Unit 13

Psychological Therapies

History

 Used to be very brutal with how disorders were handled  Beating/bleeding disorders out of people  Isolation  Locked in Cages  Laughed at  Phillipe Pinel and Dorthea Dix started movts. to treat with care and compassion

Psychotherapy

 Techniques involving a trained therapist and someone looking to overcome a disorder or achieve personal growth  Childhood repression of impulses that still impact behavior or feeling  Historical reconstruction through free association  Good for learning related disorders (phobias)

Psychoanalysis

 Freud’s process of free association   Not editing anything, letting everything out – no matter how trivial   Normally blocks would infer resistance Resistances are noted and interpreted by analyst Analyst interprets responses   Dream analysis – latent content (what you remember, censored content of the dream) Transfer of feelings towards therapist  Takes a long time/expensive

Psychodynamic Therapy

 Influenced by Freud  Try to understand current feelings/symptoms based on childhood experiences  Help the patient gain understanding and perspective  Talk face to face (unlike psychotherapy)  Shorter time working together

Humanistic Therapies

 Realizing potential for self fulfillment and self awareness/acceptance  Insight Therapies     Focuses on present and future more than the past Conscious rather than unconscious thoughts Taking immediate responsibility for actions, rather than looking for hidden causes Promoting growth instead of curing illness  Clients, not patients

Humanistic

 Carl Rogers  Client Centered Therapy  Focus on person’s conscious self perceptions  Nondirective  Listening without judging or interpreting  Therapists encouraged to exhibit genuineness, acceptance and empathy – no facades  Respond with honesty  Deepens self acceptance

 Carl Rogers  Active Listening  Echoing, restating and seeking clarification  Unconditional Positive Regard  A way to give non judgemental responses to a patient     3 techniques used 1. Paraphrase – summarize what was said in your own words, rather than say “I know how you feel” 2. Invite Clarification – ask for examples 3. Reflect Feelings – “That sounds frustrating”  Mirror feelings to get better understanding

Behavior Therapies

 Healing power of self awareness   Learning principles can eliminate certain problems Learned behaviors (like phobias and some forms of anxiety) are learned responses  These can be conditioned away and replaced  Classical Conditioning Techniques  Bedwetting  Counterconditioning   Taking the trigger stimulus and pairing it with a new response Exposure therapy and aversion therapy

Behavior Therapy

 Exposure therapy  Exposing people to things they normally avoid   Systematic Desensitization    Wolpe You cant be anxious and relaxed at the same time Proceed gradually   Progressive relaxation Fear can be replaced Virtual reality being used today

Behavioral Therapy

 Aversion therapy  Getting a negative response or unpleasant feeling when in the presence of a stimulus  Alcohol and smoking, chewing nails  Getting rid of an unwanted behavior by using a negative stimulus

Behavioral Therapy

 Operant Conditioning  Behaviors are strongly influenced by their consequences  Reinforce the desired behaviors, withhold rewards or enforce punishments for those that are unwanted  Step by step manner of rewards  Token economy – rewards given for behaviors that can be cashed in for privileges or treats   How likely will they continue the behavior when the rewards stop?

Is it ethical to control behavior like this?

Cognitive Therapy

  Thinking influences our feelings Change the way we think and we can change our feelings  Beck’s Theory for Depression  Patients constantly recalling and reliving their failures  Catastrophizing themselves – looking through dark glasses

Cognitive Behavioral Therapy

 Change the way people think and act  Labeling behaviors  Compulsive thoughts labeled and realized

Group and Family Therapy

  Group     Cheaper Still effective Social awareness that patients are not alone AA Family   No person is an island, disorders will have an impact on everyone Sometimes can be caused by others, and they may be unaware

Evaluating Psychotherapy

 How can you really measure effectiveness  Can symptoms be cured or just treated?

 Client perspective  Why is it effective?

 1. People enter therapy in crisis  2. May want to believe that it was worth the effort  3. Usually speak kindly of therapists

Evaluating Psychotherapy

  Clinician Perspective   Since most individuals are so unhappy when they enter therapy and leave happy, clinicians think it is very important Bias How can we really tell?

 Meta analysis – stat analysis using large numbers of studies  Most people will improve over time, those who get treatment improved more over time

Which treatments are best?

  Cant really say – too many variables Alternative therapies       Energy therapy Recovered memories Rebirthing therapy Crisis debriefing EMDR – Eye Movement Desensitization and Reprocessing Light Exposure Therapy

Biomedical Therapy

 Physically changing the brain’s functioning by altering its chemistry with drugs, electricity, magnetic impulses, or surgery  Psychopharmacology    Antipsychotic drugs – dampen responses  Side effects – tardive dyskinesia Antianxiety drugs - reduce symptoms , but don’t solve problems Antidepressants - Blocking neurotransmitters

Biomedical Therapy

 Brain stimulation  Electroconvulsive Therapy (ECT)  Introduced in the 1930s  No memory of treatment  Repetitive Transcranial Magnetic Stimulation (rTMS)  No amnesia  Deep brain stimulation  Implanted electrodes with a type of pacemaker

Psychosurgery

 Surgery that removes or destroys brain tissue  Lobotomy  Egas Moniz  Sever nerves in the brain will stop emotions in frontal lobes  Nobel Prize winner

Lifestyle changes

 Sometimes simple changes can have huge impacts  Increasing aerobic exercise  Sleeping more  Light exposure – Seasonal Affective Disorder  Social Connections  Anti rumination – enhancing positive thoughts  Diet and nutritional supplements