Treatment
for mental disorders is given in the form of various kinds of therapy. Therapy consists of procedures that aim
to either cure sick people or alleviate their suffering. Psychologically based therapies begin
with the assumption that mental disorders are caused by emotional conflicts,
maladaptive learning, cognitive errors, or similar behavioral processes. Psychotherapy is the general term
applied to any kind of psychologically based therapy. Biologically based therapies begin with the assumption that mental
dis-orders are caused by actual pathology of the brain and nervous system. Drug therapy is the most common form of
biologically based therapy. It is characterized by the prescription of certain
chemical agents that have been shown to either eliminate or reduce the severity
of symptoms associated with various mental disorders.
Psychodynamic
Therapy: Exploring Unconscious Roots
Psychodynamic therapy is any kind of
psychotherapy that attempts to reduce suffering by exploring the unconscious
roots of a mental-emotional problem.
Free association is the principal
“digging” tool used by psychoanalysis. Free association consists of saying
anything that comes to mind without a concern for logic or the appropriateness
of the content.
An
interpretation consists of making
sense of content that has been repressed at the unconscious level.
The
interpretation of dreams is a central feature of psychoanalytic therapy. Freud
said that dreams are “the royal road to the unconscious.” He asserted that a
dream has two levels. The manifest level
is the surface of the dream. It is what is presented to the dreaming
subject and what is remembered when the individual wakes up. The latent level is the concealed aspect of
the dream, its meaning.
Patient-initiated
transference exists when the patient
projects onto the therapist feelings obtained from an unconscious level. There
are two kinds of patientinitiated transference. A positive transference occurs when the patient sees the therapist in
glowing, magical terms and a negative
transference occurs when the patient sees the therapist in negative,
derogatory terms.
Client-Centered
Therapy: A Humanistic Approach
Client-centered therapy is based on the
assumption that the troubled person has powerful inner resources, resources
that will help the individual think and feel better. Unlike
psychodynamic therapy, client-centered therapy does not attempt to explore the
unconscious level.
In order to nurture a
personal growth process, client-centered therapy employs a number of well-defined techniques and principles. Five of
these will be identified below.
- First, the therapy should be non-directive. The therapist should not tell the client what to do or try to make decisions for him or her. Indeed, an older name for client-centered therapy was non-directive therapy.
- Second, the therapy should create a condition of unconditional positive regard. This means that the client needs to be respected as a person even if he or she speaks of moral lapses or irresponsible behavior. The aim of the therapy is to help, not to judge, the client.
- Third, the therapy should employ active listening. The therapist gives the client high-quality verbal feedback. The therapist needs, from time to time, to summarize what the client has been saying. The therapist’s remarks should help the client to recognize powerful feelings and persistent attitudes.
- Fourth, the therapist should be capable of empathy. Empathy exists when the therapist can readily imagine what it would be like to experience life as the client experiences it.
- Fifth, the therapist must be genuine. He or she should not be merely doing a job.
Behavior Therapy: A
“Bad” Habit Can Be Modified
Behavior therapy is based on the
assumption that mental and emotional problems often consist of learned
maladaptive responses.
First,
systematic desensitization is based
on principles of classical conditioning. Second,
behavior modification is based on
principles of operant conditioning. Behavior modification is of particular
value in the treatment of maladaptive behaviors that involve actions with
consequences.
Cognitive-Behavior
Therapy: How Thinking Affects Emotions and Actions
Cognitive-behavior therapy refers to
any approach to therapy that helps the patient to think more rationally in
order to bring emotional states under better control. Two kinds of
cognitive-behavior therapy will be identified.
Rational-emotive behavior therapy (REBT) operates
on the assumption that irrational thoughts induce inappropriate anxiety,
depression, and anger.
Cognitive therapy takes the same view
of the relationship between thought and emotion as does REBT.
Group Therapy:
Encountering Others
Group therapy, as its name clearly
suggests, is therapy conducted in group settings. A typical group ranges from
five to seven in number. The therapist acts as a facilitator, an individual who mediates between members of the
group, allows everyone a chance to participate, and keeps the group on track.
In
the 1960s a trend arose called the human
potential movement. The basic idea of the movement was to go beyond using a
group approach to heal the sick. Groups that aim at fostering one’s
potentialities and personal growth are called encounter groups. In an encounter,
one human being meets another human being in an authentic manner without
sham or pretense.
Drug Therapy: A
Revolution in Psychiatry
Drug
therapy has revolutionized psychiatry in the past forty years. Before the
advent of effective psychiatric drugs in the 1960s, one of the principal
treatments used with severely disturbed mental patients—patients with disorders
such as schizophrenia or major depressive episode—was electroconvulsive therapy.
Electroconvulsive therapy (ECT) passes
a mild electric current through the frontal lobes of the brain, inducing a
seizure similar to a grand mal seizure in
epilepsy.
Four
categories of psychiatric drugs are:
- Antipsychotic agents are drugs that treat mental disorders characterized by a loss of touch with reality.
- Antianxiety agents are used to treat the irrational anxiety associated with such disorders as generalized anxiety disorder, phobic disorder, and obsessivecompulsive disorder (OCD).
- Antidepressant agents are used to treat such mental disorders as dysthymia and major depressive disorder. The three basic types of antidepressants are tricyclic agents, monoamine oxidase (MAO) inhibitors, and selective serotonin reuptake inhibitors (SSRIs). The tricyclic agents and the MAO inhibitors regulate the activity of the neurotransmitter norephinephrine, and to some extent serotonin. The SSRIs, selectively regulate the activity of the neurotransmitter serotonin.
- Mood-stabilizing agents are used primarily to treat cyclothymia and bipolar disorder. Lithium carbonate, a natural mineral salt, is the best known moodstabilizing agent.
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