Insight Therapies: Psychoanalytic and Humanistic Approaches

• The psychoanalytic approach to the treatment of disordered behavior is rooted in the concept of insight.

• Insight into the cause of the problem, according to this theory, is the primary key to eliminating the problem.

Psychoanalysis

• Psychoanalysis, or psychoanalytic therapy, as it is sometimes called, was first developed by Freud and focuses on probing past defense mechanisms of repression and rationalization to understand the unconscious cause of a problem.

• Countertransference may occur if the therapist transfers his or her own feelings onto the patient.

Humanistic Therapy

• The humanistic school of psychology takes a related, yet different approach to the treatment of disordered behavior.

• Client-centered therapy was invented by Carl Rogers and involves the assumption that clients can be understood only in terms of their own realities.

  • The client-centered therapist approaches this differently from the Freudian.

• The therapist is honest, open, and emotional with the client (an active listener).

  • Rogers called this client-relationship genuineness.

• The next key for successful client-centered therapy, according to Rogers, is unconditional positive regard.

  • Unconditional positive regard is a term used in psychology to refer to an attitude of acceptance and warmth towards another person, regardless of their behavior or beliefs.

  • The therapist provides this unconditional positive regard to help the client reach a state of unconditional self-worth.

• The final key to successful therapy is accurate empathic understanding.

  • Accurate empathic understanding is the ability to accurately understand and identify what someone else is feeling.

• Rogers used this term to describe the therapist’s ability to view the world from the eyes of the client.

• This empathy is critical to successful communication between the therapist and client.

• A different type of approach toward treatment is Gestalt therapy, which combines both physical and mental therapies.

• Fritz Perls developed this approach to blend an awareness of unconscious tensions with the belief that one must become aware of and deal with those tensions by taking personal responsibility.

Behavioral Therapy

• Behavioral therapy stands in dramatic contrast to the insight therapies.

• Counterconditioning is a technique in which a response to a given stimulus is replaced by a different response.

• Counterconditioning can be accomplished in a few ways.

  • One is to use aversion therapy, in which an aversive stimulus is repeatedly paired with the behavior that the client wishes to stop.

  • Another method used for counterconditioning is systematic desensitization.

  • This technique involves replacing one response, such as anxiety, with another response, such as relaxation.

• Other forms of behavioral therapy involve extinction procedures, which are designed to weaken maladaptive responses.

  • One way of trying to extinguish a behavior is called flooding.

  • Flooding involves exposing a client to the stimulus that causes the undesirable response.

• Implosion is a similar technique, in which the client imagines the disruptive stimuli rather than actually confronting them.

• Operant conditioning is a behavior-control technique that we discussed in the chapter on learning.

  • A related approach is behavioral contracting, in which the therapist and the client draw up a contract by which they both agree to abide.

• Modeling is a therapeutic approach based on Bandura’s social learning theory.

  • This technique is based on the principle of vicarious learning.

Cognitive Therapy

• Cognitive approaches to the treatment of disordered behavior rely on changing cognitions, or the ways people think about situations, in order to change behavior.

• One such approach is rational-emotive behavior therapy (REBT) (sometimes called simply RET, for rational-emotive therapy), formulated by Albert Ellis.

• Another cognitive approach is cognitive therapy, formulated by Aaron Beck, in which the focus is on maladaptive schemas.

• Maladaptive schemas include arbitrary inference, in which a person draws conclusions without evidence, and dichotomous thinking, which involves all-or-none conceptions of situations.

Biological Therapies

• Biological therapies are medical approaches to behavioral problems.

• Biological therapies are typically used in conjunction with one of the previously mentioned forms of treatment.

• Electroconvulsive therapy (ECT) is a form of treatment in which fairly high voltages of electricity are passed across a patient’s head.

  • This treatment causes temporary amnesia and can result in seizures.

• Another form of biological treatment is psychosurgery.

  • Perhaps the most well-known form of psychosurgery is the prefrontal lobotomy, in which parts of the frontal lobes are cut off from the rest of the brain.

• Psychopharmacology is the treatment of psychological and behavioral maladaptations with drugs.

  • There are four broad classes of psychotropic, or psychologically active drugs: antipsychotics, antidepressants, anxiolytics, and lithium salts.

• Antipsychotics like Clozapine, Thorazine, and Haldol reduce the symptoms of schizophrenia by blocking the neural receptors for dopamine.

• Antidepressants can be grouped into three types: monoamine oxidase (MAO) inhibitors, tricyclics, and selective reuptake inhibitors.

• MAO inhibitors, like Eutron, work by increasing the amount of serotonin and norepinephrine in the synaptic cleft.

• Tricyclics, like Norpramin, Amitriptyline, and Imipramine increase the amount of serotonin and norepinephrine.

• The third class of antidepressants, selective reuptake inhibitors (often called the selective serotonin reuptake inhibitors, or SSRIs, for the neurotransmitter most affected by them) also work by increasing the amount of neurotransmitter at the synaptic cleft, in this case by blocking the reuptake mechanism of the cell that released the neurotransmitters.

• Anxiolytics depress the central nervous system and reduce anxiety while increasing feelings of well-being and reducing insomnia.

• Benzodiazepines, which also include Valium (Diazepam) and Librium (Chlordiazepoxide), cause muscle relaxation and a feeling of tranquility.

• Lithium carbonate, a salt, is effective in the treatment of bipolar disorder.

MODES OF THERAPY

• Group therapy, in which clients meet together with a therapist as an interactive group, has some advantages over individual therapy.

• Twelve-step programs are one form of group therapy, although they are usually not moderated by professional psychotherapists.

• Another form of therapy in which there is more than a single client is couples or family therapy.

  • This type of treatment arose out of the simple observation that some dysfunctional behavior affects the afflicted person’s loved ones.

Next Chapter: Chapter 18: Social Psychology