Cognitive Behavioral Therapy and Psychodynamic Therapy

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Cognitive Behavioral Therapy​Fundamental idea is that emotion follows thinking, not the reverse​ -A person is depressed because he thinks he worthless​ -If he stops thinking he's worthless, he won't be depressed​ Treatment addresses what patients think and correct errors in thoughtschemaspatterns of mistaken thinking that lead to psychopathology​ Three major types of schemas ​ -About Self (I'm a worthless person)​ -About Others (No one likes me)​ -About the World (It's not safe out there)​ Different types of psychopathology reflect different patterns of schemasSymptom Patterns and Schemas​Anxiety Disorders: ​ -The world is a threatening place.​ -Other people won't help you.​ Depression: ​ -I am a worthless person.​ -No one likes me.​ Narcissistic Personality Disorder​ -I'm an extraordinary person.​ -Other people ought to defer to me.​ -Everything in the world is mine to enjoy.Elements of Beck's Treatment in Depression​Depression grows from cognitive distortions about the self, other people and the world.​ Treatment involves challenging and changing these distortions.cognitive distortiona pattern of negative thinking that makes events seem worse than they areGeneral Characteristics of Cognitive Behavioral Therapy​Intellectually capable, verbally adept patients​ Therapists are very active and directive​ Treatment is highly structured with homework and clearly defined goals​ Abundant data support the approach, particularly with depressionpsychodynamic therapyBuilds on the early work of Sigmund Freud​ Underlying Principles:​ -Psychopathology derives from psychological factors of which the patient is unaware​ -A primary goal of treatment is to bring these factors to awareness​ -With awareness, patients can learn new ways of thinking and behaving, mitigating the effects of these factors​ -The relationship between patient and therapist is the catalyst for changeThe Unconscious:symptoms arise because of wishes, conflicts, feelings, thoughts, attitudes and memories that have been repressedConflict:symptoms reflect ineffective efforts to resolve repressed conflicts usually involving sexual or aggressive impulses​ Development During Childhood: symptoms have their roots in early experiencesDevelopment During Childhood:symptoms have their roots in early experiences​Freud's Structure of the Psyche:​Id​ Ego​ SuperEgoThe egoacts as a mediator between the Id and the SuperegoID:Acts according to the pleasure principle, seeking to avoid pain and to find pleasurable activities.Superego:Aims for perfection. Commonly referred to as the "conscience" ​ -criticize or inhibit drives, fantasies, feelings and actions​ -This complex system of ideals and values is internalized from one's parents.Transference:-The patient experiences the psychiatrist as a significant figure from the patient's past. -Qualities of that past person will be attributed to the psychiatrist and feelings associated with that figure will be experienced in the same way with the psychiatrist.Countertransference:Therapists bring their life experiences into the therapy experience. _______ refers to the transference of the therapist's own unconscious feelings toward his/her patient.Resistance:is the patient's wish to preserve the status quo, to oppose the therapist's efforts to produce insight and change. All _________ has in common an attempt to avoid unpleasant feelings. ​Suitability for Treatment​-Patient must be willing to participate​ -Patient must be intellectually capable of participating, i.e.:​ ^verbally adept ​ ^able to conceptualize psychologically​ -Patient must be able to accept an intimate psychological engagement with the therapist​Diagnoses that Do Not Respond to CBT or Psychodynamic Psychotherapy​-Some Narcississtic PD​ -Antisocial PD​ -Psychotic disorders and Mania, esp during psychotic episode