Chapter 8 : PSYCHOTHERAPIES

Q1. What is meant by psychotherapy?

Ans. Psychotherapy is a procedure in which persons with mental disorders interact with a trained
psychotherapist who helps them change certain behaviours, thoughts and emotions so that they feel and
function better.
Two major components of therapeutic relationship are :
1. The contractual nature of the relationship.
2. Limited duration of the therapy.
Q2. Explain the features of Psychodynamic therapy.
Ans.

 Sigmund Freud believed that Mental disorders stem from the fact that many impulses of ‘Id’ (inner
conflicts) are unacceptable to the ‘Ego’ and ‘Superego’ and are therefore repressed into the
unconscious.
 He felt that the crucial task of people was to overcome repression and recognize and confront their
hidden feelings and impulses.
 The ideas concerning the cure and cause of mental illness are reflected in psychoanalysis. Its main
features are as follows :
1. FREE ASSOCIATION : In this technique, once the therapeutic relationship is established, the client is
asked to lie down comfortably and speak whatever comes to mind without censoring it. As the therapist
does not interrupt, the free flow of ideas, desires and conflicts of the unconscious emerge into the
conscious mind.
2. DREAM ANALYSIS : It is a technique in which the client is asked to write down her/his dreams on waking
up. Psychoanalysts look upon dreams as symbols of unfulfilled desires present in the unconsciousness.
The images of the dreams are symbols which signify intrapsychic forces.
3. TRANSFERENCE : as the unconscious forces are brought into the awareness, the client starts identifying
the therapist with the authority figures of the past (usually childhood). The therapist maintains a non-
judgmental yet permissive attitude and allows the client to continue with the process of emotional
identification called transference. Transference is considered helpful in understanding the unconscious
conflicts of the client. It is of two types :
a) Positive Transference : when the client idealizes or falls in love with the therapist and seeks the
therapist’s approval.
b) Negative Transference : when the client has feeing of hostility, anger and resentment towards
one therapist.
4. RESISTANCE : due to resistance, the client opposes the process of therapy in order to protect oneself
from the recall of painful unconscious memories. It can be seen in two forms :
a) Conscious Resistannce : when the client deliberately hides some information.
b) Unconscious Resistance : when the client becomes silent during the session, doesn’t recall
emotional details, misses appointments and comes late for the session.
5. COUNTER-TRANSFERENCE : when the therapist projects his/her unresolved conflicts onto the client, it
leads to counter-transference. It is considered to be damaging for the therapy if not properly managed.
In Psychoanalysis with the help of confrontation and clarification, the therapist helps the client gain insight
into her/his conflicts and problems which in turn leads to a better understanding of oneself.
Q3. Explain the principles of Client-centered therapy.
Ans. The ‘Phenomenological’ or ‘Humanistic’ therapies are based on the following three principles:
1. Understanding other people requires trying to see the world through their eyes.
 2. Clients should be treated as equal.
3. The therapeutic relationship with the client is central to the benefits of therapy.
Client-Centered Therapy is one of the most influential humanistic therapy developed by CARL ROGERS. He
argued that mental disorders arise mainly because the efforts made by the client to attain ‘Self-Actualization’
are blocked by judgements and ideas imposed by other people.
Those Judgements lead individuals to acquire ‘UNREALISTIC CONDITIONS OF WORTH’. For example : children
may begin to believe that they will be rejected by their parents if they are not always neat and submissive.
The key principles of the Client-Centered Therapy are as follows :
1. UNCONDITIONAL POSITIVE REGARD : It is total acceptance of the client as she or he is. It indicates that
the positive warmth of the therapist is not dependent on what the client reveals or does in the session.
It ensures that the client feels secure and can trust the therapist.
2. EMPATHY : It involves understanding the client’s experience as it was his own. Empathy sets up an
emotional resonance between the therapist and the client.
In this warm and caring environment freed from the threat of rejection, individuals can come to understand
their own feelings and accept even previously unwanted aspects of their own personalities. As a result, clients
come to see themselves as unique human beings with many desirable characteristics.
Q4. Discuss the techniques of Behaviour therapy.
Ans.

 Behaviour therapies are based on the belief that many mental disorders stem from ‘faulty learning
patterns’.
 Behavioural therapy is conducted to find :
- malfunctioning behaviours,
- the antecedents of faulty learning, and
- the factors that maintain and continue faulty learning.
 The kay task in the therapy is to change current behaviour. It consists of a large set of specific techniques
and interventions which are as follows :
1. Techniques based on CLASSICAL CONDITIONING
a) Flooding : It involves exposure to the feared stimuli or to the mental representations of them,
under conditions in which persons with phobias can’t escape from them. This encourages
extinction of such fears.
b) Systematic Desensitization : It is a technique developed by JOSEPH WOPLE in which together
with the client, the therapist prepares a hierarchy of anxiety provoking stimuli. During the
presentation of ‘anxiety provoking stimuli’ the therapist relaxes the client.
Over sessions, the client is able to imagine more severe fear provoking situations. The client gets
systematically desensitized to the fear. The technique is based on the principle of ‘reciprocal
inhibition’ which states that the presence of two mutually opposing forces at the same time,
inhibits the weaker force.
2. Techniques based on OPERANT CONDITIONING
a) Shaping : it uses a series of successive reinforcement on a subject to get him/her closer and
closer to exhibiting the desired behaviour.
b) Token Economy : it uses tokens as a reward every time a desired behaviour occurs. The tokens
are collected and exchanged for a reward such as an outing for a patient or a treat for the child.
3. Technique based on OBERVATIONAL LEARNING
a) Modeling : it involves showing to the clients some live demonstrations or video tapes of how
people with good social skills behave in many situations.
Q5. Briefly discuss the Rational Emotive Therapy (RET).
Ans.

 According to cognitive therapies many mental disorders stem from faulty or ‘distorted’ modes of
thought. ALBERT ELLIS, believes that ‘irrational thoughts’ play a key role in many mental disorders.
 According to Ellis, individuals experience many activating events (things that happen to them which can
potentially trigger upsetting emotional reactions). If people allow irrational believes to shape their
thoughts, they are at serious risk for experiencing psychological problems. For example : ‘Everyone I
meet should like me’ or ‘I should be perfect in every way.’
 During RET, the therapist first attempts to identify the irrational thoughts and then tries to persuade
clients to see how unrealistic some of their ideas are.
 Gradually, the client is able to change the irrational beliefs by making or changing his/her philosophy
about life which reduces the psychological distress.
Q6. Briefly discuss the Cognitive Behaviour Therapy (CBT).
Ans.

 ARON BECK devised the Cognitive Behaviour Therapy (CBT) for reducing Depression. He assumes that
depressed individuals engage in illogical thinking and hold unrealistically negative beliefs and
assumptions about themselves, the future and the world – termed as the ‘Negative Triad of depression’.
(for example : “I’m a worthless person no one could ever love” or “If good things happen to me, it’s just
blind luck.”
 Beck emphasizes the importance of ‘mood-dependent memory’- how our current moods influence
what we remember and what we think about.
 In the therapy, the therapist and the client work together to identify and test the individual’s
assumptions, beliefs and expectations.
 For example if a client states that she is a ‘total failure’, then the therapist may ask how she defines
failure, the therapist may then ask the client whether there are any areas of her life in which she does
experience success and has succeeded in reaching goals.
 As a result of these procedure, clients learn to reinterpret negative events in ways that help them cope
with such outcomes without becoming depressed.
Q7. What is meant by Psycho-social rehabilitation? What is it’s importance?
Ans. Psycho-social rehabilitation involves efforts to help patients with serious mental disorders like
Schizophrenia, Mood Disorders, etc., to cope more effectively with their disorders and to prevent or lessen the
crisis that reduce these patient’s ability to function in the society.
The rehabilitation efforts focus on achieving several goals :
1. The first and the key goal is to help such persons understand their disorders so that they can cope with
them effectively. For example : patients may be taught to recognize early warning signs of deterioration
and to avoid high-risk situations.
2. It focuses on teaching the patients the practical skills they need to live in the community – how to use
public transportation, shop for groceries, prepare meals and interact with other persons.
3. Efforts are made to have a single professional to help the patients with respect to employment,
housing, nutrition, transportation, medical care and finances.
Such case management helps to ensure that patients get all, the help available to them and adjust with the
society in a better way.