Therapy 2
family system 9/24 "Yes, but" technique (old transactional pattern: Mr. Smith, is the sick one; isolate husband and wife两个人没有真正沟通过--one always show weakness, another complain
Byng-Hall: a case study. 9/24. disaster childhood, died bor by car/train. --> blame themselevs and regard their son as "dead brother", defer to him and cannot discipline him in order to make up the mistakes
therapy skill learned in this case: to challenge a rigid family system,,,,can reverse the role in family.eg. making Mrs. S the patient. EmphasizingMr.S centrality...
let every family member to talk their feel and story rather than judge/ complain or related to the patient (Mr. Smith)
every one have responsibility on the patient. eg. the wife is too depend/ defer to her husband. Mr. Smith use sick as a protector, and Mrs. Smith show her protectiveness (shield his behaviors).
"Don't be so sure"-- repeatedly question identification of patient but also his family in the meantime
appropriate confirm each individual in the family. rather than 一昧的criticize a person. mimic the behaviors of client also show support to him
"There is one patient"--connect the patient with family member, not a single person
talking about normal life to help the client rebuild identification. + encouragement --> this also let the therapists get closer to the family
find the common ground between the client and therapists, which help the t to get close to the client. let the client has sense of identity acceptance. like, in this case, similar age, behavior-smoke, shirtleeves......aliance
do not break the family original balance. like the relationship/ status between father and son. wife and husband.. structure maintain--family member keep their own opinion and disagree with others. parental subsystem mom disagree with son's opinion on his father. T emphasize spouse system and also let the son know he does not need to involved.
New phrase, let family member talk with themselves. (T become supportive system)
to active the accustomed transactional patterns and keep T out of the discussion (自己说话 而不是对着咨询师说话)
adjust position. face to each other.
借助spouse conflict to change Mr. Smith's usual position of weakness into a positive and powerful position-- to placate 怀柔安慰 his wife.
New segment: Talk about sex life. Evasive 逃避的---> communication , cooperation are important
let Mrs Smith becomes the weak one in sex.
Mr. Smith have many evasive attitude. In order to avoid discussing conflict and problems, he take all responsibilities by himself. this is also a weak presentation.
Connecting family therapy with client-centered therapy, no labeling.
Therapist id the one to bring hope and find breakthrough to the family. rather than also indulge in the same negative distress as the client family. important: convinced therapists themselves avoid catastrophe script 避免陷入灾难剧本 ； optimistic expectation, create a benign cycle, interrupt the triangulation sequances9/24 Byng-Hall
genogram analyse.
find the pattern and to explore new script. (bring hope to family). eg, tell out the past disaster --> emplore more implications of what had happened; do not blame themselves.
vacating the original role, taking up with new role. incorporating the change into the script. & reviewing the appropriateness of the old model. (new role--> new self-perception)
Freud's childhood experience influence personally development: suppress experience effect the behaviors in the future. Eg. Jo cannot protect her younger bro so protect her son (corrective script)
Triangulation& attachment
Both children are "distance regulators" in the family, to regulate their parents' distance. (distance appear can explained by attachment theory, an ambivalent, clinging person want to get close to the avoidant partner, who moves away to feel less threatened. This makes the clinging person cling even more strongly, and drives the pursued even further away in an escalating distance conflicts. This is a vicious circle. and make marriages unstable. )
Conflict between authority and Attachment
Dispute about authority >> insecurity >>> authority break down and intensify contradiction.
Steve (thief, son) protected status gave him power/authority and he flouted his father's authority.
plus his mother also want to protect him, which reinforce the problems of her husband was having in regaining authority.
Angela (Daughter) acts as a peacekeeper, try to stop the conflict, but her behavior further undermine her parent's authority. "parentified child"
这么多冲突导致家庭一直没能成为 a secure base
9/26 Ghosts in the nursery: A psycholoanalytic approach to the problems of impaired infant-mother relationships >>>> mom lost their past, teach them to free their baby from their own past
intruder from the past.过去没焯好的 现在都补回来"represent the repetition of the past in the present"
好的love bond are strong：也会有intrusion发生 但是会 seek professional help, >>is a good/strong alliance. 不好的： kid in peril. emotional starvation, grave symptoms, developmental impairment (ghost-prefominate; therapists --intruders. 不会主动seek help).
注意事项in therapy
sex of therapists. In this case need to be pay attention to. Mrs. does not believe men. (mom--incest in childhood)
母亲有depression。又要重建母婴关系时/救孩子, separate.
natural environment. the setting is important for client. (living room, familiar & relax)--home-based treatment>> show more verbal & nonverbal signs ((((& treatment discussion in a natural, informal, non-didactic way 更利于接受
“cannot hear her baby's cry”--- the mom whose own cries have not been heard. >>did not realized that this is a problem and have no solution
so assume when mother solve her own problem, the relationship between mom and baby can change.>> treat mom's depression. overcome the fear of man
Give her trust. teach her express emotion the connection/influence between past and current. baby also learn to express emtion and take care of other--her doll
teach her the need of her child rather than misunderstand Mary (cranky, spoiled and mean)
the importance of role model. imitate/ awareness; show vulnerability; emotional expression & empathy
Another case. "Why does Annie avoid touching and holding her baby?"-- She afraid her own destructive feeling toward her baby.
teach her to speak of her childhood sufferings, then she can move protectively toward hr baby.------the importance of emotional expression.
Psychoanalysis was founded by Sigmund Freud (1856-1939). Freud believed that people could be cured by making conscious their unconscious thoughts and motivations, thus gaining insight. The aim of psychoanalysis therapy is to release repressed emotions and experiences, i.e., make the unconscious conscious.
10/1 An Interview with a depressed & Suicidal patient (Cognitive Therapy) how you are thinking, behaving, and communicating today rather than on your early childhood experiences. The therapist assists the patient in identifying specific distortions (using cognitive assessment) and biases in thinking and provides guidance on how to change this thinking.
类似Rational emotive behavior therapy (REBT), is an active-directive, philosophically and empirically based psychotherapy, the aim of which is to resolve emotional and behavioral problems and disturbances and to help people to lead happier and more fulfilling lives. Albert Ellis. REBT is the first form of cognitive behavioral therapy (CBT)
Cognitive-behavioral therapy (CBT) is action-oriented, practical, rational, and helps the patient gain independence and effectiveness in dealing with real-life issues.
Cognitive therapy is based on the cognitive model, which states that thoughts, feelings and behavior are all connected, and that individuals can move toward overcoming difficulties and meeting their goals by identifying and changing unhelpful or inaccurate thinking, problematic behavior, and distressing emotional responses.
analysis this case:: problem:: depend on other to bring happiness
STEP establish relationshpi, assessment, overview life situation, pinpoint reason for suuicide, capacity for self-objectivity (separate herself from problem and find a way to solve them),
cognitive assessment
This involves the individual working collaboratively with the therapist to develop skills for testing and modifying beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors. Now!! A tailored cognitive case conceptualization is developed by the cognitive therapist as a roadmap to understand the individual's internal reality, select appropriate interventions and identify areas of distress.
empower self rather than depend on others.
idiosyncratic interpretations of events, patient's own interpretation is key
elicit automatic thoughts: come spontaneously, seem plausible to the patient and are associated with negative effect.
Relationship can cultivate independence. eg. Warm and close parenting can cultivate more independent child.. relationship heal relationship
"I have nothing">> give her hope >> objective reality >> didactic strategy to strengthen patient's rationality >> you are the only one yo make yo happy
Emotional expression is very important!! Admit and show your vulnerability is good for your to go through/ get rid of past.
Emotions is defense mechanism. aware>> regulation >> reflection >> transformation >> corrective emotional experience
eg. Byng-Hall: a case study. 9/24. & 10/3. Why did she put nail polish in my drink?10/3 Training assessors in **Therapeutic Assessment (TA) teach mom to express her loss in the past.
10/15 Yalom: "If Rape were legal.." Existential Psychotherapy存在主义心理治疗：理解性、在场性、体验性和信奉性为原则，分：“愿望阶段”、“意志阶段”和“决心与责任”三个阶段. emphasis on the human condition as a whole. Existential psychotherapy uses a positive approach that applauds human capacities and aspirations while simultaneously acknowledging human limitations.
case: Carlos--cancer in very late period. "if rape legal, he would do"---convert sensitization --think about her daughter.
accidence happen in therapy process, can be set as a turning point.
Whether therapists will negative treat client because of he will die soon. (evanescence幻灭)
group therapy in this case, In order to let him assimilated in the group and by coach him on appropriate social behavior
Dream analysis rent car-life body, new car--next life. and then introduce treatment goal into the analysis "you got what you deserve, depending on what you're done o the way you've lived you present life" 因果报应
Agree his honesty first then teach him to accustom to society. Realize he is human and live in the society... need to care for other human
10/22 Denham-First or nowhere? Gestalt Psychotherapy
Gestalt therapy is an existential/experiential form of psychotherapy that emphasizes personal responsibility, and that focuses upon the individual's experience in the present moment, the therapist–client relationship, the environmental and social contexts of a person's life, and the self-regulating adjustments people make as a result of their overall situation. 强调个人责任的存在/体验式心理治疗形式，侧重于个人当前的经历、治疗师与客户的关系、个人生活的环境和社会环境，以及人们根据自己的整体情况做出的自我调节。
is a client-centered approach
helps clients focus on the present and understand what is really happening in their lives right now, rather than what they may perceive to be happening based on past experience. Instead of simply talking about past situations, clients are encouraged to experience them, perhaps through re-enactment. Through the gestalt process, clients learn to become more aware of how their own negative thought patterns and behaviors are blocking true self-awareness and making them unhappy. 帮助客户关注当下，理解他们现在生活中真正发生了什么，而不是基于过去的经验，他们可能认为正在发生什么。我们鼓励客户体验过去的情况，而不是简单地谈论过去的情况。通过格式塔过程，客户们学会了更多地意识到他们自己的消极思维模式和行为是如何阻碍了真正的自我意识并使他们不快乐的。
Good candidates for gestalt therapy are those who are interested in working on their self-awareness but may or may not understand the role they play in their own unhappiness and discomfort. Gestalt techniques are often used in combination with body work, dance, art, drama, and other therapies. 格式塔疗法的好候选者是那些对自我意识感兴趣的人，他们可能理解也可能不理解自己在不开心和不舒服中所扮演的角色。格式塔技术通常与身体劳动、舞蹈、艺术、戏剧和其他疗法结合使用。
case Louisa, mental health problem; suicidal behavior; Borderline personality disorder... regard her self as a problem 累赘--shouldn't exist...self-hatred
10.22 Dialectical Behavior Therapy
Dialectical behavior therapy is an evidence-based psychotherapy designed to help people suffering from borderline personality disorder. It has also been used to treat mood disorders as well as those who need to change patterns of behavior that are not helpful, such as self-harm, suicidal ideation, and substance abuse.
works towards helping people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings, and behaviors to help avoid undesired reactions.
A modified form of cognitive behavioral therapy (CBT),is a psycho-social intervention that aims to improve mental health. CBT focuses on challenging and changing unhelpful cognitive distortions (e.g. thoughts, beliefs, and attitudes) and behaviors, improving emotional regulation,[2][4] and the development of personal coping strategies that target solving current problems. Originally, it was designed to treat depression, but its use has been expanded to include treatment of a number of mental health conditions, including anxiety
DBT is based on CBT, with greater focus on emotional and social aspects. CBT 强调thought, feelings, behaviors 相互作用。Key differences between CBT and DBT are validation and relationships. DBT teaches you that your experiences are real, and it teaches you how to accept who you are, regardless of challenges or difficult experiences. Relationships are also very important in DBT
Transparency psychology (behavior) Transparency, as used in science, engineering, business, the humanities and in other social contexts, is operating in such a way that it is easy for others to see what actions are performed. It has been defined simply as "the perceived quality of intentionally shared information from a sender".