Psychotherapy: Psychotherapy: healing of healing of the the soulsoul Early beliefs: troubled peopleEarly beliefs: troubled people— possessed by demons— possessed by demons

Later term: mental illnessLater term: mental illness Mental illness: no longer Mental illness: no longer considered an appropriate term considered an appropriate term Implies a passive, helpless person Implies a passive, helpless person Problems caused by forces over Problems caused by forces over which she/he has no controlwhich she/he has no control Person can avoid responsibility Person can avoid responsibility

The primaryThe primary goal of goal of psychotherapy is to strengthen psychotherapy is to strengthen the patient’s control over his/the patient’s control over his/ her lifeher life

People who feel trapped in People who feel trapped in behavior patterns behavior patterns Psychological conditions Psychological conditions cause a lack of freedomcause a lack of freedom with limited options inwith limited options in choosing directions choosing directions lives will take lives will take

For psychotherapy to work,For psychotherapy to work, the the client client (patient) must achieve(patient) must achieve some understanding of his/her some understanding of his/her troubles troubles

Another major Another major task of therapy task of therapy is tois to help help thethe patient find patient find meaningful meaningful alternatives to alternatives to hishis present present unsatisfactory unsatisfactory way of behaving way of behaving

Key factor: patient’s belief or hope Key factor: patient’s belief or hope that he can change that he can change

One danger One danger in in therapy is thattherapy is that

sometimes sometimes patients patients become become heavily heavily

dependent on dependent on therapists therapists

Patients often try to avoid Patients often try to avoid problems by using the therapist problems by using the therapist as a substitute parent or by as a substitute parent or by blaming him blaming him for their misfortunes for their misfortunes

Patients who get the most Patients who get the most out of psychotherapy are people out of psychotherapy are people with high intelligence, good with high intelligence, good education and middle class education and middle class backgrounds backgrounds

Identify Identify closelycloselywith their with their therapists therapists

Those who Those who benefit most: benefit most: relatively mild relatively mild problems; problems; introspective;introspective;withstand frustration withstand frustration

Differences from old stereotype Differences from old stereotype

Wide range of problems Wide range of problems besides the besides the serious DSM-IV disordersserious DSM-IV disordersAction, as well as talk & Action, as well as talk & interpretation interpretation

Trust Trust

Client and therapist must be able to Client and therapist must be able to work together as allies, on the same work together as allies, on the same side, toward same goalsside, toward same goals

Therapeutic processTherapeutic processSome or all:Some or all:Identifying the problemIdentifying the problemIdentifying the cause of the problemIdentifying the cause of the problemDeciding on and carrying out some Deciding on and carrying out some form of treatment form of treatment

Three characteristics of Three characteristics of effective therapists: effective therapists: Psychologically Psychologically healthy healthy

Experienced in dealing with people Experienced in dealing with people See through patients’ games See through patients’ games played to trick therapists played to trick therapists

Empathy—a capacity Empathy—a capacity for warmth and for warmth and understanding understanding

Kinds of therapists Kinds of therapists

Clinical psychologists: Clinical psychologists: therapists therapists with Ph.D.; have completed a 3-4 with Ph.D.; have completed a 3-4 year research-oriented program year research-oriented program in psychology plus an internship in psychology plus an internship in psychotherapy and psychological in psychotherapy and psychological assessment; some have a Psy.D: assessment; some have a Psy.D: a Doctor of Psychologya Doctor of Psychology

Kinds of therapists Kinds of therapists Counseling psychologists: Counseling psychologists: masters masters or Ph.D. in counseling; usually or Ph.D. in counseling; usually work in educational institutions;work in educational institutions; work dealing with personal work dealing with personal problems problems Clinical neuropsychologists: Clinical neuropsychologists: Ph.D. Ph.D. with education similar to clinical with education similar to clinical psychologists; extensive education psychologists; extensive education in mechanisms & operation of in mechanisms & operation of the brain; work with brain injury the brain; work with brain injury patientspatients

Kinds of therapists Kinds of therapists Psychiatrists: Psychiatrists: M.D. who specialize M.D. who specialize in treatment of mental illness; in treatment of mental illness; post-graduate training in abnormal post-graduate training in abnormal behavior; licensed to prescribe behavior; licensed to prescribe medicines & medicines & only group only group who can who can perform perform operationsoperations

Kinds of therapists Kinds of therapists

Psychoanalysts—M.D.; training in Psychoanalysts—M.D.; training in personality theory & techniques personality theory & techniques of of Sigmund Freud. Sigmund Freud. Must be psycho-Must be psycho-analyzed themselves before analyzed themselves before practicepractice

Kinds of therapists Kinds of therapists Lay analysts: Lay analysts: psychoanalysts psychoanalysts who do not have degrees in who do not have degrees in medicine but who have studied medicine but who have studied with established psychoanalystswith established psychoanalysts Psychiatric social workers: Psychiatric social workers: people people with masters degrees in social with masters degrees in social work work Paraprofessionals: Paraprofessionals: clergy, clergy, physicians, teachers, others who physicians, teachers, others who dispense considerable advice with dispense considerable advice with little or no formal training in little or no formal training in therapy or counseling therapy or counseling

Kinds of therapists Kinds of therapists Psychiatrists: The American Psychiatrists: The American Psychological Association is presentlyPsychological Association is presentlydiscussing recommending a discussing recommending a regulation regulation change thatchange thatwould would permitpermitpsychologistspsychologiststo prescribeto prescribemedication medication

Behavioral: focuses primarily Behavioral: focuses primarily on on change in behaviorchange in behavior

Kinds of psychotherapy Kinds of psychotherapy Insight therapy:Insight therapy:help people help people understand understand their problems—their problems—change thoughts,change thoughts,motives, feelingsmotives, feelings

Insight Therapy Insight Therapy Attempts to change people on Attempts to change people on the inside—the way they think the inside—the way they think and feeland feelAKA talk therapiesAKA talk therapies—share the —share the assumption that distressed assumption that distressed persons need to develop an persons need to develop an understanding of the disordered understanding of the disordered thoughts, emotions, and motives thoughts, emotions, and motives that underlie their mental that underlie their mental difficulties difficulties

Basis: anxiety Basis: anxiety about hidden about hidden conflicts conflicts between the between the unconscious components of one’sunconscious components of one’s personality personality

Based on Based on Freud’s theories Freud’s theories

Kinds of psychotherapy Kinds of psychotherapy Psychoanalysis Psychoanalysis

Kinds of psychotherapy Kinds of psychotherapy Psychoanalysis Psychoanalysis Provide insight: Provide insight: patient patient awarenessawareness of of unconscious impulses,unconscious impulses, desires, and fears desires, and fears thatthat are causing the anxietyare causing the anxiety Slow procedure—Slow procedure—assists assists

patient in a thorough patient in a thorough examination of the examination of the unconscious motives unconscious motives behind behaviorbehind behavior

Psychoanalysis Psychoanalysis PsychoanalysisPsychoanalysis begins with begins with free free associationassociation: talk about everything : talk about everything that comes into her mindthat comes into her mindAnalyst suggests that the patient Analyst suggests that the patient express everything that comes to express everything that comes to mind—mind—even what apparently is even what apparently is inconsequential may have a inconsequential may have a bearing on the problembearing on the problem Patient comfortable; analyst often Patient comfortable; analyst often says little or nothing; just asks says little or nothing; just asks guiding questionsguiding questions

Resistance: unconsciously Resistance: unconsciously holding holding back information back information

Usually,Usually, at first, at first, thethe patientpatient isis reluctant to reveal reluctant to reveal painful feelings and to examine painful feelings and to examine lifelong patterns lifelong patterns that need to that need to be changed be changed

Psychoanalysis Psychoanalysis

Psychoanalysis Psychoanalysis Eventually, the analyst begins to Eventually, the analyst begins to appear in the patient’s appear in the patient’s associations & dreams associations & dreams Process of Process of TransferenceTransference—begins —begins to feel toward the to feel toward the analyst what she/he analyst what she/he feels toward other feels toward other important people important people in her/his life in her/his life

Psychoanalysis Psychoanalysis Transference: may allow the Transference: may allow the patient to experience true feelings patient to experience true feelings toward the important person toward the important person Therapist must remain impersonal Therapist must remain impersonal to prevent the to prevent the patient from patient from treating the treating the therapist as he/ therapist as he/ she would the she would the important important person person

Psychoanalysis Psychoanalysis By eventually understanding By eventually understanding transference, the patient becomes transference, the patient becomes aware of real feelings and motives aware of real feelings and motives

One danger: can lead to One danger: can lead to symptomsymptom substitutionsubstitution—one symptom disappears—one symptom disappearsonly to be replaced by anotheronly to be replaced by another

Neo-Freudian Psychodynamic TheoriesNeo-Freudian Psychodynamic TheoriesTreat face-to-faceTreat face-to-faceOnce a week for a few monthsOnce a week for a few monthsDon’t spend as much time probing for Don’t spend as much time probing for hidden conflicts and repressed memorieshidden conflicts and repressed memoriesAlso: ego rather than id Also: ego rather than id Influence of life experiences post-childhoodInfluence of life experiences post-childhoodRole of social needs/interpersonal relationsRole of social needs/interpersonal relationsThe most eclectic form of therapyThe most eclectic form of therapy

Existential crises:Existential crises:Problems in everyday existence Problems in everyday existence

Low self-esteem Low self-esteem

Feelings of alienation Feelings of alienation

Failure to achieve all you feel Failure to achieve all you feel you shouldyou should

Difficult relationships Difficult relationships

Humanist Theories Humanist Theories People motivated by healthy needs People motivated by healthy needs for growth and psychological well-for growth and psychological well- being being Focus on the whole person engaged Focus on the whole person engaged in a continual process of change in a continual process of change Therapies help clientsTherapies help clients confront their problemsconfront their problems by recognizing their ownby recognizing their own freedom, enhancingfreedom, enhancing self-esteem, and self-esteem, and realizing fullest potentialrealizing fullest potential

Humanist Theories Humanist Theories Carl Rogers Carl Rogers Stressed Stressed actualization actualization of a person’s unique of a person’s unique potential through potential through personal personal responsibility, responsibility, freedom of choice, freedom of choice, and authentic and authentic relationships relationships Rogers: person centered therapy Rogers: person centered therapy

Humanist Theories Humanist Theories People are basically good and People are basically good and capable of handling their own capable of handling their own lives lives Goals of therapy: help client Goals of therapy: help client realize his own strength & realize his own strength & confidence; be able to live confidence; be able to live effectively by being true to effectively by being true to own standards and ideas own standards and ideas

Therapist encourages the client to Therapist encourages the client to speak freely about intimate speak freely about intimate matters that may be bothering him. matters that may be bothering him.

Therapist:Therapist: listens and listens and encourages encourages conversation, but conversation, but avoids giving avoids giving opinions opinions

Therapist tries to echo back as Therapist tries to echo back as clearly as possible the feelings clearly as possible the feelings the client has expressed the client has expressed Client and therapist together form Client and therapist together form a clearer picture of how client a clearer picture of how client feels about himself, his life & people feels about himself, his life & people around him.around him.

Person-centered therapy Person-centered therapy is conducted in anis conducted in an atmosphere atmosphere of emotional support—unconditional of emotional support—unconditional positive regardpositive regard

Therapist never says what she Therapist never says what she thinks about the client thinks about the client Therapist shows the client that Therapist shows the client that she will accept anything said she will accept anything said without embarrassment without embarrassment

Warm and accepting relationship Warm and accepting relationship

As theAs the client client reduces tensions, reduces tensions, and releases emotions,and releases emotions, feels that feels that he/she is becoming a more he/she is becoming a more complete person.complete person.Gains courage to accept parts of Gains courage to accept parts of personality he/she formerly personality he/she formerly considered weak or bad, considered weak or bad, and by and by recognizing his/her self worth & recognizing his/her self worth & can then set realistic goals & can then set realistic goals & consider steps needed to meetconsider steps needed to meetthemthem

Cognitive Therapies Cognitive Therapies Focus on changing the way Focus on changing the way people think people think

Basic assumption: faulty Basic assumption: faulty cognitions—irrational or cognitions—irrational or uninformed beliefs, expectations, uninformed beliefs, expectations, and ways of thinking—distort and ways of thinking—distort our actions, attitudes, and our actions, attitudes, and emotions emotions To improve lives, people need to To improve lives, people need to change thinking patterns change thinking patterns

Cognitive-Behavior Therapy Cognitive-Behavior Therapy

Aaron T. Beck Aaron T. Beck Use persuasion and Use persuasion and logic to change the logic to change the patient’s existing patient’s existing beliefsbeliefs

Encourage patients to test their Encourage patients to test their own beliefs through “homework” own beliefs through “homework” assignments assignments

Group Therapy Group Therapy Practical experience in getting Practical experience in getting along with others along with others Can see how other people are Can see how other people are struggling struggling with problems similar with problems similar to theirs to theirs Also discover what others think Also discover what others think of them of them People can express what they People can express what they think of others in the group—can think of others in the group—can see mistakes in views of self and see mistakes in views of self and of others & see where correct of others & see where correct

Group Therapy Group Therapy Factors that make group Factors that make group therapy therapy effective: effective: Hope Universality Hope Universality InformationInformation Altruism Modeling Altruism Modeling Corrective recreation of Corrective recreation of primary primary family social skills family social skills

Factors that make group therapy Factors that make group therapy effective: effective:

Interpersonal learning Interpersonal learning Group cohesivenessGroup cohesivenessCatharsis—people can express Catharsis—people can express feelings and vulnerability feelings and vulnerability Existential factors Existential factors

Group Therapy Group Therapy Examples of self-help groups Examples of self-help groups

Alcoholics Anonymous Weight WatchersWeight Watchers

Mutual encouragement, friendship,Mutual encouragement, friendship, emphasis on person responsibility emphasis on person responsibility

Group Therapy Group Therapy Other forms of group therapy Other forms of group therapy Family therapyFamily therapy——untangle twisted untangle twisted webs of relationships that have webs of relationships that have led one or more members in the led one or more members in the family to experience emotional family to experience emotional suffering suffering Self-help groupsSelf-help groups—people who share —people who share a common problem, a common problem, often often conducted without the active involve-conducted without the active involve- ment of professional therapistsment of professional therapists

Behavior Therapy Behavior Therapy Much more emphasis on action Much more emphasis on action

Therapist concentrates more Therapist concentrates more on on finding out what is finding out what is specifically specifically wrong with the patient’s wrong with the patient’s current current life and takes steps to life and takes steps to change it change it

Concept: disturbed people have Concept: disturbed people have learnedlearned to behave in the wrong to behave in the wrong way way Therapist must, therefore, Therapist must, therefore, re-educate the patientre-educate the patient

Reasons forReasons forundesirable undesirable behavior not behavior not important;important;

What is important: change behavior What is important: change behavior

Therapist uses conditioning Therapist uses conditioning techniques first discovered on techniques first discovered on animals in laboratoriesanimals in laboratories

Mary Cover Jones Mary Cover Jones (1924)(1924)Desensitized “Peter’s” Desensitized “Peter’s” intense fear of a rabbitintense fear of a rabbit

Classical conditioning in Classical conditioning in humanshumansHobart & Mollie Mowrer (1938) Hobart & Mollie Mowrer (1938) Bed-wetting:Bed-wetting: the the bell and pad bell and pad Alarm = UCS Alarm = UCS Waking = URWaking = URFull bladder = CSFull bladder = CSUCS + CS= UCS + CS= Child wakes (CR) Child wakes (CR)

Used to overcome Used to overcome irrational fears and irrational fears and anxieties the patient anxieties the patient has learned has learned

One behavior therapy One behavior therapy technique: technique: systematic systematic desensitizationdesensitization

Goal: encourage patients to imagine Goal: encourage patients to imagine the feared situation while relaxing, the feared situation while relaxing, thus extinguishing the fear response thus extinguishing the fear response

Joseph WolpeJoseph Wolpe

Example: intense fear of Example: intense fear of public speaking public speaking Therapist might have Therapist might have studentstudent make a list make a list of all aspects of talking of all aspects of talking with others that are with others that are frightening frightening

Next, patient rank orders Next, patient rank orders those fears—those fears—most to least most to least frighteningfrightening Next, the therapist begins teaching Next, the therapist begins teaching

the patient how to relax the patient how to relax

Consider this hierarchy of fears Consider this hierarchy of fears constructed constructed by a person who is fearful of death by a person who is fearful of death 1.1. Seeing a dead person in a coffin Seeing a dead person in a coffin

2.2. Being at a burialBeing at a burial3.3. Seeing a distant burial assemblageSeeing a distant burial assemblage4.4. Reading the obituary of a young person Reading the obituary of a young person who died of a heart attackwho died of a heart attack5.5. Driving past a cemeteryDriving past a cemetery6.6. Seeing a funeralSeeing a funeral7.7. Passing a funeral homePassing a funeral home8.8. Reading the obituary of an old personReading the obituary of an old person9.9. Being inside a hospitalBeing inside a hospital10.10. Seeing an ambulance Seeing an ambulance

Once patient knows how to really Once patient knows how to really relax: next step relax: next step Patient tries to imagine as vividly Patient tries to imagine as vividly as possible the least disturbing as possible the least disturbing thing on the list. thing on the list. May think that speaking to a May think that speaking to a single stranger and feel a mild single stranger and feel a mild anxiety. Because therapist has anxiety. Because therapist has taught him how to relax, the taught him how to relax, the the patient learns to think about the patient learns to think about the experience without fear. the experience without fear.

Counter conditioning: Counter conditioning: therapist attempts to replace therapist attempts to replace anxiety with its opposite—anxiety with its opposite— relaxation relaxation Follow that procedure step-by-step Follow that procedure step-by-step through the patient’s list of through the patient’s list of anxiety-arousing events anxiety-arousing events Patient reaches a point where he Patient reaches a point where he is able to imagine the situations is able to imagine the situations that threaten him the most that threaten him the most without feeling anxiety without feeling anxiety

Systematic Desensitization Systematic Desensitization Next the therapist starts to expose Next the therapist starts to expose the patient to real-life situations the patient to real-life situations that have previously frightened that have previously frightened him. Continues until the client him. Continues until the client can give a speech in front of an can give a speech in front of an audience audience

Virtual Reality and Systematic Virtual Reality and Systematic Desensitization Desensitization

Computer-generated images expose Computer-generated images expose phobic patients to fearful situations inphobic patients to fearful situations in a safe virtual reality environment a safe virtual reality environment

Aversion therapy Aversion therapy Drug addiction, certain sexual Drug addiction, certain sexual attractions, tendencies to violence attractions, tendencies to violence

Designed to make tempting stimuli Designed to make tempting stimuli less provocative by pairing by less provocative by pairing by pairing them with unpleasantpairing them with unpleasant(aversive) stimuli (aversive) stimuli

Behavior therapy Behavior therapy Contingency Management Contingency Management

Therapist & patient decide what Therapist & patient decide what old, undesirable behavior needs old, undesirable behavior needs to disappear and what new, to disappear and what new, desirable behavior needs to appear.desirable behavior needs to appear.

Contingency Management Contingency Management Next, arrangements are made to Next, arrangements are made to reinforce desired behavior and reinforce desired behavior and for old behavior to go unrewarded for old behavior to go unrewarded Reward is contingent (dependent)Reward is contingent (dependent)on the desired on the desired behavior behavior

Behavior therapy Behavior therapy

Therapy group project Therapy group project Write a script for and be prepared to Write a script for and be prepared to act out a therapy sessionact out a therapy sessionPsychoanalysis for histrionic person-Psychoanalysis for histrionic person- ality disorderality disorderPerson (client)-centered therapy for Person (client)-centered therapy for hypochondriasis hypochondriasis Cognitive-Behavior therapy for Cognitive-Behavior therapy for depressiondepressionFamily therapy for a dysfunctional Family therapy for a dysfunctional familyfamilyCouples therapy (marital problems)Couples therapy (marital problems)Systematic desensitization for a Systematic desensitization for a panic disorderpanic disorderParticipant Modeling therapy for a Participant Modeling therapy for a phobiaphobia..

Contingency Management Contingency Management Behavior therapy Behavior therapy

Used in mental hospitals and Used in mental hospitals and prisons—miniature system of prisons—miniature system of rewards called rewards called token economiestoken economies

People learn fears by observing othersPeople learn fears by observing othersParticipant Modeling Therapy Participant Modeling Therapy

Client observes or imitates anotherClient observes or imitates another person who is modeling desirable person who is modeling desirable behaviorsbehaviors

Symbolic modelingSymbolic modelingDesensitization therapy Desensitization therapy

Cognitive-Behavioral Therapy Cognitive-Behavioral Therapy Combines a cognitive emphasis on Combines a cognitive emphasis on thoughts and attitudes with thoughts and attitudes with behavioral strategies (dual approach)behavioral strategies (dual approach)Therapist and client work together to:Therapist and client work together to:

Modify irrational self-talkModify irrational self-talkSet attainable behavioral goalsSet attainable behavioral goalsDevelop realistic strategiesDevelop realistic strategiesEvaluate resultsEvaluate results

Rational-Emotive Therapy Rational-Emotive Therapy Albert Ellis Albert Ellis

People behave in deliberate, People behave in deliberate, rational ways, given theirrational ways, given their assumptions about life.assumptions about life. Emotional problems arise Emotional problems arise when an individual’s when an individual’s assumptions are assumptions are unrealistic unrealistic Therapist does not look for past Therapist does not look for past incidents that make the present incidents that make the present unbearable for the patientunbearable for the patient

Rational-Emotive Therapy Rational-Emotive Therapy Goal: to correct a patient’s false Goal: to correct a patient’s false and self defeating beliefs.and self defeating beliefs.

Rejection is unpleasant, but Rejection is unpleasant, but not unbearable not unbearable

Goal: teach the individual to think Goal: teach the individual to think in realistic termsin realistic terms

Rational-EmotiveRational-Emotive Therapy Therapy Therapy techniques: Therapy techniques: Role-playingRole-playing—see how beliefs —see how beliefs affect relationshipsaffect relationships Modeling—Modeling—to demonstrate other to demonstrate other ways of thinking and actingways of thinking and acting HumorHumor—to underline the —to underline the absurdity of beliefsabsurdity of beliefs Simple persuasion Simple persuasion

Rational-Emotive Therapy Rational-Emotive Therapy Ellis: patient must take three Ellis: patient must take three steps to cure or correct selfsteps to cure or correct self

Realize that some of his Realize that some of his assumptions are false assumptions are false

Must realize that he/she is Must realize that he/she is making making himself/herselfhimself/herself disturbed disturbed by acting on false beliefs by acting on false beliefs Must work to break old habits Must work to break old habits of thought and behaviorof thought and behavior

Must practice, learn self-discipline, Must practice, learn self-discipline, and take risks and take risks

Cognitive-Behavioral Therapy Cognitive-Behavioral Therapy Changes people’s minds as well as Changes people’s minds as well as changing the brain itselfchanging the brain itselfRe-label experiences as obsessionsRe-label experiences as obsessions or compulsions rather than or compulsions rather than rational thinkingrational thinkingWait out urges by distracting Wait out urges by distracting themselves for about 15 minutes themselves for about 15 minutes

Over time, part of brain responsible Over time, part of brain responsible for irrational fears becomes less for irrational fears becomes less active active

Consumer Reports Consumer Reports

Therapy worksTherapy worksLong-term better than Long-term better than short term short term All forms are aboutAll forms are about equal in effectiveness equal in effectiveness

Hans Eysenck Hans Eysenck

Roughly two-thirds of allRoughly two-thirds of all people with nonpsychotic people with nonpsychotic problems recover within problems recover within two years of the onset of two years of the onset of the problem, whether they the problem, whether they get therapy or notget therapy or notTwo conclusions:Two conclusions: Therapy is more effective than noneTherapy is more effective than none Eysenck had over-estimated the Eysenck had over-estimated the improvement rate in no-therapy improvement rate in no-therapy control groups control groups

Long-term Long-term administration: administration: tardive dyskinesiatardive dyskinesiaincurable incurable disturbance of disturbance of motor control, motor control, especially of facial especially of facial muscles muscles

Long-term Long-term administration:administration: tardive dyskinesiatardive dyskinesiaincurable incurable disturbance of disturbance of motor control, motor control, especially of facial especially of facial muscles muscles

Antidepressants relieve depression Antidepressants relieve depression Tricyclic (Tofranil and Elavil) reduce Tricyclic (Tofranil and Elavil) reduce the neuron’s re-absorption of the neuron’s re-absorption of neurotransmitters after they have neurotransmitters after they have been released in the synapsebeen released in the synapse in the brain cells (reuptake)in the brain cells (reuptake)

Prozac Prozac (1987)—(1987)—for many years for many years most popular antidepressant; most popular antidepressant; Selective serotonin reuptake Selective serotonin reuptake inhibitors (SSRIs)inhibitors (SSRIs)

Antidepressants relieve depression Antidepressants relieve depression Monoamine Oxidase (MAO)Monoamine Oxidase (MAO) inhibitors: limit the activity of MAO—inhibitors: limit the activity of MAO— a chemical that breaks down a chemical that breaks down norepinephrine in the synapse norepinephrine in the synapse

MAO inhibitors are a common MAO inhibitors are a common somatic treatment for depression somatic treatment for depression

Biological approaches to Biological approaches to treatment treatment

Antidepressants (continued) Antidepressants (continued) Lithium carbonateLithium carbonate, a natural, a natural chemical element,chemical element, is now widely is now widely used to return manic-depressive used to return manic-depressive patients to a state of equilibriumpatients to a state of equilibrium in which extreme mood swings in which extreme mood swings disappear disappear Most medications have side effects Most medications have side effects

Stimulants to Treat ADHD Stimulants to Treat ADHD Ignorance of well-established calmingIgnorance of well-established calming effect these drugs can have in effect these drugs can have in children with ADHDchildren with ADHDInterferes with normal sleep patternsInterferes with normal sleep patternsSlow growth of childrenSlow growth of childrenPotential for abusePotential for abuse

Prefrontal Lobotomies Prefrontal Lobotomies Sever nerve fibers connecting the Sever nerve fibers connecting the frontal lobes with deep brain frontal lobes with deep brain structures (thalamus & hypothalamusstructures (thalamus & hypothalamus

Prefrontal Lobotomies Prefrontal Lobotomies

Electroconvulsive Therapy Electroconvulsive Therapy

The convulsions caused by the The convulsions caused by the shock may have a positive shock may have a positive therapeutic effect therapeutic effect

Electroconvulsive Therapy Electroconvulsive Therapy

Negative side effect Negative side effect is memory loss is memory loss

Maxwell Jones Maxwell Jones Therapeutic community Therapeutic community Daily hospital routine,Daily hospital routine, structured as a therapy structured as a therapy to help patients learn to help patients learn to cope with outside to cope with outside worldworldPrivate living quarters Private living quarters Decision makingDecision makingInvolved in planning own treatmentInvolved in planning own treatment

Maxwell Jones Maxwell Jones

Group TherapyGroup Therapy

Occupational TherapyOccupational Therapy Recreational TherapyRecreational Therapy

Seasonal Affective Disorder (SAD) Seasonal Affective Disorder (SAD)

Light therapy is most commonly used Light therapy is most commonly used to treat SADto treat SAD

Rollo May Rollo May Viktor Viktor Frankl Frankl

Existential Therapy Existential Therapy

Existential Therapy Existential Therapy Believe that for most people Believe that for most people autonomy and freedom are autonomy and freedom are threatening threatening To acknowledge that you are To acknowledge that you are unique and independent is unique and independent is to acknowledge you are alone to acknowledge you are alone May May et alet al: to get in touch with : to get in touch with true feelings, must accept true feelings, must accept responsibility for lives responsibility for lives

Existential Therapy Existential Therapy Frankl: feelings of Frankl: feelings of emptiness and emptiness and boredom are primary boredom are primary source of emotional source of emotional problems problems Therapist should help Therapist should help open client’s eyes to open client’s eyes to possibilities in life and possibilities in life and guide him/her toward guide him/her toward challenges challenges

““Why don’t you commit suicide?”Why don’t you commit suicide?”

Gestalt Therapy Gestalt Therapy Emphasizes relationship between Emphasizes relationship between patient and therapist in here and patient and therapist in here and now now If a patient will not respond to If a patient will not respond to the therapist’s questions, the the therapist’s questions, the therapist will tell the patient that therapist will tell the patient that he is angry and frustrated at the he is angry and frustrated at the lack of response by the patient.lack of response by the patient.Sets an example for patient to Sets an example for patient to express feelings express feelings Significant risk Significant risk

Gestalt Therapy Gestalt Therapy Based on the belief that many Based on the belief that many people are so concerned with people are so concerned with obtaining approval that they obtaining approval that they become strangers to themselves become strangers to themselves

Transactional Analysis Transactional Analysis

Eric Berne Eric Berne Basis: people function Basis: people function from one of 3 from one of 3 perspectives called perspectives called ego statesego statesEgo states: represent Ego states: represent ways people organize ways people organize thoughts, feelings, thoughts, feelings, and actions and actions

Transactional Analysis Transactional Analysis

Child ego state Child ego state Act like a child Act like a child

Parent ego stateParent ego stateAct, think, feel like parent, Act, think, feel like parent, close friends or teachers close friends or teachers

Adult ego state Adult ego state Thoughts, feelings, behaviors Thoughts, feelings, behaviors rationally related to experiences rationally related to experiences of the present of the present

Transactional Analysis Transactional Analysis Reactions in the adult ego state Reactions in the adult ego state allow people to deal effectively allow people to deal effectively and responsibly with their and responsibly with their daily problems daily problems Goal of transactional analysis: help Goal of transactional analysis: help people to identify maladaptive people to identify maladaptive transactions or strategies for transactions or strategies for living living (usually from parent or (usually from parent or child ego state)child ego state) and also to help and also to help develop more effective adult develop more effective adult ego state responses ego state responses