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Lecture 18

Thorough Notes on Lecture 18

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Marc A Fournier

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PSYB30 PersonalityWed, March 23/2011
Lecture 18
Overview of Part III
Life-Story Revision
Psychotherapy Outcomes
Disclosure and Therapy Process
Psychotherapy as Life-Story Revision
Schools of Psychotherapy
Most psychotherapists ascribe to one of the following classifications of psychotherapy when dealing
with a patient
Psychodynamic Therapies
Conflict – Anxiety – Unconscious Defenses
Transference – Interpretation – Insight – Resistance
These therapists will talk about the conflicts inherent in their patients
Conflicts between the Id & Ego, conflicts between the Ego & superego are sources of
symptoms within the psychodynamic patient
These conflicts produce anxieties and it is the nature of the psyche to respond to those
anxieties with a number of defense mechanisms
When all of these fail, there's the chance of developing symptoms
The therapist becomes an object on which the patient projects all the underlying
problems they have (transference)
The therapist provides an interpretation of that projection (interpretation)
This produces some insight within the patient into the conflict he/she has (Insight)
The insight, however, is distressing because the mind naturally wants to keep the
problem within the unconscious so there is then resistance where patient struggles,
which leads to transference again (Resistance)
The goal is to provide repeated opportunities to give patient insight into the what the
underlying conflict is, then the patient will overtime be able to resolve the underlying
Cognitive-Behavioural Therapies
Antecedent – Behaviour – Consequence
Cognitive Restructuring & Behavioural Experiments
Antecedent events elicit behaviours, these behaviours can be overt (observable) or covert
(thoughts), and they lead to consequences. Whether those consequences are rewarding or
punitive, you will be more or less likely to engage in that behaviour in the future.
This therapist employs an entirely different repertoire of techniques than the above therapist
Example of Behavioural Experiment: A socially anxious patient will avoid situations
that make him or her anxious. This avoidance provides relief to the person, but this relief
keeps the person away from experiences that will teach them that the situation isn't
something that they need to be afraid of, so a C-B therapist will put this patient to the
test under a number of controlled circumstances that makes them anxious so they realize
that what's making them anxious really isn't that bad and needn't be avoided
A C-B therapist will tell a patient who's afraid of feeling embarrassed to go to a
bookstore and intentionally knock down a whole bunch of books. The point is to
make them realize that feeling embarrassed isn't the end of the world.
Humanistic/Existential Therapies
Internalized Conditions of Worth
Reflection & Unconditional Positive Regard
One of the goals of this therapy is to communicate to the patient, through the process of
reflection, that his or her thoughts and feelings can be revealed to the world, that they don't
have to be suppressed or hidden. Therapist acts as the person who will value and approve of
the patient unconditionally which allows the patient to consolidate a more complete and
more functioning sense of self
So the point of him going over these therapies it to convey the idea that these therapies are
technically different from each other and they all claim to produce change through very different
Given the emergence of 3 distinct forms of psychotherapy in the 20th century, one of the major
questions that haunted psychotherapy research since the 1970s has been: Which therapy is
better? Which is the best form of psychotherapy?
Schools of Psychotherapy (cont...)
A very large body of research has emerged testing the various therapies against each other
Conclusions from the Outcome Literature: there is no superior technique.
Even though these therapies are technically different from each other, they don't seem to be
different in their efficacy
This has become known as The Dodo Bird Effect
They got this from Alice in Wonderland where the Dodo Bird was asked to judge a race,
it ignored the race and after the race was done it saidEverybody has won and all must
have prizes
So they're all WINNING (charlie sheen)
This lead to the question “how is it possible that they produce the same results?”
Potential Explanations
Existing differences have yet to be detected
This suggests that the literature is wrong, but this is unlikely
Diverse Strategies to similar ends
Each of the therapies take different ways to arrive at the same conclusion
Still unlikely; it's like a foot race between 3 people and they repeatedly cross the line at
the same time over and over and over and over again
Common Factors
Has received the most attention

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