Clinical Psychology Flashcards
Freud Psychoanalysis
Freud divides the psyche into the id (pleasure principle), ego (reality principle) and
superego.
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When the ego cannot give into the id’s needs due to the superego or pressure from reality,
the person experiences conflict.
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The ego uses defense mechanisms (repression, denial, reaction formation, rationalization,
projection, displacement, fixation, sublimation, projective identification, splitting, intellectualization, and undoing) to prevent conscious activation of this conflict.
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Primary processes are unconscious (dreams, slips of the tongue, jokes), and secondary
processes are conscious (logical, sequential, and function according to reality principle).
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Techniques and goals: to gain access to the unconscious through dreams, free association,
resistance, and transference. The goal is to gain insight into the unconscious and strengthen
the ego. Improvement results from catharsis, repeated interpretations leading to insight, and working through (assimilation of insight into personality).
Structural Theory
Freud’s structural theory divides the psyche into three components: The id is the source of sexual and aggressive instinctual drives and is governed by the pleasure principle. The ego is governed by the reality principle and attempts to gratify the id’s instincts in ways that are compatible with reality. And the superego serves as the conscience and attempts to permanently block gratification of unacceptable id impulses.
Goals of Psychoanalysis
Bring unconscious unresolved conflicts into consciousness and strengthen the ego so that behavior is based less on instinctual drives and more on reality
Free Association
Used to help lower a client’s defenses and bring unconscious thoughts and feelings into conscious awareness
Dream Analysis
The use of dream analysis is based on the premise that dreams contain symbols that provide important information about unconscious impulses. During dream analysis, the therapist interprets the true meaning (latent content) of these symbols.
Psychoanalysis - Procedure of Analysis
The primary procedures of analysis are confrontation, clarification, interpretation, and working through (Greenson, 1965).
Confrontation
- Involves making statements that help clients view their own behaviors in a new way.
- For example, if a client is often late to therapy sessions, the therapist might suggest that the client’s lateness could be due to the fact that he is ambivalent about coming to therapy.
Clarification
- Ued to bring the client’s behavior into sharper focus and involves asking questions and making observations.
- The therapist might follow-up her suggestion about the client’s lateness by stating that she’s noticed that the client is most likely to be late when, in the previous session, the client started talking about a decision he is struggling with.
Interpertation
- Involves explicitly linking the client’s conscious behavior to unconscious processes. The therapist would be using interpretation if she points out that the client’s lateness might be due to the fact that he’s avoiding therapy because he’s concerned that she’ll disapprove of his decisions just like the client’s father did when he was living at home.
- Repeated interpretations lead to catharsis (an emotional release that results from the recall of repressed material) and insight (an understanding of the connection between current behavior and unconscious material)
Working through
- Slow, gradual process that involves testing, accepting, and assimilating new insights.
Countertransference
When the therapist projects unresolved feelings toward another person onto the client
Jung Analytic Psychology
Psyche =
Conscious
Personal/Individual unconscious
Collective unconscious
CONSCIOUS
- Ego
- Thoughts, feelings, which we are currently aware
PERSONAL UNCONSCIOUS (arises from repression)
- thoughts, feelings, and attitudes that are related to a particular concept (e.g., power, inferiority) and that influence behavior
COLLECTIVE UNCONSCIOUS (universally inherited neural patterns)
-“General wisdom that is shared by all people, has developed over time, and is passed along from generation to generation across the ages” (Carducci, 2009, p. 137)
- Archetypes (predispositions to perception and emotions that we all share)
- universal mental structures that predispose people to react to certain circumstances in specific ways – represented in cultural myths and symbols, frequently appear in dreams, and include the persona (the “social mask” we present to others), the shadow (repressed, disowned, and undeveloped aspects of the self), and the anima/animus (the feminine and masculine aspects of the self)
Archetypes
Jung
Collective unconscious
Universal mental structures that predispose people to react to certain circumstances in specific ways
Represented in cultural myths and symbols, frequently appear in dreams,
Include
- Persona (the “social mask” we present to others)
- Shadow (repressed, disowned, and undeveloped aspects of the self)
- Anima/animus (the feminine and masculine aspects of the self)
Personal vs. Collective Unconscious
Jung
Personal unconscious = our own forgotten/repressed memories + includes collections of thoughts, feelings, and attitudes that are related to a particular concept (e.g., power, inferiority) and that influence behavior
Collective unconscious = “general wisdom that is shared by all people, has developed over time, and is passed along from generation to generation across the ages”
Individuation
Jung
- Goal of analytical psychotherapy = bring unconscious material into consciousness to facilitate the process of individuation
- All conscious and unconscious aspects of the self into a unified whole.
- Techniques to achieve this goal = dream interpretation, active imagination, and analysis of transference
Neo-Freduians
Focused on the social and cultural determinants of personality
Fromm, Horney, Sullivan
Object Relations
- Behavior is motivated by a desire for human connection
- Focuses on the impact of early relationships between a child and significant others (“objects”)
- When young children are provided with adequate emotional/physical care, they develop object constancy (integrated/stable internal representations of self and others)
- Weak or damaged introjects result in interpersonal and intrapersonal difficulty, such as splitting or an unstable self-image
- Mahler – object constancy develops gradually in early childhood during three stages:
1. Normal autistic
2. Normal symbiotic
3. Separation-individuation.
Object Constancy
Integrated/stable internal representations of self and others**
- Develops when young children are provided with adequate emotional/physical care
- Mahler – object constancy develops gradually in early childhood during three stages:
1. Normal autistic
2. Normal symbiotic
3. Separation-individuation.
Karen Horney
Focused on early relationships; parental behavior cause child to experience basic anxiety and feelings of helplessness and isolation; to defend against anxiety the child adopts certain modes of relating to others-movement towards others, movement against others, and movement away from others; healthy people integrate all three, neurotic people use one
Harry Stack Sullivan
Relationships throughout lifespan; role of three modes of cognitive
experience in personality development;
Prototaxic mode - unconnected momentary states, experiences before language symbols are used, may characterize experience of
schizophrenics;
Parataxic mode - person sees casual connections between events that are not actually related but reduce anxiety
Syntaxic mode - emerges around the end of the first year
of life, involves logical sequential thinking and underlies language acquisition.
*Neurotic bx
caused by “parataxic distortions,” which are due to arrest in parataxic mode, and occurs when the person deals with others as if they were a significant person from their early life
Erich Fromm
Focused on the role of societal factors in personality development; was interested in how society prevents individuals from realizing their true nature (= capacity to be
creative, loving, and productive)
Identified 5 character styles a person may adopt in response to demands of society
1) Receptive
Exploitative
3) Hoarding
4) Marketing
5) Productive - only the productive style allows a person to realize his true human
nature
Person-Centered Therapy (Client-Centered Therapy)
also known as Carl Rogers Client-Centered Therapy
- People have innate SELF-ACTUALIZATION tendency that motivates behavior
- Maladaptive behavior: result of incongruence between one’s self-concept and experience
- Goal: help client realize/grow self-actualization and achieve congruence
- Therapy uses:
1. empathy (therapist understands client subject experience)
2. unconditional positive regard (therapist cares about client and affirms their value without judging client)
3. congruence (therapist is genuine, open, honest in words/actions) - Views client as own expert
Gestalt Therapy
Fritz Perls
- Each person is capable of assuming personal responsibility for own thoughts, feelings, actions, and living as an integrated “whole”
- Assumption = behavior motivated by striving for homeostasis (balance)
4 major boundary disturbances (introjection, projection, retroflection, and confluence)
- Introjection: person accepts concepts, facts, and standards from environment without fully assimilating
them (often overly compliant)
- Projection: disowning aspects of self by assigning them to other people (paranoia)
- Retroflection: doing to oneself what one wants to do to others (turn anger inward)
- Confluence: absence of a boundary b/t self and environment (feelings of guilt and resentment)
- Goal –help client achieve integration of various aspects of self to form unified whole
- In therapy = use “I” language, role-playing, dream analysis
Reality Therapy
William Glasser (used this with delinquent adolescents)
- Basic idea is to focus on present behavior, to enable him/her to meet own needs w/ out harming others (+ to encourage him to take responsibility for his/her actions)
- 5 basic needs
= (1) survival, (2) power, (3) belonging, (4) freedom, and (5) fun - When needs are met responsibly one develops “success identity,” when need are met in an irresponsible manner one develops “failure identity.” Change occurs with failure is replaced by success
Therapy techniques = here and now, emphasize value/judgements, stress conscious awareness
- Glasser developed Schools without Failure (SWF) program, which focuses on educating teachers on how to engender responsible bx from students, thinking rather than memorizing, substituting discipline for punishment, and encouraging a success-oriented philosophy of education
Existential Therapy
- Struggle between the individual and “ultimate concerns” of existence (death, isolation, meaninglessness, etc.)
-Normal anxiety vs. neurotic anxiety
- Therapists have honest, open, egalitarian relationship with patients to achieve authentic intimate relationship
*most important tool is therapeutic relationship - Goals of therapy are to eliminate neurotic anxiety and help client tolerate unavoidable existential anxiety
*Emphasis on personal choice/responsibility
Transactional Analysis
Berne - aimed to simplify the client’s understanding of maladaptive interactions.
- Ego states: child, parent, and adult
- Strokes: transactions that take place between ego states at two levels (social and covert); can be positive or negative.
- Scripts: a person’s life plan; developed early though interactions with others; reflects person’s characteristic pattern of giving and receiving strokes.
- Life position: adopt one of four primarily through interactions with parents; I’m ok- you’re ok; I’m ok- you’re not ok; I’m not ok- you’re ok; I’m not ok- you’re not ok.
- Transactions: complementary, crossed, or ulterior.
- Games: orderly series of ulterior transactions and results in bad feelings for both players; eg the boss asks “what time is it?” when a person comes in late.
- Goal of therapy: alter maladaptive life positions and life scripts and to integrate the three ego states
Beck’s Cognitive Behavioral Therapy
CBT - how people feel and act is largely determined by how they think
automatic thoughts
3 types of cognitions
1. Schemas - core beliefs, how people see the world
2. Automatic thoughts - spontaneous thoughts in response to events that people may not be fully aware of
3. Cognitive distortions - systematic errors in reasoning
- cognitive distortions: arbitrary inference, selective abstraction, overgeneralization, magnification/minimization, personalization, and dichotomous thinking.
- Cognitive techniques - eliciting automatic thought, logs, decatastrophizing, reattribution, and redefining.
- Behavioral techniques - homework, activity scheduling, graded task assignments, hypothesis testing, behavioral rehearsal, role-play, and diversion techniques.
- Cognitive triad - negative thoughts about self, future, and world.
Goal: clients identify and replace maladaptive cognitive patterns with more adaptive ones
Rational Emotive Behavior Therapy (REBT)
Modifying irrational beliefs
ABC model of emotional disturbance/dysfunctional behavior
- A = people experience undesirable event (ACTIVATING EVENT)
- B = rational/irrational BELIEFS about that event
- C = create appropriate emotions/behaviors w/ rational beliefs vs. inappropriate consequences w/ irrational beliefs (CONSEQUENCES of those beliefs)
- Focus of therapy: identifying, challenging, and replacing irrational beliefs
- Techniques: direct confrontation of irrational beliefs, contingency contracting, in-vivo desensitization, response prevention, and psychoed.
Stress Inoculation Training
Assumption: when people learn to cope with mild levels of stress, they are “inoculated” against future stressful situations
Skills training + modification of maladaptive cognitions
3 Phases
1) Conceptualization (educate client how faulty cognitions prevent adapt coping)
2) Skills acquisition (learning/reherseing new skills, e.g., relaxation techniques)
3) Application and follow-through (practice as applying to real/imagine situations gradually)
Useful for aggressive behavior and impulsive anger
Hypnosis
- Hypnosis - state of relaxed wakefulness with a relative suspension of peripheral awareness.
- 3 factors:
1. absorption (client is engrossed in central experience and ignoring all other thoughts etc.)
2. dissociation (ordinary functions of consciousness are altered)
3. suggestibility (less inhibited and restricted). - Hypnotherapy helps individuals retrieve feelings and memories that were not available by other methods
Use for PTSD and habits; contraindicated in treatment of psychosis, paranoia, and OCD
Self-Instructional Training
Based on – individuals can modify their own behaviors through the use of appropriate self-talk
5 Steps
1) Cognitive modeling
2) Overt external guidance
3) Overt self-guidance
4) Faded overt self-guidance
5) Overt self-instruction
