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Course: PSYC*1000 (DE)
Professor: Harvey Marmurek
Schedule: Summer, 2012
Textbook: Psychology – Tenth Edition in Modules authored by David G. Myers
Textbook ISBN: 9781464102615
Module 52: The Psychological Therapies
Treating Psychological Disorders
How do psychotherapy, biomedical therapy, and an eclectic approach to therapy differ?
Philippe Pinel and Dorothea Dix – gentler, more humane treatments, constructing mental hospitals. Since 1950s,
the introduction of effective drug therapies and community-based treatment programs have emptied most of those
hospitals.
Psychotherapy: trained therapist uses psychological techniques to assist someone seeking to overcome
difficulties to achieve personal growth.
Biomedical therapy: offers medication or other biological treatments.
Eclectic approach: using a blend of psychotherapies.
Psychotherapy uses a trained therapist, biomedical therapy uses medicine and eclectic uses both.
Psychoanalysis and Psychodynamic Therapy
What are the goals and techniques of psychoanalysis, and how have they been adapted in
psychodynamic therapy?
Sigmund Freud’s psychoanalysis (id-ego-supergo)
Goals: to bring patients’ repressed or disowned feelings into conscious awareness. By helping them reclaim their
unconscious thoughts and feelings and giving them insight into the origins of their disorders, he aimed to help them
reduce growth-impending inner conflicts.
Techniques: After discarding hypnosis as an unreliable excavator, Freud turned to free association.
Free Association – relax, sits out of your line of vision, say aloud whatever comes to mind, noticing you edit
thoughts as you speak.
Resistance – mental blocks indicate resistance. Anxiety lurks, defending self against sensitive material.
Interpretation – insight offered by analyst.
Transferring feelings – a suggestion that might be offered – emotions linked to other relationships
Psychodynamic Therapy: doesn’t involve much about the id, ego, and superego. Instead try to help people
understand current symptoms. They focus on themes across important relationships, including childhood
experiences and the therapist relationship. Patients meet with therapist face-to-face for a few weeks or months and
explore and gain perspective into defended-against thoughts and feelings. Therapists may also help reveal past
relationship troubles as the origin of current difficulties. Interpersonal psychotherapy, a brief (12-16 session)
variation of psychodynamic therapy, has effectively treated depression. Although interpersonal psychotherapy aims
to help people gain insight into the roots of their difficulties, its goal is symptom relief in the here and now. Rather
than focusing mostly on undoing past hurts and offering interpretations, the therapist concentrates primarily on
current relationships and on helping people improve their relationship skills. A typical psychodynamic therapist might
have helped Anna gain insight into her angry impulses and her defences against anger. An interpersonal therapist
would concur, but would also engage her thinking on more immediate issues – how she could balance work and
home, resolve the dispute with her husband, and express her emotions more effectively.
Humanistic Therapies
What are the basic themes of humanistic therapy? What are the specific goals and techniques of Rogers’ client-
centred approach?
The humanistic perspective has emphasized people’s inherent potential for self-fulfillment. Insight therapies.
Humanistic therapists differ from psychoanalytic therapists in many other ways:
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•Humanistic therapists aim to boost people’s self-fulfillment by helping them grow in self-awareness and self-
acceptance
•Promoting this growth, not curing illness is the focus of therapy
•The path to growth is taking immediate responsibility for one’s feelings and actions, rather than uncovering
hidden determinants.
•Conscious thoughts are more important than the unconscious
•The present and future are more important than the past.
Carl Rogers – client-centred therapy, which focuses on the person’s conscious self-perceptions. In this non-
directive therapy, the therapist listens, without judging or interpreting, and seeks to refrain from directing he client
toward certain insights. Believing that most people possess the resources for growth, Rogers encouraged therapists
to exhibit genuineness, acceptance, and empathy. Hearing refers to Rogers’ technique of active listening –
echoing, restating and seeking clarification of what the person expresses (verbally and non-verbally) and
acknowledging the expressed feelings. The counsellor listens attentively and interrupts only to restate and confirm
feelings, to accept what is being expressed, or to seek clarification. Rogers conceded that one cannot be totally
nondirective. But he believed that the therapist’s most important contribution is to accept and understand the client.
Given a non-judgmental, grace-filled environment that provides unconditional positive regard, people may accept
even their worst traits and feel valued and whole. Active Listening by – paraphrasing, inviting clarification, reflecting
feelings.
Behaviour Therapies
How does the basic assumption of behaviour therapy differ from those of psychodynamic and humanistic therapies?
What techniques are used in exposure therapies and aversive conditioning?
The insight therapies assume that many psychological problems diminish as self-awareness grows.
Psychodynamic therapists expect problems to subside as people gain insight into their unresolved and unconscious
tensions. Humanistic therapists expect problems to diminish as people get in touch with their feelings. Proponents
of behaviour therapy, however, doubt the healing power of self-awareness. They assume that the problem
behaviours are the problem, and the application of learning principles can eliminate them. Rather than delving
deeply below the surface looking for inner causes, behaviour therapists view maladaptive symptoms – such as
phobias or sexual disorders – as learned behaviours that can be replaced by constructive behaviours.
Classical Conditioning Techniques
Pavlov – learn various behaviours and emotions through classical condition. Reconditioning. Bed-wetting,
sleeping on a liquid-sensitive pad connected to an alarm. In ¾ cases, it works. Counter-conditioning pairs the
trigger stimulus with a new response that is incompatible with fear.
What might a psychodynamic therapist say about Mowrer’s therapy for bed-wetting? How might a behaviour
therapist reply?
A psychodynamic therapist might be more interested in helping the child develop insight about the underlying
problems that have caused the bed-wetting response. A behaviour therapist would be more likely to agree with
Mowrer that the bed-wetting symptom is the problem, and that counter-conditioning the unwanted behaviour would
indeed bring emotional relief.
Exposure Therapies: Fear of rabbits, exposed to rabbits in his relaxed settings, such as when eating.
Wolpe refined Jones’ technique into what are now the most widely used types of behaviour therapies: exposure
therapies, which expose people to what they normally avoid or escape. Facing their fear. Systematic
desensitization – repeatedly relax when facing anxiety-provoking stimuli, you can gradually eliminate your anxiety.
Using progressive relaxation, the therapist would train you to relax one muscle group after another, until you
achieve a blissful state of complete relaxation and comfort. Use imagination to think of the an anxious situation, then
to actual situations. When an anxiety-arousing situation is too expensive, difficult, or embarrassing to recreate,
virtual reality exposure therapy offers an efficient middle ground.
Aversive Conditioning: the goal is substituting a negative (aversive) response for a positive response to a
harmful stimulus (like alcohol). Weins and Menustik studied alcohol dependence with those who completed an
aversion therapy program. A year later, 63% were still abstaining. US (drug) UR (nausea) : : NS (alcohol) + US
(drug) UR (nausea) : : CS (alcohol) CR (nausea)
Operant Conditioning
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