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PSYA02H3 (961)
Chapter 18

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Steve Joordens

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 persons skulls o Was made to permit evil spirits to leave the victims 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 18 century, the idea that devils and spirits were responsible for peculiar behaviour in some people remaind popular among many Europeans - Joahann Wier (16 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 th writings did not re-emerge until the 20 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 spirits - 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 1 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 women - 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 therapists 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 clients 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 2 - Early stages of therapy, the natural of clients 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 clients 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 clients disclosures by eliminating eye contact; he in a chair at the head of a couch on which the client reclined o Freud believed that dreams were a critical component of psychoanalysis Analyst must be able to distinguish between the dreams 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 3
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