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Current Psychotherapies - Book Summary
What psychotherapeutic views are there? - Chapter 1
- Scientific research into the unconscious started in the seventeenth century under the leadership of Leibniz. In the nineteenth century, the ideas of Mesmer and Schopenhauer were leading. They influenced Freud, Adler and Jung. Mesmer was considered to be the founder of hypnotherapy.
- Fechner and von Helmholtz were important scientists in the nineteenth century. They conducted research in cognitive science. Fechner investigated the sleep-wake rhythm and Von Helmholtz discovered the phenomenon ''unconscious inference'' - the unconscious representation of an object, constructed by knowledge from the past. Fechner and von Helmholtz's ideas are called the ''organicist tradition''.
- Schopenhauer published a work that was regarded as the basis of field of psychology. His idea was to treat mental disorders in a non-biological way. Carus suggested that the conscious communicates with the unconscious, while the person himself is not fully aware of this process. The researcher, Benedikt, developed a way to treat pathogenic secrets. This became an important part of Jung's analytical psychotherapy. Grawe argued that psychotherapy appears to have its effects through changes in gene expression at the neuronal level.
What is psychoanalysis and in what context should it be seen? - Chapter 2
- The basic concepts of the psychoanalysis are the unconsciousness, fantasy, primary/secondary processes and defense mechanisms. Beck and Ellis pioneered cognitive therapy, but their original area of expertise was again psychoanalysis.
- Freud's hypnosis therapy was not reliable enough to bring back lost memories. This led to Freud developing the free association technique. Freud's seduction theory stated that sexual problems were the origin of psychological problems. Later, he suggested that fantasy and instinctive drive were important. At the beginning of the twentieth century, Freud came up with his theory about the libido. This refers to the psychic energy that can be activated by both external and internal stimuli. Freud's work on the ego, superego and the id formed the basis of the structural theory. The object relationship theory describes the process of creating internal representations in relation to significant others. In the sixties of the twentieth century, Freud's theory was dropped.
- A therapist could never function as a white canvas because each therapist brings his own unique subjectivity. According to Klein, people are born with instinctive passions related to love and aggression, related to unconscious fantasies about interpersonal relationships. This already exists before meeting others.
- Examples of developmental stop models are Winnicot's development theory and Kohut's self-psychology. Countertransfer is the therapist's response to the patient, whether consciously or not. This response is the result of the therapist's unresolved conflicts. Interpretation is the therapist's attempt to help clients become aware of their intrapsychic experiences and unconscious relationship patterns.
- The mechanisms of the psychoanalysis include: turning the unconscious into conscious, reaching emotional insight, reconstructing memories and increasing self-representation. Psychoanalytic therapy is not suitable for everyone. The client must be willing to practice self-awareness and should not perceive the therapy as too threatening.
What does the client-oriented treatment look like? - Chapter 4
- Client-centered therapy originated in 1940 from Rogers' ideas. The client-centered approach differs from the medical approach by considering man as one individual, rather than emphasizing a diagnosis. Therapists who work according to client-centered approach, believe in the client's inner resources. These inner sources are focused on growth and self-awareness. The main conditions for client-centered therapy are congruence, unconditional acceptance and empathy.
- Gendlin's focus-oriented therapy is based on the experience processes in the body. A change of feeling occurs when one listens to bodily sensations. Rice's emotion-oriented therapy was based on the therapist's calling function. The therapist aims to increase the client's experience - to access his own emotions. Cain argues that emotion-oriented therapy is a mixture of client-centered therapy, existentialism and Gestalt principles.
- Seligman's positive therapy is based both on the client-centered therapy and the humanistic therapy. Rogers' personality theory is seen more as growth-oriented than as development-oriented. The most important concepts in the client-centered therapy are experience, reaction of the organism, driving force and internal frame of reference. Zimring states that as long as someone is not aware of the unconscious, there is a bad psychological adjustment.
- The Dodo effect states that all forms of psychotherapy show comparable effect sizes. This is supported by various meta-analyzes. Wampold argues that treatment is not immediately less valuable if it is not empirically validated.There is no evidence-based evidence regarding client-centered therapy. Moreover, congruence fluctuates naturally during the therapeutic session, along with unconditional acceptance and empathy.
When and how is behavioral therapy used? - Chapter 6
- Behavioral therapy has many similarities with other psychotherapies, especially those that are short-term and directive, such as cognitive therapy and rational emotional behavioral therapy. Behavioral therapy is completely opposite to the psychodynamic approach.
- Wolpe developed the technique ''systematic desensitization'', an early form of exposure therapy. A person is slowly confronted mentally with his anxiety while relaxation techniques are applied. The underlying process was called ''reciprocal inhibition'' .
- Eysenk was the developer of the first form of behavioral therapy. Behavioral therapy emphasizes the importance of learning through classical and operant conditioning. Behavioral therapy can be used for anxiety disorders, panic disorders, obsessive-compulsive disorders, post-traumatic stress disorders, depression, eating disorders, schizophrenia, developmental disorders. Functional analysis is an important part of the behavioral evaluation. The purpose of it is to discover the sustaining factors of the behavior to be changed. Environmental variables are often manipulated and the effect on the target behavior is examined. Behavioral therapy consists of several steps: problem definition, evaluation of solutions, applying the best solution.
How is cognitive therapy structured? - Chapter 7
- Cognitive therapy is based on the idea that people respond to life events through a combination of cognitive, affective, motivational and behavioral responses based on evolution and individual learning. Information processing is crucial for the survival of any organism. All systems involved in survival - cognitive, behavioral, affective and motivational systems - are made up of schemes. These schemes have a strong influence on the information processing process. Sometimes this can cause people to process new information incorrectly.
- Cognitive therapy mainly focuses on correcting prejudices and other fallacies and adjusting core beliefs. Behavioral techniques are also often applied. Examples include social skills training, role-playing, behavioral exercises and exposure therapy. Cognitive therapy is based on phenomenological approach, structural and in-depth psychology. Current research into the theoretical background and therapeutic efficacy of cognitive psychology has shown positive results in many different forms of psychopathology.
- There are two main dimensions of personality that influence the development of psychiatric disorders: social dependence (sociotropy) and autonomy. The causal theory of cognitive therapy suggests that psychological distress is caused by an interplay of innate, biological, developmental and environmental factors.
- Cognitive distortions are: random inference, selective abstraction, overgeneralization, personalization and black and white thinking. Fundamental concepts in cognitive therapy are collaborative empiricism, Socratic dialogue and explorations. Cognitive therapy is based on empirical studies. Randomized controlled trials have shown success in depression and anxiety disorders in particular.
What forms of family therapy are there and when are they used? - Chapter 11
- Family therapists pay attention to the structure within a family - processes within a family and how they develop, adapt and change over time. A family is an ever-changing, living, complex and sustainable system with causal relationships.
- Cybernetic science has brought about clinical changes. For example, pathology is seen as part of the social environment and not just person-specific. In addition, interaction patterns are examined. Object relationship therapists are more concerned with unconscious childhood processes that now determine personality whereas family therapists focus on current interpersonal problems.
- Rogerian's therapy has had a great influence on family therapy. Family therapists place great value on exercising Rogers' sufficient and necessary conditions. The most important concepts in family therapy are: family rules and assumptions, pseudo-mutuality and pseudo-hostility, mystification.
- The main techniques in facilitating change are: redetermining, cognitive restructuring, the miracle question and externalizing. Unfortunately, there is little supporting evidence for the contribution of the therapy. Most studies have focused on cognitive and behavioral therapy. Research into the effectiveness of family therapy is difficult, because not every family member will benefit equally from the treatment.
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