Psychotherapies Flashcards
What is the topographic theory of the mind?
- Three states
- Unconscious: Includes repressed thoughts that are out of one’s awareness; involves primary process thinking (primitive, pleasure seeking urges)
- Preconscious: contains memories that are easy to bring into awareness
- Conscious: Involves current thoughts and secondary process thinking (logical, mature, delayed gratification)
What is the structural theory of the mind?
- 3 components
- Id: Unconscious; involves instinctual sexual/aggressive urges and primary process thinking
- Ego: Serves as a mediator between the id and external environment and seeks to develop satisfying interpersonal relationships; uses defense mechanisms to control instinctual urges
- Superego: moral conscience
What are defense mechanisms?
- Used by the ego to protect oneself and relieve anxiety by keeping conflicts out of awareness
- Unconscious processes that are normal and healthy when used in moderation
What are the mature defense mechanisms?
- Altruism
- Humor
- Sublimation
- Suppression
What are the neurotic defense mechanisms?
- Controlling
- Displacement
- Intellectualization
- Isolation of affect
- Rationalization
- Reaction Formation
- Repression
What is altruism?
Altruism: Performing acts that benefit others in order to vicariously experience pleasure
What is humor (defense mechanism)?
Expressing feelings through comedy without causing discomfort to others
What is sublimation?
Satisfying socially objectionable impulses in an acceptable manner (channeling them)
What is Suppression?
Purposely ignoring an unacceptable impulse or emotion in order to diminish discomfort and accomplish a task
What is controlling (defense mechanism)?
Regulating situations and events of external environment to relieve anxiety
What is displacement?
Shifting emotions from undesirable situation to one that is personally tolerable
What is intellectualization?
Avoiding negative feelings by excessive use of intellectual functions and by focusing on irrelevant details or inanimate objects
What is isolation of affect?
Unconsciously limiting the experience of feelings/emotions associated with stressful life event
What is rationalization?
Creating explanations of an event in order to justify outcomes or behaviors and to make them acceptable
What is reaction formation?
Doing the opposite of an unacceptable impulse (ex: man in love with woman insults her)
What is repression?
Preventing a thought or feeling from entering consciousness
What is the difference betwen repression and supression?
Repression is unconscious whereas suppression is a conscious act
What are immature defense mechanisms?
- Acting out
- Denial
- Regression
- Projection
What are splitting and undoing?
Types of defense mechanisms
- Splitting: labeling people as all good or all bad (often seen in borderline personality disorder)
- Undoing: Attempting to reverse a situation by adopting a new behavior (ex: man who has brief fantasy of killing his wife by sabotaging her car takes the car in for a complete checkup)
What is acting out?
Giving in to an impulse, even if socially inappropriate, in order to avoid the anxiety of suppressing that impulse
What is denial?
Not accepting reality that is too painful
What is regression?
Performing behaviors from an earlier stage of development in order to avoid tension associated with current phase of development
What is projection?
Attributing objectionable thoughts or emotions to others
What characteristics are seen in patients best suited for psychoanalysis?
- Under age 40
- Not psychotic
- Intelligent
- Stable in relationships and daily living
What are some important concepts and techniques used in psychoanalysis? (5)
- Free association
- Dream interpretation
- Therapeutic alliance
- Transference
- Countertransference
What is free association?
The patient is asked to say whatever comes into his or her mind during therapy sessions; purpose is to bring forth thoughts and feelings from the unconscious
What is therapeutic alliance?
The bond between the therapist and the patient who work together toward a therapeutic goal
Describe transference and countertransference
- Transference: Projection of unconscious feelings about important figures in the patient’s life onto the therapist; interpretation of transference is used to help the patient gain insight and resolve unconscious conflict
- Countertransference: Projection of unconscious feelings about important figures in the therapist’s life onto the patient; therapist must remain aware of this as it may interfere with objectivity
Describe the following types of psychoanalysis related therapies…
- Psychoanalytically oriented psychotherapy:
- Interpersonal therapy:
- Supportive psychotherapy:
- Psychoanalytically oriented psychotherapy: Employs same techniques as psychoanalysis, but in briefer sessions; sessions are face-to-face (no couch)
- Interpersonal therapy: Focuses on development of social skills to help treat certain psychiatric disorders (treatment is short)
- Supportive psychotherapy: Purpose is to help patient feel safe during a difficult time
What is learning theory in terms of behavioral therapy?
Behaviors can be learned by conditioning and can similarly be unlearned by deconditioning
Describe…
- Classical conditioning:
- Operant conditioning:
- Classical conditioning: A stimulus can eventually evoke a conditioned response
- Operant conditioning: Behaviors can be learned when followed by positive or negative reinforcement
What are the different deconditioning techniques?
- Systemic densitization
- Flooding and implosion
- Aversion therapy
- Token economy
- Biofeedback
What is systemic desensitization?
Patient performs relaxation techniques while being exposed to increasing doses of an anxiety-provoking stimulus
What are flooding and implosion?
Through habituation, the patient is confronted with a real (flooding) or imagined (implosion) anxiety-provoking stimulus and not allowed to withdraw from it until he or she feels calm and in control
What is aversion therapy?
A negative stimulus (such as a shock) is repeatedly paired with a specific behavior to create an unpleasant response
What is token economy deconditioning?
Rewards are given after specific behaviors to positively reinforce them
What is biofeedback?
Physiological data are given to patients as they try to mentally control physiological states
Commonly used to treat migraines, hypertension, chronic pain, asthma, and incontinence
What is the cognitive therapy?
Seeks to correct faulty assumptions and negative feelings that exacerbate psychiatric symptoms
What is the cognitive theory of depression?
Faulty assumptions (If I were smart, I would do well on tests. I must not be smart since I received average grades this semester) lead to negative thoughts (I am stupid, I will never amount to anything worthwile) which then lead to Psychopathology (Depression)
What is group therapy?
Three or more patients with a similar problem or pathology meet together with a therapist for group sessions
What are the advantages of group therapy over individual therapy?
- Patients get immediate feedback from their peers
- Patients may gain insight into their own condition by listening to others with similar problems
- If a therapist is present, there is an opportunity to observe interactions between others who may be eliciting a variety of transferences
Why is family therapy useful?
- A person’s problems usually affect the entire family
- After the development of psychopathology, new tensions and conflicts within the family may arise
- Psychopathology may arise partly or entirely from dysfunction within the family unit
What are the goals of family therapy?
- Reduce conflict
- Help members understand each other’s needs
- Help the unit cope with internally destructive forces
When is marital therapy useful?
Tretment of conflicts, sexual problems, and communication problems
What is dialectical behavioral therapy?
- Specific treatment for borderline personality disorder
- Teaches coping skills with both individual and group therapy
- 1-2-year commitment required
- Solution-focused therapy
What are the main goals of dialectical behavioral therapy?
- Reduce self-injurious behaviors
- Decrease hospitalizations
