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Behavioral Medicine > Psychotherapy 2 Types of Therapy > Flashcards

Psychotherapy 2 Types of Therapy Flashcards

1
Q

Psychodynamic psychotherapy is also known as _____.

A
  1. “old school”-Freud, Jung
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2
Q

Why is psychodynamic Psychotherapy not used commonly today?

A
  1. Often long term and intensive
  2. Hated by insurance companies
  3. Theory driven
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3
Q

Psychodynamic psychotherapy focuses on ______.

A

Resolution of the unconscious conflict

(Less focused on symptom reduction per se and more focused on restructuring fundamental relationships)

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4
Q

Freud stages of psychosexual development

A
  1. Oral stage
  2. Anal stage
  3. Phallic stage
  4. Oedipal complex
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5
Q

Oral stage time frame

A

birth to 1 year

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6
Q

Oral stage: wish and fear

A
  • wish: dependency gratification
  • fear: loss of object (i.e. mother)

(surrounds eating behaviors)

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7
Q

Anal stage time frame

A

1-3 years old (the time we are potty trained)

(if unresolved, we fear loosing approval from caretaker)

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8
Q

Anal stage: wish and fear

A
  • wish: assertion of autonomy, defiance vs. compliance
  • fear: losing the approval of the significant caretaker
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9
Q

Phallic Stage time frame

A

(ages 3-6)

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10
Q

Phallic stage wish & fear

A
  • Wish: admiration for one’s prowess and superiority; triumph
  • Fear: Inadequacy, humiliation, defeat, inferiority
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11
Q

Oedipal Complex : wish and fear

A
  • Wish: rivalry with same-sex parent for affection of opposite-sex parent
  • Fear: attack from same-sex parent
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12
Q

Latent stage time frame

A

Age 6 through puberty

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13
Q

During the latent stage, the _____ (2) develop.

A
  1. ego
  2. superego
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14
Q

Genital stage time frame

A

Puberty until death

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15
Q

The genital stage assumes successful resolution of the earlier stages this is highlighted by _____

A

mature interpersonal relationships

(highlights why dynamic therapy focuses on early childhood)

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16
Q

In Freud’s structural model, the Id is based on the ______ (2).

A
  • the pleasure principle and immediate gratification without any societal consequences of internal guilt.
  • Inability to delay gratification is central to the id. This is a primitive part of our intra-psychic makeup

(society requires us to modify the Pleasure Principle secondary to reality)

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17
Q

Define super-ego

A
  1. Societal expectations of behavior-learned from parents, teachers etc…
  2. Broken into two parts-conscious which is the source of what is inappropriate and will bring negative consequence
  3. Ego ideal which is the idealized self
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18
Q

In Freud’s structural model: Define ego

A

The balance between the id and superego-can often be viewed as the negotiator

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19
Q

2 processes of Ego (Freud’s structural model)

A
  1. primary: unconscious - no organization or coherency to thoughts
  2. secondary: conscious awareness; organized thought
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20
Q

Defense mechanisms are only pathological when they are _____.

A

consistently used in a fashion that leads to maladaptive functioning for the individual

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21
Q

Define defense mechanism

A

unconscious psychological strategies to cope with reality and maintain self image

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22
Q

George Eman Vaillant: divided defense mechanisms into four levels based on ________.

A

what level of psychoanalytic development the defense mechanism comes from

(mixture of Freud and American Heritage dictionary def.)

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23
Q

Defense mechanisms are almost always ______

A

Pathological; allow one to distort experiences in a way that denies reality

(“psychotic” defenses seen in psychiatric illness & also in dreams)

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24
Q

Delusional projection

A

Delusions about external reality usually persecutory in nature

(pathological ego defense mechanism)

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25
Q

Denial

A

This is a severe situation in which one simply doesn’t acknowledge reality thereby avoiding the threat

(pathological ego defense)

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26
Q

Distortion

A

Reshaping reality to fit internal needs

(pathological defense mechanism)

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27
Q

Splitting

A

Negative and positive emotions are not integrated

(seen as marketed idealization or devaluation)

(pathological defense mechanism)

28
Q

Level 2: Define immature defense mechanisms

A

People using these defenses are often seen as immature and character disordered

(Seen in adults and children)

29
Q

Acting out is a direct _______.

A

expression of unconscious conflicts or action

(immature ego defense mechanism)

30
Q

Define fantasy

A

Retreat into desired outcomes to cope with reality

(immature ego defense)

31
Q

Passive aggressive behavior

A

Action toward others is expressed indirectly

(immature ego defense)

32
Q

Define projection

A

Undesirable impulses or feelings are placed onto another so one doesn’t have to deal with them

(immature ego defense. different from Delusional projection: delusion about persecution that you put onto another person; pathological ego defense mechanism)

33
Q

Somatization

A

Negative feelings are turned inwards in the form of pain or illness

(immature ego defense)

34
Q

Neurotic defense mechanism

A

Adaptive and short-term situations but can be problematic if chronically unemployed

(common in adults)

35
Q

Define displacement

A

Shifting the negative emotional threat to a more accepting and less dangerous area. This is all separating the emotion from its real object.

(neurotic ego defense mechanism)

36
Q

Define dissociation

A

Temporarily but marked modification of identity or reality to avoid trauma (immature ego defense mechanism)

(neurotic defense mechanism. Common in rape victims and combat veterans. they dissociate from the memory but at a neurological level, they did not. Olfactory memories may trigger a flood of memory)

37
Q

Define intellectualization

A

Focus on the rational components of a situation to avoid the threatened emotion

(neurotic ego defense mechanism, different from rationalization: convincing onseself that there is no negative emotion/situation - faulty reasoning)

38
Q

Define rationalization

A

One convinces oneself that there was not a negative action or negative emotion through faulty reasoning

(neurotic ego defense mechanism, different from intellectualization: focusing on the rational to avoid neg. emo or threat)

39
Q

Define reaction formation

A

Converting the genuine wish into its opposite (difficult to maintain over time)

(neurotic ego defense mechanism)

40
Q

Define regression

A

Temporary reversion of ego and into an earlier stage

(neurotic ego defense mechanism)

41
Q

Define repression

A

Process of repelling the desires toward the pleasurable act by simply denying its existence

(neurotic ego defense mechanism, different from denial: not acknowledging reality to avoid threat.)

42
Q

Behavioral therapy is rooted in

A

Classical learning theory

43
Q

Behavioral therapy is truly behavioral treatments and does not focus on ______

A

Cognition

44
Q

Behavioral therapy often involves _______

A

Desensitization: exposing people to new learning in situations that will modify their maladaptive responses

(if they are terrified of driving, you gradully expose them to stress)

45
Q

Desensitization is done in two stages:

A
  1. Rehearsed in their mind
  2. performed in real life
46
Q

Supportive therapy is excellent for which patient population?

A
  1. Traumatic events
  2. Grief
  3. People suffering from health conditions

(often running a group format)

47
Q

Which type of therapy is AA, Survivors of Suicide and Compassionate Friends?

A

Supportive therapy

(best for grief or traumatic events that need normalization or a community acknowledgement)

48
Q

Cognitive therapy is based on the theory that ______

A
  • Based on the concepts of thoughts influenceing feelings
  • Event → thought → feeling → action → result

(“ there is nothing good or bad but thinking makes it so”)

49
Q

Define schema

A

Core beliefs people have about themselves, the world, and other people

50
Q

Schemas provide a mental filter that guides _____.

A

how we experience the world

(This can create distortions of cogniton than from the reality (i.e. a person who has been never gotten anything easy will assume stuff comes w/ a price, whereas somebody who got everything will assume things come more easily)

51
Q

A-B-Cs of cognitive therapy tenets

A

Patients will frequently present for therapy either focused on:

  • Cognition of emotion (C) - how they feel
  • OR
  • the events leading up to how they feel (A)
  • Belief about the event (B)

(B is a filter that can shape how we feel & this is usually the vehicle of change)

52
Q

Examples of cognitive distortions (6)

A
  1. All or nothing thinking
  2. Labeling
  3. Overgeneralizing
  4. Magnifying
  5. Mental filter (i.e. disqualifying the positive)
  6. Should Statemements

(watch out for words like, “always”, “horrible”, etc that indicate cog. distortions)

53
Q

Distortions are the difference between what we tell ourselves and _____.

A

what we would tell someone we care about regarding the same circumstance

54
Q

What is the king of distortions?

A

Should statements (true shoulds are black and white. ex: you should not murder someone. it is inflexible)

(so many of the other distortions come from this)

55
Q

Limits of cognitive therapy (2)

A
  1. Humans are not purely rational
  2. PTSD research shows that distress is encoded at lower brain levels than the cerebral cortex
56
Q

What is the most effective therapy to treat depression and anxiety?

A

Cognitive therapy

(except for borderline personality or self-harm which is dialectic therapy)

57
Q

Most successful therapy for borderline personality, alcoholism or self-harm?

A

Dialectic behavior therapy = combo of cognitive therapy + mindfulness + acceptance

(Marsha Linehan in 1970s)

58
Q

Pathological (level 1) ego defenses (4)

A
  1. Delusional projection
  2. Denial
  3. Distortion
  4. Splitting
59
Q

Immature ego defenses (level 2) (5)

A
  1. Fantasy
  2. Acting out
  3. Passive-aggressive
  4. Projection
  5. Somatization
60
Q

Neurotic ego defenses (level 3) (7)

A
  1. Displacement
  2. Dissociation
  3. Intellectualization
  4. Rationalization
  5. Reaction formation
  6. Repression
  7. Regression
61
Q

Mature ego defenses (Level 4) (5)

A
  1. Altruism
  2. Humor
  3. Identification
  4. Sublimation
  5. Thought suppression
62
Q

Define altruism

A

service to others that brings personal satisfaction

(mature ego defense mechanism)

63
Q

Define humor

A

includes self-deprivation

(mature ego defense mechanism)

64
Q

Define identification

A

modeling of oneself upon another

(mature ego defense mechanism)

65
Q

Define Sublimation

A

transform negative emotions into positive actions

(mature ego defense mechanism)

66
Q

Define thought suppression

A

conscious process of pushing thoughts away

(mature ego defense mechanism)

67
Q

Cognitive therapy is best when supplemented with ______(2)

A
  1. Self-soothing (diaphragmatic breathing, meditation, mindfulness)
  2. Yoga & exercise

Behavioral Medicine (35 decks)

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