Chapter 17 pt. 1: Chapter 17 pt. 1: Psychoanalysis, Humanistic, Psychoanalysis, Humanistic, and Behaviorism Therapiesand Behaviorism Therapies

Imagine a good friend of yours has Imagine a good friend of yours has approached you about a problem he or approached you about a problem he or she has developed recently. The friend she has developed recently. The friend describes several symptoms, including describes several symptoms, including increased feelings of depression, crying increased feelings of depression, crying spells, loss of interest in activities, and spells, loss of interest in activities, and changes in eating and sleeping changes in eating and sleeping patterns. You have asked enough patterns. You have asked enough questions to assume the person is questions to assume the person is clinically depressed. Assume the role of clinically depressed. Assume the role of therapist and develop some possible therapist and develop some possible interventions. Come up with 3 possible interventions. Come up with 3 possible ideas to help your friend. ideas to help your friend.

2 Major Types of Therapy2 Major Types of Therapy 1. 1. Psychological Psychological

Therapies:Therapies: employ employ interaction (usually interaction (usually verbal) between trained verbal) between trained professional and a client professional and a client with a problemwith a problem

2. 2. Biomedical:Biomedical: therapies directed at a therapies directed at a patient’s nervous patient’s nervous systemsystem. .

VS.

Psychotherapy Differs Psychotherapy Differs Depending on the Perspective Depending on the Perspective

of Therapistof Therapist Psychotherapy:Psychotherapy: emotionally emotionally charged, confiding interaction charged, confiding interaction between a trained therapist and between a trained therapist and someone who suffers from someone who suffers from psychological difficulties.psychological difficulties.

There are different types based on There are different types based on personality theories we discussed:personality theories we discussed:

1. Psychoanalytic1. Psychoanalytic 2. Humanistic 2. Humanistic 3. Behavioral 3. Behavioral 4. Cognitive4. Cognitive

Eclectic Approach Takes a Eclectic Approach Takes a Smorgasbord ApproachSmorgasbord Approach

Eclectic Approach:Eclectic Approach: uses a variety uses a variety of different techniques from various of different techniques from various theories of therapy depending on the theories of therapy depending on the problem of the individual.problem of the individual.

More than half of therapists take this More than half of therapists take this approach. approach.

Insight TherapiesInsight Therapies All insight therapies agree that their All insight therapies agree that their

goal is to help clients develop insight goal is to help clients develop insight about the cause of their problems and about the cause of their problems and that insight will lead to behavior that insight will lead to behavior change; problems decrease as self-change; problems decrease as self-awareness increases. awareness increases.

Insight Therapies Include:Insight Therapies Include:– 1. Psychoanalytic (Psychodynamic)1. Psychoanalytic (Psychodynamic)– 2. Humanistic (Client Centered)2. Humanistic (Client Centered)– 3. Cognitive3. Cognitive

Most often used to treat depression, Most often used to treat depression, eating disorders, and marital problems.eating disorders, and marital problems.

Psychotherapy One: Psychotherapy One: PsychoanalysisPsychoanalysis

Psychoanalysis’ main assumption? Psychoanalysis’ main assumption?

Goal of psychoanalysis? Goal of psychoanalysis?

How do Psychoanalysts How do Psychoanalysts Unmask Your “Repressed Unmask Your “Repressed

Anxiety?”Anxiety?” 1. While doing 1. While doing free associationfree association there will there will be blocks in your flow. Analysts interpret be blocks in your flow. Analysts interpret these blocks as Resistance. these blocks as Resistance. – Resistance:Resistance: the blocking from the blocking from

consciousness of anxiety-laden material. consciousness of anxiety-laden material. – Based on your resistance the analysts will Based on your resistance the analysts will

try to provide accurate try to provide accurate interpretations: interpretations: noting supposed meaning behind blocks noting supposed meaning behind blocks in flow to provide patient with in flow to provide patient with insightinsight (reason behind your problems).(reason behind your problems).

2. Psychoanalysts also interpret dreams’ 2. Psychoanalysts also interpret dreams’ latent content (underlying meaning). latent content (underlying meaning).

How do Psychoanalysts How do Psychoanalysts Unmask Your “Repressed Unmask Your “Repressed

Anxiety?”Anxiety?” 3. Interpreting 3. Interpreting TransferenceTransference– After revealing extremely personal After revealing extremely personal

things about themselves to therapists, things about themselves to therapists, patients often start to feel positive or patients often start to feel positive or negative feelings towards their negative feelings towards their analyst. analyst.

– Freud argued that the feelings you Freud argued that the feelings you feel towards a therapist represented feel towards a therapist represented transference:transference: patient’s transfer to patient’s transfer to the analyst of emotions linked with the analyst of emotions linked with other relationships (such as love or other relationships (such as love or hatred for a parent). hatred for a parent).

Criticism of Psychoanalytic Criticism of Psychoanalytic TherapyTherapy

1. Built on assumption that 1. Built on assumption that repressed memories exist.repressed memories exist.

2. Interpretations can not be 2. Interpretations can not be proven right or wrong.proven right or wrong.

3. Is very time-consuming and 3. Is very time-consuming and costly…usually takes several costly…usually takes several years to achieve insight. years to achieve insight.

Interpersonal Psychotherapy Interpersonal Psychotherapy as an Alternative To as an Alternative To

PsychoanalysisPsychoanalysis Interpersonal Psychotherapy:Interpersonal Psychotherapy: occurs in much shorter session and occurs in much shorter session and also aims to to help patients gain also aims to to help patients gain insight into the roots of their insight into the roots of their difficulties.difficulties.

However instead of focusing on past, However instead of focusing on past, this approach focuses on current this approach focuses on current relationships and how to deal with relationships and how to deal with problems….looking for symptom problems….looking for symptom relief instead of personalityrelief instead of personality change. change.

Psychotherapy Two: Psychotherapy Two: Humanistic ApproachHumanistic Approach

Humanistic perspective hopes to Humanistic perspective hopes to boost boost self-fulfillmentself-fulfillment by helping by helping people grow in people grow in self-awareness and self-awareness and self acceptance.self acceptance.

Main Focuses: Main Focuses: 1. The present and future1. The present and future 2. Conscious Rather than 2. Conscious Rather than

Unconscious ThoughtsUnconscious Thoughts 3. Individual Responsibility (free 3. Individual Responsibility (free

will) for feelingswill) for feelings 4. Promote growth instead of cures. 4. Promote growth instead of cures.

Carl Rogers’ Client or Carl Rogers’ Client or Person Centered TherapyPerson Centered Therapy

Most widely used humanistic technique is Most widely used humanistic technique is client (person) centered therapy:client (person) centered therapy: technique which involves active listening technique which involves active listening within a genuine, accepting, empathetic within a genuine, accepting, empathetic environment to facilitate clients’ growth. environment to facilitate clients’ growth.

Active listening:Active listening: technique in which technique in which therapist is non-directive towards client therapist is non-directive towards client and empathizes with them by echoing, and empathizes with them by echoing, restating, and clarifying their feelings. restating, and clarifying their feelings.

Client Centered Therapy Client Centered Therapy Promotes Self-AwarenessPromotes Self-Awareness

When given When given unconditional unconditional positive positive regardregard clients clients start to accept start to accept themselves themselves including their including their faults and feel faults and feel more valued and more valued and whole. whole.

Psychotherapy Three: Behavior Psychotherapy Three: Behavior Therapies Focus on LearningTherapies Focus on Learning

Unlike previous 2 psychotherapies, Unlike previous 2 psychotherapies, behavior therapies are not interested in behavior therapies are not interested in the underlying cause of the problem or the underlying cause of the problem or in achieving self-awareness. in achieving self-awareness.

Behavior Therapies:Behavior Therapies: assume the assume the problems are the behaviors themselves problems are the behaviors themselves and look to use well-established and look to use well-established learning principleslearning principles to eliminate the to eliminate the unwanted behavior. Usually used to unwanted behavior. Usually used to treat anxiety disorders, drug treat anxiety disorders, drug addictions, bedwetting, sexual addictions, bedwetting, sexual dysfunctions, and autism. dysfunctions, and autism.

Behavior Affects BiologyBehavior Affects Biology Biofeedback:Biofeedback: uses a uses a

system that records system that records physiological processes physiological processes such as heart rate, muscle such as heart rate, muscle tension, and skin tension, and skin temperature. temperature.

Patient can use immediate Patient can use immediate information to see degree information to see degree which they can change which they can change anxiety-related responses anxiety-related responses to lessen physiological to lessen physiological arousal. arousal.

Classical Conditioning Classical Conditioning TechniquesTechniques

Argue that learned responses like Argue that learned responses like phobias can be unlearned through phobias can be unlearned through counterconditioning.counterconditioning.

Counterconditioning:Counterconditioning: behavior behavior therapy that conditions new therapy that conditions new responses to stimuli that trigger your responses to stimuli that trigger your unwanted behaviors. unwanted behaviors.

Ex:Ex: pair fear of heights with relaxing pair fear of heights with relaxing stimuli. stimuli.

Two Types of Counterconditioning: Two Types of Counterconditioning: Systematic Desensitization and Systematic Desensitization and

Aversive ConditioningAversive Conditioning 1. 1. Systematic Desensitization:Systematic Desensitization:

exposure technique used to commonly exposure technique used to commonly treat phobias. Associates a pleasant treat phobias. Associates a pleasant relaxed state with relaxed state with gradually increasinggradually increasing anxiety-triggering stimuli until anxiety anxiety-triggering stimuli until anxiety towards stimuli is eliminated. towards stimuli is eliminated.

Goal is to extinguish previously Goal is to extinguish previously learned response.learned response.

Key to enacting procedure is move Key to enacting procedure is move gradually. gradually.

Also called Graduated Exposure Also called Graduated Exposure TheoryTheory

Anxiety HierarchyAnxiety Hierarchy Before beginning the process of Before beginning the process of

systematic desensitation: therapists systematic desensitation: therapists have patients create an have patients create an anxiety anxiety hierarchy:hierarchy: list of fears related to list of fears related to phobia from least to most terrifying. phobia from least to most terrifying. Ex: School PhobiaEx: School Phobia– 1. Thinking about school (least 1. Thinking about school (least

terrifying)terrifying)– 2. Riding the bus2. Riding the bus– 3. Walking the halls3. Walking the halls– 4. Sitting in class (most terrifying)4. Sitting in class (most terrifying)

More Aggressive Exposure More Aggressive Exposure TherapyTherapy

Flooding:Flooding: involves involves immediately immediately exposing client to a exposing client to a stimulus that causes stimulus that causes undesirable response undesirable response to show that stimulus to show that stimulus isn’t dangerous. isn’t dangerous.

Flooding can lead to Flooding can lead to extinction of fear.extinction of fear.

Less Aggressive Exposure Less Aggressive Exposure Therapy (Not in Book)Therapy (Not in Book)

Implosion:Implosion: patient patient imagines stimulus imagines stimulus rather than being rather than being exposed to actual exposed to actual negative stimulus…negative stimulus…hopes to reduce hopes to reduce anxiety.anxiety.

Usually used as first Usually used as first step in systematic step in systematic desensitization.desensitization.

Using Virtual Reality For Using Virtual Reality For Exposure TherapyExposure Therapy

Second Type of Second Type of CounterconditioningCounterconditioning

2. 2. Aversive Conditioning:Aversive Conditioning: is the is the opposite of systematic opposite of systematic desensitization. Looks to reverse a desensitization. Looks to reverse a negative behavior by associating an negative behavior by associating an unpleasant state with an unwanted unpleasant state with an unwanted behavior.behavior.

How Could We Use Aversive How Could We Use Aversive Conditioning To Reform a Conditioning To Reform a

Convicted Child Molester?Convicted Child Molester?

Aversive Therapy for Aversive Therapy for AlcoholicsAlcoholics

UCS(drug)

UCR(nausea)

UCS(drug)

UCR(nausea)

CS(alcohol)

CS(alcohol)

CR(nausea)

Although initially successful why doesn’t aversive therapy usually stop people from permanently drinking?

Operant Conditioning Operant Conditioning TherapyTherapy What is Operant Conditioning?What is Operant Conditioning?

Token Economy:Token Economy: procedure procedure that rewards desired behavior. that rewards desired behavior. Patient exchanges a token of Patient exchanges a token of some sort, earned for good some sort, earned for good behavior, for various privileges behavior, for various privileges or treats.or treats.

Observational Learning’s Observational Learning’s Impact on TherapyImpact on Therapy

Bandura’s theories onBandura’s theories on modeling modeling were extended to therapy when it were extended to therapy when it was shown that was shown that Clients learn through Clients learn through observation of appropriate behavior observation of appropriate behavior (and (and Rewards) Rewards) and will be and will be encouraged to imitate the behavior.encouraged to imitate the behavior.

Criticism of Behavior Criticism of Behavior Therapy?Therapy?