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chapter 17 - 3 - Transference Chpt 17 Treatment ofMenlal...

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Unformatted text preview: Transference Chpt 17 Treatment ofMenlal Disorders 883 *[After “forbidden” material has at last been verbalized, the patient may need some assistance in Interpreting Its significance. This is. in part. the role of the psychoanalyst But It Is a role that must be pursued with great caution until the psychoanalyst feels confident that shefhe has enough information to make a valid interpretation. Something akin to the "principal of minimal sufficiencf is best used in making the interpretation (see p. 595). After the fact. the validity of that interpretation can be judged in part by the reaction of the patient to it, which often will consist of an AHA-like emotional reaction of "understanding at last" and of “wonderful relief from some great and heretofore inescapable burden" (= catharsis” “[ln psychoanalysis It is thought to be an essential step In the course of treatment (if treatment is to be successful) for the patient to come to relate to the therapist as if that therapist was one of the major figures In the patient's life. This process of relating is called transference. Until that transference occurs {if it does). the therapist tries to remain as neutral as possible. In this way, what ever the nature of the transference, the therapist can be assured that It stems from something extremely potent and significant within the patient and hislher past [like the character of the patient's relationship with a parent). rather. than being provoked by here-and-now causes. In this fashion, the therapist can make use of the transference as a diagnostic tool to better understand the patients defenses and the sources in the past of the issues the patient is defending against and which help give rise to the patient‘s neuroses.] Psychodynamic Therapy Interpersonal Therapy [The practioners of psychodynamic theory (these also include object-relations. and ego-analytic therapists} endorse many of Freud's claims but. unlike him, emphasize current interpersonal and cultural factors rather than the psychological traumas of early childhood except to identify how the patterns of interaction in one's childhood influence current choices. The therapist and patient work together to help the patient develop a coherent and complete sense of self and to find ways of relating to others that are undistorted by past conflicts or maladaptive defense mechanisms. In doing so. conscious thoughts receive as much scrutiny as unconscious conflicts. Also efforts are made in the therapy sessions to devise ways the patient can apply what is Ieamed there to her life outside therapy.] [interpersonal therapy (IPT) builds on the claim that mental disorder are often created by a social isolation that cuts a person off from the emotional sustenance provided by healthy relationships. The therapy helps the patient gain an understanding of how he interacts with others. and then helps him learn new and more beneficial ways of interacting and communicating] Humanistic-Experiential Therapies Behavior Therapy {The humanistic-experiential therapies [of which there are several flavors) focus on helping their patients realize higher truths and meanings in their lives. Client-centered therapy seeks to help a pemon accept himself as he is, and to be himself with no pretense or self-imposed limits. In existential therapy, In contrast. a main focus is on the alienation and depersonalization of modern society and on making the patient aware of his own existence and its meaning that can be test in such a setting. In M therapy, the emphasis Is on the unity of mind and body, and a main goal is to increase self-awareness and self-acceptance. For more understanding of the goals and methods of these therapies, see pp.li45-4B and their humanistic views of personality (581-585). '[Behavioral therapist focus their treatment efforts upon the con-action of the overt. observable behavior that is causing the patient trouble rather than upon correction at the level of hypothetical underlying causes. such as unconscious thoughts and wishes. which they regard as hard to define and even harder to observe. To accomplish these ends. behavior therapists resort to the various techniques for learning and unlearnlng—extinction of fear responses. conditioning of incompatible reactions. etc.-_that we have reviewed in the chapter on learning (Chapter 6].] Exposure Techniques {Flooding} *[Essentially, by exposing the patient to hisr'her worst fears in sudden “sink-or-swim" fashion and. thereby, granting to the patient that life still continues. the therapist proves the lrrationality of these fears to the patient. in effect. flood and Implosion both are extinction methods for dealing with irrational fear. Flooding utilizes real stimuli as the frightening agents while Implosion therapy uses Imaging techniques to create semblances of these stimuli.] {Systematic Desensitr'zation} 'lflstematic Deserisitization. as a technique for neutralizing the anxieties at the heart of phobias and some obsessive-compulsive disorders, utilizes counter conditioning techniques as foilows‘. A response antagonistic to fear. such as muscular relation (a pervasive untenslng of the body‘s musculature} that is Incompatible with autonomic and skeletal reactions that underlie the fear and anxiety response. is progressively conditioned to the same or similar stimuli to which the fear response was originally conditioned. The conditioned relaxation counters (or blocks) the conditioned fear. I.E., one can not be fearful and relaxed at the same time.) Aversion Therapy '{Aversion therapy involving a variation on the counter conditioning employed in systematic desensitization is used to breakup unwanted approach tendencies to reward agents such a drugs, cigarettes. certain sex objects. etc. In aversion therapy. the obiect is to counter-condition a fear response to a stimulus that has become a OS for unwanted approach behavior. The ...
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