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Psychology, Mental Health and Distress

Psychology, Mental Health and Distress

John Cromby | Dave Harper | Paula Reavey

(2013)

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Book Details

Abstract

What does the word 'schizophrenia' mean to you? Perhaps your first thought is of someone with a medical condition that involves some kind of brain disease? But what if you knew that the person in question had been through a traumatic childhood? Would that change how you thought about their mental health? And what impact does this have on how we as a society interact with people with mental distress?
Psychology, Mental Health and Distress is the first mainstream textbook that reconsiders the traditional emphasis on the biological and psychiatric models for what is commonly, but contentiously, known as 'abnormal psychology' or 'psychopathology'. It provides a fully rounded account of mental distress, including social and relationship causes, and challenges your preconceptions about what you think you know about mental health.
Key features:
* Reflects new approaches to mental health and the kinds of psychological interventions (or 'treatments') for those experiencing distress, moving away from a limited diagnostic model
* Offers a wealth of case stories to portray the reality of living with distress, building your empathy to encourage sensitive practice
* Fully informed by current experimental, qualitative and theoretical psychological research including research into hearing voices
* Written by a team of leading clinical and social psychologists with additional contributions by renowned figures including Richard Bentall, a bestselling Penguin author whose Madness Explained won the 2004 BPS Book Award
* Includes a chapter authored by those with first-hand experience of mental health services, ensuring you understand the nuances of this emotionally charged, and often controversial, topic
The authors draw from a range of experience, examples and approaches to present this student-friendly and engaging text: core reading for anyone serious about understanding mental health issues.

This is the book that I have been waiting years to see. Superb, thoroughly researched and intellectually refreshing - a game changer in the field. It should be mandatory reading on every psychology course not just those dealing with mental health issues.' - Ron Roberts, Kingston University, UK

'At last, an undergraduate text that adopts a critical approach to 'Abnormal Psychology'. Psychology, Mental Health and Distress is the first of its kind, providng an accessible, engaging, and refreshing take on the standard material. Assembled by an impressive team of world-class scholars, this text extends the analysis of people's distress beyond biomedical and individualist framings, and toward a deeper exploration of the complext interplay between the body, the psych, and the social and political context. This is an important and revolutionary resource for students and scholars alike.' - Michelle LaFrance, St Thomas University, Canada

'I wish this book had been around when I was an undergraduate. Two aspects of the book are especially important. First, recognising the importance of culture in mental health, and secondly, giving a voice to mental health service users.'

- Kate Bennett, University of Liverpool, UK

'In simple langauge and in no ambiguous terms, the authors of this book clearly bring out the limitations of current theory and research in psychiatry, abnormal and clinical psychology. The authors also go a step further to show how we can unshackle oursleves from these limitations. I whole heartedly recommend this book to both the beginning student and seasoned practitioner of mental health who is interested in helping people afflicted by mental distress.'

- David Lackland Sam, University of Bergen, Norway

'An inspiring and ambitious text - a longed-for change to passive acceptances of psychiatric categories. This book is ideal for academics and students wishing to critically probe the limitations of DSM diganoses.'

- Leanne Franklin, Cardiff Metropolitan University

'The book gives an excellent introduction to the field of abnormal psychology and could be read by students, academics, service users and clinical psychologists both to understand the different causes to mental distress, but also how these problems could be best treated.'

- Roger Hagen, Norwegian University of Science and Technology

'This is a book that is long overdue. So many books on psychopathology tend to be overly influenced by a biomedical and cognitive approach to understanding psychological distress, and rarely go further than that. This book takes a refreshing psychological, social and critical approach. It does not discard the importance of biological factors, but it considers in detail the various psychological and social determinants of mental health and distress. I recommend this book as a must-read for clinical psychology trainees, and for students and professionals working in the field of mental health.'

- Poul Rohleder, Anglia Ruskin University, UK

 

'I think it is a brilliant book by what I have read so far - and it has been a long time in coming! I think this book could possible set the trend for the future way of perceiving and thinking about mental health.'

– Dr Fiona McConnochie, School of Social & Health Sciences, University of Abertay Dundee


John Cromby is Senior Lecturer at Loughborough University, UK. Previously, he conducted research and teaching at the Universities of Nottingham and Bradford, and he has experience of working in mental health, drug addiction, and learning disability settings. His work engages with the ways that bodies and social processes come together to produce experience, including experiences of distress. In recent years this has meant exploring topics including paranoia, clinical sadness, emotion and fear of crime, and experimenting with methods of jointly analysing textual data and embodied activity. He is a former editor of the journal Subjectivity.
 
David Harper is Reader in Clinical Psychology at the University of East London (UEL), UK. He trained as a clinical psychologist at the University of Liverpool and worked as a clinical psychologist in National Health Service mental health services in the north-west of the UK for nine years. For a number of years he combined work as a clinician with part-time study for a PhD at Manchester Metropolitan University. He has been at UEL since 2000 and his research interests are in applying critical psychology and social constructionist ideas to the understanding both of distress (particularly paranoia and unusual experiences and beliefs) and the work of mental health professions. He co-authored Deconstructing psychopathology (1995) and co-edited Qualitative research methods in mental health and psychotherapy: An introduction for students and practitioners (2012). He undertakes a small amount of clinical work as a Consultant Clinical Psychologist in Newham as part of the Systemic Consultation Service.
 
Paula Reavey is Professor of Psychology at London South Bank University, UK, where she delivers a module on the psychology of mental health and distress. She edited the volume Visual Psychologies: Using and Interpreting Images in Qualitative Research (2011) and also co-edited two volumes, New Feminist Stories of Child Sexual Abuse: Sexual Scripts and Dangerous Dialogues (with Sam Warner, 2003) and Memory Matters: Contexts for Understanding Sexual Abuse Recollections (with Janice Haaken, 2009). She is currently working on a co-authored book Vital Memory: Ethics, Affect and Agency (with Steven D. Brown, 2013) and has also published numerous articles on social remembering, child sexual abuse and sexuality, mental distress, and embodiment and space, using a variety of methodologies, including memory work, discourse analysis and visual methods.

Table of Contents

Section Title Page Action Price
Cover Cover
Half title i
Title iii
Copyight iv
Brief contents v
Long contents vii
List of illustrations xviii
Tour of the book xx
About the authors xxi
A note on authorship xxii
Additional contributor biographies xxiii
Foreword xxiv
Note to lecturers xxvi
Acknowledgements xxvii
Dedication xxix
Part 1 Concepts 1
1 From Disorder to Experience 3
Introduction 4
What is distinctive about this book? 4
Terminology 5
Stigma and discrimination 7
Discrimination 8
What is distress? 9
Why not abnormal psychology? 11
Abnormal psychology is confusing and unclear 11
Abnormal psychology is not consistently psychological 11
Abnormal psychology is unhelpful 12
Isn’t this just anti-psychiatry? 12
From disorder to experience 13
All in the mind? 15
Models of distress 16
Overview of this book 17
Part 1 17
Part 2 17
How to use this book 18
Sequence 18
Questions 18
Boxes 18
Key terms and concepts 18
Stories and experiences 18
2 History 19
Introduction 20
History from the patient’s point of view: first person narratives as ‘protest literature’? 22
The ancient Greeks: the emergence both of mythic and medical traditions of explanation 24
The rise of religious worldviews: Christianity and the Middle Ages 25
Increasingly detailed somatogenic models: from humours to nerves 26
The ‘Age of Reason’: the birth both of reason and unreason 26
The ‘great confinement?’ The madhouse, the asylum and the homogenization of those seen as insane 28
Striking off the chains of the insane? The emergence of ‘moral management’ 29
The medicalization of madness: the professionalization of asylum management 30
Abuses and reforms of the asylums 31
Increasing populations and decreasing expectations: the emergence of notions of chronicity 32
1900–1945: diagnosis, psychological therapy, eugenics and war 34
Classifying the mind: diagnostic classification and the rise of biological psychiatry 34
Treating the mind: the birth of the psychological therapies 37
Psychoanalysis 37
Behaviourism 37
Treating the body: new physical treatments 39
The participation of German psychiatry in the Nazi genocide 39
1945–1970: the Cold War, the pharmacological revolution, de-institutionalization, the DSM, new psychotherapies and anti-psychiatry 40
Psychiatry and the Cold War 40
Psychiatry and brainwashing 40
The political abuse of psychiatry 40
New psychological therapies 42
From behaviourism to behaviour therapy 42
Client-centred therapy 42
Family therapy 42
Cognitive behavioural therapy 43
The birth of psychopharmacology 43
The move from asylums to the community 44
The post-asylum growth in the ‘psy’ disciplines 44
Did community care ‘fail’? 46
Attempts to systematize diagnosis 46
Anti-psychiatry: five books which challenged psychiatry 47
1970–present: new challenges to psychiatry from within and the rise of the service user/survivor movement 49
Challenges to psychiatry from within since the 1960s 49
Challenges to psychiatry from without since the 1960s: the rise of the psychiatric survivor movement 50
The rise of the ‘ex-patients movement’ in the USA 50
The history of the service user movement in the UK 51
Unite and fight: patients get organized 51
3 Culture 55
Introduction 56
What is culture? 56
‘Professional’ cultures 57
Studying culture in the context of mental health and distress 58
Self and culture 59
Emic versus etic distinctions 61
Are the boundaries between mental health and normality similar or different across cultures? 61
Prevalence rates across cultures 62
The World Health Organization studies of schizophrenia 64
Cross-cultural differences in the course and outcome of schizophrenia 64
Family relationships and expressed emotion 65
Employment opportunities and social responses 65
Marriage and long-term relationships 65
Different cultural emphases, different problems? 66
Dissociation: spiritual enlightenment or illness? 67
Dissociation and multiple selves: Dissociative Identity Disorder in the US 67
Dissociation and religious experiences 68
Are the boundaries between madness and sanity similar or different across cultures? 69
Body, mind and society 69
Somatization 70
Culturally specific forms and diagnoses of somatization? 71
Migration 72
Cultural identification; psychosis and African–Caribbean men 72
Ethnic density and parental absence 72
4 Biology 75
Introduction 76
Biology: the primary cause of distress? 76
Genetics and distress 78
Behavioural genetics 78
Molecular genetics 81
Biological causation in context 81
Culture 82
Research funding 82
Politics 83
Self-interest 83
Common sense 83
Biology: mostly irrelevant to distress? 84
Cannabis and schizophrenia 85
Cannabis and schizophrenia: an association 86
Association is not causation 87
Epidemiological evidence 87
The clinical picture 87
Conclusion 88
Lifelines 88
Body, brain and social relations 92
Development 93
Temporal specificity and distress 95
Temporal plasticity and distress 98
5 Diagnosis and Formulation 101
Introduction 102
A brief history of psychiatric classification and diagnosis 102
Medical and psychiatric diagnosis 103
What do we mean by medical diagnosis? 104
What are the differences between diagnosis in psychiatry and in general medicine? 105
Summary 106
Problems with psychiatric diagnosis 106
Reliability 106
Co-morbidity 106
Validity 107
Cross-cultural perspectives 108
Psychiatric diagnosis as a social judgement 108
Summary 109
Consequences of diagnosis for service users 109
Comfort and reassurance 110
Access to services 110
A sense of community 110
Stigma 110
Discrimination and social exclusion 110
The sick role 110
Loss of personal meaning 110
Responses to the problems of psychiatric diagnosis 111
The present system 111
Developing alternative approaches 112
Is psychiatric diagnosis fit for purpose? 112
Formulation 114
What is a formulation? 114
Formulation and diagnosis: additions or alternatives? 115
Limitations of formulation 115
6 Causal Infl uences 118
Introduction 119
Causal influence, social process 119
Causality 120
Contingency 121
Difficulties 124
Researching causality 124
Experimental methods 124
Survey methods 126
Epidemiological studies 126
Case studies 126
Qualitative research 127
Summary 127
Recognized causal influences 127
Relational influences 127
Family relationships 127
Early experience 128
Trauma and abuse 129
Biological influences 129
Neurotransmitters 129
Brain structure 130
Genetics 130
Social influences 131
Social inequalities 132
Gender 133
Ethnicity 133
Conclusion 134
Personal agency and meaning 135
Putting this into clinical practice 136
Incorporating relationship influences 136
Incorporating biological influences 136
Incorporating social influences 136
Towards integration 137
7 Service Users and Survivors 139
Service Users/Survivors and Mental Health Services 139
Introduction 139
The service user/survivor movement – a diverse movement 140
The service user/survivor movement – underlying beliefs 141
Redefining experience 142
Origins and influences 143
Range of actions undertaken by the mental health service user/survivor movement 144
Actions: consultation and monitoring 144
Actions: training and education 145
Actions: research 145
Actions: alternative understandings 145
Actions: service provision 145
Actions: anti-discrimination and media work 146
Actions: arts and creativity 146
What has the survivor movement achieved in the UK? 146
Achievements: involvement in care and treatment 146
Achievements: independent advocacy 147
Achievements: the Mental Health Act and compulsory treatment 147
The slowness of change 148
The service user/survivor movement: problems and challenges 148
Problems and challenges: representation 148
Problems and challenges: the process of involvement 149
Beyond services: discrimination and social exclusion 149
Where are we now? Where are we going? 150
The Hearing Voices Network 151
What is voice-hearing? 151
The hearing voices network 152
‘The freedom to hear voices’: the work of Romme and Escher 152
An information and support network 153
What are hearing voices groups? 154
8 Interventions 158
Introduction 159
Psychiatric Medication 160
Models of psychiatric drug action 160
Psychoactive drugs 161
Evidence on psychiatric drugs 162
Randomized controlled trials 162
Problems with randomized controlled trials 163
Evidence for disease-centred effects 164
Characteristics of different psychiatric drugs 164
Antipsychotics 164
Antidepressants 166
Drugs used for people with a diagnosis of manic depression 167
Stimulants 167
Benzodiazepines 168
Conclusions 168
Compulsory Psychiatric Treatment 168
Why give treatment compulsorily? 168
Is it ever ethical to treat someone compulsorily? 169
What is the Mental Health Act? 169
What is meant by risk of harm to self or others? 169
Who is most likely to receive compulsory treatment? 170
The rise in the use of compulsory treatment in England and Wales 171
Electro-convulsive Therapy 171
What is ECT? 171
What are the origins of ECT? 171
How often is it used? 172
When is it used? 172
What are its side-effects? 172
Is ECT effective? 172
Psychological Therapies 173
What is psychotherapy? 173
Psychoanalysis 173
Cognitive–behavioural therapy 174
The humanistic and existential therapies 174
Does psychotherapy work? 174
Our currency, your problem: the question of power in psychotherapy 177
Implications for clinical practice 178
Feminist approaches 178
Narrative approaches 178
Systemic approaches 179
Community Psychology 179
Definitions and origins of community psychology 180
Theoretical frameworks informing community psychology 181
Community psychology and effectiveness 182
Community psychology interventions 184
Space to Write 184
Psychology in the Real World 184
Women, men, empowerment and learning disability: the WELD and MELD groups 186
Social action therapy: The White City project 187
Conclusion 188
Part 2 Forms of Distress 191
9 Sadness and Worry 193
Introduction 194
History and culture 195
History 195
Culture 196
Contemporary Western forms of sadness and worry 198
Psychiatric diagnoses 200
Prevalence and distribution 200
Causal influences 201
Social inequality 201
Gender 203
Family and childhood influences 203
Life events 204
Childhood abuse 205
Psychological processes 205
Sadness 205
Worry 206
Biological processes 208
Sadness 209
Worry 210
Lifelines, plasticity and specificity 211
Specificity 211
Plasticity 212
Interventions 212
Pharmaceutical interventions 212
Physical interventions 214
ECT 214
Psychosurgery 215
Psychological interventions 215
Cognitive and cognitive–behavioural 215
Behavioural 216
10 Sexuality and Gender: Diversity, Deviance and Disorder? 219
Introduction 220
What’s ‘normal’, sex-wise? 220
Topics covered in this chapter 221
Historical considerations 221
Culture, sexuality and the body 222
Sex and gender 222
Discrimination regarding sexual and gender identity, and its relationship to mental distress 223
Defining ‘problems’ 224
Causing distress 224
Non-consensual or illegal behaviour 224
Problems with having sex 225
General prevalence rates and issues concerning problems with having sex 225
Psychiatric diagnoses 225
Diagnostic issues for Alice 226
Diagnostic issues for Sajid 227
Causes, maintenance and risk 227
Culture 227
Age 228
Gender 228
Relationships and childhood 228
Life events 229
Thoughts and feelings 229
Chemical substances 230
Substance use 230
Prescribed psychiatric medications 230
Biological factors 230
Medical conditions 230
Hormones 231
Lifelines, plasticity and specificity 231
The problem with diagnosis 233
Summary 233
Interventions for people who have problems having sex 234
The basic structure of sex therapy 235
Interventions 235
Developing communication and sexual skills 236
Medical treatments 236
Summary of treatments and interventions 237
Variation in sexual arousal 237
Problems with diagnosis 238
Impairment or social judgment? 238
Specific paraphiliac characteristics? 239
Distress 241
Discrimination 241
Summary 241
Gender, Variance and Distress 242
Definitions 242
Gender, bodies and science 243
Gender and the DSM 244
Prescribing gender 244
Debates about diagnosis 245
Possibilities 246
Interventions 246
Section summary 247
11 Madness 249
Introduction: attempting to define madness 250
History and culture 251
History: the invention of schizophrenia 251
Symptoms 253
Causes 253
Outcomes 253
Clinical psychology and schizophrenia 253
Cultural influences on how madness is seen: stigma and prejudice 255
Public opinion about the causes of distress 256
The relationship of causal beliefs to attitudes 256
Contemporary Western forms of distress 257
Prevalence 257
The DSM 258
Problems with the traditional psychiatric account 259
Reliability 259
Validity 259
a) Symptoms 259
b) Outcomes 260
An alternative approach to researching psychotic experiences 260
Researching reliable constructs 260
Causal processes 262
The stress-vulnerability or bio-psychosocial model 262
A genetic predisposition to schizophrenia? 262
Family studies 262
The search for a schizophrenic gene 263
Schizophrenia is a brain disease? 263
Biochemistry 264
Neuroanatomy 265
Uniform prevalence? 265
Psychosocial causes 265
Poverty 266
Ethnicity 267
Adverse events in childhood and adolescence 267
Loss of parents 267
Problematic parenting 267
Child abuse and neglect 268
Substance abuse 269
Adverse events in adulthood 270
Physical assault and rape 270
War 270
Explanatory models explaining how adversity leads to psychosis 271
The traumagenic neurodevelopmental model 271
Psychodynamic theory 271
Attachment theory 272
Dissociation 272
Cognitive research 272
Hallucinations 272
Paranoid delusions 273
Lifelines, plasticity and specificity 274
The perspective of experience-based experts 274
Interventions 274
From rotating chairs to lobotomies 274
Shock therapy 275
Antipsychotic drugs 276
a) First generation, ‘conventional’ antipsychotics 276
b) Second-generation atypical antipsychotics 276
Psychosocial treatments 277
The Soteria model 277
Cognitive therapy 278
Early intervention 279
Initiatives by experience-based experts 279
The recovery approach 280
Asking about adverse life events 280
Prevention 281
12 Distressing Bodies and Eating 283
Introduction 284
Topics covered in this chapter 285
What’s normal? Contemporary Western forms of eating problems and weight concerns 285
History and culture 286
Historical considerations 286
Culture 287
The universal rise of eating problems? 287
Within cultural differences? 288
Psychiatric diagnoses 289
Prevalence and distribution 289
Risks and maintaining factors 290
Socio-cultural factors: body image and weight concerns 290
The impact of the media 291
Body image distortion and body dissatisfaction 291
Gender identity 292
Control and confusion: female development and maturation 292
Control through dieting 292
Conflicting roles and expectations that young girls and women face in a changing society 293
The complex relationship between mothers and daughters and gender transmission 293
Family and childhood influences 294
Systems theory 294
Life events 295
Childhood abuse 295
Thoughts and feelings 295
Cognitions 295
Intrapersonal and interpersonal factors 296
Cognition and bingeing 296
Emotions 296
Biological factors 297
Genetic factors 297
Neurotransmitter functioning in the hypothalamic region 298
Endogenous opioids 298
Neuroendocrine functioning 298
Lifelines, plasticity and specificity 298
Summary 299
Interventions 300
Weight gain 300
Cognitive–behaviour therapy 301
Stage 1: Engaging the patient 301
Stage 2: A review and revision (if necessary) of the original formulation 301
Stage 3: Addressing the major maintaining factors 301
Stage 4: Looking to the future: how to maintain positive change and prevent relapse 302
How effective is cognitive–behaviour therapy (CBT)? 302
Family therapy 303
How effective is family therapy? 304
How effective are drug treatments? 304
Antipsychotics 306
13 Disordered Personalities? 308
Introduction 309
History and culture 309
History 309
A brief history of personality theory and its problems 310
Culture and personality 312
Contemporary Western forms of distress 313
Prevalence 313
Psychiatric diagnosis 314
The history of diagnosing personality disorder 314
Problems with prevalence 314
Service users’ views and experiences 316
Disordered personalities or problems in relationships? 317
The reliability of personality disorder diagnoses 318
Diagnostic instability over time 320
Co-morbidity 320
Personality disorder not otherwise specified 321
Personality disorder: whither or wither? 321
Categorical versus continuum models 321
Causal influences 323
Culture and personality disorder 323
Cultural bias in the diagnosis of personality disorders? 324
Psychopaths in suits? The search for the ‘successful psychopath’ 325
Gender and personality disorder 326
Gender bias in the diagnosis of personality disorders? 327
Social inequality 328
Family and childhood influences 328
Life events 330
Psychological processes 330
Biological processes 331
Lifelines, plasticity and specificity 332
Interventions 333
Therapeutic pessimism and negative attitudes towards those with a diagnosis of personality disorder 333
Interventions: borderline personality disorder 333
Preventative interventions 334
Psychological interventions 334
Family interventions 335
Social interventions 335
Service-level interventions 336
Medication 336
Interventions: antisocial personality disorder 336
Preventative interventions 336
Psychological interventions 337
Antisocial personality disorder, dangerousness and treatability 337
Social interventions 337
Medication 337
Appendix: Mental Health Professions in the UK 339
Glossary 341
References 358
Index 409