Psychotherapy Flashcards
ID
Unconscious
Governed by pleasure
Contains contradictions
No concept of time
Neurosis
Feelings linked to memories that are unacceptable and stuffed by mental mechanisms
Ego
NO EMOTIONS
Parapraxis
Freudian slip!
Dreams
Condensation Diffusion Displacement Projection Symbolisation
NO REGRESSION
Psychosexual development
0-18 months = oral 18 months - 3 years = anal 3 years - 5 years = phallic 5 years - puberty = latent puberty - death = genital
During which psychosexual development phase is the Oedipus complex?
PHALLIC
3-5 years
Want to possess mother and replace father
Developmental stages of anxiety
- Disintegration
- Annihilation
- Separation
- Castration
- Superego
Contra-indications to psychodynamic therapy
Psychosis
OCD
SUD, active
ASPD
Defense mechanisms
George Vaillant
4-tiered hierarchy
- Primitive (psychologically fleeing reality)
- Immature
- Neurotic
- Mature
Primitive defence mechanisms?
Psychotic denial
Delusional projection
Psychotic distortion
Omnipotence
Immature defence mechanisms?
Denial Projection Splitting Regression Acting out Somatisation Projective identification Introjection Passive aggressive Schizoid fantasy Hypochondriasis
Neurotic defence mechanisms?
Displacement Intellectualisation Rationalisation Isolation of affect Reaction formation Dissociation Repression Sexualization Retroactive cancelling Control Externalizing Inhibition
Mature defence mechanisms?
Altruism Anticipation Asceticism Humor Sublimation Suppression Affirmation
Biopsychosocial model?
Georges Engel
Alfred Adler
Inferiority complex
Organ inferiority
Masculine protest
Family rank (siblings reacting to births)
Franz Alexander
Corrective emotional experience
Re-expose the patient, under more favourable circumstances, to emotional situations which could not be handled in the past.
Erikson Stages of Ego Development
0 - 18 months = Trust vs. mistrust
18 months - 3 years = Autonomy vs. shame/doubt
3 - 5 years = Initiative vs. guilt
5 - 13 years = Industry vs. inferiority
13 - 20 years = Identity vs. role confusion
20 - 45 years = Intimacy vs. isolation
40 - 60 years = Generativity vs. stagnation
> 60 years = Ego integrity vs. despair
Mahler Separation-Individuation theory
0-2 months = Normal autism 2-5 months = Normal symbiotic 5-10 months = Differentiation 10-18 months = Practicing 18-24 months = Rapprochement 24-36 months = Object CONSTANCY
Piaget cognitive development
0-2 years = sensorimotor stage (OBJECT PERMANENCE)
2-7 years = pre-operational (EGOCENTRIC)
7-11 years = concrete operational (CONSERVATION)
> 11 years = formal operational (ABSTRACT, HYPOTHETICAL)
Otto Kernberg
Borderline organization
Wilfred Bion
Projective identification
Donald Winnicott
GOOD ENOUGH MOTHER (mother gradually allows baby to experience some frustration so baby can build an external reality)
Melanie Klein
- Schizo-paranoid position: primary anxiety = annihilation, BAD BREAST
- Depressive position: incorporate good and bad, ambivalence
Assimilation
Integrate external elements in mind
Accommodation
Adjust internal structures based on situation
Bowlby
Secure base
Attachment behaviour is INNATE and triggers innate response in mother
4 stages of grief based on attachment?
- Acute despair
- Anger & research
- Empty and disorganized
- Re-organization
Mary Ainsworth attachment types
- Secure = 60% in kids @ 2yo
- Anxious-ambivalent = distressed at separation, angry rejection, ambivalent at reunion, exaggeration reaction for attention, inconsistent parental responses
- Avoidant = not affected by separation, avoids contact when reunited, focuses on toys, minimizes attachment
- Disorganized = contradictory behaviour when reunited, neglect, risk factor for dissociation
René Spitz
Anaclitic depression
Attunement
Parent mimics child’s play
Heinz Kohut
Self-object, self-psychology
- Grandiose self = mirror transference
- Alter ego = twinship transference
- Ideal parent image = idealizing transference
Carl Jung
Introverted vs. extroverted
Persona = public image
Anima = undeveloped femininity in males Animus = undeveloped masculinity in females
Thomas & Chess temperament
- Easy (40%)
- Difficult (10%) - 70% WILL DEVELOP CD
- Slow to warm up (15%)
- No category (35%)
Cloninger temperament
- Harm avoidance = SEROTONIN, high in cluster C
- Reward dependence = NE, low in cluster A
- Novelty seeking = DOPAMINE, high in cluster B
- Persistance, ANTERIOR CINGULATE CORTEX
3 character traits
Self-directedness
Cooperativeness
Self-transcendance
Malan triangles
- Urges (impulses)
- Defense
- Anxiety
- Therapist
- Parents (past relationships)
- Others (current relationships)
Systemic Desensitization
Gradual exposure + relaxation techniques
Joseph Wolpe
Classic conditioning
PAVLOV
Pairing neutral stimulus with unconditional stimulus (flooding, exposition)
Operant conditioning
SKINNER
Shaping, reinforcement, punishment
Intermittent reinforcement with variable behaviour ratio = most addictive (video-poker)
Extinction
Works with flooding
Gradual decrease in conditional response when no longer paired with unconditional stimulus (aka salivate less at bell if no longer paired with food)
Generalisation
Conditional response to conditional stimulus also triggered by other similar stimuli
Seligman
LEARNED HELPLESSNESS
Premack principle
Use a frequent behaviour to reinforce an infrequent one (AKA NO BROCCOLI = NO DESERT)
Immersion
Expose to the most fearful situation right away
Interoceptive exposure
Induce feared physiological sensations (dizziness, hyperventilation)
Aaron Beck
Empirical collaboration (explain to patient and have them agree with steps of therapy)
Socratic questioning (ask questions to lead to patient to their own answers)
Retroaction (homework)
Beck Triad
Vision of self
Vision of future
Vision of world
IPT
Klerman and Weissman
- Bereavement
- Interpersonal conflict
- Role transition
- Interpersonal deficit
Contraindications to couple therapy
- severe psychosis
- one couple desires divorce
- one parter refuses to participate
Biofeedback
OPERANT conditioning
Tension headache Migraines Asthma Arrhythmia Raynaud's
Group psychotherapy contra-indications
Severe acting out Acute psychotic/paranoid/suicidal ideations Excessif denial Doesn't tolerate group setting Incompatibility with other group members Language barrier
Most important therapeutic factor in group therapy?
COHESION
5 family therapy models
- Structural (Minuchin)
- Circular questioning (Tomm)
- Systemic/intergenerational (Bowen)
- Experiential (Satir, Whitaker)
- Strategic (Milton, Haley)
Structural family therapy
MINUCHIN
Frontiers
Hierarchy
Alliances/coalition
Circular questioning family therapy
TOMM
One member describes another in terms of differences and changes
Systemic/intergenerational family therapy
BOWEN
Neurotic repetition
Degree of differentiation
Emotional triangle (HOT TRIANGLE)
GENOGRAM
Experiential family therapy
SATIR, WHITAKER
Importance of current experience and spontaneity
FAMILY SCULPTURE
Strategic family therapy
MILTON, HALEY
Family life cycle
Resistance, power
Contraindications to family therapy
Member emotionally unstable History of violence Collusive rigid family Family religious beliefs Essential member refuses treatment Not priority (ex: treat addiction first)
Pillars of existential therapy?
Sens (meaning)
Liberté (freedom)
Isolement (isolation)
Mort (death)
How young for CBT?
6 years old
Kugler-Ross stages of grief
- Denial/shock
- Anger (why me?)
- Bargaining
- Depression (Beck triangle)
- Acceptance (death is inevitable)
Primary process
Condensation
Displacement
Symbolic representation
Reminiscence therapy
Increase tolerance of conflict Increase self-esteem Acceptance Relieve guilt and fears Resolve old problems Increase life meaning
NOT focused on intrapsychic conflict
Basic principles of motivational interviewing
Express empathy
Develop discrepancy
Roll with resistance
Support self-efficacy
Ideal size for group therapy?
8-10 patients
IPT indications
MDD (acute, recurrent, maintenance, geriatric, adolescent, HIV+, postpartum, antepartum)
BAD (adjunctive)
Dysthymia (limited evidence)
Bulimia (individual or group)
First steps in CBT
Trust Rapport Educate Normalize difficulties Instill hope Elicit/correct expectations Goal list
What’s not included in stress management therapy?
PEER SUPPORT
Order of interpretation in brief dynamic psychotherapy?
Defense
Anxiety
Impulse
Winnicott
Capacity for TRUST and FAITH
“Narcissistic” defence mechanisms
Denial
Distortion
Projection
Transference neurosis
Return to earlier forms of relating
Repeating patterns
Specific to psychoanalysis
Ego functions
Control of instinctual drives
Relation to reality
Judgment
Object relationships
Fixation
Stuck on stage of psychosexual development
NOT DEFENCE MECHANISM
