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Treatment of Psychological Disorders

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PSYC 1002
Mara Fuentes Avila

LECTURE 7 2 main categories of treatment: 1) biological/biomedical: some mental disorders are diseases - biological caused for disease - therapy: drug treatment, electroconvulsive, psychosurgery 2) psychological: mental disorders at a psychological level - insight therapy -> should be explained by understanding nature/cause - behavior based on symptoms -> symptoms are the problem  involves directly treating the symptoms Psychotherapy - all diverse approaches to deal with mental disorders and psychological problems - general term for treatments Insight (talk therapy): - goal: get insight, explore different states of the patient to understand nature/causes of the problem - verbal interactions with patient - 1) Psychoanalysis [therapy] - Freudian concepts: 3 levels of awareness, 3 structural components of personality - Root of mental disorders: unconscious problems of childhood experiences  try to uncover (unconscious) feelings to understand the nature of the problem - Patient will become aware of problems – sources and better understand themselves - Become ready to face the conflicts and find ways to resolve them 2) Client-centered therapy - Rogerian approach - Objective: gain understanding of the patients causes of the problem Behavior: - alter behavior - behavioral patterns of responses - work with therapists in order to alter behavioral patterns Biomedical: - pathologies should be treated as diseases - focus on modifying the physical functioning -> specifically the brain functioning Psychoanalysis: Freud’s view of the root of disorders Intrapsychic conflicts -> Anxiety -> Reliance on defense mechanisms Intrapsychic: conflicts between the id, ego, super-ego - Freud: persons behavior is the outcome of the conflicts - Conflicts will not manifest – will be hidden in the unconscious - Will generate specific types of behavior - Unresolved conflicts (that are hidden) will result in anxiety but person won’t know the cause of the anxiety - Distress: anxiety – find defense mechanisms in order to get rid of anxiety - > anxiety causes psychological tension - Conflicts generate anxiety, the person deals with anxiety through use of defense mechanism: (largely unconscious structures) - Rely on defense mechanism, but denying the reality – becomes a vicious cycle - At some point don’t have resources to handle the distress – seek help from outside Insight Therapies (Psychoanalysis) Therapist will conduct therapeutic sessions by 2 techniques: 1) Free Association - Patient talks about anything that comes to mind - When the patient talks about anything, whatever they say will reflect their unconscious/inner thoughts - What they are saying will reflect unconscious thoughts - Analyst writes down - At the end of the session, information is analyzed, interpreted by the analyst - Understand the meaning behind words/information given by the patient - Interpret the meaning behind associations that the patient describes 2) Dream analysis - Widely used by Freud - When a patient describes a dream: good insight to ego defenses which are relaxed during the sleep - -“dreams are royal road to unconscious” - Have to interpret after the therapy - Interpret: what the patient says in person, and what the person says through dream analysis - Analyst tries to explore the unconscious - Patient verbalizes based on his/her experiences - Techniques used to help the patient verbalize thoughts, feelings etc - Analyst: role to interpret what the patient says - Problem: making diagnosis – not the end of the problem - Give patient your interpretation and have to monitor patient’s verbal, emotional reaction to what you said - Sometimes what you observe does not correspond to internal feelings of the patient - Giving and receiving feedback from patient 3 basic mechanisms/strategies that analysts use 1) Interpretation: material that the patient provides 2) Resistance: patients seek help, but at some point in the treatment they will resist it - why? Because they are used to rely on defense mechanism - Therapists know this and know that at some points they will receive resistance - At some point patients are not ready to receive the information that the analyst is giving about their problems  example: patients comes late to the next session, even if excuses are given - Analyst will interpret this behavior as resistance - Theoretical framework: always have to interpret patients behavior at all times 3) Transference: - Patients start unconsciously relating to analysts  ie: seeing patients as mother/father/daughter - The person that they associate with, have to realize that the person is important - Even in life, some people start changing the way they relate with others - Patients response to the therapy resembles responses to significant others - Need to bring to the conscious mind the information that is in the unconscious - Once the patient knows the unconscious, it will help patient with problems - Psychoanalysis as therapy, not theory Modern Psychodynamic Therapies Not an easy process – can be slow, painful process of self-examination Requires at least 2 years Why: 1) Patients need time to work through their problems and accept troubling relationships about their life 2) The goal of the therapy to change some aspects of a persons personality - Or some aspect of a persons identity - Insight therapies: gain understanding of a persons causes of a persons problems - Once you understand the causes, have to find solutions - Modifying some aspect of personality - Classical psychoanlysis (Freud) is not widely practised anymore - England: psychoanalytical institute - Today we have psychodynamic therapies ->psychodynamic approaches to therapies: different types of variations of Freud’s approach to personality/psychoalaysis - Have been successful in phobias, anxiety*and generalized anxiety disorder* - Therapy is more oriented towards the present and future - Not a characteristics in the case of freudian psychotherapy - Recent review of this treatment suggests that interpretation, resistance and transference continue to play key in therapeutic mechanisms *psychoanalysis as a technique (not a theory) Insight Therapies: Client-Centered Therapy (Non-directive therapy, person-centered therapy) - Objective: gain understanding of patients causes of the problems - Developed by Rogers in the 1950s (Rogerian approach) - Rogers theory about causes of neurotic anxiety: different from Freud - Self is the central construct to explain anxiety - For Freud it was unconscious (central construct) - Accepted that the structure of the self is developped through interactions with others  involves awareness of being and functioning - Therapy that works with the conscious experiences (another important difference between Freud) - Self concept: an organized, consistent concept about the I or me - Cognitive structure that we use to guide/organize/regulate our behavior under relevant circumstances when we act, we are aware of what we are doing….  Ie: what am I doing? This is not me - When you ask yourself, the self concept emerges and regulates behavior - Regulates behavior under relevant circumstances - Structure is activated when you need to reinforce/understand what you are doing - Congruent: when the way you define yourself corresponds to the way other people, or reality - Functioning person - Incongruent: when you define yourself, but the information form reality is opposite Incongruent self-concept --> Anxiety --> Defense Mechanisms -Have to do something to deal with anxiety: rely on defense mechanism Rogers describes 2 types of defense mechanisms to deal with information at the conscious level: 1)Distortion 2)Denial of reality - Inconsistent self concept – evaluate situation as threatening - When you are dealing with threatening situation – results in anxiety - Dealing with contradictory situation about yourself - Vicious cycle  ie: denial of reality – misinterpret reality, wont
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