theoretical orientation that emphasizes unconscious determinants of behavior
What does the psychodynamic perspective emphasize?
Emphasizes the unconscious - the underneath
Freud's Structural Theory
Consists of the Id, Ego and Superego
acts according to the pleasure principle. It is hedonistic- it wants what it wants when it wants it. This is were sexual and aggressive instincts are.
Conscious awareness- acts according to the reality principle. This means that it is more rational and it takes into consider the reality of the world. It can see what the different constraints are.
Conscience- your morals and values. This keeps the ego in check from wanting to pursue the ids desires - very black and white, good and evil
Defense Mechanisms (Freud)
used to keep "unacceptable" thoughts, feelings or desires out of conscious awareness
what are defense mechanisms used for?
to protect ourselves, but when we use them too much it becomes problematic
refusing to accept something or acknowledge
putting information into the unconscious
you say one thing and you mean another. Freud thinks that its is based one what is preoccupied in the unconscious
transforming an "unacceptable" desire into its opposite
example of reaction formation?
homosexuals becoming a priest
attributing undesirable feelings to someone else
creating a self-serving explanation
reverting to childish behavior
turning a negative drive into something positive
psychosexual development (Freud)
the idea that you can become fixated at any stage which will cause problems in your life
What are the five psychosexual stages of development?
Oral, Anal, Phallic, Latency and Genital
(0-18 months) main source of stimulation is by the mouth. If one became fixated at this stage (oral fixation-wanting oral sources of gratification) the person wants to have something in their mouth at all time such as candy, cigarettes, pencil. Etc
(18 months - 3 years) main source of stimulation is the anus. Fixation leads to "anal retentive" these people are over controlled. The opposite is Anal Expulsive which is a person who is sloppy, impulsive, and uncontrolled.
(3-5 years) - main source of gratification is the genitals. Oedipus complex - the whole idea that boys will have a sexual attraction to their mother and want to kill their father. For girls it is Electra Complex where the girl is in love with the father and want to harm the father. **** they realize that they cannot do this so they act just like dad so you can get a women like mom. Or you can act just like mom so you can get a man like dad. It is identification with the same-sex parent. A lack of a resolution will lead to Neurotic
(5-12 years) - playing out the roles from the previous stage
(12 years) - this is when puberty starts. Any fixation at an earlier stage will impact or mess up this stage and lead to unhealthy sexuality or relationships.
Archetypes - believe to in the collective unconscious which is common to all humankind. They a images . Examples are good, evil, hero, rebirth, self, mask. They allow us to understand these. Believed people respond to events based on archetypes Goal of healthy personality development is integration of the unconscious with conscious thought (disorders are an imbalance of the two)
Alfred Adler and Karen Horney
Emphasized the ego and self-concept. Believed people are motivated to keep a positive view of themselves. Emphasized society /social and interpersonal issues in personality development.
Lifespan theory of psychosocial development. Each stage is associated with a crisis (critical period). Healthy individuals successfully resolve crises.
Object Relations Theorists
People will relate to others how they related to someone earlier in life. Believe interpersonal relationships are at core of development. Unconscious mind contains images of parents and relationships to parents.
can say whatever you want without worrying about it. Say a word and the patient has to say the first word that comes to mind
a patient would tell about their dreams and the therapist would analyze them
when the patient thinks of someone or relates to them as another person in their life
when the clinician does this
you bring these feelings from the unconscious and you work through them
holding back information, start canceling or not showing up, changing the subject. When you hit resistance that means you have hit an inner conflict that needs to be addressed
Based on belief that human motivation is based on a tendency to strive for self-fulfillment.Strong belief that people are basically good were Freud felt that people were basically bad. People are driven to understand themselves and to understand the world.
Person-Centered Theory (Carl Rogers)
Focuses on the uniqueness of the individual. Used term client-centered to emphasize inherent goodness of people. Strive for congruences between the ideal self and the real self. Believed psychological disorders are result of overly demanding and critical parents. If you didn't have acceptance and love when younger, you want/expect it later in life.
who you really are on a day to day basis
who you want to be or who you think you have the potential to be
Why do we want the real self and ideal self to be congruent?
so that who we want to be is who we really are
Self-Actualization Theory (Abraham Maslow)
Believed people strive for self-actualization. Considered motivation of the individual. (Hierarchy of Needs)
Maslow's Hierarchy of Needs
in order for people to achieve self-actualization, they must meet other needs, called deficit needs (implying that individual is seeking to obtain something that is lacking) People strive for it but many don't get there. In order to reach the top you have to meet the needs before that.
What are the five levels of Maslow's Hierarchy of Needs?
Physiological needs, safety and security, love and belonging, self-esteem and then self-actualization.
treatment within the humanistic perspective
work toward helping the person create a real self that is more similar to the ideal self. Allow client to recognize their inherent goodness.
Unconditional positive regard
you don;t judge someone and you view the person as positive and you withhold any negative judgment
putting yourself in their shoes. I feel sorry WITH you not FOR you
not being fake, being honest and truthful
influenced by humanistic approach. Emphasizes empathy, resolving ambivalence, rolling with resistance (non-confrontational approach)
Emphasizes influences of people and other social forces on individuals. Attention given to the role of social discrimination in the person's life which means to what extent is the people accepted in a group or culture. Attention is given to social and historical context of the individual.
sees pathology as being caused by patterns in familial relationships that are now maladaptive. Four approaches - Intergenerational, structural, strategic, and experiential.
it is a systems perspective. family is encouraged to find new ways of relating to each other. Work on changing communication patterns. Generally focus on the family as the client, not an individual. See family relationships as more healing than clinician-client relationships.
can help to reduce feelings of isolation. Give the client opportunity to learn from peers. Can practice learned skills on peers
treatment occurring in the environment. Create communities of clients and staff. Community works together to make decisions
emphasizes learned behavior
Cognitive behavioral perspective
focuses on the impact of thought processes on behavior
behavioral perspective, include Pavlov's dogs, based on associations. Bell--> Food --> Salivate
based on associations
behaviors are associated with stimuli
conditioned stimulus (CS)
the bell because it's neutral
Unconditioned stimulus (UCS)
food because there is no condiment required to make dogs salivate
Conditioned Response (CR)
salivating in response to the bell
Unconditioned Response (UCR)
salivating in response to food
they will salivate to any bell
they learn to salivated to one specific bell and not just nay bell
one trial learning
behavioral perspective. Form of classical conditioning in which a painful stimulus is paired with another stimulus.
based on consequences and reinforcement
anything that increases the likelihood that a behavior will occur in the future
intrinsically rewarding (e.g. food)
rewarding because of their association with primary reinforcements (e.g. money)
behavior is reinforcement by the addition of a positive/pleasurable stimulus (candy)
behavior is reinforced by the removal of a negative/unpleasant stimulus (noise)
anything that decreases the likelihood that a behavior will occur in the future
reducing behavior through the addition of a negative stimuli
reducing behavior through the removal of a positive stimuli
when a behavior stops because of the lack of reinforcement
reinforcing closer and closer approximations of the behavior that you want -- babies we reinforce closer and closer to walking
emphasizes learning behavior through observation. Modeling-- acquisition of a behavior through imitation
emphasizes impact of social environment on perceptions, judgments and thoughts
occurs when you watch someone else be reinforced for a behavior, because you identify with the person, it is as if you were being reinforced
Cognitively Based Theory
automatic thoughts and Dysfunctional thoughts/attitudes
A --> B --> C model (event, thought or belief and emotion because it's the consequence)
if you learn something through association you can unlearn it through association
working on changing your thoughts
acceptance and commitment therapy
work toward client accepting the full range of thoughts and emotion, while also committing to behavior change that will improve life
transmits information between body and brain
space between neurons into which neurotransmitter is released
disturbances in behavior are caused by abnormalities in the body, focus is on the nervous system
brain surgery-- usually disconnecting the frontal lobe from the rest of the brain
Electroconvulsive therapy (ECT)
Electric shock - electrodes placed on head and the idea is that it changes brain chemistry
Transcranial Magnetic Stimulation
Electromagnet placed on scalp and passes a current through cortex and the goal is to increase or decrease excitability of neurons
Deep Brain stimulation
Neurosurgeon places an electrode in brain that delivers a constant low electrical stimulation to small region of the raid
Selective serotonin Reuptake Inhibitors
Match the intervention to the specific client and problem
using different theoretical models in formulation on a regular basis
Common Factors Approach
Using the components of various therapies that have been shown to be effective
body's alarm response to dangerous or life threatening situations (fight or flight)
apprehension and tension about something in the future, has cognitive and emotional components
difficulty breathing, sweating, feels like a heart attack, think you are going to die which makes the physical worse. They feel dizzy, like they are choking, heart palpitations, numbness, hot flashes or chill, feel like they are losing control. Person feels overwhelmed and afraid by many physical sensations. Have sudden onset and generally reach a peak within 10 minutes
Unexpected (uncued) panic attack
don't seem to have any trigger
Situationally bound (cued) panic attack
they know what is triggering their panic attack
is diagnosed when panic attacks or recurrent or fear of another panic attack has persisted for a month after the first attack. Course of panic disorder- variable. More typical for the disorder the interfere with functioning for many years.Usually develops in people around 20 but another group in mid 30s
avoids situations with a lot of distress. They don't like leaving home. Intense anxiety about being trapped or embarrassed in a situation if a panic attack happening. Situations are avoided or endured with marked distress or anxiety or a "safe person" (more in women than in men)
biological relatives of people with panic disorder are 8 times more likely to develop panic disorder
Anxiety Sensitivity Theory
people with panic are likely to have a hypersensitive "suffocation" mechanism, making them more likely to experience sensations of suffocating or choking
bind to receptor sites of GABA neurons, leading to inhibition of brain activity (ex: Valium, Ativan, Xanaz, Klonopin) very habit forming
Conditioned Fear Reaction
individual associates certain bodily sensations with panic attack
person experiences highly negative feelings (like physical sxs of panic), causing the person to feel that what is happening in unpredictable and uncontrollable, person focuses on thoughts of helplessness, leading to more panic
behavioral ex like deep breathing is really important
the idea that you can expose people to anxiety provoking situations gradually.
heiarchy of anxiety provoking situations where you start with the least provoking and gradually make your way to the most provoking. This has to be paired with good relaxation training.
have the person close their eyes and imagine the situation.
Panic Control Therapy (Barlow)
cognitive restructuring, identifying bodily cues of panic, breathing training
irrational fear of a particular object or situation that causes an immediate anxiety response and causes significant disruption in functioning (results in avoidance behavior)
What are the four main types of phobias?
Animals, Natural Environment, Situation and Blood injection/injury
Flooding (in vivo and imaginal)
throwing someone into the situation. Can be invivo or imaginable
spider across the room and move it closer and closer until she can hold it in her hand
stopping yourself from thinking something. You usually have to do thought replacement with it. I am not going to think about that I am going to think about this.
Irrational and intense fear that behavior in a public or social situation will be judged and/or criticized
Generally associated with extensive rumination
significant time spent thinking about how they could have behaved differently in a situation, wondering if the offended someone, etc.
Generalized Anxiety Disorder
Characterized by pervasive anxiety that is not associated with a specific object or situation. Peron feels that they cannot control their worry
identify anxious thoughts, develop rational alternatives, change behavior to test alternative (behave as if you believe the alternative thought)
persistent and intrusive thought or image. Common obsessions for individuals with OCD are about contamination, doubt, or aggression
repetitive behaviors, often done in a ritualistic manner. Common compulsions relate to washing or cleaning, counting, checking, hoarding
Acute Stress Disorder and Posttraumatic Stress Disorder (PTSD)
Both occur after the experience of a traumatic event. Acute Distress Disorder occurs soon after the experience of the trauma and remains for a relatively brief period of time. PTSD occurs when symptoms persist for more than one month
Disorders in which psychological distress is translated into physical problems or complaints
Individual has one or more symptoms of that affect voluntary motor or sensory functioning (movements or 1 of 5 senses)
Physical complaints are experienced for several years and the onset is before age 30
Pain in one or more places that is significant enough to warrant clinical attention. Pain causes significant stress or impairment.
Body Dysmorphic Disorder
Preoccupation with an imagined defect in appearance (even if there is a slight abnormality, their concern is excessive). Usually accounted for another disorder (anorexia)
Preoccupied with fears of having or the idea that they do have a serious disease (misinterpret physical symptoms). Preoccupation persists despite appropriate medical evaluation or reassurance. Preoccupation is not delusional nor related to excessive concern about appearance.
no external incentive. Just to take sick role
not a DSM diagnoses because it is factitious
Factitious Disorder (Munchausen's Syndrome) by proxy
Person induces physical symptoms in another person who is in their care
Dissociative Identity Disorder
Experience of two or more distinct identities or personality states, each with an enduring pattern of perceiving, relating to, and thinking about the environment and self.DID often attributed to the experience of childhood abuse
core personality- passive-dependent
personality other than self
clients take on roles that they feel are expected in the situation- attention from others and unintentional prompting from the therapist can contribute to DID
One or more episodes in which person is unable to recall important personal information, usually of a traumatic or stressful nature (beyond ordinary forgetfulness)
when the person forgets all events in a specified period of time
can't recall some but can recall others in a specified period of time
cannot remember anything at all from their life
when a person can't recall events from a particular time up until the present time
Person travels suddenly and unexpectedly away from home or job and are unable to recall their past. Person is confused about personal identity, or they assume a partial or complete new identity
Persistent or recurrent experiences of feeling detached from own body or mental processes (feel as if they are an observing the self from outside of the self)
Sexual behavior is "abnormal" if it..?
1. causes harm to other people
2. causes distress or impairment in functioning
Disorders in which person has recurrent and intense sexually arousing fantasies, sexual urges, or behaviors involving
sexual relations with adolescents
attraction is for male adolescents
Administering female hormones
decrease sex drive
decrease sex drive
Castration or removal of testes
men will stop producing testosterone
damaging g hypothalamus (4 F's)
measures blood flow to the penis (biofeedback)
person is punished in some way while masturbating with fetishistic object (electric shock -classical conditioning)
when someone has sexually arousing fantasies where they expose their genitals to unsuspecting strangers
Imagining shame and humiliation when people person knows observe he/she engaging in this behavior
who have intensive arousing fantasies that involve objects
sexual gratification from a specific body part such as feet
person arouses self with fantasy of fetishistic object, then masturbates while looking at an "appropriate" stimulus- person is to have an orgasm while focusing on the "acceptable" stimulus.
touching or rubbing against non unsuspecting strangers
Sexually arousing fantasies, urges, or behaviors involving real or simulated acts of being humiliated, beaten, bound, or made to suffer
Sexually arousing fantasies, urges, or behaviors involving real or simulated acts in which they are sexually excited by the psychological or physical suffering or humiliation of another person
Sexually arousing fantasies, urges, or behaviors involving cross-dressing. Only in heterosexual men
Sexually arousing fantasies, urges, behaviors involving the act of observing unsuspecting people who are naked, in the process of undressing, or engaging in sexual activity
Gender Identity Disorder
Strong and persistent cross gender identification that is far greater than a desire for perceived cultural advantages associated with opposite sex
Hypoactive Sexual Desire
Deficient sexual fantasies and desire for sexual activity
Sexual Aversion Disorder
Recurrent extreme aversion to and avoidance of genital contact with a sexual partner
Female Sexual Arousal Disorder
Inability to attain or maintain lubrication and swelling response of sexual excitement during sexual activity
Male Erectile Disorder
Persistent and recurrent inability to attain or maintain adequate erection until completion of sexual activity
Female Orgasmic Disorder
Persistent or recurrent delay in or absence of orgasm following a normal phase of sexual excitement
Male Orgasmic Disorder
(aka inhibited male orgasm) persistent or recurrent delay in or absence of orgasm following a normal phase of sexual excitement
Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration, and before he wishes to ejaculate
Recurrent or persistent genital pain before, during, or after sexual intercourse (in males or females)
In women- recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina which interferes with sexual intercourse
Masters and Johnson
Observed people's sexual
Invented sex therapy
Go back and lead up
insertion of rod or inflatable device into penis
to correct blockage in arteries to the penis
Eros Clitoral Therapy Device
Vacuum type device placed over clitoris before sexual contact that increases blood flow to the area
focus on couple's sexual behavior (Masters and Johnson)
partner stimulates penis and squeezes it when he reports that he is near orgasm (delays ejaculation- shows that control over ejaculation is possible)
when man reaches point of orgasm, stimulation is stopped, man "regains composure" and stimulation is started again