Psychoanalysis - Topographical Theory of Mind - Psychiatry

Psychoanalysis is an essential part of understanding the human mind and its complexities. It helps in the assessment and treatment of various psychological and psychiatric disorders. It provides insights into the patient's psyche and helps psychiatrists gain insight into the patient's unconscious mind and past experiences, which can help develop an effective treatment plan.

In this blog we’ll cover the topographical theory of mind by Sigmund Freud and Delirium. Read on.

INTRODUCTION 

• Given by Sigmund Freud (Father of Psychoanalysis)

• Childhood experiences and unconscious internal conflicts are responsible for development of psychiatric disorders.

1. TOPOGRAPHICAL THEORY OF MIND (ALSO GIVEN BY SIGMUND FREUD)
   • Three components of Mind
     • Conscious (All those things we are aware of)
     • Preconscious (Things that we can recall by putting some efforts)
     • Unconscious (Things that we cannot recall)

Proposed Ways by Sigmund Freud Of Moving Unconscious Things to Conscious Mind

• Free association (Patient is asked to speak whatever is coming in his mind putting any filter)
• Interpretation of dreams (Dreams are The Royal Road to the Unconscious)
• Abreaction- Recall of memory with release of emotions - usually seen in psychoanalysis.

2. STRUCTURAL THEORY OF MIND- GIVEN BY SIGMUND FREUD

• ID: Instincts, pleasure principle
• Ego: Reality principle
• Superego: Moral principle

Defense Mechanisms 

• These are mechanisms used by ego to prevent buildup of exercise anxiety. They are unconscious)

Displacement

• Transfer of emotions from one individual to another (Primary defense mechanism used in Phobia)

Reaction Formation

• Transforming an impulse into its exact opposite behavior. Eg. beating other couples on valentine day because girlfriend refuses to go with you

Isolation of Affect

• Removing feeling association with a stressful event.

Undoing

• An act to nullify the previous act

Aim Inhibition

• Accepting partial fulfillment of desire. Student desires to become doctor but due to failed NEET attempt chooses to be vet- doctor.

All these defense mechanisms are used in the development of OCD.

PSYCHOSEXUAL STAGE OF DEVELOPMENT (SIGMUND FREUD)

• Oral stage (0-1.5 years/18 months)
• Anal stage (1.5 yrs. – 3 yrs.): Fixation at anal stage results in OCD according to Sigmund Freud.
• Phallic Stage (3 yrs. – 5 yrs.)
  • Oedipus Complex: Male child develops sexual feeling towards the mother and develops aggression towards the father - this complex resolved when child makes the father as role model
  • Electra Complex (Same with female child)
  • Neurosis
• Latent Stage (5-12 yrs) focused on learning and gaining skills
• Genital Stage (12 years till young adulthood)

MENTAL HEALTH CARE ACT, 2017

• Advanced Directive: Way he wishes to be treated/ not treated for a mental illness; in case he loses capacity to take mental health care decisions in future.
• Nominated Representative: Assign a person for the responsibility to take care of yourself.
• Ban on Direct ECT (No use of anesthesia and muscle relaxants), Govt. has banned all types of (direct, indirect) ECT in minors. Ban on ECT in minors (Can be done by taking permission from a Mental Health Review Board)
• Ban on psychosurgery (Can be done by taking permission from a Mental health review board)
• Decriminalization of suicide: Sec 309 IPC

Psychiatry Articles:

Obsessive Compulsive Disorder - NEET PG Psychiatry	All About Panic Disorder and Phobias
Schizophrenia: History, Etiology, Symptoms For NEET PG	Depression - Symptoms, Causes, and Treatment - NEET PG Psychiatry

Previous year Questions

Q. Freud’s theory of dream work, includes all except? (NEET Jan 2018)

A. Displacement

B. Condensation

C. Symbolization

D. Confabulation

Q. Oedipus Complex is seen in? (JIPMER Nov 2017)

A. Girl 1 to 3 yrs.

B. Girl 3 to 5 yrs. 

C. Boys 1 to 3 yrs.

D. Boys 3 to 5 yrs.

Q. Provisions of WHO mental action gap are all, except: (AIIMS Nov 2018)

A. Human rights 

B. Communication regarding care and carrier

C. Screening family members 

D. Social support

ORGANIC MENTAL DISORDER

DELIRIUM

• M/C acute organic mental disorder. 

Symptoms

• Disturbances of consciousness (Most important)
• Confused, altered sensorium, clouding of consciousness 

• Disorientation to time, place and person
• Hallucination (M/C Visual)

M/C investigation finding in delirium

• Diffuses slowing on EEG 

Important Information

• Exception: Alcohol withdrawal delirium and BZD withdrawal delirium where there is fast activity on EEG.

DIFFERENCE BETWEEN DELIRIUM AND DEMENTIA      

	Delirium	Dementia
Onset	Sudden onset	Insidious onset
Consciousness	Disturbances of consciousness	Not present (If present, means patient with dementia is also developing delirium)
Course	Fluctuating course	Progressive course

Important Information

• Carl Gustav Jung was a Swiss psychiatrist and psychoanalyst who founded analytical psychology.

Previous year Question

Q. Most common acute organic mental disorder?                (FMGE Dec 2018)

A. Delirium 

B. Dementia 

C. Amnesia 

D. Anxiety Disorder

To study this important psychiatry topic for NEET PG exam preparations, download the PrepLadder app and get access to excellent preparation resources.