Chapter 4 Lecture

Mental and Emotional Wellness


The Emerging Self

• How do you develop your values, beliefs, feelings, thoughts, and ideas about yourself?
• Personal development and emotional health of women have been tied to possible explanations or theories by well-known behaviorists
• These theories will help in differentiating behaviors of women vs. men

Theories of Development

• Until 1979, the psychology profession supported the long-held belief that women were inferior to men
• As early as 1905, Sigmund Freud developed the theory of psychosexual development around the experiences of the male child
• Freud viewed differences between men vs. women as the result from women’s developmental failure to meet the male standard
• In 1968, Erikson did recognize gender differences with regards to intimacy development, however, depicted the male pattern as the “standard” for healthy psychosocial development

Theories of Cognitive Development

• Piaget (1932) equated normal child development with male development.
• Considered females to be far less developed in capacities that would allow normal legal sense, essential to moral development
• Piaget failed to recognize the approach girls took to conflict resolution vs. boys, was equal or sometimes favorable to resolving conflict, depending upon the circumstances

Theories of Moral Development

• Kohlberg (1969) developed a scale of moral development theory based on a male subject group
• It excluded women, since he felt girls played games that are less likely to involve strict rules, based upon his observations
• By using the Kohlberg Scale, women were deficient in this area
• Gilligan proposed to the psychology profession that a new psychology for women be developed, independent of male standards, which allowed changes to eventually occur

Women’s Relational Model of Development

• Traditional male models of development emphasize separation and individuation process for psychological well-being
• A woman’s self concept (identity, self-esteem) is strongly associated with her relationship to others
• The ability to relate to others is considered a strength
• This relational approach is called “self-in-relation theory” (Stone Center/Wellesley College)
• This has now emerged to be referred to as “gender-relations theory”, emphasizing separation and individuation, but neglects the intricacies of human interconnection

Sociocultural Influences

• Sociocultural influences may significantly impact your emotional health in many different ways
• They can lead you to either life satisfaction or dysfunction
• It is important to be in touch with yourself and know when you need to make adjustments, based upon your level of satisfaction by allowing one to perform the following:

    • Integration and ongoing mindfulness (self-exploration)

The Counseling Option

• Feminist therapy (gender equity therapy)- empowers women through an egalitarian relationship with the therapist. They assist in rebuilding/reinforcing a woman’s inner strength and ability to survive, overcome, and succeed in the face of emotional burdens.
• Counseling Model- assists the counselor to establish with the client appropriate treatment goals and a treatment plan for client recover. Existing models for counseling may sometime be adapted or new counseling models developed as the needs of groups of people change or evolve over time.

    • Person-centered counseling- counselor utilizes reflection/clarification of client's verbal/non-verbal communications to enhance insight and mover them towards greater self-acceptance.
    • Cognitive behavioral therapy- identify and challenge irrational client beliefs that contribute to maladaptive feelings and behaviors.
    • Behavioral counseling- focuses on altering behavior which restricts clients’ social, occupational, and other activities thereby improving their quality of life.
    • Adlerian counseling- understanding and adapting the private logic that drives their life style in order to achieve greater social success and satisfaction in the life tasks of work, love and friendship.
    • Freudian psychoanalytic theory- clients gain awareness of the unconscious patterns of their thinking and therefore work through their trauma and relieve internal pressure.

  • Counseling Models

    • Person-centered counseling- counselor utilizes reflection/clarification of client's verbal/non-verbal communications to enhance insight and mover them towards greater self-acceptance.
    • Cognitive behavioral therapy- identify and challenge irrational client beliefs that contribute to maladaptive feelings and behaviors.
    • Behavioral counseling- focuses on altering behavior which restricts clients’ social, occupational, and other activities thereby improving their quality of life.
    • Adlerian counseling- understanding and adapting the private logic that drives their life style in order to achieve greater social success and satisfaction in the life tasks of work, love and friendship.
    • Freudian psychoanalytic theory- clients gain awareness of the unconscious patterns of their thinking and therefore work through their trauma and relieve internal pressure.
    • Gestalt counseling- clients explore an impasse, accept life circumstances, and become fully present and aware in the here and now.
    • Existential counseling- clients are encouraged to accept their freedom to make choices, take personal responsibility for these choices and decide what fears, feelings, and anxieties they will explore.
      • Logotherapy- clients have become lost in their pursuit of finding meaning in their lives.
    • Choice theory and reality therapy- all behavior is chosen and purposeful and individuals work to satisfy needs through total behavior. Reality therapy emphasizes client choice and responsibility for choosing behaviors that meet their needs.
    • Solution-focused therapy- views humans as competent with a therapeutic focus on what is possible

• Factors for Successful Counseling Outcome

  • Counselor‘s model and techniques
  • Relationship (respect, collaboration, acceptance, validation)
  • Positive Therapeutic relationship
    • Trust
    • Client factors
    • Hope factors

Life Skill Development

• Life is suppose to be a fun and challenging job
• Having life skills makes it easier to cope with the demands of life
• These skills can be taught to anyone at any age
• Examples of such skills are as follows:

    • Emotional intelligence
    • Assertiveness training
    • Effective communication
    • Problem solving
    • Maintaining a healthy self-image
    • Having good self-esteem
    • Resolving grief over loss

Emotional Intelligence

• This is the ability to recognize your emotions and those of the people around you
• The classic two step approach involves becoming aware of your own emotions and developing an action plan
• An action plan is used to resolve troubling emotions
• It may require changing the way you speak to someone or developing better listening skills

Assertiveness Training

• Standing up for personal rights and expressing thoughts or feelings that do not violate another person’s rights
• Involves respect, not deference
• A need for assertion training is more prevalent for women since the American culture teaches males to be aggressive
• Adventure based activities can have a positive influence on assertiveness for women

Effective Communication

  • The following are components of effective communication:
    • Body language
    • Encouraging responses
    • Paraphrasing
    • Clarification
    • Summarization

Effective Problem Solving

• Effective problem solving is a step-by-step approach of planning and negotiating and involves all parties to be effected
• A common model involves 6 steps:

    • Defining the problem
    • Generating possible solutions
    • Evaluating the solutions
    • Making the decision
    • Determining how to implement the decision
    • Assessing the success of the solution

Self-Esteem Enhancement

• Based on the distance between the perceived self and the ideal self
• Self-Esteem Enhancement is the process of reducing the distance between the two points
• Once the ideal self is more realistic, you can have a healthier opinion about yourself and greater self-esteem
• Maintaining or enhancing self-esteem in women varies across cultures

Body Image and Eating Disorders

• The key element to building and maintaining a positive self image is to focus on being what you want to be
• Build your image from the inside out
• Every woman has something unique to offer on the 6 levels of health dimensions
• To enhance self image, start by loving yourself and accepting yourself as you are right now
• Body dysmorphic disorder (BDD) is a body image disturbance which can lead into unhealthy behaviors

Body Image and the Media

• Glamorization of women in the media started in the 1830s
• Glamorous images projected by the media have contributed to harsh self-criticism by women
• Technology has advanced how unrealistic women are perceived by the media
• Public efforts have been placed on hiding a woman’s natural body image than in accepting the nature of a woman’s uniqueness
• There have been some instances in the past where the media have benefited women’s issues

Eating Disorders

• Poor body image is the central factor in the development of eating disorders
• 99% of people with eating disorders are women
• Eating disorders include:

    • Anorexia nervosa (starving oneself)
    • Bulimia nervosa (eating-vomiting)
    • Binge eating disorder (binge eating w/o purging)
  • It is difficult for women to lose weight due to the designation of body fat factor
  • Treatment requires a combination of mental health counseling and nutritional guidance

Grief and Bereavement

• During your lifetime, you will lose someone very important to you
• Grief is a normal response to a loss
• There is are several ways to grieve
• Sorrow, despair, and depression are natural and healthy ways to express sadness from a loss
• It is important to mourn the loss since un-reconciled or poorly reconciled grief experiences can lead to unhealthy behaviors

  • The Five Stages of Grief:
    • Denial
    • Anger
    • Sorrow
    • Despair
    • Depression
    • Bargaining

Women’s Grief

  •  Death of a relationship partner
    • Research shows that women receive more social support than men and cope better.
  • Death of a child
  • Divorce and grief
    • Women have been found to be more satisfied with their divorce settlement and were more likely to feel in control and empowered compared to men.
  • Infertility and grief
    • Consequences include sadness, frustration, hostility, helplessness, powerlessness, shame, poor self-esteem, and isolation
  • Job loss and grief

Depression

• A common emotional health concern for women
• Depression is an emotional state of persistent dejection, from mild discouragement to extreme despair
• A chemical imbalance of the neurotransmitter, serotonin, is thought to be the precursor to depression
• Causes of this imbalance may be the experience of stress or trauma, or a genetic disposition towards depression
• Women are twice as likely as men to be diagnosed with clinical depression

Psychosocial Stressors and Depression

• Experts believe that the reason behind the higher incidence of depression compared to men is due differences in women’s responses to depressing events
• Other researchers hypothesize the higher incidences of stress could be based upon having more stress and discrimination
• Childhood trauma can also impair interpersonal and psychological functioning in women

Reproductive System and Depression

• Fluctuations in female hormones and other biochemicals may influence the frequency of depression in women
• Gonadal and adrenal steroids affect neurotransmitters, which play a role in regulating mood and behavior, and neuro-endocrine physiology
• The following are reproductive concepts that can cause depression:

    • Menstruation
    • Pregnancy and Childbirth
    • Menopause
    • Infertility
    • Abortion

Depression  and Genetic Liability

• Research with female twins determined that there is a genetic liability for the onset of major depression in women who experience stressful events (Kendler et al. 1995)
• The tendency to develop depression may be inherited
• Major depressive disorder is 1.5 to 3 times more common among first degree biological relatives of persons with this disorder than among the general population

Developmental Issues and Depression

• There are no consistent gender differences in rates of depression for pre-pubescent
• However, by age 13-15, girls show significantly higher rates of depressive disorders and symptoms than boys
• Girls exhibit more passive and introspective coping styles
• Girls and women eventually face more negative life events than males
• Women are likely to develop depression in their 20s and 30s, however older women are also vulnerable.

Family of Origin Issues and Depression

• Severe losses
• Neglect
• Rejection
• Abandonment
• Physical, sexual, emotional abuse
• Lack of an empathetic caretaker
• Suppressed emotional expression

Multicultural Issues of Depression and Suicide

• African American women may experience racism as an additional stressor that contributes to depression
• Hispanic women may experience economic deprivation, migration, and political discrimination, leading to depression
• Low self-esteem are significant problems for many Asian women which contribute to depression
• Native American women have higher mortality rates than other groups, which poverty, lack of education, and their existing environment contribute to suicide and major illnesses
• The strongest risk factors for suicide are depression, alcohol and drug abuse, and separation or divorce

Medication for Depression

• Most antidepressant drugs work by raising levels in the brain of the neurotransmitters thought to be responsible for regulating moods.

    • SSRIs
    • SSNRIs

Bipolar Disorder

• Also known as manic-depression
• Affects almost 2 million Americans
• The individual cycles through episodes of mania and depression. In between, the person can usually function normally
• Bipolar Disorder is more common in women than in men.
• Has been deemed the most expensive behavioral health care diagnosis.

Anxiety

• It is the body’s natural “flight-or-flight” response gone out of control.
• Different kinds:

    • Generalized Anxiety Disorder
    • Panic Attacks
    • Panic Disorder
    • Phobias
    • OCD
    • PTSD

Positive Experiences and Mental Health

• Women who have positive experiences can enhance their self esteem and decrease depression
• Studies show a negative relationship between depression and a sense of humor
• As humor increases, depression decreases
• Increased quality of personal relationships and work status have demonstrated improvements to self esteem and evaluation in women over a 7 year period

Seasonal Affective Disorder

• Seasonal affective disorder (SAD) is a cyclic, seasonal condition

    • Fall and Winter SAD - depression, anxiety, oversleeping, appetite changes, etc.
    • Spring and Summer SAD - anxiety, insomnia, irritability, weight loss, etc.
    • Reverse SAD - elevated mood, increased social activity, hyperactivity, etc.

• 70-80% of those with SAD are women.

Self-Injury

• Self-injury/mutilation is a deliberate injury to one’s own body that causes tissue damage or leaves mark for more than a few minutes, which is done to cope with an overwhelming or distressing situation

• About 2 million people in the U.S. are self-injurers

Emotions and Health

• Emotions are natural states that result from the perceived impact of an event or the memory of an event. They serve as guideposts to help you understand just what kind of an impact something has on you.

• Without regular release of emotions, the pressure can rise to the point where you “explode”.

• Confiding in others appears to protect the body against damaging internal stresses and seems to have long-term health benefits.