Abnormal Psychology. William J. Ray

life. On a larger level, the therapist is looking for themes and patterns that came from the client’s past. In a relaxed, nonjudgmental manner, it is the task of the therapist to help the client understand the patterns and to see how they interfere with living and having rewarding relationships with others. Different versions of dynamic psychotherapy have been shown to be effective for a number of disorders, especially the personality disorders.

      existential-humanistic perspective: psychological therapy that focuses on the experience of the person in the moment and the manner in which he or she interprets the experiences

      Existential-Humanistic Perspectives

      The existential-humanistic perspective begins by asking, what is the nature of human existence? This includes both the positive experiences of intimacy and the negative experiences of loss. Historically, two clinicians influenced by Freud—Carl Jung and Karen Horney—helped to set the stage for the existential-humanistic movement in that they emphasized the value of internal experience.

      Carl Rogers

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      Karen Horney

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      As the existential-humanistic movement grew, a number of themes became critical. The first is an emphasis on human growth and the need for a positive psychology that moves beyond the discussion of stress and neurosis seen in the psychodynamic approaches. A second emphasis is the idea that psychological health is more than just the absence of pathology. Not having a problem is not the same as finding meaning in one’s life. The third theme stresses the importance of considering not only the external world and a person’s relationship to it, but also the internal world. In the humanistic-existential perspective, the internal world of a person and his or her experiences are valued. With the emphasis on experience, you will also see the therapies that developed from this approach referred to as humanistic-experiential therapies.

      Carl Rogers brought the humanistic movement to the forefront by creating client-centered therapy, also referred to as person-centered therapy. Rogers considered psychotherapy to be a releasing of an already existing capacity in a potentially competent individual. In fact, Rogers emphasized the relationship between the therapist and client as a critical key to effective therapy.

      client-centered therapy: a treatment approach in psychology characterized by the therapist’s empathic understanding, unconditional positive regard, and genuineness

      There are three key characteristics of the client-centered approach. The first is empathic understanding. As the therapist reflects back what the client says, the client begins to experience his innermost thoughts and feelings. The second is what Rogers referred to as unconditional positive regard. That is, the therapist accepts what the client says without trying to change the client. For some individuals who had experienced significant others in their lives as critical of them, to be accepted by the therapist is a new experience. The third characteristic is for the therapist to show genuineness and congruence (agreement). In this way, the therapist models what interactions between two real people could be like.

      A number of humanistic-experiential–orientated therapies have been shown to be effective (Elliott, Greenberg, Watson, Timulak, & Freire, 2013). One of these empirically supported therapies based on humanistic principles was developed by Leslie Greenberg and his colleagues. This approach is known as emotion-focused therapy or process-experiential therapy (Greenberg, 2002). In this therapy, emotion is viewed as centrally important in the experience of self. Emotion can be either adaptive or maladaptive. However, in either case, emotion is the crucial element that brings about change. In therapy, clients are helped to identify and explore their emotions. The aim is to both manage and transform emotional experiences.

      emotion-focused therapy: emotion is viewed as centrally important in the experience of self

      Emotion-focused therapy can be thought of in three phases (Greenberg & Watson, 2006). The first phase is one of bonding and awareness in which it is the job of the therapist to create a safe environment for emotional experience to take place. Empathy and positive regard are part of the way the client is helped to feel safe. In the early part of therapy, the client is helped not only to experience an emotion but also to put words to it.

      Mindfulness meditation produces positive changes in mood and coping.

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      The second phase is evocation and exploration. At this point, emotions are evoked and even intensified. The therapist also helps the client to understand how she might be interfering with her own experience of emotion. Such examples of interference would include changing the subject and beginning to talk about the emotion in a cognitive manner as a way to distance oneself from the experience. The third phase is transformation and generation of alternatives. It is at this point that the therapist helps the client construct alternative ways of thinking, feeling, and doing that are more consistent with her real self. Empirical studies have shown that emotion-focused therapy is effective with depression and emotional trauma (Greenberg & Watson, 2006).

      Another therapeutic technique that has gained popularity and been empirically shown to be effective is mindfulness. Mindfulness techniques were originally meditation techniques developed in Theravada Buddhism. These techniques involve an increased, focused, purposeful awareness of the present moment. The idea is to relate to one’s thoughts and experiences in an open, nonjudgmental, and accepting manner (Kabat-Zinn, 1990). The basic technique is for the individual to observe thoughts without reacting to them in the present. This increases sensitivity to important features of the environment and one’s internal reactions, leading to better self-management and awareness as an alternative to ruminating about the past or worrying about the future. This in turn reduces self-criticism.

      mindfulness: a therapeutic technique involving an increased, focused, nonjudgmental, purposeful awareness of the present moment

      Nonjudgmental observing allows for a reduction in stress, reduction in reactivity, and more time for interaction with others and the world. Also, feelings of compassion for another person become possible. This broadens attention and alternatives. Meta-analysis performed by Hofmann and his colleagues (Hofmann, Sawyer, Witt, & Oh, 2010) examined 39 studies of mindfulness. They found significant reductions in anxiety and depression following mindfulness techniques. Grossman and his colleagues (Grossman, Niemann, Schmidt, & Walach, 2004; see also Hofmann, Grossman, & Hinton, 2011) examined 20 studies and found overall positive changes following mindfulness approaches. Empirical evidence using mindfulness techniques has shown positive change with a number of disorders including anxiety, depression, chronic pain, and stress. Mindfulness is also a component of DBT, which is an effective treatment of borderline personality disorder.

      Overall, the existential-humanistic perspective emphasizes the emotional level. There is also an emphasis on the value of internal processes and the manner in which the exploration and experiencing of these internal processes can lead to changes in behavior and experience.

      behavioral perspective: a psychological approach focused only on actions and behaviors, not internal processes or aspects of consciousness

      Behavioral and Cognitive Behavioral Perspectives

      The behavioral perspective, as the name implies, has focused on the level of actions and behaviors. Most histories of behaviorism begin with a discussion of Ivan Pavlov, the Russian physiologist who won the Nobel Prize in 1904 for his work on the physiology of digestion. Pavlov noted in his Nobel Prize speech that the sight of tasty food