General Psychology
History of Treatment
Brown: Unit 13
Therapy & Health
Therapy
TherapyPsychoanalysis
 Psychoanalysis
 Psychotherapy
 an emotionally charged, _____ interaction
b
between
a trained
i d therapist
h
i and
d someone
who _____ from psychological difficulties
 Freud believed the patient’s free associations,
resistances, dreams, and transferences – and
the therapist’s
therapist s interpretations of them –
released previously repressed feelings,
allowing the patient to gain self-insight
 use has rapidly _____ in recent years
 _____
 blocking from consciousness of anxiety-laden
material
TherapyPsychoanalysis
 Interpretation
 the analyst’s noting supposed dream
meanings, resistances, and other significant
behaviors in order to promote insight
 _____
 the patient’s _____ to the analyst of emotions
linked with other relationships
 e.g. love or hatred for a parent
Humanistic Therapy
 Client-Centered Therapy
 humanistic therapy developed by Carl
Rogers
 therapist uses techniques such as active
listening within a genuine, accepting,
empathic environment to facilitate
clients’ growth
1
Humanistic Therapy
 Active Listening-_____ listening in which the
listener echoes, restates, and clarifies
Behavior Therapy
 Behavior Therapy
 therapy that applies learning principles to the
elimination of unwanted behaviors
 _____
 procedure that conditions new responses to
stimuli that trigger unwanted behaviors
 based on classical conditioning
 includes systematic desensitization and
aversive conditioning
Behavior Therapy
 _____ Therapy
 treat anxieties by exposing people (in imagination
or reality) to the things they fear and avoid
Behavior Therapy
 _____ _____
 type of counterconditioning
 associates a pleasant, relaxed state with
gradually increasing anxiety-triggering
anxiety triggering stimuli
 commonly used to treat phobias
 Aversive Conditioning
 type of counterconditioning that associates an
unpleasant state with an unwanted behavior
 nausea ---> alcohol
Behavior Therapy
Behavior Therapy
 Systematic Desensitization
 Aversion
therapy
for
alcoholics
2
Behavior Therapy
Cognitive Therapy
 Token Economy
 Cognitive Therapy
 an operant conditioning procedure
th t rewards
that
d d
desired
i d behavior
b h i
 patient exchanges a token of some
sort, earned for exhibiting the
desired behavior, for various
privileges or treats
Group and Family
Therapies
Cognitive Therapy
 A cognitive
perspective
on
psychological
disorders
Evaluating
Psychotherapies
Number of
persons
Average
untreated
person
Poor outcome
 teaches people new, more adaptive
ways of thinking and acting
 based on the assumption that
_____ intervene between events
and our emotional reactions
 Family Therapy
 treats the family as a _____
 views an individual’s
individual s unwanted
behaviors as influenced by or directed
at other family members
 attempts to guide family members
toward positive relationships and
improved communication
Therapists and their
Training
Average
psychotherapy
client
Good outcome
 Clinical psychologists
 Most are psychologists with a Ph.D. and
expertise in research, assessment, and
therapy, supplemented by a supervised
internship
 About half work in agencies and
institutions, half in private practice
80% of untreated people have poorer
outcomes than average treated person
3
Therapists and their
Training
Therapists and their
Training
 Clinical or Psychiatric Social Worker
 Counselors
 A two-year Master of Social Work
graduate program plus postgraduate
supervision prepares some social
workers to offer psychotherapy, mostly
to people with everyday personal and
family problems
 About half have earned the National
Association of Social Workers’
designation of clinical social worker
 Marriage and family counselors
specialize in problems arising from
family relations
 Pastoral counselors provide counseling
to countless people
 Abuse counselors work with substance
abusers and with spouse and child
abusers and their victims
Therapists and their
Training
Biomedical Therapies
 Psychiatrists
 Psychopharmacology
 Physicians who specialize in the
treatment of psychological disorders
 Not all psychiatrists have had extensive
training in psychotherapy, but as M.D.s
they can _____ _____. Thus, they tend
to see those with the most serious
problems
 Many have a private practice
Biomedical Therapies
 study of the effects of drugs on mind
and behavior
 Lithium
 chemical that provides an effective drug
therapy for the mood swings of bipolar
(manic-depressive) disorders
Biomedical Therapies
 The emptying of U.S. mental hospitals
4
Biomedical Therapies
Biomedical Therapies
 Electroconvulsive Therapy (ECT)
 therapy for severely depressed patients in
which a brief electric current is sent through
tthe
eb
brain
a o
of a
an a
anesthetized
est et ed pat
patient
e t
 Psychosurgery
 surgery that removes or destroys brain tissue
in an effort to change behavior
 lobotomy
 now-rare psychosurgical procedure once used to
calm uncontrollably emotional or violent patients
Side Effects
Psychosurgery Today
 The most common side effects from
psychosurgery were changes in
 In 1977, the U.S. Congress created a National
Committee for the Protection of Human Subjects
of Biomedical and Behavioral Research to
investigate allegations that lobotomy techniques
produced unethical after effects. It concluded
that, in general, psychosurgery could have
positive effects. Today about 10-15 lobotomies
are conducted in the US each year.
 Personality
 Affect
 Morality
 (Brain structures involved in inhibitory control may
have been adversely affected).
Psychology & Health
Stress and Illness
 Behavioral Medicine
 Leading causes of death in the US in 1900
and 2000
 interdisciplinary field that integrates behavioral and
medical knowledge and applies that knowledge to
_____and _____
 Health Psychology
 subfield of psychology that provides psychology’s
contribution to behavioral medicine
 Psychoneuroimmunology (PNI)
 new subfield of psychology that examines the
interactions among psychological factors, the nervous
system, and the immune system
5
Stress and Illness
 Stress
The Stress Response System
The hypothalamus and the pituitary gland also respond to stress dt t
(slow) by triggering outer adrenal glands to secrete glucocorticoids
(cortisol).
General Adaptation Syndrome
According to Selye stress response to any kind of
stimulation is similar. The stressed individual goes
through three phases.
Stress is not merely a stimulus or response, it is process by which we_____ and _____ with environmental threats and challenges.
Bob Daemmrich/ The Image Works
 the process by
which we
perceive and
respond to
certain events,
called stressors,
that we _____ as
threatening or
challenging
Stress and Stressors
When short‐lived or taken as a challenge, stressors can have positive effects. However, if prolonged or threatening stress can be harmful.
The Stress Response System
Canon proposed that stress response (fast) was a fight‐or‐flight response marked by outpour of epinephrine
f
and norepinephrine
from inner adrenal glands increasing heart and respiration rates, mobilizing sugar and fat and dulling pain.
Stressful Life Events
 Catastrophic Events
 earthquakes, combat stress, floods
 Life Changes
EPA/ Yuri Kochetkov/ Landov
 death of a loved one, divorce, loss of job,
promotion
 Daily Hassles
 rush hour traffic, long lines, job stress,
burnout
6
PRS
Life Change Units
 Research on the reaction of people to
stress show that most subjects can
maintain the stage of resistance for an
indefinite period of time.
 T/F
 Each life change requires some adaptation and
is thus stressful.







LCU’s








Fired from work
Retirement
Marital reconciliation
Pregnancy
Sexual difficulties
Son/daughter leaving home
Outstanding achievement
Starting school
100
73
65
63
63
53
50
LCU’s
47
45
45
40
39
29
28
26
Stress Duration and Illness
 Volunteers were
interviewed about life
stressors, then
infected with cold
virus.
 As
A length
l
th off stress
t
increased, so did the
likelihood of catching
the cold.
 Stress impairs
immune system
functioning.
Death of spouse
Divorce
Di
Separation
Death of family member
Detention in jail
Personal injury
Marriage





Graduation
Change of schools
Change of residence
Change in diet
Christmas vacation
26
20
20
15
11
 < 150 LCU’s in 12 months – good health
 150-300 LCU’s 50% chance of major illness
 >300 LCU’s 70% of major illness
The Immune System
 Immune System
 A biological surveillance system that
detects and destroys “nonself”
substances that invade the body
 Lymphocytes
 Specialized white blood cells that
secrete chemical antibodies and
facilitate the immune response
7
The Immune System
Stress and Disease
 Lymphocytes
 two types of white blood cells that are
part of the body’s immune system
 B lymphocytes form in the bone marrow
and release antibodies that fight bacterial
infections
 T lymphocytes form in the thymus and,
among other duties, attack cancer cells,
viruses, and foreign substances
Immune System Components
PRS
 The integrity of the immune system is not
influenced by stressful social relationships.
 T/F
B cell migrates
to a blood
vessel
Killer T-cell
attacks a tumor
cell
Macrophage traps
and ingests a
bacterium
Stressful Life Events
Stress and the Heart
 Chronic Stress by Age
 _____
 clogging
gg g of the vessels that
nourish the heart muscle
 leading cause of death in many
developed countries
8
Stress and the Heart
Personality & Coronary Heart
Disease
 Type A Personality
 Type A
 Friedman and Rosenman’s term for
competitive, hard-driving, _____, verbally
aggressive, and _____ people
 Type B
 Friedman and Rosenman’s term for
easygoing, relaxed people
Pathways From Stress to CHD
 Characterized by an
impatient, hard-driving,
and hostile pattern of
behavior
 Type B Personality
 Characterized by an
easygoing, relaxed
pattern of behavior
 People with Type A
personality are more
prone to coronary heart
disease (CHD).
Stress and the Heart
Hopelessness
scores
3.5
3
Men who feel extreme hopelessness
are at greater risk for heart attacks
and early death
25
2.5
2
 Under stress, people engage in behaviors that
are _____ healthy and they are _____
physiologically reactive.
 Both of these contribute to coronary heart
disease.
Stress and the Heart
1.5
1
0.5
0
Heart attack
Low risk
Death
Moderate risk
High risk
PRS
 Personality variables do not predict the
likelihood that a subject may develop
heart disease.
 T/F
9
Stress and Disease
Promoting Health
 _____
 Negative emotions and health-related
consequences
Heart
disease
Persistent stressors
and negative
emotions
Release of stress
hormones
Immune
suppression
Autonomic nervous
system effects
Unhealthy behaviors
(smoking, drinking,
poor nutrition and sleep)
(headaches,
hypertension)
 Modifying Type A life-style can reduce
recurrence of heart attacks
 Heart attack
patients were taught
to relax their pace.
Control patients
Modifying life-style
reduced recurrent
heart attacks
2
Life-style modification patients
1
0
1978
1979
1980
 blood pressure
 muscle tension
Relaxation and the Heart
Promoting Health
Percentage 6
of patients
with recurrent 5
heart attacks
(cumulative 4
average)
3
 system for
electronically
recording,
amplifying,
lif i
and
d
feeding back
information
regarding a subtle
physiological state
1981
 A control group
received
i d standard
t d d
medical care.
 After three years,
relaxation-trained
patients suffered
50% fewer second
heart attacks.
1982
Year
Coping With Stress
Social Support
 Much evidence shows that social
support has therapeutic effects.
 Women with breast cancer who joined
supportt groups lilived
d an average off
eighteen months longer than women who
did not join these groups.
 Across gender, age, income level, and
ethnicity, social support lowers mortality
rates.
Promoting Health
 Social support across the life span
Percentage
with high
support 100%
90
80
70
60
50
12-14
18-19
15-17
25-34
20-24
45-54
35-44
65-74
55-64
75+
Age in years
10
Promoting Health
Promoting Health
 The religion factor is mulitidimensional
 Religious Attendance
Healthy
behaviors
(less smoking,
drinking)
Religious
involvement
Social support
(faith
communities,
marriage)
Better health
(less immune system
suppression, stress
hormones, and suicide)
Positive
emotions
(less stress,
anxiety)
PRS
Stress and Coping
 Individuals with a strong social support
network tend to live a longer life with
fewer episodes of major illnesses.
 T/F
 Although stressful events have effects on the body,
The way people _____ can promote health or
illness.
Promoting Health
Depression 14
score 13
No-treatment
group
12
11
10
Relaxation
treatment
group
9
8
7
6
Aerobic
exercise
group
5
4
3
Before treatment
evaluation
After treatment
evaluation
 Aerobic Exercise
 sustained
exercise that
increases heart
and lung fitness
The “Self-Healing Personality”
Hopelessness and the Risk of Death
 In Finland, middleage men were
rated for
hopelessness.
 Six years later,
higher ratings of
hopelessness
predicted risk of
overall death,
cancer, and heart
attack.
11
The “Self-HealingPersonality”
 _____
 It acts as a buffer against stress.
 It is a personality style characterized
by commitment, challenge, and control.
 Commitment
 Sense of purpose in work, family, and life
 Challenge
 Openness to new experiences and change
 Control
 Belief that one has the power to influence
important future outcomes
12