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PSYA02H3 (961)
Chapter 18


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Steve Joordens

Chapter 18 The Treatment of Mental Disordersfour basic approaches to treatment of mental disorders insight therapies behaviour therapy and cognitivie therapies treatment of groups including treatment of couples and development of outreach programs that serve community and biological treatmentstherpay is complex process and outcome depends to large extent on relationship that client and therapist are able to form Mental Disorders and Psychotherapy Early Treatment of Mental DisordersTrephiningsurgical procedure in which hole is made in skull of living person earliest known attmepts to treat mental disorderscurses or insults to persuade evil demon to leave exorcismbeating starving near drowning and drinking foul tasting concoctions many accepted their persecution and even admitted to false accusationsthbelief about evil spirits held until 18 century thJohann Wierfirst to challenge treatment for mental disorders 16 centurycondemned by church and banned writingsthdid not appear again until 20 centurylater accepted view of mental illness condemned to asylums where treatment was also inhumanePhilippe Pinelbelieved that most mental patients would respond well to kind treatment experimented at La Bicetre and allowed patients to roam free later did this at Salpetriere Hospital tooencourgaed similar reforms elsewhere Dorothea Dixled campaign for humane treatment of mental patients responsible for laying groundwork for first psychiatric hospital in Nova Scotia The Development of PsychotherapythFranz Anton Mesmerfirst modern treatment of mental disorders in 18 centurydevised thoery of magnetic fluxes according to which he attempted to effect cures by manipulating iron rods and bottles of chemicalshypnotized patients and alleviated some of their symptomsJean Martin Charcotbegan to sutdy therapeutic uses of hypnosis when one of his students hypnotized woman and induced her to display symptoms of conversion reaction Freud studied with Charcot in paris where he then created practice of psychoanalysis eclectic approachform of therapy in which therapist uses whatver method they feel works best for particular client at particular timeAcierno Hersen and Van Hasseltshown that combinations of behaviour and cognitivebehaviour therapies are more effective in treating panic disorder than one aloneInsight Therapiesinsight therapyhold belief that people are essentially normal but learn maladaptive thought patterns and emotions which are revealed in maladaptive behaviours view behaviour as symptom of deeper underlying psychological problems which are cured with insightbased largely on conversation between client and therapist Psychoanalysis and Modern Psychodynamic Approachespsychoanalysisform of modern therapy aimed at providing client with insight into their unconscious motivations and impulses based on theory that unconscious conflict based on competing demands of id biological urges superego moral dictates of society and ego reality lead to anxiety traced to inadequately defended sexual and aggressive urges or incoplete progression through psychosexual stages in early stages nature of clients problems are difficult to identigy because analyst and client are unaware of underlying conflicts but repression is seldom complete and so some intrude into consciousanalyst tries to bring these into view through talk and interpret themclues revealed in dreams memories or lack of physical problems manner of speech and cognitive and emotional reactions to therapy and then told to client so they can gain insightgoals of psychoanalyst is to interpret clues about origins of intrapsychic conflict and goal of client is to provide information freud felt that amnesia lifts moment insight is achieved Psychoanalytic Techniquefreeassociationpsychoanalytic procedure in which client is encouraged to speak freely without censoring possibly embarrassing or socially unacceptable thoughts achieved in 2 ways client was encouraged to say anything that came to mind and also eliminated eye contact so to minimize authoritative influencemanifest content masks latent content because latent is anxiety provoking and causes person discomfortresistancedevelopment during therapy in which client becomes defensive unconsciously attempting to halt furhter insight by censoring true feelingspatient changes topic cancels appointments forgets what they were going to sayskilled therapist redirects discusssion while minimzing pain of discoverytransferenceprocess by which a client begins to project powerful attitudes and emotions onto therapist usually happens when childhood is brought upfreud originally thoght transference was distrction but realized its importance as means of reliving significant early experiences and therapist is able to act as tool to illuminate conflict of unconscious by becoming substitute for people in clients lifecountertransferenceprocess by which therapist projects their feelings onto client unhealthy and undesirable to prevent this analyst should undergo therapy as wellFreud was first to develop theory of abnormal behaviourModern Psychodynamic Therapypsychoanalysis now referref to as psychodynamic therapy to reflect differences from Freudian psychoanalysisplace more emphasis on social and interpesonal experiences rather than sexual factors during development and more likely to address current issues rather than issues in childhoodsee ego as having more control over psyche and less constrains on unconsciousalso performed dream interpretationanalyst must be able to distinguish between manifest actual imagesevents and latent hidden meaningsignificance contents shorter process and client is less dependant on therapist
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