Download Insight Therapies

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Chapter 14: Therapies
Insight Therapies:
Common goal: give people a better awareness and understanding of their feelings,
motivations, and actions to facilitate better adjustment.
Psychoanalysis:
Freud – anxiety symptoms of inner conflicts dating back to childhood.
Problems concern aggressive or sexual drives whose expression was forbidden to the
child.
Repressed impulses from childhood lurk in the adult’s unconscious mind – creating
various psychological disorders
Idea of psychoanalysis is to bring the unconscious to conscious awareness.
Techniques:
Free association
Blank screen – patient projects unconscious thoughts and feelings
Analysis proceeds very slowly – analyst maintains neutrality through the process. This
creates reassurance on part of the patient. Project on their analyst feelings they have
toward authority figures from their childhood – this is known as transference.
Positive transference
Negative transference – a crucial step in psychoanalysis – reveals the patients’ negative
feelings toward authority figures and their resistance to uncovering their repressed
emotions.
Analyst eventually interprets or suggests an alternative meaning for the patients’ feelings,
memories and actions.
This helps patient’s gain insight – encouraged to confront childhood events and recall
them fully. As they relive their childhood traumas, they become able to resolve conflicts
they could not resolve in the past.
Working through old conflicts is the last part of the therapeutic process.
Problems with Psychoanalysis:
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This type of traditional analysis takes 5 years or longer. It also does not give immediate
help for immediate problems. It is not effective with severely disturbed patients.
Client Centered Therapy:
Carl Rogers: also called person centered
Goal of therapy is to help people become fully functioning open them up to
all of their experiences and to all of themselves.
Insight into current feelings most important
Place responsibility for change on the patient
Most people have experienced conditional positive regard
This creates defensiveness, rigidity, anxiety and other signs of discomfort.
Love and acceptance are contingent on conforming to what others want them
to be.
Cardinal rule in person-centered therapy is unconditional positive regard.
This is a crucial first step toward getting clients to accept themselves
This is nondirective therapy. Reflect clients’ statements; create an
atmosphere of openness and genuine respect.
Sees therapy as a process.
It has been found that a therapist’s warmth and understanding increase
success no matter what therapeutic approach is used.
Gestalt Therapy:
Fritz Perls – turned completely against Freud and psychoanalysis
techniques.
Gestalt emphasizes Here and Now & Face to Face confrontations.
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Helps people become more genuine or “real” in their day-to-day
interactions.
Therapist is active and directive. Emphasis on the whole person
Filling in the holes and making the person whole again.
“Own you own feelings” He makes me angry is not owning your own
feelings
Clients are alone responsible for their feelings and for their lives.
Empty chair technique
Other therapies:
Short-term psychodynamic psychotherapy
Regardless of type of treatment improvement tends to occur fairly quickly in
most people.
Problem centered or solution focused therapy.
Behavior Therapy:
Contrasts with Insight:
1. Therapist is more active
2. Concentrate on changing people’s behavior rather than on increasing
insight into their thoughts and feelings
3. Operative within a briefer frame work
Behaviorists believe psychology should focus on observable, measurable
behavior rather than on thoughts, feelings and unconscious processes.
Insight Therapists regard personality disorders as the symptoms of
unconscious forces or products of insufficient awareness or insight.
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Behavior therapists argue that the disorder is the problem. Teacher people to
behave in more appropriate ways, they have cured the problem.
All behavior is learned. Job of the therapists is to teach patients better ways
of behaving.
Classical Conditioning:
Systematic desensitization – gradually reducing fear and anxiety.
Relaxation part of this
Hierarchy of fears
Teaches relaxation and as they encounter the fears.
The success of this may be the fact that we don’t learn a new behavior but
experience the extinction of an old.
Flooding – exposing to the fear directly and strongly.
Aversive conditioning: associate pain and discomfort with a behavior you
want to unlearn.
Used to treat alcoholism, obesity and smoking. But use has declined in
recent years. Not long-term effective.
Operant Conditioning
Behavior contracting
Token economy – levels of privileges
Token economies work in institutions, but do not always generalize to
everyday life outside the hospital or clinic. In every day life behaviors are
not always reinforced with tokens and maladaptive behavior is not always
ignored or punished.
Modeling:
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Watching others model the behavior you want. Good combined with
positive reinforcement.
Modeling used to teacher appropriate social responses and job skills for
those with mental retardation.
Cognitive Therapies
To change you way of thinking about the problem should lead to a new way
of living. They identify the erroneous ways of thinking and correct them.
Stress-inoculation therapy - self-talk to help clients cope with stressful
situations.
This is effective with anxiety disorders.
Rational emotive therapy
Most people hold a set of irrational and self-defeating beliefs.
Beck’s Cognitive Therapy:
Depression results from negative patterns of thought that people develop
about themselves.
Help clients examine each dysfunctional thought in a supportive but
objectively scientific manner. Leaders clients to a more realistic and
flexible way of thinking.
Group Therapy:
Interaction with others. Maladaptive behaviors show up quickly in a group
setting.
Provides social support. Not the only person in the world with emotional
problems.
Self-Help Groups:
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Not mental health professionals - composed of people who have a common
problem.
Most known and successful is AA. Also known as Twelve Step Groups.
Family Therapy:
Goals improving family communication, encouraging more empathy, getting
members to share responsibilities reducing intrafamily conflict.
Carl Whittaker – multigenerational family therapy.
Couples therapy improves communication and expectations. Cognitive
marital therapy – recognize ways they have been misinterpreting each
other’s communications.
Couple therapy for both partners is generally more effective that therapy for
only one of them.
Effectiveness of Psychotherapy:
Eyenck first to study – helped about 2/3 of the people, but also found 2/3
will recover within 2 years without any treatment at all. This caused a
storm of controversy.
Another study said only 1 out of 3 improves without treatment. Also,
consider some of those no therapy people can get help from friends, clergy,
teachers, etc.
Value of therapy depends on 1. People who want to change
2. More successful in mild disorders compared to severe.
Seligman study: 90% of the respondents reported feeling better.