Psychotherapy

Question 1

Topographic model of mind – Freud

Answer 1

Conscious: what you’re aware of
Preconscious: can become aware of w/ effort
Unconscious: not aware of but may be influenced by

Symptoms are result of repressed memories (tx: lifting repression)

Question 2

Ego

Answer 2

Conscious/unconscious – decision making and integration of data, integrates id and superego/deals w/ conflicts

Question 3

Id

Answer 3

Unconscious, drives of sex/aggression, controlled by ego/superego

Question 4

Superego

Answer 4

Mostly unconscious, incorporates moral conscience and values

Question 5

Denial

Answer 5

Avoiding awareness of parts of external reality that are difficult to face (disregard real data)

Question 6

Regression

Answer 6

Return to earlier phase of development/fxning to avoid conflicts w/ present development

Question 7

Somatization

Answer 7

Converting emotional pain/affect state into physical symptoms

Question 8

Projection

Answer 8

Perceiving/reacting to unacceptable inner impulse as if it were outside self (target doesn’t change)

Question 9

Projection ID

Answer 9

Aspect of the self projected onto another person and pressure is placed on person to take those characteristics –> changes to behave/think/feel like what is projected

Question 10

Acting out

Answer 10

Enacting an unconscious wish impulsively, avoid talking about painful emotions

Question 11

Idealization

Answer 11

Attributing perfect qualities to others, avoids anxiety or negative feels (e.g. contempt, anger, envy)

Question 12

Splitting

Answer 12

Compartmentalizing experiences of self/others so that integration is impossible (e.g. all good or all bad); common in borderline PD

Question 13

Passive-Aggressive Behavior

Answer 13

Aggression is expressed indirectly/ineffectively (e.g. no meeting expectations as an indirect opposition)

Question 14

Repression

Answer 14

Expel unacceptable ideas/impulses by blocking them from entering consciousness (deals w/ inner states)

Question 15

Displacement

Answer 15

Shifts feelings assc. w/ one idea/person to another that resembles the original in some way

Question 16

Dissociation

Answer 16

Drastic, temporary modification of identity/character to avoid emotional disress

Question 17

Intellectualization

Answer 17

Using excessive/abstract thoughts to talk about difficult situations/emotions to avoid difficult feelings

Question 18

Identification

Answer 18

Internalizing the qualities of another person by becoming like the person – experienced as being part of the person’s identity

Question 19

Reaction Formation

Answer 19

Unconsciously transforming unacceptable wish/impulse to its opposite

Question 20

Isolation of Affect

Answer 20

Separation of idea from assc affect state to avoid emotional turmoil

Question 21

Rationalization

Answer 21

Justifying unacceptable attitudes, beliefs, or behaviors to make them tolerable to oneself

Question 22

Humor

Answer 22

Finding comic/ironic elements in difficult situations to reduce unpleasant affect/personal discomfort – allows for distance and objectivity from events so that individual can reflect on what is happening

Question 23

Suppression

Answer 23

Consciously deciding to not thinking about a particular feeling/idea/impulse – CONSCIOUS

Question 24

Altruism

Answer 24

Committing oneself to needs of other over and above ones own needs – used for narcissism and guilt or source of great achievements and constructive contributions to society

Question 25

Sublimation

Answer 25

Transforming socially objectionable or internally unacceptable aims into socially acceptable ones that don't conflict w/ values

Question 26

Extinction

Answer 26

Conditioned stimulus constantly repeated w/o unconditioned stimulus until response evoked weakens -- disappears

Question 27

Stimulus generalization

Answer 27

Conditioned response transferred to another stimulus

Question 28

Discrimination

Answer 28

Process of recognizing/responding to differences between similar stimuli

Question 29

Continuous reinforement

Answer 29

Action reliably --> effect; most rapid initial learning but most rapid distinction if not rewarded

Question 30

Partial reinforcement

Answer 30

Action --> effect sometimes; better for maintenance, slowest extinction if not rewarded

Question 31

Transference

Answer 31

Unconscious redirection of feelings/desires retained from the past that are redirected by the PATIENT TOWARD the therapist

Question 32

Countertransference

Answer 32

Unconscious assoc. of feelings/desires from the past that the THERAPIST develops for the patient

Question 33

6 strategies to establishing rapport

Answer 33

1. Put pt at ease 2. Find pts pain and express compassion 3. Become an ally 4. Show expertise 5. Establish authority as physician/therapist 6. Balance roles of empathic listener, expert, authority

Question 34

Clarification

Answer 34

Questions/statements w/ goal to make more clear patient's current thoughts/behavior

Question 35

Interpretation

Answer 35

After listening, therapist links pts conscious thoughts/behavior to unconscious motivations

Question 36

Psychodynamic Psychotherapy

Answer 36

Insight oriented -- symptoms are from early experiences w/ buried conflicts -- tx aims to uncover unconscious aspects of pts life --> insight into old patterns of relating/improved self-understanding; main themes: unconscious conflicts, repressed feelings, family issues from early life, difficulty w/ current relationships

Question 37

Psychoanalysis

Answer 37

More intensive/rigorous psychotherapy -- same principles of psychodynamic but pt seen 3-6/wk, treated by psychoanalyst, and lies on couch w/ therapist behind

Question 38

Behavioral therapy

Answer 38

Focused on observable behavior, uses conditioning techniques, goal of improving symptoms w/o focusing on past

Question 39

Systematic desensitization

Answer 39

Approaches feared situation gradually -- relaxation training, hierarchy construction, desensitization by moving through hierarchy using relaxation techniques

Question 40

Graded exposure

Answer 40

Same as systematic desensitization but in real life rather than imagined

Question 41

Flooding

Answer 41

Pt immediately exposed to most anxiety-provoking stimulus w/o hierarchy (problem: compliance)

Question 42

Implosion

Answer 42

Same as flooding but imagined

Question 43

Token economy

Answer 43

Positive reinforcement -- reward for completing desired duties or behaving appropriately -- exchanged for privileges to act as positive reinforcers

Question 44

Cognitive therapy

Answer 44

Based on belief that people constantly process/interpret info -- interpretations based on more than just sensory info and bias --> negative/maladaptive ideas --> affect mood; therapy focuses on recognizing automatic thoughts and bringing them into awareness to be challenged

Question 45

CBT

Answer 45

Combo of cognitive and behavioral; psychopathology result of distorted thinking which has negative impact on mood/behavior; uses collaboration and psycho education to test/change maladaptive cognitions, problem/goal oriented, time limited/structured, and focuses on the present

Question 46

DBT

Answer 46

Dialectical behavioral therapy -- eclectic therapy drawing from cognitive, behavioral, and supportive therapies; individual and group; pts seen q/wk x 1yr and taught to be mindful of present, better regulate emotions, and tolerate negative feelings; indication in borderline PD; goals: reduce self-destructive/injurious behavior, improve interpersonal skills

Question 47

IPT

Answer 47

Interpersonal psychotherapy -- addresses how pt interacts w/ others by focusing on current relationship sand improving pts interpersonal life; main areas addressed: grief, role transition, interpersonal conflicts, interpersonal deficits

Question 48

Supportive psychotherapy

Answer 48

Examines symptoms, relationships, everyday fxning, patters of emotional responses w/ goal of improving symptoms, maintain/restore self-esteem, improve self-esteem, ego fxn, and adaptive skills