PSYCHOLOGICAL THERAPIES FOR DEPRESSION
To read up on psychological therapies for depression, refer to pages 459–468 of Eysenck’s A2 Level Psychology. Ask yourself
How can the behavioural approach be applied to the treatment of depression? How can the cognitive approach be applied to the treatment of depression? Which psychological therapy do you think will be most effective for depression?
What you need to know
COGNITIVE AND COGNITIVE-BEHAVIOURAL THERAPY
Freud’s psychoanalysis and newer forms of psychodynamic therapy Effectiveness and appropriateness
Forms of behaviour therapy
Effectiveness and appropriateness
Beck’s cognitive therapy
Assumptions underlying cognitive-behavioural therapy
Effectiveness and appropriateness
The original form of psychodynamic therapy was psychoanalysis, which was developed by Sigmund Freud over 100 years ago. Remember Freud linked depression to low self-esteem and excessive dependence due to over- or under-gratification in the oral stage, which meant the individual was unable to cope with loss. Consequently, Freud argued that it is crucial in therapy to uncover depressed patients’ repressed memories and allow them to gain insight into the factors causing their depression.
Freud used free association to gain access to the unconscious, which involves the client saying whatever comes into his or her mind. This method often doesn’t work very well because the client might be reluctant to say what he or she is really thinking. However, according to Freud, long pauses in what the client says indicate that he or she is moving close to an important repressed idea. Skilled therapists regard the presence of long pauses as an indication that additional questioning and discussion are required.
A second method Freud used to access the unconscious is dream analysis. He claimed we are much more likely to gain access to repressed material while dreaming than when we are awake because the censor in our minds that keeps the repressed material in the unconscious does not work as well during sleep. The repressed material is included in our dreams in a disguised or symbolic form because of its unacceptable nature. Freud called the dream as we remember it the manifest content and the true or underlying meaning the latent content. Dream analysis involves interpretation of the symbols in the manifest content and questioning clients about their dreams to work out the latent content.
Progress in therapy depends partly on transference. This involves the client transferring onto the therapist the powerful emotional reactions previously directed at his/her own parents or other highly significant others. These intense feelings can be negative or positive and the client is usually unaware of what is happening. Transference often provides a direct link back to the client’s childhood by providing a re-creation of dramatic conflicts that were experienced at that time. As a result, transference can facilitate the uncovering of repressed memories.
Psychodynamic therapy today has moved away from Freud’s original approach because patients’ social relationships are considered, and current psychotherapy does not place the same emphasis on childhood experiences that Freud did. EVALUATION OF PSYCHODYNAMIC THERAPY
Major depressive vs. bipolar disorder. Psychodynamic therapy (in line with most other forms of therapy) is more effective in treating major depressive disorder than bipolar disorder. Strong empirical support. Traditional psychodynamic therapy was often found to have very limited effectiveness. However, modern forms of psychotherapy have been found to be much more effective. For example, Leichsenring (2001, see A2 Level Psychology page 461) used the findings from a meta-analysis to compare the effectiveness of psychodynamic therapy and cognitive-behavioural therapy (CBT) and found in 58 of 60 comparisons no...
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