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PSYA02H3 (961)
Chapter 18

Chapter 18

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Steve Joordens

Chapter 18 – The Treatment of Psychological Disorders Psychological Disorders Early Treatment of Psychological Disorders - Trephining: a surgical procedure in which a hole is made in the skull of a living person o Opening was made to permit evil spirits to leave the victim’s head o Some people survived - People thought to be unwilling hosts for evil spirits were subjected to curses or insults designed to persuade the demons to leave o If this had no effect, exorcism was attempted to make the person’s body an unpleasant place for devils to reside - Other rituals included beatings, starving, near drowning, and the drinking of foul-tasting concoctions - Some with severe problems were sent to “asylums” where they were chained and wallowed in their own excrement - Others who displayed catatonic postures were displayed to the public for a fee - Philippe Pinel improved treatment by changing attitudes of patients o Used kind treatment – orderliness and general calm The Development of Psychotherapy - Anton Mesmer – modern approach to therapy o Theory of magnetic fluxes – effect cures by manipulating iron rods and bottles of chemicals  Hypnotized his patients and thereby alleviated some of their symptoms  Mesmerism - Jean Martin Charcot – studied therapeutic uses of hypnosis - Freud – created practice of psychoanalysis - Eclectic approach: a form of therapy in which the therapist uses whatever method he or she feels will work best for a particular client at a particular time Insight Therapies Psychoanalysis and Modern Psychodynamic Approaches - Psychoanalysis: a form of therapy aimed at providing the client with insight into his or her unconscious motivations and impulses - Purpose of therapy I 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 clues about the origins of intrapsychic conflict given by the client - The client’s main job is to provide the psychoanalyst with something to interpret: description of their fears, anxieties, thoughts, or repressed memories - Psychoanalytic Techniques o Free association: a psychoanalytic procedure in which the client is encouraged to speak freely, without censoring possibly embarrassing or socially unacceptable o Dream interpretation – the evaluation of the underlying meaning of dream content o Manifest – manifest content of a dream is the actual images and events that occur within the dream o Latent – latent content of a dream is the hidden meaning or significance of the dream o Resistance: 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  Freud thought of transference as a distraction from the real issue  Realized it was an important in the success of therapy o Countertransference: process by which the therapist projects his or her emotions onto the client - Modern Psychodynamic Therapy o Psychodynamic therapy: a variation o the Freudian approach to therapy in which therapists search for unconscious conflicts and motivation but do not adhere strictly to Freud’s conception of psychoanalysis o Psychodynamic therapists view the ego as playing a more active role in influencing a person’s thoughts and actions o Brief psychodynamic therapy – takes about 10-25 sessions to complete  Goal is to understand and improve the client’s interpersonal skills through the interpretation of transference processes Humanistic Therapy - A form of therapy focusing on the person’s unique potential or personal growth and self- actualization - Client-Centered Therapy o Carl Rogers o Form of therapy in which the client is allowed to decide what to talk about without strong direction and judgment from the therapist o Incongruence: a discrepancy between a client’s real and ideal selves o Reflection – sensitive rephrasing or mirroring of the client’s statements o Empathy – ability to perceive the world from another’s viewpoint o Unconditional positive regard: according to Rogers, the therapeutic expression that a client’s worth as a human being is not dependent on anything that he or she does, says, feels, or thinks o The therapist unconditionally accepts the client and approves of him or her as a person so that the client can come to understand that his or her feelings are worthwhile and important - Gestalt Therapy o Fritz Perls o A form of therapy emphasizing the unity of mind and body by teaching the client to ‘get in touch’ with unconscious bodily sensations and emotional feelings o Places exclusive emphasis on present experience – not on the past – and the therapist will often by quite confrontational, challenging the client to deal honestly with his or her emotions o Empty chair technique – client imagines that he or she is talking to someone sitting in the chair beside or her Behavior and Cognitive-Behavior Therapies Therapies Based on Classical Conditioning - Systematic Desensitization o A method of treatment in which the client is trained to relax in the presence of increasingly fearful stimuli o Designed to remove the unpleasant emotional response produced by the feared object or situation and replace it with an incompatible one - relaxation o Step 1 – construct a hierarchy of anxiety-related stimuli o Step 2 – client is trained to achieve complete relaxation o Step 3 – conditional stimuli are paired with stimuli that elicit the learned relaxation response o In vivo exposure: a form of therapy in which clients are exposed to intense levels of a feared stimuli in attempt to diminish the hear through excitement  Client’s learn that nothing bad happens when they are directly exposed to the fear-eliciting stimuli o Imaginal exposure: a form of therapy in which the therapist provides a client with graphic descriptions of a feared object; its goal is to diminish fear by extinguishing avoidance responses - Aversion Therapy o A form of treatment in which the client is trained to response negatively to a neutral stimulus that has been paired with an aversive stimulus o Attempts to establish an unpleasant response to the object that produces the undesired behavior Therapies Based on Operant Conditioning - Behavior modification: behavior therapy based on the principles of operant conditioning o Involves altering maladaptive behavior by rearranging the contingencies between behavior and its consequences - Reinforcement of Adaptive Behaviors o Behavioral techniques are often used to alter the behavior of emotionally disturbed people, and those with mental retardation, for whom communication is difficult - Token Economy o A program often used in situations in which a person’s adaptive behavior is reinforced with tokens that can be exchanged for desirable goods or special privileges - Modeling o Humans are able to learn without directly experiencing an event o People can imitate the behavior of other people, watching what they do and, if the conditions are appropriate, performing the same behavior o People learn to make new responses by imitating those of the therapist so their behavior is reinforced - Assertive Therapy o Procedure for developing coping skills I interpersonal situations in which a client might feel anxiety or be unable to function as effectively as he or she would like o Often used to help clients who feel frustrated at not being able to speak up to defend their rights, especially in those situations in which others are trying to take advantage of them or to otherwise compromise their values or moral standards - Extinction of Maladaptive Behaviors o Extinction – process through which behavior is eliminated by removing previously available reinforcers o Often combined with other methods in behavior modification programs o Extinction burst – when a reinforcer that has previously followed a behavior is no longer forthcoming, that behavior will often intensify o Not always possible to eliminate the reinforce that maintains undesirable behavior - Punishment of Maladaptive Behaviors o Person who is being punished may learn to fear or dislike the person who administers te punishment o There is a tendency to overgeneralize – to avoid performing a whole class of responses related to the response tha
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