Chapter 17_Psychotherapies

Question 1

What are the 3 components of Freud’s topographic theory?

Answer 1

Unconscious - repressed thoughts, out of one’s awareness (primary process thinking - primitive/pleasure seeking, childlike)
preconscious - memories that can easily be brought into conscious
conscious - current thoughts and secondary process thinking (logical, organized, delayed gratification)

Question 2

What are the 3 components of Freud’s structural theory?

Answer 2

Id - unconscious; instincts, sexual urges
superego - moral conscious, inner ideal to strive towards
ego - mediator between first two + environment, seeks to develop satisfying personal relationships; uses defense mechanisms; distinguishes fact and reality with reality testing

Question 3

What are 4 mature defense mechanisms?

Answer 3

altruism, humor, sublimation, suppression

Question 4

Patient’s child recently died from ovarian cancer. As part of the grieving process, the patient donates money to help raisse community awareness about symptoms of ovarian cancer

Answer 4

altruism (mature)

performing acts that benefit others in order to vicariously experience pleasure

Question 5

Person with unconscious urges to physically control others becomes a prison guard

Former gang member becomes social worker to help reform kids in gangs

Answer 5

sublimation (mature)

satisfying socially objectionable impulses in an acceptable manner (channeling them rather than preventing them)

Question 6

Nurse who feels nauseated by an infected wound puts aside feelings of disgust to clean wound and provide necessary patient care

Answer 6

suppression (mature)

conscious process that involves paying attention to a particular emotion

Question 7

Patients with which disorders tend to show neurotic defense mechanisms?

Answer 7

OCD, anxiety, stress disorders

Question 8

What are some examples of neurotic defenses?

Answer 8

controlling, displacement, intellectualization, isolation of affect, rationalization, reaction fromation, repression

Question 9

Student who is angry with his mother talks back to his teacher the next day and refuses to obey her instructions

Answer 9

displacement (neurotic)

shifting emotions from an undesirable to one that is personally tolerable

Question 10

Physician who is dying describes the pathophysiology of his disease in detail to his 12-year old son

Answer 10

intellectualization (neurotic)

avoiding negative feelings by excessive use of intellectual functions and by focusing on irrelevant details

Question 11

Woman describes the recent death of her husband without any emotion

Answer 11

isolation of affect (neurotic)

unconsciously limiting the experience of feelings/emotions associated with a stressful life event to avoid anxiety

Question 12

My boss fired me today not because she wasn’t meeting her quotas, not because i’m a bad employee

I bought this fancy new watch because the old wasn’t reliable enough and I needed to make my appointments

Answer 12

rationalization (neurotic)

explains an event to justify outcomes or make them acceptable

Question 13

Man who is in love with his married coworker insults her

Answer 13

reaction formation (neurotic)

doing the opposite of an unacceptable impulse

Question 14

Conscious version of suppression

Answer 14

Repression (preventing a thought or feeling from entering consciousness)

neurotic

Question 15

In what kinds of patients would you see immature defense mechanisms?

Answer 15

children, adolescents, psychotic patients, patients with severe personality disorders

Question 16

What are some examples of immature defense mechanisms?

Answer 16

acting out, denial, regression, projection

Question 17

Man who has been told his therpist is going on vacation “forgets” his last appointment and skips it

child throws temper tantrum, hit head on wall

Answer 17

acting out (immature)

giving into an impulse, even if socially inapprpriate in order to avoid anxiety of suppressing that impulse

Question 18

Husband who is attracted to other women believes his wife is having an affair

Wife who doesn’t listen to her husband accuses husband of not listening to her enough

Answer 18

projection (immature)

attributing objectionable thoughts/emotions to others

Question 19

Woman who has been scheduled for a breast mass appointment cancels because she believes that she is healthy

Answer 19

denial (immature)

not accepting reality that is too painful

Question 20

Woman brings her childhood teddy bear to the hospital when she needs to spend the night

Answer 20

regression (immature)

performing behaviors from an earlier stage of development to avoid tension associated with current stage of development

Question 21

A patient is awesome and great with med student but refuses to even talk to attending

Answer 21

Splitting

labeling people as all good or all bad (often seen in BORDERLINE personality)

Question 22

Man who has had a brief fantasy of killing his wife by sabotaging her car takes the car in for a complete check up

Answer 22

undoing

attempting to reverse a situation by adopting a new behavior

Question 23

What is the goal of psychoanalysis?

Answer 23

resolve unconscious conflicts by bringing repressed experiences and feelings into awareness and integrating the into the patient’s conscious

Question 24

T/F: Psychoanalysis is insight oriented

Answer 24

True. Patients should be intelligent and in stable relationships/daily living (cannot be psychotic) HIGH FUNCTIONING

Question 25

How intensive is psychoanalysis?

Answer 25

Very! 3-5 days per week fo many years (couch with therapist)

Question 26

What is psychoanalysis useful in treating?

Answer 26

• Cluster B and C personality disorders
• Anxiety disorders
• Problems coping with life events
• Sexual disorders
• PDD

Question 27

Goal of interpersonal therapy

Answer 27

focuses on development of social skills in order to improve interpersonal relations.

short once weekly sessions for a few months

Question 28

Goal of supportive psychotherapy

Answer 28

help patient feel safe during a difficult time and to help build up a patient’s healthy defenses; focuses on empathy, understanding, and education. Often used as adjunctive treatment

Question 29

Shorter version of psychoanalysis?

Answer 29

Psychoanalytically oriented psychotherapy and brief dynamic psychotherapy (less intense, briefer, no couch)

Question 30

What theory does behavioral therapy use?

Answer 30

Learning theory (conditioning and deconditioning)

classical conditioning (stimulus can evoke a conditioned response)

operant conditioning (behaviors can be learned when followed by positive/negative reinforcement

Question 31

Patient performs relaxation techniques while being exposed to increasing doses of anxiety provoking stimulus. Used to treat phobia disorders

Answer 31

systematic desensitization

Question 32

Patient who has a fear of flying is made to fly in an airplane or imagine flying (technique)

Answer 32

flooding and implosion (mor eintense form of systematic desensitizaiton), patient cannot escape until relaxed

Question 33

An aalcoholic patient is prescribed Antabuse, which makes him ill every time he drinks alcohol (technique)

Answer 33

Aversion therapy

negative stimulus (i.e. electric shock) is repeatedly paierd with a specific behavior to create an unpleasant response

Question 34

Therapy in which patient identifies maladaptive thoughts and replace them with positive ones. Useful in treating depressive and anxiety disorders used in combo with CBT

Answer 34

cognitive therapy

Question 35

Patient learns how their feelings and behaviors are influenced by their thoughts. Treatment brief from few weeks to few months

Answer 35

CBT

Question 36

What is CBT effective for?

Answer 36

Many

depression, anxiety, schizophrenia, and substance use disorders

Question 37

Which therapy is once weely individual and group treatment that diminishes self destructive behaviors and minimizing hospitalizations?

Answer 37

DBT

Question 38

What is DBT most useful for?

Answer 38

Treating borderline patients

Question 39

What is group therapy useful for?

Answer 39

substance use (AA), adjustment disorders, and personality disorders. Uses peers for immediate feedback and support

Question 40

How does family and couples therapy work?

Answer 40

Family - reduce conflict and help family members understand needs of whoever has psyhiatric condition (corrects boundaries and “triangles”)

couples - therapist sees couple together (conjoint) and may also be seen separately (concurrent) or separate therapist (collaborative)