Therapy
Therapy has evolved into a diverse field, offering various approaches to help individuals cope with emotional distress, behavioral challenges, and cognitive patterns. In this section, we will explore the origins of therapy, key psychological approaches like psychoanalysis and cognitive therapy, and the different dimensions of human therapies.
By the end of this section, you should know about:
- Origins of Therapy— Bored Out of Your Skull
- Psychoanalysis—Expedition into the Unconscious
- Dimensions of Therapy—Let Me Count the Ways
- What are the basic human therapies?
- Cognitive Therapy—Think Positive!
- Operant Therapies—All the World Is a Skinner Box?
Let’s Take a closer look at them.
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Origins of Therapy— Bored Out of Your Skull
Psychotherapy, an approach to improving mental health, comes from a long history of treating mental illness. Early stone Age techniques were often imbued with fear and superstition. Ancient practices such as trepanning created holes in the skull, presumably to release evil spirits. Such actions would have been especially troubling to those we now know to be mentally ill.
The first major change in the approach to mental health care came in 1793, when French physician Philippe Pinel reformed the Bicetre Asylum in Paris. Pinel’s actions, such as shackling prisoners and providing compassionate care, marked a step toward mentally ill people treated with mental illness This Amendment laid the foundation for modern mental health care, which is developing today.
But real psychiatric treatment didn’t come until the early 20th century. Viennese physician Sigmund Freud developed the first psychotherapy invention. Building on Freud’s work on hysteria, a condition in which people experience physical symptoms (paralysis or seizures) with any tangible physical object, he conducted a psychoanalysis This groundbreaking approach led to modern psychotherapy, which will eventually lead to the treatments used today to treat mental and emotional issues.
Psychoanalysis—Expedition into the Unconscious
Freud developed many techniques to help patients find the unconscious roots of their problems. These include:
Free association
In this technique, patients are encouraged to talk freely without interruption, allowing unconscious thoughts to emerge. The goal is to reduce defenses that prevent the expression of hidden emotions.
Dream Analysis
Freud believed that dreams were “the highway to the unconscious,” often masking repressed desires and impulses. By analyzing symbols in dreams, psychoanalysts aim to uncover their deeper hidden meanings. For example, dreaming of a sawed-off gun can indicate that feelings of sexual inactivity have been suppressed.
Resistance assessment
Patients are often resistant to discussing certain issues during treatment. These resistances associated with certain memories or emotions are viewed as indicative of unconscious conflict. Psychoanalysts help patients cope with these resistances by promoting emotional growth.
Research on transference
Transference refers to the tendency of patients to project emotions from past relationships onto their therapist. For example, the patient may treat the therapist as a parent. Recognizing and understanding this off-site response helps the patient work through unresolved problems.
The state of psychoanalysis today
Traditionally, psychoanalysis required treatment sessions several times per week, often lasting several years. As a result of this long period of intense treatment, there are few psychoanalysts today. Modern versions of psychoanalysis, such as brief psychodynamic therapy, are more focused and less time-consuming. These therapies aim to unlock the unconscious conflict more quickly and often lead to faster recovery.
Interpersonal Psychotherapy (IPT)
A prominent example of a psychodynamic shortcut is interpersonal psychotherapy (IPT), which is designed to help individuals with schizophrenia improve interpersonal relationships Research has shown IPT to be effective in treating a variety of conditions in, including eating disorders, social phobia, and substance abuse. For example, Leona, a patient with depression due to family role conflict, benefited from IPT because her therapist worked with her to clarify her family roles and relationships, which significantly improved her emotions.
The effectiveness of traditional psychoanalysis
The effectiveness of traditional psychoanalysis has been questioned, especially by psychologist Hans Eysenck, who argued that improvements in patients can come from the past rather than therapy alone but research has shown that psychoanalysis for many patients improve significantly. The controversy generated by Eysenck’s critique has led to more focused treatments and in-depth research into the aspects of psychoanalysis that are necessary for success.
Dimensions of Therapy—Let Me Count the Ways
Unlike medical therapy, psychotherapy encompasses psychological strategies aimed at creating positive changes in personality, behavior, or personal change Although medical therapy focuses on physical healing, psychotherapy often requires a dialogue between the therapist and the therapist. Some therapists may even use learning theories to change disruptive behaviors directly. Various approaches such as psychoanalysis, client-centered therapy, gestalt therapy, psychotherapy, and behavior therapy emphasize different perspectives and approaches. Optimal treatment for a person or problem may depend on these approaches, as we shall see throughout the chapter.
Major aspects of psychotherapy
Psychotherapies can be characterized by several aspects that help define the process and techniques:
Assessment and Action Therapy:
Some therapies, such as psychoanalysis, aim to gain a deeper understanding of clients’ thoughts, feelings, and behaviors. These treatments focus on screening at the beginning of cognitive difficulties. In contrast, action therapies, such as behavioral therapy, focus directly on changing troubling thoughts, attitudes, or behaviors, and often do not explore the root causes
Directive and Nondirective Therapy:
In directive therapy, the therapist plays an active role in providing strong direction, advice, or instruction. The therapist is seen as an expert who helps the client solve their problems. On the other hand, nondirective therapy places the responsibility for problem solving on the client, with the therapist providing support and facilitating self-discovery for the client
Individual and Group Therapy:
In individual therapy, a therapist works with one therapist, focusing on that individual’s personal issues and perspective. Group therapy involves the collaboration of many patients, often under the guidance of one or more therapists. Group therapy can foster shared experiences, support, and feedback from peers.
Open vs. open therapy. duration:
Some treatments are open-ended, meaning they have no fixed duration and can continue for as long as necessary. Short-term treatments, in contrast, are designed to last for a specific frequency, with clear goals and outcomes expected at the end of the treatment period.
Myths about mental health
There are many myths about psychotherapy that can lead to false expectations. A common misconception is that therapy should lead to a complete change in consciousness. In fact, psychotherapy is often most effective in dealing with specific issues such as phobias, low self-esteem, sexual problems, and marital conflict. However, more severe cases may require additional treatment, such as medical therapy, and some severe cases may not respond to psychotherapy at all.
Another myth is that psychotherapy is only for crisis situations or deep emotional problems. Of course, therapy can also be used for personal growth, even for complex individuals. For example, therapists who work within the positive psychology movement focus on helping people use their strengths and improve their well-being rather than fixing what “benign” Therapy can offer comfort, support, and tools for personal growth.
What are the basic human therapies?
Humanistic therapy focuses on research and aims to help individuals gain a deeper understanding of their thoughts, feelings, and behaviors. These therapies contrast with psychotherapies, which are more behavioral and less focused on research. Generally, anthropologists are optimistic, believing that human beings have an innate desire for health and personal growth, that people can reach their full potential to live meaningful and meaningful lives Here, we explore human beings into three main therapies: client-centered therapy, social therapy, and gestalt therapy.
Patient-centered treatment
The Therapist’s Role The therapist’s role is not to “fix” the client but to provide a supportive environment that fosters change. This is done through four main conditions:
Non-Obligatory Positive Respect: The therapist provides unwavering acceptance and refuses to react negatively to anything the patient says or feels, encouraging self-acceptance.
Empathy: The therapist tries to understand the world from the perspective of the patient and feels what the patient feels.
Authenticity: The Doctor remains authentic while avoiding professional pretensions or “fake” identities.
Reflections: The therapist expresses or rephrases the client’s thoughts and feelings, helping them understand and understand their own experiences.
The goal is to help clients develop a more realistic self-image, which in turn enables them to find solutions to their problems.
Existential Therapy
What is lifestyle medicine? Existential therapy addresses challenges inherent in human life such as mortality, independence, isolation, and meaninglessness. It emphasizes free will and the ability of an individual to choose their own path in life. Unlike client-centered therapy, which seeks to reveal the “true self” hidden by security, social therapy focuses on helping individuals embrace the freedom to make rational choices
Role of the Therapist Social therapists guide patients in exploring the “ultimate concerns” about life. These concerns include:
Death: Our awareness of mortality.
Freedom: Responsibility that comes with freedom of choice.
Loneliness: Accepting that we are ultimately alone in our experiences.
Meaninglessness: The challenge of creating meaning in life.
A well-known example of social therapy is Logotherapy, developed by Victor Frank. Frankl, a survivor of Nazi concentration camps, insisted that those who survive do so by continuing to understand. In social therapy, the therapist helps the client face these concerns and make more constructive choices to find purpose.
Gestalt Therapy
What is Gestalt Therapy? Gestalt therapy, founded by Fritz Perls, is based on the belief that individuals are rarely aware of their emotions or “themselves,” creating gaps in self-awareness and hindering personal growth Gestalt, which means “whole”. is intended to help applicants consider that, It exists to help integrate emotions and actions into a cohesive and cohesive experience
Role of the therapist Gestalt therapists focus on increasing awareness in the present moment and encourage clients to “own” their feelings. Therapy is more prescription-oriented than patient-centered or social therapy and focuses on immediate experience. The therapist helps clients become aware of how they think, feel, and act in the here and now, with the goal of resolving “unfinished business”—emotions or information that have been suppressed or avoided.
Key Techniques:
Focusing on the present moment: Therapists encourage clients to live in the present and fully express emotions without expressing them.
Insight: Clients are encouraged to recognize and express emotions they may have suppressed in the past. For example, an angry person is told to overestimate feelings of anger in order to understand better.
Accountability: Gestalt therapy encourages individuals to take responsibility for their actions and emotions, emphasizing that emotional health is about acknowledging one’s true wants and needs.
Cognitive Therapy—Think Positive!
Cognitive therapy focuses primarily on changing negative thought patterns that lead to emotional distress and unhealthy behaviors. Unlike anthropological therapies, which seek to analyze and understand individual emotions and behaviors, psychotherapy directly addresses how thought affects emotions and behaviors.
Unlike anthropology, which may examine the antecedents or “why” of behavior, psychotherapy is more concerned with the present and how changing present thoughts can lead to changes in emotional and behavioral responses. For example, a person with hoarding tendencies might work with a psychotherapist to challenge the beliefs and assumptions that perpetuate hoarding behavior, rather than explore why they just started packing.
Psychotherapy for depression:
One of the major application areas of psychotherapy is in the treatment of depression. Aaron Beck, a pioneer in psychotherapy, proposed that depression is associated with negative thinking, whereby individuals distort reality and see themselves, the world, and the future in uncertainty These distortions are common:
Selective insight: To focus only on the negative and ignore the positive.
Overgeneralization: Applying one bad action to all situations (e.g. failing a test leads one to believe it is a complete failure).
Improvement: Recognizing events that are worse than they actually are, usually by all-or-nothing measurement.
Cognitive therapists work to correct these distortions by helping clients identify and challenge these negative thoughts. For example, the client can be guided to examine their beliefs by analyzing their behavior or using exercises to identify irrational thoughts. This approach aims to change the way clients think, therefore improving their emotional well-being and relationships.
Rational and Emotional Behavioral Therapy (REBT):
Another well-known form of emotional therapy is Rational-Emotive Behavior Therapy (REBT), developed by Albert Ellis. REBT focuses on changing irrational beliefs that cause emotional distress. Ellis introduced the A-B-C model:
A: Disabling the action (e.g. denial).
B: Beliefs about the event (e.g., “Everyone should love me”).
C: Consequences (e.g. emotional distress from belief).
REBT suggests that emotional consequences are not caused by the activating event itself, but by the irrational beliefs (B) that people hold about the event. For example, a person who feels that everyone should love him feels deep pain when he is rejected.
The therapist works with the nurse to identify and challenge these irrational beliefs. Strategies include directly confronting irrational thinking, providing evidence that contradicts irrational beliefs, and using “homework” to encourage real-life practices of thinking about new ideas encourage includes Some of the most common irrational beliefs noted in REBT are:
“I have to perform well and be approved by others.”
“People are always nice to me.”
“The world has to be how I want it to be.”
Therapies Based on Classical Conditioning—Healing by Learning
Behavior therapy: An overview
Behavior therapy is an approach that focuses on applying learning theories to change problematic behaviors. Unlike traditional therapies that explore deeper psychological issues, behavioral therapy emphasizes changing specific behaviors and thoughts. The core belief in behavior therapy is that behaviors are learned so they can be learned or replaced with healthy behaviors through new learning experiences.
How behavior therapy works
Behavioral therapists think of maladaptive behaviors as learned responses, which means they can be relearned. This concept is central to behavioral research, which includes using principles of classical or operant conditioning to change behavior. Typical methods of behavior modification include addiction therapy, addiction therapy, financial exposure, and other methods that help individuals break their behavior or reduce fear and anxiety.
Classical conditioning and behavior therapy
Classical conditioning, a central concept in behavioral therapy, is the process by which simple responses (such as reflexes) are associated with novel stimuli. For example, a person may be afraid of needles (neutral stimulus) because they are usually followed by a painful treat (unconditioned stimulus) Over time, mere sight creates fear.
Behavioral therapy uses classical situations to help individuals associate negative emotions with unwanted behaviors. For example, aversion therapy is classical conditioning used to stop behaviors like smoking or drinking. A common approach to aversion is to induce a negative emotional response to a bad habit, such as smoking, by associating it with an unpleasant experience, such as a quick puff of smoke, over a long period of time without causing nausea or discomfort the taste of it
Treatment of disgust
Aversion therapy is based on associating unpleasant stimuli with a behavior that needs to be eliminated. For example, people trying to quit smoking use quick smoking, where they are forced to smoke every 6 to 8 seconds until they feel uncomfortable. The idea is that that experience of not this taste will lead to a greater aversion to smoking, making the person weaker relapse.
Similarly, detachment therapy can be used to treat other addictions or other behaviors, such as drinking alcohol or biting nails. For example, in the treatment of alcoholism, an individual may be given an electric shock while drinking, resulting in a negative association with drinking activity.
Although isolation therapy may seem harsh, many individuals volunteer for it because of its effectiveness in preventing destructive behavior. The long-term benefits are worth it, as people tend to want a short-term discomfort to overcome long-term negative changes or damaging habits
Desensitization: Fear and Fear Management
Another major approach to behavior therapy is desensitization, which is used to treat phobias and phobias. Desensitization allows a person to engage in a threatening object or situation in a controlled manner, starting with a less threatening state and gradually working up to more anxiety-provoking situations This helps the person to adjust and he overcomes his fears over time.
Insensitivity is based on the principle of mutual inhibition, which means that it is impossible to be relaxed and tense at the same time. Thus, clients are gradually taught relaxation techniques to combat anxiety when facing their fears. This process prevents individuals from becoming aware of their fears. Desensitization can be especially helpful with phobias such as stage fright, social anxiety, and fear of heights, spiders, or flying.
Vicarious desensitization and virtual reality exposure
For some fears, direct exposure may not be beneficial. In such cases, vicarious desensitization is used, where clients see others experiencing a traumatic situation. Alternatively, virtual reality is a valuable tool in severe phobias such as fear of airplanes. Virtual reality exposure uses computer simulations to put clients in a controlled, yet realistic environment where they can’t face their fears without any real danger.
Eye Movement Discovery and Reconstruction (EMDR)
Another hypnotic technique is Eye Movement Desensitization and Reprocessing (EMDR), which is especially useful for individuals who have experienced trauma. In EMDR, clients vividly recall their grief and visually track a moving object at the same time. This process is believed to contribute to the decreased emotional intensity of traumatic memories, although this remains controversial. Some studies suggest that eye movements may not be the deciding factor, but experiencing painful memories brings emotional relief.
Operant Therapies—All the World Is a Skinner Box?
Operant conditioning plays an important role in behavioral therapy by emphasizing the use of reinforcement and punishment to correct and change behavior. Unlike classical conditioning, which is based on stimulus-response relationships, operant conditioning is concerned with how behavioral consequences affect the likelihood of recurrence Behavioral therapists use operant theories to manage problematic behavior and reinforce good practice.
Basic operant principles in behavior therapy
Positive Reinforcement: Positive reinforcement is a fundamental principle of addiction in behavior therapy. Rewards or reinforcements are provided following desired behavior, making it more likely that the behavior will be repeated in the future, e.g., if children develop an attitude toward complaining, they are more likely to repeat it. And a student who consistently gets A’s in psychology can be motivated to pursue a career in psychology.
Uncontrolled reinforcement and extinction
When a behavior is not reinforced, it decreases or eventually disappears. This principle is used in behavior therapy to eliminate unwanted behaviors. For example, if an unsuccessful attempt to perform a behavior (such as pulling a club handle) fails to yield any reward, it may stop the behavior Response initially reinforced during treatment, can only be terminated by removing the compensation. For example, one case involved an overweight mental patient who stole food from other patients. By withholding food until he sat down at his appointed table, his thieving instincts were extinguished for lack of reinforcement.
Punishment
Punishment involves the application of undesirable consequences following a behavior, reducing the likelihood that the behavior will be repeated. Although punishment can be effective in deterring behavior, it does not always provide it the behavior is completely undermined. For example, if a child is spanked for hitting another child, the behavior may decrease, but it does not disappear completely.
Measurement
Measurement is the process of developing a series of approximations of desired behavior. It is especially useful when teaching complex behaviors. For example, the therapist might slowly build on the nearby word “ball” before having the child say the “b” sound. This approach is commonly used in the treatment of individuals with developmental disabilities or where the target behavior is not readily achieved.
Stimulus control
Operant conditioning also includes the concept of stimulus control, where behavior is influenced by environmental cues or conditions. A simple example of motivation is setting your watch 10 minutes faster to ensure you leave on time in the morning. The behavior of leaving the house is now subject to the fast clock, even if the person knows that the clock is inaccurate.
Time Passing
Time passing is a way of removing the person from the state in which energy input occurs. Withdrawal prevents the undesired behavior from being reinforced. For example, misbehaving children may be placed in separate rooms so that they receive no extra attention or reward. Time off is often used to address disruptive behavior in schools and at home.
Disruption and extinction of pressure in practice
Stress management and extinction have practical applications in behavioral therapy, particularly in the treatment of maladaptive behaviors. One notable example is the treatment of an overweight patient who was forced to eat sun food. The therapist used waste to eliminate the reward of stealing—food—through a structured feeding program. Each time the patient tried to steal food he was removed from the feeding station and his behavior was not further reinforced by access to food
Similarly, nonreinforcement can be used to reduce undesirable behavior in an organizational setting, such as ignoring behavior when a confused adolescent is naked and seeks attention, a it is not reinforced by attention and the behavior diminishes over time.
A tokenized economy
The token economy is a common approach to behavioral therapy, especially in institutions. A token economy uses symbolic rewards—tokens—that can be exchanged for tangible rewards, such as food, privileges, entertainment activities or tokens earned through targeted actions such as saying a word or the completion of a project. This method is most effective for individuals with intellectual disability, mental illness, or severe abstinence
The token economy encourages best practice by providing immediate reinforcement, which helps patients or clients progress towards stable practice. For example, initially a deaf psychiatric patient may experience symptoms for saying a word, then because he or she forms complete sentences, and finally engages in conversation Over time, therapy can help patients get them back into socializing, further improving their communication skills.
In an organizational setting, a token economy can be used to foster multiple transactions. Patients earn tokens for productive tasks, such as fixing clothes, taking medication, or completing household chores. These tokens can later be exchanged for prizes such as food, transportation, and private time. The use of tokens can lead to significant improvements in behavior, morale, and overall change, especially as the program gradually shifts towards using social rewards such as praise and recognition as patients prepare to.