- •Preface
- •Approach and Pedagogy
- •Chapter 1
- •Introducing Psychology
- •1.1 Psychology as a Science
- •The Problem of Intuition
- •Research Focus: Unconscious Preferences for the Letters of Our Own Name
- •Why Psychologists Rely on Empirical Methods
- •Levels of Explanation in Psychology
- •The Challenges of Studying Psychology
- •1.2 The Evolution of Psychology: History, Approaches, and Questions
- •Early Psychologists
- •Structuralism: Introspection and the Awareness of Subjective Experience
- •Functionalism and Evolutionary Psychology
- •Psychodynamic Psychology
- •Behaviorism and the Question of Free Will
- •Research Focus: Do We Have Free Will?
- •The Cognitive Approach and Cognitive Neuroscience
- •The War of the Ghosts
- •Social-Cultural Psychology
- •The Many Disciplines of Psychology
- •Psychology in Everyday Life: How to Effectively Learn and Remember
- •1.3 Chapter Summary
- •Chapter 2
- •Psychological Science
- •Psychological Journals
- •2.1 Psychologists Use the Scientific Method to Guide Their Research
- •The Scientific Method
- •Laws and Theories as Organizing Principles
- •The Research Hypothesis
- •Conducting Ethical Research
- •Characteristics of an Ethical Research Project Using Human Participants
- •Ensuring That Research Is Ethical
- •Research With Animals
- •APA Guidelines on Humane Care and Use of Animals in Research
- •Descriptive Research: Assessing the Current State of Affairs
- •Correlational Research: Seeking Relationships Among Variables
- •Experimental Research: Understanding the Causes of Behavior
- •Research Focus: Video Games and Aggression
- •2.3 You Can Be an Informed Consumer of Psychological Research
- •Threats to the Validity of Research
- •Psychology in Everyday Life: Critically Evaluating the Validity of Websites
- •2.4 Chapter Summary
- •Chapter 3
- •Brains, Bodies, and Behavior
- •Did a Neurological Disorder Cause a Musician to Compose Boléro and an Artist to Paint It 66 Years Later?
- •3.1 The Neuron Is the Building Block of the Nervous System
- •Neurons Communicate Using Electricity and Chemicals
- •Video Clip: The Electrochemical Action of the Neuron
- •Neurotransmitters: The Body’s Chemical Messengers
- •3.2 Our Brains Control Our Thoughts, Feelings, and Behavior
- •The Old Brain: Wired for Survival
- •The Cerebral Cortex Creates Consciousness and Thinking
- •Functions of the Cortex
- •The Brain Is Flexible: Neuroplasticity
- •Research Focus: Identifying the Unique Functions of the Left and Right Hemispheres Using Split-Brain Patients
- •Psychology in Everyday Life: Why Are Some People Left-Handed?
- •3.3 Psychologists Study the Brain Using Many Different Methods
- •Lesions Provide a Picture of What Is Missing
- •Recording Electrical Activity in the Brain
- •Peeking Inside the Brain: Neuroimaging
- •Research Focus: Cyberostracism
- •3.4 Putting It All Together: The Nervous System and the Endocrine System
- •Electrical Control of Behavior: The Nervous System
- •The Body’s Chemicals Help Control Behavior: The Endocrine System
- •3.5 Chapter Summary
- •Chapter 4
- •Sensing and Perceiving
- •Misperception by Those Trained to Accurately Perceive a Threat
- •4.1 We Experience Our World Through Sensation
- •Sensory Thresholds: What Can We Experience?
- •Link
- •Measuring Sensation
- •Research Focus: Influence without Awareness
- •4.2 Seeing
- •The Sensing Eye and the Perceiving Visual Cortex
- •Perceiving Color
- •Perceiving Form
- •Perceiving Depth
- •Perceiving Motion
- •Beta Effect and Phi Phenomenon
- •4.3 Hearing
- •Hearing Loss
- •4.4 Tasting, Smelling, and Touching
- •Tasting
- •Smelling
- •Touching
- •Experiencing Pain
- •4.5 Accuracy and Inaccuracy in Perception
- •How the Perceptual System Interprets the Environment
- •Video Clip: The McGurk Effect
- •Video Clip: Selective Attention
- •Illusions
- •The Important Role of Expectations in Perception
- •Psychology in Everyday Life: How Understanding Sensation and Perception Can Save Lives
- •4.6 Chapter Summary
- •Chapter 5
- •States of Consciousness
- •An Unconscious Killing
- •5.1 Sleeping and Dreaming Revitalize Us for Action
- •Research Focus: Circadian Rhythms Influence the Use of Stereotypes in Social Judgments
- •Sleep Stages: Moving Through the Night
- •Sleep Disorders: Problems in Sleeping
- •The Heavy Costs of Not Sleeping
- •Dreams and Dreaming
- •5.2 Altering Consciousness With Psychoactive Drugs
- •Speeding Up the Brain With Stimulants: Caffeine, Nicotine, Cocaine, and Amphetamines
- •Slowing Down the Brain With Depressants: Alcohol, Barbiturates and Benzodiazepines, and Toxic Inhalants
- •Opioids: Opium, Morphine, Heroin, and Codeine
- •Hallucinogens: Cannabis, Mescaline, and LSD
- •Why We Use Psychoactive Drugs
- •Research Focus: Risk Tolerance Predicts Cigarette Use
- •5.3 Altering Consciousness Without Drugs
- •Changing Behavior Through Suggestion: The Power of Hypnosis
- •Reducing Sensation to Alter Consciousness: Sensory Deprivation
- •Meditation
- •Video Clip: Try Meditation
- •Psychology in Everyday Life: The Need to Escape Everyday Consciousness
- •5.4 Chapter Summary
- •Chapter 6
- •Growing and Developing
- •The Repository for Germinal Choice
- •6.1 Conception and Prenatal Development
- •The Zygote
- •The Embryo
- •The Fetus
- •How the Environment Can Affect the Vulnerable Fetus
- •6.2 Infancy and Childhood: Exploring and Learning
- •The Newborn Arrives With Many Behaviors Intact
- •Research Focus: Using the Habituation Technique to Study What Infants Know
- •Cognitive Development During Childhood
- •Video Clip: Object Permanence
- •Social Development During Childhood
- •Knowing the Self: The Development of the Self-Concept
- •Video Clip: The Harlows’ Monkeys
- •Video Clip: The Strange Situation
- •Research Focus: Using a Longitudinal Research Design to Assess the Stability of Attachment
- •6.3 Adolescence: Developing Independence and Identity
- •Physical Changes in Adolescence
- •Cognitive Development in Adolescence
- •Social Development in Adolescence
- •Developing Moral Reasoning: Kohlberg’s Theory
- •Video Clip: People Being Interviewed About Kohlberg’s Stages
- •6.4 Early and Middle Adulthood: Building Effective Lives
- •Psychology in Everyday Life: What Makes a Good Parent?
- •Physical and Cognitive Changes in Early and Middle Adulthood
- •Menopause
- •Social Changes in Early and Middle Adulthood
- •6.5 Late Adulthood: Aging, Retiring, and Bereavement
- •Cognitive Changes During Aging
- •Dementia and Alzheimer’s Disease
- •Social Changes During Aging: Retiring Effectively
- •Death, Dying, and Bereavement
- •6.6 Chapter Summary
- •Chapter 7
- •Learning
- •My Story of Posttraumatic Stress Disorder
- •7.1 Learning by Association: Classical Conditioning
- •Pavlov Demonstrates Conditioning in Dogs
- •The Persistence and Extinction of Conditioning
- •The Role of Nature in Classical Conditioning
- •How Reinforcement and Punishment Influence Behavior: The Research of Thorndike and Skinner
- •Video Clip: Thorndike’s Puzzle Box
- •Creating Complex Behaviors Through Operant Conditioning
- •7.3 Learning by Insight and Observation
- •Observational Learning: Learning by Watching
- •Video Clip: Bandura Discussing Clips From His Modeling Studies
- •Research Focus: The Effects of Violent Video Games on Aggression
- •7.4 Using the Principles of Learning to Understand Everyday Behavior
- •Using Classical Conditioning in Advertising
- •Video Clip: Television Ads
- •Psychology in Everyday Life: Operant Conditioning in the Classroom
- •Reinforcement in Social Dilemmas
- •7.5 Chapter Summary
- •Chapter 8
- •Remembering and Judging
- •She Was Certain, but She Was Wrong
- •Differences between Brains and Computers
- •Video Clip: Kim Peek
- •8.1 Memories as Types and Stages
- •Explicit Memory
- •Implicit Memory
- •Research Focus: Priming Outside Awareness Influences Behavior
- •Stages of Memory: Sensory, Short-Term, and Long-Term Memory
- •Sensory Memory
- •Short-Term Memory
- •8.2 How We Remember: Cues to Improving Memory
- •Encoding and Storage: How Our Perceptions Become Memories
- •Research Focus: Elaboration and Memory
- •Using the Contributions of Hermann Ebbinghaus to Improve Your Memory
- •Retrieval
- •Retrieval Demonstration
- •States and Capital Cities
- •The Structure of LTM: Categories, Prototypes, and Schemas
- •The Biology of Memory
- •8.3 Accuracy and Inaccuracy in Memory and Cognition
- •Source Monitoring: Did It Really Happen?
- •Schematic Processing: Distortions Based on Expectations
- •Misinformation Effects: How Information That Comes Later Can Distort Memory
- •Overconfidence
- •Heuristic Processing: Availability and Representativeness
- •Salience and Cognitive Accessibility
- •Counterfactual Thinking
- •Psychology in Everyday Life: Cognitive Biases in the Real World
- •8.4 Chapter Summary
- •Chapter 9
- •Intelligence and Language
- •How We Talk (or Do Not Talk) about Intelligence
- •9.1 Defining and Measuring Intelligence
- •General (g) Versus Specific (s) Intelligences
- •Measuring Intelligence: Standardization and the Intelligence Quotient
- •The Biology of Intelligence
- •Is Intelligence Nature or Nurture?
- •Psychology in Everyday Life: Emotional Intelligence
- •9.2 The Social, Cultural, and Political Aspects of Intelligence
- •Extremes of Intelligence: Retardation and Giftedness
- •Extremely Low Intelligence
- •Extremely High Intelligence
- •Sex Differences in Intelligence
- •Racial Differences in Intelligence
- •Research Focus: Stereotype Threat
- •9.3 Communicating With Others: The Development and Use of Language
- •The Components of Language
- •Examples in Which Syntax Is Correct but the Interpretation Can Be Ambiguous
- •The Biology and Development of Language
- •Research Focus: When Can We Best Learn Language? Testing the Critical Period Hypothesis
- •Learning Language
- •How Children Learn Language: Theories of Language Acquisition
- •Bilingualism and Cognitive Development
- •Can Animals Learn Language?
- •Video Clip: Language Recognition in Bonobos
- •Language and Perception
- •9.4 Chapter Summary
- •Chapter 10
- •Emotions and Motivations
- •Captain Sullenberger Conquers His Emotions
- •10.1 The Experience of Emotion
- •Video Clip: The Basic Emotions
- •The Cannon-Bard and James-Lange Theories of Emotion
- •Research Focus: Misattributing Arousal
- •Communicating Emotion
- •10.2 Stress: The Unseen Killer
- •The Negative Effects of Stress
- •Stressors in Our Everyday Lives
- •Responses to Stress
- •Managing Stress
- •Emotion Regulation
- •Research Focus: Emotion Regulation Takes Effort
- •10.3 Positive Emotions: The Power of Happiness
- •Finding Happiness Through Our Connections With Others
- •What Makes Us Happy?
- •10.4 Two Fundamental Human Motivations: Eating and Mating
- •Eating: Healthy Choices Make Healthy Lives
- •Obesity
- •Sex: The Most Important Human Behavior
- •The Experience of Sex
- •The Many Varieties of Sexual Behavior
- •Psychology in Everyday Life: Regulating Emotions to Improve Our Health
- •10.5 Chapter Summary
- •Chapter 11
- •Personality
- •Identical Twins Reunited after 35 Years
- •11.1 Personality and Behavior: Approaches and Measurement
- •Personality as Traits
- •Example of a Trait Measure
- •Situational Influences on Personality
- •The MMPI and Projective Tests
- •Psychology in Everyday Life: Leaders and Leadership
- •11.2 The Origins of Personality
- •Psychodynamic Theories of Personality: The Role of the Unconscious
- •Id, Ego, and Superego
- •Research Focus: How the Fear of Death Causes Aggressive Behavior
- •Strengths and Limitations of Freudian and Neo-Freudian Approaches
- •Focusing on the Self: Humanism and Self-Actualization
- •Research Focus: Self-Discrepancies, Anxiety, and Depression
- •Studying Personality Using Behavioral Genetics
- •Studying Personality Using Molecular Genetics
- •Reviewing the Literature: Is Our Genetics Our Destiny?
- •11.4 Chapter Summary
- •Chapter 12
- •Defining Psychological Disorders
- •When Minor Body Imperfections Lead to Suicide
- •12.1 Psychological Disorder: What Makes a Behavior “Abnormal”?
- •Defining Disorder
- •Psychology in Everyday Life: Combating the Stigma of Abnormal Behavior
- •Diagnosing Disorder: The DSM
- •Diagnosis or Overdiagnosis? ADHD, Autistic Disorder, and Asperger’s Disorder
- •Attention-Deficit/Hyperactivity Disorder (ADHD)
- •Autistic Disorder and Asperger’s Disorder
- •12.2 Anxiety and Dissociative Disorders: Fearing the World Around Us
- •Generalized Anxiety Disorder
- •Panic Disorder
- •Phobias
- •Obsessive-Compulsive Disorders
- •Posttraumatic Stress Disorder (PTSD)
- •Dissociative Disorders: Losing the Self to Avoid Anxiety
- •Dissociative Amnesia and Fugue
- •Dissociative Identity Disorder
- •Explaining Anxiety and Dissociation Disorders
- •12.3 Mood Disorders: Emotions as Illness
- •Behaviors Associated with Depression
- •Dysthymia and Major Depressive Disorder
- •Bipolar Disorder
- •Explaining Mood Disorders
- •Research Focus: Using Molecular Genetics to Unravel the Causes of Depression
- •12.4 Schizophrenia: The Edge of Reality and Consciousness
- •Symptoms of Schizophrenia
- •Explaining Schizophrenia
- •12.5 Personality Disorders
- •Borderline Personality Disorder
- •Research Focus: Affective and Cognitive Deficits in BPD
- •Antisocial Personality Disorder (APD)
- •12.6 Somatoform, Factitious, and Sexual Disorders
- •Somatoform and Factitious Disorders
- •Sexual Disorders
- •Disorders of Sexual Function
- •Paraphilias
- •12.7 Chapter Summary
- •Chapter 13
- •Treating Psychological Disorders
- •Therapy on Four Legs
- •13.1 Reducing Disorder by Confronting It: Psychotherapy
- •DSM-IV-TR Criteria for Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD)
- •Psychology in Everyday Life: Seeking Treatment for Psychological Difficulties
- •Psychodynamic Therapy
- •Important Characteristics and Experiences in Psychoanalysis
- •Humanistic Therapies
- •Behavioral Aspects of CBT
- •Cognitive Aspects of CBT
- •Combination (Eclectic) Approaches to Therapy
- •13.2 Reducing Disorder Biologically: Drug and Brain Therapy
- •Drug Therapies
- •Using Stimulants to Treat ADHD
- •Antidepressant Medications
- •Antianxiety Medications
- •Antipsychotic Medications
- •Direct Brain Intervention Therapies
- •13.3 Reducing Disorder by Changing the Social Situation
- •Group, Couples, and Family Therapy
- •Self-Help Groups
- •Community Mental Health: Service and Prevention
- •Some Risk Factors for Psychological Disorders
- •Research Focus: The Implicit Association Test as a Behavioral Marker for Suicide
- •13.4 Evaluating Treatment and Prevention: What Works?
- •Effectiveness of Psychological Therapy
- •Research Focus: Meta-Analyzing Clinical Outcomes
- •Effectiveness of Biomedical Therapies
- •Effectiveness of Social-Community Approaches
- •13.5 Chapter Summary
- •Chapter 14
- •Psychology in Our Social Lives
- •Binge Drinking and the Death of a Homecoming Queen
- •14.1 Social Cognition: Making Sense of Ourselvesand Others
- •Perceiving Others
- •Forming Judgments on the Basis of Appearance: Stereotyping, Prejudice, and Discrimination
- •Implicit Association Test
- •Research Focus: Forming Judgments of People in Seconds
- •Close Relationships
- •Causal Attribution: Forming Judgments by Observing Behavior
- •Attitudes and Behavior
- •14.2 Interacting With Others: Helping, Hurting, and Conforming
- •Helping Others: Altruism Helps Create Harmonious Relationships
- •Why Are We Altruistic?
- •How the Presence of Others Can Reduce Helping
- •Video Clip: The Case of Kitty Genovese
- •Human Aggression: An Adaptive yet Potentially Damaging Behavior
- •The Ability to Aggress Is Part of Human Nature
- •Negative Experiences Increase Aggression
- •Viewing Violent Media Increases Aggression
- •Video Clip
- •Research Focus: The Culture of Honor
- •Conformity and Obedience: How Social Influence Creates Social Norms
- •Video Clip
- •Do We Always Conform?
- •14.3 Working With Others: The Costs and Benefits of Social Groups
- •Working in Front of Others: Social Facilitation and Social Inhibition
- •Working Together in Groups
- •Psychology in Everyday Life: Do Juries Make Good Decisions?
- •Using Groups Effectively
- •14.4 Chapter Summary
Important Characteristics and Experiences in Psychoanalysis
•Free association. The therapist listens while the client talks about whatever comes to mind, without any censorship or filtering. The therapist then tries to interpret these free associations, looking for unconscious causes of symptoms.
•Dream analysis. The therapist listens while the client describes his or her dreams and then analyzes the symbolism of the dreams in an effort to probe the unconscious thoughts of the client and interpret their significance.
•Insight. An understanding by the patient of the unconscious causes of his or her symptoms.
•Interpretation. The therapist uses the patient’s expressed thoughts to try to understand the underlying unconscious problems. The analyst may try out some interpretations on the patient and observe how he or she responds to them.
•Resistance. The patient’s use of defense mechanisms to avoid the painful feelings in his or her unconscious. The patient might forget or miss appointments, or act out with hostile feelings toward the therapist. The therapist attempts to help the patient develop insight into the causes of the resistance.
•Transference. The unconscious redirection of the feelings experienced in an important personal relationship toward the therapist. For instance, the patient may transfer feelings of guilt that come from the father or mother to the therapist.
One problem with traditional psychoanalysis is that the sessions may take place several times a week, go on for many years, and cost thousands of dollars. To help more people benefit, modern psychodynamic approaches frequently use shorter-term, focused, and goal-oriented approaches. In these “brief psychodynamic therapies,” the therapist helps the client determine the important issues to be discussed at the beginning of treatment and usually takes a more active role than in classic psychoanalysis (Levenson, 2010). [5]
Humanistic Therapies
Just as psychoanalysis is based on the personality theories of Freud and the neo-
Freudians, humanistic therapy is a psychological treatment based on the personality theories of Carl Rogers and other humanistic psychologists. Humanistic therapy is based on the idea that people develop psychological problems when they are burdened by limits and expectations
Saylor URL: http://www.saylor.org/books |
Saylor.org |
|
675 |
placed on them by themselves and others, and the treatment emphasizes the person’s capacity for self-realization and fulfillment. Humanistic therapies attempt to promote growth and responsibility by helping clients consider their own situations and the world around them and how they can work to achieve their life goals.
Carl Rogers developed person-centered therapy (or client-centered therapy), an approach to treatment in which the client is helped to grow and develop as the therapist provides a comfortable, nonjudgmental environment. In his book, A Way of Being (1980), [6] Rogers argued that therapy was most productive when the therapist created a positive relationship with the client—a therapeutic alliance. The therapeutic alliance is a relationship between the client and the therapist that is facilitated when the therapist is genuine (i.e., he or she creates no barriers to free-flowing thoughts and feelings), when the therapist treats the client with unconditional positive regard (i.e., values the client without any qualifications, displaying an accepting attitude toward whatever the client is feeling at the moment), and when the therapist
develops empathy with the client (i.e., that he or she actively listens to and accurately perceives the personal feelings that the client experiences).
The development of a positive therapeutic alliance has been found to be exceedingly important to successful therapy. The ideas of genuineness, empathy, and unconditional positive regard in a nurturing relationship in which the therapist actively listens to and reflects the feelings of the client is probably the most fundamental part of contemporary psychotherapy (Prochaska & Norcross, 2007). [7]
Psychodynamic and humanistic therapies are recommended primarily for people suffering from generalized anxiety or mood disorders, and who desire to feel better about themselves overall. But the goals of people with other psychological disorders, such as phobias, sexual problems, and obsessive-compulsive disorder (OCD), are more specific. A person with a social phobia may want to be able to leave his or her house, a person with a sexual dysfunction may want to improve his or her sex life, and a person with OCD may want to learn to stop letting his obsessions or compulsions interfere with everyday activities. In these cases it is not necessary to revisit childhood experiences or consider our capacities for self-realization—we simply want to deal with what is happening in the present.
Saylor URL: http://www.saylor.org/books |
Saylor.org |
|
676 |
Cognitive-behavior therapy (CBT) is a structured approach to treatment that attempts to reduce psychological disorders through systematic procedures based on cognitive and behavioral principles. As you can see inFigure 13.4 "Cognitive-Behavior Therapy", CBT is based on the idea that there is a recursive link among our thoughts, our feelings, and our behavior. For instance, if we are feeling depressed, our negative thoughts (“I am doing poorly in my chemistry class”) lead to negative feelings (“I feel hopeless and sad”), which then contribute to negative behaviors (lethargy, disinterest, lack of studying). When we or other people look at the negative behavior, the negative thoughts are reinforced and the cycle repeats itself (Beck,
1976). [8] Similarly, in panic disorder a patient may misinterpret his or her feelings of anxiety as a sign of an impending physical or mental catastrophe (such as a heart attack), leading to an avoidance of a particular place or social situation. The fact that the patient is avoiding the situation reinforces the negative thoughts. Again, the thoughts, feelings, and behavior amplify and distort each other.
Figure 13.4 Cognitive-Behavior Therapy
Cognitive-behavior therapy (CBT) is based on the idea that our thoughts, feelings, and behavior reinforce each other and that changing our thoughts or behavior can make us feel better.
Saylor URL: http://www.saylor.org/books |
Saylor.org |
|
677 |
CBT is a very broad approach that is used for the treatment of a variety of problems, including mood, anxiety, personality, eating, substance abuse, attention-deficit, and psychotic disorders. CBT treats the symptoms of the disorder (the behaviors or the cognitions) and does not attempt to address the underlying issues that cause the problem. The goal is simply to stop the negative cycle by intervening to change cognition or behavior. The client and the therapist work together to develop the goals of the therapy, the particular ways that the goals will be reached, and the timeline for reaching them. The procedures are problem-solving and action-oriented, and the client is forced to take responsibility for his or her own treatment. The client is assigned tasks to complete that will help improve the disorder and takes an active part in the therapy. The treatment usually lasts between 10 and 20 sessions.
Depending on the particular disorder, some CBT treatments may be primarily behavioral in orientation, focusing on the principles of classical, operant, and observational learning, whereas other treatments are more cognitive, focused on changing negative thoughts related to the disorder. But almost all CBT treatments use a combination of behavioral and cognitive approaches.
Behavioral Aspects of CBT
In some cases the primary changes that need to be made are
behavioral.Behavioral therapy is psychological treatment that is based on principles of learning. The most direct approach is through operant conditioning using reward or punishment. Reinforcement may be used to teach new skills to people, for instance, those with autism or schizophrenia (Granholm et al., 2008; Herbert et al., 2005; Scattone, 2007). [9] If the patient has trouble dressing or grooming, then reinforcement techniques, such as providing tokens that can be exchanged for snacks, are used to reinforce appropriate behaviors such as putting on one’s clothes in the morning or taking a shower at night. If the patient has trouble interacting with others, reinforcement will be used to teach the client how to more appropriately respond in public, for instance, by maintaining eye contact, smiling when appropriate, and modulating tone of voice.
Saylor URL: http://www.saylor.org/books |
Saylor.org |
|
678 |
As the patient practices the different techniques, the appropriate behaviors are shaped through reinforcement to allow the client to manage more complex social situations. In some cases observational learning may also be used; the client may be asked to observe the behavior of others who are more socially skilled to acquire appropriate behaviors. People who learn to improve their interpersonal skills through skills training may be more accepted by others and this social support may have substantial positive effects on their emotions.
When the disorder is anxiety or phobia, then the goal of the CBT is to reduce the negative affective responses to the feared stimulus. Exposure therapy is a behavioral therapy based on the classical conditioning principle of extinction, in which people are confronted with a feared stimulus with the goal of decreasing their negative emotional responses to it (Wolpe,
1973). [10]Exposure treatment can be carried out in real situations or through imagination, and it is used in the treatment of panic disorder, agoraphobia, social phobia, OCD, and posttraumatic stress disorder (PTSD).
In flooding, a client is exposed to the source of his fear all at once. An agoraphobic might be taken to a crowded shopping mall or someone with an extreme fear of heights to the top of a tall building. The assumption is that the fear will subside as the client habituates to the situation while receiving emotional support from the therapist during the stressful experience. An advantage of the flooding technique is that it is quick and often effective, but a disadvantage is that the patient may relapse after a short period of time.
More frequently, the exposure is done more gradually.Systematic desensitization is a behavioral treatment that combines imagining or experiencing the feared object or situation with relaxation exercises (Wolpe, 1973). [11] The client and the therapist work together to prepare a hierarchy of fears, starting with the least frightening, and moving to the most frightening scenario surrounding the object (Table 13.1 "Hierarchy of Fears Used in Systematic Desensitization"). The patient then confronts her fears in a systematic manner, sometimes using her imagination but usually, when possible, in real life.
Saylor URL: http://www.saylor.org/books |
Saylor.org |
|
679 |
Table 13.1 Hierarchy of Fears Used in Systematic Desensitization
Behavior |
Fear rating |
|
|
|
|
Think about a spider. |
10 |
|
|
|
|
Look at a photo of a spider. |
25 |
|
|
|
|
Look at a real spider in a closed box. |
50 |
|
|
|
|
Hold the box with the spider. |
60 |
|
|
|
|
Let a spider crawl on your desk. |
70 |
|
|
|
|
Let a spider crawl on your shoe. |
80 |
|
|
|
|
Let a spider crawl on your pants leg. |
90 |
|
|
|
|
Let a spider crawl on your sleeve. |
95 |
|
|
|
|
Let a spider crawl on your bare arm. |
100 |
|
|
|
Desensitization techniques use the principle of counterconditioning, in which a second incompatible response (relaxation, e.g., through deep breathing) is conditioned to an already conditioned response (the fear response). The continued pairing of the relaxation responses with the feared stimulus as the patient works up the hierarchy gradually leads the fear response to be extinguished and the relaxation response to take its place.
Behavioral therapy works best when people directly experience the feared object. Fears of spiders are more directly habituated when the patient interacts with a real spider, and fears of flying are best extinguished when the patient gets on a real plane. But it is often difficult and expensive to create these experiences for the patient. Recent advances in virtual reality have allowed clinicians to provide CBT in what seem like real situations to the patient. In virtual reality CBT, the therapist uses computer-generated, three-dimensional, lifelike images of the feared stimulus in a systematic desensitization program. Specially designed computer equipment, often with a head-mount display, is used to create a simulated environment. A common use is in helping soldiers who are experiencing PTSD return to the scene of the trauma and learn how to cope with the stress it invokes.
Saylor URL: http://www.saylor.org/books |
Saylor.org |
|
680 |