1. Therapy Chapter 17

2. Therapy The Psychological Therapies Psychoanalysis
Humanistic Therapies
Behavior Therapies
Cognitive Therapies
Group and Family Therapies

3. Therapy Evaluating Psychotherapies The Effectiveness of Psychotherapy
The Relative Effectiveness of Different Therapies
Alternative Therapies Evaluated
Commonalities Among Psychotherapies
Culture and Values in Psychotherapies

4. Therapy The Biomedical Therapies Preventing Psychological Disorders
Drug Therapies
Brain Stimulation Psychosurgery
Preventing Psychological Disorders

5. History of Insane Treatment
Maltreatment of the insane throughout the ages was the result of irrational views. Many patients were subjected to strange, debilitating, and downright dangerous treatments.
The Granger Collection
The Granger Collection

6. History of Insane Treatment
Philippe Pinel in France and Dorthea Dix in America founded humane movements to care for the mentally sick.
Culver Pictures
Philippe Pinel ( )
Dorthea Dix ( )

7. Therapies
Psychotherapy involves an emotionally charged, confiding interaction between a trained therapist and a mental patient.
Biomedical therapy uses drugs or other procedures that act on the patient’s nervous system, curing him or her of psychological disorders.
OBJECTIVE 1| Contrast psychotherapy and the biomedical therapies, and explain how an eclectic approach or psychotherapy integration varies from either of these two main forms of therapy.
An eclectic approach uses various forms of healing techniques depending upon the client’s unique problems.

8. Psychological Therapies
We will look at four major forms of psychotherapies based on different theories of human nature:
Psychoanalytical theory
Humanistic theory
Behavioral theory
Cognitive theory
OBJECTIVE 2| Define psychoanalysis, and discuss the aims of this form of therapy.

9. Psychoanalysis
The first formal psychotherapy to emerge was psychoanalysis, developed by Sigmund Freud.
Edmund Engleman
Sigmund Freud's famous couch

10. Psychoanalysis: Aims
Since psychological problems originate from childhood repressed impulses and conflicts, the aim of psychoanalysis is to bring repressed feelings into conscious awareness where the patient can deal with them.
When energy devoted to id-ego-superego conflicts is released, the patient’s anxiety lessens.

11. Psychoanalysis: Methods
Dissatisfied with hypnosis, Freud developed the method of free association to unravel the unconscious mind and its conflicts.
The patient lies on a couch and speaks about whatever comes to his or her mind.
OBJECTIVE 3| Describe some of the methods used in psychoanalysis, and list some criticisms of this form of therapy.

12. Psychoanalysis: Methods
During free association, the patient edits his thoughts, resisting his or her feelings to express emotions. Such resistance becomes important in the analysis of conflict-driven anxiety.
Eventually the patient opens up and reveals his or her innermost private thoughts, developing positive or negative feelings (transference) towards the therapist.

13. Psychoanalysis: Criticisms
Psychoanalysis is hard to refute because it cannot be proven or disproven.
Psychoanalysis takes a long time and is very expensive.

14. Do Now: How many days until the AP? 29! Review Questions: Memory Unit
What is anterograde amnesia? How does it differ from retrograde amnesia?
What is an example of organic amnesia?

15. Anterograde amnesia: inability to form new memories
Example:
Retrograde amnesia: inability to retrieve memories from the past

16. Organic amnesia: results from physical trauma or aging, examples= Alzheimer’s, car accident

17. Aim: How can psychological disorder be treated through therapy?

18. Psychodynamic Therapies
Influenced by Freud, in a face-to-face setting, psychodynamic therapists understand symptoms and themes across important relationships in a patient’s life.
OBJECTIVE 4| Contrast psychodynamic therapy and interpersonal therapy with traditional psychoanalysis.
Today, there are relatively few traditional psychoanalysts. Most have been replaced by therapists who make psychodynamic assumptions, that is, those who try to understand patients’ current symptoms by exploring their childhood experiences and by exploring the therapist-patient relationship. They may also help the person explore defended-against thoughts and feelings. However, they talk with the patient face-to-face, once a week, and for only a few weeks or months. Interpersonal psychotherapy, a brief alternative to psychodynamic therapy, emphasizes symptom relief in the present, not overall personality change. The therapist also focuses on current relationships and the mastery of relationships skills. It has been found effective with depressed patients.

19. Psychodynamic Therapies
Interpersonal psychotherapy, a variation of psychodynamic therapy, is effective in treating depression.
It focuses on current symptom relief of present problems
here and now, not an overall personality change.
Pg 689

20. Humanistic Therapy

21. Humanistic Therapies
Humanistic therapists aim to boost self-fulfillment by helping people grow in self-awareness and self-acceptance.
OBJECTIVE 5| Identify the basic characteristics of the humanistic therapies, and describe the specific goals and techniques of Carl Rogers’ client-centered therapy.
Humanistic therapists focus on clients’ current conscious feelings and on their taking responsibility for their own growth. In emphasizing people’s inherent potential for self-fulfillment, they aim to promote growth rather than to cure illness. In his client-centered therapy, Rogers used active listening to express genuineness, acceptance, and empathy. This technique, he believed, would help clients to increase their self-understanding and self-acceptance. The therapist interrupts only to restate and confirm the client’s feelings, to accept what the client is expressing, or to seek clarification. The client-centered counselor seeks to provide a psychological mirror that helps clients see themselves more clearly.

22. Person-Centered Therapy
Developed by Carl Rogers, client-centered (or person-centered) therapy is a form of humanistic therapy.
The therapist :
listens to the needs of the patient in an accepting and non-judgmental way
addresses problems in a productive way

23. Michael Rougier/ Life Magazine © Time Warner, Inc.
Humanistic Therapy
The therapist engages in active listening and echoes, restates, and clarifies the patient’s thinking, acknowledging expressed feelings.
Paraphrase- summarize the speaker’s words in your own words
Invite clarification- what might be an example of this
Reflect feelings- it sounds frustrating
Michael Rougier/ Life Magazine © Time Warner, Inc.

24. Goals of Humanistic Therapy
help person recognize their feelings about the world
genuineness- therapist is open, honest, expressive
provides unconditional positive regard- acceptance
self actualization
and then integrate (accept, understand, deal with) so they can reach their full potential
Unconditional positive regard= acceptance

25. Gestalt (Humanistic) Therapy
-Fritz Perls
-Organize our world to
create meaning
-similar to psychodynamic
-role playing
More directive questioning
Challenge the client
Dramatic
Gestalt therapy- (Fritz Perls and wife Laura)
Gestaltism- organize our world to create meaning
· more dramatic than Rogers
directive in questioning and challenge clients to help them to become aware of their feelings
Role playing
· physical- act out conflicts to become aware of connection between mind and body
· believes people’s feelings must be recognized
· importance of the present
· aim: integration of behavior, thought and feelings

26. Existential therapies · difficulty caused by lack of purpose in life ·
Existential therapies · difficulty caused by lack of purpose in life · goal is help develop a vision of their lives as worthwhile

27. Psychological Therapy April 14, 2010

28. Do Now:
1. Which part of the cerebral cortex receives information about temperature,
pressure, touch, and pain?
(A) Motor cortex
(B) Prefrontal cortex
(C) Temporal lobe
(D) Occipital lobe
(E) Parietal lobe
2. Visual negative afterimages are a result of
(A) opponent-processes
(B) simultaneous contrast
(C) spatial summation
(D) brightness oversensitivity
(E) color intensity
3. During REM sleep, which of the following is most likely to occur?
(A) Slowed respiration
(B) Sleepwalking
(C) Stable blood pressure
(D) Decreased heart rate
(E) Suppressed muscle tone

29. AP Essay

30. Behavior Therapy
Therapy that applies learning principles to the elimination of unwanted behaviors.
OBJECTIVE 6| Explain how the basic assumption of behavior therapy differs from those of traditional psychoanalytic and humanistic therapies.
Traditional psychoanalysts attempt to help people gain insight into their unresolved and unconscious conflicts. Humanistic therapists help clients to get in touch with their feelings. In contrast, behavior therapists question the therapeutic power of increased self-awareness. They assume problem behaviors are the problems and thus do not look for inner causes. Instead, they apply learning principles to eliminate a troubling behavior.
Father of behaviorism?

31. Classical Conditioning Techniques
Counterconditioning is a procedure that conditions new responses to stimuli that trigger unwanted behaviors.
2 types of counterconditioning:
Exposure therapy
a. systematic desensitization
b. flooding
2) Aversive conditioning
OBJECTIVE 7| Define counterconditioning, and describe the techniques used in exposure therapies and aversive conditioning.
Behavior Therapy- no underlying cause of problem- symptom IS the problem
Psychodynamic approach believed that treating only outer problem would result in symptom substitution (appearance of new problem)—Not correct – other symptoms usually fixed
Short term- most effective with specific problems
Counterconditioning is a behavior therapy procedure, based on classical conditioning, that conditions new responses to stimuli that trigger unwanted behaviors. Exposure therapies treat anxieties by exposing people to the things they fear and avoid.

32. Exposure Therapy Expose patients to things they fear
Through repeated exposures, anxiety lessens.
Clients habituate feared stimuli
The Far Side © 1986 FARWORKS. Reprinted with Permission. All Rights Reserved.
In systematic desensitization, a prime example of exposure therapy, a pleasant, relaxed state is associated with gradually increasing anxiety-triggering stimuli. This procedure is commonly used to treat phobias.

33. Exposure Therapy Examples
Exposure therapy involves exposing people to fear-driving objects in real or virtual environments.
Some airlines offer programs that ease fear of flying through education and gradual exposure to simulated and actual air travel
Virtual reality exposure therapy equips patients with a head-mounted display unit that provides vivid simulations of feared stimuli, such as a plane’s takeoff.
Both Photos: Bob Mahoney/ The Image Works
N. Rown/ The Image Works

34. Exposure Therapy: Systematic Desensitization
Exposure therapy that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli commonly used to treat phobias: anxiety hierarchies
1. systematic desensitization-- anxiety is gradually replaced with relaxation
· Impossible to be relaxed and anxious at the same time (theory of reciprocal inhibition)- developed by S. African psychiatrist Joseph Wolpe
· helpful with anxiety disorders especially phobias
· hierarchy of distressing images (anxiety hierarchy) is constructed (ex: picture of spider, dead spider, live spider, live spider crawling on person)
· patient learns relaxation technique
· each stressful stimulus is imagined and paired with relaxation
Implosive therapy- most distressing image is imagined
Q: How would this be helpful?
A: With guidance of therapist, patient realizes nothing bad happens and fear is extinguished or panic occurs again and again until it is gradually reduced
In vivo therapy- same as systematic desensitization except person actually experiences disturbing experience

35. Do Now: Review homework
1) Contrast Operant Conditioning and Classical Conditioning. (You may need to refer back to the Learning Chapter, (Chapter 8.) Provide an example of each.
2) Provide one example of systematic desensitization
3) Provide one example of aversive conditioning. How is aversive conditioning different from systematic desensitization?
4) Select one of the behavioral therapies mentioned in the text or discussed in class and draw a picture illustrating this therapy

36. Exposure Therapy: Flooding
A type of implosive therapy
most distressing situation occurs
Flooding- most distressing situation occurs (afraid of heights, go to empire state building)
Fear of rats- what would the therapist do?

37. Aversive Conditioning
Counterconditioning
Associates an unpleasant state with an unwanted behavior.
Temporarily effective for alcoholism
In aversive conditioning, an unpleasant state (such as nausea) is associated with an unwanted behavior (such as drinking alcohol). This method works in the short run, but for long-term effectiveness it is combined with other methods.

38. Operant Conditioning
Operant conditioning procedures enable therapists to use behavior modification, in which desired behaviors are rewarded and undesired behaviors are either unrewarded or punished. Cesar Milan
OBJECTIVE 8| State the main premise of therapy based on operant conditioning principles, and describe the views of proponents and critics of behavior modification.
A number of withdrawn, uncommunicative year-old autistic children have been successfully trained by giving and withdrawing reinforcements for desired and undesired behaviors.

39. Token Economy
Positive behaviors are rewarded with secondary reinforcers (tokens, points, etc) which can be exchanged for extrinsic rewards
In institutional settings therapists may create a token economy in which patients exchange a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats.
Activity: tokens for contributing, whoever gets the most tokens at the end wins the prize

40. Cognitive Therapy
Teaches people adaptive ways of thinking and acting to treat abnormal psychology

41. Cognitive Therapy for Depression
Aaron Beck (1979) suggests that depressed patients believe that they can never be happy (thinking) and thus associate minor failings (e.g. failing a test [event]) in life as major causes for their depression.
OBJECTIVE 9| Contrast cognitive therapy and cognitive-behavior therapy, and give some examples of cognitive therapy for depression.
Beck believes that cognitions such as “I can never be happy” need to change in order for depressed patients to recover. This change is brought about by gently questioning patients.

42. Cognitive Therapy for Depression
Rabin et al., (1986) trained depressed patients to record positive events each day, and relate how they contributed to these events. Compared to other depressed patients, trained patients showed lower depression scores.
Compared to other depressed patients, trained patients showed lower depression scores.

43. Stress Inoculation Training
Meichenbaum (1977, 1985) trained people to restructure their thinking in stressful situations.
“Relax, the exam may be hard, but it will be hard for everyone else too. I studied harder than most people. Besides, I don’t need a perfect score to get a good grade.”

44. Cognitive-Behavior Therapy (CBT)
Cognitive therapists often combine the reversal of self-defeated thinking with efforts to modify behavior.
Cognitive-behavior therapy aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy).

45. Rational Emotive Behavior Therapy
Proposed by Albert Ellis
Anxiety, guilt, depression, and other psychological problems result from self-defeating thoughts
Example of someone with social phobia- someone suffering from social phobia might voice concern over being publicly embarrassed when giving a class rpesentation. By using REBT, therapist would question both the likelihood of such embarrassment occurring and the impact that would result. Goal of showing the client it’s not his fault AND not a big deal

46. Group Therapy
Group therapy normally consists of 6-9 people attending a therapy session
OBJECTIVE 10| Discuss the rationale and benefits of group therapy, including family therapy.
What are some of the benefits of group therapy over individaul therapy?
Clients benefit from knowing others have similar problems.
Self-help groups
that can help more people and costs less.
© Mary Kate Denny/ PhotoEdit, Inc.

47. Family Therapy
Family therapy Therapy guides family members toward positive relationships and improved communication.

48. Who do people turn to for help with psychological difficulties?
Evaluating Therapies
Who do people turn to for help with psychological difficulties?

49. Evaluating Psychotherapies
Within psychotherapies cognitive therapies are most widely used, followed by psychoanalytic and family/group therapies.

50. Is Psychotherapy Effective?
It is difficult to gauge the effectiveness of psychotherapy because there are different levels upon which its effectiveness can be measured.
Does the patient sense improvement?
Does the therapist feel the patient has improved?
How do friends and family feel about the patient’s improvement?

51. Client’s Perceptions
If you ask clients about their experiences of getting into therapy, they often overestimate its effectiveness. Critics however remain skeptical.
Clients enter therapy in crisis, but crisis may subside over the natural course of time (regression to normalcy).
Clients may need to believe the therapy was worth the effort.
Clients generally speak kindly of their therapists.
OBJECTIVE 11| Explain why clients tend to overestimate the effectiveness of psychotherapy.

52. Clinician’s Perceptions
Like clients, clinicians believe in therapy’s success. They believe the client is better off after therapy than if the client had not taken part in therapy.
Clinicians are aware of failures, but they believe failures are the problem of other therapists.
If a client seeks another clinician, the former therapist is more likely to argue that the client has developed another psychological problem.
Clinicians are likely to testify to the efficacy of their therapy regardless of the outcome of treatment.
OBJECTIVE 12| Give some reasons why clinicians tend to overestimate the effectiveness of psychotherapy, and describe the phenomena that contribute to clients’ and clinicians’ misperceptions of this area.

53. How can we objectively measure the effectiveness of psychotherapy?
Outcome Research
How can we objectively measure the effectiveness of psychotherapy?
Meta-analysis of a number of studies suggests that thousands of patients benefit more from therapy than those who did not go to therapy.
OBJECTIVE 13| Discuss the importance of outcome studies in judging the effectiveness of psychotherapies, and describe some of these findings.

54. Outcome Research
Research shows that treated patients were 80% better than untreated ones.

55. The Relative Effectiveness of Different Therapies
Which psychotherapy would be most effective for treating a particular problem?
Disorder
Therapy
Depression
Behavior, Cognition, Interpersonal
Anxiety
Cognition, Exposure, Stress Inoculation
Bulimia
Cognitive-behavior
Phobia
Behavior
Bed Wetting
Behavior Modification
OBJECTIVE 14| Summarize the findings on which psychotherapies are most effective for specific disorders.

56. Evaluating Alternative Therapies
Lilienfeld (1998) suggests comparing scientific therapies against popular therapies through electronic means. The results of such a search are below:
OBJECTIVE 15| Evaluate the effectiveness of eye movements desensitization and reprocessing (EMDR) and light exposure therapies.

57. Eye Movement Desensitization and Reprocessing (EMDR)
In EMDR therapy, the therapist attempts to unlock and reprocess previous frozen traumatic memories by waving a finger in front of the eyes of the client.
EMDR has not held up under scientific testing.

58. Light Exposure Therapy
Seasonal Affective Disorder (SAD), a form of depression, has been effectively treated by light exposure therapy. This form of therapy has been scientifically validated.
Courtesy of Christine Brune

59. Commonalities Among Psychotherapies
Three commonalities shared by all forms of psychotherapies are the following:
A hope for demoralized people.
A new perspective.
An empathic, trusting and caring relationship.
OBJECTIVE 16| Describe the three benefits attributed to all psychotherapies.
© Mary Kate Denny/ PhotoEdit, Inc.

60. Culture and Values in Psychotherapy
Psychotherapists may differ from each other and from clients in their personal beliefs, values, and cultural backgrounds.
A therapist search should include visiting two or more therapists to judge which one makes the client feel more comfortable.
OBJECTIVE 17| Discuss the role of values and cultural differences in the therapeutic process.

61. Therapists & Their Training
Clinical psychologists: They have PhDs mostly. They are experts in research, assessment, and therapy, all of which is verified through a supervised internship.
Clinical or Psychiatric Social Worker: They have a Masters of Social Work. Postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems.

62. Therapists & Their Training
Counselors: Pastoral counselors or abuse counselors work with problems arising from family relations, spouse and child abusers and their victims, and substance abusers.
Psychiatrists: They are physicians who specialize in the treatment of psychological disorders. Not all psychiatrists have extensive training in psychotherapy, but as MDs they can prescribe medications.

63. http://apcentral. collegeboard

64. The Biomedical Therapies
These include physical, medicinal, and other forms of biological therapies.
Drug Treatments
Surgery
Electric-shock therapy

65. Psychopharmacology is the study of drug effects on mind and behavior.
Drug Therapies
Psychopharmacology is the study of drug effects on mind and behavior.
OBJECTIVE 18| Define psychopharmacology, and explain how double-blind studies help researchers evaluate a drug’s effectiveness.
With the advent of drugs, hospitalization in mental institutions has rapidly declined.

66. Les Snider/ The Image Works
Drug Therapies
OBJECTIVE 18| Define psychopharmacology, and explain how double-blind studies help researchers evaluate a drug’s effectiveness.
However, many patients are left homeless on the streets due to their ill-preparedness to cope independently outside in society.
Les Snider/ The Image Works

67. Double-Blind Procedures
To test the effectiveness of a drug, patients are tested with the drug and a placebo.
\Two groups of patients and medical health professionals are unaware of who is taking the drug and who is taking the placebo.
Reduces experimental bias

68. Antipsychotics treat Schizophrenia
Inappropriate symptoms present (positive symptoms)
Appropriate symptoms absent (negative symptoms)
Hallucinations, disorganized thinking, deluded ways.
Apathy, expressionless faces, rigid bodies.

69. Antipsychotic Drugs
Classical antipsychotics [Chlorpromazine (Thorazine)]: Remove a number of positive symptoms associated with schizophrenia such as agitation, delusions, and hallucinations.
Block dopamine receptors
Can lead to tardive dyskinesia (Parkinson’s like symptoms)
Atypical antipsychotics [Clozapine (Clozaril)]: Remove negative symptoms associated with schizophrenia (apathy, jumbled thoughts)
OBJECTIVE 19| Describe the characteristics of antipsychotic drugs, and discuss their use in treating specific disorders.
Antipsychotic drugs, such as chlorpromazine (sold as Thorazine), provide help to people experiencing the positive symptoms of auditory hallucinations and paranoia by dampening their responsiveness to irrelevant stimuli. Clozapine (sold as Clozaril) helps reanimate schizophrenia patients with the negative symptoms of apathy and withdrawal. Long-term use of the the first generation drugs (e.g., Thorazine) block D2 dopamine receptors and can produce tardive dyskinesia, which is marked by involuntary movements of facial muscles, tongue, and limbs. New-generation antipsychotics (e.g., clozapine) target D1 dopamine receptors and seem to increase the risk of obesity and diabetes.

70. Atypical Antipsychotic
Clozapine (Clozaril) blocks receptors for dopamine and serotonin to remove the negative symptoms of schizophrenia.

71. Antianxiety Drugs Examples: Xanax and Ativan
depress the central nervous system
reduce anxiety by elevating the levels of the Gamma-aminobutyric acid (GABA) (inhibitory) neurotransmitter.
OBJECTIVE 20| Describe the characteristics of antianxiety drugs, and discuss their use in treating specific disorders.

72. Do Now: Take home essay grading

73. Antidepressant Drugs
Antidepressant drugs elevate mood by increasing the availability of monoamines (serotonin- happy, norepinephrine- alert, boosts arousal, dopamine)
I. MAO Inhibitors
II. Tricyclics
III. SSRI’s: Selective Serotonin Reuptake Inhibitors

74. I. MAO Inhibitors First Generation
Blocks action of monoamine oxidase, an enzyme that breaks down serotonin and norepinephrine
Diet must be modified
blocks action of monoamine oxidase, an enzyme that breaks down serononin and norepinephrine within neuron after reuptake—(so levels increase in the brain)—older class, diet must be modified due to other functions of MAO

75. II. Tricyclics First Generation
Increase serotonin and norepinephrine levels by blocking reuptake of both
Ex: Amitriptyline (Elavil), imipramine (Tofranil) (DON’T NEED TO KNOW)

76. III. Selective Serotonin Reuptake Inhibitors (SSRI’s)
Block serotonin reuptake mechanism
Prozac, Zoloft
Fewer side effects (headaches, nausea, dry mouth, weight gain, blurred vision) than others- most prescribed
Now also used for OCD, PTSD, anxiety, ED
OBJECTIVE 21| Describe the characteristics of antidepressant drugs, and discuss their use in treating specific disorders.
Antidepressants aim to lift people up, typically by increasing the availability of the neurotransmitters norepinephrine and serotonin. For example, fluoxetine (Prozac) blocks the reabsorption and removal of serotonin from the synapses. Other dual action antidepressants work by blocking the reabsorption or breakdown of both norepinephrine and serotonin. Although no less effective, these dual-action drugs have more potential side effects, such as dry mouth, weight gain, hypertension, or dizzy spells. Antidepressants influence neurotransmitter systems almost immediately; their full psychological effects may take weeks. The risk of suicide for those taking these drugs has probably been overestimated.
Discussion- Should we take psychotherapeutic drugs to alter personality?
Listening to Prozac, Peter Kramer:
Prozac has helped depressed transform like for withdrawal, compulsiveness, timidity with what amounts to new personalities- able to interact with world in productive way- personality makeover
How proper is it to prescribe Prozac to those without disorder, but want to function more effectively in personal and social lives?
How is this different from drugs that induce sleep, allay anxiety, reduce depression (it transforms entire lives)
Is it good to suppress grief with Prozac when it is an important to allow?
Is it good to suppress self-examination that accompanies negative emotions?
Prozac enforces arbitrary cultural values-to be active, productive, assertive
same way that Valium for anxiety kept women in their place in the 50s and 60s

77. Mood-Stabilizing Medications
Lithium Carbonate:
(salt) has been used to stabilize manic episodes in bipolar disorders.
moderates levels of norepinephrine and glutamate neurotransmitters.
OBJECTIVE 22| Describe the use and effects of mood-stabilizing medications.
The simple salt lithium is often an effective mood stabilizer for those suffering the manic-depressive swings of bipolar disorder. Although lithium significantly lowers the risk of suicide, we do not fully understand how it works.
23. Describe the use of electroconvulsive therapy in treating severe depression, and describe some possible alternatives to ECT.
Electroconvulsive therapy (ECT), or shock treatment, is used for severely depressed patients. A brief electric current is sent through the brain of an anesthetized patient. Although ECT is credited with saving many from suicide, no one knows for sure how it works. Some patients with chronic depression have found relief through a chest implant that intermittently stimulates the vagus nerve, which sends signals to the limbic system. Repetitive transcranial magnetic stimulation (rTMS) is performed on wide-awake patients. Magnetic energy penetrates only to the brain’s surface (although tests are underway with a higher energy field that penetrates more deeply). Unlike ECT, the rTMS procedure produces no seizures, memory loss, or other side effects. Recent studies have confirmed its therapeutic effect.

78. 1)Antipsychotics 2) Antianxiety 3)Antidepressants 4) Lithium
Category of Drug
Used to Treat?
Mechanism of Action
Side Effects
1)Antipsychotics
2) Antianxiety
3)Antidepressants
4) Lithium

79. Electroconvulsive Therapy (ECT)
Brain Stimulation
Electroconvulsive Therapy (ECT)
ECT is used for severely depressed patients who do not respond to drugs. The patient is anesthetized and given a muscle relaxant. Patients usually get a 100 volt shock that relieves them of depression.
OBJECTIVE 23| Describe the use of electroconvulsive therapy (ECT) in treating severe depression, and describe some possible alternatives to ECT.

80. Transcranial Magnetic Stimulation (TMS)
Alternatives to ECT
Transcranial Magnetic Stimulation (TMS)
In TMS, a pulsating magnetic coil is placed over prefrontal regions of the brain to treat depression with minimal side effects.

81. 200 such operations do take place in the US alone.
Psychosurgery
Psychosurgery was popular even in Neolithic times. Although used sparingly today, about
200 such operations do take place in the US alone.
OBJECTIVE 24| Summarize the history of the psychosurgical procedure known as lobotomy, and discuss the use of psychosurgery today.

82. Psychosurgery
Psychosurgery is used as a last resort in alleviating psychological disturbances. Psychosurgery is irreversible. Removal of brain tissue changes the mind.

83. Psychosurgery
Modern methods use stereotactic neurosurgery and radiosurgery (Laksell, 1951) that refine older methods of psychosurgery.

84. Preventing Psychological Disorders
“It is better to prevent than cure.”
Peruvian Folk Wisdom
Preventing psychological disorders means removing the factors that affect society. Those factors may be poverty, meaningless work, constant criticism, unemployment, racism, and sexism.
OBJECTIVE 25| Explain the rationale of preventive mental health programs, and discuss how this viewpoint illustrates the biopsychosocial perspective in psychology.

85. Psychological Disorders are Biopsychosocial in Nature