Chapter 16 Reflection Paper
The textbook and lecture notes discussed Dr. Albert Ellis’s
Rational-Emotive Behavior Therapy
. Make sure to review this material. Also, if you have not already done so, make sure to listen to the brief audio recording of Ellis describing his theory.
Here is the link:
https://soundcloud.com/albertellis/theory-and-prac…
(Links to an external site.)
Albert Ellis-Theory and Practice of RET
Source: Soundcloud
Now, after having reflected on this model, answer the following question:
Do you agree with Dr. Ellis that one’s thoughts have a direct bearing on their feelings and behaviors? Why or why not? Make sure that you provide enough detail to support your answer.
Below is a transcript of the above-noted audio.
Speaker 1 (
00:00 (Links to an external site.)
):
Suppose you go out in a crowded bus or some other area, and somebody pokes you meanly and viciously in the ribs with his elbow or an umbrella, and immediately in a split second, you’re angry. And maybe you’re so mad that you’re going to poke him back, and you’re umbrella, or your elbow is already swinging in his direction to poke him back because you’re so sore at his vicious behavior when suddenly you see that he’s blind. What happens to your anger? I ask people this all the time and almost all the time, unsophisticated and sophisticated people notice right away that the anger vanishes; it does not become repressed as it would in Freudian theory, where you’d be angry, you wouldn’t want to admit that you are. You’d repress it, get rid of the anger. It doesn’t even become suppressed. Where quite consciously you’d say, oh, he’s blind
Speaker 1 (
01:04 (Links to an external site.)
):
I must not be angry at him. It goes away and is replaced in almost all instances by other emotions. Usually, the feeling that replaces anger is a pity. You start pitying this man for being blind, or maybe even guilt because you say here, I was about to strike this man, and he’s blind. Now pity and guilt are radically different emotions than anger. And what happens is the emotion of anger changes in a split second because you are about to poke him. Maybe your arm was swinging, and suddenly you stop it, and you have a different feeling. And the reason it changes I saw was because of what happens at B, and the stimulus A is still the same. He poked you in the ribs. Maybe you still have the pain in your ribs, but C, your anger at him is no longer the same, because at B, where you were telling yourself that dirty so and
Speaker 1 (
02:02 (Links to an external site.)
):
so, he poked me in the ribs; how could he do that to me? You are now saying something like that poor man is blind. Isn’t that a shame that he’s blind? He couldn’t help it, or else you’re saying something along the line of how could I possibly have got angry at him when he’s blind? And as I said before, you get guilty; well, this is what always happens to human beings. Something occurs at point A. They tell themselves something at point B; they experience an emotion at point C, then by a feedback mechanism, they notice the experience. They see their anger or their guilt, or their upset. Then they tell themselves something about that. And then they get still another emotion very often, or an intensification of the first one. And it keeps going around and around, but it is not the external environment that influences you. It is what you tell yourself, your philosophy of life, about that environment. Now, part of what you tell yourself will be because certain things happen to you. If certain things are negative all the time, there’s a normal tendency to say to yourself, well, this is terrible. This is awful. I can’t stand this rather than well; that’s too bad these negative influences occur. But the fact that there’s a normal tendency doesn’t mean that you have to do this.
Chapter 16 Lecture Notes: Therapy and Treatment
The history of the treatment of the mentally ill has not always been pretty. Your text provides a detailed summary of this
history.
Sometimes treatment is considered to be involuntary, as when an individual is mandated to get help (e.g., via a court
order). Voluntary treatment occurs when an individual decides for themselves that they need help for a particular issue.
There are different forms of therapy. These include individual, group, couples, and family therapy. Make sure to
read/study about these forms.
Substance-Related Treatment-This form of treatment is critical, as the drug problem in the US has grown to epidemic
proportions. The goal of this type of treatment is to end the one’s reliance on a specific drug. Relapse is a common
occurrence and therapy usually is long-term in nature (at least 3 months for successful treatment to occur). Some
individuals have comorbid disorders, meaning that they have two disorders at once.
Now, it is time to learn about the varied treatment methods that exist within this field. We will start with Psychoanalysis
(Freud). Dr. Freud was the first to actually create a psychotherapy to help others. The idea here is that we have repressed
(buried) material in our unconscious minds which seeks to get out. We bury things such as traumas, embarrassments,
and humiliations. It is the ego, which was conscious of such events, which buries them in our unconscious mind where
they can no longer bother us. Maybe! Here is the deal. According to Freud, once something is in the unconscious mind it
will often find ways to escape. Such material can escape via mental or physical symptoms, the things we say (Freudian
slips), and our dreams. Here is some history and how it all works:
Freud had been in contact with a colleague who was treating a woman. They called her Anna O. She had many different
complaints. She would come to treatment each week with a new issue and Freud’s buddy would hypnotize her. Under
hypnosis she was able to recall an event that was tied to her current symptoms. When she came out of hypnosis she was
able to deal with the buried memory and her symptoms would go away. At one point she had not had a drink of water for 2
weeks—she was only existing on oranges! Yikes! Under hypnosis she recalled seeing a dog drinking out of drinking glass.
After hypnosis she was able to deal with this disturbing image and asked for water—symptom gone!
Freud was intrigued and thought that things buried in our “second mind” (later the unconscious) impacted our daily
functions. Since everyone cannot be hypnotized Freud developed “free association” as a means of getting at repressed
material. Free Association is simply the process of verbalizing whatever comes to mind. Freud would have his patients lay
on a couch (see the picture in the text) and instruct them to speak freely about whatever thoughts came to mind. Freud
stated that in this state things from one’s unconscious mind would begin to slip out. Freud would take notes and interpret
for them what might be trapped in their unconscious that was causing their current suffering.
An important issue for psychoanalysis is Resistance. Resistance occurs when the ego does not want to deal with
something. For instance, if Freud stated “Ok-we will discuss your dad during your next visit”, and the patient did not show,
Freud assumed that he was correct in his assumption that there was an issue with the patient’s father. So, what we have
here is the ego making sure that we don’t discuss that which has been buried for a reason.
Freud placed on a lot of emphasis on our dreams. He stated that “they were the royal road to the unconscious mind.”
According to Freud, we don’t dream exactly about what has been repressed—that would be a nightmare! Instead, our ego
distorts the repressed material into different dream images. Freud believed that he could interpret what the images meant.
He believed that there were 2 components of a dream. The manifest and latent content.
The manifest content of a dream involves the actual dream images themselves—it is what you remember dreaming about.
For example, a recently married man might report: “Last night I dreamt about being chased by a large fire-breathing
dragon—I ran to the edge of a cliff and jumped and landed in a pit of mud and then I woke up!
Now, the latent content of the dream is what the dream images actually represent (it is what has been buried in the
unconscious mind). A Freudian might interpret the dream as: “Well, the dragon represents your mother-in-law, and the fire
is the words she insulted you with on the day you wed her daughter—the running suggests you are attempting to escape
her and getting stuck in the mud shows that you feel you will never get away from her hatred.” Wow!
Ok-now onto Behavior Therapy
Behavior therapy is based on the principles of learning (Operant and Classical Conditioning) that we covered earlier. This
type of treatment attacks the symptoms of specific disorders. Here are some examples:
Aversive Conditioning-This can be used to treat specific problem behaviors (e.g., Alcoholism). The idea is to change the
association between alcohol and good feelings to alcohol and bad feelings. So, a physician could prescribe a drug (e.g.,
Antabuse) that would cause severe sickness if mixed with alcohol. So, if the patient got severely ill, they would avoid
alcohol in the future.
Exposure Therapy-This technique is often used to help people overcome fears/phobias. There are different types.
Flooding involves direct exposure to a feared stimulus. So, a clown phobic would have to approach a clown and shake his
hand. Gradual Exposure would involve “baby steps.” So, a clown phobic might first be separated, say 30 feet from a
clown. Each day, the clown would come closer until the clown phobic could interact with him. Here is the link to a very
good video on exposure therapy: https://www.youtube.com/watch?v=wE5F-FjbTRk
Ok–recall OCD. There is a specific treatment for this disorder. It is termed: Exposure and Response Prevention. The first
part of the treatment involves exposing the OCD patient to the things they fear most (e.g., touching several things that
they believe are dirty or contaminated). Then, after exposure, the second phase of treatment, response prevention occurs.
This involves preventing the patient from engaging in their usual response. In this case it would likely be hand-washing.
So, we would refuse to allow them to wash. Over time, their anxiety should fade and they will start to learn that they can
touch things and that they will be just fine.
Cognitive Therapy (Aaron Beck)-please read in text
Cognitive therapy is based on the idea that our thoughts have a direct impact on how we feel and behave. The goal is to
help people change how they think about the issues of their lives.
Cognitive-Behavioral Therapy-Albert Ellis
Combining cognitive therapy and behavioral techniques.
Albert Ellis developed Rational-Emotive Behavior Therapy. He believed that people were often irrational (illogical) in how
they thought about the events of their lives. He developed the ABC model. It helps you understand what he meant. It is
described below.
A
B
Adversity
Beliefs About A
(events)
(Our thoughts)
C
Consequences Of Our Beliefs
(how we feel and behave)
Common Example: We get cut off in traffic. We immediately become angry and scream at the other driver. (This never
happens in real life—right?)
Here, A is getting cut off in traffic. B is our beliefs about or interpretation of getting cut off (e.g., “That no good $%@–how
dare he cut me off”). C is the anger and screaming.
So, in this model, A does not cause C. B causes C—how one thought about the event. Think about it—how could a car
cutting someone off cause someone to become enraged? That’s just a random life event. It has to be how one thought
about the event. Someone else might not even be bothered by such an event—their thoughts might be something along
the lines as: “He cut me off—no biggie—I aint’ going let that bring me down.” Here is a link to a brief audio recording in
which Ellis discusses this idea: https://soundcloud.com/albertellis/theory-and-practice-of-ret
Now, the main thing to understand is the idea that we are often irrational in how we interpret the events of our lives. Look
again at the statement above. First, calling a person that you do not know a terrible name is illogical. They might be the
nicest human being in the world! Second, stating “How dare he” suggests that one is somehow better than others (I guess
that could be true) and that nothing like this should ever happen to oneself. See the issue?
Finally, did you watch the exposure therapy video? At the beginning of the video they showed how they were working on
changing the patients thoughts (a Cognitive intervention). The patients exposure therapy was a Behavioral intervention.
Humanistic Psychotherapy (Client-Centered Therapy)–Carl Rogers
This therapy focuses on the present. The unconscious is not explored as in psychoanalysis. This therapy focuses on selfawareness and developing one’s potential. Unconditional Positive Regard (UPR) on the part of the therapist is considered
critical in this type of therapy. UPR involves a non-judgmental attitude of acceptance of the patient.
Biomedical Treatment
These treatment methods are those practiced by Psychiatrists. A Psychiatrist has a M.D. degree and is licensed to treat
mental illnesses with medicines. Psychologists have the Ph.D. degree. They help people by utilizing the treatment
techniques that are presented above.
There are many different medicines for mental illnesses. Here are some examples:
Antianxiety Drugs—Xanax, Valium, Buspar
Antidepressant Drugs—Prozac, Effexor, Zoloft
Antipsychotic Drugs—Haldol, Thorazine, Risperdal
See the chart in the text for more details.
THERAPY AND
TREATMENT
Chapter 16
PSY 101
Professor Hoyt
The history of the treatment of the
mentally ill has not always been pretty.
Your text provides a detailed summary
of this history.
Sometimes treatment is considered to
be involuntary, as when an individual is
mandated to get help (e.g., via a court
order). Voluntary treatment occurs
when an individual decides for
themselves that they need help for a
particular issue.
This Photo by Unknown Author is licensed under CC BY-SA-NC
Forms of Therapy
◦ Individual,
◦ Group, couples
◦ Family therapy
Make sure to read/study about these
forms.
This Photo by Unknown Author is licensed under CC BY-SA-NC
Substance-Related
Treatment
This form of treatment is critical, as the
drug problem in the US has grown to
epidemic proportions. The goal of this type
of treatment is to end the one’s reliance on
a specific drug. Relapse is a common
occurrence and therapy usually is longterm in nature (at least 3 months for
successful treatment to occur). Some
individuals have comorbid disorders,
meaning that they have two disorders at
once.
This Photo by Unknown Author is licensed under CC BY-SA
Now, it is time to learn about the varied
treatment methods that exist within this
field. We will start with Psychoanalysis
(Freud). Dr. Freud was the first to actually
create a psychotherapy to help others.
The idea here is that we have repressed
(buried) material in our unconscious
minds which seeks to get out. We bury
things such as traumas, embarrassments,
and humiliations. It is the ego, which was
conscious of such events, which buries
them in our unconscious mind where they
can no longer bother us. Maybe! Here is
the deal. According to Freud, once
something is in the unconscious mind it
will often find ways to escape. Such
material can escape via mental or
physical symptoms, the things we say
(Freudian slips), and our dreams. Here is
some history and how it all works:
Freud had been in contact with a colleague who was
treating a woman. They called her Anna O. She had many
different complaints. She would come to treatment each
week with a new issue and Freud’s buddy would hypnotize
her. Under hypnosis she was able to recall an event that
was tied to her current symptoms. When she came out of
hypnosis, she was able to deal with the buried memory and
her symptoms would go away. At one point she had not had
a drink of water for 2 weeks—she was only existing on
oranges! Yikes! Under hypnosis she recalled seeing a dog
drinking out of drinking glass. After hypnosis she was able
to deal with this disturbing image and asked for water—
symptom gone!
This Photo by Unknown Author is licensed under CC BY-NC-ND
Freud was intrigued and thought that things
buried in our “second mind” (later the
unconscious) impacted our daily functions.
Since everyone cannot be hypnotized Freud
developed “free association” as a means of
getting at repressed material. Free Association
is simply the process of verbalizing whatever
comes to mind. Freud would have his patients
lay on a couch and instruct them to speak
freely about whatever thoughts came to mind.
Freud stated that in this state things from one’s
unconscious mind would begin to slip out.
Freud would take notes and interpret for them
what might be trapped in their unconscious that
was causing their current suffering.
This Photo by Unknown Author is licensed under CC BY-SA-NC
An important issue for psychoanalysis is Resistance.
Resistance occurs when the ego does not want to deal
with something. For instance, if Freud stated “Ok-we
will discuss your dad during your next visit”, and the
patient did not show, Freud assumed that he was
correct in his assumption that there was an issue with
the patient’s father. So, what we have here is the ego
making sure that we don’t discuss that which has been
buried for a reason.
This Photo by Unknown Author is licensed under CC BY
Freud placed on a lot of emphasis on our dreams. He stated that “they
were the royal road to the unconscious mind.” According to Freud, we
don’t dream exactly about what has been repressed—that would be a
nightmare! Instead, our ego distorts the repressed material into
different dream images. Freud believed that he could interpret what
the images meant. He believed that there were 2 components of a
dream. The manifest and latent content.
The manifest content of a dream involves the actual dream images
themselves—it is what you remember dreaming about. For example, a
recently married man might report: “Last night I dreamt about being
chased by a large fire-breathing dragon—I ran to the edge of a cliff
and jumped and landed in a pit of mud and then I woke up!
Now, the latent content of the dream is what the dream images
actually represent (it is what has been buried in the unconscious
mind). A Freudian might interpret the dream as: “Well, the dragon
represents your mother-in-law, and the fire is the words she insulted
you with on the day you wed her daughter—the running suggests you
are attempting to escape her and getting stuck in the mud shows that
you feel you will never get away from her hatred.” Wow!
This Photo by Unknown Author is licensed under CC BY-ND
Behavioral Therapy
Behavioral therapy is based on the principles of learning (Operant and Classical
Conditioning) that we covered earlier. This type of treatment attacks the symptoms of
specific disorders. Here are some examples:
◦ Aversive Conditioning-This can be used to treat specific problem behaviors (e.g.,
Alcoholism). The idea is to change the association between alcohol and good feelings to
alcohol and bad feelings. So, a physician could prescribe a drug (e.g., Antabuse) that
would cause severe sickness if mixed with alcohol. So, if the patient got severely ill, they
would avoid alcohol in the future.
◦ Exposure Therapy-This technique is often used to help people overcome fears/phobias.
There are different types. Flooding involves direct exposure to a feared stimulus. So, a
clown phobic would have to approach a clown and shake his hand. Gradual Exposure
would involve “baby steps.” So, a clown phobic might first be separated, say 30 feet from a
clown. Each day, the clown would come closer until the clown phobic could interact with
him. Here is the link to a very good video on exposure therapy:
This Photo by Unknown Author is licensed under CC BY-NC-ND
OCD
This Photo by Unknown Author is licensed under CC BY-NC-ND
There is a specific treatment for this disorder. It is termed:
Exposure and Response Prevention. The first part of the
treatment involves exposing the OCD patient to the things
they fear most (e.g., touching several things that they
believe are dirty or contaminated). Then, after exposure, the
second phase of treatment, response prevention occurs.
This involves preventing the patient from engaging in their
usual response. In this case it would likely be handwashing. So, we would refuse to allow them to wash. Over
time, their anxiety should fade, and they will start to learn
that they can touch things and that they will be just fine.
Cognitive Therapy
(Aaron Beck)please read in text
Cognitive therapy is
based on the idea
that our thoughts
have a direct impact
on how we feel and
behave. The goal is
to help people
change how they
think about the
issues of their lives.
This Photo by Unknown Author is licensed under CC BY-SA
Cognitive-Behavioral Therapy (CBT) – Albert Ellis
Combining cognitive therapy and behavioral techniques.
Albert Ellis developed Rational-Emotive Behavior Therapy. He believed that people were often irrational (illogical) in how
they thought about the events of their lives. He developed the ABC model. It helps you understand what he meant. It is
described below.
A
B
C
Adversity
Beliefs About A
Consequences Of Our Beliefs
(events)
(Our thoughts)
(how we feel and behave)
Common Example: We get cut off in traffic. We immediately become angry and scream at the other driver. (This never
happens in real life—right?)
Here, A is getting cut off in traffic. B is our beliefs about or interpretation of getting cut off (e.g., “That no good $%@–how
dare he cut me off”). C is the anger and screaming.
So, in this model, A does not cause C. B causes C—how one thought about the event. Think about it—how could a car
cutting someone off cause someone to become enraged? That’s just a random life event. It has to be how one thought
about the event. Someone else might not even be bothered by such an event—their thoughts might be something along
the lines as: “He cut me off—no biggie—I aint’ going let that bring me down.”
Here is a link to a brief audio recording in which Ellis discusses this idea:
https://www.youtube.com/watch?v=kxrjAbhTmNQ
CBT (Cont.)
Now, the main thing to understand is the idea
that we are often irrational in how we interpret
the events of our lives. Look again at the
statement above. First, calling a person that
you do not know a terrible name is illogical.
They might be the nicest human being in the
world! Second, stating “How dare he” suggests
that one is somehow better than others (I
guess that could be true) and that nothing like
this should ever happen to oneself. See the
issue?
This Photo by Unknown Author is licensed under CC BY-NC
Finally, did you watch the exposure therapy
video? At the beginning of the video, they
showed how they were working on changing
the patients’ thoughts (a Cognitive
intervention). The patient’s exposure therapy
was a Behavioral intervention.
Humanistic Psychotherapy
(Client-Centered Therapy) – Carl Rogers
This therapy focuses on the present. The
unconscious is not explored as in
psychoanalysis. This therapy focuses on selfawareness and developing one’s potential.
Unconditional Positive Regard (UPR) on the
part of the therapist is considered critical in this
type of therapy. UPR involves a non-judgmental
attitude of acceptance of the patient.
This Photo by Unknown Author is licensed under CC BY-SA-NC
Biomedical Treatment
These treatment methods are those practiced by
Psychiatrists. A Psychiatrist has a M.D. degree
and is licensed to treat mental illnesses with
medicines. Psychologists have the Ph.D. degree.
They help people by utilizing the treatment
techniques that are presented above.
There are many different medicines for mental
illnesses. Here are some examples:
◦ Antianxiety Drugs—Xanax, Valium, Buspar
◦ Antidepressant Drugs—Prozac, Effexor, Zoloft
◦ Antipsychotic Drugs—Haldol, Thorazine,
Risperdal
See the chart in the text for more details.
This Photo by Unknown Author is licensed under CC BY-SA-NC
Purchase answer to see full
attachment
