Final Day in Psychology 107I. Treatment: Historical Perspectives in the USa. Early beliefs (1700s and earlier): Mental Illness is caused by evil spirits and is permanentb. Early 1800s  Second Great Awakeningi. Shift to view that people can be improvedii. Asylums become more prevalent as a form of treatmentiii. One focus: Moral therapy as a cure1. Religious training2. Occupational therapy3. Exercise, reacreation4. Hygiene Instruciton5. Activities for specific interests (e.g., painting, carpentry, gardening)iv. Other focus: treatment of acute issues1. Early treatments:a. Bloodlettingb. Spinning therapiesc. Cold bathsd. Sensory Deprivatione. Laxativesf. Opium & Morphinec. Late 1800’s early 1900si. Growing criticism of leaders (superintendents) of asylums1. Minimal funding, moral therapy ineffective, chronic cases demanding (schizophrenia, etc.),2. Movement toward (reintegration of psychiatry into medicine” (Grob, 1994)ii. New types of therapies1. Electroshock, lobotomiesa. By 1951, almost 20,000 lobotomies had been performed in the USd. Modern timesi. Psychological treatments (psychotherapy)ii. Biological treatmentsII. Psychodynamic Therapiesa. Freud and his followersb. The goal: to achieve insighti. Symptoms result from unconscious conflicts that were repressed during childhoodii. Understanding these conflicts alleviates mental illnessc. Techniques for accessing the unconsciousi. Free association 1. Say whatever comes to mind2. Stream of consciousnessii. Dream analysis1. People achieve unconscious wish fulfillment in their dreamsa. Their desires are satisfied2. Manifest content: the activities and senses in dreams3. Latent content: the unconscious hidden messages in dreamsiii. Transference1. Transferring thoughts or feelings from a past relationship onto the therapist2. Allows patients to have interactions that would otherwise be difficult or impossibled. Psychoanalysis in its original formi. Freudii. Therapist sits behind patientiii. Patient lies on a couchiv. 3-5 sessions a week for several yearsv. Some patients “untreatable”e. Newer psychodynamic psychotherapiesi. Freud’s followersii. Face to Faceiii. More interactive conversationiv. More goal-directed and much brieferv. Focus on early traumatic experiences; exploring daydreams & fantasies; emphasize relationship with therapistf. Freud’s lasting contributions to therapyi. Fostering insight into unconscious desires/ conflictsii. Transferenceiii. Remember, Freud made contributions to psychology as a science as well (e.g., the introduction of the unconscious)III. Cognitive & Behavioral Therapiesa. Behavioral Therapyi. Based on learning theory (behaviorism)ii. The goal is to alter maladaptive behaviorsiii. Not concerned with underlying psychological processesiv. Strives to fix the behavioral problem, not the underlying cause v. Classical conditioning1. To treat anxiety idosrders, you want extinction2. Exposureb. Cognitive Therapyi. Identify & correct distorted thinkingii. Cognitibe Restructuring: question automatic beliefs, assumptions, & predicitons that lead to negative emotions; replace them with more realistic & positive beliefsiii. Cognitive Behavioral Therapy (CBT)1. Blends behavioral therapy with cognitive restructuring techniques2. “problem focuse” and “action oriented”3. Transparent  nothing withheld form the clientIV. Biological Treatments a. the goal is alter the body’s biological functioningi. Often very effective, especially when used with therapyii. Can lead to unpleasant side effects b. Pharmacotherapy: Using medicine to treat mental disordersi. Anti-anxiety druges (tranquilizers) (e.g., Valiam, Xanax)1. Benzodiazepines (facilitates the NT GABA)2. Side effects: Drowsiness, memory, loss of coordination, tolerance, and withdrawalii. Antidepressants e.g., Prozac, Wellbutrin)1. SSRIs, SNRIs2. Side effects: Nausea, headaches, loss of sexual interest)3. Only really useful for depression, not making people extra happy4. Not a good treatment for bipolar disorderiii. Anti-psycotics (e.g., Thorazine, Clozaril)1. Dopamine( & sometimes serotonin) blockers2. Made schizophrenia much more manageable, and many were released from asylums in the 1960s3. Side effects often require additional meds4. Tardive dyskinesia: a condintoin of involuntary movemtns of the face, mouth and extrematiesc. Electroconvulsive therapy (ECT): administering electrical shock to induce a seizurei. “shock therapy”ii. Often effective fore severe depressioniii. Typically used as a last