14 th December 2015 Dr. Sami Adil

Psychoanalysis and related therapies (e.g., psychoanalytically oriented psychotherapy, brief dynamic psychotherapy) are psychotherapeutic treatments based on Freud’s concepts of the unconscious mind, defense mechanisms, and transference reactions

The central strategy is to uncover experiences that are repressed in the unconscious & integrate them into the person’s conscious

Techniques to recover repressed exp. 1. Free association. the person lies on a couch in a position facing away from the therapist and says whatever comes to mind (free association). 2. Interpretation of dreams 3. Analysis of transference reactions is used to examine important past relationships

People who are appropriate for using psychoanalysis 1. Are younger than 40 years of age. 2. Are intelligent and not psychotic. 3. Have good relationships with others (e.g., no evidence of antisocial or borderline personality disorder). 4. Have a stable life situation (e.g., not be in the midst of divorce). 5. Have the time and money to spend on treatment.

In psychoanalysis, people receive treatment 4–5 times weekly for 3–4 years; related therapies are briefer and more direct (e.g., brief dynamic psychotherapy is limited to 12– 40 weekly sessions).

Behavioral therapy Based on learning theory The unconscious is not important here Systematic desensitization, aversive conditioning, flooding and implosion, token economy, biofeedback, and CBT

Systemic desensitization (phobias)

Aversive conditioning (paraphilia, addiction)

Flooding and implosion (phobia)

Token Economy

Biofeedback (HT, headache, pain)

CBT (dep., somatic symptoms dis)

Group therapy 1. Groups with therapists -about eight people with a common problem -meet weekly for 1–2 hours - Members of the group provide the opportunity to express feelings as well as feedback, support, and friendship to each other. -The therapist has little input. He or she facilitates and observes the members’ interpersonal interactions. -Cost effective

2. Leaderless groups - no one person is in authority. - Members of the group provide each other with support and practical help for a shared problem (e.g., alcoholism, loss of a loved one, a specific illness). -e.g. Narcotics Anonymous (NA) and Overeaters Anonymous (OA) and the Alcoholics Anonymous (AA)

Family therapy it is based on the family systems idea that psychopathology in one family member (i.e., the identified patient) reflects dysfunction of the entire family system, i.e. the family (not the identified patient) is really the patient. Strategies of family therapy include identifying dyads (i.e., subsystems between two family members), triangles (i.e., dysfunctional alliances between two family members against a third member), and boundaries (i.e., barriers between subsystems) that may be too rigid or too permeable.

Specific techniques are used in family therapy. a. Mutual accommodation is encouraged. This is a process in which family members work toward meeting each other’s needs. b. Normalizing boundaries between subsystems and reducing the likelihood of triangles is encouraged. c. Redefining “blame” (i.e., encouraging family members to reconsider their own responsibility for problems).

Supportive therapy Supportive therapy is aimed not at insight into problems, but rather at helping people feel protected and supported during life crises (e.g., serious illness of a loved one). For people with chronic mental illnesses, supportive therapy may be used over many years along with medication.

Interpersonal skills Based on the idea that psychiatric problems such as anxiety and depression are based on difficulties in dealing with others, interpersonal therapy aims to develop interpersonal skills in 12–16 weekly sessions.