A Lewinian Taxonomy of Psychiatric Disorders
by Matthew Maibaum / 2nd part (click here for 1st part)
A final feature of problems in dealing with the life space that can be attendant to boundary, vector intensity, or processing efficiency problems as described in topological psychology can be called anxiety attendance. When facts are perceived too intensely or too weakly, or are perceived in a distorted way, or are related to concomitantly in an inaccurate and maladaptive way, anxiety accompanies perception and behavior. Together with the practical problems of coping with facts in oneīs life space, the self/psyche component itself then becomes host to the unpleasant and inhibitory phenomena of anxiety, angst as FREUD termed it, which as clinical literature suggests increases maladaptive behaviors in the same setting, and to the same stimuli.
It is suggested that problems in boundary placement, processing disorders, and vector intensity between self/psyche and facts in the environment, irregardless of the content of the facts in each case, and the attendance of anxiety, provide subsidiary factors in mental disturbances and abnormal functioning in most mental disorders.
It is probably noticeable by this point in the discussion that there are analogies to be drawn between Freudian psychoanalytic theory and Lewinian topological psychology theory. In a broad sense, when LEWINīs schema for looking at individual psychology topologically is perused, his schema seems to be describing psychological functioning in a manner closer to the psychoanalytic than one would first think. Lewinian topology describes the same basic processes, and disorders of them, spatially and graphically in two dimensions and rarely, in three, as in his discussion of levels of reality, whereas psychoanalytic theory generally enumerates them, if you will, linearly. The multiplicity of processes that occur in the self/psyche, that empower locomotion towards facts, are analogous to the Source and its innermost processes as defined in psychoanalytic thinking. The vectors, efforts towards facts by the self/psyche, and locomotion towards and in terms of facts, correspond to the Aim in psychoanalytic thinking. And the facts and events to which the self/psyche attends, both real and irreal and on real and irreal levels of the life space, correspond roughly to the Object that is the subject of interest, attention and motivation of the self, in psychoanalytic psychology. Thinking in terms of these kinds of analogies may make following successive theoretical points more fruitful even whilst the analogies between the two systems are far from exact as can be seen. (See Figure 3-3).
Figure 3-3: A broad analogy between the Freudian scheme of source, aim, and object and the topological picture of "person" and "environment"
It can do this in several ways at the same time, or choose one, for purposes of survival. It can regulate the strength, impermeability, of boundaries, either the self/life space boundary or the relevance boundary further out that we postulate. It can regulate the location, position, of both the self/life space boundary and the relevance boundary. It can regulate the intensity of perception of, and action towards, facts in the environment, something we have called vector intensity. It can regulate internally within itself the way it processes information about facts in the environment. Where there are problems here, we have termed these processing disorders. And lastly it can move the bulk of its attention between real and irreal levels of the life space on the whole and deal with a veritable universe of either real, or irreal, facts and events. From a Lewinian point of view maladaptive functioning and choices in any of these tasks on the part of the self/psyche can bring on psychological abnormality.
A summary representation of select mental disorders and related conditions that have been dealt with to some degree in this study, related to the major feature to be associated with each from the standpoint of topological psychology, is to be found in Table 3-9.
Lewinian psychology can illustrate in recast form withdrawal and self-insulation from the envronment, and primitive ego defense, and the perception by the patient of the therapist as transitional object, the withdrawal of ego defense against overwhelming stimuli, and increased potential for client interaction, and other phenomena. It may throw new light also, not only on mental disorders that have been elusive, but also upon approaches to psychotherapy and directions for technique-building.
We have discussed at length the boundary phenomenon so essential to topological psychology. The two discussed have been the boundary between self/psyche, and life space, and the one postulated to be somewhat less important within the life space between relevant and non-relevant facts and events in the persons life space. Given the operational terms of topological psychology, the formation of boundaries, and the maintenance of them, are questions outside the expertise of topological pschology. They have more to do with the very etiology of some psychological functions, and the basic capacities of psychic structures, within the personīs self-psyche, to carry out functions. It is proposed that the development of boundary, the strength and permeability of boundary, the position placement of boundary with respect to the life space, and the fluctuation of boundary from one perimeter size to another or from one position distal from the self-psyche to one closer and vice versa, are all governed by what the historic psychoanalyst would term energies within the psyche.
If one follows psychoanalytic theory, one can conceive of the creation of a boundary, and the maintenance of it, and the location of it, being effected by energies expended by the self/psyche outward from itself on a constant basis. A boundary might be conceived of in the manner of an energy field itself produced by the expense of energy, as in physics, wherein the maintenance of the boundary depends upon the continued life, and energy-expenditure of the self/psyche of the organism. The self/psyche also is able to move the boundary, or boundaries, further out or further in (either in an adaptive way, or maladaptive way) by regulating the manner in which it dispenses its energies.[4] It may be added here that the two boundaries that the self/psyche must effectively manage are firstly that between self/psyche and life space, and secondly that proposed in this study, between relevant and less relevant or nonrelevant sectors of the personīs life space; the outer boundary of the life space may be in a sense a perceptual construct only, a demarcation conceptually of what the client perceives consciously and subliminally to exist in his daily life.
Some of the difficulties into which an individual might fall obviously come then, from a mis-placement or weakness in, or overimpermeability of, a boundary that is brought on by processes within the details of the self/psyche and which processes, in the detail, are beyond the scope of this effort. Others, as we have suggested, are difficulties the individual gets into and manifests as a reaction to a mis-placement of a boundary, or an over- or under-permeability of a boundary combined with and given a specific collection of types of events and facts that he finds surrounding him. Part of his mental problems looking only at boundary phenomena and the number and quality of facts and events around him, as two factors in his problems, are created by the initial way his self/psyche manages its boundaries. And part of his mental problems are created by the way he on a conscious level and on an unconscious level responds to the de facto relationship between facts and events in his life space, and their positions relative to his boundaries. It is suggested that inner-psychic processes relating to boundary management have been seen to be more amenable to therapies at least in the current era, that are medically-based and chemically-based, also to some degree behavior-modification. Boundary management processes of the initial type and at their most basic, are unconscious in the extreme. But it is suggested that, likewise, problems that stem from a personīs maladaptive behavior vis a vis the relationship between facts and events in his life, and their position relative to boundaries in his psychological functioning, can be made for the most part consciously appreciable to him and these kinds of problems are a central province of insight-oriented (if difficult) psychotherapy and counseling. A personīs basic reflexes to be in topological terms underpermeable, at the self-level, overpermeable, overinclusive or under-inclusive at the relevance boundary level may be too rooted in basic psychophysiological make up to be changeable more than a little through psychotherapy and counseling alone. But this is not true where it comes to making the person see the way in which he reacts interpersonally and socially, and unconsciously, to facts and events that seem to fill his life space cognitively given the level of environment stimulability of his self/psyche, the positions of his self/environment boundary, and the position of his relevance boundary, and the apparent strengths and lability of his boundaries, for him as an individual. This can be an important basis, and aspect, of therapy.
The phenomena of vector and processing have been dealt with to some length. It is suggested that these aspects of psychological functioning, and with them vector strength/intensity and processing efficiency, are things that are based entirely within the self/psyche, and dependent upon its internal mechanism and processes. These are essentially outside the expertise of topological psychology. It is suggested that, paralleling psychoanalytic theory, vector intensity and processing efficiency depend upon two kinds of things. One is the structural organization of psychic processes including their adequacy at each age of the person. Another is the general level of what psychoanalytic thinkers have termed energy available for any psychic processes in the individual. The former depends upon adequate physical and psychophysiological growth, ultimately. The latter depends ultimately upon that, and upon the physical strength and energy of the individual as a human organism.
It is suggested that to some degree insight-oriented psychotherapy can assist a person to manifest more effective vector intensity through getting him to choose and attend to with greater concentration, those facts and events that should be important to him. Hopefully, to some degree but not entirely, less vector energies will be wasted upon less or un-relevant facts and events and thus more available for relevant ones. This very roughly parallels the psychological concept of conversation of energy, and it also parallelīs Gardner MURPHYīs concept of canalization turned about and utilized as a conceptual approach towads therapy.[5]
And it is suggested that insight-oriented therapy can, to some degree, impact ineffective processing by a personīs self/psyche where the qualitative deficits in a personīs perception of facts and events are communicated to a person, and analyzed with him, and he then mounts more of an effort to try to perceive kinds of things about facts and events he relates to, and to relate to those, where he did not before. Where structural factors within the self/psyche do not make this utterly impossible (as for example perhaps in dementias historically deemed to be essentially irreversible) a more effectice and adaptive qualitative grasp of a finer essence of facts and events in a personīs life can be had by that person. And this can be had, as if often done, with some schoziphrenics, with schizotypal individuals, and with schizoid clients.
An additional point is suggested. Whenever two or more theoretical approaches are studied in concert it is not unusual for new theories about old phenomena to suggest themselves, and to force themselves into old, and ongoing conjectures about the etiology and the maintaining process of a discorder. Perhaps a Lewinian perspective on major abnormal clinical syndromes in concert with other clinical theory may produce new theory not only leading to new theoretical insights, and new teaching possibilities, but also to new roads to improvement and remission.
It is probable that perception-oriented, communication-information based, and ecological approaches in psychology will be studied relative to and concorded with dominant classical psychology and psychiatry approaches. these former-mentioned, newer approaches have already made theoretical contributions to psychology and to psychiatry in America. It is felt that ecological approaches, particularly in their graphic aspect, can assist the understanding of psychopathology and illustrate components of it more broadly in the future. That may be in terms of both theoretical concept supports, and clinical insights, that such inter-theory concordance can bring forth.
Admittedly Lewinian topological psychology as brought to bear on clinical syndromes in this study may be seen to be able to explain or depict some disorders more effectively than it does others. It may be seen to suggest more effectively how to conceptualize the beginnings of, and approaches to therapeutic intervention with, some disorders more than others. And Lewinian psychology that was not clinical either in the basis of itīs conception, or in itīs directions. It was a conceptual scheme developed by an outstanding social psychologist with an excellent background in philosophy, utilized often by him for the study of such non-abnormal phenomena in people as alienation, and affiliation, and intergroup relations.
It is also suggested that it may have a broader utility in illustrating and in some cases explaining developmental, and also ongoing, processes in adult clinical syndromes and may have particular relevance to the study and analysis of schizoid, paranoid, and schizotypal as well as autistic process. It is suggested that topological psychology may additionally offer substantial theory-building potential to the understanding of these disorders. But it is hoped that the attempt made in this study will, if it will not answer all questions as it does not propose to, stimulate thinking from a theoretical and educational point of view in some new directions.
Table 3-3:
The hypothesized relationship between vector intensity, processing effeciency, and some syndromes
Vector Intensity |
|||
too high |
mean |
too low |
|
High processing efficiency |
Manic Disorders |
normal |
clinical depressive disorders |
Low processing efficiency |
Hysteric Schizophrenic States |
Schizophrenias Dementias |
depression associated with dementias & schizophrenia; involutional melancholia |
Table 3-4:
Mental disorders Seen As a Function of Processing Efficiency, Vector Intensity, and Relevance Boundary Placement Disorders
Relevance Boundary Position |
||
too distal |
too basal |
|
High vector intensity |
Processing efficiency high: Paranoid
psychoses
|
Processing efficiency high: Obsessive-compulsive disorders |
Processing efficiency low: Paranoid schizophrenia |
Processing efficiency low: Obsessive-compulsive disorders |
|
Processing efficiency high: depression with obsessive features |
Processing efficiency high: Clinical depression: withdrawal |
|
Low vector intensity |
Processing efficiency low: Dementias |
Processing efficiency low: Clinical depression w. psychotic features |
Table 3-5:
Four Maladaptive Personality Types as a Function of Type of Boundary Disorder and Processing Deficit
Processing Deficit: |
Boundary Disorder Too Distal Too Basal |
|
Mainly Content Info. Coding |
Paranoid personality |
Withdrawn, Isolar Personality |
Mainly Emot. Quality Coding |
Passive dependent personality with histrionic tendencies |
Narcissistic personality with schizoid features |
Table 3-6:
Theoretical relationship between Boundary disorder, and perceived stress level, and some psychological abnormalities
Level of Perceived Stress |
weak/or impermeable <------------------> Adequate |
High
Low |
severe disorders other disorders normal range functioning |
Table 3-7:
Hypoecoic process disorders in face of perceived stress seen as a progression/ on a continuum
Conceived
Stage
IV. III. II. I. |
||||
Clinical term/names |
autism |
schizoid features; isolism; autismic personality |
hysterical phenomena |
normal range functioning |
Leading characteristics |
regression to fantastic thinking, primary physical functions |
massive defensiveness against competition of ext. to int. world |
massive anxiety as signal of inability to assume challenges |
normal range functioning |
Table 3.8:
Hyperecoic process disorders in face of perceived stress seen as a progression/ on a continuum
Conceived
Stage
IV. III. II. I. |
||||
Clinical
term/names
|
Schiziphrenias |
Schizotypal and Borderline phenomena |
Neurotic Features |
normal range functioning |
Leading
characteristics
|
Disorganization/ Disintegration in face of stress |
realism-withdrawal & destabilization of function; defense against outside pressures |
massive anxiety as signal of danger |
Table 3-9:
Select mental disorders by central problem from a topological psychology perspective
Central feature from topological psychology viewpoint: |
Disorder: DSM2, DSM-3/3R |
hypertrophy and overcompartmentalization of irreal level of life space hyperecointeractive/stress disorder hypoecointeractive/stress disorder relevance boundary misplacement, hypoinclusive relevance boundary misplacement, hypoinclusive vector intensity too great: hyperlocomotory self hypolocomotory self (vector intensity too weak) fact/event cognitive hypoperception: hypoprocessing |
schizotypal disorder anxiety disorders; schizotypal, borderline, personalities; schizophrenia autism; schizoid personality paranoia schizoid processes mania clinical depression; involutional melancholia dementias; organic brain injuries |
[3] LEWIN, 1936, 1951, Cf.
[4] See Rudolf EKSTEIN, et al., The Challenge: Despair and Hope in the Conquest of Inner Space (New York: Brunner-Mazel, 1971) for a leading psychoanalytic exegesis of a relevant psychodynamic position; and for exemple, M. MAIBAUM, Mapping the Beyond Within (Ann Arbor, Mich: University Microfilms International, Research Monographs, 1975) for an earlier attempted concordance of Lewinian, and psychodynamic, theorising about origins of psychopathology.