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Lecture 18

Lecture 18 - notes

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Department
Psychology
Course Code
PSYB30H3
Professor
Marc A Fournier

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Lecture 18
The context and content of the life-story is more than just the content and context of
ones traits and motives.
Psychotherapy can be viewed as one way of systematically revising ones own life-story,
and it may contribute towards making a more coherent life story.
We can understand much of what goes on, from a theoretical point of view, during
psychotherapy, from 3 particular frameworks/categories/classifications of psychotherapy
that dominated during the 20th century:
Psychodynamic Therapies talk about the conflicts in their patients as the
sources for symptoms of their patients (conflict between the ID and the ego, between
the ego and the super-ego), so that the psychodynamic patient comes to therapy with a
whole variety of potentially underlying conflicts. These conflicts produce anxieties, and it
is the nature of the psyche to respond to these anxieties by virtue of (unconscious)
defence mechanisms (repress, deny, project, sublimate etc.) and when these defences
fail, the patients present symptoms. In this case however, the symptom itself represents
an underlying conflict. The goal, as a psychodynamic therapist, is to serve as a blank
canvas, onto which the patient can project all of their motivational unconscious issues
(Transference). The therapist provides an interpretation of that projection
(Interpretation), and this produces some insight into the conflict he/she has (Insight).
The insight however is distressing, and so it leads to resistance from the patient
(Resistance), and then were back to transference again. Its a cyclic movement, with the
notion that with repeated opportunities to experience insight, the patient will be able to
resolve their issues.
Cognitive-Behavioural Therapies (CBT) grows out of the modern learning
traditions (associative and operand learning theories). The notion is that antecedent
events illicit behaviours (overt/observable or covert/unobservable like thoughts), These
behaviours have consequences, and whether they are rewarding or punishing, you will
be more or less likely to engage in that behaviour in the future. The CBT Therapist
employs cognitive restructuring techniques & behavioural experiments. An example of a
behavioural experiment: one of the things a socially anxious patient will do, is avoid
situations that make him/her anxious in the first place. Avoidance is a very powerful
behaviour, because it produces a very powerful consequence relief, which is very
rewarding. The problem with it is that it often keeps the patient away from experiences
that teach him/her that there isnt so much to be afraid of after all. So one of the things a
CBT therapist will do is to make the patient test his/her beliefs about what will happen
under various circumstances. This makes the patients test the maladaptive beliefs about
how the world works.
Humanistic/Existential Therapies Rogerian therapy based on conditions of
worth that we all learn, the rules by which we have to live in order to receive love and
www.notesolution.com
acceptance. These however can be pathological, and lead us to have problems late in
life. So one of the things humanistic therapists do is to reflect and communicate to the
patient that his or her thoughts, feelings can be revealed to the world, that there is a
person in the world (the therapist) who will accept the patient regardless of what their
thoughts are.
These various therapies represent a technical diversity. The practitioners of each of
these therapies claim that what they are doing during psychotherapy substantially
differentiates them from other practitioners of psychotherapy. They all claim to induce
change through very different mechanisms.
The major question to haunt psychotherapy in the 1950s 1960s has been to find
which one is better? Whats the best form of psychotherapy? The conclusions from the
Outcome Literature suggest that neither one can be said to be superior to the others;
that there is no differential efficacy despite technical diversity. This has become known,
since the 1970s, in the psychotherapy literature, as The Dodo Bird Effect”, used here to
indicate that all therapies win, and all therapies deserve the prize as being the best, in
some sense.
There have been 3 potential suggestions as to why this is the case.
1.The first suggestion says that the literature is wrong. There are differences, we
just havent detected them yet. (Unlikely possibility because symptom measures
have demonstrated reliability and validity).
2.A second possibility is to simply accept that there are different ways of arriving at
the same conclusion. The 3 forms of psychotherapy may be technically different,
but they all have equally valid roots and they all lead to the same end-point
psychotherapy change. (Implausible situation something compared to a race,
where all the runners cross the finish line at exactly the same time, every time
they run the race).
3.The final explanation, that has received the most credit in the last 40 years, is the
idea that in spite of the technical differences, there are common factors to all
psychotherapies; that even though they claim to be doing very different things,
they are not in fact that different from what other therapists are doing. There are
underlying procedures/mechanisms that are common/true across all the different
types of psychotherapy, and these common factors are the “active ingredients”
producing change in psychotherapy.
So then the question becomes: What are these common factors? The common
denominator?Numerous researchers have tried deconstructing the session and taking
a look at what is going on, what is producing the change that is shown by a significant
amount of patients.
www.notesolution.com

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Description
Lecture 18 The context and content of the life-story is more than just the content and context of ones traits and motives. Psychotherapy can be viewed as one way of systematically revising ones own life-story, and it may contribute towards making a more coherent life story. We can understand much of what goes on, from a theoretical point of view, during psychotherapy, from 3 particular frameworkscategoriesclassifications of psychotherapy th that dominated during the 20 century: Psychodynamic Therapies talk about the conflicts in their patients as the sources for symptoms of their patients (conflict between the ID and the ego, between the ego and the super-ego), so that the psychodynamic patient comes to therapy with a whole variety of potentially underlying conflicts. These conflicts produce anxieties, and it is the nature of the psyche to respond to these anxieties by virtue of (unconscious) defence mechanisms (repress, deny, project, sublimate etc.) and when these defences fail, the patients present symptoms. In this case however, the symptom itself represents an underlying conflict. The goal, as a psychodynamic therapist, is to serve as a blank canvas, onto which the patient can project all of their motivational unconscious issues (Transference). The therapist provides an interpretation of that projection (Interpretation), and this produces some insight into the conflict heshe has (Insight). The insight however is distressing, and so it leads to resistance from the patient (Resistance), and then were back to transference again. Its a cyclic movement, with the notion that with repeated opportunities to experience insight, the patient will be able to resolve their issues. Cognitive-Behavioural Therapies (CBT) grows out of the modern learning traditions (associative and operand learning theories). The notion is that antecedent events illicit behaviours (overtobservable or covertunobservable like thoughts), These behaviours have consequences, and whether they are rewarding or punishing, you will be more or less likely to engage in that behaviour in the future. The CBT Therapist employs cognitive restructuring techniques & behavioural experiments. An example of a behavioural experiment: one of the things a socially anxious patient will do, is avoid situations that make himher anxious in the first place. Avoidance is a very powerful behaviour, because it produces a very powerful consequence relief, which is very rewarding. The problem with it is that it often keeps the patient away from experiences that teach himher that there isnt so much to be afraid of after all. So one of the things a CBT therapist will do is to make the patient test hisher beliefs about what will happen under various circumstances. This makes the patients test the maladaptive beliefs about how the world works. HumanisticExistential Therapies Rogerian therapy based on conditions of worth that we all learn, the rules by which we have to live in order to receive love and www.notesolution.com
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