Treatment of psychological disorders involving psychological techniques Interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth 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 run parallel • 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 History of Psychotherapy
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 Therapists
Insight Therapies • Psychoanalysis • Client-Centered (Humanistic) • Behavior • Cognitive • Cognitive-Behavioral Types of 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 Insight Therapies
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, 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!) Psychoanalysis
Unearth the past in hope 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 Elements of Psychoanalysis
Interpretations cannot be proven or disproven Psychoanalysis is therapy, not science (according to proponents) Does it Work?
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 Psychodynamic 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 Humanistic Therapy
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 Cont.