Psychotherapy
Many common names describe antisocial behavior: arrest, desertion, excessive drinking, failure to support, child neglect, cruelty, delinquency, thievery, irresponsibility, pathological lying, unsocialized aggression, and the more generalized terms of sociopath and psychopath. Benjamin Kleinmuntz, after an extensive review of antisocial behaviors, concludes that traditional psychotherapy in the form of the "talking cure" has largely failed with antisocial personalities. "This is . due, because, in part at least, of their superficial emotionality, disparaging attitudes toward treatment, lack of insight, impulsive acting out, and general lack of motivation for treatment." He points out that there are exceptions to this viewpoint. Behavior therapy holds· some promise. Let us close this chapter with a look at various types of psychotherapy.
In less disturbed cases, treatment may be restricted to counseling therapy. Two different approaches are generally used. First, there is the directive approach, where the psychiatrist or clinical psychologist, using diagnostic tests and interviews, attempts to learn about the past history of the individual and how this may relate to his or her present problems of adjustment. In nondirective therapy, the intention is to let the client arrive at his or her own concept of self in therapy sessions where one feels free to be and act himself. The clinician makes the client feel understood and accepted. The client learns to view personal problems in a new light. In the more disturbed cases, more is involved in therapy than ~nseling. Here we shall talk about psychoanalysis, rational-emotive therapy, and behavior therapy.
Psycho analysis
This is the most widely known form of psychotherapy in the popular sense. It involves uncovering the repressed experiences from childthat are assumed to be beneath adult neuroses. The major aim of dioanalysis according to Freud is to help the individual become -cious of the repressed self so that miseries, conflicts, and anxiety can be banished.
In the classic situation, the patient attends four or five hourly sessions per week, lying on a couch, verbalizing thoughts. Dreams nd fantasies are discussed and emotions are expressed. These weeky sessions may last for two years or longer. Patient and analyst dig ever deeper into the id (the more primitive part of the uncon in the attempt to remove the patient's neurotic fixations. encouragement is given to developing new interests and redirecting libido (pleasure-seeking drive) into more mature activities where. rational aspect of the personality, the ego, takes hold. Psychoanal- bas been modified by many therapists over the years.
Rational-Emotive Therapy
In contrast to psychoanalysis, this form of therapy is based on the theory that the individual has enormous control over what he both and does. He can also intervene between his environmental and his emotional output. Here the intellectual process is sed.
This theory, which can also be practiced as a "cognitive-behavior" therapy, teaches inrlividuals to understand them.5 and others, how to react differently, and how to change their : personality patterns. Three things are brought to be in getting person to learn control over his or her emotional processes. First, the person attacks irrational beliefs by disputing them. Second, once irrational beliefs are eliminated, at least to a degree, one is now free to establish new beliefs and appropriate behaviors. Third, gradually learns control over emotional processes; this increasing can, at least potentially, lead to personality change.
This therapy has been described as an A-B-C approach, where gins with "C," the upsetting emotional "consequence" that the ual has recently experienced. Typically the person has been _d in one way or another, such as not being accepted by his or her peers as he or she sees it. This is called "A" for the "activating" experience which ,he person wrongly believes directly causes "C," with such typic!li feelings as anxiousness, worthlessness, and depression. Gradually the individual learns that an activating, event (A) in the outside world does not cause or create any feeling or emotional consequence(C). How then is C caused by A? The theory holds that C is really caused by an intervening variable called "B," the individual's "belief" system.
This theory relates closely to three variables conventionally used' in experimental situations. First, we have the independent variable, the factor under experimental control to which the changes being studied are related, so named because we can change it "independently." This variable is often the stimulus. Responses which occur "depend" on these changes, and we call them the dependent variables under investigation. For example, let us say we are interested in knowing the relationship between the illumination of our study light and how long we can read before our eyes get tired. The light source, whicp can be varied in intensity, is our dependent variable. In other words, the dependent variable in the experimental situation is the "outcome" variable. But something els/? is involved. How we respond to the change in stimulus may relate to how sleepy we are to begin with, how interesting or bOring the reading material is, and other possible factors. This makes our problem more confusing becaus~ we are now dealing with something in between. We speak of these "in betweens" as intervening variagles. They come between the stimulus and the response, thus accounting for one response rather than another to the same stimulus. In the rational-emotive approach to personal problems, the intervening variables are our "beliefs" (B).
Behavior Therapy
A recent movement has been toward psychological treatment that involves applying the principles of learning to behavior modification. Joseph Wolpe defines this approach briefly: "Behavior therapy, or conditioning therapy, is the use of experimentally established principles of learning for the purpose of changing unadaptive behavior. Unadaptive habits are weakened and eliminated; adaptive habits are initiated and strengthened."
BehaviQ! therapy assumes that behavior disorders which can be learned can also be unlearned, by either weakening the responses or learning new responses. For example, obese persons, who are otherwise norm-ill, have been successfully trained to imagine that they are vomiting when they experience hunger-a way to "harness" the obvious fact that nausea removes the appetite. At the abnormal level, behavior therapy views neurosis more as a collection of bad habits that can be unlearned than as unconscious conflicts, which psychoanalysis maintains underlies neurosis. Behavior tterapy emphasizes correcting disturbed behavior rather than searching for elusive causes of neurosis.
The technique in behavior modification starts with a gradual desensitization. By talking with his client, the therapist first 'determines just what stimuli bring on feelings of anxiety. For example, let us suppose that the client is fearful of flying in an airplane, presumably because he or she has learned to associate planes with accidents and death, or injury. The therapist then establishes a hierarchy of stimuli according to how much anxiety each elicits. First, the stimuus might be a plane in a magazine picture. Second, the stimulus could be a plane overhead. Third, the stimulus situation could be checking in at the flight counter; and so on until the last and most threatening stimulus, actual flight.
When the hierarchy of stimuli has been established, the therapist asks the client to lie or sit on a comfortable couch. In a soothing ,'oice the therapist instructs the client to relax each part of the body. "Feel the tension in your left shoulder. Now begin to relax It slowly. Relax. Feel your shoulder become very limp and loose. Relax:" After a period of time the client becomes totally relaxed and virtually free of :ension. The therapist now instructs the client to imagine vividly the east threatening stimulus on the hierarchy while remaining calm. If this is done successfully, the therapist moves on to the next stimulus item and so on. Thus, the stimuli which the client formally paired with anxiety are now paired with relaxation by way of classical anditioning. Hence, the phobic person has been desensitized.
In closing, let us reemphasize the point that abnormal psychology offers the individual a base of comparison for understanding normal adjustments in living and work.
