Treatment of Abnormal Behavior Ch. 13

Categories of Treatment  Psychotherapy - talking to a psychiatrist  Biomedical therapies - medication  eclectic approach - both psychotherapy and medication

Psychoanalysis Approach  Freud’s influence – Getting at Subconscious  free association - people speak freely and quickly  dream analysis - the hidden but symbolic meaning of things in dreams  weakness - subjective

Psychoanalysis Approach  Psychodynamic therapists  a person’s childhood experiences are critical  explore the patient's underlying thoughts and feelings  Interpersonal psychotherapy  a session treatment that has been successful with treating depression  cause of their depression  goal - stop symptoms of depression  result - improving relationships with others

Humanistic therapies  insight therapies - person look inside to figure things out.  focuses on the present instead of the past  the conscious instead of the unconscious  holds a person accountable not the unconscious  it promotes growth rather than a cure

Humanistic therapies  Carl Rogers - client-centered therapy  where the patient speaks and, through self-awareness, moves himself toward his own conclusion  unconditional positive regard - Non judgmental – allows patient to “open up”  active listening - listener echoes what’s heard, restates it, then seeks clarification

Behavior therapies  Counterconditioning - “unlearn”  by conditioning or pairing a trigger stimulus with a new response.  Exposure therapy - exposes people to what they try to avoid  Systematic desensitization - can’t be worried and relaxed at the same time  Virtual reality exposure therapy  Aversive conditioning

Behavior therapies  Operant conditioning the person’s actions interplay with the stimulus and results  withhold rewards until a desired behavior  Punishments given for unwanted behavior  “token economy” – Secondary reinforcer

Cognitive therapies  cognitive-behavioral therapy  change the way people think and act  goals  Recognize negative thinking.  Change negativity to positive thinking  act on new positive thoughts

Group and family therapies  Group therapy most common type of therapy  patients not alone  Support or self-help groups  AA (Alcoholics Anonymous)

psychotherapy effectiveness?  Results – Subjective  Patients usually leave Happier  Time – Big Factor

Alternative Therapies  EMDR – Eye Movement Desensitization and Reprocessing  developed by Francine Shapiro  reports 84% to 100% success  having your eyes dart to and fro and is supposed to relieve anxiety  Person thinks of a traumatic experience, then darts his/her eyes back and forth  Skeptics - placebo effect

Alternative Therapies  Light exposure therapy  “seasonal affective disorder” (SAD)  patients under bright lights  Morning Light – 50% success

Drug therapies  Antipsychotic drugs  Schizophrenia responds best  chlorpromazine (brand name “Thorazine”).  blocks dopamine’s receptor sites.  side-effects  sluggishness,  “the shakes”,  tardive dyskinesia - facial muscles move involuntarily.  Not good for Schizophrenics with apathy or withdrawal  Clozapine  affects both dopamine AND serotonin receptors

Drug therapies  Antianxiety drugs  Antianxiety drugs depress the central nervous system  Example - Xanax.  The good—cut down on effects of PTSD and OCD  The bad—psychologically dependence and physiological dependence

Drug therapies  Antidepressant drugs  increasing neurotransmitters serotonin or norepinephrine  Examples Prozac (or Paxil or Zoloft)  side-effects - dry mouth, weight gain, hypertension, or dizziness  Aerobic exercise  Placebo Affect

Drug Therapies  Mood-stabilizing medications  Lithium - levels the emotional roller-coaster of people with bipolar disorder  7 in 10 people seem to have their moods stabilized

Brain stimulation  Electroconvulsive therapy ( ECT ) - “shock therapy”  ECT seems successful  80% of depressed people respond  ECT reduces thoughts of suicide.

Brain Stimulation  Alternative neurostimulation therapies  Magnetic stimulation  Magnetic energy pulses  repetitive transcranial magnetic stimulation ( rTMS ).  The person remains awake, it’s painless, and there’s no memory loss or side effects.  50% better than placebo group.  Deep-brain stimulation - Helen Mayberg  located a spot in cortex links the thinking frontal lobes with the limbic system - overly active in a depressed person.  implanted electrodes to stimulate these areas.  8 in 12 people have positive results.

Psychosurgery  removes or destroys part of the brain  Egas Moniz - lobotomy.  drugs replaced lobotomies

Therapeutic lifestyle change  therapeutic lifestyle change  change the way you feel, change the way you live. He says…  Exercise, Sunlight, etc  Ilardi suggests…  Aerobic exercise – 30 minutes three times a week.  Adequate sleep – about 7 to 8 hours per night.  Light exposure – about 30 minutes each morning.  Social connection – interact with others at least twice a week.  Anti-rumination – don’t dwell on negative thoughts.  Nutritional supplements – including daily fish oil with omega-3 fatty acids.  77% of the people improved from depression