Self-Inducement in Psychological Disorders, Thesis Paper Example
Words: 3683Thesis Paper
It is inescapable that, certainly in recent years, the psychological disorder has become a significant factor in the lives of millions. With the disorder, there is a kind of accessibility not evident in extreme psychological dysfunction or illness. As they are frequently far less severe than mental illnesses, they are identified within wider populations. Certain types, as in severe eating or depressive disorders, may pose considerable dangers to the lives of those affected. By and large, however, most are manageable conditions which, treated properly, do not carry such risks. Untold numbers of individuals diagnosed with Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), and various anxiety disorders and phobias, are able to conduct their lives in relatively normal ways, with medication and therapies alleviating the conditions. It is reasonable to assert that today, with exceptions noted, the psychological disorder is both a commonplace element and one typically no real threat to the sufferer or others in their lives.
It is this very commonality, however, that demands investigation. More exactly, the question arises: are there more disorders evident and being treated because medical science today is equipped to identify them, or is the extent of the problem at least in part generated by the public awareness of these disorders, which in turn enables individuals not necessarily afflicted to self-induce the conditions? The question is by no means an indictment of the public at large, as consciously instrumental in “taking on” disorder symptoms and behaviors for suspect reasons; rather, it seeks to inquire as to how the sheer prevalence of a subject in the public consciousness may foster an actual degree of participation in the developing of a disorder. In plain terms, and as will be explored in the following through assessing varieties of disorders and their known causes and impacts, the mere fear of a condition may exacerbate any potential for that condition to arise, and the relatively mild psychological disorder may then often evolve in this way.
While there is no intent in the following to minimize the severity of actual psychological disorders, it will nonetheless be seen that combinations of cultural influences, and individual vulnerabilities and/or inclinations, render many to at least partially self-induce these conditions.
Before any rational assessment of self-inducement in this area may be made, it is important to differentiate gradation and quality. The issue here is of an actual process of participation, consciously or otherwise applied, which then generates the disorder, or appearance of the disorder, which would not otherwise be present. This imperative is prompted by the reality that, to an extent and in clinical terms, some degree of patient participation is involved in virtually all disorder scenarios. The individual suffering from bulimia promotes the disorder through binge-eating and purging; the person gripped by a social anxiety disorder exacerbates the condition through the process of perceiving the fear as a dominant reality. It is difficult, if not impossible, to ascertain the dichotomy between victimization and participation when psychological distress is the issue. Extensive research has in fact been conducted regarding various degrees of sufferer participation. In one study, patients diagnosed with social phobias were asked to conduct conversations with strangers in dual circumstances; in one, they maintained a negative self-image in mind, while in the other they held to a control self-image. Not unexpectedly, the subjects uniformly reported far greater levels of anxiety in the former instances (Harvey et al, 2004, p. 121), clearly indicating that some degree of individual control or will affected the states of being of those studied. Regarding panic disorders, there is substantial evidence that individuals trigger attacks based on associative, and in some instances voluntary, processes: “Whether cognitively or noncognitively, excessive anxiety over panic-related bodily sensations is well supported” (Barlow, 2007, p. 9). What occurs is that the individual translates a certain sensation as a “cue” for panic because the feeling is known by them as linked to the extreme presence of it. When, for example, procedures elicit in subjects breathing difficulty, a reciprocal cycle is set in motion as the subjects translate the single symptom into a perceived panic attack in progress.
With eating disorders, the participation of the sufferer is clearly overt, although this in no way eviscerates the psychological determinants prompting the actual behavior. Nonetheless, modern studies and research geared to treating anorexia and bulimia increasingly focus on stressing the factor of conscious choice; more exactly, it is believed that emphasizing individual will in these cases goes to weakening the power of a disorder that is manifested through physical actions (Buckroyd, Rother, 2008, p. 97). A primary obstacle in treating anorexia and bulimia, in fact, lies in creating an awareness within the sufferer that the disorder exists as such. Vast research uniformly reveals that young girls, the most vulnerable population, seek help only in addressing symptoms of the disorders, and are fearful of the absence of them. Psychologically, anorexia provides a sense of identity the patient is disinclined to surrender, even as the eating behaviors are threatening their life (Warin, 2010, p. 79). What then ensues is something of a cognitive choice made that is clearly and significantly influenced by psychological imbalance, even as the victim seeks to retain the core disorder.
Here, as with so many other types of disorders, may be seen the peculiar and persistent element of patient participation. As noted, the issue is one of gradation and actual awareness, as the nature of any psychological disorder inherently obfuscates where individual will begins and disorder ends. It is both unjust and irrational to assert that the sufferer of anorexia is merely undergoing trauma they have the power to obviate, because they have the power to choose to eat. Similarly, it is unreasonable to expect that an individual triggering a panic attack through an association of a symptom experienced prior to any actual attack is deliberately and consciously electing to generate an episode of the disorder. Nonetheless, there remains the important reality that, whether it is exercised or not, some element of individual control has a profound effect on the existence of the disorders themselves. To some degree, and with no specious attachments of personal responsibility as neglected made, the individual literally must to some extent perpetuate the disorder. The research cited clearly indicates this relationship, apart from cognitive processes involved. This being the case, then, a further exploration of how disorders may be more directly self-induced should be conducted. As the following will reveal, the immense variety of disorders and the range of degree within them support that, at least in some instances, psychological disorders are more the product of individual choice than of mental imbalance.
Stress as Agent
In examining how individuals may actually and significantly induce states of psychological disorder, it is helpful to turn to an element both removed from the subject and linked to panic disorders: stress. The term is intrinsically broad, but it is generally held to define any negative reaction to a stimulus that upsets the routine functioning of the mind and/or body. Stress is not in fact an entity unto itself, but exists only as a reactionary process, and this then broadens the ways in which it has impact. More exactly, the stressor is defined and, in a sense, created by the stressed individual. Modern research increasingly holds, in fact, that stress is not the human response to threat it has been traditionally viewed as being, but the response generated by the individual’s perception of the event, thing, or stressor (Olpin, Hesson, 2011, p. 62). In a classic example, a person may experience intense stress due to an imminent social occasion, such as a wedding, which prompts in others only feelings of eager anticipation. The same core of perception applies to competitions, which trigger extreme anxiety in some and positive expectations in others.
This quality of perception, then, may be applied to disorders centered on anxiety issues, and may illustrate how an individual actually elects to generate the symptoms of disorder, if not outright disorder itself. To some extent, and importantly, such processes are inherently exponential; as the anxiety is first created by the person’s appraisal of the circumstances, it encourages in the person a more active seeking of cause. Processes are generated which profoundly parallel the factor of individual perception as creating stress, just as stress itself is a component within anxiety. Research reveals that many sufferers of General Anxiety Disorder (GAD) complain of living in constant states of anxiousness, and the reason is not difficult to comprehend. Anxiety is self-perpetuating because, and from its initial presence, it virtually feeds itself by promoting the sufferer’s participation. To begin with, the first stage of anxiety brings on acute self-focus; the individual is distinctly aware of being within its grip, which then enhances the attention the individual focuses on the anxiety feelings themselves. This in turn blurs the powers of subjective appraisal, as the person is no longer able to view the circumstances apart from the anxiety. Then, and critically, the anxiety typically impairs the individual’s ability to perform (Clark, Beck, 2011, p. 41). The speaker anxious about how they will be heard mumbles, as the athlete gripped by anxiety in a competition does not perform as they can, and the impairment then fuels the anxiety.
The similarity here with stress is then overt. In cases of actual anxiety disorder and stress-induced unease or anxiety, it is individual interpretation of external factors that produces the effect. No matter the individual’s actual perception of will or control, or lack thereof, they are essentially creating the disagreeable state of being. It is in fact crucial in terms of disorder thinking that stress is now viewed as a consequence of perception, rather than actual threat, because the basis of disorder investigation is then expanded. That interpretation may often not be cognitive, or a direct effect of an individual’s conscious will, does not lessen the significance of the reality, just as it promotes opportunities for addressing psychological disorders in new and empowering ways. In plain terms, and perhaps ironically, that individuals participate to some extent in disorder development translates to a far greater likelihood of easing disorders themselves. Just as stressors may be reinterpreted to relieve the anxiety caused by reflexive responses, so too may disorders be treated by altering the individual, perceptive processes enhancing them.
Cultural and Social Influences
In arguing that self-inducement is a factor in disorders, it is necessary to examine the inescapable element of how cultural forces shape perceptions and, certainly to a degree, actually promote disorders, or an individual’s inclination to become prey to them. This does not negate the presence of the individual as participant; as this focus relies upon, individual accountability, regardless of intent or awareness, is the issue. Rather, social influences merely provide further evidence of the multifaceted developments of many disorders, as the individuals are “induced” to induce the behaviors and thought processes of them. There is no escaping the reality that psychological development of all kinds is powerfully affected by external experiences throughout the life-span, as expressions of approval, disapproval, acceptance, and belonging are central to ideas of selfhood in any culture. That these same forces may easily promote unhealthy pathologies, then, is inevitable.
It is likely that no more striking example of how culture may generate disorders exists than that of the eating disorder, even as it is understood that the element of individual participation remains significant here. It is the negating of that participation, in fact, that typically defines the eating disorder in the ordinary mind. That is to say, it is widely believed that social pressures on young women to adhere to an impossibly idealized slimness eclipse individual controls, a belief certainly supported by the disorders as occurring far more commonly in women. Since the mid-20th century, most forms of cognitive therapy seeking to address anorexia nervosa and bulimia center on this cultural impact, and: “Treatment for anorexia nervosa involves swimming against this cultural stream” (Garner, Garfinkel, 1997, p. 120). Typically, the patient is counseled to consider more subjectively media images and see them as the unhealthy projections they are, just as family and peers are assessed in terms of their levels of participation in promoting the cultural conception of stark thinness. The focus is invariably on countering an enormous, external force, and the sufferer is viewed as a victim of social pressures too intense to withstand. Consequently, the victim’s participation in the presence of the disorder is rendered explicable.
Similarly, a certain type of PTSD is immensely enhanced by cultural forces, if in ways less overt than media influences on young women. It is indisputable that veterans of war are subject to PTSD by virtue of the traumatic conditions and what is witnessed by them. It is, moreover, interesting how extensive research has identified physiological effects shared by war veterans and survivors of childhood abuse, cancer, and critical care nurses; essentially, the overwhelmingly traumatic nature of the experiences as horrific encounters with death generate brain fluctuations creating functional abnormalities (Wilson, Keane, 2004, p. 301). Recent studies on veterans returning from Iraq reinforce conflicts noted in post-war circumstances from World War I on. In plain terms, the veteran is not equipped to adapt to the shift between radically hostile environment and the former society, and: “The contrast between civilian life expectations and living a life of war is immense” (Collura, Lende, 2012, p. 139). A great deal of this, however, derives from clashing expectations from both culture and veteran. More to the point, and relevant to sufferer participation, is the reality that the society anticipates disorders within its veterans, certainly to an extent. Studies on Vietnam War veterans confirms this factor, as societal perceptions of the war greatly exacerbated public concerns regarding the mental health of those returning, which in turn enhanced levels of veteran dysfunction (Dohrenwend, 1998, p. 56). In a sense, then, war experience acts as does the media in promoting eating disorders; as the culture presents a field of expectations, the individual unable to conform to them is vulnerable to psychological disorder.
Far more pertinent to how culture relates to self-inducement in disorder development, however, is the inescapable and persistent emphasis in today’s media on the disorder as an “ordinary” facet of living. The statement is no extreme; if stigma was attached to the idea of a psychological disorder in the past, the cultural perception has been largely reversed, and chiefly because pharmaceutical companies reap immense profits by advertising, and selling drugs for, a wide range of disorders. A great deal of study has examined how the movement toward the antidepressant took hold of Western culture in the late 20th century, suddenly and expansively endowing an illness with a new, if ironic, social stature. The media joined forces with the pharmaceutical companies to render Prozac a household word, and to redefine ordinary problems of living as evidence of a depressive disorder requiring medication (Horwitz, 2007, p. 183). The trend has by no means abated, and drug companies are today viewed as manufacturing disorders as a way of creating new markets. The phenomenal success of Viagra as a treatment for erectile dysfunction, in fact, actually inspired the “disorder” of Female Sexual Dysfunction (Conrad, 2008, p. 279). Tuning into virtually any television channel reveals endless commercials for drugs which will alleviate sadness, depression, and fading energy levels, all of which are identified as disorders. It is profoundly disturbing, but today’s culture obfuscates the realities of authentic disorders by insisting upon an array of them as likely within the mainstream population. Under such an onslaught, it becomes more reasonable to perceive that, for many, a psychological disorder is, perversely, an almost desirable attainment.
Self-Inducement as Integral Factor
It is necessary to note that little in the above analysis, the immediately preceding excepted, directly goes to processes by which individuals actually induce their own disorders, just as literature on the subject itself is minimal. What is found, in fact, is a focus on self-generated behaviors which are not viewed as participatory, and frequently as only symptomatic of the disorder itself, as in the anorexic’s desire to seek help only for ancillary effects of the pathology. Some study is conducted in regard to “active passivity,” wherein the individual both fails to engage in remedial efforts and demands external assistance in overcoming the problems. This has been widely observed in those with Bi Polar Disorder (BPD), yet even these behaviors are ascribed to obstacles beyond the individual’s control. For example, it is generally believed that active-passive behavior in BPD sufferers is usually the result of failed individual efforts to regulate their own emotions (Derksen, Maffei, & Groen, 1999, p. 190). In frustration, then, they deny their own roles in the disorders and utterly negate personal responsibility or power to address the issues.
If, however, models of treatment and perspectives on disorders do not directly implicate the sufferer as instrumental in the conditions, the existing research nonetheless points to this connection in a manner that is both oblique and irrefutable. As noted, individual perceptions determine stress, as the same process essentially determines anxiety. With the important exception made of when the psychological disorder is indeed traceable to biological factors and brain function, this presents the clear reality that, no matter the degree of awareness, the individual is contributing to the disorder by enabling and enhancing its impacts through response. There appears to be something of a universal reluctance in the literature to indicate this relationship as anything more than a further effect of a disorder cycle. Certainly, disorders are cyclical in nature, so the view is understandable. At the same time, it must be acknowledged as well, and as success in treating victims of eating disorders reveals, that a critical component to these cycles is the individual participation. Whether that participation takes the form of an insistence on only external aid as beneficial, a sense of helplessness, or an actual enhancing of the debilitating conditions, is irrelevant. What dominates is that, on some level, the individual is capable of combating the disorder in many cases but, because the effects are so oppressive, they are absolved of this responsibility.
This view is not to suggest a generalized dismissal of the seriousness of disorders, nor an invalid, if not insulting, advocacy of human will as being sufficient to combat such illnesses. To do so would be to ignore the immense and real effects of disorders at their most crippling. At the same time, however, it is equally unconscionable to discard human will altogether in these scenarios. The evidence indisputably reveals that disorder sufferers abet their disorders; this being the case, there is then a measure of proper response not employed, and a degree of self-inducement is evident. This is supported by comorbidity; GAD, for example, is typically experienced as both a life-span disorder and one in concert with other dysfunctions. Studies support that the majority of GAD sufferers claim to have always been subject to intense anxiety in social situations, just as the disorder is usually present alongside of personality disorder, specific phobias, and acute or mild depression (Leahy, Holland, 2012, p. 166). Consequently, it would seem that the sufferers accept the disorder to such an extent that they perceive it, as do anorexics, as a determinant of identity, in that it is permitted to so define who they are. This alone points to a virtual willingness to participate, as a lack of resistance is in these cases tantamount to acceptance.
The psychological disorder is in many ways, vast amounts of study notwithstanding, something of an enigma. It may so effect an individual, living is greatly impaired and relentless states of anxiety, depression, and fear become the norm. Then, other elements complicate the core issues. Certain disorders, often of the PTSD variety, are so intense they are manifested in physiological ways. Cultural pressures and influences as well, ranging from a media emphasis on slimness encouraging eating disorders to something of an exaltation of the disorder by pharmaceutical companies, virtually foster disorders. In all of this however, and in cases of disorders not biological in nature and/or so extreme as to create lasting trauma, there exists the consistent element of the individual’s participation. This may not be cognitive; it most likely rarely is. It may also be due to the real and debilitating effects of the disorders as weakening resistant abilities. Nonetheless, the cycles of a psychological disorder cannot occur without some level of actual assistance from the sufferer. This being the reality in cases of all but the most severe illnesses of this nature, it is then reasonable to hold that a degree of self-inducement is present in the majority of psychological disorders.
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