Psychoanalytic Psychotherapy: In its purest form, two types of problems bring an individual to a psychologist's office: Problems emerging from a patient's past life (the patient's developmental trauma and experiences) and problems which appear to arise from current internal and external stressors. It is rarely, if ever, that this separation of problems is that pure. In reality, current problems are superimposed on old and chronic problems which the patient has carried for an extended period. The skilled doctor is able to see the impact of the past upon the response to present stressors. An initial means of conceiving of psychotherapy is understanding that it is a means of creating a professional atmosphere in which old feelings and fantasies can be brought to the surface so that they may be studied, understood and resolved.

Psychotherapist believe that the unconscious motives along with unresolved conflicts lead to maladapted behavior. They believe that to develop a normal personality, a person successful go through five psychosexual stages:

• Oral - Birth to 1 year: Sucking.
• Anal - 1 to 3 years: Holding and releasing urine and feces.
• Phallic - 3 to 6 years: Pleasure in genital stimulation.
• Latency - 6 to 11 years: Sexual instincts develop.
• Genital - Adolescence: Sexual impulses return.

Inadequate resolution of any of these stages lead to flawed personality development.

Behavior therapy is a combination of the systematic application of principles of learning theory to to the analysis and treatment of behavior. It involves more than principles of learning and conditioning, however, and uses the empirical findings of social and experimental psychology. The emphasis is placed upon the observable and confrontable and not inferred mental states or constructs. The doctors seeks to relate problematic behaviors (symptoms) to other observable physiological and environmental events. This involves behavioral analysis of what is occurring (and has occurred) and means of altering the behavior.

The early development of behavior therapies occurred in the 1960s and 1970s and at that time, this mode of psychological care was defined as the systematic application of learning theory to the analysis and treatment of behavioral disorders. This is too narrow of a definition and today, behavior therapy draws not only upon principles of learning theory and conditioning but upon empirical findings from experimental and social psychology. The doctor relates that patients and their disorders to to observable events from physiological or environmental factors rather than inferring that they arise as a result of unseen/unrecognized/unconscious conflicts or trauma. Behavioral analysis, noting the events which lead to motor or verbal behaviors, is used to assist the patient in understanding cause-effect relationships and means of disrupting/discontinuing the maladaptive or counterproductive behaviors. Behavior Therapies have a wide range of application in phobic, maladaptive habit, and compulsive behaviors.

In systematic desensitization, the patient can overcome maladaptive anticipatory anxiety that is evoked by situations or objects by approaching the feared situations gradually and in a psychophysiologic state that inhibits the experience of anxiety. A variety of deep muscle relaxation procedures induces a psychophysiological state that counter-conditions the anxiety response. A graded list or hierarchy of anxiety-provoking scenes which are associated with the patient fears is prepared. The patient then approaches the de-conditioning of anxiety by beginning, in fantasy (mental imagery), with the least anxiety provoking scene and progressing up the hierarchy. The clinical goal is for the patient to be able to vividly imagine the previously most anxiety-evoking scene with equanimity. This capacity translates to real life situations but is most successful when real life situations are also used during the course of resolving each scene in the hierarchy.

Clinical Hypnosis is an attentive, receptive, focal concentration while the individual has a concurrent awareness but a constriction of peripheral events. It is very similar to visual focus and peripheral vision. Those items in the center are sharp, detailed and colorful while those in the periphery are less noticeable. It is very similar to being so absorbed in that which a person is reading that they enter the world of the book and often fail to note things occurring around them. There are psychological, sensory, and motor/behavioral changes during hypnosis. The individual may have the ability to alter perceptions, dissociate from events and have amnesia for part of the hypnotic experience. The patient has the tendency to comply with the doctor, but this suggestibility and willingness has limitations. EEG (electroencephalographic) studies suggest that the brain is experiencing resting arousal and that they are not asleep. Unfortunately, clinical hypnosis as performed by your doctor can become confused with mythology and stage performers who use similar approaches to entertain an audience.

continue: Group Psychotherapy, DBT, EMDR, Marriage and Sexual Therapy

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Reviewed: 04/2006