INTRODUCTION TO PSYCHOTHERAPY

PSYCHOTHERAPY

Treatment of psychological disorders involving psychological techniques

Involve interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth

HISTORY OF PSYCHOTHERAPY In the past, we have treated psychological disorders by

cutting holes in the head, restraining patients, beating out the devil, bleeding, by putting patients in sunny, serene environments, by giving electric shock therapy, by giving drugs, and by talking…. Biological and psychological treatments have developed

simultaneously Brutal to humane: Philippe Pinel and Dorthea Dix 19th century: treatment of hysteria (a somatoform disorder)

Franz Anton Mesmer developed hypnosis to treat hysteria Development of psychoanalysis

20th century: rise of behavioral therapy Second half of the 20th century: humanistic and cognitive

treatment Today: Evidence-Based Practice

Combines research, clinical expertise, and patient values to provide the best outcome for a patient

TYPES OF THERAPISTS

Who administers psychotherapy? General medical practitioners,

psychiatrists, psychologists, social workers, nurses, religious leaders

Can all be called psychotherapists Licensing is administered by state

governments

TYPES OF THERAPIES

Insight Therapies Psychoanalysis Client-Centered (Humanistic)

Behavior Cognitive Cognitive-Behavioral

INSIGHT THERAPIES

Therapies that aim to improve psychological functioning by increasing the client’s awareness of underlying motives and defenses

Assumes that people will improve when they understand their problems

PSYCHOANALYSIS Developed by Freud (yet few practice it today as

Freud did – relatively few therapists offer it) First psychological therapy

Reflected his belief in conflict (between the id, ego, superego), the unconscious mind, childhood experiences, and repressed memories

Therapist (psychoanalyst) takes a directive role (in charge of the session) to help the patient uncover unconscious contributions to their problems Goal: Patient brings repressed feelings into conscious

awareness and takes responsibility for their own growth

Takes several years and several sessions a week (very expensive!)

ELEMENTS OF PSYCHOANALYSIS Goal: unearth the past in hopes of unmasking the present Uses free association: a person says whatever comes to

mind Don’t think before you speak! Therapist takes notes and then interprets meaning

Some engage in dream analysis Transference: therapists uses the responses of the patient to

the therapist to understand the patient’s approach to authority figures in general Patient yells at therapist, then the therapist may infer that the

patient used to act similarly to parents or other authority figures Resistance: patient’s reluctance to accept the

interpretations of the therapist indicate that the therapist’s interpretations are correct This occurs when the patient is getting closer to insight A result of our unconscious wishes to avoid punishment and

defend ourselves Is demonstrated when the patient changes the subject, disagrees

with the interpretation, or even misses an appointment

DOES IT WORK?

Interpretations cannot be proven or disproven

Psychoanalysis is therapy, not science (according to proponents)

PSYCHODYNAMIC THERAPY

Aka short-term psychodynamic therapy Insight is still the goal Influenced by Freud, but tries to

understand a patient’s current symptoms by focusing on themes across important relationships

Once a week, only for a few weeks or month

HUMANISTIC THERAPY Client (person) centered therapy

Developed by Carl Rogers Developed in opposition to psychoanalysis

Humanists believed that humans were inherently good (opposite of Freud’s beliefs)

Conscious rather than unconscious Present/future over past Responsibility for one’s feelings and actions Promoting growth rather than curing illness

Nondirective; Client (not patient); More of an equal process; Client takes active role

Goal of therapy is eliminate discrepancies between the ideal and real selves (failing to do so leads to disorders) Help people growth in self-awareness and acceptance

CONT.

Techniques: Active-listening: echoing, restating, and seeking

clarification of what the person expresses, and acknowledging the expressed feelings

Only interrupts to do these things Empathy and unconditional positive regard

Creates a safe, supportive environment

Called it counseling rather than treatment Not necessarily effective for severe disorders