Clinical Psychology Flashcards
Freudian topography
Conscious level: thoughts, feelings, perceptions in awareness
Preconsciousness: just below the conscious level, contains material not currently in awareness but readily accessible to consciousness
Unconscious: largest component of psyche, contains threatening emotions, memories, and other material not available to awareness
Structural theory
- psychic structure consists of id, ego, and superego
Id
present at birth, consists of all of the basic biological instincts that drive or direct behavior
- the most important are sexual (life) and aggression (death) instincts
- functions according to pleasure principle, seeks immediate gratification, relies on primary process thinking (unconscious, impulsive, irrational)
- they must be deduced from dreams, slips of the tongue, and free associations
Ego
- part of the id modified by interaction with the external world
- reality principle
- seeks gratification of the id’s instincts but attempts to do so in ways compatible with reality
- operates at all 3 levels of consciousness
- relies on secondary process thinking, logical and rational
Superego
- last component to develop
- serves as the conscience, operates at all 3 levels of consciousness
- evolves from internalization of parental prohibitions, standards, and values
- attempts to permanently block the id’s socially unacceptable instincts
Freudian conflict
- anxiety emerges from conflicting demands of id, ego, and superego
- when ego is unable to resolve anxiety using realistic, rational means, it employs defense mechanisms, which operate at an unconscious level and deny or distort reality
- repression, denial, reaction formation, rationalization, projection, displacement, regression, sublimation (repression is the most basic and underlies all)
Freudian goals and techniques
- Goals: to bring unconscious unresolved conflicts into consciousness and strengthen the ego so that behavior is based less or instincts and more on reality
- Targets of analysis: client’s free associations, resistance, dreams, and transference
- Procedures of analysis: confrontation, clarification, interpretation, working through
- countertransference
Jung’s Analytical Psychology
- rejected Freudian principles, holding a more positive view of human nature, believed development continues into adulthood, behavior affected by past events and future goals
Jung’s structure of the psyche
1 - Conscious: ego with all thoughts, feelings, present awareness
2 - Personal unconscious: forgotten and repressed memories, complexes (collections of thoughts, feelings, and attitudes ie power, inferiority)
3 - Collective unconscious: wisdom shared by all people, developed and passed from generation to generation; archetypes, universal mental structures, including the persona, shadow, anima/animus
Jung’s personalities
Introversion: direct their energy inward, prefer alone time
Extroversion: direct their energy outward, seek social contact
Jung’s personality functions
sensing, thinking, feeling, and intuiting
- personality is combo of dominant attitude and function, ie introverted-sensing, extraverted-thinking
Jung’s goals and techniques
- Goal: to bring unconscious material into consciousness to facilitate the process of individuation, an integration of all conscious and unconscious aspects of the self into a unified whole
- Techniques: dream interpretation, active imagination, analysis of transference
Adler’s Individual Psychology
- rejected Freud’s theories and replaced his sexual instincts with an innate social interest, more interested in conscious processes, and adopted an approach focused on the effects of future goals on current behaviors
Adler’s inferiority v superiority
- feelings of inferiority: develop during childhood (first 4-5 years) in response to real or imagined disabilities and inadequacies, and people are motivated to overcome their sense of inferiority using some compensation
- striving for superiority: innate drive toward competence and effectiveness
Adler’s Style of Life
- describes the ways in which a person strives for superiority
- healthy style of life: goals that reflect not only concern for personal accomplishment but also the welfare of others
- mistaken/unhealthy style of life: overcompensation for feelings of inferiority, self-centeredness, lack of concern about well-being of others
Adler’s goals and techniques
- Goal: to replace a mistaken style of life with a healthier, more adaptive one
3 phases:
1 - therapeutic relationship
2 - development of the client’s mistaken style of life
3 - developing social interests - Techniques: early recollections, dream interpretation, encouragement, modeling, prescribing the symptom, modeling, encouragement, and “acting as if”
Neo-Freudians
- generally downplayed instinctual drives and focused on social and cultural influences on personality
- more positive view of human nature
- include Karen Horney, Harry Stack Sullivan, Erich Fromm
Karen Horney
focused on the impact of early relationships; certain parenting behaviors cause a child to experience basic anxiety, or a feeling of helplessness and isolation in a hostile world; child adopts certain interpersonal coping strategies - moving towards others, moving against others, or moving away from others - healthy person uses all, neurotic uses only one
Harry Stack Sullivan
- prototaxic mode: before symbols are used, discrete unconnected momentary states and an inability to differentiate between self and external world
- parataxic mode: autistic symptoms, differentiate certain aspects of experiences, seeing casual connections that are unrelated
- syntaxic mode: meaningful symbols, logical thought, and interpersonal communication
Neurosis: arrest at parataxic mode leads to parataxic distortions, due to unsatisfactory early relationships
Erich Fromm
society prevents individuals from realizing essential nature to be creative, loving, and productive; 5 character styles - receptive, exploitative, hoarding, marketing, and productive - only productive permits a person to find nature
Ego-Analysts
- Anna Freud, Erik Erikson, David Rappaport, Heinz Hartmann
- greater emphasis on ego role in development
1 - ego-defensive: resolution of internal conflicts
2 - ego-autonomous functions: adaptive, non-conflictual, learning, memory, comprehension, and perception - healthy behavior: under conscious control, pathology: ego loses autonomy from id
Object Relations Theory
- Melanie Klein, Ronald Fairbairn, Donald Winnicott, Otto Kernberg, Margaret Mahler
- behavior is motivated by a desire for human connection rather than sexual or aggressive drives
- focuses on the impact of early relationships between a child and significant other (“objects”) in the child’s life
Object Relations Theory: object constancy
the ability to maintain a predominantly positive emotional connection to a significant other independent to one’s need state or the ability to gratify one’s needs
- when a child is not provided adequate care, lead to splitting, abnormalities in object relations
Mahler’s object constancy model
1 - normal autistic stage: first few weeks of life, infant aware only of self
2 - normal symbiotic stage: infant becomes aware of the external world but is unable to differentiate between self and others
3 - separation-individuation stage: 5-36 mos - differentiation, practicing, rapprochement, and beginning of object constancy - finality is integration, stable mental representations of self and others
Object Relations goals and techniques
- Goal: to replace maladaptive internalized representations of interpersonal relationships with healthier, more adaptive ones in order to improve relationships
- Foundations: client-therapist relationship is essential, therapy as “reparenting,” providing empathy, support, and acceptance
- Techniques: analyzing resistance and transference, interpreting dream, and other psychoanalytic techniques
Person-Centered Therapy
- Rogers held the belief that people have an innate self-actualizing tendency that motivates and guides their behavior
- Incongruence: discrepancy between self and experience that can impeded self-actualization and lead to psychological maladjustment
- conditions of worth: mother provides affection, child behaves in certain ways
Person-Centered goals and techniques
- Goal: help the client maintain a state of congruence by developing a more flexible self-concept that enables one to respond to new experiences in open, non-defensive ways
- Techniques: empathy, congruence, unconditional positive regard
Gestalt Therapy
- Perls integrated psychoanalysis, behaviorism, and humanism, and focused on visual and auditory perception
- Assumption: all behavior is motivated by a striving for homeostasis/balance; when people are in a state of imbalance, they are motivated to obtain something from the environment to restore homeostasis, then retreat.
Gestalt boundary disturbances
- Boundary disturbances: chronic problems that interfere with growth, disturb the boundary between the person and the environment, person cannot satisfy needs
- Types: introjection (internalize other’s beliefs), projection (attribute aspects of self to another), retroflection (doing to oneself what one would like to do to another), deflection (avoid contact with others), confluence (blurring of separation between self and other, loss of identify)
Gestalt goals and techniques
- Goal: to help the client achieve self-awareness and assume responsibility for thoughts, feelings, and actions
- Foundation: active, directive role, focus on current reality, distinguish between fantasy (transference) and reality
- Techniques: “I” statements, dream work, empty chair techniques
Existential Therapy
- person’s struggle with the ultimate concerns of existence - death, isolation, meaninglessness, freedom, responsibility
Existential anxiety
- Existential (normal) anxiety: unavoidable consequence of life’s conditions, serves as a catalyst for personal change and growth
- Neurotic anxiety: out of proportion to cause, outside awareness, loss of subjective sense of free will and inability to take responsibility in one’s own life
Existential goals and techniques
- Goals: to help clients minimize neurotic anxiety, learn to tolerate the unavoidable existential anxiety of living, and live more fulfilling, authentic life
- Techniques: no particular techniques, use integrate those from other approaches
Reality Therapy
- incorporates humanistic-existential, cognitive, and behavioral approaches
- based on choice theory: the choices people make determine the quality of their lives
- 5 basic needs: love and belonging, power, fun, freedom, survival
- Success identity: person chooses to fulfill needs responsibly
- Failure identity: person choose to meet needs irresponsibly
Reality therapy goals and techniques
- Goal: to replace the client’s failure identity with a success identity by helping client assume responsibility for action and adopt more appropriate ways to meet needs
- Techniques: instruction, modeling, role-play, contracts, confrontation, humor
- WDEP: W - clients identify wants, needs, perceptions; D - clients identify what they are doing and their future direction; E - clients engage in critical self-evaluation; P - clients develop positive plans
Beck’s Cognitive Behavior Therapy
- how we act and feel is largely determined by how we think and that maladaptive behavior is due to a combo of biological and environmental factors that predispose a person to faulty cognitive patterns
- Schemas: core beliefs, enduring ideas, experiences, adaptive or maladaptive
- Automatic thoughts: spontaneous thoughts that arise response to events and that the person may not be fully aware of.
- Negative cognitive triad: negative thoughts about oneself, the world, and the future
Cognitive distortions
- systematic errors in reasoning
- Arbitrary inference: drawing erroneous conclusion
- Selective abstraction: focus on certain (negative) details and disregard other info
- Overgeneralization
- Personalization
- Dichotomous/all or none thinking
CBT goals and techniques
- Goal: to help the client identify and replace maladaptive cognitive patterns; also identify specific goals with client
- Foundations: collaborative empiricism
- Cognitive techniques: reattribution, redefining, thought recording, Socratic questioning
- Behavioral techniques: activity scheduling, behavioral rehearsal, exposure
Rational Emotive Behavior Therapy (Ellis)
- ABC model of emotional disturbance and dysfunctional behavior
REBT Irrational Beliefs
- beliefs that elicit emotions and behaviors that interfere with a person’s goals
- “Awfulizing”
- “I-can’t-stand-its”
- Damnation of oneself, others, or the world
REBT goals and techniques
- Goals: to help client identify irrational beliefs, understand why those beliefs are irrational, and replace them with alternative, rational ones
- add D and E to ABC - D: disputation of beliefs, E: replace with effective ones
- Techniques: disputation, reframing, humor, imagery, role-playing, etc
Stress Innoculation Training
- combines skills training with modification of maladaptive cognitions that interfere with behaviors
1 - Conceptualization: educate client about nature of stress, person’s perceptions and reactions to stress
2 - Skills acquisition: skills for coping with stress
3 - Application and follow-through: client applies new skills in stressful situations that gradually increase in intensity (imagination to in vivo)
Self-instructional training
- help impulsive children develop self-control, based on the premise that people can modify behaviors through self-talk 1 - Cognitive modeling 2 - Overt external guidance 3 - Overt self-guidance 4 - Faded overt-guidance 5 - Covert self-instruction
Problem-Solving Therapy
- assumption that psychological problems are based in deficits in social problem-solving skills
Biofeedback
- process in which a person learns to reliably influence physiological responses; monitoring the response and then provide feedback about the status of the response
- EMG biofeedback: muscle tension
- EEG biofeedback aka neurofeedback: brain wave activity
- Thermal biofeedback: skin temperature
Systems theory
-focuses on the interrelatedness of elements in a system and incorporates principles of general systems theory (structural aspects of living systems, composed of subsystems that are interdependent and autonomous), and cybernetics (how feedback mechanisms control the functioning of systems)
Family systems assumptions
- wholeness: elements of a system produce an entity that is greater than the sum of the individual elements
- open vs closed systems: family is never fully open or closed but varies depending on circumstances
- homeostasis: family members maintain stability and resist change by relying on consistent patterns of interaction
- negative vs positive feedback
- equifinality (different processes have the same outcome) vs equipotentiality (same processes have different outcomes)