PSY-470 Benchmark - Anxiety and Phobias Paper (Obj. 2.1, 2.2 & 2.3)

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Feb 20, 2024

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Benchmark - Anxiety and Phobias Paper (Obj. 2.1, 2.2 & 2.3) Rachael English College of Humanities and social Sciences, Grand Canyon University PSY-470 Abnormal Psychology Professor Wiersum February 18 th, 2024

2 In the realm of the Japanese Manga/show "Attack on Titan," where titans loom beyond the three walls of Paradise Island, Levi Ackerman stands as humanity's strongest soldier within the Survey Corps, recognized for his exceptional combat prowess and an inclination towards cleanliness often associated with signs of Obsessive Compulsive Disorder (OCD). However, beneath this facade lies a complex narrative of trauma and Post Traumatic Stress Disorder (PTSD) stemming from Levi's tumultuous past. This analysis aims to unravel the nature of Levi's PTSD, examining the traumatic events that serve as stressors, the manifestation of abnormal behaviors as defense mechanisms, and proposing potential treatment plans aligned with current diagnostic codes. Stress from PTSD Levi's traumatic past is marked by profound sorrow and loss. His mother's death during his childhood, amidst the grim confines of the Underground City, left an enduring scar on his young psyche. Bereft of access to medical treatment, Levi's mother succumbed to illness, a poignant reminder of the hardships endured by those marginalized in society. In the absence of his mother, Levi found a semblance of stability under the stern guidance of his uncle, Kenny. However, Kenny's eventual departure left Levi grappling with feelings of abandonment and betrayal. The abrupt loss of his two closest friends, Farlan and Isabel, further compounded Levi's anguish. Their tragic deaths witnessed amidst perilous missions beyond the walls, served as a stark reminder of the cruelty of fate and the fragility of life. Despite the weight of his sorrow, Levi persevered. Choosing to bury his pain beneath layers of stoicism, he pressed onward as a member of the Survey Corps. Amidst the chaos of battle, Levi sought solace, finding refuge from the tempest of his emotions. However, beneath his steely exterior lay a heart burdened by unspoken grief, a silent testament to the scars beneath

3 the surface. In the shadow of his traumatic past, Levi's journey is a testament to resilience, a beacon of hope amidst the darkness. Through the crucible of suffering, Levi's story serves as a reminder of the enduring strength of the human spirit. Manifestation of Abnormal Behavior Levi's coping mechanisms intricately weave through his behavior, revealing profound insights into his psychological landscape. His obsession with cleanliness is a defense against the specters of his impoverished upbringing in the Underground, creating a semblance of control in a tumultuous world. Denial and repression shield Levi from painful recollections, as acknowledging his traumatic history threatens to unravel his carefully constructed facade. His emotional silence acts as a shield against the overwhelming wave of grief and loss. Beneath this emotional detachment lies a torrent of suppressed emotions. Levi's response to comrades' deaths shows his ability to swiftly resume duties, driven by an indomitable will to compartmentalize emotions. Amid desolation, flickers of humanity emerge, as occasional displays of protectiveness and compassion testify to unwavering bonds forged amidst adversity. Despite the veneer of detachment, Levi's heart remains tethered to those he holds dear, a beacon of hope amid encroaching darkness. Possible Diagnosis from Current DSM and ICD Diagnostic Codes Levi's experiences align closely with the DSM-5 criteria for Posttraumatic Stress Disorder (PTSD), depicting a narrative steeped in trauma from his early loss of his mother to the hardships endured as a Survey Corps member. These events have left an enduring impact on Levi, evident in his significant distress and impaired interpersonal interactions. His coping mechanisms, marked by emotional suppression and avoidance, reflect classic PTSD symptoms. Levi's stoicism and reluctance to delve into his past are adaptive strategies, underscoring the toll

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4 of trauma on his well-being. A thorough examination through recognized diagnostic codes, such as the DSM-5 and ICD, illuminates the intricate interplay between traumatic stressors, coping mechanisms, and the pervasive effects of PTSD on Levi's daily life. This contextualization offers insights crucial for tailored interventions, emphasizing the importance of a nuanced approach to trauma-informed care. In essence, Levi's journey underscores the profound impact of trauma on psychological well-being and highlights the need for targeted interventions addressing the multifaceted dimensions of distress and impairment in those affected by PTSD. Psychological Model (Cognitive) Embedded within psychological models, Cognitive Behavioral Therapy (CBT) emerges as a promising avenue for addressing Levi Ackerman's PTSD (Cognitive Therapy, 2017). This theoretical framework posits that negative evaluations of traumatic experiences can precipitate PTSD, perpetuating maladaptive coping mechanisms. CBT, integral to the cognitive model, intervenes in negative thought patterns prevalent after trauma. Levi's coping mechanisms— denial, repression, and an obsessive focus on cleanliness—align with CBT's cognitive restructuring. Collaborative engagement enables Levi to identify and challenge dysfunctional thought patterns related to his traumatic past. The cognitive restructuring process in CBT involves recognizing and altering negative thought patterns contributing to emotional distress and maladaptive behaviors (Cognitive Therapy, 2017). By reassessing the meaning assigned to traumatic memories, Levi can attenuate their impact on emotions and behaviors. CBT incorporates behavioral interventions targeting maladaptive coping strategies (Cognitive Therapy, 2017). Exposure therapy aids Levi in gradually confronting suppressed emotions and memories associated with his traumatic past, fostering emotional processing. Given Levi's deeply ingrained coping mechanisms, the

5 collaborative and tailored nature of CBT holds promise in navigating his psychological landscape (Cognitive Therapy, 2017). The therapeutic alliance offers a pathway for reshaping distorted perceptions and fostering resilience. In essence, the cognitive model, encapsulated within CBT, stands as a beacon of hope for Levi's journey toward healing from PTSD, grounded in evidence-based practices (Cognitive Therapy, 2017). Treatment Plans for Coping Cognitive Therapy, a component of CBT, emerges as a recommended treatment plan for Levi. This Therapy aims to modify negative thoughts and behaviors that impede day-to-day functioning (Cognitive Therapy, 2017). It involves collaborative efforts between the therapist and Levi to explore traumatic memories, evaluate triggers, and reframe adverse reactions. Crafting a narrative account of the traumatic incident allows Levi to confront and restructure his cognitions, fostering a sense of control and reducing re-experiencing (Cognitive Therapy, 2017). The therapist's role extends to helping Levi grasp the underlying meaning of traumatic memories and challenging negative thoughts associated with the trauma. In conclusion, addressing Levi Ackerman's PTSD necessitates a comprehensive approach that delves into his past experiences, recognizing the significant impact of traumatic events on his psyche. Understanding his coping mechanisms, particularly his inclination towards cleanliness as a defense mechanism, is crucial for tailoring effective treatment plans (Smith et al., 2020; McLeod, 2020). Levi's complex psychological landscape, marked by a reluctance to confront his past and emotional suppression, highlights the intricate interplay between trauma and defense mechanisms. This understanding informs the selection of therapeutic modalities, with cognitive models like Cognitive Therapy emerging as promising avenues for intervention

6 (Posttraumatic stress disorder, 2013; Cognitive Therapy, 2017). Through a holistic and client- centered approach, therapists can empower Levi to confront his trauma, challenge maladaptive thought patterns, and foster adaptive coping strategies, facilitating a journey toward healing and recovery.

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7 References Cognitive Therapy (CT). (2017). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder https://www.apa.org/ptsdguideline/treatments/cognitivetherapy#:~:text=Cognitive %20therapy%20for%20PTSD%20is,a%20present%20and %20severe%20threat. McLeod, S. (2020). 10 Defense mechanisms: What are they and how they help us cope. Simply Psychology. https://www.simplypsychology.org/defensemechanisms.html Posttraumatic stress disorder. (2013). American Psychiatric Association. Retrieved from https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5- PTSD.pdf

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