Essay // Clinical Psychology: Controversies that surround modern day mental health practice

mentalhealth

Modern day mental health practice could be defined as the application of the four main schools of thoughts that dominate the field of psychology in the clinical setting, by abiding to strict criteria set out by packaged behavioural sets, diagnostically defined by names and categorised depending on the core nature of their specific characteristics in terms of behaviour, aetiology and epidemiology. While these four [biological, psychodynamic, cognitive-behavioural & systemic] main schools of thought have contributed to the development and ongoing evolution of the field of psychology, they also have downsides when applied to different types of psychological cases, with some being more efficient in treating particular disorders while others being hardly efficient and questionable. Applying and integrating these four schools of thoughts with new intuitive fact-based theories to explain psychological constructs and disorders are leading to major innovations in psychology; however with each field’s limitations controversies over the validity of their interpretations and the efficiency of their applied doctrines remain a constant topic of debate among scholars and clinicians.

One of the main controversies that surround modern day mental health practice is the medicalisation of psychological disorders, a tradition influenced by the field of medicine which contradicts an important founding philosophy of psychology, which was originally initiated to study the “mind”, not the physical characteristics of the brain as an organ. Furthermore, evidence suggests that psychological problems are not caused exclusively by organic factors. In anxiety, depression and/or schizophrenia, people with genetic vulnerability to the development of those psychological disorders only do so when exposed to particular stresses in their environment (Hankin & Abele, 2005). However, on the other side of the argument, evidence has also shown that deficiencies in genetics and neurobiological anatomy are linked to psychological difficulties and disorders, and hence nowadays, integrated approaches are used in a variety of assessments when treating patients affected by psychological disorders.

On the theme of medicalization, the debate over eating disorders has led to one of the major controversies within the field between advocates of the biomedical conceptualisation of eating disorders and the feminist position (Maine & Bunnell, 2010). The former sees an individual woman as a patient with a debilitating disease, in need of a cure to her illness; while the feminist position views eating disorders as a condition that is gender specific with the woman as a victim of socio-cultural pressures generated by a male-dominated society governed by a hedonistic economic reality focused on the pursuit of the thin ideal. There is an important distinction that should be made here for the benefit of patients since the feminist view may not fully comprehend that in the case of obesity and emaciation related to eating-disorders, the patients are at severe risk of medical complications such as growth retardation, osteoporosis, gastrointestinal bleeding, dehydration, electrolyte abnormalities and cardiac arrest [in chronic cases]. The social feminist constructivist perspective may be interpreting eating disorder as an image debate of “Fat” versus “Thin”. This may lead to the normalisation of obesity and destructive eating habits which in turn may result in further medical complications that involve surgical interventions. As for the feminists, it may be ethical to acknowledge that obesity & emaciation associated with eating disorders are major health issues that precede further complications such as diabetes, cancer and high blood pressure; and should not be confused with social stigma regarding image, but seen as a sign of poor-health and lifestyle that require attention and effort in providing patients with the medical and psychological help they need to adjust their patterns of life to a healthy one by adopting a culture synchronised with dietary & nutritional education.

Secondly, the medicalization of anxiety disorders as distinct medical & psychological conditions may seem less favourable to the biological model previously mentioned. A mass market of pharmacological products used in treatment has been favoured for being more convenient and less time consuming. This may lead to patients feeling disempowered and hopeless when being treated as victims of an uncontrollable illnesses requiring pharmacological treatment, while already being in a state of distress, shock, disbelief and/or confusion. Diazepam (Valium) or other benzodiazepines that are highly addictive have also been prescribed for years to treat anxiety disorders. The long term side effects have been trivialised along with the arrogant act of medicalizing fear and courage (Breggin, 1991). Critics of the medicalization of experiences argue that if patients are helped in understanding that panic attacks develop from the misrepresentation of bodily sensations and hyperventilation, this knowledge along with their own courage may strengthen them to take control of their fear. Research has also shown how patients who are educated in cognitive-behaviour techniques learn to use problem-solving and develop other skills (e.g. social – help them build meaningful lasting relationships while letting go of psychosocial burdens) that they lack to reappraise situations that may formerly have brought distress.
TheDownfallOfTheWildAnimals.jpgThe tragic death of one of the most talented vocalists on the planet, Chris Cornell, has sent a shock throughout the arts world and reports have revealed that the gifted artist was on Lorazepam [a benzodiazepine medication sold under the name Ativan used in the treatment of anxiety disorders], the substance is known to heighten the risk of suicide in those suffering from depression, while a recent investigation (Bushnell et al., 2017) has also shown no meaningful clinical benefit from the addition of benzodiazepines during treatment initiation. To prevent such tragedies from affecting the human race, more emphasis could be placed on « the mind » with clear guidance on the « thinking styles » (cognitive scripts) to adopt in the protection of the individual organism’s own psyche (mind). Simple foundations based on psychological logic should be propagated educationally to help people understand their uniqueness as organisms while protecting their psyche [mind] from the influence/control of external environmental factors that are beyond their control [e.g. biased negativity, uninformed prejudicial comments of meaningless acquaintances, etc]; acknowledging the fact that as long as an individual organism is within the boundaries of the law, he is allowed to live the life of his choice, and external factors would only affect one’s psyche if attention is given to them; and selectively ignoring parts of the environment  is also an acquired skill vital in maintaining sanity, along with the ability to select experiences that are positive & progressive to the organism [while discarding negative ones] in the context and theme of their chosen individual lifestyles.

ChrisCornell

An artist many might consider to be the Fréderic Chopin & the Edouard Manet of Rock, composing with his heart and painting with his voice, enigmatic vocalist Chris Cornell, known for timeless titles such as « What You Are« , « Like A Stone« , « The Last Remaining Light« , « Exploder« , « Be Yourself« , « Getaway Car » & « Dandelion » left a hole in the hearts of millions touched by his work. His tragic death is a reminder that further research is required in understanding the thought structure of artistic individuals whose psychological subjective reality would likely be deeper and more complex compared to the average person – an approach focusing on the « mind » rather than the « behaviour or brain » in the tradition of Sigmund Freud would likely reveal and explain the granularity of their psyche; and whether their suicidal decisions are rooted in full awareness and motivated by a reality they consider to be inadequate for their state of consciousness and IQ; and whether appropriate interventions involving the restructuration of their psychosocial patterns/exposure [to prevent the burden of stress] may be more individualistic & appropriate.

This would also shift the focus to the individual’s mind, courage & abilities to handle the world while maintaining a stable sense of self and resilience; and not turn them into biological organisms that are having their neurochemistry savagely altered by powerful chemical substances that are known to affect individuals differently with dangerous & sometimes fatal outcomes.

PrinciplesOfPsychology

The same would apply to sufferers of post-traumatic stress disorder who would benefit of a non-pharmacological and empowering intervention to manage and take control of recurrent intrusive and distressing memories – it may be useful to study fear, distress and courage as normal psychological processes happening on a dimensional scale on a normal continuum from one individual to another where those on the extreme ends of the scales may be considered for psychological interventions.

Similarly, antidepressant medication used to treat depression remains controversial due to its questionable efficacy and side-effects. The high level of effectiveness of SSRIs reported in academic journals was greatly due to only trials with positive results of antidepressants being published while those where antidepressants were found to be no more effective than placebos being rejected. The effects of TCAs and SSRIs have also been found to be negligible in mild to moderate depression but effective in severe depression in meta-analyses (Fournier et al., 2010). The negative side-effects of antidepressants are known to be risky and dangerous where symptoms such as loss of sexual desire and impotence, weight gain, nausea, sedation or activation, and dizziness are known to be some of the more disturbing ones, with effects varying with types of antidepressants – for depressed pregnant women, health risks may affect their offspring. Dangerous antidepressants such as MAOIs are only prescribed to patients who can follow strict dietary patterns that exclude foods with thyramine (e.g. cheese) to prevent risks of high blood pressure and hypertensive crises. Although meta-analyses suggest benefits may outweigh the risks, an increased risk of suicide has also been noted among patients under 25 (Bridge et al., 2007).

Edouard Manet - Le Suicide

Edouard Manet (1832 – 1883), « Le Suicidé« 

Electroconvulsive therapy has also sparked a major controversy as a primitive, dangerous and non-scientific practice for the brevity of its effect and negative side-effects on memory (Read & Bentall, 2010). A thorough review of studies on the effectiveness of ECT and its side-effects [retrograde and anterograde amnesia] revealed it to be effective for a brief duration in treating severe depression [in cases that are unresponsive to psychological treatment] and questionably only supported by psychiatrists with a vested interest in proving ECT’s effectiveness. ECT has also been associated with a slight but significant risk of death, and a qualitative study of patients’ negative experiences concluded that for some ECT leads to fear, shame and humiliation, and reinforces experiences of worthlessness and helplessness associated with depression.

brainbuilding

Medicalization has also led to controversy over the diagnosis of schizophrenia, a condition classified as a disease by the World Health Organization and ranked second only to cardiovascular diseases in terms of overall disease burden internationally (Murray & Lopez, 1996). Diagnosis is believed to be part of best practice in the patient’s “best” interest, however a strongly presented viewpoint by Thomas Szasz (2010) qualified diagnosis as an act of oppression as it may pave way for involuntary hospitalisation; where a deviant, maladjusted or poorly educated person may be subjected to « control » processes that they are not fully aware of – this has been proposed as a « possible » explanation for the greater rates of schizophrenia among ethnic minorities (particularly Africans in the US & those of low-SES groups). This view has also been supported by many who argue that schizophrenia as a distinct category may not be a fully valid diagnostic, but a fabrication constructed that may stigmatise disadvantaged or poorly educated people – while this may be positive in shaping « unacceptable behaviour » and protect citizens & society, some people with moderate symptoms may also be forcefully hospitalised. Thus, nowadays, schizophrenia is not a single definite disorder anymore, but one among others, as it has been revised and turned into a spectrum, known as the schizoid spectrum [with other related disorders]. In the treatment of schizophrenia, medicalisation has also led to the evaluation of psychotherapy as a possibly ineffective treatment (Lehman & Steinwachs, 1998). Freud & others in his discipline acknowledged the treatment of psychosis as problematic with psychotherapy as psychotic individuals tend not to develop transference [interpretation of their hidden feelings, defences & anxiety] to the analyst – unlike neurotic patients. For personality disorders, addictions and other severe mental health problems medicalisation has led to the development of alternative methods of treatment that unlike the traditional authoritarian & hierarchically organised inpatient mental health settings, are run in a more democratic line where service users are encouraged to take an active role in their rehabilitation rather than simply being passive recipients of treatment.

clinicalpsychology

Therapeutic communities have turned out to be effective in the long-term treatment of difficult patients with severe personality disorders with the outcome being more positive with longer treatments. These therapeutic communities are believed to lead to improvements in mental health and interpersonal functioning. For drug misuse issues, the assumption that clinicians make over users attempt to quit being due to conscious guidance & coherent plans should be revised as no evidence suggests so, and more evidence argue that unconscious processes, classical and operant conditioning, erratic impulses, and highly specific environmental cues affect the development and cessation of drug use (West, 2006). According to West, interventions should not stimulate adolescents to think of what ‘stage’ they are in or be matched to a stage, but maximum tolerable pressure should be put on the young person to cease drug use – which contradicts the stages of change model (DiClemente, 2003; Prochaska et al., 1992) where 30 days are allocated to stages [pre-contemplation, contemplation, action & maintenance] based on no evidence. While concepts such as harm reduction programmes with needle exchange, safe injection sites, and the provisions of free tests of quality of MDMA sold at raves remain controversial, some believe they prevent mortality and morbidity (Marlatt & Witkiewitz, 2010), while others argue they send the message that hard drug use [such as heroin] may be acceptable.

The second major controversy in modern day mental health practice remains the “Person or Context” debate where many in the field still question the validity of focusing on context as it shifts attention from the individualistic characteristics of the patient, and whether the focus should shift depending on the disorder and the patient’s age. For example in the treatment of childhood disorders, if difficulties are assumed to be individual ‘psychiatric’ illnesses the risk of focus being solely on the child and not on broader social environment may lead to medical treatments and individual therapy without addressing important risk factors for those of such young age who are influenced by their social environment, e.g. teacher, school and wider social context. This may not be the case for some adults who value a sense of autonomy more than being influenced by wider social contexts that they have no connection to, interest in or affinity for. In contrast, to the autonomic adult, treatment cases of other childhood behaviour disorders such as oppositional defiant disorder and conduct disorders may be particularly problematic, since the major risk factors that should be addressed are social: through interventions such as parent training, family therapy, multisystemic therapy and treatment foster care. For ADHD, the bold emphasis on medication is dangerous as the effects are limited to only 3 years (Swanson & Volkow, 2009), while growth and cardiovascular functioning may be affected that may lead to somatic complaints such as loss of appetite, headaches, insomnia and tics, which are present in 5-12% of cases (Breggin, 2001; Paykina et al., 2007; Rapport & Moffitt, 2002).

Another interesting argument comes from the Scottish psychiatrist and psychoanalyst R. D. Laing (2009) in the 1960s and 1970s who opposed the view that schizophrenia was a genetically based medical condition requiring treatment with antipsychotic medication. His dimensional approach led him to view schizophrenia as a ‘sane reaction to an insane situation’ where the contents of psychotic symptoms were simply viewed as psychological responses to complex, confusing, conflicting and powerful parental injunctions that left no scope for more rational and adaptive modes of expression. Thus, Laing proposed that the treatment involved creating a context where insight into the complex family process [e.g. poor housing, low SES, deviant parents with drug problems, over-involved family members who maintain the patient’s stress, alcohol problems, sexual deviance, incest, lack of financial stability, poor educational motivation, poor emotional education, lack of problem solving skills, lack of sophistication, poor nutrition, restricted finances, etc] of patients with schizophrenia and psychotic response to these could be facilitated. The context here seems partially important in the case where the patient’s delusions and hallucinations are linked, where their interpretation would be the client’s response to conflicting parental injunctions. The experience of psychosis and recovery was a process where the individual could emerge stronger with new and valuable insights regarding the solutions to their problems. However, this has not been supported by any evidence or subsequent research. In contrast, strong scientific evidence points to the importance of a more client-centred individual approach focussed solely on the patient with defective inherited neurobiological factors as major focus for the role they play in schizophrenia, and antipsychotic medication for the reduction of symptoms in two-thirds of psychotic patients affected (Ritsner & Gottesman, 2011; Tandon et al., 2010). Research has supported the hypothesis that suggests the family does affect the psychotic process and that psychotherapy has a place in the management of psychosis, for example personal trauma, including child abuse increases the risk of psychosis, and stressful life events including those within the family can precipitate an episode of psychosis, and high levels of family criticism, hostility and emotional over-involvement increase the risk of relapse (Bebbington & Kuipers, 2008; Hooley, 2007; Shelvin et al., 2008). So for those with a strong sense of family, and heavily involved peers, family therapy delays relapse in troubled families characterized by « extreme » levels of expressed emotion; and cognitive behaviour therapy which stresses the idea that psychotic symptoms are understandable and on a continuum with normal experience can help patients control these psychotic symptoms (Tandon et al., 2010), with solutions to rebuild their lives, their own identity and manage their social circle intelligently by differentiating types of relationship and expectations.

personality

The third and last controversy to be addressed is the ongoing debate in clinical psychology over the categorisation of psychological disorders where many have been arguing over a dimensional outlook on psychological conditions that offers more precision in diagnosis along with a more scientific approach. In the case of childhood behaviour disorders with regard to scientific approaches, there is an ongoing debate over whether they should be viewed and classified in categorical or dimensional terms. While DSM are based on rigid categories, most empirical studies support the view of a dimensional outlook. Furthermore, factor analytic studies consistently show that common childhood difficulties belong to two dimensions of internalizing and externalizing behaviour, which are normally distributed within the population (Achenbach, 2009). Young children diagnosed with oppositional defiant disorder (ODD), conduct disorder and ADHD are part of a subgroup of cases with extreme externalizing behavioural problems, while those with anxiety or depressive disorders have extreme internalizing behaviour problems (Carr, 2006a). By the same dimensional approach, children diagnosed with intellectual disability fall at the lower end of the continuum of intelligence, a trait also normally distributed within the population (Carr et al., 2007). The dimensional approach is not only more scientific, but also has a less stigmatizing and rational approach to human uniqueness. The dimensional approach has also enhanced the movement critical of qualifying psychological deficiencies as ‘real psychiatric illnesses’, conditions such as ADHD, conduct disorder and other DSM diagnoses. Questions have been raised over whether they are invalid fabrications or spurious social constructions (Kutchins & Kirk, 1999). Those who trust the evidence of the dimensionality of childhood disorders argue that they may simply be traits distributed normally among the population where some cases fall on the extreme ends of certain traits, while those who point to the interests of pharmaceutical industries’ financial motives argue that they are spurious social constructions. The latter seems unethical but is a part of the decadent and immoral economic reality that we have allowed to exist. As parents, health and educational professionals, it is clear that the pharmaceutical industry and governments may all gain from conceptualising children’s psychological difficulties as ‘real psychiatric illnesses’. Some schools or uncaring parents may prefer children to receive a diagnosis of ADHD with stimulant therapy as they may have difficulty meeting their needs for intellectual stimulation, nurturance and clear limit-setting; thus these children in their care become more aggressive and disruptive.

In the case of schizophrenia, a dimensional approach has also led to the schizotypy construct as a dimensional alternative to the prevailing categorical conceptualization of schizophrenia (Lenzenweger, 2010). In contrast to the categorical view based on Kraepelin’s (1899) work and used in the DSM which sees schizophrenia as a discrete diagnostic category, this one proposes that anomalous sensory experiences, odd beliefs and disorganized thinking exist in extreme forms of schizophrenia as hallucinations, delusions and thought disorder, but these are simply on continuum with normal experience [i.e. it is present in all ‘normal’ people but peaks in abnormal ones] – a position originally advocated by Bleuler (1911). Research measures have provided support for the dimensional construct of schizotypy (Lenzenweger, 2010) where the continuum may be composed of sub-dimensions; from normal to psychotic experiences. Schizotypy is heritable; and patients with high schizotypy scores but who are not psychotic show attentional, eye-movement and other neuropsychological abnormalities associated with schizophrenia. Further, the dimensional approach has also led to the distinction between schizophrenia and split personality where 40% in the UK equated split or multiple personality with schizophrenia – as popular culture often does. It is clear that schizophrenia does not refer to such characteristics.

dr_jekyll_and_mr_hyde_poster_d'purb

The closest equivalent to split personality is a condition known as dissociative identity disorder (DID), where the central feature is the apparent existence of two or more distinct personalities within the same individual, with only one being evident at a time. Each personality (or alter) is distinct with its own memories, behaviour and interpersonal style. In most cases, the host personality is unaware of the existence of alters and these vary in knowledge of each other. Evidence suggests that the capacity to dissociate is normally distributed within the population and an attribute many use to manage their own lives and network. Those with high degree of this trait may cope by dissociating their consciousness from the experience of trauma (such as child abuse, extreme graphic violence, etc) in early childhood by entering a trance-like state. This dissociative habit is negatively reinforced (strengthened) as an effective distress-reducing coping strategy over repeated traumas in early childhood as it brings relief from distress during trauma exposure. Eventually a sufficient number of experiences become dissociated to constitute a separate personality that may be activated in later life at times of stress or trauma through suggestion in hypnotic psychotherapeutic situations. Treatment often simply involves helping clients integrate the multiple personalities into a single personality and develop non-dissociative strategies for dealing with stress [e.g. argument with work colleagues, new manager, divorce, adolescents leaving home for studies, partner with alcohol problems, over-involved family members, etc] – this helps them deal with tough situations by facing them with problem-solving abilities and skills to come out with a firm resolution and have their views understood. Core symptoms of multiple personality disorder are not treated with psychotropic medication unlike schizophrenia but involves psychological education for patients to learn the skill of mentalizing [understand their own state of mind and that of others].

whoareyou

Finally, with personality disorders, the dimensional approach has led to the trait theory in conceptualizing important aspects of behaviour and experience from a limited number of dimensions. Any given trait is believed to be normally distributed in the population, for example, introversion – extraversion, most people show a moderate level of the trait, however those who exhibit extremely low or high levels [extremes] would have the sort of difficulties attributed in the DSM. So, normal people only differ from the abnormal in the degree to which they show particular traits. The trait theory has become dominated by the five-factor theory (McCrae & Costa, 2008) in recent years. This model includes the dimensions: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. There is evidence for the heritability of all of factors within the Five Factor Model except agreeableness which seems to be predominantly determined by one’s environment (Costa & Widiger, 1994). Thomas Widiger has proposed that the five-factor model may be used as an alternative system for describing personality disorders (Widiger & Mullins-Sweatt, 2010). Widiger also argues that trait theory offers a more scientifically useful approach to assessment with good psychometric properties embraced by its questionnaires (De Raad & Perugini, 2002) – they are reliable and valid, and have population norms. Compared to categorical classification systems, trait models offer a more parsimonious way of describing patients with rigid dysfunctional behaviour patterns which in turn offers a more parsimonious way to conceptualize the development of effective treatments.

LondonCity

Photo: The Promise of Dawn (J.Hawkes)

The major controversies in modern day mental health practice seem to revolve around the precision and the validity of constructs as psychological illnesses, and since they may stigmatise those who suffer from them, the constant research into better and more modern interpretations and explanations of their characteristics and treatment seem bound to revolutionise the field of psychology, as the movement takes a more dimensional approach; with a new generation of psychologists applying the rules with an open mind and a creative outlook on new perspectives and methods – the field of psychology looks set on a positively progressive course.

UneNation

« A great aggregation of men sane in mind & warm in the heart, creates a moral conscience that is known as a nation » – Ernest Renan / Source: Université Paris 1 Panthéon-Sorbonne

Arthur Hughes - A Music Party 1864

Arthur Hughes (1832 – 1915), « A Music Party« 

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References

  1. Achenbach, T. M. (2009). ASEBA: Development, findings, theory, and applications. Burlington, VT: University of Vermont Research Centre for Children, Youth and Families.
  2. Bleuler, E. (1911). Dementia praecox or the group of schizophrenias. New York: International University Press.
  3. Breggin (1991). Toxic psychiatry. London: Harper Collins.
  4. Breggin, P. (2001). Talking back to Ritalin: What doctors aren’t telling you about stimulants and ADHD. New York: Da Capo Press.
  5. Bridge, J. A., Iyengar, S., & Salary, C. B. (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in paediatric antidepressant treatment: A meta-analysis of randomized controlled trials. Journal of the American Medical Association, 297, 1683-1696.
  6. Bushnell, G., Stürmer, T., Gaynes, B., Pate, V. and Miller, M. (2017). Simultaneous Antidepressant and Benzodiazepine New Use and Subsequent Long-term Benzodiazepine Use in Adults With Depression, United States, 2001-2014. JAMA Psychiatry, 74(7), p.747.
  7. Carr, A. (2006a). Handbook of child and adolescent clinical psychology: A contextual approach (second edition). London: Routledge.
  8. Carr, A. (2012). Clinical psychology. 1st ed. New York: Routledge.
  9. Carr, A., O’Reilly, G., Walsh, P., & McEvoy, J. (2007). Handbook of intellectual disability and clinical psychology practice. London: Brunner-Routledge.
  10. Costa, P. & Widiger, T. (1994). Personality disorders and the five factor model of personality. Washington, DC: APA.
  11. De Raad, B., & Perugini, M. (2002). Big five assessment. Bern, Switzerland: Hogrete & Huber.
  12. DiClemente, C. (2003). Addiction and change. New York: Guilford.
  13. Fournier, J., DeRubeis, R., Hollon, S., Dimidjian, S., Amsterdam, J., & Shelton, R. (2010). Antidepressant drug effects and depression severity. Journal of the American Medical Association, 303, 7-53.
  14. Hankin, B., & Abele, J. (2005). Developmental psychopathology: A vulnerability-stress perspective. Thousand Oakes, CA: Sage.
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  16. Kutchins, H. & Kirk, S. (1999). Making us crazy: DSM – The psychiatric bible and the creation of mental disorders. New York: Constable.
  17. Laing, R. D. (2009). Selected works of R. D. Laing, Volumes 1-7. (Vol. 1. The divided self. Vol 2. Self and others. Vol. 3. Reason and violence. Vol. 4. Sanity and madness in the family. Vol. 5. The politics of the family. Vol. 6. Interpersonal Perception. Vol. 7. Knots.) London: Routledge.
  18. Lehman, A., & Steinwachs, D. (1998). At issue: Translating research into practice: The Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophrenia Bulletin, 2, 1-10.
  19. Lenzenweger, M. (2010). Schizotypy and schizophrenia. New York: Guilford.
  20. Maine, M. & Bunnell, D. (2010). A perfect biopsychosocial storm: Gender, culture, and eating disorders. In M. Maine, B. McGilley, & D. Bunnell (Eds.), Treatment of eating disorders: Bridging the research-practice gap (pp. 3-16). San Diego, CA: Elsevier.
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  25. Prochaska, J., DiClemente, C., & Norcross, J. (1992). In search of how people change: Applications to addictive behaviours. American Psychologist, 47, 1102-1114.
  26. Rapport, M. & Moffitt, C. (2002). Attention deficit/hyperactivity disorder and methylphenidate: A review of height/weight, cardiovascular, and somatic complaint side effects. Clinical Psychology Review, 22, 1107-1131.
  27. Read, J., & Bentall, R. (2010). The effectiveness of electroconvulsive therapy: A literature review. Epidemiologia e Psichiatria Sociale, 19, 333-347.
  28. Ritsner, M., & Gottesman, I. (2011). The schizophrenia construct after 100 years of challenges. In M. Ritsner (Ed.), Handbook of schizophrenia spectrum disorders, Volume I: Conceptual issues and neurobiological advances (pp. 1-44). New York: Springer.
  29. Swanson, J. M., & Volkow, N. D. (2009). Psychopharmacology: Concepts and opinions about the use of stimulant medications. Journal of Child Psychology and Psychiatry, 50 (1-2), 180-193.
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Updated 8th of August 2017 | Danny J. D’Purb | DPURB.com

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Essay // Psychological Explanations of Prejudice & Discrimination

Paralympic-Cheetah-blades

Prejudice and discrimination are usually classified as behavioural attitudes towards a certain group or individual based on a multitude of reasons [according to different psychological theories]. The main reasons for prejudice are believed to be rooted in individual psychological processes related to groups, social influence and/or upbringing.

Authoritarian Personality

One plausible explanation for prejudice is the authoritarian personality, which suggests that those belonging in the category are concerned with status and upholding conventions, are very conformist and tend to be obsequious to those they see as holding a higher status – while treating those ‘below’ with contemp. Authoritarian personality is believed to be the result of strict and punitive upbringing which later leads to hostility being directed towards disliked [justified or unjustified] groups through the process of « displacement ». Adorno et al (1950) found strong and positive correlations between respondents’ scores on the F-Scale and scores on other measures intended to assess anti-semitism (AS scale) and ethnocentrism (E scale). However, the PEC-scale (Political and economic conservatism) was not strongly related, which only led to the conclusion of how people who are anti-Semitic are also « likely » to be hostile towards most « out-groups ».

The Adorno et al (1950) test only consisted of agreement that could only be geared towards anti-Semitism, ethnocentrism and fascism, which might have led to the problem of acquiescent response. The fact that the interviewer knew the interviewee’s F-score might have also led to experimenter bias; and the theory also falls short in the explanation of mass changes in behaviour: “Antisemitism in Nazi Germany grew during a decade or so, which is much too short a time for a whole generation of German families to have adopted new forms of childrearing practices giving rise to authoritarian and prejudiced children (Brown, 1988)” [not plausible]. The reality is that anti-Semitism may have been the result of a more sinister social and economic problem caused, inflicted by or related to the jews powerful Zionist business associations on the German economy at a time where the country was suffering [people, heritage, identity, economy…].

Stereotyping

Social Roles

Individual identity differs according to heritage, education, language(s), individual choices, profession and social roles

Another form of prejudice is stereotyping, which plays a major part in the process of inter-cultural [note: culture may refer to groups defined by language, geography, religion, and other common similarities] prejudice where the root of its cause has proven to be fairly ambiguous in explanation.

Art - D'Purb Website

Groups founded and united based on the behavioural patterns of a particular geography [usually] tend to stereotype others negatively [i.e. out-group(s): the other group(s) with petty differences in the way they go by their daily activities as all human primates on this planet – as the chart below suggests].

Development Era_The World as One Consuming Unit

Where Do We Buy What? (Source: Statista)

It is believed that the process of stereotyping is the result of minimising mental effortreminiscent of Carl Jung‘s quote:

« Thinking is difficult, that is why most people judge. »

LesConsOseTout_Audiard

Stereotyping is linked to psychological processes within the individual and is assumed to be connected to environmental influences that lead to a prejudiced mind; where out-groups and there members are defined unrealistically by single characteristics (negative usually). Stereotyping can sometimes [at least when dealing with members of the public who may not be deemed as « intelligent or smart », even bordering on plain « stupid »] play a role in the legitimisation of prejudiced and discriminatory treatment of other individuals who simply [consciously or unconsciously] made the choice to live by different modes of group-oriented behavioural patterns (culture).

Rational reasoning and the humane ability to understand each group’s choices while also respecting each group’s boundaries [geographical, social, economic, psychosocial, linguistic, etc] are surprisingly never considered by individuals and authorities in the quest to correct the mistakes of a world designed on outdated ideologies [e.g. the scientifically poor logic of global communism] to design a new one based on creative scientific reasoning, evolutionary logic, design & progressive innovation.

Bloomsbury 113 D'Purb Website

Another reason why some individuals resort to stereotyping others may be insecurity. That is, some individuals may be frustrated at their inability to conquer other(s) who are above their league in terms of abilities and achievements, and may stereotype these individuals in their quest to compensate for their own lack of abilities and feeling of inferiority when faced with these individuals who are more talented than them. Arguably, it may also be that these petty common brains who stereotype, simply fear that their competitors may be able to excel and deliver a similar or even superior performance/output than them if not distracted and slowed by insignificant and childish acts of stereotyped behaviour.

Carl-Gustav-Jung

Traduction(EN): « Thinking is difficult, that is why most people judge. » -Carl G. Jung

Prejudice as an Illusionary Cure to Low Self-Esteem/Insecurity

The Social Learning Theory, on the other hand, assumes prejudice as the result of maintaining self-esteem of both the individual and the in-group (individuals with the same behavioural patterns as the individual/tribe) members – where one tends to be biased towards glorifying the group whilst also paying particular attention to criteria that make the group look better. This is related to our sense of identity being determined by the groups we belong to and thus tend to be biased towards favouring them. Tajfel et al (1982) showed how schoolboys chose the strategy to allocate more points to their own group at the expense of getting least overall – showing bias in the absence of competition. The two main problems however are the fact that [1] the tendency for favouritism might be group-oriented and not universal (Wetherall, 1982), and also how [2] most studies show bias towards in-group (which could not only be prejudice but stereotyping or other influences).

Unrealistic Conflict? Competition for the same Resource(s) while presuming in-group members to be « unconditional benefactors »

Finally, the realistic conflict theory suggests that prejudice arises when two or more groups compete for the same resource which in turn leads to a tendency to favour in-group members, while being hostile and denying resources to out-groups. This was proven in Sherif et al (1961) where the artificially stimulated competitive conflict lead to negative stereotyping towards out-group which persisted even after the competition. However, the validity was questioned over the artificiality of the situation and the samples (US American boys only?); as Tyerman & Spencer also showed how competition does not always cause prejudice – where UK scouts co-operated instead. Furthermore, individuals with different upbringing and philosophical orientations had not been considered, which in turn affects the ecological validity of the finding where inferences from generalisation would likely lack precision – with a world in constant social evolution with more psychological research being constantly published to guide society towards a more harmonious design.

LesVieuxChiensFrustrés

Conclusion and Reflections: Relocation, Adaptation, Design & Assimilation

Together, the theories seem to offer a plausible explanation for prejudice but cannot be ranked; as they compensate each other’s weak points. A sensible application of each theory – depending on the situation – seems like the rational method forward, since factors such as group-based behavioural patterns (culture), present situation/environment and norms/values remain vital considerations when researching about prejudice, its causes & a more direct approach to solutions.

Furthermore, the world has made such leap socially with the technological era, and people have been inclined towards knowledge, discoveries and innovation with social media contributing towards a more educated humanity [i.e. a civilisation with its different societies that come with their own values, philosophy, feelings and behavioural and communicative patterns, that are the main seperators and organising factors in each group’s identity].

 

Relocation

A new and strong global inclination towards a realistic synchronised unity [where the world’s population can live harmoniously in their own geographical location with their chosen units, laws and lifestyle], may shape intellectual thought in the decades to come now that the experience learnt from psychosocial disasters due to badly managed population shifts [that turned out to be destructive to the safety of Western European nations] could be considered in future policies. [Visit the website of the Banque Mondiale for more precise population statistics].

Unbelievable African Population Growth

Source: UN via The Guardian

Negro Population Counter

The current population of Africa is 1,300,976,080 as of Wednesday, December 5, 2018, based on the latest United Nations estimates. / Source: Worldometers (Click to see a live count of the majorly negro population of Africa)

La Taille Du Continent Africain

The Size of the African Continent: With the speed of progress and the development brought by the digital era, an increasing number of Negro people nowadays, with their global population rising at a rate faster than any other group, are considering a relocation to their homelands in Africa

Organisms who do not want to/cannot assimilate, should consider a relocation to an environment that is adjusted and more suited to their evolutionary needs, as this seems like the most rational solution, such as the growing number of sensible Negro people nowadays who are gradually shifting back to their homelands in Africa to help it grow economically and culturally with the world developing at a speed never seen before in this era partly accelerated with modern technology.

Africa Unite - Negro People

A great example of environmental and socio-psychological synchronisation is India, with 94% of Hindus being the native Hindi-speaking population of India who also live there, although Hinduism and its various branches of philosophy [explored by one of the most influential Western philosopher, Arthur Schopenhauer, and also many others such as Aldous Huxley, Alfred North Whitehead, Arnold Toynbee, François Voltaire, Rudolf Steiner, Wilhelm von Humbolt & Will Durant] – as other major religious cultures such as Christianity – also spread in influence globally.

India United

Hinduism, Hindus and India

Like Christianity & the other major religions, Hinduism and its philosophy also gradually spread in influence across the globe. However, 94% of people who practice Hinduism  are the native Hindi-speaking population of India

The Climate Collapse disaster has also made Civilization aware of the importance of « synchronised unity » in matters of global human advancement –  future research surrounding prejudice and discrimination would likely benefit the human world more if applied in intra-group scenarios – should the world’s population be managed and geographically engineered according to each group’s evolutionary logic [to fit their respective psycholinguistic, cultural and organic environments to further refine group evolution and guide society towards a harmonious pattern of living] for each group by their respective identities, collective beliefs, values & vision.

Chart of the Year - Global Poverty

A Visual History of Global Poverty from 1820 – 2015 / Source: Our World In Data

Infant Mortality 1950 - 2015

Infant Mortality, 1950 to 2015 / Source: Our World in Data

Global Income Inequality is Falling 1820 - 2000

Global Income Inequality is falling, 1820 – 2000

As World poverty is down, solving matters of the 3rd world on location along with a systematic and diplomatic relocation of culturally alien migrant crowds seems rational. Progress & development globally means relocation should be considered in the future if human beings are realistic about world peace, and the understanding of evolutionary science and its application to humanity.

World Charity by Country

Charitable giving by country / Source: Guardian DataBlog

libray users cite impacts from personal learning d'purb dpurb website

Library users and Learning / Source: Pew Research Centre (Internet & Technology)

We, as Western Europeans should consider a diplomatic process for relocating incompatible populations [who struggle to or cannot adapt] according to their respective societies and cultural identity for peace; with links and cooperation in business and education if necessary to support the sophistication and the continuous linguistic and cultural development of human societies on Planet Earth.

Geographical management towards synchronisation and stability by exploring the logic of the « Organic theory » involves prioritizing one’s « own organisms » [i.e. organisms that are part of or have become part of one’s own society through complete assimilation] for psycholinguistic, cultural, social & genetic chemistry, evolution and enhancement.

nous

For example, if I myself were a retrograde and atavistic burden to Western Europe or France because of my religious beliefs, maladaptive needs, genes, intelligence [lack of], organic composition, fitness/health, education, philosophical perspectives, traditions, psycholinguistic heritage and national outlook, then I would change geographical location to one that is more suited to myself to be able to live much more comfortably. But since, I am of 100% Franco-British heritage and would not feel at « home » in a different environment other than Western Europe, I have fully assimilated and live here, thus, the concept of « Geographical Management », which is simply the process of keeping together organisms sharing similar beliefs, philosophy, culture, vision, perception, goals, intellect, language(s) and identity for chemistry, stability and mutual understanding: a synchronised and functional society founded on modern evolutionary science & humanistic philosophy.

We need to understand the identity of a society in terms of linguistic, cultural [mostly behavioural and perceptive patterns], and genetic authenticity but also consider and follow the progressive course of evolution as modern and sophisticated beings to include evolved organisms that assimilate, enhance, stabilise, and strengthen the group with superior or gifted genes that also care about, have a sense of belonging, take pride, interact, speak for and identify with the culture and nation. All humans are similar yes, but not equal … similar physiologically [blood, bone, organs, etc] but not equal in any case [culture, philosophy, language(s), IQ, genetics, fitness/health, intelligence, vocabulary, sensibility, skills, etc].

Rodin

 

Adaptation

For cases of exceptional organisms who have moved to a new locations [geography] to create themselves and build their lives, it would certainly be helpful for them to see themselves as singular and individual units with the power to reshape their whole being if they intend to be able to live a life that is not restrictive and is in complete synchronisation with the new society and people they choose to be a part of; thus assimilation seems to be the only reasonable and humane option.

It is fundamental for all to understand that geographical groups have evolved and have gained and maintained a structured organisation because each region on planet Earth and its respective organisms [of a particular type of organic composition – what some refer to as “race”] have created societies and behavioural patterns that led to a group with some form of synchronisation and organisation.

Human evolution

But, it is also very important to consider that from the perspective of the universality of life on Planet Earth, any human organism of whatsoever type of organic composition can procreate with one another. This simple but fundamental scientific observation means that if the laws of evolution and nature that contain and govern all life on this planet had different intentions, then organisms of different organic compositions would not be able to create new life. This does not mean that countries should be encouraging uncontrolled and savage communist/zionist mass invasion policies in terms of migration to disrupt their own stability, since preserving a sense of synchronisation and organisation for all groups involves promoting agendas with organisms that have evolved in their environment and have the characteristics to support the continuity and  productivity of their group & societyHowever it is of vital and fundamental importance for all groups [around the world] to consider the never-ending and ongoing process of evolution and natural selection, a process that affects all organisms on planet Earth similarly and also the singular adaptive evolution of some superior and genetically gifted organisms [See: [I] Psychology: The Concept of Self, [II] How our Neurons work, [III] The Temporal Lobes: Vision, Sound & Awareness and [IV] The 3 Major Theories of Childhood Development]

Darwin sur l'adaptation environmentale Oxford University Press Quote D'Purb Website

Traduction(EN): Charles Darwin (1809 – 1882), best known for his theory on evolution by natural selection, demonstrated that all species have developed over time from common ancestors and that individuals with characteristics most suited to the environment are more likely to survive and reproduce.

Putz_Michel_Richard_Orpheus_and_Eurydice D'Purb Website

 

Design

All societies should be asking the question of whether some select superior organisms [whatever the field in which they may excel / See: Scientists discover 1,000 new “intelligence genes” & 2 types of extroverts have more brain matter than most common brains] would enhance them as a group [i.e. upscale their organic composition], since we are now in 2019 and are part of a generation that has the scientific knowledge that previous generations before us did not have.

After all, the choice of partnership should always remain that of the individual, and since the criteria in partnership selection differs from one individual to another [e.g. some may look for physical attributes, others for emotional intelligence, or philosophical sensibilities, or typical personality traits, and on extremely rare occasions some may be incrediby lucky to find all the qualities in a single organism, etc], this may lead some individuals to choose from a range of organic compositions.

Human-Design-Organic-Composition

In 2019, with the knowledge of genetics and health, couples who want children worldwide should also consider whether the future wellbeing of their children involves more than simply good food, education and upbringing, but also good genes that also lead to better attributes. Hence, couples who choose to embrace the reality of science in 2019, may choose sperm or eggs from healthy donors if they do not consider themselves as genetically healthy or gifted; and this may also open the door to creating a healthier generation of humans on planet Earth and also encourage healthy males and females, to donate sperm and eggs as a contribution to the better design of a new generation of mankind. Since, science has always been seen by many as the study of God’s work, to create a better world, and this gave us better medicines and treatments after our understanding of Nature evolved, so it seems logical to also look at genetics and design similarly.

Masters of Deception - Salvador Dali 026 - D'Purb Website

We also know that environmental and psycho-social influences have more salience and effect in shaping the mind of the individual, so avant-garde couples who choose to have a child through donated eggs or sperm should understand that the child will be theirs as the infant will carry their names, manners, attitudes and values, and not the donor’s. A good way of looking at it may be to simply think of the donor as a piece of healthy flesh that the couple borrowed to give their child a better design, health and future.

« spermini » par l'artiste maurizio cattelan d'purb website 1200

«Spermini», l’oeuvre par l’artiste Maurizio Cattelan / Source: Fondation Louis Vuitton

 

Assimilation

As for human organisms that have chosen to shift their geography to be part of a new society along with its heritage, they do not seem to have any other concrete option but to fully « assimilate » and prove their genetic fitness/health and abilities, and hence become an asset to the new group by becoming a part of it to help maintain its stability and sense of synchronisation.

Men and women who make the choice and who have the necessary education and intelligence to guide them, build themselves and change cultural / national identification registers when they have the capacity for development, the linguistic heritage and the genetics of intellect with a mastery of expression and speech. It is only then that they manage to represent a nation or an empire [or two?]. In 2019, as far as ‘The Organic Theory’ [which focuses on the singularity of the individual organism] is concerned, there is no debate between intellectuals in psychology, but simply the discovery of the new mechanical / scientific perspectives that it introduces to explain the psychological and philosophical conception of the individual – as Carl Sagan phrased it, ‘Science is a way of thinking much more than it is a body of knowledge’. Construction [training], which ‘can be’ mechanical and structured in its application [e.g. distance learning by text / video / audio], develops indirectly to create and give a socio-cultural dimension to the individual once the desired skills have been fully adopted, mastered, and deployed in life. The term ‘social’ is also far too vague to be important as such… the term ‘social’ can simply be defined as the interaction and exposure [of all types] between organisms. So the term ‘social’ is not really valid scientifically and it lacks precision itself since it may refer to a wide range of variables. What we are left with then is only the individual’s choices, language(s) & abilities of personal development [e.g. psycholinguistic & cultural synthesis]: the major factors in the psychological & philosophical explanation of his/her singular conception [to note that each conception is unique to the individual human organism such as his/her fingerprints, skull shape, or body structure: singularity]. Thus: training, meritocracy, order and love! [See: The Concept of Self]

Feuerbach_Anselm(1829-1880)_Paolo_And_Francesca D'Purb Website

If the new organisms lack genetic fitness/health, then they should consider conceiving [through healthy donors] or adopting children of the similar organic composition of the majority from the respective societies they moved to and live in, as this will not cause any instability for the future continuity of the group.

So for organisms who do change their mode of existence, i.e. organisms that have the potential and have taken the decision to and do assimilate in Western European societies, the best option seems to see, think, breathe & live” [as a way of speaking] like the new society and nation they chose to be a part of, and also “feel” the new group’s pain, joy, values and heritage [even religion if possible / See: The Relationship between Religion and Discrimination].

Assimilation generally means to see the members of one’s new community as one’s own « blood », just like those from avant-garde French schools of thought do, as it will be in any individual’s best interest in living « fully » [although it is vital for all organisms to also consider the problems of «bad blood», since social incompatibility and/or a lack of chemistry – which is not necessarily hateful – within organisms of the same geographical environment are common due to a range of factors (e.g. intelligence, philosophy, values, sensibility, personality, character, etc)].

Tennessee

Any society that cannot add highly talented organisms with exceptional genes that have the potential to enhance and sharpen them as a group through the process of assimilation, would be missing out and will forever have a weakness over avant-garde societies that can. However, it is important not to take the process of assimilation lightly as it is not a costume party. Assimilation is not an easy process as we have found.

The large majority of organisms who change geographic locations do not seem to have the abilities or the desire to assimilate, since it involves focusing their loyalty and dedication to the new society and people while also adopting [e.g names that are sycnhronised with the society’s heritage as it is commonly done in France] and mastering new behavioural and communicative patterns [as Nicolas Sarkozy also pointed out], which requires learning & adaptation. Hence, the diplomatic deportation and relocation of incompatible organisms along with campaigns to help them settle still remain the best solution to alleviate the burden of mass migration and psycho-social disruption to Western European societies, because assimilation requires skills and dedication and the majority of foreign organisms fail to master them.

Nous En France - Sarkozy - d'purb

Traduction(EN): « Us in France, we are different from others. To live, we have to drink, eat, but also to cultivate ourselves. » -Nicolas Sarkozy

We should also take note that there are some [not many] “incredible” individuals who manage to assimilate and become fully part of their new societies, and guide, manage and promote it passionately.

DocPaints

These individuals who have made the tremendous effort to become fully part of their new society where they have moved to and have the potential to enhance, guide and promote it should be applauded and encouraged because these individuals who have proven their genetic fitness/health, psycholinguistic/cultural belonging, national loyalty & identity are not in a new society simply for economic gains [as a foreign leech] but see themselves as part of the national community/family, and have taken the sensitive personal decision to completely blend in [assimilate] and be similar to the natives of their new societies where it reflects in their values, sentiments, perception, behaviour & nationalistic feelings.

Charles Darwin sur l'evolution par la sélection naturelle D'Purb Website

Traduction(EN): « I have called this principle, by which, each slight variation, if useful, is preserved by the term of natural selection. » -Charles Darwin / Note: Darwin devised the Theory of Evolution and was against bad breeding, and even supported a campaign to make marriage between cousins illegal due to the range of diseases and disabilities caused by consanguineous inbreeding [See: (1) Inbreeding, Consanguinity and Inherited Diseases, (2) The Role of Inbreeding in the Extinction of a European Royal Dynasty, (3) Royal dynasties as human inbreeding laboratories: the Habsburgs & (4) 75% of Jews Are Lactose Intolerant and 11 Other Facts 

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Bibliography

Boakes. R (1984) From Darwin to behaviourism: Psychology and the minds of animals. Cambridge University Press

Cohen D. (1979) J.B Watson: The Founder of Behaviourism. London, Boston and Henley

Gross. R (2005) Psychology: the science of mind and behaviour. London, Hodder and Stoughton Educational

 

Mis à jour le Mardi, 1er Janvier 2019 | Danny J. D’Purb | DPURB.com

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