Clinical Psychology Flash Cards

Question 0

William James

Answer 0

1. Father of American psychology
2. Developed the first American lab at Harvard University.

James-Lange Theory of Emotion

1. Theory of emotion developed simultaneously as Carl Lange in 1880s
2. Emotion results from perception of bodily sensations from physiological changes
3. Contrasts common sense notion that physiological changes come from emotion
4. Thus, James argues, we feel sad because we cry, we do not cry because we are sad

Book

1. Authored the “Principles of Psychology,” described emotion theory

Reasonable Alternatives

Cannon-Bard Theory of Emotion: Developed by physiologists Walter Cannon and Philip Bard; it states that when confronted with an arousing event, people first feel an emotion and then experience physiological reactions such as sweating, muscle tension, or trembling.
Two-Factor Theory of Emotion: Developed by Stanley Schachter and Jerome Singer; it states that emotions are the result of physiological arousal and cognition; emotional experiences are defined by how individuals interpret or appraise their physiological arousal and bodily responses to an event.

Question 1

Clinical Psychology

Answer 1

Is concerned with the study, diagnosis, and treatment of psychological and behavioral disorders.

Question 2

Covert Sensitization

Answer 2

Therapeutic Orientation: Behavioral

Process

1. Pairing of imaginary negative consequences with an undesirable behavior

Purpose

1. Reduce likelihood of undesirable behavior

Requires

1. Use of negative mental imagery and rehearsal

Not to be mistaken for: shaping, flooding, inoculation, chaining & over correction.
Shaping: Using selective reinforcement (approximations) to modify a general response to a specific response. It is building a behavior by dividing it into small increments or steps and then teaching one step at a time until the desired behavior is achieved; steps become a series of intermediate goals.
Flooding: A behavioral technique used to treat phobias in which the client is presented with the feared stimulus until the associated anxiety disappears.
Inoculation: A four-phase training program for stress management often used in Cognitive-Behavioral Therapy.
Chaining: An instructional technique that transforms a learned response into a stimulus for the next desired response.
Overcorrection: A mildly aversive behavior modification technique in which the person being treated is made to restore the environment to a better condition than before the inappropriate behavior.

Question 3

Covert modeling

Answer 3

Therapeutic Orientation: Behavioral

Premise

1. Increase desirable behavior by imaging others performing similar behaviors with positive outcomes
2. Client imagines specific positive consequences of new behavior
3. Based on (the concept of) simple modeling (more overt and not imagined).

Key components

1. Capability of the client to utilize positive imagery and mental rehearsal

Not to be mistaken for: over correction, participant modeling, covert sensitization, systemic desensitization, negative reinforcement.

Overcorrection: A mildly aversive behavior modification technique in which the person being treated is made to restore the environment to a better condition than before the inappropriate behavior.
Participant Modeling: A type of role modeling in which the therapist first engages in a desired behavior, and then through the use of aids the client gradually moves toward the ability to perform the desired task.
Covert Sensitization: A form of aversive conditioning in which the frequency of undesirable behavior is lessened by mentally associating it with unpleasant mental images.
Systematic Desensitization: A therapeutic technique that exposes persons to stressful situations under relaxed conditions, over time reducing the stress associated with the situation.
Negative Reinforcement: An increase in the frequency of a response by removing an aversive event immediately after the response is performed.

Question 4

Coping Skills Training

Answer 4

Therapeutic orientation: Cognitive Behavioral

Premise

1. Teach clients skills increasing cognitive, behavioral and affective proficiencies

Common uses

1. Managing anxiety-provoking situations, from situational-based stressors to chronic anxiety disorders

Key components

1. Positive self-statements, positive imagery

Not to be mistaken for: In-vivo desensitization, habituation, inoculation, covert sensitization, stimulus discrimination, avoidance conditioning.

Reasonable Alternatives

In Vivo Desensitization: A therapeutic intervention used in CBT; it is most often used to reduce and ultimately eliminate undesirable responses such as fear and anxiety.
Habituation: A decrease in responsiveness resulting from repeated exposure to a stimulus.
Inoculation: A four-phase training program for stress management often used in CBT.
Covert Sensitization: A form of aversive conditioning in which the frequency of undesirable behavior is lessened by mentally associating it with unpleasant mental images.
Stimulus Discrimination: The ability to distinguish among different stimuli.
Avoidance Conditioning: A form of Operant Conditioning in which an organism is trained to avoid certain responses or situations associated with negative consequences.

Question 5

Collaborative Empiricism

Answer 5

Key figure

1. Aaron Beck

Definition

1. Client and therapist are equal partners working together
2. Mutual understanding
3. Communication
4. Respect

Premise

1. Client is capable of objectively analyzing his/her own issues and arriving at own conclusions

Approaches

1. Most common is through guided discovery
   a. Socratic-style questioning to help the client arrive at objective understanding
   b. Helping the client to develop and test hypotheses about their own beliefs

Not to be mistaken for Ellis, Adler, Skinner, Covert

Ellis: Most closely associated with Rational Emotive Behavior Therapy, used a confrontational approach to challenge irrational beliefs.
Adler: An ego psychologist, known for Individual Psychology and focus on inferiority complex.
Skinner: Most commonly associated with operant conditioning, which argues that behaviors are changed through their outcomes (reinforcement); a behavioral therapy construct not a cognitive therapy construct.
Covert: Covert therapeutic approaches do not view the client and therapist as equal partners, but assume a power differential that can be applied to change the client.
.

Question 6

Cognitive Modification

Answer 6

Key Term: Cognitive Modification

FlashCard:
Key figure

1. Aaron Beck

Premise

1. Challenge unpleasant internal beliefs and assumptions to recognize and replace maladaptive cognitions with productive ones
2. Encourages cognitive flexibility
3. Affective arousal is essential to successful modification

Assumption

1. Person can change their undesirable behavior by changing their thoughts

Opposition to

1. Behavioral premise that states changes in behavior stem from changing external stimuli only

Reasonable Alternatives

Operant Conditioning: The learning process whereby the relative frequency of a response increases as a result of reward or reinforcement.
Pavlovian Conditioning: A type of learning found in animals, caused by the association (or pairing) of two stimuli.
Cognitive Triad: A set of three maladaptive ways of thinking that create and maintain depression.
Dichotomous Thinking: Thinking in absolute terms, like “always,” “every,” or “never.”

Question 7

Psychoanalytic Theory

Freud’s perspective on personality

Answer 7

Freud’s perspectives on personality

Topographic: conscious vs. unconscious

Dynamic: interaction of psychic forces

Genetic: stage-wise development

Economic: distribution and transformation of psychic energy

Structural: tripartite structure of the mind (id, ego, superego)

Adaptive: born with ability to interact with environment

Basic personality dynamic

Two primitive drives: Eros and Thanatos

The sexual and aggressive urges are in direct conflict with societal norms

Personality develops through psychosexual stages

Source of sexual gratification changes with development

Oral, Anal, Phallic, Latency, Genital

Unsuccessful attempts to have needs met at each stage results in fixation

Fixation can result in psychopathology (neurosis or hysteria)

Question 8

Emotional Reasoning

Answer 8

Therapeutic orientation: Cognitive Therapy

Definition

1. A cognitive distortion that involves using the emotional state as the evidence for rationale defending the source stimulus as the “cause” of their emotional state

Cognitive distortion

1. Emotional Reasoning is counter to the Cognitive Therapy premise that our beliefs or cognitive distortions effectively change our emotional response to any situation

Resistant to change

1. Given the circular nature of using one’s emotions to justify the rationale of the source of one’s suffering it is particularly resistant to change

Amplification of other cognitive distortions

Reasonable Alternatives

Emotional Validation: A DBT component where the therapist validates the emotional experience of the client while simultaneously encouraging change in their behaviors.
Dichotomous Thinking: Thinking of things in absolute terms, like “always,” “every,” or “never.”
Overgeneralization: Using isolated cases to make wide generalizations.
Magnification: Exaggerating negatives.
Counterconditioning: Conditioning in which a second, incompatible response is conditioned to an already conditioned stimulus.
Differential Reinforcement of Other Behavior (DRO): A procedure in which any behavior except the targeted inappropriate response is reinforced; typically, this results in a reduction of the inappropriate behavior.
Stimulus Discrimination: The ability to distinguish among different stimuli.
Stimulus Generalization: Transfer of a response learned from one stimulus to a similar stimulus.

Question 9

Psychoanalytic theory

Psychic structure

Answer 9

Psychic structure

The mind is separated into id, ego, superego

Id: urges, pleasure principle, immediate gratification

Ego: reality based, develops through interaction with world

Superego: moralistic, learned through society and parents, restrictive

Question 10

Psychoanalytic theory

Freud’s Defense mechanisms

Answer 10

Defense mechanisms

To control the sexual and aggressive urges of the id from reaching consciousness

Repression: hide id’s impulses in the unconscious

Suppression: avoidance of thoughts/emotions

Projection: placing onto others those things one cannot accept about oneself

Reaction Formation: acting or stating feelings in direct opposition to one’s true

feelings because those true feelings are unacceptable to the self.

Introjection: deeply identifying with an idea or object

Regression: reversion to an earlier stage of development

Denial: refusal to accept reality

Displacement: expression of thoughts or feelings to a safe target rather than the

true target

Sublimation: transforming negative emotions into positive action or behaviors

Rationalization: justification through faulty reasoning

Intellectualization: use of logic to rationalize a situation

Unconscious

Methods to infer unconscious thought or emotion

Direct observation of behavior

Conscious behaviors: dreams, slips of the tongue, free association

Psychic Determinism: unconscious thoughts/emotions do affect behavior

Freud’s therapeutic techniques

Confrontation, clarification, interpretation, working-through

Question 11

Psychoanalytic & psychodynamic therapies

Answer 11

Psychoanalytic and psychodynamic therapies

Object Relations Therapy, like psychoanalysis focus on the first years of life and interpersonal dynamics

Focus on how unconscious affects current relationships

Identify/interpret defenses, transference, and resistance; thus increasing insight

Transference: process of directing feelings of one person onto another (therapist)

Therapist remains a neutral stimuli allowing for client’s natural transference

Resistance: refusal to address specific issues in therapy

Projection is root of paranoia

Working-through is the integration of therapeutic insights resulting in symptom reduction

Root of psychological disorders - Psychological disorders result from reaction to unconscious

Phobias: displacement of emotions from original object to new or symbolic object

Mania/Hypomania: polar opposite expression of underlying depression

Anxiety: bolstered defenses in response to id impulses spilling into the ego.

Reasonable Alternatives

Psychosis: A state in which a person loses contact with reality in key ways.
Object-Cathexis: The id’s investment of energy into an object that will satisfy an instinctual need.
Symbolization: A way of handling inner conflicts by turning them into distinct symbols.
La Belle Indifference: A description of the unconcerned attitude toward symptoms that has been seen in Conversion Disorder.
Sibling Rivalry: An Adlerian concept which posits that brothers and sisters will often feel pressure to compete with one another.
Ego Decompensation: A made-up term.

Question 12

Psychodynamic Psychotherapies

Answer 12

All share several assumptions:

1. Human behavior is motivated largely by unconscious processes
2. Early development has a profound effect on adult functioning
3. Universal principles explain personality development and behavior.
4. Insight into unconscious processes is a key component of psychotherapy.

Question 13

Carl Jung

Answer 13

Neo-Freudian who established analytic psychology: Blending Freud’s psychodynamic and humanistic psychology

Difference from Freud: Freud believed present and future were rooted in the past

Believed that personality is the consequence of both conscious and unconscious factors.

Jung believed hopes and aspirations were as important as the past
Jung de-emphasized libido
Focused on social an aggressive origins over sexual drives

Jung de-emphasized childhood experiences
Focused on adult and mid-life experiences

Agreed with Freud that there is a personal unconscious
Introduced, in contrast to Freud, the Collective Unconscious (CU)
Common to all people

Drew on all the thoughts and behavior patterns of various cultural groups over time. Passed down from one generation to the next.

Consisted of archetypes (basic categories) for conceptualizing world

Developed from work with psychotic patients who had similar delusions and hallucinations

Four main archetype categories:

Self:regulation center of psyche, archetype for ego. The Persona: public mask?

Shadow:aka mask, part of oneself that opposes the ego (dark side of the personality?)

Anima:feminine aspect of a person

Animus:masculine aspect of the person

Neuroses develop from conflicting archetypes as people strive to be more fully functioning. Sxs are unconscious messages to the individual that something is awry with him and that present him with a task that demands to be fulfilled.

Transference was both personal unconscious and CU
Universal Symbolism: Universal symbols and the meaning of life are two areas of interest for Jung and the write extensively in the field
Categorical Personality Traits: Identified extroversion, introversion, orientations toward external or subjective inner worlds. Later these traits became part of the Myers-Briggs Type Indicator (MBTI) test
Focus is on the here-and-now and only seeks information from the past when it will help the client understand the present.

Reasonable Alternatives

Unconscious: Exists below the level of one’s awareness; it is the culmination of innate drives over someone’s lifespan.
Defense Mechanism: Strategy used by the ego to protect itself from anxiety.
Fritz Perls: Developed Gestalt Therapy, based on humanistic and existential elements. He believed that people have an innate goodness; as such, one of the central goals of Gestalt Therapy is to help clients understand and accept their needs, desires, and fears. Gestalt Therapy focuses on the “here and now” without deeply exploring the past.
Heinz Kohut: Established self-psychology. He believed that narcissistic personality disorder, which projects self-importance and self-absorption, is really a mask for fragile self-esteem, that people are born with a bipolar structure consisting of immature grandiosity and dependent over-idealization.
Melanie Klein: Known for her work with young children; she is also one of the earliest developers of object-relations theory.
Anna Freud: Created the field of child psychoanalysis and discovered that children’s symptoms differed from those of adults and were often related to developmental stages; she also provided clear explanations of the ego’s defense mechanisms.
Karen Horney: Was most well-known for her work with the neurotic personality that she developed from a childhood filled with anxiety; she identified three ways of dealing with the world: moving toward, against, and away from people.
Albert Ellis: A cognitive-behavior therapist who founded rational-emotive behavior therapy (REBT); REBT focuses on the role of irrational beliefs as the cause for psychopathology.
Id: Part of the mind present since birth that includes basic urges (food, warmth, etc.).
Ego: Part of the mind that deals with reality by mediating between the id’s demands for immediate gratification and reality.
Projection: One projects one’s own undesirable thoughts, motivations, desires, and feelings onto someone else.
Transference: Client’s responses to his or her analyst that seem to reflect attitudes and ways of behaving toward important people in the patient’s past, rather than reflecting actual aspects of the analyst-patient relationship.
Humanistic Psychology: Arose after Freud’s theories. It placed a greater emphasis on a person’s freedom of choice, regarding free will as the person’s most important characteristic. It seldom focused on how psychological problems develop, instead, humanistic psychology was (and is) interested in therapeutic interventions.

Question 14

Individuation

Answer 14

Jungian concept

Refers to an integration of the conscious and unconscious aspects of the psyche that leads to the development of a unique identity.

Question 15

Adler

Answer 15

Adler is one of the original founders of psychoanalysis. He also developed Individual Psychology (Key concepts - inferiority feelings, striving for superiority, style of life, and social interest).

1. Individual Psychology is not individualistic, but social. People are viewed within their social context. People are motivated to belong.
2. Problems from a need to belong are misdirected to power, revenge, attention, or displays of inadequacy.

Children’s misbehavior stems from these misdirections:

1. Power struggle, i.e. belonging is gained through control; compliance diminishes personal value.
2. Revenge, i.e. if they cannot be in charge, then seek revenge, feeling significant only when others hurt in the same way they have been hurt.
3. Attention, i.e. feeling significant only through attention seeking/engaging in inappropriate behavior.
4. Displays of inadequacy, i.e. belonging only through complete inadequacy, becoming helpless and incompetent; do not attempt tasks as failure is expected.

Inferiority Complex:

1. Inferiority motivates a person’s ultimate goal for perfection or develops into neurosis.
2. Neurosis develops from maladaptive efforts to compensate for inferiority and is influenced by family, friends and birth-order.
3. Adler one of the first to introduce the importance of birth-order.

Goals of Therapy

1. Increase feelings of community
2. Promote feelings of equality
3. Replace egocentric self-protection, self-enhancement and self-indulgence with self-transcending, courageous, social contributions.

Methods

1. Socratic questioning
2. Assessment
3. Guided imagery
4. Role-playing
5. Problem-focused problem-solving.

Disagreements with Freud

1. Freud believed inner conflict is sexual in nature.
2. Adler said humans are motivated by social drives.

Lifestyle and Style of Life

1. Lifestyle means integrated rules and themes of interaction that are foundational to all behavior.
2. With style of life, it is not the events of life, but the interpretation of those events that have the most influence. (Ways in which a person chooses to compensate for inferiority and achieve superiority).

Adler’s use of the Teleological Lens (Behavior is largely motivated by a person’s future goals rather than determined by past events.)

1. Investigate final causes, expected outcomes, endpoints, and purposes behind behaviors.
2. This increases the therapist’s ability to better understand motivations of individual behavior, systemic purposes of symptoms, goals of triangulation, and the use of patterned interactions and routines, in order to reframe mistaken interactions and create a new perspective on an experience.

Carl Jung: Established analytical psychology (blending Freud’s psychology and humanistic psychology). He believed in the collective unconscious, which he said is common to all humans. He was also the first to characterize extraversion and introversion. In addition, he wrote a great deal on religious symbolism and the meaning of life. Jung believed that neurosis was not an illness, but a striving for maturity.

Fritz Perls: Developed Gestalt therapy based on humanistic and existential elements. He believed that people have an innate goodness. He asserted that one of the central goals of Gestalt therapy is to help clients understand and accept their needs/desires/fears. Gestalt therapy also focuses on the “here and now,” without deeply exploring the past.

Heinz Kohut: Established self-psychology. He believed that narcissistic personality disorder, which projects self-importance and self-absorption, is really a mask for fragile self-esteem. People are born with a bipolar structure, with immature grandiosity and dependent over-idealization at opposite poles.

Melanie Klein: Known for her work with young children; also one of the earliest developers of object-relations theory.

Anna Freud: Created the field of child psychoanalysis. Her work contributed greatly to our understanding of child psychology. She also developed different techniques to treat children. Freud noted that children’s symptoms differed from those of adults, and were often related to developmental stages. She also provided clear explanations of the ego’s defense mechanisms.

Karen Horney: Was most well-known for her work with the neurotic personality that she developed from a childhood filled with anxiety. She identified three ways of dealing with the world: moving toward, moving against, and moving away from people.

Albert Ellis: A cognitive behavior therapist who founded rational-emotive behavior therapy, which focuses on the role of irrational beliefs as the cause for psychopathology.

Question 16

Ego Psychology

Answer 16

1. One of the four schools of Psychoanalytic Theory (together with Freudian, Self, and Object-Relations)
2. Evolved from basic Freudian Theory and Psychoanalysis
3. Took shape through Sigmund and Anna Freud’s contributions
4. Finalized into a distinct theory by Heinz Hartmann: “Ego Psychology and the Problem of Adaptation” (1939)
5. Other important names: Erikson, Mahler, Kris, Spitz, Lowenstein
6. Focuses on ego functions (defense, adaptation, reality-testing) in the individual’s interpersonal and socio-cultural context
7. Views individuals as innately adaptive beings, who undergo a lifelong biopsychosocial development orchestrated by the ego

Ego

1. The ego is an autonomous psychic entity that manages the process of adaptation and shaping to the environment; has great synthetic power
2. It operates through defenses, which ward off anxiety and affect coping effectiveness; can be adaptive or maladaptive
3. Personality is organized through interaction with the world; it is shaped by internal needs as well as outer forces (culture, religion, race, presence of physical challenges, etc.)
4. Ego deficits and person-environment fit contribute to psychosocial problems
5. Ego Functions: reality testing, judgment, sense of reality, affect and impulse regulation, primary and secondary thought processes and regression in the service of the ego
6. Mastery-Competence and Adaptation: The ability of the person to develop a “sense of competence” by mastering conflicts, internal needs, and environmental demands
7. Object (or Interpersonal) Relations: Forming a sense of self and of others, and the quality, as well as development, of the relationship to self and others
8. Long-term psycho-analytic therapy approach, explores ego adaptive processes within the individual’s interpersonal and socio-cultural reality.

Self-Psychology: One of the four main schools of psychology, founded by Heinz Kohut; evolved from classic Freudian approach and Ego Psychology, and highlighted importance of empathy in therapy. The subjective “I” is the focus of study.

Object Relations Psychology: School of psychology, focus on the psychological development in relations to others. Primary caregivers are particularly emphasized. “Objects” may be internal as well as external. Fairbairn, Klein, Winnicott are the main proponents.

Freudian Psychology: Main school of psychology. Treatment from this approach is the classical psychoanalytic, with the patient lying on the couch and the analyst seated behind, seeing, but unseen. Focuses on uncovering unconscious conflicts and provoking insights. It makes use of free association, dream interpretation, analysis of transference, and counter-transference and working-through.

Question 17

Anna Freud

Answer 17

Family: Youngest daughter of Sigmund Freud.

Neo-Freudians: Focus on social and cultural factors’ influence and shaping of personality.

Did not focus on the unconscious conflicts as much as Sigmund.

Population: Anna focused on children.

Stressed importance of supportive, protective, and educational attitudes toward children.

Neurotic symptoms in children can have different meaning than adult neuroses.

Diagnostic Profile: Anna Freud developed the first-known classification system of childhood symptoms.

Reflected developmental issues.

Formalized assessment procedures.

Organized and integrated data from diagnostic assessments.

Created a complete concept of patient’s personality and developmental appropriateness.

Developmental Line: Series of id-ego interactions that decrease a child’s dependence on external controls and increase ego mastery of themselves and their world.

Dependency to emotional self-reliance.

Sucking to rational eating.

Wetting and soiling to bladder and bowel control.

Irresponsibility to responsibility in body management.

Play to work.

Egocentricity to companionship.

Defenses: Anna systematized and elaborated on Sigmund’s ego defenses.

Question 18

Eric Berne

Answer 18

Key Figure:Eric Berne

Premise:Examination of interactions with other people through communication and scrutiny of habitual patterns of behavior/associations.

Goal: Awareness of the intent behind communication (eliminate deceit) resulting in client’s improved interpretation of personal behavior.

Intent:To be broadly applied, even outside of therapy.

Theme:People are capable of making their own decisions and therefore responsible for their own fate.

Focus:Enact change through behavioral and cognitive means, giving the responsibility of change to the client.

Therapeutic levels of analysis:

Structural analysis:Individual personality analyzed
Three separate ego states:

Parent: Consists of traditions and values that are copied from parental and authoritarian figures (controlling, rule-making, commanding parts of personality).

Child:Creativity, humor, excitement (impulsive parts of one’s personality).

Adult:Computer processor between the ego states and outside world (logical, reasonable, and unemotional parts of one’s personality).

Transactional analysis:Interpersonal personality analyzed
Interaction between the ego states of two people

Two levels: Social (overt); Psychological (covert)

Types of interactions:

Complementary:same ego state

Crossed:mixed ego state

Ulterior:dual levels of communication

Racket and game analysis:Repetitive relational patterns analyzed
Life positions of OKness of self and others

Four positions:

I’m okay, you’re okay

I’m okay, you’re not okay

I’m not okay, you’re okay

I’m not okay, you’re not okay

Rackets and games are used to find support for one’s life position

Rackets are habitual ways of feeling

Games are seeking confirmation (strokes) regarding perspectives of self

Strokes may be verbal, nonverbal, physical

Script analysis:Life patterns at thematic levels analyzed
These are the patterns that virtually dictate life

Arise from parents giving their children messages, injunctions

Question 19

Psychodrama

Answer 19

Key Figure:Jacob L Moreno, M.D.

Premise:Guided dramatic action to examine problems and develop insight, personal growth, and integrate cognitive, affective, and behavioral components for an individual.

Basic Elements (Operational Components):

Protagonist:person represents “theme” of the drama

Auxiliary Egos:represent significant others in the drama

Audience:witness the drama and represent the world at large

Stage:physical space to conduct the drama

Director: trained psychodramatist

Three Phases:

Warm-up:Theme is identified and protagonist selected.

Action:Dramatization occurs and protagonist explores new methods for resolution of the problem

Sharing:Group expresses connection with the protagonist’s work.

Challenges to the benefits of psychodrama: Watchel (1997) argues that success in assertiveness training stems from the structured practice in-session and daily-life practice, which distinguishes it from psychodrama. Psychodrama may appear similar to assertiveness role-play but emphasizes insight over structured therapy to change patient’s overt behaviors.

Question 20

Object Relations Theory

Answer 20

Premise

1. A psychodynamic therapy examines impact of unconscious relationship to interpret defenses and transferences.
2. Assumes child’s behavior and interactions based on quality of relationship with mother.
3. Therapy encourages safety, security and attachment.
4. People seek objects to relate to.
5. Introjects: emotionally charged aspects of significant people are incorporated with the individual’s sense of self.
6. Early attachments shape perceptions and expectations of important people in their lives
7. Early attachments shape later interpersonal relationships

Unique Object Relations Therapeutic styles and viewpoints

1. William Fairbain: Object-seeking shapes mind and personality, a basic motivation to make and keep connections with other people. Pleasure-seeking is the manner to relate to objects – opposing Freud’s belief that object-related is manner to seek pleasure.
2. Melanie Klein: Internal objects are fully internalized presence in the mind or unconscious (e.g., a voice). Part internalizations are developmentally primitive (e.g., mother’s breast). External objects are internalized then later projected in the external world again, creating a cycle. Satisfaction from early experiences such as breast-feeding lead to love or creativity. Dissatisfaction from early experiences such as breast feeding lead to hate or destruction. Splitting is defense for hostile feelings toward loved object. To protect the loved object from destruction, the infant splits the object into two, good and bad. Play is free association. Child therapy much like adult analysis, and was opposed by Anna Freud.
   3 stages
3. Normal Infantile autism - occurs during the first month of life. infant is self-absorbed and essentially oblivious to the external environment.
4. Normal Symbiotic phase - child becomes aware of the mother but is unable to differentiate between “me” and “not-me”.
5. separation -Individuation - begins at 4 to 5 months of age. Composed of 4 overlapping subphases: differentiation, practicing, reapproachement, and object constancy (by abt 3 years old, the child has developed a permanent sense of self and object and is able to perceive others as both separate and related.)

Projective identification: projects objects into, rather than onto another person

3. Margaret Mahler: Focus on the emergence of individual self through separation and individuation process. First three years of life form lifelong mature object-relations. First month of life biological needs dominate. - Corresponds to Erickson’s Trust vs. Mistrust phase. Second month of life recognition of mother-object, but not different from self (symbiosis). - Corresponds to Erickson’s Autonomy vs. Shame & Doubt phase. 6-36 months separation-individuation phase: - Separation: physical distancing - Individuation: psychological independence - Corresponds with Erickson’s Initiative vs. Guilt Successful resolution of theses phases results in permanence of emotional-object, thus the parent exists even when out of sight.
4. Nathan Ackerman and Boszormenyi-Nagi: pioneers of object relations family therapy–viewing the family as an essential bond to relationships among its members
5. Multiple transference: concept from Abusive Multiple Transference (AMT), an experimental theory put forth by David W. Bernstein. AMT proposes that when a person is abused, they may turn around and transfer the negative feelings of the abuser on to the victim, as well as transfer the power and dominance of the abuser on to him/her self.

Reasonable Alternatives

Gestalt Therapy: A humanistic, direct approach to therapy by which patients are forced to confront and take accountability for their lives in order to make changes (Walker, 1983).
Jung: An early follower of Freud who later broke off and focused more on the collective unconscious and self-actualization (Hergenhahn, 2001).
Personal Construct Therapy: A psychotherapeutic technique by which a person is assumed to control his or her world via personal constructs and cognitive categories. Therapists guide clients in daily practice at viewing the world in a new way and interacting with people using this novel point of view (Kazdin, 2000).
Reality Therapy: A cognitive behavioral-based therapy that helps people gain control over their lives and improve upon their effectiveness at meeting their own needs. When individuals make purposeful choices that better fulfill their needs they will be less frustrated and experience a more satisfying life (Glasser, 2006).
Solution-focused therapy: A therapeutic strategy that emphasizes the importance of language for constructing reality and thereby focuses on solutions and positive attributes to meet treatment goals (Kazdin, 2000).
Family Systems: based on the assumption that each individual in a family must be addressed within the context of the family because behavior of family members is interdependent (Mirsalimi, Perleberg, Stovali & Kaslow, 2003).
Power Alignment: A vague term, referring to relationship frameworks in which individuals ally themselves with individuals who are able to apply force in order to enact change (Kazdin, 2000).
Milan Systemic Family Therapy: An approach to therapy that contends pathology is not contained within an individual, but in the context of the family system. According to this approach, if interactional patterns within the systemic framework (family) changed, so would individual problem behaviors (Boscolo, Cecchin, Hoffman & Penn, 1987).
Adlerian Therapy: A psychotherapeutic technique that emphasizes the conscious mind, free will, striving for power, and a sense of inferiority (Kazdin, 2000).
Ego Psychology: A study of psychology that focuses almost entirely on the ego, for its own sake, and minimizes its relationship to the id and superego (Hergenhahn, 2001).
Cognitive-Behavioral Therapy: An approach to therapy that involves discussion of issues and real-life actions to overcome issues experienced by a patient. This type of therapy is always typified by facing stressors, being accepting, reducing tension, and being patient with time. In addition, patients are encouraged to replace negative self-statements with more positive ones (Walker, 1983).

Question 21

Catharsis

Answer 21

Definition:Significant release of emotion, results in awareness of unconscious material, thus reducing anxiety.

Theoretical perspectives:Behaviorists view this as a reduction in an emotional response resulting from extinction.

Reasonable alternatives:
Insight: When the client comes to a realization relating to the presenting problem; a moment of clarity.

Transference: When emotions or attitudes relating to a certain person are projected onto a completely different person.

Working Through: The process by which therapeutic insights are integrated into the client’s personality.

Identification: A defense mechanism in which one unconsciously takes on the characteristics of another person.

Cohesion: According to Yalom, cohesion is the necessary precondition for all other therapeutic factors to occur.

Emphasized by Freud’s early psychoanalytic work

No longer used in current psychoanalysis

Irvin Yalom identifies catharsis as necessary for interpersonal learning in group therapy

Other therapeutic factors include: altruism, cohesion, family re-enactment, guidance, identification, instillation of hope, interpersonal input, interpersonal output, self-understanding, universality, and other existential factors.

Cohesion is the necessary precondition for effective group therapy.