Treatment of Abnormal BehaviorCh. 13

Categories of Treatment

Psychotherapy - talking to a psychiatrist

Biomedical therapies - medication

eclectic approach - both psychotherapy and medication

Psychoanalysis Approach

Freud’s influence – Getting at Subconscious

 free association - people speak freely and quickly

 dream analysis -  the hidden but symbolic meaning of things in dreams

weakness - subjective

Psychoanalysis Approach

Psychodynamic therapists 

 a person’s childhood experiences are critical

explore the patient's underlying thoughts and feelings

Interpersonal psychotherapy 

a 12-16 session treatment that has been successful with treating depression

cause of their depression

goal - stop symptoms of depression

result - improving relationships with others

Humanistic therapies

insight therapies - person look inside to figure things out.

focuses on the present instead of the past

the conscious instead of the unconscious

holds a person accountable not the unconscious

it promotes growth rather than a cure

Humanistic therapies

Carl Rogers - client-centered therapy 

where the patient speaks and, through self-awareness, moves himself toward his own conclusion

unconditional positive regard - Non judgmental – allows patient to “open up”

 active listening - listener echoes what’s heard, restates it, then seeks clarification

Behavior therapies

Counterconditioning  - “unlearn”

by conditioning or pairing a trigger stimulus with a new response.

Exposure therapy - exposes people to what they try to avoid

Systematic desensitization - can’t be worried and relaxed at the same time

Virtual reality exposure therapy 

Aversive conditioning 

Behavior therapies

Operant conditioning  the person’s actions interplay with the stimulus and results

withhold rewards until a desired behavior

Punishments given for unwanted behavior

“token economy” – Secondary reinforcer

Cognitive therapies

cognitive-behavioral therapy 

change the way people think and act

goals

Recognize negative thinking.

Change negativity to positive thinking

act on new positive thoughts

Group and family therapies

Group therapy most common type of therapy

patients not alone

 Support or self-help groups

AA (Alcoholics Anonymous)

psychotherapy effectiveness?

Results – Subjective

Patients usually leave Happier

Time – Big Factor

Alternative Therapies

EMDR – Eye Movement Desensitization and Reprocessing

developed by Francine Shapiro

reports 84% to 100% success

having your eyes dart to and fro and is supposed to relieve anxiety

Person thinks of a traumatic experience, then darts his/her eyes back and forth

Skeptics - placebo effect

Alternative Therapies

Light exposure therapy

“seasonal affective disorder” (SAD)

patients under bright lights

Morning Light – 50% success

Drug therapies

Antipsychotic drugs

Schizophrenia responds best

chlorpromazine (brand name “Thorazine”).

blocks dopamine’s receptor sites.

side-effects

sluggishness,

“the shakes”,

tardive dyskinesia - facial muscles move involuntarily.

Not good for Schizophrenics with apathy or withdrawal

Clozapine

affects both dopamine AND serotonin receptors

Drug therapies

Antianxiety drugs

Antianxiety drugs depress the central nervous system

Example - Xanax.

The good—cut down on effects of PTSD and OCD

The bad—psychologically dependence and physiological dependence

Drug therapies

Antidepressant drugs

increasing neurotransmitters serotonin or norepinephrine

Examples Prozac (or Paxil or Zoloft)

side-effects - dry mouth, weight gain, hypertension, or dizziness

Aerobic exercise

Placebo Affect

Drug Therapies

Mood-stabilizing medications

Lithium - levels the emotional roller-coaster of people with bipolar disorder

7 in 10 people seem to have their moods stabilized

Brain stimulation

Electroconvulsive therapy (ECT) - “shock therapy”

ECT seems successful

80% of depressed people respond

ECT reduces thoughts of suicide.

Brain Stimulation

Alternative neurostimulation therapies

Magnetic stimulation

Magnetic energy pulses

repetitive transcranial magnetic stimulation (rTMS).

The person remains awake, it’s painless, and there’s no memory loss or side effects.

50% better than placebo group.

Deep-brain stimulation - Helen Mayberg

located a spot in cortex links the thinking frontal lobes with the limbic system - overly active in a depressed person.

implanted electrodes to stimulate these areas.

8 in 12 people have positive results.

Psychosurgery

removes or destroys part of the brain

Egas Moniz -  lobotomy.

drugs replaced lobotomies

Therapeutic lifestyle change

therapeutic lifestyle change

change the way you feel, change the way you live. He says…

Exercise, Sunlight, etc

Ilardi suggests…

Aerobic exercise – 30 minutes three times a week.

Adequate sleep – about 7 to 8 hours per night.

Light exposure – about 30 minutes each morning.

Social connection – interact with others at least twice a week.

Anti-rumination – don’t dwell on negative thoughts.

Nutritional supplements – including daily fish oil with omega-3 fatty acids.

77% of the people improved from depression