Psychological Disorders

Transcription

1 Psychological Disorders Psyc 100 Ch 15A therapies 1 Anxiety Mood Personality Dissociative Schizophrenia GAD Panic Attacks Phobias PTSD OCD Major Depression Dythymic Disorder Bipolar disorder Cyclothymic Disorder Anti-Social Paranoid Borderline Amnesia Fugue Identity Disorder Paranoid Catatonic Disorganized Undifferentiated

2 Psyc 100 Ch 15A therapies 2 Why should you care about psychological disorders? Common responses are: Psychological disorders are not that big of a problem-- No one I know has a psychological disorder. Psychological disorders will happen to someone else who is less deserving than me. Psychological disorders are fairly rare and uncommon.

3 Psyc 100 Ch 15A therapies 3 Why should you care about psychological disorders? Common responses are: Psychological disorders are not that big of a problem-- No one I know has a psychological disorder. o Due to the negative stigma attached to psychological disorders, people don't talk about psychological disorders, so you are not aware of the problems people experience. Examples are not psychologically available, and thus a tendency to underestimate the problem. o Also, due to the negative stigma, people tend to deny that it is a problem. Denial of the problem prevents you from dealing with the problem or taking responsibility for dealing with it. Psychological disorders will happen to someone else who is less deserving than me. o There is a tendency for people to think they are better than average. Assertions like this helps reduce psychological tension. Psychological disorders are fairly rare and uncommon. o People are unaware of the suffering experienced by people. Acknowledge of it can make us uncomfortable. o See the National Comorbidity Study.

4 Psyc 100 Ch 15A therapies 4 What does the National Comorbidity Survey tell us about Psychological Disorders? Almost one in two adults (48%) had experienced the symptoms of a psychological disorder at some point in their lifetime. o The lifetime prevalence rate of cancer is 30%. Psychological disorders represent a significant source of misery for individuals and lost of productivity for society. Almost 1/3 (30%) experienced the symptoms of a psychological disorder in the last 12 months. 80% of those who suffered the symptoms of a psychological disorder in the previous year did not seek treatment or help for their symptoms.

5 Psyc 100 Ch 15A therapies 5 What are the possible explanations of these findings? There is a lack of awareness about psychological disorders. We label those with a psychological disorder as strange. There is a lack of awareness and access to mental health services. There is still a stigma attached to seeking treatment for psychological disorders. People don t know where to start the process of seeking help and go seek help. There is a lack of financial resources to pay for treatment of psychological services. Most people seem to weather the symptoms without becoming completely debilitated without professional intervention.

6 Psyc 100 Ch 15A therapies 6 Evaluating the Effectiveness of Psychotherapy As seen in the previous chapter, most people with psychological symptoms do NOT seek help from mental health professionals. In fact some people do seem to get better on their own over time. This is called spontaneous remission. But how do people with psychological problems who seek psychotherapy compare to those with psychological problems who do not seek psychological treatment?

7 Psyc 100 Ch 15A therapies 7 Comparing Receiving versus Not Receiving Therapy As shown in figure 15.5, People were more likely to more improve by receiving psychological therapy o The benefits of psychotherapy compared to not seeking psychotherapy were seen in the first few weeks. o At week 8, half the people who sought therapy showed improvement compared to about 5% of the people who did not seek therapy showed improvement. People were more likely to improve faster by receiving psychological therapy

8 Psyc 100 Ch 15A therapies 8 Therapies People seek help from mental health professional for a variety of reasons, including the treatment of psychological disorders, troubled relationships (parent/child or marital), coping with the death of a loved one, ending a marriage or adjusting to retirement. In any one year, approximately one in three adults experiences the symptoms of a psychological disorder. Your textbook describes two broad categories of therapy: Psychotherapy Psychotherapy refers to the use of psychological techniques to treat emotional, behavioral, and interpersonal problems. Psychoanalysis Client-Centered Therapy Behavior Therapy Cognitive Therapies Cognitive-Behavior Therapies Group and Family Therapies Biomedical Therapies Biomedical therapies involve the use of medications or other medical treatments to treat the symptoms associated with psychological disorders. Anti-psychotic medications Anti-anxiety medications Anti-depressant medications Electroconvulsive therapy

9 Psyc 100 Ch 15A therapies 9 Psychotherapy Psychotherapy refers to the use of psychological techniques to treat emotional, behavioral, and interpersonal problems. While there are different types of psychotherapies, they all assume the psychological factors play a significant role in a person s troubling feelings, behaviors, or relationships.

10 Psyc 100 Ch 15A therapies 10 Biomedical Therapies Biomedical therapies involve the use of medications or other medical treatments to treat the symptoms associated with psychological disorders. Biomedical therapies are based on the assumption that many psychological disorders involve biological factors such as abnormal levels of neurotransmitters. Generally speaking, only licensed physicians with medical training, such as psychiatrists are allowed to prescribe medications, although there are some exceptions where clinical psychologists with additional training can prescribe a limited selection of medications.

11 Psyc 100 Ch 15A therapies 11 Psychotherapies Psychoanalytic Therapies Sigmund Freud and Psychoanalysis Short-term dynamic Therapies Humanistic Therapy Carl Rogers and Client-Centered Therapy Behavior Therapy Techniques based on Classical Conditioning Techniques based on Operant Conditioning Cognitive Therapies Albert Ellis and Rational-Emotive Therapy Aaron Beck and Cognitive Therapy Cognitive-behavior Therapy Group and Family Therapy Evaluating the Effectiveness of Psychotherapy

12 Psyc 100 Ch 15A therapies 12 Psychoanalytic Therapy: Freud and Psychoanalysis Freud and the psychoanalytic perspective asserts that early childhood experiences that result in unresolved conflicts and frustrated urges are repressed by being pushed out of conscious awareness into the unconscious. Although these unresolved conflicts are in the unconscious, they still influence the person s thinking and behavior by diverted psychological resources to keep them locked away and hidden.

13 Psyc 100 Ch 15A therapies 13 Freud believed these repressed conflicts are the source of maladjustment. The path toward psychological adjustment is to be consciously aware of these conflicts and deal with them. The role of a therapist is to help the patient identify these conflicts. Quite often these conflicts are too painful too acknowledge but occasionally surface through dreams, memory lapses, and inadvertent slips of the tongue. Techniques to identify unconscious conflicts: Free association Topics that encounter resistance Dream interpretation Projective tests

14 Psyc 100 Ch 15A therapies 14 Projective Tests to Assess Personality: Rorschach Inkblots

15 Psyc 100 Ch 15A therapies 15 Projective Tests to Assess Personality: Thematic Apperception Test

16 Short-term Dynamic Therapies Psyc 100 Ch 15A therapies 16 Traditional psychoanalysis can last for years. Short-term Dynamic therapies last for a short period of time where the therapist and patient agree on specific, concrete, attainable goals. One form of short-term psychodynamic therapy is interpersonal therapy (IPT). IPT focuses on current relationships and current social interactions rather than past relationships in traditional psychoanalysis. First, the therapist identifies the interpersonal problem that is causing difficulties in psychological functioning. Generally speaking, it is usually in one of four categories o Unresolved grief usually involves with the death of a significant other o Role dispute usually involves repetitive conflicts with others significant in their life (family members or coworkers) o Role transitions include problems involving life changes such as going away to college, becoming a parent, getting married or retiring o Interpersonal deficits are deficits in social skills that limit the ability to start or maintain healthy relationships with others Next, the therapist helps the person understand their particular problem and develop strategies to resolve it.

17 Psyc 100 Ch 15A therapies 17 Humanistic Therapy Unlike other perspectives of psychology, the humanist perspective emphasizes human potential, self awareness, freedom of choice. Humanistic psychology believe it is important to focus on a person s conscious, subjective perception of him or her self and view people as innately good and motivated to grow psychologically if they are in a genuinely accepting atmosphere and given freedom to make choices. Client-centered therapy was developed by Carl Rogers. Rogers intentionally uses the word client instead of patient. Rogers believed that the world patient suggested that the person in therapy was sick and sought treatment from an all-knowing authority figure that could heal or cure them. Like Freud, Rogers say the therapeutic relationship as the catalyst that led to insight to change. However, unlike Freud who believed that the therapist should provide interpretations of the patient s unconscious conflicts, Rogers believed that the therapist should not direct the client, make decisions for the client, or pass judgment on the client. Rogers believed that change in therapy must be chosen and directed by the client. The therapist s role is to create the conditions that allow the client, not the therapist to direct the focus on the therapy (page 634).

18 Psyc 100 Ch 15A therapies 18 Carl Rogers Rogers was impressed with his clients drive to grow and develop their potential. People are motivated by the actualization tendency the innate drive to maintain and enhance the human organism. Key ideas: The self (self-concept) Conditional positive regard o Conditions of worth Unconditional positive regard Fully-functional person

19 Psyc 100 Ch 15A therapies 19 The Self-Concept The self-concept is an organized, consistent set of perceptions and beliefs about oneself (page 481). You might think of this as a social identity. You identify yourself by your job, hobby, associations (people you associate with), possessions or religious/spiritual beliefs. Once we develop the self-concept (who we think we are), we try to live our lives in a way that is consistent with this self concept.

20 Congruence and the Self-Concept Psyc 100 Ch 15A therapies 20 Carl Rogers believes people are motivated to discover their concept and maintain a consistent and stable selfconcept. According to Roger s the larger the gap between an individual s self-concept (identity) and a person s life experiences, the poorer the person s psychological adjustment. Well adjusted individual Poorly adjusted individual A large overlap of personal experience of life and their self-concept A little overlap of personal experience of life and their self-concept

21 For example, if your self-concept involves being environmentally conscious, Psyc 100 Ch 15A therapies 21 o a well adjusted individual would be one where they use less water, recycle, ride their bike to school and work, etc. o a poorly adjusted individual doesn t recycle, drives their SUV two blocks to the store, wastes water, doesn t turn off the lights when not in use, etc.

22 Psyc 100 Ch 15A therapies 22 If your self-concept involves being an avid tennis player, A well-adjusted person would be one A poorly adjusted person would be one

23 The Poorly Adjusted Individual Psyc 100 Ch 15A therapies 23 We may experience life in a way that is inconsistent with our self-concept. These inconsistencies can arise by many means (loss of job, group failures, false beliefs, etc.). These inconsistencies evoke anxiety. Male Roles Self-Concept I m a good provider Life Experiences I lost my job and my family is going hungry and losing our house Female Roles I m nurturing I m bad with children Dealing with these inconsistencies require the use of a lot psychological energy that detracts from our ability to live a healthy life. People who choose to deny or distort their experiences ( twist reality ) to perceive consistency can lead to self-defeating behavior.

24 Psyc 100 Ch 15A therapies 24 Roger s View of the Role of a Therapist What are the therapeutic conditions that promote selfawareness, psychological growth and self-directed change? Rogers believed that three qualities of the therapist are necessary (page 634): Genuineness Unconditional positive regard Empathic understanding Genuineness means that the therapist honestly and openly shares her thoughts and feelings with a client. By modeling genuineness, the therapist indirectly encourages the client to be genuine as well. Being genuine helps build trust between the therapist and client and may make it easier to identify inconsistencies with the self-concept. Unconditional positive regard is where the therapist values, accepts and cares for the client whatever the problem or behavior is. Rogers believed that people develop psychological problems when people experience conditional acceptance which denies the person their self-concept and inner feelings. Empathic understanding from the therapist arises when the therapist reflects the content and personal meaning of the feelings being experienced by the client. By reflecting it back for the client to view, the client is better able to explore and clarify their thoughts, feelings and perceptions. Empathic understanding requires the

25 Psyc 100 Ch 15A therapies 25 therapist to actively listen for the personal meaning hidden in what the client says. When the therapist creates an atmosphere that contains genuineness, unconditional positive regard and empathic understanding, change is more likely to occur. These conditions foster feelings of being psychologically safe, accepted and valued. In this environment their self-concept and experiences are more congruent and less distortions of reality are required.

26 Psyc 100 Ch 15A therapies 26 Carl Rogers: Conditional Positive Regard Conditional positive regard: The sense that you will be valued and loved only if you behave in a way that is acceptable to others; conditional love or acceptance. For example, a person may feel uncomfortable if their parents only accept them if they pick a certain religious view or occupation. With conditional positive regard, a person is uncomfortable to express their feelings and disagreements for fear of being rejected by someone they look up to they learn to deny or distort their genuine feelings and can lead to inconsistencies in behavior. The self-concept is largely based on the evaluation of others, not your own evaluation. The person perceives behaviors as acceptable only if they meet with the approval of others. The motivations for your attitudes and behavior are external, rather than internal. Conditions of worth are created when people not behaviors are evaluated. o For example, you are accepted as long as you become a dentist like your father/mother.

27 Psyc 100 Ch 15A therapies 27 Carl Rogers: Unconditional Positive Regard Unconditional positive regard: The sense that you will be valued and loved even if you don t conform to the standards or expectations of others; unconditional love or acceptance. With unconditional positive regard, a person is comfortable in expressing their feelings and disagreements with others without fear of not being accepted by someone they look up to. For example, you are accepted as a part of the family regardless of what you choose to do as a career. When your feelings become denied, there is incongruence between your self-concept and the experience of your selfconcept. Rogers did not advocate permissive parenting. You can disapprove of a child s behavior, but not reject the child. You might have responses such as I understand your decision, but I disagree with it. You reject the behavior, but accept the person. Disapproval of Person You are a stupid driver Disapprove of Behavior Speeding in a school zone is stupid

28 Fully Functional People Psyc 100 Ch 15A therapies 28 When a person feels that they can behave in a way that is consistent with their self-concept, they are psychologically adjusted. They do not feel they expend psychological resources to deny or distort their experiences. Instead of distorting reality when inconsistencies arise, people can change their self-concept, or change your behavior and experiences to match their self-concept When the person s experience is congruent with his/her self-concept, the person becomes psychologically healthy and a fully functional person. They are psychologically healthy. Rogers define a fully functional person as one who has flexible, constantly evolving self-concept. Fully functional people are: realistic open to new experiences capable of changing in response to new experiences more likely to be creative spontaneous enjoy harmonious relations with others their sense of self is consistent with their emotions and experiences