Abnormal Psychology
3 major criteria for diagnosing psychological
disorders
• - 1. Deviance-behavior that is not
considered to be in the norm
• - 2. Maladaptive behavior-behavior that
interferes with a person’s social or
occupational functioning
• - 3. Personal distress-how much distress
it causes the individual
Costs of Mental Illness
- Costs more than $150 billion each
year for treatment
- Schizophrenia alone costs up to $30
billion
- Lithium for Bipolar Disorder has saved
approximately $145 billion since 1970
- Clozapine for Schizophrenia has
saved approximately $23,000/patient
annually
• Youth and Mental Illness
• - U.S. adolescents appear to be at high
risk for mental illness
• - Schizophrenia tends to manifest itself in
adolescence or early adulthood
• - U.S. adolescents are the only group in
which there continues to be an increase in
the death rate, from accidents, suicide and
homicide
Warning Signs of trouble
* - marked drop in school performance or increase in
absenteeism
• - excessive use of alcohol and/or drugs
• - marked changes in sleeping and/or eating habits
• - many physical complaints (headaches, stomach
aches)
• - aggressive or non-aggressive violations of the rights of
others
• - withdrawal from friends, family and regular activities
• - depression demonstrated by continued, prolonged
negative mood and often accompanied by poor
• - appetite and/or difficulty sleeping
• - frequent outbursts of anger or rage
• - low energy level, poor concentration,
complaints of boredom
• - loss of enjoyment in what used to be favorite
activities
• - unusual neglect of personal appearance
• - frequent outbursts of anger or rage
• - low energy level, poor concentration,
complaints of boredom
• - loss of enjoyment in what used to be favorite
activities
• - unusual neglect of personal appearance
Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV-TR)
• - Axis I-Clinical Syndromes-includes many of the disorders that are
in chapter 14
• - Axis II-Personality Disorders or Mental Retardation (See
personality disorders)
• - Axis III-General Medical Conditions-assesses any chronic physical
disorders or conditions that may contribute to disorders
• - Axis IV-Psychosocial and Environmental Problems-negative life
events, troubled relationships, trouble with the law, school, work,
etc.
• - Axis V-Global Assessment of Functioning-After assessing axes 14, the psychologist makes a determination regarding a score that
they would assess the person’s level of functioning. A score of a 10
means the person is in persistent danger of severely hurting
themselves or others and a score of 100 means they are functioning
at a superior level.
Generalized Anxiety Disorder
(GAD)
• "I always thought I was just a worrier. I'd feel keyed up
and unable to relax. At times it would come and go, and
at times it would be constant. It could go on for days. I'd
worry about what I was going to fix for a dinner party, or
what would be a great present for somebody. I just
couldn't let something go."
• "I'd have terrible sleeping problems. There were times I'd
wake up wired in the middle of the night. I had trouble
concentrating, even reading the newspaper or a novel.
Sometimes I'd feel a little lightheaded. My heart would
race or pound. And that would make me worry more. I
was always imagining things were worse than they really
were: when I got a stomachache, I'd think it was an
ulcer."
Anxiety Disorders
Class of disorders marked by excessive or chronic
anxiety or apprehension
• Generalized Anxiety Disorder
• - marked by a chronic, high level of anxiety that is not
due to anything specific. Age of onset may be between
10 and 14 years of age.
• - Causes-No specific threat, symptoms must be present
for at least 6 months
• - Symptoms-Restlessness or feelings of being keyed up
or on edge, being easily fatigued, difficulty concentrating,
irritability, muscle tension, sleep disturbance
• - Treatments-Benzodiazepines (Valium and Ativan),
Tricyclic Antidepressants, Psychotherapy
Panic Disorder
• "For me, a panic attack is almost a violent experience. I
feel disconnected from reality. I feel like I'm losing control
in a very extreme way. My heart pounds really hard, I
feel like I can't get my breath, and there's an
overwhelming feeling that things are crashing in on me."
• "It started 10 years ago, when I had just graduated from
college and started a new job. I was sitting in a business
seminar in a hotel and this thing came out of the blue. I
felt like I was dying."
• "In between attacks there is this dread and anxiety that
it's going to happen again. I'm afraid to go back to places
where I've had an attack. Unless I get help, there soon
won't be anyplace where I can go and feel safe from
panic."
Panic Disorder
characterized by sudden and unexpected attacks of
anxiety. Age of onset usually between 15 and 19
• - Causes-defects in the brain (specifically the brain
stem, limbic system and frontal cortex)
• - Symptoms-heart palpitations, sweating, trembling,
feeling of choking, shortness of breath, fear of dying,
chest pain or discomfort, feeling dizzy.
• - Treatments-Tricyclic Antidepressants, SSRI’s, MAOI’s,
Antianxiety druges (e.g., Xanax, Ativan), CognitiveBehavioral treatments
Panic
Attack
Phobias
• "I'm scared to death of flying, and I never do it anymore.
I used to start dreading a plane trip a month before I was
due to leave. It was an awful feeling when that airplane
door closed and I felt trapped. My heart would pound,
and I would sweat bullets. When the airplane would start
to ascend, it just reinforced the feeling that I couldn't get
out. When I think about flying, I picture myself losing
control, freaking out, and climbing the walls, but of
course I never did that. I'm not afraid of crashing or
hitting turbulence. It's just that feeling of being trapped.
Whenever I've thought about changing jobs, I've had to
think, "Would I be under pressure to fly?" These days I
only go places where I can drive or take a train. My
friends always point out that I couldn't get off a train
traveling at high speeds either, so why don't trains
bother me? I just tell them it isn't a rational fear."
Phobic Disorder
- marked by a persistent and irrational fear of
things that don’t really pose a threat. Age of
onset often between 7 and 9 years of age
• - Causes-may run in families and be present in
females more often, usually a classically
conditioned response
• - Symptoms-marked and persistent fear that is
excessive or unreasonable, intentional
avoidance of object or situation
• - Treatment-Mostly behavior therapy, but can
also use Antianxiety drugs (e.g., Valium),
Tricyclic Antidepressants, MAOI’s,
Psychotherapy
Phobias
Social Phobia
• "In any social situation, I felt fear. I would be anxious
before I even left the house, and it would escalate as I
got closer to a college class, a party, or whatever. I
would feel sick in my stomach-it almost felt like I had the
flu. My heart would pound, my palms would get sweaty,
and I would get this feeling of being removed from
myself and from everybody else."
• "When I would walk into a room full of people, I'd turn red
and it would feel like everybody's eyes were on me. I
was embarrassed to stand off in a corner by myself, but I
couldn't think of anything to say to anybody. It was
humiliating. I felt so clumsy, I couldn't wait to get out."
Obsessive-Compulsive
• "I couldn't do anything without rituals. They invaded every aspect of
my life. Counting really bogged me down. I would wash my hair
three times as opposed to once because three was a good luck
number and one wasn't. It took me longer to read because I'd count
the lines in a paragraph. When I set my alarm at night, I had to set it
to a number that wouldn't add up to a 'bad' number."
• "I knew the rituals didn't make sense, and I was deeply ashamed of
them, but I couldn't seem to overcome them until I had therapy."
• "Getting dressed in the morning was tough, because I had a routine,
and if I didn't follow the routine, I'd get anxious and would have to
get dressed again. I always worried that if I didn't do something, my
parents were going to die. I'd have these terrible thoughts of
harming my parents. That was completely irrational, but the thoughts
triggered more anxiety and more senseless behavior. Because of
the time I spent on rituals, I was unable to do a lot of things that
were important to me."
Obsessive-Compulsive Disorder
An unusual disorder of ritual and doubt.
Obsessions are persistent and intrusive thoughts, images,
ideas or impulses.
Compulsions are repetitive, purposeful behaviors that are
performed in response to an obsession.
They understand that their actions are unreasonable, but
cannot stop themselves. Age of onset is usually
between 9 and 12 years of age.
OCD
• Causes-may be genetic, may be due to
neurotransmitter activity, there has been
some indication that some have the onset
of this disorder after having strept throat
(they think that possibly the antibodies that
are supposed to fight the infection actually
attack the basil ganglia)
OCD
• - Symptoms-Obsessions: recurrent and
persistent thoughts, excessive worry about reallife problems, impulses which may be deemed
inappropriate. Compulsions: repetitive
behaviors or mental acts that a person feels
driven to perform as a result of the obsession,
behaviors done to reduce distress. Person
recognizes that obsessions or compulsions are
unreasonable. Marked distress, time consuming
or significantly interferes with a person’s normal
routine.
OCD
• - Treatments-Behavior therapy
(systematic des., flooding, thought
stopping), Tricyclic Antidepressants,
SSRI’s (today, Luvox is commonly used,
also may use Prozac or Zoloft)
Post-Traumatic Stress Disorder
• "I was raped when I was 25 years old. For a long time, I
spoke about the rape as though it was something that
happened to someone else. I was very aware that it had
happened to me, but there was just no feeling."
• "Then I started having flashbacks. They kind of came
over me like a splash of water. I would be terrified.
Suddenly I was reliving the rape. Every instant was
startling. I wasn't aware of anything around me, I was in
a bubble, just kind of floating. And it was scary. Having a
flashback can wring you out."
• "The rape happened the week before Thanksgiving, and
I can't believe the anxiety and fear I feel every year
around the anniversary date. It's as though I've seen a
werewolf. I can't relax, can't sleep, don't want to be with
anyone. I wonder whether I'll ever be free of this terrible
problem."
Post-Traumatic Stress Disorder
(PTSD)
- display of persistent anxiety following an
overwhelming traumatic event
• - Causes-traumatic event that is not a usual
event in the normal human experience
• - Symptoms-traumatic event is persistently
reexperienced, may have images or thoughts of
the event, recurrent distressing dreams of the
event, reliving the event, insomnia, exaggerated
startle response.
• - Treatments-Psychotherapy (systematic des.,
flooding), Cognitive-Behavioral therapy
Somatoform Disorders
• Disorders in which the person may feel
physical pain or problems but there is no
physiological basis for them, they are
psychological in nature.
• Psychosomatic: when the person feels
physical pain, and there is a biological
reason for them – due to stress.
Types of Somatoform Disorders
• Somatization Disorder: When the person
experiences a wide variety of physical problems that
are due to psychological problems.
• Conversion Disorder: When the person experiences
a loss of physical functioning in a body part with no
physical reason for this to happen. May effect,
vision, hearing, use of limbs.
• Hypochondriasis: When the person is excessively
worried about their health, worry about developing
illnesses and often manufacture the symptoms of
various illnesses in their head.
Causes and Treatments
• Causes of these disorders: May be due to
increased sensitivity of autonomic nervous
system, while others feel it is a personality or
cognitive defect. People who are histrionic, that
is, self-centered, suggestible, excitable, and
highly emotional may be more susceptible.
• Treatment: Psychoanalysis or cognitive therapy
may be helpful.
Dissociative Disorders
When a person experiences bouts of memory
loss, due to loss of consciousness and have
disruptions in their sense of identity.
• Dissociative Amnesia: A sudden loss of memory
for important personal information that is too
severe to be considered normal. May occur for
one traumatic event or period of time.
• Dissociative Fugue: When a person loses their
memory for their entire life along with who they
are and what their identity is. May forget name,
family, where they live, etc.
• Dissociative Identity Disorder: When there is the
existence of two or more personalities coexisting in the
same body (used to be called Multiple Personality
Disorder). The host personality is supposedly unaware
of any other personalities, however, some have reported
that one or more of the other personalities may be aware
of what is happening.
• Causes: It is thought that the cause of Dissociative
Identity Disorder is some type of repeated, chronic
psychological trauma during childhood. Dissociative
amnesia or fugue may be brought on by excessive
stress.
• Treatment: Psychoanalysis is usually a treatment
Personality Disorders
• - May be characterized by any of the following: affects a
person’s sense of self as well as others, lacks
appropriate emotional responses, impersonal functions,
lacks impulse control, behavior that is inflexible, inability
to function in social, occupational and other functions of
life, onset traced back to early adolescence or early
adulthood
• Disorders that are considered odd/eccentric
• Schizoid Personality Disorder
• - odd eccentric behavior, tend to be loners, may be
perceived to be cold and unfeeling, trouble keeping jobs
and maintaining relationships, show very little emotion
• Paranoid Personality Disorder
• - suspicious and mistrustful of others, refuse to
accept criticism or blame, may be cautious,
scheming, devious, or argumentative, does not
like to confide in others, difficult to get along with
• Schizotypal Personality Disorder
• - suspicious, shows signs of paranoia, aloof and
impersonal, shows signs of magical thinking,
unusual perceptual thinking, may have speech
that resembles schizophrenia (disorganized)
Antisocial personality disorders
• failure to conform to social norms with respect to
lawful behaviors as indicated by repeatedly performing
acts that are grounds for arrest
• deceitfulness, as indicated by repeated lying, use of
aliases, or conning others for personal profit or pleasure
• impulsivity or failure to plan ahead
• irritability and aggressiveness, as indicated by
repeated physical fights or assaults
• reckless disregard for safety of self or others
• consistent irresponsibility, as indicated by repeated
failure to sustain consistent work behavior or honor
financial obligations
• lack of remorse, as indicated by being indifferent to or
rationalizing having hurt, mistreated, or stolen from
another
Borderline personality disorder
•
•
•
•
•
•
•
•
•
frantic efforts to avoid real or imagined abandonment.
a pattern of unstable and intense interpersonal relationships characterized
by alternating between extremes of idealization and devaluation
identity disturbance: markedly and persistently unstable self-image or sense
of self
impulsivity in at least two areas that are potentially self-damaging (e.g.,
spending, sex, substance abuse, reckless driving, binge eating)
recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
affective instability due to a marked reactivity of mood (e.g., intense
episodic dysphoria, irritability, or anxiety usually lasting a few hours and
only rarely more than a few days)
chronic feelings of emptiness
inappropriate, intense anger or difficulty controlling anger (e.g., frequent
displays of temper, constant anger, recurrent physical fights)
transient, stress-related paranoid ideation or severe dissociative symptoms
Histrionic personality disorder
•
•
•
•
•
•
•
•
is uncomfortable in situations in which he or she is
not the center of attention
interaction with others is often characterized by
inappropriate sexually seductive or provocative
behavior
displays rapidly shifting and shallow expression of
emotions
consistently uses physical appearance to draw
attention to self
has a style of speech that is excessively
impressionistic and lacking in detail
shows self-dramatization, theatricality, and
exaggerated expression of emotion
is suggestible, i.e., easily influenced by others or
circumstances
considers relationships to be more intimate than they
actually are
Narcissistic personality disorder
•
•
•
•
•
•
•
•
•
has a grandiose sense of self-importance (e.g.,
exaggerates achievements and talents, expects to be
recognized as superior without commensurate
achievements)
is preoccupied with fantasies of unlimited success,
power, brilliance, beauty, or ideal love
believes that he or she is "special" and unique and
can only be understood by, or should associate with,
other special or high-status people (or institutions)
requires excessive admiration
has a sense of entitlement, i.e., unreasonable
expectations of especially favorable treatment or
automatic compliance with his or her expectations
is interpersonally exploitative, i.e., takes advantage of
others to achieve his or her own ends
lacks empathy: is unwilling to recognize or identify with
the feelings and needs of others
is often envious of others or believes that others are
envious of him or her
shows arrogant, haughty behaviors or attitudes
Avoidant personality disorder
• avoids occupational activities that involve significant
interpersonal contact, because of fears of criticism,
disapproval, or rejection
• is unwilling to get involved with people unless certain of
being liked
• shows restraint within intimate relationships because of
the fear of being shamed or ridiculed
• is preoccupied with being criticized or rejected in social
situations
• is inhibited in new interpersonal situations because of
feelings of inadequacy
• views self as socially inept, personally unappealing, or
inferior to others
• is unusually reluctant to take personal risks or to
engage in any new activities because they may prove
embarrassing
Dependent personality disorder
• has difficulty making everyday decisions without an
excessive amount of advice and reassurance from
others
• needs others to assume responsibility for most major
areas of his or her life
• has difficulty expressing disagreement with others
because of fear of loss of support or approval.
• has difficulty initiating projects or doing things on his
or her own (because of a lack of self-confidence in
judgment or abilities rather than a lack of motivation or
energy)
• goes to excessive lengths to obtain nurturance and
support from others, to the point of volunteering to do
things that are unpleasant
• feels uncomfortable or helpless when alone because
of exaggerated fears of being unable to care for himself
or herself
Obsessive-compulsive personality
disorder
•
•
•
•
•
•
•
•
is preoccupied with details, rules, lists, order, organization, or
schedules to the extent that the major point of the activity is lost
shows perfectionism that interferes with task completion (e.g., is
unable to complete a project because his or her own overly strict
standards are not met)
is excessively devoted to work and productivity to the exclusion of
leisure activities and friendships (not accounted for by obvious
economic necessity)
is overconscientious, scrupulous, and inflexible about matters of
morality, ethics, or values (not accounted for by cultural or
religious identification)
is unable to discard worn-out or worthless objects even when they
have no sentimental value
is reluctant to delegate tasks or to work with others unless they
submit to exactly his or her way of doing things
adopts a miserly spending style toward both self and others;
money is viewed as something to be hoarded for future
catastrophes
shows rigidity and stubbornness
Psychological Disorders
Part 2
Mood Disorders
• 1) Major Depression: A “whole
body” illness involving body,
mood and thoughts. Affects the
way the person eats, sleeps and
how they feel about themselves.
Symptoms can last for weeks,
months or years. Usually lasts
around 9 months, but if it goes
longer, it will usually dissipate
within 2 years.
• DEPRESSION CONTINUED
• Causes: 1) Some types run in families, 2) low
levels of serotonin, 3) low self-esteem, 4) those
who are pessimistic, 5) those overwhelmed by
stress, 6) serious loss, 7) chronic illness, 8)
difficult relationships, 9) financial problems
• Symptoms: 1) persistent sad, anxious, “empty”
mood, 2) feelings of hopelessness, 3) feelings of
guilt, worthlessness, helplessness, 4) loss of
interest in pleasures or hobbies, 5) insomnia or
oversleeping, 6) weight loss or weight gain, 7)
decreased energy/fatigue, 8) thoughts of suicide
or death
Depression continued
• Treatments: 1) Antidepressants
(Tricyclics, MAOI’s, SSRI’s), 2)
Psychotherapy (“talking” therapies, gaining
insight), 3) ECT (for severe depression),
Lithium (for recurrent major depression),
4) behavior therapy (gaining selfreinforcements for positive behavior)
Teen Depression
• Approximately 1 in 33 children and 1 in 8
adolescents are affected by depression at any
given time
• Suicide is the 3rd leading cause of death for 1524 year olds and the 6th leading cause for 5-14
year olds
• 70% of those diagnosed do not get any
treatment
• High risk: loss, attention disorders,
conduct or anxiety disorders
• High risk: Teenage girls, minorities
• Treatment is most effective when there is
early intervention, yet most people do not
know the symptoms of depression
• Often, a teen with depression may be
seen as a “normal” teen angst as they may
appear angry, belligerent, irritable and
hostile
• When this extends beyond 6 months,
however, this is considered to be a
problem
Bipolar Disorder
• Bipolar Disorder: A disorder that is characterized by
episodes of depression and mania.
• Causes: 1) runs in families, 2) many different genes
may be working together
• Symptoms:
•
Depression: See major depression
•
Mania: 1) inappropriate elation, 2) inappropriate
irritability, 3) severe insomnia, 4) increased talking, 5)
disconnected and racing thoughts, 6) inappropriate
social behavior, 7) feelings of grandiosity, 8) racing
thoughts, 9) abuse of drugs and alcohol
Bipolar is a continuous
range.
At one end is severe
depression, above
which is moderate
depression and then
mild low mood, which
many people call "the
blues" when it is
short-lived but is
termed "dysthymia"
when it is chronic.
Descriptions by Bipolars
• Depression: I doubt completely my ability to do
anything well. It seems as though my mind has
slowed down and burned out to the point of
being virtually useless…. [I am] haunt[ed]… with
the total, the desperate hopelessness of it all….
Others say, "It's only temporary, it will pass, you
will get over it," but of course they haven't any
idea of how I feel, although they are certain they
do. If I can't feel, move, think or care, then what
on earth is the point?
• Hypomania: At first when I'm high, it's
tremendous… ideas are fast… like shooting
stars you follow until brighter ones appear…. All
shyness disappears, the right words and
gestures are suddenly there… uninteresting
people, things become intensely interesting.
Sensuality is pervasive, the desire to seduce
and be seduced is irresistible. Your marrow is
infused with unbelievable feelings of ease,
power, well-being, omnipotence, euphoria… you
can do anything… but, somewhere this changes.
• Mania: The fast ideas become too fast
and there are far too many…
overwhelming confusion replaces clarity…
you stop keeping up with it—memory
goes. Infectious humor ceases to amuse.
Your friends become frightened….
everything is now against the grain… you
are irritable, angry, frightened,
uncontrollable, and trapped.
•
•
•
•
•
•
•
Treatments:
1) Lithium
2) Antipsychotic drugs
3) Psychosocial treatment
4) Psychoeducation
5) Family Therapy
6) Psychotherapy (individual and group
therapy)
• Seasonal Affective Disorder: Disorder in which
there is some form of depression associated
with the time of year (usually found in fall and
winter.
• Causes: Thought that the pineal gland monitors
the amount and quality of light that our eyes
receive. The Pineal body secretes chemicals,
which controls sleep and may switch the body
into a “hibernating” mode for the winter months.
• Symptoms: 1) depression occurs during certain
seasons in the year, 2) weight gain, 3) excessive
sleeping, 4) loss of interest in pleasures or
hobbies
• Treatments: Light therapy (phototherapy)
SD
Eating Disorders
• Anorexia: may have intense fear of
becoming overweight, heavy
preoccupation with food. May starve
themselves to the point of creating a
chemical imbalance in their bodies and
may shut down their organs. Some of
died of heart attacks. May be intensely
afraid of gaining weight. Age of onset
usually in teen years.
• Bulimia: Binging and purging, may not
look thin as they tend to stay at a more
normal weight, may vomit, use laxatives,
or enemas. Age of onset is often
adolescence or early adulthood. May find
they were initially anorexic. Acids from
vomiting may cause rotting teeth,
damaged esophagus and gums.
• Causes: May be caused by either societal
or cultural norms and standards as to what
is acceptable for body types or may be
some other type of issue such as control.
• Treatment: Psychoanalysis, Cognitive
therapy, Behavioral therapy,
Antidepressants
Schizophrenic Disorders
• Class of disorders that may be characterized by
delusions, hallucinations, disorganized speech and
maladaptive behavior. People are often on medications
for life.
• 4 types:
• 1. Paranoid type: marked by delusions of persecution
and delusions of grandeur.
•
2. Catatonic type: marked by either long periods of
motionlessness and unaware of environment or periods
of hyperactive movement and incoherent speech.
•
3. Disorganized type: marked by emotional
indifference, incoherent speech, random
babbling and silliness
• 4. Undifferentiated type: demonstrates
behaviors from the other three categories.
• Causes: May be the only disorder that people
agree has a genetic component. May be related
to neurotransmitter activity, especially an excess
of dopamine. May have structural abnormalities
of the brain.
• Treatments: Medications are usually effective.
Abnormal Psych-Therapies
Psychotherapy
• Likely to seek therapy are: insured, divorced/separated,
single, over 16 years of age, females
• Psychologists may earn a Ph.D., Psy.D., or Ed.D. They
have 5 to 7 years of training beyond bachelor’s degree.
Also there is a requirement of 1 to 2 years in a clinical
setting.
• Psychiatrists earn an M.D. degree. Graduate training
requires 4 years of coursework in medical school. There
is also a requirement of a 4 year apprenticeship in a
residency at a hospital.
Insight Therapies
• 1) Psychoanalysis-deals with unconscious
conflicts, motives, and defenses through
techniques such as free association and
transference. (Freud)
•
a) free association: where the client
spontaneously express their thought and
feelings exactly as they occur, with very little
censorship.
•
b) dream analysis: when therapist interprets
symbolic meanings of client’s dreams
• c) talking therapies: in which the client talks,
trying to reach catharsis (release of emotions)
• Possible negative problems during therapy
•
a) resistance: a mostly unconscious defense
mechanism that may hinder the progress of
therapy
• b) transference: when the client transfers
feelings for their critical relationships onto the
therapist
•
c) countertransference: when the therapist
transfers feelings they have for others onto the
client
• 2) Client-centered therapy-therapy in
which the client plays a major role in
determining the pace and direction of
therapy. The client is thought to be “their
own best therapist”. Therapist serves as a
facilitator, they provide clarification. Carl
Rogers, founder of this method of therapy,
states:
• “It is the client who knows what hurts, what
directions to go, what problems are
crucial, what experiences have been
deeply buried. It began to occur to me
that unless I had a need to demonstrate
my own cleverness and learning, I would
do better to rely upon the client for the
direction of movement in the process”
• Rogers believed that the therapist should
be:
– genuine
– empathetic (feeling for the client)
– have unconditional positive regard (be
nonjudgmental towards the client regardless
of what they tell the therapist)
• 3) Cognitive therapy: helps the client to
recognize and overcome negative thoughts
about themselves. (Aaron Beck and Albert
Ellis). Client is trained to detect their automatic
thought processes. Often utilized with
behavioral therapy today.
• 4) Group therapy: when several clients are
treated at the same time. Participants often act
as the “therapist” while the therapist serves as a
facilitator.
• Advantages:
1) saves time and money
2) clients realize that their misery is not unique
3) participants can work on social skills
• Behavior Therapies-based on the principles of
classical, operant and observational learning.
1. Aversion therapy-an aversive stimulus is
paired with a stimulus that brings on an
undesirable response.
• 2. Systematic desensitization-clients slowly
faces phobic stimulus in a step-by-step process
in which they relieve themselves of anxiety at
each step
• 3. Flooding-clients are quickly exposed to
phobic stimulus not allowing for time to relieve
anxiety
• 3. Token economies – giving tokens for correct
behavior that can be later exchanged for desired
goods.
• 4. Social skills training-designed to improve
interpersonal skills that emphasizes modeling,
behavioral rehearsal and shaping (reinforcing
each step towards desired goal behavior)
• 5. Biofeedback-a bodily function (such as heart
or blood pressure) is monitored, and information
about the bodily function is given back to the
client. Helps control physiological processes.
Biomedical Therapies
1. Psychopharmacotherapy-treatment of
mental disorders with medication
•
a) Antianxiety drugs: relieve tension,
apprehension and nervousness. Effects
are seen rather immediately and can last
for several hours. Most popular are Xanax
and Valium.
• b) Antipsychotic drugs:
•
primarily used to treat Schizophrenia, but
may be given to those with severe mood
disorders who become delusional.
•
appear to decrease the levels of dopamine in
a person’s system.
•
Most popular are Thorazine, Mellaril and
Haldol.
•
Antipsychotics may have a negative side
effect called tardive dyskinesia, which has
symptoms similar to Parkinson’s disease
(involuntary writing and ticklike movements of
the mouth, tongue, face, hands and feet).
• c) Antidepressant drugs: drugs that gradually elevate
mood and help bring people out of a depression. Takes
several weeks to see improvement. There are three
types:
•
1. Tricyclics: the first group of antidepressant
drugs. Have a tendency to have more side effects than
SSRI’s. (Elavil)
•
2. MAOI’s (monoamine oxidase inhibitors)Second group of antidepressant meds. One has to be
very careful about certain foods and meds taken with
these drugs as they could have potentially fatal results.
(Nardil)
•
3. SSRI’s (selective serotonin reuptake
inhibitors)-Newest class of antidepressant drugs.
Include meds such as Prozac, Paxil, and Zoloft.
• d) Lithium-chemical used to control mood
swings in patients with bipolar disorder.
Lithium levels in the blood must be
monitored carefully because high levels
could be toxic or even fatal.
• 2. Electroconvulsive Therapy (ECT)-treatment
in which electric shock is used to produce a
cortical seizure accompanied by convulsions.
Primarily used on those with severe depression.
May lead to gaps in memory or short-term
memory loss. Seems to “rewire” the brains
circuitry.
• 3. Lobotomy-Procedure in which cells in the
forebrain are lesioned. Has been used to treat
severe schizophrenics.