History of Clinical Psychology

Lecture 3

History of Clinical Psychology

Have tried to understand and

explain behavior that is bizarre Explanations involved magical forces/supernatural phenomena Possessed by demons, spirits and treatment involved exorcisms

 Hippocrates attempted to explain bizarre behavior through use of medical model; believed that abnormal behavior stemmed from natural causes, behavior disorders are function of distribution of four bodily fluids: (blood, black bile, yellow bile, and phlegm); paved the way for the concept of mental illness

Treatment of Mentally-Ill Socially isolated Demonized Institutionalized in sanitariums/mental hospitals often for a life-time in conditions that were in-humane Treatment began to gradually change by late 18th and early 19th century with movements led by Europeans and Americans Philippe Pinel, Benjamin Rush, William Tuke, and Dorothea Dix Pushed for more humane living conditions and treatments

Empirical Tradition of Clinical Psychology as a Profession Clinical psychology has roots that extend back before the field of psychology began -roots in philosophy, medicine, and other sciences 1879 marks the beginning of modern psychology, Wilhelm Wundt established 1st laboratory in Germany that studied mental health processes -- used empirical methods to understand human behavior -- use of observation and experimentation

 Lightner Witmer -- 1st clinical psychologist & headed the University of Pennsylvania program; Used scientific method to diagnose and treat a client Emphasis on scientific approach to understanding human behavior and diagnosis of problems Not trained in clinical application Less emphasis on treatment

 Beginning of debate between clinical psychology as a science versus clinical application (scientific research emphasis vs. treatment or clinical application) Belief that scientific evidence should be the basis for clinical practice

Witmers Influence: Established the first psychological clinic Proposed a new profession named clinical psychology Served as founder and editor of the first journa in the field called, The Psychological Clinic Influenced and anticipated future developments in clinical psychology, including an emphasis on children, use of clinical interventions, collaboration with other professions in providing treatment

The Psychometric Tradition Began early in the fields of astronomy and anatomy Studied individual differences By 19th century, German anatomist Franz Gall had interest in individual differences Developed phrenology, the study of mental characteristics and the shapes of heads -- practice of assessing personality by reading bumps or variations in the skull

Assumptions of Phrenology Each area of the brain is associated with a different function The more developed each area of the brain, the strong and better the functioning of the area of the brain Pattern of over or underdevelopment of each faculty is reflected in corresponding bumps or depressions in the skull

 Interest in individual differences continued and was heavily influenced by Charles Darwins Origin of Species, specifically that individual differences occur within and between species and natural selection takes place in part on the basis of those characteristics

Galton: Galton was influenced by ideas put forth by his cousin Darwin; used these ideas to try explain differences in mental abilities; use of quantitative methods to understand differences among people; pursued interests in sensory acuity, motor skills, and reaction time Tried to distinguish from low and high intelligence on the basis of individual ability Measured individual differences using mental imagery, word association test

 James McKeen Cattell furthered the tradition of studying individual differences and studied differences in intelligence; developed a battery of 10 tests and wanted to discover the constancy of mental processes and use the findings to determine the selection and training of people as well as in the detection of disease Credited with merging individual mental measurement with the new science of psychology First to use the term mental test Primarily used sensorimotor measurements

Alfred Binet Frenchman who was interested in mental measurement Founded the first psychology laboratory in France Developed measures of complex mental ability in normal and abnormal children to help with remediation of mentally retarded children

 Expanded measurement to include areas such as comprehension, attention, suggestibility, etc.. Believed that intelligence should be measured using higher mental processes not just sensorimotor processes Created the first true psychological test of mental ability with his colleague Theodore Simon

Standard-Binet: Introduction of modern day of intelligence testing Adapted by Lewis Terman at Stanford University Standardized items on Americans and is currently in its 5th revision Believed that intelligence was inherited and a strong predictor of ones success and wanted to use IQ tests as a means to identify appropriate job placement

 Was so popular that current APA President at that time Robert Yerkes used it to develop the Army Alpha and Army Beta tests to classify army recruits (high officer material vs. rejects)

World War I and Intelligence Tests: Raised status of psychologists Grounded psychology and no longer seen as lofty and soft Help to solidify differences in society based on innate ability/intelligence Used to justify racial, ethnic, and gender discrimination

Binet-Simon Test of Intelligence: Created a 30-item test of intelligence; Focused on three areas which were: Judgment, Comprehension, and Memory Items on test were arranged in order of difficulty from least to most difficult In later revision of test: Included more items on the test Items grouped by the ages at which children passed them

Scientific Method vs. Clinical Application: Need for clinical applications/treatments not just research driven Early psychologists very reluctant to shift from research to applied psychology

Three Factors that influenced move towards clinical application: Psychological testing of intelligence as well as personality and psychopathology Emergence of child guidance clinics and the use of treatment of social as well as educational problems Eagerness to learn psychoanalysis which was the predominant approach to psychotherapy being used by psychiatrists, particularly in Europe

 Gradually introduced psychoanalysis in the United States Psychologists were trained in psychoanalysis World War II enhanced the idea of treatment due to the large number of soldiers and their families impacted by trauma Saw the beginning of the reign of the psychoanalytic approach to the treatment of abnormal behavior

Psychoanalytic Approach: Founded by Sigmund Freud Believed abnormal behavior was rooted in past unconscious conflict that is being replayed over in the present Viewed human nature as that of being in constant conflict which takes place at the unconscious level

 Derived from constant struggle between desire to satisfy inborn sexual and aggressive instincts and need to respect the rules and realities imposed by the outside world Human mind is place where your try to reconcile the wants with the cans and dos Conflict leads to anxiety which a person tries to defend against it

There are Psychoanalytic Approach Fundamentals Basic Instincts Unconscious Motivation Psychic Determinism Energy Model

Basic Instincts: Freud believed we have 2 basic instincts: Sex and Aggression Everything we as humans do can be understood as manifestations of the life and death instincts: Life is referred to as libido -- Death referred to as thanatos Like others in the psychological traditions -- followed ideas put forth by Darwin

History of Clinical Psychology

Unconscious Motivation: We control sexual and aggressive urges by placing them in the unconscious These urges take on a life of their own and become the motivated unconscious Psychic Determinism: Nothing happens by chance or accident All behaviors, thoughts, emotions are expression of our mind

History of Clinical Psychology

Energy Model: Idea that all humans are energy systems that can be transformed but not destroyed Levels of Consciousness Conscious -- current awareness Preconscious -- not aware of material but its retrievable (via ordinary retrieval) Unconscious -- not aware of material but it is not retrievable (via ordinary retrieval)

History of Clinical Psychology

Do we have an unconscious? If so, how do we tap into it?

History of Clinical Psychology

Here are the techniques for revealing the unconscious: Free Association Dream Analysis Projective Techniques Recovered Memories

History of Clinical Psychology

Structure of the Personality: Id: Most primitive part of the mind; what we are born with Sources of all drives and urges Operates according to the pleasure principle (I want it and I want it now); think about a baby who wants to satiated when thirsty/hungry; wants food and wants it now; desire for instant gratification

 Operates according to primary process thinking, which is thinking without logical rules of conscious thought; does not necessarily operate in reality

History of Clinical Psychology

Ego: Part of the mind that constrains the id to reality Develops around the age of 2 to 3 Operates according to the reality principle and secondary process thinking Secondary process thinking refers to the development of problem solving mechanisms that satisfy the demands of the environment, id, and superego Mediates between id, superego,

History of Clinical Psychology

Superego: Part of mind that internalizes the values, morals, and ideals of society Develops by the age of five Not necessarily bound by reality Determines what is right and what is wrong, use the emotion of guilt to enforce values, morals, etc. Anxiety arises when the ego does not effectively modulate the demands of the id and superego

 Therapeutically -- therapist is like an explorer that attempts to bring to the surface these unconscious conflicts that need to be resolved, use the carthartic method combined with hypnosis to help people release them from their fears, anxieties, inhibitions, etc.. Long-term -want patients to gain insight (awareness into ones unconscious), which is the ultimate goal of psychoanalytic therapy.

History of Clinical Psychology

The Humanistic Approach: Developed as an alternative to psychodynamic approach Had a fundamental difference with psychodynamic view of human nature Believes humans are creative and unique individuals who strive for growth and understanding and want to realize their maximum human potential; termed the actualizing tendency

 Phenomenology-behavior is determined by the perceptions and experiences of the behaving person Therapeutic treatment is very clientcentered, whereby the client is actively involved in treatment (unconditional positive regard)

History of Clinical Psychology

Humanistic Perspective of Psychopathology: Carl Rogers and Abraham Maslow key figure in Humanistic Perspective Rogers approach was client centered. Importance lies in the clients construal of life. Actualizing Tendency Empathic Listening Unconditional Positive Regard

 Maslows Approach-He stressed the importance of focusing on the positive qualities in people, as opposed to treating them as a 'bag of symptoms Hierarchy of Needs

History of Clinical Psychology

Humanistic Perspective of Psychopathology: Lack of unconditional positive regard, low self-esteem; Incongruence between self and experience Results in anxiety, defensiveness, and distortion Therapists convey empathy and unconditional positive regard to counter the notion of the world as a hostile and difficult place

History of Clinical Psychology

Behavioral Perspective of Psychopathology: View human nature and development of psychopathology as a learned phenomenon through a process of conditioning,reinforcement/punishment and observation Derived from the scientific approach Key figures in the behavioral tradition include Pavlov, Watson, Jones, Wolpe, & Skinner

 Classical Conditioning, where pairing of a neutral stimulus with a conditioned stimulus yields a conditioned response; further by Watson with Baby Albert Jones helped to reduce fear by using social learning e.g., showed other children playing with furry animals to reduce anxiety Wolpe introduced systematic desensitization to reduce fear Behavior learned through a system of rewards and punishments put forth by Skinner

History of Clinical Psychology

The Cognitive Perspective: Believed that behavior and development of psychopathology was not just a result of learning but how we interpret or make meaning about life events Key figures are Piaget (cognitive development of children), Chomsky (language development), Albert Ellis (Rational-Emotive Therapy), and Aaron Beck (Cognitive Therapy) have been instrumental in constructing the cognitive approach to the explanation and treatment of abnormal behavior)

 Psychological problems come about based on peoples beliefs (assumptions, explanations, attributions) about events. For example, a depressed person may assume that a bad grade on an exam demonstrated that she is stupid and must drop out of school

History of Clinical Psychology

Cognitive Perspective of Psychopathology: Albert Ellis broke down emotional disturbance as follows: A= Activating Event (Bad grade)fact,event, behavior, or attitude B= Belief person holds about the activating event (I am stupid and otherwise not cut out for college) C= Consequence of having this belief system which in this case would be depression

Critical to this theory is B: If you have maladaptive belief, then you will have negative emotional response. Can not have negative emotional response without negative cognitions/thought Therapist is charged with the task to help clients change negative thoughts through use of various behavioral techniques that alter thoughts and improve emotional state of being