Emotion, Classification of emotion, Normal emotional reactions, Abnormal emotional reactions, Abnormal reaction of emotion, Morbid expression of emotion, Communication of mood, Categories of emotion, Pathological changes in mood, Feeling of loss, Anhedonia, Feeling of impending disaster, Ecstasy, Feelings attached with the perception of objects, Feelings directed towards people, Free floating emotion, Experience and expression of emotion, Vital feelings, Religious feelings, Manic Depressive mood, Suicidal thoughts, Depersonalization, Internal restlessness, Cyclothymia and related conditions, Depression and loss, Grief, Helplessness and hopelessness, Mania, Manic thoughts
2. •A feeling can be defined as a positive
or negative reaction to some
experience or events and is the
subjective experience of emotion.
Emotion is a stirred-up state caused
by physiological changes occurring as
a response to some event and which
tend to maintain or abolish the
causative event. Emotion is defined as
the patient’s emotional
responsiveness.
3. • According to whybrow(1997)-emotion is actually memory and
feeling intertwined. Feelings are also personal conviction,
Predictive forecasts and social sensibilities . Feelings has been
described a positive and negative reaction to an experience; it
is marked but transitory.
• Jasper(1959) has concentrated on 3 main aspect :
The involvement of self
The contrasts of opposite
The nature of the object of feeling
5. Normal Emotional Reactions
•Emotional reaction are normal
response to events or to primary
morbid psychological experiences
.The person exhibiting a normal
reaction to a stressful event is unlikely
to be incapacited from carrying out
their normal duties and acting in their
usual roles for other than the briefest
of periods.
6. Abnormal Emotional Reactions
• These are the states that are understandable in the
context of stressful events but are associated with
more prolonged impairement in functioning .
Yerkes-Dodson (1908), which shows that up to a
certain level of stress there is no impairement but
beyond a certain point functioning deteriorates .
The point at which happens is determined by
individual attributes such as genetic and personality
predisposition and by external factors including
social support and the duration and severity of the
stressors.
7. Abnormal reaction of emotion
• Excessive emotional response may be the
result of learning and of different cultural
norms .The distraught woman screaming at
the death of a loved one may be reflecting
a cultural variant of normal grief. The
converse or lack of emotional response is
also of great interest. Some depressed
people fail to exhibit any emotion where
some would be expected.
8. • An unusual but significant abnormality in
the expression of emotion is that seen in
the ‘smiling depressive’ who retains the
communicatory smile but loses the
emotional element . Although able to visibly
smile but loses the emotional element . So
although able to visibly smile, their eyes
remain unchanged and display a tension in
the surrounding muscles. A defence that
may manifest as lack of emotion is denial.
9. Morbid expression of emotion
• The patient is unaware of the morbidity in emotional
expression even though it is apparent to observer.
Inadequacy and Incongruity of affect are characteristic of
schizophrenia . some patient with schizophrenia there
seems to be a complete loss of emotional life so that the
patient is indifferent to their own well-being and that of
others . It shows itself as insensitivity to the subtleties of
social intercourse and is known as inadequacy or blunting
of affect and was called ‘parathymia’ by bleuler . It
manifest itself as social awkwardness and
inappropriateness.
10. • Liability is defined as rapid and abrupt
change in emotion largely unrelated to
external stimuli. In emotional liability patient
have difficulty controlling their emotions,
but in affective incontinence there is total
loss of control.
11. Communication of mood
• Our feelings are very much affected by
those around us. They are observable and
understandable to other people and this is
not accidental ; they are actually signalled
as a non-verbal message. The affect itself
is not directed towards another person, but
the expression of the affect is conveyed
both deliberately and unintentionally .
12. Categories of Emotion
Jasper has categorised feeling in following ways:
• According to the object of the emotion. This
include such a diverse feeling as fear of snakes,
patriotism, servile submission.
• Feelings can be categorised according to their
source . These may be localized feeling
sensation; affect experienced in the individual
region or areas of body.
13. • It is possible to evaluate emotions according to
it’s biological purpose. This would provoke a
discussion of the theory of instinct.
• Feeling state is a description of all the different
feeling occurring at one time and describe the
affective state of the individual at that time for
example of state of arousal.
• Emotion has ben categorised traditionally
according to the duration and intensity. Thus
feeling is an individual emotion reaction affect is a
complex but momentary emotional perturbation.
Mood is more prolonged emotional state which
influence all aspects of the mental state.
14. • There is an important distinction within the
ambiguous word feeling which means both
emotions and sensations. Emotions refers
to the state of self while sensation refers to
element of perception.
15. Pathological Changes In Mood
Changes in mood:-
Subjective description of change in the experience of emotion for
the worse-a state of dysphoria. Meaning the condition of being ill at
ease more rarely the patient may describe the on set of euphoria.
Bodily feeling associated with mood:-
In number of culture and languages, depression is considered
to have an anatomical location to such an extent that mood state
and the part of the body become synonymous melancholia, literally
means black bile, meaning self describe the hypochondrium
anatomically and come to mean to depression.
16. Changes in the bodily feeling are important in number of
condition. Physical illness frequently precipitates a loss of
the accustomed sense of well being , this Is subjectively
experienced as a generalized lowering of vitality and may
be associated with other psychological abnormalities .
17. • Feeling of capacity
There may be loss of the normal feelings of self-
sufficiency and the appropriate sense of self esteem,
Competence in any field of life is linked with a reasonably
accurate knowledge of self capacity-the ability to know
once own limits and not attempt the impossible. Loss of
accustomed feeling of capacity to achieve what is known to
the within the person’s capability may occur psychotic
depression: it may also be a neurotic development.
Increased feelings of capacity may be experienced in
mania.
18. Absence, Blunting and Flattening of Feeling-
Apathy is the absence of the feeling there may
also be blunting or flattening of effective response.
The patient himself is often not aware of his
deficiency but when pointed out to him may agree
that there is lack of any sort of emotional reaction.
Apathy is often associated with anergia and lack of
violation
19. The terms ‘blunting’ and ‘flattening’ are not identical
although both may occur in schizophrenia. Blunting implies
a lack of emotional sensitivity such as that displayed by a
girl with schizophrenia who with obvious relish for the
sensational effect. Flattening is a limitation of the usual
range of emotion and associated with anergia amongst
people with schizophrenia.
20. Feeling of a loss of feeling
It is experienced by the patient as a loss, a deficiency and
is all-pervasive-anger, love, pleasure and so on. The
patient present and doesn’t not understand it, suffers very
greatly and often feels guilty about the feeling, It is a
subjective experience of loss of feeling that were formally
present, rather than an objectively observed absence, a
depressed young woman said: I have no feelings for my
children. That is wicked. They are beautiful chiildren.
21. Anhedonia
In Anhedonia there is total inability to enjoy anything in life
or even get the acustomed satisfaction from everyday
events or objects a loss of ability to expirence pleasure.
Anhedonia is therefore one component of the loss of
capacity to feel feelings often the very way the patient
describes the loss of ability feel feelings demonstrates that
feelings are still there.
22. Feeling of impending disaster
This experience of dread or apprehension is
of course a common and normal emotion
and would be quite appropriate. For
example, for the ideal student a waiting his
examination results.
23. Ecstasy
• Ecstasy and euphoria occur in health
psychiatrists; are only concern with them when
they occur inappropriately or are prolonged
excessively , or are present to an abnormal
degree. heightened states of happiness such as
euphoria and ecstasy sometimes occur in people
with mental illness or abnormality of personality.
The patient may describe a calm exalted state of
happiness amounting to ecstasy, although this
tranquil mood state is relatively uncommon and
usually short lived. In schizophrenia, ecstatic
mood may be associated with exalted delusions.
24. Characteristic of ecstasy is that it’s self-referent; for
example the flowers of spring ‘open for me’. There is an
alternation of the boundaries of self so that person may feel
‘at one with the universe’.
Euphoria is a state of ecstasy of unreasonable
cheerfulness ;it may be manifested as extreme
cheerfulness as in mania, Or it may seem inappropriate
and bizarre. It is commonly seen in organic states, specially
associated with frontal lobe impairment.
25. Feelings attached with the Perception
of objects
Objects may evoke an emotional response in a
normal person . For instance a comfortable feeling
of familiar towards an armed chair in which one
rests after an energetic walk, or an apprehensive
dislike towards a dentist’s chair. Excessive feelings
of fear amounting to terror may remain associated
with objects, or alternatively profound
inappropriate happiness.
26. Feelings attached with the Perception of
objects(contd.)
The Objects to which affect is attached may not only be
physical. Inanimate object but also thoughts and patterns of
thoughts and people.
27. Feelings directed towards people
Affect may be absent or deadened, increased and
excessive or distorted. It may also be ambivalent-both
loving and hating, rejecting and over protecting
synchronously. A girl suffering from anorexia nervosa,
would take great care to cook enormous means for her twin
sister to whom she was very closed: The sister become
grossly obese whilst the patient vanished almost to
skeleton. In answer to remonstrations about feeling her
sister she said ‘ I look horrible, so she should so she should
look horrible as well’.
28. Free floating emotion
Freud(1895) considered that the condition was
characterized by free floating anxiety. A powerful
affect seems to have no goal and in associated
with no objects. The patients describes himself as
feeling generally anxious. Not anxious about
anything in particular but just anxious. Other free
floating affects occur such as restlessness,
tension, gloom, despondency, euphoria, irritability
and so on.
29. Experience and expression of emotion
The experience and expression of emotion
are separate, But closely link the expression
of mood may be abnormal in a number of
ways. Mood may be censored or denied so
that it never gains expression. It may be
altered and this is the theoretical explanation
of conversion with dissociation.
30. Vital feelings
Vital feelings was a term used by Wernicke(1906)
to describe certain somatic symptoms occurring in
the affective psychoses. The word vital comes
from the concept of the vital self which describes
the close relations of the body to awareness of
self: The way we experience our bodies and the
impression we consider our physical presence
makes on others. So vital feelings are those that
make us aware of vital self. These are the feelings
of mood which appear to emanate from the body
itself: Localized and somatised affect.
31. Vital feelings
Schneider(1920) considered vital feelings to be of
paramount diagnostic significance in depressive
illness equivalent to the first rank symptoms in
schizophrenia, the core of cyclothymic depression
and autonomic in origin.
Trethowan(1979) as considered that lowering of
vitality of fundamentals to the experience of
depressive illness. He has described this as a
lowering of vitality which is all persuasive and
leads to a marked loss of ability of the subject to
function as he did before he become ill in terms of
both mind and body.
32. Religious feelings
The discrepancy can become very obvious in the
area of ecstatic and religious experience. There is
need to acknowledge take into account have
respect for and use in treatment the patient’s on
subjective experience in this area(Sims, 1994).
Lewis, 1997 can be traced through Christian and
other cultures and only makes contacts with
recognisable mental illness at a few points.
33. Religious feelings
William James(1902) in the variety of religious
experience demonstrated the vast extent of the
phenomenology of religion and showed how
unwise it would to be equate the surprising with
pathological. Once again , the phenomenological
dichotomy of form and content is important.
34. Manic-Depressive Mood
It is important to realize that these mood states
may occur together. Mania and depression are not
opposite mood states: they are both pathological
and opposite of either would be freedom from
morbid emotion. Agitation and over activity may
ouccr with depression, irritatability and a feeling of
frustration with mania.
35. Suicidal Thoughts
This emotion of hoplessness arrises from feelings
defeated in some important area of life and feeling
closed in with no possible escape or rescue.
Sucidal behaviour is then a ‘cry of pain’, an
attempt to escape these feelings of entrapment.
Plans for suicide may not be carried out , solely
because of the degree of retardation- occassionaly
electroconvulsive therapy may lessen retardation
after three or four treatments and thereby increase
the risk of suicide.
36. Suicidal Thoughts
Because improvements from depression
from mood and lowered self-esteem
because of guilt feelings has not yet
occureed. Death of often welcomed with a
sense of relief.
37. Depersonalization
Depersonalization which is common depression
may be manifest as loss of feelings or the abilty to
feel. This a milder form of what may progress in
severe illness to nihilistic delusions: ‘My body has
been changed to water’ or ‘ I am dead’: I have no
feelings and no will. Depersonalization is when it
occurs in healthy people it is not eased but
associated with little emotion but when it is
complained of as a symptoms, it is described as
being extremely unpleasant.
38. Internal restlessness
Freud’s theory of anxiety-the resultant conflict from
the oppsoing forces of the superego and id. Mood
is a variable expression of the self; it may be a
transient feeling reactive to a certain situation or it
may be a more long lasting, sustained,
inexplicable mood that is regarded as
endogenous. Internal restlessness also describes
the emotions of neurotic disorder-anxiety, irratiblity
and the situaational fears of phobic state
39. Cyclothymia and related conditions
The major episodes of mania and depression
occurring in manic-depressive disorder. Recurrent
and cyclical conditions with episode of depression
and hypomania of mild to moderate severity with
rarely lead to hospitalization. The symptoms are
manifested as abnormality of personality such as
Cyclothymia rather than as symptoms of mood
disorder. These conditions are common in the
general population.
40. Cyclothymia and related conditions
Conditions are including contributions from the
hyperthymic temperament, subaffective dysthymic
temperament, irritable temperament and
Cyclothymic temperament.
41. Depression and loss
Any social situation of transition is associated with
some disturbance of emotion. Depression is the
affect associated with experience of loss.
Parker (1976) has demonstrated how loss of a
person , loss of a limb and even loss of a home
are stressful in similar ways and that there is a
mental process going on in which the person is
making real inside the self events which have
already occurred in reality outside. This process is
associated with marked psychic pain and
unhappiness.
42. Depression and loss
The dysphoric mood associated with the
experience of loss is always exacerbated if
there any sense of guilt or self-blame
attached to the circumstances of the loss: if
only I had called the doctor on to see mother
earlier. I shall never forgive myself.
43. Grief
The immediate experience of loss is shock and
numbness. The suddenly bereaved person may
say that he cannot believe that it has happened to
him. He just feels numb and empty. He may
describe depersonalization feelings. There is a
tendency to deny that the loss has happened.
Three distinct patterns of morbid grief have been
observed(Lieberman,1978)
44. Grief
1. Phobic avoidance of persons, places or things
related to the deceased, combined with
extreme guilt and anger abut the deceased and
his death.
2. A total lack of grieving with anger directed
towards others and over-idealization of the
deceased
3. Physical illness and recurrent nightmares of
the deceased
45. Helplessness and hopelessness
Patients have described this affect as
‘discouragement’, ‘disappear', 'giving up’ or
‘depression’. The deferent facts of this emotional
set have been described as the giving-up given-up
complex and five subjective characteristics have
been delineated(Engl,1968).
1. The affect of helplessness and hopelessness.
The patient describes himself as being at the end
of his tether, unable to cop and not knowing which
way to turn.
46. Helplessness and hopelessness
2. There is a loss of self-esteem. He feels
himself no longer to be competent or in
control. He may feel himself to be damaged,
maimed or mutilated.
3. There is a loss of gratification in his
relationship and roles in life. He may
express dissatisfaction with his marriage or
his job, And he feels a failure in achieving
his ambitions
47. Helplessness and hopelessness
4. There is disruption of the normal sense of
continuity between past, present and future. The
future seems bleak and hopeless.
5. There is a painful remembering of times when
his self-esteem and sense of well-being were
lowered. This reactivation of memory especially
concerns past failures, embarrassments and
griefs. Feelings of giving up may be directed
towards an idea or an object, as well as towards a
person or even himself.
48. Mania
Mania refers to elation of mood acceleration of
thinking and over activities. Subjectively, although
it may be described as a different state from
normal, It is rarely complained of by the patient as
a symptom.
The early stages of mania may be experienced as
enjoyable even wonderful and an enormous relief
from the depression that preceded it.
49. Manic thinking
• Exceptional distractibility is shown in the way
external events such as a noise in the street out
side are immediately incorporated into
conversation. The rapid association of thought is
called flight of ideas and the incessant need to
talk and express these ideas pressure of speech.
Behavioural changes result from this elevation of
mood and acceleration of thinking and activity.
50. Manic thinking
Restless activity associated with grandiose
schemes are often seen: a patient buried several
mattresses in this garden because he felt it would
improve the quality of his vegetables by making
composts.
Kraepelin considered that there were three
fundamental components to the symptomatology
of many-depressive psychosis: level of mood,
psychic activity and motor activity.