Theory & Therapy
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When reviewing theory & therapy we will always look at these four perspectives:

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Psychodynamic

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Behavioral & Sociocultural

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Cognitive

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Biological

    I have stressed in general psychology and now in abnormal psychology that when you see the different perspectives, you should be able to identify key elements about each perspective immediately. When you have knowledge of their differences you will be better able to look at each theory and see how the therapy and/or treatment relates to that theory!

Dissociative Disorders: Theory & Therapy

Psychodynamic Perspective: Defense Against Anxiety

Pierre Janet originated the idea of mental dissociation.

wpe10.jpg (9560 bytes)  This link will provide you with information on "Pierre Janet." Make sure you read about him and then follow the rest of the information on that site. It is informative and should be quite helpful!

    It was Freud who argued dissociation disorders were neuroses that were extreme and maladaptive defenses. You can almost hear Freud talking about defense mechanisms and how the individual tries to protect himself. Remember that Freud learned hypnosis from his friend Dr.Mesmer and used this with his clients, early on.

    Psychodynamic therapy is the most common treatment for these disorders. It may involve using hypnosis to have repressed memories revealed. Hypnosis may bring on or exacerbate the symptoms. This memory retrieval may retraumatize the individual. Therefore, it is important to retrieve memory gradually and this makes for a long process (treatment procedure) for 'dissociative identity disorder" patients.

Behavioral & Sociocultural Perspective: Dissociation as a Social Role

    Dissociative disorders are seen as a form of learned coping responses that produce symptoms in order to obtain rewards or relief from stress. Can't you hear B.F.Skinner talking to you about learning and learning principles?
    The individual adopts a social role that is reinforced by its consequences.

    Sociocultural perspective views symptoms as product of social reinforcement. It is seen as a strategy to evoke sympathy   and to escape responsibility for certain actions performed by non-responsible part of self. The patient and therapist's attention help to create disorder.  Research reveals that when a situation demands it and appropriate cues are given, "personalities" can be manufactured.
Skinner would say we are reinforcing the wrong type of behavior.    
    

    How might we treat dissociation effectively according to the behavioral perspective? We must stop reinforcing these behaviors. The treatment should involve expressing no interest "in alters" and expecting the patient to take responsibility for the actions they have committed.

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When your behavior is reinforced by consequences, is this believed to be classical conditioning or operant conditioning?

Click the worm to see my answer!

   
   

Cognitive Perspective: Memory Dysfunction

     Cognitive theorists view the dissociative syndromes as fundamentally disorders of memory. I like the way they state," what has been dissociated is all or part of the person's autobiography." The individual can still do things and his or her general knowledge are usually intact.
    An interesting note: if the name is forgotten, the life is forgotten. In some cases we have witnessed that when the individual is confronted with his name, the amnesia remits. This is not the case with all amnesia patient's.
    To treat dissociation, cognitive therapists try to improve implicit memory of the individual. They may ask the individual to think on what their name might be. They might be asked what cities come to mind immediately or phone numbers etc? They are trying to make some connection.
    To date there has been little work on cognitive therapy and dissociative disorders.

The Biological Perspective: Brain Dysfunction

    Some dissociative disorders may be neurological disorders.
        They may be the by-product of undiagnosed epilepsy.
        The hippocampus may be involved since it is involved in memory integration, which stress can affect. Also an abnormality in serotonin functioning may be involved with some dissociative disorders.


An interesting point: none of the above neurological hypotheses rules out psychological causes!

Treating Dissociation:  There have not been many drug treatments developed to treat these disorders. What has been used is "barbiturate sodium amytal" and SSRI's. However, as researchers gain more knowledge about stress induced changes in memory function, it is hoped that they will be able to develop medications to help with dissociative disorders.

I shall put four banners to emphasize what comes to my mind immediately when I see each perspective; these are just clips or phrases.

Psychodynamic ...Freud...anxiety...defense mechanisms...unconscious...etc

Behavioral...Skinner...rewards...reinforcers...operant conditioning...stimulus

Cognitive...Piaget...perceptions...intellect...memory...sensations...feelings

Biological...physical...body...genetic...nature...central nervous system

 

 

STCC Foundation Press, 2014!       Content by Carol A. Roberts