Psychotherapy

PAT

• Psychodynamic

  • Unconscious conflicts / fixations

  • Free Association, transference, hypnosis

• Behavioral

  • Reinforcements and punishments

  • Conditioning

  • UNLEARN

• Humanism

  • Hierarchy of Needs

  • Ideal self / real self, conditions of worth

  • Unconditional Positive Regard

• Cognitive

  • Locus of Control, learned helplessness

  • Change the way he thinks (SCHEMAS)

• Bio-Medical

  • Neurotransmitters, genetics

  • Medication: SSRIs (serotonin)

• Health

  • health/diet contribute to overall wellness

  • Change diet (superfoods) & exercise (yoga

• Eclectic-multiple approaches and techniques combined together for what is best for the specific patient

Therapy Basics

• Elements of Successful Therapy

  • Patient/Client must agree to it

  • Patient/Client must believe in it

  • Patient/Client must trust the therapist

  • Patient/Client must have a reason.

Psychodynamic

• Belief - Patient / Therapist MUST have rapport to gain insight to unconscious conflicts probably stemming from childhood

• Techniques:

• Free Association – NO censorship of thoughts. As trust increases, ego lowers its guard and unconscious will bubble to surface.

• Dream Analysis - Manifest (actual contents) vs. Latent Content (analysis or interpretation)

• Interpretation of “slips of the tongue”

• Hypnosis and Cathartic release (emotional release)

• ** Transference and Interpersonal Therapy (IPT) – The unconscious redirection of feelings from one person to another. Patient transfers emotional issues to the therapist.

Humanism

• Belief – All people are good and are trying to reach their ideal self. Problems occur from lack of needs, growth, congruence or presence of conditions of worth.

• Techniques:

  • Non-Directive / Client Centered Therapy (Rogerian Therapy) - Emphasis on EMPATHY and Active Listening 

  • Congruence - Real Self vs Ideal Self **

  • Unconditional Positive Regard - Avoid Conditions of Worth

  • Restating, Mirroring, Reflecting, Clarifying

  • Gestalt – The whole is greater than the sum of the parts. 

    • Gestalt Therapy focuses on the idea that the whole person is not whole anymore and is a stranger in their own body

Behavioral

• Belief – All behavior is learned and can be “unlearned”. Finding the root of the problem is unnecessary.

• Techniques:

  • Behavioral Contracts  or Behavior Modification (Operant Conditioning)

    • Token Economies

  • Modeling and Social Learning (Bandura and Bobo)

  • Group Therapy

  • Aversive Conditioning

  • Systematic Desensitization - Anxiety Hierarchy

  • Flooding

  • Cognitive Behavioral Therapy (CBT)

Cognitive

• Belief: Behavior occurs from maladaptive or illogical thoughts. Thought is guided by schemas and meaning. To change behavior, thought must be changed.

• Techniques:

  • Cognitive Therapy (Beck) - Situation - Thoughts - Emotions - Behavior = Cognitive Triad

  • Rational-Emotive Therapy (REBT) (Ellis) – conscious construction of emotional difficulties in your thoughts. 

    • A = Activating Event (relationship with wife - she cheated on him)

    • B = Rational and Irrational Beliefs (divorce is not an option)** Target for the Therapist

    • C = Consequences (unhappy marriage - leave her and be happy)

Cognitive

• Belief: Behavior occurs from maladaptive or illogical thoughts. Thought is guided by schemas and meaning. To change behavior, thought must be changed.

• Techniques:

  • Stress-Inoculation Therapy – Identify stressors and practice breaking them down. 

  • Positive Thinking (Seligman)

• Optimism leads to a more successful life!

• Thought Stopping – STOP!  

• Thought aversion – cigarettes = death

• Role Playing

Psychopharmaceuticals (treat the symptoms, not the cause)

- How do they work?

• Affect the production, release or functioning of neurotransmitters in the brain

Antagonist - BLOCKS (binds to receptor sites)

Agonist - FIRES (fit onto dendrites)

Anti-Anxiety

• Increases the reception of GABA inhibitory neurotransmitters (slows brain down)  

• More GABA, the neuron will not fire. 

• GABA helps you calm down

  • Benzodiazepine 

    • Valium 

    • Librium

    • Ativan

    • Xanax

• Side Effects? Could be physiological, appetite

Antidepressants

Selective Serotonin Reuptake Inhibitors (SSRI) – Block the reuptake of serotonin.

• Prozac

• Zoloft

• Paxil

• Celexa

• Side Effects? Weight loss/gain, mood changes, dry mouth/dry eyes, stomach issues

Antidepressants

• Tricyclics – Dual Action drugs that block the reuptake of Serotonin and Norepinephrine

• **MAO Inhibitors (MAOIs) – Blocks the reuptake of Serotonin, Norepinephrine and Dopamine.

• Bupropion – Blocks the reuptake of Norepinephrine and Dopamine

  • Wellbutrin

• Side Effects?  The more we alter neurotransmitters, the greater the side effects.

• LAST RESORT → ECT!

Neuroleptics / Antipsychotics

• Chlorpromazine – Block the reception of Dopamine (somatic / voluntary muscle movement).

  • Thorazine

  • Mellaril

  • Haldol

• Main side effect is Tardive Dyskinesia – Loss of motor control.

  • Parkinson’s → Tremors!

• Drowsiness

Others

• Ritalin, Adderall - Stimulant

• Lithium (carbonate) - Mood stabilizer

Alternative Therapies

• Pastoral Counseling

• Acupuncture

• Herbal Healing

• Spiritual Guidance

Psychology and the Law

Criminal Law- defense of INSANITY-  “not guilty by reason of insanity”

Must prove the suspect could not determine between right and wrong. Must be diagnosed prior to the court case.

Civil Law- “Involuntary Commitment”- Psychologist can rule a person deemed a danger to self or others. Will be confined to a hospital.

Confidentiality

Law that protects your therapy sessions as confidential unless risk to self or others. Need Court Order to release files.

RESULTS OF ROSENHAN: fear of labeling

Positive consequences of labeling- allows person to get help, make public more aware of prevalence.

Negative consequences- seen as weak, dangerous, problems with various medications.

Unit: Social Psychology

Kitty Genovese (murder victim)

Bystander Effect - A diffusion of Responsibility (The more people around, the less you feel responsible to do something)

• The Bystander Effect is a theory that states that individuals are less likely to offer help to a victim when there are other people present

  • “Someone else will take care of it”

Attribution

• Attribution – An inference about the cause of a behavior.

• Attribution Theory – We explain behavior with either Dispositional (internal) vs. Situational (external) factors. *The closer you know someone, you give them the benefit of the doubt

• More often than not, we commit Fundamental Attribution Error - Assuming that someone else is doing something because that is who they are

• Self Serving Bias- cognitive or perceptual process that is distorted by the need to maintain and enhance self-esteem, or the tendency to perceive oneself in an overly favorable manner. (fail something because of something external and succeed something because of yourself)

Actions over Attitudes

• Role Playing

  • Riceville Experiment

  • Zimbardo Stanford Prison Experiment (to see how quickly you could switch roles)

• Cognitive Dissonance

  • Cognitive dissonance occurs when attitudes and behaviors contradict each other

• Festinger Study

Obedience

• Stanley Milgram - Obedience Study

  • Teachers = Subjects

  • Learners = Confederates

    • Subjects are less obedient if they observe clothes who refuse to obey

Actions over Attitudes

• What you do impacts your attitude

  • We like to have consistency between actions and attitudes

  • Actions influence attitudes because people infer their attitudes by observing their own behavior

Foot in the Door Phenomenon - Asking for a tiny thing to slowly get to the point that you wanted the large request

A compliance tactic that aims at getting a person to agree to a large request by having them agree to a modest request first

• Have you ever been a victim of or used Foot in the Door Phenomenon?

  • Have you ever tried a free sample and then purchased the product?

  • Have you ever agreed to help a friend “for a few minutes” and then found yourself still helping an hour later?

  • Have you ever accepted a “free” subscription” and then paid for the service long after it expired?

Lucifer Effect

The point in time when an ordinary person crosses the boundary between good and evil to engage in an evil action (put someone in a bad place and that wins out)

Group Influence

• Solomon Asch – Conformity/Groupthink (subjects and confederates)

• Conformity - copying someone else

• Groupthink - bad outcome

  • Subject – Who you’re doing the experiment on.

  • Confederates – Who’s participating in the group.

    • The more confederates are in agreement, the more the subject is likely to comply.

  • Milgram – Look In The Sky

• Group Polarization

  • When placed in group situations, people will make decisions and form opinions to more of an extreme than when they are in individual situations.

Group Influence

• Social Loafing

  • Phenomenon of people exerting less effort to achieve a goal when they work in a group than when they work alone.

• Social Facilitation

  • The tendency for people to do better on simple tasks when in the presence of other people.

• Social Trap

  • Looking out for your own self interest will lead to individual and group loss

    • Watering restrictions

    • Farming in US History

Group Influence

• Ingroup Bias (prefer people in your own group)

  • A preference for one’s in-group.

• Outgroup Bias - prefer people in your group (you don't like a certain group b/c you are not in it)

• Deindividuation

  •  Loss of self-awareness in groups

    • LA Riots

    • Baltimore Riots

Intrapersonal Attraction

-Proximity

-Similarity in attitudes and values

-Symmetry

The Mirror Exposure Effect - Our brains love familiarity. The more we look at something, the more we like it

Gender Roles

• Gender role vs Gender identity

  • Identity = Your sense of being male or female

  • Role = Expectations about the way men and women should behave in society

Persuasion and Cults

A form of social influence in which the audience is intentionally encouraged to adopt an idea, attitude, or course of action by symbolic means.

• The Manson Family

• Waco & The Branch Davidians

• Jonestown Massacre

Reciprocity Norm - when someone gives you something so you have to give them something (Example: receiving a birthday gift and having to give one back)

Key words for people:

Solomon Asch - Conformity

Zimbardo Prison Experiment - Switch in roles

Stanley Milgram - Obedience