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- Category: A Study Of Psychopathology
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Depersonalizations and feelings of unreality were seen in highly anxious or depressed patients as fleeting phenomena, accompanying the stare of heightened fear or despair. The patients’ usual statements were “I thought the ceiling was coming down on me”; “The Virgin Mary’s face changed several times while I prayed”; or “As if 1 were removed from myself.”
The depersonalizations were particularly severe and frightening in two female patients. Only one dissociative phenomenon, with splitting of the self, was encountered. In the latter case the patient adopted a different name for each of the two personalities she assumed. One, Clara, was reserved, kind, patient, and a devoted wife; the other, Clarita, did completely different things, such as collecting pictures of Flash Elorde (the boxer), scratching herself in public, wanting other men. She was pregnant during this episode and was, in fact, referred by her obstetrician. After the delivery, she improved greatly, came only for two more sessions and from the obstetrician’s follow-up has since been doing rather well.
Paranoid-like symptomatology was discussed under the section on difficulty in mastery of anger. As mentioned, the symptom often approximated a delusion but the patient recognized reality limits and did not “manufacture” data. He enlarged upon or misinterpreted existing facts to gain sympathy or to displace guilt or blame to others. Similarly, grandiosity was achieved by exaggeration. manipulation, or distortion of facts. The patient, however, knew all the time what he or she was doing.
In the same section on aggression, as well as in the description of depressive phenomena, mention was made of ‘staring into space” or in Tagalog, titigilan. This is a rather common expression for describing a reaction to some sudden, overwhelming event, good or bad. Staring into space, however, is used more for painful or stressful experience. In mounting rage, it has the quality of “as if stunned.” In depression, it has the gloomy overtones of “as if the roof has just caved in.” In both states, there is suggested in the symptom a paralysis of action, an inability to summon any kind of reaction. This symptom is also encountered in psychotic states; in these patients, however, it was of much shorter duration and always reversible.
Shyness and inhibitedness were frequently observed in adolescent boys and girls. However, in this study, these symptoms did not appear as part of the character structure but rather as part of the non-verbal modes in this culture for transacting initial interpersonal encounters. Later, these youngsters proved to be far from shy or inhibited. Those who had a problem with excessive inhibitedness limited it to specific situations, such as great fear of getting up to recite, or to give a speech in front of a group, or for a girl, walking in front of boys. Outside these situations, there was no problem with inhibitedness.
The eight cases of drug addiction involved barbiturates, stimulants, sleeping tablets and tranquilizers. The few cases who were addicted to opiates were patients of non-Filipino parentage. Addiction in the eight cases from this study were all initiated by a doctor’s prescription and enhanced by the ease with which the drugs can be purchased over the counter. The patients were all in their twenties and thirties, who sometimes had to be hospitalized when intake became toxic. In addition to this group, there were a small number of men and women who for years had taken a tablet or two of barbiturates at bedtime in order to sleep but had not seen the need to increase the dosage or to take it at other times.
Of the eight cases of sexual deviation, only two came because they felt they had to give it up. The rest came for depression or anxiety reactions. Two of the male homosexuals were married and had several children. They were also quite ambitious and hard working, although work was often beset with anxiety reactions. The lesbian came because of stormy relationships marked by frequent emotional outbursts between herself and her love partner or with members of her family who wanted her to give up her homosexuality.