Exam 2: Mindfulness based therapy, existential therapy, gestalt therapy Flashcards
mindfulness and acceptance based approaches (4)
- Mindfulness-based stress reduction
- Mindfulness based cognitive therapy
- Dialectical behavior therapy
- Acceptance and commitment therapy
common elements across mindfulness based therapies (4)
- mindfulness originates from Buddhist meditation practices
- Emphasizes awareness and attentiveness to the present moment
- Mindfulness therapies are considered third wave of cognitive behavioral therapies ⇒ building off the evolution of behavior therapy and CBT => incorporated into western mental health practices
- Instead of changing the content of your thoughts (really hard), third wave therapies stress the importance of changing the relationship you have to distress thoughts
mindfulness
paying attention to internal (thoughts, feelings, somatic sensations) and external stimuli (sights, sounds, smells) in the present moment ⇒ paying attention to the present without distraction
- Refraining from ruminating about the future
non judgmental awareness
observing the present moment without evaluating experiences or saying whether they are good, bad, right, wrong, etc.
- Instead, maintaining an attitude of curiosity and openness and focusing on observing/describing the present moment ⇒ like thoughts flowing down a stream
- Sit calm, thoughts come and go without any judgment on them
acceptance
experiencing the present moment without attempting to avoid, escape, or terminate the phenomenon ⇒ thoughts and feeling happening in everyday life
- includes experiencing unwanted or unpleasant internal phenomena ⇒ sensations, thoughts, feelings
- This is not advocating for accepting or tolerating situations where safety is at risk
- Rather common emotions, thoughts, and sensations that happen in everyday life that cannot always be avoided
- Acceptance ≠ approval
how do problems develop in mindfulness based therapies? (2)
- insufficient attention to the present moment ⇒ keep you from regulating emotions/behaviors in the moment that may cause an automatic reaction
- excessive avoidance of experiences
- Experiential avoidance
- May reduce distress or discomfort in the short term but may be maladaptive in the long term
how does change occur in mindfulness based therapies?
Present focus → more aware of their current emotions and behaviors → self regulate more effectively (choose different behaviors, cope with emotions)
- client learns to focus their awareness on the present as a means of greater self regulation
- Mindfulness and distance tolerance skills
roles of a mindfulness based therapist (1)
Active role in teaching and coaching the client in mindfulness techniques
roles of the client in mindfulness based therapies? (1)
Active role in learning and practicing mindfulness techniques
5-4-3-2-1 technique
start with acknowledging 5 things you can see, 4 things you can touch, 3 things you can hear, 2 thinks you can smell, 1 think you can taste
- Technique that helps clients get connected with their body when they are dissociating
body scan meditation
requires the individual to get into a comfortable position ⇒ starting at the toes and slowly making your way up the body
CBT summary (4)
- Identify maladaptive thoughts that contribute to difficult emotions
- Examine the evidence for and against the thoughts
- Develop alternative thoughts that are more helpful and or more accurate
- Focus on changing the content of the thoughts
mindfulness summary (4)
- Notice and identify difficult thoughts and feelings
- Notice where the feeling is felt in the body
- Bring an attitude of openness and compassion to learn to accept the existence of difficult thoughts and emotions
- Focus on changing the relations with the thoughts and or emotions
dialectical behavioral therapy (DBT)
- developed by Dr. Marsha Linehan
- Originally develop for individuals with borderline personality disorder ⇒ emotional dysregulation is the hallmark
- Dont respond to traditional treatment or terminate early
dialects
the simultaneous existence of two opposite ideas
- In DBT, the balance between acceptance and change
- Acceptance of emotions and thoughts and skills for changing behaviors
DBT session structure
weekly group and individual therapy and occurs for 1 year
- Group skills is 2 hours/week and individual is 1x/week
- Available for phone coaching 24/7
emotional regulation components (4)
- Emotional record ⇒ similar to CBT thought record
- Identifying patterns of destructive behaviors
- Identifying thoughts that trigger emotional distress
- Opposite action ⇒ choosing to do the opposite of what your emotion would tell you to do
mindfulness skill components (4)
- Mindful breathing
- Mindful eating
- Mindful communication ⇒ apply how we respond to others
- Setting our intentions, being fully presents, being fully open, and relating to others with compassion - observe/describe emotion ⇒ try to sit with the emotion and really understand it
interpersonal effectiveness
Getting needs met from others in a skillful, healthy way and acting in a way that allows you to get what you want, keep relationships, and keep self respect
- dear man acronym
- Describe, express, assert, reinforce, Stay mindful, appear confident, negotiate
distress tolerance
skillfully coping with painful, intense, or unpleasant emotions without becoming overwhelmed
components of distress tolerance (3)
- Radical acceptance coping statements
- Developing methods of distracting self
- Relaxation and self soothing
acceptance and commitment therapy (ACT)
says distress is unavoidable and that we suffer because we are unwilling/unable to tolerate distress
- used mindfulness and cognitive defusion to help people be more willing to experience difficult emotions
- We avoid difficult emotions, making it difficult to lead committed lives
cognitive defusion
don’t change the thought, but change your relationship to the thought
Take a step back and look at your thoughts, decide whether they are working and choose how to respond
- Serves To disentangle (de-fuse) you from thoughts that cause you to suffer
- You are not your thoughts and unhelpful thinking patterns
components of ACT (3)
- Your heart deepest desires for how you want to behave as a human being; how you want to treat yourself, others, and world around you
- Values Vs. Goals
- Work as an inner compass that can guide you through life, provide motivation, and give a sense of fulfillment
values
how you want to behave in this moment and on an ongoing basis
goals
outcomes you are aiming for
existential therapy
more of a philosophy or a way of thinking about therapy than a particular style of practicing psychology
- Many of the key figures for this theory are philosophers, rather than psychologists
- He who has a why to live can bear with almost any how
- choice and meaning of life
2 overarching beliefs of existential therapy
- Clients are searching for meaning in their subjective worlds
- Humans are in constant state of transition, evolving, and becoming ⇒ due to environment
questions of existential therapy and why we need them
- Who am I
- What does it all mean
- How am I going to get to where I want to be in my life
→ without answers to these questions we feel lost and that is a source of distress
victor Frankl
- 1905-1997
born and educated in vietnam and was a neurologist, philosopher, and author as well as Holocaust survivor - Disagreed with Freud on psychoanalytic thinking ⇒ founder of logotherapy which is a type of existential therapy
- Before the second world war and all but 1 family member died in concentration camps
logotherapy
therapy through meaning and focus on finding meaning and purpose
- You still have the power to change things such as your attitude even though it is small
- Personal responsibility and self strength is important
Rolly May
- 1909-1994
another major figure for bringing existentialism from Europe to the US
Psychotherapy should be aimed at problems of being, rather than problem solving
main themes of logotherapy (4)
- Life has meaning in all circumstances
- Will to meaning is central motivation for living
- We must have freedom to find meaning in everything
- We must integrate body, mind, and spirit to be fully alive
→ meaning is created by what we engage in
components of existential therapy (4)
- reject deterministic model of traditional psychoanalysis and behaviorism where the individual is determined by unconscious forces or sociocultural conditioning
- Focuses on choices so even when we cannot determine what we experience, we can choose how we react as well as our actions
- Reacts against the identification of therapy with a set of techniques and bases practice on an understanding of what it means to be human => Limitations and tragedies vs possibilities and opportunities of human life
- Believes that every person possess a health core belief ⇒ similar to person centered therapy with humanistic approaches
what does existential therapy propose about the human condition? (6)
- increase capacity for self awareness
- freedom and responsibility
- striving for identity and relationship to others
- searching for meaning
- anxiety as a condition for living
- awareness of death and nonbeing
increase in capacity for self awareness
recognizing limit of life and limited time to do what we want so we choose our actions to create our destiny with opportunity to relate to others
- More turmoil as well as more fulfillment
freedom and responsibility
people aren’t limited by environmental and social constraints so we can choose how we react to external circumstances
striving for identity and relationship to others
clients fear they are living lives that are meaningless (aloneness or we alone cannot rely on others to give life meaning)
- Solid relationship with self before strong relationships are built with others
searching for meaning
others cannot give meaning to us so we should establish our important meanings
anxiety as a condition for living
it is normal to live in a state of anxiety
- Existential therapy
awareness of death and nonbeing
death is a basic human condition that gives significance to life
how do problems or distress develop in existential therapy? (4)
- freedom
- death => born alone and die alone
- meaningless
- isolation
other components of existential distress
- we all need to deal with these throughout our life
- it is easy to live in a state of inauthenticity ⇒ this can cause distress (Similar to person centered where genuineness is a main role)
- anxiety is normal and existential but should not be neurotic which interferes with ability to be present
how does change occur in existential therapy (2)
- clients are assisted in identifying and clarifying their assumption about the world
- Rapport and relationship are key
- Clients may initially present problems from resulting from external causes but are taught to examine how their role is played in creating their problems
- Lots of confrontation the therapist may need to challenge the client with
- Rapport and good relationship is important for this type of confrontation - clients are assisted in more fully examining the source and authority of their present value system
- Get a better sense of what kind of life they think of as worth living and develop a clearer sense of their internal valuing process
action oriented steps in existential therapy (2)
- clients are assisted in translating what they have learnt into meaningful act
- Action happens and departure from psychodynamic thinking
- can be a time limited approach which mirrors time limitedness of existence
- requires more goals and ambition because it takes less time and is very structured
goals of existential therapy (7)
- Helping clients to accept their freedom and responsibility to act ⇒ self determinism
- Assisting people in coming to terms with the crisis in their lives
- Encouraging clients to recognize the ways in which they are not living fully authentic lives
- Inviting clients to become more honest with themselves
- Broadening clients awareness of their choices
- Facilitating the clients search for purpose and meaning in life
- Assisting clients in developing a deep understanding of themselves and the ways they can effectively communicate with others
roles of the existential therapist (4)
- There are no uniform roles
- To understand the subjective world of the client and help them come to new understanding and options => To find meaning
- Therapeutic relationship is key
- Core of the therapeutic relationship
(Authenticity and Confronts clients honestly)
roles of the client in existential therapy (4)
- Responsibility for how they are choosing to be in their world at the present moment
- Active during the sessions, must decide which fears, guilt feelings, and anxiety they want to explore
- Confront ultimate concerns, rather than coping with immediate problems
- Focus is on removing roadblocks to meaningful living
therapeutic techniques of existential therapy (4)
- paradoxical intention
- dereflection
- socratic questions
- writing your own eulogy
→ the therapeutic relationship is the most effective and powerful technique because it believes there is no one right way to do therapy ⇒ client/therapist is the most essential and is a foundation for everything
paradoxical intention
tells you to do the opposite of what your intention is
- Those who have insomnia that may have them try to stay awake so they know what their struggle is
dereflection
stopping clients form reflecting too much when it
socratic questions
asking open ended questions to help challenge value systems
writing your own eulogy
speech for someone who recently died in a term for endearment
- What you accomplished or are remembered by ⇒ helps with reflection
strengths of existential therapy (3)
- Humanizes therapy
- Provides a perspective on basic human conditions
- Relevant in multicultural contexts
weaknesses of existential therapy (4)
- Concepts are abstract and ambiguous
- Lacks empirical backing
- Limited applicability: lower functioning and clients concerned about basic needs
- Highly focused on self determinism and may ignore other factors such as systematic oppression
Frederick Perls
was a psychoanalyst but then disagreed
- Emphasis how people function in their totality
- Reaction against reductionism and determinism
- Similar to person centered therapy
- we can take responsibilities for ourselves
gestalt psychology view of human nature (6)
- Law of similarity
- Law of pragnanz or good figure
- Law of proximity
- Law of continuity
- Law of closure
- Law of common region
self actualizing tendency
the process of being what one is and not a process of striving to become
- The whole is more than a sum of its parts
- Striving to coordinate the various parts into a healthy unified whole
major beliefs of gestalt psychology (3)
- stress individual responsibility and individuality
- All individuals are actors, not just reactors
- Anti deterministic
- Important to differentiate self from others and to connect self and other - believes in the power in the present
- The past is gone and the future hasn’t arrived yet ⇒ reaction to freud
- The only thing we can control is what we do right now - promotes direct experiencing
- People are going to grow in therapy if they experience what they are talking about
- Not just talk about thoughts or feelings but are expected to bring feelings into the room
how do problems develop in gestalt therapy
- lack of awareness
- Being unaware of current feelings, thoughts, and behaviors
- Lack of integration between different parts of the self inhibiting people from self regulation
- Tendency to avoid - from out inordinate focus on the past and future rather than the present ⇒ unfinished business
- Interferes with living life in the present
- Feelings of alienation develop between the self and the objective world
- Reliving the past or creating the future with maladaptive thoughts - not living in the here and now
unfinished business in gestalt psychology
unexpressed feelings that interfere with current psychological functioning
- These feelings are associated with distinct memories and fantasies
- Feelings not fully experienced linger in the background and interfere with effective contact
- major source of issues according to this therapy type ⇒ bring emotions/experiences in the room to fully experience them
results of unfinished business in gestalt psychology
- Preoccupation
- distress
- self defeating behaviors
- cognitive distortions
how do problems develop in gestalt psychology (main and 4)
resistance to contact
- introjection
- confluence
- retroflection
- deflection
resistance to contact
Defenses we develop to prevent us from experiencing the present fully
introjection
accepting others views without reviewing them
confluence
weak boundaries between self and the environment
retroflection
we do to ourselves what we would like to do to someone else
- redirecting thoughts and behaviors we feel towards others ack on to ourselves
deflection
Redirecting the focus away from a difficult topic or issue
- avoiding of contact or awareness by turning aside ⇒ useful when used with awareness rather than experiencing inappropriate emotions
gestalt techniques (5)
- internal dialogue
- enactment
- focus
- rehearsal
- reversal
→ Attend in a gestalt manner ⇒ not use metaphorical speech and pay attention to clients verbiage and behavior
→ helps the client to know themselves better
internal dialogue
takes on the role of each aspect of themselves that are in conflict and engage each side in a dialogue ⇒ empty chair
enactment
the client is asked to put feelings or thoughts into action and draumatizes part of their existence ⇒ finding what their behaviors mean and why they have them (exaggeration)
exaggeration
asked to exaggerate a feeling, thought, moment to feel it more deeply
focus
staying with the feeling and continuously focus on their present emotions/awareness
rehearsal
form of role play where the client goes through a situation practicing a behavior/conversation ⇒ process feelings ahead of time
reversal
ask the client to play the role of the person they are enacting their behavior on to shift their perspective ⇒ increase emotional awareness
roles of the therapist in gestalt therapy (4)
- Create an atmosphere that promotes growth and self actualization
- Intentionally and personally involved with clients so they become more aware - Uses immediacy skills regularly
Identifies patterns, particularly related to avoidance
- When therapeutic process is stagnant or if there is tension
- When diversity and trust issues have evolved or interpersonal connection - Uses techniques in the service of increasing client’s awareness ⇒ acting as an observer and remain aware of what is going on in the present with the client
- Person to person relationship such as in existential therapy - Strives for a person to person relationship
roles of the client in gestalt therapy (2)
- Actively engaged in therapy as experts of their own experiences
- Make interpretations and make meaning out of their experiences
strengths of gestalt therapy (5)
- Deemphasizes abstract intellectualization of ones problems
- Recognizes working with the past as it relates to here and now
- Emphasizes doing
- Heightens awareness in a novel way
- Helps individuals integrate polarities within themselves ⇒ different parts
weaknesses of gestalt therapy (4)
- Potential for abuse in therapy
- Approach may not be useful for clients who have difficulty abstracting and imagining or focusing on emotions
- Cross cultural relevance ⇒ heavy emphasis on developing separateness from one’s social circle
- Fewer studies on this approach
How does changeoccur in gestalt therapy? (4)
- Awareness
- Contact
- Greater choice
- Outcome (re-owning)
Awareness
increased awareness of all parts of the self
Contact
making contact with one’s inner and external world without losing sense of self and individuality
- Being engaged in every possible way and staying present
- Acting authentically in the space
Greater choice
helping clients assume ownership of their experience, increasing internal coping strategies
- Awareness of their life choices and responsibility
Outcome aka reowning
identification with all vital functions of the individual, including ideas, emotions, and actions
Existential anxiety
anxiety that comes from growth or motivation to change
Who created ACT?
Developed by Dr. Steven Hayes at the University of Nevada in 1982
