The view that mental disorders have physical origins was challenged in the late 19th century by Sigmund Freud. Freud believed that mental disorders were caused by internal factors he saw these as being psychological rather than physical in origin.
Freud believed that personality has three components and that all behaviour is a product of their interaction. The id – present at birth, this is the impulsive pleasure seeking part of personality, it operates on the pleasure principle (aims at immediate gratification of instinctual needs without regard for how this is achieved). The ego – develops from the id to help us cope with the external world and it is necessary for survival. The superego – is the last component to develop and is concerned with moral judgements and feelings, it consists of conscience (source of guilt when we carry out immoral/unethical behaviour). When all three of these components are “in balance” psychological “normality” is maintained. Freud saw conflict between these components as always being present and if conflict cannot be maintained, disorders arise. Freud’s belief was that early childhood experiences shape both normal and abnormal behaviour. To treat mental disorders Freud developed Psychoanalysis, “the basic goal for Psychoanalysis is to make the unconscious conscious, to undo satisfactory defences through a theraputic regression” (GROSS. R, PSYCHOLOGY, THE SCIENCE OF MIND AND BEHAVIOUR, 4th EDITION, p668). Within Classical Psychoanalysis there is a technique called Free Association , the patient is directed to re-experience repressed unconscious feelings and wishes fustrated in childhood. This takes place in the “safe” environment of the therapists consulting room, the patient lies on a couch and is encouraged to relax and talk about dreams, early relationships with parents and other topics which come into their conscious, during this the therapist remains anonymous and faceless so that they don’t show any emotion or reveal any personal information. The problem with this technique is that at first the patient may unconsciously block treatment, miss therapy appointments, report that they have no dreams to relate, talk about things not related to therapy. This behaviour protects the clients neurosis as it stops the anxiety which would be felt in bringing unconscious thoughts to the surface.
As analysis progresses clients may make a transference to the therapist of the unconscious feelings of love or hatred they have towards their parents, they may even project these feelings on to the therapist. Interpretation of the transference is the answer to successful psychoanalysis, as it allows the patient to raise the most repressed emotions of consciousness and can start to deal realistically with them. The therapist may specify that the transference is unappropriate and an example of resistance. This may cause catharsis, which is a major emotional release in which a sudden insight is achieved, this unlocking often cures the patient of the disorder. The downside to this therapy is that it can be very involved, time consuming (lots of sessions a week) and rather expensive to get.
Other techniques within the psychoanalytical approach are; Transactional Analysis and Psychodrama. Transactional Analysis is based on a book by Eric Berne “Games People Play” written in 1964. The purpose of Transactional Analysis is that if suggests most human interactions involve social games. In this therapy the adult will either act childlike (id) or like a stern parent (superego) or a sensible adult (ego). With Transactional Analysis the therapist helps the patients become more aware of the three components of their personality and to understand and recognise when they behave as the child/parent/adult. Psychodrama was developed in 1971 by J L Moreno, this technique encourages clients to act out their feelings, they dramatise their emotional attitudes instead of merely verbalising them, this allows a clearer insight into the cause of the disorders, this technique is often used with marriage counselling and teenagers, the advantage of this is that several patients can be treated at the one time. After a Psychodrama, therapist and patient discuss what they have learned.
Now that we have looked at Psychoanalysis lets look at another approach.
The Behaviourist approach to therapy is based on a Behaviourist view of human behaviour in which the environment or surroundings is crucial in moulding behaviour and “nurture” is considered more important that nature. Behaviourism made a massive contribution to psychology up until the 1950’s. At the beginning of the 20th century Ivan P. Pavlov discovered a learning process which now known as Classical Conditioning. A stimulus which does not normally cause a particular response, will eventually come to do so, if it is paired with a stimulus that does cause that response, for example: a dog that is hungry does not normally salivate when it hears the sound of a bell, but it does salivate when it sees food. Pavlov discovered that if the sound of the bell preceded the sight of food, the dog would eventually associate the bell with the food and would salivate as soon as the bell sounded in anticipation of seeing food. Classical Conditioning’s role in human learning was taken up by John Watson, who is credited with recognising its importance as a potential explanation of how mental disorders develop. John Watson and Rosalie Raynor carried out an experiment in the 1920’s, which would today be regarded as unethical.
Watson and Raynor classically conditioned a fear response in a young child of 11 months called Albert. Albert was a young child who was afraid of nothing except a loud noise made by striking a steel bar. This made him cry. By striking the bar at the same time as Albert touched a white rat, the fear was transferred to the white rat. After combined stimulations of rat and sound, Albert became greatly disturbed at the sight of the rat but his fear had spread to include fears of white rabbits, cotton wool, experimenters (white) hair. Through this experiment Watson and Raynor showed that a phobia could be acquired through classical conditioning. To treat phobias, like little Albert’s there is a technique called Behaviour Therapy, this is based on classical conditioning which focuses on how responses such as fear may be conditioned to stimuli such as rats etc. There a four types of Behaviour Therapy; Systematic Desensitisation (SD), Implosive Therapy and Flooding, Aversion Therapy.
Systematic Desensitisation (SD) Therapy is used primarily to treat anxiety disorders. With this treatment an individual learns to make a response such as relaxation to a stimulus that normally causes anxiety. Mary Cover Jones conducted the first study of SD in 1924. She presented a young child with delicious food (unconditioned stimulus) the child thoroughly enjoyed the food (unconditioned response) while a rabbit (conditioned stimulus) which the child feared (conditioned response) was kept in a cage in the corner of the room. Over a few days while the child ate the food the rabbit was brought closer and closer until it no longer caused a fear response, even when sitting on the child’s chest. All stages in this therapy would progress through a state of relaxation. Implosive Therapy/Flooding is the opposite of SD. The therapist may decide to use the technique of Implosion to get rid of a phobia quickly. The person with the phobia is thrown in at the deep end right at the start, for example; a fear of spiders, the therapist would vividly describe spiders crawling all over the patient. The patients anxiety is maintained at such a high level that eventually some process of exhaustion or stimulus satisfaction takes place. Flooding is when you are presented by a spiders or lots of spiders in the same room. Implosion and Flooding represents a form of forced reality testing. Aversion Therapy tries to create a fearful or unpleasant response to a stimulus that has previously been associated with pleasure, for example; alcohol is paired with an emetic drug (this induces nausea and vomiting) so now nausea and vomiting will become a conditioned response to alcohol.
Behaviour Modification is the process by the therapist aims to modify the patients behaviour – eliminate the behaviour responses which are dysfunctional. This process is based on operant conditioning and aims to build up appropriate behaviour. This process is implemented by a system of reinforcements, either negative or positive (this technique is applied by parents or teachers when they feel the need to change disruptive behaviour) for example a young adolescent receives £5 pocket money a week and has all their washing and ironing done for them, but refuses to tidy their room, one way a parent could modify this behaviour is to take away the pocket money until they do start to tidy their room and once this system is in place, re-introduce the pocket money. Another technique used in Behaviour Modification is Token Economy, the required behaviour is rewarded with tokens which can then be exchanged for something the person wants. This particular technique is used with people suffering from anorexia, when they eat a certain amount of food they may be allowed a certain magazine, or item of clothing.
Now that we have an in depth knowledge of both approaches lets look at how they differ and how they are also similar in their treatments. “The behaviourist approach can be contrasted with psychoanalytical approach because it focuses on the unwanted, overt behaviours rather than the internal unconscious underlying causes on mental disorders” (PSYCHODYNAMIC vs BEHAVIOURAL THERAPY HANDOUT) Behaviourist approach focuses mainly on the behavioural problem itself rather than the historical reason for its development as the Psychoanalytic approach does. How they are similar is that they give the patient an insight as to how to cope maturely with their disorder.
As we can see both approaches have different focuses on their treatments for abnormal behaviour
