Getting Help - Psychotherapy: Crash Course Psychology #35

Summary

This script explores the world of psychotherapy through the lens of Bernice's mental health struggles. It delves into various therapeutic approaches, including psychodynamic, existential-humanistic, behavioral, and cognitive therapies, each offering unique insights and techniques to address psychological issues. The video also touches on group and family therapies, highlighting the importance of understanding and treating the whole person within their social context. The script promises to reveal the effectiveness of these therapies in a subsequent episode.

Takeaways

• 😔 Bernice is struggling with depression and anxiety, which are impacting her daily life and self-worth.
• 🛑 Bernice is considering seeking professional help, and she has various therapeutic options available to her.
• 💭 Psychotherapy is the primary psychological treatment, which can take many forms with different philosophies and techniques.
• 🛋️ Freud's psychoanalysis is one approach within psychodynamic therapy, focusing on unconscious thoughts and repressed memories.
• 🔍 Psychoanalysts use techniques like free association and dream analysis to uncover resistances and promote self-insight.
• 🔄 Traditional psychoanalysis has declined due to its unverifiable interpretations and the high time and cost involved.
• 🌐 Psychodynamic therapy has evolved to include theories from Jung, Adler, Horney, and others, focusing on unconscious forces and early experiences.
• 🌱 Existential-humanistic therapies, such as those by Rogers, emphasize self-acceptance, personal growth, and the present moment.
• 🤔 Behavior therapy aims to change unwanted behaviors through new learning and conditioning, rather than focusing on the past.
• 🧠 Cognitive therapy, pioneered by Aaron Beck, targets self-defeating thoughts to change related behaviors and emotions.
• 🔗 Cognitive-behavioral therapies combine elements of both cognitive and behavioral approaches for a more integrative treatment.
• 👨‍👩‍👧‍👦 Group and family therapies are also effective, offering social support and addressing issues within a systemic context.

Q & A

What issues is Bernice facing that are affecting her daily life?

Bernice is experiencing bouts of depression that make it hard for her to get out of bed and suffers from serious anxiety around various activities such as test taking and flying, which are negatively impacting her self-worth and performance in work and life.

What is psychotherapy and how does it help a patient?

Psychotherapy is a predominant type of psychological treatment that involves a therapist using a range of techniques to help a patient overcome troubles, gain insight, and achieve personal growth.

What are the four major schools or orientations of psychotherapy mentioned in the script?

The four major schools or orientations of psychotherapy are psychodynamic, existential-humanistic, behavioral, and cognitive therapies.

How does Freud's psychoanalysis approach the treatment of psychological ailments?

Freud's psychoanalysis assumes that patients do not fully understand themselves or their motivations. It uses techniques like free association and dream analysis to help patients access repressed feelings, memories, and unconscious thoughts, with the therapist providing interpretations to promote insight.

What is the difference between psychoanalytic and psychodynamic therapy?

Psychoanalysis is Freud's specific approach, focusing on the id, ego, superego, and unconscious processes. Psychodynamic therapy is a broader family of therapies descended from psychoanalysis, focusing on gaining insight into the impact of unconscious internal forces and early relationships, but not necessarily on Freud's specific theories.

What is existential-humanistic therapy and how does it differ from psychodynamic therapy?

Existential-humanistic therapy focuses on conscious material and the inherent capacity of people to make rational choices, achieve self-acceptance, and attain their maximum potential. Unlike psychodynamic therapy, it emphasizes promoting growth rather than curing illness and pays more attention to the present and future than the past.

What is client-centered therapy and who developed it?

Client-centered therapy was developed by Carl Rogers. It is a humanistic technique where therapists provide an empathetic, genuine, and accepting environment, using active listening to help clients feel valued and work towards self-actualization.

How does behavior therapy differ from other forms of therapy in its approach to treating psychological conditions?

Behavior therapy focuses on changing behavior to alter emotions and moods. It uses learning and conditioning principles to replace unwanted behaviors with more functional ones, rather than focusing on introspection or gaining insight into unconscious processes.

What is the main goal of cognitive therapy and how does it achieve it?

The main goal of cognitive therapy is to change self-defeating thoughts to alter related behaviors. It uses techniques like Socratic questioning to help clients challenge and reverse destructive beliefs, leading to more positive thinking and behavior modification.

How do group and family therapies contribute to the therapeutic process?

Group therapy fosters therapeutic benefits through social interaction, reminding clients they are not alone and helping with social aspects of mental health. Family therapy treats the family as a system, addressing individual problems within the context of family dynamics, improving relationships, insight, and communication.

What will be discussed in the next episode of the series according to the script?

The next episode will discuss whether psychotherapy works and will include a look at the biomedical approach to therapy.

Outlines

00:00

😔 Bernice's Struggle with Mental Health and Psychotherapy Options

Bernice is depicted as an individual grappling with severe depression and anxiety, which significantly impact her daily life and self-worth. The paragraph introduces the concept of psychotherapy as a means to address these issues, highlighting its various forms and schools of thought. It emphasizes the importance of professional help and the different therapeutic approaches available, such as psychodynamic, existential-humanistic, behavioral, and cognitive therapies. The narrative suggests that the right therapeutic method can be tailored to treat specific psychological conditions, potentially helping Bernice overcome her struggles.

05:02

🛌 Exploring Different Psychotherapies: From Freudian Psychoanalysis to Existential-Humanistic Approaches

This paragraph delves into the specifics of several psychotherapy orientations, starting with Freud's psychoanalysis, which involves uncovering repressed feelings and memories through techniques like free association and dream analysis. It discusses the evolution of psychodynamic therapy, which includes but is not limited to Freudian theory, focusing on gaining insight into unconscious forces. The paragraph then contrasts this with existential-humanistic therapies, which prioritize the present and future, emphasizing self-acceptance and the realization of one's potential. Notable figures like Carl Rogers, Viktor Frankl, and Fritz Perls are mentioned for their contributions to this approach, which values the individual's inherent capacity for growth and rational choice-making.

10:05

🔧 Behavioral and Cognitive Therapies: Tackling Unwanted Behaviors and Thoughts

The focus shifts to behavioral and cognitive therapies, which address the modification of behavior and thought patterns, respectively. Behavioral therapy, rooted in classical and operant conditioning, aims to replace maladaptive behaviors with more functional ones. Techniques such as counter-conditioning, exposure, systematic desensitization, and aversive conditioning are mentioned as methods to help individuals like Bernice confront and overcome their fears. Cognitive therapy, pioneered by Aaron Beck, is then introduced as a method to challenge and change self-defeating thoughts, which can influence behavior. The paragraph illustrates how cognitive therapists use Socratic questioning to help clients like Bernice reframe their catastrophic thinking and develop more positive outlooks on their situations.

👨‍👩‍👧‍👦 Group and Family Therapies: Expanding the Therapeutic Experience

The final paragraph of the script touches on group and family therapies as additional therapeutic modalities. Group therapy is presented as a way to foster social interaction and remind clients that they are not alone in their struggles, offering the benefits of shared experiences and collective support. Family therapy, on the other hand, views the family as a system and addresses individual problems within the context of family dynamics. The paragraph concludes with a teaser for the next episode, which will discuss the effectiveness of psychotherapy and introduce the biomedical approach to therapy, while also acknowledging the contributions of the episode's writing, editing, and consulting team.

Keywords

💡Psychotherapy

Psychotherapy is a broad term that encompasses various methods of psychological treatment aimed at helping individuals overcome emotional and mental health issues. It is central to the video's theme, which explores different approaches to treating psychological ailments. The script mentions psychotherapy as involving a therapist using techniques to help a patient gain insight and achieve personal growth, and it is the overarching concept that ties together the various therapies discussed.

💡Depression

Depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities. In the script, Bernice's bouts of depression are a significant issue that make it difficult for her to function, illustrating the impact of mental health conditions on daily life and the need for professional help.

💡Anxiety

Anxiety refers to a feeling of worry, nervousness, or unease, often about an imminent event or without a clear cause. The script describes Bernice's serious anxiety around activities like test taking and flying, which brutalizes her self-worth and affects her performance, demonstrating how anxiety can interfere with various aspects of life.

💡Self-worth

Self-worth is an individual's perception of their own value or worth. The video script discusses how Bernice's mental health issues, such as depression and anxiety, are affecting her self-worth, which is a critical aspect of her overall well-being and a common theme in discussions of psychological health.

💡Psychodynamic Therapy

Psychodynamic therapy is a type of psychotherapy that explores the relationship between a person's unconscious thoughts and their conscious feelings and behaviors. The script explains that this therapy, including Freud's psychoanalysis, focuses on gaining insight into unconscious internal forces and early relationships, which is essential for understanding the roots of Bernice's issues.

💡Free Association

Free association is a technique used in psychoanalysis where patients are encouraged to express their thoughts and feelings without censorship. The script describes how Bernice might use free association during psychoanalysis to access repressed feelings and memories, which is a key method for uncovering unconscious thoughts.

💡Existential-Humanistic Therapy

Existential-humanistic therapy is a form of psychotherapy that emphasizes the individual's inherent capacity for personal growth and self-actualization. The script mentions Carl Rogers and Viktor Frankl as proponents of this approach, which focuses on the present and future rather than dwelling on the past, and it is used to illustrate an alternative perspective on psychological treatment.

💡Behavior Therapy

Behavior therapy is a type of psychotherapy that aims to change unwanted behaviors through learning and conditioning. The script discusses how behavior therapists focus on changing behavior to affect emotions and moods, using techniques like exposure and systematic desensitization to help Bernice overcome her fear of flying.

💡Cognitive Therapy

Cognitive therapy is a form of psychotherapy that focuses on changing a person's thoughts to affect their feelings and behaviors. The script explains Aaron Beck's use of Socratic questioning to help clients like Bernice challenge and reverse destructive beliefs, illustrating the impact of thought patterns on mental health.

💡Group Therapy

Group therapy is a form of psychotherapy where multiple individuals participate in a therapeutic setting, often sharing common issues or goals. The script briefly mentions group therapy as a method that fosters interaction and social aspects of mental health, emphasizing the communal benefits of shared experiences.

💡Family Therapy

Family therapy is a type of psychotherapy that views and treats the family as a system, addressing how an individual's problems are influenced by or directed at other family members. The script describes family therapy as a way to heal relationships and improve communication within the family context, which is relevant to Bernice's situation as it suggests a systemic approach to her issues.

Highlights

Bernice's mental health issues are severe enough to affect her daily life and work performance.

Psychotherapy is a predominant psychological treatment involving various techniques for overcoming troubles and personal growth.

Different philosophies and techniques exist within the field of psychotherapy, each suited for treating specific psychological conditions.

Psychodynamic therapy, including Freud's psychoanalysis, focuses on gaining insight into unconscious thoughts and repressed feelings.

Freud's psychoanalysis uses free association and dream analysis to access the unconscious mind.

Traditional psychoanalysis has been criticized for its unverifiable interpretations and high session frequency.

Existential-humanistic therapies emphasize the individual's capacity for self-acceptance and achieving maximum potential.

Carl Rogers' client-centered therapy promotes a non-judgmental environment for client self-actualization.

Existentialist perspectives in therapy deal with the human impulse to deny mortality and its impact on personal growth.

Behavior therapy aims to change unwanted behaviors through new learning and conditioning, rather than focusing on emotions.

Ivan Pavlov's classical conditioning and B.F. Skinner's operant conditioning are foundational to behavior therapy.

Cognitive therapy, pioneered by Aaron Beck, focuses on changing self-defeating thoughts to affect behavior.

Cognitive-behavioral therapies combine elements of both cognitive and behavioral approaches for more effective treatment.

Group therapy and family therapy offer additional formats for psychotherapy, focusing on social interaction and family systems, respectively.

The effectiveness of psychotherapy will be discussed in a subsequent episode, along with the biomedical approach to therapy.

The episode was produced with the collaboration of a team including writers, editors, consultants, and graphic designers.

Transcripts

Bernice has issues, and sure we all do, but hers are getting out of hand. At times she

goes through bouts of depression that make it hard for her to even get out of bed. Sometimes

she suffers from serious anxiety around things like test taking, flying, lots of things.

All of which are brutalizing her self-worth and affecting her performance in work and life.

She's ready to get professional help and, lucky for Bernice, she has a lot of options.

Psychotherapy, perhaps the predominant type of psychological treatment, involves a therapist

using a range of techniques to help a patient overcome troubles, gain insight, and achieve personal growth.

Now you know by now that there are kinds of perspectives on the human mind and lots of

different philosophies on how to approach it. So it may not come as a surprise that

there's also a variety of ways that experts analyze and treat ailments of the mind.

They each create their own kind of experience for a person seeking help and to be honest

some approaches are better suited for treating certain psychological conditions than others.

But with Bernice as our guide we can see how each of these techniques works and maybe in

the end we can get her out of bed, feeling more calm and confident, and back in the swing of things.

He's back!

If we're going to talk about psychotherapy, we've got to start with Freud, right? Psychotherapy,

you will recall, is commonly grouped into four major schools or orientations. The psychodynamic,

existential-humanistic, behavioral, and cognitive therapies. Freud's famous lay on the couch

and talk psychoanalysis is just one of several related therapies in the psychodynamic family

and it was basically the first.

In essence, Freud assumed that we didn't really know or at least fully understand ourselves

or our motivations. So psychoanalysis served as a kind of historical reconstruction that

helped patients access repressed feelings and memories and unconscious thoughts, by

using free association and dream analysis with helpful interpretations from the therapist

until they gained some self-insight.

As you free associate, talk about your past and answer questions, your psychoanalyst picks

up on sensitive subjects around which you appear to show resistance. Mental blocks that

keep you from your consciousness because they cause you anxiety. The psychoanalyst notes

these resistances and offers interpretations of what might be going on to help promote insight.

So if Bernice was visiting a psychoanalyst, talking about her day, the therapist might

say "Tell me more about that dream with the birds with the broken wings." Or he might

point out resistance, like, "I noticed that when you mentioned your fear of flying, you

tend to bring up your childhood, but you never talk about your mother. Why might that be?"

The therapist points out what may be unconscious themes to coax them into the light. Maybe

Bernice needs to deal with a traumatic childhood memory or the fact that her mom ran away with

a pilot or something to understand the roots of her fear.

Today, traditional psychoanalysis is less common. Critics have pointed out that psychoanalytic

interpretations aren't easy to prove or disprove, which is a problem when you're trying to take

the scientific approach. Plus, psychoanalysis tends to involve many sessions, sometimes

4 or 5 a week over a long period of time, and health insurance just won't cover that anymore.

Therapists who have branched off from the psychoanalytic school fall into the psychodynamic

family, which includes not just Freudian, theory, but also ideas from Karl Jung, Alfred

Adler, Karen Horney, and others.

The terms psychoanalytic and psychodynamic are often confused, but you can think of psychoanalysis

as Freud's particular baby, while psychodynamic theory is really the family descended from

that baby. Similar to psychoanalysis, psychodynamic therapy focuses on helping people gain insight

on the impact of unconscious internal forces, early relationships, and critical childhood

experiences. But these therapies don't dwell on the id and the ego and superego or all

the sex stuff, at least not like traditional psychoanalysis does.

And not all psychologists are interested in rooting through your deep unconscious recesses

like it was your underwear drawer. Some therapies focus more on conscious material and believe

the present and future are worth more attention than the past. These include the existential-humanistic

therapies, championed by Carl Rogers, Viktor Frankl, Fritz Perls, and others, who emphasized

people's inherent capacity for making rational choices, achieving self-acceptance, and attaining

their maximum potential.

Like the psychodynamic school, existential-humanistic therapy is still insight oriented, but it's

much more about promoting growth rather than curing illness. Instead of calling folks patients,

humanistic therapies refer to those they help as clients or just, ya know, people.

In the mid 1900s, Rogers developed a humanistic technique called client-centered therapy.

He encouraged therapists to help their client by providing an empathetic, genuine, and accepting

environment and using active listening where the therapist echoes and clarifies what their

clients are saying and feeling. Rogers believed these techniques helped to provide a safe,

non-judgmental place where clients could accept themselves, feel valued, and work towards

self-actualization. But other therapists in this school brought in more somber topics.

Perls, Frankl, and others incorporated the existentialist perspective, understanding

anxiety and limits to personal growth is driven by the human impulse to deny the fact that,

let's face it, we're all going to die. Sounds a little grim, but much like the existentialist

philosophers, these theorists thought to maximize human potential and meaning in life in the

face of those existential fears, helping people access their genuine selves.

So let's say Bernice sees an existentialist-humanistic therapist and talks about her depression and

how it's keeping her from living a full life. By focusing on the present, this therapist

might suggest that Bernice is afraid and avoidant of her true emotions, the bad and scary ones

as well as the good ones, which is why she feels emotionally lifeless and drained. So

her therapist might say, "Say more about the feelings that you're having right now, in this

moment, as you talk about your depression." The therapist would listen without interpreting,

at least at first, and help Bernice understand that she was being heard and accepted, which

hopefully would give her comfort and strength to begin dealing with the tough

emotions that she's been avoiding.

Now if Bernice were to make her appointments with a behavior therapist, she'd experience

quite a different session. Behavior therapists argue that simply knowing that you're afraid

of flying, for example, won't help you from freaking out at the thought of getting on

a plane. Instead these therapists suggest that the problem behavior is the actual issue

and the best way to get rid of unwanted automatic behavior is to replace it with more functional

behavior through new learning and conditioning. In other words, behavior therapy aims to change

behavior in order to change emotions and moods. Behavior therapy is rooted in the experiments

of Ivan Pavlov and his classically conditioned dogs that drooled at the sound of a bell and

work by E L Thorndike and B F Skinner on operant conditioning or changing behavior by using

positive or negative reinforcement.

So say Bernice is seeing a behavior therapist because of an intense fear of flying. We know

her fear is keeping her from personal and career goals like going to conferences and

vacationing to Baja. But sometimes it even effects her ability to look up at a blue sky

or flip through a travel magazine. Her therapist might use counter-conditioning to evoke new

responses to the stimuli that trigger this unwanted behavior or she may use other behavior

therapy methods like exposure, systematic desensitization, and aversive conditioning

to help Bernice modify her reactions and behavior. So she doesn't dwell on having Bernice relive

old memories or helping her self-actualize, she just wants to fix the problem behavior.

Aversive conditioning is less common and usually involves pairing an unpleasant stimulus with

the targeted behavior. A classic example is giving someone with an alcohol problem a pill

that makes them puke when they drink.

Far more common and better studied, the exposure therapies treat an anxiety by having a person

face their fears by exposing them to real or imagined situations that they typically

avoid. Systematic desensitization is a type of exposure therapy that associates a relaxed

state of mind with gradually increasing anxiety-inducing stimuli. Taking Bernice from, say, just thinking

about flying, to looking at photos of planes in the air to sitting on a grounded plane,

to eventually soaring in the skies for reals.

Behavior therapy works pretty well in treating specific fears and problems like phobias and

it can also work for people with generalized anxiety disorder or major depression, but

it often needs a boost. And we can get that boost from the cognitive therapies, the kind

that teach people new, more adaptive ways of thinking. Cognitive therapy focuses more

on what people think rather than what they do, assuming that if you can change a self-defeating

thought, you can change the related behavior.

This is the approach used by founding American cognitive therapist Aaron Beck. He and his

colleagues pioneered the Socratic questioning method to help clients reverse destructive

and catastrophic beliefs about themselves, the world, or the future at large, such as

everything that could possibly go wrong will go wrong.

Say Bernice has a big test coming up, like a really big, all or nothing, end of the year

exam. She's freaking out and her anxiety around the test already has her depressed, imagining

that she'll fail. If she bombs the test, she fears that her dreams of getting into the

graduate programs she wants will be dashed and her life will be over. Classic catastrophic

thinking. A cognitive therapist would actively discuss all of this with her, challenging

her thinking along the way and, in the end, help Bernice reexamine her assumptions about

what's going to happen if she does fail like the world will not end and she will not utterly

fail at life. Helping her work toward thinking more positive thoughts about herself and her future.

The cognitive therapist helps patients understand that changing what we say to ourselves is

a very effective way to cope with our anxieties and modify our behavior. In other words, it

really is the thought that counts. Not surprisingly, the cognitive and behavioral schools have

joined forces frequently enough that cognitive-behavior therapies are typically considered a single

school, and a lot of therapists use integrative approaches that try to use the best elements

of all of these schools of thought.

But all of these different psychotherapies don't always mean being alone with your therapist

and your thoughts. Most of them can be done in groups, too. Group therapy fosters the

therapeutic benefits you get from interacting with other people. Not only does it help with

the social aspects of mental health, but it also may remind clients that they're not alone.

In a similar way, family therapy treats a family as a system, and views an individual's

problem behaviors as being influenced by, or directed at, other family members. Family

therapists work with multiple family members to heal relationships, improve insight and

communication, and mobilize communal resources.

So, the big question remains. Does psychotherapy work? You're going to have to wait until next

time to find out because that is what we will be taking about, along with a look at the

biomedical approach to therapy.

For now, you've learned about the major types of psychotherapy. These include psychodynamic

therapy and Freud's famous psychoanalysis, existential-humanist therapy and Roger's

client-centered focus, and behavior and cognitive therapies.

We also took a quick look at group and family therapy.

Thanks for watching, especially to all of our Subbable subscribers who make Crash Course

free for everyone who can't pay for it. To find out how you can become a supporter, just

go to subbable.com/crashcourse.

This episode was written by Kathleen Yale, edited by Blake de Pastino and our consultant

is Dr. Ranjit Bhagwat. Our director and editor is Nicholas Jenkins. The script supervisor

is Michael Aranda who is also our sound designer, and the graphics team is Thought Cafe.