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The Psychology of Mental Health - Essay Example

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This essay provides a synopsis of engagement rape, factors that contribute to it and its impact on the victims. In doing this, the paper shall incorporate the necessary methods of intervention and prevention. This paper is based on a case study of a victim of date rape and marital breakdown, identified as Sarah. …
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The Psychology of Mental Health
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rape and marriage based crimes are perceived to be controversial and categorized as ambiguous crimes in many parts of the world. In the past twenty years, there have been deliberations on the importance, prevalence and definition of date rape. The implications of a slow response to date rape and marital abuse victims have resulted to uncertainty that is evident in the attitudes of the engagement rape sufferers or survivors. The offenders are known to avoid the full force of the law due the nature of the crimes and absence of social and legal structures that can deal with these atrocities firmly. Studies show only extremely a small number of cases of date rape are reported and prosecuted in courts. This essay provides a synopsis of engagement rape, factors that contribute to it and its impact on the victims. In doing this, the paper shall incorporate the necessary methods of intervention and prevention. This paper is based on a case study of a victim of date rape and marital breakdown, identified as Sarah. Most of these are considered to be hidden crimes. Marital breakdown and date rape victims suffer from many disorders. The most pronounced impact of these extreme happenings is the post traumatic stress disorder, (PTSD). The PTSD is a psychiatric disorder that stems from experiencing life- threatening incidences like sexual assault, betrayal and physical or emotional assaults (Andrews & Kirk 2000). Like Sarah, most of the people who survive trauma have stress reactions, which have a tendency of getting worse with time. These are the people who are said to have developed PTSD. People suffering from PTSD relive the bitter experiences through flashbacks, nightmares, difficulty in sleeping and feeling estranged or detached (Wenzlaff & Wegner 2000). These symptoms can have severity that can end up impairing the victim’s daily life. Sarah, a victim date rape and marital breakup is suffering from flashbacks and sleeping disorders (Brewin & Saunders 2001). Any traumatic reminder causes her to become upset and incapacitated. The other set of symptoms of PTSD is the separation (Gillespie & Clark 2002). This is an attempt by the victim to stay away from people or events that may serve as a reminder of the traumatic event (Schouten 2003). Sarah changed her place of work. The second set of symptoms of the PTSD involves staying away from people or a numb feeling. The third set of symptoms of PSTD includes being irritable and feeling on guard (Gillespie & Clark 2002). The disorder is marked biological changes and symptoms of a psychological nature. Victims like Sarah develop depression, physical and mental health problems (Gray & Lombardo 2001). These are considered to be additional disorders. The overall impact of the disorder is to cause Sarah, and the like to have the inability to function in their respective professions, families, society, marriage and parenting (Grey & Brewin 2001). Sarah’s experiences have caused her to develop a phobia for dating men. Early treatment goes a long way in reducing the long-term symptoms. Victims of rape and divorce or marital breakup can be treated through talk therapy (Grey & Brewin 2001). The method is known as psychotherapy in psychological profession. From her experience, Sarah did not seek early treatment especially with regard to the issue of date rape. Given the nature of these crimes, most of the victims prefer not to share with people. Almost half of the women experiencing PTSD suffer from depression (Hellawell & Brewin 2002). As a result, they end up having unemployment or professional challenges, divorce, spouse abuse and can easily get fired compared to other employees (Holeva & Tarrier 2001). A research conducted with an aim of showing the impact of PTSD revealed that the most intrusive cognition was flashback with accounted from up to 43 per cent of the patients. Flashback occurs on its own or through other things. Depression also affects the memory capacity of the victims in many ways (Holeva & Tarrier 2001). Marital breakdown and date rape can result in dissociation disorder. Dissociative symptoms that are common in PTSD include depersonalization, out-of-body experiences. They also include realizations and numbing (Grey & Holmes 2002). This develops a defensive response to any case perceived to be a replica of the traumatic experience. Various pre-trauma risk factors for PTSD have been identified. Studies show that personal pre-trauma psychiatric experiences can cause post traumatic stress reactions (Marks & Livanou 1998). Another risk factor is a family psychiatric history. Previous exposure the trauma makes the survivor vulnerable to develop emotional difficulties (Holmes & Young 2003). Clinical and research data indicate that PTSD can be classified into various classes. The initial category is the presentation which entails appraisal driven emotional content (Mack & Rock 1998). This goes together with transformation. The second class of PTSD is recovery. Recovery can be natural, or it can be a function of exposure and cognitive therapy (Hellawell & Brewin 2002). The last class of PTSD deals with the differences in the severity and the trauma. There are now several theories developed by clinical researchers that expound the scope and treatment of PTSD. One of the most effective theories is the emotional processing theory (Lee & Turner 2001). This entails repeated reliving of the traumatic events. This promotes the habituation of fear. In effect, this reduces the fear levels associated with elements of trauma memories. Intentional repeated reliving of the experiences counters the notion that anxiety is permanent (Holman & Silver 1998). The negative reinforcement of the trauma memory is successfully avoided through emotion processing theory (Mack & Rock 1998). In the case of Sarah, who has a difficult time recalling the bitter marital breakup and the date rape, she needs to objectively go through the events that took place (Marks & Livanou 1998). A rehearsal of the traumatic memory in a therapeutic setup brings safety information into the trauma memory (LeDoux 1998). The psychological aspect of mental health demands that the traumatic memory be discriminated. This causes the victim to treat it as a one off event as opposed to a representative of many of such events in the offing. This also shifts self blame and incompetence. Sarah is afraid of interacting with men (Marks & Livanou 1998). The mere thought of being touched by a man makers her shiver (Jaycox & Morral 1998). However, the incident that happened to her can be discriminated so that she can view other men differently. To this end, the emotional procession theory is vital. Eventually, the self begins to accept that it has some mastery over challenges and can face the future with courage (Holmes & Young 2003). Reflecting on the occurrences of the actual assault can cause the victim to identify some inconsistencies with the previous negative attitude and evidence (Lee & Turner 2001). The severity of the traumatic events, in this case, marital breakup and date rape, results in disruption of cognitive processes of memory and alertness. This leads to dissociative states that cause out-of-the-body experiences (Holman & Silver 1998). These mental and horrific experiences develop a fragmented and disjointed structure of fear which is responsible for causing resistance to change or modification (Marks & Livanou 1998). The memory tends to be organized through deliberated reliving of the mental experiences. When the entire memory system incorporates the reorganized memory, the cases of pain and fear reduce significantly (Marks & Livanou 1998). The theory of emotional processing leads to exposure that automatic effect of reducing the levels of anxiety positively appreciating the events that took place. The psychological treatment of Sarah’s predicament with regard to emotional processing theory and prolonged exposure would become highly effective with regard her PTSD predicaments (Wenzlaff & Wegner 2000). Studies have indicated that the initial step in this theory is to activate fear which is evidenced by changes in facial expression and increased heart rate and habituation. Emotional processing theory has enormous explanatory power, and it is extremely comprehensive (Mayou & Bryant 2001). The model is seen to offers valuable suggestions on PTSD. This model is highly effective through prolonged exposure and habituation. In cases when trauma is not altered by new information, therapy can inhibit or block these unpleasant memories. The Ehlers and Clark’s cognitive model suggests that victims of trauma experience anxiety about the future although the occurrences happened in the past. The model articulates that pathological responses to traumatic events can arise when the victims start processing information of the traumatic nature in a way that produces an internal or external threat (Michael & Halligan 2002). This is entirely dependent on the nature of the traumatic memory itself or negative appraisals of the trauma. In the case of Sarah, she feels insecure because can cannot interact freely with men. This is confounded by the fact that she could not report the rape incident to the police or close relatives. The sexual assault memories are a threat to the safety and future (Mayou & Bryant 2001). The nature of memories Sarah has and the negative appraisals of the marital breakup and rape determine the responses to the trauma. This model suggests that for Sarah to be mentally healthy again, the memories must be addressed in a way that alters her responses and improves her safety. According to Ehlers and Clark, negative appraisals can have a devastating effect to a sexual or marital abuse victim. The negative appraisals have caused the victims to feel that they deserved the wrong treatment or they are to blame (Wenzlaff & Wegner 2000). The victims accept that they have been ruined permanently and that they are not as normal as other people (Teasdale & Barnard 1993). This is extremely evident in the behavior of Sarah. The process of thoughts during the trauma coupled by experiences and expectations can increase the probability of negative appraisals (Wenzlaff & Wegner 2000). According to Ehler’s and Clark, a mindset known as mental defeat develops in the in attitudes of victims of trauma. This mindset is an inability of a victim to influence their destiny or fate due to past experiences. This causes the victims to view themselves as objects of target and helpless. They live a defensive life where they spend their lives defending themselves. This model suggests that the memory of the event is not well elaborated and, therefore, not given a proper context with regard to time and space (Metcalfe & Jacobs 1998). This causes the memories to be inappropriately incorporated into the autobiographical knowledge. This makes its difficult in recalling the intention and absence of temporal context. The emotional injuries can be triggered easily by the minute clues of the traumatic experiences. Associative memory is unintentional and is clue driven (Michael & Halligan 2002). This model explains why the victims may not be in a position to explain the cause of painful memories. Trauma-related stimuli can have a reduced impact through the use of this model. This model looks into the encoding and nature of human memory and the nature of traumatic memory. Conceptual processing of information, coupled by data-driven processing method is known to create a distinction in cognitive psychology (Nijenhuis & Spinhoven 1998). According to this model, conceptual processing facilitates integration of autobiographical database into the trauma memory. Data -driven processing causes strong perceptual priming and a memory hard to retrieve (Michael & Halligan 2002). This model argues that Sarah might have suffered from an inability to have a self-referential view or perspective in the course of the trauma (Resick & Griffin 1998). This might have extended to emotional numbing, and a weak cognitive capacity to evaluate the terrible happenings accurately. This makes any prediction of recurrence as the source of fear, worry and concern. This cognitive model provides for the leading account of maintenance and treatment of PTSD. The model expands on a wide collection of negative appraisals and their impact (McNally & Zeitlin 1996). It suggests credible coping factors. According to empirical research, aspects of this cognitive model have been found to be true. A good example is that a person who has been involved in an accident clings to the seat when a car looses balance Morgan & Southwick 2001). The thought system at the time of trauma is related to PTSD, and any successful treatment must acknowledge this fact (Ehlers & Mayou 2002). In the case of Sarah, one of the intervention strategies would be the feminist therapy (Resick & Griffin 1998). The feminist therapy seeks to emphasize the importance of taking into consideration other the societal and cultural perceptions. This gives an understanding to the nature of gender based violence and psychological difficulties faced by women across the world (Ehlers & Mayou 2002). This therapy differs sharply with the traditional ideology that causes women to place themselves when they suffer gender based violence (Murray 1997). Empirical evidence shows that, in many contexts, the sociopolitical role of women and rights violation are linked to PTSD, in addition to gender based violations (Morgan & Southwick 2001). The theory explains to the victims that are marital breakups, and date rapes indicate the failure of the society and not in any way the failure of the victims (Metcalfe & Jacobs 1998). This concept is meant to counter negative appraisal. The feminist’s therapy focuses of self guilt of the victim and the long term implication of self blame. Sarah is feeling guilty and has turned to blaming herself for what she has gone through (McNally & Zeitlin 1996). A professional intervention using the feminist theory can go a long way in redressing her emotional stability. A study showed that feminist therapy is more successful that the traditional models of addressing PTSD (Teasdale & Barnard 1993). A recent study with survivors of sexual abuse indicated tremendous improvement in depression and self blame compared to the survivors who were in the control group. According to Campbell, most therapeutic treatments in the United States of America must incorporate feminist therapy. Cognitive processing therapy can complement the feminist therapy (Mayou & Bryant 2001). A combination of both strategies would ensure that the short term and long-term concerns in the case of Sarah have been addressed (Nijenhuis & Spinhoven 1998). Both strategies address the attitude of self blame and feelings of guilt. Research has revealed that most victims of date rape and marital breakups are profoundly affected by these feelings (Wenzlaff & Wegner 2000). The psychotherapeutic experts are increasingly focusing to this challenge exclusively (Metcalfe & Jacobs 1998). Guilt that comes with trauma is known to affect victims of rape. The cognitive processing therapy or model has been known to produce positive results when it comes to reducing guilt and depression in victims of rape and marital assaults or betrayal (Pillemer 1998). Feminist theory would make Sarah understand that there are many women who are going through what she experienced. Therefore, this feminist therapy would push her back to her place in the society (Metzger & Pitman 2000). The cognitive therapy or intervention addresses the traumatic feelings Sarah has been experiencing. This intervention is more effective that prolonged exposure. The cognitive intervention would minimize the recurrence of nightmares that haunt the victims of sexual assault (Pitman & Orr 2000). Group therapy is structures and hardly focuses on the interpersonal issues (Metzger & Pitman 2000). This contributes to the symptom reduction of the sexual assaults (Pillemer 1998). Given the symptoms from Sarah’s case, a combination of therapies would be appropriate. In conclusion, the case of Sarah, the marital and sexual abuse has affected her self- image, and esteem. This resulted to high levels of stress and anxiety. Sarah’s predicament was aggravated by the fact that she had nowhere to report the date rape incident. This resulted in the withdrawal syndrome that caused her to resign and work in a less enjoyable place. This gave birth to isolation, nightmares, flashbacks and self blame. The therapies and models available can assist in addressing these challenges significantly. These strategies include cognitive therapy and feminist therapy. The strategy would reorganize her memory and help her review the assault objectively. Psychology of mental health indicates that sexual assaults and marital betrayal can affect the mental capacity of the victims and the ability to view the future with optimism. The psychological health theories are known to address the symptom and the impacts of PTSD. The choice of the mode of mental treatment and the level of understanding the victim’s condition must interact if the intended results are to be achieved. References Andrews, B., Brewin, C. R., Rose, S., & Kirk, M. 2000. Predicting PTSD symptoms in victims of violent crime: The role of shame, anger, and childhood abuse. Journal of Abnormal Psychology, 109, 69–73. Brewin, C. R., & Saunders, J. 2001 The effect of dissociation at encoding on intrusive memories for a stressful film. British Journal of Medical Psychology, 74, 467–472.Engelhard, I. M., van den Hout, M. A., Kindt, M., Arntz, A., & Schouten, E. 2003. Peri-traumatic dissociation and posttraumatic stress after pregnancy loss: a prospective study. 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A comparison of flashbacks and ordinary autobiographical memories of trauma: cognitive resources and behavioural observations. Behaviour Research and Therapy,40, 1139–1152. Holeva, V., & Tarrier, N. 2001. Personality and peri-traumatic dissociation in the prediction of PTSD in victims of road traffic accidents. Journal of Psychosomatic Research, 51, 687–692. Holman, E. A., & Silver, R. C. 1998. Getting ‘stuck’ in the past: temporal orientation and coping with trauma. Journal of Personality and Social Psychology, 74, 1146–1163. Holmes, E. A., Grey, N., & Young, K. A. D. 2003. Intrusive images and ‘‘hotspots’’ of trauma memories in posttraumatic stress disorder: emotions and cognitive themes Jaycox, L. H. F., Foa, E. B., & Morral, A. R. 1998. Influence of emotional engagement and habituation on exposure therapy for PTSD. Journal of Consulting and Clinical Psychology, 1, 185–192. LeDoux, J. E. 1998. The emotional brain. London: Weidenfeld and Nicolson. Lee, D. A., Scragg, P., & Turner, S. 2001. The role of shame and guilt in traumatic events: a clinical model of shame-based and guilt-based PTSD. British Journal of Medical Psychology, 74, 451–466. Mack, A., & Rock, I. 1998. Inattentional blindness. Cambridge, MA: MIT Press. Marks, I., Lovell, K., Noshirvani, H., & Livanou, M. 1998. Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring—a controlled study. Archives of General Psychiatry, 55, 317–325. Mayou, R., Bryant, B., & Ehlers, A. 2001. Prediction of psychological outcomes one year after a motor vehicle accident. American Journal of Psychiatry, 158, 1231–1238. McNally, R. J., Kaspi, S. P., Riemann, B. C., & Zeitlin, S. B. 1996. Selective processing of threat cues in posttraumatic stress disorder. Journal of Abnormal Psychology, 99, 398–402. Mechanic, M. B., Resick, P. A., & Griffin, M. G. 1998. 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The role of dissociation in the development and maintenance of post-traumatic stress disorder.Unpublished doctoral dissertation, Oxford University. Murray, J., Ehlers, A., & Mayou, R. 2002. Dissociation and posttraumatic stress disorder: two prospective studies of motor vehicle accident survivors. British Journal of Psychiatry, 180, 363–368. Nijenhuis, E. R. S., Vanderlinden, J., & Spinhoven, P. 1998. Animal defensive reactions as a model for trauma induced dissociative reactions. Journal of Traumatic Stress, 11, 243–260. Orr, S. P., Metzger, L. J., Lasko, N. B., Macklin, M. L., Peri, T., & Pitman, R. K. 2000. De novo conditioning intrauma-exposed individuals with and without posttraumatic stress disorder. Journal of Abnormal Psychology,109, 290–298. Pillemer, D. B. 1998. Momentous events, vivid memories. Cambridge, MA: Harvard University Press. Pitman, R. K., Orr, S. P., Altman, B., Longpre, R. E., Poire, R. E., Macklin, M. L., Michaels, M. J., & Steketee, . Pitman, R. L., Shalev, A. Y., & Orr, S. P. 2000. Posttraumatic stress disorder: emotion, conditioning, and memory. In M. S. Gazzaniga Ed., The new cognitive neurosciences 2nd ed. pp. 1133–1147. Cambridge, MA: MIT Press. Teasdale, J. D., & Barnard, P. J. 1993. Affect, cognition and change. Hove: Lawrence Erlbaum Associates. Wenzlaff, E. M., & Wegner, D. M. 2000. Thought suppression. Annual Review of Psychology, 51, 59–91. . Read More
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