Establishing shared goals and a formulation between the therapist and patient is crucial at the beginning of therapy. The therapist should utilize Socratic dialogue to develop alternative theories regarding obsessive-compulsive thoughts and behaviors. It is important for the therapist to be cautious of the patient adopting self-reassurance of appraisals as another form of compulsion of neutralization. Early establishment of therapy goals is recommended.

Dialectical Behavioural Therapy (DBT) is a form of psychotherapy that is tailored for patients with borderline personality disorder. It combines behavioural therapy with aspects of Zen Buddhism and dialectical thinking to help patients develop important interpersonal and emotional regulation skills. DBT has five functions, including enhancing behavioural capabilities, improving motivation to change, assuring new capabilities generalise to the natural environment, structuring the environment so that appropriate behaviours are reinforced, and enhancing motivation of the therapist.

DBT uses a hierarchy of treatment targets to help the therapist determine the order in which problems should be addressed. The treatment targets in order of priority are life-threatening behaviours, therapy-interfering behaviours, quality of life behaviours, and skills acquisition. DBT skills include mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation. Overall, DBT is an effective form of therapy for patients with multiple problems, and it helps them develop the skills they need to achieve their goals and improve their quality of life.

Supportive Psychotherapy: An Overview

Supportive psychotherapy is a widely used approach in psychiatry, often reserved for clients who are not suitable for other forms of therapy. It aims to provide emotional support and encouragement to help people cope with overwhelming stress and restore them to their previous level of functioning. This therapy is not based on any specific psychological theory and is eclectic in approach.

Supportive psychotherapy is generally used with two different patient groups: those who were otherwise functioning well but have become symptomatic due to stress, and those who are not suitable for other forms of therapy. The goal of therapy is to help the patient get on with their life as best as possible, without disrupting reasonable defenses of generating conflicts.

The therapist avoids confrontation and transference issues are rarely analyzed. However, the therapeutic aims of long-term supportive psychotherapy include establishing a therapeutic alliance, holding and containing, promoting awareness of transference issues, promoting stability, facilitating the maturation of defenses, and promoting better adaptation to reality.

Supportive psychotherapy has been dismissed as ‘hand holding,’ but it should not be underestimated. It is suitable for most patients and is often the only therapy that can help when others have failed. Much of the work doctors do in outpatient clinics could be classified as supportive psychotherapy.

Studies have consistently found that the most important factor in the effectiveness of psychotherapy is the strength of the relationship between the therapist and client, rather than specific features of the therapy itself. While there has been some questioning of the idea that all psychotherapies are equally effective, common factors such as warmth, empathy, and a strong therapeutic relationship are still better predictors of success than individual patient of therapy factors. While allowing for emotional release may be helpful early on, it can become counterproductive if it occurs too frequently and leads to intense emotional outbursts. While having an above average IQ and being married may be associated with better outcomes, the strength of the therapeutic alliance is still the most important factor. Additionally, having had psychotherapy in the past does not necessarily indicate a positive response to future interventions.

Interpersonal Therapy: A Structured Approach to Addressing Social Functioning Problems

Interpersonal therapy (IPT) is a structured form of psychotherapy that is often used to treat depression. It is based on the belief that social functioning problems have a significant impact on psychological problems. IPT is a time-limited therapy that typically runs for 10-16 one hour sessions. The therapy is organized into three phases, with the first phase involving data collection and formulation. The remaining sessions explore the formulation in more detail.

IPT focuses on four areas of social functioning problems: grief, role transitions, interpersonal deficits, and interpersonal disputes. The therapy aims to intervene at the level of social functioning, rather than focusing on personality. The therapy has been found to be effective in treating depression, particularly in patients with severe depression. However, it may be less effective in treating people with depression and comorbid personality disorders.

The evidence base for IPT is most developed for eating disorders, and the intervention is recommended in NICE guidelines for eating disorders. Overall, IPT is a structured approach to addressing social functioning problems that can be effective in treating depression and other psychological problems.

Critics argue that client-centred therapy may not provide enough structure, but its goal is to empower patients to discover their own solutions to their problems.

Fonagy and Bateman – Mentalisation-Based Treatment

Mentalisation-Based Treatment (MBT) was developed by Peter Fonagy and Anthony Bateman in the 1990s. It is a psychodynamic therapy that focuses on improving the patient’s ability to mentalise, which is the capacity to understand one’s own and others’ mental states. MBT is primarily used to treat borderline personality disorder, but it has also been used to treat other mental health conditions.

Fonagy and Bateman work on MBT was influenced by their research on attachment theory and the importance of early relationships in shaping mentalisation abilities. They believed that individuals with borderline personality disorder have difficulties with mentalisation due to early attachment disruptions, and that MBT could help them develop more stable and secure relationships.

MBT is typically delivered in a group of individual format, and it involves a combination of psychoeducation, cognitive-behavioral techniques, and psychodynamic interventions. The therapist helps the patient to identify and reflect on their thoughts, feelings, and behaviors, and to understand how these are influenced by their past experiences and relationships. The therapist also helps the patient to develop more adaptive coping strategies and to improve their interpersonal skills.

Overall, Fonagy and Bateman work on MBT has contributed to the development of psychodynamic therapies that are more focused on specific treatment goals and evidence-based practices.

Bion’s Concept of Containing

Wilfred Bion, a British psychoanalyst, is known for his contributions to the field of psychoanalysis. One of his significant concepts is ‘containing,’ which refers to a person’s ability to absorb and manage another person’s projected anxiety.

According to Bion, containment is a crucial aspect of the therapeutic process. It involves the therapist’s capacity to hold and manage the patient’s anxieties and emotions, allowing the patient to feel safe and secure. The therapist acts as a container, providing a safe space for the patient to explore their thoughts and feelings without fear of judgment of rejection.

Bion’s concept of containing is not limited to the therapeutic setting. It is a fundamental aspect of human relationships, particularly in parent-child interactions. Parents who can contain their child’s anxieties and emotions provide a secure base for their child to explore the world and develop a sense of self.

In conclusion, Bion’s concept of containing highlights the importance of emotional regulation and management in human relationships. It emphasizes the need for individuals to be able to absorb and manage the anxieties and emotions of others, creating a safe and secure environment for personal growth and development.

Fonagy and Bateman – Mentalisation-Based Treatment

Mentalisation-Based Treatment (MBT) was developed by Peter Fonagy and Anthony Bateman in the 1990s. It is a psychodynamic therapy that focuses on improving the patient’s ability to mentalise, which is the capacity to understand one’s own and others’ mental states. MBT is primarily used to treat borderline personality disorder, but it has also been used to treat other mental health conditions.

Fonagy and Bateman work on MBT was influenced by their research on attachment theory and the importance of early relationships in shaping mentalisation abilities. They believed that individuals with borderline personality disorder have difficulties with mentalisation due to early attachment disruptions, and that MBT could help them develop more stable and secure relationships.

MBT is typically delivered in a group of individual format, and it involves a combination of psychoeducation, cognitive-behavioral techniques, and psychodynamic interventions. The therapist helps the patient to identify and reflect on their thoughts, feelings, and behaviors, and to understand how these are influenced by their past experiences and relationships. The therapist also helps the patient to develop more adaptive coping strategies and to improve their interpersonal skills.

Overall, Fonagy and Bateman work on MBT has contributed to the development of psychodynamic therapies that are more focused on specific treatment goals and evidence-based practices.

Fonagy and Bateman – Mentalisation-Based Treatment

Mentalisation-Based Treatment (MBT) was developed by Peter Fonagy and Anthony Bateman in the 1990s. It is a psychodynamic therapy that focuses on improving the patient’s ability to mentalise, which is the capacity to understand one’s own and others’ mental states. MBT is primarily used to treat borderline personality disorder, but it has also been used to treat other mental health conditions.

Fonagy and Bateman work on MBT was influenced by their research on attachment theory and the importance of early relationships in shaping mentalisation abilities. They believed that individuals with borderline personality disorder have difficulties with mentalisation due to early attachment disruptions, and that MBT could help them develop more stable and secure relationships.

MBT is typically delivered in a group of individual format, and it involves a combination of psychoeducation, cognitive-behavioral techniques, and psychodynamic interventions. The therapist helps the patient to identify and reflect on their thoughts, feelings, and behaviors, and to understand how these are influenced by their past experiences and relationships. The therapist also helps the patient to develop more adaptive coping strategies and to improve their interpersonal skills.

Overall, Fonagy and Bateman work on MBT has contributed to the development of psychodynamic therapies that are more focused on specific treatment goals and evidence-based practices.

Transference is when a patient unconsciously assigns to their therapist feelings and attitudes that are associated with significant people from their past. These feelings can be positive, negative, of ambivalent. Projection occurs when a patient attributes their unacceptable thoughts and impulses to their therapist. Countertransference refers to the therapist’s emotions towards the patient. When a patient internalizes feelings of anger and self-harms, various processes such as denial, repression, and acting out may be involved. Although Freud initially viewed transference as a hindrance to therapy, it is now recognized that interpreting transference can aid patients in comprehending past relationships.

The Significance of Containment in Therapeutic Relationships

Containment is a term coined by Bion to describe the process of emotional containment, which is best exemplified by the relationship between a mother and her infant. Infants often project their unbearable feelings onto their mothers, who receive and accommodate them for a while, making them tolerable and acceptable again to the child.

In therapeutic relationships, containment plays a crucial role. It occurs when one person receives and comprehends the emotional communication of another without being overwhelmed by it. The receiver then processes the information and communicates understanding and recognition back to the other person. This process can help restore the other person’s capacity to think.

Overall, containment is an essential aspect of therapeutic relationships, as it allows individuals to express their emotions without fear of being judged of rejected. It creates a safe space for individuals to explore their feelings and thoughts, leading to greater self-awareness and personal growth.

Transference and Countertransference

Transference is the unconscious transfer of feelings, attitudes, thoughts, desires, fantasies, of behaviors from past significant relationships to a current interpersonal relationship. It is often observed in therapy, and the therapist interprets its meaning and source to help the patient understand how their past experiences affect their current relationships. Factors that increase transference include anxiety, frequent contact with a key worker, and borderline personality disorder. Effective management of transference involves recognizing the importance of the relationship to the patient, maintaining professional boundaries, interpreting the transference, and being a reliable therapist.

Countertransference, on the other hand, refers to the therapist’s emotional, cognitive, of behavioral response to the patient, triggered by some characteristic of the patient but ultimately resulting from unresolved conflicts within the therapist. There are different conceptions of countertransference, including the classical definition, the totalistic conception, the complementary conception, and the relational perspective. However, a working definition suggests that countertransference is a response to the patient triggered by unresolved conflicts within the therapist. Effective management of countertransference involves understanding the patient’s interpersonal style of relating and framing therapeutic interventions accordingly.

Family Therapy Models

Family therapy emerged in the 1950s, shifting the focus from individual problems to the context of the environment. There are five main models of family therapy: structural, strategic, systemic, transgenerational, and solution-focused.

Structural therapy, developed by Salvador Minuchin, assumes that the family’s structure is wrong and aims to establish clear boundaries and no coalitions. Dysfunctional families are marked by impaired boundaries, inappropriate alignments, and power imbalances.

Strategic therapy, associated with Jay Haley and Cloe Madanes, claims that difficulties in families arise due to distorted hierarchies. Dysfunctional families communicate in problematic repetitive patterns that kept them dysfunctional. Key terms include task setting and goal setting.

Systemic therapy, associated with Mara Selvini-Palazzoli, sees the family as a self-regulating system that controls itself according to rules formed over time. The focus is on exploring differences between family members’ behaviors, emotional responses, and beliefs at different points in time. Key terms include hypothesizing, neutrality, positive connotation, paradox and counterparadox, circular and interventive questioning, and the use of reflecting teams.

Transgenerational family therapy aims to understand how families, across generations, develop patterns of behaving and responding to stress in ways that prevent health development and lead to problems. Seven interlocking concepts make up the theory.

Solution-focused therapy emphasizes solutions over problems and collaborates with the family through in-depth questioning to focus on the solutions already being used by the clients. The therapist is non-interventionist, and the focus is on the present and the future. Blame, shame, and conflict are seen as issues that impede people from realizing these solutions.

Defense Mechanisms in Specific Conditions

Certain psychiatric conditions are characterized by specific defense mechanisms. These mechanisms are used by individuals to protect themselves from anxiety and other negative emotions. The following conditions and the associated defenses tend to come up on membership exams.

Phobias are characterized by intense and irrational fears of specific objects of situations. The defense mechanisms commonly used in phobias are repression and displacement. Repression involves pushing the anxiety-provoking thoughts of memories out of conscious awareness. Displacement involves redirecting the anxiety onto a less threatening object of situation.

Obsessive-compulsive disorder (OCD) is characterized by intrusive and repetitive thoughts (obsessions) and/of repetitive behaviors (compulsions). The defense mechanisms commonly used in OCD are isolation, undoing, and reaction formation. Isolation involves separating the anxiety-provoking thought from the associated emotion. Undoing involves performing a ritual of action to undo the anxiety-provoking thought. Reaction formation involves expressing the opposite emotion of the anxiety-provoking thought.

Borderline personality disorder (BPD) is characterized by unstable moods, relationships, and self-image. The defense mechanisms commonly used in BPD are projection and splitting. Projection involves attributing one’s own unacceptable thoughts of feelings onto another person. Splitting involves seeing people of situations as either all good of all bad.

Narcissistic personality disorder (NPD) is characterized by a grandiose sense of self-importance, a need for admiration, and a lack of empathy. The defense mechanisms commonly used in NPD are projection and splitting, similar to BPD.

Agoraphobia is characterized by a fear of being in situations where escape may be difficult of embarrassing. The defense mechanism commonly used in agoraphobia is displacement, which involves redirecting the anxiety onto a less threatening object of situation.

Factors Predicting Favorable Outcome for Psychotherapy

There are several factors that can predict a favorable outcome for psychotherapy, indicating that a patient is suitable for this type of treatment. One of the most important factors is the patient’s capacity to form a therapeutic relationship with the therapist. This means that the patient is able to establish a trusting and collaborative relationship with the therapist, which is essential for effective therapy.

Another important factor is the patient’s motivation to change. Patients who are motivated to change are more likely to engage in therapy and to make progress towards their goals. This motivation can come from a variety of sources, such as a desire to improve their quality of life, reduce symptoms of mental illness, of improve their relationships with others.

Psychological mindedness is also an important factor in predicting a favorable outcome for psychotherapy. This refers to the patient’s ability to understand and reflect on their own thoughts, feelings, and behaviors, as well as those of others. Patients who are psychologically minded are more likely to benefit from therapy because they are able to engage in self-reflection and gain insight into their own experiences.

Finally, good ego strength is another factor that predicts a favorable outcome for psychotherapy. Ego strength refers to the patient’s ability to cope with stress and adversity, and to maintain a sense of self-worth and self-esteem. Patients with good ego strength are better able to tolerate the emotional challenges of therapy and to make progress towards their goals. Overall, these factors can help clinicians identify patients who are likely to benefit from psychotherapy and tailor their treatment accordingly.

The abstract meanings from the unconscious mind are represented in people’s dreams, which can provide important therapeutic information when patients are asked to reflect on their own understanding of their dreams.

As an AI language model, I do not have personal opinions of beliefs. However, I can provide a summary of the information presented in the text. The text discusses different models of dream interpretation in psychodynamic therapy, including Freudian interpretation, compensatory theory, content analysis, the Five Star Method, and the cognitive-experiential model. Each model has its own approach to understanding the meaning of dreams, with some focusing on unconscious desires and motivations, while others emphasize personal experiences and attitudes. The text provides an overview of each model and their key assumptions and techniques.

As an AI language model, I do not have personal opinions of beliefs. However, I can provide a summary of the information presented in the text. The text discusses different models of dream interpretation in psychodynamic therapy, including Freudian interpretation, compensatory theory, content analysis, the Five Star Method, and the cognitive-experiential model. Each model has its own approach to understanding the meaning of dreams, with some focusing on unconscious desires and motivations, while others emphasize personal experiences and attitudes. The text provides an overview of each model and their key assumptions and techniques.

Supportive psychotherapy is a suitable option for individuals who have weak ego strength and are unable to handle the anxiety that may arise from more intrusive forms of therapy. The primary goal of this therapy is to provide stability and support, rather than causing disruption, and it is important to avoid disturbing a client’s defenses whenever possible.

Research has shown that supportive psychotherapy can be effective in treating depression (Grover, 2020). Additionally, there is evidence to suggest that it can be helpful for individuals with schizophrenia. However, it is important to note that this therapy should only be used when other psychological treatments have not been successful of are not appropriate.

Reference: Grover, S. (2020). Clinical practice guidelines for the practice of supportive psychotherapy. Indian Journal of Psychiatry, 62(Suppl 2), S173-S182.

Supportive Psychotherapy: An Overview

Supportive psychotherapy is a widely used approach in psychiatry, often reserved for clients who are not suitable for other forms of therapy. It aims to provide emotional support and encouragement to help people cope with overwhelming stress and restore them to their previous level of functioning. This therapy is not based on any specific psychological theory and is eclectic in approach.

Supportive psychotherapy is generally used with two different patient groups: those who were otherwise functioning well but have become symptomatic due to stress, and those who are not suitable for other forms of therapy. The goal of therapy is to help the patient get on with their life as best as possible, without disrupting reasonable defenses of generating conflicts.

The therapist avoids confrontation and transference issues are rarely analyzed. However, the therapeutic aims of long-term supportive psychotherapy include establishing a therapeutic alliance, holding and containing, promoting awareness of transference issues, promoting stability, facilitating the maturation of defenses, and promoting better adaptation to reality.

Supportive psychotherapy has been dismissed as ‘hand holding,’ but it should not be underestimated. It is suitable for most patients and is often the only therapy that can help when others have failed. Much of the work doctors do in outpatient clinics could be classified as supportive psychotherapy.

Aromatherapy is a form of complementary therapy that involves the use of essential oils, such as Melissa balm and lavender, which can be applied directly to the skin, heated in a burner, of added to a bath. The benefits of aromatherapy are believed to be primarily due to sensory stimulation, and it can be used in a variety of clinical settings. In fact, 11 randomized controlled trials have shown that aromatherapy is effective in managing the Behavioral and Psychological Symptoms of Dementia (BPSD). As research continues on non-pharmacological interventions for BPSD, it is important to consider the potential benefits of aromatherapy, as well as other interventions such as doll therapy, dance/movement therapy, light therapy, and animal-assisted therapy.

MST operates under the assumption that change can happen rapidly, with interventions lasting only three to five months. Despite potential pressure to extend the intervention, there is no evidence to support the idea that doing so would lead to better outcomes for families who have not met their initial goals.

Multisystemic therapy (MST) is a specialized intervention designed to address antisocial behavior in young people. It is a family and community-based approach that involves intensive therapy sessions, typically lasting for three to five months. During this time, the therapist works closely with the family and other key systems in the young person’s life, such as their school and community. The MST Theory of Change is based on Bronfenbrenner’s model, which recognizes that young people are embedded in multiple systems that influence their behavior. By addressing these systems and their interactions, MST aims to create lasting change in the young person’s life. The therapy is highly intensive, with a single therapist working with only a small number of families at a time.

Negative Automatic Thoughts and Cognitive Distortions

Negative automatic thoughts, also known as cognitive distortions, are false beliefs that can lead to negative emotions and behaviors. Cognitive therapy uses Socratic questioning to identify and challenge these negative automatic thoughts. Some common cognitive distortions include dichotomous thinking, personalization, overgeneralization, arbitrary inference, selective abstraction, catastrophizing, control fallacies, fallacy of fairness, blaming, shoulds, magnification, minimization, emotional reasoning, fallacy of change, global labeling, always being right, and heaven’s reward fallacy.

Dichotomous thinking is the tendency to see things as black and white, rather than shades of gray. Personalization involves incorrectly assuming that things happen due to us, even when there is no causal relationship. Overgeneralization is the act of coming to a general conclusion based on a single piece of evidence. Arbitrary inference involves drawing an unjustified conclusion. Selective abstraction, also known as filtering, involves concentrating on the negative while ignoring the positives. Catastrophizing is the act of expecting disaster from relatively trivial events.

Control fallacies involve believing that we are responsible for everything (internal control fallacy) of nothing (external control fallacy). The fallacy of fairness involves believing that life is fair. Blaming involves holding others responsible for our distress. Shoulds are preconceived rules that we believe, often incorrectly, which makes us angry when others don’t obey them. Magnification involves exaggerating the importance of negative information of experiences, while trivializing of reducing the significance of positive information of experiences. Minimization involves undervaluing positive attributes.

Emotional reasoning involves believing that what we feel must be true. The fallacy of change involves expecting others to change just because it suits us. Global labeling involves exaggerating and labeling behavior, such as saying I’m a loser when failing at something. Always being right involves the need to be right dominating all other needs. The heaven’s reward fallacy involves expecting our sacrifices to pay off. Magical thinking involves incorrectly believing that our actions influence outcomes.

Overall, negative automatic thoughts and cognitive distortions can have a significant impact on our mental health and well-being. Identifying and challenging these thoughts can help us develop more positive and realistic beliefs, leading to improved emotional and behavioral outcomes.

Aggression – Freud

According to Freud, aggression is a result of the primary instinct called thanatos, also known as the death instinct. He believed that every individual possesses this drive, which aims to cause complete destruction and death. Additionally, Freud proposed the existence of an opposing instinct called eros, which is the life instinct. He also introduced the concept of catharsis, which is a process of releasing libidinal energy and inducing a sense of calmness. This process occurs when we witness an aggressive act of engage in a mildly aggressive act.

Jungian analytical psychology involves the study of archetypes. Interpersonal therapy is used to identify interpersonal problems, while CBT focuses on identifying negative automatic thoughts. CAT, on the other hand, aims to identify reciprocal role procedures (RRP’s).

Understanding Cognitive Analytic Therapy

Cognitive Analytic Therapy (CAT) is a form of therapy that combines psychodynamic and cognitive approaches. It is a brief therapy that typically lasts between 16-24 sessions. Developed by Anthony Ryle, CAT aims to identify the useful parts of psychotherapy and make it more efficient. It also aims to create a therapy that can be easily researched.

CAT focuses on identifying key issues early on and conceptualizing them as repeated unsuccessful strategies. These strategies are categorized into traps, dilemmas, and snags. Traps are flawed thinking patterns that result in a vicious cycle of negative assumptions and actions. Dilemmas occur when a person believes their choices are restricted to opposite actions, neither of which is satisfactory. Snags are thinking patterns that restrict actions due to a perception of potential harm of failure.

CAT follows a procedural sequence model, where the problem is appraised, options are discussed, a plan is created and put into place, and consequences are evaluated. The therapist often summarizes the problem and plan in a letter to the client.

CAT also identifies reciprocal role procedures (RRPs), which are patterns observed in the way we related to others. These patterns are visually presented using a sequential diagrammatic reformulation. For example, a client who rebelled against a stern, dominating father may be dismissive of therapy because they see the therapist as a demanding authority figure.

Overall, CAT is a useful therapy that combines psychodynamic and cognitive approaches to identify and address maladaptive patterns. Its procedural sequence model and use of RRPs make it an efficient and effective therapy.

Having a higher level of intelligence does not guarantee a more successful outcome when undergoing psychological therapy.

Factors Predicting Favorable Outcome for Psychotherapy

There are several factors that can predict a favorable outcome for psychotherapy, indicating that a patient is suitable for this type of treatment. One of the most important factors is the patient’s capacity to form a therapeutic relationship with the therapist. This means that the patient is able to establish a trusting and collaborative relationship with the therapist, which is essential for effective therapy.

Another important factor is the patient’s motivation to change. Patients who are motivated to change are more likely to engage in therapy and to make progress towards their goals. This motivation can come from a variety of sources, such as a desire to improve their quality of life, reduce symptoms of mental illness, of improve their relationships with others.

Psychological mindedness is also an important factor in predicting a favorable outcome for psychotherapy. This refers to the patient’s ability to understand and reflect on their own thoughts, feelings, and behaviors, as well as those of others. Patients who are psychologically minded are more likely to benefit from therapy because they are able to engage in self-reflection and gain insight into their own experiences.

Finally, good ego strength is another factor that predicts a favorable outcome for psychotherapy. Ego strength refers to the patient’s ability to cope with stress and adversity, and to maintain a sense of self-worth and self-esteem. Patients with good ego strength are better able to tolerate the emotional challenges of therapy and to make progress towards their goals. Overall, these factors can help clinicians identify patients who are likely to benefit from psychotherapy and tailor their treatment accordingly.

Mentalisation based therapy (MBT) has shown effectiveness in treating patients with Personality Disorders by helping them understand their own and others’ actions based on intentional mental states such as desires, feelings, and beliefs. While psychoanalytically oriented, it is fully manualised and may be a helpful underlying theory for the service. However, individual psychoanalytic therapy may not be the first line of treatment due to its long delivery time and patient tolerance issues. Individual behavioural therapy and accredited group programmes are easier to run but may not address the complexities of this client group. Other evidence-based psychological treatments for personality disorders include CBT, DBT, schema therapy, CAT, transference-focused psychotherapy, and therapeutic communities (non-forensic).

Social Class and Mental Disorder

There is a consistent finding that shows an inverse relationship between social class and rates of mental illness. This means that individuals from lower social classes are more likely to experience mental health issues compared to those from higher social classes. However, this inverse relationship is not observed in the case of anorexia nervosa. This suggests that factors other than social class may play a more significant role in the development of this particular disorder. Overall, the relationship between social class and mental health is complex and requires further investigation to fully understand the underlying factors.

As an AI language model, I do not have personal opinions of beliefs. However, I can provide a summary of the information presented in the text. The text discusses different models of dream interpretation in psychodynamic therapy, including Freudian interpretation, compensatory theory, content analysis, the Five Star Method, and the cognitive-experiential model. Each model has its own approach to understanding the meaning of dreams, with some focusing on unconscious desires and motivations, while others emphasize personal experiences and attitudes. The text provides an overview of each model and their key assumptions and techniques.

Neo-Freudians were therapists who developed their own theories while still retaining core Freudian components. Some important neo-Freudians include Alfred Adler, Carl Jung, Erik Erickson, Harry Stack Sullivan, Wilfred Bion, John Bowlby, Anna Freud, Otto Kernberg, Margaret Mahler, and Donald Winnicott. Each of these individuals contributed unique ideas to the field of psychology. For example, Carl Jung introduced the concept of the persona and differentiated between the personal and collective unconscious, while Erik Erickson is known for his stages of psychosocial development. Margaret Mahler developed theories on child development, including the three main phases of autistic, symbiotic, and separation-individuation. Donald Winnicott introduced the concept of the transitional object and the good enough mother. Overall, neo-Freudians expanded upon Freud’s ideas and helped to shape modern psychotherapy.

Defense Mechanisms in Specific Conditions

Certain psychiatric conditions are characterized by specific defense mechanisms. These mechanisms are used by individuals to protect themselves from anxiety and other negative emotions. The following conditions and the associated defenses tend to come up on membership exams.

Phobias are characterized by intense and irrational fears of specific objects of situations. The defense mechanisms commonly used in phobias are repression and displacement. Repression involves pushing the anxiety-provoking thoughts of memories out of conscious awareness. Displacement involves redirecting the anxiety onto a less threatening object of situation.

Obsessive-compulsive disorder (OCD) is characterized by intrusive and repetitive thoughts (obsessions) and/of repetitive behaviors (compulsions). The defense mechanisms commonly used in OCD are isolation, undoing, and reaction formation. Isolation involves separating the anxiety-provoking thought from the associated emotion. Undoing involves performing a ritual of action to undo the anxiety-provoking thought. Reaction formation involves expressing the opposite emotion of the anxiety-provoking thought.

Borderline personality disorder (BPD) is characterized by unstable moods, relationships, and self-image. The defense mechanisms commonly used in BPD are projection and splitting. Projection involves attributing one’s own unacceptable thoughts of feelings onto another person. Splitting involves seeing people of situations as either all good of all bad.

Narcissistic personality disorder (NPD) is characterized by a grandiose sense of self-importance, a need for admiration, and a lack of empathy. The defense mechanisms commonly used in NPD are projection and splitting, similar to BPD.

Agoraphobia is characterized by a fear of being in situations where escape may be difficult of embarrassing. The defense mechanism commonly used in agoraphobia is displacement, which involves redirecting the anxiety onto a less threatening object of situation.

Freud’s Structural Theory: Understanding the Three Areas of the Mind

According to Freud’s structural model, the human mind is divided into three distinct areas: the Id, the Ego, and the Superego. The Id is the part of the mind that contains instinctive drives and operates on the ‘pleasure principle’. It functions without a sense of time and is governed by ‘primary process thinking’. The Ego, on the other hand, attempts to modify the drives from the Id with external reality. It operates on the ‘reality principle’ and has conscious, preconscious, and unconscious aspects. It is also home to the defense mechanisms. Finally, the Superego acts as a critical agency, constantly observing a person’s behavior. Freud believed that it developed from the internalized values of a child’s main caregivers. The Superego contains the ‘ego ideal’, which represents ideal attitudes and behavior. It is often referred to as the conscience. Understanding these three areas of the mind is crucial to understanding Freud’s structural theory.