Chapter two Approaches to Clinical Psychology

1. Chapter two Approaches to Clinical Psychology

2. - The field of clinical psychology can be most fully understood when examined from several different perspectives, each of which emphasizes some of its aspects over others. - Each of these perspectives, or approaches, tries to explain how behavior develops and becomes problematic, and each influences the assessment, treatment, and research activities of those who adopt a particular approach (e.g. food)

3. Though diet is important in many aspects of life, the thinking and activities of most clinicians today are influenced mainly by some combination of the psychodynamic, behavioral, humanistic, and interpersonal approaches to clinical psychology In this chapter, we review the assumptions and implications of these approaches.

4. THE PROS AND CONS OF TAKING A SPECIFIC APPROACH - The various approaches to clinical psychology help clinicians to organize their thinking about behavior , thereby imposing order on, and suggesting relationships among, vast amounts of complex material. - To be of greatest value to clinical psychologists, an approach should include a complete and testable account of the development, maintenance, and alteration of both problematic and nonproblematic human behavior.

5. Psychodynamic Theory Sigmund Freud

6. THE PSYCHODYNAMIC APPROACH The model is based upon the following assumptions: Human behavior is determined by impulses, desires, motives, and conflicts that are intrapsychic (within the mind) and often out of awareness. 2. Intrapsychic factors cause both normal and abnormal behaviors.

7. 3. The foundations for behavior are set down in childhood through satisfaction or frustration of basic needs and impulses 4. Clinical assessment, treatment, and research should emphasize the aspects of intrapsychic activity must be uncovered if behavior is to be understood and behavior problems are to be alleviated

8. The Psychoanalytic Perspective • Unconscious • according to Freud, a reservoir of mostly unacceptable thoughts, wishes, feelings and memories • contemporary viewpoint- information processing of which we are unaware

9. Personality Structure • Id • present at birth and contains all the psychic energy-or libido- available to motivate behavior • operates on the pleasure principle, demanding immediate gratification(i.e., "If it feels good, do it!")

10. Personality Structure • Ego • the largely conscious, “executive” part of personality • mediates among the demands of the id, superego, and reality • operates on the reality principle, satisfying the id’s desires in ways that will realistically bring pleasure rather than pain (i.e., "If you are going to do it, at least do it quietly,").

11. Personality Structure • Superego • the part of personality that presents internalized ideals • It contains all the teachings of family and culture regarding ethics, morals, and values, • also contains the conscience, which seeks to promote perfect, conforming, and socially acceptable behavior

12. Ego Conscious mind Unconscious mind Superego Id Personality Structure • Freud’s idea of the mind’s structure

13. Defense Mechanisms • The ego attempts to keep these conflicts (between the id and the superego) and their discomfort from reaching consciousness by employing a variety of defense mechanisms, usually at an unconscious level. • Repression • the basic defense mechanism where ego simply holds an unacceptable thought, feeling, or impulse out of consciousness.

14. Defense Mechanisms • when a person is aware of an impulse and consciously denies its existence, the process is called suppression • Reaction formation • in which the person thinks and acts exactly opposite to the unconscious impulse. Thus, a son who hates his father may express unbounded love and concern for him.

15. Defense Mechanisms • Regression • defense mechanism in which an individual faced with anxiety retreats to a more infantile psychosexual stage, where some psychic energy remains fixated

16. Defense Mechanisms • Projection • the son may attribute negative feelings to others and accuse them of mistreating their fathers • Displacement • allows some expression of id impulses, but it aims them at safer targets

17. Defense Mechanisms • Rationalization • defense mechanism that offers self-justifying explanations in place of the real, more threatening, unconscious reasons for one’s actions

18. Defense Mechanisms - Defense mechanisms waste alot of psychic energy, and, under stress, they may fail, thus forcing the troubled person to fall back, or regress, to levels of behavior characteristic of earlier, less mature stagesof development - The depth of regression in a given case is partly a function of the individual's history of psychosexual development.

19. Developmental Stages • Psychosexual Stages • The childhood stages of development during which the id’s pleasure-seeking energies focus on distinct erogenous zones • Fixation is an unresolved conflict during a stage of development

20. Developmental Stages • Oral stage • Eating, sucking, biting, and other oral activities are the predominant sources of pleasure • If oral needs are frustrated, the child may fail to pass through the oral stage without becoming fixated on it (smoking or overeating may be seen as orally fixated)

21. Developmental Stages • Oral stage • Freud felt that the stronger an individual's fixation at a given psychosexual stage, the more behaviors typical of that stage would be shown at a later point and the more regression to that level would occur under stress.

22. Developmental Stages • Anal stage • Freud saw the anus and the stimuli associated with eliminating and withholding feces as the important sources of pleasure at that point.

23. Developmental Stages • Anal stage • Anal fixation is thought to result from overly strict or overly permissive practices in this area. • Adults who are highly organized, and over concerned with cleanliness, or who are disorganized, and especially generous with money might be seen as fixated at the anal stage.

24. Developmental Stages • Phallic stage • The genitals become the primary source of pleasure. • Freud believed that successfully resolving conflicts in the phallic stage was crucial to healthy psychological development • Fixation at the phallic stage is responsible for many adult interpersonal behaviors, including rebellion, aggression, and problematic sexual practices such as exhibitionism and fetishism

25. Developmental Stages • latency period • Id impulses recede and the reality- principle becomes a stronger force in the child's life, allowing the child to focus on developing social and academic skills • The latency period extends until adolescence, when the individual's physical maturity guides in the genital period.

26. Developmental Stages • Genital stage • lasts throughout the adult years- pleasure is again focused on the genital area, but if all has gone well in earlier stages, sexual interest is directed not just toward the self-satisfaction characteristic of the phallic period, but toward establishment of a stable, long-term relationship in which the needs of another are valued and considered.

27. Freudian Stages Birth to 1 y 1 to 3 y 3-6 y 7-11 y 12-18 y Oral Stage Infant’s pleasure centers on mouth Anal Stage Child’s pleasure focuses on anus Phallic Stage Child’s pleasure focuses on genitals Latency Stage Child represses sexual interest and develops social and intellectual skills Genital Stage A time of sexual reawakening; source of sexual pleasure becomes someone outside of the family

28. Other Psychodynamic Approaches • The variations were stimulated by several factors including (a) dissatisfaction with the central role Freud gave to unconscious instincts in motivation (b) increased recognition of the influence of social and cultural variables on human behavior

29. Other Psychodynamic Approaches (c) recognition of the role of conscious aspects of personality (d) belief that personality development does not end in childhood

30. Other Psychodynamic Approaches • An important revision of psychoanalysis was presented by Erik H. Erikson, who emphasized social factors in human development. • Erikson outlined a sequence of eight psychosocial stages that is oriented toward people social, rather than intrapsychic activities. • A social crisis is either successfully handled or left partly unresolved at each stage.

31. Erik Erikson (1902-1994) - Identity - Adult stages of development Emphasized our social interaction with other people: * Society and culture both shape and challenge people. * His stage covered the entire life-span (8 stages) * Each stage represents a crisis that must be resolved

32. Erickson’s Epigenetic Theory: Non-genetic causes of a phenotype. Stage 1-Basic Trust vs. Mistrust Stage 2-Autonomy vs. Shame and Doubt Stage 3-Initiative vs. Guilt Stage 4-Industry vs. Inferiority Stage 5-Identity vs. Role Confusion (or "Diffusion") Stage 6-Intimacy vs. Isolation Stage 7-Generativity vs. Stagnation Stage 8-Ego Integrity vs. Despair

33. Erikson's Eight Stages or Crises and Associated Emerging Traits

34. Behavioral Approach

35. Assumptions of Behaviorism • All species of animals learn in similar (equal) ways with the same guiding principles • To understand learning processes, focus on stimulus and responses • Internal process should be excluded from the study of learning.

36. Assumptions of Behaviorism (cont.) • Learning is evidenced by a behavioral changes • Organisms are blank slates at birth • Learning is a result of environmental events

37. Classical Conditioning • Unconditioned Stimulus (stimulus that naturally produces a desired response; food) • Unconditioned Response (response naturally occurring in the presence of the US; salivation) • Conditioned Stimulus (neutral stimulus paired with the US; bell) • Conditioned Response (response occurring in the presence of the CS)

38. Classical Conditioning US UR US + CS UR CS CR • Response may generalize to other stimuli similar to the CS.

39. Operant Conditioning • Positive and Negative Reinforcement • Positive and Negative Punishment • In general, reinforcement may be continuous (or fixed) or partial (or intermittent)

40. Reinforcement • Positive reinforcer: “Rewards” or something desirable is received after a behavior occurs • Negative reinforcer: “Escapes” or something undesirable is avoided after a behavior occurs

41. Punishment • Presentation punishment: An undesirable stimulus is received after a behavior occurs • Removal punishment: A desirable stimulus is lost or removed after a behavior occurs

42. Humanistic Approach

43. Carl Rogers 1902-1987 • Taught at University of Chicago • Taught at the University of Wisconsin • Believes that a fully adjusted person can symbolize any experience in the conscious verbalization.

44. - Carl Rogers believes we are born with no self-concept, but we do have an innate urge to become fully functioning and actualized people. - At birth we have a confusing set of sensory impressions, physiological processes, and motor activities.

45. Rogers calls this sum total of our experiences the phenomenal field. • As we mature the outside world imposes a kind of order or logic into this field. • And, as we become aware to this logic, our self emerges and differentiates itself from the phenomenal field. • The self is thus the conscious portion of experience.

46. Abraham Maslow • 1908-1970 • Attended University of Wisconsin • Taught at Brooklyn College • 1951 served as the chair of the psychology dept.

47. Abraham Maslow (1954) attempted to synthesize a large body of research related to human motivation. • Maslow posited a hierarchy of human needs based on two groupings: deficiency needs and growth needs. • Within the deficiency needs, each lower need must be met before moving to the next higher level.

48. According to Maslow, an individual is ready to act upon the growth needs if and only if the deficiency needs are met. • Maslow's initial conceptualization included only one growth need-self-actualization. • Self-actualized people are characterized by: 1) being problem-focused; 2) incorporating an ongoing freshness of appreciation of life; 3) a concern about personal growth; and 4) able to have peak experiences.

50. Criticisms of Humanistic Perspective • Concepts are vague and subjective. • Cannot define or objectively measure concepts • If self-actualization is a universal motive, why is it so hard to find such people? • Encourages the need for hope, but not equally realistic. • Does not take into account human capacity for evil