Personality Disorders, Introduction - Pathopsychology

Personality Disorders


Before turning to an analysis of personality changes, we should dwell on some of the fundamental principles of general psychology. As you know, the crisis of empirical psychology led in the early XX century. to a new view of the subject and methods of psychological science. Studies LS Vygotsky, Π. N. Blonskii, B. G. Ananyev, S. L. Rubinshtein, A. Leontyev-in the USSR, K. Levin, K. Bühler-abroad were aimed at searching for new ways of psychological research, namely not for the study of individual processes, but on a systematic holistic analysis of psychological activity. Overcoming the crisis of empirical psychology inevitably led to the problem of the structure and formation of the personality, to the problem of consciousness and activity. In his book "Problems of General Psychology" SL Rubinstein directly indicates that the introduction to psychology of the concept of personality means first of all the explanation of mental phenomena from the real being of man as a real being, in his interrelations with the material world.

As an attempt to overcome the crisis of traditional psychology, one should also consider research in the field of differential, individual psychology, typology. However, despite the growth of these studies, it was clear that they did not disclose the psychology of the individual. This was pointed out at different times by SL Rubinshtein, AN Leontiev, VS Merlin, and others. SL Rubinshtein wrote that the individual properties of the individual are not the same as the personal properties of the individual, those. properties that characterize personality. On the need to separate the concept of "individual" and identity almost all Soviet psychologists write: BG Ananiev, BF Lomov, SL Rubinshtein, Sh. A. Nadirashvili, AV Petrovsky, VA Petrovsky.

The illegitimacy of substituting the psychology of the individual with research in the field of differential, typological psychology was noted by foreign psychologists (K. Levin, K. Rogers, G. Allport).

The ways of researching the psychology of personality were outlined by Soviet psychologists. Relying on the Marxist theory of the social nature of the psyche, Soviet psychology viewed the individual as a product of socio-historical development, taking as a basis the provisions of K. Marx: "What is the vital activity of individuals, such are they themselves?" [1, 119]. Studies of personality in Soviet psychology were conducted mainly in two aspects. In some studies, the structure of activity itself, of motives (AN Leontiev and co-workers), the relationship between consciousness and activity (SL Rubinshtein and co-workers) was studied. To this line are the works of VN Myasishchev devoted to the problem of attitude, the work of the Georgian school of DN Uznadze, DA Prangishvili, and also the research of BG Ananyev.

Of foreign psychologists, the structure of motives, need states was studied by such scientists as K. Levin, G. Allport, A. Maslow.

Another line of personality research is the way of the formation of personal characteristics, traits of character in the process of education and training (AV Zaporozhets, DB El'konin, P. Ya. Galperin). The pedagogical process itself becomes the subject of study of psychologists (LI Bozhovich, LS Slavina, VM Neverovich). In these studies, conditions are investigated that under the influence of which certain personality characteristics are formed in children.

If in foreign psychology, the phenomenology of the influence of social factors on the development of a child is established, then the work of Soviet researchers poses the question of analyzing the very process of the formation of these features, and studying its psychological nature. In these studies, an attempt is made to actively formulate these features, i.e. the personality is studied in the process of purposeful education (the work of AG Kovalev, AL Shnirman, AA Bodalev, etc.).

Many works are devoted to the age features of the individual. In all these studies, the question was raised about the emergence of ethical motives, the ability to act according to moral standards (DB El'konin, LI Bozhovich, LS Slavina), Vygotsky's position that the emergence of "internal instances" the child is a certain personality indicator, emerging at a certain age level.

Particularly productive in the study of personality was the introduction and development (AN Leontiev and his colleagues) of the concepts of "personal meaning" and values ​​& quot ;. In his book "Problems of the development of the psyche" AN Leontiev writes that "meaning is a reflection of reality, regardless of the individual's personal relationship to her person" [110, 291]. Value is a generalization of reality, fixed in the word: "Having become a factor of individual consciousness, the value of ns loses its objective meaning." AN Leontiev distinguishes the unit consciousness, which does not coincide with meaning, is the "subjective personal meaning of the conscious content." "The meaning," writes AN Leontiev, "is created by the objective relation reflected in the person's head of what motivates him to act, to what his action is directed to as his immediate result. In other words, the conscious meaning expresses the relation of the motive to the goal [110, 225]. The introduction of this concept is an attempt to analyze the conscious active activity of the subject. The distinction between the concepts of meaning and personal meaning made it possible to make the subject of concrete psychological analysis the structure of activity, the structure of the needs of man, his motives. It makes it possible to trace the dynamics of motives, their hierarchical construction. This was especially clearly formulated by A. II. Leontiev in his report at the XVIII International Congress of Psychologists in Moscow (1966). The meaning is generated not by values, but by the relation between the motive of the action and what the action is directed to as its direct result, i.e. its purpose [119, 9].

Pointing out that motives and goals can change, AN Leont'ev emphasizes that a goal that initially did not have a motive for the subject itself can acquire it and become a motive: the motive shifts to the goal, resulting in a the action turns into an independent activity. Changing motives does not change the meaning of an action, but their personal meaning for a person.

The introduction and at the same time the dilution of the concepts of meaning and meaning allow us to bridge the gap between the sphere of consciousness, thinking and the sphere of motives, needs. AN Leontiev himself thus forms the heuristic of the introduction of this concept: "The introduction of this concept allows us to overcome also those psychological concepts that proceed from the recognition of two different spheres acting on each other. One is the sphere of conscious thought, consciousness, the other is the sphere of needs and motives. Of course, we should distinguish between these spheres. They, however, form a single structure - the internal structure of consciousness itself " [111, 11].

In recent years, the research of the abovementioned provisions has been developing: in the theoretical plan attention is drawn to the function of regulation, self-regulation [67; 68; 185]. This problem has been associated with the problem of semantic systems [14, etc.]. Semantic systems are a system of basic personal relationships. They are related to the world view, value ideas, self-image ("I-am"). AG Asmolov correctly points out that the central feature of the semantic formations is their production from the social situation, the position of the person in society, from the interaction of the motives given by this situation, from the totality of activities. However, these sense systems also have their own movement, "their internal dynamics".

In our book there is no possibility to dwell on all the directions on which the study of the individual takes place. It should be noted that the way of studying the structure of activity, motives, their hierarchy and construction, and the way of studying their formation are the main aspects of research in the field of personality psychology.

These two aspects are the general ways of studying personality. However, recent studies of both domestic and foreign psychology have shown the fruitfulness of yet another pathway - the analysis of studies of a pathologically altered personality.

It is known that in recent years the role of related scientific disciplines, border areas of knowledge has increased, among which experimental pathopsychology has taken a strong place.

As a part of the psychological science, pathopsychology is sent from its main provisions: the principle of determinism and the principle of development.

These principles oblige to study not isolated responses of a person to some stimulus, but to the study of the qualitative content of mental activity, i.e. to the analysis of changes in the actions, actions, knowledge of man. On this side of the study of personality indicates SL Rubinshtein, arguing that determinism in its correct philosophical definition means that the external cause does not directly determine a person's reaction - it acts through internal conditions. External influence, according to SL Rubinshtein, gives this or that mental effect, only refracting through the mental state of the subject, through the system of thoughts and feelings that he has developed. As applied to specific pathopsychological studies, this means that we must move away from studying the disintegration of individual functions to a systematic study of the changes in the various forms of the patient's mental activity, including changes in personal attitudes, human motives, his experiences, his attitude, self-consciousness, etc.

The same conclusion is made by the provisions of Soviet materialistic psychology about the genesis of mental processes. The very formation of these processes is impossible without the involvement of a personal component. Pointing out that mental processes develop in life, AN Leont'ev emphasizes that this formation takes place in the process of assimilation of the world of objects and phenomena created by man. He points out that biologically inherited properties constitute only one (albeit very important) of the conditions for the formation of mental functions. The main condition for their formation is the mastery of the world of objects and phenomena created by mankind. This process of mastery is an active process. To the world of objects opened to the child, the latter must carry out active activities in dealing with other people. A child is introduced into this world by surrounding people.

Therefore, the most important condition for mastering, assimilating the world is the existence of relationships with other people. Complex mental activity is initially socially conditioned, it is formed in the mastery of the world, in communication with other people with whom the child is in certain relationships, causing his emotional experiences.

These relations are determined by concrete historical conditions, but, having formed, they themselves determine the actions and actions of man. In the process of mastering the world, social needs, motives and interests of the child arise, and its personality is formed. There are new, higher needs, differentiated and transformed already formed.

By destroying a person's mental activity, the disease under certain conditions leads to a change in the personality component. There is a formation of new motives, the relationships of needs, motives, their content and hierarchy, experiences change. A certain model of formation of needs, motives (even pathological ones) is formed.

LS Vygotsky attached much importance to the studies of the disintegration of the psyche. In constructing his theory of higher mental functions, in his discussion with Levin, he often relied on data from the field of pathology.

The pathology material served as a basis for LS Vygotsky to construct his theory of higher mental functions, to analyze their psychological structure, and for the problem of primary and secondary symptoms.

It is no coincidence that a number of foreign scientists who created psychological personality theories (K. Rogers, G. Allport, etc.) were either psychiatrists whose concepts developed in the process of psychotherapeutic practice, or researchers who attracted for their theory pathopsychology data.

The study of altered performance, studies on the restoration of mental disorders, the study of factors and conditions that contribute to its recovery, the data of all these studies are very useful for many provisions of general psychology.

Finding clear definitions for the psychological characteristics of personality disorders is difficult. As you know, psychology occupies an independent place "at the junction of" between public and natural sciences. This position is conditioned by objective laws. Consequently, any attempts to choose for her either one or the other channel are vicious.

Changes in personality are inevitably associated with changes in the basic values, social attitudes and aspirations of a person, his self-esteem, and are not in direct, but in a very complex and indirect dependence on the central nervous system. When analyzing these violations, there is a danger of mixing mental and biological categories. Such a mixture inevitably leads to veiled, but even more dangerous tendencies in the biologization of psychological and social phenomena. Slipping of psychological research into the path of direct comparison of anatomical lesions with various descriptions of behavioral changes can lead to the loss of the subject of psychological research itself.

The attempt to study mental disorders in isolation from the brain, to ignore the specific clinical material showing mental disorders due to diseases and changes in the physiological state of the brain, would be idealistic. IM Sechenov already makes an attempt to reveal the physiological basis of mental processes and develops the materialist theory of psychology. He shows that without the external sensual irritation it is impossible to imagine the existence of any kind of mental activity.

The consciousness of a person, his attitude to reality depends on the way he lives, on the way he meets his needs. Depending on the conditions of life, social and labor activity, the ideas, perceptions, intentions and aspirations of a person change.

Thus, the content of consciousness, i.e. then, as a person understands the phenomena of the surrounding world, how he treats them, what he seeks to and what is guided in his behavior, depends on his life activity. The brain is the organ that makes this connection with the outside world.

In modern American and Western European psychology, there is a different understanding of the content of consciousness and its role in human activities. Representatives of one direction are trying to prove that the leading forces of behavior to which consciousness is subordinated are the biological instincts (Freudianism), which were inherent in the depths of the psyche. Representatives of the other direction generally deny the existence of consciousness, treating man as an automaton blindly reacting to environmental irritations (behaviorists). From different sides, these and other theories tend to belittle the role of consciousness.

It is important to note that the recognition of the role of the social environment still not enough to properly understand the nature of human consciousness. As is known, pedology also recognized the "influence of the social factor", but viewed it as some "external force", "interacting" with a different force - with the makings of a child. This understanding led to ignoring the real development of the child's consciousness in the process of learning or the person in the process of his life activity, in other words, to forget the teachings of Marx about the development of human needs. The basic provisions of this doctrine are set forth by AN Leontiev. "A man first works to eat, then eats to work; labor comes from the necessity of obtaining means for the existence of the first spiritual need of man. As a motive, a source of activity, the needs are also its result. This means that the activity of a person who was previously a means of achieving some goal may later become his need.

The history of development, complication or elevation of man's spiritual needs is the history of the development of his individual consciousness. Leaders, social needs of a particular person - this is what defines, motivates, shapes the system of his actions, actions, relationships [110].

When considering violations of personality, one can not, of course, ignore the whole content side of the human psyche, that is, consciousness and direction of personality. Clinical practice reveals unquestionable qualitative disorders of all these formations with certain brain lesions. However, it is difficult to find the correct system of concepts for analyzing these violations, as we have already pointed out. We do not set ourselves the goal of solving this problem. At this stage of development of psychology, the very formulation of it is important. In any case, it is possible to drop some definitely false ideas. These include, first of all, attempts to link the antisocial behavior of patients directly to cortical damage.

Along with such clearly mechanical constructions, there are also more subtle, veiled. It would be, for example, erroneous and simplistic to imagine the case so that the defeat of any part of the brain directly leads to a change in the social attitudes of the sick person. Similarly, it is incorrect to imagine that only social causes (family conflict, frustration, stress situation, extreme conditions) are the mechanism of personality disorders.

The situation is much more complicated: social and biological mechanisms are inappropriate and do not oppose each other. With personality disorders, with neurotic states, there is an interlacing of factors, the mechanisms of the appearance of the same psychopathological syndrome are ambiguous. As indicated above, SL Rubinstein's formula that external causes act through internal conditions (which included the violation of the central nervous system), explains a lot in the violation of personality. However, in the process of human activity, the correlation of causes and conditions varies, the primary and secondary syndromes that Vygotsky spoke of are intertwined and interchangeable. The personality disorder also occurs because a person with a sick central nervous system lives up to the requirements and norms that are imposed on healthy people.

Violation of the personality is the most complex layer, where altered or affected pathological motifs, infringements of goal-setting are intertwined, emotional attitude to the world, to other people and to themselves, where compensatory, adequate and inadequate mechanisms, protective measures, realized and not realized, act.

Unravel and accurately determine the meaning and place of all these factors, give a justified strict classification of personality disorders, indicate where a certain measure of compensation or a protective mechanism ends and a new one comes in, seems difficult at this stage in the development of our science, especially as the painful process changes the dynamics of violations sometimes for a certain time, sometimes leads to stable personality changes.

However, despite these difficulties, the theoretical and experimental studies conducted by pathopsychologists, direct participation in the psychological service, in medicine make it possible to attempt some classification (even if not entirely perfect) of these violations. At the same time, we must remember the position of K. Marx that if "man is the product of social relations", then the changed person is the product of changed relations.

Before going on to describe the various forms of personality disorders, we would like to outline the strategy of a pathopsychological experiment aimed at investigating personality changes.

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