Section 6: The Therapeutic Relationship

Psyche

1. Conscious/unconscious

Psychoanalytic couples therapists explore along four channels

1. Internal experience 2. History of that experience 3. How the partner triggers that experience 4. How the session and the therapist contribute to what's going on between the partners

Personal Conscious

1. Only understood through dreams and analysis 2. Makes itself known through complexes and emotions

Archetype

1. Pathway of communication between unconscious and conscious 2. Understanding archetypes (images of unconscious) helps one to understand the self

Defense Mechanisms:

Although the individual is unaware of them, defense mechanisms provide protection against negative feelings associated with painful events. The events may be physical or mental.

Erikson Theory Implications

An implication of epigenesis is that a person's initial orientation to a crisis is influenced by all preceding stages, so one's resolutions from previous conflicts will reshape each new conflict Erikson's theory may be too simplistic • Research has demonstrated parent-child reactions are more complex than his stages suggest Not everyone may face the challenges in the exact order presented by Erikson Erikson's claims are not universal • Those in other cultures or at other times in history do not necessarily define a successful life in the same terms

Projection:

An unconscious process, projection is the assignment of unacceptable thoughts and behaviors found within oneself to another person.

behavioral research has brought four main types of behavioral therapy:

Applied behavior analysis, neurobehavioristic stimulus-response, social learning theory and cognitive-behavior modification.

Theories of Personality

Archetype Principles of Opposites Personal Shadow Psyche Personal Conscious

MULTIMODAL THERAPY (BASIC I.D.) Key Figure:

Arnold Lazarus

Normal Family Development

Average environment is sufficient for healthy development Includes "good mothering" To a young child, parents are "self objects"

acronym BASIC I.D

B Behavior (habits, actions, reactions) A Affective response (emotions and moods) S Sensation (taste, touch, smell, sight, hearing) I Images (self-concept, memory, dreams) C Cognitions (constructs, ideas, insights) I Interpersonal relationships (interactions) D Drugs (nutrition, biological functions)

Adlerian Concepts

Basic Mistake Fictional Finalism Holism Insight Style of Life Complexes Organ Inferiority Aggression Drive Masculine Protest Perfection Striving Social responsibility and understanding of social issues Positive and goal-oriented humanity People striving to overcome weakness to function productively Urge to contribute to society

BEHAVIORAL THERAPY Theory:

Behavioral therapy holds that the environment provides two types of situations for an individual to determine behavior: positive or negative. Learning occurs when there is either positive or negative reinforcement.

Erikson Theory Assumptions

Being a consciously experienced sense of self, ego identity is derived from transactions with a person's reality People must strive to reach and maintain a strong sense of ego identity The desire for competence is a motivating force behind people's actions Although a psychosocial crisis is a turning point with potential for growth, it leaves a person vulnerable • In this sense "crisis" indicates a level of importance rather than a specific event Conflict arises from the struggle between attaining some psychological quality versus failing to obtain it Conflict never ends; issues are simply re-confronted in different forms throughout a person's life People experience eight stages of psychosocial development, each stage focusing on • A particular transaction with the social environment • Some conflict and/or crisis to resolve Individuals must negotiate each stage by developing a balance between the characteristics that give the stage its name This theory rests on the principle of "epigenesis," which means the focal issue at any given stage exists in some form in every other stage Basic trust is necessary for adequate human functioning

Techniques Of Behavioral Therapy

Biofeedback Contingency Contracts Extinction Over-Correction Positive Reinforcement Premack Principle Response Cost Shaping Time-Out Token Economy

Multimodal Techniques

Biofeedback Imagery Bibliotherapy Audio therapy Assertiveness training Role-playing

Systematic Desensitization Techniques

Brief Psychodynamic Therapy (BPT) - treating selective disorders within an established time Hypnosis Dream Interpretation Free Association Projective Techniques Freudian Slips

BRIEF THERAPY Relevance:

Brief therapy is used in a wide range of situations, including individual, marital and family therapy. Anger management, relationship mending, communications skills, adolescent and children issues, behavior problems and Substance Abuse are all areas of concern. This therapy is best suited for individuals who are relatively intact in their reasoning and communication abilities.

MULTIMODAL THERAPY (BASIC I.D.) Theory:

Centered around what is perceived to be best for the individual, multimodal therapy tailors an intervention plan to each client, based upon analysis of interactions among modalities in the client's BASIC I.D. which encompasses the whole person.

_________ is a widely used form of psychotherapy that focuses on changing dysfunctional cognitions (thoughts), emotions and behavior.

Cognitive therapy

______________ is based on the theory that individuals with depression, anxiety and other emotional disorders have maladaptive patterns of information processing and behavioralrelated difficulties.

Cognitive therapy

_________________ aims at cognitive restructuring, a process for understanding how the client interprets the experiences affecting behaviors. The emphasis is on altering irrational ideas, perceptions and interpretations of individual experiences.

Cognitive-behavior modification therapy

Libido:

Comprised of the sexual and ego drives found in the id, libido affects aggression and instinctual behaviors

Behavioral Learning Theory offers three primary approaches:

Contiguity Theory Classical or Respondent Conditioning Theory Operant or Instrumental Conditioning Theory

Continuous reinforcement v. partial or intermittent reinforcement

Continuous reinforcement happens every time a behavior occurs; partial or intermittent reinforcement occurs occasionally.

Sublimation:

Dealing with inappropriate social impulses, the individual channels them into socially acceptable behaviors.

Vicarious conditioning:

Dismissed by Thorndike and Watson, vicarious conditioning or learning by observation was later demonstrated by Bandura's work with children. Bandura discovered a child could learn by observing another's experience with classical or instrumental conditioning.

Manifest Latent Dreams:

Dreams are composites of symbols derived from recent and remote memories and formed by the current feelings, attitudes and motivations of the individual. Shaped by the immediate psychological needs of the sleeper, manifest latent dreams are distortions of life experiences in accordance with the regressive thinking processes that prevail during sleep

MULTIMODAL THERAPY (BASIC I.D.) Relevance:

Due to the framework of the BASIC I.D., multimodal therapy's approach allows for a much more complete assessment of the client and provides insight into treatment goals and evaluation of successes. This enables the client to be a part of the therapy process and progress. Multimodal therapy is ideal for dealing with issues of stress management and anxiety disorders. It claims to help eliminate relapses more than other therapies.

Personality Structure

Ego Id Superego Libido Neurosis

Encouragement

Encouragement is the most powerful method available for changing a person's beliefs • Helps build self-confidence and stimulates courage Discouragement is the basic condition that prevents people from functioning Clients are encouraged to recognize they have the power to choose and act differently

Erikson Theory Limitations

Erikson's theory may be more applicable to boys than to girls Greater attention is focused on infancy and childhood than adulthood Erikson's belief in identity formation ignores those adults who rediscover themselves and develop a different understanding of their lives due to particular experiences

OBJECT-RELATIONS THERAPY Implications

A client may not let go of manipulative patterns Object-relations therapy does not work for: • Clients who are not cognitively oriented • Those who are unable to achieve the level of insight necessary to effect change The therapist must always be on guard to avoid playing into the client's manipulations

Extinction -

A conditioned response fades over time as a conditioned stimulus is repeated without the unconditioned, natural stimulus

Counter conditioning -

A conditioned stimulus is coupled with another stimulus to evoke a response contrary to that produced by the original stimulus

Stimulus generalization -

A conditioned stimulus is repeated along with another like stimulus until the latter alone produces the response

Fictional Finalism:

A imagined central goal that gives direction to behavior and unity

Denial:

A person in denial refuses to acknowledge a situation that causes anxiety or distress.

OBJECT-RELATIONS THERAPY Motivation

A person tries to fulfill unmet needs • These usually stem from early trauma by immaturely manipulating • Other people typically are engaged in similar manipulations The desire for intimacy is inborn • People strive for sustenance • Research indicates that experiencing intimacy promotes wellbeing People spend much of their lives attempting to break out of the limitations of dependency to reach the autonomy of adulthood

Id:

A primitive, selfish aspect of the personality, the id demands immediate gratification through increased pleasure and reduced tension. • Pleasure principle • "Demanding Child" • Deterministic - problems are rooted in the first six years of life and trapped in unconscious motivations • Unconscious • Satisfy basic survival

COGNITIVE-BEHAVIORAL THERAPY MODELS Key Figures:

Aaron Beck, Donald Meichenbaum, Albert Ellis, Leon Festinger, George Kelly, Steve de Shazer, Insoo Kim Berg, Bill O'Hanlon

Social Interest

Adler's most significant and distinctive concept refers to an individual's attitude toward and awareness of being part of the human community Mental health is measured by the degree to which we successfully share with others and are concerned with their welfare Happiness and success are largely related to social connectedness

Phenomenological Approach

Adlerians attempt to view the world from the client's subjective frame of reference Believe life in reality is less important than how the individual believes life to be Believe it is not the childhood experiences that are crucial, but rather our present interpretation of these events Believe unconscious instincts and our past do not determine our behavior

Adlerian Therapists

Alfred Adler T. J. Sweeney Rudolf Dreikurs - developed the Adlerian group methods

Adler's 5 Basic Tasks

1. Acceptance 2. Achieving Intimacy 3. Work 4. Spiritual Dimension 5. Community/Friendship

Principles of Opposites

1. Animus vs. Over Characteristics 2. Conscious vs. Unconscious 3. Personal vs. Shadow 4. Mind vs. Body

Personal Shadow

1. Archetype representing thoughts, feelings and actions that disowns them by projecting them outward 2. Contains everything that could or should be part of the ego that the ego denies or refuses to develop, either positive or negative 3. Reclaiming is an essential task for a mature personality

Adlerian Therapy Techniques

Establish a therapeutic relationship • Therapists need to get to know the client as a person • Collaborate together on goals for the therapy • A supportive therapist creates a caring human connection • The therapist should work to make the client feel deeply understood and accepted • The client focuses on what needs to change in therapy Explore the psychological dynamic operating in the client • To do this, begin with a subjective interview • Let the client tell their own story as the expert on their own life • The therapist listens for cues to the client's coping skills and approach to life Encourage development of self understanding (insight into purpose) • The therapist needs to understand the motives that operate in the client's life • Client disclosure and therapist interpretation must remain open ended • Turn the unconscious into conscious • Confront any resistance between the client and therapist to keep you aligned • Explore the purposes of symptoms, feelings, behaviors and human difficulties or blocks Help the client make new choices by reorientation and reeducation • Use the encouragement process • Change and search for new possibilities • Make a difference through change in behavior, attitude & perceptions

Organ Inferiority:

Everyone is born with some physical weakness, this motivates life choices

Adlerian Therapy: The Role Of The Client

Explore private logic - concepts about self, others and life Discover the purposes of behavior or symptoms of basic mistakes associated with their coping Learn how to correct faulty assumptions and conclusions

Adlerian Diagnostic Tools

Family constellation Early recollections Questioner Homework assignments Paradoxical interventions

Basic Mistake:

Faulty, self defeating perceptions, attitudes and beliefs, and personal myths

four intermittent schedules are:

Fixed interval Variable interval Fixed ratio Variable ratio

NEURO-LINGUISTIC PROGRAMMING (NLP) Theory:

Focused on creativity, learning and change, NLP seeks to evaluate the construction of reality. Modeling skills are at the heart of NLP

Manifest Content:

Formed as a composite of recent and distant memories, this is the apparent content of the dream. Actually it provides a mask for events that conceal the latent meaning of a dream.

Family Treatment Process

Fosters insight by looking beyond behavior to hidden motives Less concerned with system, more concerned with individual Therapist creates a climate of trust and safety in which the family can explore old wounds. Key techniques: • Listening • Empathy • Interpretations • Analytic neutrality

PSYCHOANALYTIC AND PSYCHODYNAMIC THEORIES AND MODELS Theory:

Freud saw neuroses as the result of unconscious sexual and aggressive conflicts. The repression of unacceptable thoughts and desires causes psychological symptoms and neuroses.

As coping strategies, individuals choose to

Go towards others Go against others Go away from others

NEURO-LINGUISTIC PROGRAMMING (NLP) Treatment:

Help the client to see his/her own perceptions of problems and work to change them, creatively adapting from the perceived to reality

Key Concepts Of The Adlerian Approach

Holism Creativity and choice Teleology Social interest

Goals Of Individual Counseling

Identify and explore faulty assumptions and mistaken goals Re-educate clients toward constructive goals Challenge and change fundamental premises, life goals and basic concepts Help clients overcome inferiorities and understand themselves

Compensation:

If an activity viewed as rewarding is substituted for one that produces tension, compensation has occurred.

Adler's Therapy Focus

Importance of the feelings of self (ego) that arise from interactions and conflicts The sense of self, or Ego, is the core individuality/personality of a person Adlerian therapy got its start from psychoanalysis It places emphasis on motivation and social interaction It is a phenomenological approach Social interest is stressed Uses the study of birth order and sibling relationships Stresses the purpose of therapy is teaching, informing, and encouraging Basic mistakes of client logic The therapeutic relationship is a collaborative partnership Focus on the importance of each person's:

BEHAVIORAL THERAPY Relevance:

In any form of behavioral therapy, the client's commitment to change, along with effective client/counselor interaction, determines success. Since such classical conditioning creates both behavioral and emotional responses, it is used to explain and treat phobias, anxieties and aberrant behavior.

Family Limitations

In dealing with families in which there had been severe trauma and abuse, it is clear that the damage from the past needs to be clarified, elaborated on and confronted in the present This has led to a re-examination of the adequacy of a past-time approach as the exclusive therapeutic modality

Suppression:

In suppression, the individual undoes various levels of consciousness, preconsciousness or unconsciousness.

Using free associative responses to a list of a hundred words, Jung presented four structural aspects, typing personality according to the following:

Introversion/extroversion Sensing/intuition Thinking/feeling Judgment/perception

CARL JUNG - ANALYTIC THERAPY

Introvert/Extrovert Anima - The feminine side of men Animus - The masculine side of women Archetypes - Universal response patterns Collective Unconscious - Determined by evolution of the human species Individuation Mask Persona - Public mask Shadow - Negative side of an individual

COGNITIVE-BEHAVIORAL THERAPY MODELS Relevance:

It is used to treat depression, anxiety disorders, phobias and other forms of mental disorders. Medication is often used in conjunction with this approach to treat mood disorders and more severe forms of mental disorders.

BEHAVIORAL THERAPY Key Figures:

Ivan Pavlov, B.F. Skinner, John Watson, Joseph Wolpe, Edward Thorndike

NEURO-LINGUISTIC PROGRAMMING (NLP) Key Figures:

John Grinder, Richard Bandler, Gregory Bateson

Masculine Protest:

Kids work to become independent from adults and people in power

MULTIMODAL THERAPY (BASIC I.D.) Treatment:

Listing the client's problems and possible interventions using a Life History Questionnaire designed by Lazarus, a modality profile results from the first client/therapist session. Bridging and tracking procedures then allow the therapist to gradually steer the client from his/her preferred modality to problem areas. Direction and techniques (called the firing order) depend upon the client's preferred modalities, varying from client to client. The therapist helps the client understand how his/her behavior is affected by antecedent causes. Continued assessment of the client's progress permits adjustment of the modality profile as needed.

COGNITIVE-BEHAVIORAL THERAPY MODELS Theory:

Maladaptive behavior is associated with patterns of thinking and response that do not result in mentally healthy outcomes. The focus of therapy is on the present rather than the past. The central premise is that behavior is maintained by its consequences: • Consequences that accelerate behavior are called reinforcers • Consequences that decelerate behavior are called punishers

PSYCHOANALYTIC AND PSYCHODYNAMIC THEORIES AND MODELS Relevance:

Many experts consider psychoanalysis to be counter-indicated in extreme psychological situations. Psychosis, suicidal depression and severe untreated drug addiction need faster, more relevant-to-the-moment types of psychotherapy. Psychoanalytic treatment of clinical depression and personality disorders is thought to be more apropos. Cases of neurosis are the common recipients of this therapy.

BRIEF THERAPY Key Figures:

Milton Erickson, Richard Bandler

OBJECT-RELATIONS THERAPY Limitations

Most of a client's behaviors and feelings are outside of his/her conscious awareness Due to the nature of the pathology, resolution may be difficult The client's current outside relationships may work against what is being learned in therapy

Childhood Experiences

Neglected children look for revenge on society Spoiled children expect society to conform to their self-centered needs Children with mental and/or physical weaknesses may develop feelings of inadequacy; however, with appropriate guidance they can transfer weaknesses into strengths

Presuppositions Of Neuro-linguistic Programming (NLP)

No one is wrong or broken People work perfectly to accomplish what they are currently accomplishing People already have all the resources they need Behind every behavior is a positive intention Every behavior is useful in some context The meaning of a communication is the response received If the response is not as desired, the person must do something different There is no failure; there is only feedback In any system, the element with the most flexibility exerts the most influence The map is not the territory If someone can do something, anyone can learn it A person cannot fail to communicate

Adlerian Therapy: Role Of The Therapist

No set of techniques Therapeutic styles vary Functions as a diagnostician Focuses on cognitive aspects of therapy

Primary vicarious conditioning:

Occurs when an observer sees the model's behavior reinforced then he/she performs the same behavior. In vicarious punishment, an observer watches the model get punished for a particular behavior and chooses not to do the same thing.

Secondary vicarious conditioning:

Occurs when symbolic representations of behavior and its consequences are absorbed through reading, looking at maps or other images or from a verbalized description. Direct classical and/or operant conditioning can modify behaviors received from observational learning.

Freud's stage theory of human development

Oral (birth to about age two) Anal (about ages two to three) Phallic (about ages three to six) Latency (about age six to puberty) Genital (puberty to old age)

Perfection Striving:

People who are not neurotically bound to an inferiority complex spend their lives trying to meet fictional goals • Elimination of perceived flaws • "As if" philosophy • Gives motivation and focus

Operant Conditioning Techniques

Premack Principle Assertiveness Training Autogenic Training Baseline Biofeedback (i.e., EMG, EEC, or Temperature) Covert Experiment with Peter Flooding of Implosive Therapy Law of Effect Jacobson Method Little Albert vs. Little Hans

Superego:

Providing motivational instincts, the superego is an internalization of parental interjections. • Moral Principle • "The Judge" • Strive for perfection

Psychodynamic therapy: How It Works

Psychodynamic therapy is a method used to discover some of the basic wants and fears that keep individuals from acting in a mature way and is based in the interpretation of unconscious impulses and the defense against them Human interaction is rooted in the depth and complexity of psychic organization Psychodynamic theory is useful to understand the self in the family system The balance of conflict should be shifted by either strengthening defenses or relaxing them to permit some gratification Self psychology • Human beings long for appreciation • Acceptance from parents leads to strong, self-confident personalities

Rationalization:

Rationalization is giving to behavior a socially acceptable motive.

Aggression Drive:

Reaction to perceived helplessness or inferiority, lashing out against the inability to achieve or master

Some Jungian Archetypes

Rebirth Hero What one does not wish to be Feminine/masculine The need for wholeness and meaning

Systematic Desensitization

Reducing anxiety by associating negative stimuli with positive events, systematic desensitization is a behavioral intervention for counter conditioning.

Avoidance learning:

Refers to a form of learning that seeks to stop an aversive stimulus or an unpleasant situation by engaging the new or learned behavior. For example, a spouse may learn to avoid an argument by providing their partner time and space the first hour they are home from work.

Regression:

Regression is a retreat to an earlier stage of development where the individual feels more comfortable.

Variable ratio:

Reinforcement happens at a rate tied to the number of responses (the actual number of responses to each reinforcement may fluctuate like payments on a capped variable rate mortgage, but the ratio, on average, stays constant)

Variable interval:

Reinforcement interval changes (such as reinforcement after 2 seconds, then after 7 seconds, then after 4 seconds and so on)

Fixed interval:

Reinforcement is repeated at timely intervals (for example, every 10 seconds)

Fixed ratio:

Reinforcement occurs at fixed response intervals (for example, giving reinforcement after every fifth response)

Therapeutic Goals

Reintegration • Merging past and present • Exploring the conscious/unconscious • Developing self-knowledge • Individualization - reclaiming undeveloped parts of self through reflection on life/past

Development Of Behavior Disorders

Rooted in childhood transference Projective identification Failure of parents to see their children as separate beings results in severe psychopathology Idealization False self Narcissism Fixation Regression

BRIEF THERAPY Theory:

Seeing the history of the problem as less important and the present as the primary focus, the brief therapist is interested in focusing on specific problems and taking a much more involved role. Spontaneous and generative change happens as the client sees the present in a wider context and develops more functional ways to interact with it. The therapist is a helper who encourages the client to find the solutions from within.

Adlerian Therapy: The Client-Therapist Relationship

Should be based on mutual trust, respect, confidence and alignment of goals It's a collaborative relationship Client and therapist should develop a therapeutic contract or goals for therapy Emphasis of responsibility should be placed on the client for his or her own behaviors

PSYCHOANALYTIC AND PSYCHODYNAMIC THEORIES AND MODELS Key Figures:

Sigmund Freud, Erik Erikson, Alfred Adler, Carl Jung, Karen Horney, Harry Stack Sullivan

Erikson Theory Intervention

Since Erikson's model asserts that change and development continue throughout life and personality continues to develop beyond childhood, the client can be encouraged to see the future as an opportunity for positive change and development instead of looking back with blame and regret People of any age should be assisted in understanding the connections between life experiences and human behavior • Adults can be shown how to help rather than hinder the development of emotional maturity in children Clients need to understand how to apply these concepts in their day-to-day lives A therapist should affirm the client's "actuality" (i.e., the world of his/her participation) and emphasize the healing role-play or work may provide The goal of treatment is the restoration of mutuality by helping the client's ego become stronger and heal itself

Erikson Theory Motivation

Successful management of a stage enhances a person's feelings of competence The goal of each stage is to reach a successful balance between the two extremes it presents, with resolution closer to the positive side than the negative When people successfully emerge from a crisis, they have a positive orientation toward future events pertaining to that conflict Successfully emerging from a stage establishes ego quality, ego strength and virtue, all of which become permanently ingrained in the personality

BEHAVIORAL THERAPY Treatment:

Techniques may include training in social skills, assertiveness training and self-control exercises (such as progressive relaxation and biofeedback), as well as performance-based techniques applied outside therapy (for example, behavior modification programs used in classrooms).

Erikson Theory Dysfunction

The absence of a strong ego identity is a major cause of poor adjustment Lacking trust in relationships or fearing the loss of relationships distorts and damages people's lives If a person does not manage a stage well, increased feelings of inadequacy result Unsuccessful negotiation of a crisis results in a destructive emotional or psychological tendency that corresponds to one of the two opposite extremes of the particular crisis

Theory Of Reciprocal Inhibition

The basic concept: an individual cannot be both anxious and relaxed at the same time.

PSYCHOANALYTIC AND PSYCHODYNAMIC THEORIES AND MODELS Treatment:

The client is encouraged to free associate and say whatever comes to mind while in a relaxed state such as lying on a couch. The therapist mostly listens with a nonjudgmental attitude, commenting only to make interpretations of patterns and inhibitions. Treatment is normally meeting intensive (several times per week) and takes a very long time, continuing on for years (three to seven years).

Operant Conditioning Theory

The concept of operant conditioning is one of using consequences to alter the form and frequency of behavior, focusing on modifying voluntary behavior. Operant behavior acts on the environment and is sustained by consequences, whereas classical conditioning is concerned with conditioning respondent behaviors elicited by antecedent conditions. Operant responses can be developed and altered by reinforcing learning and approximations of desired behavior responses.

Noncontingent reinforcement:

The delivery of a reinforcing stimulus on a response-independent basis. This element of behavioral therapy is commonly used in addressing aberrant behaviors in persons with developmental disabilities.

Repression:

The determinate of all defense mechanisms, repression occurs when a person forces painful perceptions, constructs and feelings into the unconscious.

Ego:

The ego is viewed as the reality that mediates between the id and superego. • Reality principle - maximize gratification, minimize punishment • "Traffic Cop"

COGNITIVE-BEHAVIORAL THERAPY MODELS Treatment:

The goal of cognitive-behavioral therapy is to change or substitute these patterns with more realistic and useful thoughts and responses.

Style of Life:

The individual's ways of thinking, feeling and acting

Counter Transference:

The irrational reactions therapists have toward their clients

OBJECT-RELATIONS THERAPY Assumptions

The self exists only in relation to other objects (with the object usually being another person) A person's pattern of relating to others is established by the interactions of early childhood Patterns formed in childhood tend to recur repeatedly throughout life Object representations do not always accurately reflect childhood experiences. It is more important to determine what the child perceived as happening instead of what actually occurred The bond one has to others is the main focus for personality. These relationships create the structure of the self There are three fundamental effects that may exist between one person and another: • Attachment • Frustration • Rejection

Insight:

The special form of self awareness

Holism:

The study of humans as integrated beings

OBJECT-RELATIONS THERAPY Techniques

The therapist assumes an active role As therapy proceeds, the therapist should observe the ways in which a client projects previous object relationships into therapeutic interactions By identifying and resolving the underlying causes of human conflict, object-relations therapy strives for a deeper level of resolution The therapist points out to the client patterns of distortion and manipulation used to establish and maintain relationships Since the therapist carefully avoids allowing a client to pull him/her into maladaptive patterns, the client should be compelled to seek new, healthier ways of relating

OBJECT-RELATIONS THERAPY Intervention

The therapist should assist the client in working through pathological responses by the active experience of a real relationship between the therapist and the client While encouraging independence and the development of a more autonomous sense of self, the therapist should nurture the foundation of intimacy and trust Therapy should help the client overcome developmental delays, thus enabling him/her to move forward toward maturity

The Therapeutic Process For Couples

Therapy starts with exploring the conflict between couples Focus is primarily placed on helping couples recognize the source of emotional reactions Psychoanalytic couples therapists explore along four channels

Shaping:

This conditioning is used to encourage specific behavior by rewarding actions that come increasingly closer to the desired behavior.

Dream Work:

This is a process whereby latent dream content becomes apparent. An individual gains understanding of the fundamental meaning of a dream by exploring early experiences, attitudes toward parents and siblings and defenses and conditionings, as well as emotionally charged current life experiences, interpersonal dynamics and repressed unconscious impulses.

Token economy:

This method rewards desired behaviors with tokens such as poker chips, stars and scrip that can be saved and traded for another reinforcement, such as an outing to a restaurant or a movie.

Differential reinforcement:

This program combines extinction of unwanted behavior with positive reinforcement for desirable behavior.

Other Salient Techniques Of Operant Conditioning

Token economy Shaping Differential reinforcement Vicarious conditioning Primary vicarious conditioning Secondary vicarious conditioning Avoidance learning Noncontingent reinforcement

Major Approaches To Personality Theory

Trait Psychoanalytic Humanistic Cognitive

Erikson Theory Techniques

Treatment should focus on helping the client balance the demands of: • Unconscious internal pressures (instincts and effects) • Pressures of the external world (social reality and relationships) Therapists should be aware of obligations to others, both for their clients and for themselves The therapeutic exchange, in itself, should be the essence of study • The therapist needs to be committed to continuous conceptual revision as new information emerges from the client Establishing the basis of trust is the core element of the therapeutic relationship Dream analysis and free association are included in therapy Transference is a factor • The client transfers onto the therapist significant issues from past interactions with meaningful people • The therapist, through his/her responses, must clarify the appropriateness or inappropriateness of the client's past interactions Self-awareness and relationship to the world are integrated The therapist should recognize if the client has or has not passed through various lifestyle stages and assess self-growth based on whether or not various crises have been met

Ivan Pavlov's research on Classical Conditioning

Unconditioned stimuli produce unconditioned or natural responses, such as Pavlov's dogs salivating at the smell of meat powder. By combining a known stimulus and a natural response with a neutral stimulus such as a ringing bell, Pavlov found dogs would begin to salivate upon hearing the bell alone, a conditioned stimulus producing a conditioned response.

Latent Content:

Underlying thoughts, desires and fantasies related to the emotional reactions of early infancy, latent content gives a dream its fundamental meaning.

NEURO-LINGUISTIC PROGRAMMING (NLP) Relevance:

Used as a therapeutic theory, NLP is increasingly being used to cultivate skills of outstanding performance in training, business, management, sales, coaching, counseling, education, sports and the performing arts

BRIEF THERAPY Treatment:

Using a wide range of approaches adapted to the particular client's unique situation, the therapist actively goads the client to examine behaviors that work while concentrating on successes rather than failures.

OBJECT-RELATIONS THERAPY Dysfunction

When a person is unable to mature beyond some developmental stage: • Psychological dysfunction occurs • Therefore, dysfunctional and symptomatic behaviors are usually immature attempts to resolve early traumas Failure to break away from dependent bonds leads to psychopathology When a child experiences trauma (such as abuse): • He/she may never mature emotionally, remaining in a state of identity diffusion • Lacking the ego strength necessary to form and maintain healthy relationships, the person may be likely to develop a personality disorder When a person has begun to manipulate and distort others, it is because the relationship fits an unhealthy model learned in childhood

Displacement:

When an emotion felt toward an individual or an object is transferred to a similar person or object, displacement is the result.

Reaction Formation:

When behavior is opposed to unconscious desires, reaction formation is said to have resulted.

Neurosis:

When the superego imposes guilt on the ego to limit the impulses of the id, neurosis results • Neuroses stem from childhood conflicts that occur when the relationship between the libido and ego mechanisms becomes unbalanced

Negative punishment refers to:

a behavior followed be removal of a desired or favorable stimulus, such as taking a video game away from a child resulting in decreasing the child's defiance around completing chores. Removal of the video game serves to decrease defiance.

Positive punishment refers to:

a behavior followed by an aversive stimulus that decreases the behavior, such as reprimanding a child and requiring an apology to the store manager where a child attempted to steal an item.

Reinforcement refers to:

a consequence or procedure that increases frequency of a behavior immediately preceding the consequence or procedure. Reinforcement occurs if the behavior under observation exists at a high frequency level and the behavior is sustained or reinforced, or if the behavior is increased. Reinforcement can be positive or negative.

Focusing on actual behavior rather than cognitive processes, ________________ sees behavior as a function of its consequences. This approach uses the behavior modification techniques of stimulus control, reinforcement, punishment and extinction.

applied behavior analysis

Classical Conditioning

confirms the crucial part that antecedents play in learned behavior.

Behavioral Learning Theory of personality development

differs from other theories in one primary way -- rather than having a focus on internal needs, motivations or perceptions, they focus on identifiable, observable behaviors. So to explain personality development, behaviorists aim to describe how people think, perceive and learn, whether increased and strengthened or decreased and reduced.

Horney's theory

does not contain the Oedipus complex; instead, her view declares people are moving toward (feeling), moving against (acting) or moving away (thinking). Horney rejected Freud's concepts of the Oedipal conflict and penis envy being responsible for the development of female character, as well as his theory of female masochism. Horney did agree that penis envy derived to a degree from anatomical differences between men and women, but saw the reason as the cultural and social forces of a patriarchal society that indoctrinates male superiority and female inferiority.

Multimodal therapy

is a holistic approach with behavioral components broken down into seven classifications of a person's personality termed by the acronym BASIC I.D.

Through systematic desensitization and covert conditioning, ______________ therapy is concerned with extinguishing causes of anxiety. This approach assumes the same laws of learning apply to both overt and covert processes.

neuro-behavioristic stimulus-response

Contiguity Theory

no significant role in learning is assigned to rewards or punishments, and the learning is all or none because it occurs in a single trial. Contiguity theory proposes interference is the reason for forgetting information or behavior rather than passage of time. New associations are made between stimuli and responses so previous conditioning is altered.

Programming refers

not to computer programming, but rather to the strategies used to organize inner processes to produce results.

BEHAVIORAL THERAPY assessment techniques such as:

psychological tests, behavioral observations, self-reports/monitoring, role-playing and imagery may be used.

Immediacy

refers to the closeness in time that feedback is given to a response. The more immediate the consequence or feedback, the better the response. For example, a child fails a test because he played rather than studying his spelling words and does not learn he failed the test until a week after taking it. He is less likely to associate the poor study habit with the result than if the tests were graded in class or the information learned the same day.

Size

refers to the determination the individual makes about the consequence (positive or negative) about whether or not the behavior is worth the effort. For example, if a student will be able to opt out of a final exam for maintaining good attendance and an 85% grade average, the consequence size (no final exam) may be worth the effort (attendance and 85% GPA).

Satiation

refers to the effectiveness of a consequence being reduced when the source of the stimulant has satisfied the individual or the individual was not 'hungry' for the stimulant.

Contingency

refers to the schedule of reinforcement or level of consistency of delivery of the consequence following the behavior consistently over time. If the schedule of reinforcement is consistent and immediate, the effectiveness is high. If the schedule for reinforcement is intermittent and distant, the effectiveness of learning may be decreased; but if learning was secured during the intermittent reinforcement, extinction is more difficult to achieve.

People learn by experiencing ___________ (encouraging recurrence) or ___________ (discouraging recurrence) following their behavior.

reinforcement punishment

three terms when exploring operant conditioning:

reinforcement, punishment and extinction

When utilizing consequences to alter responses, the effectiveness can be impacted my multiple factors.The factors are:

satiation, immediacy, contingency and size.

Viewing current behaviors, cognitive processes and the environment as working together to influence behavior, ______________ stresses the processes of mediation, external stimuli, and external reinforcement. In this approach, the client determines which behaviors to change, using his/her self-directing abilities.

social learning theory

Individuals need to be viewed in the context of their __________.

social relationships

key classical conditioning phenomena are:

stimulus generalization, extinction, and counter conditioning

Object-relations theorists focus on:

symbiosis, separation, differentiation and integration.

One of the primary targets of cognitive therapy is:

the identification of negative or distorted automatic thoughts.

Respondent Conditioning

the individual is responding to an environmental queue or antecedent. The basic model of the theory is a stimulus elicits a response. In classical conditioning, the origination is a reflex, which is an involuntary or innate behavior. The innate behavior is elicited by the environmental antecedent occurrence. For example: if sunlight streams from behind a cloud into your eyes, your eyes squint and pupils constrict. There is no voluntary control over this pupillary response.

Neuro refers to

the neurological processes of sight, hearing, touch, smell and taste, which form the basic building blocks of a person's experience.

Punishment

the presentation of an aversive behavior or event or the removal of a positive reinforcer that causes a behavior to decrease in frequency. Punishment may be positive or negative.

Positive reinforcement refers to:

the presentation of positive consequences or events immediately following an action or behavior that enhances the likelihood of that behavior occurring again.

Negative reinforcement refers to:

the removal of a stimulus or consequence immediately following an action or behavior that enhances the likelihood of that behavior occurring again.

Extinction involves:

the stopping of a behavior because the reinforcement is no longer effective. Unwelcome behaviors receive no reinforcement. This is most effective when all reinforcers of a behavior are eliminated all the time. In extinction, no consequence is involved, so it is separate and distinct from punishment.

Linguistic refers to

the ways language is used to represent experience and to communicate with others.

Erik Erikson's theory

views maturity as proceeding through eight stages, which are both psychosocial in nature and genetically determined: Trust vs. Mistrust (birth through 18 months) Autonomy vs. Shame and Doubt (18 months to age three) Initiation vs. Guilt (ages three to six) Industry vs. Inferiority (ages six to 12) Identity vs. Role Confusion (ages 12 to 20) Intimacy vs. Isolation (ages 20 to 40) Generativity vs. Stagnation (middle adult years, about 40 to 65) Ego Integrity vs. Despair (Later adult years, 65 on)

Complexes:

• Inferiority complex: Normal feelings of incompetence exaggerated, feeling its impossible and hopeless to reach goals • Superiority complex: Very high opinion of self, bragging, often quick to argue

View of Man

• Man's behavior is conditioned not only by his individual/racial history (causality) but also by aims and aspirations (teleology - explanation of behavior based on future goals)

Two essential qualities to create a secure and cohesive self are:

• Mirroring 1. Understanding plus acceptance - "I see how you feel." • Idealization 1. Image of strong and powerful parents

Social responsibility and understanding of social issues:

• Occupation tasks 1. Career 2. Self worth • Societal tasks 1. Creating friendships 2. Social networks • Love tasks 1. Life partner

Basic mistakes of client logic

• Overgeneralization • Exaggerated need for security • Misperceptions of life • Denial of ones worth • Faulty values

Collective Unconscious

• Shared by all, but modified by personal experience

Freud divided the psyche into three parts:

• The ID is the most primitive state and is involved with the primitive desires (hunger, sex, rage) • The SUPEREGO in one sense might be considered the conscience. It is made up of the internalized societal morals and taboos • The EGO is the mediator between the id and the superego. It is often thought of as the center of self or awareness

Personal Conscious

• Unique life experiences and perceptions

Focus on the importance of each person's:

• Unique motivations • Perceived niche in society • Goal directedness