Individual Behaviour: Sleep and Dreams and Sleep Disorders Flashcards Preview

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Flashcards in Individual Behaviour: Sleep and Dreams and Sleep Disorders Deck (62):
1

Biological Approach: Circadian Rhythms

Circadian rhythms are physical processes mainteined by sunlight an dother times cues that keep the sleep-wake patterns on a consistent 24-hour schedule. Circadian functions inlcude; body temperature, hormone levels, and the sleep-wake cycle. In healthy people, hte circadian rhythms rise adn fall throughout the day adn night to signal wakefulness or sleepiness. While many people refer to circadian rhythms as a single process, there are actually a number of body clocks that oscillate throughout the day. For example, mental alertness tends to peak twice in a day at 9AM adn 9PM, while physical strength tends to crest at 11AM adn 7PM.

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Biological Approach: Circadian Rhythms (Key Points)

- Circadian rhythms are tied to sunlight cues.
- Disrupting these patterns can lead to poor or difficult sleep.
- Without light signals, people tend to operate on a 25-hour schedule.
- Circadian rhythms also impact body temeprature, pain sensitivity, mental alertness, physical strength, and the senses.

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Biological Approach: The Role of the Brain in Sleep

A tiny cluster of approx. 20,000 neurons in the hypothalamus controls your body's many circadian rhytms. Known as the suprachiasmatic nucleus (SCN), this master control centre is responsible for acting as your body's internal pacemaker. While the exact mechanisms for how this process works are unclear, environmental cues are important. Sunlight is perhaps the most apparent, controlling our daily sleep-wake schedule.
So how does sunnlight affect circadian rhythms? As the sunlight decreases at the close of the day, the visual system sends signals to the SCN. Next the SCN sends signals to the pineal gland to increase teh production of the hormone melatonin. This hormone increase helps reduced activity and makes you feel increasingly sleepy.
Babies: 14 to 15 hrs sleep
Toddlers: 12 to 14 hrs sleep
Pre-School: 11 to 13 hrs sleep
School Age Children: 10 to 11 hrs sleep
Adolescents: 8.5 to 9.25 hrs sleep
Adults, including Elderly: 7 to 9 hrs sleep
Preganant Women: 8 + hrs sleep

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Biological Approach: Homeostasis

Homeostasis is any internal biochemical system that regulates the body's internal environment, with a view to maintaining properties such as; temperature, acidity etc in a stable and relatively condition.
Sleep-wake homeostasis, in particular, can be thought of as a kind of internal timer or counter that generates a homeostatic sleep drive or pressure for sleep as a function of the amount of time elapsed since the last adequate sleep episode. It is quite intuitive in its operation: the longer we have been awake, the stronger the desire and need to sleep becomes and the greater the likelihood of falling asleep; the longer we have been asleep, the more the pressure to sleep dissipates, and the greater then likelihood of awkening.
Compared to teh circadian drive for arousal, the actual mechanism of sleep-wake homeostasis is relatively poorly understood, despite years of research. What is known is that a naturally produced sleep-regulating substance or substances, builds up in the body's cerebrospindal fluid during our waking hours, which has the effect of increasing the pressure to sleep the more it accumulates. This pressure is only released by the act of sleeping itself, during which the levels of the sleep-regulating substance in the body rapidly declines.
The best known of these sleep-regulating substances (although probably not the only one) is adenosine. Adenosine operates as a neuromodulator in the brain, and has the effect of the inhibiting many of the bodily processes associated with wakefulness, particularly those involving the neurotransmitters adn serotonin.

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Biological Approach: The 4 Stages of Sleep

Sleep begins in stage 1 and progresses into stages 2, 3 adn 4. After stage 4 sleep, stage 3 and then stage 2 sleep are repeated before entering rapid eye movement (REM) sleep. Once REM sleep is over, the body usually returns to stage 2 sleep. Sleep cycles through these stages approximately four or five times throughout the night. On average, we enter the REM stage approximately 90 minutes after falling asleep. The first cycle of REM sleep might last only a short amount of time, but ach cycle becomes longer. REM sleep can last up to an hour.

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Biological Approach: Drowsy Resting (Just as we Fall Asleep)

More synchronised alpha waves, heart rate slows, temperature falls and mucle tension reduces.

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Biological Approach: Stage 1 of Sleep

Stage 1 is the beginning of the sleep cycle, and is a relatively light stage of sleep. Stage 1 can be considered a transition period between waefulness and sleep. In Stage 1, the brain produces high amplitude theta waves, which are very slow brain waves. This period of sleep lasts only a brief timme (around 5-10 mins). If you awaken someone during this stage, they might report that they weren't really asleep. There is less desynchronised brain activity during this stage and you may experience Hypnic Myoclonia.

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Biological Approach: Stage 2 of Sleep

Stage 2 is the second stage of sleep and lasts for approximately 20 mins. The brain begins to produce bursts of rapid, rhythmic brain wave activity known as sleep spindles. Body temperature starts to decrease and heart rate begins to slow. There is synchronised brain activity and muscle tensions is reduced.

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Biological Approach: Stage 3 of Sleep

Deep, slow brain waves known as delta waves begin to emerge during stage 3 sleep. Stage 3 is a transitional period between light sleep and a very deep sleep. There is less sleep spindles and heart, breathing rate continue to fall.

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Biological Approach: Stage 4 of Sleep

Stage 4 is sometimes referred to as delta sleep because of the slow brain waves known as delta waves that occur during this time. Stage 4 is a deep sleep that lasts for approx. 30 mins. Bed-wetting and sleepwalking are most likely to occur at teh end of stage 4 sleep. Only delta waves happen during this stage. there is synchronised brain activity, night terrors and sleepwalkiing can occur at this stage.

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Biological Approach: Stage 5 of Sleep (REM Sleep)

Most dreaming occurs about an hour after we fall asleep during the 5th stage of sleep, known as rapid eye movement (REM) sleep. Dreaming occurs durinng REM sleep and is characterised by the rapid and random movement of the eyes as well as increased respiration rate and increased brain activity There are around 3 to 5 REM episodes a night. Breathing becomes irregular, there is temporary sleep paralysis adn blood pressure rises. EEGs show REM brain waves are similar to those of wakefulness, there is desynchronised brain activity adn this stage lasts approximately 90 mins.

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Biological Approach: REM Sleep and Dreaming

REM sleep is also referred to as paradoxical sleep because while the brain and other body systems becomoe more active, muscles become more relaxed. Dreaming occurs because of increased brian activity, but voluntary muscles become paralysed. REM sleep inn adult humans typically occupies 20-25% of total sleep, about 90-120 mins of a night's sleep.

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Biological Approach: Non-REM Sleep

Non-REM sleep occurs at the beginning of the sleep cycle and the first stage of sleep cycle is a relatively light stage of sleep lasting approx. 5-10 mins.
Stage 2 of the sleep cycle and lasts for approx. 20 mins. The brain begins to produce bursts of activity known as sleep spindles.
Stage 3 of Non-REM sleep is a transition between light adnd deep sleep. Stage 4 is a deep sleep when sleepwalking or bedwetting is most likley to occur.
The brain produces very slow brain waves known as theta waves adn heart-rate slows and body temperature drops.

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Biological Approach: Factors Affecting Sleep - Environmental (Light)

Artificial lighting makes it possible for humans to be active at night time and allows us to work over a full 24-hour period. Factory workers operate heavy machinery, lorry drivers travel long distances, doctors have responsibility for patients' lives, and air traffic controllers make fast decisions at times when their body clocks (circadian sleep-wake cycles) are completely out of synchronisation with the environment. It is therefore vital to understand the effect of working at night adn sleeping during the day on safety, productivity and health.
Light exposure can cause our biological clock to advance or delay, which affects our sleep and wake cycle.
Light is one of the most important external factors that can affect sleep. It doesn't so both directly, by making it difficult for people to fall asleep, and indirectly, by influencing the timing of our internal clock and thereby affecting our preferred time to sleep.
Light influences our internal clock through specialised 'light sensitive' cells in the retina of our eyes.
due to teh invention of the electric light bulb in the late 19th century, people are now exposed to much more light at night than they have previously been exposed to throughout evolution.

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Biological Approach: Factors Affecting Sleep - Environmental (Jet Lag and Shift Work)

Jet lag is caused by the body's internal body clock being out of step with external cues. Individuals who travel across time zones or work night shift typically have two symptoms. One is insomnia when they are trying to sleep outside of their internal phase, and the other is excessive sleepiness during the time when their internal clock says that they should be asleep. (Circadian Sleep Disorder).

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Biological Approach: Factors Affecting Sleep - Chemical Stimulants/ Depressants (Caffeine)

The most marked effects of caffeine on sleep, even at levels equivalent to those of single cup of coffee, have been well documented. They consist principally of prolonged sleep latency - going from fully wakefulness to sleep, shorter total sleep time, increases in light sleep and shortening of deep sleep time, as well as more frequent awakenings. REM sleep is less affected.
The effects depend not only on the amount of caffeine ingested at bedtime, but also on the amount of caffeine ingested over the whole day. Drake et al (2013) assessed the impact on sleep of caffeinne consumption at different times of day, suggesting that caffeine consumed up to 6hrs before sleep may have disruptive effects on sleep.

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Biological Approach: Factors Affecting Sleep - Chemical Stimulants/ Depressants (Alcohol)

Alcohol is commonly used as a sleep aid. However, although alcohol can help a person fall asleep more quickly, the quality of that individual's sleep under the influence of alcohol will be compromised. Ingesting more than one or two drinks shortly before bedtime has been shown to cause increased awakenings - and in some cases insomnia - due to the arousal effect the alcohol has it is metabolised later in the night.

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Biological Approach: Sleep Hygiene

Sleep hygiene is nothing to do with whether you have a bath or shower before you go to the bed. Sleep hygiene is a variety of different practices that are necessary to have normal, quality night-time sleep and full daytime alterness. The most important sleep hygiene measure is to maintain a regular wake and sleep pattern seven days a week. It is also important to spend an appropriate amount of time in bed, not too little, or too excessive.
Sleep hygiene is important for everyone, from childhood through adulthood. A good sleep hygiene rountine promotes healthy sleep adn daytime alertness. Good sleep hygiene practises can prevent the development of sleep problems and disorders.
Sleep disturbances and daytime sleepiness are the most telling signs of poor sleep hygiene. If one is experiencing a sleep problem, he or she should evalute their sleep routine. It may take some time for the changes to have a positive effect.
If you're taking too long to fall asleep, or awakening during the night, you should consider revising your bedtime habits. Most important for everyone is to maintain a regular sleep-wake schedule throughout the week and consider how much time you spend in bed, which could be too much or too little.

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Biological Approach: Strengths

- Based on mature biological science.
- Looking at the chemical make-up of the brain has led to the successful production of a range of drug treatments in recent decades that have helped in the treatment of variety of issues.
- Biological approach is determinist and provides biological explanations about the biological causes of behaviour.

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Biological Approach: Weaknesses

- Focuses just on biology; i.e. Nature, tending to ignore experience (Nurture) adn psychological factors, e.g. thoughts adn feelings. So, it is also a reductionist approach.
- The biological approach is nomthetic - i.e. looking to make generalisations about people by finding similarities and ignoring differences.
- Drugs only treat the biologically visible effects and not the causes of problems.

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Biological Theories and Studies: Exposure to bright light and darkness to treat physiological maladaption to night work (Czeisler et al 1990)

Aim: To evaluate whether negative physical reactions to night time work could be prevented by treatment of exposure to bright light during the night and darkness during the day.
Method: 10 x 2 week studies were carried out on 8 men aged between 22 and 29 years. They had no medical or sleep disorders and none had worked shifts. The men were instructed to avoid alcohol or drugs. 5 control and 5 treatment studies were conducted. The temperature, physical activity and heart rate were recorded during a base week (normal activity). The participants then took part in a week of night shifts. In 2 conditions; in condition 1, the men were either exposed to bright light during the night shift adn told to remain in the dark at home between 09.00 and 17.00. In condition 2, participants were exposed to ordinary room light during the night shift and were given no instructions about staying in darkness durinng the day for any length of time. Participants completed hourly cognitive performance tasks and also assessments of their mood and alertness. They then went home after the night shifts.
Results: the men exposed to bright light at night and darkness during the day slept for 2 hours longer than the second group. The alertness of participants exposed to bright light was greater than before the use of bright light.
Conclusion: Exposure to a properly designed routine of light and dark induced a complete physiological adaption to night work. This has implications for industrial productivity and safety at work. Working in ordinary room light and then being exposed to bright daylight saw a failure of the circadian timing system to adapt. This was due to the biological effect of light.

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Biological Theories and Studies: Exposure to Bright Light and Darkness to Treat Physiological Maladaption to Night Work (Czeisler et al 1990) - Evaluation

- All the participants were male therefore the results cannot be generalised.
- A small sample was used.
- Experimental method lacks ecological validity.
- Give some insight into the physiological effect of nnight working.
- Participants kept diaries at home which could be subjective adn inaccurate.

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Biological Theories and Studies: Exposure to Bright Light and Darkness to Treat Physiological Maladaption to Night Work (Czeisler et al 1990) - Analysis

- The study highlighted the possible implications for industrial productivity and safety of people on night shift.
- It also highlighted the possible health consequences of sleep deprivation adn disruption of the circadian rhythm such as cardiovascular, digestive or sleep disorders.
- Further questions were posed from the study. What is more important in terms of dealing night working? Bright light at night or darkness during the day? Does age, gender play a role?

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Biological Theories and Studies: Repair and Restoration Theory of Sleep (Oswald 1966)

This theory maintains that both REM and NREM sleep serve a restorative, replenshing function. NREM restores bodily processes that have been depleted. REM sleep is a time for replenishing and renewing brain processes - through stimulation of protein synthesis.
This theory accounts for the large proportion of babies' sleeping time spent in REM sleep. During th efirst year babies sleep 18 out of 24 hours. By 12 months, they have 2 sleep periods every 24 hours (one daytime/ one night-time). Not until the age of 5 years is an adult circadian pattern established. This may be due to both environmental and maturational factors. The REM/ NREM pattern during this time shows that new born infants spen dhalf of the 18 hours in REM sleep. Adults spend one quarter of their 8 hours in REM sleep. The developing brain needs protein synthesis for cell manufacture and growth - REM sleep helps to achieve this.

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Biological Theories and Studies: Repair and Restoration Theory of Sleep (Oswald 1966) - Evaluation

- Patients who survive drug overdoses and patients who have extensive ECT treatment show prolonged increases in REM sleep for a 6-8 week period, which is the same time it takes to replace half of the brain's total protein.
- Fibrositis sufferers experience a chronic lack of normal stage 4 sleep. EEG's show Alpha-Delta patterns - a mix of sleep and waking EEG - this is fitful sllep and is 'unrestorative'.
- Cell repair goes 24 hours a day - even though it reaches a peak at night.
- Far from being restful, REM sleep is an active brain state, and burns up a substantial amount of energy. Blood flow to the brain increases during REM and this would prevent high levels of protein synthesis.
Oswald (1974) maintains that both types of sleep are involved in the process of restoring bodily tissue.

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Biological Theories and Studies: Repair and Restoration Theory of Sleep (Oswald 1966) - Evidence

- Support from Shapiro et al (1981), in a study of ultramarathon runners. After taking part in a ultramarathon, it was found that their sleep lasted on average 90 mins longer than usual over the next 2 nights. In particular, NREM sleep lengthened, rising from 25% to 45% of total sleep. However, Horne (1978) reported that sleep deprivation didn't interfere with partcicipants' ability to play sport or make them ill. It seems that sleep isn't essential for physical functioning at least in the short-term.
- Hartmann (1973) said that REM sleep is a time for making neurotransmitters to compensate fro the amount used during the day.
- Stern and Morgane (1974) also thought that REM sleep allows the brain to restore levels of neurotransmitters to 'factory settings'.
- Oswald (1980) claimed that NREM sleep restored the body and REM sleep restored the brain, through protein synthesis adn that slow wave sleep (SWS) helped the body restore itself.
- The main predictions of restoration theory are; Deficits in functioning when sleep deprived, 'Rebound' effects following sleep deprivation, Increase in REM sleep during brain growth, organistation and repair.

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Cognitive Approach: What is it?

Cognitive psychologists assume that behaviour is the result of information processing. By describing thinking as information processing, cognitive psychologists are making a comparison between minds and computers (i.e. they are adopting a computer metaphor for the mind). This is useful because minds and computers have some similarities; both have inputs, outputs, memory stores and a limited capacity for how much information they can process at any one time. Just as a computer's behaviour is determined by what information it is given and how it has been programmed, so a person's behvaiour is determined by (1) the information available in their environment; (2) the ways they have learned to manipulate (process) information; and (3) the capacities for information processing inherent in the types of brain people have.

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Cognitive Approach: Information Processing

Information Processing is based on transforming information, storing information adn retrieving information from memory. Information processing models of cognitive processes such as memory and attention assume that mental processes follow a clear sequence. For example:
Input - processes are concerned with the analysis of the stimuli.
Storage - processes cover everything that happens to stimuli internally in the brain and can include coding and manipulation of the stimuli.
Output - processes are responsible for preparing an appropriate response to a stimulus.

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Cognitive Approach: Thought Processing

Thought can refer to the ideas or arrangments of ideas that result from thinking, the act of producing thoughts, or the process of producing thoughts. Although thought is a fundamental human activity familiar to everyone, there is no generally accepted agreement as to what thought is or how it is created. Thoughts are the result or product of either spontaneous or willed acts of thinking.

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Cognitive Approach: Irrational Thoughts and Beliefs

If something gows wrong with a person's perceptual or thinking processes, then this can have an impact on both their emotional experiences and their behaviour resulting in irrational thoughts and beliefs. For example:
- Anxiety disorders, a person may perceive objects or situations as a threat, even if they are not.
- Depression, a person may interpret bad situations as being their fault, even though they are accidental.
- Paranoia, a person may assume that other people have ulterior motives for their behaviour, when they are innocent of these.

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Cognitive Approach: The Computer Analogy

Humans: Information taken in by the senses -> Information processed in the brain -> Information stored in memory -> Information retrieved from memory -> Behavioural response
Computer: Ioration taken in via keyboard -> Information recorded -> Information stored -> Information retrieved from memory -> Symbolic output

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Cognitive Approach and Sleep

- The ability to sustain attention and maintain peak cognitive performance has to do with the total amount of sleep over several days.
- 8 hours of sleep a night, means levels of alertness should remain stable throughout the day, but if there is a sleep disorder or less hours sleep for several days, a sleep deficit can build up that makes it more difficult for the brain to function.
- Sleepiness slows down thought processes. Scientists measuring sleepiness have found that sleep deprivation leads to lower alertness and concentration. It is more difficult to focus and pay attentin. This hampers the ability to perform tasks that require logical reasoning or complex thought.
- Excessive sleepiness impairs memory. Research suggests that the nerve connections that make our memories are strengthened during sleep.
- It appears that different phases of sleep play different roles in consolidating new information into memories. If sleep is cut short or disrupted, it inteferes with these cycles.
Poor sleep also makes learning difficult.

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Cognitive Approach: Strenghts

- Takes into account the internal, invisible thought processes that affect behaviour unlike the biological approach.
- Has led to the development of useful ways of understanding and treating psychological disorders.
- The approach address some of the shortcomings of other approaches by offering a much better developed account of the internal processes that shape behaviour, thanks to the use of the computer metaphor.

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Cognitive Approach: Weaknesses

- Depends largely on controlled experiments to observe human behaviour, which may lack ecological validity (being compared to real-life behaviour).
- Does not take into account genetic factors; for example hereditary correlations of mental disorders.
- However, some critics would argue that over-reliance on the computer metaphor has led cognitive psychologists to neglect the influence of emotions, which computers lack, on thinking and behaviour.

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Cognitive Theories and Studies: Reorganisational Theory of Dreaming (Crick and Mitchison, 1986)

Crick and Mitchison's (1986) compared the process of dreaming to a computer in that it was "off-line" during dreaming of the REM phase of sleep. According to the model, we dream in order to forget and ths involves a process of 'reverse learning' or 'unlearning'. During this phase, the brain supposedly sifts through information gathered throughout the day and throws out all unwanted material, called parasitic memories that are taking up valuable space. Adaptive memories that will be useful are retained. A good analogy here is the defragmentation of a computer's hard drive: Dreams are a reordering of connections to streamline the system.

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Cognitive Theories and Studies: Reorganisational Theory of Dreaming (Crick and Mitchison, 1986) - Evidence

The spiny anteater (Echidna) is a primitive egg laying mammal that has no REM sleep, but does have an enlarged brain. The bottlenose dolphin is also another exmaple of this. Crick and Mitchison clain this enlarged brain is used to store parasitic (unncessary) memories which humans dispose of in REM sleep which allows humans to have smaller brains.

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Cognitive Theories and Studies: Reorganisational Theory of Dreaming (Crick and Mitchison, 1986) - Evaluation

- Explains why we rarely recall our dreams.
- Doesn't explain why some dreams are significant (we would be less likely to be unlearning significant connections).
- Doesn't explain why some dreams can be recalled and make sense.
- Reverse learning cannot explain why dreams are meaningful. Dreams are often organised into stories (narratives) - it doesn't feel like we are getting rid of random thoughts. Later Crick and Mitchison changed their theory to apply only bizarre imagery in dreams.
- Capacity for storage may be nderestimated - perhaps the brain doesn't need to be rid of so much information.

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Cognitive Theories and Studies: Study of REM Sleep (Dement and Kleitman, 1957)

Aim: To investigate the link between dreams and stages of sleep. The function of REM sleep and whether eye movements during REM were connected to dreaming, length of REM and if dreaming occured.
Design: Laboratory experiment and observation.
Procedure: The 9 participants were 7 adult males and 2 adult females. 5 were studied intensively, while only a small amount of data was collected from the other 4 just to support the findings of the main 5 participants.
Method:The participants were studied under controlled laboratory conditions, whereby they reported to the laboratory just before their usual bedtime. They had been asked to eat normally but to avoid caffeine or alcohol on the day of the study. The participants went to bed in a quiet, dark room.
An EEG was used to record the signals of the electrodes which were attached to the participants face and scalp.
Results: During REM sleep participants were more likely to say they had been dreaming if woken during this phase. 80% of participants reported dreaming during REM sleep. Only 9% reported dreaming during NREM sleep. There appeared to be a link between eye movement and dreaming e.g. one participants reported to be having a dream about a tomato fight and while they were dreaming their eyes were moving rapidly side to side.

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Cognitive Theories and Studies: Study of REM Sleep (Dement and Kleitman, 1957) - Evaluation

- The study has a lack of ecological validity. The situation in which the participants had to sleep was unusual and could have affected their sleep patterns.
- The nature of teh method of waking participants may have affected their ability to recall their dream.
- A further problem with the study was the sample size. The sample size was small and only included 2 females so it could be argued that the results were biased towards the dream pattern of men rather than women. All the participants were of simialr age and all came from an individualist culture. This also means that the results are hard to generalise to females, different ages and cultures.
- Subsequent studies have not supported Dement and Kleitman's findings that there is a relationship between eye movements and what the person is dreaming about.
- Since the partcicipants' were volunteers they could have all been of the same personality type.
- The researcher's did find results that supported their hypothesis.
- The method was tightly controlled. For example researcher's were able to control the location, sleeping time and the participants' use of stimulus.
- To reduce researcher bias they used a bell to wake the participants and asked the questions through a recording device.

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Cognitive Theories and Studies: Study of REM Sleep (Dement and Kleitman, 1957) - Analysis

- Further research by Dement and Wolpert involved tryinng to influence dreams by flashing lights or playing music. Some subjects were influenced by the variations. This furthers the argument for not generalising results.
- People blind from birth showed signs of REM, what are they seeing?
- Through research, Dement and Kleitman argued that it was possible to study how environmental factors affected dreaming such as noise or lights.
Subsequent studies have found that there are large differences between individuals in their reports of dreaming during REM.

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Psychoanalytic Approach: Freud's Theory of Personality

According to Freud, the mind can be divided into 2 main parts:
1. The conscious mind includes everything that we are aware of. This is the aspect of our mental processing that we can think and talk about rationally. A part of this includes our memory, which is not always part of consciousness but can be retrieved easily at any time and brought into our awareness. Freud called this ordinary memory the preconscious.
2. The unconscious mind is a reservoir of feelings, thoughts, urges and memories that are outside of our conscious awareness. Most of the contents of the unconscious are unacceptable or unpleasant, such as feelings of pain, anxiety or conflict. According to Freud, the unconscious continues to influence our behaviour and experience, even when we are not aware of it doing so.
Freud claimed our personalitis were made up of three parts:
- The Id is unconscious and includes our primitive sex and aggression drives and desires. It is the unsocialised part of us. The word Id is shortened from teh word 'Libido', which means our life-force.
- The Superego is partly conscious adn is our ideal self and morality ('conscience').
- The Ego is our conscious, socialised self. It adjudicates between the competing demands of the Id and Superego.
Freud likened the human mind to an iceberg where the conscious mind is the tip of the iceberg, and the bit beneath the surface is the unconscious mind.

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Psychoanalytic ApproaPsychoanalytic Approach Theories and Studies:ch: Psychoanalytical Therapy

Psychoanalysis seeks to release repressed emotions and experiences, i.e. make the unconscious conscious. Therapy sessions involve the patient being relaxed on a couch and talking to the therapist who may take notes and ask questions. It is only by having a cathartic (i.e. healing) experience that the person can be helped and 'cured'. Techniques used;
Dream Analysis - looking at dreams which can show ideas and unconscious desires.
Hypnosis - a state of relaxation which canthen reveal unconscious thoughts.
Free Association - a simple technique of psychodynamic therapy is free association in which a patient talks of whatever comes into their mind. It is hoped that fragmennts of repressed memories will emerge into the course of free association.
Freud (1900) considered dreams to be the royal road to the unconscious as it is in dreams that the ego's defenses are lowered so that some of the repressed material comes through to awreness, albeit in distorted form. Dreams perform important functions for the unconscious mind and serve as valuable clues to how the unconscious mind operates.

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Psychoanalytic Approach Theories and Studies: Wish Fulfiilment Theory (Freud, 1900)

Freud (1900) considered dreams to be the royal road to the unconscious as it is in dreams that the ego's defenses are lowered so that some of the repressed material comes through to awreness, albeit in distorted form. Dreams perform important functions for the unconscious mind and serve as valuable clues to how the unconscious mind operates.
Freud had his own dream that was to form the basis of his theory. He had been worried about a patient, Irma, who was not doing as well in treatment as he had hoped. Freud in fact blamed himslef for this, adn was feeling guilty. Freud dreamed that he met Irma at a party and examined her. He then saw a chemical formula for a drug that another doctor had given Irma flash before his eyes and realised that her condition was caused by a dirty syringe used by the other doctor. Freud's guilt was thus relieved.
Freud interpreted this dream as wish-fulfilment. He had wished that Irma's poor condition was not his fault and the dream had fulfilled this wish by informing him that another doctor was at fault. Based on this dream, Freud (1900) went on to propose that a major function of dreams was the fulfilment of wishes. Freud suggested that dreams have 2 types of content:
Manifest Content - is the actual literal subject matter of the dream e.g. meeting Irma at a party.
Latent Content - is the hidden psychological meaning of the dream e.g. wishing Irma's conditoin was not Freud's fault.

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Psychoanalytic Approach Theories and Studies: Dream-work

Dream-work is the process whereby the underlying wish is translated into the manifest content i.e. the actual subject of the dream. According to psychoanalytic view to be able to understand dream-work fully, a person needs to understand how th emind trnasfers the latentn thoughts into manifest thoughts. Dream work involves the process of condensation, displacement and secondary elaboration.
Condensation:
Is the process in which the dreamer hides their feelings or urges by contracting it or underplaying it in to a brief dream image or event. Thus the meaning of this dream imagery may not be apparent ob obvious. Many different ideas and concepts are represented within the span of a single dream. Information is condensed into a single thought or image.
Displacement:
This occurs when the desire for one thing or person is symbolised by something or someone else. This element of dream work disguises the emotional meaning of the latent content by confusing the important and insignificant parts of the dream.
Secondary Elaboration:
Occurs when the unconscious mind strings together wish-fulfilling images in a logical order of events, further obscuring the latent content. According to Freud this is why the manifest content of dreams can b ein the form of believable events. In Freud's later work on dreams he explored the possiblity of universal symbols in dreams. Some of these were sexual in nature, inlcuding poles, guns and swords representing the penis and horse riding and dancing representing sexual intercourse.
However, Freud was cautious about symbols and stated that general symbols are personal rather than universal. A person can't interpret what the manifest content of a dream without knowing about the person's circumstances.

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Psychoanalytic Approach Theories and Studies: Dora Case Study (1905)

Dora is the pseudonym given by Freud to a patient dignosed with hysteria. Dora came to see Freud when she was 18 years old. She developed several symptoms, including a cough, depressino, avoidance of social contact, threats of suicide, fainting spells, and aphonia (loss of voice).
Dora live with her parents and her brother, Otto. Her father, Philip Bauer, was a rich textile industrialist, born in 1853. Her mother, Katherina Gerber, was born in 1862. Dora's parents had a beautiful relationship, based on real love. They became friends with another couple, Herr and Frau K. (names given by Freud).
Dora claimed that Herr K. made an advance towards her and she slapped his face. Herr K. denied all accusations. Dora's father couldn't believe that his best friend tried to seduce his daughter. Dora told Freud that her father has a relationship with Frau K. and this may be the reason for which her father didn't believe her.
Freud encouraged Dora to share with him her dreams, in order to interpret them together. According to Freud, dreams interpretation is a major part of hysteria treatment.
This is the first dream Dora recounted, a house fire where her mother wanted to back for her jewel case. Freud interprets that the jewel case is a symbol of Dora's virginity.
Through analysis, Freud interpretted Dora's hysteria as a manifestation of her jealousy toward the relationship between Frau K. and her father. At the beginning, the cure was a successful one. Freud helped Dora to get rid of her cough. Freud pushed her to accept an attraction to Herr k. Unfortunately, Dora wasn't able to accept this idea and she became more and more distant. Dora stopped the treatment, after 11 months. Freud considered this to be a therepeutic failure.

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Psychoanalytic Approach: Strengths

- Freud is a very inflential psychologist; especially in the field of personality - he continues to have an influence on everyday language and culture.
- The theory suggests a link between dreaming and desire and has generated research, speculation adn controversy in relation to the topic of dreaming.
- A study of patients suffering form strokes reveals that htey lose their capacity to dream if there is damage to areas of higher forebrain governing desires (Solmns, 1999). This supports the claim that there may be a link between dreaming and desire.

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Psychoanalytic Approach: Weaknesses

- Much of the approachis based on the interpretation of dreams and it is not possible to gather evidence to support the theory.
- The content of dreams may mirror events during a person's waking hours and may not be symbolic in any way.
- Poor research evidence/ unscientific.
- Biased sample - Freud used mainly middle class women form Vienna for his research (results are therefore not generalisable).
- Case study method can't be generalised to the wider population.
- Much emphasis is placed on sexual factors.

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Psychoanalytic Approach Theories and Studies: Analysis

- Freud's case study illustrates the powerful effect sexually traumatic experiences can have on adolescents.
- The use of talk therapy as a way to identify underlying or masked casues instituted by Freud has been accepted by mainstream psychologists as one of the best methods of treatment for psychological problems.
- Freud's dream theory has also provided useful insight into the manifestation of subconscious desires through dreams, as well as a meaningful, if sometimes overly reductive way of interpreting these dreams.
- Finally, the Dora case study identified the importance of the phenomenon of transference, the process by which the patient overlays strong emotions for a persson from their past onto the physician.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Advanced Sleep Phase Disorder (ASP)

According to the American Academy of Sleep Medicine, an estimated 1% of the population experiences ASP (AASM, 2008). People with this condition go to bed earlier than most people - typically between 6pm and 9pm. They also wake up early, usaully between 2am and 5am. People with ASP are more likely to be middle-aged or older adults.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Delayed Sleep Phase Disorder (DSP)

An estimated 7 to 16% of people have DSP (AASM, 2008). People with this condition typically go to sleep later than most people adn sleep later, too. This condition is more common in adolecents and young adults.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Jet Lag Disorder

This condition affects people of all ages and occurs when a person travels to another time zone. The body has difficulty adjusting to the new time. The greater the differernce in the time zones, the more significant the symptoms are. This condition is usually temporary, and affect aome people more than others.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Shift Work Disorder

This conditoin occurs in workers who work during the night or early morning hours. People with this condition have difficulty getting enough sleep in the daytime to compensate for lost overnight sleep.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Sleep Walking (somnabulism)

Sleep walking is a surprisingly common condition with an estimated 10% of the population experiencing it in some form at one time or another in their lifetime (some texts put the estimate to as high as 20%). One thing is clear, it is far more common in children. Only about 3% of adults experience sleep walking. Apparently more common during REM sleep, contradicts Dement adn Kleitman as the body is supposed to temporarily paralysed then.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Narcolepsy

A neurological disorder of the sleep-wake cycle which results in excessive sleepiness and often a loss of muslce tone resulting in cataplexy. About one in 2000 people suffer from the disorder and worldwide it is estimated that there are 3 million sufferers e.g. Drag Queen Jinkx Monsoon.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Sleep Apnoea

Sleep Apnoea is brief pauses in breathing resulting in a suspension of the movement of gases between the lungs and air. This is brought about by a blockage preventing oxygen entering the lungs. NB: Gaseous exchange within the alveoli of the lungs and cellular respiration continue as normal. This reduction of air movement is called hypopnoea.

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Sleep Disorders: Circadian Rhythm Sleep Disorders - Insomnia

Insommnia is an inability to fall asleep, an inability to stay asleep or both. Not surprisingly the symptoms are similar to those of sleep deprivation: tiredness, fatigue, inabilty to concentrate, irritability etc. Derivation: Latin In (not) and somnus (sleep).

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Sleep Disorders: What is Cognitive Behaviour Therapy (CBT)

CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behaviour) all interact together. Specifically, our thoughts determine our feelings and our behaviour. Therefore, negative - and unrealistic - thoughts can cause us distress and result in problems. When a person suffers with psychological distress, the way in which they interpret situations becomes skewed, which in turn has a negative impact on teh actions they take.
CBT aims to help people become aware of when they make negative interpretations, and of behavioural patterns which reinforce the distorted thinking. Cognitive therapy helps people to develop alternative ways of thinking and behaving which reduce the psychological distress (Changing The Tape).

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Sleep Disorders: Cognitive Therapy for Sleep Disorders

Cognitive behavioural therapy for insomnia (CBT-I) is a technique for treating insomnia without (or alongside) medication.
CBT-I aims to improve sleep habits and behaviour by identifying and changing the thoughts and the behaviours that are affecting the ability to allow the person to sleep or sleep well.
The first step in treating insomnia with CBT-I is to identify the underlying causes of the insomnia. People with insomnia should evaluate or have their sleep patterns evaluated and take into account all possible factors that may be affecting the person's ability to sleep. This would involve keeping a sleep diary or journal for a couple weeks. The journal will help identify habits of thought or behaviour, stress etc. that could be contributing to the person's insomnia. After identifying the possible underlying cause and the factors contributing to the insomnia, the person can begin taking steps towards getting better sleep. In CBT-I these steps include stimulus control, sleep hygiene, sleep restriction, relaxation training and cognitive therapy.
CBT-I has been found to be an effective form of treatment of insomnia. It is also effective in treatment of insomnia related to or caused by mood disorders. Those with PTSD (Post Traumatic Sleep Disorder) have also shown improvement.
In addition, CBT helps people with poor sleep establish a healthy sleep pattern. This behavioural element supports people to develop a 'pro-sleep' routine and to achieve strong connection between bed and successful sleep, meaning that falling asleep and staying alseep in bed becomes more automatic and natural.

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Sleep Disorders: Cognitive Therapy for Sleep Disorders - Evidence

Evaluation of online CBT for Chronic Insomnia Disorder (Espie et al, 2012).
The purpose of this study was to determine the effectiveness of web-based cognitive behavioural therapy (CBT) course delivered by an automated virtual therapist, when compared with a placebo. The therapy consisted of 6 sessions with an animated personal therapist as well as web, email support and a social network. The researchers concluded that CBT delivered using a media-rich web application with automated support and a community forum is effective in improving the sleep and associated daytime functioning of adults with insomnia disorder.

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Sleep Disorders: Psychotherapy

There are many different types of psychotherapy that may be used to help treat sleep disorders. Many of these differnt styles of therapy focus on:
- Changing behaviours
- Setting and achieving goals
- Becoming more self-aware
- Learning relaxation skills
- Empowering the client to take control of his or her own situation
After establishing the root cause, therapists can teach people various skills to change unwanted sleep patterns.

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Sleep Disorders: Psychotherapy - Evidence

Shedler (2010)
Shedler anaysed multiple studies conducted around the world by clustering them into a single, larger study (meta-analyses). Perhaps his most important finding, concluded from 5 different meta-analyses that he created, is that positive change and patient growth continue to develop once therapy has finished, as measured in follow-up assessments conducted as long as 3 years post-treatment. This finding suggests that psychodynamic pschotherapy provides patients with the tools to continue to function better in the world, feel better about themselves, reduce psychiatric symptoms and face life's challenges with greater flexibility and freedom well beyond the end of their sessions

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Sleep Disorders: Clinics

Sleep Clinics can be used to help diagnose a disorder and to help treat a disorder. A patient may have to stay overnight so the therapists can observe them and monitor them while they are sleeping.
An EEG can be used to study sleep cycles. REM is recorded, as well as movement during sleep, and waking up patterns. A patient's temperature may also be recorded, and their blood tested in case they have inherited a genetic disorder (Biological Approach).
Many sleep clinics are privately run, and take a holistic approach - this means they take everything into consideration (a patients age, mood, lifestyle, temperature etc), and they are treated as an individual.