Skinner developed the idea of operant conditioning in , when he tested the learning of rats through reinforcement and punishment in what is now called a Skinner box. Exposure therapy was first reported in by Mary Cover Jones, who is considered the mother of behavior therapy. Jones used exposure therapy with a boy named Peter to help him overcome his fear of rabbits.
In the second half of the 20th century, many therapists coupled behavior therapy with the cognitive therapy of Aaron Beck and Albert Ellis, forming cognitive behavioral therapy CBT. Behavior therapy has proven effective in many areas and has been used to address intimacy in couples, relationships, forgiveness, chronic pain, anorexia, chronic distress, substance abuse, depression, anxiety, insomnia, and obesity.
Behavioral applications to these problems have left clinicians with considerable tools for enhancing therapeutic effectiveness. CBT has been proven to perform slightly better at treating co-occurring depression.
Systematic desensitization has been shown to successfully treat phobias about heights, driving, and insects, as well as any anxiety that a person may have. Virtual reality treatment has been shown to be effective for a fear of heights; it has also been shown to help with the treatment of a variety of anxiety disorders. Other critics have argued that ABA and other behavior therapies are too rigid in their approach, and that effective treatment requires an acknowledgement of the subconscious as well as observable behaviors.
Some have argued that certain types of behavior therapy may make a patient too dependent on external rewards rather than internal motivation to change. Finally, many have critiqued the use of punishment in certain forms of behavior therapy as inhumane. Cognitive and cognitive-behavioral therapies address the interplay between dysfunctional emotions, maladaptive behaviors, and biased cognitions.
Cognitive therapy CT and cognitive-behavioral therapy CBT are closely related; however CBT is an umbrella category of therapies that includes cognitive therapy. CBT is a psychotherapeutic approach that addresses dysfunctional emotions, maladaptive behaviors, and cognitive processes through a number of goal-oriented, systematic procedures. The category refers to behavior therapy, cognitive therapy, and therapies based on a combination of basic behavioral and cognitive principles and research, including dialectical behavior therapy.
Basic tenets of CBT : The diagram depicts how emotions, thoughts, and behaviors all influence each other. Centered around that is a feedback loop between behavior, thoughts, and feelings, all of which are the target of CBT. Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking and behavior, as well as emotional responses.
This involves helping patients to develop skills for modifying beliefs, identifying distorted thinking, relating to others in different ways, and changing behaviors. Treatment is based on collaboration between the patient and therapist and on testing beliefs. Some examples include:. Cognitive biases : Cognitive biases are maladaptive patterns of judgment, whereby inferences about other people and situations may be drawn in an illogical fashion.
These irrational beliefs take the form of automatic thoughts; cognitive therapy believes that patients suffering from mental illness can be helped if therapists challenge these irrational beliefs. In this way, cognitive therapy encourages people to see that some of their thoughts are mistaken.
Cognitive-behavioral therapy CBT works to solve current problems and change unhelpful thinking and behavior. The basic tenet of CBT is that emotions both adaptive and maladaptive occur because of our interpretation of an event, not because of the event itself. At its most basic level, it is a combination of cognitive therapy and behavioral therapy. While rooted in rather different theories, these two therapy types have been characterized by a constant reference to experimental research to test hypotheses.
CBT is one of the most widely researched and most effective treatments for depression, anxiety disorders, eating disorders, and substance abuse disorders. When someone is distressed or anxious, the way they see and evaluate themselves can become negative. CBT therapists and clients work together to see the link between negative thoughts and mood.
This empowers people to assert control over negative emotions and to change the way they behave. CBT assumes that changing maladaptive thinking leads to change in affect and behavior. Therapists help individuals to challenge maladaptive thinking and help them replace it with more realistic and effective thoughts, or encourage them to take a more open, mindful, and aware posture toward those thoughts.
Modern forms of CBT include a number of diverse but related techniques such as exposure therapy, stress inoculation training, cognitive processing therapy, cognitive therapy, relaxation training, acceptance and commitment therapy ACT , and dialectical behavior therapy DBT , which is discussed in more detail below. Dialectical behavior therapy DBT is a form of psychotherapy that was originally developed to treat people with borderline personality disorder BPD.
DBT involves a combination of standard cognitive-behavioral techniques e. DBT research suggests that maladaptive behaviors such as self-harm or attention-seeking function to regulate negative emotions in individuals who lack emotion-regulation skills.
Thus, from a DBT perspective, the behaviors that are considered maladaptive in BPD, in people with eating disorders, and in sexual abuse survivors, are negatively reinforced, as they function to regulate emotions and decrease feelings of distress. Consequently, helping clients to develop more adaptive strategies to cope with their emotions should help patients improve their maladaptive behaviors. These strategies include mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
The modern roots of CBT can be traced to the development of behavior therapy in the early 20th century, the development of cognitive therapy in the s, and the subsequent merging of the two. During the s and s, behavioral therapy became widely utilized by researchers in the United States, the United Kingdom, and South Africa, who were inspired by the behaviorist learning theories of Ivan Pavlov, John B.
Watson, and Clark L. Cognitive therapy was developed by psychiatrist Aaron Beck in the s. One of the first forms of cognitive-behavior therapy was rational emotive therapy RET , which was founded by Albert Ellis and grew out of his dislike of Freudian psychoanalysis Daniel, n. During the s and s, cognitive and behavioral techniques were merged into cognitive-behavioral therapy.
Pivotal to this merging was the successful development of treatments for panic disorder by David M. Clark in the UK and David H. Barlow in the US. Over time, cognitive-behavioral therapy came to be known not only as a therapy, but as an umbrella category for all cognitive-based psychotherapies.
DBT is a modified form of cognitive-behavioral therapy that was originally developed in the late 20th century by psychology researcher Marsha Linehan to treat people who are chronically suicidal and those with borderline personality disorder BPD. In adults, CBT has been shown to have effectiveness and a role in the treatment plans for anxiety disorders, depression, eating disorders, chronic low back pain, personality disorders, psychosis, substance use disorders, and in the adjustment, depression, and anxiety associated with fibromyalgia and post-spinal-cord injuries.
Evidence has shown CBT is effective in helping treat schizophrenia, and it is now offered in most treatment guidelines. Some meta-analyses find CBT more effective than psychodynamic therapy and equal to other therapies in treating anxiety and depression.
However, psychodynamic therapy may provide better long-term outcomes. In children and adolescents, CBT is an effective part of treatment plans for anxiety disorders, body dysmorphic disorder, depression and suicidality, eating disorders and obesity, obsessive-compulsive disorder, and post-traumatic stress disorder, as well as tic disorders, trichotillomania, and other repetitive-behavior disorders.
The research conducted for CBT has been a topic of sustained controversy. While some researchers write that CBT is more effective than other treatments, many other researchers and practitioners have questioned the validity of such claims. A recent meta-analysis revealed that the positive effects of CBT on depression have been declining since The overall results showed two different declines in effect sizes: 1 an overall decline between and , and 2 a steeper decline between and Some critics argue that CBT studies have high drop-out rates compared to other treatments.
At times, the CBT drop-out rates can be more than five times higher than those of other treatment groups. Critics argue that one of the hidden assumptions in CBT is that of determinism, or the absence of free will, because CBT invokes a type of cause-and-effect relationship with cognition. Specifically, critics argue that since CBT holds that external stimuli from the environment enter the mind, causing different thoughts that lead to emotional states, there is no room in CBT theory for agency, or free will.
Humanistic therapy helps individuals access and understand their feelings, gain a sense of meaning in life, and reach self-actualization. As a psychotherapeutic treatment approach, humanistic therapy typically holds that people are inherently good. It adopts a holistic approach to human existence and pays special attention to such phenomena as creativity, free will, and human potential.
Humanistic psychology acknowledges spiritual aspiration as an integral part of the human psyche and is linked to the emerging field of transpersonal psychology. The aim of humanistic therapy is to help the client develop a stronger, healthier sense of self, as well as access and understand their feelings to help gain a sense of meaning in life. Empathy is one of the most important aspects of humanistic therapy. Another key element is unconditional positive regard, which refers to the care that the therapist needs to have for the client.
Unconditional positive regard is characterized by warmth, acceptance, and non-judgment. This ensures that the therapist does not become the authority figure in the relationship, and allows for a more open flow of information, as well as a kinder relationship between the two. A therapist practicing humanistic therapy needs to show a willingness to listen and ensure the comfort of the client by creating an environment where genuine feelings may be shared but are not forced upon someone.
In humanistic therapy, there are two widely practiced techniques: gestalt therapy and client-centered therapy. Gestalt therapy focuses on the skills and techniques that permit an individual to be more aware of their feelings. According to this approach, it is much more important to understand what and how clients are feeling, rather than to identify what is causing their feelings.
Previous theories are thought to spend an unnecessary amount of time making assumptions about what causes behavior. Instead, Gestalt therapy focuses on the here and now. Client-centered therapy provides a supportive environment in which clients can reestablish their true identity. This approach is based on the idea that fear of judgment prevents people from sharing their true selves with the world around them, causing them to instead establish a public identity to navigate a judgmental world.
The ability to reestablish their true identity will help the individual understand themselves as they truly are. Client-centered therapy : In client-centered therapy, a form of humanistic therapy, one of the goals is to establish a trusting relationship built on empathy and unconditional positive regard. Humanistic therapy is used to treat a broad range of people and mental health challenges. It has been used in the treatment of schizophrenia, depression, anxiety, relationship issues, personality disorders, and various addictions, such as alcoholism.
Many proponents advocate the idea that it can be useful and effective with any population; however, others have argued that it has limited effectiveness with individuals who have limited access to education.
Certain studies suggest that humanistic therapy is at least as effective as other forms of psychotherapy at producing stable, positive changes over time for clients that engage in this form of treatment. While personal transformation may be the primary focus of most humanistic psychologists, humanistic approaches have also been applied to theories of social transformation related to pressing social, cultural, and gender issues. Critics have taken issue with many of the early tenets of humanistic psychology.
As with all early psychological approaches, questions have been raised about the lack of empirical evidence used in research. Because of the subjective nature of the framework, psychologists worry about the fallibility of the humanistic approach. The holistic approach allows for much variation but does not identify enough constant variables to be researched with true accuracy. Psychologists also worry that such an extreme focus on the subjective experience of the individual does little to explain or appreciate the impact of society on personality development.
Body-oriented psychotherapies focus on the importance of working with the body in the treatment of mental health issues. Psychotherapists employ a range of techniques based on experiential relationship-building, dialogue, communication, and behavior change that are designed to improve the mental health of a client or to improve family or group relationships such as in a family.
In addition to the more common forms of psychotherapy including humanistic, cognitive-behavioral, and psychodynamic approaches , there are several alternative, body-oriented therapies that serve specific purposes. Body-oriented therapies, also referred to as body psychotherapies, are based on the principles of somatic psychology, which involves the study of the body, somatic experience, and the embodied self, including therapeutic and holistic approaches to the body.
A wide variety of techniques are used in body-oriented therapies, including sound, touch, mirroring, movement, and breath. There is an increasing use of body-oriented therapeutic techniques within mainstream psychology such as the practice of mindfulness , and psychoanalysis has recognized the use of such concepts as somatic resonance and embodied trauma.
These alternative methods include but are not limited to eye movement desensitization and reprocessing EMDR , light therapy , hypnotherapy, and yoga. Eye movement desensitization and reprocessing EMDR is a psychotherapy technique discovered in by Francine Shapiro for use in the treatment of anxiety, stress, and trauma.
The goal of EMDR is to reduce the long-lasting effects of distressing memories by developing more adaptive coping mechanisms. The therapy uses an eight-phase approach that includes having the patient recall distressing images while receiving one of several types of bilateral sensory input, such as side-to-side eye movements.
EMDR was originally developed to treat adults with post-traumatic stress disorder PTSD ; however, it is also used to treat other conditions.
Three are particularly important: the topographic model, the psychosexual stage model, and the structural model. In his book, The Interpretation of Dreams , Freud introduced his topographic model of the mind, which contended that the mind could be divided into three regions: conscious, preconscious, and unconscious.
The preconscious contains material that is capable of becoming conscious but is not conscious at the moment because your attention is not being directed toward it. You can move material from the preconscious into consciousness simply by focusing your attention on it.
Consider, for example, what you had for dinner last night. Not to worry, in a few moments it will be preconscious again, and you can move on to more important things. The unconscious—the most controversial part of the topographic model—contains anxiety-producing material for example, sexual impulses, aggressive urges that are deliberately repressed held outside of conscious awareness as a form of self-protection because they make you uncomfortable.
Freud remained devoted to the topographic model, but by he had outlined the key elements of his psychosexual stage model , which argued that early in life we progress through a sequence of developmental stages, each with its own unique challenge and its own mode of sexual gratification. Note that—consistent with the developmental challenges that the child confronts during each stage—oral fixation is hypothesized to result in a dependent personality, whereas anal fixation results in a lifelong preoccupation with control.
Oedipal fixation leads to an aggressive, competitive personality orientation. Ultimately, Freud recognized that the topographic model was helpful in understanding how people process and store information, but not all that useful in explaining other important psychological phenomena for example, why certain people develop psychological disorders and others do not.
To extend his theory, Freud developed a complementary framework to account for normal and abnormal personality development—the structural model —which posits the existence of three interacting mental structures called the id, ego, and superego.
The id is the seat of drives and instincts, whereas the ego represents the logical, reality-oriented part of the mind, and the superego is basically your conscience—the moral guidelines, rules, and prohibitions that guide your behavior. You acquire these through your family and through the culture in which you were raised. According to the structural model, our personality reflects the interplay of these three psychic structures, which differ across individuals in relative power and influence.
When the id predominates and instincts rule, the result is an impulsive personality style. When the superego is strongest, moral prohibitions reign supreme, and a restrained, overcontrolled personality ensues.
When the ego is dominant, a more balanced set of personality traits develop Eagle, ; McWilliams, In addition to being the logical, rational, reality-oriented part of the mind, the ego serves another important function: It helps us manage anxiety through the use of ego defenses. Ego defenses are basically mental strategies that we use automatically and unconsciously when we feel threatened Cramer, , For example, repression the most basic ego defense, according to Freud involves removing from consciousness upsetting thoughts and feelings, and moving those thoughts and feelings to the unconscious.
Another ego defense is denial. The conscious mind, on the other hand, includes everything that is inside of our awareness. The contents of the conscious mind are the things we are aware of or can easily bring into awareness.
Freud believed that an individual's personality had three components: the id, the ego, and the superego. The first of the key elements of personality to emerge is known as the id.
The id contains all of the unconscious, basic, and primal urges. The second aspect of personality to emerge is known as the ego. This is the part of the personality that must deal with the demands of reality. It helps control the urges of the id and makes us behave in ways that are both realistic and acceptable. Rather than engaging in behaviors that are designed to satisfy our desires and needs, the ego forces us to fulfill our needs in ways that are socially acceptable and realistic.
In addition to controlling the demands of the id, the ego also helps strike a balance between our basic urges, our ideals, and reality. The superego is the final aspect of personality to emerge, and it contains our ideals and values. The values and beliefs that our parents and society instill in us are the guiding force of the superego and it strives to make us behave according to these morals. Defense mechanisms are strategies that the ego uses to protect itself from anxiety.
These defensive tools act as a safeguard to keep unpleasant or distressing aspects of the unconscious from entering our awareness. When something is experienced as overwhelming or even inappropriate, defense mechanisms keep the information from entering our consciousness, which minimizes our distress. Over the course of the early twentieth century, the influence of psychoanalysis grew.
It was not, however, without its critics. Despite its flaws, psychoanalysis continued to play a key role in the development of psychology. It influenced our approach to treating mental health conditions and continues to exert an influence on psychology today.
Many people are skeptical of psychoanalysis because the evidence supporting its effectiveness has often been viewed as weak. One of the main arguments by those who are critical of psychoanalysis is that it's not as effective as other treatments.
However, some of the research on the effectiveness of psychoanalysis has yielded support. One systematic review of previous studies concluded that psychoanalytic therapy was an effective treatment that resulted in the reduction of symptoms and long-term changes that persisted for years after treatment ended. A review found that psychodynamic therapy could be effective in the treatment of a number of conditions include:. Another critique is that psychoanalysis often requires an investment of time, money, and effort.
Psychoanalysis is also generally a long-term proposition. In the world we live in today, people are usually seeking fast results and approaches that yield an effect in days, weeks, or months. Psychoanalytic therapy typically involves a client and therapist exploring issues over a period of years. Using the criteria established for evidence-based treatment, traditional psychoanalysis alone does not, in fact, pass muster as a method of therapy for the large majority of psychological disorders.
Many of Freud's ideas have fallen out of favor in psychology, but that certainly does not mean that his work is without merit. Research also supports at least some of Freud's original ideas. His approach to therapy specifically, the suggestion that mental illness was treatable and that talking about problems could bring relief was a revolutionary concept that changed how we approach the treatment of mental illness.
Sigmund Freud was also very much a product of his time. While he was known for his audacious theories which were considered especially shocking in the Victorian period , his view of the world was colored by the time in which he lived. If Freud were alive today, his ideas might be regarded very differently—and his own work would likely take a different direction.
Some have suggested that if Freud were alive today, he would likely be interested in topics related to brain functioning. Prior to the development of psychoanalysis, Freud's interests had centered on developing a neural model of behavior. Researchers today also suggest that the neurobiological underpinnings of psychoanalysis are worth further exploration. Psychologists today talk about the psychodynamic , not the psychoanalytic perspective. As such, this perspective refers to the dynamic forces within our personalities whose shifting movements underlie much of the basis for our observable behavior.
Psychoanalysis is a much narrower term referring to the Freudian-based notion that to understand, and treat, abnormal behavior, our unconscious conflicts must be worked through. Psychoanalysis as Freud conceived it might be on the decline, but that does not mean that the psychodynamic perspective has disappeared or that it will be going anywhere soon. If you ask someone what comes to mind when they think of psychology, Sigmund Freud and psychoanalysis are likely to be common responses.
There is no question that psychoanalysis—both as a therapeutic approach and theoretical outlook—has left its mark on psychology.
Most psychologists today employ a more eclectic approach to the field of psychology, though there are some professionals who still take a purely psychoanalytical point of view on human behavior. Many contemporary psychologists view psychoanalysis with skepticism. In a world of psychology where cognitive processes, neuroscience, and biopsychology dominate, is there still room for psychoanalysis? In general, there is a perceived decline in traditional psychoanalysis.
A report published by the APsaA in found that psychology departments typically treat psychoanalysis as a purely historical artifact, while subjects such as art, literature, history, and other humanities were more likely to teach psychoanalysis as an ongoing and relevant topic. Some suggest that psychoanalysis has fallen by the wayside as an academic topic within psychology partly because of its failure to test the validity of its therapeutic approach and earlier failures to ground the discipline in evidence-based practices.
There are a few things that psychoanalysis as a field can do to ensure its continued relevance in the world of psychology. Some things that can help improve the legitimacy and relevance of psychoanalytic methods include:.
Some current efforts to revitalize psychoanalysis focus on psychoanalytic concepts that are more evidence-based such as attachment theory or on connecting Freud's idea of the unconscious to modern neuroscience. Freud's mark on psychology is still felt today. Talk therapy is most often associated with psychoanalysis, but therapists also use the technique in other approaches to treatment, including client-centered therapy and group therapy.
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