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Chapter 17

Psychology 1000 Chapter Notes - Chapter 17: Alprazolam, Xerostomia, Antipsychotic

Course Code
PSYCH 1000

of 3
Chapter 17: Psychological Treatment
Psychoanalysis: based on Freud's theories, goal is insight—bringing unconscious conflicts to
Hidden inner conflicts; repressed wishes-- Defence Mechanisms---Insight into the causes of
psychological disorders—Consciousness--These disorders fade away
Free Association: expressing thought and feelings without censorship, Freudian slips (therapist
looking for cues, why Freud used a couch, wanted them to be relaxed and loosen their conscious
Dream Analysis: manifest (storyline) vs latent (actual meaning) content
Resistance: nearing repressed conflict, patients miss appointments or argue when they are close to
finding the heart of the matter
Transference: when client's feelings about therapist are same as toward parent, psychoanalysists want
this to occur—they want a blank slate for client to express themselves, tap to unconscious feelings
Role of therapist is interpretation, find hidden issues
YAVIS- young, attractive, verbal, insightful, successful ($ to be in therapy for that period of time)
Humanistic Therapies
focus on people's striving for personal growth
instead of inner conflicts, humanistic therapy focuses on environmental conditions that block
growth and development
helps clients become more aware of their own feelings, and to own their feelings
Rogers- client-centred therapy
emphasizes supportive emotional climate
concentrates on elimination irrational conditions of worth
3 conditions of therapeutic climate
1. Genuineness
2. Unconditional Positive Regard (separate client from behaviour)
3. Empathy (put yourself in other peoples shoes and understand how they feel)
Role of therapist is clarification
Fritz Perls- Gestalt (Whole) Therapy
designed to increase individuals' awareness of their own feelings
understand who they are and what they want, not other people, owning your feelings
role playing (helps when people are torn)
imaginary dialogue (empty chair technique)
express pent up feelings (rage, crying, used in group therapies)
Evaluating Humanistic Theories- like Freud, can be quite time consuming, better suited to YAVIS in
order to benefit
Cognitive Therapies - powerful therapy, advantage (unlike antidepressants which relapse) provide to
make future bouts of depression less likely, more work though, insight therapy (IT)- try to make you
understand the cause of your psychological distress, require clear thinking
Rational-Emotive Therapy (Ellis): overcoming irrational beliefs about the way things are, make
people overreact to normal life events, IT, very confrontational
- therapist's role to detect and challenge these beliefs
musterbation (must be this way or I will die, cant get through the day), awfulizing (this is so
awful, how could it rain today?)
ABCD theory of emotion
Activating Event (fail test) → Beliefs (shouldn't be in uni) → Emotional Consequences
(life is over) → Disputing Beliefs (why does failing a test mean my life is over?)
Beck's Cognitive-Behavioural Therapy: focus on restructuring automatic negative thinking patterns
detect cognitive tendencies that lead to depression (eg all or nothing thinking)
blend of insight and behavioural therapy
often uses “homework” assignments to produce new behaviours (write down feelings, events)
Illogical Patterns on thought- overgeneralization (one specific event turning it global, bf dumped her=
no boys will ever like her)
explaining away positive occurrences (anything good=luck, anything bad=personally
selective perception (focus on the bad, overlook the good ones)
magnifying the importance of negative events (fail exam= I should drop out of uni)
all-or-nothing thinking (black/white, I have to be perfect or I'm a failure)
Evaluating Cognitive Therapy- don’t have to go for years, can go for a few sessions, shorter terms
Behavioural Therapies- focus on behaviour: changing maladaptive patterns on behaviour, focus on
the behaviour you want to change
- change through operant (rewards/punishments) and classical (association) conditioning techniques
- behavioural therapies view symptoms as the problem, not insight oriented
- used often with phobias, don’t care why you have them, important to focus on fear
Classical Conditioning Techniques- learned that the occurrence of one stimulus will be paired with
another, phobias/fears usually occur with this and are most treated through here
Exposure Based Treatments
Systematic Desensitization: reducing anxiety through counterconditioning, high
success rate (replace anxiety with relaxation instead when stimulus presented, then
slowly increase level of exposure. Picture of spider, fake spider, real spider) involves
gradual increase in exposure to feared stimulus while engaging in relaxation techniques
Flooding: more stressful/anxiety (afraid of dogs, let into a pound, no dogs there or
afraid of water throw into shallow water=no danger)
- Aversion Conditioning: create a fear or aversion, pair to stimuli but you pair something they like
with an unpleasant stimulus, not effective for long-term, need other types of therapy to work
properly, more affective for newer users, elastic on wrist (antabuse- alcoholics take it and when
they drink they will become very sick)
Operant Conditioning Techniques- shaping behaviour through rewards and punishments
1. Identification of maladaptive behaviours (kid acting up at school, binge drinking)
2. Identifying reinforcers of behaviours (what leads people to engage in these behaviours)
3. Change environment so these behaviours aren't rewarded (kid acted up and played computers)
Other behavioural techniques:
Token Economies- do behaviours that are expected of you (make bed, do laundry) you will get tokens
that you can cash in for a tangible awards, used often in jails and institutions
Modeling- behavioural phobias, help people acquire behaviours that will help them function well in the
world (someone scared of public speaking, watch someone else do it)
Mindfulness- meditative technique, in touch with feelings and be accepting of them, meditation, used
with addictions
Evaluating Psychotherapy
Research findings- psychotherapy is effective, no single therapy stands out as “the best”
- factors relating to therapy outcomes:
- support (acceptance, empathy, encouragement, no judgement, help resolve problems)
- hope (placebo effect, engages us in the effort necessary to improve our lives)
- eclecticism- don’t have a particular preference, what they use depends on the symptoms/disorders the
patients manifest, adaptable
Biologically-Based Therapies
Psychosurgeries- lobotomies performed from 1935-1955, trying to diffuse emotions
- minor surgeries still performed
ECT Electroconvulsive Therapy- electric shocks administered to brain
- effective treatment for severe depression
- only used when drug therapies fail or if suicide is a strong possibility
Drug Therapy
Antipsychotic Drugs- effective in treating schizophrenia
- positive symptoms (hallucinations, disillusion, paranoia)
- not good with negative symptoms (lack of self care, withdrawal)
- blocks dopamine receptors in certain parts of the brain
- unpleasant side-effects (tardive dyskinesia- jerky movements, blurred vision, dry mouth, fatigue,
similar to Parkinson's disease)
Antidepressants- usually for unipolar, 3 types:
1. Tricyclics- Elavil, stop the re-uptake of serotonin and norepinephrine, more negative side effects
2. Serotonin Selective Re-uptake Inhibitors (SSRI)- Prozac, prevents only serotonin (targeted)
3. MAO inhibitors- do not block re-uptake, they stop the action of the enzyme that breaks down and so
they stay in the synapse longer, more negative side effects (dry mouth, weight gain, dizziness)
Antimania Drugs- Lithium evens out mood swings of bipolar patients, controls both manic and
depressive, small therapeutic window (easy to give too much)
- 60-70% respond well
- cannot give to pregnant women, some bipolar women don’t show symptoms during pregnancy
Antianxiety Drugs- Alcohol (self-medicate)- increase in GABA, bad side effects, affect cognitive
- Benzodiazepines: valium, ativan, xanax- enhance GABA activity, relax you but do not affect
cognitive, calms
Problems: can produce dependency (not physical), masks symptoms, not a cure