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Therapy
Insight therapies
Psychoanalysis
• Aim – get at the root of the disorder or disturbed behavior – find the
cause
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Repression
Resistance
Free association
Therapist interprets contradictions
Years
Psychodynamic
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Face to face
Shorter in term
Therapist probes for information
Interpersonal therapy – to gain insights into roots of
behaviors but also suggest practical coping strategies
Humanistic
Humanistic
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WE hold the power
self-fulfillment
Present and future
Conscious not unconscious
Carl Rogers (Rogerian psychology)
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“clients” not “patients”
“growth” not “cure”
Active listening by the therapist (echoing)
Empathy of therapist - more personal connection
• Influenced by Maslow – hierarchy of needs
Behavior therapy
• Focus on the assumption that the problem IS
the behavior, not the underlying reasons for it
• Aim: eliminate the problem behavior through
conditioning techniques
• Examples of Behavior Therapies
– Aversive conditioning
– Counter conditioning
– Operant conditioning
– Exposure and systematic desensitization
• Phobias / addictive behaviors
Counter-conditioning
• Example – Peter – fear of rabbits – counter
conditioned by pairing rabbits with treats for
Peter
Exposure therapy & systematic
desensitization
• Progress to exposure in a real environment
Has been used for phobias and obsessive compulsive disorders.
Operant conditioning Therapy
• Often used for children with self-abusing behaviors or
mental disabilities or autism
• Rewards desired behaviors and ignores or punishes
undesired behaviors
• Token economy – used / created by therapists in some
situations to create intense system of concrete rewards
– Positive behaviors rewarded with tokens that can be saved
for treats , extra TV time, etc.
– Think star charts for behavior
• Criticisms
– Subject to extinction when rewards stop (remember
reward schedules)
– Ethics of controlling other’s behavior
Aversive conditioning
• Often used for addictions or to stop troubling
impulsive behavior
• Tries to replace a positive response to a harmful
stimulus with a negative response
• Example – creating a taste aversion to alcohol or
cigarettes by lacing with a nausea producing
substance
• Criticism: people are cognitively aware that the
association is false and can override the
association
Cognitive behavioral therapy
Aimed at mood, emotional or anxiety disorders
• Emphasizes our distressed reactions are not
produced by events / outside stimuli but at how
we perceive and think about those events /
stimuli
Ex: a criticism on an essay could be the source of
stress, anger or satisfaction that the student has
gotten feedback on how to better their paper
depending on the thinking of the student about the
comment
REBT – Rational-Emotive Behavior
Therapy – Albert Ellis
"I absolutely MUST, under practically all
conditions and at all times, perform well
(or outstandingly well) and win the
approval (or complete love) of significant
others. If I fail in these important—and
sacred—respects, that is awful and I am a
bad, incompetent, unworthy person, who
will probably always fail and deserves to
suffer."
"Other people with whom I relate or
associate, absolutely MUST, under
practically all conditions and at all times,
treat me nicely, considerately and fairly.
Otherwise, it is terrible and they are
rotten, bad, unworthy people who will
always treat me badly and do not deserve
a good life and should be severely
punished for acting so abominably to me."
"The conditions under which I live
absolutely MUST, at practically all times,
be favorable, safe, hassle-free, and quickly
and easily enjoyable, and if they are not
that way it's awful and horrible and I can't
bear it. I can't ever enjoy myself at all. My
life is impossible and hardly worth living."
Holding this belief when faced with
Holding this belief when faced with
adversity tends to contribute to
Holding this belief when faced with
adversity tends to contribute to feelings of
frustration and discomfort, intolerance,
adversity tends to contribute to feelings of
anxiety, panic, depression, despair, and
self-pity, anger, depression, and to
anger, rage, fury, and vindictiveness.
worthlessness.
behaviors such as procrastination,
avoidance, and inaction.
Commonly held irrational assumptions
• I should be loved by everyone – otherwise I must be doing something
wrong!
• I should be thoroughly competent at everything.
• It is it catastrophic when things are not the way I want them to be.
• I have no control over my happiness.
• I need someone stronger than myself to be dependent on.
• My past history greatly influences my present life.
• There is a perfect solution to problems in my life, and it’s a disaster if I
don’t find it.
Group therapy
• Social context – many treated simultaneously
• Allows people to get feedback from people
with the same issues  feeling that they
aren’t alone or “crazy”
• Allows families to effectively address
relationship issues together and explore their
roles with one another
Alternative therapies
• Electroconvulsive (ECT) Psychosurgery
• Therapeutic touch
• EMDR – Eye Movement Desensitization &
Reprocessing
• Light Exposure
Electroconvulsive (ECT)
– Today – anesthetized patients
– Used to treat severe depression – 80% improval
rate – exact reasons unknown
– May stimulate norepinephrine production in brain
and boost mood
Psychosurgery
• Drastic – involves removing or destroying
(lesioning) brain tissue
• Corpus callosum removal for severe epilepsy
• Lobotomy for severe emotional disorders –
rarely used today – severs connections to
frontal lobe from emotive part of lower brain
– (disconnects emotion from thought)
• Therapeutic touch – based on “energy center
conduction” – no known benefit
• Eye Movement Desensitization & Reprocessing
(EMDR)
– Involves remembering / reviewing traumatic events
while stimulating eyes to move rapidly
– Possible benefits, unknown if placebo or due to
review of trauma in a safe environment or actual eye
movements
• Light exposure
– SAD
• Morning light is found to boost melatonin levels and 
improved mood
Drugs
• Antipsychotics
– Thorozine / clorazil - reduce irrelevant stimuli (can
relieve auditory hallucinations)
• May produce tardive dyskinesia (pursing of lips or eye
blinking, lip smacking etc.) in prolonged use
Anti-anxiety
• Ex: xanax , valium – depress CNS activity
• SSRI’s are also common
Anti-depressants
• Selective Serotonin Reuptake Inhibitors (SSRI’s)
– Increase ability of norepinephrine and serotonin to
bind to receptors
– Ex: Prozac, zoloft, paxil – block reuptake of serotonin
in the synapse
• Lithium – salt compound – used to balance
moods in bipolar disorder by interfering with the
firing of neurons.