Third Wave Therapies Flashcards
What are first wave therapies?
- Purely cognitive
- Purely behavioural
- Psychodynamic
- Psychoanalytic therapies
What are second wave therapies?
where we start to see these approaches being combined - cognitive and behavioural
e.g. CBT
What is a third wave therapy?
- Most have their roots in CBT but how they respond to thoughts is quite different
- More about accepting and giving space and allowing these thoughts to be but now having to engage with them, not having to do something in response to them
Give some examples of of 3rd wave therapies.
- mindfulness based cognitive therapy
- acceptance and commitment therapy
- compassion focused therapy
- dialectical behaviour therapy
What commonalities are in 3rd wave approaches?
- extend traditional cognitive approaches
- have an evidence base to show effectiveness
- differ from CBT in the response to negative thoughts
What is the focus for Dialectical Behaviour Therapy?
Behavioural contingencies and mindfulness and emotion regulation.
What is the focus of mindfulness based cognitive therapy?
mindfulness
What is the focus of acceptance and commitment therapy?
acceptance of what is and committing to valued action
What is the focus of compassion focused therapy?
compassion and self-soothing
What are characteristics of dialectical behaviour therapy?
- skills based
- often run as a group
- e.g. maybe your early experiences lead you to an invalidating early environment and perhaps you didn’t have the opportunity to learn some of these skills and that there are skills to be learnt
What do you learn in mindfulness based cognitive therapy?
- learning about being present in the moment and being non-judgemental
- draws on noticing what your brain is telling you
What do we learn in acceptance and commitment therapy?
how we can become more flexible in terms of our psychology and how that might support us in those tasks of acceptance and valued action
What is the role of compassion focused therapy?
- common humanity and how suffering is a common aspect of common humanity, something each of us will discover
- talking about different motivation systems and that very often we find people have an underdeveloped sense of self-soothing and struggle with the idea of relating compassion towards ourselves
Who invented compassion focused therapy?
Dr Paul Gilbert
What is compassion?
A sensitivity to the suffering of self and others - with a deep commitment to try and relieve it
From CFT perspective, what are the 2 different psychologies we aim to develop?
- Courage (the ability to understand, approach and engage with suffering and distress)
- Dedication & Wisdom (the desire and motivation to alleviate suffering, uproot its causes and seek to prevent suffering in the future
Explain emotions about emotions.
- common to have many different emotions at the same time
- e.g. anxious of getting angry, ashamed of losing our temper, ashamed of giving into temptation etc.
- conflicting emotions can be confusing
- learning to be kind and understanding of ourselves, and that our brain can be hard to fathom, can be helpful and to stop the self-attacking that can make things even more difficult to sort out
What type of approach is CFT?
- evolutionary & biopsychosocial approaches to psychological difficulties
- derived from the social mentality theory
What type of patients require CFT?
Individuals often come from harsh, critical backgrounds and find is difficult to feel safe and reassured
Explain the idea of multi-mind.
- different psychologies have been laid down at different times in evolution
- e.g. capacities for sex, fighting, and hunting can be traced back to reptiles over 500 million years ago
- evolution of mammals - psychologies for infant caring, alliance formation, play & status came into the world
- 2 million years ago saw the emergence of complex thinking, reflection, theory of mind, sense of self & self identity
What is the old brain?
various emotions and motivations that we share with other animals
- respond to that threat in a particular and behavioural and physiological pattern
What is the new brain?
gives us the ability to think, reflect, observe and form self identity
- means we can think and predict a lot more threat
How do problems arise when the old and new brain interact?
Example: bodily sensations when linked to the new brain can think, reason and give explanation that may include ‘my increased heart rate means I am going to have a heart attack and die’ - which fosters panic
Where is the analytical mind?
Neocortex brain
Where is the emotional mind?
Limbic brain
Where is the instinctive mind?
Reptilian brain
What are the 3 types of emotional regulation systems?
- incentive/resource-focused (drive)
- non-wanting/affiliative-focused (soothe)
- threat focused
What is the resource-focused system (drive system)?
Wanting, pursuing, achieving, consuming, activating
What is the affiliative-focused system (soothe system)?
safeness, kindness, soothing
What is the threat focused system?
Protection, safety-seeking, activating/inhibiting
What is the purpose of the threat system?
to pick up on threat quickly and give us bursts of feelings such as anger, anxiety, disgust which urge us to take action against threat - to self-protect Fight/Flight/Freeze/Flop
- also comes into play if there are threats to the people we love, and even imagined threats
How does the drive system work?
we’re motivated by and find pleasure in seeking out, consuming and achieving things
when we’re in drive system, we say yes more often
What is the function of the soothing system?
to bring about a certain soothing, quiescence and peacefulness to ourselves, which helps restore our balance.
linked to affection and kindness
often underdeveloped but can be very helpful
What are the compassionate attributes?
- motivation
- sensitivity
- sympathy
- empathy
non-judgemental - distress tolerance
What are compassionate skills?
- attention
- imagery
- thinking
- behaviour
- senses
- feeling
What is a threat-based mind?
- desire to fault-find
- top-down - fear of down rank attacks criticisms
- desire to punish and condemn
- backward looking - blaming and shaming
- give rise to threat-based solutions - mostly avoidance of harm or threat
What is a compassion-based mind?
- desire to understand and recognise suffering in all
- collaborative, genuine exploration - bottom-up and shared solutions
- desire to become one’s best
- shared learning and support for improvement
- open to suffering and struggle, openness to difficulties and building mutually supportive systems
What is ACT?
- at core it is a behavioural therapy: it’s about taking action
- rests of a theory of human language & cognition called relational frame theory
What does ACT aim to tap into?
- what does a person stand for in life
- what really matters to them
- what are the most important things for a person
- taking actions based on these values and taking actions mindfully
What is the aim of ACT?
to help us create a rich, full and meaningful life, while accepting the pain that inevitably goes with it
What are the 6 core therapeutic processes of ACT?
- Acceptance
- Defusion
- Contacting the present moment
- Values
- Committed action
- Self-as-context
Explain acceptance
Opening up and making room for painful feelings, sensations, urges, etc. Dropping the struggle and letting them be
Explain defusion
learning to ‘step back’ and detach from our thoughts, images, and memories. Instead of getting caught up in our thoughts or being pushed around by them, we let them come and go, recognising them for what they are - nothing more or less than words or pictures
Explain contacting the present moment
means being psychologically present, consciously paying attention and connecting with our here-and-now experience instead of drifting off into our thoughts and operating on ‘auto pilot’
Explain values
connecting to what truly matters to you.
values are desired qualities of ongoing action, they describe how we want to behave on an ongoing basis. clarifying values is essential in creating a meaningful life. values are like a compass, because they give us direction and guidancr
Explain committed action.
doing what it takes to live by our values even if that brings up pain and discomfort. taking action, guided by our values.
Explain self-as-context
the concept that we are not the content of our experience - we are not our thoughts, our feelings, our experienced sensations, the things we see, or the images that pass through our head
What is psychological flexibility?
the ability to be in the present moment with full awareness and openness to our experience, and to take action guided by our values
how does psychological flexibility improve mental health?
the greater our ability to be fully conscious, to be open to our experience and to act on our values, the greater quality of life because we can respond far more effectively to the problems and challenges life inevitably brings
How do people get so stuck?
- Cognitive Fusion
- Experiential Avoidance
What is cognitive fusion?
- being inseparable from our thoughts, caught up with them, fused to them, so much so that we aren’t even aware we are thinking
- allowing our thoughts to dominate our behaviour
- becoming so caught up in all the words & pictures running through our head that we lose contact with the world of direct experience
What is experiential avoidance?
- trying to avoid, get rid of, suppress, or escape from unwanted private experiences
- the more time and energy we spend trying to avoid or get rid of unwanted experiences, the more likely we’re to suffer psychologically in the long run
give examples of defusion
- normalising thoughts
- thanking your mind
- writing thoughts down
‘letting go’ metaphors
What cognitive competencies did pre-humans begin to evolve?
- reasoning
- reflection
- anticipating
- imagining
- mentalising
- creating a socially contextualised sense of self
what is mindfulness?
consciously bringing awareness to your here-and-now experience with openness, interest and receptiveness (how to explain it to clients)
What are core ACT interventions?
- Confronting the agenda (client’s agenda of emotional control is gently undermined)
- Control is the problem, not the solution (increase client’s awareness that emotional control strategies are largely responsible for their problems)
What disorders did Ost (2014) find that ACT should be efficacious for?
- chronic pain
- tinnitus
- depression
- psychotic symptoms
- OCD
- mixed anxiety
- drug abuse
- stress at work
