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Chapter 18

PSYA02H3 Chapter Notes - Chapter 18: Reuptake, Limbic System, Bilateral Cingulotomy

Course Code
Steve Joordens

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Chapter 18: The Treatment of Psychological Disorders
- This chapter describes four basic approaches to the treatment of
psychological disorders:
o Insight therapies
o Behaviour therapy and cognitive-behaviour therapies
o Treatment of groups
o Biological treatments
Psychological Disorders and Psychotherapy
- People view psychological disorders as illnesses
Early Treatment of Psychological Disorders
- Trephining: A surgical procedure in which a hole is made in the skull of a
living person
o Earliest known attempts to treat psychological disorders involved
drilling holes in a person’s skulls
o Was made to permit evil spirits to leave the victim’s head
o Prehistoric times, procedure was performed with sharp-edged stone;
later civilizations, such as the Egyptians, refined the practice with
more sophisticated instruments
- As late as the 18th century, the idea that devils and spirits were responsible
for peculiar behaviour in some people remaind popular among many
- Joahann Wier (16th century physician), was among the first to challenge
practices intended to combat witchcraft
o Church condemned his writings as heretical and banned them, and his
writings did not re-emerge until the 20th century
- Eventually the general public began to regard people with psychological
disorder as ill, which still did not make the lives better for mentally ill people
- Many of the treatments designed to cure mental patients were only a little
better than the tortures that had previously been used to drive out evil
- Philippe Pinel was a French physician who in 1793 was appointed director of
La Bicetre, a mental hospital in Paris
o He believed that most mental patients would respond favourably to
kind treatments
- Dorothea Dix, led the campaign for humane treatment of mental patients in
the United States; raised money for construction of mental hospitals
o Dix was responsible for first psychiatric hospital in Nova Scotia
o The process of reform in NA took a long time

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The Development of Psychotherapy
- The modern approach of therapy can be traced to Franz Anton Mesmer, an
Austrian physician
o Devised a theory of “magnetic fluxes”; would attempt to cure by
manipulating iron rods and bottles of chemicals (he would hypnotized
his patients); hypnosis was first known as mesmerism
- Jean Martin Charcot, a French neurologist began to study the therapeutic
uses of hypnosis when one of his students hypnotized a woman and induced
her to display the symptoms of a conversion reaction (then called hysteria)
o Hysteria: a psychological disorder (not now regarded as a single
definite condition) whose symptoms include conversion of
psychological stress into physical symptoms (somatization), selective
amnesia, shallow volatile emotions, and overdramatic or attention-
seeking behavior; it was formerly regarded as a disease specific to
- Before Freud began private practice, he observed the effects of hypnosis on
hysteria with Charcot in Paris
- Some Psychotherapists adopt approaches to treatment that fit their own
views of why people behave the way they do
o Therapists that believe behaviour is influenced by environment, are
likely to use cognitive-behavioral approaches in treatment
o Therapists who believe that behaviour is strongly influenced by
biological factors are likely to use a combination of drug therapy and
psychotherapy in treatment
- Most therapists adopt a more general approach called the eclectic approach
o Eclectic Approach: involves the therapist’s using whatever methods
he or she feels will work best for a particular client at particular time
o Combining aspects of several different treatment approaches
according to a particular client’s problem and personal circumstances
Insight Therapies
- Practitioners of insight therapy assume that people are essentially normal
but learn maladaptive thought patterns and emotions, which are revealed in
maladaptive behaviour
- In this section we look at insight therapies:
o Psychoanalysis
o Client-centered therapy
o Gestalt therapy
Psychoanalysis and Modern Psychodynamic Approaches
- Sigmund Freund developed psychoanalysis
o Psychoanalysis: A form of therapy aimed at providing the client with
insight into his or her unconscious motivations and impulses

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- Early stages of therapy, the natural of client’s problems are difficult to
identify because the analyst and the client are unaware of the underlying,
unconscious, conflicts
- Purpose of therapy is to create a setting in which clues about the origins of
intrapsychic conflicts are most likely to be revealed by the client
- One of the main goals of the psychoanalyst is to interpret the cleus about the
origins of intrpsychic conflict given by the client
- Interpretation is seen as the basic means of uncovering the root causes of the
clients’ problems for psychoanalysts
- The client’s job is to provide something to interpret; not an easy task for the
client to accomplish because the client unconsciously invokes one or more
defense mechanisms, prevent anxiety-provoking memories and ideas from
reaching conscious awareness
- Freud felt that the “veil of amnesias” lifts the moment that insight is achieved
- Some patients insight is achieved in a moment, while majority achieve it after
a long-term therapy
- Psychoanalytic Techniques
o Freud used free association (A psychoanalytic procedure in which the
client is encouraged to speak freely, without censoring possibly
embarrassing or socially unacceptable thoughts or ideas)
He achieved this in two ways:
Client was encouraged to speak that came to mind
without worrying about the meaning
He attempted to minimize any authoritative influence
over the client’s disclosures by eliminating eye contact;
he in a chair at the head of a couch on which the client
o Freud believed that dreams were a critical component of
Analyst must be able to distinguish between the dream’s
manifest and latent contents
o Manifest content of a dream is the actual images
and events that occur within the dream
o Latent content is anxiety provoking and causes
the person psychological discomfort
o Manifest content masks the latent content
o Resistance: A development during therapy in which the client
becomes defensive, unconsciously attempting to halt further insight
by censoring his or her true feelings
o Transference: The process by which a client begins to project
powerful attitudes and emotions onto the therapist
The client may come to love ore hate the therapist with the
same intensity of the powerful emotions experienced in
childhood toward parents or siblings
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