The Psychological Therapies

Psychological therapy, or psychotherapy, is an emotionally charged, confiding interaction between a trained therapist and someone suffering from psychological difficulties. The major psychotherapies derive from the familiar psychoanalytic, humanistic, behavioral, and cognitive perspectives on psychology.

PsychoanalysisThose influenced by the psychoanalytic perspective try to help people gain insight into the unconscious origins of their disorders and to work through the accompanying feelings. To do so, an analyst may draw on techniques such as free association and dream analysis, and interpret resistance and the transference to the therapist of long-repressed feelings.

Traditional psychoanalysis, which is no longer practiced widely, is criticized for assuming repression, for after-the-fact interpretations, and for being time-consuming and costly. The more common psychodynamic therapy is influenced by the psychoanalytic perspective’s concern for providing insight into childhood experiences and defense mechanisms. But it offers a briefer treatment form and often incorporates other techniques into the therapy sessions.

Humanistic TherapiesUnlike psychoanalysts, humanistic therapists focus on clients’ current conscious feelings and on their taking responsibility for their own growth. Carl Rogers, in his client-centered therapy, used active listening to express genuineness, acceptance, and empathy.

Behavior TherapiesBehavior therapists do not attempt to explain the origin of problem behaviors or to promote self-awareness. Instead, they attempt to modify the problem behaviors themselves. Thus, they may counter-condition behaviors through exposure therapies or aversive conditioning. Or they may apply operant conditioning principles with behavior modification techniques, such as token economies.

Cognitive TherapiesThe cognitive therapies, such as Aaron Beck’s cognitive therapy for depression, aim to change self-defeating thinking by training people to look at themselves in new, more positive ways.

Group and Family TherapiesMany therapeutic techniques can also be applied in a group context. Self-help and support groups, such as AA, engage many millions of people. Family therapy treats the family as an interactive system from which problems may arise.

The Biomedical Therapies

Drug TherapiesThe most widely used biomedical therapies are the antipsychotic, antianxiety, and antidepressant drugs. A few drugs, such as lithium for bipolar disorder, have proven very effective in double-blind studies, though many drugs are hardly more effective than placebo treatments and some have serious side effects.

Brain StimulationElectroconvulsive Therapy (ECT) is a biomedical therapy in which a brief electric current is sent through the brain of an anesthetized patient. Although controversial, ECT remains an effective, last-resort treatment for many people with severe depression who have not responded to drug therapy. Researchers are also exploring newer alternatives, such as magnetic brain stimulation.

PsychosurgeryAlthough radical psychosurgical procedures such as lobotomy were once popular, neurosurgeons now rarely perform brain surgery to alleviate specific problems. Even when MRI-guided precision surgery is considered, it is a treatment of last resort because its effects are irreversible.

Key TermsPsychotherapy - an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties.

Eclectic Approach - an approach to psychotherapy that, depending on the client's problems, uses techniques from various forms of therapy.

Resistance - in psychoanalysis, the blocking from consciousness of anxiety-laden material.

Transference - in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships.

Active Listening - empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers' client-centered therapy.

Behavior Therapy - therapy that applies learning principles to the elimination of unwanted behaviors.

Exposure Therapies - behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people (in imagination or actuality) to the things they fear and avoid.

Token Economy - an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats.

Cognitive Behavioral Therapy - a popular integrated therapy that combines cognitive therapy (changing self defeating thinking) with behavior therapy (changing behavior).

Family Therapy - therapy that treats the family as a system. views an individual's unwanted behaviors as influenced by or directed at other family members; attempts to guide family members toward positive relationships and improved communication.

Meta-Analysis - a procedure for statistically combining the results of many different research studies.

Lithium - in psychopharmacology, this is used to control bipolar symptoms.

Psychosurgery - surgery that removes or destroys brain tissue in an effort to change behavior.

Aversive Conditioning - a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol).

Psychoanalysis - Freud's theory of personality that attributes thoughts and actions to unconscious motives and conflicts.

Interpretation - in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight.

Client-Centered Therapy - A humanistic therapy based on Carl Roger's beliefs that an individual has an unlimited capacity for psychological growth and will continue to grow unless barriers are placed in the way.

Counterconditioning - a behavior therapy procedure that conditions new responses to stimuli that trigger unwanted behaviors; based on classical conditioning.

Systematic Desensitization - A type of counterconditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias.

Cognitive Therapy - therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions

Rational Emotive Therapy (RET) - A Cognitive Therapy based on Albert Ellis' theory that cognitions control our emotions and behaviors; therefore, changing the way we think about things will affect the way we feel and the way we behave.

Regression Toward the Mean - the tendency for extremes of unusual scores to fall back (regress) toward their average.

Psychopharmacology - the study of the effects of drugs on mind and behavior.

Electroconvulsive Therapy - a biomedical therapy for severely depressed patients in which a brief

electric current is sent through the brain of an anesthetized patient.

Lobotomy - a now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. The procedure cut the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain.

Tardive Dyskinesia - involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target D2 dopamine receptors.

Gestalt Therapy - existential/experiential form of psychotherapy that emphasizes personal responsibility, and that focuses upon the individual's experience in the present moment, the therapist-client relationship, the environmental and social contexts of a person's life, and the self-regulating adjustments people make as a result of their overall situation.