Psychotherapy Flashcards
What is idealization and when is it used?
Attributing perfect qualities to others while ignoring any flaws (to ignore negative thoughts)
- > avoids anxiety or negative feelings such as contempt, envy or anger
- > if you are anxious about your cancer, this might be a defense to make yourself feel like you’re in good hands
What is splitting and who is this common in?
Compartmentalizing experiences into good or bad so that ambiguity is impossible
Common in borderline personality disorder
When is repression? How does this differ from denial and suppression?
Involuntary withholding of an unacceptable idea / impulse from consciousness
Denial -> Refutation of external data. Repression is denial of inner data
Suppression -> Intentional and temporary withholding of an unacceptable idea / impulse
What is displacement?
Shifting of feelings associated with one idea or person to another
-> you get mad at your boss so you yell at your wife
What is dissociation? Give an example.
A drastic, temporary modification of identity / character to avoid emotional distress
-> feel numb and detached when thinking about abusive event
What is intellectualization?
Using excessive facts and logic to emotionally distance oneself from a stressful situation
-> i.e. focusing only on mechanism of action or survival rates of a new diagnosis rather than how you feel
What is identification? Give an example?
Unconscious assumption of the characteristics, qualities or traits of another person or group. This happens when you internalize the qualities of someone as part of their identity, and you want to be like them.
I.e. a child who stays up late to be like his parents
What is reaction formation vs sublimation?
Reaction formation -> doing the opposite of an unacceptable wish or impulse. I.e. going to a monastery when you feel like having sex, overcompensating but not being genuine.
Sublimation -> channeling those feelings into something positive / something that does not conflict with your value system -> i.e. former cocaine addict works for a substance abuse hotline to help others after he feels like smoking da crack
What is Isolation of Affect? Example?
Separating feelings from ideas and events
-> i.e. describing murder in graphic detail with no emotional response, as if he was describing the weather
What is rationalization?
Justifying unacceptable attitudes, beliefs, behaviors, or outcomes to make them tolerable to oneself, even if the justification is not a good one and you know it internally -> will still feel uncomfortable after the justification
How does suppression differ from repression and denial?
Suppression is conscious
Repression and denial are not conscious
What is transference?
Patient projects feelings about formative or other important persons on the therapist (i.e. therapist reminds patient of mother, so patient starts to feel about the therapist like she does her mother)
What is countertransference?
Therapist projects feelings about formative or other important persons on the patient (patient reminds therapist of younger sibling or previous patient)
What is behavioral therapy?
Uses classical and operant conditioning to modify maladaptive observable behaviors
-> little focus on past history
What is systematic desensitization / how does it work?
Technique of behavioral therapy: approach the feared situation gradually using relaxation techniques.
- Construct hierachy of anxiety provoking scenes
- Move through the hierarchy via imagined scenarios until you are desensitized. Paused for relaxation whenever needed
How does graded exposure differ from systematic desensitization?
Graded exposure = doing systematic desensitization in real life.
i.e. moving through the hierarchy when you have a fear of flying by looking at pictures, then going to airport, flying on plane short trip, etc
What is flooding and why is it not often done?
Behavioral therapy technique where you give the most anxiety-provoking stimulus first
Not done often due to low compliance
What is implosion?
Carrying out flooding in imagined scenarios
-> Implosion is to systematic desensitization as flooding is to graded exposure
What is cognitive therapy? What is therapy centered around?
Therapy based on belief that people constantly process / interpret sensory information, and biases in this processing can lead to maladaptive / negative ideas
-> therapy is centered around exposing automatic thoughts and challenging these thought processes by challenging the underlying beliefs which lead to them.
What is cognitive behavioral therapy? How does this relate to psychoeducation?
A combination of cognitive and behavioral therapy.
Cognitive:
Focused around stopping maladaptive automatic thoughts and challenging negative core beliefs. Psychoeducation is teaching patient to challenge these on their own
Behavioral part:
Teaching coping / relaxation strategies, for instance
What type of therapy is indicated specifically for borderline personality disorder and how does it work? What is the goal?
Dialectical Behavioral Therapy (DBT)
Individual and group therapy which draws from CBT and supportive psychotherapies.
- > see individuals weekly for 1 year. Taught to be mindful of present, regulate their emotions, and accept negative feelings
- > goal is to reduce self destructive / self harm behaviors and improve interpersonal skills
What are the advantages of general group therapy for a condition rather than individual therapy? Give an example of a group therapy group.
Immediate feedback from patient’s peers
Chance to observe patient’s responses / interactions to a variety of people
Example: Alcoholics anonymous
What is the most efficacious treatment plan for most patients?
A combination of psychotherapy and pharmacotherapy
Mild disorders -> therapy alone may be indicated
Severe (bipolar or psychotic) -> treatment with therapy as adjunct
What are a few indications for recommending psychotherapy?
Pregnancy / breastfeeding -> meds often teratogenic
At patient’s request or if patient has symptoms despite pharmacologic treatment
