Categories
Psychiatric Disorders

Prevalence, Diagnostic Criteria, and Features of Reactive Attachment Disorder

Reactive attachment disorder is a trauma- and stressor-related early childhood syndrome caused by social neglect or maltreatment, according to the DSM-5. Children with this condition have trouble making emotional connections, cannot feel pleasant emotions, cannot tolerate physical or emotional contact, and may react aggressively when held, caressed, or comforted. Children with this condition are unpredictable, hard to soothe, and hard to discipline. Children may seem to live in a “flight, fight, or freeze” state due to mood swings. Most want to control their surroundings and make decisions. Sudden routine changes, punishment efforts, or unwanted consolation may cause fury, aggression, or self-harm. These obstacles hinder academic learning and lead to teacher and peer rejection.

Social functioning is severely impaired by reactive attachment disorder (RAD). Research suggests that children with RAD may have low cognitive and verbal skills, although it is mostly from biased, institutionalized samples. An epidemiological study of 1,600 children examined the incidence of reactive attachment disorder in the general community. All children who were suspected or likely diagnosed with RAD were included in the study. It was found that children with RAD are more likely to have multiple comorbidities, lower IQs than population norms, more disorganized attachment, more problem behaviors, and poorer social skills than the general population, resulting in ESSENCE-like complexity.

Sources report that this condition is considered to be quite uncommon, with an estimated frequency of 0.9% in 1.5-year-olds. Research conducted to determine the prevalence of RAD in a community of children that come from a poor background revealed that 23 children were definitively diagnosed with RAD, indicating that the prevalence of RAD in this community of 1.40%.

The diagnostic criteria and features of RAD in the light of DSM 5 TR are given below:

Diagnostic Criteria

A. A continuous pattern of constrained, emotionally detached conduct toward adult caregivers, as evidenced by both of the following:
1. When the kid is disturbed, he or she seeks just limited reassurance.
2. When the kid is unhappy, he or she responds very little to consolation.
B. A persistent social and emotional disturbance that includes at least two of the following:
1. Low social and emotional receptivity to others.
2. Limited beneficial impact.
3. Unexplained irritation, sorrow, or fearfulness that persists even during nonthreatening encounters with adult caregivers.
C. The kid has had a pattern of extremely inadequate care, as shown by at least one of the following:
1. Social neglect or deprivation is defined as a continuous absence of essential emotional requirements for comfort, excitement, and love supplied by caring adults.
2. Frequent changes in main caregivers restrict the possibility of building solid relationships (for example, in foster care).
3. Raising children in atypical circumstances that significantly limit possibilities for selective attachment (for example, institutions with high child-to-caregiver ratios).
D. The care in Criterion C is assumed to be accountable for the disturbed behavior in Criterion A (for example, the disruptions in Criterion A began as a result of the absence of proper care in Criterion C).
E. The autism spectrum disorder diagnostic criteria are not met.
F. The disruption appears before the age of five years.
G. The child’s developmental age is at least nine months.
Specify if
Persistent: The condition has existed for longer than 12 months.
Specify the current severity:
Reactive attachment disorder is considered severe when a kid displays all of the condition’s symptoms at relatively high levels.

Diagnostic Features

  • Developmentally inappropriate attachment behaviors are called reactive attachment disorder.
  • This condition causes a youngster to seldom seek comfort, support, protection, and care from an attachment figure.
  • The child’s lack of contact with caregivers is the key indicator.
  • Some believe reactive attachment disorder youngsters can form choice attachments. However, they don’t exhibit selective bonding behavior since they don’t have many opportunities to do so as young animals.
  • They don’t always seek comfort, support, care, or protection from guardians when disturbed.
  • Kids with this condition don’t react well to adult soothing attempts when distressed. Thus, the condition involves not seeking or responding to soothing techniques.
  • This makes reactive attachment disorder youngsters less pleased with their caretakers.
  • They also have problems managing their emotions, causing unexplained dread, despair, and fury.
  • Reactive attachment disorder should not be diagnosed in youngsters who cannot build selected attachments yet. For this, the youngster must be 9 months old.
  • Multiple sources aid diagnosis, demonstrating that signals are visible in varied circumstances.
Categories
Psychiatric Disorders

Prevalence, Treatment, Diagnostic Criteria, and Features of Excoriation (Skin-Picking) Disorder

Excoriation disorder, often known as skin picking disorder, is a mental health problem defined by the recurrent act of picking one’s skin, resulting in tissue damage and causing functional impairment and/or discomfort. This pathological, obsessive, and repeated picking of skin that causes tissue damage is also referred to as neurotic excoriation, dermatillomania, or psychogenic excoriation. Anxietiestic picking has been recognized as a health issue in medical literature for quite some time. The term “neurotic excoriation” was initially used by Erasmus Wilson in 1875 to characterize the exceedingly difficult-to-control picking activities seen in neurotic patients.

In order to determine the prevalence of skin-picking disorder, a survey was administered to 10,169 persons (ranging in age from 18 to 69) who were chosen at random from the US population. 213 people (2.1%), or 55.4% of the total, reported having a skin-picking problem at the present moment, while 318 people (3.1%), or 54.1% of the total, reported having a skin-picking condition at some point in their lives. Compared to those who never picked at their skin, those with a present skin-picking condition were more likely to be female. Most often endorsed were mental health comorbidities, with 63.4% having generalized Anxiety disorder, 53.1% having depression, and 27.7% having panic disorder. Findings from this study point to the prevalence of skin-picking disorder and the high comorbidity rates that are characteristic of this illness in the general population.

The clinical evaluation of individuals with skin-picking problems involves a comprehensive mental and physical assessment, promoting a multidisciplinary strategy for diagnosis and therapy. Medication (such as naltrexone, serotonin reuptake inhibitors, or N-acetylcysteine) and cognitive-behavioral therapy (such as habit reversal or acceptance-enhanced behavior therapy) should be part of any treatment plan.

According to sources, treatment of dermatillomania requires a multi-pronged strategy that addresses the underlying mental disease, alleviates itching, and addresses the lesions on the skin. When it comes to treating dermatillomania’s mental component, selective serotonin reuptake inhibitors (SSRIs) have been quite helpful. Patients with dermatillomania have also found success with very little side effects from non-pharmacological therapies including behavioral therapy, habit reversal exercises, and support groups.

It is important to look for the signs and symptoms of the disorder to be able to diagnose the problem and seek the required treatment on time. The DSM 5 TR criteria and diagnostic features for skin picking disorder are given below:

Diagnostic Criteria

A. Skin lesions caused by repetitive skin plucking.
B. Multiple attempts to try to reduce or eliminate skin picking.
C. The skin picking leads to major trouble in social, occupational, or other crucial areas of functioning, or produces clinically substantial distress.
D. The skin picking is not caused by a medical ailment (like scabies) or the physiological effects of a drug (like cocaine).
E. No other mental disorder characterized by symptoms similar to skin picking (such as psychotic delusions or tactile hallucinations, body dysmorphic disorder, stereotypic movement disorder, non-suicidal self-injury, or attempts to improve one’s perceived appearance) is a more appropriate explanation.

Diagnostic Features

  • As per Criterion A, the defining characteristic of excoriation (skin-picking) disorder is the increased frequency with which the affected individual picks at their skin.
  • Although many people choose from a variety of body parts, the most popular ones are the face, arms, and hands.
  • People can pick at perfectly normal skin, at little skin imperfections, at lesions like calluses or pimples, or even at scabs that have formed as a result of picking at other areas.
  • While most people use their fingernails, tweezers, pins, and other instruments are also used.
  • Behaviors such as biting, squeezing, lancing, and skin plucking are also possible.
  • People who suffer from excoriation disorder frequently pick at their skin for long periods of time, sometimes even hours at a time, and this picking habit can last for months or even years.
  • Despite the fact that people with this illness frequently try to hide or mask their skin lesions (e.g., with makeup or clothes), criterion A states that skin picking must result in skin lesions.
  • Criteria B indicates that the individual with excoriation disease has made many attempts to reduce or cease skin picking.
  • If skin picking is clinically substantial and impairs social, occupational, or other critical areas of functioning, then it meets criterion C.
  • Distress encompasses a range of negative emotions that people with skin picking may experience, including a sense of helplessness, humiliation, and shame.
  • When people avoid social interactions, it can have a negative impact on their ability to perform in several aspects of life, including social, occupational, academic, and leisure activities.
Categories
Cognitive Psychology Dark Personality Psychology

Why Do Pathological Liars Lie?

M Abdullah Qureshi

Lying is a very common behavior per se. There are various reasons one might choose to lie. Perhaps you do not want to cause trouble with your boss, so you might lie that there no problems at work. Perhaps a young adolescent might lie to his parents to cover up the fact that he was hanging out with his buddies.

Pathological lying is different. Pathological lying occurs even in situations where there is no harm in telling the truth.

I have talked in great detail how one could identify pathological lying behavior. To put it very shortly, pathological lying is the continuous behavior of lying irrespective of the consequences of a situation.

In this article, I will explain why pathological lying occurs in the first place.

Why would a person choose to lie even when there is no discernable gain?

I detail multiple reasons for this behavior. Let’s begin!

Shielding from Cognitive Dissonance

Well, consider something that you believed in since childhood. If that belief were to be violated by some new information, how would you feel?

Very anxious, fearful, depressed.

This is because of cognitive dissonance. Cognitive dissonance is the disruption of one’s thoughts when the belief that they held is successfully antagonized or challenged by a new belief or reality. The newer belief seems to be antithetical to the prior belief.

This is not exactly a comfortable situation. Here’s why.

To make room for the new belief, not only is the previous one challenged but many implications of the previous belief no longer seem to have a logical basis. So, there is intense tension of thoughts. It could be that you might not know what to do anymore. And if the belief was a core one, it becomes even harder to accept either of the beliefs.

Cognitive dissonance can be observed in people who, for example, get disfranchised with religion.

So, to stave off cognitive dissonance as much as they can, some people might lie to maintain a maladaptive belief. As this belief cannot stand the test of maturity, or is too painful to handle, a pathological liar will attempt to challenge the competing belief, even if it means foregoing logic.

Operant Conditioning

Operant conditioning is a mechanism of learning or adopting behaviors by actively influencing an environment. While there is surprisingly sparse research, there is some case-study based evidence that pathological lying can develop in children as the result of their behavior being reinforcing for them.

So, for example, an individual might find that simply denying any wrongdoing, no matter the magnitude, helps them get out of trouble. As a result, they can repeat this behavior in further circumstances.

This is an example of operant conditioning as the individual operates on the environment (by lying) and they receive negative reinforcement (possibility of their punishment decreases). As they have discovered their action to be reinforcing, the individual will practice this behavior again, as it could help them out of tricky situations in the future.

With this, I will now move on to reasons which might lead to pathological lying through indirect ways. Let’s explore further!

Cognitive Distortions

A maladaptive or irrational belief is not based on a logical and balanced assessment of reality. It could be formed by demandingness, as Albert Ellis would have put it. It could be formed by an antagonistic or traumatic event. Whatever the case may be, irrational beliefs are distorted versions of the perception of reality.

One class of agents which form such irrational beliefs is of cognitive distortions.

To define very simply, cognitive distortions are elements of subjective interpretations of reality which subjectively distort the content or information of one’s beliefs about the reality.

In the case of pathological lying, one could think along certain cognitive distortions. For example, an individual could view the other person as an enemy, engaging in dichotomous thinking (all or none thinking), even when they are relatively neutral in their stance towards the person. As a result, the individual, under the influence of dichotomous thinking – which is a cognitive distortion – could start fabricating information out of paranoia or dislike for the other individual.

Psychiatric Disorders

The psychiatric disorders which contribute the most to pathological lying are usually those that are associated with impulse control. These are usually substance use disorders, gambling disorder, or kleptomania. On the other hand, pathological lying can also be found in individuals with personality disorders – particularly Cluster B personality disorders.

If a person has an impulse control problem, they might try to lie in order to maintain their condition. For example, if one has a substance use disorder, they might lie to their physician about things which could lead to desirable outcomes. They could exaggerate their experience of pain to receive more painkillers. However, this can also fall under the ambit of malingering, which is a psychiatric diagnosis.

Another example could be of lying in personality disorders. An individual with narcissistic personality disorder might lie compulsively in situations where they wish to portray a grand image of themselves.

Much like cognitive distortions, psychiatric disorders might contribute indirectly to pathological lying.

Conclusion

Cognitive dissonance, conditioning, distortion and psychiatric issues, all are interconnected phenomena. All of these aspects can be seen contributing to the incidence of pathological behavior. This is no different in the case of pathological lying. If one follows the psychoanalytic perspective strictly, this behavior could originate from one’s childhood experiences which might be traumatic or disorienting.

Safe to say, pathological lying is not a fun condition. It can disrupt one’s life greatly, causing major problems at work, home, school or any other setting which involves communication. In fact, people who have this issue might find themselves being socially isolated from their protective circle. This, as mentioned earlier, could lead to an even more intensification of their compulsive lying behavior.

If you believe that you or someone you know might have a major issue with it, perhaps speaking to a mental health professional could be the best way to ease your discomfort.

Categories
Dark Personality Psychology Psychiatric Disorders

5 Red Flags of Pathological Lying

In the current digital sphere, communication has diversified. No longer does one have to speak to each other directly. While this has greatly increased the convenience of communication, it has also increased the convenience for pathological lying.

Yes, this did just escalate quickly.

Pathological lying is a pattern of behavior of distorting or hiding information that is not really needed in the context. So, a pathological liar would be a person who lies ‘without much thought’, even in situations where he or she is not being harmed. One could connect pathological lying to psychopathy, Machiavellianism and/or narcissism.

However, compared to these large traits, pathological lying is one specific behavior. One study of 1,000 young offenders found excessive lying among 15% of males and 26% of females.

In this article, I will talk about 5 red flags that could give away someone who engages in pathological lying.

Let us begin!

1. Difficulty in Getting a Straightforward Answer

When one asks a simple question, a person who engages in pathological lying will respond with answers that are too vague. They might bring up some other topic or they might appear to connect the question to some other topic.

Not only that, you might feel as if you have to wrangle the answer out of them. This particle behavior is interesting because it directly relates to one aspect of a trait in the Five Factor Model of personality.

Straightforwardness is a major aspect of Agreeableness, a personality trait akin to being polite, honest and empathic.  Psychopaths, narcissists and Machiavellians, all generally score less on measures of straightforwardness.

2. The Behavior is Persistent across Age and Context

Scientists have also defined pathological lying as chronic lying behavior. A pathological liar would seem to lie almost indiscriminately, across multiple situations. So, one major identifier here is if you hang out with this person and he/she continues to fabricate information even when there is no real need to.

I would further argue here that a person who has had a habit of lying pathologically can also remain functional. It could be that they have learned how to lie differently in different contexts to escape being caught.

However, there is a high chance that if you are their friend, relative, family or any kind of long-term associate, you will detect small indications of missing and distorted information.

This relates to the next point.

3. Suspicious Friends, Family and Colleagues

Even if the point being lied about is not important, when we learn that something someone says is untrue and dishonest, we might not trust them. This then forms the basis of the turbulent relationships that a pathological liar would have.

In the case of people who engage in pathological lying, the social circle they have might be suspicious of them. They might say that the person is insincere. Because of that, their family members or friends and colleagues might find it difficult to confide in them.

Often this distrust could show up in behaviors like not leaving any valuables in the pathological liar’s custody. It could also show up in not including them in close-knit family gatherings.

A crucial point to remember here is that this exclusion from social gatherings further solidifies pathological lying.

So, it is not at all an attractive thing to any person, even if they pathologically lie about many things. In fact, excluding such people from these gatherings could lead to even more personal isolation, which could increase their levels of paranoia.

4. Very Frequent Contradictions in Narratives

We as humans are far from perfect. We make many of the same errors in judgment that many people around us make.

However, with respect to the majority of people, the contradictions in our speech or expressions are far lesser and in-between than in the case of a pathological liar. It could be that when recalling a memorable trip, the individual could distort multiple points of the story to make them look superior. Conversely, if they are narrating a story or some point, they might distort parts of the story to put down someone else that they might not found favorable.

Whichever route they take, pathological lying can be identified when the story that they tell seems to be fundamentally distorted, with various points excluded from it.

One could say here that this is because pathological liars lack insight.  

5. Confrontations Lead to Overreactions

No one really wants to be openly confronted about their lack of honesty. It makes us self-conscious about ourselves. However, we have enough wits about ourselves to realize genuine issues that we might have. When someone close to us tells us that we are being dishonest, we often make a goodwill attempt to understand what they mean.

Now, consider this in the context of an individual who does not realize that

  • they are being dishonest
  • being dishonest is a behavior that should be improved.

Such an individual would become defensive when they are confronted. Even in very private and personal settings. Since they do not consider you or anyone close to them trustworthy enough to tell the truth and be okay, they might see your or another friend’s advice as a challenge to their identity.

So, a pathological liar would view confrontations as open indication of antagonism.

And they would then reply according to this conception.

This could result in ‘fighting matches’ with their close associates. Further still, this could result in physical and violent confrontations.

Conclusion

While popular media portrays pathological liars as psychopaths with no distress, this is not the case. Pathological lying is one feature of many distressing psychological disorders. In fact, pathological lying is in itself considered to be a condition of its own, defined as pseudologia phantastica.

So, while pathological lying causes distress to others, it often originates from running from psychological distress in the individual. This makes it an uncomfortable condition for the person too.

If you feel as if you or someone around you has a behavior of lying pathologically, I would advise you to give this the proper time and care.

After all, wouldn’t it be great if we make our lives less distressing?

Categories
Hoarding Disorder Psychological Storybook

Horus’s Problems at Work

Storybook

This is a snapshot story from a storybook that contains clinical presentations of various mental disorders. The characters present maladaptive (and adaptive) psychological features that are associated with their disorders.
This particular story is about Hoarding Disorder.

“Horus, are you going to tell me what are we gonna do about this?” Sara asked Horus, pointing towards a pile of empty packs of cigarettes and matchboxes right underneath his desk.

Horus sighed.

Sara was an attorney and Horus was her assistant. She was not the only one who had noted the cigarette packs gathering at the foot of the desk. The cleaning lady had often brought this up, asking for Horus to dump this extra trash.

Horus had started gathering the cigarette packs for months. He had had a constant habit of misplacing his ashtray, and he found the empty boxes to be more convenient, as he had a lot of them and well – he did not have to deal with the excess ash and cigarette butts lying around his cubicle.

“Sara, I’ll get this mess away. First thing in the morning. I promise!”

This was also not the first time Horus had promised this. But this promise was never really fulfilled. He had tried to bring himself to do away the boxes.

 It was just that they were convenient to use as ‘trashcans’ and containers to hide his lighters in. Plus, it seemed like a huge hassle to do away with such a large number boxes. He had lost track of what he had hidden in each box. But they were there when he had misplaced his lighters too. He could just pop a few of them open, and usually he’d find a half-usable lighter.

It’s not like he had not tried to get rid of the mess. Sara had once forced the cleaning lady to take out every box littered in the cubicle. Horus did not like it. He did not know where he could hide his lighters or even the change that the clients would give him as tips – other than in the cigarette boxes. His pockets and his bag always seemed too full.

Nevertheless, Sara was not going to wait around for Horus to keep on putting off this issue. Many clients had complained about the smell of stale cigarettes that emanated from the pile of trash.

Moreover, some had even tried to get away from the cubicle as soon as possible, preferring to delay or call off the meetings than to stay.

While Horus had been a diligent paralegal, his habits were now causing their office more harm than good. He was aware that Sara seemed to have an issue with it, but no client had directly told him that there was a problem with his office.

Plus, Horus felt that the work was too consuming and the boxes to convenient for him to just discard them. Rather, the pile was actually a source of comfort that he would always his essentials with him. No issues with the lighters, change or ash flying around as long as the boxes were around.

When Sara had the cubicle cleaned the next morning, Horus felt as if his privacy was invaded. Moreover, he was now unable to find his lighter as he sat down, cigarette between his teeth.

So, he brought out an empty cigarette box from his bag and took out an older lighter from it.

He could not foreshadow that Sara was going to fire him the next month over a new pile of cigarette boxes.

Categories
Psychiatric Disorders

History, Prevalence, Diagnostic Criteria, and Features of Hoarding Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes hoarding disorder (HD) in the group of obsessive-compulsive and related disorders (OCRD), which also includes trichotillomania, excoriation disorder, and body dysmorphic disorder. A person with a hoarding problem develops an unjustified attachment to their material belongings and finds it difficult to let go of them. The serious societal ramifications of this condition, which is all too frequently dismissed as a strictly medical problem, are still not well understood. At present, the prevalence of Hoarding Disorder (HD) is ambiguous as a result of methodological issues in the evidence base. Estimates have varied significantly, spanning from 1.5% to 6% of the general population.

Studies state that due to reality TV shows on hoarding, the public is more aware of it. Popular culture portrays hoarding as a simple problem with an easy solution: “Just clean it up.” Unlike these sensationalist depictions, hoarding disorder is a real mental condition that has been studied empirically in psychiatry, psychology, and related sciences for over 20 years. In 1947, Erich Fromm defined a “hoarding orientation” in which people felt secure by collecting and keeping goods. In 1962, Scandinavian psychiatrist Jens Jansen used the phrase “collector’s mania” to describe elderly persons who overfilled their dwellings. Hoarding was recognized as an OCD disorder by the American Psychiatric Association in 2013. Obsessive-compulsive disorder, or hoarding disorder, requires six diagnostic criteria. Two specifiers rate hoarding acquisition and insight. In 1996, Frost and Hartl defined hoarding as acquiring a large number of useless or low-value items and failing to discard them, living spaces that are too cluttered to allow normal activities, and significant distress or impairment in functioning. Starting with this description, hoarding disorder diagnostic criteria were created. Current definitions of hoarding include an excessive gathering of goods in the home and difficulty getting rid of things most people would not keep.

If you wish to know how Hoarding Disorder might manifest, check out this link to our storybook.

According to the DSM 5 TR, the following are the diagnostic criteria and features of hoarding disorder:

Diagnostic Criteria

A. Having persistent trouble getting rid of or leaving with things, no matter how valuable they are.

B. This is hard because people think they need to keep the things and it makes them feel bad to throw them away.

C. Because people have a hard time getting rid of things, they end up collecting things that make busy living places crowded and less useful for what they were meant for. Living areas are only clear because someone else did something about it, like family members, workers, or the police.

D. The hoarding causes clinically significant grief or impairment in social, professional, or other important areas of functioning, such as keeping myself and others safe.

E. The collecting isn’t caused by another health problem, like a brain injury, heart disease, or Prader-Willi syndrome.

F. A person is hoarding if their symptoms are not better explained by those of another mental disorder. For example, obsessions in OCD, low energy in MDD, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, and limited interest in autism spectrum disorder are all examples of mental disorders.

Specify if:

With too much acquisition: If having a hard time getting rid of things is followed by getting too many things that you don’t need or have room for.

Specify if:

With good or fair understanding, the person knows that their hoarding-related thoughts and actions (like having a hard time getting rid of things, having too much stuff, or buying too much) are not healthy.

With little insight: The person is mostly sure that hoarding-related beliefs and behaviors (like having trouble getting rid of things, having too much stuff, or buying too much) are not a problem, even though there is proof of the opposite.

Without understanding or delusional beliefs: The person is sure that hoarding-related beliefs and behaviors (like having trouble getting rid of things, having too much stuff, or buying too much) are not a problem, even though there is evidence of the opposite.

Diagnostic Features

  • No matter how useful, collecting disorder is characterized by difficulty getting rid of or giving up goods (Criterion A).
  • The phrase “persistent” alludes to a long-term issue, not a short-term occurrence like obtaining property.
  • Criterion A states things are hard to get rid of.
  • People say this is challenging since they love their possessions or think they are helpful or pretty.
  • Some individuals are careful not to throw away their stuff because they feel accountable for their fate.
  • Many worry about losing vital data.
  • Newspapers, magazines, clothing, bags, books, mail, and paperwork are kept most, although nearly anything can be salvaged.
  • Stuff includes more than just worthless or low-value stuff.
  • People who collect and keep valuables sometimes stack them with less valuable items.
  • Hoarding disorder patients actively preserve items and feel anxious, frustrated, regretful, unhappy, and guilty about abandoning them (Criterion B).
  • The active preservation of goods distinguishes hoarding disorder from other psychopathologies that involve passive accumulation or little grief when possessions are removed.
  • People collect many objects that clutter active living places and make their intended use impossible (Criterion C).
  • The person may not be able to cook, sleep, or sit in a chair. Space can be exploited, but not easily.
  • Clutter is a chaotic collection of mostly unconnected or somewhat related items on tabletops, floors, and hallways.
  • Criterion C prioritizes the “active” living sections of the home over garages, attics, and basements, which are occasionally congested in non-hoarders’ homes.
  • Hoarding disorder sufferers frequently have items that flow beyond active living areas and impede the usage of automobiles, yards, the workplace, and friends’ and relatives’ homes.
  • Some living environments are only decluttered by third parties (family, cleaners, local authorities).
  • People legally made to clean out their homes still have symptoms of hoarding disorder, even though their homes are not as cluttered because of outside help.
  • Hoarding disorder is different from normal collecting behavior, which is planned and selected.
  • However, the amount of things a person has may be similar to the amount that someone with a hoarding disorder accumulates.
  • Normal collecting does not lead to the mess, stress, or problems that come with hoarding disorder.
  • Symptoms (like having trouble getting rid of trash and clutter) must cause clinically significant anxiety or impairment in social, professional, or other important areas of functioning, such as keeping oneself and others safe (Criterion D).
  • In some cases, especially when there is not enough understanding, the person may not say they are in pain, and only those close to them may notice the impairment.
  • Third parties trying to get rid of or clear out the things, on the other hand, cause a lot of grief.
Categories
Entertainment Character Analysis

Understanding the Origins of Walter White from Breaking Bad

Clinical Psychologist

M Abdullah Qureshi

Walter White – or Heisenberg – is the main protagonist of the American series Breaking Bad.

Played by Bryan Cranston (a great actor), White is a chemistry teacher at J. P. Wynne High School. Safe to say, he has a middle class life, involving all the perks and pits of ‘mediocrity’.

At the start of the series, White discovers that he has lung cancer. This makes him challenge not just the utility of getting a very expensive treatment but also of his own life. But, catering to his family’s wishes and understanding that they need him, he decides to choose to live.

Walter White is a dynamic character. In this essay, I will attempt to analyze him based on his

  • Circumstances
  • Motives

If you wish to check out Walt’s personality profile, you can do so by clicking this. So, without further ado, let’s take a deep dive into Heisenberg’s world.

Circumstances of Walter White

It is impossible to understand White without knowing where he comes from. Walter White turns 50 at the start of the series.

With relevance to the story and Walt’s situation, his circumstances can be divided along three major axes.

Work

He is a chemistry teacher at a high school. But he had not pictured himself as being in this position. He had contributed to Nobel-worthy research and he was a partner at Gray Matter Technologies, along with his best friend at the time, Elliot Schwartz.

But Walt sold his share of the company, and the company later grew into a multi-billion dollar enterprise.

Instead of having been in an active lab at a resourceful facility, being financially independent at 50, Walt was stuck teaching to classes of disinterested students and enjoying a meager pay.

So, when the news of his lung cancer is out, Walt does not feel as if he has much to live for.

Except for one major reason.

Family.

Family

Walt is married to Skyler White, with a young boy, Walter White Junior, in middle school and a daughter on the way.

However, it is not like Walt is a perfect father or husband. Rather, he struggles with himself about the fact that he hasn’t provided enough for his family. He appears to be more tired in life but he softens in the pillow therapy scene in the show, for his pregnant wife and son.

Social Circle

It is also important to note that Walt holds some of his relations in high regard. He opened up in the pillow therapy scene partly thanks to his sister-in-law, Marie Schrader, and her husband, Hank Schrader.

Other than his immediate family and his wife’s sister, Walt’s social circle extends only to associates at work and his past friends. However, he is not very happy about his friendship with Gretchen, his former lab assistant and ex-fiance, and Elliott who Gretchen married.

He is tired, dejected, broke. However, he also has a loving family, a stable job, living in a middle-class neighborhood.

The main point of contention here is not feeling unfulfilled. Rather, Walt appears to hate mediocrity.

So, it is this context that sets the stage for the rest of Walt’s life.

Motives

We have looked at Walt’s circumstances at the beginning of the story. Now, we will see what drives him.

For the purposes of simplifying White’s motives, I have divided them into two different categories.

Getting Paid and Treated Adequately

Throughout the show, a running theme is Walt being compensated with what he deserves. The central goal is not just money. After all, if he had wanted only money, he would have tried to negotiate a higher price for his services as a meth chef for Gustavo Fring. Indeed, Jesse Pinkman was furious that he had agreed to cook meth for such a small price.

Moreover, I assert here that this central belief of “I should be treated how I deserve to be treated,” runs also in Walter’s work relationship with Tuco, Pinkman, Mike and Fring. When he feels that the other person is not treating as he deserves to be treated, he tries to neutralize the threat.

While sharing finances with Mike and Pinkman, he splits the money in equal proportions. He gives others what he thinks they deserve as aligned with the general logical conception of fairness. When he does all the work, he expects the other person to not take away the outcomes of the work he does.

However, these beliefs about what someone deserves is purely based on who does the work. For example, he claims that there is no other half for Pinkman, as he thought that he was doing all the work himself.

He fights with Mike, arguing against paying off other people when he operates with Mike and Pinkman after Fring.

However, there is another core belief that has often clashed with his belief of getting what one deserves. Let’s look into Walt’s motives regarding his family.

“All I do is For the Benefit of the Family”

This seems to be among the chief rationales for Walter’s sudden move towards selling meth. He understood that this has the potential of paying off his chemo treatment. Moreover, he wants to save and leave enough money for his wife and children to live the rest of their lives in relative affluence. He buys his son a Mustang. Moreover, he discloses his secret to Skyler and then takes her counsel over conducting his business more safely.

Having said that, there are many actions of his that are not justified by the two beliefs mentioned above.

With that, let’s take a dip into Walt’s ego trip. This is where I will refer to Walt as Heisenberg.

I’m Good At It; It Makes Life Worth Living

Based on Walter’s circumstances, one could conclude that he did not really only want to teach. Rather, the way that he teaches his lectures is disinteresting to his students. While he initially tries to pursue it passionately, as seen in the pilot episode, he apparently begins to lose his own interest as well.

His entire resume right until he sells his shares in Gray Matter Technologies, speaks of work that is lab-based and interesting. So, led by his desire to earn far more money than he was earning at the time, Heisenberg constructed his own lab in an RV. Later on, this lab is greatly expanded under Gustavo Fring and when he finally began operating independently of Fring. He appears to be driven while he is working in the lab.

There are two reasons for this:

  • Increase in self-efficacy
  • Increase in interest in life

For Heisenberg, there is ambition involved in making meth. When Pinkman talks about quitting, Heisenberg argues against this, showing his ambitions for expanding his business.

Another example is when he ends up earning such a significant amount that Skyler loses count of the money – which is not normal for Skyler, who is managing an entire car wash facility. She asks Heisenberg with exasperation about how long he would continue his drug business, because if it was only for the family, then they have enough money to last lifetimes.

Conclusion

Walter White aka Heisenberg is a well-written character who grows as the series progresses. This does not mean that White did not commit many mistakes.

But, don’t we all?

To understand a character or even a living person, it is important to take their circumstances into consideration. Once you do that, you will find that it becomes much easier to trace their motives by how they act in different situations.

Even if the character is a drug-emperor!

Categories
Entertainment Character Analysis

The Personality of Walter White from Breaking Bad

Clinical Psychologist

M Abdullah Qureshi

Walter White is the main protagonist of the acclaimed show Breaking Bad. In this short analysis, I will go through the personality traits that Walter White seemed to possess.

I am using the five factor model of personality to assess Walt’s character. Below, I’ve written it down in very brief points. If you wish to understand Walter White more deeply, check out this character analysis.

Let’s begin!

Openness to Experience: Moderately High

Walt is intelligent.

He is also open to other value systems. He can justify crime but, on the other hand, he also shows some understanding of how his drug business does not conform to societal standards of clean living. Moreover, he is also creative; this is shown in how he deals with Tuco, manipulating him effectively and creatively.

It should be said, however, that he could make better aesthetic choices. While the hat on Heisenberg is certainly stylish – the outfit is put together haphazardly. A more aesthetic individual would probably put his outfit together close to someone like Hannibal or Dexter.

Concientiousness: High

Throughout the runtime of Breaking Bad, Walt is shown to be a workaholic, often coming home late.

There are also clear pieces of evidence of his ambitions; such as when he discloses to Pinkman about his plans to expand upon their business, with Gustavo Fring gone. He also organizes his attempts to get rid of threats were carefully.

Extraversion: Moderately Low

Walt does not have a very big social circle.

In fact, the people he confides in are limited to just his immediate domestic and work circle. In the beginning of the show, Walter is visibly inhibited while interacting with the many people who had come to his birthday party.

Other than this, Walt is shown to be outgoing only in situations where he has some other ulterior motive. For example, when he agrees to join Hank Schwader on a drug bust, he only seems to have the intention of seeing how the drug business is run from a house. Otherwise, he had refused Hank previously to go to such operations.

Agreeableness: Low

It will be wrong to say that Walter is not empathic. He certainly understands how Jesse Pinkman feels, when the latter’s girlfriend died early on in the show.

Having said that, Walt stands his ground over points that he disagrees with.

He firmly refuses Gustavo Fring’s offer to work for him early on, until one of his own motives was fulfilled. Furthermore, in an argument with Mike, he chose to work independently of Mike when faced with the choice of giving his money to people who he thought did not deserve it. He is also compliant only when his own interests are involved. When his interests are not met, he seemingly is discarding of others’ worth – as was the case in his paranoia towards Gustavo Fring.

Neuroticism: Moderately Low

Walter appears to handle the news of his death fairly well.

Rather, he is accepting of it.

While there certainly is a factor of being bored and disinterested in his life at the beginning, he does not display enough dysfunction to qualify for depression, anxiety or a fixation on negative emotions.

Even after ‘having lost everything’, Walter does all the tasks that he sets for himself at the end of the show.

There are, however, indications of anger issues. Some of his thoughts seem to be off base. For example, he believes that his former friend Elliott and former fiancé mistreated him, reaping the benefits of his work. However, it was he who impulsively sold his share of Gray Matter Technologies.

Summary

Walter exhibits signs of having a creative, industrious and meticulous personality. He likes to work long hours on his craft to the point where the money that he earns is almost irrelevant. However, he also considers himself to be a dutiful family member, and this justification is often used for his workaholism and continued meth-cooking. He can bear social gatherings, but he would rather spend the time with a few people who are within his closer social circles.

Furthermore, Walt retaliates quickly when he senses danger near to his close social circles, indicating a secure attachment style. Due to his intellectual capacity to formulate complex plans, he is able to stay aloof of both his competitors and the law enforcement.

In some ways, his thoughts and actions seems to align somewhat close to a high-intelligence subclinical antisocial personality.

Categories
Film

7 Movies You Should Watch to Understand Panic Attacks

Are you looking for movies on panic attacks to understand what they look like? If that is the case, you are at the right place! The following is the list of 7 movies you must watch to understand panic attacks:

Girl, Interrupted (1999)

In the film, Winona Ryder plays the role of a young lady who, following an unsuccessful attempt at suicide, is sent to a psychiatric institution for a period of eighteen months between the years 1967 and 1968. In light of the fact that anxiety problems are the root cause of her nervous breakdown, she makes use of a wide range of coping techniques. At the end of the day, she discovers a way to achieve wellness by avoiding escapism and engaging with her creative side.

Safe (1995)

Safe is a challenging film about an extreme kind of anxiety disorder. Julianne Moore shines in the role of the protagonist in this psychological horror film. An unidentified sickness does, in fact, cause a lady from a suburban area to assume that she is developing an allergy to everything that is present in contemporary life. It demonstrates how anxiety can lead to further anxiety.

The Aviator (2004)

Who would have thought that a film about Howard Hughes would be considered one of the top 10 movies on anxiety disorder? On the other hand, success and money do not provide protection against mental disease. Because of his anxiety problem and the various phobias he suffers from, Hughes chooses to spend the latter years of his life in seclusion.

The Black Swan (2010)

In the ballet Swan Lake, Natalie Portman plays the role of a ballet dancer who is competing for the role of the White Swan. As a result, the narrative illustrates how anxiousness may be caused by imaginative expectations. In point of fact, she engages in combat with the dark dancer, Mila Kunis, who is an excellent performance for the role of the Black Swan. On the other hand, is the dark dancer a genuine person, or is she only a representation of the White Swan’s dread and fear?

The Spider Within: A Spider-Verse Story (2023)

Following an especially trying day, Miles suffers a panic attack, which compels him to confront the symptoms of his worry and teaches him that calling out for assistance may be just as courageous an act as defending his city from impending danger.

Stutz (2022)

As Hill and his therapist investigate his mental health and the constantly worsening anxiety attacks induced by movie marketing, which have turned his perfect profession into a nightmare, you will be able to follow their journey.

The Perks of Being a Wallflower (2012)

Depression and suicide are important issues that are dealt with in this movie. For example, Charlie is released from a mental hospital after being depressed for a long time after his friend’s death. Charlie meets brothers; Patrick (Ezra Miller) and Sam (Emma Watson), who also feel like “outsiders” at school. As they become friends, these three kids win over viewers’ hearts. Based on the famous book of the same name, The Perks of Being a Wallflower does a good job of showing how hard it is to deal with mental illness, make friends, fit in, and deal with trauma. Many people can connect to this. In the end, it’s a beautiful story about trying to fit in and make friends, and it shows exactly how kids deal with the ups and downs of being a teenager.

So these are the 7 movies you must add to your watch list to understand panic attacks better! If you have seen these movies, do let us know your reviews about them!

Categories
Psychological Storybook Obsessive Compulsive Disorder

Oben’s Problems at Work

Oben could not stop thinking about what just happened. The day was going fine, he had had a good bout of meetings with his clients. Everything was going great in fact. But his heart dropped when he went back into his office.

Oben had a neat array of fountain pens, always on the right side of his desk. They were color-coded. And each pen was aligned neatly, the capped nib facing his revolving chair. But when he came back into his office, he noticed that one of the pens was missing.

It was his midnight blue pen, one that he had just gotten this summer.

His mind started racing as he began to think about all the places that he might have dropped his pen.

It couldn’t be that far from my office – I never take these pens off my desk unless I have to! He thought.

So, he began searching. Oben began by shifting the table to see underneath it. But then, exasperated, he began emptying the drawers. The notebooks that he threw out made heavy thuds against the floor and the furniture. People from outside his office started noticing until a colleague, Roma, who he was dating opened the door.

“Oben, is everything alright?” But then she stopped.

Oben was frantically now skimming through the shelf behind his chair, clearing all the papers and files out onto the floor.

“It was just here! I don’t believe how it could be anywhere else!”

This was not the first time that Roma and several other colleagues had seen Oben ‘lose his mind’ over very small things. He had had a similar breakdown when he noticed that a paper weight was missing.  

And Roma had only borrowed it. Well, she should have told him beforehand, but she thought, that’s nothing to freak out over, right?

Hearing the commotion, a colleague of Oben’s summoned the HR. Safe to say, Oben was not liked. But it took more than 10 minutes for the HR team to convince him to join them in the conference room.

Oben felt exasperated. But he also knew he was in trouble. He had promised them that he would be taking regular sessions with his shrink. But, this time he could not control himself.

Because of the damage that was caused to the shelf and the desk and the ‘disruptiveness’ of Oben’s actions, he was given a 2 week suspension from work. This was not the first time Oben had had such a mental breakdown.

But the HR representative’s message this time was clear:

‘Get your act together, or do not join the office again.”

But Oben felt hopeless, powerless.

2 weeks later, Oben returned. He had had made an active effort to not lose it anymore. Roma met him at the door and greeted him with a donut. While Roma and Oben had had conversations within this time, he told her that he was busy working on himself.

‘So, what’s up? How do you feel?’ Roma inquired.

‘Everything’s fine, Roma. Absolutely fine!’ Oben cheerily replied, as he began arranging his pens neatly on the right side of his desk.