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0:00
[cheerful music]
0:04
>> We're going to talk about psychological disorders. Take your clickers out for me, if you brought them.
0:15
Here's what I'd like you to do. Click it if you haven't yet. I'm going to ask you a series of questions.
0:28
Turn on your clickers real quick cause I'm going to turn this off and we're going to go to a series of questions. What I want to do is ask about your experiences
0:40
in your own families but also in interacting with the public
0:47
that is strangers out there about any encounters with people that you thought had a psychological disorder. And what I'd like to do today is just simply start the conversation about what psychologists know about certain kinds of disorders. The prevalency, the types, and the characteristics of some disorders, and then we'll go from there, so here's what I'd like you to do.
1:21
Let's start with the first question.
1:27
Alright question number one, yes or no, and it's just simply this, have you ever had an encounter with a person with a mental disorder while in public, like at a mall or a supermarket or the airport. Have you ever had an encounter with a person with a mental disorder while in public. A, yes; B, no.
1:48
Just by show of hands, we'll show this in a minute. But how many have had within the last maybe month or two an encounter, anybody, even recent like that?
1:59
That's a lot, we'll see with it here. For you, there are by far the vast majority, 320 some of you said you have had an encounter in a public location and very few of you, only 35 have not. Let me ask this, and it's the next question. A is yes, B is no, did you feel uncomfortable, in this encounter.
2:30
One of the things we're going to talk about is mental disorders often times lead to us feeling uncomfortable, and we'll talk about what that means. The unknown sometimes comes into play. You can see with the answers up here, about a little more than half, 2/3 said you did feel uncomfortable, 219, 134 said it didn't make you uncomfortable. Did you feel that the person's behavior was unpredictable? A would be yes, B would be no. Did you feel that the person's behavior was unpredictable,
3:06
unpredictable simply means you weren't sure what was going to happen next or how they were going to behave, which maybe caused the uncomfortableness for some, but was it an element of being unpredictable and
3:23
that seems to have captured even more, it's probably like 3/4 of you said yes, 267, 80 said it wasn't the unpredictability side, but maybe it was this, not unpredictable or both unpredictable, did the person seem dangerous. A yes, B no, did the person seem dangerous.
3:51
We'll talk a little bit about the relationship between psychological disorders and aggressive behavior,
4:00
or dangerous behavior to others, and we'll mention that here in just a minute. The answer by the way, for most of you, they didn't seem dangerous for 270 of you, but for a few, 75, it did feel there was something about danger involved, maybe to you. And let's start with a more personal question, are there any members of your family that suffer from an anxiety disorder, we'll talk about anxiety disorders being in the categories of phobias and panic attacks,
4:30
or something called obsessive compulsive disorders. Any members of your family that suffers from an anxiety disorder.
4:39
If you're not sure you don't have to answer, put B, but again it's all anonymous. The numbers by the way are: about 2/3 say no,
4:53
about 1/3, which is a good percentage, about 146 say someone in their family suffers from phobias, panic attacks, or obsessive compulsive disorder. Another personal question, are there any members of your family that suffer from schizophrenia.
5:10
This one usually you don't have to guess at, because often times it comes with a diagnosis you're familiar with, so are there any members of your family that suffer from schizophrenia. Does anyone know the percentage of schizophrenics? What likelihood you'll find in a given population? What is the percent of people who will suffer from schizophrenia, anyone know the number?
5:35
Well you'll know it by the end of today, answer, 28 people in here have a family member
5:44
that suffers from schizophrenia, 28. By the way it strikes on average one in 100 people. One in 100 people will be diagnosed with schizophrenia, and let's start with another one, somewhat personal question but it will give us an idea, and that is are there any members of your family that suffers from depression?
6:13
By the way I'm going to define all of these terms, not only anxiety and schizophrenia and depression, but even what a psychological disorder is, and I'll give you a chance, if you have questions about psychological disorders that you would like just to ask, write them down or raise your hand, and bring them up because today's the day, as well as next time we meet. By the way, as far as members that suffer from depression, almost half, 50-50 in this room.
6:42
So 160 people out of those that clicked in said that yes, someone in their family suffers, does that strike you as a big number or a little number? [students mumble] Half the students in here have somebody in their family that suffers from depression, that seems like a big number to me.
7:01
Alright, so it gives you a sense that what we're dealing with is a fairly wide spread
7:10
area of experiences that we have that
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disorders seem to affect most of us in here in some degree, shape or form, here's what we're going to do, we'll talk about what disorders are,
7:31
Agmonst still out there, how many have ever seen that show before, oh gosh, almost all of y'all.
7:37
How many love this show, it's a fun show, why do you like it so much?
7:42
Well, he's got a very interesting, I'll be honest with you, I've saw maybe, I don't know I've seen it once or twice I think.
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I'm assuming he suffers from something called obsessive compulsive disorder, and we'll talk about accurate reflections and are these accurate accounts when it comes to media's representations of some of these things.
8:08
So let's just start with a quick introduction, you don't have to put any of these numbers down, but this one is one of the most shocking numbers, and that is in of the percentage of the population reporting a mental disorder, in their lifetime, basically it's 50%. One half of all the people will eventually report a mental disorder. Now, that could be substance use disorder,
8:35
which you might recognize as someone that deals with an alcohol addiction or an addiction to another substance, as a good percentage of that, but anxiety disorders, one quarter of those will be in the area of anxiety, 20% in mood disorders, and about one percent of the time it's schizophrenia, what this says, what does this say to anybody, real quick, 50%, surprising number or not surprising? I'm going to say that's a pretty surprising number,
9:02
yeah, 50%, in their lifetime will report a mental disorder
9:11
at some time, in this the proportion of the population that meet the criteria of a disorder, again same kind of thing, these are the in any disorder meeting the criteria and these are the different ones which we'll talk about. One other key note, this is related to meeting somebody in a public place, you could have meet someone with a psychological disorder if you are in this country 40 years ago, it might not have been as prevalent or likely as it is today simply because of a change
9:46
in many of our law in how we treat somebody with a psychological disorder. For a long time, in-patients, that is somebody who was you could put into a hospital and leave there because of a mental disorder,
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there was a time in this country if you had a doctor and/or you could convince a person of authority that the person you were interacting with was disordered they could put them into an institution until they could prove they were not disordered.
10:20
So they would literally end up in places, now again you needed a doctor to confirm this, but it wasn't that difficult to put someone into an institution because you thought they were suffering from a psychological disorder. That has been changed now, so if you suspect that someone is they can go in to an evaluation period, but say I don't want to be here, you can't keep me against my will, and we, that is these state and institutions, will not keep you unless you're a danger to yourself
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or to somebody else, so a lot of individuals will say I don't need help, I'm not disturbed, I don't have problems, so they end up not being able to often times care for themselves, or get the help that they need but they're convinced they don't need it so they end up frequently on our streets living in places just trying to survive. And so this declining, right here, the slow movement down out of in-patient populations is correlated with an increase in people that are in out-patient treatment.
11:29
It has a lot to do with the way in which a person can now determine if they want to be hospitalized or not. Again, in some cases they don't have any choice. Danger to themselves, danger to others, they will be put into an evaluation,
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into a longer evaluation period. So, today the number of people that are dealing with major psychological disorders among our homeless is going up all the time. Probably the estimate is anywhere from 1/3 to 1/2
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of the homeless are dealing with a psychological disorder. Well this puts all kinds of pressure on people to actually even come up with what is, what does it mean that a person has a psychological disorder, let's start with that question. How do you know if a person has a psychological disorder? Some of you told me that you interacted with someone in a public setting and you believed they had a disorder. Tell me why you thought they did. [student inaudible] They were talking to themselves,
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is talking to yourself a sign of mental disorder? How many suffer from that on a regular basis, yeah? Half the hands went up.
12:45
But, there was something different about this wasn't there. This person, often times that we see is carrying on a conversation with themselves and nobody's there. I told you my story, right? About the person that was talking with themselves, talking to themselves as he walked past my office over there and was banging and yelling and screaming.
13:04
You remember that story.
13:08
There is something different when we talk to ourselves, it feels like, but when someone does this in a public setting we tend to think about it as that's not normal, what else, how else did you know or why did you think that this person was disordered? [student inaudible] Maybe what they were saying, like how they spoke, or?
13:30
Okay, maybe just there were some different things about their quality of speech, right? Their quality of speech influence that, yeah. >> Male Student: Having a conversation on a cell phone that had no battery. >> Okay, they were having a conversation with nobody on a phone that didn't work. [student mumbles] Um maybe for some we might think that they're showing un- what one would say normal emotional reactions to things. Right good yeah? >> Female Student: They don't pick up on social cues.
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>> Okay, there's a lack of knowing socially what's going on, or what's appropriate or what's not. [student inaudible] Body language tells us what, that they're feeling emotions intensely, or? [student mumbles] Okay there seems to be something off. Or erratic, strange behavior. >> Student: Mood swings. >> And massive mood swings. >> Male Student: Unaware of surroundings or too aware of surroundings. >> Okay, so he, great examples, ready?
14:36
The answer is it's really hard to define what's a disorder and what's not. There's a student who went to the school here who never one day in the four years that I saw her, I told you this, never wore shoes. In four year, not at the first day of classes and not at graduation and never in between. I never saw her wear a pair of shoes. Now in this part of the world, that's probably not that difficult, but is that weird?
15:00
It's a little different.
15:05
In Colorado I was lecturing just like this, to a class just like this at Colorado State when I was first starting, and there were doors, just kind of like this and there were trashcans outside of these doors and every Tuesday and Thursday, during my lecture time, a guy wearing a sombrero singing songs very loudly in Spanish, listening to, you know with the earplugs in, or headphones whatever over his head, singing out loud, very loudly songs in Spanish, wearing a sombrero, collecting cans
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from all of the trashcans.
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Is that a psychological, is he disturbed? Does he have a disorder? [students mumbling] His singing wasn't that good. [students laugh] But that doesn't mean he was disordered. Collecting cans, wearing a sombrero, all of these things are like, well there's something different about that, its' odd but does that make it a disorder? Bottom line, how we define disorders, there's no easy, straight-forward formula. If you're sad, and you stay sad for four days and you can't get out of bed for four days,
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do you have, are you suffering from a depressive disorder? Well, there are criteria that help. There are ways we begin to define disorders.
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What is abnormal?
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Is wearing a sombrero in this culture, right here where we're at in this location, is that abnormal?
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Some of you qualify with some of the things you wear, because, sorry, I didn't mean that about you.
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So what is it, how do we know this line, where does the light green separate itself out from the dark green, where do we draw it? Do we just say, oh yeah anybody here, that's abnormal.
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What would be some criteria we could use? [student inaudible] Is, are they successful, did the guy, maybe he made a living with collecting cans.
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Maybe he wasn't maladaptive at all, and was fairly adaptive, maybe that's a great criteria. Does it make him unable to be employed, or feed his family or himself, or. [student mumbles] Are they able to function. Well we start looking at some of these and there's just a real quick guide to how we define a psychological disorder, well the first one is are they statistically deviant. Does this, if the answer, by the way, you start to going down and you start to ask, is their behavior atypical.
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Do they have any sort of, the person who didn't wear their shoes, that's atypical. Give me some atypical behaviors that you've noticed around
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that's just statistically outside of the norm. >> Female Student: Wearing a cape. >> Wearing a cape. >> Student: Hey! >> Hey.
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[students laugh] Anybody else, maybe we won't do this then. [students giggle] I'll stick with my stories.
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This lady, who is she? [awkward laughter] She's a deviant, she's abnormal in one category.
18:28
Her name, Marilyn vos Savant. Remember me telling her story?
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Marilyn vos Savant, did I tell you this? She scored highest score ever on an IQ test.
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She has the highest score on an IQ test, she beat me by like one, I was so mad. [students laugh] I was like dang, that's bad, like that. But I used big words. [students giggle] So it is that, is that atypical, uh huh, is she on the fore-end, uh huh, nobody's out there with her.
19:05
That doesn't make her abnormal does it. Alright, the other thing is, another layer we have down from our previous, is it unjustifiable, does the person's behavior violate our cultural standards. Now wearing the sombrero, it kind of borderlined, I guess it violates some of our standards. If you dress up in cross-gender clothing, in most places, that's weird. That's what we call violating a cultural standard, but not all cultures. How about this woman, right there?
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Lady Gaga.
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Does that violate cultural standards? >> Students: Yes. >> Much of her behavior violates, does this mean she's abnormal? >> Female Student: Yes. >> No it doesn't.
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Doesn't mean she's abnormal, by the definition we're trying to get at, which is, for her, it's a little bit of an atypical and unjustifiable or weird, but does it cause emotional distress, that's another very important category, and I would definitely say this one is neither the person
20:18
who was barefoot or the person who collected cans while wearing a sombrero, nor Lady Gaga find emotional distress in their behavior. They don't say this is undesirable, I don't like this, I don't want to be here, this makes me depressed, I want out, I can't stop, right?
20:34
So there for, if it doesn't meet all of these criteria, we tend to not define it as a disorder. Is maladaptive, as someone said, does this person function and get along well, well adaptive usually means they can behave or act in a certain way that allows them to live a life
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in an adaptive way, that's another one. So, all that to say, in defining normality from abnormality, this is very, over time, it's changed by culture, we try to put these things on here so that if you put down a behavior that's both are, includes being atypical, unjustifiable, undesirable, and maladaptive, it gets a little bit easier to say yes, this is a behavior that seems normal, that clearly falls here in the abnormal, and it gives us a way of trying to define this.
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Still doesn't make it easy, yep.
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There are situations in which people do things that are very weird and different, if it happens by the way, I just want to make a real quick clarification, that if it happens in a legal setting, we call it impaired judgment, and so we define, the legal system would define impairment, and hence abnormality differently, they'd call it sanity or insanity. You've heard of an insanity defense? That goes with somebody who, what's the insanity defense mean? >> Male Student: It means that the person
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wasn't fully aware of what he was doing. >> A person who was not fully aware or unable to control their behavior is what we call impaired, so they are not treated the same way when it comes to convicting them of a crime they committed. If they committed a crime during a period in which they lacked self control and impaired judgment, what we call insane, you can actually, well, a guy who shot the president of this country, Ronald Reagan, the guy who shot him,
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John Hinckley, Jr. claimed that he was insane. By the way evidence was clear in his case that he was insane, and therefore he was convicted of a different charge than he would have been if he wouldn't have been insane. So John Hinckley, Jr., well one of the evidences that he was not in full control, believed that he shot somebody important like the president, that Jody Foster the actress would love him, and he believed, he had lots of issues that were going on.
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Now here's the thing with John Hinckley, Jr. He's still serving time but at a state hospital, for the criminally insane because he shot the president. But he can leave the day the went.
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He can leave, anyone convicted of a crime of insanity, should they serve whatever amount of time they had, they'll stay there until they can prove that they are sane. If you prove you're sane, you're out. That's it, because now there's no longer any danger that you're showing to society because you were insane at the time this happened and now you're sane. Does that make sense? Do you think a lot of-- how many believe a lot of people who are tried as a criminal or a felon, they go to court
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and they claim to be insane. What percentage do you think do that? They say, Oh I was insane at the time, I don't want to be convicted of this, I want a lesser charge, how many think that this is fairly common? Yeah, a lot of you, how many think it's like, I don't know, not that common, well, the answer is, it's exceedingly uncommon. It almost never happens.
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In less than one percent of all felons that are tried and eventually convicted claim the insanity defense, and the reason is it's still on our books as a humane society that allows this for individuals who suffer this, but to prove it, or to validate it, it's very difficult. Anyone from San Francisco area, your downtown are is known as what, what are your main convention centers called, called the Mascone Center, why is it called the Mascone center. How many saw the movie "Milk"?
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Remember it, George Mascone was the what of San Franciso? George Mascone was the major of San Francisco, he fired the city supervisor, two city supervisors, one named Dan White, and as he fired them, [student laugh]
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as he fired them, Dan White went home a city supervisor, believed that it was because he was outspoken critic of homosexuality, and that he went home, got a gun, climbed through a window to avoid a metal detector, went up to the major George Mascone, bam bam bam, shot him six times, killed him, went to the city supervisor next to him, Harvey Milk bam bam bam, shot him, killed him, and he went to court, went to trial, claimed a lack of awareness, of ability to have self control
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and impaired judgment, and that he ultimately convinced the jury and one of the arguments that showed and demonstrated that he was insane, was that the only thing he had eaten for the last six months were Twinkies, and there was evidence presented in court, I think it was three months, maybe not six, but either way, his only meal consisted, every meal of every day consisted of this and the jury went well, no one who's thinking rightly would eat a Twinky for that long
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and that often and that frequently, he was convicted not of first degree murder but of manslaughter and was released from his
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sentence about four years into after he was, about three to four years later, he was released. Which, by the way, he committed suicide a couple of weeks after being released, that was Dan White. All that big story to tell you, that insanity is not a psychological definition we deal with, what is a mental disorder, and to classify them from a psychological standpoint is very clear, though often times reupdated and edited versions of this book called the Diagnostic Statistical Manual.
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And in it, do you guys have one?
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If you go through a PhD or a PsyD program, or any type of training at the graduate level, you will probably own and buy this book. And inside this DSM, is it now DSM-5, has it come out yet, not yet but it's coming, and that's a revision of this, but inside you can see a listing of almost every psychological disorder, and it lists, it's aim is to name and describe all of these disorders, but it also says the criteria by which you would be able to diagnose somebody with this disorder.
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One of the characteristics, how frequently does a behavior have to occur, what are the likelihood of certain ages of being affected, let's say with clinical depression. And then what are the signs that would allow somebody to be able to name this and describe this disorder. Now, the criticism, or not the criticism, but one of the controversies is, once a person is given a label, let's say of schizophrenia or obsessive compulsive disorder or manic depression, that label stays with that person.
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Then if you're ever filling out a job application and you have to say, have you ever been diagnosed with a psychological disorder, you have to write yeah, I was diagnosed with clinical depression, and sometimes that's not a good thing , in many places in our culture because it does put the person under a different level of analysis, and some employers go I would not hire somebody like that, even though they outwardly may not say, that may be how they behave.
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Here was a simple rating of these two applicants, they thought one, they're the exact same applicant, exactly the same applicant, same resume, except one for one of them did say I was in the past diagnosed with a disorder and was briefly hospitalized. And there level of rating by people on the outside went way down with just that simple label on there, so it does have an effect on how we perceive people which is why there's a somewhat controversy.
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There are lots of things by the way that we still use, questions by the way? Yeah? >> Male Student: Who creates the DSM? >> The DSM is done by APA American Psychiatric Association. It's a group of psychologists and psychiatrists who sit on a panel, it's a large and extensive group who meet probably every couple of years to update and put out new versions, probably every five to 10 years. Yeah, that's what it is, American Psychiatric Association. >> Male: Does that label [mumbles]
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>> You know that's a great question, I don't know if I know the answer, maybe someone else in here knows, if you were diagnosed with clinical depression and then asked on a job application, do you have to reveal that um, I guess I don't know the answer,
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it probably varies state by state, now that I think about it, so. Your questions is whether you have to do that for the rest of your life by putting that on there. I am not sure, it's a good question. By the way, just lastly too, there are somethings we no longer refer to, that we used to, so how many have heard of the word neurotic? Or the word psychotic, it was very common, and somebody had a neurotic disorder or a psychotic, we don't use that anymore, it's still out there
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in popular language that there's such a thing such as a neurotic disorder or a psychotic, but the psychotic is still there, people can still have psychotic episodes, but we don't use the word neurotic as now one of the categories of somebody, but it has stayed around in our kind of common language use in the culture, but neurotics would be in the past somebody, I don't know, who would have a disorder that may not be all that, like, you may think of a neurotic would build castles in the sky,
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have you heard that, they build castles in the sky. That is their feet is planted in reality, but they just build castles, and the psychotic would what,
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they would live in those castles. That's the kind of way of knowing, psychotics are a whole level different, and then the psychiatrist comes around and collect the rent. That's the difference too. [laughter] We don't use that terminology because now it's been specified to be a lot more cleanly and I'll show you some of that in just a minute. One, is in the area of anxiety, I'm going to talk about three major disorders
31:55
that we group broadly into the category of anxiety, mood disorders, and schizophrenia. So if you have questions about any types of disorders, that may don't fit in there and you wonder about, certainly raise your hand and ask, and we'll go through that. When is anxiety normal and when is it not normal? How many of you felt anxious sometime in the last week, you felt anxious, almost everyone. Can I ask somebody with your hand up, how did you know, how did you know you were anxious?
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What did you, what went on with you or what did you feel? >> Female: I felt restless. >> Restless, how many say you felt restless. Okay, that's a good one, anyone else have a different symptom? >> Female: Stomach ache. >> How many have, when you feel anxious, your stomach gives you problems, stomach ache or pain? Anything else you knew, you felt when you felt anxious?
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What's that? >> Male: Lip quiver.
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>> Lip quiver, okay, how many felt that before, when your lips like, only him, alright. [students laugh] It's kind of quivering, no it's not.
33:04
Shaking, how many sweat, how many sleep a lot when you get anxious? How many sleep a lot when you get anxious, how many don't sleep when you get anxious, just the opposite, yeah. Okay, when is your anxiety and your symptoms, the things that you're describing, when does it become what we call abnormal? If your feelings of these things feelings of dread or doom, persist over time, and are distressing,
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you are experiencing, or at least this is one definition of anxiety, a distressing persistent feeling of dread or doom. Bad things are going to happen, are happening, and you're feeling this dread going on. Now there are different levels of anxiety, I'm going to show you some very clear cut cases, and there are lots of different ways that this comes into play, generalized anxiety is a broad category
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that is just simply anxiety in its long lasting, or even a kind of apprehension. That we call long lasting, you just feel this.
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And generalized anxiety may not even, you may not even identify a specific cause, or thing going on in life, it just feels like its long standing and again call that anxiety. Now if it has a specific thing, the most specific type would be something like a phobia.
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A phobia could be about almost any specific thing,
35:04
[students protest] Does anyone have a snake phobia, or spider, sorry.
35:12
It's an unrealistic fear, does the picture, for some people with phobias, maybe even seeing a picture isn't a good thing, but, seeing most of you are all right with this. Unrealistic fear of specific situation, thing or activity, anyone have one in here that, or knows somebody that has one that isn't up here, like? >> Female Student: Fear of going over bridges. >> Fear of going over bridges, how many have that one? Couple people, yeah, others, fear of heights?
35:42
How many have fear of heights, acrophobia? Any other ones that you know of, yeah? [student mumbles] Don't know if its true, could very well be. Fear of frogs, not you, but somebody, we're not talking--
36:01
Fear of getting diseases, yeah, what's that called, anybody? >> Students: Hypochondria. >> Yeah, hypochondria, way back there? [student mumbles] Fear of dinosaurs, yeah that one died out though a long time ago, not around, it's still there. How about fear of, how about Santaclaustrophobia? Heard of that one, it's a fear of getting stuck in a chimney now that's a drag.
36:28
[students laugh]
36:32
That wasn't even really all that funny, huh. Santa Claus phobia. Listen, phobias, for the person that suffer from these, can be very powerful and very difficult at taming, best thing is though, it's usually a specific thing they can avoid, like spiders or snakes, or chimneys. But, it also is sometimes more devastating if it is, or it encompasses things that's in a daily part of life, like crossing bridges. Number one identified, snakes, okay? Heights, flying, storms, and dentists.
37:08
Which would really, if you think about going into a profession to have this up there, to have people fear you, going to a dentist. By the way, for fears specifically related to social phobias there are some, there are eight percent identified that speaking in public, speaking to strangers, even eating in public can be very difficult for them, so you can see how this could be a little more interfering in life. They're very common, anybody know the most common,
37:37
or at least the one besides this specific thing of a snake, the broad category of phobias, it's like agrophobia but it's the most common, at least we believe that people suffer from, anybody know what it's called, it's called the fear of open spaces, or fear of fear itself, is known as agoraphobia. Agoraphobics would be those who are afraid of
38:07
or associate being out in an open space, or even outside of their home with something like panic, or a panic attack and they're just afraid to step out, and sometimes end up living the majority of their life without ever leaving their home.
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This is not uncommon of a phobia, agoraphobia, I have a little video clip on it, I'll save for just a minute here. But it would not be uncommon for a person who suffers from agoraphobia to just simply stay in their house, and everything's fine. Soon as they leave, they're afraid they're about to get, have some sort of a attack or anxiety panic attack. Agoraphobia however has more than just leaving the house, it can be related to a fear of bridges,
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fear of tunnels, fear of going through public transport or even being in crowds or being by oneself.
39:03
Okay, questions about phobias, or agoraphobias? When they list it by the way, the asked different people what's your most common fear, survey of 1000 Americans about 10 tens ago, they found the difference between men and women, what do you think was the number one top five fear of men, and it wasn't woman, what was the number one?
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>> Male Student: Getting rejected? >> Getting rejected, top fear of men. >> Male: Death. >> Death.
39:36
What, heights, for men now.
39:40
Number one fear of men? Showering? [girls laughter]
39:49
Wow, that was funny, fear of being buried alive.
39:54
How many now have that fear, now that you think about it for just a second. Number one fear of women identified by this survey was, anybody, fear of women, number one fear?
40:06
Fear of snakes.
40:10
Tell me, you don't have to write all these down, I'll just put them up to show you, they're about the same in some cases, fear of heights for men, fear of being bound or tied up, fear of snakes number three, fear of being buried alive showed up for women, fear of drowning, fear of heights, fear of public speaking, and fear of public speaking.
40:29
This could change, again this was just a survey of Americans 10 years ago, it might be different today, it might be different in this class. Causes of phobias are all over,
40:42
probably some of the most likely causes of phobias involve associations and learning, not always,
40:53
but some object becomes associated with anxiety or fear or somebody screaming that, or somebody grossing out and now you see that same object and now all of sudden you have similar type of association, and classical conditioning processes that we talked about in here, the reason we know this happens is because we can take somebody and one of the most common treatments, and we'll talk about in therapy for people with phobias, is what we use called using conditioning processes.
41:25
Counter-conditioning, but did you have a question? Yeah, arachnephobia is high, like I said it was only one of these surveys, and fear of spiders is still fairly common. It's just that in that particular survey, well okay, enough about phobias, unless you have, yeah? The answer, we'll talk a little about what are some treatments for phobias and for phobic disorders that most successful, some of those have been things like counter-conditioning, but we'll talk about some others that actually
41:56
expose people to the very thing that they're afraid of, in a controlled environment, which actually starts to lessen or decrease, if done the right way, decreases their feelings of anxiety, and decreases their phobias, so now we'll talk about, by the way, obsessive compulsive disorder are this, are also what we call anxiety disorders, but if they involved a slightly different element in that they involve both an obsession, that is an unwanted or a persistent thought, and often times,
42:29
a repetitive behavior which we call a compulsion, which is where we get the word obsessive, the thinking part, unwanted continuous persistent thoughts or something you don't want, and then the compulsion, which is this behavior that often times is repetitive. Give me an example of either the thought or the compulsion for some people suffering from OCD, obsessive compulsive disorder. [student mumbles] Yeah, there are many cases that would have, somebody who would be afraid or have this obsession
43:07
that they didn't lock the door when they went to bed at night so they go back and check it again, and they check it again and they're doing this 15, 20 times before they feel right, safe to lay down now the door's been locked. Not uncommon for us to maybe go, did I lock the door, maybe when I checked it I unlocked it, doing it a couple of times. When it becomes interfering with normal functioning is when we start to find problems. Yeah, go ahead, question way back there, no? [student inaudible]
43:38
Yeah, good, fairly common one, in fact one of the most common compulsions is hand washing because the fear that you're contaminated or have germs and I'll show you a video clip of this, they become problematic, by the way as I mentioned when they interfere with daily functioning. So let me show you in this case, a person that deals with a fairly devastating compulsion,
44:09
and here is both hand washing and fear
44:15
about what could happen, and here is this young mother, her struggle with OCD. But that would dominate and interfere your life, right that's an unmanageable anxiety, and the only way she's managing is by doing something so detrimental it begins to be a problem then in situations like this. Hers, by the way, isn't necessarily uncommon. In severe cases, this is what you find, cases where people just say I can't live with this anymore I don't know what to do,
44:54
and medication by the way, we'll talk some about medication and treatment of some of this next time, but it does help, but any questions from this now about OCD or phobias like that? It's a very powerful visual of how this causes sufferers to live now she may not ever need to seek treatment since everything, she has messed up hands, and she can't go do certain things, might take her a little bit longer to go for a walk, but this doesn't always come to the attentions of people
45:26
because in some cases it's manageable in their minds. When it becomes interfering with life is when it becomes problematic, so. Surprising how detailed and shocking this one was. By the way when it comes to causes, again there is probably more and more evidence coming out that something is going on physiologically in the brain,
45:53
quite possibly a neurotransmitter level, because anti-anxiety medications do help but it's not the end of the story, there is some therapy that usually must take place in addition and we'll talk about that as well. Yeah question? >> Female: Does that change your behavior [mumbles] >> Um, I don't think, well the question is whether her son developed this if she were to stay the same way, my guess is he wouldn't have any greater likelihood, though, it might influence some his behavior
46:26
and some of his thoughts depending of strongly she expressed it to him, you can see here she's trying to protect him a little bit from it, but no I don't want him to see this side of me, or to do this, so my guess is he wouldn't have other than the genetic likelihood that slightly increased with this but, I don't know, I would say the answer is, um, well ultimately by the way for her, treatment does calm and there is some help which is why she consented to filming this.
46:55
I don't have exactly how she's doing today, but,
47:01
there, of all the anxiety disorders, social phobias are quite possibly, 13% of anxiety disorders suffer from social disorders, agoraphobia which we talked about. Remember social phobias are a bunch of different kinds, and obsessive compulsive disorder, by the way it's going up,
47:21
this is probably closer to eight to 10% of anxiety disorders but they just kind of vary over time. Yes? [student mumbles] Um, what we're finding is increasing numbers of anxiety disorders, the question is why are they going up, I'll tell you this it's a question lots of people, lots of researchers tried to find out today.
47:47
There is some indication that our lifestyles, by the way with anxiety disorders going up, your use of technology, we're finding more and more cases of anxiety younger and younger. People not getting enough sleep, any of y'all, we go back and look at records, not y'alls, but in studies of texting, and we're find it going on when, all night long. And often times a lot of this is interfering with sleep, sleep has a very strong tie in to certain disorders,
48:19
and constantly being on and constantly doing somethings without finding large and quiet space, maybe accelerating some of the sufferers of things like anxiety. But again it's not clear why, but there could be some other things going on in our culture.
48:40
>> Female: Does it have to do with just like the stress levels that we're under constantly? >> Yeah, and the world is, because of these kinds of things, the world it feels more stressful, it feels like there is more time demands, more pressure demands and things like that, question? >> Male: Are there people that are obsessive compulsive over studying, they can't sleep unless they-- >> Yeah, some people could identify with some obsessive compulsive tendencies, and even in the way you study,
49:08
how many of you need to have your room a certain way, the books a certain way, it has to be certain environment, or it's not necessarily obsessive compulsive, it's just simply a tendency, and then, yeah it could be a variety of different areas. Not necessarily feeling you know, clean or you know contaminated or anything. Okay, next level up, how many saw the movie "A Beautiful Mind".
49:36
Beautiful Mind is a great story,
49:42
it's even a better book if you want to read it, it gives the full detailed history of a sufferer of schizophrenia that was pretty accurate.
49:56
It took you, if you haven't seen the movie yet, it was a great way of characterizing what goes on
50:04
in this person's life and you only find out later on that the person had schizophrenia.
50:12
It's a group of disorders, that's an important word, schizophrenia is not a single disorder but it's a group. They share some symptoms and some other characteristics in common and so they've been given the label of schizophrenia, but it's almost always related to disorganized thinking,
50:31
and then disturbed emotions and perceptions.
50:36
Schizophrenia numbers? One in 100, fairly consistently across cultures, throughout the world, I was in Russia standing in a corner and crossing the street, and I didn't know the language but I knew the disorder, it was schizophrenia it was clear. He was talking to cars that were going by and other people, and again it was clear schizophrenia, I've seen the exact same behavior on the corner over here. Of a individuals, its for whatever reason,
51:12
this is a disorder that also strikes not only all cultures, but male and female equally. It is a very difficult group of disorders, let me show you a little video. You know, unfortunately he falls into this category, often times we call it the law of thirds. A third of people diagnosed of schizophrenia get better, a third kind of go in and out, struggle with it, but there are period in which they're not suffering, and then the third third, kind of shown here,
51:49
are the chronic schizophrenics, when you're either in homes where the family is able to keep the person there, or sometimes institutions if the case is necessary there.
52:05
But, schizophrenia has these similar, even though it's a group it has some similar symptoms, and I'll just give them to you real quick, there's these, you've saw a little bit in there, these bizarre kind of delusions, some can be a paranoid nature, a lot of times it's somebody's out to get them, somebody's out to find them, I'll show you a clip here in a minute of a paranoid schizophrenic who is simply convinced that the FBI, the CIA, the NYPD are all following him.
52:40
He's homeless, he doesn't have a place other than the streets that he lives, but he is convinced that these people are out to get them, to chase him, to follow him, kind of like the person I described recently in this class that I described his situation here in this class where he came onto campus, wasn't a student, but showed these signs that people were following him, and he didn't even want to urinate in public because people were gathering that op,
53:10
so he would urinate in cans and keep those so no one could follow him and that's a delusion, or better yet a paranoid delusion. There are also delusions of grandeur, that somebody is bigger or more important. Not long ago I met a guy in the mill over here recently, and as we stood in line here's what he said, I said how you doing, fine, everything going okay? And he said, yeah it's fine, you know, I said let's eat together, so I was with my young daughter
53:40
at that time who was probably only four or five, and we sat down and it was clear he was schizophrenic, and as we ate I just asked a bunch of questions, are you getting a place to stay, how is life treating you all of this, and it's fairly clear right away, he says yeah I'm fine, you know my aunt, they're kind of after her, she's the Black Dahlia. And I said your aunt is? Yeah, and they're after her a lot. And I said, well so everything else okay in life, yeah, you know I'm trying to finish,
54:16
I don't he probably, he looked 20 maybe. And was talking about how he's had three or four master degrees, one from Harvard, one from Stanford, he was just finish up his masters at MIT he was saying and so he had these delusions about things and about life and a lot of his stories would tumble out in a way we call like a word salad. But he wasn't dangerous, he was hungry. So a lot of people think, people like that are weird or odd or strange and they do deal with some things
54:48
but most of the time there isn't a dangerous quality. Another guy was telling me, a different person, same thing, kind of setting, how's it going, fine, I said what are you doing, as well, I'm getting ready to go back to the old country. I said really, he said yeah, my sister she's on the throne but it's my throne, when I get back there I will be crowned the king. And I said well that sounds cool, you know you want mustard on that thing or ketchup, and he said, oh just nothing please.
55:15
I said okay, and he said yeah I'll get back there one day, you know it's hard, and that was like 10 years ago, he's still hanging around over here. Paranoid delusions, or delusions of grandeur come into play but there are other symptoms that mark some schizophrenics, hallucinations, auditory, visual or tactile. At a state hospital that I did an internship at with the criminally insane, it was not uncommon for them to feel or see things, one believed that the television
55:51
was talking to him and sending him messages directly to his brain even if the TV was off. It still had the potential of sending messages to his brain, and those were probably the result of some visual hallucinations. I know a person who one time believed that, listen to this, every time a dog barked, he'd go like this, he'd say, did you hear that, dogs are anthropologists, sent here from other planets to follow me, and when they would bark, it would tell him
56:22
that they're following me, they're tracking me, that is a paranoid delusion that has some hallucinationatory qualities,
56:31
and there was this also tendency for what we call word salad, incoherent loose word associations severe emotional abnormalities, and a sense of withdrawing into this inner world. So here's what I'd like you to do. If you have questions, you can ask them now. I'd like you to, make sure you read about, if you haven't yet, anxiety or schizophrenia, finish that reading, read about depression as well, I'll show you some, couple of additional clips of schizophrenics then I'll show you a little bit
57:07
about manic depression, bipolar disorder, and then we'll talk a little about therapy, and how we handle people or deal with these at that level. Any questions as we go, okay cause that'll be on Monday, where we'll do that. [cheerful music] >> Female Narrator: Biola unviversity offers a variety of biblically centered degree programs, ranging from business to ministry to the arts and sciences. Visit Biola.edu to find out how Biola could make a difference in your life.
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