History of Mental Illness Treatment
Philippe Pinel in France and Dorthea Dix
     in America founded humane movements
     to care for the mentally sick.
                                   Point to
                                     Consider:
                                                     Patient:
                                                       Biomedical /
                                                       psychoanalytic
Philippe Pinel (1745-1826) Dorthea Dix (1745-1826)
                                                     Client: Other
                                                       therapists
           Psychotherapy
 An interaction between a trained
  therapist and someone suffering from
  psychological difficulties.
 Treatment of mental illness by
  psychological rather than medical
  means.
        Types of Psychotherapies
      Psychoanalytic
                               Insight Therapy
      Humanistic
      Behavioral
      Cognitive
            Types of Therapists
 Psychiatrists - Medical doctor + PhD / prescribes meds
 Clinical psychologists  tend to work with more serious
  conditions and patients (PH.D.)
 Counseling psychologist  tend to work with more
  healthier, less pathological populations, and conduct
  more career and vocational assessments. (M.A./PhD.)
Insight Therapies
Assumes that a person's behavior,
thoughts, and emotions become disordered
as a result of the individual's lack of
understanding as to what motivates him
or her, such as unresolved old conflicts
or beliefs.
                   Goal: Help individual discover
                  the reasons and motivation for
                  their behavior, feelings, and
                  thinking so that they may make
                  appropriate changes and thus
                  improve their mental health.
Psychoanalysis        Freuds therapy
                      Couch sitting (lying down)
     A set of         Goal: Make the unconscious
  techniques for
   releasing the       conscious
    tension of
  repression and       How?
     resolving
 unconscious inner    Dreams: talk about the
     conflicts.        Latent Content.
                      Resistance: When patient
                       seems reluctant to speak
                       about certain subjects
                      Freud initially used
                       hypnosis, but then believed
                       it was unnecessary.
                  Free association: the
Psychoanalysis     patient speaks freely about
                   memories, dreams, feelings
             Transference
 In psychoanalysis, the patient projected
  feelings upon the analyst based on
  emotions linked with past relationships.
  (primarily childhood relationships.)
 Psychoanalysis: Points of interest
 Patient attends treatment 4-5 x a week!!
 Analysts looks for & records repetitions
  of behavior (unconscious)
 Therapist says little (then interprets at
  the end of session)
       Psychoanalysis: Criticisms
1. Psychoanalysis is hard to refute because
   it cannot be proven or disproven.
2. Psychoanalysis takes a long time and is
   very expensive and is not covered by ins.
Psychodynamic                         Interpersonal
   Therapy                               Therapy
 Less intensive, modern version      A further extension of
  of psychoanalysis                    psychoanalysis
    Fewer sessions per week and      The goal is less focused
     fewer years                       on insight, and more on
    Less theory about sex, id, and    relational behavior
     superego                          change and symptom
 The goal of a psychodynamic          relief.
  therapist is to enable insight by  The focus is less on the
                                       past, and more on
  looking for common, reoccurring      current feelings and
  themes, especially in relationships. relationships including
 In addition to insight, therapists   the interaction with the
  suggest changes in patterns of       therapist.
  thinking and relating to others.
CASE STUDY  Anna
A 34-year-old married professional.
Five months after receiving a promotion, with
accompanying increased responsibilities and longer hours,
Anna experienced increased tensions with her husband
over his wish for a 2nd child. She began feeling
depressed, had trouble sleeping, became irritable and
gained weight.
                                 Interpersonal Therapist 
    Psychodynamic approach       Also wanted Anna to gain
     would look to help         these insights, but also
    Anna gain insight into       engaged her thinking on
    her angry impulses and       more immediate issues,
    her defenses against         such as how to balance
    anger.                       work and home, resolve
                                 the dispute with her
                                 husband, and express her
                                 emotions.
Humanistic Therapy
General philosophy: At their core, people are good. If
people can learn to accept themselves as they are, then they
can grow into their full potential.
 Focuses of peoples potential for self-
  fulfillment (self-actualization).
Focus on the present and future (not the
past).
Focus on conscious thoughts (not unconscious
ones).
Take responsibility for you actions- instead of
blaming childhood anxieties.
   Most widely used Humanistic technique is:
  Client (Person) Centered Therapy
Therapist should use genuineness,
acceptance and empathy to show
unconditional positive regard towards
their clients.
Nondirective:
Therapist
allows the
client to direct
the session
rather than
directing it
herself.
Carl Rogers  Client Centered Therapy
  Active Listening (Mirroring)
 Central to Rogers
  client-centered
  therapy
 Empathetic listening
 where the listener
 echoes, restates and
 clarifies.
  Style of the Client-                    Showing Empathy Through
                                          Active Listening
  Centered Therapist                      Client-centered therapists
Being non-directive                       show that they are tuning in
 Let insight and goals come from the      to clients feelings and
 client, rather than dictating            meanings.
 interpretations.                         1. Summarize, paraphrase
Being genuine                                 So your father wasnt
Be yourself and be truthful; dont put        around much?
on a therapist faade.                    2. Invite clarification and
                                              elaboration
Being accepting and showing                   When you say anxiety,
unconditional positive regard                 what does that feel like
Help the client learn to accept               to you? What is going on
themselves despite any weaknesses.            in your body and
                                              thoughts?
Being empathetic
                                          3. Reflect Feelings
Demonstrate careful attention to the
clients feelings, partly by reflecting       It seems like you are
what you hear the client saying.              disappointed; am I
                                              right?
Humanistic vs. Psychoanalytic Therapy
                 Humanistic                 Psychoanalytic
                psychotherapy               psychotherapy
  Goal         Promote growth              Cure mental illness
  How to     Take responsibility for   Bring unconscious conflicts
 improve      feelings and actions      into conscious awareness
 Role of    Provide an environment Provide interpretations (e.g.
therapist     in which growth can   of dreams, resistance and
                     occur                transference)
Content of Conscious feelings,           Unconscious conflicts
 therapy actual self and ideal self
Time focus The present and future               The past
Carl Rogers and Gloria  Active Listening