Psychotherapy lectures
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, HC1 Introduction
There is a gap between academic psychology and clinical practice. Research findings have only a
small impact. Furthermore, there is little theoretical integration across psychotherapy schools.
Strong effects have been found for disorder-specific treatment and there are sound disorder-specific
psychopathology theories, but these account for psychotherapy only partially.
Mental disorder =
(subjective) experience
of feelings, thoughts, behavior tendencies, bodily experiences
that are problematic; unwanted, untolerable, abnormal, uncontrollable, absurd
of which the person does not feel in charge
The goal of psychotherapy:
a. Change unwanted patterns of subjective experiences
b. Reduce agreed upon symptoms, disorders etc.
You are not trying to make the patient happy, or understand reality.
Means of psychotherapy
1) Changing propositional representations:
- these are language based, symbolic, deductive reasoning
o not about experience
- a belief can be changed, but an experience cannot
using language to reason to patients often does not help change the
experience
therapist is authoritarian
patient is passive
persuasion is often transient / ineffective
2) Discover who you are:
- self-knowledge
- core of psychoanalysis and client-centered therapy
o psychoanalysis = ineffienct -> costs very many sessions
o client-centered therapy has untenable assumptions (no proof)
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,There are many processes going on without being aware of them (left), these are called ‘english
butlers’ and they are implicit. Once interconnections are made in convergence zones, you become
aware.
Gazzaniga: ‘consciousness is the last to know’
You want to change these automatic implicit processes, and the only way this can be done is by
changing neurons = synaptogenesis.
Synaptogenesis is positively influenced by:
emotions
experience based
repeated encounters (associative representations: S-R)
o different schema’s (neuronal networks) activated at the same time -> change of
schematic representations = corrective emotional experience
eg: induce emotions, connect past present future, images, previous
experiences
chair technique
imagery rescripting
this can only occur in sessions, no homework possible
o changing narrative (propositional representations) may be helpful
3) systematic exercise
Training changes associative representations. This is the core business of cognitive therapy, behavior
therapy and systems therapy. Training occurs in and between sessions.
- examples: exposure, assertiveness training, symptoms monitoring
It is proven to be very effective (it changes the English butlers), but patients have to participate.
4) patient activation and involvement
Without involvement, there is no change in the way patient experiences things. You have to
guarantee safety as a therapist.
5) high quality therapeutic alliance
This is optimized in client-centered therapy and psychoanalysis. The patient expresses himself.
Used for motivation and involvement enhancement in directive forms of therapy.
Related to therapy results, but the relationship is not the only necessary ingredient of treatment.
Problem: fuzzy and untested theories in clinical psychology. However, there are sound theories from
social psychology and communication science about social influence.
6) recognizing environment and social interactions
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
, Examples: communication rules, facilitate activities, job-related interventions. Also: care plan, alert
plan, relapse prevention plan and treatment packages for severe psychiatric disorders.
This is not real treatment, as you don’t change the patient, but the environment.
The power of new insights and behaviors consists of letting go of the older ones.
HC 2 psychodynamic psychotherapy
Generally, it only takes 1 psychologist to change a person, given that the person wants to change. In
general, all psychotherapies are effective (dodo-bird effect).
What is it?
Psychodynamic therapy is a form of dept psychology (trying to give the client insight). It used to
reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension. Having
insight can already help the client. It is a form of psychoanalysis, but it also relies on the
interpersonal relationship between client and therapist. The problem with psychoanalysis is that the
theory behind it cannot be proven. Psychodynamic therapy lasts shorter than psychoanalysis.
The principles of psychodynamics were first introduced in the 1874 publication Lectures of
Physiology by Brücke. Brücke suggested all living organisms are energy systems and operate on
energy conservation. Freud adopted this concept and applied this dynamic characteristic to the
human psyche. Further development is done by Jung, Adler, Rank, and Klein.
Psychoanalysis:
- Requires daily visits,
- Analysand lies on a couch with the analyst. The therapist sits out of sight and behind (for
transference; the patient can project anything to the therapist; the client cannot see
whether the therapist approves or what he thinks. This can also raise anxiety as you don’t
know what the therapist approves).
- The main goal is free association by analysand and a silent analyst, the analyst breaks silence
whenever ‘interpretation’ is required (resulting in insight into your conflicts).
- It is a not a very interactive process.
- It is imposed on the analysand; payment is required whether they attend the session or not
(so that the client takes it seriously and because of transaction; it says something about the
relation between the therapist and client and many unconscious feelings).
- It takes several years to be effective.
Dynamic psychotherapy:
- is once a week (twice/thrice for unstable or highly motivated clients),
- client and therapist sit face to face.
- The psychotherapist usually talks quite a lot, compared to the ‘silence’ of psychoanalyst
(always ask what the patient is thinking and feeling and what that means to them, to
generate interpretations).
- It is a highly interactive process.
- There is no binding on the client, it is flexible and client pays therapist on each visit
- Treatment generally lasts 1-12/20 sessions (BPP) to more than 50 sessions/several years.
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
, HC1 Introduction
There is a gap between academic psychology and clinical practice. Research findings have only a
small impact. Furthermore, there is little theoretical integration across psychotherapy schools.
Strong effects have been found for disorder-specific treatment and there are sound disorder-specific
psychopathology theories, but these account for psychotherapy only partially.
Mental disorder =
(subjective) experience
of feelings, thoughts, behavior tendencies, bodily experiences
that are problematic; unwanted, untolerable, abnormal, uncontrollable, absurd
of which the person does not feel in charge
The goal of psychotherapy:
a. Change unwanted patterns of subjective experiences
b. Reduce agreed upon symptoms, disorders etc.
You are not trying to make the patient happy, or understand reality.
Means of psychotherapy
1) Changing propositional representations:
- these are language based, symbolic, deductive reasoning
o not about experience
- a belief can be changed, but an experience cannot
using language to reason to patients often does not help change the
experience
therapist is authoritarian
patient is passive
persuasion is often transient / ineffective
2) Discover who you are:
- self-knowledge
- core of psychoanalysis and client-centered therapy
o psychoanalysis = ineffienct -> costs very many sessions
o client-centered therapy has untenable assumptions (no proof)
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
,There are many processes going on without being aware of them (left), these are called ‘english
butlers’ and they are implicit. Once interconnections are made in convergence zones, you become
aware.
Gazzaniga: ‘consciousness is the last to know’
You want to change these automatic implicit processes, and the only way this can be done is by
changing neurons = synaptogenesis.
Synaptogenesis is positively influenced by:
emotions
experience based
repeated encounters (associative representations: S-R)
o different schema’s (neuronal networks) activated at the same time -> change of
schematic representations = corrective emotional experience
eg: induce emotions, connect past present future, images, previous
experiences
chair technique
imagery rescripting
this can only occur in sessions, no homework possible
o changing narrative (propositional representations) may be helpful
3) systematic exercise
Training changes associative representations. This is the core business of cognitive therapy, behavior
therapy and systems therapy. Training occurs in and between sessions.
- examples: exposure, assertiveness training, symptoms monitoring
It is proven to be very effective (it changes the English butlers), but patients have to participate.
4) patient activation and involvement
Without involvement, there is no change in the way patient experiences things. You have to
guarantee safety as a therapist.
5) high quality therapeutic alliance
This is optimized in client-centered therapy and psychoanalysis. The patient expresses himself.
Used for motivation and involvement enhancement in directive forms of therapy.
Related to therapy results, but the relationship is not the only necessary ingredient of treatment.
Problem: fuzzy and untested theories in clinical psychology. However, there are sound theories from
social psychology and communication science about social influence.
6) recognizing environment and social interactions
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
, Examples: communication rules, facilitate activities, job-related interventions. Also: care plan, alert
plan, relapse prevention plan and treatment packages for severe psychiatric disorders.
This is not real treatment, as you don’t change the patient, but the environment.
The power of new insights and behaviors consists of letting go of the older ones.
HC 2 psychodynamic psychotherapy
Generally, it only takes 1 psychologist to change a person, given that the person wants to change. In
general, all psychotherapies are effective (dodo-bird effect).
What is it?
Psychodynamic therapy is a form of dept psychology (trying to give the client insight). It used to
reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension. Having
insight can already help the client. It is a form of psychoanalysis, but it also relies on the
interpersonal relationship between client and therapist. The problem with psychoanalysis is that the
theory behind it cannot be proven. Psychodynamic therapy lasts shorter than psychoanalysis.
The principles of psychodynamics were first introduced in the 1874 publication Lectures of
Physiology by Brücke. Brücke suggested all living organisms are energy systems and operate on
energy conservation. Freud adopted this concept and applied this dynamic characteristic to the
human psyche. Further development is done by Jung, Adler, Rank, and Klein.
Psychoanalysis:
- Requires daily visits,
- Analysand lies on a couch with the analyst. The therapist sits out of sight and behind (for
transference; the patient can project anything to the therapist; the client cannot see
whether the therapist approves or what he thinks. This can also raise anxiety as you don’t
know what the therapist approves).
- The main goal is free association by analysand and a silent analyst, the analyst breaks silence
whenever ‘interpretation’ is required (resulting in insight into your conflicts).
- It is a not a very interactive process.
- It is imposed on the analysand; payment is required whether they attend the session or not
(so that the client takes it seriously and because of transaction; it says something about the
relation between the therapist and client and many unconscious feelings).
- It takes several years to be effective.
Dynamic psychotherapy:
- is once a week (twice/thrice for unstable or highly motivated clients),
- client and therapist sit face to face.
- The psychotherapist usually talks quite a lot, compared to the ‘silence’ of psychoanalyst
(always ask what the patient is thinking and feeling and what that means to them, to
generate interpretations).
- It is a highly interactive process.
- There is no binding on the client, it is flexible and client pays therapist on each visit
- Treatment generally lasts 1-12/20 sessions (BPP) to more than 50 sessions/several years.
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
