(not drugs or biological techniques)Individual, group, insight, action, directive, non-directive, time-limited, supportivefocus is on empowering the individual to make changes in his or her life
Myths about psychotherapy
Trepanning - boring holes in the head to let out the illness, or to inject (pour in) a supposed treatment liquid.
- the therapist is in control of your mind
- you will be hypnotized without knowing it
- the therapist knows you better than you know yourself
- therapy can work immediately
- all therapists are the same
- all therapists will get you to say or do things you don't want to
- the therapist can make you change even if you don't want to
- if you go to a therapist, everyone will know
- you have to be seriously mentally ill to go to a therapist
- therapy is often undertaken when a person wants to improve some area of his life
Demonology - exorcism - illness thought to be caused by evil spirits
Philippe Pinel – Bicetre Asylum in Paris - unchained mental patients in institutions
Sigmund Freud – treated cases of Hysteria - physical symptoms with no identifiable biological cause (now called Somatoform Disorders).
Psychoanalysis – resolve internal conflicts
Free association
Dream analysis – latent,
manifest content
Analysis of resistance
Analysis of transference
Short-term dynamic therapy – direct interviewing to uncover unconscious conflicts- actively provoke emotional reactions - get the "splinter out of the mind"
Hans Eysenck - demonstrated that spontaneous remission often occurs during psychoanalysis - improvement due to the passage of time
60-90 % of patients in psychoanalysis show significant improvement
Humanistic therapies
Carl Rogers – conscious thoughts and feelings- client-centered therapy – unconditional positive regard – empathy – be authentic – reflect back to the client what she says
Existential therapy – focuses on the problems of existence as a cause of psychological conflict in people
Free will, focus on giving clients the courage to
make
Choices – death, freedom, isolation, meaninglessness
Gestalt therapy – awareness is out of adjustment in disturbed individuals – helps people rebuild thinking, feeling, and acting into coherent wholes
We often shy away from expressing our true feelings
Health comes from knowing what you want to do and doing it
Clients are urged to stop intellectualizing, and
to talk about feelings in the here and now
Behavior therapy – using behavior learning principles to make constructive changes in behavior
Behavior modification – rewards and punishments
Aversion therapy – e.g., rapid smoking
Alcohol aversion – pair with atabuse
Response-contingent shock therapy
Desensitization – hierarchy of steps – closer and closer approximations to the goal
Based on the principle of reciprocal inhibition – one emotional state is used to block another- can’t be relaxed and anxious at the same time
Helps with Phobias
Virtual reality exposure
Eye Movement Desensitization and Reprocessing
Operant conditioning
Positive reinforcement
Anorexic - Give stars for eating healthy today.
Non-reinforcement
Depressed – Don’t respond when self-pity statements are made
Extinction
Exhibitionist – no response to “flashing” will, over time, cause the behavior to drop out
Punishment
Substance Abuse – Being fired from a job, failing a class, losing a partner, are painful experiences that may be recognized as connected to the abuse
Shaping
Phobias – reward agoraphobic for getting dressed; walking outside; walking around the block; walking to the store; going to the movies.
Time out
ADHD – Hyperactivity is paired with time spent alone in a room with no distractions
Problem with Time Out is people usually don’t use it correctly – it works with far less intelligent animals
Token economy – give tokens to shape behavior – tokens are immediately rewarding, and can be “cashed in” later for a primary reward (tokens are secondary rewards). MONEY serves the same purpose for working people.
Cognitive Therapy – try to change the person’s faulty beliefs – self-defeating thoughts – self-criticism and negative interpretations of reality
People don’t like me, I’m fat, I’m ugly.
Anorexics and Bulimics
Very effective for depression
Rational-Emotive Therapy – based on the idea that people can LOGICALLY solve their problems – including problems of thinking
Irrational beliefs are the main problem
Ten irrational beliefs – p. 629
Attack the client’s self-talk
Group Therapy – one therapist, several to a dozen clients
Work on problems together.
Improve interpersonal skills
Challenge irrational statements
and behaviors
See that other people have
problems, too
Less “power-oriented” than
individual therapy
Clients are more “in charge”
Psychodrama - role playing, role reversal, mirror technique
Family therapy
Focus is on the contribution each family member makes to a problem – substance abuse, depression, aggression, abuse, anorexia
View family as a System
Core features of psychotherapy