Therapy Approaches • Biological Treatment • Surgery & Electroshock • Psychotherapy • The Power of Forgiveness
Biological TreatmentsDrugs • 1-Antipshchotic Drugs • 2-Antidepressant Drugs • 3-Tranquilizers • 4-Lithium Carbonate
1-Antipsychotic Drugsor Neuroleptics Good for treating psychosis and schizophrenia Examople: Thorazine Reduce receptivity to dopamine or increase serotonin Reduce positive symptoms of schizophrenia Do not relieve other negative symptoms Can have dangerous side effect: tardive dyskinesia & neurolyptic malignant syndrome
Good for reducing: Agitation Delusions Hallucinations Can shorten schizophrenic episodes Offers little relief from: Jumbled thoughts Difficulty concentrating Inability to interact with others Antipsychotic Drugsand Schizophrenia
2-Antidepressant Drugs • Treat depression, anxiety, phobias, OCD • Example: Prozac, Zoloft, and Paxil • Non addictive but can cause side effects • 1-Monoamine oxidase inhibitors (elevate levels of ser. & nor. by blocking inhibitors) • 2-Tricyclic antidepressants (boost nor. & ser. by preventing their reabsorption) • 3-Selective serotonin reuptake inhibitors (work on serotonin)
3-Tranquilizers • Prescribed for depressed mood, panic, and anxiety • Example: Valium • Increase activity of neurotransmitter GABA • If overused can result in tolerance and withdrawal
4-Lithium Carbonate • Prescribed for bipolar disorder • Can be dangerous if not given in the right doze
Cautions about Drugs • Placebo effect • Relapse and drop out rates • Dosage problems • Long-term risks • Overprescription • Sometimes they have to be with therapy
The Placebo EffectKirsch and Sapirstein (1998) • 7315 participants • 41% of those receiving antidepressants experienced reduced symptoms. • 31% of those given placebos also received reduced symptoms.
Surgery & Electroshock • Psychosurgery • Shock Therapy
Psychotherapy • Psychodynamic • Behavioral • Cognitive • Humanistic/Existential • Therapy in Social Context
Psychodynamic Therapy • Probes the past • Doesn’t tackle the immediate problem • The goal is insight • Takes a long time • Explores the unconscious • Methods: free association, interpretation of dreams, & transference
Interpretation The analyst noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight. • Resistance In psychoanalysis, the blocking from consciousness of anxiety-laden material. • Transference The patient’s transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)
Behavioral Techniques Learning Conditioning Association between Environmental Stimuli + Response Classical Conditioning Operant Conditioning Association Reinforcement/ Stimulus-Response Punishment
Behavioral Techniques • There are no mental processes (will, mind) • Derived from classical and operant conditioning • The focus is on changing the behavior • Works on the immediate problem • Focuses on the present
Classical Conditioning • Ivan Pavlov • Conditioning Learning that involves associations between environmental stimuli and the organism’s responses • Stimulus-response Learning
Classical Conditioning in Real Life • Learning to like • Learning to fear • Accounting for Taste • Reacting to Medical Treatment
Operant Conditioning • The behavior is more likely or less likely to occur based on its consequences. • B. F. Skinner modified Pavlov’s concept. • Skinner used reinforcement and punishment to enhance learning.
Behavioral Techniques • Systematic Desensitization/Counter Conditioning • Aversive Conditioning • Exposure Treatment (Flooding) • Behavioral Records & Contracts • Skills Training
Systematic Desensitization • Fear of Flying • Read about safety • Look at pictures of airplanes • Visit an airport • Take a short flight • Take a long flight • Fear is extinguished • Counterconditioning
Cognitive Therapy • Albert Ellis (Rational Emotive Behavior Therapy) • Aaron Beck
Cognitive Distortions • Labeling • Mind Reading • Exaggeration • Unrealistic Expectations • Belief in Entitlement • Belief in Absolute Fairness
Hot Thoughts He is always mean to me. I did a lousy job. I deserve better. It’s not fair. That jerk! They’re driving me crazy. Cool Thoughts Maybe he had a bad day. It’ll be better next time But people are people Life is not fair. It’s his problem! Just don’t accept the ride. Fighting Dysfunctional Thought
Humanistic/ExistentialTherapy • Works on self-fulfillment and self-actualization • Does not delve into the past • Helps the client think about the present and the future • Helps people feel good about themselves • Tackles conscious rather than unconscious thoughts
Carl RogersClient-Centered TherapyPerson-Centered Therapy • The therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate clients’ growth.
Carl RogersClient-Centered Therapy • Offers unconditional positive regard • No specific techniques • Therapist should be warm, genuine and empathetic • Client adopts these views and becomes self-accepting • Promotes growth instead of curing illness.
Active Listening • Paraphrase. Summarize the speakers words in your own words. • Invite Clarification. Encourage the speaker to say more. • Reflect Feelings. Reflect what you’re sensing from the speakers words and body language.
Existential Therapy • Helps client explore meaning of existence • Helps client choose a destiny • Helps client accept self-responsibility.
Therapy in Social Context • Family Therapy • Family Kaleidoscope • Family Systems • Group Therapy
Communication ApproachVirginia Satir • Offered description of conjoint family therapy • Emphasized growth enhancing techniques to evoke feeling and clarify family communications patterns • (dance, massage, sensory awareness, group encounter techniques)
Contextual Family TherapyIvan Boszormenyi-Nagy • Effective family therapy must attend to family context especially to those dynamic and ethical connections – past, present, future – that bind families together
The Structural ApproachSalvador Minuchin • The individual’s symptoms are best understood as rooted in the context of family transaction patterns. • The family’s hierarchical organization • The wholeness of the family system • The interdependent functioning of its subsystems • Enmeshment The family boundaries are too diffuse to allow for individual autonomy
Strategic ApproachJay Haley • The therapist devices a strategy for solving the client’s present problems • Goals are clearly set • Therapy is carefully planned to achieve these goals
Object Relations • Introjects – the psychological representations of external objects • The most powerful obstacle to change is people’s attachment to their parental introjects
Family Systems TheoryMultigenrationalMurray Bowen • Conceptualizes the family as an emotional unit, a network of interlocking relationships, best understood when analyzed within a multi generational or historic framework • Genograms
When Therapy Helps • When clients have enough sense of self • When clients have enough distress to motivate them to change • When therapists are warm and empathetic • When client and therapist establish a good rapport • Hostile, negative clients are less likely to benefit
When Therapy Harms • Bias on the therapist’s part because of gender, religion, or race • Coercion by the therapist to accept his/her advice • Coercion by the therapist to have sexual intimacy
Alternatives to Psychotherapy • Community Psychologists • Half-way houses • Clubhouse model • Foster care • Family support groups • Rehabilitation Psychologists • Epilepsy, physical injury, arthiritis, chronic pain
The Power of Forgiveness • Giving up grudges can reduce chronic back pain • Forgiveness limited the number of relapses among women battling substance abuse problems. • Using MRI scans to explore how just thinking about empathy and reconciliation sparks activity in the brains left middle gyrus, suggesting we all have a mental forgiveness center set to be tapped.
The Power of Forgiveness • Cortisol’s depressive effect on the immune system has been linked to serious disorders. • Forgiveness stops the cortisol and adrenaline from flowing.
American Psychosomatic SocietyA Study • 36 male veterans who had coronary artery disease and who were also burdened by other war-related issues • Those who received forgiveness training showed greater blood flow to the heart.