychoanalyst to examine mother-child relation- involved re-experiencing the trauma of birth. On a trip to ships, including separation anxiety. He also was one of the United States in 1924, Rank lectured on his own the first to practice a briefer form of psychotherapy, ideas as well as Freud’s. Although Freud originally called “active therapy.” His work, in contrast to orthodox praised Rank’s new work, soon he was attacking him, Freudian psychology, emphasized free will, relation- and they broke off their relationship in 1926. Rank ships, and creativity. Many of Rank’s ideas, including moved his family to Paris and began spending a great the importance of the ego, consciousness, and the pre- deal of time in the United States, lecturing and treating sent, have become mainstays of psychoanalytic theory. patients. His new “active therapy” stressed a more equal relationship between the patient and therapist, with a Born in Vienna, Austria, in 1884, Otto Rosenfeld focus on terminating the analysis, as opposed to the changed his name to Otto Rank as an adolescent. It was open-ended and intensive psychoanalysis of Freud. The one of his first acts of “self-creation.” The second son of Freudians labeled Rank as mentally ill, and he was ex- Simon Rosenfeld, a jeweler, and Karoline Fleischner, the pelled from the American Psychoanalytic Association. family could only afford a higher education for one son. To remain in the Association, those who had undergone Rank attended trade school, despite recurring bouts of analysis with Rank were forced to undergo analysis rheumatic fever, and became a locksmith, while his again with a Freudian practitioner. brother studied law. In 1904, Rank suffered a suicidal de- pression, after which he experienced a spiritual rebirth. Rank was a prolific writer. His works included a 700-page survey, The Incest Theme in Literature and Legend,first published in 1912. Between 1926 and 1931, Hired by Freud he wrote important works on developmental psycholo- Rank was extremely well-read in literature and phi- gy, education, and therapeutic methods. The English losophy. After discovering the works of Freud, he wrote translation of an expanded version of his early essay on an essay that applied Freud’s theory of dreams to the cre- art, Art and Artist,appeared in 1932. In sharp contrast to ativity of artists. On reading the essay, Freud was so im- Freudian principles, Will Therapy (1936) stressed con- pressed that in 1906 he hired Rank as the secretary of the sciousness, choice, responsibility, and action. Rank ar- newly founded Vienna Psychoanalytic Society. Soon, gued that neurotics were failed artists who could regain Rank was a member of the “Committee of Seven,” Freud’s their will through analysis, in a process of self-creation inner circle. Although only 22, Rank was considered to be or rebirth. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 535

Rape Emigrates to the United States victim’s home. Rape is one of the most underreported crimes in the United States, due to the victim’s fear of With the rise of Nazi Germany, Rank, a Jew, emi- embarrassment, humiliation, or retaliation by the rapist. grated to the United States in 1935. Teaching at the Penn- Estimates of the percentage of rapes reported to authori- sylvania School of Social Work, he adopted the nickname ties range from 10 to 50 percent. Because of the difficul- “Huck,” after his favorite American book, The Adventures ty of obtaining a conviction, about two percent of all of Huckleberry Finn. Rank and his wife separated in rapists are convicted, and most serve approximately half 1934. Three months before his death in New York City in of their original sentence. 1939, from side effects of the sulfa drug he was taking for a kidney infection, Rank married Estelle Buel. A survey conducted in 1987 found that 57 percent of women who have been raped develop post-traumatic Rank has never received full credit for his contribu- stress disorder. These women may lose their appetite, tions to psychoanalysis and psychotherapy, primarily be- become easily startled, and suffer from headaches, cause of the attacks by Freudians. Although Rank ab- sleep disorders, or fatigue. Many women have difficul- horred the Nazis, in 1939 the psychologist Erich ty maintaining a normal life following a rape, and may Fromm labeled Rank’s “will therapy” a Nazi-style phi- repress the experience for an extended period before losophy. Rank’s work was ignored for years, until the they are able to talk about it. Over the past 20 years 1970s when it was resurrected by the psychologists feminist organizations have fought successfully to Rollo May and Carl Rogers, among others, and by writ- change public attitudes toward rape as well as treatment ers such as Anaïs Nin. The Journal of the Otto Rank As- of rape victims. Efforts have been made to increase the sociation, with writings by Rank and his followers, was sensitivity of police and hospital personnel to rape vic- published biannually from 1966 until 1983. Rank’s 1930 tims through special training programs. Today, women work, Psychology and the Soul,was finally published in police officers routinely investigate rape cases. Rape English in 1998. crisis centers in local communities throughout the na- tion counsel rape victims and perform other services, Margaret Alic such as instruction on rape prevention, providing hot- line services and legal advice, and supplying hospital emergency room advocates to offer emotional support Further Reading to victims and assure that they are treated fairly by Lieberman, E. James. Acts of Will: The Life and Work of Otto physicians and the police. Rank: With a New Preface. Amherst, MA: University of Massachusetts Press, 1993. Despite these and other advances in combating Menaker, Esther. Otto Rank: A Rediscovered Legacy. New rape, it remains a difficult crime to prosecute. Tradi- York: Columbia University Press, 1982. tionally, rape victims have been questioned about their Rudnytsky, Peter L. The Psychoanalytic Vocation: Rank, Win- sexual histories, although most states now place restric- nicott, and the Legacy of Freud. New Haven, CT: Yale tions on the admissibility and usage of such informa- University Press, 1991. tion at trial. In some states, evidence by witnesses or Taft, Jessie. Otto Rank: A Biographical Study Based on Note- proof of bodily injury to the victim are still required; in books, Letters, Collected Writings, Therapeutic Achieve- other states, a struggle between the woman and her at- ments and Personal Associations. New York: Julian Press, 1958. tacker must be proven. Most states require physical evi- dence of recent sexual intercourse in which the victim most undergo a medical examination within 24 hours of the assault. Rape In recent years, increased attention has been focused on “date” or “acquaintance” rape, a widespread phenom- Sexual intercourse forced on a person without the ena that is particularly insidious because women who are person’s consent. victimized in this way are more likely to blame them- selves and are less likely to seek help or prosecute their Rape is essentially an act of power and dominance. attackers. A 1987 study of acquaintance rape at 32 col- Although an estimated 15 to 40 percent of American lege campuses sponsored by Ms. magazine found that women are victims of rape or attempted rape, men are one in four women surveyed were victims of rape or at- raped as well. Women are more likely to be raped by tempted rape, that most rape victims knew their attack- someone they know; between 50 and 70 percent of all ers, and over half the assaults were date rapes. Only 27 rapes occur within the context of a romantic relationship, percent of the women identified themselves as rape vic- and more than half the time the assault takes place in the tims, and five percent reported the rapes to police. Of the 536 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

RAPE: DOES THE VICTIM KNOW THE OFFENDER? Offender was a stranger 68,140 Rate per 1,000 persons for cases involving strangers 0.3 Offender was a nonstranger* 72,790 Rapid eye movement (REM) Rate per 1,000 persons for cases involving nonstrangers 0.4 *A “nonstranger” offender is someone who is either related to, well-known to, or casually acquainted with the victim. Source: Statistics on Crime & Punishment, p. 32. acquaintance rape victims in the Ms. magazine survey, hardest to waken during REM sleep. The contradictions 38 percent were between 14 and 17 years old. Rape can between the active, “awake” features of REM sleep and be particularly devastating for adolescents; the damage it its soundness have caused some people to refer to REM inflicts on the victim’s sense of personal integrity inter- sleep as “paradoxical sleep.” At birth about 50 percent feres with the fragile personal identity and sense of self- of all sleep is REM sleep, but by the age of 10 this figure esteem that are being forged during this period. It also drops to 25 percent. upsets the adolescent’s need to assert some control over In the course of a night, periods of REM sleep occur her environment. Young rape victims, who are often every 90 to 100 minutes, becoming longer as the night sexually inactive at the time of the attack, may have their progresses, in contrast to the deeper stage four sleep, ideas and feelings about sex distorted by the experience. most of which occurs early in the night. About 80 per- Often, they have daily encounters with their attacker or cent of the time, people awakened from REM sleep will his friends at school or social events, adding to their say they have been dreaming, while those awakened dur- sense of shame and humiliation. Most are unlikely to re- ing other sleep stages rarely report dreams. Experiments port the rape to parents or other adults, fearing they will be blamed or that their parents may press charges against their own wishes. Further Reading Brownmiller, Susan. Against Our Will: Men, Women, and Rape. Bantam, 1986. Guernsey, JoAnn B. The Facts about Rape. Crestwood, 1990. Parrot, Andrea. Coping with Date Rape and Acquaintance Rape. Rosen Publishers, 1988. Rapid eye movement (REM) The stage of sleep most closely associated with dreaming. First described in 1953 by Nathaniel Kleitman and Eugene Aserinsky, rapid eye movement (REM) sleep is also called active sleep because the EEG ( electroen- cephalogram) patterns in this stage are similar to the pat- terns during the awake stage. The four stages of slow- wave, or non-REM, sleep are accompanied by deep breathing, a relatively slow heartbeat, and lowered blood pressure. In contrast, levels of physiological arousal dur- ing REM sleep resemble those of the waking state. In some ways, however, people are more deeply asleep dur- ing the REM stage than at other times: the major muscle REM sleep decreases from about 50 percent of a newborn groups go limp in a sort of paralysis, and people are baby’s sleep to about 25 percent by age 10. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 537

Rating scale have shown that people repeatedly awakened during the Rational-emotive behavior REM stage for several nights will compensate by spend- ing twice as much time in REM sleep the first night they therapy are left alone, an observation that has led to much specu- A therapeutic technique that reduces maladaptive lation about the role of this type of sleep. behaviors by showing clients that their behavior is Some researchers have hypothesized that REM caused by irrational thoughts. sleep strengthens neural connections in the brain,a theory supported by the fact that infants and children, Rational-emotive behavior therapy (REBT) be- whose brains are still developing, require larger longs to a class of therapies termed “cognitive-behav- amounts of REM sleep than adults. It has also been ioral” therapies. The defining features of these therapies suggested that REM sleep may be linked to a specific are an emphasis on achieving measurable goals by ma- neurotransmitter, norepinephrine, which helps main- nipulating internal and external reinforcers. That is, cog- tain alertness when people are awake. In addition, REM nitive-behavioral therapists help clients identify the sleep has been investigated in connection with learning thoughts and beliefs that might be prolonging their dis- and memory in studies that showed decreased retention tress or anxiety. The assumption is that attitudes and ex- of learned skills in persons who were deprived of REM pectations that we have for ourselves influence how we sleep. However, a contrasting (and controversial) theo- cope and respond to challenge. ry maintains that the REM stage is a way for the body to “empty” the brain so that its neural networks do not Rational-emotive behavior therapy is the creation of become overloaded. psychologist Albert Ellis. Ellis believes that people are born with a predisposition to be either rational or irra- Further Reading tional, and that mental disorders are the product of Hartmann, Ernest. The Functions of Sleep. New Haven, CT: faulty learning. Specifically, REBT conceptualizes psy- Yale University Press, 1973. chological disturbances as the products of maladaptive Hobson, J. Allan. Sleep. New York: Scientific American Li- brary, 1989. and irrational cognitions (thoughts) that have been learned, and which cause and are in turn caused by emo- ——— . The Dreaming Brain. New York: Basic Books, 1988. tions and behaviors. It is not only the events in our lives, but also our interpretation of those events that can cause psychological disturbances. This is an optimistic theory, inasmuch as it predicts that, since mental disorders are Rating scale the result of learning, they can be unlearned. The ulti- mate goals of REBT are to teach clients to think more Any instrument designed to assist in the measure- ment of subjective evaluations of, or reactions to, a rationally, to feel more appropriately, and to behave person, object, event, statement, or other item of more adaptively. interest. As a therapy, REBT is active and sometimes con- frontational. Cognitive, emotive, and behavioral meth- Several varieties of rating scales have been devel- ods are used in combination to facilitate client change. oped. One common form of rating scale presents the Some of the cognitive methods include: disputing irra- rater with a spectrum of potential responses that in- tional beliefs (e.g., pointing out how irrational it would cludes antithetical elements at each end of a range of be for a client to believe he/she had to be good at intermediate possibilities, on which the rater is expect- everything in order to consider himself/herself worth- ed to indicate the position that most accurately repre- while); thought stopping (the therapist interrupts the sents the rater’s response to the subject in question. An- maladaptive thought by yelling “STOP”); reframing other form of rating scale presents the rater with a list (situations are looked at from a more positive angle); of characteristics or attributes from which the rater is and problem solving. The emotive techniques, includ- expected to select those which the rater believes apply ing role playing, modeling, the use of humor, and to the subject in question. Rating scale instruments are shame-attacking exercises, are all aimed at diffusing used in psychological research primarily to assess qual- the upsetting emotions connected with certain behav- ities for which no objective measurement techniques iors or situations. Finally, behavioral techniques such have been developed. as the use of homework assignments, risk-taking exer- Further Reading cises, systematic desensitization (which involves in- Bech, Per. Rating Scales for Psychopathology, Health Status, cremental exposure to the frightening situation while and Quality of Life. New York: Springer-Verlag, 1993. focusing on remaining relaxed), and bibliotherapy 538 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION

(reading about the disorder) are all used to teach clients that they can safely and comfortably substitute Reaction time adaptive behaviors for the maladaptive ones they have Generally, in psychological measurement, the in- Reality therapy relied on in the past. terval of time between the presentation of a stimu- REBT uses something called the ABCDE model to lus to a subject and the beginning of the subject’s response to that stimulus. help clients understand how their thoughts, feelings, and behaviors are related. The A stands for “activating events,” which are related to rational or irrational “be- Several categories of reaction time, such as simple liefs” (B). The beliefs involve “consequences” (C), reaction time, have been established and studied in ex- which, if the belief is irrational, may be emotional dis- perimental psychology. In a simple reaction time exper- turbances. The D represents the therapist “disputing” iment, the subject is presented with one simple stimulus, the irrational belief and the E stands for the more “ef- such as a light, and instructed to perform one simple re- fective” way of thinking that marks success with sponse, such as pressing a button. In a discrimination re- REBT. action time experiment, the subject is presented with one of two or more different stimuli, such as a red light and a Consider, as an example, a student who performs green light, and instructed to perform a response to only badly on an exam. The poor grade is the activating event. one of the stimuli, such as pressing a button when the red The student’s irrational belief is that, because of this bad light is presented but not when the green light is present- grade, he or she is neither intelligent nor a worthwhile ed. In a choice reaction time experiment, the subject is person. The consequence is depressed mood and perhaps presented with one of two or more different stimuli, such feelings of anxiety connected to test-taking. These reac- as a red light and a green light, and instructed to perform tions could, in turn, result in avoidance of classes and different responses depending upon which stimulus is tests or withdrawal from academically related activities. presented, such as pressing a red button when the red In REBT, the therapist would dispute the student’s belief light is presented and pressing a green button when the that the bad grade represents incompetence or worthless- green light is presented. There are other types, and many ness. The therapist would help the student to adopt more variations of reaction time experiments. effective behaviors and beliefs, such as the belief that the poor grade is simply a reflection of course difficulty or the student’s inadequate preparation, rather than a mea- sure of the student’s worth as a person. Readiness test REBT has been extensively researched. Many stud- A test designed to assess the developmental condi- ies have demonstrated its success in treating various psy- tion of an individual to determine whether or not, chological troubles ranging from depression to anxiety or to what extent, the individual could gain from disorders and even eating disorders such as bulimia. some particular experience. Additionally, REBT has been shown to work in both in- dividual and group counseling settings. Because REBT Readiness tests are commonly used in educational teaches clients to monitor and alter their thoughts, feel- situations, and often include the measurement of cogni- ings and behaviors, it teaches clients to help themselves. tive, perceptual, emotional, motivational, and other fac- This feature is one of its greatest strengths, and is reflect- tors involved in the learning process, in an attempt to de- ed in low relapse rates, compared to drug treatment in termine if a student is in a position to benefit from a par- the absence of any accompanying therapy. Further ad- ticular course of instruction. Readiness tests are based on vantages of REBT include its rapid symptom reduction the view, shared by almost all psychologists, that an indi- and the short duration of therapy; therapeutic goals are vidual reaches maturityin various areas only by passing frequently achieved within 10 to 20 sessions. through corresponding series of consecutive develop- mental levels, and that these series of levels are essential- ly similar in all normal individuals. Timothy Moore Further Reading Capuzzi, D., & Gross, D. Counselling & Psychotherapy: Theo- ries and Interventions. New Jersey: Prentice Hall, 1999. Reality therapy Ellis, A. & Blau, S. “Rational emotive behavior therapy.” Di- A therapeutic approach in which a therapist helps rections in Clinical and Counseling Psychology, 8, 41-56, a client understand the reality of the world around 1993. them and how to function accordingly. GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION 539

Reality therapy was developed by William Glasser, Reflective listening who wrote a book of the same name in the 1960s. This parent who does the homework is harming the student by not teaching that child responsibility. Reality therapy holds that we learn responsibility through involvement type of counseling suggests that all psychiatric subjects have the same basic underlying problem, namely an in- with another responsible person. We can learn and re- learn responsibility at any time in life. ability to fulfill their essential needs. Specific problems, like alcoholism or misbehavior in school, are the symp- toms and not the problem. Troublesome symptoms occur when a person cannot or will not meet their needs. Procedure The procedure of reality therapy is basically three- fold. First, an involvement must be established between the Language of reality therapy therapist and the client. This means a firm emotional bond must be established fairly quickly through discussing all Essential needscan be broken down into two cate- aspects of a client’s current life. This way the client begins gories. One is the need to love and be loved at all times to understand that the therapist cares and also that the ther- during the course of a lifetime. The other is the need to apist is a responsible person who can help clarify the reali- feel worthwhile to oneself and others. In order to feel ty of the client’s world. It has been suggested that through worthwhile, one must maintain a satisfactory standard of this involvement a client also develops increased self- behavior. In other words, if a person is drinking to avoid worth. Once involvement has been established, the thera- facing reality, then he or she is not maintaining a satis- pist begins rejecting the unrealistic or irresponsible behav- factory standard of behavior and not feeling worthwhile. ior of the client. The therapist points out irresponsible be- Everyone has these essential needs but peoples’s abilities havior. Irresponsible behavior is never justified, nor is it to fulfill them vary. viewed as caused by anyone but the client. The therapist The process of fulfilling the essential needs requires, expects and encourages new behavior that is builds confi- first and foremost, involvement with other people who dence in the client. Finally, the therapist acts as a guide or a are in touch with the reality of the world. Without in- teacher of responsible behavior. Clients learn that happi- volvement with other people, we try to fulfill the basic ness can only be gained by being responsible. A therapist needs in unhealthy ways, like overeating or abusing illuminates a client’s hopes, helps a person expand a range drugs. Not knowing how to fulfill essential needs always of interests, and teaches a client to recognize his or her leads to pain, either physical or emotional, for the client own needs and use new behaviors to fulfill those needs. or those around him or her. Reality therapy holds that any time a person comes to therapy, they are lacking a Lara Lynn Lane true involvement with a healthy person. A therapist can be the person who becomes healthily involved with a client. Since fulfilling essential needs is part of person’s Further Reading present life, reality therapy does not concern itself with a Collins, Perry L. “The historical development of reality thera- client’s past. Neither does this type of therapy deal with py.” TCA Journal vol. 25(2) Fall 1997, 50-57. Glasser, William, M.D. Reality Therapy: A New Approach to unconscious mental processes. In these two ways reality Psychiatry. NY: Harper & Row, Publishers, 1965. therapy is very different from other forms of psychology Glasser, William. Reality Therapy in Action. NY, US: Harper- like psychoanalysis. collins Publishers, 2000. Reality therapy tends not to use typical psychology Further Information labels, like “neurotic” or “dysfunctional,” because these William Glasser Institute. 22024 Lassen Street, Suite 118, terms tend to stereotype people. Responsibility and irre- Chatsworth, CA, USA. 91311, fax: 818-700-0555, 800- sponsibility are two terms commonly used in reality ther- 899-0688. Email: [email protected]. apy. Responsibility refers to the ability to fulfill one’s www.glasserinst.com. needs and to do so in a way that doesn’t interfere with someone else fulfilling their needs. Irresponsible people cannot fulfill their own needs, or they fulfill their needs at the cost of negatively affecting someone else. For ex- Reflective listening ample, responsible students do their own homework. Ir- responsible students look for someone else to do their Listening practice used by psychotherapists that re- work. If a parent does the homework for the child, the quires focus, intent, and very active participation. parent is also being irresponsible. The student who does- n’t do their homework is harming his or her learning Very often in Western culture, listening is consid- process and being a burden on those around them. The ered to be the passive part of a conversation while 540 GALE ENCYCLOPEDIA OF PSYCHOLOGY, 2ND EDITION