Psychotherapy Flashcards
Topographic model of mind – Freud
Conscious: what you’re aware of
Preconscious: can become aware of w/ effort
Unconscious: not aware of but may be influenced by
Symptoms are result of repressed memories (tx: lifting repression)
Ego
Conscious/unconscious – decision making and integration of data, integrates id and superego/deals w/ conflicts
Id
Unconscious, drives of sex/aggression, controlled by ego/superego
Superego
Mostly unconscious, incorporates moral conscience and values
Denial
Avoiding awareness of parts of external reality that are difficult to face (disregard real data)
Regression
Return to earlier phase of development/fxning to avoid conflicts w/ present development
Somatization
Converting emotional pain/affect state into physical symptoms
Projection
Perceiving/reacting to unacceptable inner impulse as if it were outside self (target doesn’t change)
Projection ID
Aspect of the self projected onto another person and pressure is placed on person to take those characteristics –> changes to behave/think/feel like what is projected
Acting out
Enacting an unconscious wish impulsively, avoid talking about painful emotions
Idealization
Attributing perfect qualities to others, avoids anxiety or negative feels (e.g. contempt, anger, envy)
Splitting
Compartmentalizing experiences of self/others so that integration is impossible (e.g. all good or all bad); common in borderline PD
Passive-Aggressive Behavior
Aggression is expressed indirectly/ineffectively (e.g. no meeting expectations as an indirect opposition)
Repression
Expel unacceptable ideas/impulses by blocking them from entering consciousness (deals w/ inner states)
Displacement
Shifts feelings assc. w/ one idea/person to another that resembles the original in some way
Dissociation
Drastic, temporary modification of identity/character to avoid emotional disress
Intellectualization
Using excessive/abstract thoughts to talk about difficult situations/emotions to avoid difficult feelings
Identification
Internalizing the qualities of another person by becoming like the person – experienced as being part of the person’s identity
Reaction Formation
Unconsciously transforming unacceptable wish/impulse to its opposite
Isolation of Affect
Separation of idea from assc affect state to avoid emotional turmoil
Rationalization
Justifying unacceptable attitudes, beliefs, or behaviors to make them tolerable to oneself
Humor
Finding comic/ironic elements in difficult situations to reduce unpleasant affect/personal discomfort – allows for distance and objectivity from events so that individual can reflect on what is happening
Suppression
Consciously deciding to not thinking about a particular feeling/idea/impulse – CONSCIOUS
Altruism
Committing oneself to needs of other over and above ones own needs – used for narcissism and guilt or source of great achievements and constructive contributions to society
Sublimation
Transforming socially objectionable or internally unacceptable aims into socially acceptable ones that don’t conflict w/ values
Extinction
Conditioned stimulus constantly repeated w/o unconditioned stimulus until response evoked weakens – disappears
Stimulus generalization
Conditioned response transferred to another stimulus
Discrimination
Process of recognizing/responding to differences between similar stimuli
Continuous reinforement
Action reliably –> effect; most rapid initial learning but most rapid distinction if not rewarded
Partial reinforcement
Action –> effect sometimes; better for maintenance, slowest extinction if not rewarded
Transference
Unconscious redirection of feelings/desires retained from the past that are redirected by the PATIENT TOWARD the therapist
Countertransference
Unconscious assoc. of feelings/desires from the past that the THERAPIST develops for the patient
6 strategies to establishing rapport
- Put pt at ease
- Find pts pain and express compassion
- Become an ally
- Show expertise
- Establish authority as physician/therapist
- Balance roles of empathic listener, expert, authority
Clarification
Questions/statements w/ goal to make more clear patient’s current thoughts/behavior
Interpretation
After listening, therapist links pts conscious thoughts/behavior to unconscious motivations
Psychodynamic Psychotherapy
Insight oriented – symptoms are from early experiences w/ buried conflicts – tx aims to uncover unconscious aspects of pts life –> insight into old patterns of relating/improved self-understanding; main themes: unconscious conflicts, repressed feelings, family issues from early life, difficulty w/ current relationships
Psychoanalysis
More intensive/rigorous psychotherapy – same principles of psychodynamic but pt seen 3-6/wk, treated by psychoanalyst, and lies on couch w/ therapist behind
Behavioral therapy
Focused on observable behavior, uses conditioning techniques, goal of improving symptoms w/o focusing on past
Systematic desensitization
Approaches feared situation gradually – relaxation training, hierarchy construction, desensitization by moving through hierarchy using relaxation techniques
Graded exposure
Same as systematic desensitization but in real life rather than imagined
Flooding
Pt immediately exposed to most anxiety-provoking stimulus w/o hierarchy (problem: compliance)
Implosion
Same as flooding but imagined
Token economy
Positive reinforcement – reward for completing desired duties or behaving appropriately – exchanged for privileges to act as positive reinforcers
Cognitive therapy
Based on belief that people constantly process/interpret info – interpretations based on more than just sensory info and bias –> negative/maladaptive ideas –> affect mood; therapy focuses on recognizing automatic thoughts and bringing them into awareness to be challenged
CBT
Combo of cognitive and behavioral; psychopathology result of distorted thinking which has negative impact on mood/behavior; uses collaboration and psycho education to test/change maladaptive cognitions, problem/goal oriented, time limited/structured, and focuses on the present
DBT
Dialectical behavioral therapy – eclectic therapy drawing from cognitive, behavioral, and supportive therapies; individual and group; pts seen q/wk x 1yr and taught to be mindful of present, better regulate emotions, and tolerate negative feelings; indication in borderline PD; goals: reduce self-destructive/injurious behavior, improve interpersonal skills
IPT
Interpersonal psychotherapy – addresses how pt interacts w/ others by focusing on current relationship sand improving pts interpersonal life; main areas addressed: grief, role transition, interpersonal conflicts, interpersonal deficits
Supportive psychotherapy
Examines symptoms, relationships, everyday fxning, patters of emotional responses w/ goal of improving symptoms, maintain/restore self-esteem, improve self-esteem, ego fxn, and adaptive skills
