 So, today we are going to begin our discussion on the last module, where our focus would primarily be on the pathological side of human behavior. And that is the reason the title of the module is psychological disorders. See psychological disorders are usually discussed at two, three forums as part of their course work, when the doctors they get training for psychiatry, they also know learn about psychological disorders. Usually in the university system when you do your masters in psychology, one of the paper usually talks about psychological disorder. In psychology if you specialize in the clinical branch of psychology, then again you go into the exhaustive details of psychological disorder. And many a times you would find that in courses which are otherwise nowhere related to psychiatry or clinical psychology staff, even there you will find a mention of psychological disorder. So, we fall in the last bracket that although we are aware that none of you are going to become psychiatrists, none of you are going to become clinical psychologists. But the primary intention of knowing about selected psychological disorders is that the more well informed you are, the higher are the chances that you would be able to at least perceive a potential problem within yourself or in people who are close to you. This is important because of two, three reasons. One, India is a country where you still have a very, very few handful of practicing psychiatrists and clinical psychologists, whereas the population is extremely large. So, for a country of the size of ours, it is surprising to know that we have only 3,000 licensed psychiatrists, so it is very small number. That is one because you have a dearth of experts available in your nearby surroundings. Two, we already have that historical baggage like all of the cultures, all other cultures in the world, where you have certain type of practitioners of certain type of faith, of certain type of healing practices, who have a larger degree of social acceptance compared to a practicing psychiatrist or clinical psychologist. So, somebody simply tells you that you are under the influence of a which, you are under the influence of a ghost and there is somebody who has an expertise in handling with the ghost or can identify and go for witch crafting. There is a larger degree of social acceptance for this compared to when you are told that I guess you are suffering from x type of psychological disorder and therefore, you should meet a consultant psychiatrist. Acceptance level is very low because there are certain stigma that has been attached to such type of things. You do not hesitate meeting a doctor in the health center because you have certain problem that you anticipate, but you would have lot of hesitation going to the counseling site and then finding out how to book a slot with the institute consultant psychiatrist. You will find lot of reluctance and three many of us I would say or I would say most of us are completely ignorant about the aberrations that we usually see in the behavior, but nobody has told us that this is actually an aberration, we are not aware of it the ignorance goes to the extent that because you find a good number of people displaying such type of behavior. Therefore, the acceptance increase and you say I know Suresh had this, Ramesh had this, no Santosh had it. So, you have two three people who you say I know there were three four and because I know there were three four with the problem therefore, this is not a problem at all then you would realize that gradually the problem aggravates in many cases which finally drags the attention of a consultant psychiatrist or a clinical psychologist, but by that time you have already spent a lot of time either ignoring the disease neglecting the disease or whatsoever. So, that is primarily the our intention behind going through psychological disorders we first come to a little bit of description which is not needed, but it is good to have overall view point and then we will narrow it down there are two ways of classification of the disease are done one what is called as the ICD classification the international classification of disease that is the world health organization and then we have the DSM classification which is done by the American Psychiatric Association it is called diagnostic and statistical manual. Four is the fourth version TR represents text revision. So, as of now the latest version of DSM that we have is DSM 4 TR, but by the time we will be completing our end same and by the time these video footages will be ready DSM 5 will come into being. Now what DSM 4 TR talks about the disorder is that you can have disorders first diagnosed in infancy, childhood or adolescence, so you could have one set of psychological disorders that has to do with early level of diagnosis infancy, childhood or adolescence. For example, mental retardation, for example, learning disorders, motor skills, communication disorders these are the disorders which are usually identified much earlier in the life perhaps I must have shared with you that in our country the one of the biggest problem with early stage diagnosis is once again the tendency in the parents to negate the diagnosis. I remember many, many, many cases now I will tell you two cases in particular one which is very old and one which is very, very recent long back there was a camp that was being organized in collaboration with one of the nationalized banks. And we already had the information that there was a locality in one of the cities in stern UP where the density of children with mental retardation and autism cerebral palsy was very high. The camp was organized there and till 4 o'clock or so we had very, very negligible number of parents coming forward with their children to the camp. The idea was that we would have some doctors, some psychologist who will make diagnosis, psychologist will perform the test so and doctors will then recommend what has to be done. And accordingly whatever is needed will be immediately given. So, if the level of the problem is known the experts can tell you that fine you need to go to this center or you need to go for such type of behavioral practices and so forth. Till 4 p.m. there was negligible presence these stuffs were distributed and in certain cases where it was realized that it is only the possibility of training is there. So, some sewing machines and stuffs like that were also distributed and then by the time the camp was about to be closed suddenly there was a large crowd. But what was very sad to experience was that the crowd was more interested getting stuffs which are being distributed free of cost. They were not interested in diagnosis of their children and that is really a sad part of the reality. Second I know somebody very recently around say 6, 8 months back or 1 year back I received a call from somebody who is known to me saying that his daughter has delivered a baby who is now I do not remember the age perhaps 2 years, 3 years something like this. But the child shows certain peculiar forms of behavior. The most peculiar form of behavior was that the child was deliberately trying to ignore contacts with any member of the family. Usually children love to play with the members of the family first. But this child was extremely reluctant doing that and in turn the child was much more passionate about playing with mobile phones. One, two verbal instructions given by the members of the family were not adhered to compared to the voice messages that was sent through mobile phone. This was how it was described and some reason was given for that. I do not want to share the reason here, but some reason was given by the father, by the grandfather that my daughter has delivered a baby who is now this age and now these are the problems. The most interesting thing was that he asked me do you think it is really a problem? I am sure all he wanted to hear was that no, this is not at all a problem and I knew what he wanted to listen to and therefore, I did not very clearly say that this is a problem. But I made a whole story out of it and said that you should certainly go and meet an expert. Then he says that fine I did meet an expert and the expert said that the child seems to have a problem and he has suggested certain training sessions for him. I said fine then you have already cancelled it and the expert follow his advice and he said I do not think he has been able to diagnose it. This was around one year back I think two, three months back now the daughter gives me a call earlier it was the grandfather. Now the daughter gives me a call saying that my father had talked to you and I think there is some problem and I have already consulted a doctor but as parents we want to do our best. So, suggest the best place in India where I can take my child. I did suggest an institution down south and I said that is the best place in the country you can go there. The good part of the story was that some time back I received a call saying that just today itself we have come back from that institution and the child has been diagnosed with something they used a word. I am happy to share this story with you that at least after these many experiences these two stories that I have narrating has changed a lot. Now parents have gone for diagnosis but again there is a sad part in this story too that approximately one, one and half year was lost in diagnosis and coming forward with what the child should have been actually exposed to. And therefore, it is very important that when you have certain types of disorders where the likelihood of diagnosis is very high it can be within few months the doctors can very easily predict or even the elderly members of the family can say that there seems to be a trouble. Elderly members who have seen many, many children growing in the family will very easily be able to tell you that this child has some peculiar behavior. What that peculiarity is that you need to get diagnosed. So, this is one set of disorder that DSM talks about to delirium, dementia, amnesia and other forms of cognitive disorders. Usually all of this has to do with the decline in your cognitive ability either to retain information or to perform on the basis of a given situation. I am told that gradually in our country there is an increase in the number of reported patients in the clinic who belong to the second category. But once again there is a larger social acceptance that people say that this happens in old age and because it happens in usually this is most of them will be apparent in 60 plus age group. Therefore, again there is a greater degree of acceptance. Third mental disorders due to general medical conditions you find in DSM there is a whole lot of description about certain type of mental disorders which are basically a by product of some other form of medical condition. Then substance related disorders or forms of substance abuses, whole sort of psychotic disorders, mood disorder, anxiety disorders, somatopharm disorder, fictitious disorders, dissociative disorders, sexual and gender identity disorders, eating disorder, sleep disorder, impulse control disorders, adjustment disorder and personality disorders. So, you find whole lot of description it is really such a thick book and truly speaking if you are really not that matured enough to really read the whole set of diagnostic criteria. There are chances that you would find I also have a bit of this read the second disorder I also have a bit of this. So, you run on that risk also therefore, there is no point reading the full text of all types of disorders. Let the experts read them and then find out that nothing lies in me everything the problem always lies outside me this is the experts view point. But usually those who are non experts and will still go through the text will have great difficulty for 15, 20 days after reading the book because you become disoriented most of the problem you find in yourself. For certain reasons we are not interested in discussion on any of these disorders except the last three. Once again as I told in the beginning that I know that you are not going to practice either as a psychologist or as a psychiatrist. So, there is no point no reading the disorders at length. I just wanted to show you the classification. We have already discussed impulse control disorders just in our last module when we were talking about aggression. This module we would be exclusively discussing about adjustment disorder and personality disorders only two types of disorders we would be talking about. But before we go into all this what we would do is the way we did it for impulse control disorder. We will have exactly the way it is written in DSM 40 or we will have the exact text here on our projection. And we will see know all the diagnostic criteria for different types of sub classification within these broad category of disorders. But let me tell you that when you look at the diagnostic criteria across disorders you would find that there is an overlap. It is same say for example, if you visit physician and you just report that I have chronic stomach ache since last two days. So, doctors can anticipate that you have gastroenteritis problem. The doctor might anticipate that you have some inflammation within your stomach. You can anticipate of potential ulcer problem. He can anticipate know that probably know there is an infection in your appendicitis and that needs to be taken out. A doctor can say that fine perhaps there seems to be a stone in your gallbladder. There could be multiple possibilities because when you read about the physical diagnosis of diseases you realize that know stomach ache is reported for all these types of diseases. Similarly, you find overlap of know shared symptoms in terms of psychological disorders also. Say for example, change in sleep pattern, change in the eating practices, difficulty in memory concentration or attention. These you would find across disorders. Now, in most of the disorders you will find these things being discussed. Therefore, the skill of the actual practitioner lies in what is called as differential diagnosis. That there is a possibility of three different types of disorders, but I am able to identify one out of the potential three and this is called differential diagnosis. Now, before we go to the adjustment and personality disorders, we will know quickly look at the basic causes of these psychological disorders. Biological causes, constitutional causes, sociocultural causes and psychological or interpersonal causes. Biological causes includes genetic, biochemical and all types of organic reasons. Constitutional is know was advocated at one point in time has now been refuted. Therefore, we will just touch on this issue and would not go into the details. Sociocultural whole set of issues like mass violence, economic problems, persistent economic problems, group prejudice or rapid social change. Similarly, psychological or interpersonal causes like pathogenic family pattern, maladaptive family structure, pathological interpersonal relationship or sustained severe stress. We will very quickly know go through these causes to understand finally, what leads to different types of problems. Once again the idea is to make you realize that find these are the potential causes and therefore, one can know be very, very cautious about the fact that certain type of things if it sustains for longer in the family, in the society then it could be detrimental for the mental fitness of the people. As all of us know, we have 23 pairs of chromosomes, 22 autosomes, 1 sex chromosome and because these chromosomes have 100s and 1000s of genes, so approximately we have 30,000 to 40,000 genes and approximately 6 billion of our DNA base pairs. One of the primary reasons for certain type of specially organic disorders is certain form of mutation that takes place and genetic mutation has been found in whole lot of disorders. Remember the first criteria where we talked about mental disorders which are diagnosed in early infancy childhood or adolescence. Mental retardation mostly it go the discredit goes to the biological causes, mutation that takes place. You can have even certain types of problems that comes later on in the life of the child. For example, if you are using certain types of paints in the house and if children they usually have the habit of taking peeling out the surface of the paint and then putting it in their mouth that can lead to poisoning in the brain. So, certain area of the brain decays, it does not function. There could be genetic anomaly that can lead to something like say phenyl ketoneuria for example, where the phenyl aniline, the phenylperivic acid does not disintegrate properly and usually what you experience early in the child is a musty type of a smell. So, those who are close to the children they will smell that there is some musty smell around the child, but the problem basically lies that certain enzymes do not break down and therefore certain types of functions that usually our body is able to perform. It is not performed in those children, but the interesting part is that in phenyl ketoneuria for example, it is basically the phenylperivic acid that gradually accumulates in the body, but finally it starts influencing the cognitive abilities of the child. So, you will find a whole set of disorders like this, usually when we talk of mutation either it could be germ line mutation which is basically inherited or it could be a somatic mutation which is acquired. The example of exposure to certain types of chemicals in the environment that is the example of the somatic mutation, whereas germ line mutation would be know where you inherit faulty gene pattern from your predecessors. I do not know if you are aware of there is a family in UK where in alternate generations you find somebody in the family who has severe language impairment and the severity of this language impairment comes out of the fact that the orophacial muscle, this muscle know the lip muscle and the muscle near it which basically allows your lips to move. The orophacial muscle movement has tremendous retardation and then those children born in that family who have know this deformity of the orophacial muscle they cannot speak properly. It was found in one, found in next generation and generation after generation it is being repeated. Few years back know the whole set of research took place on the members of that family fortunately they agreed to give their samples for DNA analysis and now it has been analyzed that we have a gene called Fox P 2 gene which is primarily responsible for the movement of this orophacial muscle. So, one aberration at one point and then you know that some ability is lost or it is compromised with, but in one case because of mutation it happens that is fine. But if you have know perennial know persistence of that deformity that runs across generation that is what is called as germ line mutation that generations after generations in that very family it is a popularly in the scientific literature you will find the mention of K E family. K E family is the family know where you have a long list of people with the problem in the movement of the orophacial muscles. Now, there are know other possibilities where you can have an acquired mutation something like say exposure to ultraviolet radiation that can also lead to it, but what is also important to learn is that besides the genes which are responsible for transcription and translation of DNA into proteins. Basically it is know how these genetic mutations or whether it is germ line or acquired somatic basically know it somewhere it starts influencing the protein synthesis mechanism in the body and because protein has much to do with the proper growth and development of the brain. Therefore, many of the cognitive abilities are compromised with and once you have a severe compromise that takes place with the cognitive abilities you are bound to be considered to have one or the other type of disorders. When we talk of the brain anatomy means the structural know part of the brain or when we talk of the four important neurotransmitters that primarily are considered to be responsible for holding ourselves to the base line normal level or whether it is the receptors or the neural interconnections all of them therefore, they depend on the genes and therefore, once you have problem with know any of these know genetic mutation there could be a severe impact on the protein synthesis mechanism finally, adversely influencing the brain. I am sure know right from your school days you must have seen several such images know that if you have know two parents who are basically carrier of a particular problem this is the usual Mendelian principle know one is to two is to one the first generation you will have where the first child will not be affected two children will be carrier and one will be severely affected. Such type of informations are important for know sharing with others the reason being that many a times the discredit for having a particular type of child is always know put on the mother that you have delivered a child like this or the poor child who is basically genetically affected suffers a lot because there is a great degree of rejection within the family and within the community because one has certain type of problems and nobody know even get gives the discredit to the parents that because you were the carriers of the genes therefore, this force child has developed one or the other type of a problem. We are know just going through one typical example we all know of the ADHD know attention deficit hyperactivity disorder know you will find many school going kids know having certain type of behavior which the teachers will report at all is the most know notorious child of the class and some of them who are taken to the doctors the doctors will tell let know this is a ADHD child know. So, you have an attention deficit you cannot focus attention on one thing for long. So, attention deficit, but you also have hyperactivity know you are hyperactive doing this doing that multiple things that you do. Now, the behavior genetics research show an association between variant of dopamine receptor gene and ADHD symptom. Polymorphism of DRD4 this is the dopamine D4 receptor gene is known as this is called the 7 repeat form in the biological language and individuals who have this know 7 repeat form of DRD4 they have thinner tissue where in their right orbital frontal area. So, this is a right side of your cortex. So, the orbital frontal area the inferior parietal area and the posterior parietal cortex of the brain you will have a thinner cortex this would mean that the total number of neural interconnections that a normal child would have in these areas of the brain the children who have this know 7 repeat form of DRD4 they will not have those million neural interconnections. Now, if you do not have the neural interconnection the way others have this would ensure that neurologically you are different from other children and this neurological difference in terms of behavior is what is people call as ADHD. A most naughtiest child know will always do this always do that and the teacher most of the time instead of retaining the child in the class will ask him or her to go and stand out in schools this can happen or that teacher simply say no you just get up and go and sit in the corner. So, you are isolated from the rest of the class, but nobody know accepts the fact that fine this child has a neural interconnection which is different from the rest of the children and therefore, needs a complete different form of treatment in the classroom setup for all types of learning abilities right from academic to social skills to interpersonal skills and therefore, the child has to be handled differently. Fox speed 2 gene right now we discussed about it that once you have the verbal dyspraxia know you have this faulty movement of the orophacial muscles you have severe problem with the language communication and the discredit goes not to you, but the discredit goes to the faulty gene the fox speed 2 gene that you have inherited. Now, body chemistry has been also found important for the psychological disorders for example, dopamine and serotonin are involved in muscle control, memory, sleep and emotional behavior. So, the 4 important neurotransmitters that we were referring to right now 2 you find being mentioned here serotonin would be the 3rd one and basically it is the dopamine serotonin know the balance or the imbalance which will influence most of the psychological disorders. Now, you find the dopamine serotonin know levels responsible for things like mood disorder things like sleep disorders you also find it even in say Parkinson's disorder for example, know where you have grave problem in terms of having muscle control voluntary muscle control. The whole range of organic disorders such as say mental retardation such as degenerative disorders such as dementia or circular disorders or cerebro arteriosclerosis the head injury they all have the routine the anatomy the function of the brain and this anatomical and the functional know part of the brain actually largely depends on how you are genetically configurated. So, problem with the genetic configuration mutation of the gene and then you realize that many of the disorders come because of that reason. We want to go into the details, but I must tell you that for most of the disorders which are the byproduct of one or the other type of biological reason for most of them you have one or the other remedy that is available. For example, somebody who is diagnosed with ADHD we have discussed ADHD here forget about this fact that know you have a thinner tissue in certain selected regions of the brain, but there are no training sessions and remember these training sessions for ADHD is for the parents. So, parents are trained how to handle children who have ADHD and basically all of this is basically the behavior modification techniques. Finally, you have to learn certain techniques with the help of which you can very generously handle these children. Unfortunately, we do not have parents training program my recent experience shows that in the hospitals now at least in the urban areas good hospitals when a prospective mother is taken to the maternity ward the doctors will console or the sisters there will console the all the attendants including the prospective mother and they will ask know that for how many kids do you have and there should not be an issue if you have a girl child. So, there is a counseling that I see in the urban localities in good hospitals, but this counseling is only for facilitating the acceptance of girl child, but you do not find a proper mechanism where you are already told that find if you have a child with these type of things this is how you should handle the child. There is no such training program in our country in most of the western countries you would find that there are proper training programs even for prospective parents. So, parenting skill which also includes that find if you have children who have this who have that then how to handle them. Especially teachers who are handling the pre primary school children know it is good to expose them also to such type of training sessions how to handle children who show this type of problems in the class. Unfortunately, nowhere to the best of my knowledge as of now we have training programs for pre primary school teachers to handle children like this, but I must tell you that you visit an expert and they will tell you that you know meet us on weekends one of the week days for say next one half month two months and they will train you in how to handle children. Autistic children you have no such session similarly for MR children. There are a hope for most of these things now you have certain types of recommendations certain modifications that the experts would like the caregivers to have in their behavior which will be very very conducive for those children. We go to the second cause now that is the constitutional cause and now I am coming to a debatable issue which was you know initially proposed in the domain of personality psychology, but later on it was rejected. Although it was rejected you still find you know at times one or two you know researchers reporting something related to this therefore, we will devote very less time to understanding of this. Sheldon was a man what he did was that he looked at the body structure of the human beings know and all he did was that he would ask his clients to remove the clothes which today if you do it you will be put in the jail. He used to ask his clients to remove the clothes and then he would take the body measurement know. So, all body parts he will measure diameter this you know length height density these all types of stuffs he would have and finally, what he came forward with was basically that the people who used to visit him what type of body structure did they have and what type of temperament they had and he finally classified people into three categories ectomorphs mesomorphs and endomorphs and you can see basically how they look like. Then he attach the personality profile to these types of body makeup he said that ectomorphs they have restrained and they have they apply restrained and they are very self conscious people compared to the mesomorphs who are noisy people who are aggressive, but you also find that they are active and he said that when you meet an endomorph they are very social people very sociable very relaxed in their life, but the later researches did not confirm that Sheldon's classification was accurate. It is not that if you are really plump you will be very relaxed you can have a relaxation session even when you are here in the class you feel drowsy you feel sleepy it has nothing to do with whether you are an endomorph or not, but I must tell you that if you go into the details of you know constitutional causes you will find many many types of classifications. One very interesting classification which is the recent edition was by frontman and Rosenman what they they are basically not doctors sorry they are not psychiatrists they are actually cardiologists. These two cardiologists they looked at the what you call profile of the patients who used to come to their clinic. So, basically what he had was a large number of patients who had problem with their heart some type of cardiac attention is needed and based on that they came forward with a type what they call as type A and type B people. One set of people who are very active a very volatile very noisy very aggressive, but then they are also the people who are extremely susceptible to heart diseases compared to the second set of people relaxed social they do perform their task, but not so aggressively and actively the way the other type of people do, but they are the people who are not prone to heart diseases. So, Rosenman and frontman's classification is the latest addition to such type of classification personality classification what is popularly in psychology called as type A and type B personalities, but I must tell you that this is not a sacrosan type of a classification not so scientific the way the biological causes were talked about. Now we come to the socio cultural causes where you have a whole set of problems basically if you look at them you have the persistence of the violence which threatens your survival or the survival of your loved ones and because you have this persistent threat you show certain form of behavior which others will consider to be very weird which reminds me of a joke although it was jokingly told, but I think that know there is some degree of seriousness attached to it and we will talk about it. The joke was that somebody who was a travel ticket examiner in the Indian Relevance after certain years of his duty as the TTE of a running train he used to come home and instead of sleeping on the pillow he would take out his shoes put it on the bed and then rest his head over it because he was accustomed of travelling like this in the train because somebody will steal your shoe therefore you keep it under your head use it as a pillow in the running train and even though you have come back home instead of using a pillow you still use that and this was one part of the joke it has many all this is a long string it has many many things know one thing was that after certain interval he would wake up and know ask so what is the time and this time was attached to the next station where he had to get down because his duty will be over there are many such things that was attached to this story but if you extend it to the persistent threat of violence which can be inflicted either on you or your loved ones there would be a whole lot of change that you see in the behavior of the individual problems that continues for long you have been in the war inflicted zone for example and you realize that you have a frequent wake up sessions when you sleep there is a great degree of acceptance for aggressive behavior whole lot of no great degree of misery in the behavior less degree of no acceptance of strangers great prevalence of loss of faith that you have in others these are very commonly seen in people who are in the violence prone zone for long we do not have the opportunity of having the data from Afghanistan or Iraq as of now but in psychology will find a whole lot of literature that is available on what happened to the Vietnam is and also the US forces who participated in the Vietnam war whole lot of description you will find there in fact I must tell you that this area of clinical psychology became extremely enriched during the second world war had second world war not taken place probably this area of psychology would not have evolved the way it has evolved today globally the highest number of degrees are awarded in clinical branch of psychology compared to any other branch globally discredit again goes to the war if war would not have taken place all these growth and development would not have taken place but there is a heavy price that you pay for it if you are interested I must have shared this with you I am just repeating it when India was celebrating 50 years of independence a study was carried out in India Pakistan and Bangladesh by three set of psychologists in these three countries and they were primarily looking at the changes in the behavior that took place in people who migrated 50 years back who were forced to migrate so from which country to which country you have migrated is not an issue the fact that you were forced to leave your place in one country and you were forced to move to the other country the psychological profile of people and interestingly the result shows that irrespective of which religion and faith you belong to from which country you were forced to flee to the other country respective of this there were permanent patterns in the behavior that was observed in the people who were spread in these three countries who were forced to migrate from one place to the other and the most striking of that was the distrust you do not trust anybody including your own family members and that could be the worst when you sleep on the bed with your spouse and you do not trust him or her whether you are going to be dazed you are going to be killed you are going to be stabbed you are going to be robbed what type of life would that be extremely painful no very recently I visited one of the very prestigious organizations of this country I would not name it and the sad part I realized which I had never thought I had never thought of it I had a meeting with one of the top rank offices there and he said that you know all of us are under constant vigilance so we keep an eye on others and within the organization someone has been deputed to keep an eye on me and all of us know that we are being watched round the clock and then I asked him that then how do you develop friendship here no see there would be a comradeship in the workplace you are friendly to somebody and if I know that somebody is keeping an eye on me and the other person also knows that somebody is keeping eye on him or her and everybody knows that one is being watched all through how do you trust people then this is an organization with a great degree of distrust so on the face I must be friendly but inwardly I will always distrust I do not know perhaps he is the one who is supposed to keep an eye on me I am in the restaurant and very curious know who is keeping an eye on me I am going with my family to an amusement park and no looking at no who is keeping an eye on me life would be terrible I have never experienced a life like that and somebody know imagine somebody who is recruited given this high stick responsibility in a government job and he invests a long career watching others and being watched what type of life would this be and there would be a great degree of psychological price that one would pay for it it was basically the calculation of the psychological price because of the reason I had visited them we will continue with this we will continue with socio cultural causes and then we will move to the next course.