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Treatment
Unit XIII
Therapy
• throughout time we have treated
psychological disorders with a variety of harsh
and gentle methods
– examples: cutting holes in the head and by giving
warm baths and massages
• restraining, bleeding, or "beating the devil" out of
people
• placing them in sunny, serene environments or by
giving drugs and electric shocks
• talking about childhood experiences, about current
feelings, or about maladaptive thoughts and behaviors
Therapy
• the transition from brutal to gentler treatments
occurred because of the efforts of reformers like
Philippe Pinel and Dorothea Dix
• both advocated constructing mental hospitals to
offer more humane methods of treatment
• therapeutic drugs and community-based
treatment programs has largely emptied mental
health hospitals since the mid 1950s
• treatment today often depend's on the
therapist's viewpoint
Therapy
• if the doctor believes the disorder is learned then
the doctor will lean more toward psychological
therapies
• if the doctor believes the disorder is biological
they will lean more to medication therapy
• if the doctor believes the disorder is a response
to social conditions they will look to reform the
"sick" environment
• therapies are classified into two categories:
– Psychological therapies
– Biomedical therapies
Therapy
• Psychotherapy- an emotionally charged, confiding
interaction between a trained therapist and
someone who suffers from psychological
difficulties
– 250 types of psychotherapy have been identified
• they are each built on one or more of
psychology's major theories:
– psychoanalytic, humanistic, behavioral, and cognitive
• some therapists like to use a combination of
therapies
Therapy
• half of psychotherapists describe themselves as
taking an eclectic approach
– an approach to psychotherapy that, depending on the
client's problems, uses techniques from various forms
of therapy
• psychotherapy integration- closely related to
eclecticism
– instead of picking and choosing methods, integration
advocates trying to combine them into a single,
coherent system
Therapy
• Psychoanalysis- Freud's therapeutic technique
– the patient's free associations, resistances,
dreams, and transferences- and the therapist's
interpretations of them- released previously
repressed feelings, allowing the patient to gain
self-insight
• assumes that many psychological problems
are fueled by childhood's residue of repressed
impulses and conflicts
Therapy
• in order to become healthier, patients must release the
energy they had previously devoted to id-ego-superego
conflicts
• psychoanalysis is historical reconstruction
• Freud believed hypnosis to be unreliable
• he used free association more often but many times
the patient would hesitate to talk about embarrassing
things
• the blocks in the flow of free association indicates
resistance
– the blocking from consciousness of anxiety-laden material
Therapy
• when a psychoanalysis sees the existence of
resistance, they look to explore that sensitive
area
• the therapists wants the patient to recognize
their own resistance and interpret its underlying
meaning
• the therapist's interpretations look to provide the
patient with insight
– interpretations- the analyst's noting supposed dream
meanings, resistances, and other significant behaviors
in order to promote insight
Therapy
• Freud also used dream analysis to reach those
repressed thoughts and feelings
• most of the things discussed in a session will
focus on childhood memories
• often times a patient will find themselves
experiencing strong positive or negative feelings
for their analyst
• the feelings may express the dependency or
mingled love and anger that you earlier
experienced toward family members or other
important people in your life
Therapy
• when a patient experiences these feelings,
Freud would say the patient is actually
transferring their strongest feelings from
those other relationships to the analyst
– transference- the patient's transfer to the analyst
of emotions linked with other relationships
• by expressing these feelings with the analysts,
the patient can finally work through the
repressed feelings with the analyst
Therapy
• psychoanalysis is built on the assumption that
repressed memories exist
• that assumption is being highly debated in
today's psychology circles
• psychoanalysts' interpretations are hard to
prove or disprove
– if the patient agrees with the interpretations it
supports their ideas, if the patient disagrees with
the analysts they are said to be facing resistance
Therapy
• psychoanalysis is said to be therapy, not
science
• psychoanalysts believe their interpretations
provide great help to the patients
• traditional psychoanalysis takes time, up to
several years of several sessions a week, and is
expensive
Therapy
• there are few traditional psychoanalysts today
• psychoanalytic assumptions do influence many
therapists though
• Psychodynamic therapists are greatly influenced by
psychoanalytic assumptions
• Psychodynamic therapists try to understand a patient's
current symptoms by exploring childhood experiences
• they probe for supposed repressed, emotion-laden
information, seeking to help the person gain insight
into the unconscious roots of problems
Therapy
• these therapists may talk to the patient face to
face, rather than out of the line of vision like
psychoanalysts
• they will see the patient once a week instead of
several times a week
• they will only see them for a couple of weeks or
months instead of several years
• Interpersonal psychotherapy is an alternative to
psychodynamic therapy
– effective with depressed patients
– focus on current relationships instead of past ones
Therapy
• interpersonal therapy tries to help people
improve their relationship skills
– its goal is not personality change but symptom
relief in the here and now
Therapy
• humanistic therapists aim to boost selffulfillment by helping people grow in selfawareness and self-acceptance
• focus on:
– the here and now more than the past
– conscious rather than unconscious thoughts
– taking immediate responsibility for one's feelings
and actions rather than blaming the past
– promoting growth instead of curing illness
Therapy
• Carl Roger's developed the widely used technique
called client-centered therapy
– the therapist uses techniques such as active listening
within a genuine, accepting, empathic environment to
facilitate clients' growth
– does not focus on the therapist's interpretations
• the therapist will use a nondirective therapy
when using client-centered therapy
– the therapist listens, without judging or interpreting,
and refrains from directing the client toward insights
Therapy
• Rogers encourages therapists to use genuineness,
acceptance, and empathy
• if the therapists shows these traits it can help the
clients deepen their self-understanding and selfacceptance
• Rogers also uses the technique of active listening
– empathic listening in which the listener echoes,
restates, and clarifies- used in client-centered
• this technique is widely accepted today
Therapy
• behavior therapists doubt the healing power of
self-awareness
• they assume that problem behaviors are the
problem
• instead of trying to resolve an underlying
problem, they look to behavior therapy
– applies learning principles to the elimination of
unwanted behaviors
• for example to treat a phobia they do not look for
underlying causes but look to switch bad learned
behaviors with constructive behaviors
Therapy
• some behavior therapists try to use classical
conditioning to change certain maladaptive
learned behaviors
– example: having an alarm go off when a child wets
the bed waking the child up
• Counterconditioning is also used
– conditions new responses to stimuli that trigger
unwanted behaviors; based on classical
conditioning
Therapy
• exposure therapies are a way to conduct
counterconditioning
– treats anxiety by exposing people to the things
they fear and avoid
• Systematic desensitization is a form of
exposure therapy
– associates a pleasant relaxed state with gradually
increasing anxiety-triggering stimuli
• used to treat phobias usually
Therapy
• Aversive conditioning is another form of
counterconditioning
– associates an unpleasant state with an unwanted
behavior
• operant conditioning can be used as well by
reinforcing desired behaviors or to punish
undesired behaviors