Therapy

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psychotherapy: the treatment of emotional, behavioral, and interpersonal problems through the use of psychological techniques designed to encourage understanding of problems and modify troubling feelings behaviors, or relationships

  • talking therapy

  • psychoanalysis originated by Freud, uses free association

    • they lay on the sofa out of the view of the therapists

    • dream interpretation — remembered manifest underlying latent

    • analysis of resistance and transference are used to explore, repressed or unconscious impulses, anxieties, and internal conflicts

    • therapist interprets the patient’s answers

    • interpretation: psychoanalysis offers a carefully timed explanation of the patient's dreams, free associations, or behaviors to facilitate the recognition of unconscious conflicts or motivation

    • resistance: the patient's unconscious attempts to block the revelation of repressed memories and conflicts

      • if they aren’t letting the therapist make the insight

    • transference: the process by which emotions and desires originally associated with a significant person in the patient's life such as a parent are unconsciously transferred to the psychotherapist

      • they can express what they want toward the therapist to what they had for another person — getting angry at them for something someone else did

  • psycho-dynamic therapy: derives from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences that seek to enhance self-insight

    • specific type: interpersonal psychotherapy

    • interpersonal psychotherapy: often used to treat depression a variation of psycho-dynamic that helps people gain insight into the roots of their difficulties so that they can help them relieve the symptoms also focuses on current relationships and helps them improve relationship skills

  • humanistic therapy: emphasizes human potential, self-awareness, and freedom of choice they contend that the most important factor in personality is the person's conscious subjective perception of themselves they see people as being innately good and motivated by the need to grow psychologically

    • also referred to as client-centered therapy

    • this was developed by Carl Rogers, where the therapist is non-directive (so the client directs the therapy) and is reflective (reflects on their experiences and prior sessions)

    • there are three qualities of a therapist that are critical:

      • genuineness: where the therapist honestly and openly shares their thoughts and feelings with the client and encourages the client to express their true feelings without defensiveness or pretension

      • unconditional positive regard: allows the client to be open and honest because they know that they will be accepted and they don’t fear rejection or judgment

      • empathetic understanding: where the therapist communicates by reflecting the content and personal meanings of the feelings being expressed by the client they are like a psychological mirror the goal is to help the client explore and clarify their feelings, thoughts, and perceptions

        • the therapist repeats back to you what you just said like a parrot

  • Gestalt therapy: combines the psychoanalytic emphasis on bringing unconscious feelings to awareness and the humanistic emphasis on “getting in touch with oneself” and aims to help people become more aware of and able to express their feelings and take responsibility for their feelings and actions

    • also called insight therapy

    • developed by Perls

    • “the whole exceeds the sum of its parts”

  • behavior therapy: focuses on directly changing maladaptive patterns of behavior by using basic learning principles and techniques

    • also called behavior modification

    • involves operant and classical techniques

      • counter-conditioning: based on classical conditioning and it involves modifying behavior by conditioning a new response that is incompatible with a previously learned response

        • a strategy created by Mary Cover Jones,

        • She worked with Peter who was afraid of a rabbit, so she let him eat his favorite snack at first she started just talking about the rabbit, then she would show him a picture, over time she became not afraid of the rabbit, eventually, the rabbit could sit on his lap while he was eating, the eating pleasure overrode the problem

      • systematic desensitization: this is where phobic responses are reduced by pairing relaxation with a series of mental images or real-life situations that the person finds progressively more fear-provoking

        • often used with phobias

        • developed by Joseph Wolpe

        • 3 steps:

          • progressive relaxation: teaching how to relax our body

          • construct an anxiety hierarchy: what’s the least anxiety-inducing to what is the most anxiety-inducing

            • least: talking about it

            • most: having it near or touching it

          • desensitization: where the two steps are combined

            • you start talking about snakes, and when you get anxious you go through the relaxation

      • aversive conditioning: repeatedly pairing an aversive stimulus with the occurrence of undesirable behaviors or thoughts

        • used for alcoholics they could take a drug that makes them nauseous when they drink

        • nail biters when they wear nail polish or (intentionally) gross-tasting nail polish

        • not used very often

      • token economy: often used in a therapeutic environment it is a type of therapy that is structured to reward desired behavior with tokens or points that may eventually be exchanged for tangible rewards

        • operant strategy

  • cognitive therapies: a group of psychotherapies that are based on the assumption that psychological problems are due to maladaptive patterns of thinking and treatment techniques focus on recognizing and altering these unhealthy thinking patterns

    • rational emotive therapy RET: the key premise is that people's difficulties are caused by their faulty expectations and irrational beliefs

      • developed by Albert Ellis

      • steps:

        • identify the core irrational beliefs that underlie the personal distress, often the core beliefs involve absolutes like “I have to, I must, I should,”

        • for the therapist to vigorously dispute and challenge the irrational beliefs

      • what sets it apart is that it is very direct and even confrontational

      • Dr Phil

    • cognitive therapy (CT): developed by Aaron Beck

      • often used to treat depression

      • Aaron Beck: he believes that psychological problems are caused by distorted thinking and unrealistic beliefs the therapist encourages the client to empirically test the accuracy of their assumptions and beliefs

      • steps:

        • help the client learn to recognize and monitor the automatic thoughts that occur without conscious effort or control

        • the therapist helps the client learn how to empirically test the reality of the automatic thoughts that are upsetting

      • the therapist might assign them to talk to three acquaintances and see how many times they do whatever they think they are doing

        • ex. thinking you say incorrect things so when you are with those 3 people you count how many times you think you say an incorrect thing and then test to see if it was actually correct

  • Group Therapy: involves one or more therapists working simultaneously with a small group of clients

    • advantages:

      • cost-effective

      • instead of relying on a client's self-perceptions about how they relate to people, they can observe them interacting with others

      • the support and encouragement provided by other group members can help a person feel less alone and understand that their problems are not unique

      • group members may provide each other with helpful practical advice for solving common problems and can act as models for successfully overcoming difficulties

      • they can try out new behaviors in a safe supportive environment

    • a lot of places with in-patient care encourage them to go to group therapy as well as their one-on-one counsel

  • Family therapy: the goal is to improve communication and problem-solving skills

    • could be an entire family or couples therapy

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biomedical: the use of medications, electroconvulsive therapy, or other medical treatments, to treat the symptoms associated with psychological disorders

people were institutionalized

psychopharmacology: the study of the effects of drugs on the mind and behavior

drugs are still being introduced

anti-psychotic drugs

anti-psychotic drugs: prescription drugs that are used to reduce psychotic symptoms frequently used in the treatment of schizophrenia

  • Drug examples:

    • Risperdal

    • Zyprexa

    • Thoraziane

    • Clozapine

      • Clozaril

  • These drugs work by reducing the level of dopamine

  • They typically reduce or eliminate hallucinations and delusions

  • A lot of patients don't like it cause of side effects

    • sluggishness

    • tremors

    • toxic effect on white blood cells — makes you more susceptible to a variety of other illnesses

    • longer-term use can cause: tardive, dyskinesia which is the involuntary movement of facial muscles, tongue, and limbs

  • They also affect serotonin, sometimes another problem with schizophrenia is some of them end up homeless

Anti-anxiety drugs

Anti-anxiety drugs: used to alleviate the symptoms of anxiety

  • among the most widely prescribed and widely abused drugs

  • they work by depressing the central nervous system

  • They calm jittery feelings, relax muscles, and promote sleep

  • Common drug names:

    • Valum

    • Librium

    • Ativan

    • Halcion

    • Xanax

    • Buspar

  • if they are used in combination with psychotherapy they may be very helpful

  • one of the criticisms though is that if they are used without psychotherapy you are not resolving the underlying problems

  • these work by increasing the level of GABA

  • side effects: can reduce coordination, alertness, and reaction time, the effects are intensified with alcohol

anti-depressants: used to reduce the symptoms associated with depression

  • also prescribed a lot

  • most of these increase the availability of norepinephrine and serotonin which elevate arousal and mood that appears scarce during depression

  • some of these are selective serotonin reuptake inhibitors

  • drug names:

    • Prozac

    • Wellbutrin

    • Zoloft

    • Paxil

    • Effexor

    • Luvox

    • Celexa

  • some of the side effects are: dry mouth, loss of appetite or weight gain, dizzy spells, headaches, nervousness, and difficulty sleeping

mood stabilizing

mood stabilizing drugs:

  • most widely prescribed that works for a lot of people is lithium

    • lithium: a chemical that provides an effective drug therapy for the mood swings of bipolar disorder

    • it stops the acute manic episodes over the course of a week or two and once under control the long-term use can prevent relapse

    • the patient's blood levels have to be monitored

    • if the lithium is too low the manic symptoms persist

    • if the lithium is too high lithium poisoning may occur causing vomiting, muscle weakness, and reduced muscle coordination

    • effects the levels of glutamate (an excitatory neurotransmitter) to keep it in normal range preventing abnormal and lows

  • depakote

    • a deconvulsant

    • used for those who don’t respond to lithium

Electroconvulsive therapy (ECT): they send a brief electrical current of 100 volts to the brain, this is going to induce a seizure that will last for about a minute

  • often used for severely depressed patients when nothing else has worked

  • shock therapy

  • typically takes 6-10 treatments over a period of several weeks for it to work

  • They can suffer short-term and long-term memory loss

  • you are very vulnerable to relapse — usually within 4 months

  • so it is possible within one year that you may have to have it done 2-3 times

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psycho-surgery: surgery that removes or destroys brain tissue in an effort to change behavior

  • lobotomy: a rare procedure that was once used to calm uncontrollably emotional or violent patients, it cuts the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain, often times produces a lethargic, immature, impulsive personality