PSYC 356 Lecture Notes - Lecture 5: Truancy, Age 13, Derealization
4 Jun 2018
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Psyc356 – Oct. 27, 2017 1
Psyc356 – Oct.27.17
• Writing assignments:
o There are several possible diagnoses, so mention them
▪ Look at possible diagnoses and list the appropriate symptoms associated
with that disorder. Do this for all possible diagnoses in the assignment
o Reasonable discussion on comorbidity and why it’s difficult to have one diagnosis
only
o Speak about treatment in general terms. Pick a therapeutic orientation (or not, but
it’s easier), and how you would approach treatment from that orientation. Pick a
treatment, three things or so that have to do with that treatment, and you’re good
• Que-ggestions:
o Watch out for margins again, as the deduction is pretty large
o Why do people stay in abusive relationships?
▪ It comes down to what the person expects of others. It could stem from an
attachment relationship, or even just a pattern of what they expect a
boyfriend should be.
▪ Ex: woman who has history of abusive boyfriends thinks that her new one
is a great boyfriend because he never hits her. Maybe he is a great
boyfriend, but if that’s her standard (‘he doesn’t hit me’), then it’s a
couple shades of fucked up.
▪ “love is not enough of a reason to be with somebody. If that’s all you
have, then you’re in trouble” – Martin
▪ “The other side of love is being in pain. It’s beautiful. If you don’t have
pain, then you don’t have love” – Martin on a clip from Louis CK
▪ Davidson obliterates the friend zone. “one you develop those feelings for a
friend, your friendship is over. You either say nothing and resent yourself
when they start dating other people, or you say something and either date
or get rejected. It’s over, so you might as well say something now”.
• At this point, Martins struggles with the microphone clip and blames the AV people for
sabotaging him
Anxiety Disorders:
• Slightly different form DSM IV, because there are no anxiety disorders particular to kids
o Adults can now have separation anxiety (distress from separation with a loved
one, but specified as caregiver in DSM).
• Separation anxiety: Could be at school, extracurricular activities, whenever there’s
separation
o Super anxious whenever separation occurs
o Can be met with straight up refusal to attend school due to separation anxiety
o School system: once you’re here, you’ll be fine. Most of the time, once they settle
into school, they are fine. But it’s not unusual to hear stories about kids being
pulled out of cars because they absolutely did not want to attend school. In the
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Psyc356 – Oct. 27, 2017 2
situation, the parents feel a lot of pressure to get the kid into school and separated
from caregiver
o ‘something might happen’ to parental figures to make sure that we won’t get
reunited again. Sensitivity in physiological responses already, so experiences such
as parent being late escalates the worry and discomfort. This fuels the
physiological responses of heart beat increase, and this makes separation anxiety
take hold
o Sometimes there’s a lack of trust between the dyad, where the caregiver says
they’ll be there and don’t end up being there
▪ Ex: 16 year old kid had parent leave for a week, stay home for one night,
then leave again. Kid lost it on his parents, because he felt like they were
leaving him, and he became overtly aggressive as a result.
o CBT: exposure is good for anxiety. For separation anxiety, you would expose
them to being away from parents. For some kids, it’s difficult to get parents out of
the same room as the kid without a meltdown.
▪ Problem: you need to find the step that the anxiety is too much. If this is
an attachment issue (the relationship is the cause), then exposure won’t be
good.
▪ You will have to rebuild attachment relationship if the relationship is the
problem. Only then can you begin the exposure therapy. If there’s no trust
in the relationship, then this therapy won’t work at all
o “Developmentally inappropriate and excessive fear or anxiety concerning
separation form home or from those to whom the individual is attached”
▪ Three of the following:
• Distress when anticipating or experiencing separation
• Worry about losing major attachment figure, such as through harm,
illness, disaster, or death
• Worry about experienced an event that causes separation, such as
being lost, kidnapped, having an accident, illness
• Reluctance or refusal to go out
• Fear or reluctance about being home alone without major
attachment figures
• Reluctance to sleep away from home or to go to sleep without
being near attachment figure
• Repeated nightmares involving the theme of separation
• Repeated complaints of physical symptoms when separation from
major attachment figures occurs or is anticipated
▪ Fear/anxiety is persistent for at least 4 weeks in children/adolescents, and
12 months in adults
▪ Not explained by some other disorder, and must causes impairment to
their everyday functioning
• Generalized Anxiety Disorder (GAD)
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Psyc356 – Oct. 27, 2017 3
o Excessive anxiety and worry about a number of events or activities for at least 6
months
o Difficult to control the worry
▪ Someone who just worries a lot. Less theoretical than Separation Anxiety,
as GAD is like a label for someone who just worries a lot – Davidson
▪ Perfectionists might fall into this category (redoing assignments,
constantly seeking reassurance and approval) as there’s no better category
for them to fall under
o Anxiety and worry associated with 3 of the symptoms (only 1 for kids):
▪ Restlessness/keyed up
▪ Easily fatigued
▪ Difficulty concentrating
▪ Irritability
▪ Muscle tension
▪ Sleep disturbance
o Not better explained by other disorder
• Specific Phobia
o Marked fear or anxiety about a specific object or situation (flying, heights,
animals, injections, blood, etc.)
o Phobic object/situation almost always provokes immediate fear or anxiety
▪ Could be crying for kids, or tantrums, freezing, or clinging
o Want to see if anything else is going on underneath that might be the root of this
disorder. If there’s nothing else that can be found, then you just treat with CBT
o Fear is out of proportion to the actual danger posed by object or situation
o Specifiers:
▪ Animal
▪ Natural environment
▪ Blood-injection-injury
▪ Situational
▪ Other (loud sounds, costumed characters, etc.)
• Social Anxiety Disorders:
o Marked fear or anxiety about one or more social situations in which the person is
exposed to possible scrutiny by others
▪ Social interactions, being observed, or performing in front of others
o Doing something in front of others, you anticipate being humiliated or something
o Performance anxiety fits in this category
o Fear of acting in a way that will be negatively evaluated
o There’s a cycle; trying so hard not to be embarrassed or humiliated, so they plan
so much to prevent that, so they think through everything that might happen, and
analyze themselves so much. They scrutinize themselves so much, and are real
assholes to themselves. You turn into somebody who hates yourself, because you
want to be ahead of all this in your interactions. They project and expect others to
be this way too
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Document Summary
Psyc356 oct. 27. 17: writing assignments, there are several possible diagnoses, so mention them. Look at possible diagnoses and list the appropriate symptoms associated with that disorder. Do this for all possible diagnoses in the assignment: reasonable discussion on comorbidity and why it"s difficult to have one diagnosis only, speak about treatment in general terms. Pick a therapeutic orientation (or not, but it"s easier), and how you would approach treatment from that orientation. It comes down to what the person expects of others. Maybe he is a great boyfriend, but if that"s her standard ( he doesn"t hit me"), then it"s a couple shades of fucked up: love is not enough of a reason to be with somebody. If that"s all you have, then you"re in trouble martin: the other side of love is being in pain. If you don"t have pain, then you don"t have love martin on a clip from louis ck: davidson obliterates the friend zone.
