Anglia Ruskin University Psychopathology Case Study 3 Word Count 1450 excluding references This essay is based on the case study of Kate Kate is a young female who is recently single following an unex.
Anglia Ruskin University Psychopathology Case Study Word Count: 1450 excluding references This essay is based on the case study of Kate Kate is a young female who is recently single following an unexpected traumatic break-up with her partner Kate had a dysfunctional childhood, due to her parents being substance dependant and divorcing at an early age Kate’s Mother has bipolar and her Father died of a heart attack Based on the information provided, it can be hypothesised that her psychopathological diagnosis is border line personality disorder, comorbid with anxiety and depression The case study will formulate an understanding of Kate’s underlying psychopathological disorders following the theoretical models of psychodynamic and cognitive approaches The Psychodynamic approach was founded by Sigmund Freud Freud has been a huge influence in psychology and is his work is still used today (Glassman & Hadad, 2013) The Psychodynamic approach findings were largely based on Freud’s subjective case studies, and provide minimal empirical evidence and much of the work is queried today for its falsifiability The contrasting model is the Cognitive Approach Cognitive psychology was introduced in the 1960s by Aaron T Beck The underlying principles are based on providing a cohesive narrative of the patient’s internal world Evidence and findings are obtained by objective measures, including questionnaires and formulating models (Beck & Beck, 1995) The Psychodynamic foundations centre on the notions that a dysfunctional relationship with parents in early childhood are a determinant for the development of psychopathologies in adulthood This can be taken into consideration when reflecting on the patient’s childhood It can be assumed that Kate’s parents were distant and displayed an inconsistent parenting style When a parent suffers with addictions, they unable to provide consist attention to children Kate states: “It was basically a case of who was most able to look after me at the time” Showing evidence of an insecure attachment style Self-criticism and dependency are proposed personality dimensions the confer a vulnerability to developing depression Research from (Luyten, Sabbe, Blatt, & Meganck, 2007) investigated diagnostic specificity of these traits, and their relationship with severity of depression, gender differences and specific symptoms They found, self-criticism was strongly related with higher severity of depression, with medium effect sizes of dependency and larger for self-criticism “omen showed higher levels of dependency than men in the depressed group, and dependence and self-criticism may be effect of depression and not a cause Object relations theory (Lubbe, 2010) identifies depression as a pattern of insecure attachment, set by the foundations established in childhood and progresses into adult life A study from (Herbert, McCormak, & Callahan, 2010) investigated the relationship between attachment of both friends and parents and made comparisons with symptoms of depression The results supported perceptions that childhood attachments and adult peer attachments, are predictive of current depressive symptoms Object relation theories speculate depression can arise from fearing the loss of an important and loved object, adopted in early life, and extends to being repeated in adult relationships (Kaslow & Magnavita, 2002) In the understanding of personality disorders, defence mechanisms are a central aspect to understanding the pathology and development of the ego Patients diagnosed with borderline personality disorder use a variety of defence mechanisms, such as repression In respect to this case, the patient may have repressed memories of childhood trauma or of the death of her father (Cooper, Perry, & Arnow , 1988) provide empirical evidence on studying defence mechanisms, evaluating the effect of Rorschach defence scales They concluded that the scales can predict aspects of psychological functioning, regarding interpersonal relationships and tendencies towards self-destructive behaviour, but are not able to accurately detect specific defines mechanisms Further research from (Davidson & MacGregor, 1998) established that individuals with experienced early traumatic relationships and repressed memories are a factor of greater risk to mental health disorders The psychodynamic theory focuses on internal conflict and explains that experiencing thoughts of low self-worth and harbouring feelings of guilt, blame and anger, are a product of ongoing unconscious conflict in the mind This can manifest in an individual as symptoms of anxiety A study from (Shevrin, 2012) focusing on patients with anxiety disorders aimed to measure unconscious conflicts contributed towards symptoms of anxiety Underlying conflicts were inferred by the researcher and their symptoms measured on a scale They concluded that those with unconscious conflict scored greater, than those without, but further research should be considered as a direct measurement of unconscious conflict is not possible In contrast to the psychodynamic approach, the cognitive model considers personal beliefs and not behaviour, and argues that psychopathology results from patterns of negative thinking Behaviour, emotional and occasionally physical symptoms can occur from abnormal cognitions (Beck & Beck, 1995) (Beck A T., 1967) argues that personality disorders assign individuals to behave in dysfunctional ways because of negative internal beliefs Core beliefs are assumptions held about the world, other people are ourselves When the individual’s belief system is distorted are biased, this causes situations to be misinterpreted Dysfunctional behaviour can result in provoking reactions from the outside world which are consistent with the internal beliefs, and strengthening the initial incorrect belief (Beck A T., 1967) theory of depression argues that people who negatively appraise events are prone to depression The underlying mechanisms contributing to depression are: a cognitive triad of automatic negative thinking, including thoughts about the self, the world and the future In respect to the current case, Kate experiences thoughts of “not being able to move forward” and feels “she has nothing to offer” Examples of these negative thinking patterns arise naturally and automatically Negative schemas are personal expectations and can be beliefs that are negative and pessimistic in nature (Beck A T., 1967) argues these schemas are acquired in early life following from a traumatic event Traumatic events are defined as death or a loved one, dysfunctional parenting or relationships and bullying or exclusion from friendship groups Depressive schemas are dormant, but will be triggered following a stressful life event, influencing how the experience is interpreted and the development of dissatisfaction from the event Evidence from (Brown & Harris, 1986) conducted a longitudinal study on females, measuring personal support, levels of self-esteem, psychological disorders and personal life events They found that those who were diagnosed with depression had experienced traumatic life events in the last six months They concluded that those who had personal support were less likely to experience depression, and those without pose a greater risk of relapse And suggested poor intimacy and care from a parent in childhood is closely related to a poor self-image in adulthood External validation from others is a source of selfregard and those exposed to poor care in childhood are more likely to underestimate their own worth (Seeds & Dozois, 2010) Studied the interaction of negative self-schemas and negative life events of those diagnosed with depression There report found that those with cognitive vulnerabilities, such as negative schemas, contributes to the onset of depression (Ingram, Miranda, & Sagal, 1998) However, those without cognitive vulnerabilities experience stressful events with appropriate levels of negative mood and thoughts, and does not necessarily result in onset of depression (Seligman & Maier, 1976) Provide a cognitive model of depression called learned helplessness Seligman’s theory argues depression can occur when someone learns their attempts to remove themselves from a negative situation makes no difference to the negativity of the situation Consequently, they can become passive and remain stuck in the negative situation, and no longer are motivated to escape This theory relates to this case and explains a small number of symptoms to an extent, but it fails to consider causal cognitions (Golib & Colby, 1987) Studied people who have previously suffered with depression and those who have not, they found that those who had been depressed showed no differences when viewing their situation with attitudes of learned helplessness Suggesting helplessness could be a symptom of depression and not a cause In conclusion, it is important to consider the relationship between both approaches, and how they explain psychopathologies One theory does not fit everyone and comes down to the individual experiences The psychodynamic theory was argued by Freud as a universal model of development for all, focusing on past events It has evolved and been modified over time, there is evidently observable evidence for his theories, but they remain unable to be falsified In comparison to the cognitive model, it is passive and assuming Whereas, the cognitive model considers the interaction between maladaptive thinking and core belief systems and how they interact with depression and anxieties It is based on a construction of models and lays out foundations, with an objective means of measurement, focusing on aspects of the present, taking a holistic approach References Beck, A T (1967) Depression: Causes and treatment Philadelphia: University of Pennsylvania Press Beck, J S., & Beck, A T (1995) Cognitive Therapy: Basics and Beyond Brown, G W., & Harris, T (1986) Stressor, vulnerability and depression: a question of replication Psychological Medicine, 16(4), 739-744 Cooper, S H., Perry, J C., & Arnow , D (1988) An emperical approach ti the study of defense mechanisms: Reliability and preliminary validy of the Rorschach defense scales Journal of Personality Assessment, 55(6), 187-203 Davidson, K., & MacGregor, M W (1998) A Critical Appraisal of Self-Report Defense Mechanism Measures Journal of Personality, 66(6), 965-992 doi:10.1111/1467-6494.00039 Glassman, W E., & Hadad, M (2013) Approaches to Psychology: Theoretical Foundations In Approaches to Psychology: Theoretical Foundations Golib, I H., & Colby, C A (1987) Treatment of depression: An interpersonal systems approach Pergamon Press Herbert, G L., McCormak, V., & Callahan, J L (2010) AN INVESTIGATION OF THE OBJECT Psychoanalytic Psychology, 219-234 Ingram, R E., Miranda, J., & Sagal, Z V (1998) In Cognitive vulnerability to depression New York: Guildford Press Kaslow, F., & Magnavita, J (2002) Comprehensive handbook of psychotherapy New York: Wiley Lubbe, T (2010) Object Relations in Depression A Return To Theory Hoboken: Taylor & Francis Luyten, P., Sabbe, B., Blatt, S., & Meganck, S (2007) Dependency and selfcriticism: Relationship with major depressive disorder, severity of depression, and clinical presentation Depression and Anxiety, 24, 586-596 Seeds, P M., & Dozois, D J (2010) Prospective evaluation of a cognitive vulnerability-stress model for depression: the interaction of schema selfstructures and negative life events Journal of Clinical Psychology, 66(12), 1307–1323 doi:10.1002/jclp.20723 Seligman, M., & Maier, S (1976) Learned Helplessness: Theory and Evidence Journal ol Experimental Psychology, 105(1), 3-46 Shevrin, H (2012) University of Michigan Health Retrieved from http://www.uofmhealth.org/news/unconscious-anxiety Psychopathology MOD002515 PSYCHOPATHOLOGY In psychology, there are key principles and concepts of different models that help a psychologist understand a patient’s issue In the case study, Sophie is a 66-year-old woman who has been referred by her GP to the community mental health team following a physical check-up in which she described feeling “useless” and “lonely.” Her closest confidant, the husband, died some years earlier and she has been feeling the worst feelings possible In the following discussion, the author analyzes the case study based on psychodynamic and social approaches in understanding the problem in the case study Brandwein (2011) reports that the approach combines all the theories in psychology, especially the idea that human’s actions are affected by the unconscious from different aspects of the patient’s life The theory, developed from Sigmund Freud’s ideas postulate that a person’s feelings and behavior are influenced by a variety of factors The basic assumptions of the approach are, first, that human behavior is affected by the unconscious (Greenson, 2016) Secondly, the approach argues that a person’s behavior and feelings are rooted in childhood experiences, and that all actions are determined by the unconscious As the following discussion shows, psychodynamic approach can be used to understand the issues bedeviling the client The first concept of the approach is that human behavior is determined by the unconscious Wilson (2004) asserts that the unconscious part of the mind consists of mental processes which the conscious mind cannot access Freud (1916) had earlier theorized that the mind is the primary source of human behavior and that the most important part is the unconscious part that a person cannot see Bornstein (2015) says that psychodynamic perspective emphasizes unconscious psychological processes The idea behind psychodynamic is that the issues individuals have and not resolved are usually pushed into the subconscious and subsequently affects a person’s behavior PSYCHOPATHOLOGY Freud (1916) postulated that the conscious and the unconscious part of a human mind usually come into conflict producing a phenomenon called depression In majority of the cases, a person stores the undesired experiences they are not prepared to deal with in the unconscious mind, and they usually exploded bringing forth psychological issues In Sophie’s cases, she had a rough life that caused her current psychological situation Sophie is a caretaker; she used to take care of her parents, siblings, and later her husband In all these situations, it was not ideal because the majority of the people she had to take care of were unwell and emotionally draining Hence, according to psychodynamic approach, she repressed these feelings, pushing them into the unconscious mind Her current problems are a manifestation of the issues in her life she has repressed into the unconscious mind Bateman, Brown, and Pedder (2010) noted that early childhood experiences play role in future psychological underpinnings of the concerned person According to the approach, traumatic childhood events have a significant influence on how adult live their lives and their psychological situations Traumatic events that occur in childhood are usually pushed into the subconscious (as discussed above), but later causes problems because they have never been resolved Sophie had a rough childhood She had to take care of her sick mother while at the same time ensuring the family was cared for because her father was a drunk who did not look after the family’s interests These early childhood experiences of taking care of sick people could be the reason she is feeling “useless” and “lonely” because she has no one to take care of Robinson and Gordon (2011) argues that psychodynamic approach is further based on the assumption that nothing in the mental sphere of a person happens by chance From Freudian thoughts, psychodynamic theory is strongly determinist because it assumes that a person’s behavior is affected by unconscious issues which the individual has not control over (Freud, PSYCHOPATHOLOGY 1916) The subconscious thoughts and feelings can affect the conscious mind by revealing those issues that are deeply rooted in the mind to the extent that the conscious mind articulates them In the case of Sophia, her rough childhood, later taking care of her sick husband and the abandonment that followed after his death are the reason she is feeling lonely and useless The social approach in understanding psychological issues argues that an individual cannot be understood without examining her social context (Feldman and Lynch, 1988) In the social context, Sophie’s psychological issues can be explained by studying social connection she has with her parents, friends, institutions, and wider society (Tew, 2011) When she was a child, Sophie was entrusted with taking care of her sick mother Being a second born, she was also obligated to take care of her siblings because her mother was sick and the father was an accomplished drunk She had to work variety of jobs to ensure the people around her were well taken of, while later in life she had to take care of her sick husband These are the social context that Sophie grew up and currently lives in A study carried out by Reicher, Spears, and Haslam (2010) demonstrated how people identify themselves socially and how the same identification affects their thinking In the case of Sophie, she identified herself as a caretaker to the extent that when she did not have someone to look after, she felt “lonely” and “useless.” At a young age, she had to take care of her mother and was also entrusted with ensuring that the family was intact Further, at the age of 15, she had to drop out school to look for work because she needed to take care of her family Later, as an adult, she had to take care of her sick husband and his death left her with no one to take care of PSYCHOPATHOLOGY The experiences in relation to other people had a tremendous effect on Sophie’s life leading to the feeling she has at the age of 60 years Throughout her life, Sophie was forced by circumstance to take care of family members to the extent that she felt she was a “warrior” fighting for a healthy course At the age of 66, with no one to take care of, she felt “useless” and “lonely” because she was used to taking care of people in need Therefore, she was unable to be at peace psychologically because she did not have someone to look after The social approach explains her situation because she was used to be the caretaker of people around her, and in the current situation where she has no one to take care of, she feels “lonely” and “useless” and not the “warrior” she is used to being As postulated by Smith, Mackie and Claypool (2014), the social context in which a person finds herself in is influential on her subsequent behaviors and thoughts Sophie had always considered herself a “warrior” who is able to take care of others, and right now she feels “useless” because she has no one to take care of Further, she is afraid of seeking help, whether from her family members or a mental institution because she is afraid such a decision will make her appear weak and vulnerable Therefore, taking care of weak and vulnerable family members had a tremendous impact on how Sophie behaved later in life and the reason for her current psychological problems The two approaches in analyzing Sophie’s case have some similarities and differences Regarding similarities, Glassman, Glassman, and Hadad (2008) report that the two approaches contend that early childhood experience have a significant impact on the psychology of an adult According to Freud (1916), early childhood experiences are important in analyzing a patient’s psychological issues On the other hand, Glassman, Glassman, and Hadad (2008) say that a child’s familial connections have a significant impact on the concerned person’s adult life Thus, PSYCHOPATHOLOGY both approaches believe that the relationship Sophie had with her family member could explain the current psychological crisis she is experiencing However, the two approaches diverge on one pertinent issue regarding the causes of psychological problems Sophie is facing According to Freud (1916), the unconscious is responsible for some of the repressed feelings Sophie has, which is manifested by her current psychological conundrum On the other hand, the social approach argues that what is happening to Sophie is based on the quality of the social context she grew up in (Brooks, 2012) Therefore, according to psychodynamic approach, repressed unconscious feelings can be used to explain what is happening to Sophie, while the social approach postulates that it is the societal context that best explains her predicament In a nutshell, the two approaches can be used to explain the cause of Sophie’s problems First, psychodynamic approach shows that taking care of her family engraved in Sophie’s subconscious a care take attitude, which later affected her when she did not have anyone to take care of Secondly, the social approach shows that Sophie’s social life was filled with issues which later affected her psychological state Thus, the two approaches are helpful in determining the issues bedeviling Sophie PSYCHOPATHOLOGY Brandwein, D (2011) Psychodynamic Approaches In Encyclopedia of Child Behavior and Development (pp 1174-1176) Springer US Bornstein, R (2015) The Psychodynamic Perspective Feldman, J M., & Lynch, J G (1988) Self-generated validity and other effects of measurement on belief, attitude, intention, and behavior Journal of applied Psychology, 73(3), 421 Bateman, A., Brown, D., & Pedder, J (2010) Introduction to psychotherapy: An outline of psychodynamic principles and practice Routledge Robinson, M D., & Gordon, K H (2011) Personality dynamics: Insights from the personality social cognitive literature Journal of Personality Assessment, 93(2), 161-176 Tew, J (2005) Social perspectives in mental health: Developing social models to understand and work with mental distress Jessica Kingsley Publishers Reicher, S., Spears, R., & Haslam, S A (2010) The social identity approach in social psychology Sage identities handbook, 45-62 Smith, E R., Mackie, D M., & Claypool, H M (2014) Social psychology Psychology Press Glassman, W., Glassman, W E., & Hadad, M (2008) Approaches to psychology McGraw-Hill International Freud, S (1916) The future of psychoanalytic therapy The Psychoanalytic Review (19131957), 3, 215 Brooks, D (2012) The social animal: The hidden sources of love, character, and achievement Random House Incorporated Greenson, R R (2016) The Technique and Practice of Psychoanalysis: A Memorial Volume to Ralph R Greenson Karnac Books Wilson, T D (2004) Strangers to ourselves Harvard University Press PSYCHOPATHOLOGY Psychopathology Coursework 2017-18 Case Study Sophie is a 66-year-old woman who has been referred by her GP to the community mental health team following a physical check-up in which she described feeling “useless” and “lonely” The GP was also concerned that Sophie had not been eating well or looking after herself properly and suspected she might be suffering from depression Sophie lives on her own in a small village Her husband John died three years ago (he had dementia and vascular problems) For the last year of his life, John was very unwell and had significant memory impairment and became very dependent on his wife, Sophie Sophie dedicated herself to looking after him; a role which could be quite physically and emotionally exhausting Because of her caring commitments, she had to give up other activities including voluntary work and a book group Sophie was the second oldest of four children Her sister Clare (the youngest one) is still alive but her two sisters have both passed away Her mother died young and was often unwell during Sophie’s childhood Sophie recalls her mother as “kind but never really happy”, and explains that she often had to look after her mother and siblings whilst growing up Her father was a heavy drinker and she describes him as “very harsh” Sophie left school aged 15 and then worked on the land to raise money for the family She later went on to attend evening classes where she studied geography, English and IT She worked in various jobs throughout her career, most recently as a receptionist in a dental surgery Sophie met John at college and they married aged 22 She describes him as a “wonderful man” but one who “always worked too hard” They were both looking forward to retirement together but “everything changed” after John became unwell They had two children, a son and a daughter, both of whom now have families of their own Sophie retired from her job aged 65 She enjoyed her work, and had been with the same firm for 26 years Sophie describes herself as a “worrier” She says she has never felt very confident in herself, and often worries that other people see her as “foolish” Just recently, she has been worried about being referred to mental health services and people finding out and thinking she’s “losing it” Since her husband’s death, Sophie has found it hard to re-engage with activities she formerly enjoyed, saying she simply “doesn’t have the will” Sophie says she can’t seem to concentrate on books any more, and remarks “I never have anything clever to say anyway” She has also been experiencing frequent headaches and worries about her memory She found it tough turning 60, she says, as “it seems so old” Sophie largely confines herself to the house and spends most of the time on her own She sees her family only occasionally as they live a long way away Sophie says she wishes she was closer to her children and grandchildren but she tends to wait for them to make contact as she is “sure she annoys them” and “doesn’t like to burden them” with her problems Her sister Claire says that Sophie is someone who “always puts others first” and has been encouraging her to think about her own needs at this time Case Study David is a thirty-five-year-old veteran of the British army, who returned from a tour of duty in Iraq five years ago and now lives with his wife Ruth and their two children Whilst he was in Iraq, an improvised explosive devise blew up several metres from the vehicle he was driving David suffered severe burns to his face and neck as well as significant spinal injuries He has undergone extensive medical treatment and now walks with the aid of crutches David lost two of his close friends in the incident Since his return from Iraq, David has found it difficult to readjust to civilian life He describes feeling like he “can’t be the man he was before” He finds images of Iraq popping into his mind seemingly out of the blue Particularly terrifying is the feeling of helplessness that often comes with these memories, which he connects with being trapped inside his vehicle and unable to help himself or his fellow soldiers David rarely talks about what happened, often dismissing the topic with comments like “you’ve just got to put it behind you” He says: “a lot of it I can’t remember very clearly” He acknowledges, however, feeling “wracked with guilt” about the fact that his friends didn’t survive, frequently asking himself whether there were things he could have done to prevent it David is an only child and grew up in Manchester His parents were young when they had him and he describes his childhood as “kind of chaotic: there was always someone staying or some party to go to” His parents divorced when he was 11 which, he says, was “really sudden and unexpected” Not long after then, he went through a period when he became “pretty anxious and obsessive - worrying all the time about locking doors and stuff.” David ended up dropping out of college (“I was never one for sitting at a desk all day”) After working for a while as a car mechanic, he joined the army aged 23 He says, “I guess I liked the routine It felt like a second home” Ruth is worried that David has become more emotionally withdrawn, and struggles to be affectionate with her and their children He finds it difficult to talk about what happened in Iraq and Ruth feels he is “pushing away the good things as well as the bad” She describes him as “tetchy” and says he will sometimes “fly off the handle” at little things She struggles with what she describes as his “military behaviour” – wanting things to be “just so”, getting stressed and annoyed if things don’t go according to plan David spends most of his time at home, doing what he can around the house and “trying to figure out what to with my life” He finds it difficult to relax and is often tense and on edge He describes feeling “like his body is still in Iraq” – on the lookout for the enemy – and says: “it’s just as well to be alert; you never know what anyone is capable of” David is diligent with his physiotherapy and keen to get back into work He can no longer drive on account of his injuries, and avoids public transport because being in a vehicle “brings it all back” In fact, he generally avoids crowded places altogether, explaining “I can’t tell how my body’s going to react – it’s easier just to stay at home” A few times now he has found himself overwhelmed with panicky feelings whilst out He says, “it’s like something is broken in my body, I have no control over it I can’t stand that.” Case Study Kate is a 29-year-old woman who has has been referred for an urgent psychiatric assessment following a tumultuous few weeks which have left her feeling extremely low to the point where she has been experiencing suicidal thoughts The trigger for Kate’s recent distress was the breakup of her relationship with her partner Paula Kate and Paula had been together for three years Kate says that the difficulties had been brewing for some time but “she never thought it would really happen” because “we’ve been through so much together and understand each other so well” The breakup came about as a result of frequent explosive arguments, often centred around a recurring dynamic whereby Paula experienced Kate as “possessive” and “hot-headed”, and Kate experienced Paula as “rejecting” and “cold” Kate was born as the younger of two children Her parents had a volatile relationship which was at times violent They separated when she was 12 and Kate grew up living “between her parents” She reflects: “it was basically a case of who was most able to look after me at the time” Her mother had bipolar disorder and a history of drug use, and spent periods of time in hospital She is now well and lives nearby, although Kate describes their relationship as “tortured” Her father worked as an actor and was often away on tour He had a history of alcohol use and died from a heart attack when Kate was just 23 Kate did well at school and enjoyed acting and dance She went on to drama school but had a tough time making friends and ended up feeling quite isolated She describes constantly comparing herself to others and feeling she had “nothing to offer” She tried hard to play “the glamorous actress”, she said, but underneath it all was this “constant feeling of inadequacy” Kate describes how she would often form strong attachments to others but inevitably “there would be some disappointment at some point” She would often then find herself feeling very hurt and angry She says, “I’d usually end up blaming and hating myself” It was at this time that she began to start bingeing and making herself sick She describes how food became “her only comfort” but at the same time left her feeling “disgusted” with herself A couple of years after her father died, Kate went through a really tough period when she experienced periods of very low mood and disordered eating She was diagnosed with depression and then later borderline personality disorder, and received therapy and psychiatric medication from a community mental health team The therapy was helpful, she says, but “it was meeting Paula that really restored my faith in myself” Kate feels that without Paula she “has nothing – that she is nothing” She feels deeply depressed and cannot see how she can move forward She describes living in “a state of nervous exhaustion” – hardly sleeping or eating Her mother has moved in to live with her as she is very worried about her daughter ... reports that the approach combines all the theories in psychology, especially the idea that human’s actions are affected by the unconscious from different aspects of the patient’s life The theory,... asserts that the unconscious part of the mind consists of mental processes which the conscious mind cannot access Freud (1916) had earlier theorized that the mind is the primary source of human behavior... their attempts to remove themselves from a negative situation makes no difference to the negativity of the situation Consequently, they can become passive and remain stuck in the negative situation,