The Rationality of Psychological Disorders: Psychobizarreness Theory

417 Pages·2000·8.995 MB·English

by  Yacov Rofé (auth.)

THE RATIONALITY OF
PSYCHOLOGICAL DISORDERS
Psychobizarreness Theory
THE RATIONALITY OF
PSYCHOLOGICAL DISORDERS
Psychobizarreness Theory
by
Yacov Rofe
Bar-Ilan University, Israel
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging-in-Publication Data
Rofe, Yacov.
The rationality of psychological disorders: psychobizarreness theory I by Yacov Rofe.
p.cm.
mcludes bibliographical references and index.
ISBN 978-1-4613-6946-2 ISBN 978-1-4615-4333-6 (eBook)
DOI 10.1007/978-1-4615-4333-6
1. Psychology, Pathological. 2. Mental illness-Etiology. 1. Title.
RC454.4 .R635 2000
616.89-dc21
00-059272
Copyright O 2000 Springer Science+Business Media New York
Originally published by Kluwer Academic Publishers, New York in 2000
Softcover reprint of the hardcover 1 st edition 2000
AlI rights reserved. No part of this publication may be reproduced, stored in a
retrieval system or transmitted in any form or by any means, mechanical, photo
copying, recording, or otherwise, without the prior written permission ofthe publisher,
Springer Science+Business Media, LLC .
Printed on acid-Iree paper.
To my wife Sara,
and our children
Yoav, Esti and Yochai.
With love.
CONTENTS
List of Tables and Figures xi
Forward xiii
Preface xvii
Acknowledgements xxv
Part I
Shortcomings of Traditional Theories of Psychopathology
1 Psychoanalysis: Flaws in Repression 3
The Unconscious System 4
Forgetting and Permanency of Memory 14
Pathogenic Effect of Repression 19
Discussion 24
2 Flaws in Behavioral-Cognitive Theories of Fear 33
Behavioral Models 33
Cognitive Models 47
Non-Associative Account of Fear 56
Discussion 58
3 Biological Models of Psychopathology: A Critique 61
Neurosis 61
Psychosis 77
Discussion 85
viii
Part II
Psychobizarreness Theory
Introduction 93
4 Repression: The Cornerstone of PBT 95
Definition 95
Normal Repression 96
Pathological Repression 98
Diagnosis of Bizarreness 103
Emotional Function of Bizarreness 105
Case Studies 107
Discussion 115
5 Choice of Neurotic Symptom 119
The Preliminary Stage 120
The Symptom Adoption Stage 124
Controllability 124
Availability 140
Cost-Benetlt 159
Discussion 168
6 Unawareness: A Self-Deceptive Process 171
Detlnition 171
Generation of Unawareness 174
Preservation of Unawareness 181
Stabilization of Unawareness 192
Exceptional Cases 201
Discussion 206
7 PBT as a Unified Theory of Psychotherapy 209
Introduction 209
Behavioral Therapy 212
Cognitive Therapy 235
Informal Therapy 242
Psychoanalysis 246
Drug Therapy 249
Discussion 251
ix
8 Psychoses 255
Definition 255
Schizophrenia 256
Typical Schizophrenia 258
Paranoid Schizophrenia 273
Catatonic/Schizoaffective Disorders 278
Bipolar Disorder 283
A Unified Therapeutic Theory of Psychoses 287
Discussion 295
9 Rational-Automatic Theory 299
Theoretical Foundations 301
Facilitating/Inhibiting Factors of Conditioning 305
Spontaneous Conditioning Method 309
Resistance to Extinction 313
Discussion 314
10 Concluding Remarks 317
References 323
Index 397
LIST OF TABLES AND FIGURES
Tables
Table 1 Criteria of bizarre behaviors 104
Table 2 Level of awareness in illness vs. denial group 191
Figures
Figure 1 Possible relationships in unawareness and bizarreness 172
Figure 2 The deceptive cycle 199
Figure 3 RAT's model of conditioning 312
Foreword
Kalman J. Kaplan, Ph.D.
Professor of Psychology, Wayne State University
and
Director, Suicide Research and Prevention Center, Michael Reese Hospital
In this original book, Yacov Rofe manages to develop and suggest a
rational approach to the understanding of psychological disorders. I have
always felt that our current understanding of psychopathological processes is
somewhat limited and that there is a need for alternative theoretical
viewpoints in this field. Rofe reviews the current literature and offers
Psychobizarreness Theory as a new theory of psychopathology. This is
impressive and will undoubtedly generate a heated theoretical controversy,
challenging the existing beliefs.
Several novel and interesting questions were posed to all the traditional
theories. For example, Rofe asks why women have a higher incidence of
almost all neurotic disorders than men. To my knowledge, not one theory has
taken this approach. Additionally, Rofe asks many questions that relate
specifically to each theory he presents, paving the way for the introduction of
his own approach.
Rofe's book provides a through critical review of the inherent deficiencies
of the current theories of psychopathology. This unique approach to the
relevant literature can help both clinicians and researchers enhance their
evaluation of the prevailing theories in the field.
After reading the book, I became convinced of two things: 1. There are
still several fundamental mysteries about psychopathology. 2. Rofe's ideas are
logical, straightforward and encompass a large body of data.
Rofe has seriously contemplated the suggestion of leading investigators to
reconsider classical psychoanalytic concepts, and his concise review of the
literature on repression reveals the lack of reasonable scientific ground for the
existing psychoanalytic concepts of repression and unconscious. Rofe offers
reasonable and acceptable alternatives for both these concepts. He proposes
that repression be viewed as an active method of distracting one's self from an
extreme and intolerable level of stress related thoughts. In this sense, because
of their high distractive value, neurotic and psychotic symptoms are viewed as
powerful repressive measures.
Rofe also suggests the alternative term of "self-deception" in the
development of psychopathology to account for patients' state of unawareness
regarding insight to their pathology; a role that psychoanalytic theory
attributes to the unconscious. Using this concept of "self-deception," Rofe
xiv
demonstrates the creativity employed by neurotics and psychotics in
deceiving themselves. Thus, he does not view psychiatric patients as
senseless victims of irrational psycho-pathological processes. Instead,
Rofe depicts both neuroses and psychoses as pathological coping
mechanisms where the individual consciously and sophisticatedly
activates several cognitive maneuvers to create a state of unawareness.
His approach to unawareness is worth exploring. It gives a new insight
into an understanding of the mystery of unawareness and seems as
reasonable as all the other available alternatives, at the same time being
integrative, parsimonious, and readily lending itselfto empirical validation.
Rofe's approach to therapy is original and provocative. Based on his
Psychobizarreness Theory, Rote suggests that all therapies share common
mechanisms, thereby producing a unified therapeutic approach. This
integrative model may enhance the effectiveness of therapeutic interventions,
as it provides clinicians with a theoretical guideline for an eclectic approach
to psychotherapy.
Beyond his contribution to understanding the development of bizarre
behaviors (a term that he uses for neuroses and psychoses), Rofe also offers
insight into how simple fears develop. I originally thought that the
development of fear was a relatively simple and understood process, but, upon
completion of the second chapter, I became aware of the theoretical
confusion, and lack of understanding surrounding this basic psychological
phenomenon. In the ninth chapter of his book, Rofe clarified many of the
issues that he had raised. His resolution emerged as a result of a fundamental
but very necessary distinction between simple fears, which are learned
responses, and bizarre fears, which are mechanisms used to cope with
stressful situations.
Finally, since one of my main interests is suicide research, I naturally tried
to extract from the book principles applicable to current suicide theories and
research. According to Rofe, suicide is one of the several options that
individuals consciously and rationally choose when faced with an unbearable
level of stress. Here too, Rote's approach to suicide is quite interesting and
originative. While his basic view of suicide as a rational decision is not new,
he goes one step further by delineating the principals by which a deviant
behavior is adopted. He enables the reader to glimpse the underlying
psychological processes that motivate people to choose deviant behaviors
(e.g., suicide, drug abuse, or bizarre behaviors) when their coping resources
are insufficient. He proposes that three principals govern the choice of any
given behavioral deviation: controllability, availability, and cost-benefit
balance. These three principles seem remarkably accurate for the field of
suicide and, until now, they had not been conceptualized in an organized
fashion. The large number of studies that Rofe has reviewed in support of this