Processes and reactions to the changing picture presented in John’s case.

1. Freud and Adler’s theories do have some similarities however there are also areas where they differ. These two theories are similar in the sense that both psychologists believed that an individual’s personality is formed very early in life (Wedding & Corsini, 2019). Also, both of these psychologists had similar views on how environmental conditions have the ability to create limitations for individuals (Wedding & Corsini, 2019). However, these theories appear to differ in more ways than they are similar.

These theories differ in quite significant ways. For example, while Freud’s psychoanalysis strays away from focusing on external factors, Adler’s theory prefers to focus on external influences, more specifically how one’s childhood affects how people act later in life (Wedding & Corsini, 2019). Freud and Adler also disagreed on the role of sexuality and whether it was a main factor in motivation; Adler believed that relationships were more influential for motivation (Wedding & Corsini, 2019). Another way these two psychologists differ is how they think individuals make decisions. Freud believed that people are driven by instinct whereas Adler thought that people can make their own conscious decisions (Wedding & Corsini, 2019). The role of the therapist is also a significant difference between these two theories. In psychoanalysis, the therapist acts as a blank canvas for the client to give all of their experiences and feelings (Wedding & Corsini, 2019). On the other hand, in Adlerian theory, the therapist is more of an empathetic individual that gathers information to assist the client with healing and growth (Wedding & Corsini, 2019).

When it comes to multicultural considerations, family dynamic may be the most prominent. Since Adler’s theory tends to incorporate how childhood experiences impact adult decisions and actions (Wedding & Corsini, 2019), it could be important to consider how family dynamic may differ in certain cultures. The culture of the family is important in considering who has the most responsibility, the role of men, women, and children, and even cross-generational influences (Connell, 2010).

Personally, I would utilize Adlerian therapy in my own practice. I believe the therapist should serve as an outlet of empathy to the client. I think that it is important to acknowledge past experiences in resolving current issues to promote healing and growth for the client. I also agree more with Adler’s belief that relationships are a driving force in motivation in contrast with Freud’s sexual beliefs. Overall, I agree more with Adler’s way of thinking than with Freud’s.

 

2. Most of today’s psychotherapy practices stem from Freudian methodologies at their core but this week’s reading showed clearly where there are divides between psychoanalytic psychotherapies and Adlerian psychotherapy. The most basic of these is that Adler tailored his methods to the individual and their presenting issues, where as Freud believed that therapy work should be much more prescriptive and that all people go through the same stages and issues can be narrowed down to just a few root causes, as I read his methodologies. While I agree with the evidence showing some aspects of each method of therapy treatment to be accurate and effective, both psychotherapy modalities have room for additional development as it relates to the treatment of all potential clients.

Sigmund Freud, considered to be the original founder of psychoanalysis, developed his theories around the idea that all humans are motivated by unconscious motivations and that understanding those unconscious motivations will allow for greater agency and therefore reduce self-defeating patterns (Wedding, 2019). Adler began his career using a Freudian psychoanalytic methodology but quickly diverted when he felt that Freud’s methods were inadequate and unavailable to a large portion of the population. Where the methods are similar in one way is through the incorporation of dream analysis. Both psychoanalysis and Adlerian psychotherapy use dreams and dream processing as a way for the client to understand how their unconscious plays out in waking life as well. The video showcasing Freudian psychoanalysis went deeply into this process and was a great example of how dreams can be important in understanding our motivations (Psychoanalysis). As we read in “Current Psychotherapies,” Adler wrote that one of Freud’s greatest accomplishments was the analysis of dreams and their place in therapy as a healing facilitator.

Psychoanalysis differs from Adlerian psychotherapy in many ways but most importantly, in my opinion, is in the treatment of the patient. Adler was an advocate for interaction with the patient during therapy. Whereas Freud believed that the therapist and client should not see one another, Adler had his clients face the therapist and sit up in a chair to take a more active and equal position (Wedding, 2019). This is important because one of Adler’s ongoing criticism’s of Freud was the discrepancy between a practitioner and client, creating a feeling of inferiority in the client and reducing access to psychoanalysis work by demeaning the client in status and availability to treatment. The other major disagreement between Freud and Adler that cannot be forgotten was Freud’s mindset of women as inferior to men because of their lack of a penis, while Adler thought that women were equal to men in mental aptitude but help back by society (Wedding, 2019).

Beyond gender assumptions as a multicultural barrier to female participation in Freudian psychoanalysis, Freud advocated for intensive, long-term, multi-day treatment plans. A therapy schedule of this magnitude is unrealistic for almost anyone who has a job or family obligations, meaning that the originally intended method of psychoanalysis treatment was available only to those in the upper echelons of society, as Adler criticized as well. Adlerian psycotherapy is more open to a variety of socio-economic statuses, ethnic backgrounds, and genders for a variety of factors but in part becasue of the more open and equal stance that practitioners take with their clients. The video showing an Adlerian practitioner in session showed this, by calling out the empathy identification that the therapist practiced with her client (Adlerian Therapy).

Personally, I found Adler’s methodology much more appealing. Not only do I prefer to have interaction with clients by asking questions and creating baseline empathy, I also appreciate Adler’s theory of personality. I am a big believer in the significance of birth order, family atmosphere, parenting style, and the other elements mentioned in our textbook. This being said, there are many other factors that can alter a personality, such as a traumatic event or physical injury. I also appreciated the early recollection integration, as I think there is much to be gleaned from a client’s framing of their own life experiences in stories.

Instructions for 3:

Provide feedback regarding your perceptions of their analysis, along with the reasons for your analysis and evaluation of their response.

3. For this discussion, I read the diagnostic criteria for Specific Phobias under the section for anxiety disorders.

Diagnostic Features: The diagnostic features were all self-explanatory and easy to understand. The diagnostic criteria state that this fear usually lasts for 6 months or more which helps to distinguish this disorder from common fears and this disorder cannot be better explained by symptoms of another mental disorder, such as OCD, PTSD, or social anxiety (APA, 2013). The fear associated with phobias tends to be out of proportion to the actual danger presented.

Subtypes and Specifiers: This section was well covered, but I felt as if it could use more information. There are many specifiers because individuals have specific phobias, such as fear of any sort of animal, fear of nature, fear of blood/injection/injury, or situational fears. People may also have more than one specific phobia. When diagnosing someone with a specific phobia, each code must be provided. All of the codes presented in the diagnostic criteria cover the various types of phobias one can have.

Associated features and disorders: This section is well-covered. It states what physiological arousal is associated with each type of phobia listed. This information helps when looking over symptoms to diagnose someone. Similar to the diagnostic features, this information was self-explanatory and easy to understand.

Laboratory Findings: This disorder did not include a section on laboratory findings.

Physical examination and general medical condition findings: This disorder did not include a section on physical examination and medical condition findings

Culture, age, and gender features: The information for culture-related issues was very brief, but it still provided enough information to understand the difference in cultures. The only information provided about age differences was the difference in prevalence rates across ages and how the disorder is presented in children. The information on gender was extremely brief and only included the difference in prevalence rates.

Prevalence: This section included information on prevalence rates of specific phobias not just in the United States, but also in European countries, Asian, African, and Latin American Countries. This section also provides the difference in prevalence rates for the different age groups. This information helps to put things in perspective. The prevalence rates of specific phobias in the United States are only 7%-9% which is lower than I imagined it would be. The prevalence rates are lower in older individuals compared to teens which are actually understandable (APA, 2013).

The course of the disorder: This section was covered very effectively. This section also provides information that is easy to understand. This section provides thorough information on how specific phobias may be presented and expressed in children. This section does provide some contradictory information which was slightly confusing; it is stated that specific phobias remain one of the more commonly experienced disorders later in life, yet the prevalence rate of specific phobias in the older population is the smallest. This information should have been better clarified.

Familial Pattern: The information on familial patterns was extremely brief. It was only stated that people may be genetically susceptible to certain types of specific phobias. More information could have been provided on how common it is for family members to have the same specific phobia and information could have been provided on what types of phobias are more likely to be passed down.

Differential Diagnoses: This information was extremely helpful because it explained how to tell the difference between specific phobias and common fears, such as agoraphobia, PTSD, and OCD. These disorders include symptoms that match the symptoms for specific phobias so it may be easy to confuse them and misdiagnose someone. Thorough information was provided for 8 different disorders that share similar features with specific phobias

Instructions for 4-5: In each case, comment on the learner’s thoughts about John’s case. What additional insights can you offer? The case study is attached in a word document.

4. Write your thought processes and reactions to the changing picture presented in John’s case.

The study on John was very interesting and provided a lot of detailed information. One thing that I noticed is that a client can provide you with details in the beginning, but it is your job to ask questions so that you can get all of your unanswered questions answered. This case study was a roller coaster as from the beginning John provided little information but as the session progressed more information was provided. When I first began to read this case study, I assumed that John would have mood disorders but now I have learned that it is deeper than that and he is having hallucinations which is a sign of schizophrenia.

Use the diathesis-stress model to assess John’s case and state the salient vulnerabilities and stressors that come to mind.

John is very worried about how others view him which causes him to be very depressed as some may view him as homosexual as he has stated that he is not. Because of this John has isolated himself and has become a loner. Also, within Johns family there are a lot of mental health disorders from his brother being Schizophrenia and his sister being bipolar and not to mention that his father was also an alcoholic as well. These diagnostics are within the family which places John’s mental health on a continuing cycle.

Attempt a diagnosis for John, based on your current knowledge, providing the DSM-5 and ICD-10 codes, according to the format provided in Unit 1.

Diagnoses (APA, 2013):

295.70 Schizoaffective Disorder

(F25.1) (Depressive Type)

Other Factors:

V60.0 (Z59.0) Homelessness

V62.29 (Z56.9) Problem related to Employment (job loss)

5. What were your thought processes and reactions as you noted the changing picture presented in John’s case?

Originally it seemed as if John had a depressive disorder based on the symptoms that he presented with. John was very tearful and hopeless. He had little appetite and no desire to socialize. He was also prescribed an antidepressant medication. The more information the psychologist gathered and the longer he talked with John, symptoms began to surface. He began to become increasingly paranoid, delusional, agitated, and anxious. John was also having auditory hallucinations. The longer the interview went on the better it was in diagnosing John because the psychologist was able to obtain more information about John’s stressors, symptoms, and history.

Using the diathesis-stress model to assess John’s case, what salient vulnerabilities and stressors come to mind?

The salient vulnerabilities and stressors that come to mind in John’s case is the fact that mental illness runs in his family. His brother is schizophrenic and his sister has bipolar disorder. His brother is also gay, and John had a period in his life where he identified as homosexual. He no longer considers himself gay, but believe others perceive him this way which is affecting his self-image.

Attempt a diagnosis for John, based on your current knowledge, providing the DSM-5 and ICD-10 codes, according to the format provided in Unit 1.

Diagnosis: (APA, 2013)

295.70 (F25.1)

Schizoaffective Disorder, Depressive Type

Other Factors:

V60.0

(Z59.0)

Homelessness

V62.4

(Z60.4)

Social exclusion or rejection

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