Psychotherapy Flashcards
What is the theory of psychotherapy
One’s present outlook shaped by past and unconscious psychological forces
Three stages of conflict
Non-resolvable conflict
Attempt to repress
Return of conflict in disguised form
What are defense mechanisms
Unconsciously activated in response to anxiety provoking events and feelings
Types of defense mechanisms
Level 1->Psychotic defenses
Level 2->Immature defenses
Level 3->Neurotic defenses
Level 4->Mature defenses
What are the psychotic defenses and when are they seen
Seen in psychotic disorders, childhood and dreams
Denial->replace reality with wishful thinking
Distortion->distorting reality to meet inner beliefs
Projection->Interpreting internal impulses as though they are outside oneself, delusion about reality
What are the immature defenses and when are they seen (7)
Seen in personality disorders, severe depression and adolescence
Acting out->unconscious wishes expressed through impulsive action
Introjection->internalise qualities of object
Blocking->feeling, affect, impulse
Hypochondriasis->exagerration of illness
Somatisation->unconsious expression of psychic pain/tension as physical symptoms
Regression->revert to earlier stage of development to avoid current stressors
Passive agressive
What are the neurotic defenses and when are they seen
Common in adults
Controlling
Displacement->shifting emotional response to object/person which resembles anxiety provoking
Externalisation->attributing moods/attitudes/conflicts to external world or objects
Inhibition->limiting function to avoid anxiety provoking internal conflicts
Intellectualisation
Isolation
Rationalisation->rationality to justify behaviours which are unacceptable
Dissociation->modification of sense of self to avoid emotional distress
Reaction formation->transforming an unacceptable impulse to itsopposite
Repression-> removing from consciousness an idea/feeling
Sexualisation
What are the mature defences and when are they seen
Common in emotionally healthy individuals
Altruism
Anticipation->planning for future discomfort
Asceticism->denying pleasurable effects of an experience
Humor
Suppression->postpone attention to impulse/conflict
Types of psychodynamic therapy (4)
Psychoanalysis
Supportive psychotherapy
Short/brief psychotherapy
Interpersonal psychotherapy
What is psychoanalysis
Original psychotherapy Developed by Frued Self-revelation and insight Time intensive Need tolerance for ambiguity
What is supportive psychotherapy->goal and techniques
Goal is to reduce anxiety, not insight \+mature defenses Enhancing self esteem Clarification Confrontation Rationalisation Reframing Encouragement Anticipation De-catastrophising
What is brief psychotherapy used for
Resolution of particular emotional problems, acute crisis
Limited time
What is interpersonal psychotherapy
Looks at relationship patterns, coping
Personal social roles/relationships and how that causes problems with current functioning
Behavioural therapy->what is it, use, techniques
Modification of internal/external events which precipitate/maintain distress Systematic desensitisation Flooding Positive reinforcement Negative reinforcement Extinction (not rewarding behaviour) Punishment (aversion therapy) Relaxation Breathing Graded tasks Coping cards
Cognitive therapy->theory, goal, use, techniques
Moods/emotions influenced by thoughts Goal is to identify the automatic thoughts and correct assumptions Use-anxiety, depression Thought records->situation, feeling, thoughts, cognitive distortion Socratic questioning Guided discovery Examining the evidence Examining advantages and disadvantages Identifying cognitive errors Generating rational alternative Imagery Role play Rehearsal
How does CBT work
Combination of behaviour and cognitive->learn to weaken associations between cognition, behaviours and mood/anxiety
What is dialectical behavioural therapy, four skills and use
Combination of CBT and buddhist mindfullness
Originally for borderline personality
Skills->mindfullness, emotional regulation, interpersonal effectiveness and distress tolerance
Other therapies->
Group psychotherapy
Family therapy
Hypnosis
Mindfullness-based-cognitive therapy
Excesses and deficits in behavioural therapy
Excesses->anxiety, depression, avoidance, drinking, aggression, over-activity
Deficits->problem solving, impulse control, physical calming strategies, regular time out, sexual arousal, pleasurable activities, social skills
How to treat excesses
Reward more adaptive alternative behaviours
Impulse control strategies
Reduce rewards for undesired behaviours
Behavioural contracts with self/other to raise motivation
How are deficits treated
Acquire/strengthen more adaptive alternative behaviours
Instruction, modelling, supporting
Behavioural contracts with others to +motivation
Assumptions of CBT
Our thoughts interact with affect, behaviour and events.
So the event in itself does not automatically generate anxiety/depression
Our self talk depends on our past experiences, views and experiences
Adaptive changes in any part of the cycle->Event, cognitive appraisal, emotion and behaviour can improve response
CBT addresses cognitive, behavioural, physiological, emotional and environmental dimensions
Controlled breathing for panic attack
Patient education->fight, flight, freeze response
Feedback from lungs to limbic system via vagus nerves reduces NE->positive feedback
Calm body cal mind rationale
Slow and stead breathing
Breath-holding for 6 seconds ->in 3 seconds, out 3 seconds, via nostrils / pursed lips
Demonstrate for one hour
12-20 breaths/minute
Thought change record
Situation Negative thoughts Degree of belief Feeling Alternative thoughts Degree of belief in original thought Feeling
