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PsychoTherapies Various forms Psychoanalytic (Freud) Psychodynamic (Ego Analysts) Cognitive-behavioral Humanist Eclectic Approach An approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy Medulla oblongata Psychoanalysis Psychoanalysis An emotionally charged, confiding interaction between a therapist and a patient suffering from psychological difficulties The use of a patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretation – to release repressed feelings, allowing the patient to gain insight Use has rapidly decreased…why? Cross-sectional research Psychoanalysis Resistance Blocking anxiety-laden material from consciousness Interpretation Supposed dream meanings, resistances, and other significant behaviors in order to promote insight Transference The patient’s transfer to the analyst of emotions linked with other relationships Countertransference When therapist mistakenly transfers feelings onto patients (not good) Just noticeable difference (jnd) aka Psychoanalysis Catharsis/abreaction Expression of repressed feelings, allowing psychic energy to spill forth Dream interpretation “Royal road to the unconscious” Wish fulfillment The id's attempt to gratify basic urges/ instincts in dreams Latent and Manifest content Surface v. deep structure Contemporary Psychoanalysis Psychodynamic therapy or simply Dynamic Therapy More brief, less intense. Neo-Freudians deemphasize role of the id, sexual and aggressive impulses Therapists are called Ego analysts object permanence Humanistic Therapy (Third Force) Client-Centered Therapy developed by Carl Rogers Emphasis on growth and fulfillment Therapist uses active listening in a genuine, accepting, empathetic environment to facilitate growth Unconditional positive regard Congruence and Unconditional self-worth Fully functional person Episodic memory Behavior Therapy Counterconditioning Procedure based on classical conditioning that conditions new responses to stimuli that trigger unwanted behaviors Systematic Type of CC that associates pleasant, relaxed states with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias Aversive Desensitization Conditioning Type of CC that associates an unpleasant state with an unwanted behavior, e.g. antabuse (nausea) ---> alcohol Association areas Behavior Therapy Exposure Therapy Treats anxieties by exposing people (in imagination or reality) to the things they fear and avoid. Systematic desensitization and flooding Chunking Behavior Therapy Token Economy An operant conditioning procedure that rewards desired behavior Behavioral contracting Social/observational learning Shaping/successive approximations/chaining Halo effect Gestalt Therapy Fritz Perls Attempts to integrate conflicting parts of personality. Highly directive. Confrontational Importance of dialogue Empty chair/role play chunking Cognitive Therapy Cognitive Therapy Teaches people new, more adaptive ways of thinking and acting Based on the assumption that thoughts intervene between events and our emotional reactions ventromedial hypothalamus Cognitive Therapy A cognitive perspective on psychological disorders K complex Cognitive Therapies Stress-inoculation therapy - Self-talk process to cope with stress, especially effective with anxiety disorders Ellis and Rational Emotive Behavior Therapy Beck’s Cognitive Therapy GABA Cognitive Therapy - Ellis and Rational Emotive Therapy Rational emotive therapy (RET) - Albert Ellis focuses on how irrational expectations create anxiety and disappointment Goal is to restructure an individual's belief system with respect to the irrational "musts" or "oughts" that are preventing a more positive sense of self-worth (e.g. our lives should turn out a certain way, people (even our parents) should love us). An active and direct approach that uses persuasion, challenge, commands and rational disputation random assignment Beck’s Cognitive Therapy Pathological behaviors result from illogical and negative thoughts about selves, the world and the future cognitive distortions Encourages patients to challenge errors and pessimistic assumptions. Types of cognitive errors unrealistic expectations, selective perception, overgeneralization, noticing only negative feedback, magnification, dichotomous thinking More supportive and scientific ("What evidence do you have for..?") divergent thinking Evaluating Psychotherapies Number of persons Average untreated person Poor outcome 80% of untreated people have poorer outcomes than average treated person Convolutions Average psychotherapy client Good outcome Biomedical Therapies - Psychopharmacology Antipsychotics (aka neuroleptics or major tranquilizers) used to treat schizophrenia Phenothiazines, chlorpromazine (l-dopa blockers). Good for positive symptoms/less for negative Blocks dopamine Serious side effects tardive dyskensia. Characterized by repetitive, involuntary movements; grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Movements of the extremities may also occur. Patients have difficulty not moving debriefing Biomedical Therapies – Mood Disorders Antidepressants Tricyclics(SNRIs) - First used. Side effects. Still used as 2nd line Monoamine oxidase inhibitors (MAO inhibitors) Inhibits breakdown of dopamine. Last resort due to interactions Selective serotonin reuptake inhibitors (SSRIs) Trade names - Prozac and Zoloft Side effects/arguments against Lithium salts – Treats bipolar disorder Biomedical Therapies biofeedback More Biomedical Therapies Psychostimulants – ADHD treatment. Ritalin, Concerta and Adderal. Use and efficacy Side effects and overprescription Anxiolytics – To treat anxiety disorders. Barbiturates and benzodiazepines. Trade names valium, xanax). Increases GABA (low levels=anxiety). Rebound anxiety and inability to cope imprinting Biomedical Therapies Electroconvulsive Therapy (ECT) Brief electric current is sent through the brain of an anesthetized patient Bilateral v. unilateral ECT for non-repsonsive MDD and mania Contemporary use and efficacy Facial feedback hypothesis Electroconvulsive Therapy Biomedical Therapies - Psychosurgery Psychosurgery lobotomy – a surgery that removes or destroys brain tissue in an effort to change behavior Used on tens of thousands of uncontrollably emotional and/or violent patients. Ummm…crude and barbaric Modern psychosurgery? Possible benefits Prefrontal The Lobotomist Biomedical Therapies Deinstitutionalization - The emptying of U.S. mental hospitals The Consequences Deinstitutionalization: The New Asylums