The PsychoDynamics of PAIN!!!

OBJECTIVES

• BioPsychoSocial Model = Wadell• Indexed Definitions• Neurosis• Psychosis• Emotional Overlay• Conflict Resolution• Special Topics = Addiction, Eating disorders,

Body Dysmorphia

BIOPSYCHOSOCIAL MODEL

BPS MODEL continued...

NEUROSIS

• Class of functional disorders involving distress w/o delusions or hallucinations....

• Invisible injury...

• DMS Classification = Anxiety Disorders..

NEUROSISS&S

• OCD• HYSTERIA• PHOBIAS• PYROMANIA• PERFECTIONISM• DEVIANCE

PSYCHOSIS

• Abnormal condition of the mind...• Hallucinations• Delusions• Gross excitement• Impaired insight

Psychosis• schizophrenia and schizophreniform disorder• affective (mood) disorders, including severe depression, and severe

depression or mania in bipolar disorder (manic depression). People experiencing a psychotic episode in the context of depression may experience persecutory or self-blaming delusions or hallucinations, while people experiencing a psychotic episode in the context of mania may form grandiose delusions.

• schizoaffective disorder, involving symptoms of both schizophrenia and mood disorders

• brief psychotic disorder, or acute/transient psychotic disorder• delusional disorder (persistent delusional disorder)• chronic hallucinatory psychosis

PSYCHOSISS&S

• schizotypal disorder• certain personality disorders at times of stress (including

paranoid personality disorder, schizoid personality disorder, and borderline personality disorder)

• major depressive disorder in its severe form although it is possible and more likely to have severe depression without psychosis

• bipolar disorder in severe mania and/or severe depression although it is possible to have severe mania and/or severe depression without psychosis as well, in fact that is more commonly the case

• post-traumatic stress disorder• induced delusional disorder

Variations.....• Normal states• Brief hallucinations are not uncommon in those without any

psychiatric disease. Causes or triggers include[16]

• falling asleep and waking: hypnagogic and hypnopompic hallucinations, which are entirely normal[18]

• bereavement, in which hallucinations of a deceased loved one are common[16]

• severe sleep deprivation[19][20][21]

• sensory deprivation and sensory impairment• caffeine intoxication• extremely stressful event

COMORBIDITIES• A very large number of medical conditions can cause psychosis, sometimes

called secondary psychosis.[16] Examples include:• disorders causing delirium (toxic psychosis), in which consciousness is disturbed• neurodevelopmental disorders and chromosomal abnormalities, including

velocardiofacial syndrome• neurodegenerative disorders, such as Alzheimer's disease,[22]

dementia with Lewy bodies,[23] and Parkinson's disease[24]

• focal neurological disease, such as stroke, brain tumors,[25] multiple sclerosis,[26] and some forms of epilepsy

• malignancy (typically via masses in the brain, paraneoplastic syndromes, or drugs used to treat cancer)

• infectious and postinfectious syndromes, including infections causing delirium, viral encephalitis, HIV,[27] malaria,[28] Lyme disease,[29][30][31] syphilis[32][33]

Subcatagories....• Subtypes• Subtypes of psychosis include:• Menstrual psychosis, including circa-mensual (approximately monthly)

periodicity, in rhythm with the menstrual cycle.• Postpartum psychosis, occurring recently after childbirth• Monothematic delusions• Myxedematous psychosis• Occupational psychosis• Stimulant psychosis• Tardive psychosis• Shared psychosis• Cycloid psychosis

NEUROPSYCHOLOGYTheories...

NEUROPSYCHOLOGY THEORY

NEUROPSYCHOLOGY THEORY

CONFLICT RESOLUTION

CONFLICT RESOLUTION

CONFLICT RESOLUTION

CONFLICT RESOLUTION

So... How do we resolve conflict?

• CEASE AND DESIST!!!!

• YIELD INORDER TO PROCEED....

• DIFFUSE THE SITUATION...

• MOTIVATE WITH POSITIVE RE-ENFORCEMENT!

RESOLUTION

SPECIAL TOPICS

• ADDICTION

• EATING DISORDERS

• BODY DYSMORPHIA

ADDICTION...

PAPEZ CKT....

WTF??!!!

PAPEZ CKT

BRAIN REWARD

EATING DISORDERS

EATING DISORDERS

BODY DYSMORPHIA

• Body dysmorphic disorder is a type of chronic mental illness in which you can't stop thinking about a flaw with your appearance — a flaw that is either minor or imagined. But to you, your appearance seems so shameful that you don't want to be seen by anyone. Body dysmorphic disorder has sometimes been called "imagined ugliness."