PSY 0010 notes Treatments for Psychological Disorders page 1 Treating psych disorders for most of history primitive and often harmful o medical treatments in general moral reforms late 18th century o humane treatment in asylums Philippe Pinel medical model late 19th century o diagnostic categorization of mental illnesses Emil Kraepelin effective methods for relieving psychological suffering 20th century Psychotherapy providing relief from psych emotional behavioral problems and suffering through talking and other forms of interaction Psychoanalysis first form of psychotherapy Hysteria and hypnosis Jean Martin Charcot 1862 o glove anesthesia complaint of no sensation in hand doesn t make any sense physiologically physical symptoms without physical causes o could induce hysteria via hypnosis in prone individuals Breuer Freud 1895 o Anna O hydrophobia can t drink water hypnotized recalls a dog drinking from a glass removed from trance asks for a glass of water and drinks without problem the symptom had a meaning of which Anna was not aware we can become unaware of what upsets us the memory and her revulsion were expressed indirectly symbolically by the symptom making Anna aware of the meaning relieved the symptom therefore the indirect expression was no longer needed once something is conscious there s no need to exhibit symptoms the dynamic unconscious forgetting painful experiences and also being unaware of uncomfortable feelings and wishes can be motivated the psychopathology of everyday life o parapraxes Freudian slips o jokes o dreams defense mechanisms maneuvers to minimize anxiety performed without our awareness o repression motivated forgetting of memories desires women 38 treated for sexual abuse as children did not recall it as adults o denial motivated forgetting of distressing external experiences o projection attribution of characteristics or feelings we have but don t want to have to others PSY 0010 notes Treatments for Psychological Disorders page 2 o rationalization providing a reasonable sounding explanation for behavior motivated by unacceptable desires o displacement directing a desire from an unacceptable target onto a safer one Freudian personality theory id it unconscious biological energies experienced psychologically as drives o libido aggression o the pleasure principle release of energy satisfaction of drives and reduction of tension is pleasurable o demands immediate gratification ego I source of conscious rational thinking o functions according to the reality principle seek satisfying objects of desire postpone gratification until it is safe superego over I source of moral judgment o comes into being through internalization of parents moral standards during childhood a child s understanding of right and wrong what is permitted and what is prohibited black and white thinking harsh and punitive judgments the ego has three masters whose demands often conflict with each other o id gratify libidinal and aggressive urges o reality do not put self in danger o superego do not violate moral standards Post Freudian psychoanalytic personality theory ego psych ego has its own motives o development of cognitive abilities behavior skills and impulse control Karen Horney basic motive is to feel loved wanted safe Heinz Kohut basic motive is self esteem o positive views of the self The adult personality objects of desire and forms of satisfaction are established in childhood o continue to be sources of good feeling o may seem unacceptable or unsafe conflicts result in mental compromises o what we desire is forced out of awareness o satisfaction comes in disguise through a variety of behaviors and relationship patterns o accompanied by anxiety shame guilt self punishment Psychoanalytic therapy psychoanalytic technique o patient free association on the couch PSY 0010 notes Treatments for Psychological Disorders page 3 circumventing the censor of conscious awareness o analyst blank screen leads the patient to displace and project his her wishes and fears onto the analyst so they can be analyzed transference o analyst interprets unconscious meanings dreams jokes slips symptoms resistance defenses transference o patient works through insights into hidden meanings of behavior feelings thoughts accept what can t be changed change what can o meet 3 5 times per week for years psychodynamic psychotherapy o variety of approaches emphasis may be on emotional expression relationship patterns self esteem o importance of therapeutic relationship supportive as well as expressive component o meet 1 2 times per week face to face maybe time limited 16 26 weeks o common threads accepting unacknowledged wishes overcoming fears often formed in childhood that keep us from obtaining them understanding connections between current and past relationships as a way to improve current relationships recognizing ways in which we limit or defeat ourselves without knowing it Person centered theory Carl Rogers o persons strive to actualize their potentials and grow in positive constructive creative relational maturing o from infancy onward we engage in an ongoing process of valuing all directions we encounter self concept develops from what we value in ourselves and how we are valued by others o from infancy onward we also have a need for positive regard love approval esteem o when who we are is valued unconditionally prized we are free to develop ourselves in the direction of self actualization by trusting our own valuing process o conditions of worth messages from others about how we must act and think in order to be worthwhile when internalized an ideal self forms that is in tension with our real self o denial and distortion PSY 0010 notes Treatments for Psychological Disorders page 4 defenses against awareness of the real self employed to meet conditions of worth defenses can fail intense anxiety and distress disorganization o wellbeing requires reversing these patterns decrease power of conditions of worth o fully functioning person openness to experience trust in self creativity appreciation of deep intimate relationships valuing others self actualization process 3 therapist provided conditions of growth o empathy communication of accurate understanding of the client s experience as if from inside o unconditional positive regard nonjudgmental acceptance warm and prizing o genuineness congruence in the relationship further developments o experiential emotion focused therapies 3 conditions plus