UNIT 7 Applications of Psychological Science Domain

CHAPTER 14 Treatment of Psychological Disorders

MODULE 33 Psychological Therapies

“Analysis does not set out to make pathological reactions impossible, but to give the patient’s ego freedom to decide one way or another.” - Sigmund Freud

“In my early professional years, I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth? - Carl Rogers

Psychotherapy: an interaction between a trained therapist and someone who is seeking to overcome psychological difficulties or achieve personal growth – Developed by Sigmund Freud Eclectic approach: approach to psychotherapy that, depending on the person’s problems, uses techniques from various forms of therapy

Psychoanalysis Psychoanalysis: Freud’s theory of personality; also, a therapeutic technique that attempts to provide insight into the thoughts and actions by exposing and interpreting the underlying unconscious motives and conflicts

Psychoanalytic Assumptions Freud’s iceberg theory of personality – Primary elements: id, ego, superego – Waterline represents border between conscious and unconscious mind Personality forms during early childhood through stages of psychosexual development – Potential conflicts at each stage can lead to psychological problems later in life

Psychoanalytic Methods Free association: patient relaxes, is told to think of childhood memories, and talk about whatever comes to mind Resistance: the blocking from consciousness of anxiety-laden material – Embarrassing or painful memories Interpretation: the analyst’s noting of ideas on the meaning behind dreams, resistances, and other significant behaviors to promote insight

Freud: dreams represent the “royal road to the unconscious” Dream analysis is key element of psychoanalytic process – Latent content: censored meaning of dreams Transference: the patient’s transfer of strong emotions (such as love or hatred) linked with other relationships to the analyst

Contemporary critiques of Freud’s methods: (1)Foundation of psychoanalysis based on Freud’s belief in repressed memories; many psychologists doubt legitimacy of repression (2)Traditional psychoanalysis is expensive, requires several sessions a week, can last several years (3)Difficult to refute psychoanalytic interpretation; seen as resistance

The Psychodynamic Perspective Few therapists practice strict psychoanalysis, but Freud’s innovative techniques have broadly influenced many Therapists make psychodynamic assumptions (assumptions related to psychoanalysis) – Childhood experiences, unconscious drives, unresolved conflicts

Weekly meetings for a few months, not several meetings weekly for many years Interpersonal psychotherapy: – sessions; foster insight into origins of problem, but focus on what’s going on in patient’s life now – Mend current relationships, improve social skills

Humanistic Therapies Promotes self-fulfillment through self- acceptance and self-awareness Differs from psychoanalytic approach by: – Fostering growth instead of relieving illness; therapists refer to people as clients – Focusing on present and future instead of past – Emphasizing conscious thoughts instead of unconscious thoughts

Humanistic therapists use nondirective methods; listen without interpreting, to not direct clients towards particular insight Carl Rogers developed most famous form – Client-centered therapy: therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate the client’s growth

– Active listening: empathic listening in which the listener echoes, restates, and clarifies – Client should feel unconditional positive regard: feeling of being accepted that does not depend on any specific behaviors Provide nonjudgmental, accepting environment

Behavior Therapies Behavior therapy: therapy that applies learning principles to the elimination of unwanted behaviors

Classical Conditioning Techniques Classical conditioning: type of learning in which we associate two things that occur together – Pioneered by John B. Watson – Learn to associate emotions with behaviors – Unlearn by counterconditioning – Associate new responses

Systematic Desensitization: a type of counterconditioning that associates a pleasant, relaxed state with gradually increasing, anxiety-triggering stimuli – Commonly used to treat phobias – Establish hierarchy of anxiety-provoking situations Trained to relax using progressive relaxation

Virtual reality exposure therapy: anxiety- treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking Wear headset projecting a 3-dimensional virtual world * Systematic desensitization has been combined with modeling to help patients overcome disruptive fears

Aversive conditioning: type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol) – Opposite of systematic desensitization – Replaces a positive response to a harmful experience with a negative (aversive) response – Used to treat alcoholism, sexual deviancy, nail-biting, etc.

Operant Conditioning Techniques Operant conditioning: type of learning in which the frequency of a behavior depends on the consequence that follows that behavior – Reward desired behaviors, withhold rewards or punish unwanted behaviors – Used to treat schizophrenia (inappropriate behaviors), autism

– Token economy: operant conditioning procedure that attempts to modify behavior by rewarding desired behaviors with some small item Successfully used with various groups (schizophrenia, delinquent teens, etc.) in various settings (day-care centers, schools, hospitals, etc.)

Problems with behavior modification: – What happens when a person is no longer reinforced for proper behavior? Gradually shift rewards to more internal ones – Ethical issue: Is it right to deprive someone of something in order to obtain a desired behavior? Do pros outweigh cons?

Cognitive Therapies Cognitive therapy: therapy that teaches people new, more adaptive ways of thinking and acting – Nearly half of all therapy is at least in part cognitive-based – Thinking affects the way we feel

– Best psychological therapies for depression, especially major depression, appears to be cognitively based – Self-serving bias absent during depression – Self-blame common among depressed people – Cognitive therapists teach clients to think constructively Optimistic explanatory styles

Cognitive-behavioral therapy: integrated therapy that combines changing self-defeating thinking with changing inappropriate behaviors – Make people become aware of their irrationally negative thoughts; taught to think more realistically – Used to treat OCD, depression, anxiety

Family & Group Therapies Group therapy participants discuss and react to one another’s issues Advantages: (1) therapists can help more people in less time, (2) sessions typically cost less, (3) social context: people discover that other people have similar problems, (4) group meetings foster sense of community

Family therapy: therapy that views an individual’s unwanted behaviors as influenced by or directed at other members of the family and attempts to guide the family toward positive relationships and improved communications – Open lines of communication, learn new ways of resolving and preventing conflicts