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Chapter 18

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University of Toronto Scarborough

Ch18 Treatment of Mental DisordersMENTAL DISORDERS AND PSYCHOTHERAPHYEarly Treatment of Mental DisordersTrephininga surgical procedure in which a hole is made in the skull of a living person earliest known attempt to treat mental disordersopening was made to permit evil spirits to leave victims headin prehistoric times this procedure was performed with a sharpedged stonemany other painful and degrading practices were directed at peoples presumed possession by evil spritspeople thought to be unwilling hosts for evil spirits were subjected to curses or insults designed to persuade demons to leaveif this approach did not work exorcism was attempted to make persons body an unpleasant place for devils to resideother rituals included beatings starving near drowning drinking of foultasting concoctions th18 centurymany Europeans still believed that devils and spirits were responsible for peculiar behaviours in some peopleLater on medical authorities and general public regarded people with mental disorders as illtorture and extreme prosecution stoppedPeople with mental illness eventually regarded as harmless but strangemost consigned to asylums that were inhumane patients tied up doused in cold water bled made to vomit etcPinel physician believed that most mental patients would respond well to kind treatmentoHe tried an experiment where he took off chains from patients and took them out of dungeons and allowed them to walk freely about the hospital groundsit was a successMany patients were discharged bc they were okoLed to campaign for humane treatment of mental patients and building of first mental hospital in Nova ScotiaThe Development of PsychotherapyJean Martin Charcot a French neurologist began to study therapeutic uses of hypnosis when one of his students hypnotized a woman and induced her to display symptoms of a conversation reaction hysteriaconcluded she was a hysterical patientThe student then woke the woman and her symptoms vanishedCharcot had previously believed that hysteria had an organic basis but this experience changed his opinion Some psychotherapists adopt approaches to treatment that fit their own views of why people behave the way they doie therapists who believe that behaviour is strongly influenced by environmental contingencies and peoples perceptions of them are likely to use cognitivebehavioural approaches to treating their clients problemsTherapists who believe that behaviour is strongly influenced by biological factors are likely to use combination of drug therapy and psychotherapy in treating their clients problems1Eclectic Approacha form of therapy in which the therapist uses whatever method heshe feels will work best for particular client at particular timeoNot strongly wedded to particular theoretical orientationsoCombining aspects of several different treatment approaches according to particular clients problem and personal circumstancesINSIGHT THERAPIESPsychoanalysis and Modern Psychodynamic ApproachesPsychoanalysisa form of therapy aimed at providing the client with insight into hisher unconscious motivations and impulsesin the early stages of therapy the nature of the clients problems are difficult to identify bc the analyst and the client are unaware of the underlying unconscious conflictsrepression of these conflicts is seldom complete though and they frequently intrude into consciousness in subtle waysby encouraging the client to talk the analyst tries to bring these conflicts into viewobscurity of conflicts requires that analyst interpret them in order to uncover their true meaning an gradually weave together a complete picture of unconsciouspurpose of therapy is to create a setting in which clues about origins of intrapsychic conflicts are most likely to be revealed by clientin dreams physical probs memory manner of speech cognitiveemotional reactions to therapymain goal of psychoanalyst is to interpret clues about origins of intrapsychic conflict given by clientemphasize interpretation as basic means of uncovering root causes of clients problemsclients main job is to provide psychoanalyst with something to interpret fears anxieties thoughts repressed memoriessuccessful treatment depends not only on the psychoanalysts interpretations but also on ensuring that the patient has capacity to understand and integrate what is learned in therapyPsychoanalytic TechniquesFree associationa psychoanalytical procedure in which the client is encouraged to speak freely without censoring possibly embarrassing or socially unacceptable thoughts or ideasclient encouraged to report any thoughts or images that came to mind without worrying about their meaningminimize any authoritative influence over clients disclosures by eliminating eye contactdream interpretationevaluation of underlying meaning of dream contentmanifest contentactual images and events that occur within the dreamlatent contenthidden meaning or significance of dreammanifest content masks latent bc it is anxiety provoking and causes person psychological discomforttherapist must be skilled in recognizing symbolic nature of dreamsresistancea development during therapy in which client becomes defensive unconsciously attempting to halt further insight by censoring hisher true feelings2
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