Psychotherapies Flashcards
For what population is psychoanalysis contraindicated?
patient w/ reality testing failure (ie psychosis, mania)
Freud’s normal stages of development:
1) id: birth
2) ego: after birth
3) superego by age 6
Contrast id and superego
id: primary instincts (sexual, aggressive)
superego: morality, society, parental teaching
Describe ego
mediator between id and superego (primitive vs morals)
What is “ego ideal”
superego, what one wants to become
Topographic theory involves what three though processes?
- unconscious
- preconcious
- conscious
Compare topographic and structural theory components
- unconscious ~ id
- conscious ~ ego
- preconcious ~ superego
Which component (topographic and structural) uses defense mechanisms?
ego, unconscious
Which component completes reality testing?
ego
What are the four mature defense mechanisms?
SASH
1) sublimation
2) altruism
3) suppression
4) humor
Is sublimation conscious or unconscious?
conscious
What mature defense mechanism is described in the following example:
- street thug becomes social worker to reform kids in gangs
- person with unconscious urges to physically control others becomes prison guard
-sublimation!
unacceptable impulse –> acceptable action
In addition to mature defense mechanism, what other types exist?
- neurotic
- immature
What are the four immature defense mechanisms?
Note, mature= SASH, immature = ____, neurotic= all others
- RAP-D
- regression
- acting out
- projection
- denial
What immature defense mechanism is described in the following example?
-man accuses his wife of cheating on him which he himself is involved in an affair
projection
(ones own objectionable thought/emotion/action pinned on another)
I’m cheating –> you’re cheating
What neurotic defense mechanism is described in the following examples?
- student is angry with mom, so he talks back to his teacher at school
- husband is angry with female boss, so he yells at his wife at home
-displacement
(angry with mom –> angry with teacher)
(angry with boss –> angry with wife)
**Contrast with projection
(my thought= your thought, projection)
(my emotion towards one person= my emotion towards a less threatening target, displacement)
What type of defense mechanism is projection? displacement?
projection= immature displacement= neurotic
What neurotic defense mechanism is described in the following example?
-physician is dying of colon cancer –> describes details of pathophys for colon cancer to his young son
intellectualization
What neurotic defense mechanism is described in the following example?
-I bought a 500 dollar watch because I cant be late for appointments
-rationalization
(contrast with intellectualization, both of which are neurotic defenses)
intellectualization= avoid negative feelings toward situation by focusing on intellectual details rationalization = explain an event in order to justify it
Describe reaction formation
doing the opposite of an unacceptable impulse
kindergarteners are mean to the girls they have a crush on
Contrast repression and suppression
repression: unconscious removal of thought, neurotic
suppression: conscious act, mature
Describe “undoing”
attempting to reverse a situation by adopting a new behavior
(want to kill wife, clean her car instead)
(want to kill gullo, be nice to him anyways)
Psychoanalysis is _____ oriented.
Its goal is what?
insight
bring unconscious conflicts into awareness
Psychoanalysis is useful in the treatment of what disorders?
- PD (clusters B-C)
- anxiety
- sexual disorders
- PDD
- coping with life events
What are transference and countertransference in psychoanalysis?
- transference: unconscious feelings of patient toward an important figure transferred to therapist
- countertransference: projection of therapsists unconscious feelings onto patient
What are four psychoanalysis based therapies?
- psychoanalytically oriented psychotherapy
- brief dynamic psychotherapy
- interpersonal therapy
- supportive psychotherapy
Describe supportive psychotherapy
helps patient feel safe during difficult time, builds up mature defenses
(not insight oriented like typical psychoanalysis)
Who pioneered behavioral therapy?
Skinner
psychoanalysis= Freud
Behavioral theory is based on _____
learning theory
Describe classical conditioning
stimulus evokes a conditioned response
pavlovs dogs
Describe operant conditioning
behaviors learned via positive/negative reinforcement
Describe the systematic desensitization type of behavioral therapy
patient performs relaxing technique during anxiety provoking situation at increases doses
eventually they associated the experience with a relaxing technique
What is a behavioral therapy very similar to systematic desensitization
flooding and implosion
no low –> high dose of exposure, all at once
What is aversion therapy (behavioral therapy type)
that nail polish that tastes like poop to make you stop biting nails.
disulfiram for alcoholics
What is token economy behavioral therapy?
sticker charts in kindergarten.
do good desired behavior, get reward
What is biofeedback behavioral therapy?
patients are given their physiologic data during anxiety, migraine etc so they can tret to control visceral changes? weird?
What are the key types of behavioral therapy?
- systematic desensization/ flooding and implosion
- aversion therapy
- token economy
- biofeedback
Who pioneered cognitive therapy
Beck
freud= psychoanalysis, Skinner= behavioral
Cognitive therapy is most often used to treat what disorders?
depression and anxiety
usually combined with behavioral = CBT
How effective is cognitive therapy compared to medication
can just EQUALLY effective
Cognitive therapy is based on what?
cognitive theory of depression
(cognitive distortions and negative thoughts)
cognitive distortions= faulty assumptions. I’m not smart since I made a B.
Therapy that commonly involves “homework” after each session?
CBT
Good treatment for borderline PD?
DBT (dialectical behavioral therapy)
Therapy good for addiction?
group therapy
Why is group therapy so effective for addiction?
- patients gain insight into their own condition by listening to others talk about their own similar problem
- patients get immediate support from others
Family therapy is especially useful for _____
anorexia
schizophrenia
