Tag Archives: psychopathology

Psychopathology Monday


Happy New Year all. Our semester begins today with the first session of Psychopathology for the first year students. Before launching into the various forms of mental illness and emotional maladies, we consider the larger concept of suffering. Without a careful understanding of (a) the nature, causes, and theology of suffering, (b) the meanings of suffering, and (c) our beliefs and responses to suffering, we counselors become a dangerous lot. We fall prey to simplistic understandings and responses–and fall prey to false hope and false despair.

Sound like a great way to start of the New Year? It does to me because we now have an opportunity to look at ourselves and our world with more realistic eyes than we may have during the stress of the holidays.

Coincidentally, we had a Sunday School class yesterday on the topic of suffering. Our church has buried 10 people who died before their time (so it seems to us!) in the past 5 years. Not only have we had these tragedies, we’ve also splanted a church and been in a transitional malaise for maybe 7 years? The class allowed individuals to talk about suffering and heartache. Good class. We heard those who felt that what was going on was a message from the Lord, from those who just felt confused and in pain, from those who felt the nearness of the Lord during these normal ups and downs of life in a fallen world.

What was said in multiple ways was that one’s perspective or expectations about suffering really impact how one feels about the struggle of life. If you expect life to always be healthy then repeated sicknesses and death will set you back. Someone said there that if you lived in a dirt hut that moving into a trailer would seem wonderful but if you lived in a palace, the trailer would seem a terrible thing.

So, what should we think about suffering and the seeming explosion of death and heartache?

  1. God is saying something AND yet He may not be sending some special message to us
  2. Our actions may cause some of our own suffering but living more righteous lives does not prevent suffering
  3. Suffering is to be expected in this world AND yet it is NOT THE WAY IT IS SUPPOSED TO BE
  4. Isolation and failure to connect to others in suffering ALWAYS makes that suffering worse
  5. Even those who only observe those in suffering suffer as well and need to connect with others in order to avoid despair
  6. Good may come out of suffering, but suffering itself is not good
  7. God, through the cross, bears our suffering and yet it still hurts
  8. It will not last forever

Finally, how do you respond to suffering? Turn away? Become numb? Angry? Probably all the above, right? Take a moment to consider how you respond to suffering right in front of you and watch yourself for those trite statements that can hurt those who are already in pain.

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Filed under christian counseling, christian psychology, Christianity, counseling, counseling skills, Doctrine/Theology, suffering

Try your hand at diagnosing clients…


Ever wondered if your counselor really knows what is in the Diagnostic & Statistical Manual (DSM, ver. 4TR)? Or do they just do the flip and dip method (let the large book open to any page and blindly point to a spot on the page)? Let’s hope not. Well, some professors are trying to increase the accuracy of their students via video vignettes.

One such person, Dr. Aaron Rochlen of U. Texas, has a website with 5 video vignettes available on his website (http://www.edb.utexas.edu/psychopathologypractice/index2.html) for students to watch and then try their hand at giving a DSM diagnosis.

Warning. Site is free. There are no answers given so don’t bother submitting your diagnostic considerations as they won’t go anywhere unless you send them to someone. Second warning: At least one of the “clients” uses some curse words.

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Filed under counseling, counseling science, counseling skills, Psychology, teaching counseling

Science Monday: The end of Psychopathology


No, we haven’t found the cure for psychological problems. We’ve just come to the end of the course today. We’ll be looking at the problem of Borderline Personality Disorder. In order to understand personality disorders, we need to have an adequate understanding of both biblical anthropology (who does God say we are) AND the self (how we experience ourself and the world and so develop a consistent identity). Given that we live in a fallen world where deception rules the day, it is helpful to see how we tend to develop our self identity.  One such theory is called Constructivist Self-Development Theory. In short, the authors suggest the self is made up of

1. Frame of Reference: (one’s identity, worldview, beliefs, etc.)
2. Self-capacity: (inner capabilities that allow the individual to maintain a consistent coherent sense of self and to manage emotions)
3. Ego resources: (ability to conceive consequences, set boundaries, and self protect–ability to develop interpersonal strategies)
4. Sense of safety: (self-perception, trust, control, and connection to others)

This theory (and I haven’t done justice to it in this small space) suggests that these 4 areas work to help people form cognitive schemas that enable them to interpret events and memories from past events).

I like the theory’s attempt to address matters of safety and internal resources. Some people seem to have an innate sense of organization, boundaries, and ability to manage emotions. Others struggle more. In both cases, we develop a coherent sense of self as we construct our sense of ourselves in the world. Those who grow up in more chaotic and destructive environments have a much tougher time getting a bead on themselves and others. The world just doesn’t make as much sense.

The problem is what is not said or explored. Frame of reference, in my opinion, comes not only from experiences but also from God himself (Romans 1). We construct our perceptions of self but not in a vacuum.

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Suppressed Anger enhances pain perception?


Today in Psychopathology we will be discussing the problem of problem anger. In doing some additional research I found that there has been a fair amount of literature produced on the topic of angry emotions and a good amount in the last year or so.

We know that chronic anger has significant impact on the body and may influence certain disease states such as high blood pressure, atrial fibrillation, etc. But, Quartana & Burns (Rosalind Franklin University of Medicine & Science, Chicago) investigated the relationship between anger suppression and increased pain sensitivity. Here’s how they explore the possible connection:

1. They asked 209 healthy and pain-free college students to perform a mental arithmetic task (serial sevens). While doing the task, some were harassed (made angry) and some were told to express their feelings, to suppress their experience and/or expression of their feelings, etc.

2. After the task, they had to put their non-dominant hand into a bucket of ice until they reached the point where they could not tolerate pain any further.

What did they find? Well, first they found that 32% kept their hand in the water so long as to be not helpful in their research. But, they also found that, “Participants who attempted to suppress either experiential or expressive aspects of emotion during anger provocation reported greater pain in response to subsequent pain induction than did participants who suppressed during anxiety induction and those instructed not to suppress, irrespective of emotion-induction condition.” They also found, “Participants who suppressed anger not only reported the greatest pain severity, but also described the quality of the pain as more physically hurtful (e.g., throbbing) than their counterparts who suppressed anxiety or those who experienced angerbut did not engage in effortful suppression. More important, those who suppressed anger also described their pain as annoying and irritating to a greater extent than those who suppressed anxiety.”

This makes sense. When I’m angry, everything becomes an irritant.

Does this suggest that to be more healthy we should be more free with our anger by giving vent to it? Not necessarily so. It does mean that those who hold it in (become embittered?) may become quite sensitive to perceptions of pain–that is, notice all the other things wrong with the world. But anger expression isn’t necessarily the opposite of suppression. Rather, honest self-evaluation, bringing our anger to the Lord, remembering that He is our vindicator may be more important than outward expressions of our anger.

Biblio: Emotion, 7:2, pp 400-414 (2007).

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Psychopathology and diagnosing After Bath Mania?


Today marks the beginning of my winter term with the start of Psychopathology class. After exploring the concept of suffering, we’ll look at 11 key classes of pathology (from depression and anxiety to psychoses and personality disorders). Each Monday I will return to a habit I had last year and post a “Science Monday” where I look at some interesting science related to psychopathology.

On a lighter note, my wife and I may have discovered a new disorder. I put its name and diagnostic symptoms out there to see if any of you may have witnessed this malady.

After-Bath Mania (ABM)

ABM is a condition usually found only in elementary age children. After soaking in a warm bath, they become loud, silly, tempted to engage in many kinds of foolish behavior including, but not limited to: (3 of 6 criteria needed)

  1. Nude gyrating or running about the house
  2. Singing nonsense syllables, inventing raps, or repeating High-school Musical lines
  3. Tackling brother and tickling without mercy
  4. Standing on head or climbing door casing
  5. Answering questions in loud singsong voice
  6. Making sounds from parts of body besides the voice-box

These symptoms do not appear prior to bath (whether at 7 am or 7 pm) but do appear post bath more times than not, cause distress in others (e.g., brother angry, parent’s yelling to stop making that racket and to get ready for school), and subside only after parent loses control or the school bell rings. Symptoms may abate once child becomes self-conscious pre-teen. If these symptoms are found in an adult, they may not be considered a pathology unless individuals other than spouse are in the room.  

What is it about baths that makes my son crazy? Anybody have boys that do this? I thought warm baths would calm someone down and get them ready for bed.

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