Treatment of Abnormal Psychology
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Created by David Silverman
Historical Treatment of Abnormal
Psychology
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People who were mentally ill were thought to be possessed by evil spirits in
early societies. Archaeologists have found human skulls with regularly shaped
holes in them that seem intentionally made. Researchers have theorized that
this process was called trephining, which was a way to release harmful
spirits.
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Hippocrates (Greece circa 500 B.C.E) proposed the idea that psychological
illnesses were influenced by biological factors and could therefore be treated
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The Enlightenment led to treating victims of mental illness more humanely.
Philippe Pinel in France and Dorothea Dix in the United States fought against a
system that treated the mentally ill as if they were criminals (they were even
caged and beaten).
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These two helped bring about the development of safer and ethical institutions for
people with severe psychological disorders.
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Following the development of drugs in the 1950s that could help the effects of
severe disorders, many people were released from mental institutions in a process
called deinstitutionalization
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However, many of the people released were schizophrenics who ended up homeless and
delusional as they were unable to seek the psychological or the financial care they
needed.
Preventative efforts
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If psychological problems can be treated proactively, (before they become
severe) the suffering of the client as well as the cost of providing care can be
reduced.
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Primary prevention efforts attempt to reduce societal problems (joblessness,
homelessness) that can cause mental health issues.
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Secondary prevention involves working with people who are considered “at-risk”
for developing specific problems. An example would be counseling people who live
in an area that has experienced a natural disaster or terrorist attack.
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Tertiary prevention efforts try to keep mental health issues from increasing in
severity.
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Working with hurricane survivors who already have an anxiety disorder to try to prevent
the disorder from becoming more severe.
Psychoanalytic Therapy
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Developed by Sigmund Freud
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View the cause of disorders as unconscious conflicts.
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Their focus is on identifying the underlying cause of the problem.
Other methods of therapy don’t address the “root” of problem, and patients
will suffer symptom substitution.
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Symptom substitution occurs after a person is successfully treated for one
psychological disorder, then that person begins to experience a new psychological
problem.
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Psychoanalytic therapists say that a person’s symptoms are, “the outward
manifestations of deeper problems that can be cured only through analysis.”
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Freud developed many techniques to study the unconscious mind
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Hypnosis- When in this state, psychoanalysts believe that people are less likely to
repress troubling thoughts.
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Free Association-Having your patient say whatever comes to their mind without
thinking. The theory is that if we force ourselves to say whatever pops into our
minds, we are more likely to reveal clues about what is really bothering us.
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This is thought to be a way to elude the ego’s defenses.
Dream Analysis- ask their patients to describe their dreams.
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Since the ego’s defenses are relaxed during sleep, psychologists hope the dreams can
reveal what is at the root of the patient’s problem.
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Patients focus on the manifest content (what is actually happening in the dream)
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Therapists focus on the latent content (the hidden content of the dream)
Issues with Psychoanalytic Theory
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Most of these techniques rely heavily on the interpretations of the therapist,
which can be heavily biased.
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Resistance occurs when patients often disagree and reject what their
therapists interpretations are.
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This is especially true when dealing with particularly sensitive (emotional)
information.
Transference is when patients begin to have strong feelings toward their
therapists.
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Patients may think they are in love with their therapists, may view their therapists
as parental figures, or may feel extreme hatred towards them.
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While people who strictly adhere to Freudian theory are still psychoanalytic,
there are many other psychologists who have been in influenced by his work.
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Psychodynamic theorists still view the unconscious as an important element in
understanding people, but they also employ a variety of techniques from other
perspectives when assessing people.
Humanistic Therapies
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Humanistic therapies focus on helping people to understand and accept
themselves, and strive to self-actualize.
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Purposes that people are innately good and possess free will.
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Self-actualization means to reach one’s highest potential.
Determinism (the opposite belief) says that people have no influence over what
happens to them and that their choices are predetermined by forces outside of
their control.
Carl Rogers thought that people need unconditional positive regard in order
reach self-actualization.
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Most humanistic therapies are non-directive.
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Rogerian therapists would not tell their clients what to do, but would try to help
the clients choose a course of action for themselves.
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They use a technique called active listening, which encourages the client to talk a
lot and to mirror back or clarify the feelings of the client.
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Gestalt therapy (developed by Fritz Perls) encourages their clients to get in
touch with their “whole” selves, and to focus on the present instead of the
past or future.
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Existential therapies see clients’ troubles as being caused by the clients
having lost or failed to develop a sense of their lives’ purpose.
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These therapists help them develop a vision of their lives that the client feels is
worthwhile.
Behavioral Therapies
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Behaviorists believe that all behavior is learned. Three examples of learning
techniques are modeling, classical conditioning, and operant conditioning.
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Counterconditioning is a kind of classical conditioning developed by Mary Cover
Jones. This is when an unpleasant conditioned response is replaced with a
pleasant one.
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Bringing a child’s favorite toy’s and snacks to the dentist’s to counter the child’s fear of
the office.
Joseph Wolpe developed what is called systematic desensitization, which had a
lot of success in helping people with anxiety disorders (especially phobias).
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This process involves teaching the client to replace the feelings of anxiety with
relaxation.
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In the process of in vivo desensitization, the client confronts the actual feared objects
or situations.
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in covert desensitization the client imagines the fear-inducing stimuli.
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Flooding can also be in vivo or covert. Unlike the gradual process of
systematic desensitization, flooding involves having the client address the
scariest scenario first.
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Modeling is a process where one person learns by observing and then imitates
the behavior of another.
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Modeling, systematic desensitization and flooding all are exposures therapies. This
means they all involve some degree of contact with the feared stimuli.
aversive conditioning involves pairing a habit a person wishes to break
(smoking or bed-wetting) with an unpleasant stimulus (electric shock or
nausea).
Cognitive Therapies
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As cognitive therapists believe the cause of psychological problems is in the way
people think.
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Methods of therapy concentrate on changing unhealthy thought patterns.
Attributional style is the way that people interpret (consciously or unconsciously)
and rationalize life events to themselves.
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A pessimistic attributional style would involve thinking, ”I am an idiot who will fail all
tests in all subjects all the time”.
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A healthier attributional style would be to view failure as external (the test was
difficult), specific (this topic was particularly difficult), and temporary (she will do
better next time).
cognitive therapy involves trying to get clients involved in activities and programs
they will be successful at.
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This can alleviate the depression while challenging the irrational ideas that cause their
unhappiness.
Cognitive Behavioral Therapies
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Combines techniques of cognitive and behavioral psychology (CBT).
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Rational emotive behavior therapy (REBT) was developed by Albert Ellis to
reveal and confront the dysfunctional thoughts their clients had.
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Someone suffering from a social phobia might get nervous when giving a class
presentation. Using REBT, a therapist would question how likely the client would
actually be embarrassed, and what would really happen if the embarrassing
scenario played out.
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The therapist’s goal would be to show the client that not only is his or her failure unlikely,
but even if it did happen it wouldn’t be such a big deal.
Somatic Therapies
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Biological Psychologists focus on:
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Imbalances in neurotransmitters or hormones
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Structural abnormalities in the brain
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Genetic predispositions to disorders
These psychologists use somatic therapies, which are therapies that produce
bodily changes.
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The most common type of somatic therapy is drug therapy
(psychopharmacology, also known as chemotherapy).
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Schizophrenia is usually treated with antipsychotic drugs, which generally
work by blocking the receptor sites for dopamine.
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Drugs treat many kinds of psychological problems, examples include anxiety
disorders, mood disorders, and schizophrenia.
A side effect of antipsychotic medication is tardive dyskinesia, Parkinsonian-like,
chronic muscle tremors.
Most of the drugs used to treat mood disorders tend to increase the activity of
serotonin.
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Lithium, a metal, is often used to treat the manic phase of bipolar disorder.
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Anxiety disorders are also often treated with drugs. These drugs make people
feel more relaxed by depressing the activity of the central nervous system.
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Another kind of somatic therapy is electroconvulsive therapy (ECT).
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In bilateral ECT, electric current is passed through both hemispheres of the brain.
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Unilateral ECT involves running current through only one hemisphere.
Psychosurgery involves, “the purposeful destruction of part of the brain to
alter a person’s behavior.”
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This is rarely done and is highly intrusive.
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Prefrontal lobotomy’s were an early form of this that cut the main neurons to the
frontal lobe of the brain. This was done to calm patients, but often left them in
vegetative states.
Kinds of Therapists
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Psychiatrists are medical doctors and are the only therapists allowed to
prescribe medication in most U.S. states.
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Clinical psychologists usually deal with people who are suffering from
problems more severe than everyday hassles with work or family.
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Counseling therapists often have some kind of graduate degree in psychology.
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Their training also usually includes an internship overseen by a more experienced
professional.
Psychoanalysts are trained in the Freudian method and may or may not have a
degree.
References
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This powerpoint presentation was adapted using information from the
Barron’s AP Psychology 5th edition prep book.
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Weseley, Allyson, Robert McEntarffer, and Robert McEntarffer. AP® Psychology.
Hauppauge, N.Y.: Barron's Educational Series, 2014. Print.