Psychotherapies

Definition of Psychotherapy The use of psychological techniques used to facilitate positive changes in personality, behavior, and interpersonal problems.

What are reasons that bring people to therapy?

What are reasons that bring people to therapy? Increase self-awareness Personal growth Stress management Heal past Recover from addictions Behavioral changes Relationships/family problems Integrate different parts of themselves Catharsis (emotional release) Among many other reasons

Each school of psychology has it’s own assumption about the origin of the problem or issue, and meaning of the problem; Consequently, each school has it’s own tools to remedy the problem.

Let’s begin with Psychoanalysis The assumption is that problems result from repressed material (impulses, urges pushed into the unconscious) during childhood namely. So what techniques did Freud and now other psychoanalysts and psychodynamic therapists use to ameliorate or improve people’s symptoms as they saw them?

One technique is Free Association Free association is when a therapist notes any change in pattern (ie. pause before a response or change in voice tone) or defenses indicate to repressed material.

The second tool that psychoanalysts use is Dream Interpretation Dream interpretation existed before Freud, however he was the first to talk about this phenomena openly in the modern Western world. Freud wrote the first book on dreams in the Western world entitled The interpretation of dreams (1890). Freud saw dreams as the “Royal road to the unconscious.” Dreams were where the unconscious revealed repressed sexual thoughts and impulses that the dreamer did not allow expression during waking life.

The third tool is Transference Transference is where the patient projects mother, father, or other primary caregiver on to the therapist to relive old patterns that the patient was not previously aware of. The goal is for the therapist to use this transference material to help the patient move through it.

One last note about psychoanalysis: This form of therapy is directive,which means that the therapist leads, determines direction of therapy session, and meaning of free association and dreams. The therapist also helps the patient gain insight by drawing connections between one’s past and present situation.

The next form of therapy we will be learning about comes from Humanistic Psychology The assumption of this school is that individuals are innately good. If given a supportive environment, he or she will naturally flourish and grow. We learned about Abraham Maslow in the Motivation and Emotion chapter, now let’s turn our attention to Carl Rogers.

Roger’s form of Humanistic therapy is called: Client-centered therapy. Roger’s coins the term “client” because it establishes more of an equal power relationship between the person seeking help and the person providing the service. This differs from Freud’s use of the term “patient”, which places more power to heal with the clinician than the person seeking treatment.

As a result, client-centered therapy is: Non-directive. This means that the client leads and determines direction of therapy. This fits with the humanistic view that humans tend towards growth if given a supportive environment. And as a result, the individual will take the therapy session to where he or she needs.

Carl Roger’s highlights four primary components to client-centered therapy: The first is unconditional positive regard This is where the therapist creates a supportive atmosphere and provides total acceptance to client. The idea is that problems arise due to conditional love, which results in negative self-concept/image or low-self esteem. If a person experiences total acceptance and unconditional love from therapist, the person will naturally begin to regard self as better person and feel more compelled to move towards life/self-actualization.

Client-Centered Therapy How do you feel when another person is totally supportive of you and accepts you know matter what? With this school, do you see that we get out of the shaming part of discipline or treatment of people?

The next component of Client-Centered Therapy is: Empathy Empathy is the ability to place oneself in another’s shoes with compassion. Even if you have never experienced what the other person is going through, you can imagine and try to place yourself in that situation.

Empathy differs from sympathy Empathy means to place yourself in another’s shoes as we just discussed, and Sympathy means to feel sorry for another person. Sometimes, another person is sharing an experience not for you to feel sorry or bad for them, but for them to have a loving witness and compassion.

The third component of Client-Centered Therapy is: Reflecting or mirroring This is where the therapist shows true interest and actively listening to the client by reflecting back (in essence summarizing) what she heard the client say is going on and the underlying meaning. It also provides clarification of problems, self-concept (how one sees oneself), and gives a change for the client to hear how the therapist understood what she was saying, with the possibility of clarifying, if necessary.

The last component of Client-Centered Therapy is: Genuineness This is really the heart to how one approaches client-centered therapy. As Roger’s says in the video clip for this week’s assignments, genuineness for him is being real. Sometimes, people report that it sounds too “by the book” or scripted to reflect back what someone else says, however, if you really try to capture the essence of what another is grappling with and either use key words or paraphrase, then it can be experienced as sincere by the giver and receiver.

The third therapy we will be looking at comes from the Behavioral school Behavior Therapy, also known as Behavior modification, where we are attempting to change a maladaptive behavior, and not the entire personality. For example, even if know why do something (ie. afraid of public speaking because of critical parent) you still do it. Here we are working on simply changing the behavior.

The assumption for behavior therapy is that: Maladapted behavior is learned and arises out of poor conditioning. As a result, we will recondition person to have a more productive behavior.

This form of therapy is: Action based And, Directive

Behavior Therapy relies on Systematic Desensitization Systematic desensitization is a form of classical conditioning. The behavioral therapist helps create an anxiety hierarchy, where the least anxiety provoking situation is listed on the bottom, gradually moving to most anxiety provoking situation, at the top of the list.

For example, Let’s take the fear of flying. This is a possible anxiety hierarchy: 5) Sitting on a stationary plane 4) Buying an airplane ticket for a trip 3) Driving to the airport 2) Watching a video clip of a plane flying 1) Looking at a picture of a plane Do you see how each successive step becomes increasingly anxiety provoking?

Think of a phobia or fear that you have and: Construct your own anxiety hierarchy, starting with the least anxiety provoking at the bottom moving your way up (try to think of at least five steps).

Reciprocal inhibition This is where one emotional state blocks another It is important to note that before moving on to subsequent stages we need to consider: Reciprocal inhibition This is where one emotional state blocks another For example, relaxation and anxiety cannot exist simultaneously. Before moving up each subsequent step, the client must achieve complete relaxation.

To help the person achieve relaxation, Behavioral Therapy relies on: Progressive Muscle Relaxation (PMR) This is where each muscle group contracts for several seconds, and then rests for 20 seconds. After the contraction of muscles, your body actually feels more relaxed. Constructing a control scene This is where one visualizes a peaceful place, where one feels safe and relaxed.

As a person goes through each step of the anxiety hierarchy, it is important for the individual to turn to his or her control scene and to practice PMR to achieve complete relaxation prior to moving to the next step on the anxiety hierarchy.

The last form of therapy we will be addressing comes form the Cognitive School.

Cognitive Therapy (CT) Was created by Aaron Beck. In the beginning of the term, we explored Albert Ellis’ ABC Model which is part of his Rational Emotive Behavioral Therapy (REBT).

The assumption this school has for why a person has an issue or problem is: Our dysfunctional thinking patterns lead to destructive behavior and emotional life. The goal then would be to change destructive self-talk and core beliefs.

Please read the “Dysfunctional Thought Patterns” article to get a thorough understanding of the 8 patterns Aaron Beck lists. Once we become aware of our thoughts, we can then shift them so that they are aligned with our highest good, healthy, and productive!! It is the idea that our thoughts create our reality, and if this is indeed the case, then we need to become much more vigilant of our thoughts!!

In Conclusion: Like we learned from the first chapter on schools of psychology, Each school has their own assumption as to why a person has a problem, and consequently, their own tools to address the issue. As we learn about the tools from each school, we are increasing our tool bag so that we can use the best tool to address the particular issue or person. Remember, when we use them in an integrated fashion at look at people holistically, the most profound transformation is possible.