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Psychotherapy
The Psychodynamic, Humanistic,
Behavioral, and Cognitive
Approaches
What are Psychoanalytic methods?
• Dream Analysis – Manifest content (actual
content) AND Latent content (hidden)
• Transference – strong emotional
outburst/connection with therapist
• Hypnosis
• Free association – talk about whatever and
Dr. analyzes it
All rely on exposing unconscious thoughts and
interpreting them.
Psychoanalytic methods of therapy
Free Association – patient reports anything that
comes to his/her mind.
The psychoanalyst takes whatever you say
and treats it like a window into your
unconscious mind.
The Dr. listens for when you
pause, or edit something you
are saying…this pause reveals
RESISTANCE (suggests
something is going on in your
unconscious)
Transference
• Feelings of love or other emotions (hatred)
are expressed toward the therapist.
• These feelings are actually unconsciously felt
toward others; the patient is projecting these
feelings onto the therapist.
• This provides clues about the client’s feelings
about these other people.
Hypnosis
• Hypnosis is a psychoanalytic therapeutic
technique.
• Some people are more susceptible to hypnosis
than others – can’t by hypnotized against your
will.
• Whatever you think, patients report benefits
from hypnosis.
Psychodynamic Therapy
• Branches off of Freud’s techniques
• Works to understand current symptoms
through an analysis of relationships, including
childhood relationships (similar to
psychoanalysis)
• But there are differences…
– Discussion style
– Timing and commitment to therapy
Psychodynamic techniques
• Interpersonal therapy
– Therapist doesn’t focus as much on the past and
focuses more on current symptoms and getting to
the foundation of the problems that the patient is
experiencing. The therapist helps the patient
improve upon their relationship skills
Humanistic Perspective of
Psychology
Humanistic Therapy
• Humanists are really touchy-feely, but without them
we are just rats in a cage.
• Rogers and Maslow put the “human” element back
into psychology and therapy.
• Their philosophy: We are all humans striving to
maximize our potential. A therapist’s job is to remove
obstacles to self-actualization.
• If therapists simply listen to the patients, and if people
receive the attention that they need, they can have
the confidence to “cure themselves.”
• Humanistic therapy includes: client-centered therapy,
which includes active listening
Humanistic therapy?
• Remember Carl Rogers? Carl Rogers was the founder
of person-centered therapy, reflective listening,
unconditional positive regard, empathy.
• The patient/client has all the answers and the means
to treat themselves. In person-centered therapy, the
therapist acts as a sounding board for the patient,
sometimes rephrasing what the patient says
(reflective listening). Empathy is important!
• The responsibility of the therapist is to exemplify
unconditional positive regard
Active listening: paraphrase, invite
clarification, and reflect feelings
• Patient to Rogerian therapist: I feel like I have no self worth.
• Therapist: You feel that way now? That you are no good and
worthless? Those are really lousy feelings. Hmm.
• Patient: Yeah, that’s what my friend told me.
• Therapist: So, your friend told you that you were no good? Did
I get that right?
• Patient: yup..
• T: So, I guess that this person means a lot to you, and this
person has told you that you are no good. I am sure that hurts
pretty badly.
• P: Whatever, I don’t care
• T: You tell yourself that you don’t care, but it sounds like some
part of you really cares, and that makes you upset.
Person-Centered Therapy
(Client-centered or Rogerian)
Show the client unconditional positive regard: accepting and
valuing self (and people) regardless of their behavior
Allow the client to take responsibility for his life
Mirror the clients emotions and thoughts so that he/she can
decide their path in life
Be congruent (honest, genuine, vulnerable)
Show empathy
Behavioral causes of disorders?
• Behaviorists believe that mental problems are
caused by classical conditioning (for example,
phobias), operant conditioning (addictions,
depression), and observational learning (we
watch our parents and friends suffer so we
copy them).
• Treatment: they change maladaptive behavior.
What are classical conditioning
techniques?
• Counterconditioning: Associating the stimulus
(the negative trigger, like something you fear)
with a new response– like relaxation.
• 2 types of counterconditioning techniques:
exposure therapy and aversive conditioning
Exposure therapies
• Focus is to expose people to things that they
would normally avoid
• Systematic desensitization (gradual exposure)
to your phobia or germs (for OCD and
phobias). This is the counterconditioning
strategy that would introduce relaxation
techniques with the feared stimulus, but it
would introduce the feared stimulus gradually
• Flooding – overexposure to what bugs you
Aversive conditioning
• Opposite of systematic desensitization
• Goal is to create a negative reaction to
something that used to cause a positive
reaction
• Good example: making alcohol taste bad to
alcoholics
Operant conditioning treatment
• Focuses on behavior modification (reinforcing
desired behaviors; punishing bad behaviors)
• Token economy – (operant conditioning)
Therapists will reward desirable behaviors
with a reward system. This is usually applied
to groups like hospital mental wards or
classrooms or workplaces.
• If everyone passes, we’ll have a pizza party.
Cognitive perspective
• We are depressed because we are irrational.
Our expectations are too high and misplaced.
We want everyone to love us and accept us.
We want every thing to go our way. We stay
angry about stuff that happened a looong
time ago.
• WE MUST CHANGE THE WAY WE THINK TO BE
HAPPY AND SUCCESSFUL.
Who are famous cognitive therapists?
• Aaron Beck –
cognitive therapy
• Albert Ellis – rational
emotive therapy
Cognitive Behavioral Therapy
• Assumes that how we THINK, how we FEEL,
and how we ACT (behave) all influence each
other – thoughts determine feelings and
behaviors
• Goal is to make people aware of their
thoughts and how they are reinforced by
behaviors that confirm those thoughts
• 2 types: rational emotive therapy and
cognitive therapy
Rational Emotion
• People hold a basic set of irrational assumptions (called
basic irrational assumptions). Examples:
–
–
–
–
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We should be competent at everything
It is disastrous if things are not the way we want them to be
We are in control of our happiness
There are perfect solutions
The past influences the present
• Therapy technique: ABC approach
– A = activating the event
– B = beliefs during the trigger event
– C = consequence – feelings that resulted from the behavior
• Negative thoughts connect an event to undesirable feelings
Example
Gina is upset because she got a low mark on a math test. The Activating event, A, is
that she failed her test. The Belief, B, is that she must have good grades or she is
worthless. The Consequence, C, is that Gina feels depressed.
After irrational beliefs have been identified, the therapist will often work with the
client in challenging the negative thoughts on the basis of evidence from the
client's experience by reframing it, meaning to re-interpret it in a more realistic
light. This helps the client to develop more rational beliefs and healthy coping
strategies.
A therapist would help Gina realize that there is no evidence that she must have good
grades to be worthwhile, or that getting bad grades is awful. She desires good
grades, and it would be good to have them, but it hardly makes her worthless.
If she realizes that getting bad grades is disappointing, but not awful, and that it
means she is currently bad at math or at studying, but not as a person, she will feel
sad or frustrated, but not depressed. The sadness and frustration are likely healthy
negative emotions and may lead her to study harder from then on.
Aaron Beck? Cognitive therapy
• People’s reaction to events influence abnormal
behavior
• Distorted thinking has a negative effect on our
behavior no matter what type of disorder (Aaron
Beck, 1997).
• Reveal the reactionary thoughts and remove that
type of thinking from your life
• Used most commonly with depression
Differences?
• Albert Ellis views the therapist as a teacher and does
not think that a warm personal relationship with a
client is essential. In contrast, Beck stresses the quality
of the therapeutic relationship.
• REBT is often highly directive, persuasive and
confrontive. Beck places more emphasis on the client
discovering misconceptions for themselves.
• REBT uses different methods depending on the
personality of the client, in Beck’s cognitive therapy,
the method is based upon the particular disorder.
• Source: http://www.simplypsychology.org/cognitivetherapy.html