Dr Nesif Al- Hemiary M.B.Ch.B - F.I.C.M.S.(Psych.)
Definition The individuals current awareness of external and internal stimuli ( that is of events in the environment and of body sensations, memories, and thoughts). We are also conscious when we try to solve a problem or deliberately select one course of action over others in response to environmental circumstances and personal goals. We are conscious not only when we monitor our environment (internal and external) but also when we seek to control ourselves and our environment.A- Monitoring B-Controlling MONITORING Ourselves and our environment so that percepts, memories, and thoughts are presented in awareness. CONTROLLING Ourselves and our environment so that we are able to initiate and terminate behavioral and cognitive activities.
Many memories and thoughts are not part of your consciousness at a certain moment of time ,but can be brought to consciousness when needed. THE MEMORY IS ACCESSIBLE. Preconscious memories are used to refer to memories that are accessible to consciousness ,like memories of personal events as well as information accumulated over time. Also include learned skills like procedures involved in driving a car.
According to the psychoanalytic theory :some emotionally painful memories and impulses are not available to consciousness because they have been repressed ( that is diverted to the unconscious).BUT, they continue to influence our behavior even though they reach consciousness only in indirect ways through dreams, irrational behavior, and slips of the tongue.The Freudian term slips refer to unintentional remarks that are assumed to reveal hidden impulses. (Good morning beheaded – uhm l mean beloved.)FREUD believed that unconscious desires and impulses are the cause of most mental illnesses .He developed the method of psychoanalysis ,which attempts to draw the repressed material back in to consciousness ,and in so doing, cure the individual.
Automaticity: Some activities are practiced so often that they become habitual or automatic. Dissociation: Pierre Janet(1889)-French Psychiatrist Under certain conditions some thoughts and actions become slip off, or dissociated, from the rest of consciousness and function outside of awareness. Example: Day dreaming
We spend one fourth to one third of our lives in sleep. There are many stages of sleep in which brain activity recorded by the Electroencephalogram ( EEG )differ from each other. Types of sleep: Non-rapid eye movement sleep (NREM) -4 stages Rapid eye movement sleep (REM).
During NREM sleep: Eye movements are absent. Heart and breathing rates decrease markedly. There is increased muscle relaxation. There is diminished brain activity. During REM sleep: Eye movements occur about 40-60 times (they beat in bursts lasting 10-20 seconds). Heart rate increases to its day time level. The brain is more active than it is when we are awake. We are completely paralyzed ( only the heart ,diaphragm, eye muscles and smooth muscles are spared )
Sleepers awakened during REM sleep almost always report having a dream, but when awakened during NREM sleep they will report a dream only about 50% . Dreams of REM sleep are visually vivid and have a bizarre , illogical character, while in NREM sleep dreams are more like normal thinking; neither as visual, nor as emotionally charged as REM dreams ,and are more related to what is happening in waking life.
Why we are awake at certain times and asleep at others? Opponent process model of sleep & wakefulness.( Dale Edgar &William Dement -1992 ):according to this model ,the brain possesses two opponent processes that govern the tendency to fall asleep or remain awake. They are: 1. The homeostatic sleep drive. 2. The clock dependent alerting process (biological clock)
A physiological process that strives to obtain the amount of sleep required for a stable level of daytime alertness. It is active throughout the night, but it also operates during daytime. Throughout the day, the need to sleep is continuously building . If we have slept too little the previous night , the tendency to fall asleep during the day will be significant.
Is the process in the brain that arouses us at a particular time each day.Controlled by the biological clock.The so-called biological clock consists of two tiny neural structures located in the center of the brain(pineal bodies).It controls circadian rhythms.Daylight signals it to stop the secretion of melatonin, a hormone that induces sleep.The two opponent processes – homeostatic sleep drive and clock-dependent alerting process- interact to produce our daily cycle of sleep and wakefulness.Whether we are asleep or awake at any given time depends on the relative strength of the two processes.
Dreaming is an altered state of consciousness in which picture stories are constructed based on memories and current concerns, or on fantasies and images.
Freud –Interpretation of dreams (1900)Dreams provide a royal road to a knowledge of the unconscious activities of the mind. He believed that dreams are a disguised attempt at wish fulfillment. By this he meant that the dream touches on wishes ,needs ,or ideas that the individual finds unacceptable and have been repressed to the unconscious. These wishes and ideas are the latent content of the dream.
Fisher &Greenberg (1977): There is good evidence that the content of dreams has psychological meaning, but there is none that supports Freud’s distinction between manifest and latent content.Evans (1984): Sleep is a period when the brain disengages from the external world and uses this off-line time to sift through the information that was input during the day and to incorporate it into memory.Hobson(1997): Dreams are similar to delirium.Cartwright (1978,1992,1996): Dreams have a problem-solving function.Antrobus,1991;Domhoff,1996;Foulkes,1985: Dreaming is a cognitive process that reflects the individuals conceptions ,concerns, and emotional preoccupations.
Achieving an altered state of consciousness by performing certain rituals and exercises, such as controlling and regulating breathing, sharply restricting ones field of attention, eliminating external stimuli, assuming yogic body positions, and forming mental images of an image or a symbol. The result is a pleasant , mildly altered subjective state in which the individual feels mentally and physically relaxed.
A social interaction in which one person (designated the subject) responds to suggestions offered by another person (designated the hypnotist) for experiences involving alterations in perception, memory and voluntary action. 5-10% of people cannot be hypnotized even by a skilled hypnotist. Willing and cooperative individual is the only one that can be hypnotized.
Planfulness ceases. Attention becomes more selective than usual. Enriched fantasy is readily evoked. Reality testing is reduced and reality distortion accepted. Suggestibility is increased. Posthypnotic amnesia is often present.
. Hypnosis as therapy : In Medicine: Reduce anxiety related to medical and dental procedures. Asthma. Gastrointestinal diseases. Nausea associated with cancer treatment. General pain management. In Psychiatry Addiction. Emotional disorders.
Drugs that affect behavior , consciousness, and/or mood. TYPES: 1. Depressants( sedatives): Alcohol, barbiturates, benzodiazepines, inhalants. 2. Opiates: Opium & its derivatives: codeine, heroine, morphine, methadone. 3. Stimulants: Amphetamines, cocaine, nicotine, caffeine. 4. Hallucinogens: L.S.D., mescaline, psilocybin ,PCP. 5. Cannabis: marijuana, hashish.
Whether a particular drug is legal or not does not reflect the risks and dangers associated with the drug. The prevalence of substance use and abuse increased substantially in the last four decades. The drugs listed in the previous slide are assumed to affect behavior and consciousness because they act on the brain in specific biochemical ways. With repeated use ,an individual can become dependent on any of them. Drug dependence has three characteristics: tolerance, withdrawal, and compulsive use.
Tolerance: with continued use ,the individual must take more and more of the drug to achieve the same effect. Withdrawal: if use of the drug is discontinued, the person experiences unpleasant physical and psychological reactions. Compulsive use: the individual takes more of the drug than intended, tries to control his or her drug use but fails , and spends a great deal of time trying to obtain the drug.
The degree to which tolerance develops and the severity of withdrawal symptoms vary from one drug to another. Tolerance for opiates ,for example, develops fairly quickly ,and heavy users can tolerate a dosage that would be lethal to a nonuser. In contrast, marijuana smokers seldom build up much tolerance. Withdrawal symptoms are common and easily observed following heavy and sustained use of alcohol, opiates and sedatives. They are common but less apparent ,for stimulants ,and non existent after repeated use of hallucinogens.
Although tolerance and withdrawal are the primary characteristics of drug dependence; they are not necessary for the diagnosis. A person who shows a pattern of compulsive use without any signs of tolerance or withdrawal, as some marijuana users do, would still be considered drug dependent. Drug dependence is usually distinguished from drug abuse which is continued use of a drug ,despite serious consequences, by a person who is not dependent on it (that is ,show no symptoms of tolerance, withdrawal or compulsive craving). For example ,someone whose overindulgence of alcohol results in repeated accidents , absence from work, or marital problems (without signs of dependence) is said to abuse alcohol.
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