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psychotherapy,treatment of mental and emotional disorders using psychological methods. Psychotherapy, thus, does not include physiological interventions, such as drug therapy or electroconvulsive therapyelectroconvulsive therapy
in psychiatry, treatment of mood disorders by means of electricity; the broader term "shock therapy" also includes the use of chemical agents. The therapeutic possibilities of these treatments were discovered in the 1930s by Manfred Sakel, a Polish
..... Click the link for more information. , although it may be used in combination with such methods. This type of treatment has been used in one form or another through the ages in many societies, but it was not until the late 19th cent. that it received scientific impetus, primarily under the leadership of Sigmund FreudFreud, Sigmund
, 1856–1939, Austrian psychiatrist, founder of psychoanalysis. Born in Moravia, he lived most of his life in Vienna, receiving his medical degree from the Univ. of Vienna in 1881.
His medical career began with an apprenticeship (1885–86) under J.
..... Click the link for more information. . Although Freud's theoretical formulations have come sharply into question, his treatment method involving individualized client-psychologist sessions has been used in modified forms for years (see psychoanalysispsychoanalysis,
name given by Sigmund Freud to a system of interpretation and therapeutic treatment of psychological disorders. Psychoanalysis began after Freud studied (1885–86) with the French neurologist J. M.
..... Click the link for more information. ).
Behavior therapy aims to help the patient eliminate undesirable habits or irrational fears through conditioning. Techniques include systematic desensitization, particularly for the treatment of clients with irrational anxieties or fears, and aversive conditioning, which uses negative stimuli to end bad habits. Humanistic therapy tends to be more optimistic, basing its treatment on the theory that individuals have a natural inclination to strive toward self-fulfillment. Therapists such as Carl RogersRogers, Carl,
1902–87, American psychologist, b. Oak Park, Ill. In 1930, Rogers served as director of the Society for the Prevention of Cruelty to Children in Rochester, New York. He lectured at the Univ. of Rochester (1935–40), Ohio State Univ.
..... Click the link for more information. and Abraham MaslowMaslow, Abraham Harold
, 1908–70, American psychologist, b. Brooklyn, New York, Ph.D. Univ. of Wisconsin (1934). He taught at Brooklyn College from 1937, then became head of the psychology department at Brandeis Univ. (1951–69).
..... Click the link for more information. used a highly interactive client-therapist relationship, compelling clients to realize exactly what they are saying or how they are behaving, in order to foster a sense of self-awareness. Cognitive therapies try to show the client that certain, usually negative, thoughts are irrational, with the goal of restructuring such thoughts into positive, constructive ideas. Such methods include Albert Ellis's rational-emotive therapy, where the therapist argues with the client about his negative ideas; and Aaron Beck's cognitive restructuring therapy, in which the therapist works with the client to set attainable goals. Other forms of therapy stress helping patients to examine their own ideas about themselves.
Psychotherapy may be brief, lasting just a few sessions, or it may extend over many years. More than one client may be involved, as in marriage or family counseling, or a number of individuals, as in group psychotherapygroup psychotherapy,
a means of changing behavior and emotional patterns, based on the premise that much of human behavior and feeling involves the individual's adaptation and response to other people.
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See S. L. Garfield and A. E. Bergin, ed., Handbook of Psychotherapy and Behavior Change (4th ed. 1993); A. Roth et al., What Works for Whom?: A Critical Review of Psychotherapy Research (1996); W. Gaylin, Talk Is Not Enough: How Psychotherapy Really Works (2000).
Any treatment or therapy that is primarily psychological in nature. In recent years, counseling also has been included in this categorization.
Historically, psychoanalysis—created by Sigmund Freud—has played an important role in the growth and development of psychotherapy. Central to Freud's theories was the importance of unconscious conflicts in producing the symptoms and defenses of the patient. The goal of therapy is to help the patient attain insight into the repressed conflicts which are the source of difficulty. Since patients resist these attempts bring to consciousness the painful repressed material, therapy must proceed slowly. Consequently, psychoanalysis is a long-term therapy requiring several years for completion and almost daily visits. Since Freud's time, there have been important modifications associated with former disciples such as Alfred Adler and Carl Jung. Self psychology and ego psychology are among more recent emphases. However, the popularity of psychoanalysis has waned. See Psychoanalysis
A number of related therapies are included in this group. Probably best known was the patient-centered therapy of Carl Rogers appearing in the 1940s. In Rogers' therapy, a major emphasis is placed on the ability of the patient to change when the therapist is empathic and genuine and conveys nonpossessive warmth. The therapist is nondirective in the interaction with the patient and attempts to facilitate the growth potential of the patient. Other therapeutic approaches considered as experiential include Gestalt therapy, existential approaches, and transpersonal approaches. The facilitation of experiencing is emphasized as the basic therapeutic task, and the therapeutic relationship is viewed as a significant potentially curative factor.
Cognitive, behavioral, and interpersonal therapies
In behavioral therapies, therapists play a more directive role. The emphasis is on changing the patient's behavior, using positive reinforcement, and increasing self-efficacy. More recently, cognitive therapies such as those of A. T. Beck have tended to be combined with behavioral emphases. The cognitive-behavioral therapies have focused on changing dysfunctional attitudes into more realistic and positive ones and providing new information-processing skills. See Cognition
Most of the developments in interpersonal therapy have occurred in work with depressed patients. The goal of interpersonal therapy (a brief form of therapy) is centered on increasing the quality of the patient's interpersonal interactions. Emphasis is placed on enhancing the patient's ability to cope with stresses, improving interpersonal communications, increasing morale, and helping the patient deal with the effects of the depressive disorder. See Personality theory
Eclectic and integrative therapies
The largest number of psychotherapists consider themselves to be eclectics. They do not adhere strictly to one theoretical orientation or school but use any procedures that they believe will be helpful for the individual patient. Eclecticism has been linked with the development of a movement for integration in psychotherapy. The emphasis in this new development is on openness to the views of other approaches, a less doctrinaire approach to psychotherapy, and an attempt to integrate two or more different theoretical views or systems of psychotherapy.
Group, family, and marital therapy
Most psychotherapy is conducted on a one-to-one basis—one therapist for one patient—and the confidentiality of these sessions is extremely important. However, there are other instances where more than one patient is involved because of particular goals. These include marital, family, and group therapy. Outpatient groups have been used for smoking cessation, weight loss, binge eating, and similar problems as well as for what were traditionally viewed as psychoneurotic problems. Inpatient group therapy was frequently employed in mental hospital settings.
There has been research on the combined use of medication and psychotherapy. In general, where two highly successful treatments are combined in cases with depressive or anxiety disorders, there appears to be little gain in effectiveness. However, in several studies of hospitalized patients with schizophrenia where individual psychotherapy has been ineffective, a combination of psychotherapy and medication has produced better results than medication alone. See Affective disorders, Psychopharmacology, Schizophrenia
psychotherapythe clinical practice of healing the mind. Help for people with mental or psychological problems can come from many sources, from friends, family, voluntary workers, to counsellors, clinical psychologists, psychotherapists, psychiatrists. Psychotherapists are generally trained, often intensively and extensively trained, as Jungian or Freudian psychotherapists may be, but are not generally medically qualified. It is this that primarily distinguishes them from psychiatrists (see PSYCHIATRY). Psychotherapy aims to help the person in mental distress by a ‘talking cure’, examining past and present concerns and encouraging the person to understand themselves better. See also FREUD, JUNG, PSYCHOANALYSIS.
a system of psychological measures designed to treat a patient. The purpose of psychotherapy is to eliminate painful abnormalities and alter the patient’s attitude toward himself, his condition, and his environment.
The possibility of influencing the human mind was noted even in antiquity. Scientific psychotherapy developed in the 1840’s, with the work of the British physician J. Braid, who attributed the efficacy of psychological influences to the functional characteristics of man’s nervous system. Theoretical substantiation and practical development of special psychotherapeutic techniques are attributable to J.-M. Charcot, V. M. Bekhterev, and many others. The development of psychotherapy was to a certain extent influenced by psychoanalytic techniques, which emphasized the world of emotions and inner experiences and its role in the origin and development of disease. However, Freudianism—and earlier in the first half of the 19th century, the school of “psychics” who regarded mental disorders as the result of the “burden of sin”—adopted an irrational approach to the understanding of mental disorders. In the USSR, psychotherapy is based on the findings of medical psychology, research on the physiology of higher nervous activity, and clinical and experimental methods of study.
General and specific psychotherapy are distinguished. By general psychotherapy is meant the complex of psychological influences that strengthen a patient in his struggle against a particular disease. This encompasses relations between physician and patient, optimal psychological climate in a hospital or clinic (to prevent psychic traumatization and iatrogenic disease), and prevention or timely elimination of secondary neurotic developments that may be caused by the basic disease. General psychotherapy is an essential element of the healing process in all forms of disease. Specific psychotherapy is a method of treating patients with neuroses, psychopathies, and other borderline forms of neuropsychic disorders. It employs special means of exerting psychotherapeutic influences: rational (explanatory) psychotherapy, suggestion (sometimes under hypnosis), counter-attracting psychotherapy, autogenous training, and group psychotherapy, in combination with drug treatment and other modes of treatment. Psychotherapy requires positive emotional contact with the patient.
REFERENCESPlatonov, K. I. Slovo kakfiziologicheskii i lechebnyi faktor, 3rd ed. Moscow, 1962.
Rukovodstvo po psikhoterapii. Edited by V. E. Rozhnov. Moscow, 1974.
Langen, D. Psychotherapie, 2nd ed. Stuttgart, 1971.
V. E. ROZHNOV
Before Sigmund Freud‘s groundbreaking work in the late nineteenth and early twentieth centuries, mental illness was commonly believed to be primarily a physiological problem that, at least theoretically, could be dealt with through a variety of physical treatments (baths, bleedings, diets, and the like). One of the chief contributions of Freud and later psychotherapists—a contribution that is difficult to fully appreciate in a culture that accepts Freud’s basic discoveries as “obvious”—is the reconceptualization of mental illness as primarily a psychological problem. Shifting the locus of these disorders from the body to the mind, however, also makes the task of properly diagnosing, understanding, and treating mental disturbances more difficult.
Freud theorized that so-called civilized human beings were bedeviled by the conflict between the urges of their infantile, animal selves and the demands of society. Under normal circumstances, we can manage this inner conflict by repressing awareness of the socially unacceptable urges into the unconscious mind. In this view, mental disturbances occur when one’s inner conflicts overwhelm the usual coping mechanisms of the psyche. The great majority of contemporary psychotherapists agree with this basic picture, although they disagree with Freud’s assertion that all of these conflicts are ultimately sexual.
Freud also established the importance of dreams for understanding the psyche of the dreamer—particularly for uncovering the dreamer’s psychological problems. In Freud’s view, the purpose of dreams is to allow us to satisfy in fantasies the instinctual urges that society judges unacceptable. So that we do not awaken as a result of the strong emotions that would be evoked if we were to dream about the literal fulfillment of such desires, the dreaming mind transforms dream content so as to disguise its true meaning. Hence, the purpose of Freudian dream interpretation, which is a significant part of traditional Freudian therapy, is to penetrate this disguise.
Other kinds of psychotherapy derived from the larger tradition of depth psychology have also approached dreams as messages from the unconscious mind that have been shaped by the dreamer’s psychological state. In each of these schools of thought, dreams are regarded as less-than-clear communications that require some form of interpretation to reveal their true meaning. This basic interpretive orientation is evident in Jungian therapy, Gestalt therapy, and similar treatments.