PSYCHODYNAMICS of RESIDUAL SCHIZOPHRENIA

PREDISPOSING FACTORS

Psychological Factors Psychodynamic theorists believe that schizophrenia involves regression to a pre-ego state of primary narcissism and restitutive efforts to reestablish ego control. Behaviorists theorize that schizophrenic people fail to attend to relevant social cues and as a result develop bizarre responses to the environment. The family explanation for schizophrenia holds that family environment contains such confusing elements as a schizophrenic mother, double-bind communications, marital schism and marital skew. R. D. Laings theory states that schizophrenia is actually a constructive process by which people try to cure themselves of the confusion and unhappiness caused by their social and family environment. Cognitive theorists contend that when schizophrenic people try to explain their biologically -induced hallucinations or other strange sensations, they develop delusional thinking. Their logical processes lead them to delusional conclusions. Most clinical theorists now agree that schizophrenia, in whatever form, can probably be t traced to a combination of factors such as these.

Socio-cultural and Environmental Factors Some theorists proposed that poverty, society, and cultural disharmony could cause schizophrenia or that people chose to become schizophrenic to cope with insanity of the modern world. Others proposed that schizophrenia was caused by living in the city or living in isolation in the country. An enduring and consistent finding has been the strong association between schizophrenia and lower socio-economic status. This unenviable status enhances their vulnerability by exposing them to constant s stressors.

-Mr. Mucho Choco he grew up in Tondo, Manila. He experienced being threatened by Boy Lopez which influenced him to do vices such as smoking and influenced him to be the cause of trouble in their place. He failed in studying Dentistry.

-Mr. Mucho Choco has claimed that he used to be cared for by his parents when he was still young. He grew up very protected and cared for.

Biological Factors Genetics: Based on the principle that some people inherit a biological predisposition to schizophrenia, is supported by studies of several kinds, including twin studies, adoption studies, and chromosomal mapping studies. - According to our client, his older brother had schizophrenia. Biological Views: This attempt to identify the biological abnormalities that are inherited or developed by persons with schizophrenia. The two most likely candidates are biochemical abnormalities and abnormal brain structures. The predominant biochemical explanation of schizophrenia focuses on an unusually high level of activity in neurons that used the neurotransmitter dopamine. There is evidence that the brains of schizophrenic people contain Health Factors Psychological Factors an unusually large number of dopamine receptors. In addition, modern brain imaging techniques have detected abnormal brain structures in Mucho Choco misses his family. He talks about -Information-processing overload: Too much - Mr. schizophrenic people. The most typical abnormality is the presence of enlarged ventricles. -Unfortunately, the tests needed are not done.

information is sent at the same time to be filtered his Kuya Boy. by the frontal lobe. In schizophrenia, the frontal lobe -His best friend is Darwin. loses its ability to slow down the transmission and PRECIPATING FACTORS reception of stimuli, causing an overload. - Mr. Mucho Choco experienced intimate relationship with Jinky, Hazel, and Marichel but because of -Abnormal gating mechanism: This is manifested by his illness he was left and longing for love. the inability to selectively attend to stimuli. -Undergoing the degeneration process; Diminished cognitive functioning; Diminished judgment ability - He has expressed difficulty in speaking and interacting with others.

Environmental Factors - Client is usually left alone in the house or is left with the helper. - Some of his relatives avoid him because they fear that he might hurt them. - He lives with his family, but when he failed in his study misunderstandings started between him and his father.

Health: Poor nutrition; Fatigue; Lack of exercise Environment: Social isolation; Stigmatization; disruption in interpersonal relationships; lack of social support; inability to mingle with other people. TRIGGERING FACTORS Attitudes: Low self-concept; lack of self-confidence; poor social skills; history of violent behavior; feeling overwhelmed by symptoms; difficulty in expressing emotions.

Stressors: inadequate food; social isolation; poor support system; lack of friends; inability to express emotions and control anger. Experiences and develops crisis Tries to cope with crisis using habitual-problem solving response and adaptive coping mechanisms.
Projection - Client verbalized, that he would concentrate on playing guitars and listening to music -Failure to acknowledge an of The Beatles and Air Supply to keep his mind occupied. He used to go out on -Unconscious blaming of unbearable condition; failure to weekends and mingle with girls and smoke 1 dozen of cigarette a day. He never unacceptable inclinations mentioned friends. Smoking for our client was a way for him to relax. or thoughts on an external - When asked about his problems he always answer, "Ok raman to. Wala naman...Ayos lang." Denial

Failure to be relieved from crisis causes increase in tension

Reaction Formation -Development of conscious attitudes and behavior patterns that are opposite to what one really feels or would like to do. DEFENSE MECHANISMS -Inappropriately smiles while talking about his problems.

object. Projection relates to the development of paranoid delusions and auditory hallucinations. Our client suffered from visual and auditory hallucinations prior to admision. verbalized, "May anghel at demonyo akong nakikita sabi nila punta ka rito sa amin.

Impaired ego integrity

Negative Symptoms -Lapses of incoherence. - Inappropriate affect: smiles while talking about his life. - Poor rapport with others - Short attention span, and brings up the same topic again and again - Has trouble sequencing events prior to his illness, but can clearly remember events after that. - Has difficulty in expressing his feelings and dealing with them appropriately, as claimed Positive Symptoms - Violent behavior: boxed his co-resident. - Had visual and auditory hallucinations before admission - Mannerism

Residual Schizophrenia

PSYCHOPATHOLOGY of RESIDUAL SCHIZOPHRENIA (Based on the Theory of Erik Erikson)

NEUROSTR

Failed in his study

Started vice such as Smoking

Misunderstanding with his father Intimate relationships with 3 women Confinement in mental institution Separation from family

Cause of trouble in Tondo with Boy Lopez

Low self-esteem

WEAK EGO

PSYCHOPATHOLOGY of RESIDUAL SCHIZOPHRENIA

BIOCHEMICAL AND NEUTROSTRUCTURAL THEORY

DEPRESSION Feeling of Withdrawal

Problems in ADLs Problems in Metabolic Activity

Cause of Deliquency

Decreased Amount of cerebral blood flow in the pre-frontal lobe of the cerebral cortex Increased demand in cognitive functioning

Marked changes in the process of organizing, planning, learning from experience Prolonged use of coping mechanisms Failure to be relieved from crisis causes increase in tension Impaired ego formation

Progressive deterioration of personality