Mackenzie Furnari 3rd hour 1. History a. Evil Spirits i. The mentally ill were seen as possessed ii. Trephining 1. an early form of treatment that was supposed to let the spirits escape 2. making holes in the skull b. Middle Ages i. Hippocrates (Greece 500 B.C.) and Galen (Rome 200 A.D.) thought that mental illness had biological roots 1. Europeans still returned to belief in demon possession 2. mentally ill persecuted c. Enlightenment i. Philippe Pinel (France) and Dorothea Dix (U.S.) 1. fought for humane treatment of the mentally ill 2. helped the development of kinder institutions d. Deinstitutionalization i. 1950s 1. development of drugs for the mentally ill 2. many people were released from mental institutions ii. intended to save money and benefit patients
iii. many were unable to care for themselves
e. Preventative Efforts i. Primary prevention 1. attempt to reduce the incidence of societal problems that give rise to mental health issues ii. Secondary prevention 1. working with people at risk for developing specific problems iii. Tertiary prevention 1. aim to keep peoples mental health issues from becoming more severe 2. Types of Therapy a. Overview i. Psychotherapy 1. psychoanalytic, humanistic, behavioral, and cognitive psychologists ii. Somatic treatments 1. biomedical 2. ex. drugs iii. Patients vs. clients 1. patients go to a. biomedical psychologists, psychoanalysts 2. clients go to a. other therapists b. Psychoanalytic Theories i. Psychoanalysis
1. a therapeutic technique developed by Freud
2. focuses on identifying the underlying causes of a problem ii. Other therapies lead to symptom substitution 1. after treated for one disorder, a new psychological problem arises iii. Hypnosis 1. patients are less likely to repress thoughts iv. Free association 1. say whatever comes to mind without thinking 2. supposed to elude the egos defenses v. Dream analysis 1. patients asked to describe their dreams 2. manifest content a. what the patient reports 3. latent content a. the interpreted underlying meaning vi. Resistance 1. protecting yourself from the painful process of psychoanalysis 2. ex. disagreeing with your therapists interpretations vii. Transference 1. patients redirect strong emotions felt towards others with whom theyve had a troubling relationship onto the therapist viii. Insight therapies 1. highlight the importance of the patient gaining an
understanding of his problems
c. Humanistic Therapies i. Strive to self-actualize ii. Beliefs 1. people are innately good 2. people have free will a. determinism- opposite iii. Client/Person-centered therapy 1. therapist must provide unconditional positive regard 2. non-directive a. therapists dont tell clients what to do b. help clients choose course of action c. active listening iv. Gestalt therapy 1. clients encouraged to get in touch with whole selves 2. stress importance of present 3. integrate actions, feelings, thoughts into a whole v. Existential therapies 1. focus on helping clients achieve a subjectively meaningful perception of their lives d. Behavioral Therapies i. Counterconditioning 1. Mary Cover Jones 2. an unpleasant conditioned response is replaced with a pleasant one
ii. Systematic desensitization
1. Joseph Wolpe 2. teach the client to eliminate anxiety through relaxation 3. construct anxiety hierarchy a. a rank-ordered list of what the clients fears, from least to most 4. in vivo desensitization a. the client confronts feared objects or situations 5. covert desensitization a. client imagines the feared stimuli 6. climb the hierarchy, using counterconditioning to replace fear with relaxation iii. Flooding 1. the client addresses the most frightening scenario first iv. Modeling 1. client watches someone else interact with feared object 2. client reenacts what he saw v. Aversive conditioning 1. pairs a habit the client wants to break with an unpleasant stimulus vi. Operant conditioning 1. uses rewards and punishments to modify behavior 2. ex. token economy e. Cognitive Therapies i. Concentrate on changing unhealthy thought patterns
ii. Cognitive therapy
1. most often used to treat depression 2. aims to engage clients in pursuits that will bring them success 3. make beliefs about cognitive triad more positive 4. Aaron Beck f. Cognitive Behavioral Therapies (CBTs) i. Rational emotive behavior therapy 1. REBT/RET 2. Albert Ellis 3. goals a. show client that his failure is unlikely b. show that even if client does fail, it wouldnt be a big deal c. expose and confront the clients dysfunctional thoughts g. Group Therapy i. Family therapy ii. Meeting with a number of people experiencing similar difficulties iii. Self-help groups 1. dont involve a therapist h. Somatic Therapies i. Therapies that produce bodily changes ii. Psychopharmacology/ Chemotherapy 1. drug therapy
2. more likely to be used for severe disorders
a. especially schizophrenia iii. Antipsychotic drugs 1. block receptor sites for dopamine 2. used for schizophrenia 3. ex. Thorazine, Haldol 4. side effect a. tardive dyskinesia (muscle tremors) iv. Chemotherapy 1. used for mood disorders 2. increase serotonin activity 3. lithium- for manic phase of BPD 4. for unipolar depression: a. tricyclic antidepressants b. monoamine oxidase (MAO) inhibitors c. serotonin-reuptake-inhibitor drugs v. Barbiturates 1. antianxiety drugs 2. types a. Miltown b. benzodiazepines 3. ex. xanax, valium vi. Electroconvulsive therapy (ECT) 1. bilateral
a. electric current passed through both brain
hemispheres 2. unilateral a. electrical current through one hemisphere 3. more effective 4. worse side effects a. memory loss b. brief seizure c. brief loss of consciousness 5. used for depression when other methods fail 6. less common than chemotherapy vii. Psychosurgery 1. rarest treatment 2. last resort 3. purposeful destruction of part of the brain to alter a persons behavior 4. prefrontal lobotomy a. cutting the main neurons leading to the frontal lobe b. calms behavior c. makes you a vegetable 3. Kinds of Therapists a. Psychiatrists i. Can prescribe meds ii. Less trained in psychotherapy b. Clinical Psychologists
i. earn Ph.D.s that require at least 4 years of study
c. Counseling Psychologists i. Graduate degree in psychology ii. Deal with less severe problems d. Psychoanalysts i. Trained in Freudian methods 4. Dont need medical degree