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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
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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

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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

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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
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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

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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
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Deinstitutionalization - The emptying of U.S. mental hospitals
The Consequences Deinstitutionalization: The New Asylums