Psych Ch 14

• a prescribed medication or medical procedure that acts directly on the pts nervous system
• used for biologically influenced disorders such as schizophrenia

an approach to psychotherapy that, depending on the client's problems, uses techniques from various forms of therapy

attempts to combine a selection of assorted techniques into a single coherent system

• treatment involving psychological techniques
• consists of interactions btwn a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth

• Sigmund Freud's therapeutic technique
• he believed the pt's free associations, resistances, dreams, and transferences - and the therapist's interpretations of them - release previously repressed feelings, allowing the pt to gain self-insight

• Freud believed that psychoanalysis would help people achieve healthier, less anxious lives by gaining insight into the unconscious origins of their disorders and by taking responsibility for their own growth
• Methods: free association, dream analysis, and interpretation of resistances and transference to the therapist of long-repressed feelings

• is briefer and less expensive than traditional psychoanalysis
• if focuses on current symptoms and themes common to many past and present important relationships

• in psychoanalysis, the blocking from consciousness of anxiety-laden material
• to the analyst, hints that anxiety lurks and you are defending against sensitive material

in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight

in psychoanalysis, the pts transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)

therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight

• a variety of therapies which aim to improve psychological functioning by increasing the client's awareness of underlying motives and defenses 
• psychoanalytic and humanistic therapies are often referred to as this

aim to boost people's inherent potential for self-fulfillment by helping them grow in self-awareness and self-acceptance

• they focus on:
• the present and future more than the past by exploring feelings as they occur, rather than delving into childhood origins of the feelings
• conscious rather than unconscious thoughts
• taking immediate responsibility for one's feelings and actions, rather than uncovering hidden determinants
• promoting growth instead of curing illness
• *thus, those in therapy became clients rather than pts

• a humanistic therapy, developed by Carl Rogers, in which the therapist used techniques such as active listening within a genuine, accepting, & empathic environment to facilitate clients' growth
• considered nondirective therapy, where the therapist listens to persons conscious self-perceptions w/o judging, interpreting or directing client toward insights

• empathic listening in which the listener echoes, restate, and clarifies what the person expresses, and acknowledging the expressed feelings
• a feature of Rogers' client-centered therapy, who felt the therapists most important contribution is to accept and understand client

a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help clients to develop self-awareness and self-acceptance

• therapy that applies learning principles to the elimination of unwanted behaviors
• *do not attempt to explain the origin of problems or to promote self-awareness.  Instead, they attempt to modify the problem behaviors themselves

• a behavior therapy procedure that uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors
• the therapist pairs the trigger stimulus with a new reponse that is incompatible with fear
• includes exposure therapies and aversive conditioning

• behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people (in imagination or actuality) to the things they fear and avoid
• First started with Mary Cover Jones, then Joseph Wolpe

• a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli 
• goal is substituting a positive response for a negative response to harmless stimuli
• commonly used to treat phobias
• widely used

relaxing one muscle group after another, until you achieve a drowsy state of complete relaxation and comfort

used when anxiety-arousing situation is too expensive, difficult, or embarrassing to recreate

• opposite of systematic desensitization
• goal is to substitute a negative (aversive) response for a positive response to a harmful stimulus
• Simply associates the unwanted behavior with unpleasant feelings; such as nausea to drinking alcohol

• it can, but the problem is that cognition influences conditioning
• people know that outside the therapist's office they can drink w/o fear of nausea

• that voluntary behaviors are strongly influenced by their consequences
• So, therapists use positive reinforcers to shape behavior in a step-by-step manner, rewarding closer and closer approximations of the desired behavior

reinforcing desired behaviors and withholding reinforcement for, or punishing, undesired behaviors

an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats

• 1. How durable are the behaviors? (will the behaviors stop when the rewards stop?)
• 2. Is it right for one human to control another's behavior?

• therapy that teaches people new, more adaptive ways of thinking and acting
• based on the assumption that thoughts intervene btwn events and our emotional reactions
• *gentle questioning seeks to reveal irrational thinking and then persuade people to remove the dark glasses through which the view life

• teaching people to restructure their thinking in stressful situations
• offered by Donald Meichenbaum

• widely practiced, a popular integrative therapy that aims not only to alter the way people think (cognitive therapy), but also to alter the way they act (behavior therapy)
• seeks to make people aware of irrational neg. thinking, to replace it w new ways of thinking, and to practice more pos. approach in everyday settings

• therapy that treats the family as a system
• views an individual's unwanted behaviors as influenced by, or directed at, other family members

• Prob: unconscious forces and childhood experiences
• Aims: reduces anxiety through self-insight
• Method: analysis and interpretation

• Prob: barriers to self-understanding and self-acceptance
• Aims: personal growth through self-insight
• Method: active listening and unconditional positive regard

• Prob: maladaptive behavior
• Aims: extinction and relearning
• Method: counterconditioning, exposure, desensitization, aversive conditioning, and operant conditioning

• Prob: negative, self-defeating thinking
• Aims: healthier thinking and self-talk
• Method: reveal and reverse self-blaming

• Prob: stressful relationships
• Aims: relationship healing
• Method: understanding family social system; exploring roles, imporving communication

bed-wetting, phobias, compulsion, marital problem and sexual disorders

coping with depression and reducing suicide risk

• Energy therapies - propose to manipulate people's invisible energy fields
• Recovered-memory therapies - aim to unearth "repressed memories" of childhood abuse
• Rebirthing therapies - engage people in reenacting the supposed trauma of their birth
• Facilitated communication - has an assistant touch the typing hand of a child with autism
• Crisis debriefing - forces people to verbalize, rehearse, and "process" their traumatic experiences

• clinical decision making that integrates the best available research with clinical expertise and pt characteristics and preferences
• believe by basing practice on evidence and making mental health professionals accountable for effectiveness, therapy will only gain in credibility

• no one type of psychotherapy has been found to be generally superior to all others
• therapy is most effective for those w clear-cut, specific problems

• controlled research has not supported the therapeutic power of eye movements during eye movement desensitization and reprocessing therapy (EMDR)
• Light exposure therapy does seem to relieve the symptoms of seasonal affective disorder (SAD)

• eye movement desensitization and reprocessing
• developed by Francine Shapiro
• she had people imagine traumatic scenes while she triggered eye movements by waving her finger in front of their eyes, supposedly enabling them to unlock and reprocess previously frozen memories

• seasonal affective disorder
• the depression that happens during the darker months of winter

• used to treat SAD,
• study's show morning light does, in fact help

• hope for demoralized people
• a new perspective on oneself and the world
• an empathic, trusting, caring relationship

• the emotional bond btwn therapist and client
• key aspect of effective therapy

• prescribed medications or medical procedures that act directly on the pts nervous system
• physically changing the brains functioning by altering it's chemistry with drugs, or affecting it's circuitry with various kinds of direct stimulation or psychosurgery

the study of the effects of drugs on mind and behavior

• 1. rates of spontaneous recovery, normal recovery among untreated persons
• 2. recovery due to the placebo effect

disorders in which hallucinations or delusions indicate some loss of contact with reality

• drugs used to treat schizophrenia and other forms of severe thought disorder
• dampens responsiveness to irrelevant stimuli
• most helped pts experiencing positive symptoms of schizophrenia

Ex: thorazine (chlorpromazine)

• the molecules of most conventional antipsychotic drugs are similar enough to molecules of the neurotransmitter dopamine to occupy it's receptor sites and block it's activity
• this finding reinforces the idea that an overactive DOPAMINE system contributes to schizophrenia

• Some produce sluggishness, tremors, and twitches similar to those of Parkinson's disease, marked by too little dopamine
• Long term can produce tardive dyskinesia with involuntary movements of facial muscles (such as grimacing), toue, and limbs

• newer antipsychotic drugs, target both dopamine and serotonin receptors
• helps alleviate negative symptoms of schizophrenia, sometimes enabling "awakening" 
• may also help those w positive symptoms who haven't responded to other drugs
• Ex: clozapine (Clozaril)

may increase risk of obesity and diabetes

• drugs used to control anxiety and agitation
• depresses central nervous system activity
• Ex: xanax and Ativan

• a new anti-anxiety drug, acts upon a receptor that facilitates the extinction of learned fears
• experiments indicate that the durg enhances the benefits of therapy and helps relieve symptoms of PTSD and OCD

• drugs used to treat depression, also increasingly prescribed for anxiety
• different types work by altering the availability of various neurotransmitters: increasing the availability of norepinephrine or serotonin, neurotransmitters that elevate arousal and mood and appear scarce during depression

also known as prozac, partially blocks the reabsorption and removal of serotonin from synapses

• drugs that slow the synaptic vacuuming of serotonin
• Prozac, Zoloft, Paxil

• work by blocking the reabsorption or breakdown of both norepinephrine and serotonin
• side effects: dry mouth, weight gain, hypertension, dizzy spells

• the birth of new brain cells, perhaps reversin stress-inducing loss of neurons
• A possible reason for the delay in effectiveness of antidepressants

a simple sale, can be an effective mood stabliizer for those suffering the emotional highs and lows of bipolar disorder

• duh
• depakote, originally used to treat epilepsy and recently found effective in control of manic episodes associated with bipolar

• ECT
• a biomedical therapy for severely depressed pt's in which a brief electric current is sent through the brain of an anesthetized pt

deep-brain stimulation and magnetic stimulation

• repetitive transcranial magnetic stimulation
• a painless procedure where repeated pulses surge through a magnetic coil held close to a person's skull, energy penetrates only to brains surface
• One explanation is the stimulation energizes pts relatively inactive left frontal lobe. When repeated, nerve cells form functioning circuits through long-term potentiation (LTP)

surgery that removes or destroys brain tissue in an effort to change behavior

• a now rare psychosurgical procedure once used to calm uncontrollably emotional or violent pts. 
• The procedure cut the nerves connecting the frontal lobes to the emotion-controlling centers of the inner brain
• usually decreased the persons misery or tension, but also produced permanently lethargic, immature, uncreative person